Tag: nevin manimala

Eur J Pain. 2022 May 22. doi: 10.1002/ejp.1978. Online ahead of print.

ABSTRACT

BACKGROUND: Multisite musculoskeletal pain is common and disabling. This study aimed to prospectively investigate distribution of musculoskeletal pain anatomically, and explore risk factors for increases/reductions in the number of painful sites.

METHODS: Using data from participants working in 45 occupational groups in 18 countries, we explored changes in reporting pain at 10 anatomical sites on two occasions 14 months apart. We used descriptive statistics to explore consistency over time in the number of painful sites, and their anatomical distribution. Baseline risk factors for increases/reductions by ≥3 painful sites were explored by random intercept logistic regression that adjusted for baseline number of painful sites.

RESULTS: Amongst 8,927 workers, only 20% reported no pain at either time point, and 16% reported ≥3 painful sites both times. After 14 months, the anatomical distribution of pain often changed but there was only an average increase of 0.17 painful sites. Some 14% workers reported a change in painful sites by ≥ 3. Risk factors for an increase of ≥ 3 painful sites included female sex, lower educational attainment, having a physically demanding job, and adverse beliefs about the work-relatedness of musculoskeletal pain. Also predictive were: older age, somatising tendency, and poorer mental health (each of which was also associated with lower odds of reductions of ≥ 3 painful sites).

CONCLUSIONS: Longitudinally, the number of reported painful sites was relatively stable but the anatomical distribution varied considerably. These findings suggest an important role for central pain sensitisation mechanisms, rather than localised risk factors, among working adults.

PMID:35598315 | DOI:10.1002/ejp.1978

Cancer Med. 2022 May 22. doi: 10.1002/cam4.4839. Online ahead of print.

ABSTRACT

OBJECTIVES: Microinvasive breast cancer (MIBC) is a special type of breast cancer with a relatively low prevalence, of which the understanding remains controversial. In this article, we aimed to clarify the clinicopathological characteristics and prognosis of MIBC in the setting of different molecular subtypes and give feasible suggestions on clinical practice in MIBC.

METHODS: This study utilized the data from Surveillance, Epidemiology, and End Results (SEER) database. Patients were divided into subgroups based on the molecular subtypes, of which the clinicopathological characteristics were further undergone comparative analyses. Kaplan-Meier method and Cox proportional hazard regression analysis were employed to determine the prognosis of the subtypes, and to explore the prognostic factors. Patients were randomly assigned in a 7:3 ratio to the training and validation cohorts. The independent risk variables were then adopted to generate a nomogram to predict the 3- and 5-year survival probability.

RESULTS: A total of 4301 MIBC patients between 2010 and 2016 were obtained from the SEER database, which were subsequently separated into HR+/HER2- (n = 2598), HR+/HER2+ (n = 723), HR-/HER2+ (n = 633), and HR-/HER2- (n = 347) groups. The HR+/HER2+ group showed the best overall survival (OS) (81.28 months, 95% CI 80.45-82.11) compared with other groups (p = 0.0089). The application of radiotherapy in HR+/HER2- and HR+/HER2+ MIBC patients brought out additional survival benefit compared with those without radiotherapy (p < 0.0001 and p = 0.024, respectively). The prognosis among four subgroups with or without chemotherapy showed no statistical difference. Based on the curated nomogram, the high-score group exhibited a better OS compared with patients from the low-score group.

CONCLUSIONS: Profound heterogeneity was detected among different molecular subtypes in MIBC patients, of which HR+/HER2+ subtype presented the best prognosis. For HR-positive MIBC patients, increasing survival benefits could be retrieved from radiotherapy. Chemotherapy was not recommended for patients with MIBC. Individual-based protocols were introduced based on the nomogram which warranted further validation.

PMID:35598300 | DOI:10.1002/cam4.4839

Eur J Neurol. 2022 May 22. doi: 10.1111/ene.15413. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the extent of sudomotor dysfunction in people with neuromyelitis optica spectrum disorder (pwNMOSD) and to compare findings with a historical cohort of people with relapsing remitting multiple sclerosis (pwRRMS).

METHODS: We enrolled 48 pwNMOSD from four clinical centers. All participants completed the Composite Autonomic Symptom Score-31 (COMPASS-31) to screen for symptoms of sudomotor dysfunction. Sudomotor function was assessed using the quantitative sudomotor axon reflex test (QSART). The results were compared with a historical cohort of 35 pwRRMS matched for age, sex and disease duration.

RESULTS: symptoms of sudomotor dysfunction, defined by a score in the COMPASS-31 secretomotor domain >0, were present in 26 (54%) of pwNMOSD. The QSART-confirmed a sudomotor dysfunction in 25 (52.1%) of pwNMOSD; in 14 thereof (29.2%) sudomotor dysfunction was moderate or severe. No difference was observed between pwNMOSD and pwRRMS in any of the studied parameters. However, symptomatic sudomotor dysfunction was more frequent in pwNMOSD (n=8, 22.9%) compared to pwRRMS (n=1, 3%; p=0.028). In a multivariable logistic regression analysis, statistically significant predictors for symptomatic sudomotor failure were age and diagnosis of NMOSD.

CONCLUSIONS: Sudomotor dysfunction is common in pwNMOSD and more often symptomatic compared to pwRRMS.

PMID:35598288 | DOI:10.1111/ene.15413

J Orthop Res. 2022 May 22. doi: 10.1002/jor.25384. Online ahead of print.

ABSTRACT

To determine the cross-sectional and longitudinal associations of patella alignment with cartilage relaxation and patients’ self-reported symptoms. Thirty participants with isolated patellofemoral joint (PFJ) degeneration (6 males, 53.7 ± 9.3 years) and 24 controls (12 males, 47.6 ± 10.7 years) were included. Magnetic resonance assessment was performed to provide grading of structural abnormalities, cartilage relaxation times, and patella alignment. Self-reported symptoms were assessed using the self-administrated Knee Injury and Osteoarthritis Outcome Score (KOOS). All participants were examined at baseline and 3 years. Statistical parametric mapping and Pearson partial correlation were used to evaluate the associations between patella alignment with cartilage relaxation times and self-reported symptoms, respectively. The analyses were performed between baseline (cross-sectional) as well as baseline against 3 years (longitudinal). Results indicated that patella height and patella flexion were associated with T_1ρ and T₂ relaxation times at baseline (percentages of voxels showing significant correlation [PSV] = 10.1 to 24.8%; mean correlations [R] = 0.34 to 0.36; mean p values = 0.015 to 0.026). Further, greater patella lateral alignment, lateral tilt, and lateral spin were associated with longer T₂ times at 3 years (PSV = 11.0 to 14.4%, R = 0.39 to 0.44, p = 0.017 to 0.028). Last, a higher patella was associated with a lower KOOS at baseline and at 3 years (R = -0.33 to -0.35). The study suggests that patella malalignment as a risk factor for worsening cartilage health, informing clinicians with a better rehabilitation program that targets PFJ degeneration. This article is protected by copyright. All rights reserved.

PMID:35598282 | DOI:10.1002/jor.25384

Eur Arch Otorhinolaryngol. 2022 May 22. doi: 10.1007/s00405-022-07452-1. Online ahead of print.

ABSTRACT

OBJECTIVE: A planning study was performed to evaluate dosimetric differences between intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) for head and neck cancer (HNC) for sequential boost (Seq-boost) and simultaneous integrated boost techniques (SIB).

METHODS: 30 patients with HNC were included, 15 treated with SIB and 15 with Seq-Boost. For all patients both VMAT and IMRT plans were completed. The planning objective for PTV was 95% of dose covering minimum 95% of PTV; for spinal cord and brainstem Dmax was limited to 45 Gy and 54 Gy respectively. The parotids had a mean dose < 26 Gy limitation. The number of monitor units (MU) were scored for treatment delivery time efficiency.

RESULTS: Both techniques achieved the set objectives regarding PTV coverage and organ sparing. SIB plans presented a statistically significant better homogeneity for VMAT (p = 0.0096), while Seq-boost showed a statistically significant better conformity for VMAT (p = 0.0049). For parotids only SIB plans showed a lower Dmean value obtained with VMAT, while Seq-boost plans showed statistically insignificant differences. For SIB plans the MU was reduced by 33.4% with VMAT, whereas in Seq-boost plans the reduction was by 19.1%.

CONCLUSION: VMAT shows dosimetric superiority to IMRT in some cases, however an adequate coverage of the target volumes and a suitable OAR sparing can be achieved with both techniques. Though IMRT is still the standard in HNC radiotherapy, VMAT can be safely implemented, offering at least similar target coverage and organ sparing, with significantly reduced MU.

PMID:35598230 | DOI:10.1007/s00405-022-07452-1

Curr Diabetes Rev. 2022 May 19. doi: 10.2174/1573399818666220519142118. Online ahead of print.

ABSTRACT

BACKGROUND: Self-care behaviours among diabetes patients is often hindered because of various psycho-social factors which become obstacles to their better diabetes management and its proper outcome. The current study aims to find out these psycho-social factors that influence the execution of self-care behaviours among Type II diabetes patients from the perspective of various behaviour change models.

METHODS: The study adopted a correlational research design. A total of 266 participants above the age group of 18 years and diagnosed with type 2 diabetes were selected using purposive sampling from the Indian state of Karnataka. The data were collected using The Health Belief Questionnaire, Theory of Planned Behaviour Questionnaire (TPBQ), Socio-Ecological Model Questionnaire, and Diabetic Self-Care Activities Revised (SDSCA-R). The data were analysed using descriptive statistics, Pearson product-moment correlation and multiple regression Results: From the findings, it was observed that the domains of perceived susceptibility, cues to action and subjective norms are positively correlated with self-care behaviours significantly at p<0.05 levels while the domains of socio-ecological theory Personal, Interpersonal, Media & Policy and Community organizations are significantly positively correlated with self-care behaviour at p<0.01 levels. The linear regression of the domains of health belief model, theory of planned behaviour and socio-ecological theory on self-care behaviour showed that the statistically significant final model explained 14.9% (R2 =.149), F (3,262) =15.337, p< 0.000. The significant predictors are Community at p<0.000 level, Self-efficacy and Perceived severity at p<0.05 levels.

CONCLUSION: The study results ascertain the necessity of a psychosocial approach or the socio-cognitive perspective to understand the factors that actually enable a diabetes patient to engage in more self-care behaviours. In the Indian scenario, where health literacy is very minimum, the findings of the study can be used to implement better strategies for diabetes management both at the level of medical/mental health professionals and at the level of media and policy.

PMID:35598234 | DOI:10.2174/1573399818666220519142118

Eur Arch Otorhinolaryngol. 2022 May 22. doi: 10.1007/s00405-022-07451-2. Online ahead of print.

ABSTRACT

PURPOSE: The relatively new technique of trans-canal endoscopic ear surgery (TEES) when compared to microsurgery for ossiculoplasty has advantages of better visualization and no external incision but also has the disadvantage of being a one-handed procedure. Our study aimed to compare audiometric outcomes following ossiculoplasty performed via TESS with results of microsurgery.

MATERIALS AND METHODS: Data from a prospective audit of 157 consecutive patients who underwent ossiculoplasty by a single otologist from 2009 to 2018 was analyzed. TEES was introduced in the department in 2014; therefore, all patients before this period underwent microsurgery. Patients were classified by surgical approach, TEES, or microsurgery. Audiological outcomes were recorded at 3 and 12 months postoperatively and compared to pre-operative levels. Other variables included were the condition of stapes and reconstruction material used.

RESULTS: Of the 157 cases, 50 were TEES and 107 were microsurgery (81 microscope only and 27 combined with endoscope). There was statistically significant improvement (p < 0.001) in AC (43.4 dB pre-operatively, 36.2 dB postoperatively), BC (20.3 dB pre-operatively, 17.6 dB postoperatively), and ABG (21.8 dB pre-operatively, 16.7 dB postoperatively) in the total cohort. Both groups achieved an ABG better than 20 dB; 72% in TEES, 73% in the microscopic group, and there was no significant difference. There was no change in hearing at 12 months when compared to 3 months. No statistically significant difference was noted based on stapes condition, type of material used for ossiculoplasty, or tympanic membrane graft.

CONCLUSION: TEES is safe and as effective as microsurgery in ossiculoplasty with possibly much less pain and morbidity.

PMID:35598229 | DOI:10.1007/s00405-022-07451-2

Bull Math Biol. 2022 May 22;84(7):69. doi: 10.1007/s11538-022-01022-6.

ABSTRACT

Model discovery methods offer a promising way to understand biology from data. We propose a method to learn biological dynamics from spatio-temporal data by Gaussian processes. This approach is essentially “equation free” and hence avoids model derivation, which is often difficult due to high complexity of biological processes. By exploiting the local nature of biological processes, dynamics can be learned with data sparse in time. When the length scales (hyperparameters) of the squared exponential covariance function are tuned, they reveal key insights of the underlying process. The squared exponential covariance function also simplifies propagation of uncertainty in multi-step forecasting. After evaluating the performance of the method on synthetic data, we demonstrate a case study on real image data of E. coli colony.

PMID:35598223 | DOI:10.1007/s11538-022-01022-6

Asian Pac J Allergy Immunol. 2022 May 22. doi: 10.12932/AP-071121-1267. Online ahead of print.

ABSTRACT

BACKGROUND: Nasal irrigation is an effective component of sino-nasal disease management. Nonetheless, bacterial contamination is worrisome.

OBJECTIVE: To study bacterial colonization incidence using squeeze-bottle nasal irrigation devices, after disinfection with soap or soap-plus-microwave technique, in pediatric acute rhinosinusitis.

METHODS: A randomized, prospective, controlled study was conducted on acute rhinosinusitis children, aged 2-15 years. Each participant was randomized into a soap-cleaning or soap-plus- microwave group. For a two-week period, participants irrigated their nostrils with NSS twice daily and cleaned the bottle after each use. In the end, bottles were sent to a microbiological laboratory for bacterial identification.

RESULTS: The mean 5S Score and satisfaction score gradually improved in both groups with no significant differences between groups. Bacterial identification frequency in the soap group was slightly higher than in the soap-plus-microwave one, without statistical significance. For safety and tolerability, all participants reported 100% adherence to nasal irrigation. The soap-plus-microwave group reported more minor adverse outcomes than the soap-cleaning one. No thermal deformation of irrigation bottles was observed.

CONCLUSIONS: Regular cleaning of nasal irrigation devices is needed to minimize bacterial contamination. Only soap or soap plus microwave disinfection appeared simple and safe for disinfection. Both techniques can equally minimize the rate of bacterial contamination. Although no gross thermal deformation at optimal power and duration, chemical irritants after high power or long microwave durations may be a concern.

PMID:35598187 | DOI:10.12932/AP-071121-1267

Bull Math Biol. 2022 May 22;84(7):68. doi: 10.1007/s11538-022-01023-5.

ABSTRACT

Host diversification methods such as within-field mixtures (or field mosaics, depending on the spatial scale considered) are promising methods for agroecological plant disease control. We explore disease spread in host mixtures (or field mosaics) composed of two host genotypes (susceptible and resistant). The pathogen population is composed of two genotypes (wild-type and resistance-breaking). We show that for intermediate fractions of resistant hosts, the spatial spread of the disease may be split into two successive fronts. The first front is led by the wild-type pathogen and the disease spreads faster, but at a lower prevalence, than in a resistant pure stand (or landscape). The second front is led by the resistance-breaking type, which spreads slower than in a pure resistant stand (or landscape). The wild-type and the resistance-breaking genotypes coexist behind the invasion fronts, resulting in the same prevalence as in a resistant pure stand. This study shows that host diversification methods may have a twofold effect on pathogen spread compared to a resistant pure stand (or landscape): on the one hand, they accelerate disease spread, and on the other hand they slow down the spread of the resistance-breaking genotype. This work contributes to a better understanding of the multiple effects underlying the performance of host diversification methods in agroecology.

PMID:35598221 | DOI:10.1007/s11538-022-01023-5