Tag: nevin manimala

J Appl Biomech. 2023 Apr 27:1-5. doi: 10.1123/jab.2022-0271. Online ahead of print.

ABSTRACT

Electromechanical delay (EMD) of muscle is influenced in part by its in-series arrangement with connective tissue. Therefore, studying EMD might provide a better understanding of the muscle-connective tissue interaction. Here, EMD of the thoracic and lumbar erector spinae muscles were investigated under conditions that could influence muscle-connective tissue interaction. A total of 19 participants performed isometric back extension contractions in 3 different postures that influence lumbar spine angle: sitting, standing, and kneeling. They then performed a 15-minute dynamic stretching routine and repeated the standing contractions. Mean lumbar flexion angles of 0.5°, 9.9°, and 19.8° were adopted for standing, kneeling, and sitting, respectively. No statistically significant differences in the thoracic erector spinae EMD were found between the different postures. Lumbar erector spinae EMD was significantly longer in the sitting (94.1 ms) compared to the standing (69.9 ms) condition, with no differences compared to kneeling (79.7 ms). There were no statistically significant differences of the thoracic or lumbar erector spinae EMDs before and after dynamic stretching. These results suggest that dynamic stretching does not affect the mechanical behavior of the muscle-tendon-aponeurosis units in a way that alters force generation and transmission, but a sitting posture can alter how force is transmitted through the musculotendinous complex of the lumbar erector spinae.

PMID:37105546 | DOI:10.1123/jab.2022-0271

Ann Coloproctol. 2023 Apr 28. doi: 10.3393/ac.2022.00913.0130. Online ahead of print.

ABSTRACT

PURPOSE: Most predictive factors for lymph node metastasis in rectal neuroendocrine tumors (NETs) have been based on local and endoscopic resection. We aimed to evaluate the risk factors for lymph node metastasis in patients who underwent radical resection for rectal NETs and stratify the risk of lymph node metastasis.

METHODS: Sixty-four patients who underwent radical resection for rectal NETs between January 2001 and January 2018 were included. We investigated the risk factors of lymph node metastasis using clinicopathologic data. We also performed a risk stratification for lymph node metastases using the number of previously known risk factors. For oncologic outcomes, the 5-year overall survival and recurrence-free survival were evaluated in both groups.

RESULTS: Among the patients who underwent radical surgery, 32 (50.0%) had lymph node metastasis and 32 (50.0%) had non-lymph node metastasis. In the multivariable analysis, only the male sex was identified as a risk factor for lymph node metastasis (odds ratio, 3.70; 95% confidence interval, 1.13-12.11; P=0.030). When there were 2 or more known risk factors, the lymph node metastasis rate was significantly higher than when there were one or no risk factors (odds ratio, 3.667; 95% confidence interval, 1.023-13.143; P=0.046). There was also no statistical difference between the 2 groups in 5-year overall survival (P=0.431) and 5-year recurrence-free survival (P=0.144).

CONCLUSION: We found that the rate of lymph node metastasis increased significantly when the number of known risk factors is 2 or more. Favorable oncological outcomes have been observed in patients who undergo surgery, even those with lymph node metastasis.

PMID:37105525 | DOI:10.3393/ac.2022.00913.0130

Ann Thorac Surg. 2023 Apr 25:S0003-4975(23)00401-0. doi: 10.1016/j.athoracsur.2023.04.019. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the impact of proximal versus extensive repair on mortality, and how this impact is influenced by patient characteristics.

METHODS: 5510 acute type A aortic dissection (ATAAD) patients from 13 Chinese hospitals (2016-2021) were categorized by proximal versus extensive repair: 4038 patients for model derivation using eXtreme gradient boosting and 1472 patients for model validation.

RESULTS: Operative mortality of extensive repair was higher than proximal repair (10.4% vs 2.9%; odd ratio [OR] 3.833 [95%CI 2.810-5.229], P<0.001) with the number needed to harm (NNH) of 15 (95%CI 13-19). Seven top features of importance were selected to develop Alphabet risk model (age, body mass index, platelet-leucocyte ratio, albumin, hemoglobin, serum creatinine, urea nitrogen, and preoperative malperfusion), with an AUC of 0.767 (95%CI 0.733-0.800) and 0.727 (95%CI 0.689-0.764) in the derivation and validation cohort, respectively. The absolute rate differences in mortality between two repair strategies increased progressively as predicted risk rose, however, it did not become statistically significant until the predicted risk exceeded 4.5%. Extensive repair was associated with similar risk of mortality (OR 2.540 [95%CI 0.944-6.831]) for patients with risk probability <4.5%, but higher risk (OR 2.164 [95%CI 1.679, 2.788]) for patients with risk probability >4.5% compared with proximal repair.

CONCLUSIONS: Extensive repair is associated with higher mortality than proximal repair; however, it did not carry a significantly higher risk of mortality until the predicted probability exceed a certain threshold. Choosing the right surgery should be based on individualized risk prediction and treatment effect.

PMID:37105511 | DOI:10.1016/j.athoracsur.2023.04.019

J Biomed Inform. 2023 Apr 25:104372. doi: 10.1016/j.jbi.2023.104372. Online ahead of print.

ABSTRACT

Phenotype-based prioritization of candidate genes and diseases has become a well-established approach for multi-omics diagnostics of rare diseases. Most current algorithms exploit semantic analysis and probabilistic statistics based on Human Phenotype Ontology and are commonly superior to naive search methods. However, these algorithms are mostly less interpretable and do not perform well in real clinical scenarios due to noise and imprecision of query terms, and the fact that individuals may not display all phenotypes of the disease they belong to. We present a Phenotype-driven Likelihood Ratio analysis approach (PheLR) assisting interpretable clinical diagnosis of rare diseases. With a likelihood ratio paradigm, PheLR estimates the posterior probability of candidate diseases and how much a phenotypic feature contributes to the prioritization result. Benchmarked using simulated and realistic patients, PheLR shows significant advantages over current approaches and is robust to noise and inaccuracy. To facilitate clinical practice and visualized differential diagnosis, PheLR is implemented as an online web tool (http://phelr.nbscn.org).

PMID:37105510 | DOI:10.1016/j.jbi.2023.104372

J Biomed Inform. 2023 Apr 25:104367. doi: 10.1016/j.jbi.2023.104367. Online ahead of print.

ABSTRACT

Cytokine release syndrome (CRS), also known as cytokine storm, is one of the most consequential adverse effects of chimeric antigen receptor therapies that have shown otherwise promising results in cancer treatment. When emerging, CRS could be identified by the analysis of specific cytokine and chemokine profiles that tend to exhibit similarities across patients. In this paper, we exploit these similarities using machine learning algorithms and set out to pioneer a meta-review informed method for the identification of CRS based on specific cytokine peak concentrations and evidence from previous clinical studies. To this end we also address a widespread challenge of the applicability of machine learning in general: reduced training data availability. We do so by augmenting available (but often insufficient) patient cytokine concentrations with statistical knowledge extracted from domain literature. We argue that such methods could support clinicians in analyzing suspect cytokine profiles by matching them against the said CRS knowledge from past clinical studies, with the ultimate aim of swift CRS diagnosis. We evaluate our proposed methods under several design choices, achieving performance of more than 90% in terms of CRS identification accuracy, and showing that many of our choices outperform a purely data-driven alternative. During evaluation with real-world CRS clinical data, we emphasize the potential of our proposed method of producing interpretable results, in addition to being effective in identifying the onset of cytokine storm.

PMID:37105509 | DOI:10.1016/j.jbi.2023.104367

J Endod. 2023 Apr 25:S0099-2399(23)00235-2. doi: 10.1016/j.joen.2023.04.007. Online ahead of print.

ABSTRACT

INTRODUCTION: The efficacy of sodium hypochlorite (NaOCl) as an intracanal irrigant is widely debated in endodontic therapy. This study aimed to analyze and compare the penetration abilities of different modes of NaOCl application and assess the impact of various agitation strategies on promoting root canal cleanliness.

MATERIALS AND METHODS: This study included 168 single-rooted mandibular premolars that were randomly divided into eight groups. The two modes of application of 5% NaOCl evaluated were intracanal heating and preheating, and the agitation strategies included ultrasonic, sonic, and manual dynamic agitations (MDAs). The samples were sectioned and observed at a magnification of 1000× under a scanning electron microscope.

RESULTS: The analysis of variance test showed a statistically significant difference among the various groups of agitation (P < 0.05). The post hoc Tukey test confirmed that preheated NaOCl with ultrasonic agitation, intracanal-heated NaOCl with sonic agitation, and MDA had significantly higher debris scores of 1, 4, and 5, respectively, in the apical third of the canal.

CONCLUSION: The results indicated that the combination of intracanal-heated NaOCl and ultrasonic agitation is an effective method for reducing debris in the root canal system. These findings highlight the importance of considering both the mode of application and the agitation strategies when optimizing the use of NaOCl as an intracanal irrigant in endodontic therapy.

PMID:37105500 | DOI:10.1016/j.joen.2023.04.007

J Stomatol Oral Maxillofac Surg. 2023 Apr 25:101488. doi: 10.1016/j.jormas.2023.101488. Online ahead of print.

ABSTRACT

INTRODUCTION: The current most common technique for mandibular split is the sagittal split osteotomy described by Obwegeser and modified by Dalpont and Epker. Several studies have shown a lower face enlargement while employing these techniques. The supra-basilar sagittal split osteotomy described in 2017 seems to be an interesting alternative as mandibular angles remain in continuity with the internal valve. The aim of this study was to evaluate lower face enlargement by comparing two techniques: sagittal split osteotomy and supra-basilar sagittal split.

MATERIALS AND METHODS: Cephalograms were analyzed before and after surgery. Bigonial distances (BGD) were measured in frontal cephalograms, ramus length and distances between upper and lower incisors on lateral cephalogram. Control of those measures was also performed by measuring the Nasion-Anterior Clinoid distance and intercanthal distance to assess the comparability and error rate. Finally, a comparison of cephalograms before and after surgery to assess bigonial enlargement, ramus elongation and advancement was performed.

RESULTS: Out of the 69 patients, 18 had a Bilateral Sagittal Split (BSSO) and 52 had a Supra-Basilar Sagittal Split (SBSSO). The error rate and patients’ characteristics were the same in the two groups. A statistically significant widening of the bigonial distance with the BSSO in comparison with the SBSSO was found (BGD difference: 5.82 mm (BSSO) vs – 1.47 mm (SBSSO), p < 0,001). A greater ramus elongation with the SBSSO was found (ramus elongation: 1.12 mm (BSSO) vs 5.1 mm (SBSSO)). This study has shown that the supra-basilar sagittal split is an interesting way to avoid the widening of the mandibular angles.

PMID:37105491 | DOI:10.1016/j.jormas.2023.101488

Sci Total Environ. 2023 Apr 25:163713. doi: 10.1016/j.scitotenv.2023.163713. Online ahead of print.

ABSTRACT

The water quality of a waterbody is determined by internal hydrodynamic processes as well as external loadings. Understanding the interaction between the external loading and internal process of a waterbody is essential for efficient water management and water quality improvement. Studies and efforts have focused on water and nutrient loading from drainage watersheds, but the contribution of the waterbody’s internal process to water quality is often ignored and not well documented. This study investigated how the water quality of Lake Okeechobee is controlled by external and internal factors using statistical and numerical modeling approaches. Water quantity and quality observed at the outlets of the Lake Okeechobee drainage basins and 19 monitoring sites located within the lake were statistically analyzed using multilinear regression. A three-dimensional numerical model, namely Environmental Fluid Dynamics Code (EFDC), was calibrated to the observations to mathematically represent the lake’s internal hydrodynamic process. The multilinear regression found that the water quality was the most sensitive to air temperature, the total phosphorus (TP) concentration of inflow entering the lake from the Kissimmee River basins, and the amount of outflow discharged from the lake among external factors. However, the regression models and their explanatory power were substantially varied by the monitoring stations. The model parameter sensitivity analysis of the calibrated EFDC model showed that model parameters related to the lake’s internal algal processes including algal growth, predation, and basal metabolism rates had greater impacts on algal biomass than other model parameters controlling nutrient-related processes such as nutrient half-saturation and hydrolysis rates. The EFDC input data sensitivity analysis found that wind (speed) is the major driving force for the internal hydrodynamic processes; its impact on algal biomass was greater than those of the external loadings. In addition, the algal biomass was found to have an inverse relationship with wind-induced horizontal currents. The results demonstrate the dynamic contribution of the internal and external drivers to the water quality of Lake Okeechobee, suggesting the need to consider both internal hydrodynamic and external loading processes for efficient water quality improvement of the lake.

PMID:37105475 | DOI:10.1016/j.scitotenv.2023.163713

J Affect Disord. 2023 Apr 25:S0165-0327(23)00534-7. doi: 10.1016/j.jad.2023.04.074. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a common and complex mental disease, and its pathogenesis involves several brain regions. Abnormalities in the amygdala-hippocampal neural circuits have been shown to be involved in depression. However, the underlying molecular mechanisms remain unclear.

METHODS: A rat model was used to determine the transcriptome changes in the amygdala-hippocampal neural network under chronic unpredictable mild stress (CUMS). Depression-related modules in this neural network were identified using weighted gene co-expression network analysis (WGCNA). Difference and enrichment analyses were used to determine differential gene expression in the two brain regions.

RESULTS: The modules in the amygdala and hippocampus associated with depression-like behavior contained 363 and 225 genes, respectively. Forty-two differentially expressed genes were identified in the amygdala candidate module and 37 in the hippocampus. Enrichment analysis showed that candidate genes in the amygdala were associated with neuronal myelination and candidate genes in the hippocampus were associated with synaptic transmission. Finally, based on module hub gene statistics, differential gene expression, and protein-protein interaction networks, 11 central genes were found in the amygdala candidate module, and one central gene was found in the hippocampal module.

LIMITATIONS: Our study was based on a rat CUMS model. Further evidence is needed to prove that our results are applicable to patients with depression.

CONCLUSION: This study identified critical modules and central genes involved in the amygdala-hippocampal circuit in the context of depression, and may provide further understanding of the pathogenesis of depression and help identify potential targets for antidepressant therapy.

PMID:37105469 | DOI:10.1016/j.jad.2023.04.074

J Acad Nutr Diet. 2023 Apr 25:S2212-2672(23)00220-4. doi: 10.1016/j.jand.2023.04.007. Online ahead of print.

NO ABSTRACT

PMID:37105445 | DOI:10.1016/j.jand.2023.04.007