Tag: nevin manimala

Diagn Interv Radiol. 2023 Mar 29;29(2):244-250. doi: 10.5152/dir.2022.21562. Epub 2023 Feb 27.

ABSTRACT

PURPOSE: To investigate the diagnostic efficiency of the kinetic curves of enhanced lesions on contrast-en-hanced spectral mammography (CESM) and whether they were similar to those of magnetic resonance imaging (MRI).

METHODS: Two hundred and twelve patients with 222 enhanced lesions were included in this prospective study. Single-view craniocaudal of an affected breast was acquired at 3, 5, and 7 min after contrast media injection. The kinetic patterns of each lesion were evaluated and classified as elevated (type I), steady (type II), and depressed (type III). Statistical comparison used the chi-squared test, the receiver operating characteristic (ROC) curve, and Cohen’s kappa.

RESULTS: Of 222 enhanced lesions, 140 were breast cancers, and 82 were benign lesions. The distribution of the kinetic curves for breast cancer was type I, 3.57%, type II, 35.71%, and type III, 60.72%. As for benign lesions, the distribution was type I, 43.90%, type II, 45.12%, and type III, 10.98%. The difference in the enhancement patterns between benign lesions and breast cancers was significant (P < 0.001). The likelihood of breast cancer related to a type I, II, and III curve was 12.20%, 57.47%, and 90.43%, respectively. For the enhancement intensity, the area under curve (AUC) of the ROC curves was 0.702 ± 0.036; for enhancement patterns, the AUC increased to 0.819 ± 0.030. Cohen’s kappa coefficient was 0.752 (P < 0.001) regarding the kinetic curves for CESM and MRI.

CONCLUSION: The kinetic patterns on CESM show promise in differentiating between benign lesions and breast cancers, with good agreement, when compared with MRI.

PMID:36987842 | DOI:10.5152/dir.2022.21562

Diagn Interv Radiol. 2023 Mar 29;29(2):234-243. doi: 10.5152/dir.2022.21266. Epub 2023 Feb 6.

ABSTRACT

PURPOSE: This study aimed to determine the accuracy of texture analysis in differentiating adrenal lesions on unenhanced computed tomography (CT) images.

METHODS: In this single-center retrospective study, 166 adrenal lesions in 140 patients (64 women, 76 men; mean age 56.58 ± 13.65 years) were evaluated between January 2015 and December 2019. The lesions consisted of 54 lipid-rich adrenal adenomas, 37 lipid-poor adrenal adenomas (LPAs), 56 adrenal metastases (ADM), and 19 adrenal pheochromocytomas (APhs). Each adrenal lesion was segmented by manually contouring the borders of the lesion on unenhanced CT images. A texture analysis of the CT images was performed using Local Image Feature Extraction software. First-order and second-order texture parameters were assessed, and 45 features were extracted from each lesion. One-Way analysis of variance with Bonferroni correction and the Mann-Whitney U test was performed to determine the relationships between the texture features and adrenal lesions. Receiver operating characteristic curves were performed for lesion discrimination based on the texture features. Logistic regression analysis was used to generate logistic models, including only the texture parameters with a high-class separation capacity (i.e., P < 0.050). SPSS software was used for all statistical analyses.

RESULTS: First-order and second-order texture parameters were identified as significant factors capable of differentiating among the four lesion types (P < 0.050). The logistic models were evaluated to ascertain the relationships between LPA and ADM, LPA and APh, and ADM and APh. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the first model (LPA vs. ADM) were 85.7%, 70.3%, 81.3%, 76.4%, and 79.5%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of the second model (LPA vs. APh) were all 100%. The sensitivity, specificity, PPV, NPV, and accuracy of the third model (ADM vs. APh) were 87.5%, 82%, 36.8%, 98.2%, and 82.7%, respectively.

CONCLUSION: Texture features may help in the characterization of adrenal lesions on unenhanced CT images.

PMID:36987841 | DOI:10.5152/dir.2022.21266

Exp Clin Transplant. 2023 Mar;21(3):245-250. doi: 10.6002/ect.2022.0417.

ABSTRACT

OBJECTIVES: In right lobe living donor liver transplant, proper reconstruction of the segment 5 vein and segment 8 vein is essential. Herein, we compared 2 different techniques for segment 5 vein reconstruction.

MATERIALS AND METHODS: This prospective nonrandomized study included all recipients of modified right lobe living donor liver transplant who had reconstruction of the segment 5 vein, with or without segment 8 veins, from October 2018 to October 2021. Patients were grouped into group A (classical technique) and group B (modified technique). For group A, the segment 5 (and segment 8, if present) vein was anastomosed in an end-to-side fashion to a polytetrafluoroethylene synthetic graft positioned parallel to the cut surface of the liver graft; then, during implant, its proximal end was anastomosed to recipient’s middle hepatic or middle-left hepatic veins unified orifice. In group B (modified technique), the stumps of segment 5 (and segment 8 if present) were anastomosed in an end-to-end fashion to 2 different polytetrafluoroethylene grafts; then during implant, the other ends of the segment 5 grafts were anastomosed directly to the inferior vena cava. Postoperative segment 5 vein patency and graft recovery were compared.

RESULTS: Forty patients were included: 22 in group A and 18 group B. There were no significant differences in the demographic data or characteristics of donors, grafts, and recipients between the groups. There was better patency in segment 5 synthetic grafts in group A at all time points compared with group B, but this difference was statistically significant only at 1 month (18 [81.8%] vs 9 [50%, respectively; P = .046).There was no statistically significant difference in the markers of graft recovery in both groups.

CONCLUSIONS: Reconstruction of the segment 5 vein by polytetrafluoroethylene synthetic graft in a fashion to resemble the native middle hepatic vein in modified right lobe living donor liver transplant has better patency than anastomosis of the segment 5 vein in an end-to-end fashion to the synthetic graft and then to the inferior vena cava. Both techniques did not affect graft recovery.

PMID:36987800 | DOI:10.6002/ect.2022.0417

Exp Clin Transplant. 2023 Mar;21(3):211-215. doi: 10.6002/ect.2023.0028.

ABSTRACT

OBJECTIVES: Given the shortage of kidney donations relative to the ever-increasing demand, there is an ongoing need to utilize available donor organs efficiently and fairly. The purpose of the deceased donor Kidney Allocation System is to optimize and equalize organ access for candidates nationwide. We investigated the outcomes of kidney transplant cases before and after the new allocation placement in March 2021 and the effect of the new allocation system on these outcomes.

MATERIALS AND METHODS: We retrospectively reviewed the medical records of the recipients. Outcomes in recipients of renal allografts were compared before and after the changes in March 2021 to the Kidney Allocation System.

RESULTS: There were 333 (73.7%) renal allografts transplanted before the 2021 new allocation, and 119 (26.3%) recipients received their renal allografts after the new allocation. The rate of delayed graft function was 33.3% in the preallocation group and 38.65% in the postallocation group (P = .29). The rate for patient readmission within 30 days was compared between the groups and did not show a statistically significant difference (37.8% vs 39.5%; P = .75). The 1-year graft survival rate was 97.5% in the postallocation group and 95.5% in the preallocation group (P = .526). The 1-year patient survival rate was 98.3% in the postallocation group and 95.8% in the preallocation group (P = .499).

CONCLUSIONS: This study provides reassurance in finding no statistically significant differences between patient outcomes before and after the implementation of the March 2021 change to the Kidney Allocation System. However, the new allocation measures would help for a more equal distribution of the kidneys.

PMID:36987797 | DOI:10.6002/ect.2023.0028

J Health Popul Nutr. 2023 Mar 28;42(1):24. doi: 10.1186/s41043-023-00366-6.

ABSTRACT

BACKGROUND: A preponderance of evidence suggests that higher income inequality is associated with poorer population health, yet recent research suggests that this association may vary based on other social determinants, such as socioeconomic status (SES) and other geographic factors, such as rural-urban status. The objective of this empirical study was to assess the potential for SES and rural-urban status to moderate the association between income inequality and life expectancy (LE) at the census-tract level.

METHODS: Census-tract LE values for 2010-2015 were abstracted from the US Small-area Life Expectancy Estimates Project and linked by census tract to Gini index, a summary measure of income inequality, median household income, and population density for all US census tracts with non-zero populations (n = 66,857). Partial correlation and multivariable linear regression modeling was used to examine the association between Gini index and LE using stratification by median household income and interaction terms to assess statistical significance.

RESULTS: In the four lowest quintiles of income in the four most rural quintiles of census tracts, the associations between LE and Gini index were significant and negative (p between < 0.001 and 0.021). In contrast, the associations between LE and Gini index were significant and positive for the census tracts in the highest income quintiles, regardless of rural-urban status.

CONCLUSION: The magnitude and direction of the association between income inequality and population health depend upon area-level income and, to a lesser extent, on rural-urban status. The rationale behind these unexpected findings remains unclear. Further research is needed to understand the mechanisms driving these patterns.

PMID:36978201 | DOI:10.1186/s41043-023-00366-6

J Orthop Surg Res. 2023 Mar 28;18(1):255. doi: 10.1186/s13018-023-03718-4.

ABSTRACT

BACKGROUND: To develop a machine learning model based on tumor-to-bone distance and radiomic features derived from preoperative MRI images to distinguish intramuscular (IM) lipomas and atypical lipomatous tumors/well-differentiated liposarcomas (ALTs/WDLSs) and compared with radiologists.

METHODS: The study included patients with IM lipomas and ALTs/WDLSs diagnosed between 2010 and 2022, and with MRI scans (sequence/field strength: T1-weighted (T1W) imaging at 1.5 or 3.0 Tesla MRI). Manual segmentation of tumors based on the three-dimensional T1W images was performed by two observers to appraise the intra- and interobserver variability. After radiomic features and tumor-to-bone distance were extracted, it was used to train a machine learning model to distinguish IM lipomas and ALTs/WDLSs. Both feature selection and classification steps were performed using Least Absolute Shrinkage and Selection Operator logistic regression. The performance of the classification model was assessed using a tenfold cross-validation strategy and subsequently evaluated using the receiver operating characteristic curve (ROC) analysis. The classification agreement of two experienced musculoskeletal (MSK) radiologists was assessed using the kappa statistics. The diagnosis accuracy of each radiologist was evaluated using the final pathological results as the gold standard. Additionally, we compared the performance of the model and two radiologists in terms of the area under the receiver operator characteristic curves (AUCs) using the Delong’s test.

RESULTS: There were 68 tumors (38 IM lipomas and 30 ALTs/WDLSs). The AUC of the machine learning model was 0.88 [95% CI 0.72-1] (sensitivity, 91.6%; specificity, 85.7%; and accuracy, 89.0%). For Radiologist 1, the AUC was 0.94 [95% CI 0.87-1] (sensitivity, 97.4%; specificity, 90.9%; and accuracy, 95.0%), and as to Radiologist 2, the AUC was 0.91 [95% CI 0.83-0.99] (sensitivity, 100%; specificity, 81.8%; and accuracy, 93.3%). The classification agreement of the radiologists was 0.89 of kappa value (95% CI 0.76-1). Although the AUC of the model was lower than of two experienced MSK radiologists, there was no statistically significant difference between the model and two radiologists (all P > 0.05).

CONCLUSIONS: The novel machine learning model based on tumor-to-bone distance and radiomic features is a noninvasive procedure that has the potential for distinguishing IM lipomas from ALTs/WDLSs. The predictive features that suggested malignancy were size, shape, depth, texture, histogram, and tumor-to-bone distance.

PMID:36978182 | DOI:10.1186/s13018-023-03718-4

BMC Sports Sci Med Rehabil. 2023 Mar 28;15(1):45. doi: 10.1186/s13102-023-00654-y.

ABSTRACT

BACKGROUND: The aim of this study was two-fold: (i) to determine the correlation between 2D:4D, maximal oxygen uptake (VO_2max), body fat percentage (BF%), maximum heart rate (HRmax), change of direction (COD), and accumulated acute and chronic workload variables; (ii) to verify if the length of the second digit divided by fourth digit (2D:4D) can explain fitness variables and accumulated training load.

METHODS: Twenty elite young football players (age: 13.26 ± 0.19 years; height: 165.8 ± 11.67 cm; body mass: 50.70 ± 7.56 kg; VO_2max, 48.22 ± 2.29 ml.kg^{– 1}.min^{– 1}) participated in the present study. Anthropometric and body composition variables (e.g., height, body mass, sitting height, age, BF%, body mass index, right and left finger 2D:4D ratios) were measured. The following fitness tests were also conducted: 30 – 15 Intermittent Fitness Test (VO_2max and HRmax), COD (5-0-5 agility test), and speed (10-30msprint test. HRmax and the training load were also measured and monitored using the Rate of Perceived Exertion during the 26 weeks.

RESULTS: There were associations between HRmax and VO_2max, between 2D and 4D lengths and Left and Right hand ratios. Also, in AW with Right and Left 4D. The CW and de ACWR with the Right 4D. There were other associations between physical test variables and workload variables.

CONCLUSIONS: Under-14 soccer players with low right and left-hand 2D:4D ratios did not perform better in the selected fitness tests to assess VO_2max, COD, or sprint ability. However, it cannot be ruled out that the absence of statistically significant results may be related to the small sample size and the maturational heterogeneity of the participants.

PMID:36978178 | DOI:10.1186/s13102-023-00654-y

BMC Med. 2023 Mar 29;21(1):111. doi: 10.1186/s12916-023-02809-7.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has highlighted health disparities affecting ethnic minority communities. There is growing concern about the lack of diversity in clinical trials. This study aimed to assess the representation of ethnic groups in UK-based COVID-19 randomised controlled trials (RCTs).

METHODS: A systematic review and meta-analysis were undertaken. A search strategy was developed for MEDLINE (Ovid) and Google Scholar (1st January 2020-4th May 2022). Prospective COVID-19 RCTs for vaccines or therapeutics that reported UK data separately with a minimum of 50 participants were eligible. Search results were independently screened, and data extracted into proforma. Percentage of ethnic groups at all trial stages was mapped against Office of National Statistics (ONS) statistics. Post hoc DerSimonian-Laird random-effects meta-analysis of percentages and a meta-regression assessing recruitment over time were conducted. Due to the nature of the review question, risk of bias was not assessed. Data analysis was conducted in Stata v17.0. A protocol was registered (PROSPERO CRD42021244185).

RESULTS: In total, 5319 articles were identified; 30 studies were included, with 118,912 participants. Enrolment to trials was the only stage consistently reported (17 trials). Meta-analysis showed significant heterogeneity across studies, in relation to census-expected proportions at study enrolment. All ethnic groups, apart from Other (1.7% [95% CI 1.1-2.8%] vs ONS 1%) were represented to a lesser extent than ONS statistics, most marked in Black (1% [0.6-1.5%] vs 3.3%) and Asian (5.8% [4.4-7.6%] vs 7.5%) groups, but also apparent in White (84.8% [81.6-87.5%] vs 86%) and Mixed 1.6% [1.2-2.1%] vs 2.2%) groups. Meta-regression showed recruitment of Black participants increased over time (p = 0.009).

CONCLUSIONS: Asian, Black and Mixed ethnic groups are under-represented or incorrectly classified in UK COVID-19 RCTs. Reporting by ethnicity lacks consistency and transparency. Under-representation in clinical trials occurs at multiple levels and requires complex solutions, which should be considered throughout trial conduct. These findings may not apply outside of the UK setting.

PMID:36978166 | DOI:10.1186/s12916-023-02809-7

BMC Psychol. 2023 Mar 28;11(1):83. doi: 10.1186/s40359-023-01122-5.

ABSTRACT

OBJECTIVES: The study aimed to (i) compare the maladaptive domains and facets according to the Alternative Model of Personality Disorders (AMPD) Criterion B in patients with a type II bipolar disorder (BD-II) or major depressive disorder (MDD) with healthy controls (HCs), and (ii) investigating the relationship between affective temperaments and these domains and facets in the total sample.

METHODS: Outpatients diagnosed with current BD-II (n = 37; female 62.2%) or MDD (n = 17; female 82.4%) based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria and community HCs (n = 177; female 62.1%) in Kermanshah from July to October 2020 included this case-control study. All participants completed the Personality Inventory for DSM-5 (PID-5), the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), and the second version of the Beck Depression Inventory (BDI-II). Data were analyzed using analysis of variance (ANOVA), Pearson correlation, and multiple regression.

RESULTS: The score of patients with BD-II in all five domains and those with MDD in three domains including negative affectivity, detachment, and disinhibition are significantly higher than the HCs (p < 0.05). Depressive temperament (related to negative affectivity, detachment, and disinhibition) and cyclothymic temperament (related to antagonism and psychoticism) were the most important correlates of the maladaptive domains.

CONCLUSIONS: Two unique profiles are proposed, including three domains of negative affectivity, detachment, and disinhibition associated with the depressive temperament for MDD, and two domains of antagonism and psychoticism related to cyclothymic temperament for BD-II.

PMID:36978163 | DOI:10.1186/s40359-023-01122-5

BMC Nutr. 2023 Mar 28;9(1):59. doi: 10.1186/s40795-023-00713-0.

ABSTRACT

BACKGROUND: Child under-nutrition remains a widespread problem around the globe. Improving child nutrition and empowering women are two important and closely connected development goals. These two interconnected goals will affect one another through different mechanisms, and the net effect may not necessarily be positive. Yet, the impact of maternal employment, one method of empowering mothers, on children’s nutritional is not well studied in Ethiopia. Hence, this study is to compare the prevalence of under-nutrition and its associated factors among 6-23 months old children of employed and unemployed mothers in town kebeles of Dera district, Northwest Ethiopia, 2022.

METHODS: A community-based comparative cross-sectional study design was conducted among 356 employed and 356 unemployed mothers having 6-23 months old children. A systematic random sampling technique was used to select study participants. Epi-data version 3.1 and SPSS version 25.0 statistical software were used for data entry and analysis, respectively. Both bi-variable and multivariable binary logistic regression was done to assess the association between independent and dependent variables. A p-value of less than 0.05 in a multivariable binary logistic regression was declared as the level of statistical significance.

RESULT: The prevalence of under-nutrition was 69.8% (95% CI: 65.0, 74.7) among children of unemployed mothers, compared to 27.4% (95% CI: 22.7, 32.2) among children of employed mothers. Under-nutrition among children of unemployed mothers was significantly associated with being a male child, age increase by one month, household food insecurity, lack of ANC follow-up, and not exclusively breastfed. Whereas, among children of employed mothers, being a male child, age increase by one month, being sick during the last two weeks prior to data collection, not immunized to their age, and low meal frequency were significantly associated with their under-nutrition.

CONCLUSION: The prevalence of under-nutrition among children of unemployed women is significantly higher than those children of employed women which consolidate the evidence that women’s employment status have a positive association with child nutrition. Different factors were also identified as significant predictors of child under-nutrition among these two groups (employed and unemployed women). Thus, multi-sectoral intervention approach together with agriculture and education offices should be strengthened.

PMID:36978152 | DOI:10.1186/s40795-023-00713-0