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Nevin Manimala Statistics

Deep-learning prediction of amyloid deposition from early-phase amyloid positron emission tomography imaging

Ann Nucl Med. 2022 Aug 1. doi: 10.1007/s12149-022-01775-z. Online ahead of print.

ABSTRACT

OBJECTIVE: While the use of biomarkers for the detection of early and preclinical Alzheimer’s Disease has become essential, the need to wait for over an hour after injection to obtain sufficient image quality can be challenging for patients with suspected dementia and their caregivers. This study aimed to develop an image-based deep-learning technique to generate delayed uptake patterns of amyloid positron emission tomography (PET) images using only early-phase images obtained from 0-20 min after radiotracer injection.

METHODS: We prepared pairs of early and delayed [11C]PiB dynamic images from 253 patients (cognitively normal n = 32, fronto-temporal dementia n = 39, mild cognitive impairment n = 19, Alzheimer’s disease n = 163) as a training dataset. The neural network was trained with the early images as the input, and the output was the corresponding delayed image. A U-net convolutional neural network (CNN) and a conditional generative adversarial network (C-GAN) were used for the deep-learning architecture and the data augmentation methods, respectively. Then, an independent test data set consisting of early-phase amyloid PET images (n = 19) was used to generate corresponding delayed images using the trained network. Two nuclear medicine physicians interpreted the actual delayed images and predicted delayed images for amyloid positivity. In addition, the concordance of the actual delayed and predicted delayed images was assessed statistically.

RESULTS: The concordance of amyloid positivity between the actual versus AI-predicted delayed images was 79%(κ = 0.60) and 79% (κ = 0.59) for each physician, respectively. In addition, the physicians’ agreement rate was at 89% (κ = 0.79) when the same image was interpreted. And, the actual versus AI-predicted delayed images were not readily distinguishable (correct answer rate, 55% and 47% for each physician, respectively). The statistical comparison of the actual versus the predicted delated images indicated that the peak signal-to-noise ratio (PSNR) was 21.8 dB ± 2.2 dB, and the structural similarity index (SSIM) was 0.45 ± 0.04.

CONCLUSION: This study demonstrates the feasibility of an image-based deep-learning framework to predict delayed patterns of Amyloid PET uptake using only the early phase images. This AI-based image generation method has the potential to reduce scan time for amyloid PET and increase the patient throughput, without sacrificing diagnostic accuracy for amyloid positivity.

PMID:35913591 | DOI:10.1007/s12149-022-01775-z

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The role of urethral ligation after AUS failure and end stage urethra

Int Urol Nephrol. 2022 Aug 1. doi: 10.1007/s11255-022-03315-0. Online ahead of print.

ABSTRACT

PURPOSE: To provide our single-center experience with an approach to refractory stress urinary incontinence (SUI) with permanent urethral ligation (PUL) and suprapubic tube (SPT) placement, in hopes of contributing to the limited body of research surrounding this surgical treatment option for patients with end-stage urethra (ESU).

METHODS: All patients undergoing PUL with SPT placement from 01/01/2018 to 04/30/2022 were identified from an institutional database. Institutional Review Board exempt status was granted for the conduct of this study. Patients were seen postoperatively at 1 month and 1 year. If there were any concerns of incontinence, an antegrade urethrogram via the SPT was performed. Descriptive statistics were used to evaluate patients.

RESULTS: Seven patients underwent PUL with SPT in our timeframe and were included in the study. All patients previously had an AUS placed, and two patients had a urethral sling previously placed. The median follow-up time was 21 months, ranging between 2 and 48 months. Complications included bladder spasms (43%) and continued leakage per urethra (14%). Of the 7 patients, 6 have reported continence through their urethra at their most recent follow-up.

CONCLUSION: This initial data suggest that PUL with SPT placement may be a viable surgical approach to treating refractory SUI, especially for patients with ESU who wish to avoid the morbidity associated with more formal supravesical diversion. Further study of this technique and longer follow-up is required to determine its long-term efficacy and tolerability for patients.

PMID:35913590 | DOI:10.1007/s11255-022-03315-0

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Analysis of the Geographic Transmission Differences of COVID-19 in China Caused by Population Movement and Population Density

Bull Math Biol. 2022 Aug 1;84(9):94. doi: 10.1007/s11538-022-01050-2.

ABSTRACT

The coronavirus disease (COVID-19) has led to a global pandemic and caused huge healthy and economic losses. Non-pharmaceutical interventions, especially contact tracing and social distance restrictions, play a vital role in the control of COVID-19. Understanding the spatial impact is essential for designing such a control policy. Based on epidemic data of the confirmed cases after the Wuhan lockdown, we calculate the invasive reproduction numbers of COVID-19 in the different regions of China. Statistical analysis indicates a significant positive correlation between the reproduction numbers and the population input sizes from Wuhan, which indicates that the large-scale population movement contributed a lot to the geographic spread of COVID-19 in China. Moreover, there is a significant positive correlation between reproduction numbers and local population densities, which shows that the higher population density intensifies the spread of disease. Considering that in the early stage, there were sequential imported cases that affected the estimation of reproduction numbers, we classify the imported cases and local cases through the information of epidemiological data and calculate the net invasive reproduction number to quantify the local spread of the epidemic. The results are applied to the design of border control policy on the basis of vaccination coverage.

PMID:35913582 | DOI:10.1007/s11538-022-01050-2

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Human epididymis protein 4 (HE4) is a novel immunohistochemical marker of neuroendocrine differentiation

Virchows Arch. 2022 Aug 1. doi: 10.1007/s00428-022-03387-4. Online ahead of print.

ABSTRACT

Human epididymis protein 4 (HE4) is originally described as an epididymis specific protein and now clinically used as a serum marker for ovarian carcinoma. However, the expression of HE4 in neuroendocrine neoplasms (NENs) has not been studied. By immunohistochemistry, the expressions of HE4 in 94 normal tissues and 484 NENs which included 242 well-differentiated NENs and 242 poorly differentiated NENs were studied. HE4 was positive in 90/94 (95.7%) of the neuroendocrine cells in normal tissues, 228/242 (94.2%) of well-differentiated NENs, and 206/242 (85.1%) of poorly differentiated NENs, and the expression of HE4 decreased progressively with loss of histological differentiation, with the positive rate of 96.2%, 92.7%, 92.3%, 85.4%, and 84.4% in NET-G1/carcinoid, NET-G2/atypical carcinoid, NET-G3, NEC-LC, and NEC-SC respectively. In NET-G1 and NET-G2, HE4 staining showed a peculiar polarized distribution, with an extraordinarily strong granular staining in subnuclear cytoplasm. A diffuse and uniform cytoplastic HE4 staining was observed in NET-G3 and poorly differentiated NENs. The positive rate of HE4 in primary tumors (91.1%, 387/425) was significantly higher than that of metastases (79.7%, 47/59) (p < 0.05). In a series of 70 pure non-NENs poorly differentiated carcinomas, the specificity rate of HE4 was 92.9% (65/70), which was in line with that of Syn. The negative rate of HE4 was 87.0% (40/46) in the non-neuroendocrine components of the MiNEN cases, which was lower than that of the pure non-neuroendocrine carcinomas (92.9%, 65/70) but without statistical significance (p > 0.05). HE4 may prove to be a useful immunohistochemical marker of neuroendocrine differentiation, although comparative studies and a more extensive analysis of other tissue types are necessary.

PMID:35913578 | DOI:10.1007/s00428-022-03387-4

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The role of physical activity promoting thinking skills and emotional behavior of preschool children

Psicol Reflex Crit. 2022 Aug 1;35(1):24. doi: 10.1186/s41155-022-00223-1.

ABSTRACT

OBJECTIVES: Physical activity is critical, not only for the normal growth and development of children, but also for emotional and social behavior. The purpose of the article is to determine the relationship between physical education and social and emotional development of preschool children.

METHODS: The study involved 366 children (188 boys and 178 girls) at the ages of 5 (N = 191) and 6 (N = 174), who study in public kindergartens in Beijing (China). Within 3 months, additional physical education and fitness classes were held. Before and after the study, a test was conducted: Ages & Stages Questionnaires: Social-Emotional (ASQ:SE), which was completed by the parents. The research process did not affect the performance or development of children participants.

RESULTS: As a result of the study, the main regularities of the influence of physical education on social and emotional behavior of children were established. Based on the results of the study, it was determined that there is a positive correlation between age, physical education, and social-emotional behavior (r +-= 0.668).

CONCLUSION: Gender differences are not statistically significant when it comes to physical activity’s effect on social and emotional behavior (p-value = 0.004). The results can be applied to programs for the prevention of psychosocial and social-emotional development delays of children in kindergartens.

PMID:35913559 | DOI:10.1186/s41155-022-00223-1

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Effect of refractive status on retinal nerve fiber layer thickness in Chinese Population

Graefes Arch Clin Exp Ophthalmol. 2022 Aug 1. doi: 10.1007/s00417-022-05753-z. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the relationship between retinal nerve fiber layer (RNFL) thickness and other related parameters measured by spectral-domain optical coherence tomography and the refractive error of eyes.

METHODS: A total of 5394 subjects were enrolled in this population-based cohort study, who were divided into three groups by refractive state after they underwent a standardized ophthalmic examination: emmetropia (the absolute value should range from 0 to 0.5 D), low-moderate myopia (the absolute value of myopic error should range from 0.5 to 6 D), and high myopia (the absolute value of myopic error should be over than 6 D). R 3.6.1 software was adopted for statistical analysis.

RESULTS: Two thousand five hundred fifty-two subjects (4548 eyes) were collected in this study, with an average age of 53.14 ± 10.64 years. There were significant differences among groups in average central corneal curvature, spherical equivalent, and axial length (P < 0.001). The measurements of average retinal nerve fiber layer (RNFL) were 113.95 ± 10.62 μm, 112.97 ± 11.59 μm, and 101.88 ± 15.67 μm, respectively, in the emmetropia, low-moderate, and high myopia groups (P < 0.001). Meanwhile, there was a decreasing trend of cup area, cup volume, disc area, and rim area in the high myopia group compared with the emmetropia group (P < 0.001).

CONCLUSION: The measurements of RNFL thickness vary greatly with refractive error, and this study indicated that it is of great significance for the accurate diagnosis of glaucoma to establish an individualized RNFL thickness database.

PMID:35913557 | DOI:10.1007/s00417-022-05753-z

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Impact evaluation of the run-of-river hydropower projects on the water quality dynamics of the Sindh River in the Northwestern Himalayas

Environ Monit Assess. 2022 Aug 1;194(9):626. doi: 10.1007/s10661-022-10303-5.

ABSTRACT

As the run-of-river (RoR) hydropower projects remain understudied, we conducted this study to understand how these projects affect the hydro-chemical dynamics and water quality index (WQI) of the Sindh River in the Kashmir Himalayas. We used multivariate statistical techniques and WQI to identify the spatiotemporal dynamics of 18 physico-chemical parameters from 11 sampling stations distributed along the length of river Sindh from December 2017 to December 2019. The dataset was classified into three groups using hierarchical cluster analysis based on similarities between hydro-chemical characteristics, and the results were confirmed by discriminant analysis. Wilk’s quotient distribution further showed that ions, nutrients, free carbon dioxide, water temperature, and pH contributed to the formation of clusters. Principle component analysis revealed that the chloride (Cl), total phosphorus (TP), ortho-phosphorus (PO4-P), nitrate-nitrogen (NO3-N), nitrite-nitrogen (NO2-N), and sulfate ion (SO42-) are significant factors that influence the water quality. Furthermore, our results suggest that diverting water for RoR operation did not significantly raise the WQI value to the point where water in the bypassed reaches could be declared unfit for drinking. Our analysis concluded that inclusive assessments are vital for framing policies on expanding RoR hydropower in the region.

PMID:35913530 | DOI:10.1007/s10661-022-10303-5

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Efficacy of nivolumab as second line treatment for recurrent or metastatic head and neck squamous cell carcinoma: a national DAHANCA cohort study

Acta Oncol. 2022 Aug 1:1-7. doi: 10.1080/0284186X.2022.2103387. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to investigate phase IV efficacy, of the PD-1 inhibitor nivolumab among an unselected and unbiased national cohort of recurrent/metastatic Head and Neck Squamous Cell Carcinoma (rmHNSCC) patients.

MATERIAL AND METHODS: Inclusion criteria included histologically confirmed rmHNSCC and nivolumab as a second-line palliative treatment. Data were collected from patient files at the five Danish head and neck cancer centers and from the DAHANCA database. The iRECIST criteria were used for treatment evaluation.Endpoints were response rate (RR), overall survival (OS), and progression-free survival (PFS), calculated from the start of treatment to the date of event/censoring by the KM-method. Descriptive statistics were used to describe patients and treatment. Analyses were two-sided, with p < .05 considered significant.

RESULTS: A total of 146 patients were identified in the period 2017-2020. They had a RR of 14%, median OS of 10.2 months [95% CI: 8.2-12.2] and median PFS of 3.1 months [95% CI: 2.3-4.2]. Patient age (≥ 70 years) or comorbidity did not significantly affect outcome. WHO performance status (PS) =1 was associated with an increased risk of death (HR: 2.1 [95% CI: 1.2-4.0], p = .02) and progression (HR: 1.9 [95% CI: 1.2-3.2], p = .01). Concomitant glucocorticoid-treatment during immunotherapy (≥ 50% of treatment time) appeared important for risk of death (HR: 6.4 [95% CI: 2.3-17.8], p < .001) and risk of progression (HR: 4.8 [95% CI: 1.8-12.5], p = .001). PD-L1 expression ≥ 20% was associated with a lowered risk of progression (HR: 0.5 [95% CI: 0.3-0.7], p = .001), but not lowered risk of death.

CONCLUSION: In this unselected national cohort, outcome of second-line treatment reflects data from the registration studies. Furthermore, the results suggest that immunotherapy should be used with great care in treatment of rmHNSCC in patients with poor performance.

PMID:35913523 | DOI:10.1080/0284186X.2022.2103387

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Biotics in neonatal period: what’s the evidence?

Minerva Pediatr (Torino). 2022 Aug 1. doi: 10.23736/S2724-5276.22.06968-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Breastfeeding is considered the gold standard for infants’ nutrition and provides unique benefits for infants’ health.

EVIDENCE ACQUISITION: Great research interest has been raised about the use of bioactive components in neonatal medicine, both as standalone products and as addition to infant formula, in the attempt to reproduce human milk beneficial effects. Thus, the aim of this narrative review is to summarize most recent evidence on biotics’ use in the neonatal period, with a focus on infant formula (IF) supplemented with probiotics, prebiotics, synbiotics and postbiotics.

EVIDENCE SYNTHESIS: Growing data indicate overall positive effects of biotic supplemented formula on microbiome composition and metabolic activity. Furthermore, some benefits are also emerging from randomized controlled trials (RCTs) evaluating the clinical impact these enriched formulas may have on the health of formula fed infants. However, clear evidence still lacks and none of this supplemented IF has demonstrated conclusive superiority.

CONCLUSIONS: To date, whereas no routine recommendations can be done, biotics supplemented IF have generally proven to be well-tolerated and safe in ensuring infants’ normal growth, paving the way for future IF alternatives for those infants who are not able to be (fully) breastfed. More RCTs, with adequate design and statistical power, are still needed to better clarify, if present, which benefits the supplementation of IF may confer to infants’ short and long-term outcomes.

PMID:35912792 | DOI:10.23736/S2724-5276.22.06968-3

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Prevalence, characteristics, contributing factors, work sector, and impact of work-related musculoskeletal disorders among otorhinolaryngology practitioners in Saudi Arabia: A cross-sectional study

Work. 2022 Jul 24. doi: 10.3233/WOR-211054. Online ahead of print.

ABSTRACT

BACKGROUND: Otorhinolaryngology practitioners are known to be susceptible to work-related musculoskeletal disorders (WMSDs), but the incidence of WMSDs in Saudi Arabia has not been documented.

OBJECTIVES: This study aimed to establish the prevalence, characteristics, contributing factors, work sector, and impact of WMSDs among otorhinolaryngology practitioners in Saudi Arabia.

METHODS: A cross-sectional survey was conducted on 104 otorhinolaryngology practitioners in Saudi Arabia using a six-component questionnaire. Descriptive statistics, prevalence, percentages, and chi-square tests were used for data analysis.

RESULTS: The response rate was 65.3% . The reported 12-month incidence of WMSDs was 72.7% . The neck region (67.3%) was the most common site of disorders, followed by the shoulder (49%). The elbow and hip (10.5%) regions were the least commonly affected regions. WMSD prevalence was related to gender, with men more affected than women (neck, shoulders, low back); age, with younger otorhinolaryngology practitioners more affected than older ones (neck, shoulder); work sector, with greater prevalence in government than other sectors (neck); and sub-specialty, with general otolaryngology reporting the highest WMSD frequency, followed by otology and neurotology (neck, shoulder, low back, upper back, knees). Most otorhinolaryngology practitioners experienced two to four episodes of neck, shoulder, and low-back WMSDs. The most significant risk factor for WMSDs was sustained posture for long periods of time (61.5%). The most common strategy implemented against WMSDs was modifying the practitioner’s position during treatment (58.6%).

CONCLUSIONS: WMSDs among otorhinolaryngology practitioners in Saudi Arabia are very common, with the neck and shoulders regions most often involved. Improved professional skills and an understanding of the principles of ergonomics can prevent the initial development of WMSDs in otorhinolaryngology practitioners.

PMID:35912780 | DOI:10.3233/WOR-211054