Tag: nevin manimala

Int J Neural Syst. 2023 Apr 20:2350025. doi: 10.1142/S0129065723500259. Online ahead of print.

ABSTRACT

Alcohol use is a leading risk factor for substantial health loss, disability, and death. Thus, there is a general interest in developing computational tools to classify electroencephalographic (EEG) signals in alcoholism, but there are a limited number of studies on convolutional neural network (CNN) classification of alcoholism using topographic EEG signals. We produced an original dataset recorded from Brazilian subjects performing a language recognition task. Then, we transformed the Event-Related Potentials (ERPs) into topographic maps by using the ERP’s statistical parameters across time, and used a CNN network to classify the topographic dataset. We tested the effect of the size of the dataset in the accuracy of the CNNs and proposed a data augmentation approach to increase the size of the topographic dataset to improve the accuracies. Our results encourage the use of CNNs to classify abnormal topographic EEG patterns associated with alcohol abuse.

PMID:37078369 | DOI:10.1142/S0129065723500259

Curr HIV Res. 2023 Apr 20. doi: 10.2174/1570162X21666230420090756. Online ahead of print.

ABSTRACT

BACKGROUND: Previous studies have implicated human adenovirus 36 (Adv36) as a potential contributor to overweight and obesity. People living with HIV have an altered body composition compared to healthy individuals. There is still no evidence to confirm the relationship of Adv36 as one of the causes of lipohypertrophy. The main objective of this study was to verify the viral Adv36 infection as a factor associated with the presence of lipohypertrophy in HIV-infected individuals.

METHODS: A case-control study on people with HIV treated at a specialized public health service in southern Brazil. Subjects underwent interviews, diagnostic tests, and anthropometry to determine lipodystrophy and its classification. Demographic and clinical data were examined to investigate the presence of Adv36. The cases were participants with lipohypertrophy, and the controls were eutrophic participants.

RESULTS: 101 participants were included (38 cases and 63 controls), and the frequency of Adv36 infection was 10.9%. There was a statistically significant association between lipohypertrophy and the female sex (p < 0.001), and a trend for the presence of Adv36 (p = 0.059) and lipohypertrophy. After adjustment for confounders, Adv36 has not considered an independent risk factor for lipohypertrophy. Lower levels of glucose were associated with Adv36 infection.

CONCLUSION: There was a significant association between lipohypertrophy and the female sex, and no association with lipohypertrophy and Adv36, perhaps due to the small sample size.

PMID:37078357 | DOI:10.2174/1570162X21666230420090756

Otolaryngol Head Neck Surg. 2023 Apr 20. doi: 10.1002/ohn.353. Online ahead of print.

ABSTRACT

OBJECTIVE: Untreated sleep-disordered breathing (SDB) is associated with problem behaviors in children. The neurological basis for this relationship is unknown. We used functional near-infrared spectroscopy (fNIRS) to assess the relationship between cerebral hemodynamics of the frontal lobe of the brain and problem behaviors in children with SDB.

STUDY DESIGN: Cross-sectional.

SETTING: Urban tertiary care academic children’s hospital and affiliated sleep center.

METHODS: We enrolled children with SDB aged 5 to 16 years old referred for polysomnography. We measured fNIRS-derived cerebral hemodynamics within the frontal lobe during polysomnography. We assessed parent-reported problem behaviors using the Behavioral Response Inventory of Executive Function Second Edition (BRIEF-2). We compared the relationships between (i) the instability in cerebral perfusion in the frontal lobe measured fNIRS, (ii) SDB severity using apnea-hypopnea index (AHI), and (iii) BRIEF-2 clinical scales using Pearson correlation (r). A p < .05 was considered significant.

RESULTS: A total of 54 children were included. The average age was 7.8 (95% confidence interval, 7.0-8.7) years; 26 (48%) were boys and 25 (46%) were Black. The mean AHI was 9.9 (5.7-14.1). There is a statistically significant inverse relationship between the coefficient of variation of perfusion in the frontal lobe and BRIEF-2 clinical scales (range of r = 0.24-0.49, range of p = .076 to <.001). The correlations between AHI and BRIEF-2 scales were not statistically significant.

CONCLUSION: These results provide preliminary evidence for fNIRS as a child-friendly biomarker for the assessment of adverse outcomes of SDB.

PMID:37078337 | DOI:10.1002/ohn.353

Clin Gerontol. 2023 Apr 20:1-13. doi: 10.1080/07317115.2023.2203139. Online ahead of print.

ABSTRACT

OBJECTIVES: Cognitive stimulation therapy (CST) is an evidence-based intervention for dementia. This program evaluation examined the outcomes of a modified CST program in a veteran sample.

METHODS: Twenty-five veterans who participated in a once-weekly, 7-week CST program and completed pre/post-group assessments were selected for inclusion in this chart review study. In this diverse sample (M_age = 74.40; 44% White, 44% Hispanic/Latinx, 8% Black, 4% multiracial), most had a suspected neurodegenerative etiology. Paired-samples t-test examined QoL and cognitive pre/post-intervention scores.

RESULTS: Statistically significant improvements were observed in RBANS total index scores (Cohen’s d = 0.46). Although there was not a statistically significant change in MoCA scores or patient QoL-AD ratings, there were small effects in the predicted direction (Cohen’s d = 0.29 and 0.30, respectively). There was no significant change or effect on caregiver QoL-AD ratings (Cohen’s d = .09).

CONCLUSIONS: A modified, once-weekly 7-week CST program for veterans was feasible and demonstrated positive outcomes. Improvements were observed in global cognition and there was a small, positive effect on patient-rated QoL. Given that dementia is often progressive, stability of cognition and QoL are suggestive of the protective effects of CST.

CLINICAL IMPLICATIONS: CST is feasible and beneficial as a once-weekly brief group intervention for veterans with cognitive impairment.

PMID:37078292 | DOI:10.1080/07317115.2023.2203139

Circulation. 2023 Apr 20. doi: 10.1161/CIRCULATIONAHA.122.063281. Online ahead of print.

ABSTRACT

BACKGROUND: Myocardial injury is an important pediatric diagnosis. Establishing normative data from a representative pediatric sample is vital to provide accurate upper reference limits (URLs) for defining myocardial injury using high-sensitivity cardiac troponin.

METHODS: Among participants 1 to 18 years of age in the 1999-2004 National Health and Nutrition Examination Survey, we measured high-sensitivity troponin T using one assay (Roche) and high-sensitivity troponin I using 3 assays (Abbott, Siemens, and Ortho). In a strictly defined healthy subgroup, we estimated 97.5th and 99th percentile URLs for each assay using the recommended nonparametric method.

RESULTS: Of 5695 pediatric participants, 4029 met criteria for the healthy subgroup (50% males; mean age 12.6 years). Our 99th percentile URL estimates for all 4 high-sensitivity troponin assays among children and adolescents were lower than the manufacturer-reported URLs (derived from adults). The 99th percentile URLs (95% CI) were 15 ng/L (95% CI, 12-17) for high-sensitivity troponin T, 16 ng/L (95% CI, 12-19) for high-sensitivity troponin I with the Abbott assay, 38 ng/L (95% CI, 25-46) for high-sensitivity troponin I with the Siemens assay, and 7 ng/L (95% CI, 5, 12) for high-sensitivity troponin I with the Ortho assay. The 95% CIs for age-, sex-, and race-specific 99th percentile URLs overlapped. However, the 97.5th percentile URL for each assay was measured with superior statistical precision (ie, tighter 95% CIs) and demonstrated differences by sex. For male compared with female children, 97.5th percentile URLs were 11 ng/L (95% CI, 10-12) versus 6 ng/L (95% CI, 6-7) for high-sensitivity troponin T, 9 ng/L (95% CI, 7-10) versus 5 ng/L (95% CI, 4-6) for high-sensitivity troponin I with the Abbott assay, 21 ng/L (95% CI, 18-25) versus 11 ng/L (95% CI, 9-13) for high-sensitivity troponin I with the Siemens assay, and 4 ng/L (95% CI, 3-5) versus 2 ng/L (95% CI, 1-3) for high-sensitivity troponin I with the Ortho assay. In contrast to the 99th percentiles, the point estimates of 97.5th percentile pediatric URLs for cardiac troponin were also much more stable to differences in the analytic approaches taken to estimate URLs.

CONCLUSIONS: Because myocardial infarction is rare in adolescents, the use of statistically more precise and reliable sex-specific 97.5th percentile URLs might be considered to define pediatric myocardial injury.

PMID:37078280 | DOI:10.1161/CIRCULATIONAHA.122.063281

J Biophotonics. 2023 Apr 20:e202300001. doi: 10.1002/jbio.202300001. Online ahead of print.

ABSTRACT

Skin cancer, an anomalous development of skin cells in the epidermis, is among the most common types of cancer worldwide. Because of its clinical importance and in order to improve early diagnosis and patient management there is an urgent need to develop noninvasive, accurate medical diagnostic tools. To this aim, light reflectance spectroscopy over the visible and near-infrared spectral range (400 – 1000 nm) based on a single-fiber six-around-one optical probe was applied to extract nine features used for diagnostics. These features include skewness, entropy, energy, kurtosis, scattering amplitude, and others, and are spread over each of four different spectral signatures, namely, light reflectance, absorbance, scattering profile approximation, and absorption / scattering ratio. Our preliminary studies focused on 11 adult patients with diagnoses of malignant melanoma (MM, n=4), basal cell carcinoma (BCC, n=5) and squamous cell carcinoma (SCC, n=2) in a variety of locations on the body. Measurements were taken first in vivo before surgery, at the site of the lesion and from healthy skin of the same patient, and ex vivo after surgical excision, where the lesion was rinsed in saline solution and measurements of the reflected light from the “inside” facing plane of the tissue were taken in the same manner. Overall, experimental results demonstrate that by examining a variety of wavebands, features, and statistical metrics we can detect and distinguish cancer from normal tissue and different cancer subtypes. Nevertheless, discrepancies in results between in vivo and ex vivo tissue were observed and explanations for these discrepancies are discussed. This article is protected by copyright. All rights reserved.

PMID:37078262 | DOI:10.1002/jbio.202300001

Pediatrics. 2023 Apr 20:e2022058080. doi: 10.1542/peds.2022-058080. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Pediatric hospitalizations are costly, stressful events for families. Many caregivers, especially those with lower incomes, struggle to afford food while their child is hospitalized. We sought to decrease the mean percentage of caregivers of Medicaid-insured and uninsured children who reported being hungry during their child’s hospitalization from 86% to <24%.

METHODS: Our quality improvement efforts took place on a 41-bed inpatient unit at our large, urban academic hospital. Our multidisciplinary team included physicians, nurses, social workers, and food services leadership. Our primary outcome measure was caregiver-reported hunger; we asked caregivers near to the time of discharge if they experienced hunger during their child’s hospitalization. Plan-do-study-act cycles addressed key drivers: awareness of how to obtain food, safe environment for families to seek help, and access to affordable food. An annotated statistical process control chart tracked our outcome over time. Data collection was interrupted because of the COVID-19 pandemic; we used that time to advocate for hospital-funded support for optimal and sustainable changes to caregiver meal access.

RESULTS: We decreased caregiver hunger from 86% to 15.5%. A temporary test of change, 2 meal vouchers per caregiver per day, resulted in a special cause decrease in the percentage of caregivers reporting hunger. Permanent hospital funding was secured to provide cards to purchase 2 meals per caregiver per hospital day, resulting in a sustained decrease in rates of caregiver hunger.

CONCLUSIONS: We decreased caregivers’ hunger during their child’s hospitalization. Through a data-driven quality improvement effort, we implemented a sustainable change allowing families to access enough food.

PMID:37078248 | DOI:10.1542/peds.2022-058080

Orthop Surg. 2023 Apr 20. doi: 10.1111/os.13722. Online ahead of print.

ABSTRACT

OBJECTIVE: Using a fibula autograft (FA) to reconstruct defects after en bloc resection of giant cell tumor of bone (GCTB) in the distal radius is classic but has high complication rates. We describe a novel reconstruction method employing the cooperative application of LARS® and a 3D-printed prosthesis (L-P) and investigate whether it improves postoperative outcomes.

METHODS: From April 2015 to August 2022, 14 patients who underwent the cooperative L-P reconstruction method after en bloc resection of distal radial GCTBs and 31 patients who received FA reconstruction were enrolled as two retrospective cohorts in this comparative study. The properties of the implants and critical surgical techniques were elaborated in the L-P group. Preoperative function, intraoperative data, and postoperative clinical, functional, and radiographic outcomes of all patients were recorded and compared between the two groups. The grip strength and range of wrist motion, including extension, flexion, radial deviation, and ulnar deviation, were measured. The Mayo modified wrist and Musculoskeletal Tumor Society scores were chosen to assess wrist function and surgical functional outcomes, respectively. Kaplan-Meier curves were generated to analyze the significant differences in complication rates and implant survival between the two groups.

RESULTS: In both groups, all 45 patients underwent the operation without complication with similar average osteotomy lengths and bleeding volumes, while a shorter operative duration was achieved in the L-P group (201.43 ± 22.87 min vs. 230.16 ± 51.44 min, P = 0.015). At a mean follow-up of 40.42 ± 18.43 months (range, 14-72 months), both reconstruction methods effectively ameliorated postoperative function. Patients who received L-P showed higher postoperative modified Mayo wrist scores (81.43 ± 5.49 vs. 71.13 ± 16.10, P = 0.003), Musculoskeletal Tumor Society scores (27.64 ± 1.34 vs. 25.06 ± 2.95, P = 0.004), and grip strength on the normal side (68.71% ± 8.00% vs. 57.81% ± 12.31%, P = 0.005) than the FA group. Better wrist extension (63.21° ± 8.99° vs. 45.32° ± 14.53°, P < 0.001) and flexion (45.36° ± 7.90° vs. 30.48° ± 12.07°, P < 0.001) were also observed in the L-P group. The complication rate was significantly higher in the FA group (29/31, 93.55%) than in the L-P group (1/14 7.14%, P < 0.001). The L-P group showed higher implant survival than the FA group, but the difference was not statistically significant.

CONCLUSION: The cooperative application of LARS® and 3D-printed prostheses is an effective modality for reconstructing musculoskeletal defects after en bloc resection of distal radial GCTBs, which can improve functional outcomes, diminish complication rates, and promote wrist joint stability and motion.

PMID:37078245 | DOI:10.1111/os.13722

Hosp Pediatr. 2023 Apr 20:e2022006795. doi: 10.1542/hpeds.2022-006795. Online ahead of print.

ABSTRACT

OBJECTIVES: Pediatric Hospital Medicine fellowship programs need to abide by Accreditation Council for Graduate Medical Education requirements regarding communication and supervision. Effective communication is critical for safe patient care, yet no prior research has explored optimal communication practices between residents, fellows, and attending hospitalists. Our objective is to explore communication preferences among pediatric senior residents (SRs), Pediatric Hospital Medicine fellows, and hospitalists on an inpatient team during clinical decision-making.

METHODS: We conducted a cross-sectional survey study at 6 institutions nationwide. We developed 3 complementary surveys adapted from prior research, 1 for each population: 200 hospitalists, 20 fellows, and 380 SRs. The instruments included questions about communication preferences between the SR, fellow, and hospitalist during clinical scenarios. We calculated univariate descriptive statistics and examined paired differences in percent agreement using χ2 tests, accounting for clustering by institution.

RESULTS: Response rates were: 53% hospitalists; 100% fellows; 39% SRs. Communication preferences varied based on role, scenario, and time of day. For most situations, hospitalists preferred more communication with the fellow overnight and when a patient or family is upset than expressed by fellows (P < .01). Hospitalists also desired more communication between the SR and fellow for an upset patient or family than SRs (P < .01), but all respondents agreed the SR should call the fellow for adverse events. More fellows and hospitalists felt that the SR should contact the fellow before placing a consult compared with SRs (95%, 86% vs 64%).

CONCLUSIONS: Hospitalists, fellows, and SRs may have differing preferences regarding communication, impacting supervision, autonomy, and patient safety. Training programs should consider such perspectives when creating expectations and communication guidelines.

PMID:37078243 | DOI:10.1542/hpeds.2022-006795

Turk J Gastroenterol. 2023 Apr 20. doi: 10.5152/tjg.2023.22489. Online ahead of print.

ABSTRACT

BACKGORUND: We aimed to show whether the serum level of Human Epididymitis Protein 4 increases in rats with an experimental acute pancreatitis model created by cerulein.

METHODS: This study included 24 male Sprague-Dawley rats which were randomly divided into 4 groups each containing 6 rats.

CONTROL: the group treated with saline, Group 1: pancreatitis group created with cerulein at a total dose of 80 µg/kg, Group 2: pancreatitis group created with cerulein at a total dose of 120 µg/kg, Group 3: pancreatitis group created with cerulein at a total dose of 160 µg/kg.

RESULTS: There were statistically significant differences between edema, acinar necrosis, fat necrosis, and perivascular inflammation scores among the study groups. While the degree of all histopathological findings is lowest in the control group, pancreatic parenchyma damage increases as the amount of injected cerulein increases. There was no statistically significant difference between alanine aminotransferase, aspartate aminotransferase, and Human Epididymis Protein 4 values between study groups. On the other hand, there was a statistically significant difference between amylase and lipase values. The lipase value of the control group was significantly lower than the lipase value of the second and third groups. The amylase value of the control group was significantly lower than all other groups. The highest Human Epididymis Protein 4 value was measured as 104 pmol/L in the first pancreatitis group, where the severity of pancreatitis was mild.

CONCLUSIONS: In the present study, it was concluded that the Human Epididymis Protein 4 value increased in the case of mild pancreatitis, but there is no correlation between the severity of pancreatitis and the Human Epididymis Protein 4 value.

PMID:37078202 | DOI:10.5152/tjg.2023.22489