Tag: nevin manimala

Am J Phys Anthropol. 2021 Mar 30. doi: 10.1002/ajpa.24275. Online ahead of print.

ABSTRACT

OBJECTIVES: Some previous studies suggest that humans do not conform to geometric similarity (isometry) in anthropometric dimensions of the upper and lower limbs. Researchers often rely on a single statistical approach to the study of scaling patterns, and it is unclear whether these methods produce similar results and are equally robust. This study used one bivariate and one multivariate method to examine how linear anthropometric dimensions scale in a sample of adult humans.

MATERIALS AND METHODS: Motion capture marker data from 104 adults of varying height and mass were used to calculate anthropometric dimensions. We analyzed scaling patterns in pooled and separate sexes with two methods: (1) bivariate log-log regression and (2) multivariate principal component analysis (PCA). We calculated 95% highest density/confidence intervals for each method and defined positive/negative allometry as estimates lying outside those intervals.

RESULTS: Results identified isometric scaling of the upper arm, thigh, and shoulder, positive allometry of the forearm and shank, and negative allometry of the pelvis in the pooled sample using both statistical methods. Patterns of allometry in the pooled sample were similar between methods but differed in magnitude. Sex-specific results differed in both pattern and magnitude between log-log regression and PCA. Only one measurement (shoulder width) departed from isometry in the sex-specific log-log regressions.

DISCUSSION: Our findings suggest that especially in sex-specific analyses, the pattern and magnitude of allometry are sensitive to statistical methodology. When body mass was selected as the size variable, most human linear anthropometric dimensions in this sample scaled isometrically and were therefore geometrically similar within sexes.

PMID:33782957 | DOI:10.1002/ajpa.24275

Z Orthop Unfall. 2021 Mar 29. doi: 10.1055/a-1401-0477. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study was to evaluate the relationship between the correction rate in Cobb angle and the improvement in quality of life profile in terms of Scoliosis Research Society (SRS)-22 values.

PATIENTS AND METHODS: Between January 2007 and December 2013, posterior instrumentation and fusion was performed to 30 patients with adolescent idiopathic scoliosis (AIS). Patients were grouped according to their improvement rate in Cobb angles after surgery. Patients with an improvement rate of > 80% were grouped as Group A; those with an improvement rate of > 60% and ≤ 80% as Group B and those with an improvement rate of ≤ 60% were grouped as Group C. The SRS-22 questionnaire of these three groups was calculated and their relationship with the improvement in Cobb angle was evaluated.

RESULTS: No statistical difference was found among the three groups in terms of pain, appearance, function, spirit, satisfaction, and SRS-22 values (all p > 0.05).

CONCLUSION: The results of this study demonstrate that the degree of correction rate does not correlate with the degree of improvement in the SRS-22 questionnaire in patients with AIS that underwent posterior fusion and instrumentation.

PMID:33782933 | DOI:10.1055/a-1401-0477

Transplant Cell Ther. 2021 Mar;27(3):261.e1-261.e7. doi: 10.1016/j.jtct.2020.12.019. Epub 2020 Dec 22.

ABSTRACT

Central nervous system (CNS) involvement in Epstein-Barr virus-related post-transplant lymphoproliferative disorders (EBV-PTLDs) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is poorly defined. We analyzed the incidence, clinical and pathological characteristics, and impact on outcomes of EBV-PTLDs with CNS involvement (CNS-PTLDs) in 1009 consecutive adult patients undergoing allo-HSCT at a single-center institution. Four hundred eighty-two patients received matched sibling donor (MSD) transplants, 388 umbilical cord blood transplants (UCBTs), 56 matched unrelated donor (MUD) transplants, and 83 haploidentical transplants. We detected 25 cases of biopsy-proven EBV-PTLDs. Of these, nine patients (36%) had CNS-PTLDs: six after UCBT (67%), one after MSD transplantation (11%), one after MUD transplantation (11%), and one after haploidentical transplantation (11%). The 5-year cumulative incidence risk of CNS-PTLDs was 0.9%. Median time from transplant to CNS-PTLDs was 187 days, and all patients had neurological symptoms at diagnosis. Six out of the nine cases (67%) occurred with systemic involvement, and three cases (33%) had isolated CNS involvement. The most frequent histological subtype was monomorphic EBV-PTLD, and laboratory characteristics were similar to EBV-PTLDs without CNS involvement. We observed statistical differences in the rate of positive EBV DNA detection in plasma between isolated CNS-PTLDs (detection in one out of three, 33%) and the rest of the EBV-PTLDs (100%) (P = .01). Treatment strategies included chemotherapy, radiotherapy, and T cell therapy. However, seven out of nine patients died due to progression of the CNS-PTLDs at a median time of 17 days (range, 8 to 163) from diagnosis. The 5-years overall survival in patients who developed CNS-PTLDs was 22% (95% confidence interval [CI], 7% to 75%) and 5-year treatment-related mortality was 78% (95% CI, 51% to 100%), with no statistically significant differences between CNS-PTLDs and the rest of the EBV-PTLDs. In conclusion, despite advances in EBV monitoring and treatment strategies, CNS-PTLDs remain an uncommon but serious complication after allo-HSCT, with very poor prognosis.

PMID:33781531 | DOI:10.1016/j.jtct.2020.12.019

Transplant Cell Ther. 2021 Mar;27(3):262.e1-262.e11. doi: 10.1016/j.jtct.2021.01.004. Epub 2021 Jan 7.

ABSTRACT

Bloodstream infections (BSIs) occur in 20% to 45% of inpatient autologous and allogeneic hematopoietic cell transplant (HCT) patients. Daily bathing with the antiseptic chlorhexidine gluconate (CHG) has been shown to reduce the incidence of BSIs in critically ill patients, although very few studies include HCT patients or have evaluated the impact of compliance on effectiveness. We conducted a prospective cohort study with historical controls to assess the impact of CHG bathing on the rate of BSIs and gut microbiota composition among adults undergoing inpatient HCT at the Duke University Medical Center. We present 1 year of data without CHG bathing (2016) and 2 years of data when CHG was used on the HCT unit (2017 and 2018). Because not all patients adhered to CHG, patients were grouped into four categories by rate of daily CHG usage: high (>75%), medium (50% to 75%), low (1% to 49%), and none (0%). Among 192 patients, univariate trend analysis demonstrated that increased CHG usage was associated with decreased incidence of clinically significant BSI, defined as any BSI requiring treatment by the medical team (high, 8% BSI; medium, 15.2%; low, 15.6%; no CHG, 30.3%; P = .003), laboratory-confirmed BSI (LCBI; P = .03), central line-associated BSI (P = .04), and mucosal barrier injury LCBI (MBI-LCBI; P = .002). Multivariate analysis confirmed a significant effect of CHG bathing on clinically significant BSI (P = .023) and MBI-LCBI (P = .007), without consistently impacting gut microbial diversity. Benefits of CHG bathing were most pronounced with >75% daily usage, and there were no adverse effects attributable to CHG. Adherence to daily CHG bathing significantly decreases the rate of bloodstream infection following HCT.

PMID:33781532 | DOI:10.1016/j.jtct.2021.01.004

Transplant Cell Ther. 2021 Mar;27(3):274.e1-274.e5. doi: 10.1016/j.jtct.2020.12.024. Epub 2020 Dec 25.

ABSTRACT

Data on stem cell transplantation (SCT) for Diamond-Blackfan Anemia (DBA) is limited. We studied patients transplanted for DBA and registered in the EBMT database. Between 1985 and 2016, 106 DBA patients (median age, 6.8 years) underwent hematopoietic stem cell transplantation from matched-sibling donors (57%), unrelated donors (36%), or other related donors (7%), using marrow (68%), peripheral blood stem cells (20%), both marrow and peripheral blood stem cells (1%), or cord blood (11%). The cumulative incidence of engraftment was 86% (80% to 93%), and neutrophil recovery and platelet recovery were achieved on day +18 (range, 16 to 20) and +36 (range, 32 to 43), respectively. Three-year overall survival and event-free survival were 84% (77% to 91%) and 81% (74% to 89%), respectively. Older patients were significantly more likely to die (hazard ratio, 1.4; 95% confidence interval, 1.06 to 1.23; P < .001). Outcomes were similar between sibling compared to unrelated-donor transplants. The incidence of acute grades II to IV of graft-versus-host disease (GVHD) was 30% (21% to 39%), and the incidence of extensive chronic GVHD was 15% (7% to 22%). This study shows that SCT may represent an alternative therapeutic option for transfusion-dependent younger patients.

PMID:33781541 | DOI:10.1016/j.jtct.2020.12.024

Med Eng Phys. 2021 Apr;90:1-8. doi: 10.1016/j.medengphy.2021.01.009. Epub 2021 Feb 16.

ABSTRACT

This paper addresses an important issue faced by neurosurgeons during surgical skull bone grinding, a common process used to remove bone in skull base tumour removal surgery to enable the neurosurgeon to reach the target region. The heat generated during bone grinding could harm the soft tissues and can lead to osteonecrosis and cell death. In the present study, a novel process of rotary ultrasonic bone grinding (RUBG) was proposed for osteotomy to limit the temperature to a safe level. A systematic investigation was conducted to determine the effect of varying process parameters on osteonecrosis at the cut surface. Three input parameters – rotational speed, feed rate and frequency – were investigated (at three levels) in terms of change in temperature and thermal biological damage. A sterile solution was used as a coolant to irrigate the grinding zone. Viable lacunae (filled osteocytes), non-viable lacunae (empty lacunae), necrosed tissues, and Haversian canal were found during the histological examination. Statistical analysis revealed that feed rate (45.43%) had the highest contribution towards temperature rise during grinding, followed by ultrasonic frequency (23.87%), and rotational speed (12.85%). The optimal machining parameters to avoid osteonecrosis and thermal trauma were rotational speed 35,000 rpm, feed rate 20 mm/min and ultrasonic frequency 20 kHz. Furthermore, histograms revealed that ultrasonic skull bone grinding was associated with greater cell viability and reduced temperature compared with conventional bone grinding.

PMID:33781475 | DOI:10.1016/j.medengphy.2021.01.009

Med Eng Phys. 2021 Apr;90:54-65. doi: 10.1016/j.medengphy.2021.02.007. Epub 2021 Feb 25.

ABSTRACT

Ex vivo analysis of artificial discs is essential to better understand their ability to replace degenerated intervertebral discs. The Mobi-C differs from some other contemporary disc designs in that it has a mobile polyethylene insert that is sandwiched between superior and inferior cobalt chromium endplates. While some studies claim the Mobi-C to have restored normal cervical spinal biomechanics, others have noted high levels of migration. Our objective was to contribute to this debate by, for the first time, analysing an explanted Mobi-C cervical disc which was removed due to worsening myelopathy at the nano and macro scales. Intraoperatively, the insert was found to have excessively migrated and it compressed the spinal cord. Roughness was measured as 0.016 ± 0.006 μm (Sa) and 0.055 ± 0.020 μm (Sa) for the superior and inferior plates, and 1.210 ± 0.154 μm (Sa) and 0.446 ± 0.083 μm (Sa) for the superior and inferior surfaces of the insert. Compared to unworn surfaces, the roughness increased for the superior and inferior plates and decreased for both surfaces of the insert. However, the only statistically significant change occurred on the articulating surface of the inferior plate (p = 0.04). At the nanoscale, valleys dominated the articulating surfaces. The superior plate had a burnished appearance whereas the inferior plate appeared matt. Impingement was observed on the endplates. The insert was severely damaged, burnished and had scratches. Additionally, subsurface whitening and internal cracking were observed on the insert.

PMID:33781480 | DOI:10.1016/j.medengphy.2021.02.007

Transplant Cell Ther. 2021 Mar;27(3):259.e1-259.e6. doi: 10.1016/j.jtct.2020.12.006. Epub 2020 Dec 16.

ABSTRACT

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) feasibility has increased in the last decades because of haplo-HSCT, changes in chemotherapy schedules, and the possibility of an outpatient-based HSCT. The main barriers remain in low-middle income countries. There is a lack of information regarding haplo-HSCT with a myeloablative (MAC) regimen on an outpatient basis.

OBJECTIVES: Our primary objective was to determine if outpatient haplo-HSCT was feasible.

STUDY DESIGN: Single center, retrospective cohort, n=60 adult patients undergoing Haplo-HSCT. Descriptive statistical analysis, univariate and multivariate comparison.

PATIENTS AND METHOD: We analyzed 60 adult patients transplanted with an intended haplo-HSCT on an outpatient basis from 2015 to 2019 in our unit. A multivariate analysis was performed on risk factors for hospitalization.

RESULTS: Median age was 27 years (15-64). All patients underwent conditioning as outpatients, and none required hospitalization before day 0. Thirteen patients (21.6%) were followed completely in the outpatient clinic and 47 (78.3%) required hospitalization in a median of 3 days after infusion (range, 1-14). The median length of stay (LOS) was 8 days (IQR, 3-17). Fever secondary to cytokine release syndrome (CRS) was the most common reason for hospitalization occurring in 43/47 (91.5%), 4 were related to infection and 36 were related to CRS. In the univariate analysis, CRS, slower engraftment, and female sex were associated with the need for hospitalization. In the multivariate analysis, only CRS remained significant (OR 9.14 [95%CI, 1.58-56.46]). The 2-year overall survival (OS) was 41.7% for ambulatory transplant vs. 38% for those requiring hospitalization (P = 0.12). The 2-year event-free survival (EFS) was 33% for outpatient patients and 16.7% for those hospitalized (log-rank, P = 0.062).

CONCLUSIONS: We demonstrated the feasibility and safety of carrying out an outpatient haplo-HSCT, potentially resulting in cost savings and perhaps a higher quality of life.

PMID:33781529 | DOI:10.1016/j.jtct.2020.12.006

J Equine Vet Sci. 2021 Apr;99:103374. doi: 10.1016/j.jevs.2021.103374. Epub 2021 Jan 12.

ABSTRACT

The dynamic upper airway functional (URT) problems of Colombian paso horses (CPH) have not been investigated in literature up to date. These horses perform special walking gaits with high poll flexion of the neck. Our goal is to evaluate the upper airway mechanics in CPH, showing abnormal respiratory sounds and poor performance during exercise. Resting and overground endoscopy was performed in 40 CPHs. Statistical analyses were performed using the sciPy package. One-tailed Fisher exact tests were used to check for positive contingency between each pair of upper respiratory tract disorder (P < .05). Arytenoid cartilage collapse was observed in 35 of 40 cases during exercise. Among these, dynamic laryngeal collapse (DLC) was the most significant finding, but ventromedial luxation of the apex of the corniculate process of the arytenoid and recurrent laryngeal neuropathy was also observed. Dorsal displacement of the soft palate was only detected in 4 of 40 cases. DLC was significantly associated with vocal cord collapse, nasopharyngeal collapse, and medial collapse of the margins of the epiglottis, and medial collapse of the margins of the epiglottis was associated with nasopharyngeal collapse. DLC is only a typical feature in some special breeds worldwide. We suggest that the extensive poll flexion and the relatively small laryngeal lumen and high intensitivity workload are the most important predisposing factors of DLC. Ventromedial luxation of the apex of the corniculate process of the arytenoid was over-represented in our caseload, compared with other studies. Whereas, despite the intensive workload, dorsal displacement of the soft palate was relatively uncommon. We presume that this could also be tailored to the high poll flexion performed during the special gaits.

PMID:33781434 | DOI:10.1016/j.jevs.2021.103374

J Equine Vet Sci. 2021 Apr;99:103397. doi: 10.1016/j.jevs.2021.103397. Epub 2021 Feb 3.

ABSTRACT

In order to evaluate the effect of three different primary vaccination intervals on EI vaccine response, 21 unvaccinated thoroughbred foals were randomly divided into three groups of 7 and vaccinated with three different intervals of primary immunization (i.e., with 1, 2 or 3 months intervals between V1 and V2, respectively). The antibody response was measured for up to 1 year after the third immunization V3 (administered 6 months after V2) by single radial hemolysis (SRH) assay. All weanlings had seroconverted and exceeded the clinical protection threshold 2 weeks after V2 and 1 month after V3 until the end of the study. Significant differences were measured at the peak of immunity after V2 and for the duration of the immunity gap between V2 and V3. The group with one month primary vaccination interval had a lower immunity peak after V2 (158.05 ± 6.63 mm²) and a wider immunity gap between V2 and V3 (18 weeks) when compared with other groups (i.e., 174.72 ± 6.86 mm² and 16 weeks for a two months interval, 221.45 ± 14.48 mm² and 12 weeks for a 3-month interval). The advantage observed in the group with 1 month primary vaccination interval, which induces an earlier protective immunity, is counterbalance with a lower peak of immunity and a wider immunity gap after V2, when compared with foals vaccinated with 2- and 3-month intervals.

PMID:33781435 | DOI:10.1016/j.jevs.2021.103397