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Nevin Manimala Statistics

Agreement between the Skull Vibration-Induced Nystagmus Test and Semicircular Canal and Otolith Asymmetry

J Am Acad Audiol. 2021 Apr 19. doi: 10.1055/s-0041-1723039. Online ahead of print.

ABSTRACT

BACKGROUND: How significant asymmetries in otolith organ function in the presence of symmetrical and asymmetrical semicircular canal function influence skull vibration-induced nystagmus testing (SVINT) has not been well described.

PURPOSE: The aim of the study is to examine the agreement between SVINT and caloric testing, ocular vestibular-evoked myogenic potentials (oVEMP), and cervical vestibular-evoked myogenic potentials (cVEMP) for detecting asymmetric vestibular function.

RESEARCH DESIGN: This is a retrospective study of patients presenting with the chief complaint of vertigo, dizziness, or imbalance.

STUDY SAMPLE: A total of 812 patients were studied with a median age at testing of 59 years (interquartile range 46-70; range 18-93) and included 475 (59%) women.

INTERVENTION: Either the monothermal warm caloric test or alternate binaural bithermal caloric test, oVEMP, and cVEMP tests were administered to all patients. All patients underwent the SVINT prior to vestibular laboratory testing.

DATA COLLECTION AND ANALYSIS: Agreement between tests categorized as normal versus abnormal was summarized using percent concordance (PC). Sensitivity and specificity values were calculated for SVINT compared with other tests of vestibular function.

RESULTS: There was higher agreement between ipsilateral and contralateral SVINT with the caloric test (PC = 80% and 81%, respectively) compared with oVEMP (PC = 63% and 64%, respectively) and cVEMP (PC = 76% and 78%, respectively). Ipsilateral and contralateral SVINT showed higher sensitivity for the caloric test (sensitivity = 47% and 36%, respectively) compared with oVEMP (sensitivity = 26% and 21%, respectively), or cVEMP (sensitivity = 33% vs. 27%, respectively). Specificity of SVINT was high (>80%) for all assessments of vestibular function.

CONCLUSION: The presence of SVIN is a useful indicator of the asymmetry of vestibular function between the two ears when making judgments about semicircular canal asymmetry but is less sensitive to asymmetries in otolith organ function.

PMID:33873220 | DOI:10.1055/s-0041-1723039

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Nevin Manimala Statistics

Using SHRP2 NDS data to examine infrastructure and other factors contributing to older driver crashes during left turns at signalized intersections

Accid Anal Prev. 2021 Apr 16;156:106141. doi: 10.1016/j.aap.2021.106141. Online ahead of print.

ABSTRACT

Drivers age 65 and over have higher rates of crashes and crash-related fatalities than other adult drivers and are especially over-represented in crashes during left turns at intersections. This research investigated the use of SHRP2 Naturalistic Driving Study (NDS) data to assess infrastructure and other factors contributing to left turn crashes at signalized intersections, and how to improve older driver safety during such turns. NDS data for trips involving signalized intersections and crash or near-crash events were obtained for two driver age groups: drivers age 65 and over (older drivers) and a sample of drivers age 30-49, along with NDS pre-screening and questionnaire data. Video scoring of all trips was performed to collect additional information on intersection and trip conditions. To identify the most influential factors of crash risk during left turns at signalized intersections, machine learning and regression models were used. The results found that in the obtained NDS dataset, there was a relatively small volume of crashes during left turns at signalized intersections. Further, model results found the statistically significant variables of crash risk for older drivers were associated more with health and cognitive factors rather than the infrastructure or design of the intersections. The results suggest that a study using only SHRP2 NDS data will not lead to definitive findings or recommendations for infrastructure changes to increase safety for older drivers at signalized intersections and during left turns. Moreover, the findings of this study indicates the need to consider other data sources and data collection methods to address this critical literature gap in older driver safety.

PMID:33873135 | DOI:10.1016/j.aap.2021.106141

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Nevin Manimala Statistics

Transcranial photobiomodulation changes topology, synchronizability, and complexity of resting state brain networks

J Neural Eng. 2021 Apr 19. doi: 10.1088/1741-2552/abf97c. Online ahead of print.

ABSTRACT

OBJECTIVE: Transcranial photobiomodulation (tPBM) is a recently proposed non-invasive brain stimulation approach with various effects on the nervous system from the cells to the whole brain networks. Specially in the neural network level, tPBM may alter the topology and synchronizability of functional brain networks. However, the functional properties of the neural networks after tPBM are still poorly clarified.

APPROACH: Here, we employed electroencephalography (EEG) and different methods (conventional and spectral) in the graph theory analysis to track the significant effects of tPBM on the resting state brain networks. The non-parametric statistical analysis showed that just one short-term tPBM session over right medial frontal pole can significantly change both topological (i.e., clustering coefficient, global efficiency, local efficiency, eigenvector centrality) and dynamical (i.e., energy, largest eigenvalue, and entropy) features of resting state brain networks.

MAIN RESULTS: The topological results revealed that tPBM can reduce local processing, centrality, and laterality. Furthermore, the increased centrality of central electrode (Cz) was observed.

SIGNIFICANCE: These results suggested that tPBM may alter topology of resting state brain network to facilitate the neural information processing. However, the reduction of local processing after tPBM can be assumed as a negative point for this approach. On the other hand, the dynamical results showed that tPBM reduced stability of synchronizability but increased complexity in the resting state brain networks. These effects can be considered in association with the increased complexity of connectivity patterns among brain regions and the enhanced information propagation in the resting state brain networks. Overall, both topological and dynamical features of brain networks suggest that although tPBM decreases local processing and disrupts synchronizability of network, but it can increase the level of information transferring and processing in the brain network.

PMID:33873167 | DOI:10.1088/1741-2552/abf97c

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Nevin Manimala Statistics

Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study

Urol Int. 2021 Apr 19:1-6. doi: 10.1159/000515652. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension.

METHODS: Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated.

RESULTS: Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (p = 0.071, p = 0.973, respectively), but the increase in age and hypertension duration (p = 0.030 and p < 0.001, respectively) and the presence of metabolic syndrome (p = 0.002) significantly decreased the complete response rates.

CONCLUSIONS: Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.

PMID:33873196 | DOI:10.1159/000515652

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Nevin Manimala Statistics

Lower lung-volume level induces lower vertical center of mass position and alters swimming kinematics during front-crawl swimming

J Biomech. 2021 Apr 9;121:110428. doi: 10.1016/j.jbiomech.2021.110428. Online ahead of print.

ABSTRACT

We examined the impact of lung-volume levels on the vertical center of mass (CoM) position and kinematics during submaximal front-crawl swimming at constant velocity. Thirteen well-trained male swimmers (21.2 ± 2.0 years) swam the front-crawl for 15 m at a target velocity of 1.20 m s-1 while holding one of three lung-volume levels: maximal inspiration (MAX), maximal expiration (MIN), and intermediate between these (MID). The three-dimensional positions of 25 reflective markers attached to each participant’s body were recorded using an underwater motion capture system and then used to estimate the body’s CoM. The swimming velocity and the vertical CoM position relative to the water’s surface were calculated and averaged for one stroke cycle. Stroke rate, stroke length, kick rate, kick amplitude, kick velocity, and trunk inclination were also calculated for one stroke cycle. Swimming velocity was statistically comparable among the three different lung-volume levels (ICC [2,3] = 0.875). The vertical CoM position was significantly decreased with the lower lung-volume level (MAX: -0.152 ± 0.009 m, MID: -0.163 ± 0.009 m, MIN: -0.199 ± 0.007 m, P < 0.001). Stroke rate, kick rate, kick amplitude, kick velocity, and trunk inclination were significantly higher in MIN than in MAX and MID, whereas the stroke length was significantly lower (all P < 0.05). These results indicate that a lower lung-volume level during submaximal front-crawl swimming induces a lower vertical CoM position that is accompanied by a modulation of the swimming kinematics to overcome the increased drag arising from a larger projected frontal area.

PMID:33873108 | DOI:10.1016/j.jbiomech.2021.110428

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Nevin Manimala Statistics

The statistical mechanics of life: Comment on “Dynamic and thermodynamic models of adaptation” by A.N. Gorban et al

Phys Life Rev. 2021 Apr 14;37:100-102. doi: 10.1016/j.plrev.2021.04.003. Online ahead of print.

NO ABSTRACT

PMID:33873119 | DOI:10.1016/j.plrev.2021.04.003

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Nevin Manimala Statistics

EASY score (Eloquent, Age and baseline SYmptoms score) for outcome prediction in patients with acute ischemic stroke

Clin Neurol Neurosurg. 2021 Apr 1;205:106626. doi: 10.1016/j.clineuro.2021.106626. Online ahead of print.

ABSTRACT

OBJECTIVE: A pragmatic tool for the early and reliable prediction of recovery in patients with acute ischemic stroke is needed. We aimed to test the addition of brain eloquent areas involvement in variables predicting poor outcome, using a simple scoring system.

METHODS: Retrospective study of patients with anterior circulation acute ischemic stroke treated with best medical treatment and/or endovascular reperfusion. Primary outcome measure was 3-months poor outcome (mRs 3-6). We developed a prognostic model based on clinical data and a quantitative scoring system of the main eloquent brain areas involved on early follow-up CT, and analyzed its accuracy to predict poor outcome comparatively to three other prognostic models. The final model was used to develop a score for outcome prediction based on the multivariable analysis.

RESULTS: A total of 197 patients were included (poor outcome = 62; mean age 67 ± 15.1 years; 44% females). Independent predictors of poor outcome were increasing age (p < 0.001), baseline NIHSS (p = 0.03), and the involvement of two brain areas: posterior limb of internal capsule (p < 0.001) and postero-superior corona radiata (p < 0.001). This model showed to be the most accurate to predict poor outcome (Balance Accuracy = 77.74%; C-Statistic = 0.891). The derived risk score attributing points for each of these variables (EASY score) showed similar performances (Balance Accuracy = 82.11%; C-Statistic = 0.90).

CONCLUSION: The EASY score is an easy-to-apply and accurate tool to predict the 3-months functional outcome after ischemic stroke, relying on simple clinical features and the assessment of two key eloquent brain areas on early follow-up CT.

PMID:33873121 | DOI:10.1016/j.clineuro.2021.106626

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Nevin Manimala Statistics

Demographic risk factors for pelvic organ prolapse: Do smoking, asthma, heavy lifting or family history matter?

Eur J Obstet Gynecol Reprod Biol. 2021 Apr 12;261:25-28. doi: 10.1016/j.ejogrb.2021.04.006. Online ahead of print.

ABSTRACT

OBJECTIVE: Our objective was to identify non-obstetric risk factors for pelvic organ prolapse in women attending a urogynecology clinic.

STUDY DESIGN: A retrospective study of 662 women referred for pelvic floor dysfunction between January 2017 and August 2018. Participants underwent a standardized interview, clinical exam including Pelvic Organ Prolapse Qualification (POP-Q) assessment, and four-dimensional transperineal ultrasound. They were questioned about smoking, asthma, heavy lifting and family history of pelvic organ prolapse, as well as prolapse symptoms. Significant clinical prolapse was defined as POP-Q stage ≥2 for anterior and posterior compartments and stage ≥1 for apical prolapse. Offline analysis of volume data was performed blinded against all other data. Statistical analysis included logistic regression with multivariable models adjusted for age, body mass index, vaginal parity, levator hiatal area and levator avulsion.

RESULTS: Participating women were assessed at a mean age of 58 (SD 13.3) years with a mean body mass index of 28.93 kg/m2 (standard deviation 5.98). The vast majority were vaginally parous (88.2 %) with a median of two vaginal deliveries (range 0-7). Previous hysterectomy was reported by 29.3 % of women (n = 194) and previous prolapse repair by 17.2 % (n = 114). Past or current smoking was reported by 300 (45.6 %) women, 113 (17.2 %) reported asthma, 246 (37.6 %) heavy lifting and 186 (28.6 %) a family history of pelvic organ prolapse. Heavy lifting was associated with sonographic prolapse (odds ratio 1.71, 95 % confidence interval 1.2-2.4), confirmed on multivariable analysis (P = 0.046). Heavy lifting was positively associated with symptoms (P = 0.053) and clinical signs of pelvic organ prolapse (P = 0.056) on univariate analysis; however, this became non-significant on multivariable analysis. No associations were found for individual compartments except for a trend towards more posterior compartment prolapse with heavy lifting.

CONCLUSIONS: Smoking, asthma and family history of prolapse were not found to be a significant risk factor for prolapse in our study population. Heavy lifting may be a potential risk factor, in particular for posterior compartment prolapse.

PMID:33873084 | DOI:10.1016/j.ejogrb.2021.04.006

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Nevin Manimala Statistics

Effects of cigarette smoke on the aggravation of ovalbumin-induced asthma and the expressions of TRPA1 and tight junctions in mice

Mol Immunol. 2021 Apr 16;135:62-72. doi: 10.1016/j.molimm.2021.04.006. Online ahead of print.

ABSTRACT

The occurrence of asthma is closely related to environmental factors such as cigarette smoke (CS), one of the common risk factors. Environmental stimuli have the potential to activate transient receptor potential ankyrin 1 (TRPA1) and cause or aggravate asthma. The destruction of tight junctions (TJs) between airway epithelial cells by environmental stimuli in asthma has been researched. It is worth exploring whether CS can injury TJs and aggravate asthma by activating TRPA1. The objective of this study was to investigate the aggravation of CS on ovalbumin (OVA)-induced asthma related phenotypes and TJs expression in mice, and to explore the relationship between TRPA1 and the expression of TJs protein. Female wild type (WT) C57BL/6 mice, induced by OVA, CS and OVA plus CS (OVA + CS) respectively, were used to establish a 42-day asthma model, and mice with TRPA1 knockout (TRPA1-/-) were treated in the same way. This study detected the number of inflammatory cells in peripheral blood and bronchoalveolar lavage fluid (BALF), the levels of IL-4, IL-5, IL-13 in BALF, enhanced pause (Penh) of lung function, pathological changes and the gene and protein expressions of TRPA1 and TJs (including ZO-1, Occludin and Claudin-2) in lung tissues. Compared with normal saline (NS) group, WT mice in the OVA group and OVA + CS group were significantly higher in asthma related phenotypes. The WT-OVA + CS group also showed higher Penh value, levels of IL-5 and IL-13 in BALF and lung tissue injury scores when compared with the WT-OVA group and WT-CS group. However, WT-OVA + CS group mice had significantly larger number of neutrophils in BALF than the WT-OVA group, and had larger number of eosinophils in peripheral blood and higher levels of IL-4 in BALF than the WT-CS group. Meanwhile, compared with the WT-NS group, the expressions of TRPA1 and Claudin-2 in lung tissues increased in other three groups while their expressions of ZO-1 and Occludin decreased, among which, the WT-OVA + CS group showed more remarkable changes. Compared with the WT-OVA + CS group, mice in the TRPA1-/--OVA + CS showed a significant decrease in the number of inflammatory cells, levels of IL-4, IL-5 and IL-13 in BALF, Penh value and lung tissue injury score, and a downregulation of Claudin-2 expression while an upregulation of ZO-1 and Occludin expressions. In addition, the airway inflammation and injury, and the expressions of ZO-1, Occluding and Claudin-2 expressions were found with no statistic differences between TRPA1-/--OVA group and TRPA1-/--OVA + CS group. These results suggest that CS has aggravated the airway inflammation, pathological damage and destruction of TJs in airway epithelium of OVA-induced asthmatic mice, the processes of which are related to the increase of TRPA1 expression.

PMID:33873095 | DOI:10.1016/j.molimm.2021.04.006

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Nevin Manimala Statistics

Olfactory dysfunction in SARS-CoV-2 infection: Focus on odorant specificity and chronic persistence

Am J Otolaryngol. 2021 Apr 13;42(5):103014. doi: 10.1016/j.amjoto.2021.103014. Online ahead of print.

ABSTRACT

BACKGROUND: Smell dysfunction has been recognized as an early symptom of SARS-CoV-2 infection, often occurring before the onset of core symptoms of the respiratory tract, fever or muscle pain. In most cases, olfactory dysfunction is accompanied by reduced sense of taste, is partial (microsmia) and seems to normalize after several weeks, however, especially in cases of virus-induced complete smell loss (anosmia), there are indications of persisting deficits even 2 months after recovery from the acute disease, pointing towards the possibility of chronic or even permanent smell reduction for a significant part of the patient population. To date, we have no knowledge on the specificity of anosmia towards specific odorants or chemicals and about the longer-term timeline of its persistence or reversal.

METHODS: In this longitudinal study, 70 participants from a community in Lower Austria that had been tested positive for either IgG or IgM SARS-CoV-2 titers in June 2020 and a healthy control cohort (N = 348) underwent smell testing with a 12-item Cross-Cultural Smell Identification Test (CC-SIT), based upon items from the University of Pennsylvania Smell Identification Test (UPSIT). The test was performed in October 2020, i.e. 4 months after initial diagnosis via antibody testing. Results were analyzed using statistical tests for contingency for each smell individually in order to detect whether reacquisition of smell is dependent on specific odorant types.

RESULTS: For all odorants tested, except the odor “smoke”, even 4 months or more after acute SARS-CoV-2 infection, participants with a positive antibody titer had a reduced sense of smell when compared to the control group. On average, while the control cohort detected a set of 12 different smells with 88.0% accuracy, the antibody-positive group detected 80.0% of tested odorants. A reduction of accuracy of detection by 9.1% in the antibody-positive cohort was detected. Recovery of the ability to smell was particularly delayed for three odorants: strawberry (encoded by the aldehyde ethylmethylphenylglycidate), lemon (encoded by citronellal, a monoterpenoid aldehyde), and soap (alkali metal salts of the fatty acids plus odorous additives) exhibit a sensitivity of detection of an infection with SARS-CoV-2 of 31.0%, 41.0% and 40.0%, respectively.

CONCLUSION: Four months or more after acute infection, smell performance of SARS-CoV-2 positive patients with mild or no symptoms is not fully recovered, whereby the ability to detect certain odors (strawberry, lemon and soap) is particularly affected, suggesting the possibility that these sensitivity to these smells may not only be lagging behind but may be more permanently affected.

PMID:33873048 | DOI:10.1016/j.amjoto.2021.103014