Nevin Manimala

J Stroke Cerebrovasc Dis. 2022 Aug 20;31(10):106682. doi: 10.1016/j.jstrokecerebrovasdis.2022.106682. Online ahead of print.

ABSTRACT

BACKGROUND: Carotid web (CaW) is non-atheromatous, shelf-like intraluminal projection, generally affecting the posterolateral wall of the proximal internal carotid artery, and associated with embolic stroke, particularly in younger patients without traditional stroke risk factors. Treatment options for symptomatic CaWs include interventional therapy with carotid endarterectomy or carotid stenting versus medical therapy with antiplatelet or anticoagulants. As safety and efficacy of these approaches have been incompletely delineated in small-to-moderate case series, we performed a systematic review of outcomes with interventional and medical management.

METHODS: Systematic literature search was conducted and data analyzed per PRISMA guidelines (Preferred Reporting Items for Systemic Reviews and Meta-Analyses) from January 2000 to October 2021 using the search strategy: “Carotid web” OR “Carotid shelf” OR “Web vessels” OR “Intraluminal web”. Patient-level demographics, stroke risk factors, technical procedure details, medical and interventional management strategies were abstracted across 15 series. All data were analyzed using descriptive statistics.

RESULTS: Among a total of symptomatic 282 CaW patients across 14 series, age was 49.5 (44-55.7) years, 61.7% were women, and 76.6% were black. Traditional stroke risk factors were less frequent than the other stroke causes, including hypertension in 28.6%, hyperlipidemia 14.6%, DM 7.0%, and smoking 19.8%. Thrombus adherent to CaW was detected on initial imaging in 16.2%. Among 289 symptomatic CaWs across 15 series, interventional management was pursued in 151 (52.2%), carotid artery stenting in 87, and carotid endarterectomy in 64; medical management was pursued in 138 (47.8%), including antiplatelet therapy in 80.4% and anticoagulants in 11.6%. Interventional and medical patients were similar in baseline characteristics. The reported time from index stroke to carotid revascularization was median 14 days (IQR 9.5-44). In the interventional group, no periprocedural mortality was noted, major periprocedural complications occurred in 1/151 (0.5%), and no recurrent ischemic events were observed over follow-up range of 3-60 months. In the medical group, over a follow-up of 2-55 months, the recurrence cerebral ischemia rate was 26.8%.

CONCLUSION: Cumulative evidence from multiple series suggests that carotid revascularization is a safe and effective option for preventing recurrent ischemic events in patients with symptomatic carotid webs.

PMID:35998383 | DOI:10.1016/j.jstrokecerebrovasdis.2022.106682

Psychol Sci. 2022 Aug 23:9567976221094630. doi: 10.1177/09567976221094630. Online ahead of print.

ABSTRACT

Does growing up with a sister rather than a brother affect personality? In this article, we provide a comprehensive analysis of the effects of siblings’ gender on adults’ personality, using data from 85,887 people from 12 large representative surveys covering nine countries (United States, United Kingdom, The Netherlands, Germany, Switzerland, Australia, Mexico, China, and Indonesia). We investigated the personality traits of risk tolerance, trust, patience, locus of control, and the Big Five. We found no meaningful causal effects of the gender of the next younger sibling and no associations with the gender of the next older sibling. Given the high statistical power and consistent results in the overall sample and relevant subsamples, our results suggest that siblings’ gender does not systematically affect personality.

PMID:35998357 | DOI:10.1177/09567976221094630

J Neurosci. 2022 Jul 13;42(28):5564-5579. doi: 10.1523/JNEUROSCI.2054-21.2022. Epub 2022 Jun 3.

ABSTRACT

Neural adaptation enables the brain to efficiently process sensory signals despite large changes in background noise. Previous studies have established that recent background spectro- or spatio-temporal statistics scale neural responses to sensory stimuli via a canonical normalization computation, which is conserved among species and sensory domains. In the auditory pathway, one major form of normalization, termed contrast gain control, presents as decreasing instantaneous firing-rate gain, the slope of the neural input-output relationship, with increasing variability of background sound levels (contrast) across time and frequency. Despite this gain rescaling, mean firing-rates in auditory cortex become invariant to sound level contrast, termed contrast invariance. The underlying neuromodulatory mechanisms of these two phenomena remain unknown. To study these mechanisms in male and female mice, we used a 2-photon calcium imaging preparation in layer 2/3 neurons of primary auditory cortex (A1), along with pharmacological and genetic KO approaches. We found that neuromodulatory cortical synaptic zinc signaling is necessary for contrast gain control but not contrast invariance in mouse A1.SIGNIFICANCE STATEMENT When sound levels in the acoustic environment become more variable across time and frequency, the brain decreases response gain to maintain dynamic range and thus stimulus discriminability. This gain adaptation accounts for changes in perceptual judgments in humans and mice; however, the underlying neuromodulatory mechanisms remain poorly understood. Here, we report context-dependent neuromodulatory effects of synaptic zinc that are necessary for contrast gain control in A1. Understanding context-specific neuromodulatory mechanisms, such as contrast gain control, provides insight into A1 cortical mechanisms of adaptation and also into fundamental aspects of perceptual changes that rely on gain modulation, such as attention.

PMID:35998293 | DOI:10.1523/JNEUROSCI.2054-21.2022

J Trauma Acute Care Surg. 2022 Sep 1;93(3):409-417. doi: 10.1097/TA.0000000000003618. Epub 2022 Apr 12.

ABSTRACT

BACKGROUND: Emergency general surgery (EGS) patients have increased mortality risk compared with elective counterparts. Recent studies on risk factors have largely used national data sets limited to administrative data. Our aim was to examine risk factors in an integrated regional health system EGS database, including clinical and administrative data, hypothesizing that this novel process would identify clinical variables as important risk factors for mortality.

METHODS: Our nine-hospital health system’s billing data were queried for EGS International Classification of Disease codes between 2013 and 2018. Codes were grouped by diagnosis, and urgent or emergent encounters were included and merged with electronic medical record clinical data. Outcomes assessed were inpatient and 1-year mortality. Standard and multivariable statistics evaluated factors associated with mortality.

RESULTS: There were 253,331 EGS admissions with 3.6% inpatient mortality rate. Patients who suffered inpatient and 1-year mortality were older, more likely to be underweight, and have neutropenia or elevated lactate. On multivariable analysis for inpatient mortality: age (odds ratio [OR], 1.7-6.7), underweight body mass index (OR, 1.6), transfer admission (OR, 1.8), leukopenia (OR, 2.0), elevated lactate (OR, 1.8), and ventilator requirement (OR, 7.1) remained associated with increased risk. Adjusted analysis for 1-year mortality demonstrated similar findings, with highest risk associated with older age (OR, 2.8-14.6), underweight body mass index (OR, 2.3), neutropenia (OR, 2.0), and tachycardia (OR, 1.7).

CONCLUSION: After controlling for patient and disease characteristics available in administrative databases, clinical variables remained significantly associated with mortality. This novel yet simple process allows for easy identification of clinical data points imperative to the study of EGS diagnoses that are critical in understanding factors that impact mortality.

LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level III.

PMID:35998289 | DOI:10.1097/TA.0000000000003618

J Card Surg. 2022 Aug 23. doi: 10.1111/jocs.16878. Online ahead of print.

ABSTRACT

BACKGROUND: Off-pump coronary artery bypass (OPCAB) previously demonstrated its potential benefits in women; however, robotic-assisted OPCAB was scarcely studied.

OBJECTIVES: To investigate whether robotic-assisted OPCAB could further improve the outcomes in women and the potential impact of hybrid approaches with stents and completeness of revascularization on the late outcomes.

METHODS: Women who underwent robotic-assisted or conventional OPCAB (with sternotomy) between May 2005 and January 2021 at Lankenau Heart Institute were included. Propensity score matching was used to match 273 pairs on 27 characteristics.

RESULTS: In the intraoperative period, women who underwent robotic-assisted OPCAB presented longer operative times (6.00 vs. 5.38 h; p < 0.001), higher rates of extubation in the operating room (83.9% vs. 75.5%; p = 0.019) and lower rates of blood transfusion (13.2% vs. 32.2%; p < 0.001). In the postoperative period, women who underwent robotic-assisted OPCAB presented lower rates of new onset atrial fibrillation (16.8% vs. 25.6%; p = 0.016), need of blood transfusion (33.0% vs. 54.9%; p < 0.001), shorter intensive care unit (ICU) (46.1 vs. 49.8 h; p = 0.006) and hospital length of stay (5.0 vs. 6.0 days; p < 0.001). We observed no statistically significant differences in the rates of operative death between the groups (1.47% vs. 1.47%; p = 0.771). In the follow-up, we observed no differences in terms of overall survival regardless of hybrid procedures with stents and completeness of revascularization.

CONCLUSIONS: Robotic-assisted OPCAB in women is as safe as conventional OPCAB and may further improve outcomes. Hybrid coronary revascularization was a valuable adjunct in the robotic scenario and completeness of revascularization did not play a role in this setting.

PMID:35998275 | DOI:10.1111/jocs.16878

Res Q Exerc Sport. 2022 Aug 23:1-11. doi: 10.1080/02701367.2022.2097625. Online ahead of print.

ABSTRACT

Purpose: To date no studies have compared resistance training loading strategies combined with dietary intervention for fat loss. Methods: Thus, we performed a randomised crossover design comparing four weeks of heavier- (HL; ~80% 1RM) and lighter-load (LL; ~60% 1RM) resistance training, combined with calorie restriction and dietary guidance, including resistance trained participants (n=130; males=49, females=81). Both conditions performed low-volume, (single set of 9 exercises, 2x/week) effort matched (to momentary failure), but non-work-matched protocols. Testing was completed pre- and post-each intervention. Fat mass (kg) was the primary outcome, and a smallest effect size of interest (SESOI) was established at 3.3% loss of baseline bodyweight. Body fat percentage, lean mass, and strength (7-10RM) for chest press, leg press, and pull-down exercises were also measured. An 8-week washout period of traditional training with normal calorie interspersed each intervention. Results: Both interventions showed small statistically equivalent (within the SESOI) reductions in fat mass (HL: -0.67 kg [95%CI -0.91 to 0.42]; LL: -0.55 kg [95%CI -0.80 to -0.31]) which were also equivalent between conditions (HL – LL: -0.113 kg [95%CI -0.437 kg to 0.212 kg]). Changes in body fat percentage and lean mass were also minimal. Strength increases were small, similar between conditions, and within a previously determined SESOI for the population included (10.1%). Conclusions: Fat loss reductions are not impacted by resistance training load; both HL and LL produce similar, yet small, changes to body composition over a 4-week intervention. However, the maintenance of both lean mass and strength highlights the value of resistance training during dietary intervention.

PMID:35998256 | DOI:10.1080/02701367.2022.2097625

Res Q Exerc Sport. 2022 Aug 23:1-8. doi: 10.1080/02701367.2022.2096843. Online ahead of print.

ABSTRACT

Purpose: We investigated the effect of drop-set (DS) and rest-pause (RP) systems compared to traditional (TRAD) resistance training on muscular adaptations and psychophysiological responses. Methods: Twenty-seven trained men (age: 23.4 ± 3.4 years; resistance training experience: 5.1 ± 1.7 years) were assigned to experimental groups (DS: n = 9, 3 × 10 repetitions at 75% with 6 additional repetitions at 55% 1RM; RP: n = 9, 3 × 16 repetitions at 75% 1RM; TRAD: n = 9, 4 × 12 repetitions at 70% 1RM) and performed lower-limb training sessions twice a week for 8 weeks. Maximum dynamic strength (1RM) and localized muscular endurance (LME) tests were performed in 45° leg press at baseline and post intervention. Session-RPE was assessed 15 min after the end of each training session. Results: A significant time vs. group interaction was observed for 1RM (p = .012) and LME (p < .0001). Post hoc comparisons revealed that RP elicited greater gains in muscular strength than DS (p = .044) but not TRAD (p = .116); and DS elicited greater LME than RP (p < .001) and TRAD (p = .001). No statistical differences were observed in Session-RPE and training strain between conditions; however, RP promoted higher training monotony (p = .036) than DS and TRAD. Conclusions: The DS and RP systems have a potential role in training programs aiming to promote muscle strength and localized muscular endurance adaptations, respectively. However, RP may promote higher training monotony than DS and TRAD, even though the other psychophysiological responses are similar.

PMID:35998251 | DOI:10.1080/02701367.2022.2096843

J Oral Pathol Med. 2022 Aug 23. doi: 10.1111/jop.13348. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study is to analyze if the results of the Oral Health Impact Profile-14 questionnaire (OHIP-14) in patients with primary Sjögren’s syndrome (pSS) are correlated with salivary flow and level of xerostomia.

METHODS: This observational cross-sectional study was conducted in sixty-one patients (60 women, one man, mean age 57.64 (13.52)) diagnosed of pSS according to the American-European Criteria (2002). After recording demographic, medical and dental data (decayed-missing-filled teeth index (DMFT)), unstimulated (UWS) and stimulated (SWS) salivary flows were collected. Subsequently, UWS flow was categorized into two groups (<0.1 mL/min and ≥0.1mL/min) and SWS into three groups (<0.1 mL/min, 0.1-0.7 mL/min and >0.7 mL/min). Patients also filled out a visual analog scale (VAS) for xerostomia and OHIP-14 for self-reported quality of life (QoL).

RESULTS: Data showed positive and significant correlation between OHIP-14 and xerostomia, based on VAS results (r=0.52; p=0.001). Furthermore, there was a negative correlation between UWS and OHIP-14 scores (r=-0.34; p=0.006) and VAS for xerostomia (r=-0.22; p=0.09). No significant correlation was found between SWS and OHIP-14 or VAS neither between DMFT and OHIP-14. When assessing the level of QoL by the UWS and SWS flow categories a significant association was found for UWS (p=0.001) but not for SWS (p=0.11). The OHIP-14 values were higher in the groups with lower salivary flow. The multiple linear regression to predict OHIP-14 only selected VAS for xerostomia as a statistically significant predictor.

CONCLUSIONS: Increased level of xerostomia and reduced UWS flow decrease oral health-related QoL in patients with pSS.

PMID:35998227 | DOI:10.1111/jop.13348

Proc Natl Acad Sci U S A. 2022 Aug 30;119(35):e2202764119. doi: 10.1073/pnas.2202764119. Epub 2022 Aug 23.

ABSTRACT

The use of spoken and written language is a fundamental human capacity. Individual differences in reading- and language-related skills are influenced by genetic variation, with twin-based heritability estimates of 30 to 80% depending on the trait. The genetic architecture is complex, heterogeneous, and multifactorial, but investigations of contributions of single-nucleotide polymorphisms (SNPs) were thus far underpowered. We present a multicohort genome-wide association study (GWAS) of five traits assessed individually using psychometric measures (word reading, nonword reading, spelling, phoneme awareness, and nonword repetition) in samples of 13,633 to 33,959 participants aged 5 to 26 y. We identified genome-wide significant association with word reading (rs11208009, P = 1.098 × 10^-8) at a locus that has not been associated with intelligence or educational attainment. All five reading-/language-related traits showed robust SNP heritability, accounting for 13 to 26% of trait variability. Genomic structural equation modeling revealed a shared genetic factor explaining most of the variation in word/nonword reading, spelling, and phoneme awareness, which only partially overlapped with genetic variation contributing to nonword repetition, intelligence, and educational attainment. A multivariate GWAS of word/nonword reading, spelling, and phoneme awareness maximized power for follow-up investigation. Genetic correlation analysis with neuroimaging traits identified an association with the surface area of the banks of the left superior temporal sulcus, a brain region linked to the processing of spoken and written language. Heritability was enriched for genomic elements regulating gene expression in the fetal brain and in chromosomal regions that are depleted of Neanderthal variants. Together, these results provide avenues for deciphering the biological underpinnings of uniquely human traits.

PMID:35998220 | DOI:10.1073/pnas.2202764119

PLoS One. 2022 Aug 23;17(8):e0273449. doi: 10.1371/journal.pone.0273449. eCollection 2022.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the levels of pro-inflammatory cytokines in aqueous humor (AH) from dogs with anterior uveitis and post-operative ocular hypertension (POH) following phacoemulsification, in AH from dogs with primary glaucoma, and in normal healthy eyes with no signs of anterior uveitis or other ocular diseases.

METHODS: An exploratory study including 21 samples of AH collected from 15 dogs; post-phacoemulsification with anterior uveitis and POH (‘POH group’, n = 10 samples), primary glaucoma (‘glaucoma group’, n = 6 samples), and normal (‘normal group’, n = 5 samples). Target mass spectrometry via multiple reaction monitoring (MRM-MS) with the Canine Cytokine SpikeMix™ as internal standard was used to measure the pro-inflammatory cytokine levels.

RESULTS: The MRM-MS method measured 15 pro-inflammatory cytokines. Tumor-necrosis-factor-alpha (TNFα) and interleukin-18 (IL-18) levels in AH were different between all three groups (glaucoma>POH>normal) (p = .05, p = .02, respectively). Additionally, IL-6 was higher in the ‘POH group’ compared to the ‘glaucoma group’ (p = .04) and IL-4 was higher in the ‘POH group’ compared to the ‘normal group’ (p = .04). Intraocular pressure (IOP) was positively associated with increased AH levels of IL-18 (Spearman correlation = .64, p = .03).

CONCLUSIONS: MRM-MS using the Canine Cytokine SpikeMix™ as an internal standard was established as a method to detect pro-inflammatory cytokine levels in canine AH. The study demonstrated increased levels of IL-4, IL-6, IL-18, and TNFα in AH from canines with POH following phacoemulsification. Primary glaucomatous eyes had the highest levels of IL-18 and TNFα which may indicate that inflammation plays a role in the pathogenesis of primary glaucoma in dogs.

PMID:35998207 | DOI:10.1371/journal.pone.0273449