Tag: nevin manimala

Neurosurgery. 2022 Sep 2. doi: 10.1227/neu.0000000000002117. Online ahead of print.

ABSTRACT

BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) represents an effective treatment for severe Parkinson’s disease (PD), but little is known about the long-term benefit.

OBJECTIVE: To investigate the survival rate and long-term outcome of DBS.

METHODS: We investigated all 81 patients including 37 males and 44 females who underwent bilateral STN DBS from March 2005 to March 2008 at a single institution. The current survival status of the patients was investigated. Preoperative and postoperative follow-up assessments were analyzed.

RESULTS: The mean age at the time of surgery was 62 (range 27-82) years, and the median clinical follow-up duration was 145 months. Thirty-five patients (43%) died during the follow-up period. The mean duration from DBS surgery to death was 110.46 ± 40.8 (range 0-155) months. The cumulative survival rate is as follows: 98.8 ± 1.2% (1 year), 95.1 ± 2.4% (5 years), and 79.0 ± 4.5% (10 years). Of the 81 patients, 33 (40%) were ambulatory up to more than 11 years. The Unified Parkinson’s Disease Rating Scale (UPDRS) score was significantly improved until 5 years after surgery although it showed a tendency to increase again after 10 years. The patient group with both electrodes located within the STN showed a higher rate of survival and maintained ambulation.

CONCLUSION: STN DBS is a safe and effective treatment for patients with advanced PD. This study based on the long-term follow-up of large patient populations can be used to elucidate the long-term fate of patients who underwent bilateral STN DBS for PD.

PMID:36084204 | DOI:10.1227/neu.0000000000002117

Lasers Surg Med. 2022 Oct;54(8):1051-1059. doi: 10.1002/lsm.23594.

ABSTRACT

BACKGROUND: Conventional high fluence Q-switched (HFQS) Alexandrite 755-nm are widely used in clinical café-au-lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q-switched (LFQS) Nd: YAG 1064-nm lasers.

OBJECTIVE: To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs.

METHODS: Within 3 months, 20 patients underwent prospective self-controlled split-lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow-up visit. Patient and physician preferences for laser selection were also recorded.

RESULTS: The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82-2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment.

CONCLUSIONS: The efficacy difference between the LFQS 1064-nm laser and HFQS 755-nm laser in treating CALMs in a 3-month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.

PMID:36084202 | DOI:10.1002/lsm.23594

J Acquir Immune Defic Syndr. 2022 Sep 8. doi: 10.1097/QAI.0000000000003095. Online ahead of print.

ABSTRACT

OBJECTIVE: To conduct a population-based analysis and compare life expectancy between people with HIV and the general population in New York City (NYC).

METHODS: We obtained the annual total number and age, sex, and race/ethnicity distributions of people with HIV from the NYC HIV registry and generated comparable numbers for the NYC general population from the Census 2000 and 2010 data using linear interpolation.

RESULTS: Life expectancy at age 20 among people with HIV increased from 38.5 years (95% confidence interval [CI]: 37.4, 39.5) in 2009 to 50.6 (95% CI: 48.5, 52.7) in 2018, while it increased from 62.0 years (95% CI: 61.8, 62.1) to 63.6 (95% CI: 63.5, 63.7) among the NYC general population. The gap between the two populations narrowed from 23.5 years (95% CI: 22.4, 24.6) in 2009 to 13.0 (955 CI: 10.9, 15.1) in 2018. By sex and race/ethnicity, life expectancy at age 20 among people with HIV increased from 36.7 years in 2009 to 47.9 in 2018 among Black males; 37.5 to 50.5 years among Black females; 38.6 to 48.9 years among Hispanic males; 46.0 to 51.0 years among Hispanic females; 44.7 to 59.7 years among White males; and 38.0 years in 2009-2013 to 50.4 years in 2014-2018 among White females.

CONCLUSIONS: Life expectancy among people with HIV improved greatly in NYC in 2009-2018, but the improvement was not equal across sex and racial/ethnic groups. The gap in life expectancy between people with HIV and the general population narrowed but remained.

PMID:36084201 | DOI:10.1097/QAI.0000000000003095

J Addict Med. 2022 Sep 8. doi: 10.1097/ADM.0000000000001054. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigated the occurrence rate of psychiatric disorders comorbid with gambling disorder, and their clinical significance in the severity of gambling disorder using a retrospective cross-sectional design.

METHODS: The medical records of 359 patients (men/women, 326/33; median age, 37.0 years) with gambling disorder as the primary disorder from 12 treatment facilities specializing in addiction (9 clinics and 3 hospitals) in Japan were studied. We investigated patients’ comorbid psychiatric disorders, demographic and clinical characteristics, and the severity of gambling disorder based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition.

RESULTS: Of all patients, 58.3% had comorbidities (tobacco use disorder, 20.9%; alcohol use disorder, 13.9%; major depressive disorder, 13.1%; behavioral addictions, 13.1%; attention-deficit hyperactivity disorder, 6.1%; etc.). Statistical analysis indicated that as the number of comorbid psychiatric disorders increased, psychosocial problems also increased (e.g., proportion of adverse childhood experiences [P < 0.001], and history of suicide attempts [P = 0.009]). In the multivariable analysis, behavioral addictions (β = 0.666; t = 3.151) were significantly associated with gambling disorder severity. Specifically, individuals with gambling disorder comorbid with behavioral addictions including kleptomania, excessive buying, and excessive sex-related behavior may present more severe gambling problems than those without behavioral addictions.

CONCLUSIONS: Patients with gambling disorder should be carefully assessed for psychiatric comorbidities and interventions should reflect the individual diagnosis.

PMID:36084180 | DOI:10.1097/ADM.0000000000001054

Neurosurgery. 2022 Aug 22. doi: 10.1227/neu.0000000000002099. Online ahead of print.

ABSTRACT

BACKGROUND: Moya Moya disease (MMD) and Moya Moya syndrome (MMS) are cerebrovascular disorders, which affect the internal carotid arteries (ICAs). Diagnosis and surveillance of MMD/MMS in children mostly rely on qualitative evaluation of vascular imaging, especially MR angiography (MRA).

OBJECTIVE: To quantitatively characterize arterial differences in pediatric patients with MMD/MMS compared with normal controls.

METHODS: MRA data sets from 17 presurgery MMD/MMS (10M/7F, mean age = 10.0 years) patients were retrospectively collected and compared with MRA data sets of 98 children with normal vessel morphology (49 male patients; mean age = 10.6 years). Using a level set segmentation method with anisotropic energy weights, the cerebral arteries were automatically extracted and used to compute the radius of the ICA, middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and basilar artery (BA). Moreover, the density and the average radius of all arteries in the MCA, ACA, and PCA flow territories were quantified.

RESULTS: Statistical analysis revealed significant differences comparing children with MMD/MMS and those with normal vasculature (P < .001), whereas post hoc analyses identified significantly smaller radii of the ICA, MCA-M1, MCA-M2, and ACA (P < .001) in the MMD/MMS group. No significant differences were found for the radii of the PCA and BA or any artery density and average artery radius measurement in the flow territories (P > .05).

CONCLUSION: His study describes the results of an automatic approach for quantitative characterization of the cerebrovascular system in patients with MMD/MMS with promising preliminary results for quantitative surveillance in pediatric MMD/MMS management.

PMID:36084178 | DOI:10.1227/neu.0000000000002099

Neurosurgery. 2022 Aug 22. doi: 10.1227/neu.0000000000002079. Online ahead of print.

ABSTRACT

BACKGROUND: Stereoelectroencephalography (sEEG) facilitates electrical sampling and evaluation of complex deep-seated, dispersed, and multifocal locations. Granger causality (GC), previously used to study seizure networks using interictal data from subdural grids, may help identify the seizure-onset zone from interictal sEEG recordings.

OBJECTIVE: To examine whether statistical analysis of interictal sEEG helps identify surgical target sites and whether surgical resection of highly ranked nodes correspond to favorable outcomes.

METHODS: Ten minutes of extraoperative recordings from sequential patients who underwent sEEG evaluation were analyzed (n = 20). GC maps were compared with clinically defined surgical targets using rank order statistics. Outcomes of patients with focal resection/ablation with median follow-up of 3.6 years were classified as favorable (Engel 1, 2) or poor (Engel 3, 4) to assess their relationship with the removal of highly ranked nodes using the Wilcoxon rank-sum test.

RESULTS: In 12 of 20 cases, the rankings of contacts (based on the sum of outward connection weights) mapped to the seizure-onset zone showed higher causal node connectivity than predicted by chance (P ≤ .02). A very low aggregate probability (P < 10-18, n = 20) suggests that causal node connectivity predicts seizure networks. In 8 of 16 with outcome data, causal connectivity in the resection was significantly greater than in the remaining contacts (P ≤ .05). We found a significant association between favorable outcome and the presence of highly ranked nodes in the resection (P < .05).

CONCLUSION: Granger analysis can identify seizure foci from interictal sEEG and correlates highly ranked nodes with favorable outcome, potentially informing surgical decision-making without reliance on ictal recordings.

PMID:36084171 | DOI:10.1227/neu.0000000000002079

PLoS Comput Biol. 2022 Sep 9;18(9):e1010497. doi: 10.1371/journal.pcbi.1010497. Online ahead of print.

ABSTRACT

Competitive endogenous RNA (ceRNA) represents a novel mechanism of gene regulation that controls several biological and pathological processes. Recently, an increasing number of in silico methods have been developed to accelerate the identification of such regulatory events. However, there is still a need for a tool supporting the hypothesis that ceRNA regulatory events only occur at specific miRNA expression levels. To this end, we present an R package, ceRNAR, which allows identification and analysis of ceRNA-miRNA triplets via integration of miRNA and RNA expression data. The ceRNAR package integrates three main steps: (i) identification of ceRNA pairs based on a rank-based correlation between pairs that considers the impact of miRNA and a running sum correlation statistic, (ii) sample clustering based on gene-gene correlation by circular binary segmentation, and (iii) peak merging to identify the most relevant sample patterns. In addition, ceRNAR also provides downstream analyses of identified ceRNA-miRNA triplets, including network analysis, functional annotation, survival analysis, external validation, and integration of different tools. The performance of our proposed approach was validated through simulation studies of different scenarios. Compared with several published tools, ceRNAR was able to identify true ceRNA triplets with high sensitivity, low false-positive rates, and acceptable running time. In real data applications, the ceRNAs common to two lung cancer datasets were identified in both datasets. The bridging miRNA for one of these, the ceRNA for MAP4K3, was identified by ceRNAR as hsa-let-7c-5p. Since similar cancer subtypes do share some biological patterns, these results demonstrated that our proposed algorithm was able to identify potential ceRNA targets in real patients. In summary, ceRNAR offers a novel algorithm and a comprehensive pipeline to identify and analyze ceRNA regulation. The package is implemented in R and is available on GitHub (https://github.com/ywhsiao/ceRNAR).

PMID:36084156 | DOI:10.1371/journal.pcbi.1010497

PLoS Genet. 2022 Sep 9;18(9):e1010345. doi: 10.1371/journal.pgen.1010345. Online ahead of print.

ABSTRACT

Genome-wide association studies (GWAS) have revealed that the striking natural variation for DNA CHH-methylation (mCHH; H is A, T, or C) of transposons has oligogenic architecture involving major alleles at a handful of known methylation regulators. Here we use a conditional GWAS approach to show that CHG-methylation (mCHG) has a similar genetic architecture-once mCHH is statistically controlled for. We identify five key trans-regulators that appear to modulate mCHG levels, and show that they interact with a previously identified modifier of mCHH in regulating natural transposon mobilization.

PMID:36084135 | DOI:10.1371/journal.pgen.1010345

PLoS One. 2022 Sep 9;17(9):e0273694. doi: 10.1371/journal.pone.0273694. eCollection 2022.

ABSTRACT

Accurate estimates of natural and/or vaccine-induced antibodies to SARS-CoV-2 are difficult to obtain. Although model-based estimates of seroprevalence have been proposed, they require inputting unknown parameters including viral reproduction number, longevity of immune response, and other dynamic factors. In contrast to a model-based approach, the current study presents a data-driven detailed statistical procedure for estimating total seroprevalence (defined as antibodies from natural infection or from full vaccination) in a region using prospectively collected serological data and state-level vaccination data. Specifically, we conducted a longitudinal statewide serological survey with 88,605 participants 5 years or older with 3 prospective blood draws beginning September 30, 2020. Along with state vaccination data, as of October 31, 2021, the estimated percentage of those 5 years or older with naturally occurring antibodies to SARS-CoV-2 in Texas is 35.0% (95% CI = (33.1%, 36.9%)). This is 3× higher than, state-confirmed COVID-19 cases (11.83%) for all ages. The percentage with naturally occurring or vaccine-induced antibodies (total seroprevalence) is 77.42%. This methodology is integral to pandemic preparedness as accurate estimates of seroprevalence can inform policy-making decisions relevant to SARS-CoV-2.

PMID:36084125 | DOI:10.1371/journal.pone.0273694

PLoS One. 2022 Sep 9;17(9):e0274114. doi: 10.1371/journal.pone.0274114. eCollection 2022.

ABSTRACT

Analysis of language geography is increasingly being used for studying spatial patterns of social dynamics. This trend is fueled by social media platforms such as Twitter which provide access to large amounts of natural language data combined with geolocation and user metadata enabling reconstruction of detailed spatial patterns of language use. Most studies are performed on large spatial scales associated with countries and regions, where language dynamics are often dominated by the effects of geographic and administrative borders. Extending to smaller, urban scales, however, allows visualization of spatial patterns of language use determined by social dynamics within the city, providing valuable information for a range of social topics from demographic studies to urban planning. So far, few studies have been made in this domain, due, in part, to the challenges in developing algorithms that accurately classify linguistic features. Here we extend urban-scale geographical analysis of language use beyond lexical meaning to include other sociolinguistic markers that identify language style, dialect and social groups. Some features, which have not been explored with social-media data on the urban scale, can be used to target a range of social phenomena. Our study focuses on Twitter use in Buenos Aires and our approach classifies tweets based on contrasting sets of tokens manually selected to target precise linguistic features. We perform statistical analyses of eleven categories of language use to quantify the presence of spatial patterns and the extent to which they are socially driven. We then perform the first comparative analysis assessing how the patterns and strength of social drivers vary with category. Finally, we derive plausible explanations for the patterns by comparing them with independently generated maps of geosocial context. Identifying these connections is a key aspect of the social-dynamics analysis which has so far received insufficient attention.

PMID:36084118 | DOI:10.1371/journal.pone.0274114