Nevin Manimala

Clin Gastroenterol Hepatol. 2021 Jun 30:S1542-3565(21)00699-6. doi: 10.1016/j.cgh.2021.06.035. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: We developed and validated a magnetic resonance imaging (MRI-)based index to predict Crohn’s disease (CD) post-operative recurrence (POR).

METHODS: Patients with CD having undergone a post-operative evaluation for recurrence (with colonoscopy and MRI no longer than 105 days apart) were included between 2006 and 2016 in university hospital of Nancy, France. MRI-items with good levels of intra and inter-rater agreement (Gwet’s coefficient ≥0.5) were selected. The MONITOR index’s performance was assessed in terms of the area under the receiver operating characteristic curve (AUROC) and accuracy, by considering the Rutgeerts score as the gold standard. The MONITOR index was validated with a bootstrap method and an independent cohort.

RESULTS: Seventy-three MRI datasets were interpreted by two radiologists. Seven items (bowel wall thickness, contrast enhancement, T2 signal increase, diffusion-weighted signal increase, edema, ulcers, and the length of the diseased segment) had a Gwet’s coefficient ≥0.5 and were significantly associated with the Rutgeerts score, leading to their inclusion in the MONITOR index. All the items had a weighting of 1, except the “ulcers” item weighting 2.5, reflecting the higher adjusted odds ratio. The AUROC [95% confidence interval] for the prediction of endoscopic POR (Rutgeerts score >i1) was 0.80 [0.70; 0.90]. The optimal threshold was a MONITOR index ≥1, giving a sensitivity of 79%, a specificity of 55%, a predictive positive value of 68%, and a predictive negative value of 68%. The bootstrap validation gave an AUROC of 0.85 [0.73; 0.97]. In the validation cohort, a MONITOR index ≥1 gave a sensitivity of 87%, a specificity of 75%, a predictive positive value of 84,6%, and a predictive negative value of 75%.

CONCLUSIONS: The MONITOR index is an efficient, reliable, easy-to-apply tool that can be used in clinical practice to predict the POR of CD.

PMID:34216820 | DOI:10.1016/j.cgh.2021.06.035

Clin Gastroenterol Hepatol. 2021 Jun 30:S1542-3565(21)00691-1. doi: 10.1016/j.cgh.2021.06.027. Online ahead of print.

ABSTRACT

BACKGROUND: Epidemiological studies from Europe and North America report an increasing incidence of microscopic colitis (MC) in the late twentieth century followed by a plateau. This population-based study assessed recent incidence trends and the overall prevalence of MC over the past decade.

METHODS: Residents of Olmsted County, Minnesota diagnosed with collagenous colitis (CC) or lymphocytic colitis (LC) between January 1, 2011 and December 31, 2019 were identified using the Rochester Epidemiology Project. Clinical variables were abstracted by chart review. Incidence rates were age- and sex-adjusted to the 2010 US population. Associations between incidence and age, sex, and calendar periods were evaluated using Poisson regression analyses.

RESULTS: A total of 268 incident cases of MC were identified with a median age at diagnosis of 64 years (range, 19-90); 207 (77%) were women. The age- and sex-adjusted incidence of MC was 25.8 (95% confidence interval [CI] 22.7-28.9) cases per 100,000 person-years. The incidence of LC was 15.8 (95% CI, 13.4-18.2) and CC 9.9 (95% CI, 8.1-11.9) per 100,000 person-years. A higher MC incidence was associated with increasing age and female sex (p<0.01). There was no significant trend in age- and sex-adjusted incidence rate over the study period (p=0.92). On December 31, 2019, the prevalence of MC, LC, and CC (including cases diagnosed before 2011) was 246.2, 146.1, and 100.1 per 100,000 persons, respectively.

CONCLUSION: The incidence of MC and its subtypes was stable between 2011-2019, but its prevalence is higher than in previous periods. MC incidence continues to be associated with increasing age and female sex.

PMID:34216819 | DOI:10.1016/j.cgh.2021.06.027

J Biomed Inform. 2021 Jun 30:103855. doi: 10.1016/j.jbi.2021.103855. Online ahead of print.

ABSTRACT

Aging is a major risk factor for various eye diseases, such as cataract, glaucoma, and age-related macular degeneration. Age-related changes are observed in almost all structures of the human eye. Considerable individual variations exist within a group of similarly aged individuals, indicating the need for more informative biomarkers for assessing the aging of the eyes. The morphology of the anterior segment has been reported to vary across age groups, focusing on only a few corneal parameters, such as keratometry and thickness of the cornea, which could not provide accurate estimation of age. Thus, the association between eye aging and the morphology of the anterior segment remains elusive. In this study, we aimed to develop a predictive model of age based on a large number of anterior segment morphology-related features, measured via the high-resolution Pentacam. This approach allows for an integrated assessment of age-related changes in corneal morphology, and the identification of important morphological features associated with different eye aging patterns. Three machine learning methods (neural networks, Lasso regression and extreme gradient boosting) were employed to build predictive models using 276 anterior segment features of 63,753 participants from 10 ophthalmic centers in 10 different cities of China. The best performing age prediction model achieved a median absolute error of 2.80 years and a mean absolute error of 3.89 years in the validation set. An external cohort of 100 volunteers was used to test the performance of the prediction model. The developed neural network model achieved a median absolute error of 3.03 years and a mean absolute error of 3.4 years in the external cohort. In summary, our study revealed that the anterior segment morphology of the human eye may be an informative and non-invasive indicator of eye aging. This could prompt doctors to focus on age-related medical interventions on ocular health.

PMID:34216803 | DOI:10.1016/j.jbi.2021.103855

J Shoulder Elbow Surg. 2021 Jun 30:S1058-2746(21)00527-9. doi: 10.1016/j.jse.2021.05.028. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment of posterior shoulder instability (PSI) associated with excessive glenoid retroversion is a rare, challenging problem in shoulder surgery. One proposed technique is posterior opening wedge glenoid osteotomy to correct excessive glenoid retroversion as described by Scott. However, this operation is rarely performed and limited long-term outcomes using this approach are available. It was the goal to analyze long-term outcome of posterior open wedge glenoid osteotomy for PSI associated with excessive glenoid retroversion.

METHODS: Six consecutive patients (7 shoulders) with a mean age of 24 (range, 19-34) years were treated with posterior open wedge glenoid osteotomy for PSI associated with a glenoid retroversion greater than 15° and followed-up clinically and radiographically at a mean of 15 (range, 10-19) years.

RESULTS: Recurrent, symptomatic PSI was observed in 6 out of 7 shoulders (86%). One necessitated revision with a posterior (iliac crest) bone block procedure and was rated as a failure and excluded from functional analysis. One patient rated his result as excellent, 3 as good, 1 as fair and 1 as unsatisfactory. Mean relative Constant Score (CS%) was unchanged from preoperatively to final follow-up (CS%: 72%) and pain did not significantly decrease (Constant pain scale: 7 to 10 points; p=0.969). The mean Subjective Shoulder Value (SSV) was improved postoperatively but with 7 patients the improvement did not reach statistical significance (SSV: 42% to 67%; p=0.053) and the total WOSI score averaged 30% at the final follow-up. Mean glenoid retroversion of all 7 shoulders was corrected from 20° (Range, 16-26°) to 3° (range, (-)3-(+)8°; p=0.018). In the five shoulders with preoperative static posterior subluxation of the humeral head (PSH), the humeral head was not recentered. All seven shoulders showed progression of glenoid arthritic changes.

CONCLUSIONS: Posterior open wedge glenoid osteotomy for PSI associated with excessive glenoid retroversion did neither reliably restore shoulder stability nor recenter the joint or prevent progression of osteoarthritis. Alternative treatments for PSI associated with excessive glenoid retroversion have to be developed and evaluated.

PMID:34216782 | DOI:10.1016/j.jse.2021.05.028

Neuroimage. 2021 Jun 30:118323. doi: 10.1016/j.neuroimage.2021.118323. Online ahead of print.

ABSTRACT

Axon diameter mapping using diffusion MRI in the living human brain has attracted growing interest with the increasing availability of high gradient strength MRI systems. A systematic assessment of the consistency of axon diameter estimates within and between individuals is needed to gain a comprehensive understanding of how such methods extend to quantifying differences in axon diameter index between groups and facilitate the design of neurobiological studies using such measures. We examined the scan-rescan repeatability of axon diameter index estimation based on the spherical mean technique (SMT) approach using diffusion MRI data acquired with gradient strengths up to 300 mT/m on a 3T Connectom system in 7 healthy volunteers. We performed statistical power analyses using data acquired with the same protocol in a larger cohort consisting of 15 healthy adults to investigate the implications for study design. Our study revealed a high degree of repeatability in voxel-wise restricted volume fraction estimates and tract-wise estimates of axon diameter index derived from high-gradient diffusion MRI data. On the region of interest (ROI) level across white matter tracts in the whole brain, the Pearson’s correlation coefficient of the axon diameter index estimated between scan and rescan experiments was r = 0.72 with an absolute deviation of 0.18 μm. For an anticipated 10% effect size in studies of axon diameter index, most white matter regions required a sample size of less than 15 people to observe a measurable difference between groups using an ROI-based approach. To facilitate the use of high-gradient strength diffusion MRI data for neuroscientific studies of axonal microstructure, the comprehensive multi-gradient strength, multi-diffusion time data from all individuals included in this work will be made publicly available, in support of open science and increasing the accessibility of such data to the greater scientific community.

PMID:34216774 | DOI:10.1016/j.neuroimage.2021.118323

J Vet Emerg Crit Care (San Antonio). 2021 Jul 3. doi: 10.1111/vec.13085. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare hemostatic variables performed on blood samples obtained from indwelling jugular catheters or direct venipuncture over a 72-hour period.

DESIGN: Prospective experimental study.

SETTING: University research laboratory.

ANIMALS: Five healthy neutered male purpose-bred Beagle dogs.

INTERVENTIONS: Each dog was sedated to facilitate placement of a long-stay 20-Ga polyurethane IV catheter into the jugular vein. Blood samples were obtained from the preplaced catheters at 4 time points corresponding to 0, 24, 48, and 72 hours relative to placement. Blood samples were also obtained by direct venipuncture of a peripheral vein using a 21-Ga butterfly catheter and evacuated blood tubes at the same time points. Platelet count, platelet closure time, prothrombin time, activated partial thromboplastin time, fibrinogen, and kaolin-activated thromboelastography were performed on these paired samples at each time point. The patency of the indwelling catheters was maintained by flushing every 6 hours with heparinized saline.

MEASUREMENTS AND MAIN RESULTS: No significant differences were identified in any of the hemostatic variables obtained by either blood collection technique at any time point during the study (P > 0.05). There was also no significant day-to-day variation in any catheter-derived hemostatic variable obtained from individual dogs identified over the course of the study.

CONCLUSIONS: These data suggest that accurate hemostatic variables may be obtained using blood collected from indwelling jugular catheters, maintained with heparinized saline for at least 72 hours, in healthy dogs.

PMID:34216531 | DOI:10.1111/vec.13085

Colorectal Dis. 2021 Jul 3. doi: 10.1111/codi.15801. Online ahead of print.

ABSTRACT

We read with interest the paper by Park et al [1]. The authors analyzed a population of 107 patients with mid-transverse colon cancer (MTCC), who underwent either extended hemicolectomy (EC=70) or segmental colectomy (SC=37) [1]. No statistically significant difference was found in perioperative and long-term outcomes, following propensity score matching [1]. In particular, the authors underlined the lack of significant differences in 3-year disease-free survival (DFS; 86.5% vs. 90.9%, p = 0.675) and 5-year overall survival (OS; 87.4% vs. 93.0%, p = 0.349) [1].

PMID:34216529 | DOI:10.1111/codi.15801

Eur J Pain. 2021 Jul 3. doi: 10.1002/ejp.1835. Online ahead of print.

ABSTRACT

This journal recently published a paper by Rong et al., entitled “Persistent moderate to severe pain and long-term cognitive decline.” (Rong et al., 2021). The authors demonstrate that, to a small but statistically significant degree, older adults with persistent moderate-to-severe pain (an approximation for chronic pain) experience a faster rate of late-life cognitive decline than older adults without pain. Given these findings, should clinicians be alert for accelerated cognitive decline in older adults with chronic pain? Rong and colleagues argue yes. But, interestingly, using the same data source, an earlier study by Veronese and colleagues concluded that there was no evidence for an effect (Veronese et al., 2018). What are we to make of this?

PMID:34216525 | DOI:10.1002/ejp.1835

Eur J Neurol. 2021 Jul 3. doi: 10.1111/ene.15004. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Previous literature has demonstrated an association between high serum levels of type-II secretory phospholipase A2 (sPLA2) concentration and an increased risk of coronary artery disease. However, such association has not been established in terms of ischemic stroke risk. We aimed to evaluate the association between both sPLA2 concentration and activity as continuous variables with risk of future ischemic stroke.

METHODS: We conducted a nested case-control study using data from the European Prospective Investigation into Cancer – Norfolk study. Cases (n=145) in the current study were participants who developed ischemic stroke during follow-up, with controls (n=290) matched in a 2:1 ratio based on age and sex. Statistical analyses were performed using SPSS (version 25.0, Chicago, Ill) software. Logistic regression was used to determine odds ratios (OR) and corresponding 95% confidence intervals (95% CIs) for ischemic stroke.

RESULTS: After adjusting for a wide array of cardiovascular confounders, sPLA2 activity was found to be associated with an increased risk of ischemic stroke using both multiple imputations with chained equations and complete case analysis: OR 1.20 (95% CI: 1.01-1.43) and OR 1.23 (95% CI: 1.01 -1.49), respectively. However, sPLA2 concentration was not found to be associated with increased risk of ischemic stroke.

CONCLUSIONS: The activity of sPLA2, but not sPLA2 concentration, is associated with an increased risk of future ischemic stroke. This finding may be significant in risk group stratification, allowing targeted prophylactic treatment, or the development of novel therapeutic agents.

PMID:34216520 | DOI:10.1111/ene.15004

Mol Ecol. 2021 Jul 3. doi: 10.1111/mec.16057. Online ahead of print.

ABSTRACT

Differences in the geographic scale and depth of phylogeographic structure across co-distributed taxa can reveal how microevolutionary processes such as population isolation and persistence drive diversification. In turn, environmental heterogeneity, species’ traits and historical biogeographic barriers may influence the potential for isolation and persistence. Using extensive SNP data and a combination of population genetic summary statistics and landscape genomic analyses, we explore predictors of the scale and depth of phylogeographic structure in co-distributed lizard taxa from the topographically and climatically complex monsoonal tropics (AMT) of Australia. We first resolve intraspecific lineages and then test whether genetic divergence across space within lineages is related to isolation by distance, resistance and/or environment, and whether these factors differ across genera or between rock-related versus habitat generalist taxa. We then test whether microevolutionary processes within lineages explain differences in the geographic scale and depth of intraspecific phylogeographic lineages. Results indicate that landscape predictors of phylogeographic structure differ between taxa. Within lineages, there was prevalent isolation by distance, but the strength of isolation by distance is independent on the taxonomic family, habitat specialization and climate. Isolation by environment is the strongest predictor of landscape-scale genetic divergence for all taxa, with both temperature and precipitation acting as limiting factors. The strength of isolation by distance does not predict the geographic scale of phylogeographic structure. However, more localized lineages had higher mean individual heterozygosity and less negative Tajima’s D. This result implies that finer-scale phylogeographic structuring within species is associated with larger and more stable populations and, hence, persistence.

PMID:34216506 | DOI:10.1111/mec.16057