Nevin Manimala

Wien Klin Wochenschr. 2022 Feb 11. doi: 10.1007/s00508-021-01992-y. Online ahead of print.

ABSTRACT

OBJECTIVE: To increase knowledge of discrete symptoms shall help to avoid misinterpretation of test results and to gain better understanding of associations between early symptoms and severe disease to provide additional criteria for targeted early interventions.

DESIGN: Retrospective observational study.

SETTING: Austrian GP practices in the year 2020, patients above 18 years were included.

PARTICIPANTS: We recruited 25 practices which included 295 participants with a positive SARS-CoV‑2 test.

MAIN OUTCOME MEASURES: Data collection comprised basic demographic data, risk factors and the recording of symptoms at several points in time in the course of the illness. Descriptive analyses for possible associations between demographics and symptoms were conducted by means of cross tabulation. Group differences (hospitalized yes/no) were assessed using Fisher’s exact test. The significance level was set to 0.05; due to the observational character of the study, no adjustment for multiplicity was performed.

RESULTS: Only one third of patients report symptoms generally understood to be typical for COVID‑19. Most patients presented with unspecific complaints. We found symptoms indicating complicated disease, depending on when they appear. The number of symptoms may be a predictor for the need of hospital care. More than 50% of patients still experience symptoms 14 days after onset.

CONCLUSION: Unspecific symptoms are valuable indicators in the detection of early COVID‑19 disease that practitioners and the general public should be aware of also in the interpretation of low sensitivity tests. Monitoring patients using the indicators we identified may help to identify patients who are likely to profit from early intervention.

PMID:35149931 | DOI:10.1007/s00508-021-01992-y

J Plant Res. 2022 Feb 11. doi: 10.1007/s10265-022-01378-9. Online ahead of print.

ABSTRACT

Prosopis chilensis (Molina) Stuntz (Leguminosae) is a valuable native species in Argentina that has been proposed to be used in reforestation, afforestation and restoration programmes. Natural provenances show important differentiation in height, shape, spine size, fruits and foliar traits throughout their distribution in the semiarid Monte ecoregion. The goal of this work was to characterize the genetic basis of the leaf variation in P. chilensis aiming to contribute to the improvement management program. We analyzed morphological variation and estimate narrow sense heritability for ten quantitative traits from a provenance-progeny trial founded from open pollinated families. We assessed the variance components by a generalized linear mixed model. Differences among provenances were quantified through univariate Q_ST statistics and multivariate discriminant analysis of principal components. Finally, univariate and multivariate neutrality test were conducted to unveil the evolutionary forces that shape the variation. Univariate and multivariate analysis showed low genetic variation in foliar traits among provenances grown in the common garden. Consistently, the Q_ST estimates for each trait were low. Both, the univariate (Q_ST-F_ST comparison) and the multivariate neutrality test suggest that the leaf variation among provenances may be shaped by genetic drift rather than selective forces. Heritability estimates were significant only for leaflet apex and leaflet apex/leaflet area. Since genetic variation for most foliar traits among provenances estimated under controlled environmental conditions were very low or absent, the variation described in the wild would be explained merely by plastic response to varying environments. These results are discussed in terms of adaptive strategies and the use of different provenances as seed sources within the framework of the improvement program. It is expected that P. chilensis seeds or seedlings from trees selected under economical criteria will be able to develop in different areas thanks to the phenotypic plasticity of leaf traits.

PMID:35149910 | DOI:10.1007/s10265-022-01378-9

Arch Orthop Trauma Surg. 2022 Feb 11. doi: 10.1007/s00402-022-04372-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Classifying complex acetabular defects in revision total hip arthroplasty (THA) by means of conventional radiographs comes with significant limitations. Statistical shape modelling allows the virtual reconstruction of the native pelvic morphology, hereby enabling an analytic acetabular defect assessment. Our objective was to evaluate the effect of advanced imaging augmented with analytic representations of the defect on (1) intra- and inter-rater reliability, and (2) up- or downscaling of classification scores when evaluating acetabular defects in patients undergoing revision THA.

MATERIALS AND METHODS: The acetabular defects of 50 patients undergoing revision THA were evaluated by three independent, fellowship-trained orthopaedic surgeons. Defects were classified according to the acetabular defect classification (ADC) using four different imaging-based representations, namely, standard radiographs, CT imaging, a virtual three-dimensional (3D) model and a quantitative analytic representation of the defect based on a statistical shape model reconstruction. Intra- and inter-rater reliabilities were quantified using Fleiss’ and Cohen’s kappa scores, respectively. Up- and downscaling of classification scores were compared for each of the imaging-based representations and differences were tested.

RESULTS: Overall inter-rater agreement across all imaging-based representations for the classification was fair (κ 0.29 95% CI 0.28-0.30). Inter-rater agreement was lowest for radiographs (κ 0.21 95% CI 0.19-0.22) and increased for other representations with agreement being highest when using analytic defect models (κ 0.46 95% CI 0.43-0.48). Overall intra-rater agreement was moderate (κ 0.51 95% CI 0.42-0.60). Intra-rater agreement was lowest for radiographs (κ 0.40 95% CI 0.23-0.57), and highest for ratings including analytic defect models (κ 0.64:95% CI 0.46-0.82). Virtual 3D models with quantitative analytic defect representations upscaled acetabular defect scores in comparison to standard radiographs.

CONCLUSIONS: Using 3D CT imaging with statistical shape models doubles the intra- and inter-rater reliability and results in upscaling of acetabular defect classification when compared to standard radiographs. This method of evaluating defects will aid in planning surgical reconstruction and stimulate the development of new classification systems based on advanced imaging techniques.

PMID:35149888 | DOI:10.1007/s00402-022-04372-x

Jpn J Clin Oncol. 2022 Feb 12:hyac011. doi: 10.1093/jjco/hyac011. Online ahead of print.

ABSTRACT

Older patients tend to have comorbidities and physiological decline, which require adaptation in terms of standard treatment. Therefore, the care of older patients poses a unique challenge for healthcare providers. Their standard care is relatively less established than for younger patients because older patients are often excluded from clinical trials, resulting in limited representation. This review, using various data sources, such as cancer registries and national statistics, aims to describe the nationwide status of older patients in Japan and the care provided to them. Incidence statistics have revealed that each age group’s most common types of cancers are different. Relevant data have also shown that older patients are more likely to be left without treatment compared with their younger counterparts, although the extent of such differences tends to depend on the cancer type. A survey of the general population has shown that older patients are more likely to be treated for common diseases; however, they are found to have undetected diseases when screened for the common diseases. Individuals’ life expectancies may vary depending on their physical conditions. The social lives of older persons, which often revolve around their jobs and family structures, vary widely. Thus, clinicians and caregivers should consider the background information of older patients in order to accommodate their special needs.

PMID:35149875 | DOI:10.1093/jjco/hyac011

Cereb Cortex. 2022 Feb 12:bhac021. doi: 10.1093/cercor/bhac021. Online ahead of print.

ABSTRACT

Semantic processing is the ability to discern and maintain conceptual relationships among words and objects. While the neural circuits serving semantic representation and controlled retrieval are well established, the neuronal dynamics underlying these processes are poorly understood. Herein, we examined 25 healthy young adults who completed a semantic relation word-matching task during magnetoencephalography (MEG). MEG data were examined in the time-frequency domain and significant oscillatory responses were imaged using a beamformer. Whole-brain statistical analyses were conducted to compare semantic-related to length-related neural oscillatory responses. Time series were extracted to visualize the dynamics and were linked to task performance using structural equation modeling. The results indicated that participants had significantly longer reaction times in semantic compared to length trials. Robust MEG responses in the theta (3-6 Hz), alpha (10-16 Hz), and gamma (64-76 Hz and 64-94 Hz) bands were observed in parieto-occipital and frontal cortices. Whole-brain analyses revealed stronger alpha oscillations in a left-lateralized network during semantically related relative to length trials. Importantly, stronger alpha oscillations in the left superior temporal gyrus during semantic trials predicted faster responses. These data reinforce existing literature and add novel temporal evidence supporting the executive role of the semantic control network in behavior.

PMID:35149873 | DOI:10.1093/cercor/bhac021

Radiol Oncol. 2022 Feb 11;56(1):37-45. doi: 10.2478/raon-2022-0005.

ABSTRACT

BACKGROUND: We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method.

PATIENTS AND METHODS: Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon’s and Karlsson’s) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%).

RESULTS: Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI. The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant (p < 0.001). Gordon’s method calculating MI reached a positive predictive value (PPV) of 83%, negative predictive value (NPV) of 83%, 77% sensitivity, 88% specificity, and 83% overall accuracy. Karlsson’s method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy. Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy.

CONCLUSIONS: We found that objective TVUS assessment of myometrial invasion was performed with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer.

PMID:35148470 | DOI:10.2478/raon-2022-0005

Clin Oral Implants Res. 2022 Feb 11. doi: 10.1111/clr.13904. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this in vitro study was to determine accuracy defined by trueness and precision of computer-assisted implant surgery comparing two guided surgery kits designed for either closed sleeves or open sleeves with a lateral window.

MATERIAL AND METHODS: Each n=20 implants were placed fully guided (sleeve-bone distance of 2 or 4mm) in identical replicas using a surgical guide with both closed sleeve or an open sleeve, partially guided, or free hand. The achieved implant position was digitized and compared with the planned position. Trueness and precision were determined. The angular deviation was defined as the primary outcome parameter. The means, standard deviation, and 95%-confidence intervals were analyzed statistically with 1-way ANOVA and the Scheffé procedure.

RESULTS: The accuracy of guided implant placement using closed and open sleeves was comparable when the sleeve-bone distance was 2 mm. Accuracy decreased when the sleeve-bone distance increased in both fully guided groups, more so in the open than in the closed sleeve group. The least accurate method was the free hand group. Partially guided implant surgery was more accurate than free hand placement, but less accurate than the fully guided groups with 2 mm sleeve-bone distance.

CONCLUSIONS: The closer the sleeve to the bone, the more accurate and precise is computer-assisted implant surgery using a closed system and a system using open sleeves. Partially guided implant surgery using only the static guide for the pilot drill is less accurate than both fully guided approaches, but more accurate than free hand surgery.

PMID:35148444 | DOI:10.1111/clr.13904

Nutr Clin Pract. 2022 Feb 11. doi: 10.1002/ncp.10832. Online ahead of print.

ABSTRACT

The administration of intravenous vitamin C (IV-VC) in treating patients with coronavirus disease 2019 (COVID-19) is still highly controversial. There have been no previous studies on the effect of IV-VC on the severity and mortality of COVID-19. Hence, we conducted a systematic review and meta-analysis to compare the disease severity and mortality in patients with COVID-19 who promptly received IV-VC treatment vs those who did not. We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, MEDLINE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, up to June 23, 2021. We identified a total of seven related articles, which were included in this study. This meta-analysis showed that IV-VC treatment did not affect disease severity compared with placebo treatment or usual care (odds ratio [OR], 0.70; 95% CI, 0.45 to 1.07; P = 0.10). In addition, no statistically significant difference in mortality was observed between patients who received IV-VC treatment and those who did not (OR, 0.64; 95% CI, 0.41 to 1.00; P = 0.05). Moreover, the adjusted meta-analysis revealed that the use of IV-VC did not influence disease severity (OR, 0.67; 95% CI, 0.34 to 1.31; P = 0.242) or mortality (OR, 1.02; 95% CI, 0.75 to 1.40; P = 0.877) in comparison with a control group. The results of this meta-analysis demonstrated that short-term IV-VC treatment did not reduce the risk of severity and mortality in patients with COVID-19.

PMID:35148440 | DOI:10.1002/ncp.10832

J Oral Rehabil. 2022 Feb 11. doi: 10.1111/joor.13311. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a specially designed mobile application developed to provide patients with a sense of anxiety control during the various stages of endodontic treatment. The patients’ anxiety was assessed by measuring their salivary cortisol levels.

METHODS: A total of 46 patients requiring endodontic treatment were recruited. The patients were randomly assigned to two groups. The experimental group used the special communication application, while the control group did not. Salivary samples were collected from all patients preoperatively, postanesthesia, and postoperatively. The samples were analyzed with an enzyme-linked immunosorbent assay to measure the cortisol levels.

RESULTS: A significant difference in cortisol levels was observed between the experimental and the control group (Mann-Whitney U test, P < .05). This difference was significant in the experimental group in each step (P < .01). No difference was found in the control group steps (P > .05).

CONCLUSIONS: Perceived control of anxiety using the specially designed software was effective in reducing salivary cortisol levels.

PMID:35148428 | DOI:10.1111/joor.13311