Nevin Manimala

J Clin Psychiatry. 2021 Jul 27;82(5):20m13637. doi: 10.4088/JCP.20m13637.

ABSTRACT

Objective: This study aimed to estimate the survival probabilities related to the occurrence of major depressive episodes (MDEs) after the onset of substance use disorders (SUDs) using data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III.

Methods: The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 was used to diagnose SUD, and psychiatric diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Individuals with incidents of various SUDs with no prior history of MDEs (n = 5,987 with alcohol use disorder [AUD], 1,353 with cannabis use disorder [CUD], 351 with opioid use disorder [OUD], 827 with stimulant use disorder [STUD], and 5,363 with nicotine use disorder [NUD]) were included. The survival probabilities of these groups were compared to those of a control group without an SUD (n = 20,034). Outcome measures included the number of years from the age at SUD onset until MDE occurrence or the time of the interview.

Results: The probabilities of experiencing MDEs after 1 year were 3.56%, 4.80%, 7.78%, 8.46%, and 5.31% for AUD, CUD, OUD, STUD, and NUD, respectively. The groups differed statistically significantly from each other and from the control group (P < .0001). Individuals with AUD and STUD, respectively, had a lower and higher probability of having an MDE compared to those with other SUDs. Young age, family history of depression, anxiety disorder presence, and failure to achieve full remission consistently predicted an MDE for all substances.

Conclusions: The findings highlight that users of all studied substances have an increased probability of having an MDE over the lifespan.

PMID:34320696 | DOI:10.4088/JCP.20m13637

J Chiropr Educ. 2021 Jul 28. doi: 10.7899/JCE-20-28. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate coping strategies adopted by chiropractic college students and how these strategies affect student-perceived stress levels.

METHODS: Four hundred seven (407) 1st-quarter students were recruited during 2014 and 2015. The validated Brief COPE inventory was used to assess coping strategies during the 1st week of classes. Perceived Chiropractic College Stress (PCCS) was assessed via a modification of Vitaliano Perceived Medical School Stress survey instrument. The modified coping instrument was administered during the 1st quarter (PCCS1) and 6 months later during the 3rd quarter (PCCS2).

RESULTS: Mean perceived stress levels were greater after 6 months. Although perceived stress increased more for females than for males over that period, it was not statistically significant. Male and female coping strategies differed only in the preferential use of emotional support by females. Students generally adopted active coping strategies (eg, active coping and planning) rather than avoidant strategies (eg, substance abuse). Regression analysis revealed a moderate positive relationship between avoidant-emotion coping and PCCS1 with a weaker positive correlation between problem-focused coping, sex, and PCCS1. Avoidant-emotion coping also demonstrated a moderate positive correlation with PCCS2. Neither sex nor the 3 coping strategies were predictors of PCCS change (PCCS2 – PCCS1).

CONCLUSION: This study is a starting point for exploring the relationship between perceived stress and coping behaviors in a chiropractic training institution. Students generally used healthy adaptive coping strategies with minimal sex differences. Avoidant-emotion coping appears to be a reliable predictor of PCCS, with sex being a poor predictor.

PMID:34320658 | DOI:10.7899/JCE-20-28

J Natl Cancer Inst. 2021 Jul 28:djab113. doi: 10.1093/jnci/djab113. Online ahead of print.

ABSTRACT

BACKGROUND: Uncertainty about the benefit/risk ratio of regional lymph node irradiation led to varying clinical protocols. We investigated long-term late side effects after internal mammary and medial supraclavicular (IM-MS) lymph node irradiation to improve shared decision-making.

METHODS: The multicentre EORTC trial (ClinicalTrials.gov, NCT00002851) randomized stage I-III breast cancer patients with involved axillary nodes and/or a medially located primary tumor. We analyzed late side effects, both longitudinally at every follow-up and cross-sectionally at 5-year intervals. All statistical tests were 2-sided.

RESULTS: Between 1996 and 2004, 46 departments from 13 countries accrued 4004 patients. Median follow-up was 15.7 years. Longitudinal follow-up data showed cumulative incidence rates at 15 years of 2.9% (95% confidence interval [CI] = 2.2%-3.8%) vs. 5.7% (95% CI = 4.7%-6.9%) (P<.001) for lung fibrosis, of 1.1% (95% CI = 0.7%-1.7%) vs. 1.9% (95% CI = 1.3%-2.6%) (P=.07) for cardiac fibrosis, and of 9.4% (95% CI = 8.0%-10.8%) vs. 11.1% (95% CI = 9.6%-12.7%) (P=.04) for any cardiac disease, when treated without or with IM-MS lymph node irradiation. There was no evidence for differences between left- and right-sided breast cancer (Wald chi-square test of treatment by breast side interaction, P=.33 and P=.35, for cardiac fibrosis and for any cardiac disease, respectively). The cumulative incidence probabilities of cross-sectionally reported side effects with a score of 2 or greater at 15 years were 0.1% (95% CI = 0.0%-0.5%) vs. 0.8% (95% CI = 0.4%-1.4%) for pulmonary (P=.02), 1.8% (95% CI = 1.1%-2.8%) vs. 2.6% (95% CI = 1.8%-3.7%) for cardiac (P=.15), and 0.0% (95% CI not evaluated) vs. 0.1% (95% CI = 0.0%-0.4%) for oesophageal (P=.16), respectively. No difference was observed in the incidence of second malignancies, contralateral breast cancer or cardiovascular deaths.

CONCLUSIONS: The incidence of late pulmonary side effects was statistically significantly higher after IM-MS lymph node irradiation, as were some of the cardiac events, without a difference between left- and right-sided treatments. Absolute rates and differences were very low, without increased non-breast cancer related mortality, even before introducing heart-sparing techniques.

PMID:34320651 | DOI:10.1093/jnci/djab113

Pain Med. 2021 Jul 28:pnab229. doi: 10.1093/pm/pnab229. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigated the relationship between pain location and fracture type in the patients with acute osteoporotic vertebral fracture (OVF).

DESIGN: A prospective observation study.

SUBJECT: A total of 306 patients with acute OVF were included.

METHODS: The site of pain of each patient was recorded, and the patients were divided into pain at fracture site group (group 1) and pain at non-fracture site group (group 2). The fracture type was classified into four types: type I, upper endplate type; type II, central type; type III, lower endplate type; type IV, burst type.

RESULTS: There were 146 patients in the group 1, of which 20.55% (30/146) were type I, 33.56% (49/146) were type II, 15.75% (23/146) were type III, and 30.14% (44/146) were type IV. There were 227 patients in the group 2, of which 57.27% (130/227) were type I, 5.29% (12/227) were type II, 35.24% (80/227) were type III, and 2.20% (5/227) were type IV. There was a statistical difference in the fracture type distribution between the two groups (P < 0.05). The VAS in the group 1 was higher than that in the group 2 at the initial diagnosis (P < 0.05).

CONCLUSIONS: For patients with acute OVF, the site of pain is related to the type of fracture. The pain at the fracture site is more often observed in the central type and burst type of fractures, while pain at the non-fracture site is more often observed in the upper and lower endplate type of fractures. Additionally, when OVF are suspected, radiological assessment of thoracic and lumbar spine is recommended to better detect fractures that could cause pain distal to the site of the fracture.

PMID:34320640 | DOI:10.1093/pm/pnab229

Bioinformatics. 2021 Jul 28:btab549. doi: 10.1093/bioinformatics/btab549. Online ahead of print.

ABSTRACT

MOTIVATION: Characterizing cells with rare molecular phenotypes is one of the promises of high throughput single-cell RNA sequencing (scRNA-seq) techniques. However, collecting enough cells with the desired molecular phenotype in a single experiment is challenging, requiring several samples preprocessing steps to filter and collect the desired cells experimentally before sequencing. Data integration of multiple public single-cell experiments stands as a solution for this problem, allowing the collection of enough cells exhibiting the desired molecular signatures. By increasing the sample size of the desired cell type, this approach enables a robust cell type transcriptome characterization.

RESULTS: Here, we introduce rPanglaoDB, an R package to download and merge the uniformly processed and annotated scRNA-seq data provided by the PanglaoDB database. To show the potential of rPanglaoDB for collecting rare cell types by integrating multiple public datasets, we present a biological application collecting and characterizing a set of 157 fibrocytes. Fibrocytes are a rare monocyte-derived cell type, that exhibits both the inflammatory features of macrophages and the tissue remodeling properties of fibroblasts. This constitutes the first fibrocytes’ unbiased transcriptome profile report. We compared the transcriptomic profile of the fibrocytes against the fibroblasts collected from the same tissue samples and confirm their associated relationship with healing processes in tissue damage and infection through the activation of the prostaglandin biosynthesis and regulation pathway.

AVAILABILITY: rPanglaoDB is implemented as an R package available through the CRAN repositories https://CRAN.R-project.org/package=rPanglaoDB.

PMID:34320637 | DOI:10.1093/bioinformatics/btab549

Bioinformatics. 2021 Jul 28:btab555. doi: 10.1093/bioinformatics/btab555. Online ahead of print.

ABSTRACT

MOTIVATION: BAli-Phy, a popular Bayesian method that co-estimates multiple sequence alignments and phylogenetic trees, is a rigorous statistical method, but due to its computational requirements, it has generally been limited to relatively small datasets (at most about 100 sequences). Here we repurpose BAli-Phy as a “phylogeny-aware” alignment method: we estimate the phylogeny from the input of unaligned sequences, and then use that as a fixed tree within BAli-Phy.

RESULTS: We show that this approach achieves high accuracy, greatly superior to Prank, the current most popular phylogeny-aware alignment method, and is even more accurate than MAFFT, one of the top performing alignment methods in common use. Furthermore, this approach can be used to align very large datasets (up to 1000 sequences in this study).

AVAILABILITY: See https://doi.org/10.13012/B2IDB-7863273_V1 for datasets used in this study.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:34320635 | DOI:10.1093/bioinformatics/btab555

Arch Cardiol Mex. 2021 Jul 28. doi: 10.24875/ACM.21000053. Online ahead of print.

ABSTRACT

OBJECTIVE: Heart failure with preserved ejection fraction is a highly prevalent disease; some advances for improving the diagnosis are the development of the H2FPEF score and the diastolic stress test for the evaluation of diastolic function. The objective is to describe the clinical and echocardiographic characteristics of patients referred for stress tests, and the association between the H2FPEF score and the results of the diastolic test.

METHODS: This is an analytical, observational, retrospective study. An exercise stress test was performed. The Chi-square test was used to establish an association between H2FpEF score and diastolic stress test results. Patients over the age of 18, in sinus rhythm, with the left ventricular ejection fraction > 54%, with no more than mild diastolic dysfunction on the baseline echocardiogram were included in the study.

RESULTS: A total of 99 patients met the eligibility criteria. About 49.5% were women, median age was 62.2 years. The H2FPEF score was low in 27.2%, intermediate 71.7%, and 1% in the high range. There was a high prevalence of hypertension 58.6%, diabetes 12.1%, and coronary disease 20.2%. The stress test was positive for diastolic dysfunction in 36.4% of the patients. A statistically significant association was found between the H2FPEF score and the diastolic stress test (p = 0.02).

CONCLUSIONS: Although clinical scores such as H2FPEF help identify patients, a high percentage of patients are classified in the intermediate range. The diastolic stress test can help to make the diagnosis of diastolic function in this group of patients.

PMID:34320623 | DOI:10.24875/ACM.21000053

N Z Med J. 2021 Jul 30;134(1539):56-62.

ABSTRACT

AIM: The aim of this study was to evaluate the learning environment of the 13-week Community Based Attachment (CBA) (or ‘rotation’) during the prevocational training years at a metropolitan hospital in New Zealand, and to compare the results with general hospital attachments’ scores using an internationally validated survey, the Postgraduate Hospital Educational Environment Measure (PHEEM).

METHOD: A retrospective analysis of data gathered from the PHEEM over four years was conducted. Responses from interns who undertook a CBA attachment at Waikato District Health Board (DHB) were compared with those who undertook a hospital-based attachment at the same DHB during that time period.

RESULTS: CBAs were rated significantly higher than the hospital-based attachments for all subscales (autonomy, teaching and social support) as well as the PHEEM total score. The majority of individual items also rated higher with the CBA cohort, with 26/40 items being statistically significant. Four items were rated higher by the hospital cohort; however, none were significantly different.

CONCLUSIONS: In this study, the CBA attachments appear to have provided valuable learning experiences for prevocational doctors at Waikato DHB. Resident medical officers (RMOs) who have undertaken CBAs confirm a positive, supportive learning environment with enthusiastic and motivated clinical supervisors.

PMID:34320615

J Craniofac Surg. 2021 Jul 27. doi: 10.1097/SCS.0000000000008013. Online ahead of print.

ABSTRACT

BACKGROUND: The reduction malarplasty has become one of the most popular esthetic surgeries among Asian women to improve facial contour. However, it is still controversial whether midfacial soft tissue changes after surgery, and more studies are needed.

METHODS: This retrospective observational study reviewed 30 patients who underwent L-shaped reduction malarplasty during January 2018 and August 2019. The preoperative and postoperative soft tissue thickness and the angle of nasolabial fold of the midfacial were assessed using photographs, three-dimensional skull computerized tomography images, and the Wrinkle Severity Rating Scale.

RESULTS: The postoperative average level of nasolabial fold angle was lower than that observed in preoperative conditions, with the difference being statistically significant (t = -10.262, P < 0.001). The postoperative fifth and sixth layers of soft tissue in the midface were significantly higher than those observed in preoperative tissues.

CONCLUSIONS: Although L-shaped reduction malarplasty has evident effects on soft tissue changes of middle face, they are within acceptable ranges and do not affect patient satisfaction.

PMID:34320586 | DOI:10.1097/SCS.0000000000008013

J Craniofac Surg. 2021 Jul 27. doi: 10.1097/SCS.0000000000008033. Online ahead of print.

ABSTRACT

Three-dimensional (3D) measurements of the upper airway have been extensively applied and researched, but the division of the airway is carried out in various ways, especially when demarcating the anterior boundary of the nasopharynx. The present study was to propose a new method based on the anatomical definition for the anterior boundary demarcation of the nasopharynx used in three-dimensional analysis. Twenty computed tomography scans (age 9.5 ± 2.5 years, 11 males, and 9 females) of head and neck were randomly selected and transferred to Materialism’s interactive medical image control system 19.0 for segmentation of the nasopharynx. Precise localization of the reference points that determining the nasopharyngeal anterior and inferior boundaries was managed by recording their coordinates in the interface of the software. The area of the anterior and the inferior boundaries, and the volume of the nasopharynx were measured and repeated with a 2-week interval for the consistency test. Both the interobserver reliability as well as the intra-observer reliability were very high (intraclass correlation coefficients, 0.985-0.997). Paired t test showed no significant difference between the first and the second examinations. This new simple method proposed for demarcation of the nasopharyngeal anterior boundary was based on the innate anatomical boundary, which was statistically reliable, technically convenient, and clinically reasonable.

PMID:34320585 | DOI:10.1097/SCS.0000000000008033