Tag: pubmed

J Magn Reson Imaging. 2022 Nov 18. doi: 10.1002/jmri.28517. Online ahead of print.

ABSTRACT

BACKGROUND: Renal diffusion-weighted imaging (DWI) involves microstructure and microcirculation, quantified with diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM), and hybrid models. A better understanding of their contrast may increase specificity.

PURPOSE: To measure modulation of DWI with cardiac phase and flow-compensated (FC) diffusion gradient waveforms.

STUDY TYPE: Prospective.

POPULATION: Six healthy volunteers (ages: 22-48 years, five females), water phantom.

FIELD STRENGTH/SEQUENCE: 3-T, prototype DWI sequence with 2D echo-planar imaging, and bipolar (BP) or FC gradients. 2D Half-Fourier Single-shot Turbo-spin-Echo (HASTE). Multiple-phase 2D spoiled gradient-echo phase contrast (PC) MRI.

ASSESSMENT: BP and FC water signal decays were qualitatively compared. Renal arteries and velocities were visualized on PC-MRI. Systolic (peak velocity), diastolic (end stable velocity), and pre-systolic (before peak velocity) phases were identified. Following mutual information-based retrospective self-registration of DWI within each kidney, and Marchenko-Pastur Principal Component Analysis (MPPCA) denoising, combined IVIM-DTI analysis estimated mean diffusivity (MD), fractional anisotropy (FA), and eigenvalues (λi) from tissue diffusivity (D_t ), perfusion fraction (f_p ), and pseudodiffusivity (D_p , D_p,axial , D_p,radial ), for each tissue (cortex/medulla, segmented on b0/FA respectively), phase, and waveform (BP, FC). Monte Carlo water diffusion simulations aided data interpretation.

STATISTICAL TESTS: Mixed model regression probed differences between tissue types and pulse sequences. Univariate general linear model analysis probed variations among cardiac phases. Spearman correlations were measured between diffusion metrics and renal artery velocities. Statistical significance level was set at P < 0.05.

RESULTS: Water BP and FC signal decays showed no differences. Significant pulse sequence dependence occurred for λ₁ , λ₃ , FA, D_p , f_p , D_p,axial , D_p,radial in cortex and medulla, and medullary λ₂ . Significant cortex/medulla differences occurred with BP for all metrics except MD (systole [P = 0.224]; diastole [P = 0.556]). Significant phase dependence occurred for D_p , D_p,axial , D_p,radial for BP and medullary λ₁ , λ₂ , λ₃ , MD for FC. FA correlated significantly with velocity. Monte Carlo simulations indicated medullary measurements were consistent with a 34 μm tubule diameter.

DATA CONCLUSION: Cardiac gating and flow compensation modulate of measurements of renal diffusion.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY STAGE: 2.

PMID:36399101 | DOI:10.1002/jmri.28517

J Sex Res. 2022 Nov 18:1-11. doi: 10.1080/00224499.2022.2120597. Online ahead of print.

ABSTRACT

We aimed to test whether the association between same-sex marriage and common mental health diagnoses was explained by shared genetic and environmental familial influences using sibling comparison and adoption analyses. For the sibling comparison analysis, participants (1,177,712 men and 1,266,917 women) were individuals born in Sweden between 1932 and 1994 and had ever been recorded as married (in opposite-sex or same-sex marriages). For the adoption analysis, participants were 147,164 and 1,298 female-female full sibling and adoptive sibling pairs, respectively. Based on medical records, prescribed medication, and death certificates, depression, substance abuse, and suicide (completed and attempted) from age 18 years were identified. For both sexes, being in a same-sex marriage was associated with greater risk of depression, substance abuse, and suicide, compared with being in an opposite-sex marriage. Controlling for shared familial confounding reduced this difference by less than 20% in magnitude, but overall mental health disparities for individuals in same-sex marriages remained statistically significant. Among women, only the genetic correlation between same-sex marriage and depression was statistically significant (r = .33). Same-sex marriage, as a proxy for sexual orientation, was associated with increased risk of certain mental health diagnoses and shared familial confounding explained a small component of this association, depending on the diagnosis. The findings indicate that sexual orientation disparities in mental health outcomes may involve unmeasured factors, and a relatively small proportion should be considered that may be due to shared familial confounding relevant to both sexual orientation and psychopathology.

PMID:36399099 | DOI:10.1080/00224499.2022.2120597

J Hepatobiliary Pancreat Sci. 2022 Nov 18. doi: 10.1002/jhbp.1275. Online ahead of print.

ABSTRACT

BACKGROUND: The 2018 Tokyo Guidelines (TG18) recommend urgent endoscopic biliary drainage based on acute cholangitis (AC) severity. Therefore, we evaluated the safety and mortality benefits of urgent endoscopic retrograde cholangiopancreatography (ERCP) in different age groups.

METHODS: Using International Classification of Diseases-10 (ICD-10) codes, we sampled adult AC patients from National Inpatient Sample. TG18 definition of cholangitis severity was used to identify patients with severe and non-severe (mild or moderate) AC. Age categories were 18 to 64, 65 to 79, and 80 and above. Multivariate linear or logistic regression was used as appropriate. We used Stata, version 14.2, to perform analyses considering 2-sided P< 0.05 as statistically significant.

RESULTS: Among 137,100 patients, there were 93,365 (68.09%) patients with non-severe cholangitis and 43,735 (31.91%) patients with severe cholangitis. Urgent ERCP (within 24 hours) resulted in decreased mortality in all age groups for both severe and non-severe AC. Post-sphincterotomy bleeding was more common in patients ≥80 years of age, whereas post-ERCP acute cholecystitis was more common in patients 65-79 years. The rates of post-ERCP pancreatitis, bile duct perforation, and duodenal perforation did not differ among the age groups. In addition, there were no differences in the rate of sedation-related complications between different age groups who underwent urgent ERCP.

CONCLUSION: This study demonstrates the mortality benefit from urgent ERCP for AC in different age groups and describes the safety of performing urgent ERCP in patients of various ages. Therefore, we recommend that urgent ERCP be performed according to the TG18 guidelines regardless of age.

PMID:36399089 | DOI:10.1002/jhbp.1275

Altern Ther Health Med. 2022 Nov 18:AT7779. Online ahead of print.

ABSTRACT

CONTEXT: The main pathological features of jaw cysts are bone defects. Obtaining autologous bone for transplantation repair has been associated with postoperative complications, and the amount of bone that dentist can collect is limited. Studies have found that autologous tooth bone powder is safe and has good bone-formation ability and stability.

OBJECTIVE: The study intended to examine the efficacy of implantation of autologous tooth bone powder and inorganic bovine bone powder, after marsupialization and second-stage curettage for large jaw cysts that dentist can’t directly remove by surgery in clinical practice.

DESIGN: The research team designed a prospective randomized controlled trial.

SETTING: The study took place in the Head and Neck Surgery Department at Chongqing University Cancer Hospital in Chongqing, China.

PARTICIPANTS: Participants were 60 patients at the hospital between 2016 and 2018 who had mandibular cysts that surgical operation couldn’t directly remove by surgery in clinical practice.

INTERVENTION: At 4 months after curettage, the research team randomly divided participants into three groups: (1) an intervention group who received implants of autologous tooth bone powder into the bone defects, (2) a positive control group who received implants of inorganic bovine bone powder, and (3) a negative control group who received no implants of any material.

OUTCOME MEASURES: The research team performed: (1) periodontal probing at a fixed anatomical point for the intervention and both control groups postintervention at one day and 4 months after surgery and recorded the changes in probing depth and (2) computed tomography (CT) scans at baseline one day before and postintervention at 4 months after the implantation to determine changes in the bone mineral density and compared them among the three groups.

RESULTS: The change in the height of the intervention group’s fixed anatomical point postintervention at 4 months after surgery was significantly smaller than that of the positive control group (P < .05). In the CT scan analysis, the differences between the intervention and negative control groups and between the positive and negative control groups were statistically significant (P < .05); however, the difference between the intervention and positive control groups wasn’t significant (P > .05).

CONCLUSIONS: Autologous tooth bone powder and inorganic bovine bone powder can effectively repair bone defects caused by large jaw cysts and that the repaired effect may be better than that of spontaneous osteogenesis. The autologous tooth bone powder was associated with lower levels of bone loss than those seen with use of inorganic bovine bone powder.

PMID:36399081

Gigascience. 2022 Nov 18;11:giac104. doi: 10.1093/gigascience/giac104.

ABSTRACT

BACKGROUND: The alignment of large numbers of protein sequences is a challenging task and its importance grows rapidly along with the size of biological datasets. State-of-the-art algorithms have a tendency to produce less accurate alignments with an increasing number of sequences. This is a fundamental problem since many downstream tasks rely on accurate alignments.

RESULTS: We present learnMSA, a novel statistical learning approach of profile hidden Markov models (pHMMs) based on batch gradient descent. Fundamentally different from popular aligners, we fit a custom recurrent neural network architecture for (p)HMMs to potentially millions of sequences with respect to a maximum a posteriori objective and decode an alignment. We rely on automatic differentiation of the log-likelihood, and thus, our approach is different from existing HMM training algorithms like Baum-Welch. Our method does not involve progressive, regressive, or divide-and-conquer heuristics. We use uniform batch sampling to adapt to large datasets in linear time without the requirement of a tree. When tested on ultra-large protein families with up to 3.5 million sequences, learnMSA is both more accurate and faster than state-of-the-art tools. On the established benchmarks HomFam and BaliFam with smaller sequence sets, it matches state-of-the-art performance. All experiments were done on a standard workstation with a GPU.

CONCLUSIONS: Our results show that learnMSA does not share the counterintuitive drawback of many popular heuristic aligners, which can substantially lose accuracy when many additional homologs are input. LearnMSA is a future-proof framework for large alignments with many opportunities for further improvements.

PMID:36399060 | DOI:10.1093/gigascience/giac104

Phys Chem Chem Phys. 2022 Nov 18. doi: 10.1039/d2cp03823d. Online ahead of print.

ABSTRACT

We examine the current-voltage (I-V) characteristics of different polyacenes, such as anthracene, tetracene, pentacene, etc., under the influence of arbitrarily polarized light. The irradiation effect produces an anisotropy in the system and acenes may therefore be employed as molecular rectifiers. We find that the rectification efficiency can be more than 90% with a specific set of light parameters. The phase of rectification (positive or negative) can suitably be engineered by controlling the light conditions. The effect of light irradiation is incorporated through the Floquet-Bloch ansatz with the minimal coupling scheme. The transport properties are calculated using Green’s function technique following the Landauer-Büttiker formalism. Given the promising rectification results, the present prescription may be useful in designing functional elements, employing several other single/complex molecular structures in digital circuit design with the possibility of immense applications.

PMID:36399012 | DOI:10.1039/d2cp03823d

Orbit. 2022 Nov 18:1-6. doi: 10.1080/01676830.2022.2146727. Online ahead of print.

ABSTRACT

PURPOSE: To our knowledge, there have been no previous reports that investigate trends in ophthalmology residents’ exposure to oculoplastic procedures without Accreditation Council for Graduate Medical Education (ACGME) minimum requirements. To fill this knowledge gap, we investigated publicly available ACGME ophthalmology residency case logs from 2009 to 2021.

METHODS: National resident averages and standard deviations were collected for the following oculoplastic procedures without minimum ACGME requirements: eye removal and implant, lacrimal surgery, other orbital surgery (e.g. orbitotomy), tarsorrhaphy, entropion/ectropion repair, temporal artery biopsy, and other oculoplastic surgery. We also collated average yearly surgical volumes of all oculoplastic procedures, “Total Oculoplastic Surgery,” which includes procedures with minimum requirements and procedures without requirements. Finally, we collected the average yearly volumes of all ophthalmic procedures. Linear regressions were used to characterize trends in resident oculoplastic surgical volume.

RESULTS: We provide evidence that the average yearly volumes of all but one oculoplastic procedure without ACGME minimum requirements have been decreasing. The decreases in volume for these procedures are driven by residents having fewer cases both as primary surgeon and as assistant. In addition, while the total number of ophthalmic procedures logged by residents on average increased (β = 7.519, p = 0.0163), the average volume of total oculoplastic procedures did not demonstrate any statistically significant trends.

CONCLUSIONS: Volumes of oculoplastic procedures without ACGME minimum requirements between 2009 and 2021 have been decreasing among ophthalmology residents.

PMID:36398702 | DOI:10.1080/01676830.2022.2146727

Disabil Rehabil. 2022 Nov 18:1-9. doi: 10.1080/09638288.2022.2146215. Online ahead of print.

ABSTRACT

PURPOSE: To compare the short and medium-term effects of physiotherapy plus corticosteroid injection (combined) with physiotherapy alone on pain intensity, disability, Quality of Life (QoL), and treatment effectiveness in patients with Subacromial Pain Syndrome (SAPS).

METHODS: In this double-blind, parallel Randomized Controlled Trial (RCT), 50 patients with SAPS were randomly assigned into combined (N = 25, a single injection 3-6 days before physiotherapy) and physiotherapy alone group (N = 25). Pain, disability, QoL, and treatment-effectiveness were measured at pre-intervention, post-intervention, and 3 and 6-month follow-up with Visual Analog Scale (VAS), Shortened Disability of the Arm, Shoulder, and Hand (Quick-DASH), Shoulder Pain and Disability Index (SPADI) (primary outcome measure), Western Ontario Rotator Cuff (WORC), and Global Rating of Change (GRC) respectively. A 2 × 4 (group × time) mixed model analysis of variance (ANOVA) was applied for analysis.

RESULTS: The ANOVA revealed statistically significant group-in-time interaction for all outcome measures (p-value < 0.05). The independent t-test showed more effectiveness in the combined group at medium-term, as the mean scores of almost all outcome measures were substantially lesser (p < 0.01). Moreover, in short-time, despite a greater number of patients stating “completely recovered” in the combined group, there was no statistically significant difference between groups.

CONCLUSIONS: Effects of physiotherapy plus corticosteroid injection could be more long-lasting than physiotherapy alone in improving pain intensity, disability, QoL, and treatment effectiveness in patients with SAPS.

TRIAL REGISTRATION NUMBER: IRCT20201010048980N1.IMPLICATIONS FOR REHABILITATIONShoulder pain is common, persistent, and predominantly results from subacromial pain syndrome (SAPS).Physiotherapy and corticosteroid injections are effective interventions for this condition.Comprehensive physiotherapy alone can be as effective as corticosteroid injection combined with physiotherapy in the short term.A combined approach versus physiotherapy alone may have more medium-term effects on SAPS patients’ pain, disability, quality of life, and treatment effectiveness.

PMID:36398695 | DOI:10.1080/09638288.2022.2146215

Int J Lang Commun Disord. 2022 Nov;57(6):1244-1254. doi: 10.1111/1460-6984.12749. Epub 2022 Jun 15.

ABSTRACT

BACKGROUND: Texture-modified foods (TMF) is a common intervention for improving swallowing safety and efficiency for people with dysphagia. Non-standardized texture classification (NSTC) of foods is used worldwide. However, as this study documents, it can introduce a lack of clarity and confusion over definitions that can potentially harm patients’ safety. The International Dysphagia Diet Standardisation Initiative (IDDSI) framework offers international terminology and standardized methods for texture testing that can address this issue AIMS: To document differences between NSTC and standardized texture classification (STC) of the IDDSI, to document changes in the STC in the 30 min following meal delivery, and to explore the relationship between food intake and texture level.

METHODS & PROCEDURES: In this observational study, data were collected from 24 long-term care departments during five meals served to 624 residents, including at least one breakfast, lunch and dinner. To document differences between NSTC and STC, all NSTC food textures used in the LTC facilities were reclassified to match the IDDSI texture level at the time food left the kitchen (n = 1276). To document time-related changes in texture, the STC texture as food left the kitchen was compared with texture 30 min later (n = 1276). Finally, to explore the relationship between texture and consumption, estimates were made of single-item food consumption (n = 3820) using a subjective evaluation of consumption percentage OUTCOMES & RESULTS: A total of 1276 food items were classified over the course of five meal services (with at least one each from breakfast, lunch and dinner). Statistically significant differences in NSTC and STC texture levels were found that revealed that residents were consuming food that was more difficult to eat than intended by the TMF prescription. In addition, significant changes in food texture were found over time, with texture levels significantly increasing 30 min after food left the kitchen. Finally, greater consumption was found for softer textures in comparison with regular foods; moreover, food consumption was greatest during breakfast and lowest during lunch.

CONCLUSIONS & IMPLICATIONS: Residents requiring TMF received harder textures than intended which required complex swallowing ability, thus introducing a choking risk. Using the STC as proposed by the IDDSI could improve patient safety, oral intake and nutritional status. Time-related changes should also be considered in circumstances where patients do not consume food soon after service. Lastly, reduced food consumption during lunch might negatively impact overall nutrient intake, particularly in cultures where lunch is the main meal of the day.

WHAT THIS PAPER ADDS: What is already known on the subject Despite widespread agreement on the importance of STC, institutional care providers widely use NSTC. The IDDSI framework offers international terminology and standardized methods for texture testing. The clinical importance of using STC is not well understood. What this paper adds to existing knowledge This study found that residents who required texture-modified foods were eating food textures that were more challenging to swallow than intended. Differences were found in food texture between when it left the kitchen compared with texture 30 min later. Pureed texture had greater consumption than regular textured food. Food consumption was found to be the highest during breakfast, and reduced during lunch, which might negatively impact overall nutrient intake. What are the potential or actual clinical implications of this work? Accurate food texture prescription is the first step towards increasing patients’ safety. However, food preparation and handling are also very important steps, not to be disregarded. Time-related changes in food texture are remarkable and should be considered in circumstances where patients do not consume food soon after service, as these can compromise patients’ safety.

PMID:36398686 | DOI:10.1111/1460-6984.12749

Health Commun. 2022 Nov 18:1-12. doi: 10.1080/10410236.2022.2145781. Online ahead of print.

ABSTRACT

Pre-exposure prophylaxis (PrEP) is a highly effective daily pill that decreases the likelihood of HIV acquisition by up to 92% among individuals at risk for HIV. PrEP can be discretely used, autonomously controlled, and in place at the time of risk exposure, making it an especially promising method for HIV prevention for cisgender women (CGW). But, PrEP is underutilized by CGW relative to the demonstrable need. We apply the Integrative Model of Behavioral Prediction to identify the critical psychosocial factors that shape CGW’s intentions to use PrEP and their relevant underlying beliefs. We surveyed (N = 294) community- and clinic-recruited PrEP eligible CGW to understand the relative importance of attitudes, norms, and efficacy in shaping PrEP intentions. We utilized structural equation modeling to identify the relevant paths. We inspected the summary statistics in relation to three message three selection criteria. We identified beliefs that demonstrated (1) an association with intention, (2) substantial room to move the population, (3) practicality as a target for change through communication intervention. Results show that PrEP awareness was low. When women learned about PrEP, they voiced positive intentions to use it. There were significant and positive direct effects of SE (0.316***), attitudes (0.201**), and subjective norms (0.249***) on intention to initiate PrEP. We illustrate the strategic identification of beliefs within the relevant paths using the 3 belief selection criteria. We also discuss implications for social and structural communication interventions to support women’s HIV prevention.

PMID:36398676 | DOI:10.1080/10410236.2022.2145781