Tag: nevin manimala

Asian Spine J. 2022 Apr 18. doi: 10.31616/asj.2021.0405. Online ahead of print.

ABSTRACT

STUDY DESIGN: A systematic review.

PURPOSE: This study aimed to evaluate the prevalence of coexisting lumbar spondylosis (LS) and knee osteoarthritis (KOA), which has clinical implications on the screening, diagnosis, and management of orthopedic patients.

OVERVIEW OF LITERATURE: Due to current global health trends, the number of affected patients is expected to increase substantially. However, no prior systematic reviews have discussed this topic.

METHODS: A systematic literature search was conducted in June 2021 in the PubMed, Embase, Scopus, CINAHL, and Cochrane CENTRAL databases. Clinical and epidemiological studies that reported quantitative data on the prevalence of coexisting LS and KOA were included. Studies which reported data on only LS or KOA alone were excluded. Odds ratios (ORs) and 95% confidence intervals (CI) for LS or KOA were retrieved or calculated for meta-analysis. Fixed-effects and random-effects models were used, and statistical significance was considered when p<0.05. Heterogeneity was evaluated using Cochran’s Q test and the I2 statistic. Risk of bias was assessed using the MINORs (methodological index for nonrandomized studies) criteria.

RESULTS: This review included nine studies (5,758 patients). Four studies (4,164 patients) defined KOA and LS by a Kellgren-Lawrence (KL) grade of ≥2 and were included in the meta-analysis. Two other studies defined KOA and LS by a joint space narrowing grade of ≥2. The remaining three studies reported other outcomes. The combined ORs of having KOA of KL grade ≥2 due to LS was 1.75 (95% CI, 1.22-2.50; p=0.002), while the combined OR of having LS of KL grade ≥2 due to KOA was 1.84 (95% CI, 1.23-2.77; p=0.003).

CONCLUSIONS: In patients with either KOA or LS, the odds of having a concurrent knee-spine presentation are significantly increased. This may have implications for clinical decision-making and treatment strategies. Further high-level studies with larger patient populations are required to confirm these results in specific populations.

PMID:35421911 | DOI:10.31616/asj.2021.0405

Angle Orthod. 2022 May 1;92(3):347-352. doi: 10.2319/121520-1009.1.

ABSTRACT

OBJECTIVES: To evaluate root resorption of lower incisors and canines quantitatively in a group of patients who underwent orthodontic treatment with piezocision and/or a collagen reinforcement technique with a fully resorbable three-dimensional (3D) collagen xenograft matrix compared with a control group.

MATERIALS AND METHODS: The study sample of this secondary analysis consisted of 32 periodontally healthy patients with angle Class I malocclusion or mild Class II or III malocclusion and moderate irregularity index scores who underwent orthodontic treatment and had before (T0) and after treatment (T1) cone-beam computed tomography scans. Root resorption of lower incisors and canines was assessed quantitatively in the following four groups: the control group received orthodontic treatment without piezocision, experimental group 1 received orthodontic treatment with piezocision, experimental group 2 received orthodontic treatment with piezocision and a 3D collagen matrix, and experimental group 3 received orthodontic treatment with a 3D collagen matrix.

RESULTS: An overall statistically significant decrease in root length from T0 to T1 for all groups was observed (P < .05). However, there was no significant difference among the groups in the amount of root length decrease from T0 to T1.

CONCLUSIONS: Orthodontic treatment combined with piezocision does not increase the risk of root resorption of lower incisors and canines when compared with orthodontic treatment without acceleration techniques. More studies with larger samples should be undertaken to confirm these results.

PMID:35421894 | DOI:10.2319/121520-1009.1

Nanoscale. 2022 Apr 14. doi: 10.1039/d1nr06861j. Online ahead of print.

ABSTRACT

The DNA toehold mediated strand displacement reaction is one of the semi-synthetic biology technologies for next-generation computers. In this article, we present a framework for a novel nonlinear neural network based on an engineered biochemical circuit, which is constructed by several reaction modules including catalysis, degradation and adjustment reaction modules. The proposed neural network possesses an architecture that is similar to that of an error back propagation neural network, and is built of an input layer, hidden layer and output layer. As a proof of concept, we utilize this nonlinear neural network based on an analog DNA toehold mediated strand displacement reaction circuit to learn the standard quadratic form function and analyze the robustness of the nonlinear neural network toward DNA strand concentration detection, DNA strand displacement reaction rate and noise. Unlike in error back propagation neural networks, the adaptive behavior of this DNA molecular neural network system endows it with supervised learning capability. This investigation will highlight the potential of analog DNA displacement reaction circuits for implementing artificial intelligence.

PMID:35421885 | DOI:10.1039/d1nr06861j

J Chin Med Assoc. 2022 Apr 11. doi: 10.1097/JCMA.0000000000000730. Online ahead of print.

ABSTRACT

BACKGROUND: Low-grade appendiceal mucinous neoplasm (LAMN) is a rare disease, which prognostic factors were difficult to evaluate. Inflammtion markers, like neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were used as prognosticators for various cancers. This study aimed to investigate the prognostic value of pretreatment NLR, and PLR on LAMN.

METHODS: From January 2000 to September 2018, there were 57 patients diagnosed with LAMN in Taipei Veterans General Hospital. Patients diagnosed with mucinous cystadenoma, mucinous tumor with uncertain malignant potential before 2010 were also included based on previous classification. Clinical and pathological data were collected. Patients were separated into high NLR (NLR-H), and low NLR (NLR-L) groups according to cutoff value of 3. Similarly, they were separated into high PLR (PLR-H), and low PLR (PLR-L) groups with cutoff value of 300. Overall survival (OS) and recurrence free survival (RFS) were analyzed.

RESULTS: Among all patients, the median follow-up time was 42 months. Age, gender, clinical manifestations, type of surgery, T stage were similar in different NLR, PLR groups. Both NLR-H and PLR-H groups had higher rate of M1 stage of diseases (22.7% vs. 9.4%, p = 0.04; 57.1% vs. 8.8%, p < 0.01, resepectively). PLR-H group had more presence of pseudomyxoma peritonei (PMP) (57.1% vs. 15.2%, p = 0.03). In univariate analysis, factors such as age, gender, tumor perforation, operation did not have impact on OS nor RFS. On the other hand, M1b stage is the only significantly poor prognostic factor on RFS. (Hazard ratio= 57.96, 95% confidence interval=5.16-651.23, p < 0.01).

CONCLUSION: Both NLR-H and PLR-H had more M1 stage of diseases, but they were not correlated to OS nor RFS. PLR-H group had higher rate of presence PMP. Nevertheless, patients with LAMN and cellular PMP (M1b stage) had a higher rate of recurrence, and other factors showed no statistical difference in OS nor RFS.

PMID:35421867 | DOI:10.1097/JCMA.0000000000000730

J Phys Condens Matter. 2022 Apr 14. doi: 10.1088/1361-648X/ac6786. Online ahead of print.

ABSTRACT

We study the conductance $G$ of 2D Dirac semimetal nanowires at the presence of disorder. For an even nanowire length $L$ determined by the number of unit cells, we find non-integer values for $G$ that are independent of $L$ and persist with weak disorder, indicated by the vanishing fluctuations of $G$. The effect is created by a combination of the scattering effects at the contacts(interface) between the leads and the nanowire, an energy gap present in the nanowire for even $L$ and the topological properties of the 2D Dirac semimetals. Unlike conventional materials the reduced $G$ due to the scattering at the interface, is stabilized at non-integer values inside the nanowire, leading to a topological phase for weak disorder. For strong disorder the system leaves the topological phase and the fluctuations of $G$ are increased as the system undergoes a transition/crossover toward the Anderson localized(insulating) phase, via a non-standard disordered phase. We study the scaling and the statistics of $G$ at these phases. In addition we have found that the effect of robust non-integer $G$ disappears for odd $L$, which results in integer $G$, determined by the number of open channels in the nanowire, due to resonant scattering.

PMID:35421858 | DOI:10.1088/1361-648X/ac6786

Int Arch Allergy Immunol. 2022 Apr 14:1-9. doi: 10.1159/000523869. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVE: The objective of this study was to describe the molecular sensitization profile of mite allergy in an area with a high environmental exposure of house dust mites (HDM) and storage mites.

METHODS: Skin prick tests were performed with standardized extracts (DIATER, Madrid, Spain). A specific commercial molecular panel (MADx) for Dermatophagoides pteronyssinus (Dpt), Dermatophagoides farinae (Dfar), Lepidoglyphus destructor (Ldt), Tyrophagus putrescentiae (Tput), and Blomia tropicalis (Blot) was correlated with clinical parameters in Galician (northwestern of Spain) HDM allergic patients.

RESULTS: Fifty patients (60% female) met the inclusion and exclusion criteria. All of the patient’s present rhinitis (50), 28% (14) rhinitis and asthma, and 18% (9) atopic dermatitis (AD). Hundred patients had a positive prick test for Dpt, followed by Dfar (92%), Ldt and Tput (74%), and Blot (68%). More than 50% recognized specific IgE for Der p 1, Der p 2, reaching 86% in the case of Der p 23. No statistically significant differences in IgE levels were found between patients with/without asthma and those with mild or moderate-severe rhinitis. Der p 7 was higher among rhinitis patients (p value 0.05). AD relative risk (RR) was increased in patients sensitized to Der f 2, Der p 2, and Der p 23. Der p 10 decreases the risk to have AD (RR 0.80).

CONCLUSION: The evaluation of IgE results in a comprehensive panel of allergens allows differentiation of serological reactivity profiles with their clinical expression, to perform an optimal management. Improvements in component resolved diagnosis and more research on the clinical relevance of mite allergens are needed to achieve a genuine diagnosis leading to specific immunotherapy.

PMID:35421864 | DOI:10.1159/000523869

Phys Med Biol. 2022 Apr 14. doi: 10.1088/1361-6560/ac678a. Online ahead of print.

ABSTRACT

The interest for machine learning (ML) has grown tremendously in recent years, partly due to the performance leap that occurred with new techniques of deep learning, convolutional neural networks for images, increased computational power, and wider availability of large data sets. Most fields of medicine follow that popular trend and, notably, radiation oncology is one of those that are at the forefront, with already a long tradition in using digital images and fully computerized workflows. ML models are driven by data, and in contrast with many statistical or physical models, they can be very large and complex, with countless generic parameters. This inevitably raises two questions, namely, the tight dependence between the models and the data sets that feed them, and the interpretability of the models, which scales with its complexity. Any problems in the data used to train the model will be later reflected in their performance. This, together with the low interpretability of ML models, makes their implementation into the clinical workflow particularly difficult. Building tools for risk assessment and quality assurance of ML models must involve then two main points: interpretability and data-model dependency. After a joint introduction of both radiation oncology and ML, this paper reviews the main risks and current solutions when applying the latter to workflows in the former. Risks associated with data and models, as well as their interaction, are detailed. Next, the core concepts of interpretability, explainability, and data-model dependency are formally defined and illustrated with examples. Afterwards, a broad discussion goes through key applications of ML in workflows of radiation oncology as well as vendors’ perspectives for the clinical implementation of ML.

PMID:35421855 | DOI:10.1088/1361-6560/ac678a

ESMO Open. 2022 Apr 11;7(3):100469. doi: 10.1016/j.esmoop.2022.100469. Online ahead of print.

ABSTRACT

BACKGROUND: In the American Joint Committee on Cancer (AJCC) classification, acral lentiginous melanoma (ALM) histotype ALM is not included as an independent prognostic factor; in small series its negative prognostic impact on disease-free survival (DFS) and overall survival (OS) has been linked to the greater Breslow thickness (BT).

PATIENTS AND METHODS: The study was carried out at four referral melanoma centers (three Italian and one Polish). Clinical consecutive patients with stage I-II melanoma, who were diagnosed, treated, and followed up between January 1998 and March 2018 in annotated specific databases were included.

RESULTS: Overall, 6734 were evaluable, 4349 with superficial spreading melanoma (SSM), 2132 with nodular melanoma (NM), and 253 with ALM. At univariable analysis, a statistically significant worse DFS [hazard ratio (HR) 2.72, 95% confidence interval (CI) 2.24-3.30; P < 0.001] and OS (HR 2.67, 95% CI 2.15-3.32; P < 0.001) were found in patients with ALM compared with SSM. Similarly, the NM histotype was associated with a worse prognosis compared with the SSM histotype (DFS: HR 2.29, 95% CI 2.08-2.52; P < 0.001 and OS: HR 2.21, 95% CI 1.99-2.46; P < 0.001). At multivariable analysis, after adjusting for age, sex, BT, ulceration, and the sentinel lymph node status, a statistically significant worse DFS [adjusted HR (aHR; ALM versus SSM) 1.25, 95% CI 1.02-1.52; P = 0.028] was confirmed for patients with ALM. For patients with NM, instead, no impact of histology was found in terms of DFS [aHR (NM versus SSM) 1.04, 95% CI 0.93-1.15; P = 0.513] and OS [aHR (NM versus SSM) 0.96, 95% CI 0.86-1.08; P = 0.548].

CONCLUSIONS: ALM is associated with a worse long-term DFS. Our results could have important clinical implications for patients’ stratification in future clinical trials and the incorporation of ALM histotype in the new AJCC classification as an independent prognostic factor.

PMID:35421840 | DOI:10.1016/j.esmoop.2022.100469

Healthc (Amst). 2022 Apr 11;10(2):100627. doi: 10.1016/j.hjdsi.2022.100627. Online ahead of print.

ABSTRACT

BACKGROUND: Intensive primary care programs have had variable impacts on clinical outcomes, possibly due to a lack of consensus on appropriate patient-selection. The US Veterans Health Administration (VHA) piloted an intensive primary care program, known as Patient Aligned Care Team Intensive Management (PIM), in five medical centers. We sought to describe the PIM patient selection process used by PIM teams and to explore perspectives of PIM team members regarding how patient selection processes functioned in context.

METHODS: This study employs an exploratory sequential mixed-methods design. We analyzed qualitative interviews with 21 PIM team and facility leaders and electronic health record (EHR) data from 2,061 patients screened between July 2014 and September 2017 for PIM enrollment. Qualitative data were analyzed using a hybrid inductive/deductive approach. Quantitative data were analyzed using descriptive statistics.

RESULTS: Of 1,887 patients identified for PIM services using standardized criteria, over half were deemed inappropriate for PIM services, either because of not having an ambulatory care sensitive condition, living situation, or were already receiving recommended care. Qualitative analysis found that team members considered standardized criteria to be a useful starting point but too broad to be relied on exclusively. Additional data collection through chart review and communication with the current primary care team was needed to adequately assess patient complexity. Qualitative analysis further found that differences in conceptualizing program goals led to conflicting opinions of which patients should be enrolled in PIM.

CONCLUSIONS: A combined approach that includes clinical judgment, case review, standardized criteria, and targeted program goals are all needed to support appropriate patient selection processes.

PMID:35421803 | DOI:10.1016/j.hjdsi.2022.100627

Cancer Epidemiol. 2022 Apr 11;78:102157. doi: 10.1016/j.canep.2022.102157. Online ahead of print.

ABSTRACT

BACKGROUND: Serum iron is associated with the risk of several diseases. However, limited prospective studies have been performed between serum iron and the subsequent risk of chronic liver disease (CLD) and primary liver cancer (PLC) incidence.

METHODS: We performed a nested case-control study using data from the Linxian Nutrition Intervention Trials among participants who developed PLC incidence or died from CLD over 22-years of follow-up. We calculated the odds ratios (ORs) and 95% confidence intervals (CIs) to estimate the risk of PLC incidence or CLD death in different quintile of baseline serum iron using logistic regression.

RESULTS: Individuals with serum iron in the highest quintile, compared to those in the second quintile (the reference), had an increased risk of CLD mortality (OR=2.02, 95% CI=1.27-3.27, P_trend=0.011). The association was stronger among HCV-positive participants (P_interaction=0.005). For PLC incidence, the risk estimates were above one, but not statistically significant (all P > 0.05).

CONCLUSIONS: A significant positive association was found between serum iron and the risk of CLD-related mortality, especially in HCV-positive subjects. Our results suggest that serum iron plays a risk role in CLD death but not in PLC incidence.

PMID:35421712 | DOI:10.1016/j.canep.2022.102157