Nevin Manimala

Plast Reconstr Surg. 2022 Jan 31. doi: 10.1097/PRS.0000000000008895. Online ahead of print.

ABSTRACT

BACKGROUND: Since its first description in 2012, the Goldilocks procedure has become an option for immediate breast reconstruction, particularly for obese patients who are poor candidates for traditional implant or autologous reconstruction. In this work, the authors performed a longitudinal study of patients who underwent mastectomy with Goldilocks reconstruction to assess the incidence of additional surgical procedures, and to assess surgical outcomes and patient satisfaction.

METHODS: A retrospective review of patients who underwent mastectomy with the Goldilocks procedure only at Mayo Clinic Rochester between January of 2012 and September of 2019 was performed. Demographics, complications, additional breast procedures performed to attain the final results, and patient-reported outcomes using the BREAST-Q were recorded. Univariate and multivariable analyses were performed to identify statistical associations and risk factors.

RESULTS: Sixty-three patients (108 breasts) were included. Mean age was 57.8 years. Mean body mass index was 37.6 kg/m2. Median follow-up time after the mastectomy with the Goldilocks procedure was 15 months. The major complication rate within the first 30 days was 9.3 percent. Forty-four breasts (40.7 percent) underwent additional surgery. Dyslipidemia was significantly associated with an increased risk of additional surgery (adjusted hazard ratio, 2.00; p = 0.045). Scores in the four BREAST-Q domains were not statistically different between patients who had additional procedures and those who did not.

CONCLUSIONS: Based on the results, the authors recommend a thorough preoperative discussion with patients who are candidates for the Goldilocks procedure to explore all options for reconstruction and their expectations, because it is crucial to reduce the necessity for additional operations in this high-risk population.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

PMID:35103645 | DOI:10.1097/PRS.0000000000008895

Med Image Comput Comput Assist Interv. 2021 Sep-Oct;12902:166-176. doi: 10.1007/978-3-030-87196-3_16. Epub 2021 Sep 21.

ABSTRACT

A long-standing challenge in multimodal brain network analyses is to integrate topologically different brain networks obtained from diffusion and functional MRI in a coherent statistical framework. Existing multimodal frameworks will inevitably destroy the topological difference of the networks. In this paper, we propose a novel topological learning framework that integrates networks of different topology through persistent homology. Such challenging task is made possible through the introduction of a new topological loss that bypasses intrinsic computational bottlenecks and thus enables us to perform various topological computations and optimizations with ease. We validate the topological loss in extensive statistical simulations with ground truth to assess its effectiveness of discriminating networks. Among many possible applications, we demonstrate the versatility of topological loss in the twin imaging study where we determine the extend to which brain networks are genetically heritable.

PMID:35098263 | PMC:PMC8797159 | DOI:10.1007/978-3-030-87196-3_16

Biomed Res Int. 2022 Jan 21;2022:9971780. doi: 10.1155/2022/9971780. eCollection 2022.

ABSTRACT

BACKGROUND: Most patients with drug-resistant epilepsy (DRE) have cognitive impairment and sleep disturbance. There was a significant correlation between sleep disorders and cognitive dysfunction. This study performed surgical treatment on patients with DRE and observed seizures, sleep, and cognition in patients with DRE in 6th month after operation to clarify the correlation between sleep and cognition in DRE patients.

METHODS: 21 individuals with DRE were recruited to enroll in this trial. Each participant completed epileptic focus resection. Seizure frequency was the principle index; the mean seizure frequency was 1 month before surgery and six months after surgery. Cognitive function was assessed by MMSE, and sleep status was assessed by PSQI and ActiGraph; assessments were performed before and 6 months after surgery.

RESULTS: There were significant differences between conditions on all outcome measures; after 6 months of surgery, compared with before treatment, the monthly average seizure frequency of DRE decreased, which was statistically significant (P < 0.001) compared with that before treatment. The MMSE score of DRE patients was significantly higher than before (P < 0.01), especially the ability of attention, calculation, and recall in MMSE score, which was significantly higher than before operation (respectively, P < 0.001 and P < 0.01). The subjective sleep evaluation index PSQI and objective measurement of sleep latency, total sleep time, and sleep efficiency of patients with DRE by ActiGraph were statistically significant (respectively, P < 0.01) compared with that before treatment. There was a correlation between seizure frequency and MMSE (r = -0.8887, P < 0.0001), PSQI (0.5515, P < 0.01), sleep latency (0.5353, P < 0.05), total sleep time (-0.7814, P < 0.0001), and sleep efficiency (-0.4380, P < 0.05).

CONCLUSIONS: Surgery can effectively reduce the epileptic seizures frequency in patients with DRE and indirectly improve the computational power, attention, recall ability, and sleep status of patients. However, this result did not show a correlation between improved cognitive function and sleep, so the patient’s cognitive function may be caused by surgery to improve the frequency of seizures. So, whether the improvement of patients’ sleep conditions can also significantly improve the frequency of attacks and cognitive function in patients with DRE needs further exploration.

PMID:35097128 | PMC:PMC8799343 | DOI:10.1155/2022/9971780

Biomed Res Int. 2022 Jan 21;2022:1775190. doi: 10.1155/2022/1775190. eCollection 2022.

ABSTRACT

OBJECTIVE: To investigate the serum cystatin (CysC), Chemerin, and gastrin-releasing peptide precursor (ProGRP) levels in patients with chronic renal failure (CRF).

METHODS: CRF patients admitted to our hospital from February 2019 to July 2019 were selected as the observation group, and 50 healthy patients were selected as the control group. The serum levels of CysC, Chemerin, ProGRP, and Scr of all subjects were detected. Patients with CRF were admitted for peritoneal dialysis (PD) treatment for 1 week, and continued treatment was performed. The survival rate of patients with CRF in nearly 1 year after continuous treatment was observed. Multivariate analysis of factors affecting survival time of CRF patients undergoing peritoneal dialysis was performed. The results were compared with those in the health group. The expression levels of CysC, Chemerin, ProGRP, and Scr in the observation group were all decreased, and the differences were statistically significant (P < 0.05). Pearson correlation analysis showed that Scr expression in CRF patients is positively correlated with CysC, Chemerin, and ProGRP (P < 0.001). The survival rate of 98 patients with CRF was 80.61% (79/98), and the mortality rate was 19.39% (19/98). Serum levels of CysC, Chemerin, ProGRP, and Scr in the death group are all higher than those in the survival group, and the differences are statistically significant (P < 0.05). CysC, Chemerin, ProGRP, and Scr are independent risk factors affecting survival time (P < 0.05). The AUC aspects of serum CysC, Chemerin, ProGRP, and Scr in predicting the survival rate of CRF patients in the treatment phase are 0.840, 0.775, 0.782, and 0.725, respectively.

CONCLUSION: The serum levels of CysC, Chemerin, and ProGRP of CRF patients are abnormally elevated and are positively correlated with serum Scr of patients, which can be used as a reliable indicator of pathogenesis and prognosis assessment of CRF patients.

PMID:35097109 | PMC:PMC8799334 | DOI:10.1155/2022/1775190

Int J Reprod Med. 2022 Jan 21;2022:8646724. doi: 10.1155/2022/8646724. eCollection 2022.

ABSTRACT

BACKGROUND: The World Health Organization Report noted that unintended pregnancy is the most common cause of maternal mortality in developing countries. Most unintended pregnancies occur where access to maternal care is limited, and because of this, many mothers lose their life. Therefore, this study was an attempt to assess the proportion of unintended pregnancy and associated factors among women who live in Ilu Gelan District, Western Ethiopia, 2021.

METHOD: A community-based cross-sectional study was conducted in the rural and urban kebeles of Ilu Gelan Woreda West Shoa Zone, Ethiopia, from March 1 to 30, 2021. The study population consists of 540 pregnant women who were living in Ilu Gelan Woreda for at least the last six months during the data collection period. Simple random sampling by lottery method was used to recruit the study subject. Data were checked, coded, entered to EpiData version 3, and then exported to SPSS version 25 for analysis. Both descriptive and analytical statistical procedures were utilized. Both bivariable and multivariable logistic regressions was implemented.

RESULT: In this study, the proportion of unintended pregnancy was found to be 55%, at 95% CI: 50.7-59.3. Multivariable logistic regression results showed that married women (AOR = 0.117, CI: 0.04-0.38), monthly income less than 1000 Ethiopian Birr (AOR = 4.93, CI: 1.72-14.09), gravidity greater than or equal to five (AOR = 6.07, CI: 2.4-15.28), birth interval less than 2 years (AOR = 3.35 (1.44-7.8)), lack of awareness about contraceptive (AOR = 2.06 (1.03-4.15)), and husband decision-making on health care (AOR = 11.1 (2.07-59.51)) were significantly associated with unintended pregnancy. Conclusion and Recommendation. This study indicated that more than half of pregnant women reported that their current pregnancy was found to be unintended pregnancy. Married women, family monthly income less than 1000 Ethiopian Birr, gravidity greater than or equal to five, birth space less than two years, lack of contraceptive awareness, and health care decisions by husband only showed a significant association with unintended pregnancy. To decrease the current level of unintended pregnancy, all concerned stakeholders should emphatically consider those identified factors for intervention; specifically, Ilu Gelan District Health Bureau and health providers should empower women with health education about family planning and decision-making related to their health issues in the study area.

PMID:35097105 | PMC:PMC8799332 | DOI:10.1155/2022/8646724

J Transp Health. 2022 Mar;24:101292. doi: 10.1016/j.jth.2021.101292. Epub 2021 Dec 10.

ABSTRACT

BACKGROUND AND OBJECTIVE: No research to date has causally linked built environment data with health care costs derived from clinically assessed health outcomes within the framework of longitudinal intervention design. This study examined the impact of light rail transit (LRT) line intervention on health care costs after controlling for mode-specific objectively assessed moderateto-vigorous physical activity (MVPA), participant-level neighborhood environmental measures, demographics, attitudinal predispositions, and residential choices.

DATA AND METHODS: Based on a natural experiment related to a new LRT line in Portland – 282 individuals divided into treatment and control groups were prospectively followed during the pre- and post-intervention periods. For each individual, we harness high-resolution data on Electronic Medical Record (EMR) based health care costs, mode-specific MVPA, survey-based travel behavior, attitudinal/perception information, and objectively assessed built environment measures. Simulation-assisted longitudinal grouped random parameter models are developed to gain more accurate insights into the effects of LRT line intervention.

RESULTS: Regarding the “average effect” of the LRT line intervention, no statistically significant reductions in health care costs were observed for the treated individuals over time. However, substantial heterogeneity was observed not only in the magnitude of effects but its direction as well after controlling for the within- and between-individual variations. For a subgroup of treated individuals, the LRT line opening decreased health care costs over time relative to the control group. Further comparative analysis based on the findings of heterogeneity-based models revealed that the effect of LRT intervention for the treated individuals differed by individual characteristics, attitudes/perceptions, and neighborhood level environmental features.

CONCLUSIONS: The study revealed the presence of significant effect modifiers and distinct subgroup structures in the data related to the effects of LRT line intervention on health care costs. Severe implications of ignoring unobserved heterogeneity are highlighted. Limitations and potential avenues for future research are discussed.

PMID:35096526 | PMC:PMC8797061 | DOI:10.1016/j.jth.2021.101292

Int J Hypertens. 2022 Jan 21;2022:6912502. doi: 10.1155/2022/6912502. eCollection 2022.

ABSTRACT

BACKGROUND: Hypertension is one of the leading causes of cardiovascular mortality. Although the pathogenetic process involved is not yet fully understood, the disease involves endothelial damage and inflammation. Calprotectin is an inflammatory marker that rises in parallel with disease activity in conditions such as systemic inflammatory diseases, infection, and atherosclerosis. The purpose of this study was to evaluate inflammation through serum calprotectin levels in newly diagnosed primary hypertension patients.

METHODS: Forty-nine newly diagnosed hypertensive patients and 38 healthy adults were included in the study. Patients’ office blood pressure values, biochemical findings, and demographic characteristics were recorded. Serum calprotectin levels were measured using ELISA. Parameters affecting serum calprotectin levels and determinants of hypertension were evaluated.

RESULTS: Serum calprotectin levels were 242.8 (72.4-524) ng/mL in the control group and 112.6 (67.4-389.8) ng/mL in the hypertensive patient group, the difference being statistically significant (p=0.001). There was no correlation between serum calprotectin levels and other parameters (blood pressure values, age, gender, serum creatinine, uric acid, and calcium levels) in the hypertensive group. A lower serum calprotectin level was found to be independently related to hypertension (β = -0.009, p=0.005). Serum calprotectin at a cutoff level of 128.6 ng/mL differentiated hypertensives from healthy controls with a sensitivity of 69.4% and specificity of 68.4% (AUC = 0.767).

CONCLUSIONS: The results of this study were the opposite of our hypothesis that a higher calprotectin level may reflect subclinical endothelial damage in newly diagnosed hypertensive patients. Further comparative studies involving patients at different stages of hypertension may contribute to clarifying the relationship between calprotectin and hypertension. We conclude that molecular studies seem essential for understanding the place of calprotectin in hypertension-associated inflammation, a complex process.

PMID:35096423 | PMC:PMC8799354 | DOI:10.1155/2022/6912502

Evid Based Complement Alternat Med. 2022 Jan 21;2022:3147319. doi: 10.1155/2022/3147319. eCollection 2022.

ABSTRACT

BACKGROUND: Acute gouty arthritis (AGA) is a common arthritis disease, with the characteristics of acute onset, severe condition, and poor prognosis. The conventional treatments have shown certain curative effects but are accompanied with many adverse reactions. The combination of orally taken Qinpi Tongfeng Formula (QPTFF) and bloodletting therapy could effectively alleviate arthralgia and joint swelling in AGA patients. However, there is a lack of high-quality randomized controlled trials (RCTs) to evaluate the clinical efficacy and safety of the combined therapy against AGA.

METHODS: This is a prospective, randomized, parallel controlled trial conducted in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine to explore the efficacy and safety of QPTFF combined with bloodletting therapy in the treatment of AGA. Eighty-six AGA patients meeting the inclusion and exclusion criteria will be randomly divided into the treatment group and control group in a 1 : 1 ratio using a randomization table. The investigators and the patients will not be blinded, while the outcome assessors and statisticians will be blinded to the allocation. Patients in the treatment group will take QPTFF and bloodletting therapy simultaneously, while patients in the control group will be instructed to orally take colchicine tablets. The primary outcome is the total effective rate, and the secondary outcomes are the pain changes after the first treatment, pain scores, complete pain relief time, joint symptom scores, TCM syndrome score, and laboratory test. SPSS22.0 will be used for statistical analysis. Discussion. This study will evaluate the clinical efficacy and safety of QPTFF combined with bloodletting therapy in the treatment of AGA, and the results of this study will provide reliable clinical evidence for the clinical use of QPTFF combined with bloodletting in the treatment of AGA. The trial is registered with ChiCTR2100048836.

PMID:35096107 | PMC:PMC8799338 | DOI:10.1155/2022/3147319

Condens Matter Phys. 2021;24(3):33503. doi: 10.5488/CMP.24.33503. Epub 2021 Jul 22.

ABSTRACT

Monte Carlo computer simulations in the canonical and grand canonical statistical ensemble were used to explore the properties of the central force (CF1) water model. The intramolecular structure of the H₂O molecule is well reproduced by the model. Emphasis was made on hydrogen bonding, and on the tehrahedral, q, and translational, τ, order parameters. An energetic definition of the hydrogen bond gives more consistent results for the average number of hydrogen bonds compared to the one-parameter distance criterion. At 300 K, an average value of 3.8 was obtained. The q and τ metrics were used to elucidate the water-like anomalous behaviour of the CF1 model. The structural anomalies lead to the density anomaly, with a good agreement of the model’s density with the experimental ρ(T) trends. The chemical potential-density projection of the model’s equation of state was explored. Vapour-liquid coexistence was observed at sufficiently low temperatures.

PMID:35095377 | PMC:PMC8794338 | DOI:10.5488/CMP.24.33503

Bioinformation. 2021 May 31;17(5):599-607. doi: 10.6026/97320630017599. eCollection 2020.

ABSTRACT

The prevalence of self-medication (SM) has increased in health professionals due to awareness of disease and symptoms. Incorrect use of medication caused harmful effects. To assess the knowledge, attitude and practice of health professionals, this survey was conducted. A cross-sectional study was carried out among health professionals of different specialities. Knowledge, attitude and practice-based questions were asked through an electronically distributed questionnaire. Data were statistically tested using the Chi-square test with SPSS. Most of the health professionals were aware with the term of self-medication; however the knowledge about related questions was not satisfactory. Almost half of the participants practiced self-medication. The prevalence of self-medication among participants was high. They need to be trained and educate about the incorrect use of self-medication.

PMID:35095234 | PMC:PMC8770411 | DOI:10.6026/97320630017599