Tag: nevin manimala

J Neurotrauma. 2023 Apr 12. doi: 10.1089/neu.2022.0221. Online ahead of print.

ABSTRACT

Prognostic prediction of traumatic brain injury (TBI) in patients is crucial in clinical decision and health care policy making. This study aimed to develop and validate prediction models for in-hospital mortality after severe traumatic brain injury (sTBI). We developed and validated logistic regression (LR), LASSO regression, and machine learning (ML) algorithms including support vector machines (SVM) and XGBoost models. Fifty-four candidate predictors were included. Model performance was expressed in terms of discrimination (C-statistic) and calibration (intercept and slope). For model development, 2804 patients with sTBI in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) China Registry study were included. External validation was performed in 1113 patients with sTBI in the CENTER-TBI European Registry study. XGBoost achieved high discrimination in mortality prediction, and it outperformed logistic and LASSO regression. The XGBoost model established in this study also outperformed prediction models currently available, including the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) core and International Mission for Prognosis and Analysis of Clinical Trials (CRASH) basic models. When including 54 variables, XGBoost and SVM reached C-statistics of 0.87 (95% confidence interval [CI]: 0.81-0.92) and 0.85 (95% CI: 0.79-0.90) at internal validation, and 0.88 (95% CI: 0.87-0.88) and 0.86 (95% CI: 0.85-0.87) at external validation, respectively. A simplified version of XGBoost and SVM using 26 variables selected by recursive feature elimination (RFE) reached C-statistics of 0.87 (95% CI: 0.82-0.92) and 0.86 (95% CI: 0.80-0.91) at internal validation, and 0.87 (95% CI: 0.87-0.88) and 0.87 (95% CI: 0.86-0.87) at external validation, respectively. However, when the number of variables included decreased, the difference between ML and LR diminished. All the prediction models can be accessed via a web-based calculator. Glasgow Coma Scale (GCS) score, age, pupillary light reflex, Injury Severity Score (ISS) for brain region, and the presence of acute subdural hematoma were the five strongest predictors for mortality prediction. The study showed that ML techniques such as XGBoost may capture information hidden in demographic and clinical predictors of patients with sTBI and yield more precise predictions compared with LR approaches.

PMID:37062757 | DOI:10.1089/neu.2022.0221

Biol Rev Camb Philos Soc. 2023 Apr 16. doi: 10.1111/brv.12961. Online ahead of print.

ABSTRACT

Policy makers require high-level summaries of biodiversity change. However, deriving such summaries from raw biodiversity data is a complex process involving several intermediary stages. In this paper, we describe an operational workflow for generating annual estimates of species occupancy at national scales from raw species occurrence data, which can be used to construct a range of policy-relevant biodiversity indicators. We describe the workflow in detail: from data acquisition, data assessment and data manipulation, through modelling, model evaluation, application and dissemination. At each stage, we draw on our experience developing and applying the workflow for almost a decade to outline the challenges that analysts might face. These challenges span many areas of ecology, taxonomy, data science, computing and statistics. In our case, the principal output of the workflow is annual estimates of occupancy, with measures of uncertainty, for over 5000 species in each of several defined ‘regions’ (e.g. countries, protected areas, etc.) of the UK from 1970 to 2019. This data product corresponds closely to the notion of a species distribution Essential Biodiversity Variable (EBV). Throughout the paper, we highlight methodologies that might not be applicable outside of the UK and suggest alternatives. We also highlight areas where the workflow can be improved; in particular, methods are needed to mitigate and communicate the risk of bias arising from the lack of representativeness that is typical of biodiversity data. Finally, we revisit the ‘ideal’ and ‘minimal’ criteria for species distribution EBVs laid out in previous contributions and pose some outstanding questions that should be addressed as a matter of priority. Going forward, we hope that this paper acts as a template for research groups around the world seeking to develop similar data products.

PMID:37062709 | DOI:10.1111/brv.12961

Wei Sheng Yan Jiu. 2023 Mar;52(2):292-299. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.019.

ABSTRACT

OBJECTIVE: To conduct a Meta-analysis of the effects of whole grains on insulin resistance in overweight and obese adults in randomize controlled trials.

METHODS: Data were retrieved from PubMed, EMBASE, MEDLINE, Cochrane Library, CBM, CNKI and other databases from the database establishment to August 9, 2021. Randomize controlled trials of the effects of whole grains on insulin resistance in overweight and obese adults were screened out. Data extraction and quality evaluation were conducted for the literatures meeting the inclusion criteria. The Meta-analysis was conducted using R4.1.2 software.

RESULTS: A total of 10 randomized controlled trials were included. Among the overweight and obese adults, the whole grains intake decreased their fasting plasma glucose(FPG)(MD=-0.08, 95%CI-0.12, -0.04), homeostasis model assessment of insulin resistance(HOMA-IR)(MD=-0.37, 95%CI-0.60, -0.14) and quantitative insulin sensitivity index(QUICKI)(MD=0.006, 95%CI 0.005, 0.007). However, there were no statistically significant among fasting insulin(FINS), postprandial blood glucose(PG), postprandial insulin(PI), and triglycerides(TG) in overweight and obese adults. In subgroup analysis, FPG was statistically significant in German, quality score 4, 150-200 g intake of whole grain, and health subgroups of each population. There was no statistical significance of the QUICKI group. In sensitivity analysis and publication bias, FINS, PG, PI and TG became significant after one article was removed. However, HOMA-IR result were not statistically significant after the removal of one article. Meanwhile, the publication bias of each index was analyzed by Egger regression. Based on the results of subgroup analysis, a further dose-response analysis was conducted on the whole grains intake. The result showed that the FPG effects scale was better when the daily intake of whole grains was between 140 g and 160 g.

CONCLUSION: Daily intake of 140 g to 160 g of whole grains improves FPG levels in overweight and obese adults.

PMID:37062696 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.019

Wei Sheng Yan Jiu. 2023 Mar;52(2):188-192. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.003.

ABSTRACT

OBJECTIVE: To explore the relationship between red meat intake and the prevalence of diabetes.

METHODS: Using the data of the China Health and Nutrition Survey in 1997, 2000, 2004, 2006, 2009, 2011, 2015 and 2018, 1154 people aged 18-75 years were included, and age, gender, urban and rural, education, marital status, income, occupational physical activity, total energy intake, fat energy ratio, smoking, drinking, body mass index and hypertension were adjusted. The Cox proportional hazard regression analysis was used to calculate diabetes hazard ratio(HR) and corresponding 95%CI.

RESULTS: In the study population, the per capita intake of red meat increased from 40.59 g/d in 1997 to 73.91 g/d in 2018, and the prevalence of diabetes rose from 6.14% in 2009 to 7.00% in 2018. In the early adjustment model, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.92(95% CI 0.51-1.68), and the HR of 40-74 g/d group was 0.86(95% CI 0.47-1.58), and the HR of the group ≥75 g/d was 1.02(95% CI 0.62-1.68). In model 2, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.71(95% CI 0.37-1.35), and the HR of 40-74 g/d group was 0.71(95% CI 0.38-1.35), the HR of ≥75 g/d group was 1.06(95% CI 0.69-1.87). In the fully adjusted model, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.75(95% CI 0.61-1.55), the HR of 40-74 g/d group was 0.66(95% CI 0.57-1.43), and the HR of ≥75 g/d group was 1.27(95% CI 0.87-2.04).

CONCLUSION: With the increase of red meat intake, the prevalence of diabetes was also increasing, but there was no statistically significant association.

PMID:37062680 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.003

Wei Sheng Yan Jiu. 2023 Mar;52(2):173-178. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.001.

ABSTRACT

OBJECTIVE: To investigate the dietary consumption of branched-chain amino acids(BCAAs)intake status of middle-aged and elderly people 50 years and older in China, and to analyze the distribution differences between different ages, genders and regions.

METHODS: The research sample was derived from the 2015 Chinese adult chronic disease and nutrition monitoring data. The survey adopts the stratified multi-stage cluster random sampling method, and selects 298 monitoring points from 31 provinces(autonomous regions and municipalities), a total of 44 218 people aged 50 years and over were sampled. Condiment weighing method, 24-hour dietary review method, and weighing method were used to obtain individual dietary data, and the dietary BCAAs intake of middle-aged and elderly people was calculated based on the Chinese Food Composition Table.

RESULTS: In 2015, the dietary BCAAs of middle-aged and elderly people in China accounted for 45.1% of leucine, 29.8% of valine and 25.1% of isoleucine. The top six dietary sources were cereals, red meat, vegetables, fish and seafood, beans and eggs. There were differences in the intake of three branched-chain amino acids(F=1926.67, P<0.01), the intake of leucine was greater than that of valine, and the intake of valine was greater than isoleucine. There were statistically significant differences in dietary BCAAs intake between different age groups, genders, urban and rural areas and regions(P<0.01), among which men were greater than women(t=12.89, P<0.01), and the south was greater than the north(t=-6.36, P<0.01), the eastern part was larger than the central part, and the central part was larger than the western part(F=82.42, P<0.01). The intake of BCAAs decreased with the increase of age groups(F=22.69, P<0.01), and there was no significant difference in age groups over 70 years old. The dietary intake of BCAAs was higher in the eastern coastal areas and Inner Mongolia, Xinjiang and Tibet.

CONCLUSION: There were gender, age and geographical differences in dietary BCAAs intake among middle-aged and elderly people in China, and the contribution of various foods to dietary BCAAs was also different.

PMID:37062678 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.001

J Cardiothorac Vasc Anesth. 2023 Mar 17:S1053-0770(23)00181-7. doi: 10.1053/j.jvca.2023.03.012. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite inherent comorbidities, obese cardiac surgical patients paradoxically had shown lower morbidity and mortality, although the nature of this association is still unclear. Thus, the authors intended in this large registry-based study to investigate the impact of obesity on short- and long-term postoperative outcomes, focusing on bleeding and transfusion requirements.

DESIGN: Retrospective registry study.

SETTING: Three university hospitals.

PARTICIPANTS: A cohort of 12,330 prospectively compiled data from coronary bypass grafting patients undergoing surgery between 2007 to 2020 were retrieved from the Western Denmark Heart Registry.

INTERVENTIONS: The parameters were analyzed to assess the association between body mass index (BMI) and the selected outcome parameters.

MEASUREMENTS AND MAIN RESULTS: The crude data showed a clear statistically significant association in postoperative drainage from 637 (418-1108) mL in underweight patients with BMI <18.5 kg/m² to 427 (295-620) mL in severely obese patients with BMI ≥40 kg/m² (p < 0.0001, Kruskal-Wallis). Further, 50.0% of patients with BMI <18.5 received an average of 451 mL/m² in red blood cell transfusions, compared to 16.7% of patients with BMI >40 receiving 84 mL/m². The obese groups were less often submitted to reexploration due to bleeding, and fewer received perioperative hemostatics, inotropes, and vasoconstrictors. The crude data showed increasing 30-day and 6-month mortality with lower BMI, whereas the one-year mortality showed a V-shaped pattern, but BMI had no independent impact on mortality in logistic regression analysis.

CONCLUSION: Patients with high BMI may carry protection against postoperative bleeding after cardiac surgery, probably secondary to an inherent hypercoagulable state, whereas underweight patients carry a higher risk of bleeding and worse outcomes.

PMID:37062665 | DOI:10.1053/j.jvca.2023.03.012

Acad Radiol. 2023 Apr 14:S1076-6332(23)00129-0. doi: 10.1016/j.acra.2023.03.018. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this prospective study was to evaluate the virtual monoenergetic images (VMI) and virtual noncontrast (VNC) phase in the detection of endoleaks after endovascular abdominal aortic repair (EVAR). The potential dose reduction of abbreviated examination protocols was calculated.

MATERIALS AND METHODS: Ninety-seven patients after the EVAR procedure were enrolled in this study. An initial single-source noncontrast acquisition was followed by two dual-energy acquisitions (arterial and 60 s delayed). Fast-kVp switching scanner was used. VNC images were reconstructed from the delayed phase. First examination session (reference) included a full triphasic study protocol consisting of true noncontrast (TNC) images and two postcontrast phases, the latter ones presented as classical polyenergetic reconstructions. Reading sessions II and III were performed by two independent and blinded readers evaluating VMIs in abbreviated protocols-biphasic (VNC + arterial, delayed phase), monophasic (VNC + delayed phase). The diagnostic accuracy of sessions II and III was calculated.

RESULTS: The calculated sensitivity of the biphasic protocol with the use of VMIs in endoleak detection was 100%, with a statistically significant increase in the number of endoleaks detected in comparison with the reference study. The monophasic protocol showed 83.33% sensitivity. The use of abbreviated examination protocols led to a decrease in the mean effective dose (ED) of 23.28% (biphasic protocol) and 61.37% (monophasic protocol).

CONCLUSION: The use of VMIs increases the number of endoleaks diagnosed with a possible radiation reduction by up to ¼ (biphasic protocol). Further reduction to a monophasic protocol leads to over 60% dose reduction but with a decrease in diagnostic accuracy.

PMID:37062628 | DOI:10.1016/j.acra.2023.03.018

Eur J Cancer. 2023 Mar 17:S0959-8049(23)00144-2. doi: 10.1016/j.ejca.2023.03.010. Online ahead of print.

ABSTRACT

BACKGROUND: An increasing number of clinical trials are being conducted exploring the efficacy of neoadjuvant immune checkpoint inhibitors. Surrogate end-points for overall survival (OS) are urgently needed.

METHODS: Phase II or III trials of neoadjuvant immunotherapy that reported data on OS and surrogate end-points were identified from January 1, 2000, to November 25, 2022. Individual patient data, and trial-level data were requested from corresponding authors or extracted from eligible trials. At the individual level, correlations between radiological and pathological response and OS were measured by the Cox model and quantified by hazard ratio (HR). C-statistic was used to quantify the predictive performance of radiological and pathological response for OS. The coefficient of determination (R²) between RFS and OS was evaluated by a bivariate survival model.

RESULTS: A total of 29 trials reporting 2901 patients were included. ORR correlated with improved OS (3-year OS: 87.0% versus 70.4% for ORR versus non-ORR, respectively; HR, 0.34, 95% confidence interval [CI], 0.17-0.68). The HRs for OS in patients achieving MPR and pCR were 0.24 (95% CI, 0.12-0.46) and 0.13 (95% CI, 0.05-0.36). The survival benefit maintained after adjusting tumour type. C-statistics of ORR, MPR and pCR were 0.63, 0.63 and 0.65, respectively. The strength of association between RFS and OS was strong (R² = 0.88, 95% CI, 0.79-0.94).

CONCLUSIONS: These findings suggest that ORR, MPR, pCR and RFS are valid predictors for OS when using neoadjuvant immune checkpoint inhibitors. Moreover, MPR, pCR and RFS may be the most optimal surrogates for OS.

PMID:37062625 | DOI:10.1016/j.ejca.2023.03.010

Phys Med. 2023 Apr 14;109:102586. doi: 10.1016/j.ejmp.2023.102586. Online ahead of print.

ABSTRACT

PURPOSE: To develop an automated planning approach in Raystation and evaluate its feasibility in multiple clinical application scenarios.

METHODS: An automated planning approach (Ruiplan) was developed by using the scripting platform of Raystation. Radiotherapy plans were re-generated both automatically by using Ruiplan and manually. 60 patients, including 20 patients with nasopharyngeal carcinoma (NPC), 20 patients with esophageal carcinoma (ESCA), and 20 patients with rectal cancer (RECA) were retrospectively enrolled in this study. Dosimetric and planning efficiency parameters of the automated plans (APs) and manual plans (MPs) were statistically compared.

RESULTS: For target coverage, APs yielded superior dose homogeneity in NPC and RECA, while maintaining similar dose conformity for all studied anatomical sites. For OARs sparing, APs led to significant improvement in most OARs sparing. The average planning time required for APs was reduced by more than 43% compared with MPs. Despite the increased monitor units (MUs) for NPC and RECA in APs, the beam-on time of APs and MPs had no statistical difference. Both the MUs and beam-on time of APs were significantly lower than that of MPs in ESCA.

CONCLUSIONS: This study developed a new automated planning approach, Ruiplan, it is feasible for multi-treatment techniques and multi-anatomical sites cancer treatment planning. The dose distributions of targets and OARs in the APs were similar or better than those in the MPs, and the planning time of APs showed a sharp reduction compared with the MPs. Thus, Ruiplan provides a promising approach for realizing automated treatment planning in the future.

PMID:37062102 | DOI:10.1016/j.ejmp.2023.102586

J Mech Behav Biomed Mater. 2023 Apr 5;142:105804. doi: 10.1016/j.jmbbm.2023.105804. Online ahead of print.

ABSTRACT

PURPOSE: This in vitro study aims to evaluate the bonding strengths of Polyether ether ketone (PEEK), Polyether ketone (PEKK), Fiber, and Zirconia (ZrO₂) post-core restorations with posts in different diameter and length following chewing simulator.

MATERIALS AND METHODS: Endodontic treatment was performed on 256 intact maxillary central teeth. The test specimens were prepared in four groups according to the types of materials: Glass fiber post-composite core (FB-n:64), Zirconia post-core (Zr-n:64), PEEK post-core (PE-n:64), and PEKK post-core (PK-n:64). The groups were divided into four subgroups according to diameter and length (n:16): Group 1: 10 mm length 1.75 mm diameter, Group 2: 10 mm length 1.5 mm diameter, Group 3: 7 mm length 1.75 mm diameter, Group 4: 7 mm length 1.5 mm diameter. Custom PEKK, PEEK, Zirconia post-cores, and Zirconia crowns were milled on the CAD/CAM. The post-cores and crowns were cemented to the teeth with dual-cure resin cement. After that, all subgroups were divided into control and cyclic loading groups. During the cycling, the control test group was kept in distilled water at 37±1^oC before the push-out test. Half of the specimens were loaded with 250,000 cycles and 50 N with a chewing simulator. All test specimens had 1.5 mm sections taken from their roots. Then, the push-out test was applied to these sections for bond strength. Data were analyzed by Mann-Whitney U test, Shapiro-Wilk, Kruskal-Wallis’s test, and Chi-Square. The statistical significance level was determined as 0.05.

RESULTS: The bond strength of all test groups decreased after the cycling loading. The bond strength values of zirconia posts showed a statistically significant difference (p < 0.05). The 10 mm length 1.75 mm diameter posts made of Zirconium had the highest bond strength observed in all control and cyclic loading groups of test specimens (9.74 MPa-6.25 MPa). The PEEK test specimens with a 7 mm length and 1.75 mm diameter showed the weakest bond strength in all control and cyclic loading groups (5.44 MPa-3.37 MPa). The average of the cervical region’s bond strength values was statistically significantly higher than the apical region (p < 0.05).

CONCLUSION: Within the limitations of this study, one-piece custom-milled Zirconia post-cores appear promising, as they perform well under functional forces, especially in the anterior region. In addition, custom-milled PEKK post-cores might be considered a suitable alternative to prefabricated fiber-reinforced posts.

PMID:37062099 | DOI:10.1016/j.jmbbm.2023.105804