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Nevin Manimala Statistics

Percutaneous hamstring lengthening in cerebral palsy: Technique and gait outcomes based on GMFCS level

Gait Posture. 2021 Oct 29;91:318-325. doi: 10.1016/j.gaitpost.2021.10.035. Online ahead of print.

ABSTRACT

BACKGROUND: Increased knee flexion at initial contact and in stance is a common problem for children with cerebral palsy. Surgical correction with percutaneous hamstring lengthening is an alternative to open hamstring lengthening; however, outcomes are less well documented, and there is concern about increasing anterior pelvic tilt. The purpose of this study was to evaluate the short-term outcomes of percutaneous hamstring lengthenings in children with cerebral palsy using comprehensive gait analysis techniques.

RESEARCH QUESTION: Does percutaneous hamstring lengthening improve knee function, and do knee and anterior pelvic tilt outcomes vary by GMFCS level?

METHODS: A convenience sample of 52 patients with both pre and post-surgical gait analyses was evaluated retrospectively for changes in gait function in terms of temporal-spatial parameters, kinematics and kinetics. Patients were divided into two GMFCS subgroups: GMFCS level I/II and III.

RESULTS: The percutaneous hamstring lengthening results in statistically significant improvements in knee function during gait with increased knee extension at initial contact (mean 32° SD 13° to mean 21° SD 11°, p = 0.000) and improved mean knee flexion in stance (mean 23° SD 12° to mean 16° SD 11°, p = 0.000) for the total study cohort. Beneficial changes were found for knee function in both GMFCS level subgroups; however, there was an increase in pelvic tilt pre to post-surgery in the GMFCS level III subgroup (mean 21° SD 8° to mean 26° SD 6°, p = 0.012) but not the GMFCS level I/II subgroup (mean 18° SD 7° to mean 20° SD 8°, p = 0.427).

SIGNIFICANCE: Percutaneous hamstring lengthening can improve knee function for all patients; however, the impact on anterior pelvic tilt varies by GMFCS level, with increasing anterior tilt for GMFCS level III only. This study highlights the importance of understanding differences in surgical outcomes by GMFCS level to better predict post-surgical function.

PMID:34823200 | DOI:10.1016/j.gaitpost.2021.10.035

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Nevin Manimala Statistics

Cytokine signature for predicting new-onset prediabetes after acute pancreatitis: A prospective longitudinal cohort study

Cytokine. 2021 Nov 22;150:155768. doi: 10.1016/j.cyto.2021.155768. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: Acute inflammation of the pancreas often leads to metabolic sequelae, the most common of which is new-onset prediabetes (and, ultimately, diabetes). However, there is a lack of studies on predictors of this sequela. The aim was to investigate whether cytokines/chemokines measured at baseline are predictive of new-onset prediabetes after acute pancreatitis (NOPAP).

METHODS: This was a prospective longitudinal cohort study (as part of the LACERTA project) that included 68 individuals with non-necrotising acute pancreatitis who had no diabetes mellitus. Of them, 17 individuals had prediabetes at baseline and during follow-up, 37 individuals had normoglycaemia at baseline and during follow-up, and 14 individuals had normoglycaemia at baseline and developed NOPAP during follow-up. A commercially available human cytokine/chemokine multiplex kit was used to measure a total of 28 analytes at baseline. Multinomial regression analyses were conducted to investigate the associations between the cytokines/chemokines and the three study groups.

RESULTS: Interleukin-1β and interferon γ significantly predicted progression to NOPAP with an odds ratio (95% confidence interval) of 1.097 (1.002, 1.201) and 1.094 (1.003, 1.192), respectively (after accounting for age, sex, body mass index, and aetiology of acute pancreatitis). None of the studied cytokines/chemokines showed statistically significant associations with the antecedent prediabetes group (after accounting for the above covariates).

CONCLUSION: Elevated levels of interleukin-1β and interferon γ in acute pancreatitis individuals with normoglycaemia at baseline may predict progression to NOPAP during follow-up.

PMID:34823207 | DOI:10.1016/j.cyto.2021.155768

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Nevin Manimala Statistics

Research Note: Growth and meat features of broiler chicken with the use of halloysite as a technological additive to feed and peat litter

Poult Sci. 2021 Oct 19;101(1):101543. doi: 10.1016/j.psj.2021.101543. Online ahead of print.

ABSTRACT

The current trends in the production of broiler chickens indicate the need to look for natural solutions that affect the efficiency of production and the quality of meat. The aim of the study was to evaluate the growth performance and quality of broiler chicken meat with the addition of halloysite in feed and litter. Two hundred Ross 308 were used and divided into 2 groups (10 replicates each). The control group (C) did not have any additive, while in the experimental group (H) 0.5% halloysite was used in feed and 0.500 kg/m2 in peat litter. The production results and litter traits were checked. The presence of footpad dermatitis (FPD) was assessed. After 42 d, 20 birds were randomly selected and slaughtered. Dissection was performed. The slaughter yield and the percentage of carcass elements were calculated, including offal. Breast and leg muscles were analysed qualitatively (pH, colour, water-holding capacity, drip loss, chemical composition). In group H there were no changes to FPD, and in group C there were 6 cases of benign lesions and 1 with severe damage and scabs on the soles of the feet. Significantly higher preslaughter body weight was shown, as well as carcass and wings weight in group H. The H group had a higher pH24 than the C group, as well as higher protein and water content, and lower intramuscular fat and salt, both in the breast and leg muscles. No significant differences were found in growth performance carcass, meat’ colour or water-holding capacity features. The litter with halloysite was characterized by a lower pH but without statistical confirmation. Addition of halloysite to feed and litter reduced the occurrence of skin lesions and had a positive effect on higher protein content and lower intramuscular fat in the breast and leg muscles. This demonstrates the potential for the practical use of halloysite in the production of broiler chickens, both as a feed and peat litter additive.

PMID:34823170 | DOI:10.1016/j.psj.2021.101543

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Nevin Manimala Statistics

Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department

Am J Emerg Med. 2021 Nov 17;51:384-387. doi: 10.1016/j.ajem.2021.11.023. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency physicians (EP) are frequently interrupted to screen electrocardiograms (ECG) from Emergency Department (ED) patients undergoing triage. Our objective was to identify discrepancies between the computer ECG interpretation and the cardiologist ECG interpretation and if any patients with normal ECGs underwent emergent cardiac intervention. We hypothesized that computer-interpreted normal ECGs do not require immediate review by an EP.

METHODS: This was a retrospective study of adult (≥ 18 years old) ED patients with computer-interpreted normal ECGs. Laboratory, diagnostic testing and clinical outcomes were abstracted following accepted methodologic guidelines. The primary outcome was emergent cardiac catheterization (within four hours of ED arrival). All ECGs underwent final cardiologist interpretation. When cardiology interpretation differed from the computer (discrepant ECG interpretation), the difference was classified as potentially clinically significant or not clinically significant. Data was described with simple descriptive statistics.

MAIN FINDINGS: 989 ECGs interpreted as normal by the computer were analyzed with a mean age of 50.4 ± 16.8 years (range 18-96 years) and 527 (53%) female. Discrepant ECG interpretations were identified in 184 cases including 124 (12.5%, 95% CI 10.4, 14.7%) not clinically significant and 60 (6.1%, 95% CI 4.6, 7.7%) potentially clinically significant. The 60 potentially clinically significant changes included: ST/T wave changes 45 (75%), T wave inversions 6 (10%), prolonged QT 3 (5%), and possible ischemia 10 (17%). Of these 60, 21 (35%) patients were admitted. Six patients had potassium levels >6.0 mEq/L, with one having a potentially clinically significant ECG change. No patient (0%, 95% CI 0, 0.3%) underwent immediate (within four hours) cardiac catherization whereas two underwent delayed cardiac interventions.

CONCLUSIONS: Cardiologists frequently disagree with a computer-interpreted normal ECG. Patients with computer-interpreted normal ECGs, however, rarely had significant ischemic events. A rare number of patients will have important cardiac outcomes regardless of the computer-generated normal ECG interpretation. Immediate EP review of the ECG, however, would not have changed these patients’ ED courses.

PMID:34823195 | DOI:10.1016/j.ajem.2021.11.023

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Nevin Manimala Statistics

Predicting the trend of infectious diseases using grey self-memory system model: a case study of the incidence of tuberculosis

Public Health. 2021 Nov 22;201:108-114. doi: 10.1016/j.puhe.2021.09.025. Online ahead of print.

ABSTRACT

OBJECTIVES: The prediction and early warning of infectious diseases is an important work in the field of public health. This study constructed the grey self-memory system model to predict the incidence trend of infectious diseases affected by many uncertain factors.

STUDY DESIGN: The design of this study is a combination of the prediction method and empirical analysis.

METHODS: By organically coupling the self-memory algorithm with the mean GM(1,1) model, the tuberculosis incidence statistics of China from 2004 to 2018 were selected for prediction analysis. Meanwhile, by comparing with the other traditional prediction methods, three representative accuracy check indexes (MSE, AME, MAPE) were conducting for error analysis.

RESULTS: Owing to the multiple time-points initial fields, which replace the single time-points, the limitation of the traditional grey prediction model, which is sensitive to the initial value, is overcome in the self-memory equation. Consequently, compared with the mean GM model and other statistical methods, the grey self-memory model shows significant forecasting advantages, and its single-step rolling prediction accuracy is superior to other prediction methods. Therefore, the incidence of tuberculosis in China in the next year can be predicted as 55.30 (unit: 1/105).

CONCLUSIONS: The grey self-memory system model can closely capture the individual random fluctuation in the whole evolution trend of the uncertain system. It is appropriate for predicting the future incidence trend of infectious diseases and is worth popularizing to other similar public health prediction problems.

PMID:34823142 | DOI:10.1016/j.puhe.2021.09.025

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Nevin Manimala Statistics

Automated preprocessing and phase-amplitude coupling analysis of scalp EEG discriminates infantile spasms from controls during wakefulness

Epilepsy Res. 2021 Nov 7;178:106809. doi: 10.1016/j.eplepsyres.2021.106809. Online ahead of print.

ABSTRACT

OBJECTIVE: Delta-gamma phase-amplitude coupling in EEG is useful for localizing epileptic sources and to evaluate severity in children with infantile spasms. We (1) develop an automated EEG preprocessing pipeline to clean data using artifact subspace reconstruction (ASR) and independent component (IC) analysis (ICA) and (2) evaluate delta-gamma modulation index (MI) as a method to distinguish children with epileptic spasms (cases) from normal controls during sleep and awake.

METHODS: Using 400 scalp EEG datasets (200 sleep, 200 awake) from 100 subjects, we calculated MI after applying high-pass and line-noise filters (Clean 0), and after ASR followed by either conservative (Clean 1) or stringent (Clean 2) artifactual IC rejection. Classification of cases and controls using MI was evaluated with Receiver Operating Characteristics (ROC) to obtain area under curve (AUC).

RESULTS: The artifact rejection algorithm reduced raw signal variance by 29-45% and 38-60% for Clean 1 and Clean 2, respectively. MI derived from sleep data, with or without preprocessing, robustly classified the groups (all AUC > 0.98). In contrast, group classification using MI derived from awake data was successful only after Clean 2 (AUC = 0.85).

CONCLUSIONS: We have developed an automated EEG preprocessing pipeline to perform artifact rejection and quantify delta-gamma modulation index.

PMID:34823159 | DOI:10.1016/j.eplepsyres.2021.106809

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Nevin Manimala Statistics

Transitional care from hospital to home for frail older adults: A systematic review and meta-analysis

Geriatr Nurs. 2021 Nov 22;43:64-76. doi: 10.1016/j.gerinurse.2021.11.003. Online ahead of print.

ABSTRACT

Frail older adults are vulnerable to hospitalization and transitional care is needed to maintain care continuity; however, there exists no review regarding transitional care focusing on frailty. This study aimed to investigate transitional care for frail older adults and its effectiveness. Search terms were (P) frail older adults; (I) transitional care initiated before discharge; (C) usual care; (O) all health outcomes. Fourteen trials were identified. The most measured outcome was readmission (n = 13), followed by mortality (n = 9), function (n = 7), quality of life (n = 5), and self-rated health (n = 5). Statistical significance effects were reported in the followings: n = 6, readmission; n = 0, mortality; n = 3, function; n = 2, quality of life; and n = 4, self-rated health. The meta-analysis demonstrated that transitional care reduced readmission at six months but not other time points nor mortality or quality of life. The intervention effectiveness was inconclusive; therefore, an evidence-based yet novel approach is necessary to establish an adequate transitional care intervention for frail older adults.

PMID:34823079 | DOI:10.1016/j.gerinurse.2021.11.003

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Nevin Manimala Statistics

Association of selenium, zinc and copper concentrations during pregnancy with birth weight: A systematic review and meta-analysis

J Trace Elem Med Biol. 2021 Nov 18;69:126903. doi: 10.1016/j.jtemb.2021.126903. Online ahead of print.

ABSTRACT

BACKGROUND: Normal fetal growth is associated with maternal nutrition. Trace elements play important roles in fetus growth. This review aims to provide a summary of the literature evaluating the relation between selenium, zinc and copper levels during pregnancy with birth weight.

METHOD: A systematic literature search was conducted in Medline database (PubMed), Scopus, Web of science and Google scholar up to September 2020. Fifty observational studies were included in the final analyses. The desired pooled effect size was considered as standardized mean differences with 95 % CI or correlation. Cochran’s Q statistic was used to test the heterogeneity between the included studies (I2).

RESULT: A significant differences were found between pooled standardized mean differences (SMD) of umbilical cord blood copper levels in small-for-gestational age birth weight (SGA) and appropriate-for-gestational age birth weight (AGA) (SMD: 0.34 μg/L, 95 % CI: 0.13 to 0.56). There was a significant pooled correlation between umbilical cord blood selenium concentrations and birth weight (r: 0.08, 95 % CI: 0.01 to 0.16). A significant pooled correlation was found between umbilical cord blood zinc concentrations and birth weight (r: 0.09, 95 % CI: 0.04 to 0.15), with significant heterogeneity (I2 % = 0.63). There was significant positive association between maternal blood zinc concentrations and birth weight.

CONCLUSION: Findings showed the association of trace elements including selenium, zinc and copper during pregnancy with birth weight. There was significant correlation between umbilical cord and maternal blood selenium and zinc levels with birth weight. The umbilical cord blood copper levels in SGA birth weight was higher than copper levels in AGA birth weight.

PMID:34823102 | DOI:10.1016/j.jtemb.2021.126903

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Nevin Manimala Statistics

Value and pitfalls of assessing bone marrow morphologic findings to predict response in patients with myelofibrosis who undergo hematopoietic stem cell transplantation

Ann Diagn Pathol. 2021 Nov 17;56:151860. doi: 10.1016/j.anndiagpath.2021.151860. Online ahead of print.

ABSTRACT

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative option for patients with myelofibrosis (MF). Bone marrow (BM) morphologic evaluation of myelofibrosis following allo-HSCT is known to be challenging in this context because resolution of morphologic changes is a gradual process.

PATIENTS AND METHODS: We compared BM samples of patients with myelofibrosis who underwent first allo-HSCT and achieved molecular remission by day 100 with BM samples of patients who continued to have persistent molecular evidence of disease following allo-HSCT.

RESULTS: The study group included 29 patients: 17 primary MF, 7 post-polycythemia vera (PV) MF, and 5 post-essential thrombocythemia (ET) MF. In this cohort there were 18 JAK2 p.V617F, 8 CALR; 1 MPL, and 2 patients had concurrent JAK2 p.V617F and MPL mutations. The control group included 5 patients with primary MF, one with post-PV MF, one with post-ET MF (5 JAK2 p.V617F; 2 CALR). Following allo-HSCT, both groups showed reduction in BM cellularity and number of megakaryocytes. The study cohort also less commonly had dense megakaryocyte clusters and endosteal located megakaryocytes and showed less fibrosis. There was no statistical difference in BM cellularity, presence of erythroid islands, degree of osteosclerosis, or megakaryocyte number, size, nuclear lobation, presence of clusters or intrasinusoidal location.

CONCLUSIONS: Following allo-HSCT at 100 days, morphologic evaluation of BM in patients with MF cannot reliably predict persistence versus clearance of molecular evidence of MF. Disappearance of BM MF, dense megakaryocyte clusters, and endosteal localization of megakaryocytes are suggestive of disease response.

PMID:34823075 | DOI:10.1016/j.anndiagpath.2021.151860

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Nevin Manimala Statistics

Influence of fentanyl, ketamine and lidocaine on tear production in healthy conscious dogs

Top Companion Anim Med. 2021 Nov 22:100615. doi: 10.1016/j.tcam.2021.100615. Online ahead of print.

ABSTRACT

Tear production is an important factor in maintaining proper function of the cornea and conjunctiva. The purpose of this study was to determine the effects of bolus followed by infusion of fentanyl, lidocaine and ketamine on tear production as measured by the Schirmer I Tear Test (STT-I) in dogs. A prospective, randomized, “double-blind” study was performed. A total of 55 healthy conscious client-owned dogs were included in the study. Dogs were randomly allocated to one of four groups and given intravenous fentanyl 0.005 mg kg-1 followed by 0.005 mg kg-1 hour-1 (FEN-group), ketamine 0.6 mg kg-1 followed by 0.6 mg kg-1 hour-1 (KET-group), lidocaine 1 mg kg-1 followed by 1 mg kg-1 hour-1 (LID-group), or saline 0.3 mL kg-1 followed by 2 mL kg-1 hour-1 (SAL-group). The STT-I was performed prior to (baseline) and again 30 minutes (T30) after initiation of drug administration. Data were expressed as the median (minimum – maximum) and analyzed by Wilcoxon and Steel-Dwass tests (p < 0.05). The STT-I values increased little but were statistically significant in the KET-group from 18 (14-23) to 19 (14-25) (P = 0.039) and in the LID-group from 21 (14-25) to 20 (17-29) (P = 0.027). At 30 minutes, STT-I values were significantly higher in LID-group 20 (17-29) than in FEN-group 18 (12-22) (P = 0.006). Fentanyl, ketamine and lidocaine administered at the studied doses as a bolus and then followed by an infusion within 30 minutes in healthy conscious dogs demonstrated a clinically insignificant effect on tear production as measured by STT-I.

PMID:34823068 | DOI:10.1016/j.tcam.2021.100615