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Nevin Manimala Statistics

Grey and white matter microstructure changes in epilepsy patients with vagus nerve stimulators

Clin Neurol Neurosurg. 2021 Aug 28;209:106918. doi: 10.1016/j.clineuro.2021.106918. Online ahead of print.

ABSTRACT

OBJECTIVES: Vagus nerve stimulation (VNS) has been widely used as an effective treatment for patients with drug-resistant epilepsy (DRE). However, little is known about grey matter (GM) and white matter (WM) microstructure changes caused by VNS. This study aimed to detect consistent GM and WM alterations in epilepsy patients with vagus nerve stimulators.

METHODS: The diffusion tensor imaging data was acquired from 15 patients who underwent VNS implantation. The voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) were used to detect group differences in GM and WM microstructure and explore their correlation with postoperative seizure reduction.

RESULTS: After 3 months of stimulation, GM density reduced in right cerebellum, left superior temporal gyrus, right inferior temporal gyrus and left thalamus, and increased in left cerebellum, left inferior parietal lobule, left middle occipital gyrus and left gyrus rectus. No significant volume changes had been found in 14 subcortical nuclei. The fractional anisotropy (FA) values reduced in left superior longitudinal fasciculus and left corticospinal tract, and increased in bilateral cingulum and body of corpus callosum. The mean diffusivity (MD) values reduced in right retrolenticular part of internal capsule, right posterior corona radiata and right superior longitudinal fasciculus. The seizure reduction had positive correlation trends with the volume reduction in left nucleus accumbens and right amygdala, and MD reduction in right medial lemniscus and right posterior corona radiata.

CONCLUSIONS: The results showed that VNS could cause changes of GM density, WM FA and MD values in epilepsy patients. The volume and MD reduction in some subcortical structures might participate in the seizure frequency reduction of VNS.

PMID:34500340 | DOI:10.1016/j.clineuro.2021.106918

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Nevin Manimala Statistics

Repetitive transcranial magnetic stimulation and transcranial direct current stimulation for auditory hallucinations in schizophrenia: Systematic review and meta-analysis

J Psychiatr Res. 2021 Sep 3;143:163-175. doi: 10.1016/j.jpsychires.2021.09.001. Online ahead of print.

ABSTRACT

Through imaging studies, a significant increase in cerebral activity has been detected in fronto-temporal areas in patients experiencing auditory verbal hallucinations. Therefore, non-invasive neuromodulation, in particular transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), has been considered as a therapeutic intervention for medication-resistant auditory verbal hallucinations in schizophrenia. We aimed to synthesize results from randomized trials on either rTMS or tDCS versus placebo in patients with schizophrenia by including five recently published trials in the field. A systematic review and meta-analysis of relevant literature was conducted. Studies were included on the basis of pre-defined selection criteria. The quality of the studies was assessed by the Cochrane Risk of Bias Tool for Randomized Controlled Trials. RevMan 5.3 was used to conduct the statistical analysis. Including 465 and 960 patients, respectively, 12 tDCS and 27 rTMS studies were included. Regarding treatment of medication refractory auditory verbal hallucinations, no significant effect of tDCS (-0.23 [-0.49, 0.02], p = 0.08) or rTMS (-0.19 [-0.50, 0,11], p = 0.21) was found compared to sham in this meta-analysis. The current study found that it cannot be concluded that rTMS and tDCS are efficacious in treating medication-resistant auditory verbal hallucinations. Larger randomized controlled tDCS trials of a higher quality should be conducted in the future to establish substantial evidence of tDCS. The interventions appear safe and may have beneficial effects on other outcomes.

PMID:34500345 | DOI:10.1016/j.jpsychires.2021.09.001

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Nevin Manimala Statistics

Response surface methodology to investigate the effects of operational parameters on membrane fouling and organic matter rejection in hard-shell encased hollow-fiber membrane

Chemosphere. 2021 Sep 2;287(Pt 2):132132. doi: 10.1016/j.chemosphere.2021.132132. Online ahead of print.

ABSTRACT

The response surface methodology (RSM) was found useful statistical tool for understanding combined effect of filtration, backwashing time and dosage of sodium hypochlorite (NaOCl) added into backwash water as three operational parameters on transient behavior of transmembrane pressure (TMP) and organic rejection efficiency. Here, encased, hollow-fiber ultrafiltration (UF) system was developed for treating synthetic humic acid (HA) solution. To carry out RSM analysis, experimental matrix was designed by Box-Behnken model. Results showed that the NaOCl dosage for the chemical enhanced backwashing (CEB) as single parameter played most dominant role in fouling mitigation. Effect of hydraulic cleaning by applying the permeate backwashing only without performing the CEB was almost negligible to flush the fouling layer from membrane. Considering two correlated parameters, backwashing time combined with NaOCl dosage was found much more important than combination of other parameter such as filtration time to reduce fouling rate. Regardless of the operational parameters, the organic rejection efficiency was maintained 30% only. The RSM analysis also found that 40.1 min of filtration, 1.1 min of backwashing and 834 mg/L of NaOCl were optimum operating parameters to enhance both permeate recovery and fouling mitigation.

PMID:34500327 | DOI:10.1016/j.chemosphere.2021.132132

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Nevin Manimala Statistics

The Dyadic Cancer Outcomes Framework: A general framework of the effects of cancer on patients and informal caregivers

Soc Sci Med. 2021 Aug 30;287:114357. doi: 10.1016/j.socscimed.2021.114357. Online ahead of print.

ABSTRACT

It is widely acknowledged that cancer affects not only patients but also their friends and family members who provide informal, and typically unpaid, care. Given the dual impact that cancer often has on patients and their informal caregivers (i.e., family members, partners, or friends), an expanded dyadic framework that encompasses a range of health and psychosocial outcomes and includes primary caregivers with a range of relationships to the patients is critically needed. Moreover, an emphasis on the role of social and contextual factors may help the framework resonate with a broader range of patient-caregiver relationships and allow for the development of more effective dyadic interventions. This article describes the development of the Dyadic Cancer Outcomes Framework, which was created to guide future research and intervention development. Using an iterative process, we conducted a conceptual review of currently used dyadic and/or caregiving models and frameworks and developed our own novel dyadic framework. Our novel Dyadic Cancer Outcomes Framework highlights individual- and dyad-level predictors and outcomes, as well as incorporating the disease trajectory and the social context. This framework can be used in conjunction with statistical approaches including the Actor Partner Interdependence Model to evaluate outcomes for different kinds of partner-caregiver dyads. This flexible framework can be used to guide intervention development and evaluation for cancer patients and their primary caregivers, with the ultimate goal of improving health, psychosocial, and relationship outcomes for both patients and caregivers. Future research will provide valuable information about the framework’s effectiveness for this purpose.

PMID:34500320 | DOI:10.1016/j.socscimed.2021.114357

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Nevin Manimala Statistics

Short Nutritional Assessment Questionnaire as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy: A retrospective study

Eur J Oncol Nurs. 2021 Aug 12;54:102013. doi: 10.1016/j.ejon.2021.102013. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this retrospective study was to verify whether the revised Short Nutritional Assessment Questionnaire© (SNAQ), a simplified nutritional assessment, could be comparable with serum albumin (ALB) levels as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy.

METHODS: Of 111 patients, 79 patients with baseline ALB levels ≥3.5 g/dL were included in the analysis. Patients completed the revised SNAQ, which evaluated items including appetite loss, weight loss, nutritional supplement usage, age, and body mass index, using a maximum of 12 points (a score of ≥3 was marked as severe undernutrition). ALB levels were then monitored for 1 year using patient medical records.

RESULTS: There was a significant difference in event-free survival (EFS) when the SNAQ scores were classified into two groups [i.e., scores of ≤3 (SNAQ3) or scores of ≥4 (SNAQ4)]. The 150-day EFS rate was 86.8% and 57.6% for SNAQ3 and SNAQ4, respectively (hazard ratio: 2.92; 95% confidence interval: 1.31-6.51; p = 0.009). Based on the Cox proportional-hazards analysis, a higher risk of undernutrition was associated with SNAQ4 (compared with SNAQ3), C-reactive protein levels, and serum transthyretin levels.

CONCLUSION: The revised SNAQ is a predictor of undernutrition in cancer patients receiving outpatient chemotherapy. In particular, it is important that patients with a SNAQ score of ≥4 receive dietary guidance at an early stage as they are likely to become undernourished within a year.

PMID:34500316 | DOI:10.1016/j.ejon.2021.102013

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Nevin Manimala Statistics

Occurrence and perceived effectiveness of activities used to decrease chemotherapy-induced peripheral neuropathy symptoms in the feet

Eur J Oncol Nurs. 2021 Sep 2;54:102025. doi: 10.1016/j.ejon.2021.102025. Online ahead of print.

ABSTRACT

PURPOSE: Investigate the reported use and perceived effectiveness of self-care activities for chemotherapy-induced peripheral neuropathy (CIPN) symptoms in the feet.

METHODS: Cancer survivors with CIPN (n = 405) completed a questionnaire that assessed the use and perceived effectiveness of 25 self-care activities. Effectiveness was rated on a 0 (not at all) to 10 (completely effective) numeric rating scale. Descriptive statistics and regression analyses were conducted to identify demographic, clinical, and pain characteristics associated with the use and effectiveness of selected self-care activities.

RESULTS: The five most commonly used activities were: went for a walk (73.8%); watched television (67.8%); read a book, newspaper or magazine (64.4%); listened to radio, music (60.0%); and did exercises (jogging, swimming) (58.6%). The five most effective self-care activities were: had a trigger point injection (8.3 ( ± 1.3)); took tranquilizers (4.8 ( ± 2.6)); went for ultrasonic stimulation treatment (4.3 ( ± 3.1)); used a heating pad or hot water bottle (4.3 ( ± 2.5)); and used a transcutaneous electric nerve stimulator (4.2 ( ± 2.6)). Demographic, clinical, and pain characteristics influenced use and perceived effectiveness of selected self-care activities to varying degrees.

CONCLUSIONS: Two-thirds of the survivors used at least seven self-care activities to manage CIPN symptoms. The most commonly used activities did not receive the highest effectiveness ratings. Some activities that were rated as highly effective warrant more rigorous evaluation. Survivors can try a range of activities to decrease CIPN symptoms in the feet following discussion of their potential risks and benefits with their clinicians.

PMID:34500317 | DOI:10.1016/j.ejon.2021.102025

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Nevin Manimala Statistics

Metachronous second primary neoplasia in oropharyngeal cancer patients: Impact of tumor HPV status. A GETTEC multicentric study

Oral Oncol. 2021 Sep 6;122:105503. doi: 10.1016/j.oraloncology.2021.105503. Online ahead of print.

ABSTRACT

INTRODUCTION: Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk to develop a metachronous second primary neoplasia (MSPN). HPV and non-HPV-related OPSCC are 2 distinct entities with biological, clinical and prognostic differences. The aims of our study were to analyze the impact of tumor HPV status and other relevant clinical factors, such as tobacco and/or alcohol (T/A) consumption, on the risk and distribution of MSPN in OPSCC patients and to assess the impact of MSPN on patient survival.

MATERIAL AND METHODS: All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. P16 immunohistochemical expression was used as a surrogate maker of tumor HPV status. The impact of tumor p16 status on the risk of MSPN was assessed in uni- and multivariate analyses. Overall survival (OS) was determined by Kaplan-Meier analysis.

RESULTS: Among the 1291 patients included in this study, 138 (10.7%) displayed a MSPN which was preferentially located in the head and neck area (H&N), lung and esophagus. Multivariate analyses showed that p16- tumor status (p = 0.003), T/A consumption (p = 0.005) and soft palate tumor site (p = 0.009) were significantly associated with a higher risk of MSPN. We found no impact of p16 tumor status on the median time between index OPSCC diagnosis and MSPN development, but a higher proportion of MSPN arising outside the H&N, lung and esophagus was found in p16 + than in p16- patients. MSPN development had an unfavorable impact (p = 0.04) on OS only in the p16 + patient group.

CONCLUSION: P16 tumor status and T/A consumption were the main predictive factors of MSPN in OPSCC patients. This study provides crucial results with a view to tailoring global management and follow-up of OPSCC patients.

PMID:34500315 | DOI:10.1016/j.oraloncology.2021.105503

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Nevin Manimala Statistics

Predictive coding feedback results in perceived illusory contours in a recurrent neural network

Neural Netw. 2021 Aug 26;144:164-175. doi: 10.1016/j.neunet.2021.08.024. Online ahead of print.

ABSTRACT

Modern feedforward convolutional neural networks (CNNs) can now solve some computer vision tasks at super-human levels. However, these networks only roughly mimic human visual perception. One difference from human vision is that they do not appear to perceive illusory contours (e.g. Kanizsa squares) in the same way humans do. Physiological evidence from visual cortex suggests that the perception of illusory contours could involve feedback connections. Would recurrent feedback neural networks perceive illusory contours like humans? In this work we equip a deep feedforward convolutional network with brain-inspired recurrent dynamics. The network was first pretrained with an unsupervised reconstruction objective on a natural image dataset, to expose it to natural object contour statistics. Then, a classification decision head was added and the model was finetuned on a form discrimination task: squares vs. randomly oriented inducer shapes (no illusory contour). Finally, the model was tested with the unfamiliar “illusory contour” configuration: inducer shapes oriented to form an illusory square. Compared with feedforward baselines, the iterative “predictive coding” feedback resulted in more illusory contours being classified as physical squares. The perception of the illusory contour was measurable in the luminance profile of the image reconstructions produced by the model, demonstrating that the model really “sees” the illusion. Ablation studies revealed that natural image pretraining and feedback error correction are both critical to the perception of the illusion. Finally we validated our conclusions in a deeper network (VGG): adding the same predictive coding feedback dynamics again leads to the perception of illusory contours.

PMID:34500255 | DOI:10.1016/j.neunet.2021.08.024

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Nevin Manimala Statistics

Dental phenotype in Crouzon syndrome: A controlled radiographic study in 22 patients

Arch Oral Biol. 2021 Sep 3;131:105253. doi: 10.1016/j.archoralbio.2021.105253. Online ahead of print.

ABSTRACT

OBJECTIVE: This retrospective radiographic controlled study investigates the dental phenotype in patients with Crouzon syndrome to determine if differences are observed as suggested by the FGFR2C342Y/+ Crouzon mouse models, and whether these models could be of interest to study the role of this mutation in tooth development.

DESIGN: We assessed dental phenotype using dedicated linear measurements in 22 children with Crouzon syndrome and compared tooth morphology in both primary and permanent dentitions to an age-matched control group. Descriptive statistics were performed with “Sex” and “Age” as covariates for the permanent tooth models and “Sex” only for the primary tooth models, to take into account potential confounding factors.

RESULTS: We showed that permanent but not primary tooth dimensions were globally reduced in Crouzon syndrome, without microdontia. In permanent dentition, crown height, mesiodistal and faciolingual cervical diameters were reduced by 6.3%, 5.7% and 5.5% respectively (p < 0.05).

CONCLUSION: Our results underline the implication of Fibroblast Growth Factor Receptor 2 (FGFR2) in dental development of humans and contribute to support FGFR2C342Y/+ Crouzon mouse models as partial replicas of this condition, including in the oral region.

PMID:34500259 | DOI:10.1016/j.archoralbio.2021.105253

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Nevin Manimala Statistics

Integrating social media inspired features into a personalized normative feedback intervention combats social media-based alcohol influence

Drug Alcohol Depend. 2021 Sep 1;228:109007. doi: 10.1016/j.drugalcdep.2021.109007. Online ahead of print.

ABSTRACT

BACKROUND: Research suggests that the social media platforms popular on college campuses may reflect, reinforce, and even exacerbate heavy drinking practices among students. The present study was designed to directly examine: (1) whether exposure to alcohol-related content on social media diminishes the efficacy of a traditional web-based personalized normative feedback (PNF) alcohol intervention among first-year drinkers; and (2) if social media inspired features and digital game mechanics can be integrated into a PNF intervention to combat social media-based alcohol influence and increase efficacy.

METHOD: Alcohol experienced first-year college students (N = 223) completed a pre-survey that assessed exposure to alcohol-related content and social media and were randomized to 1 of 3 web-based alcohol PNF conditions (traditional, gamified only, or social media inspired gamified). One month later, participants’ alcohol consumption was reassessed.

RESULTS: Among participants who received traditional PNF, social media-based alcohol exposure interacted with pre-intervention drinking such that traditional PNF was less effective in reducing drinking among heavier drinkers reporting greater exposure to alcohol-related social media content. Further, when regression models compared the efficacy of all three conditions, the social media inspired gamified PNF condition was significantly more effective in reducing drinking than was traditional PNF among moderate and heavy drinkers reporting greater exposure to alcohol on social media.

CONCLUSION: Although additional research is needed, these findings suggest that representing the population of students on whom normative statistics are based with social media-like user avatars and profiles may enhance the degree to which alcohol PNF is relatable and believable among high-risk students.

PMID:34500245 | DOI:10.1016/j.drugalcdep.2021.109007