Tag: pubmed

Vascular. 2022 Nov 17:17085381221140621. doi: 10.1177/17085381221140621. Online ahead of print.

ABSTRACT

OBJECTIVES: The normalisation of Achilles tendon thickness (ATT) to anthropometric parameters may increase the diagnostic efficiency of the assessment of ATT. The aim of this study was to compare the diagnostic value of AT dimensions depending on their normalization to body surface area (BSA) in patients with asymptomatic peripheral arterial disease (PAD).

METHODS: All patients underwent duplex scanning of the carotid arteries and the lower limb arteries. Asymptomatic PAD was defined as the presence of ≥50% stenosis in the carotid and/or lower limb arteries. ATT was measured using a longitudinal scan, width (ATW) and cross-sectional area (AT CSA), which was determined during a cross-sectional scan.

RESULTS: The study included 369 patients, among whom asymptomatic PAD was detected in 18 (4.88%) patients. Only the ATT demonstrated diagnostic value for asymptomatic PAD. After normalizing the size of the AT to the BSA, the diagnostic performance of ATT, ATW and AT CSA became statistically significant. Among the studied parameters, only an increase in ATT/BSA >0.29 cm/m² was associated with a significant increase in the odds ratio (OR) of asymptomatic PAD by 4.11 times (95% CI 1.08-15.7; p = .038) after adjustments.

CONCLUSION: An increase in ATT/BSA >0.29 cm/m² predicted the presence of asymptomatic PAD with a sensitivity of 61.1% and a specificity of 77.9%. ATT/BSA values of less than 0.29 cm/m² made it possible to exclude asymptomatic PAD with a probability of 97.5%. An increase in ATT/BSA >0.29 cm/m² was associated with a 4.11-fold increase in the OR of asymptomatic PAD (95% CI 1.08-15.7).

PMID:36395485 | DOI:10.1177/17085381221140621

Am J Surg Pathol. 2022 Nov 2. doi: 10.1097/PAS.0000000000001991. Online ahead of print.

ABSTRACT

To compare the diagnostic accuracy of core needle biopsies (CNBs) and surgical excisional biopsies (SEBs), samples of lymphoid proliferation from a single institution from 2013 to 2017 (N=476) were divided into groups of CNB (N=218) and SEB (N=258). The diagnostic accuracy of these samples was evaluated as a percentage of conclusive diagnosis, according to the World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The contribution of clinical data, the assessment of sample adequacy by a pathologist during the procedure, the number and size of fragments, the needle gauge, the ancillary tests, and the type of lymphoid proliferation were also examined. The diagnostic accuracy of SEB was 97.3% and CNB 91.3% (P=0.010). Additional factors considered essential for establishing the final diagnosis in some cases were: clinical information (20.6% CNB, 7.4% SEB; P<0.001); immunohistochemistry (96.3% CNB, 91.5% SEB; P=0.024); flow cytometry (12% CNB, 6.8% SEB; P=0.165); and other complementary tests (8.2% CNB, 17.3% SEB; P=0.058). Factors that did not influence performance were the evaluation of sample adequacy during the procedure, the number and size of fragments, and the needle gauge. Increased percentage of nondiagnostic CNB was observed in T-cell lymphomas (30%), followed by classic Hodgkin lymphoma (10.6%). The main limitation of CNB was the evaluation of morphologically heterogenous diseases. CNB is useful and safe in lymphoma diagnosis provided it is carried out by a team of experienced professionals. Having an interventional radiology team engaged with pathology is an essential component to achieve adequate rates of specific diagnoses in CNB specimens.

PMID:36395467 | DOI:10.1097/PAS.0000000000001991

Am J Dermatopathol. 2022 Dec 1;44(12):879-885. doi: 10.1097/DAD.0000000000002321.

ABSTRACT

Patients submitted to radiotherapy for tinea capitis in childhood have an increased incidence of scalp basal cell carcinomas (BCCs) but also of other neoplasms, namely, follicular tumors. In a cohort of such patients, we also found a high incidence of infundibulocystic BCCs, an otherwise rare variant. We thus hypothesized that postradiotherapy BCCs could be more prone to display follicular differentiation. We compared the histological and immunohistochemical features of postradiotherapy BCCs [both conventional (16 cases) and infundibulocystic (16 cases)] with those of BCCs arising in sun-exposed areas (16 cases), using markers of follicular differentiation (PHLDA-1, CK15, CD34, β-catenin, and calretinin). Postradiotherapy BCCs showed slightly higher tendency for infundibular and/or trichilemmal differentiation than BCCs from sun-exposed areas (37.5% vs. 18.8%), but this difference was not statistically significant. Nevertheless, infundibulocystic BCCs showed more frequent expression of PHLDA-1 and stronger cytoplasmic expression of CK15 compared with the other lesions. In addition, CD34 highlighted a characteristic meshwork of stromal cells surrounding the epithelial component in all infundibulocystic BCCs, in contrast to the other postradiotherapy BCCs and UV-related BCCs, in which 78.1% were negative or only focally positive. In conclusion, our study suggests a tendency for more frequent follicular differentiation in postradiotherapy BCCs compared with BCCs from sun-exposed areas. In addition, the immunohistochemical study confirms previous data from the literature regarding infundibulocystic BCCs (higher CK15 and PHLDA-1 expression) and shows a distinctive stromal positivity for CD34 that has not been previously acknowledged in these tumors.

PMID:36395444 | DOI:10.1097/DAD.0000000000002321

Pancreas. 2022 Aug 1;51(7):723-732. doi: 10.1097/MPA.0000000000002113.

ABSTRACT

OBJECTIVES: Chronic pancreatitis (CP) is a chronic fibroinflammatory condition of the pancreas difficult to diagnose in early stages. Novel biomarkers useful to facilitate early diagnosis or treatment responses may be found in biofluids. Although saliva can be easily and noninvasively collected from patients, useful salivary biomarkers from CP patients have not yet been identified.

METHODS: Here, we analyzed the proteome by quantitative proteomics, cytokine/chemokine levels by Luminex analysis, prostaglandin E2 (PGE2) levels by a mass spectrometry-based assay, and bacterial species diversity by 16S ribosomal ribonucleic acid sequencing in saliva samples from confirmed CP patients and healthy controls.

RESULTS: Our results indicate the presence of various differentially expressed proteins, cytokines/chemokines, and a loss of oral bacterial diversity in the saliva of CP patients. The PGE2 levels trend toward elevation in CP patients. Area under the receiver operating characteristic curve models for proteomic, cytokine, and PGE2 assays ranged from 0.59 to 0.90.

CONCLUSIONS: Collectively, our studies identify a range of putative CP biomarkers and alterations in human saliva requiring further validation. The biomarker discovery approaches we used might lead to identification of biomarkers useful for CP diagnosis and monitoring.

PMID:36395395 | DOI:10.1097/MPA.0000000000002113

J Athl Train. 2022 Nov 17. doi: 10.4085/1062-6050-0111.22. Online ahead of print.

ABSTRACT

CONTEXT: There is limited evidence regarding the assessment of single-item patient-reported outcomes when patients are medically cleared to return-to-sport following a lateral ankle sprain (LAS) injury.

OBJECTIVE: To evaluate self-report of improvement in health status, pain, function, and disability at return-to-sport following a LAS.

DESIGN: Descriptive study.

SETTING: Sixty-nine athletic training facilities across 24 states.

PATIENTS OR OTHER PARTICIPANTS: Six hundred and thirty-seven patients (male=53.2%) were included in our final analysis. Patients were diagnosed with a LAS, restricted from sport following injury, and subsequently medically cleared to return-to-sport within 60 days were included.

MAIN OUTCOME MEASURES: Descriptive statistics were used to summarize scores for health status (Global Rating of Change), pain (Numeric Pain Rating Scale), function (Global Rating of Function), and disability (Global Rating of Disability). Mann-Whitney U Tests were used to compare score differences between sexes. A Kaplan-Meier analysis was performed to provide a visual depiction of sex differences in time to return-to-sport.

RESULTS: Most patients sustained a LAS injury while participating in basketball, football, or soccer and cleared to return-to-sport 8 days following injury. Over two-thirds of patients reported a meaningful improvement in health status between time of injury and return-to-sport. However, many reported some level of deficits related to pain (65.1%), function (86.2%), and disability (35.8%) at return-to-sport. No differences were noted between males and females for pain (p=.90), function (p=.68), change (p=.45), or disability (p=.21) at return-to-sport. Males, however, returned to sport slightly sooner than females (p=.025).

CONCLUSIONS: Despite self-perceived improvements in health status from time of injury, patients typically return-to-sport with deficits in pain, function, and disability following a LAS. Patients may be returning to unrestricted sport participation before they feel their bodies have fully recovered from the injury.

LEVEL OF EVIDENCE: Level III; retrospective cohort study.

PMID:36395375 | DOI:10.4085/1062-6050-0111.22

Anal Chem. 2022 Nov 17. doi: 10.1021/acs.analchem.2c01614. Online ahead of print.

ABSTRACT

The widespread abuse of “legal high” psychoactive plants continues to be of global concern because of their negative impacts on public health and safety. In forensic science, a major challenge in controlling these substances is the paucity of methods to rapidly identify them. We report the development of the Database of Psychoactive Plants (DoPP), a new user-friendly tool featuring an architecture for the identification of plant unknowns, and the necessary regression statistics for the development and validation of psychoactive compound quantification. The application relies on the knowledge that terrestrial plants exhibit species-specific chemical signatures that can be revealed by direct analysis in real time─high-resolution mass spectrometry (DART-HRMS). Subsequent automated machine learning processing of libraries of these spectra enables rapid discrimination and species identification. The chemical signature database includes 57 available plant species. The rapid acquisition of mass spectra and the ability to sample the materials in their native form enabled the generation of the vast amounts of spectral replicates required for database construction. For the identification of sample unknowns, a data analysis workflow was developed and implemented using the DoPP tool. It utilizes a hierarchical classification tree that integrates three machine learning methods, namely, random forest, k-nearest neighbors, and support vector machine, all of which were fused using posterior probabilities. The results show accuracies of 98 and 99% for 10-fold cross-validation and external validation, respectively, which make the classification model suitable for identity prediction of real samples.

PMID:36395354 | DOI:10.1021/acs.analchem.2c01614

PLoS One. 2022 Nov 17;17(11):e0270093. doi: 10.1371/journal.pone.0270093. eCollection 2022.

ABSTRACT

INTRODUCTION: A typical heat acclimation (HA) protocol takes 5-7 d of 60-90 minutes of heat exposure. Identifying the minimum dose of HA required to elicit a heat adapted phenotype could reduce financial constraints on participants and aid in the tapering phase for competition in hot countries. Therefore, the aim of this study was to investigate a 4 d HA regimen on physical performance.

METHODS: Twelve moderately trained males were heat acclimated using controlled hyperthermia (Tre>38.5°C), with no fluid intake for 90 min on 4 consecutive days, with a heat stress test (HST) being completed one week prior to (HST2), and within one-week post (HST3) HA. Eleven completed the control study of HST1 versus HST2, one week apart with no intervention. Heat stress tests comprised of cycling for 90 min @ 40% Peak Power Output (PPO); 35°C; 60%RH followed by 10 minutes of passive recovery before an incremental test to exhaustion. Physical performance outcomes time to exhaustion (TTE), PPO, end rectal temperature (Tre END), and heart rate (HREND) was measured during the incremental test to exhaustion.

RESULTS: Physiological markers indicated no significant changes in the heat; however descriptive statistics indicated mean resting Tre lowered 0.24°C (-0.54 to 0.07°C; d = 2.35: very large) and end-exercise lowered by 0.32°C (-0.81 to 0.16; d = 2.39: very large). There were significant improvements across multiple timepoints following HA in perceptual measures; Rate of perceived exertion (RPE), Thermal Sensation (TS), and Thermal Comfort (TC) (P<0.05). Mean TTE in the HST increased by 142 s (323±333 to 465±235s; P = 0.04) and mean PPO by 76W (137±128 to 213±77 W; P = 0.03).

CONCLUSION: Short-term isothermic HA (4 d) was effective in enhancing performance capacity in hot and humid conditions. Regardless of the level of physiological adaptations, behavioural adaptations were sufficient to elicit improved performance and thermotolerance in hot conditions. Additional exposures may be requisite to ensure physiological adaptation.

PMID:36395344 | DOI:10.1371/journal.pone.0270093

PLoS One. 2022 Nov 17;17(11):e0276152. doi: 10.1371/journal.pone.0276152. eCollection 2022.

ABSTRACT

Facial nerve palsy (FP) is the most common cranial nerve lesion, leading to partial or complete immobility of the affected half of face. If food residues on tooth surfaces cannot be removed by natural self-cleaning mechanisms that this is likely to lead to an increase dental plaque formation and the risk of dental, periodontal and general diseases. It was the aim of this study to assess oral health, oral hygiene with the influence of handedness and oral health related quality of life in patients with chronic peripheral FP. This study included 86 people. Patients with FP (n = 43) in an FP-group (FPG) were matched with 43 participants without ever diagnosed FP in a control group (CG). Oral health and oral hygiene were assessed in a clinical examination performed in hospital. Decayed-missing-filled-teeth-index, periodontal-screening-index, approximal plaque index and sulcus bleeding index were used to evaluate dental caries and periodontal health status. Oral health-related quality of life data (OHQoL) was collected with the Oral health impact profile (Germany-14) by interview. Oral health parameters in the FPG were significantly worse than in the CG. The median revealed 14.3% more proximal plaque (p = 0.014), 20.8% more sulcus bleeding (p = 0.002) and more than twice as much caries (p = 0.024). The paretic side compared to the non-paretic side of patients was significantly more affected by inflammatory periodontal diseases (p = 0.032) and had a higher prevalence of caries (p = 0.163). Right-handed patients with right-sided FP performed worse than right-handed patients with left-sided FP (p = 0.004). Patients with FP described a greater limitation of OHQoL than patients without this disease (p < 0.001). In conclusion, facial nerve palsy affects oral health, oral hygiene and OHQoL of patients while handedness influences oral hygiene and oral health.

PMID:36395343 | DOI:10.1371/journal.pone.0276152

PLoS Comput Biol. 2022 Nov 17;18(11):e1010713. doi: 10.1371/journal.pcbi.1010713. Online ahead of print.

ABSTRACT

The relationship between interactions, flexibility and disorder in proteins has been explored from many angles over the years: folding upon binding, flexibility of the core relative to the periphery, entropy changes, etc. In this work, we provide statistical evidence for the involvement of highly mobile and disordered regions in complex assembly. We ordered the entire set of X-ray crystallographic structures in the Protein Data Bank into hierarchies of progressive interactions involving identical or very similar protein chains, yielding 40205 hierarchies of protein complexes with increasing numbers of partners. We then examine them as proxies for the assembly pathways. Using this database, we show that upon oligomerisation, the new interfaces tend to be observed at residues that were characterised as softly disordered (flexible, amorphous or missing residues) in the complexes preceding them in the hierarchy. We also rule out the possibility that this correlation is just a surface effect by restricting the analysis to residues on the surface of the complexes. Interestingly, we find that the location of soft disordered residues in the sequence changes as the number of partners increases. Our results show that there is a general mechanism for protein assembly that involves soft disorder and modulates the way protein complexes are assembled. This work highlights the difficulty of predicting the structure of large protein complexes from sequence and emphasises the importance of linking predictors of soft disorder to the next generation of predictors of complex structure. Finally, we investigate the relationship between the Alphafold2’s confidence metric pLDDT for structure prediction in unbound versus bound structures, and soft disorder. We show a strong correlation between Alphafold2 low confidence residues and the union of all regions of soft disorder observed in the hierarchy. This paves the way for using the pLDDT metric as a proxy for predicting interfaces and assembly paths.

PMID:36395332 | DOI:10.1371/journal.pcbi.1010713

PLoS One. 2022 Nov 17;17(11):e0277826. doi: 10.1371/journal.pone.0277826. eCollection 2022.

ABSTRACT

INTRODUCTION: Most cases of neonatal mortality are preventable but a substantial number of cases get complicated and become irreversible not only due to scarcity but also due to inefficient utilization of available resources in the health service. However, limited evidence shows the efficiency level of health facilities in Ethiopia. Therefore, this study aimed to assess the technical efficiency of neonatal health service and its associated factors among primary hospitals in three zones of Northwest Ethiopia.

METHODS: A facility-based cross-sectional study was conducted among fifteen randomly selected primary hospitals from March 17 to April 17, 2021. Input data on non-salary recurrent costs, salary costs, and the number of beds, and output data on neonatal admissions, outpatient visits, and referrals for the 2019/20 fiscal year were collected using a document review. In the first stage of analysis, input-oriented data envelopment analysis with a variable return-to-scale assumption was employed to estimate the efficiency scores using DEAP 2.1. A Tobit regression model was fitted in the second stage to identify the associated factors with technical efficiency. Variables with a p-value <0.05 were declared as statistically associated factors.

RESULTS: In this study, 80% of the primary hospitals were pure technical efficient whereas 46.67% of the facilities were scale efficient with all of the scale inefficient hospitals operating below their scale. The mean pure technical and scale efficiency score of primary hospitals was 0.948±0.113 and 0.887±0.143, respectively. Total catchment population, incentive packages for the clinical staff, and the educational status of the manager were positively associated with the technical efficiency of hospitals. On the other hand, technical efficiency was negatively associated with the presence of a health facility that provides neonatal health services near the hospital and the distance of the manager’s residence.

CONCLUSION: Though most of the primary hospitals in Northwest Ethiopia were technical efficient, more than half of them were working below their scale of operation. Our results also indicated that introducing the performance-based provision of incentive packages for clinical staff and employing master’s and above-educated health professionals as a manager might improve the efficient utilization of resources in primary hospitals.

PMID:36395289 | DOI:10.1371/journal.pone.0277826