Tag: nevin manimala

Eur J Pediatr. 2024 Nov 29;184(1):54. doi: 10.1007/s00431-024-05891-y.

ABSTRACT

The short-term respiratory consequences of small for gestational (SGA) are only partially known. Our aim was to compare the early respiratory features between SGA and appropriate for gestational age (AGA) in very preterm infants. We conducted a secondary analysis of the French prospective EPIPAGE-2 cohort. Eligible children were those born alive before 32 weeks’ gestation. The exposed group consisted of children with SGA. The unexposed group consisted of AGA children. SGA and AGA children were randomly matched in a ratio of 1:1 on the same gestational age and sex. Primary outcomes were age at final extubation and age at weaning from any respiratory support. Among 3.964 very preterm from the EPIPAGE2 cohort, 1123 SGA and 1123 AGA very preterm children were included in the study. The median gestational age was 30.0 weeks (interquartile range 28.0-31.0) in both groups. The median birthweight was 1440 g (1138-1680) in the AGA group and 1000 g (780-1184) in the SGA group. Invasive mechanical ventilation was less common in the SGA than in the AGA group: 68.6% (770/1123) versus 72.0% (808/1062), odds ratio 0.85 (95% CI [0.72-1.00]). In cases of mechanical ventilation, median age at final extubation was 4 days (1-23) and 2 days (1-9) in the SGA and AGA groups. Median postmenstrual age at weaning from any respiratory support was 33.4 weeks (31.7-35.9) in the SGA group and 32.4 weeks (31.4-34.3) in the AGA group.

CONCLUSION: SGA is associated with delayed extubation and respiratory support weaning.

WHAT IS KNOWN: • Small for gestational age concerns more than 30% of very preterm children. • The condition is strongly associated with increased neonatal mortality and morbidity, including bronchopulmonary dysplasia.

WHAT IS NEW: • Small for gestational age is associated with delayed extubation and respiratory support weaning in very preterm children. • Shortening invasive mechanical ventilation as much as possible is a crucial issue in this population to try to reduce the risk of bronchopulmonary dysplasia.

PMID:39612049 | DOI:10.1007/s00431-024-05891-y

Sleep Breath. 2024 Nov 29;29(1):25. doi: 10.1007/s11325-024-03184-0.

ABSTRACT

PURPOSE: This study aimed to compare cervical proprioception and related biomechanical factors among patients with Obstructive Sleep Apnea (OSA) and asymptomatic controls.

METHODS: In this case-control study, polysomnography scores (apnea-hypopnea index-AHI) were examined to determine the disease severity of the OSA group. Also, we evaluated cervical proprioception by using a laser pointer to detect joint repositioning error sense in cervical rotational movements. Comparison statistics were also conducted for the cervical musculoskeletal variables such as range of motion (ROM) with bubble inclinometer, cranio-cervical (CVA), and thoracic posture (TKA) through photometric analysis, neck flexor muscle endurance test, and pain pressure thresholds of trapezius (PPT).

RESULTS: This case-control study included 59 male participants: patients with OSA (n = 29; mean age = 49.10 years; mean BMI = 28.41 kg/m2) and asymptomatic controls (n = 30; mean age = 49.73 years; mean BMI = 26.89 ± 3.60 kg/m2). The mean AHI score was 26.06 events/hour, categorizing the severity of OSA as mild (31.03%), moderate (31.03%), and severe (37.94%). Patients with OSA demonstrated significantly poorer cervical proprioception compared to controls for both sides of cervical rotation with larger effect sizes (d:1.36-1.45; p < 0.05). Also, cervical ROM, CVA, TKA, neck flexor muscle endurance test, and PPT values were altered in the OSA group compared to the control group (p < 0.05).

CONCLUSION: Impaired cervical proprioception may be a previously unrecognized factor associated with OSA. This finding has implications for understanding the mechanisms underlying cervical musculoskeletal changes in OSA and for developing potential new interventions or exercise designs targeting postural control.

PMID:39612037 | DOI:10.1007/s11325-024-03184-0

J Math Biol. 2024 Nov 29;90(1):1. doi: 10.1007/s00285-024-02167-9.

ABSTRACT

We study a diffusive epidemic model and examine the spatial spreading dynamics of a multi-strain infectious disease. In particular, we address the questions of competitive-exclusion or coexistence of the disease’s strains. Our results indicate that if one strain has its local reproduction function spatially homogeneous, which either strictly minimizes or maximizes the basic reproduction numbers, then the phenomenon of competitive-exclusion occurs. However, if all the local reproduction functions are spatially heterogeneous, several strains may coexist. In this case, we provide complete information on the large time behavior of classical solutions for the two-strain model when the diffusion rate is uniform within the population and the ratio of the local transmission rates is constant. Particularly, we prove the existence of two critical superimposed functions that serve as threshold values for the ratio of the transmission rates and that of the recovery rates. Furthermore, when the populations’ diffusion rates are small, our result on the asymptotic profiles of coexistence endemic equilibria indicate a spatial segregation of infected populations.

PMID:39612006 | DOI:10.1007/s00285-024-02167-9

Sleep Breath. 2024 Nov 29;29(1):22. doi: 10.1007/s11325-024-03172-4.

ABSTRACT

PURPOSE: Drug-induced sleep endoscopy (DISE) helps select patients with obstructive sleep apnea (OSA) for surgery by identifying upper airway collapse patterns. This study aimed to predict the probability of complete concentric collapse at the palatal level (CCCp) during DISE based on patient characteristics, specifically body mass index (BMI).

METHODS: We retrospectively reviewed records of OSA patients who underwent DISE from January 2018 to July 2023. Logistic regression with receiver operating characteristic (ROC) analysis and classification and regression tree (CART) analysis were used to assess the diagnostic efficiency of BMI and other predictors for CCCp.

RESULTS: A consecutive series of 1761 eligible patients was included for analysis. CCCp was observed in 22.3% of cases. The CCCp group had significantly higher BMI, neck circumference, apnea-hypopnea index (AHI) and height as well as increase in partial and complete collapse at oropharyngeal level. The ROC analysis for predicting CCCp for a BMI cut-off was similar for males and females 29.4 kg/m² and 29.5 kg/m², with an area under the curve (AUC) of 0.65 and 0.73, respectively. Adding predictors like tonsils, AHI, height and neck circumference improved the model’s performance.

CONCLUSION: Although confirming an association between increasing BMI and presence of CCCp, we were unable to define an accurate BMI cut-off value for predicting CCCp. The multifactorial nature of this collapse pattern challenges BMI’s efficacy as a sole predictor. Our findings underscore the continued importance of DISE in evaluating CCCp and other collapse patterns for clinical decision-making in patients considered for hypoglossal nerve stimulation therapy.

PMID:39612003 | DOI:10.1007/s11325-024-03172-4

Surg Radiol Anat. 2024 Nov 29;47(1):11. doi: 10.1007/s00276-024-03528-1.

ABSTRACT

PURPOSE: This study aimed to examine the anatomical variations and morphometric characteristics of the sulci in the dural venous sinuses within the intracranial cavity, with a particular focus on sex differences and asymmetry.

METHODS: Thirty fixed cadaveric heads were used to measure the dimensions (length, width, and depth) and spatial relationships of the dural venous sinus sulci within the intracranial cavity, including the distance to the midline, distance to each other, and lateral margin of the skull. Comparisons were made between sexes and sides of the body.

RESULTS: A significant difference was observed in the length of the marginal sinus on the right side between sexes (p = 0.028). Various measurements, including the width of the transverse sinus, origin and insertion sites of the superior petrosal sinus, and distances between the sinuses and midline, showed statistically significant differences between the left and right sides (p < 0.05). Furthermore, the width of the inferior petrosal sinus and depth of the sigmoid sinus were notably higher on the right side (p < 0.05).

CONCLUSION: The results suggest an asymmetric distribution of the sigmoid, superior/inferior petrosal, and transverse sinuses in terms of diameter and distance from the midline. Surgeons should consider these anatomical variations during procedures in this region.

PMID:39611993 | DOI:10.1007/s00276-024-03528-1

Psychol Health Med. 2024 Nov 29:1-17. doi: 10.1080/13548506.2024.2433545. Online ahead of print.

ABSTRACT

Postpartum Depression (PPD) is a major health challenge with potentially devastating maternal and physical health outcomes. Development of diabetes mellitus has been hypothesized as one of the potential adverse effects of PPD among mothers in the postpartum period, but this association has not been adequately studied especially in low resource settings. This study aimed at determining prevalence of postpartum depression and its association with diabetes mellitus among mothers in Mbarara District, southwestern Uganda. We conducted a facility based cross-sectional study of 309 mothers between 6th week to 6th month after childbirth. Using proportionate stratified consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health center IV. PPD was diagnosed using the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diabetes mellitus was diagnosed by measuring Hemoglobin A1c (HbA1c). Logistic regression was used to determine the association of PPD and diabetes mellitus among mothers. The study established that PPD prevalence of PPD among mothers of 6th weeks to 6th months postpartum period in Mbarara was 40.5% (95% CI: 35.1-45.1%) and it was statistically significantly associated with diabetes mellitus in mothers between 6 weeks and 6 months postpartum. The prevalence of diabetes mellitus among mothers with PPD was 28% compared to 13.6% among mothers without PPD. Mothers with PPD had 3 times higher odds of being newly diagnosed with diabetes as compared to those without PPD (aOR = 3.0, 95% CI: 1.62-5.74, p = 0.001). Mothers with PPD between 6 weeks and 6 months postpartum are more likely to have diabetes mellitus as compared to those without PPD. Well-designed prospective analytical studies are needed to conclude on the risk of diabetes mellitus in relation to PPD. Early screening of PPD may be considered in postpartum mothers.

PMID:39611342 | DOI:10.1080/13548506.2024.2433545

J Orthod. 2024 Nov 29:14653125241283053. doi: 10.1177/14653125241283053. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the space closure, root resorption and canine angulation during en-masse retraction of the labial segment after extraction of first premolars with or without interseptal bone reduction distal to the maxillary canines.

DESIGN: A single-centre, parallel randomised control trial included 16 participants with a mean age of 21.5 years. Participants were allocated into treatment groups using blocked randomisation, and blinding was employed for outcome assessors and data analysts.

INTERVENTIONS: The control group consisted of eight participants who underwent therapeutic extraction of maxillary first premolars, while the experimental group included eight participants who underwent interseptal bone reduction immediately after premolar extraction. En-masse retraction was performed using conventional friction mechanics with absolute anchorage in both groups.

OUTCOMES: Measurements of space closure were conducted over 3 consecutive months during retraction. The time taken for total space closure was recorded. Cone-beam computed tomography scans were taken before and 3 months after retraction to assess root resorption and canine angulation.

RESULTS: The experimental group demonstrated a significant increase in the rate of en-masse retraction compared to the control group over 3 months (mean difference [MD] = 1.09 mm, 95% confidence interval [CI] = 0.78-1.40), with an overall space closure rate of MD 0.26 mm/month (95% CI = 0.17-0.34). However, these changes were of minimal clinical significance. The change in canine angulation (MD = 4.50°, 95% CI = -1.61-10.61) did not exhibit statistical significance. Substantial root resorption was observed in six maxillary anterior teeth, with no difference between the groups.

CONCLUSION: Interseptal bone reduction is a minimally invasive surgical technique, resulting in a notably accelerated rate of en-masse retraction in the experimental group over 3 months. However, despite the statistical significance, the clinical impact on overall space closure was minimal, with a difference of only 0.26 mm/month observed between the groups. Interseptal bone reduction did not affect the change in canine angulation and root resorption.

PMID:39611308 | DOI:10.1177/14653125241283053

Eur Heart J Cardiovasc Pharmacother. 2024 Nov 28:pvae092. doi: 10.1093/ehjcvp/pvae092. Online ahead of print.

NO ABSTRACT

PMID:39611306 | DOI:10.1093/ehjcvp/pvae092

Biom J. 2024 Dec;66(8):e70014. doi: 10.1002/bimj.70014.

ABSTRACT

We develop a variable selection method for interactions in regression models on large data in the context of genetics. The method is intended for investigating the influence of single-nucleotide polymorphisms (SNPs) and their interactions on health outcomes, which is a p ≫ n $pgg n$ problem. We introduce cross leverage scores (CLSs) to detect interactions of variables while maintaining interpretability. Using this method, it is not necessary to consider every possible interaction between variables individually, which would be very time-consuming even for moderate amounts of variables. Instead, we calculate the CLS for each variable and obtain a measure of importance for this variable. Calculating the scores remains time-consuming for large data sets. The key idea for scaling to large data is to divide the data into smaller random batches or consecutive windows of variables. This avoids complex and time-consuming computations on high-dimensional matrices by performing the computations only for small subsets of the data, which is less costly. We compare these methods to provable approximations of CLS based on sketching, which aims at summarizing data succinctly. In a simulation study, we show that the CLSs are directly linked to the importance of a variable in the sense of an interaction effect. We further show that the approximation approaches are appropriate for performing the calculations efficiently on arbitrarily large data while preserving the interaction detection effect of the CLS. This underlines their scalability to genome wide data. In addition, we evaluate the methods on real data from the HapMap project.

PMID:39611288 | DOI:10.1002/bimj.70014

Euro Surveill. 2024 Nov;29(48). doi: 10.2807/1560-7917.ES.2024.29.48.2400759.

ABSTRACT

We analysed trends in new HIV diagnoses and factors contributing to late diagnosis among migrants in countries in the European Union (EU)/European Economic Area (EEA) from 2014 to 2023. Of the total reported HIV diagnoses, 45.9% were in migrants, with 13.3% born in EU/EEA countries and 86.7% in non-EU/EEA countries. Late diagnosis was observed in 52.4% of migrants, particularly among non-EU/EEA migrants with heterosexual transmission, regardless of sex. Improved HIV prevention and testing strategies are essential for at-risk migrant populations.

PMID:39611209 | DOI:10.2807/1560-7917.ES.2024.29.48.2400759