Tag: nevin manimala

Disabil Rehabil. 2023 Oct 11:1-19. doi: 10.1080/09638288.2023.2266178. Online ahead of print.

ABSTRACT

PURPOSE: The study aims to assess the efficacy of robot-assisted rehabilitation training on upper and lower limb motor function and fatigue in Parkinson’s disease (PD), and to explore the best-acting robotic rehabilitation program.

METHODS: We searched studies in seven databases and the search period was from the build to 30 June 2023. Two researchers independently screened studies and assessed the quality of the studies for data extraction.

RESULTS: A total of 21 studies were included, 18 studies related to lower limbs rehabilitation and 3 studies related to upper limbs rehabilitation, involving a total of 787 participants. The results showed that robot-assisted rehabilitation significantly improved indicators of lower limb motor function UPDRS Part III (WMD = -3.58, 95% CI = -5.91 to -1.25, p = 0.003) and BBS (WMD = 4.24, 95% CI = 2.88 to 5.54, p < 0.001), as well as non-motor symptoms of fatigue (WMD = -13.39, 95% CI = -17.92 to -8.86, p < 0.001) in PD patients. At the level of upper limb function, there was no statistically significant difference in the outcome measures of PFS (WMD = -0.25, 95% CI = -4.44 to 3.93, p = 0.9) and BBT (WMD = 1.73, 95% CI = -2.85 to 6.33, p = 0.458).

CONCLUSION: Robot-assisted rehabilitation significantly improved motor function, fatigue, and balance confidence in PD patients, but current evidence doesn’t show that intelligent rehabilitation systems improve upper limb function. In particular, robotics combined with virtual reality worked best.

PMID:37818694 | DOI:10.1080/09638288.2023.2266178

Folia Neuropathol. 2023;61(3):317-325. doi: 10.5114/fn.2023.131014.

ABSTRACT

INTRODUCTION: CD8 + T-cells and MHC-I have been detected in brain gliomas with a significant outcome. The effect of chemotherapies on the crosstalk interaction between CD8 + T-cells and MHC-I has never been explored.

MATERIAL AND METHODS: The protein expression profiling of CD8 cytotoxic T-cells and the gene expression assay of MHC-I in 35 patients diagnosed with WHO grade 4 astrocytoma were performed. The impact of these two factors on tumor recurrence was analyzed.

RESULTS: IDH was wildtype in 13 tumors. MHC-I protein expression was absent or low in 34 tumors and dense in a single case. MHC-I gene expression was upregulated in 10 tumors and 25 tumors showed MHC-I gene downregulation. Temozolomide (TMZ) was given to 24 patients and 11 patients received TMZ plus other chemotherapies. No statistically significant association was observed between IDH mutation and CD8 + T-cells ( p = 0.383). However, this association was significant in recurrence-free interval (RFI) ( p = 0.012). IDH-wildtype tumors with highly infiltrated CD8 + T-cells or IDH-mutant tumors with low CD8 + T-cells showed late tumor recurrence. There was a statistically significant difference in RFI between tumors with different MHC-I expression and CD8 + T-cell counts after treatment with TMZ or TMZ plus ( p = 0.026).

CONCLUSIONS: No association between IDH mutation and CD8+ cytotoxic T-cell was found. IDH is directly linked to tumor recurrence regardless of CD8 + T-cells infiltration. TMZ plus other adjuvants is proved to be more effective in improving patient survival and delaying tumor recurrence, as compared to using TMZ alone. Nonetheless, none-TMZ adjuvants may increase tumor sensitization to cytotoxic T-cells more than TMZ.

PMID:37818692 | DOI:10.5114/fn.2023.131014

J Int Med Res. 2023 Oct;51(10):3000605231200371. doi: 10.1177/03000605231200371.

ABSTRACT

OBJECTIVE: Esophageal varix (EV) bleeding is a particularly serious complications of cirrhosis. Prediction of EV bleeding requires extensive endoscopy experience; it remains unreliable and inefficient. This retrospective cohort study evaluated the feasibility of using deep learning (DL) to predict the 12-month risk of EV bleeding based on endoscopic images.

METHODS: Six DL models were trained to perform binary classification of endoscopic images of EV bleeding. The models were subsequently validated using an external test dataset, then compared with classifications performed by two endoscopists.

RESULTS: In the validation dataset, EfficientNet had the highest accuracy (0.910), followed by ConvMixer (0.898) and Xception (0.875). In the test dataset, EfficientNet maintained the highest accuracy (0.893), which was better than the endoscopists (0.800 and 0.763). Notably, one endoscopist displayed higher recall (0.905), compared with EfficientNet (0.870). When their predictions were assisted by artificial intelligence, the accuracies of the two endoscopists increased by 17.3% and 19.0%. Moreover, statistical agreement among the models was dependent on model architecture.

CONCLUSIONS: This study demonstrated the feasibility of using DL to predict the 12-month risk of EV bleeding based on endoscopic images. The findings suggest that artificial intelligence-aided diagnosis will be a useful addition to cirrhosis management.

PMID:37818651 | DOI:10.1177/03000605231200371

Network. 2023 Oct 11:1-37. doi: 10.1080/0954898X.2023.2257773. Online ahead of print.

ABSTRACT

Dimension reduction is one of the most sought-after strategies to cope with high-dimensional ever-expanding datasets. To address this, a novel deep-learning architecture has been designed with multiple deconstruction and single reconstruction layers for non-negative matrix factorization aimed at low-rank approximation. This design ensures that the reconstructed input matrix has a unique pair of factor matrices. The two-stage approach, namely, pretraining and stacking, aids in the robustness of the architecture. The sigmoid function has been adjusted in such a way that fulfils the non-negativity criteria and also helps to alleviate the data-loss problem. Xavier initialization technique aids in the solution of the exploding or vanishing gradient problem. The objective function involves regularizer that ensures the best possible approximation of the input matrix. The superior performance of MDSR-NMF, over six well-known dimension reduction methods, has been demonstrated extensively using five datasets for classification and clustering. Computational complexity and convergence analysis have also been presented to establish the model.

PMID:37818635 | DOI:10.1080/0954898X.2023.2257773

Nord J Psychiatry. 2023 Oct 11:1-7. doi: 10.1080/08039488.2023.2267032. Online ahead of print.

ABSTRACT

Objective: Borderline personality disorder (BPD) is a common disorder in healthcare settings but estimates of BPD prevalence vary greatly. This study aimed to estimate the one-year prevalence of BPD in psychiatric outpatients and analyze the psychiatric comorbidity presented with BPD.Method: The data comprised 18-60-year-old patients who had a BPD diagnosis recorded in their medical certificate B (mcB) and were treated in specialized psychiatric outpatient services in the city of Oulu, northern Finland, in 2014. An mcB is a comprehensive summary of a patient’s medical history written by a doctor, and patients need it in the Finnish healthcare system when applying for social benefits and rehabilitation measures.Results: The prevalence of BPD was 12.8% among patients with an mcB treated in the psychiatric outpatient services. BPD was 3.0 times more common in female than male psychiatric outpatients with an mcB. The most common comorbid psychiatric disorders written in mcBs of BPD patients were mood (81.0%) and anxiety (39.2%) disorders. The only statistically significant gender difference was found in behavioral and emotional disorders (16.7% in men, 1.6% in women).Conclusions: The mcB-based BPD prevalence estimate and psychiatric comorbidity was consistent with previous studies researching psychiatric outpatients with BPD. McBs appear to be a reliable and comprehensive data source for diagnostic information in research.

PMID:37818619 | DOI:10.1080/08039488.2023.2267032

Hosp Pediatr. 2023 Oct 11:he2022007037. doi: 10.1542/hpeds.2022-007037. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Late preterm (LPT) and low birth weight (LBW) infants are populations at increased risk for NICU admission, partly due to feeding-related conditions. This study was aimed to increase the percentage of LPT and LBW infants receiving exclusive nursery care using quality improvement methodologies.

METHODS: A multidisciplinary team implemented interventions at a single academic center. Included infants were 35 to 36 weeks gestational age and term infants with birth weights <2500 g admitted from the delivery room to the nursery. Drivers of change included feeding protocol, knowledge, and care standardization. We used statistical process control charts to track data over time. The primary outcome was the percentage of infants receiving exclusive nursery care. Secondary outcomes included rates of hypoglycemia, phototherapy, and average weight loss. Balancing measures were exclusive breast milk feeding rates and length of stay.

RESULTS: Included infants totaled 1336. The percentage of LPT and LBW infants receiving exclusive nursery care increased from 83.9% to 88.8% with special cause variation starting 1 month into the postintervention period. Reduction in neonatal hypoglycemia, 51.7% to 45.1%, coincided. Among infants receiving exclusive nursery care, phototherapy, weight loss, exclusive breast milk feeding, and length of stay had no special cause variation.

CONCLUSIONS: Interventions involving a nursery feeding protocol, knowledge, and standardization of care for LPT and LBW infants were associated with increased exclusive nursery care (4.9%) and reduced rates of neonatal hypoglycemia (6.6%) without adverse effects. This quality initiative allowed for the preservation of the mother-infant dyad using high-value care.

PMID:37818615 | DOI:10.1542/hpeds.2022-007037

Comb Chem High Throughput Screen. 2023 Oct 10. doi: 10.2174/0113862073247219230927050009. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Remimazolam is a water-soluble sedative-anesthetic with short-acting properties and less hemodynamic effects. Currently, it is primarily used for gastroenteroscopy sedation. The aim of this study is to investigate the effectiveness and safety of Remimazolam as an alternative intravenous anesthetic agent in surgical patients, in order to expand clinical options beyond Propofol.

METHODS: Eighty patients aged 20-69 and classified as an American Society of Anesthesiologists physical status I-II were randomly assigned to either the Remimazolam group (RM group) or the Propofol group (PR group) for anesthesia induction and maintenance. Hemodynamics and Bispectral Index (BIS) were recorded before and after anesthesia, along with other relevant indices such as the time, to loss of consciousness (LoC), operation time, anesthesia time, awakening time, the number of cases of injection site pain. Additionally, the Ramsay sedation score, intraoperative awareness, dreaming, and postoperative adverse events were also assessed.

RESULTS: After anesthesia, both groups experienced a significant decrease in blood pressure compared to baseline values, however, the reduction in blood pressure was less significant in the RM group than in the PR group (P<0.05). The heart rate of patients in the RM group remained relatively stable at all time points. There were significantly more cases of injection site pain and use of pressor or atropine during operation observed in the PR group compared to the RM group (P<0.05). There were no significant differences between the two groups in terms of time to loss of consciousness, anesthesia time, operation time, awakening time, and intraoperative awareness (P>0.05). However, at 5 and 30 minutes after awakening, the Ramsay sedation score was significantly better in the RM group compared to the PR group (P<0.05).

CONCLUSION: When remimazolam is used for intravenous anesthesia induction and maintenance, it can achieve a favorable anesthetic effect while maintaining a relatively stable blood pressure and heart rate. Patients experience shorter awakening times (8.3±3.7 min), better awakening quality (5min Ramsay sedation score is 2 points ), and no intraoperative awareness.

TRIAL REGISTRATION NUMBER: AF SOP/3.6-01/5.1.

PMID:37818571 | DOI:10.2174/0113862073247219230927050009

Curr Med Chem. 2023 Oct 10. doi: 10.2174/0109298673245890231004152136. Online ahead of print.

ABSTRACT

BACKGROUND: Indomethacin is a non-steroidal anti-inflammatory drug (NSAID) used for medication to reduce fever, spondylitis, or shoulder pain. It mainly works by the inhibition of prostaglandins, the endogenous signaling molecules.

METHODS: Fifteen indomethacin derivatives have been analyzed in relation to their physicochemical and molecular properties. Two-dimensional (2D) structures of fifteen indomethacin derivatives were drawn using the ACD Lab Chem Sketch version. Most of the topological parameters, such as wiener index (W), mean wiener index (Wa), Balaban indices (J), Balaban centric index (BAC), and molecular connectivity (χ), were calculated by using E Dragon software. The most common molecular file formats accepted in E-Dragon software were SMILES notations created online by Babel software and 2D structures of various derivatives, which were converted into 3D optimized structures using online CORINA, provided by Molecular Networks GMBH. 3D structures of compounds were also drawn on Gauss View software for calculations of various density functional theory (DFT) based quantum chemical descriptors, such as total energy (TE), softness (S), hardness (η), chemical potential (μ), highest occupied molecular orbital energy (HOMO), and lowest unoccupied molecular orbital energy (LUMO). All species were fully optimized in the gas phase with a 6-31+G* basis set. The harmonic vibrational frequency calculations were used to confirm that the optimized structures were minima, as characterized by positive vibrational frequencies.

RESULTS: Combinations of various descriptors, such as D, ID, IOR, Log P, Mr, Mv, Mw, Pc, BAC, Pz, St, W, Wa, 0χ, 1χ, 2χ,3χ,4χ, 5χ, and Xeq have been found to be significant for modeling of activity. QSAR model no. 2: pIC50= -20.605 (±6.600) IOR – 0.747 (±0.454) I1 -5.083 (±3.478) Xeq + 51.647 optimized with empirical parameters with high statistical quality (R= 0.921, R2=0.848) was found to be the best model obtained.

CONCLUSION: The QSAR model obtained suggests that substituents with a lesser value of the index of refraction and less electronegative groups were favourable for the activity, whereas indomethacin derivatives with a CH2CH2NHCONH (CH2)3ONO2 group at R1 position were unfavourable for the activity. The results were critically discussed based on regression data and cross-validation techniques. Pogliani factor Q and the results of the LOO (leave-one-out) method confirmed the reliability and predictability of the proposed models that could be highly beneficial for the future designing of new analogues with higher potency.

PMID:37818563 | DOI:10.2174/0109298673245890231004152136

Zhonghua Kou Qiang Yi Xue Za Zhi. 2023 Oct 9;58(10):1034-1040. doi: 10.3760/cma.j.cn112144-20230814-00075. Online ahead of print.

ABSTRACT

Objective: To investigate and analyze the allocation status of oral health resources in Yunnan Province at the end of the 13th Five-Year Plan, providing a scientific basis for the rational resource allocation and formulation regional oral health plan for government health administrative departments. Methods: With the method of general survey, a cross-sectional study was conducted to investigate the allocation of material and human resources of all kinds of stomatological medical institutions registered in the health administrative departments in Yunnan before January 1, 2020. The general situation of oral health resources was analyzed by descriptive statistical analysis. Results: There were 2 712 stomatological medical institutions in Yunnan, 634 public and 2 078 non-public included. The largest number was in Kunming (1 167) and the least in Diqing (19). There were 9 018 dental chairs in total, among which 2 584 in public and 6 434 in non-public. Kunming had the largest number of chairs (3 612) and Nujiang had the least (57). There were 702 oral and maxillofacial surgical beds, all of which were distributed in public. There were 15 148 stomatological personnel, including 3 667 in public and 11 481 in non-public. The average ratio of stomatologist to population was 1∶6 615. Dehong (1∶6 620) was close to this average level, while Kunming (1∶2 283) and Yuxi (1∶4 936) were lower than the average and the other 13 states (cities) were higher. The population ratio of licensed stomatologist was only 1∶9 110. The average ratio of stomatologist to nurses was 1∶0.94. Honghe (1∶1.05), Kunming (1∶1.00), Yuxi (1∶1.18) and Qujing (1∶0.94) was better than or reached the average level, while the other 13 states (cities) were lower than this average. And this ratio in public comprehensive medical institutions was only 1∶0.38. Conclusions: The distribution of oral health resources in Yunnan was unbalanced between public and non-public institutions and among states (cities), mainly distributed in economically developed states (cities) and non-public institutions. For the oral health in Yunnan Province, the workforce was insufficient and the structure was unreasonable, and the proportion of nurses was seriously insufficient in public comprehensive medical institutions.

PMID:37818539 | DOI:10.3760/cma.j.cn112144-20230814-00075

Zhonghua Kou Qiang Yi Xue Za Zhi. 2023 Oct 9;58(10):1027-1033. doi: 10.3760/cma.j.cn112144-20230817-00089. Online ahead of print.

ABSTRACT

Objective: To analyze the temperature difference of benign and malignant parotid gland tumors in preoperative infrared thermography (IRT), and to provide the basis for predicting tumor properties. Methods: The clinical data of 98 patients with parotid gland tumor admitted to the Department of Oral and maxillofacial Surgery of the First Affiliated Hospital of Bengbu Medical College, from May 2021 to April 2023 were retrospectively analyzed. There were 61 males and 37 females, aged (51.1±16.0)years (10-86 years). In addition to routine examination, the temperature difference between the lesion site of parotid gland and the contralateral mirror area was measured by infrared thermal imager in all patients one day before surgery. The maximum diameter (dmax) and location of the tumor (deep or superficial lobe) were recorded according to preoperative clinical examination and imaging examinations such as CT and ultrasound. The patients were divided into three groups by tumor size: dmax≤2 cm, 2 cm<dmax≤4 cm, dmax>4 cm. The patients were also divided into different groups: deep lobe group and superficial lobe group (according to the tumor location), benign group and malignant group (according to postoperative pathological results). The relationship between temperature difference, pathology, size and location was analyzed. Results: There were 79 cases in the benign group and 19 cases in the malignant group. The temperature difference of the healthy and affected side in the malignant group [(1.73±0.21) ℃] was significantly higher than that in the benign group [(0.73±0.32) ℃] (t=16.70, P<0.001). There was no significant difference in temperature difference between the healthy and affected sides of tumors with different diameters (P>0.05). The temperature difference of healthy and affected side of tumor in superficial lobe [(0.97±0.50) ℃] was significantly higher than that in deep lobe [(0.67±0.44) ℃] (t=2.24, P=0.028). Conclusions: The difference of temperature difference between benign and malignant parotid gland tumors detected by IRT is statistically significant, which can be used to predict tumor properties, and has certain clinical application value.

PMID:37818538 | DOI:10.3760/cma.j.cn112144-20230817-00089