Tag: nevin manimala

Interact Cardiovasc Thorac Surg. 2021 Dec 22:ivab359. doi: 10.1093/icvts/ivab359. Online ahead of print.

ABSTRACT

OBJECTIVES: Aortic arch type is a readily recognizable and obtainable morphological feature of the aorta that does not require complex measurements. The goal of this study was to evaluate whether aortic arch type is a comparable and alternative morphological parameter for predicting acute type B aortic dissection (aTBAD) by comparing the prognostic value of the aortic arch type with that of other morphological parameters such as aortic length, angulation and tortuosity index.

METHODS: The patients with aTBAD (n = 216) were matched 1:1 with a control group (n = 263) by propensity score matching. The morphological data of the ascending aorta and the aortic arch, which included diameter, length, angulation and tortuosity index, were collected on a three-dimensional aortic model using 3mensio Vascular software. The aortic arch type was identified by the vertical distance from the origin of the brachiocephalic trunk to the top of the arch. The binary logistic regression models were analysed to determine the independent geometric variables related to the aTBAD. The nonparametric approach was performed to assess whether there were statistical differences between the area under the receiver operating characteristic curves (AUC) of the models.

RESULTS: After propensity score matching, 151 matched pairs of patients were selected. The diameters at the sinotubular junction and the mid-ascending aorta, the ascending aorta length and the ascending aorta angulation in the aTBAD group were significantly greater than those of the controls. Compared with the control group, the diameters at the proximal aortic arch, mid-aortic arch and distal aortic arch, the angulation and the tortuosity index of the aortic arch were significantly greater in the aTBAD group. The proportion of the type III arch in the patients with aTBAD is higher than that of the type I arch and the type II arch (χ2 = 70.187; P < 0.001). Binary logistic regression analysis showed that the diameter at the mid-aortic arch, the ascending aorta length, the aortic arch angulation and the tortuosity index were independently related to the aTBAD with an AUC value of 0.887. Another binary logistic regression analysis indicated that the diameter at the mid-aortic arch and the aortic arch type were independent correlative variables associated with the aTBAD with an AUC of 0.874. No significant difference was observed in the prognostic value of receiver operating characteristic curves between the 2 models (P = 0.716).

CONCLUSIONS: The type III arch, which has the characteristics of aortic elongation, incremental angulation and tortuosity index, is a comparable and alternative identifier for patients at high risk for aTBAD.

PMID:34935037 | DOI:10.1093/icvts/ivab359

Eur Arch Psychiatry Clin Neurosci. 2021 Dec 21. doi: 10.1007/s00406-021-01363-8. Online ahead of print.

ABSTRACT

BACKGROUND: Significant evidence links white matter (WM) microstructural abnormalities to cognitive impairment in schizophrenia (SZ), but the relationship of these abnormalities with functional outcome remains unclear.

METHODS: In two independent cohorts (C1, C2), patients with SZ were divided into two subgroups: patients with higher cognitive performance (SZ-HCP-C1, n = 25; SZ-HCP-C2, n = 24) and patients with lower cognitive performance (SZ-LCP-C1, n = 25; SZ-LCP-C2, n = 24). Healthy controls (HC) were included in both cohorts (HC-C1, n = 52; HC-C2, n = 27). We compared fractional anisotropy (FA) of the whole-brain WM skeleton between the three groups (SZ-LCP, SZ-HCP, HC) by a whole-brain exploratory approach and an atlas-defined WM regions-of-interest approach via tract-based spatial statistics. In addition, we explored whether FA values were associated with Global Assessment of Functioning (GAF) scores in the SZ groups.

RESULTS: In both cohorts, mean FA values of whole-brain WM skeleton were significantly lower in the SCZ-LCP group than in the SCZ-HCP group. Whereas in C1 the FA of the frontal part of the left inferior fronto-occipital fasciculus (IFOF) was positively correlated with GAF score, in C2 the FA of the temporal part of the left IFOF was positively correlated with GAF score.

CONCLUSIONS: We provide robust evidence for WM microstructural abnormalities in SZ. These abnormalities are more prominent in patients with low cognitive performance and are associated with the level of functioning.

PMID:34935072 | DOI:10.1007/s00406-021-01363-8

F S Rep. 2021 Jul 3;2(4):421-427. doi: 10.1016/j.xfre.2021.06.010. eCollection 2021 Dec.

ABSTRACT

OBJECTIVE: To investigate whether there is a difference in the ectopic/heterotopic pregnancy rate of blastocyst-stage frozen-thawed embryo transfers (FETs) compared with that of cleavage-stage FETs.

DESIGN: A retrospective cohort study.

SETTING: Not applicable.

PATIENTS: Women undergoing autologous FETs at either the blastocyst stage (n = 118,572) or the cleavage stage (n = 117,619), as reported to the Society for Assisted Reproductive Technology from 2004 to 2013.

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: Pregnancy outcomes, specifically ectopic pregnancy rates and heterotopic pregnancy rates.

RESULTS: Among those who became pregnant, there was a significantly lower incidence of ectopic/heterotopic pregnancies in blastocyst-stage FETs versus that in cleavage-stage FETs (0.8% vs. 1.1%). The differences in ectopic/heterotopic pregnancy rates remained statistically significant after controlling for confounders such as tubal factor infertility and number of embryos transferred.

CONCLUSIONS: Blastocyst-stage FET was associated with a lower ectopic/heterotopic pregnancy rate compared with cleavage-stage FET.

PMID:34934982 | PMC:PMC8655396 | DOI:10.1016/j.xfre.2021.06.010

F S Rep. 2021 Sep 8;2(4):440-447. doi: 10.1016/j.xfre.2021.08.009. eCollection 2021 Dec.

ABSTRACT

OBJECTIVE: To examine the association between serum antimüllerian hormone (AMH) and live birth among women aged ≥41 years undergoing in vitro fertilization (IVF).

DESIGN: Retrospective cohort study using the 2012-2014 Society for Assisted Reproductive Technology Clinic Outcome Reporting System database.

SETTING: Fertility clinics reporting to the Society for Assisted Reproductive Technology.

PATIENTS: The analysis included 7,819 patients aged ≥41 years who underwent a first fresh, autologous IVF cycle during the study period. Cycles with preimplantation genetic testing were excluded.

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: Live birth rate.

RESULTS: The empirical distribution of AMH was examined, and extreme values were observed. Therefore, the natural logarithm transformation of AMH (log-AMH) was used in all analyses. Before adjustment for covariates, a one-unit increase in log-AMH was associated with doubling of the odds of live birth up to a log-AMH of -0.34 (equivalently, AMH, 0.71 ng/mL; odds ratio [OR], 2.02; 95% confidence interval [CI], 1.66-2.46). Above an AMH level of 0.71 ng/mL, the odds of live birth increased by only 40% with each unit increase in log-AMH (OR, 1.40; 95% CI, 1.22-1.61). After adjusting for covariates, the odds of live birth increased by 91% with each unit increase in log-AMH up to -0.34 (AMH, 0.71 ng/mL; OR, 1.91; 95% CI, 1.56-2.34). Above an AMH level of 0.71 ng/mL, the odds of live birth increased by only 32% with each unit increase in log-AMH (OR, 1.32; 95% CI, 1.15-1.53).

CONCLUSIONS: Among women aged ≥41 years undergoing fresh, autologous IVF, the odds of live birth significantly increase with increasing serum AMH level. As the AMH level increases above 0.71 ng/mL, the association maintains statistical significance, but the effect size is diminished.

PMID:34934985 | PMC:PMC8655414 | DOI:10.1016/j.xfre.2021.08.009

Eur Urol Open Sci. 2021 Nov 17;34:86-93. doi: 10.1016/j.euros.2021.10.002. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Metformin has been linked to improved survival among diabetic prostate cancer (PCa) patients, while hyperinsulinemia and insulin usage has been related to worse prognosis.

OBJECTIVE: To evaluate the association of metformin and other antidiabetic drugs with PCa death and androgen deprivation therapy (ADT).

DESIGN SETTING AND PARTICIPANTS: The study cohort included 14 424 men who underwent radical prostatectomy in Finland during 1995-2013. Cases were identified, and clinical data were collected from patient files and national registries using personal identification numbers.

INTERVENTION: Information on the use of each antidiabetic drug during 1995-2014 was collected from prescription registry of the Social Insurance Institution of Finland.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The risks of PCa death and initiation of ADT were analyzed by antidiabetic drug use with the Cox regression method. Each antidiabetic drug group was analyzed separately to model simultaneous usage. Pre- and postdiagnostic uses were analyzed separately.

RESULTS AND LIMITATIONS: Prediagnostic use of antidiabetic drugs in general had no association with the risk of PCa death. Prediagnostic use of metformin was related to a reduced risk of ADT initiation (hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.59-0.96), while high-dose insulin users had an increased risk. Overall, antidiabetic drug use after PCa diagnosis was associated with an elevated risk of PCa death. Only postdiagnostic metformin use was associated with reduced risks of PCa death (HR 0.47, 95% CI 0.30-0.76) and ADT initiation compared with nonusers. Study limitations are missing information on glycemic control, smoking, living or exercise habits, prostate-specific antigen, and Gleason score.

CONCLUSIONS: Among surgically treated PCa patients, use of metformin was associated with improved disease-specific survival, while insulin and insulin secretagogues were associated with poor survival. Metformin might be a favorable diabetes treatment among men with PCa.

PATIENT SUMMARY: In this Finnish nationwide study, we found that the risks of prostate cancer death and cancer progression are lowered among metformin users, but not among other antidiabetic drug users. Metformin might be a favorable treatment choice for diabetes in men with prostate cancer.

PMID:34934970 | PMC:PMC8655383 | DOI:10.1016/j.euros.2021.10.002

Rev Esp Salud Publica. 2021 Dec 22;95:e202112200.

ABSTRACT

OBJECTIVE: Eating disorders (EDs) usually begin during puberty and adolescence, a time when attention should be paid to the factors that influence the development of the disease. The aim of this study was to assess attitudes towards eating and the risk of developing EDs, taking into account personal and family variables in a population of secondary school students.

METHODS: A total of 790 Compulsory Secondary School students enrolled in the 2019/2020 academic year in secondary schools in the Autonomous Community of Galicia participated, of whom 410 were male and 380 female (M=13.84; SD=1.37). In this descriptive-cross-sectional study, eating disorders were assessed using Garner’s Eating Attitudes Test (EAT-26), adapted to Spanish subjects. The statistical treatment of the data was carried out by means of a multivariate analysis of variance (MANOVA), which took the form of frequency analysis and contingency tables.

RESULTS: With regard to the personal variables analysed, no significant differences in eating disorders were found across adolescents’ gender (p>0.05), but there were significant differences in age (p<0.001), school year (p<0.001) and use of social networks (p<0.05). Similarly, the data do showed significant differences in eating disorders according to the level of studies of the families (p<0.01) and their family relationship (p<0.001).

CONCLUSIONS: The results obtained in this research confirm an influence of personal and family variables in attitudes associated with EDs. Further investigation of these variables may facilitate better intervention, as well as improve the design of preventive strategies.

PMID:34934040

Ann Transplant. 2021 Dec 22;26:e934163. doi: 10.12659/AOT.934163.

ABSTRACT

BACKGROUND Dobutamine stress echocardiography (DSE) is commonly used for cardiovascular assessment before orthotopic liver transplantation (OLT). The coronary artery calcium score (CACS) is a useful screening tool for coronary artery disease (CAD). We aimed to compare the sensitivity and specificity of DSE and CACS for CAD in OLT candidates. MATERIAL AND METHODS A total of 265 of the 1589 patients who underwent OLT at our center between 2008 and 2019 had preoperative coronary angiography (CAG). Of these, 173 had DSE and 133 had a CT scan suitable for CACS calculation within 1 year of OLT. Patients with a nondiagnostic DSE were excluded (n=100). Two reviewers evaluated CACS on CT scans. The sensitivity/specificity of DSE and CACS for detection of angiographically significant CAD were calculated for patients with both tests (n=36). A separate analysis compared the sensitivity/specificity of a diagnostic DSE (n=73) and CACS (n=133) against CAG for all patients with either test. RESULTS Sensitivity and specificity were 57.1% and 89.7%, respectively, for DSE, compared with 71.4% and 62.1% for CACS at ≥100 Agatston score. For the analysis of all patients with either test, the sensitivity/specificity of DSE for detection of CAD and CACS were 30.8% and 85.0% and 80.0% and 62.8%, respectively. On ROC analysis, CACS was a satisfactory predictor of obstructive CAD (AUC, 0.76±0.06, 95% CI, 0.66-0.87; P<0.001). CONCLUSIONS CACS may be an important tool for cardiovascular assessment in patients undergoing OLT. DSE was nondiagnostic in a large percentage of OLT candidates, limiting its use in this population.

PMID:34934037 | DOI:10.12659/AOT.934163

Med Sci Monit. 2021 Dec 22;27:e933450. doi: 10.12659/MSM.933450.

ABSTRACT

BACKGROUND In the field of forensic medicine, sex estimation is a critical step in personal identification. Teeth are the hardest tissue and have high temperature resistance and corrosion resistance. In cases such as an airplane crash or the corpse of an unknown person, teeth often play a crucial role in identification. This study applied 3-dimensional technology to obtain odontometrics of permanent maxillary teeth and to examine the sexual dimorphism, finding suitable discriminant indicators to construct appropriate equations for sex estimation. MATERIAL AND METHODS A total of 204 participants (104 men and 100 women) from the Han population in Kashgar were included. Plaster models of their maxillary dentition were obtained to scan and measure through an accepted and commonly used 3-dimensional digital method. Descriptive statistics, t tests, and discriminant analyses were statistically analyzed using IBM SPSS 23.0 software. RESULTS This study showed high intra- and interexaminer reliability (intraclass correlation coefficient >0.950). There were statistically significant sex-related differences (P<0.05), with male values generally being higher for buccolingual distance, mesiodistal distance, intercanine distance, crown area, crown module, crown index, and maxillary canine index. Compared with other measurements, mesiodistal distance and crown area indicator exhibited distinct sexual dimorphism. In addition, several appropriate equations were constructed through different discriminant analyses that could be used to estimate sex in our specific population. CONCLUSIONS Three-dimensional digital technology offers a promising method for odontometry. Combining mesiodistal distance and buccolingual distance of particular teeth or using maxillary canine index in discriminant functions are acceptable auxiliary tools for sex estimation in the forensic field.

PMID:34934039 | DOI:10.12659/MSM.933450

Retina. 2021 Dec 17. doi: 10.1097/IAE.0000000000003385. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the correlation of volumetric measurements of intraretinal (IRF) and subretinal fluid (SRF) obtained by deep learning and central retinal subfield thickness (CSFT) based on optical coherence tomography (OCT) in retinal vein occlusion (RVO), diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD).

METHODS: A previously validated deep learning-based approach was used for automated segmentation of IRF and SRF in spectral domain-OCT images. OCT volumes of 2.433 patients obtained from multicenter studies were analyzed. Fluid volumes were measured at baseline and under anti-vascular endothelial growth factor (VEGF) therapy in the central 1, 3, and 6 mm.

RESULTS: Patients with nAMD demonstrated generally the weakest association between CSFT and fluid volumes measurements in the central 1mm (0.107 to 0.569). In patients with DME, IRF correlated moderately with CSFT (0.668 to 0.797). In patients with RVO, IRF volumes showed a moderate correlation with CSFT (0.603 to 0.704).

CONCLUSION: The correlation of CSFT and fluid volumes depends on the underlying pathology. Although the amount of central IRF seems to partly drive CSFT in DME and RVO, it has only a limited impact on patients with nAMD. Our findings do not support the use of CSFT as primary or secondary outcome measure for quantification of exudative activity or treatment guidance.

PMID:34934034 | DOI:10.1097/IAE.0000000000003385

Proc Natl Acad Sci U S A. 2021 Dec 28;118(52):e2106178118. doi: 10.1073/pnas.2106178118.

ABSTRACT

While the social sciences have made impressive progress in adopting transparent research practices that facilitate verification, replication, and reuse of materials, the problem of publication bias persists. Bias on the part of peer reviewers and journal editors, as well as the use of outdated research practices by authors, continues to skew literature toward statistically significant effects, many of which may be false positives. To mitigate this bias, we propose a framework to enable authors to report all results efficiently (RARE), with an initial focus on experimental and other prospective empirical social science research that utilizes public study registries. This framework depicts an integrated system that leverages the capacities of existing infrastructure in the form of public registries, institutional review boards, journals, and granting agencies, as well as investigators themselves, to efficiently incentivize full reporting and thereby, improve confidence in social science findings. In addition to increasing access to the results of scientific endeavors, a well-coordinated research ecosystem can prevent scholars from wasting time investigating the same questions in ways that have not worked in the past and reduce wasted funds on the part of granting agencies.

PMID:34933997 | DOI:10.1073/pnas.2106178118