Tag: pubmed

Psychophysiology. 2022 Nov 23:e14223. doi: 10.1111/psyp.14223. Online ahead of print.

ABSTRACT

Independent components analysis (ICA) is an effective and ubiquitous tool for cleaning EEG. To reduce computation time, many analysis pipelines decrease EEG dimensionality prior to ICA. A 2018 report by Artoni and colleagues detailed the deleterious effects of such reduced-dimensionality ICA (rdICA) on the dipolarity and reliability of independent components. Though valuable for researchers interested in directly analyzing independent components, ICA is more commonly used for cleaning EEG. Thus, a direct examination of the impact of artifact removal via rdICA on EEG data quality is needed. We conducted a registered analysis of 128 electrode recordings of 43 healthy subjects performing an active auditory oddball task. We preprocessed each subject’s data under the following conditions: (1) ICA without dimension reduction, (2) ICA with only 64 electrodes included, (3) ICA preceded by PCA retaining 99% of the original data variance and (4) ICA preceded by PCA retaining 90% variance. We then quantified ERP data quality by measuring mean-amplitude, standardized measurement error (SME) of the single-trial mean-amplitudes, and split-half reliability of the N1 and P3 components. We then attempted to replicate our findings in an independent validation dataset. We observed statistically and practically significant changes in the mean amplitude of early sensory components for the 90% condition. Unexpectedly, the SME was only larger for the 64 electrode condition. Also unexpectedly, the effect of rdICA on split-half reliability was inconsistent between datasets. Based on the observed data, we argue that PCA-based rdICA is justifiable when used cautiously.

PMID:36416715 | DOI:10.1111/psyp.14223

Ann Plast Surg. 2022 Dec 1;89(6):684-693. doi: 10.1097/SAP.0000000000003314.

ABSTRACT

BACKGROUND: This study evaluated the potential of Wharton’s jelly mesenchymal stem cells with high tolerogenic properties in reducing immunosuppressive dosage and related adverse effects.

METHODS: A 4- to 6-week-old, 30-40 g weight, male inbred CD57BL/6 mice were used as skin allograft donors, whereas Balb/c mice with similar characteristics were used as recipients. Wharton’s jelly stem cells were obtained from a commercial kit sourced from human umbilical cord. Skin allografts were performed from CD57Bl6 to Balb/c mice (day 0). Group 1 (control) received no treatment. Group 2 received 15 mg/kg cyclosporin A on days 0 to 30. Group 3 received 5.7 × 106 and 10.3 × 106 cell/kg Wharton’s jelly stem cells on days 0 and 3, respectively. Groups 4, 5, and 6 received a combination of 15, 10, and 5 mg/kg per day cyclosporine A (days 0 to 30) with the same stem cell dose with group 3, respectively. Graft rejection was evaluated with digital photography and thermal imaging, histopathology (Banff grading, epithelialization scores, dermoepidermal dissociation), immunochemistry (Ki-67 and Bcl-2), and biochemical methods (interleukin 10, interleukin 2, interferon γ, tumor necrosis factor α) (day 10). Cumulative adverse effects of cyclosporin A occurring in the groups were revealed by histopathological evaluation of kidney and liver (a modified semiquantitative method of infiltration of inflammatory cells around the portal area and lobular region in liver; modification of the Banff rating of proximal tubules and hypertrophia of juxtaglomerular apparatus cells in kidney) (day 30).

RESULTS: There was no rejection in groups 2, 4, and 5 until the end of study. These were statistically different versus groups 1 (day 10 ± 0.71), 3 (day 11 ± 0.82), and 6 (day 11 ± 0.58) (all P’s < 0.05). Groups 4 and 5 have exhibited statistically similar findings in histopathological (4 epithelization score: 3.7 ± 1.3; 5 epithelization score: 3.5 ± 0.5; 4 Banff grading score: 0.8 ± 0.6; 5 Banff grading score: 1.0 ± 0.5; both P’s = 1.00), immunohistochemical (4 Bcl-2 score: 3.5 ± 0.5, P = 0.618; 5 Bcl-2 score: 3.4 ± 0.5, P = 1.00; 4 Ki-67 score: 3.7 ± 0.4, P = 1.00; 5 Ki-67 score: 3.5 ± 0.5, both P’s = 1.00), and levels of cytokines (both P’s = 1.00) versus group 2. Adverse effects on kidneys and liver were lowest and statistically similar in groups 3, 5, and 6 (all P’s = 00) versus group 1.

CONCLUSIONS: Wharton’s jelly mesenchymal stem cells alter bioavailability of cyclosporine, albeit at much lower doses and with fewer systemic adverse effects.

PMID:36416704 | DOI:10.1097/SAP.0000000000003314

Ann Plast Surg. 2022 Dec 1;89(6):670-674. doi: 10.1097/SAP.0000000000003332.

ABSTRACT

BACKGROUND: In complex abdominal wall reconstruction, maintenance and follow-up are vital to effective long-term patient care. This can present a challenge for individuals from a low-income household who may have less ability to afford time away from work or caring for dependents as well as challenges with transportation to and from follow-up appointments. Given the expenses and high complication rate in abdominal wall reconstruction, we elected to determine whether socioeconomic status had an impact on patient outcomes.

METHODS: After obtaining institutional review board approval, all patients who underwent complex abdominal wall reconstruction between 2002 and 2021 by the senior author were reviewed in a retrospective cohort analysis of a prospectively maintained database. Complications were classified into overall, major, infection, and delayed wound healing. Outcomes were classified into recurrence and reoperation. The cohort was divided by median household income (MHI) level and race.

RESULTS: A total of 478 patients received complex abdominal wall repair over a 19-year interval. A total of 324 patients identified MHI as <$75,000 (low MHI), and 154 patients identified MHI as > $75,000 (high MHI). Mean patient age was 53.9 (SD, 12.3) years. Mean patient body mass index (BMI) was 32.1 (SD, 7.8) kg/m2. There was no significant difference in age between the 2 MHI cohorts. There was a significant difference in BMI between MHI cohorts, with higher BMI among patients with low MHI (P = 0.0001). The majority of risk factors and surgical techniques were comparable. There was a statistically significant difference in hernia etiology, with higher rates of recurrent hernia repair among patients with low MHI (P = 0.007). The risk of overall complications (P = 0.0307) and delayed wound healing (P = 0.0263) was higher among patients with low MHI. Median household income was found to be an independent risk factor for complications after controlling for BMI, diabetes mellitus, and hernia etiology. There was no significant difference in follow-up time between cohorts.

CONCLUSION: Patients with low MHI who undergo complex abdominal wall reconstruction are at an increased risk for complications and poor outcomes, including delayed wound healing and hernia recurrence. This indicates the need to provide resources to address barriers to follow-up and maintenance following complex abdominal wall reconstruction in this patient cohort.

PMID:36416697 | DOI:10.1097/SAP.0000000000003332

Ann Plast Surg. 2022 Dec 1;89(6):637-642. doi: 10.1097/SAP.0000000000003299.

ABSTRACT

BACKGROUND: Nasal bone fractures are the most common type of facial fracture. Nasal bone fractures often occur in combination with septal cartilage fractures, because the nasal septal cartilage acts as a vertical strut and provides structural support for the nose and bilateral nasal airway. However, the treatment for nasal septal cartilage fracture remains controversial, and if untreated, nasal septal cartilage fracture can lead to various complications, such as nasal obstruction and posttraumatic nasal and septal deformity. This study aimed to evaluate the effectiveness and safety of our procedure in which septal cartilage fractures were treated with septoplasty using an absorbable plate as an internal splint.

METHODS: Between January 2017 and November 2020, 21 patients with nasal septal cartilage fractures were treated with septoplasty using an absorbable plate as an internal splint. The severity of the septal cartilage fracture was graded from 0 to 3 according to the computed tomography septal grading system. The numeric graded scale of nasal septal cartilage fracture was evaluated preoperatively and 6 months postoperatively using a computed tomography scan.

RESULTS: Of 21 patients with septal cartilage fractures, 12 were treated with a polycaprolactone (PCL) mesh plate, and 9 were treated with a polydioxanone (PDS) plate. In the PDS plate group, the preoperative numeric scale of nasal septal cartilage fracture was 2.50 (2.00-3.00), whereas the postoperative numeric scale was 1.00 (1.00-1.25, P = 0.023). In the PCL mesh plate group, the preoperative numeric scale of nasal septal cartilage fracture was 2.00 (2.00-3.00), whereas the postoperative numeric scale was 1.00 (1.00-1.50, P = 0.034). The effectiveness of the PCL mesh plate and that of the PDS plate group according to the septal grading scale were 1.45 (SD, 0.522) and 1.18 (SD, 0.603), respectively. However, these differences were not statistically significant.

CONCLUSIONS: Our study shows that septoplasty using absorbable plates provides satisfactory and safe clinical outcomes in patients with nasal septal cartilage fractures.

PMID:36416690 | DOI:10.1097/SAP.0000000000003299

Ann Plast Surg. 2022 Dec 1;89(6):e11-e17. doi: 10.1097/SAP.0000000000003313.

ABSTRACT

INTRODUCTION: Partial breast reconstruction with oncoplastic reduction can provide breast cancer patients with improved aesthetic outcomes after breast conservation therapy. This study evaluates the implications of simultaneous oncoplastic reduction with lumpectomy on complication rates, time to adjuvant radiation therapy, and rates of margin reexcision compared with lumpectomy alone.

METHODS: The Clinformatics Data Mart Database is a national deidentified commercial claims data warehouse. From 2003 to 2020, adult female patients were queried to identify patients with a breast cancer diagnosis with International Classification of Disease codes. Among those, current procedural terminology codes were used to identify those who underwent lumpectomy alone versus lumpectomy with oncoplastic reduction. Patient demographics, complications, adjuvant oncologic therapies, and need for reexcision were recorded. Patients not continuously enrolled for at least 6 months before and after the index procedure were excluded. Multivariable regression and χ2 tests were used for statistical analysis.

RESULTS: Of 53,165 patients meeting criteria (mean age, 61.4 ± 11.6 years), 1552 (2.9%) underwent oncoplastic reduction. Diagnoses of most nonsurgical complications (seroma, wound dehiscence, postoperative infection, fat necrosis, tissue necrosis, and nonspecified complications of surgical care) were significantly higher in the oncoplastic reduction group, as were rates of some surgical complications (hematoma, seroma, and tissue debridement). However, undergoing oncoplastic reduction did not impact time to adjuvant radiation (P = 0.194) and protected against positive margins requiring repeat lumpectomy or completion mastectomy (P < 0.001).

CONCLUSIONS: In patients undergoing breast conservation therapy, simultaneous oncoplastic reduction decreased occurrence of positive margins and did not impact time to adjuvant radiation therapy despite increased rates of surgical and nonsurgical complications.

PMID:36416687 | DOI:10.1097/SAP.0000000000003313

Ann Plast Surg. 2022 Dec 1;89(6):600-609. doi: 10.1097/SAP.0000000000003247.

ABSTRACT

PURPOSE: The aim of this study was to understand how opioid prescribing practices of plastic surgery residents changed after instituting opioid prescribing education (OPE) interventions.

METHODS: Plastic surgery residents at a single academic institution completed a survey (fall 2017) assessing opioid prescribing following 8 common procedures. The Division then completed 3 multidisciplinary OPE interventions over 2.5 years, which provided passive learning to raise awareness without top-down prescribing guidelines. Residents were resurveyed at 2 time points after the interventions (fall 2018 and spring 2020). The primary outcome measure was self-reported morphine milligram equivalents prescribed.

RESULTS: Survey response rates were 84% to 100%. Preintervention opioid prescriptions were characterized by high variability and absolute doses for all procedures. We observed statistically significant decreases in prescribed doses for most procedures at 9 months post intervention and further decreases at 2.5 years. In the most recently surveyed cohort, only 3 of 16 residents (18.8%) had OPE before residency, whereas 12 of 16 residents (75.0%) participated in OPE during residency. Eighty-eight percent of respondents “always” (8/16, 50%) or “usually” (6/16, 38%) considered the opioid epidemic when prescribing opioids, suggesting an improved prescribing culture. Barriers to better prescribing included duplicate prescriptions/accessing state-run prescription drug monitoring programs (75.0%), remote prescribing (75%), providing refills (56%), and prescribing opioids for patients on chronic opioid therapy (56%).

CONCLUSION: This prospective cohort study demonstrates that a simple multidisciplinary, didactic OPE intervention that aimed to increase residents’ awareness has the potential to reduce self-reported opioid prescribing and sustain prescribing practices over many years. We identify persistent barriers facing our resident prescribers today, enabling more opioid educational interventions in the future.

PMID:36416684 | DOI:10.1097/SAP.0000000000003247

Pharmacol Res Perspect. 2022 Dec;10(6):e01024. doi: 10.1002/prp2.1024.

ABSTRACT

The immunosuppressive agents sirolimus and everolimus are sensitive CYP3A4 substrates with narrow therapeutic index. Ritonavir is a strong CYP3A inhibitor. A phase 1 study was conducted to evaluate the pharmacokinetics, safety, and tolerability of the co-administration of sirolimus or everolimus with the ritonavir-containing 3D regimen of the direct-acting antiviral agents ombitasvir, ritonavir-boosted paritaprevir, and dasabuvir in healthy subjects. This study had two independent arms, each with a two-period, single-sequence, crossover study design. A single dose of sirolimus 2 mg (N = 12) or everolimus 0.75 mg (N = 12) was administered in Period 1. In Period 2, multiple doses of the 3D regimen (ombitasvir/paritaprevir/ritonavir 25/150/100 mg once daily and dasabuvir 250 mg twice daily) were administered for 34 or 28 days, with a single dose of sirolimus 0.5 mg or everolimus 0.75 mg co-administered on Day 15. Following co-administration with the 3D regimen, the sirolimus dose-normalized maximum observed blood concentration (C_max ) and area under the blood concentration-time curve from time zero to infinity (AUC_inf ) increased to 6.4-fold and 38-fold, respectively. Following co-administration with the 3D regimen, the everolimus C_max and AUC_inf increased to 4.7-fold and 27-fold, respectively. Sirolimus and everolimus half-lives increased from 96 to 249 h, and 42 to 118 h, respectively. There were no major safety or tolerability issues in this study. The ritonavir-containing 3D regimen resulted in a significant increase in sirolimus or everolimus exposure, consistent with the known strong inhibitory effect of ritonavir on CYP3A requiring dose and/or frequency modification when co-administered with each other.

PMID:36416673 | DOI:10.1002/prp2.1024

Dentomaxillofac Radiol. 2022 Nov 23:20220225. doi: 10.1259/dmfr.20220225. Online ahead of print.

ABSTRACT

OBJECTIVE: To define which are and how the radiomics features of jawbone pathologies are extracted for diagnosis, predicting prognosis and therapeutic response.

METHODS: A comprehensive literature search was conducted using eight databases and gray literature. Two independent observers rated these articles according to exclusion and inclusion criteria. 23 papers were included to assess the radiomics features related to jawbone pathologies. Included studies were evaluated by using JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

RESULTS: Agnostic features were mined from periapical, dental panoramic radiographs, cone beam CT, CT and MRI images of six different jawbone alterations. The most frequent features mined were texture-, shape- and intensity-based features. Only 13 studies described the machine learning step, and the best results were obtained with Support Vector Machine and random forest classifier. For osteoporosis diagnosis and classification, filtering, shape-based and Tamura texture features showed the best performance. For temporomandibular joint pathology, gray-level co-occurrence matrix (GLCM), gray level run length matrix (GLRLM), Gray Level Size Zone Matrix (GLSZM), first-order statistics analysis and shape-based analysis showed the best results. Considering odontogenic and non-odontogenic cysts and tumors, contourlet and SPHARM features, first-order statistical features, GLRLM, GLCM had better indexes. For odontogenic cysts and granulomas, first-order statistical analysis showed better classification results.

CONCLUSIONS: GLCM was the most frequent feature, followed by first-order statistics, and GLRLM features. No study reported predicting response, prognosis or therapeutic response, but instead diseases diagnosis or classification. Although the lack of standardization in the radiomics workflow of the included studies, texture analysis showed potential to contribute to radiologists’ reports, decreasing the subjectivity and leading to personalized healthcare.

PMID:36416666 | DOI:10.1259/dmfr.20220225

Tidsskr Nor Laegeforen. 2022 Nov 21;142(17). doi: 10.4045/tidsskr.22.0256. Print 2022 Nov 22.

ABSTRACT

BACKGROUND: Studies have shown a high incidence of emergency caesarean sections among immigrant women, especially those born in Sub-Saharan Africa, but the risk of planned and emergency caesarean section varies with the mother’s level of education. The proportion of women with little or no education is higher among those born in Sub-Saharan Africa and other low- and middle-income countries than those born in Norway. We therefore wanted to investigate the relationship between maternal birthplace, level of education and risk of caesarean section.

MATERIAL AND METHOD: The study was based on all births recorded in the Medical Birth Registry of Norway between 2008 and 2017 linked to data from Statistics Norway. Maternal birthplace, divided into four categories, was the exposure variable. The outcome was planned or emergency caesarean section. We used multinomial logistic regression and stratified the analyses by level of education. Norwegian-born women constituted the reference group.

RESULTS: Of 572 349 births, immigrant women accounted for 26.6 %. Caesarean sections and emergency caesareans made up 15.1 % and 9.6 % of all births respectively. Norwegian-born women had the highest proportion of planned caesarean sections (5.7 %), while women born in Sub-Saharan Africa had the highest proportion of emergency caesareans (16.3 %). Among women with a higher education, the proportion of emergency caesareans was 8.3 % among Norwegian-born women and 18.1 % among women born in Sub-Saharan Africa (adjusted relative risk 2.41, 95 % confidence interval 2.18 to 2.66).

INTERPRETATION: The impact of education level on risk of caesarean section differed between immigrant women and Norwegian-born women.

PMID:36416648 | DOI:10.4045/tidsskr.22.0256

J Am Nutr Assoc. 2022 Nov 23:1-10. doi: 10.1080/27697061.2022.2144540. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to evaluate the effect of daily consumption of high-polyphenol (HP) olive oil on neurogenesis by investigating neuronal cell proliferation and maturation in the hippocampus of old rats, and to evaluate the relationship between neurogenesis, spatial memory, and anxiety-like behavior.

METHODS: A total of 34 female, 20-22-month-old Sprague Dawley rats were divided into three groups: control group, low-polyphenol (LP) group, and high-polyphenol (HP) group. The animals were fed distilled water, LP olive oil and HP-extra virgin olive oil, respectively for 6 weeks using an oral gavage. At 43 days, animals were tested using the Morris Water Maze to evaluate spatial memory, and the Open-field test to evaluate anxiety-like behavior. Neural cell proliferation in the dentate gyrus (DG) was determined by BrdU labeling and Nestin protein expression. Neuronal maturation was determined by NeuN labeling. Synaptic density in the hippocampus and prefrontal cortex was examined by measuring Synaptophysin (SYN) levels. Hippocampal Calbindin levels were measured to assess cellular calcium metabolism.

RESULTS: Daily consumption of HP olive oil significantly improved cell proliferation and neuronal maturation in the DG of old rats. HP-olive oil significantly increased SYN levels in the prefrontal cortex, and nestin and calbindin levels in the hippocampus (p < 0.05). LP olive oil diet has shown no effect on any parameter (p > 0.05). We also did not find any statistically significant difference between the groups in terms of spatial memory and anxiety-like behavior (p > 0.05).

CONCLUSION: Our study is first to show that daily consumption of HP-olive oil enhances hippocampal neurogenesis in old rats, which has been confirmed by proliferation and maturation biomarkers. In addition, increased SYN and calbindin levels showed that the generated cells were also functionally developed in the HP group. We suggest that daily consumption of HP olive oil may have beneficial effects on brain aging by triggering neurogenesis.

PMID:36416641 | DOI:10.1080/27697061.2022.2144540