Tag: pubmed

Epilepsia. 2022 Mar 14. doi: 10.1111/epi.17224. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary purpose is to determine if the time between epilepsy surgery and first seizure recurrence can estimate the timing of the next seizure event for temporal and extratemporal epilepsy. A secondary endpoint aimed to compare temporal and extratemporal epilepsy surgery and examine which subgroup has a higher hazard of subsequent seizure recurrence.

METHODS: Data was used from a retrospective database at Thomas Jefferson University Hospital. Records were stratified into temporal (N = 943) and extratemporal (N = 125) surgeries. Analyses were done using SAS and utilized Cox-Proportional hazards models while controlling for demographics and clinical factors. The primary predictor of time between surgery and first recurrence was treated as a nominal variable binned into six segments, while secondary endpoints used a categorical predictor of epilepsy location while controlling for seizure latency.

RESULTS: Generally, as seizure latency following surgery increased, the time between first seizure and second seizure increased. These results were statistical meaningful in the temporal set (Wald Chi Square: 40.4715, df = 5, p<0.0001). Outcomes could also be interpreted based on predictor group, for instance, if seizure one occurred between one to two months following surgery in the temporal set, the median number of days until the next seizure was 35.5 days (95% CIs: 21 – 89 days). Secondary analysis showed that temporal lobe epilepsy had a lower hazard of a second seizure than extratemporal lobe epilepsy (89.2% reduction in hazard; 95% CIs: 0.015 – 0.795).

SIGNIFICANCE: This analysis provides a framework to use initial seizure latency to predict the median number of days until the next seizure event, while stratifying based on epilepsy location and controlling for multiple variables. It also suggests that the hazard of seizure recurrence in temporal lobe epilepsy is lower than extratemporal lobe epilepsy.

PMID:35286721 | DOI:10.1111/epi.17224

J Surg Oncol. 2022 Mar 14. doi: 10.1002/jso.26845. Online ahead of print.

ABSTRACT

INTRODUCTION: Adrenocortical carcinoma (ACC) is associated with a poor prognosis. We reviewed the National Cancer Database (NCDB) to analyze the prognostic factors in surgically resected ACC patients and the association of surgical approaches with overall survival (OS).

METHODS: A retrospective NCDB (2004-2014) review of patients undergoing curative-intent surgical resection for ACC was performed. Effects of patient demographics, tumor characteristics, histopathology, and perioperative course on OS were analyzed. Log-rank statistics were used to associate clinical variables with OS. The multivariable Cox proportional hazard model included only statistically significant variables.

RESULTS: A total of 1599 patients with ACC were included. A majority of patients were female (60.73%) and presented with a Charlson-Deyo score of zero (75.42%). A majority of the ACC cases were Grade 3 (45.69%), and almost a third (30.64%) underwent margin-positive resections. Univariate analysis demonstrated a decrease in OS associated with increasing age and comorbidities. A negative resection margin and lack of lymphovascular invasion predicted better OS. Multivariable analysis showed that age, grade, surgical resection margins, and hospital length of stay were associated with OS.

CONCLUSIONS: Advanced age, grade, presence of lymphovascular invasion, and positive surgical margins predicted a worse overall survival for adrenocortical cancer in our analysis. Resection with negative margins improves outcomes.

PMID:35286718 | DOI:10.1002/jso.26845

Sports Med. 2022 Mar 14. doi: 10.1007/s40279-022-01668-1. Online ahead of print.

ABSTRACT

BACKGROUND: Continued participation after sport-related concussion (SRC) worsens outcomes, but it is unknown if duration of continued participation after SRC impacts recovery outcomes, and which athletes who continue to participate are at greatest risk for poor SRC outcomes. The purpose of this National Collegiate Athletic Association/Department of Defense (NCAA/DoD) Concussion Assessment, Research, and Education (CARE) Consortium study was to evaluate the association of estimated duration of continued participation after SRC with symptom severity and recovery time in collegiate athletes.

METHODS: Clinicians estimated if/how long athletes continued participation after SRC. Collegiate athletes who continued participation after suspected SRC (n = 195/373, 52.3%) completed the Graded Symptom Checklist to evaluate the severity of total symptoms and migraine/fatigue, cognitive/ocular, and affective symptom clusters. Linear regression analyzed the associations between estimated duration of continued participation, symptom severity, and recovery time. Binary logistic regression examined the association of estimated duration of continued participation with the odds of recovery ≥ 14 and ≥ 21 days. Statistical significance was p < 0.05.

RESULTS: Athletes who continued to participate did so for 27.9 ± 25.3 min (mean ± standard deviation; range 1-90 min). Longer estimated continued participation (1-90 min) was associated with greater symptom severity (β = 0.122, p = 0.02), affective (β = 0.171, p = 0.001) and migraine/fatigue symptoms (β = 0.104, p = 0.049), longer symptom duration (β = 0.193, p < 0.001), and longer time missed (β = 0.156, p = 0.003). Longer estimated continued participation positively interacted with female sex (cognitive/ocular: female R² = 0.03, male R² = 0.01, p = 0.02; affective: female R² = 0.06, male R² = 0.02, p = 0.006), migraine history (affective symptoms: no migraine R² = 0.02; migraine R² = 0.18; p = 0.04), and concussion history (affective: 2 + prior concussions [R² = 0.14] compared with those with 1 [R² = 0.07] or 0 [R² < 0.01] prior concussions [p = 0.003]).

CONCLUSIONS: Longer estimated duration of continued participation after SRC was associated with higher symptom severity, particularly affective and migraine/fatigue; longer symptom duration; and more time missed from sport. SRC outcomes in those who continue to play may be especially severe for female athletes, athletes with migraine history, and athletes with prior concussion(s). The findings can help clinicians and administrators to educate athletes on the importance of immediate removal following a suspected SRC.

PMID:35286616 | DOI:10.1007/s40279-022-01668-1

Med Phys. 2022 Mar 14. doi: 10.1002/mp.15597. Online ahead of print.

ABSTRACT

PURPOSE: Radiochromic material used in recent commercial films has been suggested as a candidate for in vivo dosimetry because of its dose sensitivity, real-time response, and atomic composition. It was observed that its sensitive material, Lithium Pentacosa-10,12-diynoate (LiPCDA), can have two distinct forms, with main absorbance peaks at ∼635 nm and ∼674 nm. The spectrum of the latter is similar to that of Pentacosa-10,12-diynoic acid (PCDA) used in the commercial predecessor, obtained through desiccation of the commercial film. Water was suggested to be a part of the crystal structure and thus its presence or absence would affect dosimetric parameters. The objective of this study was to: (a) investigate how desiccated commercial films compare to the native form in terms of macroscopic crystal structure, dose-response, signal linearity and post-exposure kinetics; (b) demonstrate proof of concept that the two versions can be combined into one optical dosimeter and measured simultaneously.

METHODS: Commercial radiochromic film, EBT-3, was desiccated for 10 days at 45°C. Using a 6 MV LINAC beam and standard set-up of 100 SAD, 10 cm x 10 cm field size, and 1.5 cm depth, commercial and desiccated films were irradiated to 50, 100, 200, 500, 1000, 2000, 3000 cGy and the latter to 4000, 5000 and 7000 cGy. A custom phantom equipped with optical fibres for real-time read-out was used for all measurements. Absorbance spectra were collected at ∼ 1 Hz before, during, and after irradiation. Data was collected for ∼1 hour after the end of irradiation for 200 cGy experiments. The radiation-induced change in optical density (∆OD) was calculated with a 10 nm band around the primary absorbance peak. The post-exposure percent optical density change was calculated and compared to ∆OD at the end of irradiation. Both commercial and desiccated films were also irradiated and measured simultaneously as proof of concept for using two materials within one optical path. For electron microscopy imaging, active material from commercial and desiccated films were imaged on a scanning electron microscope at an accelerating voltage of 10 kV.

RESULTS: Scanning electron microscope images showed that desiccated film was similar in topographical structure to the commercial EBT-3 form. It maintained a non-linear ∆OD with dose but resulted in ∼1/3 signal compared to the commercial film. Evaluation of post-exposure response showed significantly lower percent increase in ∆OD for desiccated film initially, with no statistically significant difference at 1 h after the end of irradiation. Combining both films and simultaneously measuring their absorbance illustrated that the two absorbance peaks were identifiable and resolvable to allow for an independent determination of dose from each.

CONCLUSIONS: Water is implicated in the crystal structure of the EBT-3 radiochromic film, with its removal through desiccation affecting both dosimetric and spectroscopic characteristics of the material. The two forms of radiochromic material (with and without water) are spectrally resolvable allowing for independent dose determination from each, opening up possibilities for dose measurements at different locations along a single fiber. This article is protected by copyright. All rights reserved.

PMID:35286716 | DOI:10.1002/mp.15597

Neuroinformatics. 2022 Mar 14. doi: 10.1007/s12021-022-09579-2. Online ahead of print.

ABSTRACT

The present study shows new findings that reveal the high association between emotional arousal and neuro-functional brain connectivity measures. For this purpose, contrasting discrete emotional states (happiness vs sadness, amusement vs disgust, calmness vs excitement, calmness vs anger, fear vs anger) are classified by using Support Vector Machines (SVMs) driven by Graph Theoretical segregation (clustering coefficients, transitivity, modularity) and integration (global efficiency, local efficiency) measures of the brain network. Emotional EEG data mediated by short duration video film clips is downloaded from publicly available database called DREAMER. Pearson Correlation (PC) and Spearman Correlation have been examined to estimate statistical dependencies between relatively shorter (6 sec) and longer (12 sec) non-overlapped EEG segments across the cortex. Then the corresponding brain connectivity encoded as a graph is transformed into binary numbers with respect to two different thresholds (60%max and mean). Statistical differences between contrasting emotions are obtained by using both one-way Anova tests and step-wise logistic regression modelling in accordance with variables (dependency estimation, segment length, threshold, network measure). Combined integration measures provided the highest classification accuracies (CAs) (75.00% 80.65%) when PC is applied to longer segments in accordance with particular threshold as the mean. The segregation measures also provided useful CAs (74.13% 80.00%), while the combination of both measures did not. The results reveal that discrete emotional states are characterized by balanced network measures even if both segregation and integration measures vary depending on arousal scores of audio-visual stimuli due to neurotransmitter release during video watching.

PMID:35286574 | DOI:10.1007/s12021-022-09579-2

Breast Cancer Res Treat. 2022 Mar 14. doi: 10.1007/s10549-022-06528-0. Online ahead of print.

ABSTRACT

PURPOSE: Beta blockers (BB) have been associated with improved, worsened, or unchanged breast cancer outcomes in previous studies. This study examines the association between the post-diagnostic use of BBs and death from breast cancer in a large, representative sample of New Zealand (NZ) women with breast cancer.

METHODS: Women diagnosed with a first primary breast cancer between 2007 and 2016 were identified from four population-based regional NZ breast cancer registries and linked to national pharmaceutical data, hospital discharges, and death records. The median follow-up time was 4.51 years. Cox proportional hazard models were used to estimate the hazard of breast cancer-specific death (BCD) associated with any post-diagnostic BB use.

RESULTS: Of the 14,976 women included in analyses, 21% used a BB after diagnosis. BB use (vs non-use) was associated with a small and nonstatistically significant increased risk of BCD (adjusted hazard ratio: 1.11; 95% CI 0.95-1.29). A statistically significant increased risk confined to short-term use (0-3 months) was seen (HR = 1.40; 1.14-1.73), and this risk steadily decreased with increasing duration of use and became a statistically significant protective effect at 3 + years of use (HR = 0.55; 0.34-0.88).

CONCLUSION: Our findings suggest that any increased risk associated with BB use may be driven by risk in the initial few months of use. Long-term BB use may be associated with a reduction in BCD.

PMID:35286523 | DOI:10.1007/s10549-022-06528-0

MAGMA. 2022 Mar 14. doi: 10.1007/s10334-022-01004-8. Online ahead of print.

ABSTRACT

OBJECTIVE: This proof-of-principle study integrates joint reaction forces (JRFs) and bone shape to assess acute cartilage changes from walking and cycling.

METHODS: Sixteen women with symptomatic knee osteoarthritis were recruited. Biomechanical assessment estimated JRFs during walking and cycling. Subsamples had magnetic resonance imaging (MRI) performed before and after a 25-min walking (n = 7) and/or cycling (n = 9) activity. MRI scans were obtained to assess cartilage shape and composition (T₂ relaxation time). Bone shape was quantified using a statistical shape model built from 13 local participants and 100 MRI scans from the Osteoarthritis Initiative. Statistical parametric mapping quantified cartilage change and correlations between cartilage change with JRFs and statistical shape model features.

RESULTS: Cartilage thickness (interior lateral, Δ – 0.10 mm) and T₂ (medial, Δ – 4 ms) decreased on the tibial plateau. On the femur, T₂ change depended on the activity. Greater tibiofemoral JRF was associated with more cartilage deformation on the lateral femoral trochlea after walking (r – 0.56). Knees more consistent with osteoarthritis showed smaller decreases in tibial cartilage thickness.

DISCUSSION: Walking and cycling caused distinct patterns of cartilage deformation, which depended on knee JRFs and bone morphology. For the first time, these results show that cartilage deformation is dependent on bone shapes and JRFs in vivo.

PMID:35286512 | DOI:10.1007/s10334-022-01004-8

Insights Imaging. 2022 Mar 14;13(1):47. doi: 10.1186/s13244-022-01189-5.

ABSTRACT

BACKGROUND: We aimed to assess whether the quantitative parameters of esophageal varices (EV) based on computed tomography (CT) can noninvasively predict severe EV and the risk of esophageal variceal bleeding (EVB).

METHODS: A total of 136 endoscopically confirmed EV patients were included in this retrospective study and were divided into a non-conspicuous (mild-to-moderate EV, n = 30) and a conspicuous EV group (severe EV, n = 106), a bleeding (n = 89) and a non-bleeding group (n = 47). EV grade (EVG), EV diameter (EVD), cross-sectional surface area (CSA), EV volume (EVV), spleen volume (SV), splenic vein (SNV), portal vein (PV), diameter of left gastric vein (DLGV), and the opening type of LGV were measured independently using 3D-slicer. Univariate and multivariate logistic analysis were used to determine the independent factors and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic performance.

RESULTS: The difference of EVG, EVD, CSA, EVV, DLGV, SNV between the conspicuous and non-conspicuous EV group were statistically significant (p < 0.05), area under the curves (AUCs) of them for predicting severe EV were 0.72, 0.772, 0.704, 0.768, 0.707, 0.65, with corresponding sensitivities of 70.3%, 63.5%, 50%, 74.3%, 52.7%, 48.6%, specificities of 71.4%, 85.7%, 100%, 71.4%, 81%, 81%, respectively. EVG, CSA (odds ratio 3.258, 95% CI 1.597-6.647; 1.029, 95% CI 1.008-1.050) were found to be independent predictive factors. However, there was no significant difference of the included indices between the bleeding and non-bleeding group (p > 0.05).

CONCLUSIONS: CT can be used as a noninvasive method to predict the severity of EV, which may reduce the invasive screening of endoscopy.

PMID:35286491 | DOI:10.1186/s13244-022-01189-5

Egypt Heart J. 2022 Mar 14;74(1):15. doi: 10.1186/s43044-022-00254-0.

ABSTRACT

BACKGROUND: Pulse wave velocity (PWV) and central blood pressure (CBP) have been intoduced into managment of hypertensive patients. PWV is positively correlated with arterial wall stiffness while central aortic pressure becomes better predictor of cardiovascular outcome than peripheral pressure. Reduction in CBP provides protective properties against subclinical organ damage. This work aims to investigate the effect of a new combination therapy of Amlodipine/Nebivolol (A/N) on central BP, peripheral BP and PWV. The results of using this combination will be compared to the well-established fixed-dose combination of Amlodipine/Valsartan (A/V). The study conducted between October 2018 and August 2020. One hundred and two hypertensive patients were assigned for Amlodipine 10 mg/Valsartan 160 mg combination therapy (A/V, n = 52) or Amlodipine 10 mg/Nebivolol 5 mg combination therapy (A/N, n = 50) by simple 1:1 randomization. Office, central blood pressure and PWV were measured on first (0 week), second (4-8 weeks) and third visit (10-12). Difference in BP (in each arm and between arms) was calculated along all visits.

RESULTS: No statistical significant difference was found between A/V and A/N regarding age, gender, BMI and CV history. OBP, CBP and PWV were significantly reduced in each arm, but no differences were found when comparing both arm results to each other. Recorded side effects were insignificant.

CONCLUSIONS: The new combination therapy Amlodipine/Nebivolol (A/N) affords a significant reduction in CBP, PBP and PWV with minor and tolerable side effects. It has provided comparable results to Amlodipine/Valsartan (A/V) combination therapy.

PMID:35286492 | DOI:10.1186/s43044-022-00254-0

Brain Struct Funct. 2022 Mar 14. doi: 10.1007/s00429-022-02468-z. Online ahead of print.

ABSTRACT

Natural scenes are characterized by diverse image statistics, including various parameters of the luminance histogram, outputs of Gabor-like filters, and pairwise correlations between the filter outputs of different positions, orientations, and scales (Portilla-Simoncelli statistics). Some of these statistics capture the response properties of visual neurons. However, it remains unclear to what extent such statistics can explain neural responses to natural scenes and how neurons that are tuned to these statistics are distributed across the cortex. Using two-photon calcium imaging and an encoding-model approach, we addressed these issues in macaque visual areas V1 and V4. For each imaged neuron, we constructed an encoding model to mimic its responses to naturalistic videos. By extracting Portilla-Simoncelli statistics through outputs of both filters and filter correlations, and by computing an optimally weighted sum of these outputs, the model successfully reproduced responses in a subpopulation of neurons. We evaluated the selectivities of these neurons by quantifying the contributions of each statistic to visual responses. Neurons whose responses were mainly determined by Gabor-like filter outputs (low-level statistics) were abundant at most imaging sites in V1. In V4, the relative contribution of higher order statistics, such as cross-scale correlation, was increased. Preferred image statistics varied markedly across V4 sites, and the response similarity of two neurons at individual imaging sites gradually declined with increasing cortical distance. The results indicate that natural scene analysis progresses from V1 to V4, and neurons sharing preferred image statistics are locally clustered in V4.

PMID:35286478 | DOI:10.1007/s00429-022-02468-z