Tag: nevin manimala

J Magn Reson Imaging. 2021 Sep 3. doi: 10.1002/jmri.27909. Online ahead of print.

ABSTRACT

BACKGROUND: Autoimmune encephalitis (AE) is a noninfectious emergency with severe clinical attacks. It is difficult for the earlier diagnosis of acute AE due to the lack of antibody detection resources.

PURPOSE: To construct a deep learning (DL) algorithm using multi-sequence magnetic resonance imaging (MRI) for the identification of acute AE.

STUDY TYPE: Retrospective.

POPULATION: One hundred and sixty AE patients (90 women; median age 36), 177 herpes simplex virus encephalitis (HSVE) (89 women; median age 39), and 184 healthy controls (HC) (95 women; median age 39) were included. Fifty-two patients from another site were enrolled for external validation.

FIELD STRENGTH/SEQUENCE: 3.0 T; fast spin-echo (T₁ WI, T₂ WI, fluid attenuated inversion recovery imaging) and spin-echo echo-planar diffusion weighted imaging.

ASSESSMENT: Five DL models based on individual or combined four MRI sequences to classify the datasets as AE, HSVE, or HC. Reader experiment was further carried out by radiologists.

STATISTICAL TESTS: The discriminative performance of different models was assessed using the area under the receiver operating characteristic curve (AUC). The optimal threshold cut-off was identified when sensitivity and specificity were maximized (sensitivity + specificity – 1) in the validation set. Classification performance using confusion matrices was reported to evaluate the diagnostic value of the models and the radiologists’ assessments before being assessed by the paired t-test (P < 0.05 was considered significant).

RESULTS: In the internal test set, the fusion model achieved the significantly greatest diagnostic performance than single-sequence DL models with AUCs of 0.828, 0.884, and 0.899 for AE, HSVE, and HC, respectively. The model demonstrated a consistently high performance in the external validation set with AUCs of 0.831 (AE), 0.882 (HSVE), and 0.892 (HC). The fusion model also demonstrated significantly higher performance than all radiologists in identifying AE (accuracy between the fuse model vs. average radiologist: 83% vs. 72%).

DATA CONCLUSION: The proposed DL algorithm derived from multi-sequence MRI provided desirable identification and classification of acute AE.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.

PMID:34478565 | DOI:10.1002/jmri.27909

Mol Ecol. 2021 Sep 3. doi: 10.1111/mec.16162. Online ahead of print.

ABSTRACT

Evidence that telomere length (TL) and dynamics can be interpreted as proxy for ‘life stress’ experienced by individuals stems largely from correlational studies. We tested for effects of an experimental increase of workload on telomere dynamics by equipping male great tits (Parus major) with a 0.9 gram backpack for a full year. In addition, we analysed associations between natural life-history variation, TL and TL dynamics. Carrying 5% extra weight for a year did not significantly accelerate telomere attrition. This agrees with our earlier finding that this experiment did not affect survival or future reproduction. Apparently, great tit males were able to compensate behaviourally or physiologically for the increase in locomotion costs we imposed. We found no cross-sectional association between reproductive success and TL, but individuals with higher reproductive success (number of recruits) lost fewer telomere base pairs in the subsequent year. We used the TRF method to measure TL, which method yields a TL distribution for each sample, and the association between reproductive success and telomere loss was more pronounced in the higher percentiles of the telomere distribution, in agreement with the higher impact of ageing on longer telomeres within individuals. Individuals with longer telomeres and less telomere shortening were more likely to survive to the next breeding season, but these patterns did not reach statistical significance. Whether successful individuals are characterized by losing fewer or more base pairs from their telomeres varies between species, and we discuss aspects of ecology and social organisation that may explain this variation.

PMID:34478576 | DOI:10.1111/mec.16162

Oper Dent. 2021 Sep 3. doi: 10.2341/20-112-L. Online ahead of print.

ABSTRACT

OBJECTIVES: The exposure reciprocity law (ERL) has been used to calculate the optimal irradiation time of dental composites. This study examined the applicability of ERL for fast polymerization of restorative composites containing various photoinitiating systems using a high-power multi-peak light-emitting diode (LED) lamp.

METHODS: Three commercial composites differing in photoinitiating systems were tested: Filtek Ultimate Universal Restorative (FU) with a camphorquinone-amine (CQ-A) photoinitiating system, Tetric EvoCeram (TEC) with CQ-A and (2,4,6-trimethylbenzoyl)phosphine oxide (TPO), and Estelite Σ Quick (ESQ) with CQ and a radical amplified photopolymerization (RAP) initiator. Specimens 2-mm thick were polymerized using a high-power multipeak LED lamp (Valo) at 3 pairs of radiant exposures (referred to as low, moderate, and high) ranging from 15.8-26.7 J/cm2. They were achieved by different combinations of irradiation time (5-20 seconds) and irradiance (1300-2980 mW/cm2) as determined with a calibrated spectrometer. Knoop microhardness was measured 1, 24, and 168 hours after polymerization on specimen top (irradiated) and bottom surfaces to characterize the degree of polymerization. The results were statistically analyzed using a three-way analysis of variance and Tukey’s post hoc tests, α = 0.05.

RESULTS: Microhardness increased with radiant exposure and except for ESQ, top-surface microhardness was significantly higher than that on bottom surfaces. Combinations of high irradiance and short irradiation time significantly increased the top-surface microhardness of TEC at low and moderate radiant exposures, and the bottom-surface microhardness of FU at a low radiant exposure. In contrast, the microhardness of ESQ on both surfaces at high radiant exposure increased significantly when low irradiance and long irradiation time were used. With all tested composites, bottom-surface microhardness obtained at low radiant exposure was below 80% of the maximum top-surface microhardness, indicating insufficient polymerization.

CONCLUSION: Combinations of irradiance and irradiation time had a significant effect on microhardness, which was affected by photoinitiators and the optical properties of composites as well as spectral characteristics of the polymerization lamp. Therefore, ERL cannot be universally applied for the calculation of optimal composite irradiation time. Despite high irradiance, fast polymerization led to insufficient bottom-surface microhardness, suggesting the necessity to also characterize the degree of polymerization on the bottom surfaces of composite increments when assessing the validity of ERL.

PMID:34478559 | DOI:10.2341/20-112-L

Int J Gynaecol Obstet. 2021 Sep 3. doi: 10.1002/ijgo.13912. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effect of hemostatic techniques (bipolar energy versus hemostatic sealants versus suture) on the ovarian reserve of patients submitted to laparoscopic cystectomy for the surgical excision of a unilateral endometrioma.

METHODS: A randomized controlled trial conducted in a teaching hospital included 84 patients with a unilateral endometrioma. The patients underwent laparoscopic stripping for excision of the unilateral endometrioma between March 2018 and February 2020. Three different hemostatic techniques – bipolar energy (Group 1), hemostatic sealants (Group 2) and suture (Group 3) – were compared. Anti-Müllerian hormone (AMH) levels were measured prior to and 1 and 6 months after surgery to determine changes in ovarian function.

RESULTS: Following surgery, AMH levels decreased in all the groups; however, this decrease was not statistically significant. Comparison between groups showed no statistically significant differences in AMH levels between the three hemostatic techniques used. Six months after surgery, median AMH levels were: 1.65 (interquartile range [IQR]: 0.62-2.08) ng/ml in Group 1, 1.87 (IQR: 1.27-2.97) in Group 2, and 1.53 (IQR: 1.18-2.44) in Group 3.

CONCLUSION: The present study suggests that there is no difference between the different hemostatic techniques used in laparoscopic cystectomy for the treatment of unilateral endometriomas.

PMID:34478564 | DOI:10.1002/ijgo.13912

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_10. doi: 10.7547/18-147.

ABSTRACT

BACKGROUND: Hallux valgus, one of the most common deformities of the great toe, may cause pain, dysfunction, and impaired gait pattern. In this retrospective study we report the results of a new type of distal metatarsal osteotomy combined with distal soft-tissue release in patients with mild-to-moderate hallux valgus deformity.

METHODS: This new technique was used in the management of 32 feet of 31 patients (eight men and 23 women) with mild-to-moderate hallux valgus. Hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle were measured on preoperative, early postoperative (6-8 weeks), and late (1 year) postoperative radiographs. American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal score was calculated. Sesamoid position, by considering medial sesamoid position, and metatarsal shortness were also measured.

RESULTS: Statistically significant differences were detected between the preoperative and late postoperative measurements of the hallux valgus angle, distal metatarsal articular angle, intermetatarsal angle, and sesamoid position parameters in patients operated on with this technique. Improvement was 14° for the hallux valgus angle, 4° for the distal metatarsal articular angle, and 4° for the intermetatarsal angle. Sesamoid position was also improved, and the mean American Orthopaedic Foot and Ankle Society score was significantly improved. Metatarsal shortness greater than 2 mm was observed in two patients without resulting in any clinical discomfort.

CONCLUSIONS: This new technique was easy, safe, and promising in patients diagnosed as having mild-to-moderate hallux valgus deformity.

PMID:34478540 | DOI:10.7547/18-147

Oper Dent. 2021 Sep 3. doi: 10.2341/19-296-L. Online ahead of print.

ABSTRACT

The anticaries potential of restorative ionomeric materials should be evaluated under a pH-cycling regime that simulates the caries process of demineralization and remineralization. Ten glass ionomer cement (GIC) materials and five resin-modified glass ionomer cement (RMGIC) materials were evaluated. A resin composite was used as a negative control. Six discs of each material were immersed for 6 and 18 hours each day in demineralizing (De-) and remineralizing (Re-) solutions, respectively. The solutions were changed daily over 12 days, during which the fluoride concentration was determined using an ion-specific electrode. The results were expressed as (1) the daily fluoride concentration in the De- and Re- solutions (μg F/ml), (2) the amount of fluoride released daily in the De- + Re- solution per area of specimens (μg F/cm2/day), and (3) the cumulative release over the 12-day period (μg F/cm2). During the first days, all materials showed a surge in fluoride release, followed by a gradual decline; however, three distinct patterns were observed, specifically: (1) greater fluoride release in the De- solution compared to the Re- solution during the study period; (2) an initial higher release in De- solution; and (3) a similar release in both solutions over the whole period. The materials differed statistically (p<0.05) with respect to daily and cumulative fluoride release. One GIC (Maxxion R) and one RMGIC (Resiglass R) had the highest and lowest ability to release fluoride, respectively. In conclusion, the GICs and RMGICs evaluated exhibited distinct qualitative and quantitative patterns of fluoride release under conditions simulating the caries process, which might reflect their anticaries potential.

PMID:34478544 | DOI:10.2341/19-296-L

J AOAC Int. 2021 Sep 3:qsab114. doi: 10.1093/jaoacint/qsab114. Online ahead of print.

ABSTRACT

BACKGROUND: Prednisolone is immunosuppressant and anti-inflammatory drug; it may cause peptic ulcers as a side effect. Esomeprazole is used for treatment of peptic ulcers therefore; the two drugs are co-administered in case of organ transplantation and autoimmune diseases.

OBJECTIVE: This work aims to determine simultaneously the two drugs together in bulk and spiked human plasma by eliminating the overlapping between the spectra of each other and the interference of plasma matrix.

METHODS: Two simple and effective model updated chemometric models called principal component analysis (PCA) and partial least square (PLS) were established using UV spectrophotometric data.

RESULTS: The two updated models have been validated according to the U.S. Food and Drug Administration guidelines with accepted results. The results were statistically compared with those of the reported methods, where no significant difference was found, indicating the validity of the developed methods. The two updated models have been successfully applied for prediction of the proposed drugs with good results regarding accuracy and precision.

CONCLUSION: The two updated models are simple, rapid, sensitive, and precise and could be easily applied in quality control laboratories for determination of PRD and ESO, without any preliminary separation steps or interference from plasma matrix.

HIGHLIGHTS: Two model updated chemometric models called PCA and PLS were established for determination of prednisolone and esomeprazole in spiked human plasma using UV spectrophotometric data.

PMID:34478551 | DOI:10.1093/jaoacint/qsab114

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_5. doi: 10.7547/20-218.

ABSTRACT

BACKGROUND: The aim of the present study was to contribute new and updated information to the literature by comparing the clinical and radiologic results of arthroscopic microfracture, platelet-rich plasma (PRP) after arthroscopic microfracture, and BST-Cargel scaffold application after arthroscopic microfracture in the treatment of talar osteochondral lesions.

METHODS: Sixty-two talar osteochondral lesion patients (31 women and 31 men) who underwent ankle arthroscopy in two different centers were randomized into three groups. The first group consisted of patients who underwent only arthroscopic microfracture (MF) (n = 22); the second group consisted of patients who underwent the PRP procedure after arthroscopic MF (PRP; n = 19); and the third group consisted of patients who underwent the BST-Cargel procedure after arthroscopic MF was (BST-Cargel; n = 21). The talar osteochondral lesions in the three groups were classified according to magnetic resonance and arthroscopic images. American Orthopedic Foot and Ankle Society, Foot and Ankle Ability Measurement (overall pain, 15-minute walking, running function), and visual analog scale scores were evaluated preoperatively and postoperatively, and postoperative return time to sports activities was performed.

RESULTS: Compared to the preoperative score, postoperative American Orthopedic Foot and Ankle Society score increased 48.80 ± 9.60 in the BST-Cargel group, whereas there was an increase of 46.68 ± 3.65 in the PRP group and 29.63 ± 3.69 in the MF group, which were statistically significant (P < .05).There was a statistically significant postoperative change in the visual analog scale scores of the patients in all three groups compared to the preoperative scores (P < .05). At the end of the follow-up, the Foot and Ankle Ability Measurement overall pain, 15-minute walking, and running function results of all three groups increased significantly postoperatively compared to the preoperative values (P < .005).

CONCLUSIONS: BST-Cargel application with microfracture is a method that can be applied easily and safely with arthroscopy to lesions larger than 1.5 cm2 regardless of the size of the cartilage defect, and it has been found to be superior to the other two methods in terms of pain, functional score, radiologic recovery, and return to sports activities.

PMID:34478532 | DOI:10.7547/20-218

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_7. doi: 10.7547/19-047.

ABSTRACT

BACKGROUND: We sought first to determine the efficacy of lateral ankle fixation alone in maintenance of medial clear space and talar valgus in bimalleolar equivalent ankle fractures not receiving primary deltoid repair, and second to assess perceived outcomes via the Foot and Ankle Outcome Score. To our knowledge, no study has quantified the reduction of medial clear space and talar valgus in bimalleolar equivalent ankle fractures receiving lateral ankle fixation alone.

METHODS: We compared preoperative, initial postoperative, and greater than 1-year follow-up radiographs of medial clear space and talar valgus in individuals who received lateral ankle fixation alone in bimalleolar equivalent ankle fractures. Subjective outcomes were measured via the Foot and Ankle Outcome Score.

RESULTS: Thirty-seven patients participated in the study and showed a statistically significant reduction of medial clear space and restoration of talar position, and maintenance with this fixation method during follow-up in patients with bimalleolar equivalent ankle fractures. Adjunctively, patients perceived their outcomes to be satisfactory, as demonstrated by the results of the Foot and Ankle Outcome Score.

CONCLUSIONS: We aimed to assess the efficacy of lateral ankle fixation in the maintenance of medial clear space and talar valgus reduction at midterm follow-up. Although some authors contend that primary deltoid repair in bimalleolar equivalent ankle fractures is warranted, these midterm study results suggest that isolated lateral ankle fixation is adequate for medial ankle stabilization in bimalleolar equivalent fractures, and thus primary deltoid repair is not indicated.

PMID:34478535 | DOI:10.7547/19-047

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_4. doi: 10.7547/20-075.

ABSTRACT

BACKGROUND: Previous study indicates that pharmacologic antithrombotic therapy may be an inhibitory factor for wound healing and should merit consideration among the other core factors in wound healing optimization.

METHODS: This study provides a retrospective analysis of the effect of antithrombotic therapy on wound healing rates of uncomplicated diabetic foot ulcerations. Wounds treated with standard of care in the presence of clinical anticoagulation were compared to control wounds.

RESULTS: The results indicate a statistically significant negative correlation between antithrombotic therapy and diabetic foot wound healing rate. This represents the first study focusing on this correlation in the uncomplicated diabetic foot wound.

CONCLUSIONS: This retrospective study demonstrates that antithrombotic therapy has a statistically significant negative effect on healing rates of uncomplicated diabetic foot ulcerations. Both wound area and depth improvement over 4 weeks was significantly better in treated patients who were not on antithrombotic therapy for comorbidity not associated with peripheral arterial disease.

PMID:34478530 | DOI:10.7547/20-075