Tag: nevin manimala

Med Biol Eng Comput. 2022 Mar 18. doi: 10.1007/s11517-022-02503-5. Online ahead of print.

ABSTRACT

Coronary artery disease (CAD) is among the leading causes of death worldwide. Initial studies require an electrocardiogram stress test often followed by cardiac imaging procedures. However, conventional indices still show insufficient diagnostic performance. We propose quaternion methods to evaluate abnormal alterations during ventricular depolarization and repolarization. Assessment was conducted during a Bruce protocol treadmill stress test and after the end of the exercise. We developed an algorithm to automatically determine the beginning and end of exercise and then, computed the angular and linear velocities. Statistical analysis for feature selection and classification between ischaemic and non-ischaemic patients was used. The most significant markers were maximum linear velocity during ventricular depolarization (p < 5E-9) and maximum angular velocity during the second half of the repolarization loop (p < 5E-16). The latter reached sensitivity / specificity pair of 78 / 92 (AUC 0.89). A linear classifier showed a trend of reduction in cardiac vector velocity in at-risk patients after the end of exercise. The sensitivity / specificity pair reached was 86 / 100. Trajectory deviations of depolarization / repolarization loops that result from ischaemia effects, could be responsible for the observed reduction in dynamic changes during exercise. Further studies could provide non-invasive complementary tools to detect CAD risk. Graphical abstract This data is mandatory, please provide.

PMID:35304671 | DOI:10.1007/s11517-022-02503-5

Cancer Causes Control. 2022 Mar 19. doi: 10.1007/s10552-022-01565-y. Online ahead of print.

ABSTRACT

PURPOSE: Previous studies show that consuming foods preserved by salting increases the risk of gastric cancer, while results on the association between total salt or added salt and gastric cancer are less consistent and vary with the exposure considered. This study aimed to quantify the association between dietary salt exposure and gastric cancer, using an individual participant data meta-analysis of studies participating in the Stomach cancer Pooling (StoP) Project.

METHODS: Data from 25 studies (10,283 cases and 24,643 controls) from the StoP Project with information on salt taste preference (tasteless, normal, salty), use of table salt (never, sometimes, always), total sodium intake (tertiles of grams/day), and high-salt and salt-preserved foods intake (tertiles of grams/day) were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age, and gastric cancer risk factors) odds ratios (aORs), and the corresponding 95% confidence intervals (95% CI).

RESULTS: Gastric cancer risk was higher for salty taste preference (aOR 1.59, 95% CI 1.25-2.03), always using table salt (aOR 1.33, 95% CI 1.16-1.54), and for the highest tertile of high-salt and salt-preserved foods intake (aOR 1.24, 95% CI 1.01-1.51) vs. the lowest tertile. No significant association was observed for the highest vs. the lowest tertile of total sodium intake (aOR 1.08, 95% CI 0.82-1.43). The results obtained were consistent across anatomic sites, strata of Helicobacter pylori infection, and sociodemographic, lifestyle and study characteristics.

CONCLUSION: Salty taste preference, always using table salt, and a greater high-salt and salt-preserved foods intake increased the risk of gastric cancer, though the association was less robust with total sodium intake.

PMID:35304655 | DOI:10.1007/s10552-022-01565-y

Brain Inform. 2022 Mar 18;9(1):7. doi: 10.1186/s40708-022-00154-8.

ABSTRACT

Directed transfer function (DTF) is good at characterizing the pairwise interactions from whole brain network and has been applied in discrimination of motor imagery (MI) tasks. Considering the fact that MI electroencephalogram signals are more non-stationary in frequency domain than in time domain, and the activated intensities of α band (8-13 Hz) and β band [13-30 Hz, with [Formula: see text](13-21 Hz) and [Formula: see text](21-30 Hz) included] have considerable differences for different subjects, a dynamic DTF (DDTF) with variable model order and frequency band is proposed to construct the brain functional networks (BFNs), whose information flows and outflows are further calculated as network features and evaluated by support vector machine. Extensive experiments are conducted based on a public BCI competition dataset and a real-world dataset, the highest recognition rate achieve 100% and 86%, respectively. The experimental results suggest that DDTF can reflect the dynamic evolution of BFN, the best subject-based DDTF appears in one of four frequency sub-bands (α, β, [Formula: see text] [Formula: see text]) for discrimination of MI tasks and is much more related to the current and previous states. Besides, DDTF is superior compared to granger causality-based and traditional feature extraction methods, the t-test and Kappa values show its statistical significance and high consistency as well.

PMID:35304652 | DOI:10.1186/s40708-022-00154-8

Eur Radiol. 2022 Mar 18. doi: 10.1007/s00330-022-08579-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To validate a deep learning (DL) algorithm for measurement of skeletal muscular index (SMI) and prediction of overall survival in oncology populations.

METHODS: A retrospective single-center observational study included patients with metastatic renal cell carcinoma between 2007 and 2019. A set of 37 patients was used for technical validation of the algorithm, comparing manual vs DL-based evaluations. Segmentations were compared using mean Dice similarity coefficient (DSC), SMI using concordance correlation coefficient (CCC) and Bland-Altman plots. Overall survivals (OS) were compared using log-rank (Kaplan-Meier) and Mann-Whitney tests. Generalizability of the prognostic value was tested in an independent validation population (N = 87).

RESULTS: Differences between two manual segmentations (DSC = 0.91, CCC = 0.98 for areas) or manual vs. automated segmentation (DSC = 0.90, CCC = 0.98 for areas, CCC = 0.97 for SMI) had the same order of magnitude. Bland-Altman plots showed a mean difference of -3.33 cm² [95%CI: -15.98, 9.1] between two manual segmentations, and -3.28 cm² [95% CI: -14.77, 8.21] for manual vs. automated segmentations. With each method, 20/37 (56%) patients were classified as sarcopenic. Sarcopenic vs. non-sarcopenic groups had statistically different survival curves with median OS of 6.0 vs. 12.5 (p = 0.008) and 6.0 vs. 13.9 (p = 0.014) months respectively for manual and DL methods. In the independent validation population, sarcopenic patients according to DL had a lower OS (10.7 vs. 17.3 months, p = 0.033).

CONCLUSION: A DL algorithm allowed accurate estimation of SMI compared to manual reference standard. The DL-calculated SMI demonstrated a prognostic value in terms of OS.

KEY POINTS: • A deep learning algorithm allows accurate estimation of skeletal muscle index compared to a manual reference standard with a concordance correlation coefficient of 0.97. • Sarcopenic patients according to SMI thresholds after segmentation by the deep learning algorithm had statistically significantly lower overall survival compared to non-sarcopenic patients.

PMID:35304638 | DOI:10.1007/s00330-022-08579-9

Support Care Cancer. 2022 Mar 19. doi: 10.1007/s00520-022-06969-9. Online ahead of print.

ABSTRACT

PURPOSE: Few large-scale studies have focused on the prevalence of symptoms and signs during the last days of patients diagnosed with advanced cancer. Identifying the patterns of specific symptoms according to cancer type is helpful to provide end-of-life care for patients with advanced cancer. We investigated the prevalence and severity of symptoms and signs associated with impending death in patients with advanced cancer.

METHODS: In this secondary analysis of an international multicenter cohort study conducted in three East Asian countries, we compared the severity of symptoms and signs among dying patients in the last 3 days of life according to the type of primary cancer using one-way analysis of variance (ANOVA). Post hoc analysis was conducted for multiple comparisons of each symptom according to the type of primary cancer.

RESULTS: We analyzed 2131 patients from Japan, Korea, and Taiwan. The prevalence of most symptoms and signs were relatively stable from 1 week after admission to the last 3 days of life. According to cancer type, edema of the lower extremities was the most common symptom and fatigue/ ascites were the most severe symptoms in digestive tract cancer. For lung cancer, respiratory secretion was the most prevalent and dyspnea/respiratory secretion were the most severe symptoms.

CONCLUSION: We demonstrated the prevalence and severity of symptoms and signs associated with the impending death of patients with advanced cancer in East Asia. Our study can enable clinicians to recognize the specific symptoms and signs at the very end of life.

PMID:35304634 | DOI:10.1007/s00520-022-06969-9

Nat Rev Genet. 2022 Mar 18. doi: 10.1038/s41576-022-00465-w. Online ahead of print.

ABSTRACT

DNA methylation data have become a valuable source of information for biomarker development, because, unlike static genetic risk estimates, DNA methylation varies dynamically in relation to diverse exogenous and endogenous factors, including environmental risk factors and complex disease pathology. Reliable methods for genome-wide measurement at scale have led to the proliferation of epigenome-wide association studies and subsequently to the development of DNA methylation-based predictors across a wide range of health-related applications, from the identification of risk factors or exposures, such as age and smoking, to early detection of disease or progression in cancer, cardiovascular and neurological disease. This Review evaluates the progress of existing DNA methylation-based predictors, including the contribution of machine learning techniques, and assesses the uptake of key statistical best practices needed to ensure their reliable performance, such as data-driven feature selection, elimination of data leakage in performance estimates and use of generalizable, adequately powered training samples.

PMID:35304597 | DOI:10.1038/s41576-022-00465-w

Surg Endosc. 2022 Mar 18. doi: 10.1007/s00464-022-09188-9. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal surgical approach to perform during pregnancy is still controversial. This study evaluated pregnancy and operative outcomes in women undergoing an appendectomy or cholecystectomy during pregnancy, and compared them between the laparoscopic and open approach using nationwide population-based data.

METHODS: Between 2009 and 2019, a total of 2941 pregnant women with procedure codes for an appendectomy or cholecystectomy were extracted from the Korean National Health Insurance claims data (laparoscopy: 1504; open: 1437). Surgical outcomes [length of stay (LOS), anesthesia time, 30-day readmission rates, transfusion rates, second laparotomy, and 30-day mortality rates] and pregnancy outcomes (live birth rate, overall and spontaneous abortion rates, threatened abortion rate, type of delivery, preterm labor, stillbirth, fetal screening abnormalities, and intrauterine growth retardation) were compared between the open and laparoscopic groups.

RESULTS: The laparoscopic group had a significantly shorter LOS than the open group, and transfusions were less frequent in the laparoscopic group. Mortality, 30-day readmission rates, and second laparotomy were not statistically significant between the two groups. There were no significant differences in fetal loss and live birth rates between the two groups in all gestational ages. Preterm labor within 30 days of surgery was more frequent in the laparoscopy group than in the open surgery group, especially for those in their first and third trimesters. Open procedures were associated with an increased rate of cesarean sections.

CONCLUSIONS: Laparoscopic surgery was found to be feasible and safe without adverse postoperative outcomes. Careful observation of postoperative preterm labor is necessary, especially for women who undergo laparoscopic surgery in their first and third trimesters.

PMID:35304619 | DOI:10.1007/s00464-022-09188-9

Sci Rep. 2022 Mar 18;12(1):4733. doi: 10.1038/s41598-022-08845-2.

ABSTRACT

This study evaluated the relationship between arsenic uptake via drinking water ingestion and arsenic concentration in fingernails as a biomarker for human exposure. For this purpose, we collected fingernail samples from 40 healthy participants of arsenic-affected rural regions of Kaboudrahang County, the west of Iran. A total of 49 fingernail samples were also collected from individuals who lived in areas where contamination of drinking water sources with arsenic had not been reported. It was found that the fingernails arsenic contents in 50 and 4.08% of the samples collected from arsenic-contaminated and reference villages were higher than the normal arsenic values of nails (0.43-1.08 µg/g), respectively. Based on the results of adjusted multiple linear regression, a significant association was found between groundwater and fingernails arsenic concentration (p < 0.001). Moreover, a statistically significant association was shown between arsenic in the fingernail samples and gender (p = 0.037). Fingernails arsenic contents were not significantly affected by other variables including age, smoking habits, and BMI (p > 0.05). In light of the results of this study, the use of biological indicators such as fingernail tissues due to easier sampling and less risk of external contamination is suitable for assessing exposure to heavy metals in contaminated areas.

PMID:35304571 | DOI:10.1038/s41598-022-08845-2

Sci Rep. 2022 Mar 18;12(1):4727. doi: 10.1038/s41598-022-08764-2.

ABSTRACT

To compare the anatomical/functional changes after navigated subthreshold pulse laser (SML) and oral eplerenone therapy for chronic central serous chorioretinopathy (cCSC). A total of 36 eyes of 36 patients suffering from cCSC treated with navigated SML (Navilas® 577s; OD-OS GmbH, near Berlin, Germany) (18 eyes, SML group) and oral eplerenone (18 eyes, eplerenone group) were enrolled in this retrospective study. Main outcome measures during a 3-month follow up period included changes of best corrected visual acuity (BCVA), central macular thickness (CMT), foveal subretinal fluid thickness (FSRFT), and subfoveal choroidal thickness (SFCT). At baseline average duration of symptoms was 6.8 ± 0.6 months in SML group and 6.4 ± 0.9 months in eplerenone group (p = 0.127). Mean BCVA, CMT and FSRFT changed significantly over time (p < 0.001). From baseline to 90 days the BCVA improved from 0.3 ± 0.1 to 0.1 ± 0.1 logMAR in SML group and from 0.3 ± 0. to 0.2 ± 0.1 logMAR in eplerenone group, CMT reduced from 357.1 ± 104.3 to 210.6 ± 46.7 μm and from 428.7 ± 107.7 to 332.5 ± 27.5 μm in SML group and eplerenone group respectively, FSRFT reduced from 144.4 ± 108.2 to 22.6 ± 37.2 μm and from 217.1 ± 105.9 to 54.4 ± 86.2 μm in SML group and eplerenone group. 55.6% of patients in SML group and 66.7% in eplerenone group showed a complete resolution of FSRFT during follow up. The interaction between group and time was statistically significant with greater absolute variation for CMT and FSRFT in SML group compared to eplerenone group (p < 0.001 and p = 0.043). SFCT did not change significantly during follow up (p = 0.083) for both groups. Both navigated SML and oral eplerenone were effective treatments showing recovery of retinal morphology and related visual acuity improvement in cCSC.

PMID:35304566 | DOI:10.1038/s41598-022-08764-2

Am J Transplant. 2022 Mar 18. doi: 10.1111/ajt.17032. Online ahead of print.

ABSTRACT

Donor infection affects organ utilization, especially the infections by multidrug-resistant bacteria, which may have disastrous outcomes. We established a rat model, inoculated with Escherichia coli (E. coli) or carbapenem-resistant Klebsiella pneumoniae (CRKP), to investigate whether hypothermic machine perfusion (HMP), normothermic machine perfusion (NMP), or static cold storage (SCS) combined with antibiotic (AB) could eliminate the bacteria. E. coli or CRKP-infected kidneys were treated with cefoperazone-sulbactam and tigecycline, respectively. The HMP+AB and NMP+AB treatments had significant therapeutic effects on E. coli or CRKP infection compared with the SCS+AB treatment. The bacterial load of CRKP-infected kidneys in the HMP+AB (22050±2884 CFU/g vs. 1900±400 CFU/g, p=0.007) and NMP+AB groups (25433±2059 CFU/g vs. 500±458 CFU/g, p=0.002) were significantly reduced, with no statistically significant difference between both groups. Subsequently, the CRKP-infected kidneys of the HMP+AB and SCS+AB groups were transplanted. The rats in the SCS+AB group were severe infected and euthanized on day 4 post-transplant. By contrast, the rats in the HMP+AB group were in good condition. In conclusion, HMP and NMP combined with AB seems to be efficient approaches to decrease bacterial load of infected kidneys. This might lead to higher utilization rates of donors with active infection.

PMID:35303398 | DOI:10.1111/ajt.17032