Tag: pubmed

J Orofac Orthop. 2022 Apr 8. doi: 10.1007/s00056-022-00387-6. Online ahead of print.

ABSTRACT

PURPOSE: The present study aims to compare the M‑mode ultrasound findings of different skeletal malocclusions and to evaluate whether sonographic parameters can be used for the diagnosis of malocclusions.

METHODS: Tongue movements of 36 adolescents aged between 10.37 and 17.29 years (mean 14.25 ± 1.78 years) were assessed using simultaneous two-dimensional real-time B‑mode and M‑mode sonography. The swallowing patterns of the subjects were visualized recording the motion of the tongue surface in the ultrasound images utilizing a fixed scan line through the middle of the tongue. M‑mode scans of tongue motion during empty deglutition were recorded. The parameters range, duration, and speed were computed for the entirety of the swallowing process using M‑mode examination. Findings were evaluated and statistically analyzed.

RESULTS: No clear intraindividual repeatability in the M‑mode imaging of the subjects’ swallowing process could be observed. Considering the setup used in the study, it was not always possible to distinguish individual swallowing stages in the M‑mode images with regard to the chosen reference points. The average duration, range of motion, and speed of swallowing were found to be 2.43 s, 24.06 mm, and 10.34 mm/s, respectively. The findings showed both intra- and intersubject variability during empty swallowing.

CONCLUSION: With the help of the metrics that could be calculated based on the M‑mode images, it was not possible to differentiate the swallowing acts of different skeletal malocclusion types. It remains unclear whether M‑mode imaging can accurately visualize the swallowing pattern. Therefore, further progress in technology and multidisciplinary work is needed in order to establish diagnostic references regarding swallowing.

PMID:35394138 | DOI:10.1007/s00056-022-00387-6

Psychopharmacology (Berl). 2022 Apr 8. doi: 10.1007/s00213-022-06114-8. Online ahead of print.

ABSTRACT

RATIONALE: Pre-ejection period (PEP) and T-wave amplitude (TWA) have been used to assess sympathetic nervous system (SNS) activity. Here we report two single-blinded, placebo-controlled intravenous (IV) drug application studies in which we pharmacologically modified SNS activity with epinephrine (study 1) as well as dexmedetomidine (alpha2-agonist) and yohimbine (alpha2-antagonist) (study 2). Restricted heart rate (HR) intervals were analyzed to avoid confounding effects of HR changes.

OBJECTIVE: Study 1 served to replicate previous findings and to validate our approach, whereas study 2 aimed to investigate how modulation of central SNS activity affects PEP and TWA.

METHODS: Forty healthy volunteers (58% females) participated in study 1 (between-subject design). Twelve healthy men participated in study 2 (within-subject design). TWA and PEP were derived from ECG and impedance cardiography, respectively.

RESULTS: Epinephrine shortened PEP and induced statistically significant biphasic TWA changes. However, although the two alpha2-drugs significantly affected PEP as expected, no effects on TWA could be detected.

CONCLUSION: PEP is better suited to reflect SNS activity changes than TWA.

PMID:35394159 | DOI:10.1007/s00213-022-06114-8

Knee Surg Sports Traumatol Arthrosc. 2022 Apr 8. doi: 10.1007/s00167-022-06957-w. Online ahead of print.

ABSTRACT

PURPOSE: The number of primary total knee arthroplasties (TKA) is expected to rise constantly. For patients and healthcare providers, the early identification of risk factors therefore becomes increasingly fundamental in the context of precision medicine. Others have already investigated the detection of risk factors by conducting literature reviews and applying conventional statistical methods. Since the prediction of events has been moderately accurate, a more comprehensive approach is needed. Machine learning (ML) algorithms have had ample success in many disciplines. However, these methods have not yet had a significant impact in orthopaedic research. The selection of a data source as well as the inclusion of relevant parameters is of utmost importance in this context. In this study, a standardized approach for ML in TKA to predict complications during surgery and an irregular surgery duration using data from two German arthroplasty-specific registries was evaluated.

METHODS: The dataset is based on two initiatives of the German Society for Orthopaedics and Orthopaedic Surgery. A problem statement and initial parameters were defined. After screening, cleaning and preparation of these datasets, 864 cases of primary TKA (2016-2019) were gathered. The XGBoost algorithm was chosen and applied with a hyperparameter search, a cross validation and a loss weighting to cope with class imbalance. For final evaluation, several metrics (accuracy, sensitivity, specificity, AUC) were calculated.

RESULTS: An accuracy of 92.0%, sensitivity of 34.8%, specificity of 95.8%, and AUC of 78.0% were achieved for predicting complications in primary TKA and 93.4%, 74.0%, 96.3%, and 91.6% for predicting irregular surgery duration, respectively. While traditional statistics (correlation coefficient) could not find any relevant correlation between any two parameters, the feature importance revealed several non-linear outcomes.

CONCLUSION: In this study, a feasible ML model to predict outcomes of primary TKA with very promising results was built. Complex correlations between parameters were detected, which could not be recognized by conventional statistical analysis. Arthroplasty-specific data were identified as relevant by the ML model and should be included in future clinical applications. Furthermore, an interdisciplinary interpretation as well as evaluation of the results by a data scientist and an orthopaedic surgeon are of paramount importance.

LEVEL OF EVIDENCE: Level IV.

PMID:35394135 | DOI:10.1007/s00167-022-06957-w

Adv Clin Exp Med. 2022 Apr 8. doi: 10.17219/acem/147672. Online ahead of print.

ABSTRACT

BACKGROUND: One of the groups most exposed to potentially harmful effects of the current pandemic on physical and mental health is medical personnel, in particular those working directly with patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or suffering from coronavirus disease 2019 (COVID-19).

OBJECTIVES: The response of the body to a persisting threat, constant contact with dying people and frequent deaths of patients is chronic stress syndrome. Its symptoms may take the form of psychosomatic or somatic reactions. The aim of the study was to determine the effect of stress on the severity of temporomandibular syndrome (TMD) in medical personnel.

MATERIAL AND METHODS: The study included a group of 160 people – 120 women and 40 men aged 35-60 years, working at the hospital wards as doctors, nurses and support staff, directly with patients infected with SARS-CoV-2 and suffering from COVID-19. The research was conducted in the form of a cross-sectional survey with the use of anonymous questionnaire. The final questionnaire was developed based on the tools commonly used for TMD, bruxism, anxiety, and depression assessment – 8Q/TMD and the Patient Health Questionnaire-8 (PHQ-8).

RESULTS: After checking the significance of differences in responses to individual questions among men and women and applying the Bonferroni correction for multiple comparisons, Fisher’s test and p-values for individual responses, an increase in pathological reactions was shown. The results showed that the COVID-19 pandemic has caused significant adverse effects on the psychoemotional status and causes or aggravates TMD symptoms.

CONCLUSION: The aggravation of the psychoemotional status caused by the COVID-19 pandemic can result in intensification of TMD symptoms and other symptoms in the stomatognathic system in medical staff working with patients infected with COVID-19.

PMID:35394124 | DOI:10.17219/acem/147672

J Magn Reson Imaging. 2022 Apr 8. doi: 10.1002/jmri.28195. Online ahead of print.

ABSTRACT

BACKGROUND: Prenatal quantitative evaluation of myelin is important. However, few techniques are suitable for the quantitative evaluation of fetal myelination.

PURPOSE: To optimize a modified Look-Locker inversion recovery (MOLLI) T1 mapping sequence for fetal brain development study.

STUDY TYPE: Prospective observational preliminary cohort study.

POPULATION: A total of 71 women with normal fetuses divided into mid-pregnancy (gestational age 24-28 weeks, N = 25) and late pregnancy (gestational age > 28 weeks, N = 46) groups.

FIELD STRENGTH/SEQUENCE: A 3 T/MOLLI sequence.

ASSESSMENT: T1 values were measured in pedunculus cerebri, basal ganglia, thalamus, posterior limb of the internal capsule, temporal white matter, occipital white matter, frontal white matter, and parietal white matter by two radiologists (11 and 16 years of experience, respectively).

STATISTICAL TESTS: The Kruskal-Wallis test was used for reginal comparison. For each region of interest (ROI), differences in T1 values between the mid and late pregnancy groups were assessed by the Mann Whitney U test. Pearson correlation coefficients (r) were used to evaluate the correlations between T1 values and gestational age for each ROI. Intraobserver and interobserver agreement was determined by the intraclass correlation coefficient (ICC). A P value <0.05 was considered statistically significant.

RESULTS: Interobserver and intraobserver agreements of T1 were good for all ROIs (all ICCs > 0.700). There were significant differences in T1 values between lobal white matter and deep regions, respectively. Significant T1 values differences were found between middle and late pregnancy groups in pedunculus cerebri, basal ganglion, thalamus, posterior limb of the internal capsule, temporal, and occipital white matter. The T1 values showed significantly negative correlations with gestational weeks in pedunculus cerebri (r = -0.80), basal ganglion (r = -0.60), thalamus (r = -0.68), and posterior limb of the internal capsule (r = -0.77).

DATA CONCLUSION: The T1 values of fetal brain may be assessed using the MOLLI sequence and may reflect the myelination.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

PMID:35394092 | DOI:10.1002/jmri.28195

Asia Pac J Clin Oncol. 2022 Apr 8. doi: 10.1111/ajco.13668. Online ahead of print.

ABSTRACT

BACKGROUND: Though concurrent chemoradiotherapy (CCRT) with cisplatin remains a standard of care for patients with locally advanced nasopharyngeal carcinoma (LA-NPC), carboplatin has alternatively been used without sufficient supportive evidences. Thus, we evaluated an efficacy and tolerability of carboplatin CCRT compared with cisplatin in LA-NPC patients.

METHODS: Patients with LA-NPC treated with CCRT were identified through the Thai multicenter head and neck cancer database. Patient tolerability and survival were analyzed and compared between regimens. Survivals were calculated by using the Kaplan-Meier method, and compared by the log-rank test. A p-value of <0.05 was considered statistically significant.

RESULTS: A total of 135 of 980 patients (13.8%) were treated with carboplatin. Patients treated with carboplatin were significantly associated with older age (p < 0.001), smoking (p = 0.003), more comorbidity (p = 0.014), kidney disease (p = 0.016), and lower baseline creatinine clearance (p < 0.001). Intensity-modulated radiation therapy was used significantly more in the cisplatin group than carboplatin group (p < 0.001). Patients who received carboplatin were associated with delay (p = 0.049) and hospitalization (p = 0.006), whereas cisplatin CCRT had more dose reduction (p = 0.001). Patients treated with cisplatin had CCRT interruption from grade 3-4 mucositis (p = 0.019) more than carboplatin, whereas carboplatin had more grade 3-4 thrombocytopenia (p < 0.001). The 5-year overall survival (OS) of patients treated with cisplatin and carboplatin was 59% and 49%, respectively (p = 0.128). Cisplatin or carboplatin CCRT was not a significant predictor for OS and locoregional recurrence-free survival in multivariate analysis.

CONCLUSIONS: Carboplatin CCRT provided acceptable efficacy and tolerability profiles in real-world practice. Carboplatin should be considered as an alternative regimen, particularly in cisplatin-ineligible patients with LA-NPC treated with CCRT.

PMID:35394108 | DOI:10.1111/ajco.13668

J Dermatol. 2022 Apr 8. doi: 10.1111/1346-8138.16384. Online ahead of print.

ABSTRACT

In 2020, 5% sofpironium bromide (ECCLOCK^® ) gel (hereinafter referred to as sofpironium) was approved in Japan for the topical treatment of primary axillary hyperhidrosis. A phase III study of sofpironium demonstrated the efficacy and safety of sofpironium; however, no study has assessed its early efficacy at <6 weeks after starting treatment. Therefore, to assess the earlier effectiveness of sofpironium, we conducted a 2-week, single-center, exploratory, prospective, observational study in Japanese patients with primary axillary hyperhidrosis. Patients aged ≥20 years and satisfying with a Hyperhidrosis Disease Severity Scale (HDSS) score of 3 or 4 at baseline were eligible for the study. The primary endpoint for the effectiveness was change in the proportion of patients with a HDSS score of 1, 2, 3, or 4 during the 2-week study period. In 80 patients included in the full analysis set (FAS), there were more women than men (93.8% vs. 6.3%), and the mean age (±standard deviation [SD]) was 33.3 ± 9.4 years. In the FAS, the proportion of patients with a HDSS score of 1 or 2 was 55.0% on day 7, and statistically significant changes were observed after day 3 compared to baseline (p < 0.05). Mean HDSS scores (±SD) were significantly decreased from baseline value of 3.5 ± 0.5 to 2.4 ± 0.9 on day 7 (p < 0.001). The median period for sofpironium treatment to achieve a HDSS score of 1 or 2 for a continuous 2 days was 6 days (95% confidence interval, 4-8). Safety was evaluated in 92 patients in the safety analysis set, and no adverse events were reported during the study period of 2 weeks. These results suggest that after 1-week treatment with sofpironium for patients with a HDSS score of 3 or 4, approximately 50% of the patients can achieve a HDSS score of 1 or 2, which is a clinically significant improvement for the patients.

PMID:35394087 | DOI:10.1111/1346-8138.16384

Vet Surg. 2022 Apr 8. doi: 10.1111/vsu.13814. Online ahead of print.

ABSTRACT

OBJECTIVE: Determine compression generated by lag and neutral screws over 12 h using two bone analogs.

STUDY DESIGN: Experimental study.

SAMPLE POPULATION: Bone analogs were made of composite synthetic bone (CSB) or three-dimensional printed polylactic acid (PLA). Analogs had a 2 mm exterior shell with a 10 mm thick internal layer of open-cell material.

METHODS: Bone analogs were opposed, making a 4-sided box with open ends. A central channel contained the sensor and the screws passed through it to engage both paired analogs. Four screw/analog conditions were tested: neutral and lag screw with bicortical engagement, neutral and lag screw with unicortical engagement. All screws were tightened to 2 Nm torque and compression values recorded at 0, 0.5, 1, 2, 6, and 12 h (six trials per condition). Medians were compared across groups for statistical significance.

RESULTS: There was no difference in median compression between lag and neutral bicortical screws. For PLA, greater median compression was generated by neutral (median 437 N) and lag (median 379 N) bicortical screws compared to neutral unicortical screws (median 208 N, p < .001); lag bicortical screws generated greater median compression than lag unicortical screws (median 265 N, p = .012). For CSB, lag bicortical screws (median 293 N) generated greater median compression than neutral unicortical screws (median 228 N, p = .008).

CONCLUSION: Lag and neutral screws generated similar compression. Bicortical screws had higher median compression than unicortical screws in bone analogs.

CLINICAL SIGNIFICANCE: Neutral screws generate compression in cancellous bone analogs that can be increased with bicortical bone engagement.

PMID:35394080 | DOI:10.1111/vsu.13814

Med Phys. 2022 Apr 8. doi: 10.1002/mp.15647. Online ahead of print.

ABSTRACT

PURPOSE: This study explored the feasibility of reducing the scan time of Patlak parametric imaging on the uEXPLORER.

METHODS: A total of 65 patients (27 females and 38 males, age 56.1±10.4) were recruited in this study. ¹⁸ F-FDG was injected and its dose was adjusted by body weight (4.07 MBq / kg).Total-body dynamic scanning was performed on the uEXPLORER Total-Body PET/CT scanner with a total scan time of 60 minutes from the injection. The image derived input function (IDIF) was obtained from the aortic arch. The voxelwise Patlak analysis was applied to generate the K_i images designated as G_IDIF with different acquisition times (20-60, 30-60, 40-60, and 44-60 min). The population-based input function (PBIF) was constructed from the mean value of the IDIF from the population, and K_i images designated as G_PBIF were generated using the PBIF. Non-localmeans (NLM) denoising was applied to the generated images to get two extra groups of (NLM-designated) images: G_IDIF+NLM and G_PBIF+NLM . Two radiologists evaluated the overall image quality, noise, and lesion detectability of the K_i images from different groups. The 20-60 min scans in G_IDIF were selected as the gold standard for each patient. We determined that image quality is at sufficient level if all the lesions can be recognized and meet the clinical criteria. K_i values in muscle and lesion were compared across different groups to evaluate the quantitative accuracy.

RESULTS: The overall image quality, image noise, and lesion conspicuity were significantly better in long time series than short time series in all 4 groups (all p<0.001). The K_i images in the G_IDIF and G_PBIF groups generated from 30-min scans showed diagnostic value equivalent to the 40-min scans of G_IDIF . While the image quality of the 16-min scans was poor, all lesions could still be detected. No significant difference was found between K_i values estimated with G_IDIF and G_PBIF in muscle and lesion regions (all p>0.5). After applying the NLM filter, The coefficient of variation could be reduced on the order of [1%, 15%, 19%,37%] and [110%, 125%, 94%, 69%] with four acquisition time schemes for lesion and muscle. The reduction percentage did not have a substantial difference in IDIF and PBIF group. The K_i images in the G_IDIF+NLM and G_PBIF+NLM groups generated from the 20-min acquisitions showed acceptable quality. All lesions could be found on the NLM processed images of the 16-min scans. No significant difference was found between K_i values produced with G_IDIF+NLM and G_PBIF+NLM in muscle and lesion regions(all p>0.7).

CONCLUSIONS: The K_i images generated by the PBIF-based Patlak model using a 20-min dynamic scan with the NLM filter achieved a similar diagnostic efficiency to images with G_IDIF from 40-min dynamic data, and there is no significant difference between K_i images generated using IDIF or PBIF (p>0.5). This article is protected by copyright. All rights reserved.

PMID:35394071 | DOI:10.1002/mp.15647

East Mediterr Health J. 2022 Mar 29;28(3):204-212. doi: 10.26719/emhj.22.007.

ABSTRACT

BACKGROUND: The main social contradictions in China have changed: the core concept is high quality development. Health care investment improves the health of residents and promotes regional economic growth.

AIMS: To analyse the direct and indirect economic effects of health expenditure during 2012-2018 and to test whether China’s investment in health care meets the requirements for high quality development.

METHOD: We selected spatial panel data reflecting the input and output of health resources. We used the knowledge production function and a model of spatial economics to conduct empirical analysis of 31 provinces to show the effects of health expenditure on economic growth.

RESULTS: Economic development (LnGDP) was the dependent variable; explanatory variables included health financial input (LnHI), health personnel input (LnHR), health assets (LnCW) and health insurance expenditure (LnHIE). The regression coefficients for indirect, direct and total effects of LnHI were 0.4346, 0.0623 and 0.4970 respectively (all statistically significant). The direct effect coefficient of LnHR (0.3343) was statistically significant. The regression coefficients for the indirect and total effects were -0.6779 and -0.3436, respectively. The direct, indirect and total effect regression coefficients for LnCW and LnHIE were all statistically significant.

CONCLUSION: Both LnHI and LnHIE positively promote economic growth within provinces and in neighbouring provinces, i.e. there are direct and indirect positive effects from investing in health care. Increasing the input of health care personnel can promote the economic growth of a province but not that of neighbouring provinces. Overall planning and coordinated development will facilitate high quality development and economic advancement.

PMID:35394052 | DOI:10.26719/emhj.22.007