Nevin Manimala

Pediatr Emerg Care. 2022 Aug 23. doi: 10.1097/PEC.0000000000002833. Online ahead of print.

ABSTRACT

OBJECTIVES: Removal of nasal foreign bodies in children should be completed as few numbers of times as possible to reduce the burden on the child. This study aimed to reveal the characteristics of pediatric nasal foreign body cases that required multiple removal procedure and to investigate the appropriate removal method for each shape of foreign body.

METHODS: We retrospectively reviewed patients who visited a pediatric emergency department because of nasal foreign body from November 1, 2018, to October 31, 2020. We compared the characteristics of patients, foreign bodies, and treatment between the success and failure groups in the first removal procedure. Moreover, we described the detail of patients in the failure group. We also showed final successful removal methods according to the shape of the foreign bodies.

RESULTS: We included 104 children in our analysis. Between the success and failure groups in the first removal procedure, there was no statistically significant difference in the characteristics of patients and foreign bodies but a significant difference in the removal method (P < 0.001). In the failure groups, the most frequent number of times required for removal is 2 and the most common methods in the first removal procedure was the parent’s kiss, most of which were performed on spherical foreign bodies in younger children, Finally, only 7 cases (6.7%) failed to remove the foreign body. According to the shape of the foreign bodies, the percentage of forceps and clamps used for successful removal was high in every shape.

CONCLUSIONS: There was a significant difference in the removal method between the success and failure groups in the first removal procedure, but finally, most foreign bodies were removed by emergency physicians. Therefore, further research is needed to determine the appropriate removal method for each patient and foreign body.

PMID:36001298 | DOI:10.1097/PEC.0000000000002833

Sports Med. 2022 Aug 24. doi: 10.1007/s40279-022-01752-6. Online ahead of print.

ABSTRACT

BACKGROUND: The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts.

OBJECTIVE: This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents.

METHODS: Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel.

RESULTS: There was strong between-panel agreement (panel 1: r_s = 0.76, p < 0.01; panel 2: r_s = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) “conduct longitudinal studies to assess changes in fitness and associations with health”. This was followed by (ii) “use fitness surveillance to inform decision making”, and (iii) “implement regular and consistent international/national fitness surveys using common measures”.

CONCLUSIONS: The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.

PMID:36001291 | DOI:10.1007/s40279-022-01752-6

Pharmacol Rep. 2022 Aug 24. doi: 10.1007/s43440-022-00408-6. Online ahead of print.

ABSTRACT

BACKGROUND: The real-world effectiveness of molnupiravir (MOL) during the dominance of Omicron SARS-CoV-2 lineage is urgently needed since the available data relate to the period of circulation of other viral variants. Therefore, this study assessed the efficacy of MOL in patients hospitalized for COVID-19 in a real-world clinical practice during the wave of Omicron infections.

METHODS: Among 11,822 patients hospitalized after 1 March 2020 and included in the SARSTer national database, 590 were treated between 1 January and 31 April 2022, a period of dominance of the Omicron SARS-CoV-2 variant. MOL was administered to 203 patients, whereas 387 did not receive any antiviral regimen. Both groups were similar in terms of sex, BMI and age allowing for direct comparisons.

RESULTS: Patients who did not receive antiviral therapy significantly more often required the use of Dexamethasone and Baricitinib. Treatment with MOL resulted in a statistically significant reduction in mortality during the 28-day follow-up (9.9 vs. 16.3%), which was particularly evident in the population of patients over 80 years of age treated in the first 5 days of the disease (14.6 vs. 35.2%). MOL therapy did not affect the frequency of the need for mechanical ventilation, but patients treated with MOL required oxygen supplementation less frequently than those without antivirals (31.7 vs. 49.2%). The time of hospitalization did not differ between groups.

CONCLUSIONS: The use of molnupiravir in patients hospitalized for COVID-19 during the dominance of Omicron variant reduced mortality. This effect is particularly evident in patients over 80 years of age.

PMID:36001284 | DOI:10.1007/s43440-022-00408-6

J Ultrasound. 2022 Aug 24. doi: 10.1007/s40477-022-00710-2. Online ahead of print.

ABSTRACT

AIMS: Current ultrasound (US) Doppler techniques cannot demonstrate the vascularization of the dermis. The purpose of this study was to investigate whether the new Superb Vascular Imaging (SMI) and Microvascular Flow (MV-Flow) techniques improve the detection of normal dermis vessels. SMI and MV-Flow were compared side-by-side to conventional power-Doppler (PD) imaging.

METHODS: By using US, 50 healthy volunteers were evaluated at level of five body areas: forehead, forearm, palm, buttock, and thigh. Two off-site operators evaluated the images to assess the difference between SMI and PD imaging and between MV-Flow and PD imaging in terms of dermis flow amount. A 0-3 scoring system was adopted.

RESULTS: SMI scored grade 0 in 0% of body areas, grade 1 in 58%, grade 2 in 33%, and grade 3 in 9%. In comparison with SMI, PD scored grade 0 in 38% of body areas, grade 1 in 56%, grade 2 in 6%, and grade 3 in 0%. MV-Flow scored grade 0 in 0% of body areas, grade 1 in 52%, grade 2 in 43%, and grade 3 in 6%. Comparted to MV-Flow, PD scored grade 0 in 53% of body areas, grade 1 in 34%, grade 2 in 13%, and grade 3 in 0%. The difference in terms of sensitivity was statistically significant for all the body areas investigated.

CONCLUSIONS: We found both SMI and MV-Flow to be superior to PD imaging and capable to demonstrate normal vascularization of the dermis.

PMID:36001281 | DOI:10.1007/s40477-022-00710-2

Breast Cancer. 2022 Aug 24. doi: 10.1007/s12282-022-01396-4. Online ahead of print.

ABSTRACT

BACKGROUND: It remains unclear whether original full-field digital mammograms (DMs) can be replaced with synthesized mammograms in both screening and diagnostic settings. To compare reader performance of artificial intelligence computer-aided detection synthesized mammograms (AI CAD SMs) with that of DM alone or in combination with digital breast tomosynthesis (DBT) images in an experimental setting.

METHODS: We compared the performance of multireader (n = 4) and reading multicase (n = 388), in 84 cancers, 83 biopsy-proven benign lesions, and 221 normal or benign cases with negative results after 1-year follow-up. Each reading was independently interpreted with four reading modes: DM, AI CAD SM, DM + DBT, and AI CAD SM + DBT. The accuracy of probability of malignancy (POM) and five-category ratings were evaluated using areas under the receiver operating characteristic curve (AUC) in the random-reader analysis.

RESULTS: The mean AUC values based on POM for DM, AI CAD SM, DM + DBT, and AI CAD SM + DBT were 0.871, 0.902, 0.895, and 0.909, respectively. The mean AUC of AI CAD SM was significantly higher (P = 0.002) than that of DM. For calcification lesions, the sensitivity of SM and DM did not differ significantly (P = 0.204). The mean AUC for AI CAD SM + DBT was higher than that of DM + DBT (P = 0.082). ROC curves based on the five-category ratings showed similar proximity of the overall performance levels.

CONCLUSIONS: AI CAD SM alone was superior to DM alone. Also, AI CAD SM + DBT was superior to DM + DBT but not statistically significant.

PMID:36001270 | DOI:10.1007/s12282-022-01396-4

Int Urol Nephrol. 2022 Aug 24. doi: 10.1007/s11255-022-03342-x. Online ahead of print.

ABSTRACT

PURPOSE: Detrusor pressure-volume relationship evaluation by urodynamics provides useful clinical information; however, it is invasive, and requires specific installations. An alternative technique proposed by our research group is the electrical bioimpedance (BI) which is an easily performed and non-invasive method. In this work, we assess the relationship between BI and detrusor bladder pressure in adults with neurogenic lower urinary tract dysfunction.

METHODS: A prospective observational study was conducted. 20 patients (11 females and 9 male) previously diagnosed with neurogenic bladder were included. All participants underwent simultaneously a urodynamic evaluation (UDS) and BI determination, and both examination signals were recorded and subjected to Shapiro-Wilks statistical test. A correlational statistical test was used to compare the pressure parameters (detrusor, vesical and abdominal) with their respective BI determinations. Subsequently, a linear regression test was performed to evaluate the concordance between BI and their respective pressure values.

RESULTS: From the 20 correlations, between detrusor bladder pressure (PDET) and abdominal bioimpedance determinations (ZABD), obtained for all participants, 16 evidenced significant results over 90% (p < 0.05).

CONCLUSIONS: A significantly high correlation between abdominal bioimpedance determinations and the detrusor bladder pressures was evidenced. These results should be confirmed in a larger group of participants.

PMID:36001269 | DOI:10.1007/s11255-022-03342-x

Environ Sci Pollut Res Int. 2022 Aug 24. doi: 10.1007/s11356-022-22649-x. Online ahead of print.

ABSTRACT

Environmental geological disasters pose a significant threat to human life, property and environmental safety. It is necessary to conduct targeted governance in key prevention and control areas based on reasonable susceptibility assessment. Using the debris flow disaster in Xiuyan County as an example, this study compares and analyzes prone prediction models such as the frequency ratio (FR), decision tree (DT) and random forest (FR) models and evaluates the cost of prevention and control and the protection of life and property. The research results show that the FR, DT and RF models have good performance. The ROC test, disaster point density statistics and cross-validation results show that the RF model has the best performance. The study area was mainly less and mildly prone areas. The highly prone areas are mainly distributed in the northeast and southwest of the study area. It is the key area of disaster prevention and control. Elevation, rainfall intensity and population density have the largest influence on the susceptibility to debris flows. Based on the RF model, the disaster points in the highly prone areas account for 54% of the disaster points of the whole area, and the project treatment cost of the disaster points is 0.78 million yuan per single gully, which protects 56% of the lives and property in the study area, which is better than the DT and FR models. The RF model not only has good prediction performance in terms of susceptibility. It can realize the targeted management of disasters, achieve the targeted investment of governance costs and the effective protection of life and property and serve the sustainable development of the regional environment and economy with greater value.

PMID:36001261 | DOI:10.1007/s11356-022-22649-x

Cerebellum. 2022 Aug 24. doi: 10.1007/s12311-022-01462-9. Online ahead of print.

ABSTRACT

BACKGROUND: Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach. A new model of care-ClearSpeechTogether-is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias.

METHOD: This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation.

RESULTS: Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing.

DISCUSSION: ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia.

PMID:36001243 | DOI:10.1007/s12311-022-01462-9

Neuroinformatics. 2022 Aug 24. doi: 10.1007/s12021-022-09599-y. Online ahead of print.

ABSTRACT

Identification of informative signatures from electrophysiological signals is important for understanding brain developmental patterns, where techniques such as magnetoencephalography (MEG) are particularly useful. However, less attention has been given to fully utilizing the multidimensional nature of MEG data for extracting components that describe these patterns. Tensor factorizations of MEG yield components that encapsulate the data’s multidimensional nature, providing parsimonious models identifying latent brain patterns for meaningful summarization of neural processes. To address the need for meaningful MEG signatures for studies of pediatric cohorts, we propose a tensor-based approach for extracting developmental signatures of multi-subject MEG data. We employ the canonical polyadic (CP) decomposition for estimating latent spatiotemporal components of the data, and use these components for group level statistical inference. Using CP decomposition along with hierarchical clustering, we were able to extract typical early and late latency event-related field (ERF) components that were discriminative of high and low performance groups ([Formula: see text]) and significantly correlated with major cognitive domains such as attention, episodic memory, executive function, and language comprehension. We demonstrate that tensor-based group level statistical inference of MEG can produce signatures descriptive of the multidimensional MEG data. Furthermore, these features can be used to study group differences in brain patterns and cognitive function of healthy children. We provide an effective tool that may be useful for assessing child developmental status and brain function directly from electrophysiological measurements and facilitate the prospective assessment of cognitive processes.

PMID:36001238 | DOI:10.1007/s12021-022-09599-y

Vasc Med. 2022 Aug 24:1358863X221117608. doi: 10.1177/1358863X221117608. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to evaluate changes in the arterial spectral Doppler waveform in a canine artery stenosis model.

METHODS: Canine femoral artery stenosis models were established in 12 beagle dogs. Doppler waveforms were recorded in the femoral artery preoperatively and postoperatively in the femoral artery and at the ankle after formation of a 50%, 70%, and 90% stenosis or occlusion. Major descriptors for arterial Doppler waveform were used to analyse waveforms.

RESULTS: The proportion of multiphasic waveforms proximal to a moderate stenosis decreased compared to normal baseline, although the difference was not statistically significant, whereas the decreases at the stenosis, distal to the stenosis, and at the ankle were significant (p < 0.05). The decreases in arteries with a more severe stenosis or occlusion were significant at all locations (p < 0.05). The proportion of high resistive waveforms decreased significantly at the ankle in the arteries with a moderate stenosis (50%) (p = 0.002), but the decreases proximal to, at, and distal to the stenosis were not significant. The decreases were significant at all locations in the arteries with a more severe stenosis (p < 0.05). The decrease was significant at the ankle in the arteries with an occlusion (p < 0.001) but not significant pre, at, and post an occlusion.

CONCLUSIONS: Phasicity and resistance of Doppler waveforms alter in canine femoral arteries with a stenosis. Phasicity change seems more sensitive in response to an arterial stenosis than resistance change. Additional information on arterial resistance could be obtained using end-diastolic ratios, resistive indices, and potentially end-systolic notch velocity measurements.

PMID:36000474 | DOI:10.1177/1358863X221117608