Tag: nevin manimala

Alzheimer Dis Assoc Disord. 2023 Jan-Mar 01;37(1):35-41. doi: 10.1097/WAD.0000000000000542. Epub 2023 Feb 23.

ABSTRACT

INTRODUCTION: Atherosclerosis has been shown to impact cognitive impairment, with most of the evidence originating from European, African, or East Asian populations that have employed carotid intima-media thickness (cIMT) as a biomarker for atherosclerosis. Vascular disease is related to dementia/cognitive decline. There is no community-based study from India that has looked at the association of cIMT with cognitive performance.

METHODS: In this cross-sectional study between December 2014 and 2019, we recruited 7505 persons [(mean age 64.6 (9.2) y) and 50.9% women] from a community-dwelling population in New Delhi. These persons underwent carotid ultrasound to quantify cIMT and a cognitive test battery that tapped into memory, processing speed, and executive function. We also computed the general cognitive factor (g-factor), which was identified as the first unrotated component of the principal component analysis and explained 37.4% of all variances in the cognitive tests. We constructed multivariate linear regression models adjusted for age, sex, education, and cardiovascular risk factors. Additional adjustment was made for depression, anxiety, and psychosocial support in the final model.

RESULTS: We found a significant association of higher cIMT with worse performance in general cognition (β=-0. 01(95% CI: -0.01; -0.01); P<0.001), processing speed (β=-0.20; 95% CI: -0.34; -0.07); P=0.003), memory (β=-0.29; 95% CI: -0.53; -0.05); P=0.016), and executive function (β=-0.54; 95% CI: -0.75; -0.33); P=<0.001). There was no statistically significant association of cIMT with Mini-Mental Status Examination score (β=0.02; 95% CI: -0.34; 0.40; 0.89).

CONCLUSION: The cross-sectional study found significant associations of increased cIMT with worse performance in global cognition, information processing, memory, and executive function.

PMID:36821176 | DOI:10.1097/WAD.0000000000000542

Appl Opt. 2023 Feb 1;62(4):844-860. doi: 10.1364/AO.478668.

ABSTRACT

This study proposes a color image encryption method combining Fresnel diffraction, multi-phase retrieval, and hyperchaotic mapping in two stages. First, the color image is converted into an amplitude-type computer-generated hologram (CGH) that overlaps in the frequency domain and separates in the spatial domain. The Gerchberg-Saxton (GS) multi-phase retrieval algorithm encrypts the CGH into a meaningless ciphertext in the second stage, scrambling/diffusing it further using four random sequences generated from the Lorenz hyperchaotic system. The experiment on public color images shows that the decrypted color images are highly consistent with plaintext images. This method’s key has a large space (approximately 10^∧301) and a small volume. Slight changes to the plaintext completely alter the ciphertext, and its pixel values are statistically independent, thus securing the proposed method against chosen-plaintext attacks and chosen-ciphertext attacks.

PMID:36821148 | DOI:10.1364/AO.478668

J Urol. 2023 Feb 23:101097JU0000000000003390. doi: 10.1097/JU.0000000000003390. Online ahead of print.

ABSTRACT

PURPOSE: Although Children’s Oncology Group renal tumor protocols mandate lymph node sampling (LNS) during extirpative surgery for pediatric renal tumors, LNS is often omitted or low yield. Concerns over morbidity associated with extended LNS have led to hesitancy in adopting a formal LNS template. We hypothesized that complications in children undergoing LNS for renal tumors would be rare, and not associated with the number of LNs sampled.

METHODS: A single-institution, retrospective review of patients aged 0-18yrs undergoing extirpative renal surgery with LNS for a suspected malignancy between 2005-2019 was performed. Patients with 0 or an unknown number of LNs sampled or <150 days of follow-up were excluded. A “clinically significant” (CS) complication was defined as any Clavien-Dindo complication ≥ III, small bowel obstruction (SBO), chylous ascites, organ injury, or wound infection. The number of LNs sampled and its influence on the odds of experiencing a CS complication was examined.

RESULTS: 144 patients met inclusion criteria. Median patient age was 38 months. Twenty-one patients (15%) had a CS complication, the most common of which was ileus/SBO (n = 16). In a multivariable analysis, increased LN yield was not found to influence the odds of experiencing a CS complication (P = .6).

CONCLUSIONS: In this cohort, there was no statistically significant difference in CS complications in patients who underwent more extensive LNS during surgery for a suspected malignant pediatric renal tumor. Future studies on protocol adherence, staging accuracy, and survival trends using a LNS template in these patients should be performed.

PMID:36821137 | DOI:10.1097/JU.0000000000003390

JAMA Otolaryngol Head Neck Surg. 2023 Feb 23. doi: 10.1001/jamaoto.2022.5186. Online ahead of print.

ABSTRACT

IMPORTANCE: Clear surgical margins reduce the risk of local recurrence, improve survival, and determine decision-making with regard to adjuvant treatment of squamous cell carcinoma of the head and neck (SCCHN). However, the definitions of clear, close, or positive surgical margins vary in both the literature and in practice.

OBJECTIVE: To examine whether the association between surgical margin distance and survival varies by primary tumor site.

DESIGN, SETTING, AND PARTICIPANTS: This was a secondary analysis of a multi-institutional, multinational randomized clinical trial. The trial enrolled patients from January 22, 2007, to March 29, 2013, with stage II to IVA resected SCCHN with extranodal extension (ENE) or positive margins (<5 mm from invasive tumor to the resected margin). The current analysis included those patients with known ENE and margin status and was conducted from April 29, 2022, to December 19, 2022.

INTERVENTIONS: Patients received adjuvant chemoradiotherapy plus either placebo or lapatinib.

MAIN OUTCOMES AND MEASURES: Overall survival (OS) was calculated to examine association with surgical margin distance, primary site, and survival, with stratification by ENE status.

RESULTS: Among 688 patients enrolled in the trial, 630 patients with known ENE and margin status were included. Exact patient ages were not made available; 523 (83%) patients were male, and 415 (66%) patients were White. Patients with 1 high-risk feature (positive margins or ENE) had significantly better OS vs 2 high-risk features (hazard ratio [HR], 0.65; 95% CI, 0.49-0.87), although most other results were not statistically significant. For example, in the cohort with ENE-negative disease, multivariable adjusted analysis showed nonsignificant improvements with shorter surgical margin distance (1- to 5-mm margins), and no association with OS was found in the cohort with ENE-positive status (either >5 mm margins or 1-5 mm margins). The association between survival and margin distance varied based on primary site, human papillomavirus (HPV) status, and ENE status. For example, HPV-positive status was associated with a significant and clinically meaningful increase in survival (adjusted HR, 0.33; 95% CI, 0.11-0.97). The improvement was greatest, although not significantly so, in patients with ENE- and HPV-negative oropharynx (OP), hypopharynx (HP), and larynx cancer (HR, 0.57; 95% CI, 0.30-1.10). No survival benefit was seen in ENE-negative oral cavity cancer (HR, 0.89; 95% CI, 0.45-1.77), nor was an association observed between margins and OS in HPV-positive OP cancer.

CONCLUSIONS AND RELEVANCE: In this secondary analysis of a randomized clinical trial, the presence of high-risk features (extranodal extension, positive margins, or both) was associated with worse survival; longer survival was observed with greater surgical margin distance among patients with oral cavity tumors and human papillomavirus-negative tumors of the OP, larynx, or HP. No other significant differences were found. These findings support variable interpretation of surgical margin distance based on the primary site and HPV status.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00424255.

PMID:36821132 | DOI:10.1001/jamaoto.2022.5186

JAMA Netw Open. 2023 Feb 1;6(2):e230070. doi: 10.1001/jamanetworkopen.2023.0070.

ABSTRACT

IMPORTANCE: Conditional cash transfers (CCTs) have been consistently associated with improvements to the determinants of maternal health, but there have been insufficient investigations regarding their effects on maternal mortality.

OBJECTIVE: To evaluate the association between being a Bolsa Família program (BFP) beneficiary and maternal mortality and to examine how this association differs by duration of BFP receipt, maternal race, living in rural or urban areas, the Municipal Human Development Index (MHDI), and municipal primary health care coverage.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis was nested within the 100 Million Brazilian Cohort. Girls and women aged 10 to 49 years (hereinafter referred to as women) who had at least 1 live birth were included, using data from Brazilian national health databases linked to the 100 Million Brazilian Cohort (January 1, 2004, to December 31, 2015). Propensity score kernel weighting was applied to control for sociodemographic and economic confounders in the association between BFP receipt and maternal mortality, overall and stratified by different subgroups (race, urban or rural area, and MHDI), and duration of BFP receipt. Data were analyzed from July 12, 2019, to December 31, 2022.

MAIN OUTCOME(S) AND MEASURES: Maternal death.

RESULTS: A total of 6 677 273 women aged 10 to 49 years were included in the analysis, 4056 of whom had died from pregnancy-related causes. The risk of maternal death was 18% lower in women who received BFP (weighted odds ratio [OR], 0.82 [95% CI, 0.71-0.93]). A longer duration receiving BFP was associated with an increased reduction in maternal mortality (OR for 1-4 years, 0.85 [95% CI, 0.75-0.97]; OR for 5-8 years, 0.70 [95% CI, 0.60-0.82]; OR for ≥9 years, 0.69 [95% CI, 0.53-0.88]). Receiving BFP was also associated with substantial increases in the number of prenatal appointments and interbirth intervals. The reduction was more pronounced in the most vulnerable groups.

CONCLUSIONS AND RELEVANCE: This cross-sectional analysis nested within the 100 Million Brazilian Cohort found an association between BFP receipt and maternal mortality. This association was of greater magnitude in women with longer exposure to BFP and in the most vulnerable groups. These findings reinforce evidence that programs such as BFP, which have already proven effective in poverty reduction, have great potential to improve maternal survival.

PMID:36821115 | DOI:10.1001/jamanetworkopen.2023.0070

JAMA Netw Open. 2023 Feb 1;6(2):e230569. doi: 10.1001/jamanetworkopen.2023.0569.

ABSTRACT

IMPORTANCE: Cardiotoxicity is a serious adverse effect that can occur in women undergoing treatment for breast cancer. Identifying patients who will develop cardiotoxicity remains challenging.

OBJECTIVE: To identify, describe, and evaluate all prognostic models developed to predict cardiotoxicity following treatment in women with breast cancer.

EVIDENCE REVIEW: This systematic review searched the Medline, Embase, and Cochrane databases up to September 22, 2021, to include studies developing or validating a prediction model for cardiotoxicity in women with breast cancer. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess both the risk of bias and the applicability of the prediction modeling studies. Transparency reporting was assessed with the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) tool.

FINDINGS: After screening 590 publications, we identified 7 prognostic model studies for this review. Six were model development studies and 1 was an external validation study. Outcomes included occurrence of cardiac dysfunction (echocardiographic parameters), heart failure, and composite clinical outcomes. Model discrimination, measured by the area under receiver operating curves or C statistic, ranged from 0.70 (95% IC, 0.62-0.77) to 0.87 (95% IC, 0.77-0.96). The most common predictors identified in final prediction models included age, baseline left ventricular ejection fraction, hypertension, and diabetes. Four of the developed models were deemed to be at high risk of bias due to analysis concerns, particularly for sample size, handling of missing data, and not presenting appropriate performance statistics. None of the included studies examined the clinical utility of the developed model. All studies met more than 80% of the items in TRIPOD checklist.

CONCLUSIONS AND RELEVANCE: In this systematic review of the 6 predictive models identified, only 1 had undergone external validation. Most of the studies were assessed as being at high overall risk of bias. Application of the reporting guidelines may help future research and improve the reproducibility and applicability of prediction models for cardiotoxicity following breast cancer treatment.

PMID:36821108 | DOI:10.1001/jamanetworkopen.2023.0569

Lifetime Data Anal. 2023 Feb 23. doi: 10.1007/s10985-023-09590-y. Online ahead of print.

ABSTRACT

Survival causal effect estimation based on right-censored data is of key interest in both survival analysis and causal inference. Propensity score weighting is one of the most popular methods in the literature. However, since it involves the inverse of propensity score estimates, its practical performance may be very unstable, especially when the covariate overlap is limited between treatment and control groups. To address this problem, a covariate balancing method is developed in this paper to estimate the counterfactual survival function. The proposed method is nonparametric and balances covariates in a reproducing kernel Hilbert space (RKHS) via weights that are counterparts of inverse propensity scores. The uniform rate of convergence for the proposed estimator is shown to be the same as that for the classical Kaplan-Meier estimator. The appealing practical performance of the proposed method is demonstrated by a simulation study as well as two real data applications to study the causal effect of smoking on survival time of stroke patients and that of endotoxin on survival time for female patients with lung cancer respectively.

PMID:36821062 | DOI:10.1007/s10985-023-09590-y

Environ Monit Assess. 2023 Feb 23;195(3):424. doi: 10.1007/s10661-023-11023-0.

ABSTRACT

The Chao Phraya River Deltaic Plain is the largest basin in Thailand and the second largest one in Southeast Asia after the Mekong River Delta. In recent decades, the groundwater quality in the Lower Chao Phraya River Basin in Thailand has deteriorated due to salinization caused by seawater intrusion. In the present study, hydrogeochemical and statistical methods were employed to determine the hydrochemical characteristics of the groundwater and to investigate the possible sources of salinity in the study region for the years 2008 and 2020. In addition, samples were taken from precipitation, sea water, and river water to analyze their hydrochemical properties. Then, they were used as input in the “Simmr” code in the R programming language to model the hydrochemical conditions of the study area and their evolution over time. The results indicated that in the non-coastal regions, water-rock interaction (mineral weathering and ion exchange), and brine/connate water infiltration affected the quality of the groundwater. However, the seawater intrusion was limited only to the coastal regions. Furthermore, the groundwater quality deteriorated from 2008 to 2020. Finally, using stepwise regression in the R language, the salinity of the groundwater was simulated and compared with the measured salinity data. The results obtained by the stepwise model were in close agreement with those obtained from the hydrochemical studies. This study confirmed seawater intrusion in the coastal aquifer as well as the deterioration of groundwater quality over time. To slow down this process and to achieve sustainable conditions, groundwater extraction should be reduced in the study region.

PMID:36821059 | DOI:10.1007/s10661-023-11023-0

Arch Orthop Trauma Surg. 2023 Feb 23. doi: 10.1007/s00402-023-04814-0. Online ahead of print.

ABSTRACT

BACKGROUND: Proximal humeral shaft fractures are surgically challenging and plate osteosynthesis with a long straight plate is one operative treatment option in these patients although endangering the radial nerve distally. Helical plates potentially avoid the radial nerve by twisting around the humeral shaft. Aim of the study was to investigate in a human cadaveric model the biomechanical competence of helical plates versus straight lateral plates used for fixation of proximal third comminuted humeral shaft fractures.

METHODS: Eight pairs of humeral cadaveric humeri were instrumented using either a long 90°-helical plate (Group1) or a straight long PHILOS plate (Group2). An unstable proximal humeral shaft fracture was simulated by means of a 5 cm osteotomy gap. All specimens were tested under quasi-static loading in axial compression, internal and external rotation, and bending in four directions. Subsequently, progressively increasing cyclic loading in internal rotation until failure was applied and interfragmentary movements were monitored by motion tracking.

RESULTS: During static testing flexion/extension deformation in Group1 was significantly higher, however, varus/valgus deformation as well as shear and torsional displacement under torsional load remained statistically indifferent between both groups. During cyclic testing shear and torsional displacements were both significantly higher in Group1 compared to Group 2. However, cycles to catastrophic failure remained statistically indifferent between the groups.

CONCLUSIONS: From a biomechanical perspective, although 90°-helical plating is associated with higher initial stability against varus/valgus collapse and comparable endurance under dynamic loading, it demonstrates lower resistance to flexion/extension and internal rotation with bigger shear interfragmentary displacements versus straight lateral plating and, therefore, cannot be considered as its real alternative. Alternative helical plate designs should be investigated in the future.

PMID:36821049 | DOI:10.1007/s00402-023-04814-0

Reprod Sci. 2023 Feb 23. doi: 10.1007/s43032-023-01194-z. Online ahead of print.

ABSTRACT

Polycystic ovary syndrome (PCOS) is an endocrine-metabolic syndrome that involves hyperandrogenism, menstrual irregularities, and/or small cysts in one or both ovaries which might lead to infertility in women. The genetics of PCOS is heterogenous with the involvement of several genes reported in the hypothalamic-pituitary-gonadal axis. Follicular growth and steroidogenesis regulation are both critically dependent on follicle-stimulating hormone (FSH). The variants of FSHR cause abnormal folliculogenesis, steroidogenesis, and oocyte maturation at various stages of growth and may render women more susceptible to PCOS development. The present case-control study evaluated the association of FSHR rs6165 and rs6166 variants with PCOS. A total of 743 females were recruited. PCR-RFLP method was used for the genotypic analysis of FSHR polymorphisms. Obesity was examined according to the categorization of body mass index (BMI) and waist-hip ratio (WHR). Biochemical analysis, including a lipid profile, LH, FSH, and testosterone levels, was done in both PCOS women and controls. BMI and WHR revealed a statistically significant difference between PCOS cases and controls. Overall, levels of HDL were significantly lower, whereas cholesterol, triglycerides, LDL, and VLDL levels were higher in PCOS women (p < 0.05). The genotypic and allelic frequencies of rs6165 and rs6166 did not demonstrate significant differences when PCOS women were compared with the control group. However, clinical features of PCOS including gonadotropic hormone (FSH), hyperandrogenism, and dyslipidemia were significantly correlated with variants of FSHR. The present study concludes that rs6165 and rs6166 were significantly related to clinical features of PCOS, regardless of providing direct disease risk.

PMID:36821034 | DOI:10.1007/s43032-023-01194-z