Tag: pubmed

Andrology. 2022 Oct 17. doi: 10.1111/andr.13321. Online ahead of print.

ABSTRACT

BACKGROUND: Male circumcision is a well know old surgery, and several recently developed techniques have been scaled up, including the introduction of laser technology, as alternative approaches to overcome morbidity of conventional surgery scalpel/suture method OBJECTIVES: We aimed to perform a systematic review and meta-analysis of studies comparing laser circumcision versus conventional circumcision technique in terms of perioperative outcomes and efficacy (complications, unacceptable appearance, reoperation rate) both in children and adults.

MATERIALS AND METHODS: This review was performed following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Continuous variables were analyzed using the inverse variance of the mean difference (MD) with a random effect, 95% Confidence Interval (CI), and p-values. The incidence of complications, unacceptable appearance, and reoperation rate were pooled using the Cochran-Mantel-Haenszel Method with the random effect model and reported as Odds Ratio (OR), 95% CI, and p-values. Significance was set at p-value ≤0.05 and 95%CI.

RESULTS: Seven studies were included. In comparison to the conventional circumcision, laser circumcision shoved lower visual analogue score at 24-hour, and 7 days after surgery, a lower rate of overall complication rate (OR 0.33, 95% CI 0.24 – 0.47, p<0.001), scarring (OR 0.09, 95% CI 0.02,0.41, p = 0.002) and unacceptable appearance (OR 0.09, 95% CI 0.05, 0.15, p<0.001). We found no statistically significant difference in surgical time, and incidence of bleeding, infection, wound dehiscence, and reoperation rate.

DISCUSSION AND CONCLUSION: Our review infers that laser-assisted circumcision is certainly a safe and strong contender as the procedure of choice in both children and adult populations. This article is protected by copyright. All rights reserved.

PMID:36251782 | DOI:10.1111/andr.13321

J Clin Endocrinol Metab. 2022 Oct 17:dgac602. doi: 10.1210/clinem/dgac602. Online ahead of print.

ABSTRACT

CONTEXT: Gestational diabetes (GDM) imposes long-term adverse health effects on the mother and fetus. The role of magnetic resonance imaging (MRI) during early gestation in GDM has not been well-studied.

OBJECTIVE: To investigate the role of quantitative MRI measurements of placental volume and perfusion, with distribution of maternal adiposity, during early-gestation in GDM.

DESIGN: ∼200 pregnant women recruited in the first trimester were followed temporally through pregnancy until parturition.

SETTING: Outpatient antenatal obstetrics clinics.

INTERVENTIONS: Two placental MRI scans were prospectively performed at 14-16 weeks and 19-24 weeks gestational age (GA). Placental volume and blood flow (PBF) were calculated from placental regions of interest; maternal adiposity distribution was assessed by subcutaneous fat area ratio (SFAR) and visceral fat area ratio (VFAR). Statistical comparisons were performed using the two-tailed t-test. Predictive logistic regression modeling was evaluated by area under the curves (AUC).

RESULTS: Of a total 186 subjects, 21 subjects (11.3%) developed GDM. VFAR was higher in GDM versus the control group, at both time points (p < 0.001 each). Placental volume was greater in GDM versus the control group at 19-24 weeks GA (p = 0.01). Combining VFAR, placental volume and perfusion, improved the AUCs to 0.83 at 14-16 weeks (PPV = 0.77, NPV = 0.83), and 0.81 at 19-24 weeks GA (PPV = 0.73, NPV = 0.86).

CONCLUSION: A combination of MRI-based placental volume, perfusion and visceral adiposity during early pregnancy demonstrates significant changes in GDM and provides a proof of concept for predicting the subsequent development of GDM.

PMID:36251771 | DOI:10.1210/clinem/dgac602

ACS Nano. 2022 Oct 17. doi: 10.1021/acsnano.2c07240. Online ahead of print.

ABSTRACT

We demonstrate DNA translocations through silicon nitride pores formed by simple chemical etching on glass substrates using microscopic amounts of hydrofluoric acid. DNA translocations and transmission electron microscopy (TEM) prove the fabrication of nanopores and allow their characterization. From ionic measurements on 318 chips, we report the effective pore diameters ranging from zero (pristine membranes) and sub-nm to over 100 nm, within 50 μm diameter membranes. The combination of ionic conductance, DNA current blockades, TEM imaging, and electron energy loss spectroscopy (EELS) provides comprehensive information about the pore area and number, from single to few pores, and pore structure. We also show the formation of thinned membrane regions as precursors of pores. The average pore density, about 5 × 10^-4 pores/μm², allows pore number adjustment statistically (0, 1, or more). This simple and affordable chemical method for making solid-state nanopores accelerates their adoption for DNA sensing and characterization applications.

PMID:36251751 | DOI:10.1021/acsnano.2c07240

Med Sci Sports Exerc. 2022 Oct 12. doi: 10.1249/MSS.0000000000003062. Online ahead of print.

ABSTRACT

BACKGROUND: High impact loads have been linked with running injuries. Fatigue has been proposed to increase impact loads, but this relationship has not been rigorously examined, including the associated role of muscle strength, power, and endurance.

PURPOSE: To investigate the effect of fatigue on impact loading in runners, and the role of muscle function in mediating changes in impact loading with fatigue.

METHODS: Twenty-eight trained endurance runners performed a fixed-intensity time to exhaustion test at 85% of V̇O2max. Tibial accelerations were measured using leg-mounted inertial measurement units (IMUs) and sampled every minute until volitional exhaustion. Tests of lower-limb muscle strength, power, and endurance included maximal isometric strength (soleus, knee extensors, knee flexors), single leg hop for distance, and the one leg rise test. Changes in peak axial tibial acceleration (PTA, g) were compared between time-points throughout the run (0, 25, 50, 75 and 100%). Associations between the change in PTA and lower limb muscle function tests were assessed (Spearman’s rho [rs]).

RESULTS: Peak tibial acceleration increased over the duration of the fatiguing run. Compared to baseline (0%) (9.1 g SD 1.6), there was a significant increase at 75% (9.9 g SD 1.7., p = 0.001) and 100% (10.1 g SD 1.8, p < 0.001), with no change at 25% (9.6 g SD 1.6, p = 0.142) or 50% (9.7 g SD 1.7, p = 0.053). Relationships between change in peak tibial acceleration and muscle function tests were weak and not statistically significant (rs = -0.153 to 0.142, all p > 0.05).

CONCLUSIONS: Peak axial tibial acceleration increased throughout a fixed-intensity run to exhaustion. The change in PTA was not related to performance in lower limb muscle function tests.

PMID:36251400 | DOI:10.1249/MSS.0000000000003062

JMIR Med Inform. 2022 Oct 17;10(10):e38936. doi: 10.2196/38936.

ABSTRACT

BACKGROUND: Despite the many opportunities data reuse offers, its implementation presents many difficulties, and raw data cannot be reused directly. Information is not always directly available in the source database and needs to be computed afterwards with raw data for defining an algorithm.

OBJECTIVE: The main purpose of this article is to present a standardized description of the steps and transformations required during the feature extraction process when conducting retrospective observational studies. A secondary objective is to identify how the features could be stored in the schema of a data warehouse.

METHODS: This study involved the following 3 main steps: (1) the collection of relevant study cases related to feature extraction and based on the automatic and secondary use of data; (2) the standardized description of raw data, steps, and transformations, which were common to the study cases; and (3) the identification of an appropriate table to store the features in the Observation Medical Outcomes Partnership (OMOP) common data model (CDM).

RESULTS: We interviewed 10 researchers from 3 French university hospitals and a national institution, who were involved in 8 retrospective and observational studies. Based on these studies, 2 states (track and feature) and 2 transformations (track definition and track aggregation) emerged. “Track” is a time-dependent signal or period of interest, defined by a statistical unit, a value, and 2 milestones (a start event and an end event). “Feature” is time-independent high-level information with dimensionality identical to the statistical unit of the study, defined by a label and a value. The time dimension has become implicit in the value or name of the variable. We propose the 2 tables “TRACK” and “FEATURE” to store variables obtained in feature extraction and extend the OMOP CDM.

CONCLUSIONS: We propose a standardized description of the feature extraction process. The process combined the 2 steps of track definition and track aggregation. By dividing the feature extraction into these 2 steps, difficulty was managed during track definition. The standardization of tracks requires great expertise with regard to the data, but allows the application of an infinite number of complex transformations. On the contrary, track aggregation is a very simple operation with a finite number of possibilities. A complete description of these steps could enhance the reproducibility of retrospective studies.

PMID:36251369 | DOI:10.2196/38936

JMIR Serious Games. 2022 Oct 17;10(4):e37938. doi: 10.2196/37938.

ABSTRACT

BACKGROUND: Although more people are experiencing cybersickness due to the popularization of virtual reality (VR), no official standard for the cause and reduction of cybersickness exists to date. One of the main reasons is that an objective method to assess cybersickness has not been established. To resolve this, research on evaluating cybersickness with physiological responses that can be measured in real time is required. Since research on deriving physiological responses that can assess cybersickness is at an early stage, further studies examining various physiological responses are needed.

OBJECTIVE: This study analyzed the effects of cybersickness caused by head-mounted display-based VR on physiological responses.

METHODS: We developed content that provided users with a first-person view of an aircraft that moved (with translation and combined rotation) over a city via a predetermined trajectory. In the experiment, cybersickness and the physiological responses of participants were measured. Cybersickness was assessed by the Simulator Sickness Questionnaire (SSQ). The measured physiological responses were heart rate, blood pressure, body temperature, and cortisol level.

RESULTS: Our measurement confirmed that all SSQ scores increased significantly (all Ps<.05) when participants experienced cybersickness. Heart rate and cortisol level increased significantly (P=.01 and P=.001, respectively). Body temperature also increased, but there was no statistically significant difference (P=.02). Systolic blood pressure and diastolic blood pressure decreased significantly (P=.001).

CONCLUSIONS: Based on the results of our analysis, the following conclusions were drawn: (1) cybersickness causes significant disorientation, and research on this topic should focus on factors that affect disorientation; and (2) the physiological responses that are suitable for measuring cybersickness are heart rate and cortisol level.

PMID:36251360 | DOI:10.2196/37938

JMIR Cardio. 2022 Oct 17;6(2):e37437. doi: 10.2196/37437.

ABSTRACT

Digital health is a promising tool to support people with an elevated risk for atherosclerotic cardiovascular disease (ASCVD) and patients with an established disease to improve cardiovascular outcomes. Many digital health initiatives have been developed and employed. However, barriers to their large-scale implementation have remained. This paper focuses on these barriers and presents solutions as proposed by the Dutch CARRIER (ie, Coronary ARtery disease: Risk estimations and Interventions for prevention and EaRly detection) consortium. We will focus in 4 sections on the following: (1) the development process of an eHealth solution that will include design thinking and cocreation with relevant stakeholders; (2) the modeling approach for two clinical prediction models (CPMs) to identify people at risk of developing ASCVD and to guide interventions; (3) description of a federated data infrastructure to train the CPMs and to provide the eHealth solution with relevant data; and (4) discussion of an ethical and legal framework for responsible data handling in health care. The Dutch CARRIER consortium consists of a collaboration between experts in the fields of eHealth development, ASCVD, public health, big data, as well as ethics and law. The consortium focuses on reducing the burden of ASCVD. We believe the future of health care is data driven and supported by digital health. Therefore, we hope that our research will not only facilitate CARRIER consortium but may also facilitate other future health care initiatives.

PMID:36251353 | DOI:10.2196/37437

Med Phys. 2022 Oct 17. doi: 10.1002/mp.16046. Online ahead of print.

ABSTRACT

PURPOSE: Determination of reliable change of radiomics feature over time is essential and vital in delta-radiomics, but has not yet been rigorously examined. This study attempts to propose a methodological approach of using reliable change index (RCI), a statistical metric to determine the reliability of quantitative biomarker changes by accounting for the baseline measurement standard error, in delta-radiomics. The use of RCI was demonstrated with the MRI data acquired from a group of prostate cancer (PCa) patients treated by 1.5 Tesla MRI-guided radiotherapy (MRgRT).

METHODS: Fifty consecutive PCa patients who underwent five-fractionated MRgRT were retrospectively included, and 1023 radiomics features were extracted from the clinical target volume (CTV) and planning target volume (PTV). The two MRI datasets acquired at the first fraction (MRI11 and MRI21) were used to calculate the baseline feature reliability against image acquisition using intraclass correlation coefficient (ICC). The RCI was constructed based on the baseline feature measurement standard deviation, ICC and feature value differences at two time points between the fifth (MRI51) and the first fraction MRI (MRI11). The reliable change of features was determined in each patient only if the calculated RCI was over 1.96 or smaller than -1.96. The feature changes between MRI51 and MRI11 were correlated to two patient-reported quality-of-life clinical endpoints of urinary domain summary score (UDSS) and bowel domain summary score (BDSS) in 35 patients using the Spearman correlation test. Only the significant correlations between a feature that was reliably changed in ≥7 patients (20%) by RCI and an endpoint were considered as true significant correlations.

RESULTS: 352 (34.4%) and 386 (37.7%) features among all 1023 features were determined by RCI to be reliably changed in more than five (10%) patients in the CTV and PTV, respectively. Nineteen features were found reliably changed in the CTV and 31 features in the PTV, respectively, in ten (20%) or more patients. These features were not necessarily associated with significantly different longitudinal feature values (group p-value <0.05). Most reliably changed features in more than 10 patients had excellent or good baseline test-retest reliability ICC, while none showed poor reliability. The RCI method ruled out the features to be reliably changed when substantial feature measurement bias was presented. After applying the RCI criterion, only four and five true significant correlations were confirmed with UDSS and BDSS in the CTV respectively, with low true significance correlation rates of 10.8% (4/37) and 17.9% (5/28). No true significant correlations were found in the PTV.

CONCLUSIONS: The RCI method was proposed for delta-radiomics and demonstrated using PCa MRgRT data. The RCI has advantages over some other statistical metrics commonly used in the previous delta-radiomics studies, and is useful to reliably identify the longitudinal radiomics feature change on an individual basis. This proposed RCI method should be helpful for the development of essential feature selection methodology in delta-radiomics. This article is protected by copyright. All rights reserved.

PMID:36251320 | DOI:10.1002/mp.16046

Transl Vis Sci Technol. 2022 Oct 3;11(10):24. doi: 10.1167/tvst.11.10.24.

ABSTRACT

PURPOSE: The purpose of this study was to develop a model, based on initial optic nerve head (ONH) characteristics, predictive of long-term rapid retinal nerve fiber layer (RNFL) thinning in patients with open-angle glaucoma (OAG).

METHODS: This study evaluated 712 eyes with OAG that had been followed up for >5 years with annual evaluation of RNFL thickness. Baseline ophthalmic features were incorporated into the machine learning models for prediction of faster RNFL thinning. The model was trained and tested using a random forest (RF) method, and was interpreted using Shapley additive explanations. Factors associated with faster rate of RNFL thinning were statistically evaluated using a decision tree.

RESULTS: The RF model showed that greater lamina cribrosa (LC) curvature, higher intraocular pressure (IOP), visual field mean deviation converging towards -5 dB, and thinner peripapillary choroid at baseline were the four most significant features predicting faster RNFL thinning. Partial interaction between the features showed that larger LC curvature was a strong factor for faster RNFL thinning when it exceeded approximately 12.0. When the LC curvature was ≤12, higher initial IOP and thinner peripapillary choroid played a role in the rapid RNFL thinning. Based on the decision tree, higher IOP (>26.5 mm Hg), greater laminar curvature (>13.95), and thinner peripapillary choroid (≤117.5 µm) were the 3 most important determinants affecting the rate of RNFL thinning.

CONCLUSIONS: Baseline ophthalmic data and ONH characteristics of patients with OAG were predictive of eyes at risk of faster progression. Combinations of important characteristics, such as IOP, LC curvature, and choroidal thickness, could stratify eyes into groups with different rates of RNFL thinning.

TRANSLATIONAL RELEVANCE: This work lays the foundations for developing prediction models to estimate glaucoma prognosis based on initial ONH characteristics.

PMID:36251319 | DOI:10.1167/tvst.11.10.24

JAMA Netw Open. 2022 Oct 3;5(10):e2236676. doi: 10.1001/jamanetworkopen.2022.36676.

ABSTRACT

IMPORTANCE: Loneliness and social isolation are public health concerns faced by older adults due to physical, cognitive, and psychosocial changes that develop with aging. Loneliness and social isolation are associated with increased morbidity and mortality.

OBJECTIVE: To evaluate interventions, targeting older adults, associated with a reduction in loneliness and social isolation.

DATA SOURCES: OVID, CINAHL, CENTRAL, Embase, PsychINFO, Web of Science, and Scopus were searched from inception to March 2020.

STUDY SELECTION: Peer-reviewed randomized clinical trials measuring loneliness and social isolation or support in adults aged 65 years or older. Only English language articles were included.

DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened studies, extracted data, and assessed risk of bias. Random-effects models were performed to pool the overall effect size by intervention. Statistical heterogeneity was evaluated with the I2 statistic and by estimating prediction intervals. Data were analyzed from November 2021 to September 2022.

MAIN OUTCOMES AND MEASURES: Quantitative measures of loneliness, social isolation, or social support based on an effect size of standardized mean differences.

RESULTS: Seventy studies were included in the systematic review (8259 participants); 44 studies were included in the loneliness meta-analysis (33 in the community with 3535 participants; 11 in long-term care with 1057 participants), with participants’ ages ranging from 55 to 100 years. Study sizes ranged from 8 to 741 participants. Interventions included animal therapy, psychotherapy or cognitive behavioral therapy, multicomponent, counseling, exercise, music therapy, occupational therapy, reminiscence therapy, social interventions, and technological interventions. Most interventions had a small effect size. Animal therapy in long-term care, when accounting for studies with no active controls, had the largest effect size on loneliness reduction (-1.86; 95% CI, -3.14 to -0.59; I2 = 86%) followed by technological interventions (videoconferencing) in long-term care (-1.40; 95% CI, -2.37 to -0.44; I2 = 70%).

CONCLUSIONS AND RELEVANCE: In this study, animal therapy and technology in long-term care had large effect sizes, but also high heterogeneity, so the effect size’s magnitude should be interpreted with caution. The small number of studies per intervention limits conclusions on sources of heterogeneity. Overall quality of evidence was very low. Future studies should consider measures of social isolation in long-term care and identify the contextual components that are associated with a reduction in loneliness.

PMID:36251294 | DOI:10.1001/jamanetworkopen.2022.36676