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Nevin Manimala Statistics

Outcomes of reoperative aortic root surgery

J Thorac Cardiovasc Surg. 2021 Oct 23:S0022-5223(21)01491-4. doi: 10.1016/j.jtcvs.2021.09.060. Online ahead of print.

ABSTRACT

OBJECTIVE: The study objective was to determine the impact of reoperative aortic root replacement on short-term outcomes and survival.

METHODS: This was a retrospective study of aortic root operations from 2010 to 2018. All patients with a complete aortic root replacement were included, and patients undergoing valve-sparing root replacements were excluded. Patients were dichotomized by first-time sternotomy versus redo sternotomy, which was defined as having had a prior sternotomy for whatever reason. Within the redo sternotomy group, reoperative aortic root replacements were identified, being defined as a complete aortic root replacement in patients with a prior aortic root replacement; 1:1 nearest neighbor propensity matching was used to compare outcomes across groups. Kaplan-Meier survival estimates were generated and compared using log-rank statistics.

RESULTS: A total of 893 patients undergoing complete ARR were identified, of whom 595 (67%) underwent first-time sternotomy and 298 (33%) underwent redo sternotomy. After matching, postoperative outcomes were similar for the first-time and redo sternotomy groups, including operative mortality. Redo sternotomy was not associated with reduced survival after aortic root replacement compared with first-time sternotomy (P = .084), with 5-year survival of 73.7% for first-time sternotomy and 72.9% for redo sternotomy. In the redo sternotomy group (n = 298), 69 (23%) were reoperative aortic root replacements and 229 (77%) were first-time aortic root replacements. After matching, postoperative outcomes were similar for the first-time and reoperative aortic root replacement groups, including operative mortality. Reoperative aortic root replacement was not associated with reduced survival, compared with first-time aortic root replacement (P = .870), with 5-year survival of 67.9% for first-time aortic root replacement and 72.1% for reoperative aortic root replacement.

CONCLUSIONS: Reoperative aortic root replacement can be performed safely and provides similar survival to first-time aortic root replacement.

PMID:34776246 | DOI:10.1016/j.jtcvs.2021.09.060

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Effects of core stability training program on trunk muscle endurance in deaf children: A preliminary study

J Bodyw Mov Ther. 2021 Oct;28:6-12. doi: 10.1016/j.jbmt.2021.07.014. Epub 2021 Aug 12.

ABSTRACT

INTRODUCTION: Sport participation is an important for deaf children as participants experience physical, psychological and social benefits; however, the beneficial effect of core stability training on core muscle endurance is unclear. The present study aimed to examine the effects of an 8-week core stability exercise training program on endurance of trunk muscles in deaf children.

METHODS: Twenty male deaf students (age, 16.5 ± 0.65 y; body mass, 62.08 ± 5.39 kg; BMI, 22.33 ± 2.24 kg/m2) volunteered to participate in this study and were randomly assigned to experimental (EXP, n = 10) and control (CON, n = 10) groups. The subjects in the EXP group performed 3 times a week for 8 weeks period of core stability training program and tested trunk muscle endurance including prone bridge, supine bridge and flexor endurance tests at pre and post 8 weeks intervention.

RESULTS: The CON group did not show any significant change after training period (p > 0.05). The EXP group showed significantly changes in core stability muscle endurance tests following the 8-week core stability training program (p < 0.05). In addition, the EXP group indicated statistically significant changes than the CON group in truck muscle endurance (p < 0.05).

CONCLUSIONS: The results indicated that core stability training program improved trunk muscle endurance. Therefore, this training approach can be recommended in deaf rehabilitation programs to improve trunk muscle endurance.

PMID:34776200 | DOI:10.1016/j.jbmt.2021.07.014

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Effect of dynamic tape on postural sway in individuals with chronic ankle instability

J Bodyw Mov Ther. 2021 Oct;28:62-67. doi: 10.1016/j.jbmt.2021.07.026. Epub 2021 Aug 8.

ABSTRACT

OBJECTIVE: To examine the effects of dynamic tape on balance control in subjects with chronic ankle instability (CAI).

METHODS: This two group experimental pre- and post-treatment design included 18 individuals with CAI and 18 controls. The single-limb stance test with eyes open and closed, standing on a force plate (Accusway Plus; AMTI) for 30 s, was conducted before, 10 min (T1) and 24 h (T24) after a dynamic tape application over the gastrocnemius muscle. Outcome measurements were: mean sway velocity, sway area (circular area), and standard deviation of the body center of pressure path length in both mediolateral and anteroposterior directions. Individuals with poor (unable to perform a single leg test for at least 30 s, eyes closed) vs. good postural stability, were also compared.

RESULTS: In both groups, a repeated analysis of variance demonstrated a significant time main effect on sway velocity (F = 14.95; p < 0.001) and path length (F = 14.95; p < 0.001) during eyes closed. Post-hoc analysis revealed a significant decrease in T1 values compared to baseline. When comparing individuals with poor vs good stability amongst the CAI group, a statistically significant interaction was observed between group, time on sway velocity and path length (F = 3.92; p < 0.05) during eyes closed. In the poor postural group, most T1 values were significantly lower than baseline.

CONCLUSIONS: Dynamic tape when applied to posterior calf muscles, enhanced balance control with no difference between CAI individuals and controls. The contribution of the tape was greater in those with poor postural stability.

PMID:34776201 | DOI:10.1016/j.jbmt.2021.07.026

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The effect of smartphone addiction on physical activity level in sports science undergraduates

J Bodyw Mov Ther. 2021 Oct;28:530-534. doi: 10.1016/j.jbmt.2021.09.003. Epub 2021 Sep 25.

ABSTRACT

BACKGROUND: Smartphones are thought to have many negative effects on interpersonal relationships, physical-mental health, and general functionality as well as bring many conveniences to our daily lives. This study aimed to determine the effect of smartphone addiction on physical activity level in sports science undergraduates. Secondly, comparing the physical activity level in students by gender was aimed.

METHOD: A total of 300 (134 female, 166 male) healthy university students were included in this study. The mean age of the subjects was 21.36 ± 2.33 years. The universe of the study consisted of volunteer students (Coaching Education, Physical Education and Sports Teaching, Sports Management, Recreation Departments) at the Faculty of Sport Sciences. Participants’ demographic information was obtained and their physical activity levels were questioned with International Physical Activity Questionnaires (IPAQ) and smartphone addictions with the Smartphone Addiction Scale- Short Version (SAS-SV). The significance level was accepted as p < .05 in statistical evaluations.

RESULTS: According to IPAQ scores, physical activity levels of the participants were as follows; 65.3% were adequate, 32.7% low and 2% inactive. One-hundred and twenty-six participants (42%) were smartphone addicts according to the SAS-SV results. When the departments were examined within themselves, it was found that IPAQ and SAS-SV scores were negatively correlated for Physical Education and Sports Teaching (r = – 0.262; p = .021) and Sports management (r = – 0.295; p = .01).

PMID:34776190 | DOI:10.1016/j.jbmt.2021.09.003

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Immediate effects of rhythmic joint mobilization of the temporomandibular joint on pain, mouth opening and electromyographic activity in patients with temporomandibular disorders

J Bodyw Mov Ther. 2021 Oct;28:563-569. doi: 10.1016/j.jbmt.2021.09.001. Epub 2021 Sep 23.

ABSTRACT

BACKGROUND: Rhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD.

MATERIALS AND METHODS: This was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package.

RESULTS: A statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85-1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49).

CONCLUSION: In this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.

PMID:34776197 | DOI:10.1016/j.jbmt.2021.09.001

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Risk of preterm birth in relation to history of preterm birth: a population-based registry study of 213,335 women in Norway

BJOG. 2021 Nov 14. doi: 10.1111/1471-0528.17013. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the relationship between preterm first birth and preterm second birth according to gestational age and to determine the role of placental disorder to recurrent preterm birth.

DESIGN: Population-based registry study.

SETTING: Medical Birth Registry of Norway and Statistics Norway.

POPULATION: Women (N=213,335) who gave birth to their first and second singleton child during 1999-2014 (N=426,670 births).

METHODS: Multivariate logistic regression analyses, adjusted for placental disorders, maternal, obstetric, and socioeconomic factors.

MAIN OUTCOME MEASURES: Extremely preterm (<28+0 weeks), very preterm (28+0 -33+6 weeks), and late preterm (34+0 -36+6 weeks) second birth.

RESULTS: Preterm birth (<37 weeks) rates were 5.6% for first births and 3.7% for second births. Extremely preterm second births (0.2%) occurred most frequent among women with an extremely preterm first birth (aOR 12.90; CI, 7.47-22.29). Very preterm second births (0.7%) occurred most frequent after an extremely preterm birth (aOR 12.98; CI 9.59-17.58). Late preterm second births (2.8%) occurred most frequent after a previous very preterm birth (aOR, 6.86; CI, 6.11-7.70). Placental disorders contributed with 30~40% of recurrent extremely and very preterm births and 10~20% of recurrent late preterm birth.

CONCLUSION: A previous preterm first birth was a major risk factor for a preterm second birth. The contribution of placental disorders was more pronounced for recurrent extremely and very preterm birth than for recurrent late preterm birth. Among women with any category of preterm first birth, more than one in six also had a preterm second birth (17.4%).

PMID:34775676 | DOI:10.1111/1471-0528.17013

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Computational Image Translation from Mueller Matrix Polarimetry to Bright-field Microscopy

J Biophotonics. 2021 Nov 14:e202100242. doi: 10.1002/jbio.202100242. Online ahead of print.

ABSTRACT

Mueller matrix (MM) polarimetry can provide comprehensive information about the polarization properties which are closely related to the microstructural features and has demonstrated its potential in biomedical studies and clinical practices, and bright-field microscopy is widely used in pathological diagnosis as the golden standard. In this work, we improve the throughput of MM microscopy by learning a statistical transformation between these two imaging systems based on deep learning. Using this approach, the MM microscope can generate image that is equivalent to a bright-field microscope image of the matching field of view. We add new transformative capability to the existing MM imaging system without requiring extra hardware. The translation model is based on conditional generative adversarial network with customized loss functions. We demonstrated the effectiveness of our approach on liver and breast tissues, and evaluated the performance by four quantitative similarity assessment methods in pixel, image and distribution levels respectively. This article is protected by copyright. All rights reserved.

PMID:34775685 | DOI:10.1002/jbio.202100242

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Are severe adverse events commonly observed in dogs during cancer chemotherapy? A retrospective study on 155 dogs

Vet Comp Oncol. 2021 Nov 14. doi: 10.1111/vco.12782. Online ahead of print.

ABSTRACT

Overall prevalence of severe adverse events (sAE) has been poorly studied in veterinary medicine and peer-reviewed studies mostly focused on a single protocol, making it difficult to have a general overview. The aim of this retrospective study was to assess the frequency and risk factors of sAE secondary to various protocols of chemotherapy in dogs. Medical records of one hundred and fifty-five dogs receiving chemotherapy between January 2013 and December 2018 were reviewed. Adverse events (AE) were graded according to VCOG-CTCAE grading system. Statistical analyses were performed to determine whether demographic, cancer type and chemotherapy protocol were associated with development of sAE and their consequences. AE were reported at least once in 124 (80%) dogs and sAE were observed in 50 (32.3%) dogs. Among them, 23 (14.8%) had gastro-intestinal and 31 (20.0%) had myelotoxic events. sAE led to hospitalization in 37 (23.9%) dogs, to chemotherapy arrest in 12 (7.7%) dogs and to euthanasia or death in 9 (5.8%) dogs. Haematopoietic tumours were statistically associated with a higher frequency of sAE (p=0.004), gastrointestinal sAE (p=0.009), and hospitalization (p=0.004). A body weight over 10 kg was associated with less haematological sAE (p<0.001). The use of a multi-agent protocol was highlighted as a risk factor for sAE (p=0.038) and haematological sAE (p<0.001). sAE following chemotherapy and leading to hospitalization, chemo arrest or death were relatively common. A special attention during chemotherapy follow-up should be given to small dogs and those receiving multi-agent protocol or treated for haematopoietic tumours. This article is protected by copyright. All rights reserved.

PMID:34775666 | DOI:10.1111/vco.12782

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Predictors for the risk of permanent pacemaker implantation after transcatheter aortic valve replacement: A systematic review and meta-analysis

J Card Surg. 2021 Nov 14. doi: 10.1111/jocs.16129. Online ahead of print.

ABSTRACT

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a less invasive treatment than surgery for severe aortic stenosis. However, its use is restricted by the fact that many patients eventually require permanent pacemaker implantation (PPMI). This meta-analysis was performed to identify predictors of post-TAVR PPMI.

METHODS: The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Relevant studies that met the inclusion criteria were included in the pooling analysis after quality assessment.

RESULTS: After pooling 67 studies on post-TAVR PPMI risk in 97,294 patients, balloon-expandable valve use was negatively correlated with PPMI risk compared with self-expandable valve (SEV) use (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.37-0.53). Meta-regression analysis revealed that history of coronary artery bypass grafting and higher Society of Thoracic Surgeons (STS) risk score increased the risk of PPMI with SEV utilization. Patients with pre-existing cardiac conduction abnormalities in 28 pooled studies also had a higher risk of PPMI (OR: 2.33, 95% CI: 1.90-2.86). Right bundle branch block (OR: 5.2, 95% CI: 4.37-6.18) and first-degree atrioventricular block (OR: 1.97, 95% CI: 1.38-2.79) also increased PPMI risk. Although the trans-femoral approach was positively correlated with PPMI risk, the trans-apical pathway showed no statistical difference to the trans-femoral pathway. The approach did not increase PPMI risk in patients with STS scores >8. Patient-prosthesis mismatch did not influence post-TAVR PPMI risk (OR: 0.88, 95% CI: 0.67-1.16). We also analyzed implantation depth and found no difference between patients with PPMI after TAVR and those without.

CONCLUSIONS: SEV selection, pre-existing cardiac conduction abnormality, and trans-femoral pathway selection are positively correlated with PPMI after TAVR. Pre-existing left bundle branch block, patient-prosthesis mismatch, and implantation depth did not affect the risk of PPMI after TAVR.

PMID:34775652 | DOI:10.1111/jocs.16129

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Effects of Balance Training with Stroboscopic Glasses on Postural Control in Chronic Ankle Instability Patients

Scand J Med Sci Sports. 2021 Nov 14. doi: 10.1111/sms.14098. Online ahead of print.

ABSTRACT

Individuals with chronic ankle instability (CAI) are believed to rely more on visual information during postural control due to impaired proprioceptive function, which may increase the risk of injury when their vision is limited during sports activities.

OBJECTIVES: To compare (1) the effects of balance training with and without stroboscopic glasses on postural control and (2) the effects of the training on visual reliance in patients with CAI.

DESIGN: A randomized controlled clinical trial.

METHODS: Twenty-eight CAI patients were equally assigned to one of 2 groups: strobe or control group. The strobe group wore stroboscopic glasses during a 4-week balance training. Static postural control, a single-leg hop balance test calculated by Dynamic Postural Stability Index (DPSI), and the Y-Balance test (YBT) were measured. During the tests, there were different visual conditions: eyes-open (EO), eyes-closed (EC), and strobe vision (SV). Romberg ratios were then calculated as SV/EO, and EC/EO and used for statistical analysis.

RESULTS: The strobe group showed a higher pre-posttest difference in velocity in the medial-lateral direction and vertical stability index under SV compared with the control group (p < 0.05). The strobe group showed higher differences in EC/EO for velocity in the medial-lateral and anterior-posterior directions, and 95% confidence ellipse area (p < 0.05), and in SV/EO for velocity in the medial-lateral, 95% confidence ellipse area, and YBT-anterior direction (p < 0.05).

CONCLUSION: The 4-week balance training with stroboscopic glasses appeared to be effective in improving postural control and altering visual reliance in patients with CAI.

PMID:34775656 | DOI:10.1111/sms.14098