Tag: pubmed

Dermatology. 2021 Apr 13:1-8. doi: 10.1159/000515158. Online ahead of print.

ABSTRACT

BACKGROUND: Mobile teledermoscopy is an emerging technology that involves imaging and digitally sending dermoscopic images of skin lesions to a clinician for assessment. High-quality, consistent images are required for accurate telediagnoses when monitoring lesions over time. To date there are no tools to assess the quality of sequential images taken by consumers using mobile teledermoscopy. The purpose of this study was to develop a tool to assess the quality of images acquired by consumers.

METHODS: Participants imaged skin lesions that they felt were concerning at baseline, 1-, and 2-months. A checklist to assess the quality of consumer sequential imaging of skin lesions was developed based on the International Skin Imaging Collaboration guidelines. A scale was implemented to grade the quality of the images: 0 (low) to 18 (very high). Intra- and inter-reliability of the checklist was assessed using Bland-Altman analysis. Using this checklist, the consistency with which 85 sets of images were scored by 2 evaluators were compared using Kappa statistics. Items with a low Kappa value <0.4 were removed.

RESULTS: After reliability testing, 5 of the items were removed due to low Kappa values (<0.4) and the final checklist included 13 items surveying: lesion selection; image orientation; lighting; field of view; focus and depth of view. Participants had a mean age of 41 years (range 19-73), and 67% were female. Most participants (84%, n = 71/85) were able to select and image the correct lesion over time for both the dermoscopic and overview images. Younger participants (<40 years old) scored significantly higher (8.1 ± 2.1) on the imaging checklist compared to older participants (7.1 ± 2.4; p = 0.037). Participants had most difficulty with consistent image orientation.

CONCLUSIONS: This checklist could be used as a triage tool to filter images acquired by consumers prior to telediagnosis evaluation, which would improve the efficiency and accuracy of teledermatology and teledermoscopy processes. It may also be used to provide feedback to the consumers to improve image acquisition over time.

PMID:33849022 | DOI:10.1159/000515158

J Environ Manage. 2021 Apr 10;289:112522. doi: 10.1016/j.jenvman.2021.112522. Online ahead of print.

ABSTRACT

COVID-19 pandemic has caused profound impacts on human life and the environment including freshwater ecosystems globally. Despite the various impacts, the pandemic has improved the quality of the environment and thereby creating an opportunity to restore the degraded ecosystems. This study presents the imprints of COVID-19 lockdown on the surface water quality and chemical characteristics of the urban-based Bagmati River Basin (BRB), Nepal. A total of 50 water samples were collected from 25 sites of BRB during the monsoon season, in 2019 and 2020. The water temperature, pH, electrical conductivity, total dissolved solids, dissolved oxygen (DO), and turbidity were measured in-situ, while the major ions, total hardness, biological oxygen demand (BOD), and chemical oxygen demand (COD) were analyzed in the laboratory. The results revealed neutral to mildly alkaline waters with relatively moderate mineralization and dissolved chemical constituents in the BRB. The average ionic abundance followed the order of Ca²⁺ > Na⁺ > Mg²⁺ > K⁺ > NH₄⁺ for cations and HCO₃^–> Cl^– > SO₄^2- > NO₃^– > PO₄^3- for anions. Comparing to the pre-lockdown, the level of DO was increased by 1.5 times, whereas the BOD and COD were decreased by 1.5 and 1.9 times, respectively during the post-lockdown indicating the improvement of the quality water which was also supported by the results of multivariate statistical analyses. This study confirms that the remarkable recovery of degraded aquatic ecosystems is possible with limiting anthropic activities.

PMID:33848878 | DOI:10.1016/j.jenvman.2021.112522

Child Abuse Negl. 2021 Apr 10;117:105069. doi: 10.1016/j.chiabu.2021.105069. Online ahead of print.

ABSTRACT

BACKGROUND: Adult substance use contributes to high rates of child maltreatment, adverse parenting, and poor child well-being outcomes. The Children’s Bureau in the Administration for Children and Families, U.S. Department of Health and Human Services funded the Regional Partnership Grant (RPG) program to improve safety, well-being, and permanency outcomes for children at risk of or in out-of-home placements because of caregivers’ substance use.

OBJECTIVE: This study estimates the effect of the RPG program on adult parenting and recovery outcomes, as well as child safety, permanency, and well-being outcomes.

PARTICIPANTS AND SETTING: This study included samples from three RPG projects funded in 2014. A total of 437 families were included in the evaluation: 198 enrolled in RPG and 239 in the comparison group.

METHODS: Outcomes included both administrative data and standardized instruments collected at program entry and exit. Impacts were calculated by comparing regression-adjusted differences between RPG participants and a well-matched comparison group.

RESULTS: The RPG program showed two favorable and statistically significant impacts on adult outcomes: reduced trauma symptoms (ES = -0.25, p = 0.02), and depressive symptoms (ES = -0.25, p = 0.03). In addition, children enrolled in RPG had reduced behavior problems (ES = -0.31, p = 0.02) and reduced executive functioning deficits (ES = -0.31, p = 0.04). There were no significant impacts observed for child safety and permanency outcomes.

CONCLUSIONS: The RPG approach has produced several favorable impacts on key mental health needs of caregivers and children, establishing foundational evidence of program effectiveness. Additional evaluation research is necessary to understand the effectiveness on additional outcomes with a larger, more generalizable sample.

PMID:33848956 | DOI:10.1016/j.chiabu.2021.105069

J Neural Eng. 2021 Apr 13. doi: 10.1088/1741-2552/abf772. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the viability of developing a computer-aided diagnostic system for Parkinsonian syndromes using dynamic [11C]raclopride PET and T1-weighted MRI data.

APPROACH: The biological heterogeneity of Parkinsonian syndromes renders their statistical classification a challenge. The unique combination of structural and molecular imaging data allowed different classifier designs to be tested. Datasets from dynamic [11C]raclopride PET and T1-weighted MRI scans were acquired from six groups of participants: healthy controls (CTRL n=15), patients with Parkinson’s disease (PD n=27), multiple system atrophy (MSA n=8), corticobasal degeneration (CBD n=6), and dementia with Lewy bodies (DLB n=5). MSA, CBD, and DLB patients were classified into one category designated as atypical parkinsonism (AP). The distribution volume ratio (DVR) kinetic parameters obtained from PET data were used to quantify the reversible tracer binding to D2/D3 receptors in the subcortical regions of interest (ROI). Grey matter (GM) volumes obtained from the MRI data were used to quantify GM atrophy across cortical, subcortical, and cerebellar ROI.

RESULTS: The classifiers CTRL vs PD and CTRL vs AP achieved the highest balanced accuracy combining DVR and GM (DVR-GM) features (96.7%, 92.1%, respectively), followed by the classifiers designed with DVR features (93.3%, 88.8%, respectively), and GM features (69.6%, 86.1%, respectively). In contrast, the classifier PD vs AP showed the highest balanced accuracy (78.9%) using DVR features only. The integration of DVR-GM (77.9%) and GM features (72.7%) produced inferior performances. The classifier CTRL vs PD vs AP showed high weighted balanced accuracy when DVR (80.5%) or DVR-GM features (79.9%) were integrated. GM features revealed poorer performance (59.5%).

SIGNIFICANCE: This work was unique in its combination of structural and molecular imaging features in binary and triple category classifications. We were able to demonstrate improved binary classification of healthy/diseased status (concerning both PD and AP) and equate performance to DVR features in multiclass classifications.

PMID:33848996 | DOI:10.1088/1741-2552/abf772

Acta Haematol. 2021 Apr 13:1-9. doi: 10.1159/000514907. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to determine the expression of G protein-coupled receptors (GPCRs) in platelets from adult patients with chronic immune thrombocytopenic purpura (ITP).

METHODS: Peripheral blood samples were collected from 40 patients with chronic ITP in the Second Affiliated Hospital of Shantou University Medical College, and 40 peripheral blood samples from healthy volunteers were collected; expressions of the adenosine diphosphate receptors (P2Y1 and P2Y12), alpha-2A adrenergic receptor (α2A-AR), and thromboxane A2 receptor (TP) in platelets were detected by flow cytometry. Gα protein, protease-activated receptor 1 (PAR1), and protease-activated receptor 4 (PAR4) were analyzed by Western blot and analyzed statistically.

RESULTS: Flow cytometry measurements of mean fluorescence intensities showed platelets from patients with chronic ITP, compared to healthy individuals, had significantly higher levels of P2Y1 (31.4 ± 2.2 vs. 7.8 ± 0.8), P2Y12 (29.6 ± 2.1 vs. 7.2 ± 1.3), α2A-AR (25.8 ± 2.9 vs. 9.8 ± 0.9), and TP (39.8 ± 3.1 vs. 4.7 ± 0.6) (all p < 0.01). Similarly, integrated optical density analysis of Western blots showed that platelets from patients with chronic ITP had significantly higher levels of Gα (1046.3 ± 159.96 vs. 254.49 ± 39.51), PAR1 (832.98 ± 98.81 vs. 203.92 ± 27.47), and PAR4 (1518.80 ± 272.45 vs. 431.27 ± 41.86) (all p < 0.01).

CONCLUSION: Expression of GPCRs is increased in platelets from patients with chronic ITP, suggesting that platelets of chronic ITP may participate in the complicated biological process by means of GPCR-mediated signaling pathways.

PMID:33849009 | DOI:10.1159/000514907

J Biomech. 2021 Apr 5;121:110417. doi: 10.1016/j.jbiomech.2021.110417. Online ahead of print.

ABSTRACT

A frog can jump several times higher than its own height and then land smoothly on the ground. During the buffering phase, both forelimbs touch the ground and compact quickly to absorb most of the impact energy. However, the adjustment of the joint angles of the forelimb and the induced cushioning effect during the landing process have not been thoroughly investigated. In this study, we statistically summarized the angular displacements of forelimb joints with respect to landing velocities by using a high-speed motion capture system. It is found many joint angles were linearly influenced by landing velocity at both ground touching moment and maximum compression moment. Moreover, the double-peak pattern of ground reactive force was measured, which attributes to the forelimb landing and the followed abdomen/hindlimb landing. Before the appearance of the first peak, the compression of the forelimb and the reactive force revealed a linear relationship regardless of velocity, implying that the forelimbs act as a constant stiffness spring in landing. Accordingly, a simple spring-mass model was proposed and verified by simulation for forelimb cushioning of the frog. We anticipate our achievements to inspire the design of future landing mechanisms.

PMID:33848828 | DOI:10.1016/j.jbiomech.2021.110417

J Surg Res. 2021 Apr 10;264:462-468. doi: 10.1016/j.jss.2021.02.044. Online ahead of print.

ABSTRACT

BACKGROUND: Using the platform of morbidity and mortality conference, we developed and executed a combined faculty-resident intervention called “Education M&M” to discuss challenges faced by both parties in the operating room (OR), identify realistic solutions, and implement action plans. This study aimed to investigate the impact of this intervention on resident OR training.

MATERIALS AND METHODS: Two resident case presentations were followed by audience discussion and recommendations regarding actionable solutions aimed at improving resident OR training from an expert faculty panel. Postintervention surveys were completed by participants immediately and 2 mo later to assess perceived short and long-term impact on OR teaching and/or learning and the execution of two recommended solutions. Descriptive statistical analysis was applied.

RESULTS: Immediate post-intervention surveys (n = 44) indicated that 81.8% of participants enjoyed the M&M “a lot”; 90.1% said they would use some or a lot of the ideas presented. Awareness of OR teaching/learning challenges before and after the M&M improved from 3.0 to 3.7 (P = 0.00001) for faculty and 3.0 to 3.9 for trainees (P = 0.00004). Understanding of OR teaching and/or learning approaches improved from 3.1 to 3.7 for faculty (P = 0.00004) and 2.7 to 3.9 for trainees (P = 0.00001). In 2-mo post-intervention surveys, most residents had experienced two recommended solutions (71% and 88%) in the OR, but self-reported changes to faculty behavior did not reach statistical significance.

CONCLUSIONS: A department-wide education M&M could be an effective approach to enhance mutual communication between faculty members and residents around OR teaching/learning by identifying program-specific challenges and potential actionable solutions.

PMID:33848846 | DOI:10.1016/j.jss.2021.02.044

Epilepsy Behav. 2021 Apr 10;118:107946. doi: 10.1016/j.yebeh.2021.107946. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was aimed to analyze the effectiveness of sodium channel blockers (SCBs) in CDKL5 deficiency disorder (CDD)-related epilepsy.

METHODS: A retrospective, observational study was performed, including patients with CDD diagnosis evaluated between 2016 and 2019 at three tertiary Epilepsy Centers. Demographic, electroclinical and genetic features, as well as ASM treatments and their outcomes were analyzed, with special focus on SCBs.

RESULTS: Twenty-one patients evaluated at three tertiary Epilepsy Centers were included, of which 19 presented with epilepsy (90.5%); all had pathogenic mutations of CDKL5. Six patients (31.6%) were classified as SCB responders (more than 50% reduction), four being currently seizure free (mean seizure-free period of 8 years). Most frequent SCB drugs were oxcarbazepine (OXC), carbamazepine (CBZ), and lacosamide (LCM). None of them presented relevant adverse events. In contrast, three patients showed seizure aggravation in the non-responder group. When comparing both groups, responders had statistically significant younger age at SCB treatment and epilepsy onset, higher proportion of focal epileptiform activity and less frequent history of West syndrome.

CONCLUSIONS: The results of this study indicate that treatment with SCBs might be effective and safe in a subset of patients with CDD-related epilepsy.

PMID:33848848 | DOI:10.1016/j.yebeh.2021.107946

Surg Oncol. 2021 Apr 5;37:101565. doi: 10.1016/j.suronc.2021.101565. Online ahead of print.

ABSTRACT

BACKGROUND: We compared the curettage/bone grafting and the curettage/bone graft substitutes surgical techniques in their relation to functional outcomes, oncologic outcome (recurrence, malignant transformation), the rate of postsurgical complications, durations of surgery and of postsurgical immobilization for hand-localized cases of solitary and multiple enchondromas.

METHODS: The current prospective randomized trial analyzed 200 adult patients (2012-2017) with enchondroma who underwent surgical intervention. The cases were randomly divided into Group 1 (n = 100; F 56, M 44) for surgeries with curettage and autogenous bone grafting, and Group 2 (n = 100; F 55, M 45) for surgeries with curettage and bone graft substitutes. The placebo control Group 3 consisted of cases operated by curettage only (n = 56; F 31, M 25). The follow-up period was set at 30 months.

RESULTS: The duration of surgery was 51 ± 4 min in Group 1 and 27 ± 1 min in Group 2 (p = 0.008). In Group 1, the rate of recurrence was 6% against 1% in Group 2 (p = 0.005). No other statistically significant differences in postsurgical outcomes between three involved groups were noted.

CONCLUSION: In cases of enchondroma of the hand, postsurgical functional outcomes, the rate of postsurgical complications, the duration of immobilization, and the time to complete recovery are not influenced by the type of chosen grafting material. The implementation of HAp-collagen bone substitutes in granules instead of autogenous bone grafting reduces the duration of surgery. The implementation of autogenous bone grafting may increase the rate of tumor recurrence.

PMID:33848764 | DOI:10.1016/j.suronc.2021.101565

Leg Med (Tokyo). 2021 Apr 7;51:101877. doi: 10.1016/j.legalmed.2021.101877. Online ahead of print.

ABSTRACT

Heroin-related mortality is a complex phenomenon involving several factors that make an individual more susceptible to opioid toxicity. Among these, pre-existing pathological conditions play an important role. The current paper reviewed 51 autopsied cases performed over the last 30 years, each subject (“frequent heroin user”) having taken heroin intravenously alone before death. For each case, total blood morphine concentration determined by gas chromatography-mass spectrometry (GC-MS) was obtained from the archives. For histopathological evaluation we examined microscopic sections of the heart, lung, brain, liver and kidney, and for each organ a score table with a numerical value from 1 to 5, as an indicator of increasing severity, was drawn up. Finally, we created a scoring system based on the Injury Severity Score (ISS), generated by the sum of the squares of the three highest organ scores. We investigated the relationship between total blood morphine value (mg/l) and pathological score by inserting the two variables in a linear regression model: Score = a + b·Morphinemia (p-value <0.001). The results demonstrated a statistically significant correlation between the two variables: individuals with low total blood morphine values tended to have a higher pathological score. Our study provides useful assessment tools for forensic practice, confirming the need to combine two important disciplines in drug death investigation: forensic pathology and toxicology.

PMID:33848788 | DOI:10.1016/j.legalmed.2021.101877