Nevin Manimala

Addiction. 2021 Jun 25. doi: 10.1111/add.15571. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Existing assessments of the time-trends of opioid-related mortality, hospitalization and emergency department visits in Canada have relied mainly on provincial databases, while national assessments generally do not provide information before 2016. We aimed to estimate Canadian national time trends in opioid-related mortality from 2000 to 2017 and opioid-related hospitalization and emergency department visits between 2000 and 2012.

DESIGN: Retrospective cohort study.

SETTING AND PARTICIPANTS: Residents of all Canadian provinces and territories for which comparable data were available from 2000 to 2017.

MEASUREMENTS: We identified opioid-related mortality, hospitalization and emergency department visits using validated algorithms using ICD codes from administrative databases. We calculated crude rates and sex- and age-adjusted rates per million. For hospitalizations, we calculated case-fatality, 90-day and 365-day all-cause mortality and opioid-related re-hospitalization rates. We used Poisson regression to examine the significance of the time trend.

FINDINGS: From 2000 to 2017, the adjusted opioid mortality rate in Canada (outside Quebec) increased significantly by 592.9% (from 20.0 opioid deaths per million in 2000 to 118.3 in 2017). The highest year-to-year increases were from 2015 to 2016 (31.8%) and from 2016 to 2017 (52.2%). The adjusted hospitalizations doubled significantly during the study period (an increase of 103.7%, from 159.7 opioid hospitalizations per million Canadians in 2000 to 325.3 in 2012). The adjusted rate of emergency department visits increased significantly by 188.7% (from 280.6 per million in 2000 to 810.1 in 2012). Case-fatality was 2.3% overall and was mainly constant during the study period. Both 90- and 365-day all-cause mortality increased significantly between 2000 and 2011 (from 1.7 to 3.1% and 3.9 to 7.4%, respectively), while re-hospitalization for opioid-related diagnoses was reduced (from 7.8 to 6.4% and 14.2 to 12.9%, respectively).

CONCLUSIONS: Opioid-related mortality, hospitalization and emergency department visits in Canada have been increasing gradually since 2000.

PMID:34170044 | DOI:10.1111/add.15571

Infant Ment Health J. 2021 Jun 25. doi: 10.1002/imhj.21922. Online ahead of print.

ABSTRACT

Perinatal mental illness is a known risk to maternal-infant attachment and healthy infant development. Mothers experiencing complex mental health issues in the first year following birth are less likely to become involved in parenting programs or day stay interventions because of their mental health difficulties and perceived stigma. Currently, most perinatal day or group treatment programs only include the mother and not their infant. This paper describes “Together in Mind,” a perinatal and infant mental health day program developed by the Queensland Centre for Perinatal and Infant Mental Health, targeting mothers with moderate to severe mental illness and their infants under 12 months. The service model was a 6-week, 1 day per week psychoeducation intervention. Psychoeducational material and support were provided across each day session by an adult perinatal mental health clinician, an infant mental health clinician, and a child health nurse working in collaboration. The program was trialed across seven Hospital and Health Service sites in Queensland, Australia, during 2016-18. In total, 24 group day programs were delivered with 84 mothers and their infants. Pre and post intervention quantitative measures and a post-program qualitative survey about participant satisfaction were collected. Statistically significant improvements in all quantitative measures showed a large to medium effect size on the: Health of the Nation Outcome Scale (HoNOS) (d = 0.82; p < .000); Depression, Anxiety and Stress Scale (DASS-21) (d = 0.5; p < .000); Karitane Parenting Confidence Scale (KPCS) (d = 0.63; p < .000); Maternal Postnatal Attachment Scale (MPAS) (d = 0.49; p < .000), Ages and Stages Questionnaire: Social-Emotional (6 months) (d = 0.83; p < .000). The results indicate collaboration and early intervention contributes to strengthening the emerging development of the maternal-infant relationship within the context of complex maternal mental health issues.

PMID:34170035 | DOI:10.1002/imhj.21922

Magn Reson Med. 2021 Jun 25. doi: 10.1002/mrm.28881. Online ahead of print.

ABSTRACT

PURPOSE: The proposed method aims to create label maps that can be used for the segmentation of animal brain MR images without the need of a brain template. This is achieved by performing a joint deconvolution and segmentation of the brain MR images.

METHODS: It is based on modeling locally the image statistics using a generalized Gaussian distribution (GGD) and couples the deconvolved image and its corresponding labels map using the GGD-Potts model. Because of the complexity of the resulting Bayesian estimators of the unknown model parameters, a Gibbs sampler is used to generate samples following the desired posterior probability.

RESULTS: The performance of the proposed algorithm is assessed on simulated and real MR images by the segmentation of enhanced marmoset brain images into its main compartments using the corresponding label maps created. Quantitative assessment showed that this method presents results that are comparable to those obtained with the classical method-registering the volumes to a brain template.

CONCLUSION: The proposed method of using labels as prior information for brain segmentation provides a similar or a slightly better performance compared with the classical reference method based on a dedicated template.

PMID:34170032 | DOI:10.1002/mrm.28881

Cogn Sci. 2021 Jun;45(6):e13009. doi: 10.1111/cogs.13009.

ABSTRACT

The investigation of visual categorization has recently been aided by the introduction of deep convolutional neural networks (CNNs), which achieve unprecedented accuracy in picture classification after extensive training. Even if the architecture of CNNs is inspired by the organization of the visual brain, the similarity between CNN and human visual processing remains unclear. Here, we investigated this issue by engaging humans and CNNs in a two-class visual categorization task. To this end, pictures containing animals or vehicles were modified to contain only low/high spatial frequency (HSF) information, or were scrambled in the phase of the spatial frequency spectrum. For all types of degradation, accuracy increased as degradation was reduced for both humans and CNNs; however, the thresholds for accurate categorization varied between humans and CNNs. More remarkable differences were observed for HSF information compared to the other two types of degradation, both in terms of overall accuracy and image-level agreement between humans and CNNs. The difficulty with which the CNNs were shown to categorize high-passed natural scenes was reduced by picture whitening, a procedure which is inspired by how visual systems process natural images. The results are discussed concerning the adaptation to regularities in the visual environment (scene statistics); if the visual characteristics of the environment are not learned by CNNs, their visual categorization may depend only on a subset of the visual information on which humans rely, for example, on low spatial frequency information.

PMID:34170027 | DOI:10.1111/cogs.13009

J Ultrasound Med. 2021 Jun 25. doi: 10.1002/jum.15766. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare musculoskeletal changes on a physical examination (PE), ultrasound (US) and magnetic resonance imaging (MRI) of the hands and wrists of patients with Chikungunya fever (CF).

METHODS: The sample consisted of 30 patients in the chronic phase of CF. The sites analyzed were the interphalangeal (IP), metacarpophalangeal (MCP) and wrist/mediocarpal (WMC) joints and periarticular soft tissue. The interval between the PE and imaging tests was 7 days, and the interval between US and MRI was 2 days. The kappa coefficient was calculated to estimate the agreement between the PE and US and MRI findings and between the US and MRI findings.

RESULTS: Significant agreement was observed between PE and US in the diagnosis of synovitis. The only statistically significant agreement between US and MRI was the finding of flexor tenosynovitis; the agreement was moderate.

CONCLUSIONS: US has great potential for use in diagnosing synovitis suspected based on a PE. The limited agreement observed between US and MRI, in turn, may suggest a complementary role of these methods.

PMID:34170018 | DOI:10.1002/jum.15766

Clin Cardiol. 2021 Jun 25. doi: 10.1002/clc.23678. Online ahead of print.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is the most common cardiac rhythm disturbance and leads to morbidity and mortality. Peripheral artery disease (PAD) is associated with atherosclerotic risk factors and always classified as a vascular disease and deemed to be a bad complication of AF. In patients with AF, the risk and prognostic value of PAD have not been estimated comprehensively.

HYPOTHESIS: PAD is associated with all-cause mortality, cardiovascular (CV) mortality, and other outcomes in patients with AF.

METHODS: We searched PubMed, Embase, and Cochrane Library databases for prospective studies published before April 2021 that provided outcomes data on PAD in confirmed patients with AF. Heterogeneity was estimated using the I² statistic. The fixed-effects model was used for low to moderate heterogeneity studies, and the random-effects model was used for high heterogeneity studies.

RESULTS: Eight prospective studies (Newcastle-Ottawa score range, 7-8) with 39 654 patients were enrolled. We found a significant association between PAD and all-cause mortality (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.25-1.62; p < .001), CV mortality (HR, 1.64; 95% CI, 1.32-2.05; p < .001) and MACE (HR, 1.75; 95% CI, 1.38-2.22; p < .001) in patients with AF. No significant relationship was found in major bleeding (HR, 1.22; 95% CI, 0.95-1.57; p = 0.118), myocardial infarction (MI) (HR, 2.07; 95% CI, 1.17-3.67; p = .038), and stroke (HR, 1.14; 95% CI, 0.87-1.50, p = 0.351).

CONCLUSIONS: PAD is associated with an increased risk of all-cause mortality, CV mortality, and MACE in patients with AF. However, no significant association was found with major bleeding, MI, and stroke.

PMID:34170015 | DOI:10.1002/clc.23678

Turk Neurosurg. 2021 Apr 13. doi: 10.5137/1019-5149.JTN.33760-21.3. Online ahead of print.

ABSTRACT

AIM: This study aimed to compare the morphometric characteristics of the foramen ovale (FO) and rotundum (FR) and their localization in the middle cranial fossa in head and neck computed tomography images in patients with trigeminal neuralgia (TN) and asymptomatic individuals.

MATERIAL AND METHODS: FO and FR length, width and area parameters were examined in 158 asymptomatic individuals and 19 patients with TN. Their location in the middle cranial fossa was determined according to the sagittal (y) axis passing through the middle of the dorsum sella and connecting the foremost point and the rearmost point of the skull, and the transverse (x) axis passing through the middle of this axis. In comparisons with asymptomatic individuals, data on the painful side of patients with trigeminal neuralgia were used.

RESULTS: The mean width of the FO and its distance from the transverse axis were determined 3.36±0.79 mm and 1.44±0.39 mm in asymptomatic individuals, 2.88±0.83 mm and 1.23±0.45 in TN patients, respectively. These FO parameters were statistically significantly smaller in patients with TN. In asymptomatic individuals, while the mean width of the FR was determined to be 2.05±0.48 mm, the mean length was 2.14±0.47 mm, and its distance to the transverse axis and sagittal axis was found to be 2.65±0.35 mm and 1.96±0.25 mm, respectively. In patients with TN, while the mean width of the FR was revealed to be 1.77±0.46 mm, the mean length was 1.78±0.42 mm, and its distance to the transverse axis and sagittal axis was found to be 2.33±0.40 mm and 1.87±0.16 mm, respectively. These FR parameters were statistically significantly smaller in patients with TN.

CONCLUSION: The fact that the dimensions of the FO and FR and their distances to the sagittal and transverse axes were statistically significantly smaller in patients with TN suggested that it may be one of the causes of TN.

PMID:34170000 | DOI:10.5137/1019-5149.JTN.33760-21.3

Turk Neurosurg. 2021 Mar 21. doi: 10.5137/1019-5149.JTN.33347-20.2. Online ahead of print.

ABSTRACT

AIM: To elucidate the association of MTHFR, MTRR and RAD54L gene variations in Turkish meningioma cohort.

MATERIAL AND METHODS: DNAs were isolated from 87 retrospective meningioma tumor samples. MTHFR, MTRR and RAD54L genes hot spot regions were amplified with specific primers by polymerase chain reaction (PCR) and next generation sequencing (NGS) was performed. All detected variations and single nucleotide polymorphisms were listed and compared with healthy control frequencies in different genomic databases. Histopathological characteristics of tumors and genomic variations were compared. The Pearson’s chi-square test was used to detect statistical differences of SNPs and correlation analysis was performed.

RESULTS: rs1801131, rs1801133 and rs4846051 on MTHFR gene, rs1801394 on MTRR gene, rs1048771 on RAD54L gene frequencies found to be significantly altered in overall cohort of 87 meningioma patients. The frequency of rs18011031 is 0.09 in meningioma which is significantly correlated with WHO grades of tumors (p=0.038). The frequency of rs18011033 is 0.29, and significantly correlated with WHO grades of tumors (p=0.045). The frequency of rs4846051 is 0.18 in meningioma cohort which is significantly correlated with WHO grades of tumors (p=0.023) and also with low Ki67 proliferation index (p=0.00455). The frequency of rs1801394 is 0.15 and significantly associated with high Ki67 proliferation index on meningioma tumors (p=0.0144). The frequency of rs1048771 is 0.09 in meningioma cohort and it is significantly associated with non-necrotic histopathological form of tumor (p=0.05).

CONCLUSION: We reported significant association between genetic alterations of folate metabolism (MTHFR, MTRR) and DNA repair mechanism (RAD54L) genes with the histopathological characteristics of the meningioma tumors. Five significant SNPs on these genes and four significant correlations of SNPs with histopathological characteristics were identified. Our study is a preliminary promising study to establish the genetics marker analysis for meningioma diagnosis and prognosis for folate metabolism and DNA repair associated genes in Turkish cohort.

PMID:34169999 | DOI:10.5137/1019-5149.JTN.33347-20.2

Turk Neurosurg. 2021 Jan 20. doi: 10.5137/1019-5149.JTN.32701-20.3. Online ahead of print.

ABSTRACT

AIM: Foramina transversaria (FT) are located on the transverse process of cervical vertebrae. These foramina are known to exhibit variations with regard to shape, size and may even absent, incomplete or duplicated. The aim of this study was to investigate the variations in number, shape, size of foramina transversaria of the human cervical vertebrae and their clinical importance Material and Methods: 200 dry cervical vertebrae (C3-C7) of 40 spines were studied for the presence of variations in number, size and shape of the FT. The foramina were further classified according to their shape depending upon the direction of their main diameter Results: Accessory foramina was found in 40 cervical vertebrae. Bilateral accessory foramen was slightly more common than a unilateral one. Occurrence of accessory foramen followed a particular pattern. Incidence increased in descending order of cervical vertebrae and most commonly found in C7. On the right side, the mean of antero-posterior and transverse diameter was 4.96±1.08 mm and 5.68±1.20 mm respectively whereas on the left side it was 5.07±1.12 mm and 5.76±1.29 mm respectively. The difference was statistically non-significant. Five types of shape were noted. Type I was predominant on right side, type IV was predominant on the left side.

CONCLUSION: variations in the number, shape and size of the foramen transversarium is not an uncommon phenomenon. Anatomical knowledge regarding such variations is clinically important since the course of the vertebral artery may be distorted in such situations and may result in vertebro-basilar insufficiency. Data provided in this study can be useful in interpretation of radiographic images (computerized tomography and angiograms).

PMID:34169994 | DOI:10.5137/1019-5149.JTN.32701-20.3

Biomed Instrum Technol. 2020 Jun 1;54(s1):64-72. doi: 10.2345/0899-8205-54.s3.64.

ABSTRACT

The validation of a radiation sterilization dose involves an initial sterilization dose determination as well as maintenance of that sterilization dose. The procedures for maintenance of the sterilization dose typically include the periodic use of two types of tests: bioburden and dose audits. The details for the procedures are outlined in the ISO radiation sterilization standards. These documents also provide guidelines for recommended actions in response to the results of the two tests. The results for the dose audit are based on the number of positive tests of sterility (TOS) for products that have been irradiated at a verification or experimental dose. When the dose audit yields TOS positives, it is often thought that they indicate a sterilization failure and nonsterile product. The belief that any TOS positive is a failure is an incorrect assumption because of the statistical basis used for the determination of the sterilization dose. This article will outline the truth of what dose audit TOS positives mean in terms of the sterility assurance of product, as well as the consequences of TOS positives.

PMID:34169976 | DOI:10.2345/0899-8205-54.s3.64