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Nevin Manimala Statistics

Socio-demographic and clinical characteristics of patients admitted at the Lunatic Asylum, Bengaluru (now NIMHANS) and treatment outcome in the early 20th century (1903-1911)

Asian J Psychiatr. 2021 Jul 2;62:102747. doi: 10.1016/j.ajp.2021.102747. Online ahead of print.

ABSTRACT

OBJECTIVE: Historiography of South Asian mental asylums is generally skewed towards asylums operated by the British. The Lunatic asylum, Bengaluru, later to become NIMHANS, was one of the early asylums and was administered by a princely state (Mysore). This study aims to evaluate socio-demographic and clinical characteristics as well as the treatment outcome of patients admitted to the Lunatic Asylum, Bengaluru in the early 20th century (1903-1911).

METHODS: A review of inpatient registers at the Lunatic Asylum, Bengaluru was conducted for the years 1903-1911 and analysed using descriptive statistical methods.

RESULTS: There were 620 admissions during this period and three-fourths were men (n = 465, 75.0 %). The mean age of the patients was 32.09 ± 10.29 years at the time of admission. Acute mania (n = 209, 33.7 %), chronic mania (n = 125, 20.2 %) and dementia (n = 65, 10.5 %) were the most frequent diagnoses. At the time of discharge, 35.5 % reported being cured and 12.1 % improved. The overall death rate of patients at the asylum was 27.2 %. Subjects who died had a mean duration of in-patient stay of 11.9 years. The mean age at death was 45.7 years with the comparable life-expectancy of the general population during the period being around 23 years.

CONCLUSIONS: In-patients in the Lunatic Asylum, Bengaluru in the pre-antipsychotic era had a good outcome with approximately 50 % being cured or showing improvement and longer life expectancy than the general population.

PMID:34246064 | DOI:10.1016/j.ajp.2021.102747

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Nevin Manimala Statistics

Fracture toughness of dental incremental composite-composite interfaces at elevated temperatures

J Mech Behav Biomed Mater. 2021 Jun 25;122:104655. doi: 10.1016/j.jmbbm.2021.104655. Online ahead of print.

ABSTRACT

The aim of the present laboratory study was to mechanically characterize the interface between two dental resin-based composite (RBC) increments, and to investigate if elevated temperatures have an influence on the quality of the interface mimicking clinical filling procedure. Four RBCs (CLEARFIL MAJESTY™ Posterior, Kuraray (CMP)/Filtek™ Supreme XTE, 3M (FSX)/Grandio®SO, VOCO (GSO)/VisCalor® bulk, VOCO (VCB)) were tested with a fracture toughness test using Chevron notched beams (KI,CNB) at 23, 37 and 54 °C. KI,CNB specimens (3 × 4x25mm) with a V-shaped notch at the incremental interface were loaded until failure in a 4-point bending set-up. Failure modes were characterized using light microscopy, microstructural interface was analyzed using SEM. Statistical analysis was performed using Kolmogorov-Smirnoff test, two-way ANOVA and Tukey Post-Hoc test (p = 0.05). Mean KI,CNB ranged between 0.73 ±0.14 MPam0.5 (VCB, 23 °C) and 1.11 ± 0.11 MPam0.5 (FSX, 23 °C). The tested conventional highly filled RBCs presented fracture toughness at the incremental interface comparable to the cohesive strength of the bulk materials. VCB showed reduced interfacial fracture toughness at 23 and 37 °C, but performed well at elevated temperature of 54 °C.

PMID:34246080 | DOI:10.1016/j.jmbbm.2021.104655

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Nevin Manimala Statistics

Complications of tunneled peripherally inserted and tunneled-cuffed central catheters in home parenteral nutrition

Nutrition. 2021 May 26;91-92:111354. doi: 10.1016/j.nut.2021.111354. Online ahead of print.

ABSTRACT

OBJECTIVES: We sought to compare complications associated with tunneled peripherally inserted central catheters (tPICCs) and tunneled-cuffed centrally inserted central catheters (tCICCs) in adult home parenteral nutrition (HPN).

METHODS: The study (2017-2019) identified 257 people with type III chronic intestinal failure requiring HPN. The data were analyzed for tPICC- and tCICC-related complications. The rate of catheter-related complications was recorded as the number of complications analyzed per 1000 d of catheter use, and rates were compared using the Mann-Whitney Wilcoxon test.

RESULTS: A total of 273 venous access devices were included to the analyses: 150 (55%) non-cuffed tPICCs and 123 (45%) tCICCs. In-dwelling time for tPICCs and tCICCs were 23 045 and 43 789 catheter d, respectively. Median (interquartile range) catheter days and duration of HPN, for tPICCs and tCICCs, were respectively 119 (166) and 324 (314) d and 108 (159) and 324 (322) d. The overall complication rates per 1000 catheter d for tPICCs and tCICCs were 1.52 and 0.8, respectively (P = 0.565). On analysis, there was no statistical difference between complication rates per 1000 catheter d. The removal rate and conversion ratio due to complications were similar for tPICCs and tCICCs.

CONCLUSIONS: Both tPICCs and tCICCs have similar complication rates per 1000 d. This study highlights that tCICCs, the preferred and currently used venous access devices in HPN, can be effectively and safely replaced by tPICCs, depending on the indications.

PMID:34246088 | DOI:10.1016/j.nut.2021.111354

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Prevalence of dysphonia due to COVID-19 at Salahaddin General Hospital, Tikrit City, Iraq

Am J Otolaryngol. 2021 Jun 29;42(5):103157. doi: 10.1016/j.amjoto.2021.103157. Online ahead of print.

ABSTRACT

BACKGROUND: Dysphonia is a feature of the COVID-19 disease with different prevalence rates of occurrence among various nations.

OBJECTIVES: To determine the prevalence of dysphonia in hospitalized patients with COVID-19 disease.

MATERIALS AND METHODS: The study was conducted at Salahaddin General Hospital during the period from January to March 2021. Hospitalized COVID-19 patients with or without dysphonia were enrolled in the study. Demographic and clinical data were recorded. The severity, duration, laryngoscopic finding, and fate of the dysphonia were registered too.

RESULTS: Out of 94 subjects, there were 21 (22.3%) with dysphonia. The age was ranged from 23 to 101 years, with nearly equal gender distribution. Non-smokers were found in 52.1% of the cases. Dyspnea (100%), fever (100%), and cough (98.9%) were the most common presenting symptoms. There was a statistically significant difference between the dysphonic and non-dysphonic groups regarding fatigue, nasal obstruction, and diarrhea (P-value<0.05). Mild dysphonia was found in 10 (47.6%) of the dysphonic cases. The most common laryngoscopic finding was the bowing of the vocal cords (5/18). Most of the patients (11/18) were with dysphonia for more than a month duration. Similar numbers were not recovered for a one-month follow-up.

CONCLUSION: The prevalence of dysphonia was 22.3%. Dyspnea, fever, and cough were the commonest symptoms. Fatigue, nasal obstruction, and diarrhea affected dysphonia. Bowing of the vocal cords was the most common abnormality. Most of the cases were with mild dysphonia, persisting for more than a month, and were not resolved during the follow-up period of one month.

PMID:34246025 | DOI:10.1016/j.amjoto.2021.103157

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Nevin Manimala Statistics

Response of antimony distribution in street dust to urban road traffic conditions

J Environ Manage. 2021 Jul 7;296:113219. doi: 10.1016/j.jenvman.2021.113219. Online ahead of print.

ABSTRACT

Little is known about the relationship between traffic congestion and antimony (Sb) distribution in street dust, which is essential for Sb control and emission reduction in urban areas. Sb concentrations and mass load of the street dust collected in 19 cities of China were determined before investigating the mechanism of traffic influence on Sb distribution through diverse statistical means. The results showed that the Sb concentrations in each city were 1.10-4.76 times higher than the local background values. Sb concentrations in transportation areas were significantly higher than those in residential and industrial areas, and were significantly affected by road network density. The effect of congestion on Sb load of street dust was influenced by vehicle flowrate. Only when the vehicle flowrate was high, the traffic congestion would promote the increase of Sb load obviously. The improved accounting method showed that the Sb dissipation from brake wear in major Chinese cities were higher than that in Stockholm, Sweden, in 2005. The latent path analysis illustrated that a 1% increase in congestion index was correlated with a 0.886% increase in the Sb load. Compared with Switzerland, which has a typical industrialized Sb consumption pattern, China needs to recycle brake pads in addition to taking various measures to alleviate traffic congestion and reduce brake pad wear, despite the fact that the maximum health risk of Sb was far below the safety threshold. This study will provide valuable insights for urban traffic management and brake pad recycling.

PMID:34246026 | DOI:10.1016/j.jenvman.2021.113219

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Ovarian Sertoli-Leydig cell tumours: A systematic review of relapsed cases

Eur J Obstet Gynecol Reprod Biol. 2021 Jun 28;263:261-274. doi: 10.1016/j.ejogrb.2021.06.036. Online ahead of print.

ABSTRACT

OBJECTIVE: To synthesize the evidence on Sertoli-Leydig cell tumour (SLCT) relapses, and identify the clinicopathological characteristics and prognosis of patients with recurrent SLCT.

METHODS: A literature search was undertaken of all published cases of SLCT relapse found in PubMed, Embase and Web of Science databases between January 1998 and January 2021. All articles in English reporting at least one case of SLCT relapse and mentioning the relapse location or the follow-up data were included. All reported data on relapsed cases were extracted. Student’s t-test and Chi-squared test were used for the descriptive analysis, and the Kaplan-Meier statistical method was applied for survival analysis.

RESULTS: Eighty-five patients from 33 articles were included in this review. The median age was 20 years (range 3-76 years) with a median time to relapse of 14 months (range 1-168 months). Forty-eight percent (36/75) of relapses were local and 52% (39/75) were distant. In the subgroup of conservative primary surgery, contralateral ovarian SLCT events (metachronous or recurrent) were more frequent in the paediatric population than in the adult population (58.3 vs 18.2%; p = 0.005). Eleven cases had multiple relapses. Twenty-one percent (12/57) of cases were treated with conservative surgery after recurrence, and 64.9% (37/57) of cases were treated with radical surgery which tends to have a better 2-year survival rate (78.5% vs 61.0%; p = 0.177). Overall median survival was 48 months after recurrence (95% confidence interval ±21.0 months) with overall 5-year survival of 38.9%. The mean survival time was significantly higher for patients diagnosed at an early stage (I and II) compared with patients diagnosed at an advanced stage (p = 0.003).

DISCUSSION: The results showed that SLCT relapses have a poor prognosis and occur mainly in young patients, soon after the initial diagnosis. The majority of SLCT relapses are located in the abdominopelvic region. Contralateral ovarian SLCT events (metachronous or recurrent) occurred more frequently in paediatric cases. Multi-modal treatment with surgery and chemotherapy appears to be the best approach. The best chemotherapeutic regimen has yet to be defined.

PMID:34245994 | DOI:10.1016/j.ejogrb.2021.06.036

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Nevin Manimala Statistics

Possibility to discriminate benign from malignant breast lesions detected on dual-layer spectral CT-evaluation

Eur J Radiol. 2021 Jun 24;142:109832. doi: 10.1016/j.ejrad.2021.109832. Online ahead of print.

ABSTRACT

OBJECTIVES: Intramammary mass lesions are reportedly present in up to 5.8% of all contrast enhanced CT-examinations of the female chest. We aimed to assess whether their biological relevance can be estimated using spectral CT-datasets.

METHODS: In this bicentric retrospective study patients with breast masses visualized on spectral CT-examinations from 07/2017 to 06/2019 were included. Lesions were characterized as malignant or benign based on histology and/or a stable follow-up of >2 years. Conventional CT-images, iodine density-maps, virtual monoenergetic-images (40 keV, 100 keV) and Zeffective-maps were evaluated by two independent readers. Statistical analysis derived from the Regions of interest (ROIs) was done by calculating the Areas under the Receiver operating characteristic (ROC) curve (AUC) and Youden-indices.

RESULTS: 106 breast masses (malignant/benign: 81/25, 76.4%/23.6%) were included. The mean AUCs of the variables “iodine content” (reader 1/2:0.97;0.98), “monoenergetic curve-slope” (0.97;0.96) and “Zeffective” (0.98;0.98) measured in the target lesions (TL) showed superior results compared to those derived from the variable “density” (0.92;0.93) (p < 0.001). The ratios “TL to aorta” calculated for the variables “iodine content”, “monoenergetic curve-slope” and “Zeffective” showed superior results compared to normal breast tissue and muscle (p < 0.001). The optimal cutpoint for the “iodine content” in the TL was 0.7-0.9 mg/ml (sensitivity 96.6%, specificity 91.7%). The best diagnostic results were achieved by normalizing the iodine content in the TL to that in the aorta (optimal cutpoint 0.1, sensitivity 95.5%, 98.9%, specificity 91.7%).

CONCLUSIONS: Our preliminary results suggest that spectral CT-datasets might allow to estimate the biological dignity of breast masses detected on clinically indicated chest-examinations.

PMID:34246013 | DOI:10.1016/j.ejrad.2021.109832

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Nevin Manimala Statistics

Characteristics of mHealth app use in an international sample of people with multiple sclerosis

Mult Scler Relat Disord. 2021 Jun 22;54:103092. doi: 10.1016/j.msard.2021.103092. Online ahead of print.

ABSTRACT

The management of multiple sclerosis (MS) has progressed significantly with the emergence of mHealth technologies. Uptake of mHealth apps amongst people with MS, and clinical and demographic characteristics of mHealth adopters is unknown outside North America. Participants of the HOLISM study were queried about their mHealth apps use. We summarize mHealth app usage, and clinical and demographic characteristics of mHealth app adopters using descriptive statistics. Overall, 3.1% of respondents reported using an mHealth app, most of whom were located in Australasia and North America. This study provides insight regarding mHealth app usage within a large international cohort of people with MS.

PMID:34246024 | DOI:10.1016/j.msard.2021.103092

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Nevin Manimala Statistics

A Randomized Trial on Clinical Outcomes and Stent Related Symptoms Following Intraureteral Stent on a String versus Conventional Stent Placement

BJU Int. 2021 Jul 10. doi: 10.1111/bju.15540. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVE: To minimize stent-related symptoms (SRS), a modified complete intra-ureteral stent with extraction suture was designed. The objective was to compare SRS of the conventional DJ stent and the complete intraureteral stent using the validated Ureteral Stent Symptom Questionnaire (USSQ).

MATERIALS AND METHODS: We randomized 124 patients after uncomplicated ureteroscopic lithotripsy into complete intraureteral stent (CIUS) and conventional DJ stent (CUS) placement group. The USSQ scores were evaluated on postoperative day 1, day 7 (just before stent removal) and 4 weeks after stent removal (control values). Pain scores after stent removal were also recorded using visual analogue scale (VAS). Sub-domain analysis of all stent related symptoms and stent related complications were also compared.

RESULTS: No significant intergroup differences were found in the domain scores of urinary symptoms (P = 0.74), pain (P = 0.32), general health (P = 0.27), work (P = 0.24), or additional problems (P = 0.29). However, statistically significant difference was noted on VAS scores (P = 0.015). Analysis of sub-domains of USSQ item scores revealed the CIUS group had significantly better scores for ”urge incontinence” (1.21 vs. 1.00; p = <0.001), ”discomfort on voiding” (2.07 vs. 1.50; p = <0.001), ”difficulties with respect to light physical activity” (1.131 vs. 1.00; p = <0.001), ”fatigue” (1.84 vs. 1.57; p = 0.002), “feeling comfortable” (3.68 vs. 3.16; p = 0.003), ”need for extra help” (1.96 vs. 1.00; p = <0.001), and ”change in duration of work”(4.27 vs. 1.86; p = <0.001). However, the patients in the CIUS group were sexually inactive for the time till stent was indwelling (mean: 7.34 days). There was no difference in the complication rate between the 2 groups.

CONCLUSION: The use of complete intra ureteral stent placement with strings after URS decreases SRS.

PMID:34245667 | DOI:10.1111/bju.15540

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Population genomics reveals variable patterns of immune gene evolution in monarch butterflies (Danaus plexippus)

Mol Ecol. 2021 Jul 10. doi: 10.1111/mec.16071. Online ahead of print.

ABSTRACT

Humoral and cellular immune responses provide animals with major defenses against harmful pathogens. While it is often assumed that immune genes undergo rapid diversifying selection, this assumption has not been tested in many species. Moreover, it is likely that different classes of immune genes experience different levels of evolutionary constraint, resulting in varying selection patterns. We examined the evolutionary patterns for a set of 91 canonical immune genes of North American monarch butterflies (Danaus plexippus), using as an outgroup the closely related soldier butterfly (D. eresimus). As a comparison to these immune genes, we selected a set of control genes that were paired with each immune for approximate size and genomic location. As a whole, these immune genes had a significant but modest reduction in Tajima’s D relative to paired-control genes, but otherwise did not show distinct patterns of population genetic variation or evolutionary rates. When further partitioning these immune genes into four functional classes (recognition, signaling, modulation, and effector), we found distinct differences among these groups. Relative to control genes, recognition genes exhibit increased non-synonymous diversity and divergence, suggesting reduced constraints on evolution, and supporting the notion that coevolution with pathogens results in diversifying selection. In contrast, signaling genes showed an opposite pattern of reduced diversity and divergence, suggesting evolutionary constraints and conservation. Modulator and effector genes showed no statistical differences from controls. These results are consistent with patterns found in immune genes in fruit flies and Pieris butterflies, suggesting that consistent selective pressures on different classes of immune genes broadly govern the evolution of innate immunity among insects.

PMID:34245613 | DOI:10.1111/mec.16071