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Nevin Manimala Statistics

Sonographic pathoanatomy of greater trochanteric pain syndrome

J Ultrasound. 2023 Dec 12. doi: 10.1007/s40477-023-00836-x. Online ahead of print.

ABSTRACT

AIMS: To identify and highlight pertinent US features that could serve as imaging biomarkers to describe different patient phenotypes, within Great Trochanteric Pain Syndrome (GTPS) clinical diagnosis.

MATERIALS AND METHODS: Using ultrasound we evaluated eighty-eight clinically diagnosed patients with GTPS, for tendon matrix changes and calcium deposits in the gluteus medius (superoposterior and lateral aspects) and in the gluteus minimus. Peritrochanteric examination included fascia lata, trochanteric bursa, cortical irregularities and the presence of enthesophytes. The association of pathological changes with pain and functionality was evaluated using multivariate regression models.

RESULTS: Out of the 88 patients, 86 examinations (97.7%) detected gluteus medius tendinopathy, and 54 patients (61.4%) had gluteus minimus tendinopathy in addition. Calcium deposits were present in 97.7% of patients, associated with tenderness (p = 0.009), and most often located in the gluteus medius rather than in the gluteus minimus (p = 0.014); calcifications were associated with tendon thickness (p = 0.042), hypoechogenicity (p = 0.005) and the presence of partial tears (p = 0.030). Bursa swelling occurred in 36 patients (40.9%); multivariate regression models predicted less pain in patients with bursa distension (p = 0.008) and dysfunction in patients with gluteal muscle atrophy (p = 0.001) and loss of fibrillar pattern in the gluteus medius (p = 0.002).

CONCLUSION: GTPS involves both degenerative calcifying gluteal tendinopathy and alterations in the peritrochanteric space associated with physical function and pain. The severity of GTPS can be assessed using ultrasound imaging biomarkers.

PMID:38082193 | DOI:10.1007/s40477-023-00836-x

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Nevin Manimala Statistics

Managing a cyanobacteria harmful algae bloom “hotspot” in the Sacramento – San Joaquin Delta, California

J Environ Manage. 2023 Dec 10;351:119606. doi: 10.1016/j.jenvman.2023.119606. Online ahead of print.

ABSTRACT

Cyanobacterial harmful algal blooms (CHABs) have become a persistent seasonal problem in the upper San Francisco Estuary, California also known as the Sacramento-San Joaquin Delta (Delta). The Delta is comprised of a complex network of open water bodies, channels, and sloughs. The terminus of the Stockton Channel is an area identified as a CHAB “hotspot.” As CHABs increase in severity, there is an urgent need to better understand CHAB drivers to identify and implement mitigation measures that can be used in an estuarine complex like the Delta. We investigated water quality conditions and nutrient dynamics in the Stockton Channel by measuring nutrients in the water column, sediments, and pore waters. In situ nutrient addition bioassay experiments were used to assess the effects of nutrient enrichment on total algal/cyanobacterial growth and pigment concentrations. In both June and September, relative to unamended controls, total chlorophyll and cyanobacterial pigment concentrations were unaffected by nutrient additions; hence, the study area showed signs of classical hypereutrophication, with ambient nitrogen and phosphorus present in excess of algal growth requirements. A cyanobacterial bloom, dominated by Microcystis spp. was present throughout the study area but was most severe and persistent at the shallowest site at the channel terminus. At this site, Microcystis spp. created water quality conditions that allowed for a prolonged bloom from June through September. While targeted nutrient reductions are recommended for long term mitigation, on a shorter timescale, our findings suggest that physical/mechanical controls are the more promising alternative approaches to reduce the severity of CHABs in the terminus of the Stockton Channel.

PMID:38081090 | DOI:10.1016/j.jenvman.2023.119606

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Nevin Manimala Statistics

The role of law in end-of-life decision-making in emergency departments and intensive care units: a retrospective review of current practice in a Queensland health service

Aust Health Rev. 2023 Dec 12. doi: 10.1071/AH23160. Online ahead of print.

ABSTRACT

ObjectiveThere is limited evidence about how legal frameworks that underpin end-of-life decisions are applied in practice. This study aimed to identify how end-of-life decisions are made and documented in emergency departments and intensive care units. The secondary aim was to explore the extent to which the legal processes featured in these decisions.MethodsA retrospective chart audit of 85 adult patients who died in the emergency departments and intensive care units of a Queensland health service was undertaken. Quantitative data were analysed and reported using descriptive statistics. Qualitative textual data were analysed using inductive content analysis.ResultsNearly all admissions were unplanned (97.6%), and most patients (74.1%) were admitted from home. Only one patient had an advance health directive, although all had an eligible substitute decision-maker. The qualitative analysis revealed two main concepts – ‘healthcare professionals choreograph the end of life’ and ‘patients and families are carried on an unplanned journey’.ConclusionsThere was limited documentation related to the application of the legal framework in these decisions. Healthcare professionals relied on their clinical judgment about what was in the best interest of the patient. It was common for there to be a substantial effort to achieve consensus in decision-making which coincidently complied with the law.

PMID:38081044 | DOI:10.1071/AH23160

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Nevin Manimala Statistics

The effect of uterine closure technique on cesarean scar niche development after multiple cesarean deliveries

J Perinat Med. 2023 Dec 13. doi: 10.1515/jpm-2023-0211. Online ahead of print.

ABSTRACT

OBJECTIVES: To use saline infusion sonohysterography (SIS) to evaluate the effect of uterine closure technique on niche formation after multiple cesarean deliveries (CDs).

METHODS: Patients with at least one prior CD were evaluated for niche via SIS. Subgroups of any number repeat CD (>1 prior), lower-order CD (<4 prior), and higher-order CD (≥4 prior) were analyzed, stratifying by hysterotomy closure technique at last cesarean preceding imaging; techniques included Technique A (endometrium-free double-layer closure) and Technique B (single- or double-layer routine endo-myometrial closure). Niche defects were quantified (depth, length, width, and residual myometrial thickness). The primary outcome was clinically significant niche, defined as depth >2 mm. Statistical analysis was performed using chi-square, ANOVA, t-test, Kruskal-Wallis, and multiple logistic regression, with p-values of <0.05 were statistically significant.

RESULTS: A total of 172 post-cesarean SIS studies were reviewed: 105 after repeat CDs, 131 after lower-order CDs, and 41 after higher-order CDs. Technique A was associated with a shorter interval to imaging and more double-layer closures. Technique B was associated with more clinically significant niches across all subgroups, and these niches were significantly longer and deeper when present. Multiple logistic regression demonstrated a 5.6, 8.1, and 11-fold increased adjusted odds of clinically significant niche following Technique B closure in the repeat CD (p<0.01), lower-order CD (p<0.001), and higher-order CD (p=0.04) groups, respectively.

CONCLUSIONS: While multiple CDs are known to increase risk for niche defects and their sequelae, hysterotomy closure technique may help to reduce niche development and severity.

PMID:38081042 | DOI:10.1515/jpm-2023-0211

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Nevin Manimala Statistics

Obstetrical Statistics

West J Med Phys Sci. 1838 Apr-Jun;6(1):149-150.

NO ABSTRACT

PMID:38080888 | PMC:PMC10470978

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Nevin Manimala Statistics

Epidemic Cholera: Miscellaneous Observations-Historical, Statistical, Ætiological and Therapeutic, on the Prevailing Epidemic

West J Med Phys Sci. 1833 Jul-Sep;1(2):161-181.

NO ABSTRACT

PMID:38080776 | PMC:PMC10467859

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Nevin Manimala Statistics

Mortality Statistics of the U.S. Census for 1850

N Am Medchir Rev. 1858 Mar;2(2):334-340.

NO ABSTRACT

PMID:38080312 | PMC:PMC10348215

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Nevin Manimala Statistics

Statistics of Insanity

N Am Medchir Rev. 1861 Sep;5(5):927-937.

NO ABSTRACT

PMID:38080064 | PMC:PMC10344228

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Nevin Manimala Statistics

Statistics of Insanity in the United States

N Am Medchir Rev. 1860 Jul;4(4):656-692.

NO ABSTRACT

PMID:38080035 | PMC:PMC10344187

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Nevin Manimala Statistics

Control of chaotic systems through reservoir computing

Chaos. 2023 Dec 1;33(12):121101. doi: 10.1063/5.0176358.

ABSTRACT

Chaos is an important dynamic feature, which generally occurs in deterministic and stochastic nonlinear systems and is an inherent characteristic that is ubiquitous. Many difficulties have been solved and new research perspectives have been provided in many fields. The control of chaos is another problem that has been studied. In recent years, a recurrent neural network has emerged, which is widely used to solve many problems in nonlinear dynamics and has fast and accurate computational speed. In this paper, we employ reservoir computing to control chaos in dynamic systems. The results show that the reservoir calculation algorithm with a control term can control the chaotic phenomenon in a dynamic system. Meanwhile, the method is applicable to dynamic systems with random noise. In addition, we investigate the problem of different values for neurons and leakage rates in the algorithm. The findings indicate that the performance of machine learning techniques can be improved by appropriately constructing neural networks.

PMID:38079650 | DOI:10.1063/5.0176358