Nevin Manimala

Cogn Psychol. 2021 Oct 16;131:101441. doi: 10.1016/j.cogpsych.2021.101441. Online ahead of print.

ABSTRACT

Distributional models of lexical semantics have proven to be powerful accounts of how word meanings are acquired from the natural language environment (Günther, Rinaldi, & Marelli, 2019; Kumar, 2020). Standard models of this type acquire the meaning of words through the learning of word co-occurrence statistics across large corpora. However, these models ignore social and communicative aspects of language processing, which is considered central to usage-based and adaptive theories of language (Tomasello, 2003; Beckner et al., 2009). Johns (2021) recently demonstrated that integrating social and communicative information into a lexical strength measure allowed for benchmark fits to be attained for lexical organization data, indicating that the social world contains important statistical information for language learning and processing. Through the analysis of the communication patterns of over 330,000 individuals on the online forum Reddit, totaling approximately 55 billion words of text, the findings of the current article demonstrates that social information about word usage allows for unique aspects of a word’s meaning to be acquired, providing a new pathway for distributional model development.

PMID:34666227 | DOI:10.1016/j.cogpsych.2021.101441

J Surg Res. 2021 Aug 30;270:145-150. doi: 10.1016/j.jss.2021.08.020. Online ahead of print.

ABSTRACT

BACKGROUND: On March 17, 2020 the Association of American Medical Colleges recommended dismissal of medical students from clinical settings due to the COVID-19 pandemic. Third-year (M3) and fourth-year (M4) medical students were at home, M4s were interested in teaching, and residents and faculty had fewer clinical responsibilities due to elective surgery cancellations. To continue M3 access to education, we created a virtual surgery elective (VSE) that aimed to broaden students’ exposure to, and elicit interest in, general surgery (GS).

METHODS: Faculty, surgical residents, and M4s collaborated to create a 2-wk VSE focusing on self-directed learning and direct interactions with surgery faculty. Each day was dedicated to a specific pathology commonly encountered in GS. A variety of teaching methods were employed including self-directed readings and videos, M4 peer lectures, case-based learning and operative video review with surgery faculty, and weekly surgical conferences. A VSE skills lab was also conducted to teach basic suturing and knot-tying. All lectures and skills labs were via Zoom videoconference (Zoom Video Communications Inc). A post-course anonymous survey sent to all participants assessed changes in their understanding of GS and their interest in GS and surgery overall.

RESULTS: Fourteen M3s participated in this elective over two consecutive iterations. The survey response rate was 79%. Ninety-one percent of students believed the course met its learning objectives “well” or “very well.” Prior to the course, 27% reported a “good understanding” and 0% a “very good” understanding of GS. Post-course, 100% reported a “good” or “very good” understanding of GS, a statistically significant increase (P = 0.0003). Eighty-two percent reported increased interest in GS and 64% reported an increase in pursuing GS as a career.

CONCLUSIONS: As proof of concept, this online course successfully demonstrated virtual medical student education can increase student understanding of GS topics, increase interest in GS, and increase interest in careers in surgery. To broaden student exposure to GS, we plan to integrate archived portions of this course into the regular third-year surgery clerkship and these can also be used to introduce GS in the preclinical years.

PMID:34666220 | DOI:10.1016/j.jss.2021.08.020

Eur J Cancer. 2021 Oct 16;158:133-143. doi: 10.1016/j.ejca.2021.09.018. Online ahead of print.

ABSTRACT

AIM: This study investigated how material deprivation in Italy influences the stage of hepatocellular carcinoma (HCC) at diagnosis and the chance of cure.

METHODS: 4114 patients from the Italian Liver Cancer database consecutively diagnosed with HCC between January 2008 and December 2018 were analysed about severe material deprivation (SMD) rate tertiles of the region of birth and region of managing hospitals, according to the European Statistics on Income and Living Conditions. The main outcomes were HCC diagnosis modalities (during or outside surveillance), treatment adoption and overall survival.

RESULTS: In more deprived regions, HCC was more frequently diagnosed during surveillance, while the incidental diagnosis was prevalent in the least deprived. Tumour characteristics did not differ among regions. The proportion of patients undergoing potentially curative treatments progressively decreased as the SMD worsened. Consequently, overall survival was better in less deprived regions. Patients who moved from most deprived to less deprived regions increased their probability of receiving potentially curative treatments by 1.11 times (95% CI 1.03 to 1.19), decreasing their mortality likelihood (hazard ratio 0.78 95% CI 0.67 to 0.90).

CONCLUSIONS: Socioeconomic status measured through SMD does not seem to influence HCC features at diagnosis but brings a negative effect on the chance of receiving potentially curative treatments. Patient mobility from the most deprived to the less deprived regions increased the access to curative therapies, with the ultimate result of improving survival.

PMID:34666215 | DOI:10.1016/j.ejca.2021.09.018

J Proteomics. 2021 Oct 16:104394. doi: 10.1016/j.jprot.2021.104394. Online ahead of print.

ABSTRACT

The beneficial role of yogurt on metabolic profile has been widely reported. Yet, few studies have intended to describe the integrated metabolic alterations in response to yogurt. Yogurt and milk (220 g/d) were given to 48 and 44 obese women with metabolic syndrome and nonalcoholic fatty liver disease for 24 weeks in a randomized controlled trial (registered at http://www.chictr.org.cn as ChiCTR-IPR-15006801). Fasting serum samples were collected before and after intervention for global, untargeted metabolomics based on ¹H nuclear magnetic resonance (NMR) and ultra-high-performance liquid chromatography coupled with electrospray ionization time-of-flight mass spectrometry (UPLC-Q-TOF-MS) (in positive and negative ion modes). Multivariable statistical analysis and pathway analysis were conducted. In both ¹H NMR and UPLC-Q-TOF-MS metabolomics, no clustering was observed between the two groups at baseline. While, a clear clustering was shown after intervention, and the yogurt group had significantly different metabolic status from the milk. The metabolites that contributed mostly to class separation were identified, and involved into pathway analysis. Pathways on amino acids metabolism, fatty acid oxidation, cholesterol catabolism and choline metabolism significantly changed after yogurt intervention. The study revealed the integrated metabolic alterations in response to yogurt via two metabolomics approaches, suggesting the potential mechanisms of yogurt against metabolic disorders. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-IPR-15006801. Registered 20 July 2015, http://www.chictr.org.cn/ ChiCTR-IPR-15006801. SIGNIFICANCE: Both review from prospective studies and our randomized clinical trial showed the protective role of yogurt against multiple metabolic disorders. However, they were focus on targeted glucose, lipid, and other metabolic indicators, which were only part of human metabolism, failing to show an integrated metabolic feature on yogurt. Therefore, two global, untargeted metabolomics were applied in our current randomized clinical trial, trying to uncover the significant metabolic alterations characterizing the effects of yogurt on obese women with multiple metabolic disorders, and to explore the potential biological mechanisms of yogurt. The finding will shed light on a more comprehensive picture of how yogurt affects host metabolism, and provide theoretical foundation for dietary prevention of chronic diseases.

PMID:34666202 | DOI:10.1016/j.jprot.2021.104394

Photodiagnosis Photodyn Ther. 2021 Oct 16:102584. doi: 10.1016/j.pdpdt.2021.102584. Online ahead of print.

ABSTRACT

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) and laser-activated irrigation (LAI) are adjunctive therapies developed to enhance the effectiveness of root canal disinfection. Sealer penetration into dentinal tubules is significant for preventing re-infection, and the sealer’s penetration ability is affected by the chemo-mechanical preparation of the root canal. This study aimed to evaluate the efficacy of aPDT and LAI on dentinal tubule penetration of MTA-based root canal sealer.

METHODS: Forty single-rooted mandibular premolars were divided into four groups (n=10): control, methylene blue 50 mg/L (MB50), curcumin 500 mg/L (C500), and Er,Cr:YSGG and sodium hypochlorite (LAI). The smear removal efficiency of the groups on intraradicular dentin was evaluated with a scanning electron microscope (SEM). Confocal laser scanning microscopy (CLSM) was performed to determine the depth of penetration of MTA Fillapex into dentinal tubules. Data were analyzed statistically.

RESULTS: The maximum penetration depth of the C500 group was significantly higher than that of the other groups in all three levels of root sections (p<0.05). Regarding mean penetration depth, the highest values were obtained from the C500 group. However, there was no statistically significant difference between the C500 and MB50 groups in the middle and coronal thirds of the root (p>0.05). The LAI group showed the lowest penetrated area percentage in the middle and coronal third of the root (p<0.05). The C500 and LAI groups were more effective in removing the smear layer than the control and MB50 groups.

CONCLUSION: aPDT could enhance the penetration of MTA-based root canal sealer into dentin tubules.

PMID:34666196 | DOI:10.1016/j.pdpdt.2021.102584

Spine J. 2021 Oct 16:S1529-9430(21)00950-5. doi: 10.1016/j.spinee.2021.09.011. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Cutibacterium acnes (C. acnes) is a gram-positive facultative anaerobe found in the deep sebaceous follicles of the skin on the shoulder and back. C. acnes has been increasingly recognized as a pathogen in spinal surgical site infection (SSI) especially in the presence of instrumentation.

PURPOSE: This study assesses whether a silver carboxylate-doped titanium dioxide-polydimethylsiloxane (TiO₂-PDMS) coating can decrease C. acnes adherence and biofilm formation on PEEK and four other commonly used spinal implant materials, Stainless Steel, Cobalt Chromium, Titanium, and Titanium Alloy.

STUDY DESIGN: We compared the adherence of C. acnes over 24 hours between uncoated, 95:5 TiO₂ to PDMS ratio with 10x silver carboxylate coating and a 100% silver carboxylate coating on each implant material, which were uniformly saw cut and sterilized. Implants were then subjected to scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM).

METHODS: Samples were coated using 95:5 TiO₂-PDMS 10x silver carboxylate, 100% silver carboxylate, or left uncoated. C. acnes was applied onto the samples and allowed to adhere for periods of 4, 8, 12, 16, or 20 hours. Non-adherent bacteria were then washed from the samples. These samples were then allowed to continue incubating for a total of 24 hours. SEM and CLSM were used to visualize all samples for the presence of biofilm and quantification of C. acnes adherence at each time point.

RESULTS: The 95:5 TiO₂-PDMS 10x silver carboxylate coating was able to significantly decrease C. acnes adherence on PEEK after 8, 12, 16, and 20 hours of adherence. No statistical difference was found between the 95:5 TiO₂-PDMS 10x silver carboxylate coating and the 100% silver carboxylate positive control. We previously observed extensive C. acnes biofilm formation on uncoated PEEK, but none on PEEK coated with either the 95:5 TiO₂-PDMS 10x silver carboxylate or 100% Ag coating [1]. Furthermore, no biofilm formation was observed on Stainless Steel, Cobalt Chromium, Titanium, and Titanium Alloy coated with 95:5 TiO₂-PDMS 10x silver carboxylate or 100% Ag coating.

CONCLUSION: A 95:5 TiO₂-PDMS 10x silver carboxylate coating decreases C. acnes adhesion and prevents biofilm formation on PEEK and other common orthopedic implant materials.

CLINICAL SIGNIFICANCE: A 95:5 TiO₂-PDMS 10x silver carboxylate coating may help decrease spinal SSI due to C. acnes, especially in procedures with instrumentation.

PMID:34666180 | DOI:10.1016/j.spinee.2021.09.011

Spine J. 2021 Oct 16:S1529-9430(21)00952-9. doi: 10.1016/j.spinee.2021.10.002. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: The use of spinal image guidance systems (IGS) has increased patient safety, accuracy, operative efficiency, and reduced revision rates in pedicle screw placement procedures. Traditional intraoperative 3D fluoroscopy or CT imaging produces potentially harmful ionizing radiation and increases operative time to register the patient. An IGS, FLASH Navigation, uses machine vision through high resolution stereoscopic cameras and structured visible light to build a 3D topographical map of the patient’s bony surface anatomy enabling navigation use without ionizing radiation.

PURPOSE: We aimed to compare FLASH navigation system to a widely used 3D fluoroscopic navigation (3D) platform by comparing radiation exposure and pedicle screw accuracy.

DESIGN: A randomized prospective comparative cohort study of consecutive patients undergoing open posterior lumbar instrumented fusion.

PATIENT SAMPLE: Adults diagnosed with spinal pathology requiring surgical treatment and planning for open posterior lumbar fusion with pedicle screws implanted into 1-4 vertebral levels.

OUTCOME MEASURES: Outcome measures included mean intraoperative fluoroscopy time and dose, mean CT dose length product (DLP) for preoperative and day 2 CT, pedicle screw accuracy by CT, estimated blood loss and revision surgery rate.

METHODS: Consecutive patients were randomized 1:1 to FLASH or 3D and underwent posterior lumbar instrumented fusion. Radiation doses were recorded from pre- and postoperative CT and intraoperative 3D fluoroscopy. Two independent blinded radiologists reviewed pedicle screw accuracy on CT.

RESULTS: A total of 429 (n=210 FLASH, n=219 3D) pedicle screws were placed in 90 patients (n=45 FLASH, n=45 3D) over the 18-month study period. Mean age and indication for surgery were similar between both groups, with a non-significantly higher ratio of males in the 3D group. Mean intraoperative fluoroscopy time and doses were significantly reduced in FLASH compared to 3D (4.51±3.71s vs 79.6±23.0s, p<0.001 and 80.9±68.1cGycm² vs 3704.1±3442.4 cGycm², p<0.001, respectively). This represented a relative reduction of 94.3% in the total intraoperative radiation time and a 97.8% reduction in the total intraoperative radiation dose. Mean preoperative CT DLP and mean day 2 postoperative CT DLP were significantly reduced in FLASH compared to 3D (662.0±440.4mGy-cm vs 1008.9±616.3 mGy-cm, p<0.001 and 577.9±294.3 mGy-cm vs 980.7±441.6 mGy-cm, p<0.001, respectively). This represented relative reductions of 34.4% and 41.0% in the preoperative CT dose and postoperative total DLP, respectively. The FLASH group required an average of 1.2 registrations in each case with an average of 2447 (±961.3) data points registered with a mean registration time of 106s (±52.1). A rapid re-registration mechanism was utilized in 22% (n=10/45) of cases and took 22.7s (±11.3). Re-registration was used in 7% (n=3/45) in the 3D group. Pedicle screw accuracy was high in FLASH (98.1%) and 3D (97.3%) groups with no pedicle breach >2mm in either group (p<0.001). EBL was not statistically different between the groups (p=0.38). No neurovascular injuries occurred, and no patients required return to theatre for screw repositioning.

CONCLUSIONS: FLASH and 3D IGS demonstrate high accuracy for pedicle screw placement. FLASH showed significant reduction in intraoperative radiation time and dose with lower but non-significant blood loss. FLASH showed significant reduction in preoperative and postoperative radiation, but this may be associated to the lower number of males/females preponderance in this group. FLASH provides similar accuracy to contemporary IGS without requiring 3D-fluoroscopy or radiolucent operating tables. Reducing registration time and specialized equipment may reduce costs.

PMID:34666179 | DOI:10.1016/j.spinee.2021.10.002

Ocul Surf. 2021 Oct 16:S1542-0124(21)00120-8. doi: 10.1016/j.jtos.2021.10.003. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the alteration in lipid composition of meibum, objective clinical signs, and subjective symptoms associated with aging and meibomian gland (MG) dysfunction (MGD).

METHODS: In 10 MGD patients [4 males/6 females, mean age: 65.6 ± 7.9 years (range: 50-79 years)] and 24 healthy volunteer subjects [young subjects: 6 males/6 females, mean age: 25.7 ± 3.8 years (range: 20-35 years), elderly subjects: 6 males/6 females, mean age: 58.4 ± 7.5 years (range: 50-79 years)], three objective clinical signs were evaluated: MG orifice obstruction, meibum score, and tear film lipid layer interference pattern. Subjective symptoms were analyzed via a 15-item questionnaire. After careful collection of meibum samples, comprehensive lipid analysis was performed via liquid chromatography-mass spectrometry. Data was analyzed via JMP® ver. 13 (SAS Institute, Inc., Cary, NC) statistical analysis software.

RESULTS: In the MGD patients and elderly subjects, there was a significant decrease in non-polar lipids such as cholesterol esters (ChEs), while a significant increase in polar lipids [cholesterol (Ch), (O-acyl)-ω-hydroxy fatty acid (OAHFA), and free fatty acid (FA)] in total lipids (Tukey-Kramer test: p < 0.05). Triglyceride was significantly increased only in MGD patients (p < 0.05). Symptom scores representative of vision quality (i.e., blurred vision/haziness) were significantly negatively-correlated with the ratio of the non-polar lipid ChE, while significantly positively correlated with the polar lipids Ch, OAHFA, and FA (Spearman’s rank correlation coefficient: p < 0.05).

CONCLUSIONS: Our findings revealed that both MGD and aging affect the composition ratio of major meibum lipids, resulting in the appearance of subjective symptoms.

PMID:34666148 | DOI:10.1016/j.jtos.2021.10.003

Ann Vasc Surg. 2021 Oct 16:S0890-5096(21)00710-X. doi: 10.1016/j.avsg.2021.08.013. Online ahead of print.

ABSTRACT

OBJECTIVE: To provide an overview of the literature on the mid-term outcomes of chimney EVAR (ChEVAR) for the treatment of juxtarenal abdominal aortic aneurysms (JAAA).

METHODS: Different electronic databases were searched for published articles up to January 2020. The eligibility criteria were studies describing mid- or long-term outcomes of chimney EVAR (mean follow-up at least 1 year) for treatment of JAAA, including more than 10 cases, published in English, and with full text available. The outcomes measure were overall survival rate, target vessel patency, and freedom from reintervention at 3 years. Quality of the included studies was analysed using the MINORS criteria. Pooled effect estimates were analysed using random-effect models and heterogeneity was tested using I² statistics.

RESULTS: Thirteen articles met the inclusion criteria. The included studies described 1,019 patients. According to the quality assessment, methodological quality was moderate to poor. The pooled overall survival, freedom from reintervention, and target vessel patency at 3 year was 81.4 % (95%CI 73.8 to 87.9), 85.7% (95%CI 75.6 to 93.5), and 95.1% (95%CI 89.3 to 98.7) respectively.

CONCLUSION: The results of this review show good to acceptable short and mid-term survival and good mid-term durability, which supports that ChEVAR as a suitable alternative in high-risk JAAA. However, proper patient selection for ChEVAR seems essential to attain good mid-term outcomes, and further large prospective and good quality studies are required to demonstrate its long-term results and enable conclusions on specific determinants for outcome.

PMID:34666145 | DOI:10.1016/j.avsg.2021.08.013

Klin Lab Diagn. 2021 Oct 18;66(10):618-622. doi: 10.51620/0869-2084-2021-66-10-618-622.

ABSTRACT

To determine the relative content of monocytes in the peripheral blood producing IL-4, IL-6, IL-10, IFNγ, to identify new criteria for predicting abortion before 22 weeks of gestation in women with the threat of early termination and recurrent miscarriage. Materials and methods. A survey of 91 women in the gestation period of 5-12 weeks was carried out. The main group consisted of 59 women with recurrent miscarriage and the threat of early termination at the time of the study. Depending on the outcome of pregnancy, the main group was subdivided into 3 subgroups: subgroup I – 44 women whose pregnancy ended in timely delivery, II – 8 women who had preterm labor, III – 8 women with termination of pregnancy up to 22 weeks ( missed pregnancy or spontaneous miscarriage). The control group consisted of 32 women with uncomplicated pregnancy. The relative content of IL-4 +, IL-6 +, IL-10 +, IFNγ + monocytes was determined by flow cytometry on FACSCanto II (Becton Dickinson, USA). In women with threatened early miscarriage and recurrent miscarriage, the percentage of IL-4 + and IL-10 + cells in the population of peripheral monocytes is significantly lower, while IL-6 + cells are higher compared to the control group (p = 0.0001 in in all cases), no statistically significant differences were found in the percentage of IFNγ + cells (p = 0.076). A retrospective analysis revealed that in the group of women with termination of pregnancy up to 22 weeks, there was a significant decrease in IL-10 + monocytes in the peripheral venous blood. Prediction of termination of pregnancy before 22 weeks of gestation is possible with a relative content of IL-10 + monocytes equal to 27.0% or less (sensitivity 87.5%, specificity 95.2%, accuracy 93.1%).

PMID:34665948 | DOI:10.51620/0869-2084-2021-66-10-618-622