Tag: nevin manimala

J Vet Intern Med. 2022 Feb 22. doi: 10.1111/jvim.16392. Online ahead of print.

ABSTRACT

BACKGROUND: Autoantibody biomarkers are valuable tools used to diagnose and manage autoimmune diseases in dogs. However, prior publications have raised concerns over a lack of standardization and sufficient validation for the use of biomarkers in veterinary medicine.

OBJECTIVES: Systematically compile primary research on autoantibody biomarkers for autoimmune disease in dogs, summarize their methodological features, and evaluate their quality; synthesize data supporting their use into a resource for veterinarians and researchers.

ANIMALS: Not used.

METHODS: Five indices were searched to identify studies for evaluation: PubMed, CAB Abstracts, Web of Science, Agricola, and SCOPUS. Two independent reviewers (AET and ELC) screened titles and abstracts for exclusion criteria followed by full-text review of remaining articles. Relevant studies were classified based on study objectives (biomarker, epitope, technique). Data on study characteristics and outcomes were synthesized in independent data tables for each classification.

RESULTS: Ninety-two studies qualified for final analysis (n = 49 biomarker, n = 9 epitope, and n = 34 technique studies). A high degree of heterogeneity in study characteristics and outcomes reporting was observed. Opportunities to strengthen future studies could include: (1) routine use of negative controls, (2) power analyses to inform sample sizes, (3) statistical analyses when appropriate, and (4) multiple detection techniques to confirm results.

CONCLUSIONS: These findings provide a resource that will allow veterinary clinicians to efficiently evaluate the evidence supporting the use of autoantibody biomarkers, along with the varied methodological approaches used in their development.

PMID:35192227 | DOI:10.1111/jvim.16392

Clin Endocrinol (Oxf). 2022 Feb 22. doi: 10.1111/cen.14703. Online ahead of print.

ABSTRACT

OBJECTIVE: The indication of surgery in primary hyperparathyroidism has been controversial, as many patients experience mild disease. The primary aim was to evaluate fracture incidence in a contemporary population-based cohort of patients having surgery for primary hyperparathyroidism. The secondary aim was to investigate whether preoperative serum calcium, adenoma weight or multiglandular disease influence fracture incidence.

DESIGN: A retrospective cohort study with population controls. Primary outcomes, defined by discharge diagnoses and prescriptions, were any fracture and fragility fracture, secondary outcomes were multiple fractures anytime and osteoporosis. Subjects were followed 10 years pre- and up to 10 years postoperatively (or 31/12/2015). Multiple events per subject were allowed. Fracture incidence rate ratios for patients pre- and postoperatively were tabulated and evaluated with mixed-effects Poisson regression. Secondary outcomes were evaluated using conditional logistic regression.

PATIENTS: A Swedish nationwide cohort of patients having surgery for primary hyperparathyroidism (n = 5,009) from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal surgery between 2003-2013 was matched with population controls (n = 14,983). Data were cross-linked with Statistics Sweden and the National Board of Health and Welfare.

MEASUREMENTS: Preoperative serum calcium and adenoma weight at pathological examination.

RESULTS: Patients had an increased incidence rate of any fracture preoperatively, IRR 1.27 (CI95% 1.11-1.46), highest in the last year prior to surgery. Fracture incidence was not increased postoperatively. Serum calcium, adenoma weight and multiglandular disease were not associated with fracture incidence.

CONCLUSIONS: Fracture incidence is higher in patients with primary hyperparathyroidism, but is normalised after surgery. This article is protected by copyright. All rights reserved.

PMID:35192220 | DOI:10.1111/cen.14703

Artif Organs. 2022 Feb 22. doi: 10.1111/aor.14217. Online ahead of print.

ABSTRACT

BACKGROUND: Implantable Cardioverter-Defibrillator (ICD) surgery in patients with implanted left ventricular assist devices (LVAD) is associated with an increased risk of bleeding complications because of the need to ensure that these patients are adequately anticoagulated. Our study aimed to evaluate the safety of our new strategy of uninterrupted oral anticoagulation compared to heparin-bridging during the surgical interval.

METHODS: Between 01/2009 and 01/2020, 116 patients with LVAD underwent ICD surgery. Since 01/2015, 60 patients were operated under continued sufficient oral anticoagulation with a vitamin k antagonist (VKA group). Fifty-six patients underwent a heparin-bridging regimen (heparin group). Demographics, perioperative data, complications, and mortality were analyzed.

RESULTS: Bleeding complications attributable to the surgical intervention occurred more often (19.6% vs. 10.0%, p=0.142) and at a higher rate of re-exploratory surgery (14.3 % vs. 5.0%, p=0.088) in the heparin group without reaching statistical significance. Moreover, the heparin group patients’ postoperative total length of stay was 10 days longer. (17.8 ± 23.8 days vs. 8.3 ± 9.5 days, p=0.007). There were no procedure-related deaths, no thromboembolic events, and no LVAD-related thrombosis.

CONCLUSION: Our strategy of uninterrupted oral anticoagulation is safe and results in a reduction by more than half the number of days in hospital without an increase in adverse events.

PMID:35192216 | DOI:10.1111/aor.14217

Ann Surg Oncol. 2022 Feb 21. doi: 10.1245/s10434-022-11417-3. Online ahead of print.

ABSTRACT

BACKGROUND: Implementing a prospective lymphadenectomy protocol, we investigated the nodal yields and metastases per anatomical stations and nodal echelon following upfront pancreatoduodenectomy (PD) for cancer. Next, the relationship between the extension of nodal dissection, the number of examined and positive nodes (ELN/PLN), disease staging and prognosis was assessed.

METHODS: Lymphadenectomy included stations 5, 6, 8a-p, 12a-b-p, 13, 14a-b, 17, and jejunal mesentery nodes. Data were stratified by N-status, anatomical stations, and nodal echelons. First echelon was defined as stations embedded in the main specimen and second echelon as stations sampled as separate specimens. Recurrence and survival analyses were performed by using standard statistics.

RESULTS: Overall, 424 patients were enrolled from June 2013 through December 2018. The median number of ELN and PLN was 42 (interquartile range [IQR] 34-50) and 4 (IQR 2-8). Node-positive patients were 88.2%. The commonest metastatic sites were stations 13 (77.8%) and 14 (57.5%). The median number of ELN and PLN in the first echelon was 28 (IQR 23-34) and 4 (IQR 1-7). While first-echelon dissection provided enough ELN for optimal nodal staging, the aggregate rate of second-echelon metastases approached 30%. Nodal-related factors associated with recurrence and survival were N-status, multiple metastatic stations, metastases to station 14, and jejunal mesentery nodes.

CONCLUSIONS: First-echelon dissection provides adequate number of ELN for optimal staging. Nodal metastases occur mostly at stations 13/14, although second-echelon involvement is frequent. Only station 14 and jejunal mesentery nodes involvement was prognostically relevant. This latter station should be included in the standard nodal map and analyzed pathologically.

PMID:35192154 | DOI:10.1245/s10434-022-11417-3

Environ Sci Pollut Res Int. 2022 Feb 22. doi: 10.1007/s11356-022-18644-x. Online ahead of print.

ABSTRACT

The water quality index is one of the prominent general indicators to assess and classify surface water quality, which plays a critical role in river water resources practices. This research constructs a hybrid artificial intelligence model namely sequential minimal optimization-support vector machine (SMO-SVM) along with random forest (RF) as a benchmark model for predicting water quality values at the Wadi Saf-Saf river basin in Algeria. The fifteen input water quality datasets such as biochemical oxygen demand (BOD), oxygen saturation (OS), the potential for hydrogen (pH), chemical oxygen demand (COD), chloride (Cl^–), dissolved oxygen (DO), electrical conductivity (EC), total dissolved solids (TDS), nitrate-nitrogen (NO₃-N), nitrite-nitrogen (NO₂-N), phosphate (PO₄^3-), ammonium (NH₄⁺), temperature (T), turbidity (NTU), and suspended solids (SS) were employed for constructing the predictive models. Different input data combinations are evaluated in terms of predictive performance, using a set of statistical metrics and graphical representation. Results show that less than 40% of samples were observed to be poor quality water during the dry season in downstream northeastern part of the basin. The findings also show that the RF model mostly generates more precise water quality index predictions than the SMO-SVM model for both training and testing stages. Although thirteen input parameters attain the optimal predictive performance (R² testing = 0.82, RMSE testing = 5.17), a couple of five input parameters, e.g., only pH, EC, TDS, T, and saturation, gives the second optimal predictive precision (R² test = 0.81, RMSE testing = 5.55). The sensitivity analysis results indicate a greater sensitivity by the all input variables chosen except NO₂^– of the predictive outcomes to the earlier influencing water quality parameters. Overall, the RF model reveals an improvement on earlier tools for predicting water quality index, according to predictive performance and reducing in the number of input variables.

PMID:35192167 | DOI:10.1007/s11356-022-18644-x

J Gastrointest Cancer. 2022 Feb 22. doi: 10.1007/s12029-021-00739-2. Online ahead of print.

ABSTRACT

BACKGROUND: With the continuous advent of magnifying endoscopy, endoscopic submucosal dissection (ESD) has gradually become the mainstream treatment for early esophageal cancer. We aimed to compare the outcomes of patients with T1 superficial esophageal cell carcinoma treated with ESD vs. esophagectomy.

METHODS: We retrospectively analyzed patients who underwent ESD or radical surgery at the First Affiliated Hospital of Nanchang University from January 1, 2010, to December 31, 2018. The purpose of propensity score matching is to reduce selection bias. Precise subgroup analysis according to depth of invasion was performed to reduce the influence of confounding factors.

RESULT: We reviewed patients who underwent ESD (n = 117) or radical surgery (n = 217) at the First Affiliated Hospital of Nanchang University from 2010 to 2018. The OS rate and progression-free survival rate in the ESD group were better than those in the surgery group (OS, P = 0.002. PFS, P = 0.004). The ESD group had a lower early adverse event rate (74.6% vs. 91%, P = 0.012), shorter hospital stays (median 10 days vs. 18 days, P < 0.001), and lower hospitalization costs (median 15,455 vs. 62,376 RMB, P < 0.001). Multivariate Cox regression analysis found that the treatment method was an independent risk factor affecting the prognosis of patients with superficial esophageal cancer, and the death risk of patients in the ESD group was 0.377 times that of the radical surgery group (HR = 0.377, P = 0.023). We conducted a subgroup analysis of patients again according to the depth of invasion; 37 pairs of patients were included in the T1a stage, and 19 pairs of patients were included in the T1b stage. In T1a and T1b patients, the difference in OS rate and PFS rate between the two treatments was statistically significant (T1a, OS, P = 0.002, PFS, P = 0.004; T1b, OS, P = 0.019, PFS, P = 0.022), and the OS rates in the ESD group were better than those in the radical surgery group.

CONCLUSION: For patients with T1b superficial esophageal cancer, ESD has a longer overall survival and progression-free survival compared with radical surgery. These results support ESD as the preferred treatment for stage T1b superficial esophageal cancer.

PMID:35192141 | DOI:10.1007/s12029-021-00739-2

Tech Coloproctol. 2022 Feb 22. doi: 10.1007/s10151-022-02580-6. Online ahead of print.

ABSTRACT

BACKGROUND: Hospital readmissions after creation of an ileostomy are common and come with a high clinical and financial burden. The aim of this review with pooled analysis was to determine the incidence of dehydration-related and all-cause readmissions after formation of an ileostomy, and the associated costs.

METHODS: A systematic literature search was conducted for studies reporting on dehydration-related and overall readmission rates after formation of a loop or end ileostomy between January 1990 and April 2021. Analyses were performed using R Statistical Software Version 3.6.1.

RESULTS: The search yielded 71 studies (n = 82,451 patients). The pooled incidence of readmissions due to dehydration was 6% (95% CI 0.04-0.09) within 30 days, with an all-cause readmission rate of 20% (CI 95% 0.18-0.23). Duration of readmissions for dehydration ranged from 2.5 to 9 days. Average costs of dehydration-related readmission were between $2750 and $5924 per patient. Other indications for readmission within 30 days were specified in 15 studies, with a pooled incidence of 5% (95% CI 0.02-0.14) for dehydration, 4% (95% CI 0.02-0.08) for stoma outlet problems, and 4% (95% CI 0.02-0.09) for infections.

CONCLUSIONS: One in five patients are readmitted with a stoma-related complication within 30 days of creation of an ileostomy. Dehydration is the leading cause for these readmissions, occurring in 6% of all patients within 30 days. This comes with high health care cost for a potentially avoidable cause. Better monitoring, patient awareness and preventive measures are required.

PMID:35192122 | DOI:10.1007/s10151-022-02580-6

Matern Child Health J. 2022 Feb 22. doi: 10.1007/s10995-021-03370-6. Online ahead of print.

ABSTRACT

INTRODUCTION: The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from underrepresented minorities. We aimed to evaluate the success of this program based on three domains: (1) demographic characteristics, (2) academic and career development, and (3) attitudes towards the field of MCH and the training programs among graduates.

METHODS: Three domains of success were determined through a collaborative effort between current program directors and the funding agency project officers. The survey with questions related to the three domains was distributed via an online platform to graduates from seven sites (one former site and six current sites). Data were analyzed and presented utilizing descriptive statistics.

RESULTS: The survey was distributed to 550 graduates, 162 responded (37% response rate). Demographically, 78% were female, 54% were Black/African American, 22% were Latinx and 83% did not report any disability. Eighty percent of respondents applied to graduate/professional schools, 67% received admission. Graduates often continued to work in MCH fields (70%). Majority felt confident and knowledgeable in the field (89%) and agreed the faculty were supportive at their training sites (90%).

CONCLUSION: The study highlights successes in recruiting from underrepresented minorities, particularly Black/African Americans and first-time college goers in the family into the MCH Pipeline Training Programs. Programs were successful in furthering academic and career development for most trainees. Attitudes towards MCH and the training programs were overwhelmingly positive. Continued support of these programs is critical in addressing health disparities and achieving health equity.

PMID:35192126 | DOI:10.1007/s10995-021-03370-6

Cancer Causes Control. 2022 Feb 22. doi: 10.1007/s10552-021-01535-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To characterize the epidemiological trends and sociodemographic variation of pediatric and adolescent neurological cancers by histological subtypes over time in the USA.

METHODS: A total of 16,511 patients aged 0-19 years diagnosed with neurological cancers between 2000 and 2018, including 13,024 with central nervous system (CNS) neoplasms and 3,487 with neuroblastomas, were identified from 18 registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Incidence trends over time and incidence rate ratios by race/ethnicity, sex, and age were calculated for histological subtype. Age-standardized incidence rates (ASIR) by year of diagnosis and average annual percent changes (AAPC) were calculated to measure incidence rates. ASIR by race/ethnicity, sex, and age were calculated to examine the incidence variation by these factors.

RESULTS: Overall, age-standardized annual incidence per 100,000 person-years increased from 2.20 in 2000 to 3.21 in 2018 with an AAPC of 1.4% (95% confidence interval or CI: 0.5% to 2.4%); however, that of Hispanic decreased from 2.93 in 2000 to 2.59 in 2018 with an AAPC of – 0.8% (95% CI: – 1.2% to – 0.3%). Non-Hispanic Black children and adolescents had a statistically significantly lower incidence than non-Hispanic White peers both for CNS neoplasms (incidence rate ratio or IRR: 0.67; 95% CI: 0.63 to 0.71) and neuroblastomas (IRR: 0.75; 95% CI: 0.68 to 0.83). Females generally had a lower incidence than males, especially among those with intracranial and intraspinal embryonal tumors (IRR: 0.69; 95% CI: 0.64 to 0.75). The highest incidence rate of neuroblastoma was among newborns aged less than 1 year, and the highest incidence rate of CNS neoplasms was among children aged 1-4 years.

CONCLUSION: The incidence of neurological cancers has increased among children and adolescents from 2000 to 2018, with wide variation across demographic groups.

PMID:35192107 | DOI:10.1007/s10552-021-01535-w

Int J Cardiovasc Imaging. 2022 Feb 22. doi: 10.1007/s10554-022-02566-3. Online ahead of print.

ABSTRACT

There is a growing body of literature supporting the utilization of machine learning (ML) to improve diagnosis and prognosis tools of cardiovascular disease. The current study was to investigate the impact that the ML framework may have on the sensitivity of predicting the presence or absence of congenital heart disease (CHD) using fetal echocardiography. A comprehensive fetal echocardiogram including 2D cardiac chamber quantification, valvar assessments, assessment of great vessel morphology, and Doppler-derived blood flow interrogation was recorded. The postnatal echocardiogram was used to ascertain the diagnosis of CHD. A random forest (RF) algorithm with a nested tenfold cross-validation was used to train models for assessing the presence of CHD. The study population was derived from a database of 3910 singleton fetuses with maternal age of 28.8 ± 5.2 years and gestational age at the time of fetal echocardiography of 22.0 weeks (IQR 21-24). The proportion of CHD was 14.1% for the studied cohort confirmed by post-natal echocardiograms. Our proposed RF-based framework provided a sensitivity of 0.85, a specificity of 0.88, a positive predictive value of 0.55 and a negative predictive value of 0.97 to detect the CHD with the mean of mean ROC curves of 0.94 and the mean of mean PR curves of 0.84. Additionally, six first features, including cardiac axis, peak velocity of blood flow across the pulmonic valve, cardiothoracic ratio, pulmonary valvar annulus diameter, right ventricular end-diastolic diameter, and aortic valvar annulus diameter, are essential features that play crucial roles in adding more predictive values to the model in detecting patients with CHD. ML using RF can provide increased sensitivity in prenatal CHD screening with very good performance. The incorporation of ML algorithms into fetal echocardiography may further standardize the assessment for CHD.

PMID:35192082 | DOI:10.1007/s10554-022-02566-3