Nevin Manimala

Neurocase. 2022 Apr 22:1-9. doi: 10.1080/13554794.2021.1978502. Online ahead of print.

ABSTRACT

Two service members were diagnosed with PTSD due to military trauma exposure. One presented with the classical manifestation; the other presented with the dissociative subtype. A statistical map revealed anterior localization of insula connectivity in the classical PTSD patient and posterior localization in the dissociative PTSD patient. These differences suggest that dissociative PTSD may be identified, understood, and treated as a disorder related to increased posterior insula connectivity. This double case study provides preliminary evidence for a concrete neuroanatomical discrepancy between insula function in classical and dissociative PTSD that may help explain the emergence of different coping strategies.

PMID:35452340 | DOI:10.1080/13554794.2021.1978502

Am J Hosp Palliat Care. 2022 Apr 22:10499091221092699. doi: 10.1177/10499091221092699. Online ahead of print.

ABSTRACT

Objective: We aim to explore patterns of inpatient code status during the COVID-19 pandemic compared with a similar timeframe the previous year, as well as utilization of palliative care services.Methods: This is a retrospective cohort study using data from the Montefiore Health system of all inpatient admissions between March 15-May 31, 2019 and March 15-May 31, 2020. Univariate logistic regression was performed with full code status as the outcome. All statistically significant variables were included in the multivariable logistic regression.Results: The total number of admissions declined during the pandemic (16844 vs 11637). A lower proportion of patients had full code status during the pandemic (85.1% vs 94%, P < .001) at the time of discharge/death. There was a 20% relative increase in the number of palliative care consultations during the pandemic (12.2% vs 10.5%, P < .001). Intubated patients were less often full code (66.5% vs 82.2%, P < .001) during the pandemic. Although a lower portion of COVID-19 positive patients had a full code status compared with non-COVID patients (77.6% vs 92.4%, P<.001), there was no statistically significant difference in code status at death (38.3% vs 38.3%, P = .96).Conclusions: The proportion of full code patients was significantly lower during the pandemic. Age and COVID status were the key determinants of code status during the pandemic. There was a higher demand for palliative care services during the pandemic.

PMID:35452316 | DOI:10.1177/10499091221092699

Omega (Westport). 2022 Apr 22:302228221093461. doi: 10.1177/00302228221093461. Online ahead of print.

ABSTRACT

The study was conducted to determine the death anxiety experienced by heart patients and the affecting factors in the COVID-19 pandemic. The study was conducted with 148 patients hospitalized in the cardiology clinic of a university hospital between April and August 2021 in the southeast in Turkey. The data were collected with the personal information form, death anxiety scale, coronavirus anxiety scale and Covid-19 fear scale developed by the researchers. Data analysis was performed by using IBM SPSS Statistics 25. Descriptive statistics were used in the analysis of the data. Correlation and regression analysis were performed to determine the relationship between scales. The mean age of the patients was 64.99+15.56 years and 56.1% were male. 57.4% of them were hospitalized with a diagnosis of coronary artery disease. During the pandemic, it was determined that 74.3% of the patients followed social distance, 71.6% wore masks, 58.8% used disinfectants. The patients had moderate death anxiety, low coronavirus anxiety, and high covid 19 fear. A positive linear correlation was found between anxiety and fear scale and death anxiety total and sub-dimensions. As a result, the fear of COVID-19 may increase the fear of death in individuals with heart disease. Patients who are worried about being infected with Covid 19 during the pandemic process have more fear of death.

PMID:35452277 | DOI:10.1177/00302228221093461

Am J Speech Lang Pathol. 2022 Apr 22:1-14. doi: 10.1044/2022_AJSLP-21-00313. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this pilot study was to determine the impact of including peers with typically developing language (TDL) in language intervention sessions for preschool children with diagnosed developmental language disorder (DLD).

METHOD: To measure peer effects, participants received 8 weeks of group language intervention in their neighborhood head start. Twenty children with DLD were randomly assigned to one of two conditions. Children in the experimental condition received language intervention with a peer with TDL; children in the control condition received language intervention with another peer with DLD. Pre- and posttest measures of language (semantics, syntax, morphology, and narrative) were collected. Teachers, speech-language pathologists, and assessors were blind to study condition.

RESULTS: All children in the study showed gains from pre- to posttest; there were no statistically significant differences between conditions. However, effect size estimates (Cohen’s d) indicated that the children in the experimental condition showed an advantage over the control condition in syntax, morphology, and narrative.

CONCLUSIONS: This study provides preliminary evidence that children with DLD show increased gains in language when paired with peers with TDL. This finding supports previous research in educational literature, suggesting that children’s development is influenced by the skills of their peers. Additional research is warranted to further explore and understand the role of peers for children with DLD.

PMID:35452261 | DOI:10.1044/2022_AJSLP-21-00313

J Phys Chem A. 2022 Apr 22. doi: 10.1021/acs.jpca.2c01050. Online ahead of print.

ABSTRACT

The rate coefficients for 52 hydrogen shift reactions for silicon nitrides containing up to 6 atoms of silicon and nitrogen have been calculated using the G3//B3LYP composite method and statistical thermodynamics. The overall reaction of substituted acyclic and cyclic silylenes to their respective silene and imine species by a 1,2-hydrogen shift reaction was sorted by three different types of H shift reactions using overall reaction thermodynamics: (1) endothermic H shift between N and Si:, (2) endothermic H shift between Si and Si:, and (3) exothermic H shift between Si and Si:. Endothermic H shift reactions between Si atoms have one dominant activation barrier where the exothermic H shift reaction between Si atoms has two barriers and a stable intermediate. The rate-determining step was determined to be from the intermediate to the substituted silene, and then kinetic parameters for the overall reaction were calculated for the two-step pathway. The single event pre-exponential factors, Ã, and activation energies, E_a, for the three different classes of hydrogen shift reactions of silicon nitrides were computed. The hydrogen shift reaction was explored for acyclic and cyclic monofunctional silicon nitrides, and the type of hydrogen shift reaction gives the most significant influence on the kinetic parameters. Using a supervised machine learning approach, the models for predicting the energy barrier of three different hydrogen shift reactions were generalized and suggested based on selected descriptors.

PMID:35452242 | DOI:10.1021/acs.jpca.2c01050

BMJ Open Ophthalmol. 2022 Apr 1;7(1):e000929. doi: 10.1136/bmjophth-2021-000929. eCollection 2022.

ABSTRACT

Myopia is a global healthcare concern and effective analyses of dioptric power are important in evaluating potential treatments involving surgery, orthokeratology, drugs such as low-dose (0.05%) atropine and gene therapy. This paper considers issues of concern when analysing refractive state such as data normality, transformations, outliers and anisometropia. A brief review of methods for analysing and representing dioptric power is included but the emphasis is on the optimal approach to understanding refractive state (and its variation) in addressing pertinent clinical and research questions. Although there have been significant improvements in the analysis of refractive state, areas for critical consideration remain and the use of power matrices as opposed to power vectors is one such area. Another is effective identification of outliers in refractive data. The type of multivariate distribution present with samples of dioptric power is often not considered. Similarly, transformations of samples (of dioptric power) towards normality and the effects of such transformations are not thoroughly explored. These areas (outliers, normality and transformations) need further investigation for greater efficacy and proper inferences regarding refractive error. Although power vectors are better known, power matrices are accentuated herein due to potential advantages for statistical analyses of dioptric power such as greater simplicity, completeness, and improved facility for quantitative and graphical representation of refractive state.

PMID:35452207 | PMC:PMC8977790 | DOI:10.1136/bmjophth-2021-000929

J Clin Neurophysiol. 2021 Oct 12. doi: 10.1097/WNP.0000000000000902. Online ahead of print.

ABSTRACT

PURPOSE: During intraoperative neurophysiological monitoring of motor pathways, two types of transcranial electrical stimulation are available, i.e., constant-current and constant-voltage stimulation. Few previous studies, performed only during spinal surgery, analyzed and compared them during intraoperative neurophysiological monitoring. The aim of our study was to compare these two stimulation techniques for eliciting motor-evoked potentials during intraoperative neurophysiological monitoring in a group of patients affected by supratentorial lesions.

METHODS: Supratentorial lesions from 16 patients were retrospectively collected and analyzed. Motor-evoked potentials were performed only from transcranial electrical stimulation because the inability to place the subdural strip electrodes correctly did not permit to perform direct cortical stimulation. At the beginning of surgery, in each patient, motor-evoked potentials were monitored by using both “fast-charge” constant-voltage and “slow-charge” constant-current stimulation. Several neurophysiological parameters were collected and compared between the two stimulation techniques by means of statistical analysis.

RESULTS: “Fast-charge” constant-voltage stimulation allowed statistically higher efficiency rates for eliciting motor-evoked potentials compared with “slow-charge” constant-current stimulation, both for upper and lower limbs. We also found that threshold and maximal charge as well as charge density were significantly lower during constant-voltage stimulation, thus lowering the potential tissue damage.

CONCLUSIONS: “Fast-charge” constant-voltage transcranial electrical stimulation is feasible and safe during intraoperative neurophysiological monitoring for supratentorial surgery and may be preferable to “slow-charge” constant-current stimulation.

PMID:35452204 | DOI:10.1097/WNP.0000000000000902

Neuroradiology. 2022 Apr 22. doi: 10.1007/s00234-022-02958-1. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the study was to assess the prevalence and characteristics of spinal cord cavernous malformations (SCCM) and intraosseous spinal vascular malformations (ISVM) in a pediatric familial cerebral cavernous malformation (FCCM) cohort and evaluate clinico-radiological differences between children with (SCCM +) and without (SCCM-) SCCM.

METHODS: All patients with a pediatric diagnosis of FCCM evaluated at three tertiary pediatric hospitals between January 2010 and August 2021 with [Formula: see text] 1 whole spine MR available were included. Brain and spine MR studies were retrospectively evaluated, and clinical and genetic data collected. Comparisons between SCCM + and SCCM- groups were performed using student-t/Mann-Whitney or Fisher exact tests, as appropriate.

RESULTS: Thirty-one children (55% boys) were included. Baseline spine MR was performed (mean age = 9.7 years) following clinical manifestations in one subject (3%) and as a screening strategy in the remainder. Six SCCM were detected in five patients (16%), in the cervico-medullary junction (n = 1), cervical (n = 3), and high thoracic (n = 2) regions, with one appearing during follow-up. A tendency towards an older age at first spine MR (P = 0.14) and [Formula: see text] 1 posterior fossa lesion (P = 0.13) was observed in SCCM + patients, lacking statistical significance. No subject demonstrated ISVM.

CONCLUSION: Although rarely symptomatic, SCCM can be detected in up to 16% of pediatric FCCM patients using diverse spine MR protocols and may appear de novo. ISVM were instead absent in our cohort. Given the relative commonality of asymptomatic SCCM, serial screening spine MR should be considered in FCCM starting in childhood.

PMID:35451625 | DOI:10.1007/s00234-022-02958-1

Alzheimers Dement. 2022 Apr 22. doi: 10.1002/alz.12663. Online ahead of print.

ABSTRACT

INTRODUCTION: We examined whether German claims data are suitable for dementia risk prediction, how machine learning (ML) compares to classical regression, and what the important predictors for dementia risk are.

METHODS: We analyzed data from the largest German health insurance company, including 117,895 dementia-free people age 65+. Follow-up was 10 years. Predictors were: 23 age-related diseases, 212 medical prescriptions, 87 surgery codes, as well as age and sex. Statistical methods included logistic regression (LR), gradient boosting (GBM), and random forests (RFs).

RESULTS: Discriminatory power was moderate for LR (C-statistic = 0.714; 95% confidence interval [CI] = 0.708-0.720) and GBM (C-statistic = 0.707; 95% CI = 0.700-0.713) and lower for RF (C-statistic = 0.636; 95% CI = 0.628-0.643). GBM had the best model calibration. We identified antipsychotic medications and cerebrovascular disease but also a less-established specific antibacterial medical prescription as important predictors.

DISCUSSION: Our models from German claims data have acceptable accuracy and may provide cost-effective decision support for early dementia screening.

PMID:35451562 | DOI:10.1002/alz.12663

Hum Brain Mapp. 2022 Apr 22. doi: 10.1002/hbm.25878. Online ahead of print.

ABSTRACT

One important approach to human brain mapping is to define a set of distinct regions that can be linked to unique functions. Numerous brain parcellations have been proposed, using cytoarchitectonic, structural, or functional magnetic resonance imaging (fMRI) data. The intrinsic smoothness of brain data, however, poses a problem for current methods seeking to compare different parcellations. For example, criteria that simply compare within-parcel to between-parcel similarity provide even random parcellations with a high value. Furthermore, the evaluation is biased by the spatial scale of the parcellation. To address this problem, we propose the distance-controlled boundary coefficient (DCBC), an unbiased criterion to evaluate discrete parcellations. We employ this new criterion to evaluate existing parcellations of the human neocortex in their power to predict functional boundaries for an fMRI data set with many different tasks, as well as for resting-state data. We find that common anatomical parcellations do not perform better than chance, suggesting that task-based functional boundaries do not align well with sulcal landmarks. Parcellations based on resting-state fMRI data perform well; in some cases, as well as a parcellation defined on the evaluation data itself. Finally, multi-modal parcellations that combine functional and anatomical criteria perform substantially worse than those based on functional data alone, indicating that functionally homogeneous regions often span major anatomical landmarks. Overall, the DCBC advances the field of functional brain mapping by providing an unbiased metric that compares the predictive ability of different brain parcellations to define brain regions that are functionally maximally distinct.

PMID:35451538 | DOI:10.1002/hbm.25878