Tag: pubmed

Comput Biol Med. 2021 Apr 21;134:104401. doi: 10.1016/j.compbiomed.2021.104401. Online ahead of print.

ABSTRACT

Novel Coronavirus is deadly for humans and animals. The ease of its dispersion, coupled with its tremendous capability for ailment and death in infected people, makes it a risk to society. The chest X-ray is conventional but hard to interpret radiographic test for initial diagnosis of coronavirus from other related infections. It bears a considerable amount of information on physiological and anatomical features. To extract relevant information from it can occasionally become challenging even for a professional radiologist. In this regard, deep-learning models can help in swift, accurate and reliable outcomes. Existing datasets are small and suffer from the balance issue. In this paper, we prepare a relatively larger and well-balanced dataset as compared to the available datasets. Furthermore, we analyze deep learning models, namely, AlexNet, SqueezeNet, DenseNet201, MobileNetV2 and InceptionV3 with numerous variations such as training the models from scratch, fine-tuning without pre-trained weights, fine-tuning along with updating pre-trained weights of all layers, and fine-tuning with pre-trained weights along with applying augmentation. Our results show that fine-tuning with augmentation generates best results in pre-trained models. Finally, we have made architectural adjustments in MobileNetV2 and InceptionV3 models to learn more intricate features, which are then merged in our proposed ensemble model. The performance of our model is statistically analyzed against other models using four different performance metrics with paired two-sided t-test on 5 different splits of training and test sets of our dataset. We find that it is statistically better than its competing methods for the four metrics. Thus, the computer-aided classification based on the proposed model can assist radiologists in identifying coronavirus from other related infections in chest X-rays with higher accuracy. This can help in a reliable and speedy diagnosis, thereby saving valuable lives and mitigating the adverse impact on the socioeconomics of our community.

PMID:34010794 | DOI:10.1016/j.compbiomed.2021.104401

J Minim Invasive Gynecol. 2021 May 16:S1553-4650(21)00224-7. doi: 10.1016/j.jmig.2021.05.002. Online ahead of print.

ABSTRACT

STUDY OBJECTIVE: The “illusion of validity” is a cognitive bias in which the ability to interpret and predict surgical performance accurately is overestimated. To address this bias, we assessed participants comparing FLS and non FLS tasks to cadaveric vaginal cuff suturing in order to determine the most representative simulation task for laparoscopic vaginal cuff suturing.

DESIGN: Validity (Messick Framework) study comparing FLS and non-FLS tasks to cadaveric vaginal cuff suturing.

SETTING: Simulation center cadaver lab PARTICIPANTS: : Obstetrics and gynecology residents (n=21), minimally invasive gynecologic surgery fellows (n=3), gynecologic surgical subspecialists (n=4), general obstetrician/gynecologists (n=10).

INTERVENTIONS: Tasks included a simulated vaginal cuff (ipsilateral port placement), needle passage through a metal eyelet loop (contralateral and ipsilateral), and intracorporeal knot tying (contralateral and ipsilateral). Simulation task times were compared to the placement of the first cadaveric vaginal cuff suture time, as well as the in-person and blinded Global Operative Assessment of Laparoscopic Skills (GOALS) score (“relations to other variables” validity evidence). Statistical analyses included Spearman’s test of correlation (continuous and ordinal variables) or Wilcoxon rank sum test (categorical variables).

MEASUREMENTS AND MAIN RESULTS: There was a stronger association with cadaver cuff suturing time for simulated vaginal cuff suturing time (r: 0.73, P<0.001) compared to FLS intracorporeal contralateral suturing time (r: 0.54, P<0.001). Additional measures associated with cadaveric performance included subspecialty training (Median: 82 vs. 185 seconds, P=0.002), number of total laparoscopic hysterectomies (r: -0.53, P<0.001), number of laparoscopic cuff closures (r: -0.61, P<0.001), number of simulated laparoscopic suturing experiences (r: -0.51, P<0.001), and eyelet contralateral time (r: 0.52, P<0.001). Strong agreement between the in-person and blinded GOALS (ICC=0.80) supports response process evidence. Correlations of cadaver cuff time with in-person (Spearman’s r: -0.84, P<0.001), and blinded GOALS (r: -0.76, P<0.001) supports relations to other variables evidence CONCLUSION: : The weaker correlation between FLS suturing and cadaver cuff suturing compared to a simulated vaginal cuff model may lead to an “illusion of validity” for assessment in gynecology. Since gynecology specific validity evidence has not been well established for FLS, we recommend prioritizing the use of a simulated-vaginal cuff suturing assessment in addition to FLS.

PMID:34010696 | DOI:10.1016/j.jmig.2021.05.002

Cytokine. 2021 May 16;144:155578. doi: 10.1016/j.cyto.2021.155578. Online ahead of print.

ABSTRACT

Spexin is a newly described peptide and is known to reduce the uptake of long-chain fatty acids into adipocytes. The serum spexin levels of obese children between the ages of 12-18 are lower. The effect of serum spexin and free 25(OH) vitamin D3 levels on intrauterine development in newborns is unknown. Our aims is to evaluate the effects of spexin and adipocytokin levels in the cord blood of term newborn babies on the weight of the baby according to the gestation age (GA) and anthropometric measurement results. Babies who were born in our hospital and whose GA was ≥37 weeks were evaluated in three groups as appropriate for GA (AGA), small for GA (SGA) and large for GA (LGA). A total of 84 babies, including an equal number of infants in AGA, SGA and LGA groups, were included in the study. Spexin, leptin, active ghrelin, free 25(OH) vitamin D3, glucose, and insulin levels in the cord blood of infants were examined at birth. The results were compared according to GA and birth weight (BW). There was no statistically significant difference between groups in terms of mean spexin, active ghrelin, free 25(OH) vitamin D3, and insulin levels. The mean leptin level was significantly higher in LGA group than SGA and AGA groups (p 0.004). The mean spexin and leptin levels were higher in girls than in boys (respectively p value 0.029, 0.003). Although there is a significant positive correlation between BW, head circumference, height, umbilical circumference, umbilical circumference/height ratio and the mean leptin levels (p < 0.001), there was no significant correlation between mean spexin, active ghrelin, free 25 (OH) vitamin D3, insulin, and glucose levels. This study suggests that spexin may not have an effect on intrauterine development.

PMID:34010726 | DOI:10.1016/j.cyto.2021.155578

Indian Pacing Electrophysiol J. 2021 May 16:S0972-6292(21)00079-6. doi: 10.1016/j.ipej.2021.05.003. Online ahead of print.

ABSTRACT

INTRODUCTION: The epidemiology of atrial fibrillation (AF) in India has not been studied systematically in large scale population based surveys. Stroke is one of the leading causes of death and disability in India. As AF is a major contributor of stroke, it is important to know the burden of AF and stroke risk in the population. The Andhra Pradesh Atrial Fibrillation (AP-AF) study aims to assess the prevalence, etiology, risk factors and stroke risk among the rural population in Andhra Pradesh, India.

METHODS: This is a cross-sectional survey done using a two-stage sampling process. Adults (≥18years) from villages in East and West Godavari districts were sampled. Field investigators used a structured questionnaire to collect information on basic demographics, cardiovascular risk factors and medical history. Anthropometric measurements were performed, blood pressure measured and fasting capillary blood glucose was assessed. Electrocardiogram was done using a hand-held mobile ECG device-KardioMobile. ECGs were interpreted by study cardiologists. Participants diagnosed to have AF were invited to participate in a camp conducted by cardiologists where echocardiogram was done and also a focused history related to AF was collected. Along with age and sex stratified prevalence of AF, descriptive statistics will be used to present demographics, clinical profile, and cardiovascular risk factors. Stroke risk will be calculated using CHA 2 DS 2 -Vasc score.

CONCLUSION: The AP-AF study is expected to provide important information on AF epidemiology in rural India. The information may help improve health care policies in preventing stroke and other complications of AF.

PMID:34010662 | DOI:10.1016/j.ipej.2021.05.003

J Stomatol Oral Maxillofac Surg. 2021 May 16:S2468-7855(21)00117-8. doi: 10.1016/j.jormas.2021.05.007. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to assess the quality of the posts about wisdom teeth on Instagram in terms of patients benefit.

METHODS AND MATERIALS: The #Wisdomteeth hashtag was searched on Instagram. The first 200 posts were reviewed. 50 posts were included in this study. Upload sources were categorized as health care professionals, health companies and individuals users. Post types were categorized as patient’s experience, educational and scientifically erroneous. The posts were evaluated under eight titles for evaluating the usefulness score. The usefulness scores of the posts were classified as poor, moderate and excellent. Kruskal-Wallis test and Chi² test was used for data. Significance level was accepted as P < 0.05 RESULTS: The usefulness score was between 0 and 2, with a mean of 0.16. There were no statistically significant differences between upload sources and usefulness score (p=0.328). There were no statistically significant differences between the usefulness score and the number of comments (p=0.126).

CONCLUSION: The results of the study showed that Instagram posts do not contain reliable information for patients.

PMID:34010672 | DOI:10.1016/j.jormas.2021.05.007

Am J Hum Genet. 2021 May 11:S0002-9297(21)00150-6. doi: 10.1016/j.ajhg.2021.04.019. Online ahead of print.

ABSTRACT

Importin 8, encoded by IPO8, is a ubiquitously expressed member of the importin-β protein family that translocates cargo molecules such as proteins, RNAs, and ribonucleoprotein complexes into the nucleus in a RanGTP-dependent manner. Current knowledge of the cargoes of importin 8 is limited, but TGF-β signaling components such as SMAD1-4 have been suggested to be among them. Here, we report that bi-allelic loss-of-function variants in IPO8 cause a syndromic form of thoracic aortic aneurysm (TAA) with clinical overlap with Loeys-Dietz and Shprintzen-Goldberg syndromes. Seven individuals from six unrelated families showed a consistent phenotype with early-onset TAA, motor developmental delay, connective tissue findings, and craniofacial dysmorphic features. A C57BL/6N Ipo8 knockout mouse model recapitulates TAA development from 8-12 weeks onward in both sexes but most prominently shows ascending aorta dilatation with a propensity for dissection in males. Compliance assays suggest augmented passive stiffness of the ascending aorta in male Ipo8^-/- mice throughout life. Immunohistological investigation of mutant aortic walls reveals elastic fiber disorganization and fragmentation along with a signature of increased TGF-β signaling, as evidenced by nuclear pSmad2 accumulation. RT-qPCR assays of the aortic wall in male Ipo8^-/- mice demonstrate decreased Smad6/7 and increased Mmp2 and Ccn2 (Ctgf) expression, reinforcing a role for dysregulation of the TGF-β signaling pathway in TAA development. Because importin 8 is the most downstream TGF-β-related effector implicated in TAA pathogenesis so far, it offers opportunities for future mechanistic studies and represents a candidate drug target for TAA.

PMID:34010605 | DOI:10.1016/j.ajhg.2021.04.019

Depress Anxiety. 2021 May 19. doi: 10.1002/da.23169. Online ahead of print.

ABSTRACT

BACKGROUND: Rates of depression among Pakistani mothers are high, leading to poor developmental outcomes in their children. This study tested the effectiveness of a manualized integrated parenting program; Learning through Play Plus (LTP+) for maternal depression in Karachi, Pakistan.

METHODS: A cluster randomized control trial conducted from January 2014 to December 2015 across 120 villages in Karachi. A total of 774 depressed mothers aged 18-44 years with children aged 0-30 months old, were included. Villages were randomized to receive LTP+ added to treatment as usual (TAU) or TAU alone. Primary outcomes were severity of maternal depression at 3 and 6 months measured by the Edinburgh Postnatal Depression Scale and child socio-emotional development at 6 months measured by the Ages and Stages Questionnaire (ASQ). Secondary outcomes included maternal anxiety, quality of life, social support, parenting competence, and knowledge about child development.

RESULTS: Mothers in the LTP+ group reported significantly lower depression scores compared to those in the TAU group (6.6 vs. 13.8, effect size [ES]: -7.2; 95% confidence interval [CI]: -8.2, -6.1) at 3 and 6 months (7.2 vs. 12.00; ES: -4.6; 95% CI: -5.9, -3.4). Child socio-emotional development at 6 months was significantly better in the LTP+ group on all domains of the ASQ. There were also statistically significant improvements on all secondary outcomes at 3- and 6-month follow-up.

CONCLUSION: In low-resource settings like Pakistan, low-cost integrated parenting interventions delivered by lay health workers can provide effective treatment for depressed mothers, leading to improvements in child development.

PMID:34010505 | DOI:10.1002/da.23169

Biometrics. 2021 May 19. doi: 10.1111/biom.13487. Online ahead of print.

ABSTRACT

The human microbiome plays an important role in our health and identifying factors associated with microbiome composition provides insights into inherent disease mechanisms. By amplifying and sequencing the marker genes in high-throughput sequencing, with highly similar sequences binned together, we obtain Operational Taxonomic Units (OTU) profiles for each subject. Due to the high-dimensionality and non-normality features of the OTUs, the measure of diversity is introduced as a summarization at the microbial community level, including the distance-based Beta-diversity between individuals. Analyses of such between-subject attributes are not amenable to the predominant within-subject based statistical paradigm, such as t-tests and linear regression. In this paper, we propose a new approach to model Beta-diversity as a response within a regression setting by utilizing the functional response models (FRM), a class of semiparametric models for between- as well as within-subject attributes. The new approach not only addresses limitations of current methods for Beta-diversity with cross-sectional data, but also provides a premise for extending the approach to longitudinal and other clustered data in the future. The proposed approach is illustrated with both real and simulated data. This article is protected by copyright. All rights reserved.

PMID:34010477 | DOI:10.1111/biom.13487

Pediatr Transplant. 2021 May 19:e13993. doi: 10.1111/petr.13993. Online ahead of print.

ABSTRACT

Impaired renal function after pediatric (LT) is a recognized problem. Accurate monitoring of (GFR) is imperative to detect declining renal function. GFR can be estimated via s-creatinine and/or p-cystatin C or measured by inulin and or/iohexol clearances. We retrospectively compared eGFRcrea and eGFRcyst, to mGFRiohex after LT. Data from 91 children with 312 concomitant measurements of s-creatinine, p-cystatin C, and iohexol clearance, obtained between 2007 and 2015, were analyzed. eGFR was calculated by using the p-cystatin C-based CAPA and CKD-EPI formulas, and the s-creatinine-based Schwartz-LYON, FAS, revised Schwartz and MDRD formulas. Also, the arithmetic means of cystatin C-based and creatinine-based equations were used. Every calculated eGFR was compared to mGFRiohex in statistical correlation, accuracy, precision, bias, and misclassifications. Among the different equations, p-cystatin C-based formulas (CAPA and CKD-EPI) as well as the s-creatinine-based Schwartz-LYON formula showed the most correct estimates regarding accuracy (84-87.5%), bias (0.19-4.0 ml/min/1.73 m² ), and misclassification rate (24.7-25%). In patients with renal function <75 ml/min/1.73 m² , cystatin C-based formulas were significantly more accurate and less biased than creatinine-based formulas. In conclusion, S-creatinine could be used in a clinical setting on a regular basis in liver transplanted pediatric patients, with reliable results, if eGFR is calculated by the Schwartz-LYON formula. When suspected renal dysfunction, cystatin C-based eGFR should be calculated, since it gives more accurate and less biased estimates than creatinine-based eGFR, and should be confirmed by mGFR (iohexol).

PMID:34010490 | DOI:10.1111/petr.13993

Endokrynol Pol. 2021 May 19. doi: 10.5603/EP.a2021.0034. Online ahead of print.

ABSTRACT

Introduction Elevated serum parathormone (PTH) levels have been observed in acute kidney injury and are related to calcium-phosphate metabolism disturbance, decreased renal production of 1,25 dihydroxyvitamin D3, impaired renal PTH excretion and other renal-independent factors. There are no data regarding PTH concentration kinetics in critically ill patients undergoing continuous renal replacement therapies (CRRT) in an intensive care setting. The primary objective of this study was to investigate trends in PTH serum levels in critically ill patients with multiorgan failure, undergoing CRRT by performing periodic PTH measurements in the acute phase of critical illness. Material and methods Single center, prospective, observational study conducted in an mixed, university affiliated, intensive care unit. Critically ill patients were included who fulfilled all of the following criteria: respiratory failure; circulatory failure; acute kidney injury treated by CRRT; sequential organ failure assessment score (SOFA score) of 5 or more. Patients who met any of the following criteria were excluded: acute liver failure; hypercalcemia at admission (total calcium serum level > 10.6 mg/dl; total ionized calcium plasma level > 1.35 mmol/l); parathyroid gland disease, end-stage renal disease, patients undergoing therapeutic plasma exchange or extracorporeal membrane oxygenation procedures, aged under 18 years, pregnant, life expectancy after admission to the intensive care unit anticipated to be less than 72 hours as assessed by the investigator. Results Thirty patients met the inclusion criteria. A statistically significant change in PTH over time was observed (Friedman ANOVA; p=0.0001). The post-hoc test showed a statistically significant decrease in PTH: measurements 5-8 relative to measurement 1, measurements 4-8 relative to measurement 2 (p.

PMID:34010434 | DOI:10.5603/EP.a2021.0034