Nevin Manimala

Front Med (Lausanne). 2021 Sep 23;8:711809. doi: 10.3389/fmed.2021.711809. eCollection 2021.

ABSTRACT

Background: Quantitative (q) polymerase chain reaction (PCR) cycle threshold (Ct) values represent the number of amplification cycles required for a positive PCR result and are a proxy of pathogen quantity in the tested sample. The clinical utility of Ct values remains unclear for gastrointestinal infections. Objectives: This systematic review assesses the global medical literature for associations between Ct values of gastrointestinal pathogens and patient presentation and clinical outcomes. Data Sources: MEDLINE, EMBASE, Cochrane library databases: searched January 14-17, 2020. Study Eligibility Criteria: Studies reporting on the presence or absence of an association between Ct values and clinical outcomes in adult and pediatric populations were included. Animal studies, reviews, meta-analyses, and non-English language studies were excluded. Participants: Humans infected with gastrointestinal pathogens, detected with qPCR. Interventions: Diagnostics assessing Ct values. Extracted data were reported narratively. Results: Thirty-three eligible studies were identified; the most commonly studied pathogens were Clostridioides difficile (n = 15), norovirus (n = 10), and rotavirus (n = 9). Statistically significant associations between low C. difficile Ct values and increased symptom severity or poor outcome were reported in 4/8 (50%) studies, and increased risk of death in 1/2 (50%) studies; no significant associations were found between Ct value and duration of symptoms or length of hospital stay. Among studies of norovirus, 5/7 (71%), mainly genogroup II, reported symptomatic cases with significantly lower median Ct values than controls. Significantly lower rotavirus Ct values were also observed in symptomatic cases vs. controls in 3/7 (43%) studies, and associated with more severe symptoms in 2/2 studies. Contradictory associations were identified for non-C. difficile bacterial and parasitic pathogens. Conclusions: In conclusion, some studies reported clinically useful associations between Ct values and patient or healthcare outcomes; additional, well-designed, large-scale trials are warranted based on these findings. Systematic Review Registration: [PROSPERO], identifier [CRD42020167239].

PMID:34631732 | PMC:PMC8496934 | DOI:10.3389/fmed.2021.711809

Front Public Health. 2021 Sep 23;9:695141. doi: 10.3389/fpubh.2021.695141. eCollection 2021.

ABSTRACT

The COVID-19 pandemic has taken more than 1.78 million of lives across the globe. Identifying the underlying evolutive patterns between different countries would help us single out the mutated paths and behavior of this virus. I devise an orthonormal basis which would serve as the features to relate the evolution of one country’s cases and deaths to others another’s via coefficients from the inner product. Then I rank the coefficients measured by the inner product via the featured frequencies. The distances between these ranked vectors are evaluated by Manhattan metric. Afterwards, I associate each country with its nearest neighbor which shares the evolutive pattern via the distance matrix. Our research shows such patterns is are not random at all, i.e., the underlying pattern could be contributed to by some factors. In the end, I perform the typical cosine similarity on the time-series data. The comparison shows our mechanism differs from the typical one, but is also related to each it in some way. These findings reveal the underlying interaction between countries with respect to cases and deaths of COVID-19.

PMID:34631642 | PMC:PMC8495132 | DOI:10.3389/fpubh.2021.695141

Front Pediatr. 2021 Sep 22;9:715091. doi: 10.3389/fped.2021.715091. eCollection 2021.

ABSTRACT

Despite clinical improvements in neonatal intensive care units (NICUs), prematurity keeps causing several comorbidities. To enhance the management of such conditions, in previous studies we devised the Neonatal Assessment Manual scorE (NAME) model, a structured touch-based assessment that aims to evaluate how newborns respond to gentle touch-based stimuli. The present study aimed to begin assessing the NAME interrater reliability and specific agreements. At the “Vittore Buzzi” Pediatric Hospital NICU ward in Milan, Italy, we enrolled 144 newborns, 85 male and 59 female, with a mean age of 35.9 weeks (±4.1) and a weight of 2,055.3 g (±750.6). Two experienced manual professionals performed the NAME procedure on all the infants. Regarding the total sample and the analysis by sex, we found moderate and statistically significant results for the interrater reliability (p < 0.001) and the specific agreements (p < 0.05), in particular for the “Marginal” score. Furthermore, interrater reliability significantly (p < 0.05) increased as age and weight increased, whereas there was an almost constant moderate and significant (p < 0.05) agreement especially for the “Marginal” score. Therefore, we found preliminary results showing that the NAME could be a reliable diagnostic tool for assessing the newborns’ general condition.

PMID:34631618 | PMC:PMC8492991 | DOI:10.3389/fped.2021.715091

Zhongguo Fei Ai Za Zhi. 2021 Oct 11. doi: 10.3779/j.issn.1009-3419.2021.102.30. Online ahead of print.

ABSTRACT

BACKGROUND: With the extensive development of minimally invasive surgery for pulmonary nodules, preoperative localization becomes more and more critical. There are some defects in traditional localization methods, so it is necessary to improve. The aim of this study was to compare and analyze the safety and effectiveness of two new methods, namely four-hook needle and memory alloy coil, in the localization of pulmonary nodules.

METHODS: A retrospective analysis of 152 patients was performed. 76 cases were in four-hook needle group, 76 cases were in memory alloy coil group. Pulmonary nodules were located before operation, and then video-assisted wedge resection was performed. The average procedure time, localization complications and nodule resection time were counted.

RESULTS: The target pulmonary nodules were successfully removed in both groups. In four-hook needle group, 76 patients found localization devices, all the pulmonary nodules were successfully removed, and one case was transferred to open the chest for wedge resection of pulmonary nodules due to severe thoracic adhesion. All 76 patients in memory alloy coil group were successfully resected with pulmonary nodules, and one patient underwent compromising enlarged resection because no lesion was found after the specimen was removed during the operation. There was no significant difference in the incidence of pneumothorax and pulmonary hemorrhage, the success rate of localization and nodule wedge resection time between the two groups. The average time of localization in four-hook needle group was (13.66±3.11) min lower than that of memory alloy coil group (15.51±3.65) min, and the difference was statistically significant (P=0.001). In memory alloy coil group, when the distance from the nodule to the pleura was ≥1.5 cm and <1.5 cm, the average localization time was (17.20±4.46) min and (14.91±3.15) min, respectively, and there was a statistical difference between the two (P=0.044).

CONCLUSIONS: Four-hook needle and memory alloy coil have good safety and effectiveness, and the localization time of four-hook needle is shorter. When using memory alloy coil, the effect of the method is better for pulmonary nodules with a distance less than 1.5 cm to pleura.

PMID:34628780 | DOI:10.3779/j.issn.1009-3419.2021.102.30

Zhongguo Yi Liao Qi Xie Za Zhi. 2021 Sep 30;45(5):487-491. doi: 10.3969/j.issn.1671-7104.2021.05.004.

ABSTRACT

Aiming at the shortcomings of traditional medical device tracking and supervision mode, such as delayed feedback of medical device positioning information, poor visual tracking effect of medical device, and missing early warning of medical device working state supervision, a medical device visual tracking and supervision system based on wireless Local Area Network (LAN) real-time positioning system is developed. Introduction of wireless LAN real-time positioning system, using standard coding algorithm generating device object ID tags, with the only attribute based on RFID read-write terminal complete physical mapping of medical equipment and material ID label, we realize a real-time positioning and traceability of medical equipment, with the help of active warning algorithm based on depth of learning medical equipment working state supervision for early warning, with the help of indoor map generation and trajectory playback medical equipment to realize visualization back regulation. Choose equipment of hospital of Linyi Central Hospital for performance evaluation of the carrier, the evaluation model of engineering practice and clinical statistical analysis, the results show that the system has a complete real-time positioning, visible trace, abnormal warning function. In medical equipment real-time positioning information visual tracing feedback, abnormal state warning etc, medical equipment has obvious advantages.

PMID:34628758 | DOI:10.3969/j.issn.1671-7104.2021.05.004

Zhongguo Yi Liao Qi Xie Za Zhi. 2021 Sep 30;45(5):473-478. doi: 10.3969/j.issn.1671-7104.2021.05.001.

ABSTRACT

We developed a portable non-specific low back pain measurement system EasiLBP and evaluated its performance in collecting EMG signals:during the wearer’s movement without the assistance of a doctor, the collection of EMG signals by portable devices met problems such as large noise interference, difficulty in accurately calibrating the start and end points of the action interval, and imbalanced samples for feature recognition, et al. To challenge these problems, we proposed a small group-based noise removal method, a dynamic dual-threshold automatic method for identifying the start and end points of the motion interval, and a sampling method to balance group samples, respectively. Portable device and a medical EMG acquisition equipment Thought Technology FlexComp Infiniti 10 were used to perform EMG measurements on 15 patients with non-specific low back pain and 15 normal people. Clinical experiments and statistical analysis show that the portable EMG acquisition system has significant differences in EMG signal characteristics between normal people and non-specific low back pain patients, and it has good measurement consistency and accuracy with the medical EMG acquisition equipment.

PMID:34628755 | DOI:10.3969/j.issn.1671-7104.2021.05.001

Res Synth Methods. 2021 Oct 10. doi: 10.1002/jrsm.1529. Online ahead of print.

ABSTRACT

Recent, high-profile, large-scale, preregistered failures to replicate uncover that many highly-regarded experiments are ‘false positives;’ that is, statistically significant results of underlying null effects. Large surveys of research reveal that statistical power is often low and inadequate. When the research record includes selective reporting, publication bias and/or questionable research practices, conventional meta-analyses are also likely to be falsely positive. At the core of research credibility lies the relation of statistical power to the rate of false positives. This study finds that high (> 50-60%) median retrospective power (MRP) is associated with credible meta-analysis and large-scale, preregistered, multi-lab ‘successful’ replications; that is, with replications that corroborate the effect in question. When median retrospective power is low (< 50%), positive meta-analysis findings should be interpreted with great caution or discounted altogether. This article is protected by copyright. All rights reserved.

PMID:34628722 | DOI:10.1002/jrsm.1529

Haemophilia. 2021 Oct 10. doi: 10.1111/hae.14433. Online ahead of print.

ABSTRACT

INTRODUCTION: A massive increase of soluble thrombomodulin (sTM) due to variants in the thrombomodulin gene (THBD) has recently been identified as a novel bleeding disorder.

AIM: To investigate sTM levels and underlying genetic variants as a cause for haemostatic impairment and bleeding in a large number of patients with a mild to moderate bleeding disorder (MBD), including patients with bleeding of unknown cause (BUC).

PATIENTS AND METHODS: In 507 MBD patients, sTM levels, thrombin generation and plasma clot formation were measured and compared to 90 age- and sex-matched healthy controls. In patients, genetic analysis of the THBD gene was performed.

RESULTS: No difference in sTM levels between patients and controls was found overall (median ([IQR] 5.0 [3.8-6.3] vs. 5.1 [3.7-6.4] ng/ml, p = .762), and according to specific diagnoses of MBD or BUC, and high sTM levels (≥95th percentile of healthy controls) were not overrepresented in patients. Soluble TM levels had no impact on bleeding severity or global tests of haemostasis, including thrombin generation or plasma clot formation. In the THBD gene, no known pathogenic or novel disease-causing variants affecting sTM plasma levels were identified in our patient cohort.

CONCLUSION: TM-associated coagulopathy appears to be rare, as it was not identified in our large cohort of patients with MBD. Soluble TM did not arise as a risk factor for bleeding or altered haemostasis in these patients.

PMID:34628704 | DOI:10.1111/hae.14433

Scand J Med Sci Sports. 2021 Oct 10. doi: 10.1111/sms.14076. Online ahead of print.

ABSTRACT

In theory, professional sport ‘entry drafts’ are designed to promote parity by granting poorly performing teams with early selections and winning teams with later selections. While this process has intentions to ‘level the playing field’, mixed findings exist in the literature. The aim of this review is to identify and synthesize the literature examining the efficacy of the draft for professional, North American sport leagues. A systematic review of four databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Full-text articles containing relevant data on the draft system for the four major professional North American sports were identified. Further restrictions were made to include articles focusing on a specific outcome regarding future success (i.e., whether the draft related to a measure of future performance). The search returned 10,962 records and after screening, 18 articles were synthesized. Of the articles examined, the measures of future success with relation to draft order were (a) career length and/or number of games played at the majors (n=8), (b) future performance statistics at the professional level (n=5), (c) change in winning percentage and/or number of wins produced (n=3), (d) financial compensation (n=1), and (e) a combination measures (a) to (d), (n=1). Most commonly, the first/early rounds most accurately predicted future measures of success (i.e., number of games played, singing bonuses and playing statistics) across sports. The middle and late rounds were less accurate, with the degree of accuracy increasing slightly in the last rounds. This review highlights several opportunities to better understand the draft process (e.g., potential improvements in middle round picks) and emphasizes the need for more research on analyzing and scrutinizing the draft.

PMID:34628688 | DOI:10.1111/sms.14076

Australas J Dermatol. 2021 Oct 10. doi: 10.1111/ajd.13730. Online ahead of print.

ABSTRACT

Hypertrophic scars present collagen deposition and an abnormal extracellular matrix that cause abnormal shape changes and limit normal movement. Although fractional carbon dioxide (CO₂ ) laser therapy has provided promising evidence, the improvement of scarring has not been thoroughly reviewed. A systematic review of prospective randomised trial articles collected from PubMed, MEDLINE, EMBASE, Cochrane and Scopus databases was conducted on 15 March 2020 in accordance with the PRISMA-P statement. Types and duration of fractional carbon dioxide laser used in this study along with the comparative modalities were recorded in this review. Treatment efficacy was assessed as the primary outcome. Adverse events and patient satisfaction were assessed as the secondary outcome. Five prospective randomised studies were included in this study. All studies included showed a consistent result with a conclusion that CO₂ fractional laser treatment demonstrated statistically significant improvement for various scar scoring methods. Combination with other modalities may yield better results in some studies with the risk of more severe adverse events. Temporary side effects such as itching or burning sensation, erythema and oedema were present but appeared to be minimal and well tolerated. Overall patients reported significant improvement in quality of life. Some of the studies are uncontrolled with relatively short-term follow-up. Controlled comparative studies within the same scar with larger sample size and longer follow-up period are required. This evidence suggests that fractional CO₂ laser treatment is effective for improving the clinical appearance of hypertrophic scars with a good safety profile.

PMID:34628639 | DOI:10.1111/ajd.13730