Tag: pubmed

J Speech Lang Hear Res. 2022 Oct 5:1-11. doi: 10.1044/2022_JSLHR-22-00157. Online ahead of print.

ABSTRACT

OBJECTIVE: Currently, no clinically feasible objective measures exist that are specific to the signs of adductor laryngeal dystonia (LD), deterring effective diagnosis and treatment. This project sought to establish concurrent validity of a new automated acoustic outcome measure, designed to be specific to adductor laryngeal dystonia (AdLD): the spectral aggregate of the high-passed fundamental frequency contour (SAHf _o).

METHOD: Twenty speakers with AdLD read voiced phoneme-loaded (more symptomatic) and voiceless phoneme-loaded (less symptomatic) sentences. LD discontinuities (defined as phonatory breaks, frequency shifts, and creak), the acoustic ramifications of laryngeal spasms, were manually identified. The frequency content of the f _o contour was examined as a function of time, and content above 1000 Hz was summed to automatically calculate SAHf _o. Multiple linear regression analysis was applied to SAHf _o based on LD discontinuities and sentence type (voiced or voiceless phoneme-loaded).

RESULTS: The regression model accounted for 41.1% of the variance in SAHf _o. Both the LD discontinuities and sentence type were statistically related to SAHf _o.

CONCLUSION: Results of this study provide evidence of concurrent validity. SAHf _o is an automatic outcome measure specific to acoustic signs of AdLD that may be useful to track treatment progress.

PMID:36198059 | DOI:10.1044/2022_JSLHR-22-00157

J Clin Psychiatry. 2022 Oct 3;83(6):22m14447. doi: 10.4088/JCP.22m14447.

ABSTRACT

Objective: Determine if sublingual dexmedetomidine, a selective α₂ adrenergic receptor agonist, reduces symptoms of acute agitation associated with schizophrenia or schizoaffective disorder.

Methods: This phase 3, randomized, double-blind, placebo-controlled study was conducted in adults diagnosed with schizophrenia or schizoaffective disorder per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The study was conducted at 15 US sites between January 23, 2020, and May 8, 2020. Participants were randomized to sublingual dexmedetomidine 180 μg, 120 μg, or matching placebo. The primary efficacy endpoint was mean change from baseline in the Positive and Negative Syndrome Scale-Excited Component (PEC) total score at 2 hours postdose.

Results: Altogether, 380 participants (mean age 45.6 years, 63.4% identifying as male, 77.9% identifying as Black or African American) were randomized; 380 (100%) self-administered study medication, and 372 (97.9%) completed the study. The mean PEC total score at baseline (17.6) indicated mild to moderate agitation. At 2 hours postdose, the least squares mean changes (SE) from baseline were -10.3 (0.4) for sublingual dexmedetomidine 180 μg, -8.5 (0.4) for 120 μg, and -4.8 (0.4) for placebo. Least squares mean differences (97.5% confidence intervals) in the sublingual dexmedetomidine groups were -5.5 (-6.7 to -4.3) for 180 μg and -3.7 (-4.9 to -2.5) for 120 μg (both P < .001 vs placebo). The most commonly encountered adverse events with dexmedetomidine (incidence ≥ 5% and ≥ 2× rate observed with placebo) were somnolence, dry mouth, and hypotension for the 120 μg dose, and somnolence, dizziness, orthostatic hypotension, and oral hypoesthesia for the 180 μg dose.

Conclusions: Treatment with sublingual dexmedetomidine 180 μg or 120 μg was more efficacious than placebo in reducing acute agitation associated with schizophrenia as measured by PEC scores at 2 hours postdose.

Trial Registration: ClinicalTrials.gov identifier: NCT04268303.

PMID:36198061 | DOI:10.4088/JCP.22m14447

J Speech Lang Hear Res. 2022 Oct 5:1-11. doi: 10.1044/2022_JSLHR-22-00136. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated whether listener processing of dysarthric speech requires the recruitment of more cognitive resources (i.e., higher levels of listening effort) than neurotypical speech. We also explored relationships between behavioral listening effort, perceived listening effort, and objective measures of word transcription accuracy.

METHOD: A word recall paradigm was used to index behavioral listening effort. The primary task involved word transcription, whereas a memory task involved recalling words from previous sentences. Nineteen listeners completed the paradigm twice, once while transcribing dysarthric speech and once while transcribing neurotypical speech. Perceived listening effort was rated using a visual analog scale.

RESULTS: Results revealed significant effects of dysarthria on the likelihood of correct word recall, indicating that the transcription of dysarthric speech required higher levels of behavioral listening effort relative to neurotypical speech. There was also a significant relationship between transcription accuracy and measures of behavioral listening effort, such that listeners who were more accurate in understanding dysarthric speech exhibited smaller changes in word recall when listening to dysarthria. The subjective measure of perceived listening effort did not have a statistically significant correlation with measures of behavioral listening effort or transcription accuracy.

CONCLUSIONS: Results suggest that cognitive resources, particularly listeners’ working memory capacity, are more taxed when deciphering dysarthric versus neurotypical speech. An increased demand on these resources may affect a listener’s ability to remember aspects of their conversations with people with dysarthria, even when the speaker is fully intelligible.

PMID:36198057 | DOI:10.1044/2022_JSLHR-22-00136

J Am Vet Med Assoc. 2022 Oct 4:1-7. doi: 10.2460/javma.22.08.0367. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of the cyclooxygenase-2-selective NSAID firocoxib, compared to the nonselective NSAID flunixin meglumine on viscoelastic coagulation parameters in healthy horses.

ANIMALS: 12 healthy adult mixed-breed horses.

PROCEDURES: Following a crossover protocol, horses were administered flunixin meglumine (1.1 mg/kg, IV, q 12 h for 5 days), allowed a 6-month washout period, and then administered firocoxib (0.3 mg/kg, PO, once, then 0.1 mg/kg, PO, q 24 h for 4 days). Omeprazole (1 mg/kg, PO, q 24 h) was administered concurrently with each NSAID. Viscoelastic coagulation profiles and traditional coagulation parameters (prothrombin time, partial thromboplastin time, and fibrinogen) were measured before and after each treatment.

RESULTS: Viscoelastic coagulation parameters were within reference intervals before and after both treatments. There was a statistically significant difference between treatments for amplitude at 10 minutes after clot time (P = .02) and maximum clot formation (P = .02); however, the magnitude of change was not clinically significant.

CLINICAL RELEVANCE: Short-term administration of flunixin meglumine and firocoxib did not result in significant alteration of viscoelastic coagulation profiles in healthy horses. However, clinicians should be aware of possible coagulopathy secondary to NSAID administration with long-term use or critical illness, and further study is indicated.

PMID:36198050 | DOI:10.2460/javma.22.08.0367

Nutr Health. 2022 Oct 5:2601060221130424. doi: 10.1177/02601060221130424. Online ahead of print.

ABSTRACT

Purpose: This study aimed to evaluate the acute changes in retinal vasculature following coffee consumption. Methods: This is an interventional case series. The subjects were 22 healthy young adults. They were asked to rest in a silent room for 15 min; then, their heart rate, blood pressure, and arterial oxygen saturation pressure were measured with a single patient monitoring system. Optical coherence tomography (OCT) and OCT angiography (OCT-A) imaging of the disc and macula were performed for both eyes of the subjects. These measurements were repeated 45 min after drinking a cup of 450 ml of coffee containing a standard dose of 130 mg of caffeine. Macular and optic nerve head neurovasculature changes were assessed. Results: The results of our study did not show a significant change in peripapillary retinal nerve fiber layer thickness and neural structural and vascular parameters of the optic nerve head. Although assessments of macular vasculature showed a significant decrement in superficial (p = 0.01) and deep vessel density (p = 0.05) at parafovea, vessel densities (VDs) at the fovea, and deep capillary plexus at perifovea showed no significant change. Conclusion: Consuming one cup of coffee (150 mg caffeine) statistically changes central foveal thickness and parafoveal blood flow but likely does not have a clinical impact in healthy young adults.

PMID:36198039 | DOI:10.1177/02601060221130424

Nutr Health. 2022 Oct 5:2601060221129695. doi: 10.1177/02601060221129695. Online ahead of print.

ABSTRACT

BACKGROUND: Anaemia is a serious global public health problem with high prevalence (>40%) in children particularly in low- and middle-income countries including Namibia with a current 46.1% prevalence rate.

AIM: This study was aimed at examining the sociodemographic factors influencing the occurrence of childhood anaemia levels in Namibia.

METHOD: A multivariate ordinal regression model was applied to statistically identify potential sociodemographic factors associated with anaemia levels among children under-5 years old using data collected from the 2013 NDHS.

RESULTS: The odds of having mild anaemia level was lower for sociodemographic characteristics such as mother’s age, total children ever born, health insurance coverage, child’s residency, child’s age and main language spoken at home. The odds of having moderate anaemia level was higher for characteristics such as mother’s age, place of residence, highest education level and child’s diarrhoea status, while it was lower for characteristics such as age of head of household, total children ever born, health insurance coverage and sex of child. Similarly, the odds of having severe anaemia level was higher for characteristics such as region, place of residence, highest education level, number of household members, wealth index, health insurance coverage, child’s residency and child’s diarrhoea status, while it was lower for characteristics such as total children ever born and sex of child.

CONCLUSION: It is therefore recommended that the policies and practices concerning anaemia diagnosis, treatment and prevention in the country be substantially revised by policy-makers, starting with the known prevalent causes and identified sociodemographic factors from this study.

PMID:36198037 | DOI:10.1177/02601060221129695

Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221130063. doi: 10.1177/10760296221130063.

ABSTRACT

BACKGROUND: Percutaneous coronary intervention (PCI) is the main treatment option for acute coronary syndromes (ACS) often related to the progression and rupture of vulnerable plaques. While drug-eluting stents (DES) are now routinely used in PCI, drug-coated balloons (DCB) are a new strategy to PCI and their practice in the treatment of ACS with vulnerable plaques has not been reported. This study aimed to evaluate the safety and efficacy of DCB in ACS complicated with vulnerable plaque lesions.

METHODS: 123 patients were retrospectively analyzed and diagnosed with ACS and given PCI in our Cardiology Department from December 2020 to July 2022. Vulnerable plaques were confirmed by intravenous ultrasound (IVUS) in all patients. According to individual treatment plan, patients were entered into either DCB (n = 55) or DES (n = 68) groups. The results of coronary angiography and IVUS before and immediately after percutaneous coronary intervention were analyzed. The occurrence of major adverse cardiovascular events (MACE) and the results of coronary angiography were also evaluated during follow-up.

RESULTS: There were no significant differences in baseline clinical characteristics, preoperative minimal luminal diameter (MLD), and preoperative diameter stenosis (DS) between the two groups. Also, there were no differences in IVUS plaque burden (PB), vessel area, and lumen area in the two groups before and immediately after PCI. The efficacy analysis showed that immediately after PCI, the DCB group had smaller MLD and higher degrees of lumen stenosis than the DES group (P < 0.05). However, during follow-up, no significant differences in MLD and DS were seen in two groups; relatively, late loss in luminal diameter（LLL）in the DCB group was smaller (P＜0.05). Safety analysis showed that during follow-up, 9 patients developed restenosis after DCB implantation while restenosis occurred in 10 patients with DES treatment, no statistical difference in the incidence of restenosis in the two groups. Besides, there was no statistical difference in the incidence of major adverse cardiac events（MACE）during hospitalization and follow-up in the DCB group (7.3% (4/55)) and the DES group (8.8% (6/68)).

CONCLUSION: DCB is safe and effective for ACS complicated with vulnerable plaque and has an advantage over DES in LLL.

PMID:36198017 | DOI:10.1177/10760296221130063

Magn Reson Med. 2022 Oct 5. doi: 10.1002/mrm.29462. Online ahead of print.

ABSTRACT

PURPOSE: Through-time spiral GRAPPA is a real-time imaging technique that enables ungated, free-breathing evaluation of the left ventricle. However, it requires a separate fully-sampled calibration scan to calculate GRAPPA weights. A self-calibrated through-time spiral GRAPPA method is proposed that uses a specially designed spiral trajectory with interleaved arm ordering such that consecutive undersampled frames can be merged to form calibration data, eliminating the separate fully-sampled acquisition.

THEORY AND METHODS: The proposed method considers the time needed to acquire data at all points in a GRAPPA calibration kernel when using interleaved arm ordering. Using this metric, simulations were performed to design a spiral trajectory for self-calibrated GRAPPA. Data were acquired in healthy volunteers using the proposed method and a comparison electrocardiogram-gated and breath-held cine scan. Left ventricular functional values and image quality are compared.

RESULTS: A 12-arm spiral trajectory was designed with a temporal resolution of 32.72 ms/cardiac phase with an acceleration factor of 3. Functional values calculated using the proposed method and the gold-standard method were not statistically significantly different (paired t-test, p < 0.05). Image quality ratings were lower for the proposed method, with statistically significantly different ratings (Wilcoxon signed rank test, p < 0.05) for two of five image quality aspects rated (level of artifact, blood-myocardium contrast).

CONCLUSIONS: A self-calibrated through-time spiral GRAPPA reconstruction can enable ungated, free-breathing evaluation of the left ventricle in 71 s. Functional values are equivalent to a gold-standard cine technique, although some aspects of image quality may be inferior due to the real-time nature of the data collection.

PMID:36198001 | DOI:10.1002/mrm.29462

Biomed Tech (Berl). 2022 Oct 6. doi: 10.1515/bmt-2022-0100. Online ahead of print.

ABSTRACT

Research shows that Attention Deficit Hyperactivity Disorder (ADHD) is related to a disorder in brain networks. The purpose of this study is to use an effective connectivity measure and graph theory to examine the impairments of brain connectivity in ADHD. Weighted directed graphs based on electroencephalography (EEG) signals of 61 children with ADHD and 60 healthy children were constructed. The edges between two nodes (electrodes) were calculated by Phase Transfer Entropy (PTE). PTE is calculated for five frequency bands: delta, theta, alpha, beta, and gamma. The graph theory measures were divided into two categories: global and local. Statistical analysis with global measures indicates that in children with ADHD, the segregation of brain connectivity increases while the integration of the brain connectivity decreases compared to healthy children. These brain network differences were identified in the delta and theta frequency bands. The classification accuracy of 89.4% is obtained for both in-degree and strength measures in the theta band. Our result indicated local graph measures classified ADHD and healthy subjects with accuracy of 91.2 and 90% in theta and delta bands, respectively. Our analysis may provide a new understanding of the differences in the EEG brain network of children with ADHD and healthy children.

PMID:36197950 | DOI:10.1515/bmt-2022-0100

PLoS One. 2022 Oct 5;17(10):e0275250. doi: 10.1371/journal.pone.0275250. eCollection 2022.

ABSTRACT

BACKGROUND: Measurement of care quality and safety mainly relies on abstracted administrative data. However, it is well studied that administrative data-based adverse event (AE) detection methods are suboptimal due to lack of clinical information. Electronic medical records (EMR) have been widely implemented and contain detailed and comprehensive information regarding all aspects of patient care, offering a valuable complement to administrative data. Harnessing the rich clinical data in EMRs offers a unique opportunity to improve detection, identify possible risk factors of AE and enhance surveillance. However, the methodological tools for detection of AEs within EMR need to be developed and validated. The objectives of this study are to develop EMR-based AE algorithms from hospital EMR data and assess AE algorithm’s validity in Canadian EMR data.

METHODS: Patient EMR structured and text data from acute care hospitals in Calgary, Alberta, Canada will be linked with discharge abstract data (DAD) between 2010 and 2020 (n~1.5 million). AE algorithms development. First, a comprehensive list of AEs will be generated through a systematic literature review and expert recommendations. Second, these AEs will be mapped to EMR free texts using Natural Language Processing (NLP) technologies. Finally, an expert panel will assess the clinical relevance of the developed NLP algorithms. AE algorithms validation: We will test the newly developed AE algorithms on 10,000 randomly selected EMRs between 2010 to 2020 from Calgary, Alberta. Trained reviewers will review the selected 10,000 EMR charts to identify AEs that had occurred during hospitalization. Performance indicators (e.g., sensitivity, specificity, positive predictive value, negative predictive value, F1 score, etc.) of the developed AE algorithms will be assessed using chart review data as the reference standard.

DISCUSSION: The results of this project can be widely implemented in EMR based healthcare system to accurately and timely detect in-hospital AEs.

PMID:36197944 | DOI:10.1371/journal.pone.0275250