Nevin Manimala

Pediatr Radiol. 2021 May 15. doi: 10.1007/s00247-021-05094-9. Online ahead of print.

ABSTRACT

BACKGROUND: The sacral ratio has been used as a tool for evaluating sacral development in patients with anorectal malformations. Sacral ratios can be calculated by obtaining sacral radiographs in the anteroposterior (AP) and lateral planes.

OBJECTIVE: The objective of the study was to determine the correlation and agreement in sacral ratio calculations.

MATERIALS AND METHODS: In this single institution retrospective cohort study, we reviewed medical charts of all pediatric anorectal malformation patients treated between March 2014 and September 2018 who had both AP and lateral images of their sacrum. All sacral ratios were measured by three radiologists. Pearson’s correlation coefficients and corresponding 95% confidence intervals (CIs) were used to assess the correlation between the AP and lateral radiographs. A weighted Kappa statistic was used to measure the agreement between how the AP and lateral sacral ratios categorized observations into risk groups.

RESULTS: Our initial cohort consisted of 646 observations from patients with anorectal malformations who had radiographs obtained in both AP and lateral planes. We excluded all observations (n=76) where the radiographs were deemed to be inadequate or not appropriately centered to measure sacral ratio. For a given pair of measurements, the mean lateral sacral ratio was 0.07 units greater than the AP plane (95% CI 0.06-0.09, paired t-test P-value <0.0001). AP and lateral images had a moderate positive correlation (Pearson’s r=0.76, 95% CI 0.73-0.79, P<0.0001) and moderate agreement in risk categorization (unweighted kappa = 0.60, P<0.0001). AP and lateral readings conducted by all three radiologists had excellent inter-rater reliability with intraclass correlations for AP and lateral sacral ratios of 0.88 and 0.84, respectively.

CONCLUSION: Even though the AP and lateral sacral ratios had moderate positive correlation, the mean sacral ratio determined by images in the lateral plane was 0.07 units greater than the AP plane. AP and lateral sacral ratios concluded different risk categories relatively often. Future studies are needed to determine whether AP or lateral sacral ratios correlate better with continence in patients with anorectal malformations.

PMID:33991195 | DOI:10.1007/s00247-021-05094-9

Diabetologia. 2021 May 15. doi: 10.1007/s00125-021-05474-8. Online ahead of print.

ABSTRACT

AIMS: CVD is the main cause of morbidity and mortality in individuals with diabetes. It is currently unclear whether daily glucose variability contributes to CVD. Therefore, we investigated whether glucose variability is associated with arterial measures that are considered important in CVD pathogenesis.

METHODS: We included participants of The Maastricht Study, an observational population-based cohort, who underwent at least 48 h of continuous glucose monitoring (CGM) (n = 853; age: 59.9 ± 8.6 years; 49% women, 23% type 2 diabetes). We studied the cross-sectional associations of two glucose variability indices (CGM-assessed SD [SD_CGM] and CGM-assessed CV [CV_CGM]) and time in range (TIR_CGM) with carotid-femoral pulse wave velocity (cf-PWV), carotid distensibility coefficient, carotid intima-media thickness, ankle-brachial index and circumferential wall stress via multiple linear regression.

RESULTS: Higher SD_CGM was associated with higher cf-PWV after adjusting for demographics, cardiovascular risk factors and lifestyle factors (regression coefficient [B] per 1 mmol/l SD_CGM [and corresponding 95% CI]: 0.413 m/s [0.147, 0.679], p = 0.002). In the model additionally adjusted for CGM-assessed mean sensor glucose (MSG_CGM), SD_CGM and MSG_CGM contributed similarly to cf-PWV (respective standardised regression coefficients [st.βs] and 95% CIs of 0.065 [-0.018, 0.167], p = 0.160; and 0.059 [-0.043, 0.164], p = 0.272). In the fully adjusted models, both higher CV_CGM (B [95% CI] per 10% CV_CGM: 0.303 m/s [0.046, 0.559], p = 0.021) and lower TIR_CGM (B [95% CI] per 10% TIR_CGM: -0.145 m/s [-0.252, -0.038] p = 0.008) were statistically significantly associated with higher cf-PWV. Such consistent associations were not observed for the other arterial measures.

CONCLUSIONS: Our findings show that greater daily glucose variability and lower TIR_CGM are associated with greater aortic stiffness (cf-PWV) but not with other arterial measures. If corroborated in prospective studies, these results support the development of therapeutic agents that target both daily glucose variability and TIR_CGM to prevent CVD.

PMID:33991193 | DOI:10.1007/s00125-021-05474-8

Brain Behav. 2021 May 15:e02172. doi: 10.1002/brb3.2172. Online ahead of print.

ABSTRACT

OBJECTIVE: We report a review of outcomes in schizophrenia in the twenty-first century, replicating and extending work undertaken by the late Richard Warner in his seminal book, “Recovery from Schizophrenia: Psychiatry and Political Economy” (1985;2004).

METHOD: Warner’s methods were followed as closely as possible. Only observational/naturalistic studies were included. Six scientific databases were searched from 2000 to 2020. 6,640 records were retrieved. 47 met inclusion criteria.

RESULTS: Overall, complete recovery is higher in this study than in Warner’s (37.75% cf 20.4%), especially for first episode psychosis (FEP) (57.1% cf 20.7%). Clinical recovery, annualized remission rate (ARR), and employment outcomes were significantly superior for first episode psychosis compared with multiple episode psychosis (MEP). ARR shows a trend toward reduction over time, from 2.2 before the financial crash of 2008 to 1.6 after (t = 1.85 df 40 p = .07). The decline is statistically significant for the MEP group (t = 2.32 df18 p = .03). There were no differences in outcome by region, sample characteristics, outcome measures used, or quality of studies. Heterogeneity of clinical outcome measures across the literature makes evidence synthesis difficult. Weak and inconsistent reporting of functional and employment outcomes mean that findings lack meaning with respect to lived experience.

CONCLUSION: Future research strategies should aim to reduce heterogeneity in clinical outcome measures and to increase the emphasis on capture and reporting of more sophisticated measures of social and functional outcome. Outcome domains should be disaggregated rather than conflated into unitary recovery constructs.

PMID:33991072 | DOI:10.1002/brb3.2172

J Biophotonics. 2021 May 14:e202100035. doi: 10.1002/jbio.202100035. Online ahead of print.

ABSTRACT

As an important biomedical imaging method, endoscopic optical coherence tomography (OCT) is necessary to check its performance regularly. The ordinary plane phantoms are only able to evaluate part of image tangent to the probe. In this research, a spatial resolution estimate method of the endoscope OCT system is proposed. The annular phantom, made by uniformly distributing golden scattered microparticles in polydimethylsiloxane (PDMS), can provide dynamic scanning imaging evaluation of endoscopic OCT system, closer to its actual working status. The point spread function (PSF) analysis method is used to analyze the imaging results of the annular phantom with the endoscopic OCT system. And many scattered particles are statistically analyzed to determine the spatial resolution of the endoscope OCT system. The method is low in cost, simple and convenient. It is valuable for the development of test standards for endoscope OCT systems. This article is protected by copyright. All rights reserved.

PMID:33991071 | DOI:10.1002/jbio.202100035

J Cachexia Sarcopenia Muscle. 2021 May 14. doi: 10.1002/jcsm.12712. Online ahead of print.

ABSTRACT

BACKGROUND: Reference ranges for lean mass (LM) and fat mass (FM) are essential in identifying soft tissue disorders; however, no such reference ranges exist for the most commonly used Hologic dual-energy X-ray absorptiometry (DXA) machine in Australia.

METHODS: Cross-sectional study of community-dwelling adults (aged 18-88 years) who underwent a Hologic DXA scan at one of three commercialized densitometry centres in Australia. Age-specific and sex-specific percentile curves were generated for LM [LM, appendicular lean mass (ALM), ALM adjusted for height squared (ALM/h² ), and ALM adjusted for body mass index (ALM/BMI)] and FM [FM, FM adjusted for height squared (FM/h² ), appendicular fat mass, and android and gynoid fat] parameters using the LMS statistical method. Cutpoints equivalent to T-scores of -1, -2, and -2.5 standard deviations below the young mean reference group (20-29 years) were also generated for LM parameters.

RESULTS: A total of 15 479 community-dwelling adults (54% men) with a median age of 33 years (interquartile range: 28, 42) were included. LM, ALM, and ALM/h² remained stable until age 50, after which these parameters started to decline in both sexes. Compared with age 50, median percentiles of LM, ALM, and ALM/h² declined by -5.9 kg, -3.7 kg, and -0.86 kg/m² in men and by -2.5 kg, -1.8 kg, and -0.10 kg/m² in women at age 70, respectively. Adjusting ALM for BMI (rather than height squared) resulted in different trends, with ALM/BMI decreasing from as early as age 20. Compared with age 20, median percentiles of ALM/BMI at age 40 declined by -0.10 kg/kg/m² in men and by -0.06 kg/kg/m² in women; and at age 70, ALM/BMI declined by -0.25 kg/kg/m² in men and by -0.20 kg/kg/m² in women. Cutpoints equivalent to T-scores of -1, -2, and -2.5 standard deviations for ALM/BMI were 1.01, 0.86, and 0.77 kg/kg/m² in men and 0.70, 0.59, and 0.53 kg/kg/m² in women, respectively. All FM parameters progressively increased from age 20 and continued up until age 70.

CONCLUSIONS: We developed reference ranges for LM and FM parameters from Hologic DXA machines in a large cohort of Australian adults, which will assist researchers and clinicians in identifying soft tissue disorders such as obesity, sarcopenia, and cachexia.

PMID:33991068 | DOI:10.1002/jcsm.12712

Diagn Cytopathol. 2021 May 14. doi: 10.1002/dc.24774. Online ahead of print.

ABSTRACT

BACKGROUND: Liquid-based cytology (LBC) tests SurePath (SP) and ThinPrep (TP) have largely replaced conventional Papanicolaou (Pap) tests for cervical cytology screening due to higher sensitivity. However, comparison between SP and TP test sensitivity and efficacy in detecting squamous abnormalities is lacking. Our study aims to compare high-grade squamous intraepithelial lesion (HSIL) reporting rates, human papillomavirus (HPV) positivity rates, and histologic outcome between these two LBC methods.

MATERIALS AND METHODS: We performed a retrospective search of the period between January 2014 and June 2017, when both TP and SP were utilized at our institution, to identify HSIL cases and collect the HPV testing and histologic follow-up results for those cases.

RESULTS: One hundred twenty-five HSILs were identified from the 15 382 TP specimens (0.81%) and 93 HSILs were identified from the 25 105 SP specimens (0.37%), a statistically significant difference (P < .0001). The corresponding HPV positivity rates were 95.6% and 89.7% in TP-HSILs and SP-HSILs, respectively, a statistically non-significant difference. Histologic follow-up showed HSILs or carcinomas were identified in 78% (49/63) of TP-HSILs and 79% (45/57) of SP-HSILs, with no statistically significant difference.

CONCLUSION: TP demonstrated a higher HSIL detection rate than SP with no significant difference in follow-up HPV or histologic results.

PMID:33991062 | DOI:10.1002/dc.24774

Int J Lab Hematol. 2021 May 15. doi: 10.1111/ijlh.13576. Online ahead of print.

ABSTRACT

INTRODUCTION: Haematology laboratories are increasingly faced with requests for add-on coagulation testing. This study explores extending the specimen storage proposals by examining coagulation parameters on refrigerated citrated plasma retained on a cellular fraction over a 24-hour period.

METHODS: Sodium citrate (Sarstedt^® S-Monovette 3.2%) specimens from 206 patients in University Hospital Limerick, Ireland were refrigerated immediately post-analysis and re-analysed in the centrifuged primary container at 4, 8 and 24-hour intervals using the Diagnostica Stago coagulometer and reagent combination. Coagulation assays examined for statistically and clinically significant differences included PT, APTT, D-Dimer, fibrinogen and Protein C.

RESULTS: PT, APTT and Protein C values displayed statistical significance from 4 hours. Fibrinogen differences were statistically significant from 8 hours. D-Dimer differences were not statistically significant at any interval over the 24-hour period. The refrigerated storage limit for PT and APTT results was determined to be 4 hours. D-Dimer was the only test parameter to report a mean percentage variance >10%. However, result changes at the threshold region of 0.5 µg/mL FEU were found to be within assay precision limits and desirable bias up to 8 hours. Maximum mean differences for Protein C (-1.3%) and fibrinogen (2.3%) were within assay precision limits and desirable biases up to 24 hours.

CONCLUSION: PT and APTT results are stable in refrigerated citrated plasma maintained on a cellular fraction up to 4 hours post-phlebotomy. D-Dimers results are reliable up to 8 hours, while fibrinogen and Protein C results are stable for at least 24 hours.

PMID:33991057 | DOI:10.1111/ijlh.13576

J Occup Health. 2021 Jan;63(1):e12233. doi: 10.1002/1348-9585.12233.

ABSTRACT

OBJECTIVES: This study compared differences in age-standardized suicide mortality rates, personal characteristics (demographics, employment conditions, and details of suicide), and work-related stress by gender and occupation among workers who had committed suicide in Korea.

METHODS: Data comprised 413 suicide death claims lodged with the Industrial Accident Compensation Insurance (IACI) from 2010 to 2018, which were coded. We calculated age-standardized suicide mortality rates by gender and occupation. The chi-square test, Fisher’s exact test, and t-test were conducted to examine gender differences. Frequency and percentage distribution by gender and occupation were calculated using descriptive statistics.

RESULTS: Regardless of gender, age-standardized suicide mortality rate was highest among “Managers.” Women who died by suicide were significantly younger and more likely to be unmarried, live alone, and have fewer years of continuous employment than men. “Managers,” “Professionals and Related Workers,” and “Clerks” experienced similar work-related stresses, including “Difficult work to achieve,” “Fail to achieve allocation workload,” and “Change of job contents or workload.” “Skilled Agricultural, Forestry and Fishery Workers,” “Craft and Related Trades Workers,” and “Equipment, Machine Operating and Assembling Workers” had higher work-related stress related to “Severe disease/injury” or “Causing a serious accident” compared with other workers.

CONCLUSIONS: Work-related stress related to suicide deaths differed by gender and occupation. The gender gap of labor market participation in Korea may affect gender differences in terms of demographics and employment conditions among workers who died by suicide. Our study suggests that gender- and occupation-specific strategies and policies to reduce work-related stress can prevent suicide among workers.

PMID:33991042 | DOI:10.1002/1348-9585.12233

Stat Med. 2021 May 14. doi: 10.1002/sim.8999. Online ahead of print.

ABSTRACT

It is difficult to estimate sensitivity and specificity of diagnostic tests when there is no gold standard. Latent class models have been proposed as a potential solution as they provide estimates without the need for a gold standard. Using a motivating example of the evaluation of point of care tests for leptospirosis in Tanzania, we show how a realistic violation of assumptions underpinning the latent class model can lead directly to substantial bias in the estimates of the parameters of interest. In particular, we consider the robustness of estimates of sensitivity, specificity, and prevalence, to the presence of additional latent states when fitting a two-state latent class model. The violation is minor in the sense that it cannot be routinely detected with goodness-of-fit procedures, but is major with regard to the resulting bias.

PMID:33990992 | DOI:10.1002/sim.8999

J Comput Chem. 2021 May 14. doi: 10.1002/jcc.26556. Online ahead of print.

ABSTRACT

We explore how ideas and practices common in Bayesian modeling can be applied to help assess the quality of 3D protein structural models. The basic premise of our approach is that the evaluation of a Bayesian statistical model’s fit may reveal aspects of the quality of a structure when the fitted data is related to protein structural properties. Therefore, we fit a Bayesian hierarchical linear regression model to experimental and theoretical ¹³ C^α chemical shifts. Then, we propose two complementary approaches for the evaluation of such fitting: (a) in terms of the expected differences between experimental and posterior predicted values; (b) in terms of the leave-one-out cross-validation point-wise predictive accuracy. Finally, we present visualizations that can help interpret these evaluations. The analyses presented in this article are aimed to aid in detecting problematic residues in protein structures. The code developed for this work is available on: https://github.com/BIOS-IMASL/Hierarchical-Bayes-NMR-Validation.

PMID:33990982 | DOI:10.1002/jcc.26556