Tag: nevin manimala

Jpn J Clin Oncol. 2021 Dec 23:hyab196. doi: 10.1093/jjco/hyab196. Online ahead of print.

ABSTRACT

BACKGROUND: Anastomotic leakage is one of the most severe and critical complications of laparoscopic surgery for colorectal cancer. However, definitive preoperative predictors of anastomotic leakage remain elusive. With the ageing of society, the number of colorectal cancer patients with arteriosclerotic disease in Japan is increasing. This study was performed to evaluate the correlation between preoperative arteriosclerosis and anastomotic leakage.

METHODS: In total, 98 patients undergoing laparoscopic surgery for colorectal cancer with reconstruction using the double-stapling technique without diversion of the stoma were enrolled in the study. Preoperative assessment of arteriosclerotic disease was performed by abdominal computed tomography. The calcification volume percentage of the aorta between the level of the celiac artery root and aortic bifurcation was calculated using ZIOstation2 software, and the relationship between arteriosclerosis and anastomotic leakage was analysed.

RESULTS: Among 98 cases, anastomotic leakage was observed in 16 (16.3%). The median calcification volume percentage (range) was 2.35% (0-40.3%). Age, male sex, hypertension, dissection number, estimated glomerular filtration rate and tumour location were correlated with anastomotic leakage on statistical analysis. Statistical analysis showed that calcification volume percentage was one of the robust risk factors for anastomotic leakage (odds ratio: 1.09, 95% confidence interval: 1.03-1.17, P < 0.01).

CONCLUSIONS: Calcification of the abdominal aorta may be a promising predictor of AL after laparoscopic surgery for colorectal cancer reconstruction using the double-stapling technique.

PMID:34937089 | DOI:10.1093/jjco/hyab196

Z Orthop Unfall. 2021 Dec 22. doi: 10.1055/a-1647-3914. Online ahead of print.

ABSTRACT

INTRODUCTION: The human bone structure changes with an increase in age. Both material and structural properties affect bone strength. Despite the ageing of society, however, hardly any data are available on these parameters for elderly individuals. Therefore, in the present study, cancellous bone cylinders were taken from the center of each vertebral body (C3 to L5) and examined with regard to bone volume fraction, trabecular thickness, separation, number of trabeculae, cross-linking, connectivity density and degree of anisotropy.

MATERIAL AND METHODS: Samples were obtained from 440 body donors using a Jamshidi needle and analysed using microcomputed tomography. Existing deformities, fractures and bone mineral density of each vertebra were recorded by quantitative computed tomography.

RESULTS: With regard to the microcomputed tomography parameters, statistically significant differences were found between the different sections of the vertebrae: the trabeculae of the cervical vertebrae were significantly thicker and more closely spaced than in the thoracic and lumbar vertebrae. The bone volume fraction was significantly higher in this spinal segment, as was the connection density and the number of trabeculae and cross-links. In addition, the degree of anisotropy was significantly lower in the cervical vertebrae than in the other spinal segments. With regard to quantitative computed tomography, there was a significantly higher bone mineral density in the cervical vertebrae.

CONCLUSION: Even with osteoporosis, cervical vertebrae fracture significantly later than thoracic and lumbar vertebrae due to their unique microarchitecture and higher density. Thus, the cervical vertebrae has specific properties.

PMID:34937100 | DOI:10.1055/a-1647-3914

PLoS One. 2021 Dec 22;16(12):e0261496. doi: 10.1371/journal.pone.0261496. eCollection 2021.

ABSTRACT

Clinical studies on the efficacy of sonic toothbrushes show inconsistent results, most studies have been conducted without sufficient supervision of appropriate toothbrush usage. Aims of the explorative clinical trial were therefore to investigate whether the usage of an activated sonic toothbrush reduces plaque more effectively than an inactivated one used as a manual toothbrush, and to which extent the correct use of such toothbrush plays a role in its efficacy. The clinical trial was designed as a video-controlled interventional study. Thirty participants (mean (±SD) age 22.9 (±2.5) years) were included, areas of interest were the buccal surfaces of the upper premolars and the first molar (partial mouth recording). Toothbrushing was performed without toothpaste in a single brushing exercise under four different conditions: switched off, habitually used as manual toothbrush, no instruction; switched on, habitually used as powered toothbrush, no instruction; switched off, used as manual toothbrush, instruction in the Modified Bass Technique; switched on, used as powered toothbrush, instruction in a specific technique for sonic toothbrushes. Brushing performance was controlled by videotaping, plaque was assessed at baseline (after 4 days without toothbrushing) using the Rustogi modified Navy-Plaque-Index and planimetry. Main study results were that plaque decreased distinctly after habitual brushing regardless of using the sonic brush in ON or OFF mode (p for all comparisons < 0.001). After instruction, participants were able to use the sonic brush in ON mode as intended, with only minor impact on efficacy. Using the toothbrush in OFF mode with the Modified Bass Technique was significantly less effective than all other conditions (p for all comparisons < 0.001). Under the conditions used, the sonic toothbrush was not more effective when switched on than when switched off, and there was no evidence that the correct use of the toothbrush was more effective than the habitual use.

PMID:34937069 | DOI:10.1371/journal.pone.0261496

J Oral Implantol. 2021 Dec 22. doi: 10.1563/aaid-joi-D-21-00055. Online ahead of print.

ABSTRACT

The aims of this study were to evaluate the effect of (i) the different surgical guide designs and (ii) implant placement location on the accuracy of fully guided implant placement in single edentulous sites using an in vitro study model. Forty-five partially edentulous models were scanned and divided into three groups: group 1, tooth-supported full-arch surgical guide; group 2, three different tooth-supported shortened surgical guides (SSGs); and group 3, tooth-supported full-arch surgical guide with a crossbar. All surgical guides were printed and used for fully guided implant placement. A total of 180 implants (60 per group) were placed, and scanbodies were positioned on all models, and postoperative surface scan files (STL) files were obtained. Superimposition of preoperative and postoperative STL files was performed, and the accuracy of implant position was evaluated. The interaction between group and implant location was statistically significant for angle, 3D offset at the base, and at the tip (p<0.001). The post-hoc tests showed a statistically significantly higher deviation for group 2 compared to group 3 for all outcomes for implants #4 (p<0.05) and #7 (p<0.05). There was also a statistically significant difference in all outcomes between groups 1 and 3 for implant #7 (p<0.05). All surgical guide designs presented satisfactory performance with clinically acceptable levels of deviation. However, SSGs presented higher accuracy for guided implant placement in a single-edentulous site, whereas a full-arch surgical guide with a crossbar presented superior outcomes when two or more guided implants were placed simultaneously.

PMID:34937081 | DOI:10.1563/aaid-joi-D-21-00055

PLoS One. 2021 Dec 22;16(12):e0261176. doi: 10.1371/journal.pone.0261176. eCollection 2021.

ABSTRACT

BACKGROUND: Bilateral internal thoracic arteries (BITA) are uncommonly used in the every-day practice due to safety concerns and technical challenges with Y-grafts. We hypothesized that in-situ BITA use during coronary artery by-pass grafting (CABG) for two vessel disease is equally safe to standard strategy with left internal thoracic artery-left anterior descending artery revascularization and venous graft to other target vessels.

METHODS: A propensity score matched analysis was used to compare elective on-pump CABG patients who received in-situ BITA (BITA-group), versus left internal thoracic artery graft to the left anterior descending artery plus vein (SITA-group). Primary end points were 30-days all-cause-mortality, major adverse cardiac events and incidents and deep sternal wound infections.

RESULTS: A total of 50 matched pairs (c-statistics 0.769) were selected from patients operated on between January 2015 and April 2020 using BITA (n = 50) and SITA (n = 2170). There were no inter-group differences in demographics and basic clinical characteristics. The total operation time was longer in the BITA-group (4.0 vs 3.6 hours; p = 0.004). The rate of complete revascularization was similar, as was median aortic cross-clamp time, median extracorporeal circulation time, rate of re-explorations for bleeding, deep sternal wound infections or length of stay. One patient died in BITA group, 3 days after surgery, from a non-cardiac cause. After 36 months, the survival rate was 98% for BITA-group and 96% for controls (log-rank, p = 0.577).

CONCLUSIONS: In-situ use of BITA during coronary revascularization for two-vessel disease is as safe and effective, as use of single ITA and vein graft. In-situ strategy abolishes allows to avoid the technically demanding composite graft configuration.

PMID:34937067 | DOI:10.1371/journal.pone.0261176

PLoS One. 2021 Dec 22;16(12):e0261494. doi: 10.1371/journal.pone.0261494. eCollection 2021.

ABSTRACT

PURPOSE: Patients undergo dilatation and evacuation for abortion or miscarriage. However, bleeding is sometimes problematic. Despite reports on the association between volatile anesthetics and increased bleeding during the procedure, firm evidence is lacking. Therefore, we conducted a systematic review and meta-analysis to compare the effects of volatile anesthetics and propofol on the amount of bleeding in patients undergoing dilatation and evacuation.

METHODS: We conducted a systematic search of four databases, namely PubMed, Embase, Cochrane Central Register of Controlled Trials databases, and Web of Science (Clarivate Analytics), from their respective inception to April 2021. Moreover, we searched two trial registration sites. The inclusion criterion was randomized controlled trials of patients who underwent dilatation and evacuation under general anesthesia using volatile anesthetics or propofol. The primary outcome was the amount of perioperative bleeding. The mean difference of the bleeding was combined using a random-effects model. The I2 statistic was used to assess heterogeneity. We assessed risk of bias with Cochrane domains. We controlled type I and II errors due to sparse data and repetitive testing with Trial Sequential Analysis. We assessed the quality of evidence with GRADE.

RESULTS: Five studies were included in the systematic review. The amount of bleeding was compared in four studies and was higher in the volatile anesthetic group, with a mean difference of 164.7 ml (95% confidence interval, 43.6 to 285.7; p = 0.04). Heterogeneity was considerable, with an I2 value of 97%. Two studies evaluated the incidence of significant bleeding, which was significantly higher in the volatile anesthetic group (RR, 2.42; 95% confidence interval, 1.04-5.63; p = 0.04).

CONCLUSION: Choosing propofol over volatile anesthetics during dilatation and evacuation might reduce bleeding and the incidence of excessive bleeding. However, the quality of the evidence was very low. This necessitates further trials with a low risk of bias.

TRIAL REGISTRATION: PROSPERO (CRD42019120873).

PMID:34937059 | DOI:10.1371/journal.pone.0261494

PLoS One. 2021 Dec 22;16(12):e0260042. doi: 10.1371/journal.pone.0260042. eCollection 2021.

ABSTRACT

This study was concerned with how accurate people are in their knowledge of population norms and statistics concerning such things as the economic, health and religious status of a nation and how those estimates are related to their own demography (e.g age, sex), ideology (political and religious beliefs) and intelligence. Just over 600 adults were asked to make 25 population estimates for Great Britain, including religious (church/mosque attendance) and economic (income, state benefits, car/house ownership) factors as well as estimates like the number of gay people, immigrants, smokers etc. They were reasonably accurate for things like car ownership, criminal record, vegetarianism and voting but seriously overestimated numbers related to minorities such as the prevalence of gay people, muslims and people not born in the UK. Conversely there was a significant underestimation of people receiving state benefits, having a criminal record or a private health insurance. Correlations between select variables and magnitude and absolute accuracy showed religiousness and IQ most significant correlates. Religious people were less, and intelligent people more, accurate in their estimates. A factor analysis of the estimates revealed five interpretable factors. Regressions were calculated onto these factors and showed how these individual differences accounted for as much as 14% of the variance. Implications and limitations are acknowledged.

PMID:34937066 | DOI:10.1371/journal.pone.0260042

Phys Med Biol. 2021 Dec 22. doi: 10.1088/1361-6560/ac459d. Online ahead of print.

ABSTRACT

Multi-energy spectral CT has a broader range of applications with the recent development of photon-counting detectors. However, the photons counted in each energy bin decrease when the number of energy bins increases, which causes a higher statistical noise level of the CT image. In this work, we propose a novel iterative dynamic dual-energy CT algorithm to reduce the statistical noise. In the proposed algorithm, the multi-energy projections are estimated from the dynamic dual-energy CT data during the iterative process. The proposed algorithm is verified on sufficient numerical simulations and a laboratory two-energy-threshold PCD system. By applying the same reconstruction algorithm, the dynamic dual-energy CT’s final reconstruction results have a much lower statistical noise level than the conventional multi-energy CT. Moreover, based on the analysis of the simulation results, we explain why the dynamic dual-energy CT has a lower statistical noise level than the conventional multi-energy CT. The reason is that: the statistical noise level of multi-energy projection estimated with the proposed algorithm is much lower than that of the conventional multi-energy CT, which leads to less statistical noise of the dynamic dual-energy CT imaging.

PMID:34937002 | DOI:10.1088/1361-6560/ac459d

J Neural Eng. 2021 Dec 22. doi: 10.1088/1741-2552/ac4595. Online ahead of print.

ABSTRACT

OBJECTIVE: Electroencephalography microstates (EEG-ms), which reflect a large topographical representation of coherent electrophysiological brain activity, are widely adopted to study cognitive processes mechanisms and aberrant alterations in brain disorders. EEG-ms topographies are quasi-stable lasting between 60-120 milliseconds. Some evidence suggests that EEG-ms are the electrophysiological signature of resting-state networks (RSNs). However, the spatial and functional interpretation of EEG-ms and their association with functional MRI (fMRI) remains unclear.

APPROACH: In a large cohort of healthy subjects (n = 52), we conducted several statistical and machine learning approaches analyses on the association among EEG-ms spatio-temporal dynamics and the blood-oxygenation-level dependent (BOLD) simultaneous EEG-fMRI data using statistical and machine learning approaches.

MAIN RESULTS: Our results using a generalized linear model unraveled that EEG-ms transitions were largely and negatively associated with blood-oxygenation-level dependent (BOLD) signals in the somatomotor, visual, dorsal attention, and ventral attention fMRI networks with limited association within the default mode network. Additionally, a novel recurrent neural network (RNN) confirmed the association between EEG-ms transitioning and fMRI signal while revealing that EEG-ms dynamics can predict BOLD signals and vice versa.

SIGNIFICANCE: Results suggest that EEG-ms transitions may represent the deactivation of fMRI RSNs and provide evidence that both modalities can measure common aspects of undergoing brain neuronal activities. Moreover, our results may help to better understand the electrophysiological interpretation of EEG-ms and solve several contradicting findings in the literature.

PMID:34937003 | DOI:10.1088/1741-2552/ac4595

Int J Sports Physiol Perform. 2021 Dec 21:1-6. doi: 10.1123/ijspp.2020-0836. Online ahead of print.

ABSTRACT

PURPOSE: Modern pentathlon is a multidisciplinary sport that involves exhaustive training which can cause tissue damage and metabolic changes. However, few studies have evaluated the metabolic changes that occur in pentathletes. Accordingly, we aimed to evaluate the metabolomic profile of pentathletes during a 3-week training period before competition using nuclear magnetic resonance.

METHODS: Blood samples from 6 members of a Brazilian modern pentathlon team were collected at the beginning (Pre1, Pre2, and Pre3) and end (Post1, Post2, and Post3) of each week. Low molecular-weight metabolite profiles were analyzed by nuclear magnetic resonance spectroscopy, and biochemical markers were assessed using enzyme-linked immunosorbent assays. Data were assessed using partial least-squares discriminant analysis and univariate statistical model.

RESULTS: Metabolic changes were observed between pre- and postdata of each week and over the 3 weeks before the competition in the partial least-squares discriminant analysis. Creatine kinase concentration increased in the first 2 weeks (P = .045 and P = .039), but there was no difference in the last week (P > .05). Lactate levels increased significantly after training in each week (P < .001). Cortisol levels at Post3 were different from all other time points (P < .05) and the concentrations of peroxides increased over the weeks (P < .05). Among all metabolites, sarcosine showed the greatest differences (P = .004) in the pretraining and posttraining periods of the 3 weeks.

CONCLUSION: Serum analysis of athletes using nuclear magnetic resonance showed metabolic changes depending on the intensity of the training performed each week.

PMID:34936983 | DOI:10.1123/ijspp.2020-0836