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Nevin Manimala Statistics

Validity and reliability of the Farsi version of the ascertain dementia 8-item (AD8-F) informant interview in Iranian patients with mild neurocognitive disorder

BMC Geriatr. 2022 Oct 14;22(1):801. doi: 10.1186/s12877-022-03391-y.

ABSTRACT

BACKGROUND: For screening and distinguishing between mild neurocognitive disorder (mNCD) and normal cognitive age-related changes in primary care centers, a simple and practical tool is necessary. Therefore, this study aims to determine the validity and reliability of the Farsi version of the Ascertain Dementia 8-item (AD8-F) informant interview in patients with mNCD.

METHODS: This is a study of the psychometric properties of the Farsi AD8. The participants include sixty informant-patient dyads with mNCD and sixty controls with normal cognition. The AD8 was compared to the mini-mental state examination (MMSE) and the Mini-Cog. As a gold standard, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for mNCD was used. The reliability was measured using internal consistency and test-retest. Validity was assessed by evaluating the content, concurrent, and construct validity. Data were analyzed via Cronbach’s α, Pearson correlation, independent t-test, and analysis of variance (ANOVA) and area under the curve (AUC) by statistical package for the social sciences (SPSS) v.23.

RESULTS: Cronbach’s α was 0.71. Test-retest reproducibility was 0.8. The AD8 had inverse correlations with the Mini-Cog (r = – 0.70, P < 0.01) and MMSE (r = – 0.56, P < 0.01). The area under the curve was 0.88. The optimal cutoff score was > 2. Sensitivity and specificity were 80 and 83%, respectively. The positive predictive value was 83%. The negative predictive value was 81%.

CONCLUSION: Our results suggest that this tool can be used as a screening tool to detect a mild neurocognitive disorder in primary care centers.

PMID:36241985 | DOI:10.1186/s12877-022-03391-y

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Nevin Manimala Statistics

DENSEN: a convolutional neural network for estimating chronological ages from panoramic radiographs

BMC Bioinformatics. 2022 Oct 14;23(Suppl 3):426. doi: 10.1186/s12859-022-04935-0.

ABSTRACT

BACKGROUND: Age estimation from panoramic radiographs is a fundamental task in forensic sciences. Previous age assessment studies mainly focused on juvenile rather than elderly populations (> 25 years old). Most proposed studies were statistical or scoring-based, requiring wet-lab experiments and professional skills, and suffering from low reliability.

RESULT: Based on Soft Stagewise Regression Network (SSR-Net), we developed DENSEN to estimate the chronological age for both juvenile and older adults, based on their orthopantomograms (OPTs, also known as orthopantomographs, pantomograms, or panoramic radiographs). We collected 1903 clinical panoramic radiographs of individuals between 3 and 85 years old to train and validate the model. We evaluated the model by the mean absolute error (MAE) between the estimated age and ground truth. For different age groups, 3-11 (children), 12-18 (teens), 19-25 (young adults), and 25+ (adults), DENSEN produced MAEs as 0.6885, 0.7615, 1.3502, and 2.8770, respectively. Our results imply that the model works in situations where genders are unknown. Moreover, DENSEN has lower errors for the adult group (> 25 years) than other methods. The proposed model is memory compact, consuming about 1.0 MB of memory overhead.

CONCLUSIONS: We introduced a novel deep learning approach DENSEN to estimate a subject’s age from a panoramic radiograph for the first time. Our approach required less laboratory work compared with existing methods. The package we developed is an open-source tool and applies to all different age groups.

PMID:36241969 | DOI:10.1186/s12859-022-04935-0

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Nevin Manimala Statistics

Trait related aberrant connectivity in clinically stable patients with schizophrenia: A seed based resting state fMRI study

Brain Imaging Behav. 2022 Oct 14. doi: 10.1007/s11682-022-00731-9. Online ahead of print.

ABSTRACT

Aberrant resting-state connectivity within and between the Default Mode Network, the Executive Control Network, and the Salience Network is well-established in schizophrenia. Meta-analyses have identified that bilateral lingual gyrus is as the only region showing hyperactivity in schizophrenia and there are reports of increased connectivity between the lingual gyrus and other brain regions in schizophrenia. It is not clear whether these abnormalities represent state or trait markers of the illness, i.e., if they are only present during the acute phase of the illness (state) or if they reflect a predisposition to schizophrenia (trait). In this study, we used a seed-based functional connectivity analysis to investigate brain networks in schizophrenia patients who are in the stable phase of their illness and assess functional connectivity using seeds in the lingual gyrus, the posterior cingulate, the right dorsolateral prefrontal cortex (dlPFC), the right anterior insula (rAI) and the right orbital frontoinsula. Twenty patients with schizophrenia in a stable phase of their illness (as defined by the course of illness and Signs and Symptoms of Psychotic Illness (SSPI) scores) and 20 age and sex-matched healthy controls underwent resting-state functional Magnetic Resonance Imaging (rs-fMRI). Data was analysed using the Data Processing Assistant for Resting-State fMRI Advanced Edition (DPARSFA) V3.1 ( http://rfmri.org/DPARSF ) and the statistical parametric mapping software 8 (SPM8). Compared with healthy controls, patients with schizophrenia showed increased connectivity between the left lingual gyrus and the middle frontal gyrus, and the cingulate cortex. Lingual gyrus hyper-connectivity may be a stable trait neuroimaging marker for schizophrenia. Our findings suggest that aberrant connectivity in major resting-state networks may not be present after the acute illness has stabilised.

PMID:36241961 | DOI:10.1007/s11682-022-00731-9

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Nevin Manimala Statistics

Importance of Arterial Vessel Length for Metastatic Lymph Node Retrieval and Survival in Standardized Left- and Right-Sided Colon Cancer Surgery

J Gastrointest Cancer. 2022 Oct 14. doi: 10.1007/s12029-022-00863-7. Online ahead of print.

ABSTRACT

BACKGROUND: We investigated the localization of lymph node metastases, and the role of arterial vessel and specimen lengths in left- and right-sided colon cancer surgery, for survival.

METHODS: This was a prospective cross-sectional population-based study of specimens from patients who underwent standardized surgical resection for colon cancer in 2012-2015. The mesocolon of the specimens was divided into four sections for pathological analysis of lymph nodes. Multiple linear regression analysis was used to explore the relationship between lymph node counts and patient- and surgery-related factors. For survival analysis, a multivariable Cox regression method was used.

RESULTS: A total of 317 patients (160 females) were included. Median (range) age was 74 (30-95) years. Median number of lymph node retrieval was 32 (8-198) and was associated with increased specimen length but not to arterial vessel length. One hundred and thirty-three (42%) patients had lymph node metastases. All patients had these located < 5 cm from the tumour. Ten, two, and three specimens had lymph node metastases around the central and peripheral ligation of the ileocolic artery and at the central ligation of the inferior mesenteric artery, respectively. The tumour stages in these specimens were T3-4N2M0-1. No statistically significant survival benefit was associated with longer arterial vessel length (p = 0.429).

CONCLUSIONS: Neither retrieval of lymph nodes nor statistically significant survival was affected by vessel length in standardized left- and right-sided colon cancer surgery.

PMID:36241960 | DOI:10.1007/s12029-022-00863-7

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Nevin Manimala Statistics

Innovations in Clinical Development in Rare Diseases of Children and Adults: Small Populations and/or Small Patients

Paediatr Drugs. 2022 Oct 15. doi: 10.1007/s40272-022-00538-7. Online ahead of print.

ABSTRACT

Many of the afflictions of children are rare diseases. This creates numerous drug development challenges related to small populations, including limited information about the disease state, enrollment challenges, and diminished incentives for pediatric development of novel therapies by pharmaceutical and biotechnology sponsors. We review selected innovations in clinical development that may partially mitigate some of these difficulties, starting with the concept of development efficiency for individual clinical trials, clinical programs (involving multiple trials for a single drug), and clinical portfolios of multiple drugs, and decision analysis as a tool to optimize efficiency. Development efficiency is defined as the ability to reach equally rigorous or more rigorous conclusions in less time, with fewer trial participants, or with fewer resources. We go on to discuss efficient methods for matching targeted therapies to biomarker-defined subgroups, methods for eliminating or reducing the need for natural history data to guide rare disease development, the use of basket trials to enhance efficiency by grouping multiple similar disease applications in a single clinical trial, and the use of alternative data sources including historical controls to augment or replace concurrent controls in clinical studies. Greater understanding and broader application of these methods could lead to improved therapies and/or more widespread and rapid access to novel therapies for rare diseases in both children and adults.

PMID:36241954 | DOI:10.1007/s40272-022-00538-7

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Nevin Manimala Statistics

Differentiation of Human Wharton Jelly Mesenchymal Stem Cells into Germ-Like Cells; emphasis on evaluation of Germ-long non-coding RNAs

Mol Biol Rep. 2022 Oct 15. doi: 10.1007/s11033-022-07961-6. Online ahead of print.

ABSTRACT

BACKGROUND: The proliferation and differentiation of stem cells into Germ-Like Cells (GLCs) is mediated by several growth factors and specific genes, of which some are related to long non-coding RNAs (lncRNAs). We have developed a modified differentiation process and identified a panel of GermlncRNAs related to GLCs.

METHODS: Human Wharton Jelly Mesenchymal Stem Cells were treated with 25 ng/ml Bone Morphogenetic Protein (BMP)-4 and 10– 5 M all-trans retinoic acid to differentiate them into germ-like cells. To confirm the differentiation, changes in the expression of Oct-4, C-kit, Stella, and Vasa genes were assessed using quantitative Real-Time PCR (qPCR) and immunocytochemistry. QPCR was also used before and after differentiation to evaluate the changes in a lncRNA panel, using a 96-well array. Statistical analysis of the data was performed by SPSS 21.

RESULTS: After 21 days of induction, the HWJ-MSCs derived germ-like cells were formed. Also, qPCR and immunocytochemistry showed that the pluripotent Oct4 marker was expressed in the undifferentiated HWJ-MSCs, but its expression gradually decreased in the differentiated cells. C-kit was expressed on days 7, 14, and 21 of differentiation. Both GLC markers of Stella and Vasa genes/proteins were present only in differentiated cells. Of the 44 lncRNA genes array, 36 of them showed an increase and eight genes showed a decrease.

CONCLUSION: Our study showed that BMP4 and RA are effective in inducing HWJ-MSCs differentiation into GLCs. In addition, our study for the first time showed changes in the lncRNAs expression during the differentiation of HWJ-MSCs into GLCs by using BMP4 and RA.

PMID:36241921 | DOI:10.1007/s11033-022-07961-6

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Nevin Manimala Statistics

Epidemiology of cardiac amyloidosis in Germany: a retrospective analysis from 2009 to 2018

Clin Res Cardiol. 2022 Oct 14. doi: 10.1007/s00392-022-02114-y. Online ahead of print.

ABSTRACT

BACKGROUND: Improved imaging modalities contributed to increasing awareness of cardiac amyloidosis. Contemporary data on frequency trends in Germany are lacking.

METHODS: In a retrospective study using health claims data of a German statutory health insurance, patients with diagnostic codes of amyloidosis and concomitant heart failure between 2009 and 2018 were identified.

RESULTS: Prevalence increased from 15.5 to 47.6 per 100,000 person-years, and incidence increased from 4.8 to 11.6 per 100,000 person-years, with a continuous steepening in the slope of incidence trend. In patients with amyloidosis and heart failure age and proportion of men significantly increased, whereas the frequency of myeloma and nephrotic syndrome significantly decreased over time. Median (IQR) survival time after first diagnosis was 2.5 years (0.5-6 years), with a 9% (95% CI 2-15%, p = 0.008) reduced risk of death in the second compared to the first 5 years of observation. In the 2 years prior and 1 year after diagnosis, mean total health care costs were 6568 €, 11,872 € and 21,955 € per person and year.

CONCLUSION: The rise in cardiac amyloidosis has continuously accelerated in the last decade. Considering the adverse outcome and high health care burden, further effort should be put on early detection of the disease to implement available treatment.

PMID:36241897 | DOI:10.1007/s00392-022-02114-y

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Nevin Manimala Statistics

Impact of Merging Into a Comprehensive Cancer Center on Health Care Teams and Subsequent Team-Member and Patient Experiences

JCO Oncol Pract. 2022 Oct 14:OP2200280. doi: 10.1200/OP.22.00280. Online ahead of print.

ABSTRACT

PURPOSE: Comprehensive health care centers are increasingly popular as they offer inclusive health care services under one roof. Often, these centers are formed by merging previously separate clinics. However, there is a lack of systematic guidance on the interprofessional, and interteam and intrateam dynamics that may develop during such an organizational change process. Using team process literature, we identify a possible model to explain how merging into a comprehensive cancer center (CCC) might influence health care teams and their subsequent outcomes, including patient experience.

METHODS: We used a mixed-method research design. Qualitative data were collected via semistructured interviews from 20 health care professionals employed at a recently merged CCC. During the time frame the interviews were collected, quantitative data were collected from 50 patients receiving treatment at the cancer center through anonymous paper-pencil surveys. Qualitative interviews were analyzed using thematic analysis, on the basis of the input-process-output team dynamics framework. Descriptive statistics were calculated for patient experience data. Trends between data collections were identified.

RESULTS: On the basis of our qualitative analysis, we provide an input-process-output framework that documents positive and negative aspects of interteam and intrateam dynamics associated with the merger process. Additionally, a number of connections were found between health care professional perceptions and quality patient experiences (eg, merger impacts on interteam and patient communication).

CONCLUSION: Our findings and model may assist in future merging efforts. Future CCCs may use the proposed framework to better understand and visualize their postmerger progress, in particular from the aspects of interprofessional, and interteam and intrateam dynamics.

PMID:36240476 | DOI:10.1200/OP.22.00280

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Nevin Manimala Statistics

The role of ADC value and Ki-67 index in predicting the response to neoadjuvant chemotherapy in advanced stages of olfactory neuroblastoma

Br J Radiol. 2022 Oct 14:20220367. doi: 10.1259/bjr.20220367. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the efficacy of pretreatment ADC and Ki-67 index in the prediction of the response to neoadjuvant chemotherapy (NACT) in advanced olfactory neuroblastoma (ONB) patients.

METHODS: A total of 21 advanced ONB patients (mean 43.48 years ± 14.26; range 25-69 years; 13 men and 8 women) with diffusion weighted imaging (DWI) before NACT between June 2015 and October 2021 were retrospectively analyzed. Patients were categorized into responders and non-responders according to RECIST 1.1 after two cycles of NACT. The clinical data, ADCmean value and Ki-67 index were analyzed.

RESULTS: Kadish stage, ADCmean value and Ki-67 index showed statistical significance between responders and non-responders. Patients with Kadish C stage were more likely to respond to platinum-based NACT (p = 0.035). Patients with the lower ADCmean value showed response to NACT (p = 0.002) and the cutoff point was 1.04 × 10-3 mm2/s. Patients with the higher Ki-67 index showed response to NACT (p = 0.003) and the cutoff point was 17.5%. Predictive performance of Ki-67 index and ADCmean value showed no significance between responders and non-responders (p = 0.865). A significant negative correlation was found between ADCmean value and Ki-67 index (r = -0.539, p = 0.038).

CONCLUSIONS: The pretreatment ADCmean value, Ki-67 index and Kadish stage have the potential to predict the response to NACT in advanced ONB patients.

ADVANCES IN KNOWLEDGE: This is the first study that investigated the feasibility of DWI in predicting the response to NACT in ONB patients, and showed that Kadish stage, pretreatment ADCmean and Ki-67 index may play an important role in the prediction.

PMID:36240450 | DOI:10.1259/bjr.20220367

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Nevin Manimala Statistics

Increasing trend in enterococcal bacteraemia and vancomycin resistance in a tertiary care hospital in Croatia, 2017-2021

Infect Dis (Lond). 2022 Oct 14:1-8. doi: 10.1080/23744235.2022.2131901. Online ahead of print.

ABSTRACT

BACKGROUND: The epidemiology of enterococcal bacteraemia has changed worldwide and vancomycin-resistant enterococci increasingly cause healthcare-associated infections) with limited treatment options. Studies show heterogeneity among countries, regions and individual hospitals.

METHODS: We retrospectively analysed enterococcal bacteraemia with Enterococcus faecalis and E. faecium at the largest hospital in Croatia, University Hospital Centre Zagreb from January 2017 to December 2021.

RESULTS: A total of 432 cases of enterococcal bacteraemia were identified with 256 (59.3%) due to E. faecalis and 176 (40.7%) to E. faecium. Enterococcal bacteraemia occurred more frequently in men (n = 270; 62.5%) and the median age of all patients was 62 years (IQR: 0-92). We found statistically significant increase in the incidence trend of bacteraemic episodes with an annual percent change of 20.9% (95% confidence interval 14.3 to 27.8; p = .002) predominantly due to an increase of E. faecalis bacteraemia. The majority of patients (362/432; 83.8%) had healthcare-associated infections and 38.0% (165/432) of patients were in the intensive care unit. The proportion of vancomycin-resistant enterococcal bacteraemia increased from 12.7% (n = 8/63) in 2017 to 25.7% (n = 29/113) in 2021, statistically significant increasing trend (p = .0455), mainly due to an increased proportion of vancomycin-resistant E. faecium (p = .0169).

CONCLUSIONS: This is the first study describing the trends in enterococcal bacteraemia and vancomycin-resistance in enterococci in Croatia. We found a rising trend in enterococcal bacteraemia and in the proportion of vancomycin resistance and identified the most vulnerable patient groups, notably intensive care unit patients.

PMID:36240424 | DOI:10.1080/23744235.2022.2131901