Tag: pubmed

Chin J Traumatol. 2023 Oct 27:S1008-1275(23)00100-1. doi: 10.1016/j.cjtee.2023.05.007. Online ahead of print.

ABSTRACT

PURPOSE: Upper extremity injuries (UEIs) and lower extremity injuries (LEIs) constitute a considerable component of traumas. However, their epidemiologic differences and short-term in-hospital outcomes are not fully elucidated. This study aims to compare such discrepancies in a large-scale study.

METHODS: In this retrospective study, all patients with UEIs and/or LEIs hospitalized from 24th July 2016 to 16th May 2020 in Sina Hospital, Tehran, Iran, and registered at the National Trauma Registry of Iran were enrolled in the study. Relevant demographic and clinical characteristics were extracted from the National Trauma Registry of Iran database. Patients were grouped into either UEI or LEI. For those with concomitant UEIs and LEIs, the more severe one based on the abbreviated injury scale was defined as the principal diagnosis. In addition, cases with the abbreviated injury scale > 3 for both UEI and LEI or concomitant injuries to body areas other than the limbs were excluded. Independent samples t-test, Mann-Whitney U test, Chi-square test, quintile regression models, and logistic regression models with “margins” command were used for statistical analyses, as indicated.

RESULTS: In this research, 3170 eligible cases were identified. For the LEI group, there was a much higher proportion of male patients (86.7% vs. 82.0%) and higher mean age (years, 42.9 vs. 35.3) compared to the UEI group (both p < 0.001). Patients with an injury severity score (ISS) of 9 – 15 were outnumbered in the LEI group (22.9% vs. 1.6%, p < 0.001), while the proportion of those with an ISS < 9 was higher in the UEI group (98.1% vs. 76.8%, p < 0.001). The multiple logistic regression model showed a statistically significant association between intensive care unit (ICU) admission and ISS (odds ratio (OR) = 4.01 for ISS 9 – 15 vs. ISS <9, 95% confidence interval (CI)|: 3.01 – 5.35; OR = 17.65 for ISS ≥16 vs. ISS < 9, 95% CI: 4.03 – 77.27), age (OR = 1.02, 95% CI: 1.01 – 1.03), cause of injury (OR = 0.27 for blunt trauma vs. road traffic crash, 95% CI: 0.08 – 0.90; OR = 0.49 for cut/stab injuries vs. road traffic crash, 95% CI: 0.28 – 0.84) and body region (OR = 1.65 for lower extremity, 95% CI: 1.19 – 2.29). Having adjusted for other covariates, the odds of ICU admission in patients with LEIs was 1.65 times the odds in patients with UEIs.

CONCLUSIONS: Patients with LEIs were older and suffered from more severe injuries. In addition, the age- and ISS-adjusted ICU admission and length of hospital stay were significantly higher in LEI patients. The chance of ICU admission was associated with age, cause of injury, ISS, and body region. The findings of this study can aid in the meticulous selection of ICU-candidate patients. In addition, the role of factors other than ISS and age in ICU admission and prolongation of hospitalization should be addressed by prospective studies.

PMID:37925271 | DOI:10.1016/j.cjtee.2023.05.007

Surgery. 2023 Nov 2:S0039-6060(23)00635-9. doi: 10.1016/j.surg.2023.06.053. Online ahead of print.

ABSTRACT

BACKGROUND: Machine learning has been increasingly used to develop algorithms that can improve medical diagnostics and prognostication and has shown promise in improving the classification of thyroid ultrasound images. This proof-of-concept study aims to develop a multimodal machine-learning model to classify follicular carcinoma from adenoma.

METHODS: This is a retrospective study of patients with follicular adenoma or carcinoma at a single institution between 2010 and 2022. Demographics, imaging, and perioperative variables were collected. The region of interest was annotated on ultrasound and used to perform radiomics analysis. Imaging features and clinical variables were then used to create a random forest classifier to predict malignancy. Leave-one-out cross-validation was conducted to evaluate classifier performance using the area under the receiver operating characteristic curve.

RESULTS: Patients with follicular adenomas (n = 7) and carcinomas (n = 11) with complete imaging and perioperative data were included. A total of 910 features were extracted from each image. The t-distributed stochastic neighbor embedding method reduced the dimension to 2 primary represented components. The random forest classifier achieved an area under the receiver operating characteristic curve of 0.76 (clinical only), 0.29 (image only), and 0.79 (multimodal data).

CONCLUSION: Our multimodal machine learning model demonstrates promising results in classifying follicular carcinoma from adenoma. This approach can potentially be applied in future studies to generate models for preoperative differentiation of follicular thyroid neoplasms.

PMID:37925261 | DOI:10.1016/j.surg.2023.06.053

J Cyst Fibros. 2023 Nov 3:S1569-1993(23)01666-1. doi: 10.1016/j.jcf.2023.10.017. Online ahead of print.

ABSTRACT

BACKGROUND: Aspergillus infection is known to be associated with worse respiratory outcomes in people with CF (pwCF) and is a well-recognised complication of severe SARS-CoV-2 infection. The aim of this observational cross-sectional study was to examine the association of pre-existing Aspergillus infection and/or allergic bronchopulmonary aspergillosis (ABPA) in pwCF and severity of COVID-19.

METHODS: Data on SARS-CoV-2 infections in pwCF from January 2020 to June 2021 were collected by the European Cystic Fibrosis Society Patient Registry. The primary outcome was COVID-19 severity measured by hospitalisation comparing those with Aspergillus infection and/or ABPA in the 12 months preceding COVID-19and those without.

RESULTS: In total, 1095 pwCF were diagnosed with SARS-CoV-2 and information on pre-existing Aspergillus/ABPA status was available from 807. PwCF and SARS-CoV-2 in the Aspergillus/ABPA group (n = 153), in comparison to the non-Aspergillus/ABPA group (n = 654), were more likely to be hospitalised (adjusted OR 1.79 (1.19 to 2.85); p = 0.005) and their disease course was more likely to be complicated by sepsis (adjusted OR 7.78 (1.78 to 49.43); p = 0.008). The association with hospital admission was no longer significant after excluding patients with ABPA. Secondary analysis comparing pwCF who received antifungal treatment (n = 18), versus those who did not (n = 474) during COVID-19, showed a higher rate of hospitalisation (p < 0.001); intensive care unit admission (p < 0.001), and requirement for invasive ventilation (p < 0.001) in the antifungal treated group.

CONCLUSION: We show that pre-existing Aspergillus/ABPAis associated with increased rates of hospitalisation and sepsis during COVID-19 in pwCF.

PMID:37925255 | DOI:10.1016/j.jcf.2023.10.017

J Prosthet Dent. 2023 Nov 2:S0022-3913(23)00683-2. doi: 10.1016/j.prosdent.2023.10.004. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: The use of zirconia in dentistry has increased. However, little attention has been given to the difficulty experienced by clinicians when cutting zirconia restorations intraorally. Evidence for which grit size and type of rotary instrument is best for cutting zirconia intraorally is lacking.

PURPOSE: The purpose of this in vitro study was to identify the most efficient diamond rotary instrument grit size for cutting zirconia intraorally.

MATERIAL AND METHODS: Efficiency was measured by comparing the cutting depth of each rotary instrument into zirconia, analyzing zirconia specimens for surface damage after cutting, and measuring instrument deterioration. Thirty zirconia specimens of the same measurements were used as test specimens and cut with 30 diamond rotary instruments with different grit sizes. An electric handpiece was used with constant force (1.7 N), speed (40 000 rpm), time (1 min), and water flow rate (25 mL/min) to produce comparative data. The mean cutting efficiency values were compared by analysis, and the median values were compared by the nonparametric Kruskal-Wallis test (α=.05). Each test was followed up with pair wise comparisons of the mean or median values if significance was indicated.

RESULTS: The greatest cutting depth was achieved with a fine-grit instrument with a mean cutting depth of 5.79 mm compared with 4.54 mm for the coarse-grit instrument (P=.032). The greatest damage to zirconia was done by the coarse- and supercoarse-grit instruments (both 33%), with no substrate damage by the superfine-, fine-, and medium-grit instruments. The greatest instrument deterioration was found on the supercoarse rotary instruments (9.05%). With only 3 exceptions, the power calculations were all sufficient and above 83%.

CONCLUSIONS: The fine grit rotary instrument (between 40 and 50 µm) was the most efficient, achieving the greatest cutting depth, with no detectable macroscopic damage to the zirconia and minimal instrument deterioration.

PMID:37925249 | DOI:10.1016/j.prosdent.2023.10.004

Aging (Albany NY). 2023 Nov 2;15. doi: 10.18632/aging.205170. Online ahead of print.

ABSTRACT

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a long-lasting and incapacitating disease, and the exact factors that affect its onset and advancement are still uncertain. Thus, the main aim was to explore new biomarkers and possible therapeutic targets for IC/BPS. Next-generation high-throughput sequencing experiments were performed on bladder tissues. Based on the interactions between circRNA and miRNA, as well as miRNA and mRNA, candidates were selected to build a network of circRNA-miRNA-mRNA. The STRING database and Cytoscape software were utilized to build a protein-protein interaction (PPI) network to pinpoint the hub genes associated with IC/BPS. The expression levels of circRNA and miRNA in the network were confirmed through quantitative polymerase chain reaction. Western blot was applied to confirm the stability of the lipopolysaccharide-induced IC/BPS model, and the effect of overexpression of circ.5863 by lentivirus on inflammation. Ten circRNA-miRNA interactions involving three circRNAs and six miRNAs were identified, and IFIT3 and RSAD2 were identified as hub genes in the resulting PPI network with 19 nodes. Circ.5863 showed a statistically significant decrease in the constructed model, which is consistent with the sequencing results, and overexpression via lentiviral transfection of circ.5863 was found to alleviate inflammation damage. In this study, a circRNA-miRNA-mRNA network was successfully constructed, and IFIT3 and RSAD2 were identified as hub genes. Our findings suggest that circ.5863 can mitigate inflammation damage in IC/BPS. The identified marker genes may serve as valuable targets for future research aimed at developing diagnostic tools and more effective therapies for IC/BPS.

PMID:37925174 | DOI:10.18632/aging.205170

Pediatr Infect Dis J. 2023 Oct 30. doi: 10.1097/INF.0000000000004119. Online ahead of print.

ABSTRACT

BACKGROUND: Periportal fibrosis is a late-stage manifestation of chronic infection with Schistosoma mansoni. Praziquantel (PZQ), the only drug available for the treatment of schistosomiasis, has limited effect in treating established morbidity. Preschool-aged children (PSAC) are not considered to be an at-risk population for severe morbidity. However, the prevalence of periportal fibrosis in PSAC in S. mansoni endemic settings is unknown.

METHODS: As part of a phase II clinical trial comparing different dosing regimens of PZQ in children age 12-47 months infected with S. mansoni in Uganda (“praziquantel in preschoolers” trial), we present baseline results assessing liver ultrasound (US) findings as per the WHO Niamey Protocol.

RESULTS: A total of 7/347 (2%) PSAC had Image Pattern C with pipe stems and echogenic rings suggestive of periportal fibrosis, 29/347 (8%) had Image Pattern B and 58 (17%) had evidence of periportal thickening There were higher adjusted odds of periportal thickening with older age [odds ratio (OR): 1.04; 95% confidence interval (CI): 1.00-1.07], primary maternal education (OR: 1.04; 95% CI: 1.00-1.07) and being taken to the lake weekly (OR: 3.02; 95% CI: 1.19-7.63). A further 44/347 children (13%) had a rounded caudal liver edge which was associated with high S. mansoni infection intensity (adjusted OR: 3.31; 95% CI: 1.46-7.51).

CONCLUSIONS: Incipient schistosomiasis-related liver morbidity was detected in young children enrolled in the praziquantel in preschoolers trial. Adequate age-adjusted reference measurements for liver ultrasound findings in very small children are lacking but urgently needed. Schistosomiasis-related fibrosis may be delayed or averted with early and repeated PZQ treatment.

PMID:37922490 | DOI:10.1097/INF.0000000000004119

J Low Genit Tract Dis. 2023 Nov 3. doi: 10.1097/LGT.0000000000000778. Online ahead of print.

ABSTRACT

OBJECTIVES: The aims of the study are to examine the perception of the human papillomavirus (HPV) vaccine among those with and without a history of cervical dysplasia and to examine perceptions of the vaccine for their children.

MATERIALS AND METHODS: Patients were recruited to complete a survey about the HPV vaccine for both themselves and their children. Patients in a colposcopy clinic with a history of abnormal cervical cytology and patients in a benign gynecology clinic without a history of abnormal cervical cytology were recruited. Participants’ medical records were reviewed. Demographics and survey answers were described, and Fisher exact test was used to compare the groups.

RESULTS: One hundred eighty-three patients participated: 73 in colposcopy clinic and 110 in benign clinic. The majority self-identified as Black (74% colposcopy, 71% benign, p = .588) and reported an income less than $39,000 a year (77% colposcopy, 65% benign, p = .089). Fifty-six percent in benign clinic agreed the HPV vaccine is a good way to protect oneself from disease compared with 48% in colposcopy clinic (p = .022). When examining results based on cytology, fewer patients in the highest-grade cytology group agreed the vaccine was effective (30% high-grade, 48% normal, 57% low-grade, p = .027) or a good way to protect themselves from disease (29% high-grade, 53% normal, 62% low-grade, p = .002). There was otherwise no statistically significant difference between the groups on questions regarding self or child vaccination.

CONCLUSIONS: In a majority Black, low-income population, patients without a history of abnormal cervical cytology have more favorable perceptions of the HPV vaccine’s effectiveness in preventing disease. Those with the highest-grade cytology had more negative perceptions of the vaccine’s effectiveness and protectability.

PMID:37922471 | DOI:10.1097/LGT.0000000000000778

J Chem Theory Comput. 2023 Nov 3. doi: 10.1021/acs.jctc.3c00894. Online ahead of print.

ABSTRACT

This paper presents a novel theoretical measure, μ^EMD, based on the earth mover’s distance (EMD), for quantifying the density shift caused by electronic excitations in molecules. As input, the EMD metric uses only the discretized ground- and excited-state electron densities in real space, rendering it compatible with almost all electronic structure methods used to calculate excited states. The EMD metric is compared against other popular theoretical metrics for describing the extent of electron-hole separation in a wide range of excited states (valence, Rydberg, charge transfer, etc.). The results showcase the EMD metric’s effectiveness across all excitation types and suggest that it is useful as an additional tool to characterize electronic excitations. The study also reveals that μ^EMD can function as a promising diagnostic tool for predicting the failure of pure exchange-correlation functionals. Specifically, we show statistical relationships among the functional-driven errors, the exact exchange content within the functional, and the magnitude of μ^EMD values.

PMID:37922416 | DOI:10.1021/acs.jctc.3c00894

ACS Appl Mater Interfaces. 2023 Nov 3. doi: 10.1021/acsami.3c11349. Online ahead of print.

ABSTRACT

The growing prevalence of methicillin-resistant Staphylococcus aureus (S. aureus) infections necessitates a greater understanding of their initial adhesion to medically relevant surfaces. In this study, the influence of the mechanical properties and oligomer content of polydimethylsiloxane (PDMS) gels on the initial attachment of Gram-positive S. aureus was explored. Small-amplitude oscillatory shear rheological measurements were conducted to verify that by altering the base to curing (B:C) ratio of the commonly used Sylgard 184 silicone elastomer kit (B:C ratios of 60:1, 40:1, 10:1, and 5:1), PDMS gels could be synthesized with Young’s moduli across four distinct regimes: ultrasoft (15 kPa), soft (30 kPa), standard (400 kPa), and stiff (1500 kPa). These as-prepared gels (unextracted) were compared to gels prepared from the same B/C ratios that underwent Soxhlet extraction to remove any unreacted oligomers. While the Young’s moduli of unextracted and extracted PDMS gels prepared from the same B:C ratio were statistically equivalent, the associated adhesion failure energy statistically decreased for the ultrasoft gels after extraction (from 25 to 8 J/mm²). The interactions of these eight well-characterized gels with bacteria were tested by using S. aureus SH1000, a commonly studied laboratory strain, as well as S. aureus ATCC 12600, which was isolated from a human lung infection. Increased S. aureus inactivation occurred only when the bacteria were incubated directly on top of the unextracted gels prepared at high B:C ratios (40:1 and 60:1), whereas none of the extracted gels (no unreacted oligomers) had significant levels of inactivated bacteria. S. aureus adhered the least to the stiffest extracted PDMS gels (no unreacted oligomers) and the most to soft, unextracted PDMS gels (with ∼17% unreacted oligomers). These findings suggest that both unreacted oligomers and Young’s moduli are important material factors to consider when exploring the attachment behavior of Gram-positive S. aureus to hydrophobic elastomer gels.

PMID:37922414 | DOI:10.1021/acsami.3c11349

Psychother Res. 2023 Nov 3:1-16. doi: 10.1080/10503307.2023.2277866. Online ahead of print.

ABSTRACT

OBJECTIVE: Blended cognitive behavioral therapy (bCBT) combines face-to-face therapy with digital elements, such as digital health apps. This pilot study aimed to explore the effectiveness and safety of a novel bCBT application for treating unipolar depression in adults combined with cognitive behavioral therapy (CBT) compared to CBT alone in routine care.

METHODS: Patients (N = 82) were randomly assigned to bCBT (n = 42) or CBT (n = 40) over 12 weeks. bCBT consisted of weekly CBT sessions accompanied by the elona therapy depression module (a bCBT application for unipolar depression) for use between sessions. Standard CBT consisted of weekly CBT sessions. Outcomes (6,12 weeks) were analyzed with linear mixed models.

RESULTS: Improvements in depressive symptoms (BDI-II, PHQ-9) were descriptively larger for the bCBT group. Yet, this difference did not reach statistical significance. bCBT was superior to standard CBT in secondary outcome measures of psychological health (d = .50) and generalized anxiety symptoms (d = -.45). In other secondary outcomes (BAI, PSWQ, GSE, WHOQOL-BREF), improvements were descriptively larger for bCBT compared to CBT.

CONCLUSION: This pilot study provided preliminary evidence that bCBT might be advantageous in comparison to CBT alone in the treatment of depression, but larger RCTs of the bCBT application are needed.

PMID:37922395 | DOI:10.1080/10503307.2023.2277866