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Nevin Manimala Statistics

Independent validation and clinical implications of the risk prediction model for long QT syndrome (1-2-3-LQTS-Risk): comment-Authors’ reply

Europace. 2022 Mar 18:euac013. doi: 10.1093/europace/euac013. Online ahead of print.

NO ABSTRACT

PMID:35303087 | DOI:10.1093/europace/euac013

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Nevin Manimala Statistics

Caught in the ACTS: Defining Abstract Cognitive Task Sequences as an Independent Process

J Cogn Neurosci. 2022 Mar 20:1-12. doi: 10.1162/jocn_a_01850. Online ahead of print.

ABSTRACT

Cognitive neuroscience currently conflates the study of serial responses (e.g., delay match to sample/nonsample, n-back) with the study of sequential operations. In this essay, our goal is to define and disentangle the latter, termed abstract cognitive task sequences (ACTS). Existing literatures address tasks requiring serial events, including procedural learning of implicit motor responses, statistical learning of predictive relationships, and judgments of attributes. These findings do not describe the behavior and underlying mechanism required to succeed at remembering to evaluate color, then shape; or to multiply, then add. A new literature is needed to characterize these sorts of second-order cognitive demands of studying a sequence of operations. Our second goal is to characterize gaps in knowledge related to ACTS that merit further investigation. In the following sections, we define more precisely what we mean by ACTS and suggest research questions’ further investigation would be positioned to address.

PMID:35303079 | DOI:10.1162/jocn_a_01850

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Nevin Manimala Statistics

Comparative evaluation of the antimicrobial effects of probiotic milk and probiotic powder on the salivary Streptococcus mutans counts and the plaque scores in children aged 3-6 years: A randomized controlled trial

Dent Med Probl. 2022 Mar 17. doi: 10.17219/dmp/139731. Online ahead of print.

ABSTRACT

BACKGROUND: Probiotics have been shown to have a positive influence on systemic and oral health. The prevention of dental caries and gingival diseases through the consumption of probiotics has been studied extensively.

OBJECTIVES: The aim of this research was to determine the effects of a short-term intake of probiotic milk and powder on the salivary levels of Streptococcus mutans (S. mutans) and the plaque scores in children.

MATERIAL AND METHODS: In this short-term study, 34 healthy 3-6-year-old children were randomly assigned to group A (control), group B (enKor‑D) or group C (Yakult). The probiotics were taken for 7 days. To screen for the amount of S. mutans measured in colony-forming units per milliliter of saliva (CFU/mL), unstimulated saliva samples were collected and cultured on Mitis Salivarius Agar plates before and after the intervention. The plaque scores were also recorded at preand post-intervention visits.

RESULTS: A statistically significant reduction of salivary S. mutans was recorded after the consumption of probiotic milk (Yakult®) and powder (enKor®-D) (p < 0.05), with the decrease being greater for the enKor‑D group. However, only the consumption of Yakult decreased the plaque scores significantly (p < 0.05).

CONCLUSIONS: A short-term use of Yakult and enKor‑D can have a cariostatic effect by lowering oral microbial load in children with certain risk profiles. Further research is required to confirm this probiotic effect over a long-term period. Prior to prescribing or promoting Yakult or enKor‑D as an adjunct caries prevention therapy for children, a thorough risk evaluation may be needed.

PMID:35302301 | DOI:10.17219/dmp/139731

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Nevin Manimala Statistics

Bayesian optimisation for efficient parameter inference in a cardiac mechanics model of the left ventricle

Int J Numer Method Biomed Eng. 2022 Mar 18:e3593. doi: 10.1002/cnm.3593. Online ahead of print.

ABSTRACT

We consider parameter inference in cardio-mechanic models of the left ventricle, in particular the one based on the Holtzapfel-Ogden (HO) constitutive law, using clinical in vivo data. The equations underlying these models do not admit closed form solutions and hence need to be solved numerically. These numerical procedures are computationally expensive making computational run times associated with numerical optimisation or sampling excessive for the uptake of the models in the clinical practice. To address this issue, we adopt the framework of Bayesian optimisation (BO), which is an efficient statistical technique of global optimisation. BO seeks the optimum of an unknown black-box function by sequentially training a statistical surrogate-model and using it to select the next query point by leveraging the associated exploration-exploitation trade-off. To guarantee that the estimates based on the in vivo data are realistic also for high-pressures, unobservable in vivo, we include a penalty term based on a previously published empirical law developed using ex vivo data. Two case studies based on real data demonstrate that the proposed BO procedure outperforms the state-of-the-art inference algorithm for the HO law. This article is protected by copyright. All rights reserved.

PMID:35302293 | DOI:10.1002/cnm.3593

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Nevin Manimala Statistics

Do Radiographic Results of Transforaminal Lumbar Interbody Fusion Vary with Cage Position in Patients with Degenerative Lumbar Diseases?

Orthop Surg. 2022 Mar 18. doi: 10.1111/os.13224. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate whether the radiographic results are affected by cage position in single-level transforaminal lumbar interbody fusion (TLIF).

METHOD: Between January 2016 and June 2018, 130 patients (62 males and 68 females, average age: 55.28 ± 10.11 years) who underwent single-level TLIF were analyzed retrospectively. Standing lateral radiographs of the lumbar spine were collected and evaluated preoperatively, postoperatively, and at the time of last follow-up. Cage position in the fused segment was recorded using a central point ratio (CPR), which indicated the cage position. CPR is calculated by dividing the distance between the cage center point and the posterior extent of the superior endplate of the inferior vertebra by the length of the superior endplate of the inferior vertebra. Based on cage positions, the patients were divided into three groups: Anterior Group (n = 38); Middle Group (n = 68); and Posterior Group (n = 24). Segmental lumbar lordosis (SLL), foraminal height (FH), posterior disc height (PDH), and anterior disc height (ADH) were evaluated. A subanalysis was also performed on cage height within each group.

RESULTS: The average follow-up time of the patients was 35.20 ± 4.43 months. The mean values of CPR in Anterior Group, Middle Group, and Posterior Group were 0.64, 0.51, and 0.37, respectively. The FH, PDH, and ADH were significantly increased after TLIF in all groups (P < 0.05). There were significant differences in increase of SLL in Anterior Group (4.4°) and Middle Group (3.0°), but not in Posterior Group (0.3°). Furthermore, in the comparison of the three groups, the increase of SLL, FH, and PDH was statistically different (P < 0.05), while not for ADH (P > 0.05). The significant correlations in surgery were: CPR and ΔSLL (r = 0.584, P < 0.001), CPR and ΔFH (r = -0.411, P < 0.001), and CPR and ΔPDH (r = -0.457, P < 0.001). However, ADH had a positive correlation with cage height when the cage was located in anterior and middle of the endplate. Moreover, cage height had a positive correlation with SLL when the cage was located anteriorly and had a negative correlation with SLL when the cage was located posteriorly. FH and PDH both had a positive correlation with cage height in any cage position.

CONCLUSION: The cage located in different positions has different effects on radiographic results in single-level TLIF. A thicker cage located anteriorly will gain maximum SLL and avoid the reduction of FH and PDH.

PMID:35302296 | DOI:10.1111/os.13224

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Nevin Manimala Statistics

Magnetic Resonance Imaging-Based Nomogram to Antenatal Predict Cesarean Delivery for Cephalopelvic Disproportion in Primiparous Women

J Magn Reson Imaging. 2022 Mar 18. doi: 10.1002/jmri.28164. Online ahead of print.

ABSTRACT

BACKGROUND: Cephalopelvic disproportion (CPD)-related obstructed labor is associated with maternal and neonatal morbidity and mortality. Accurate prediction of whether a primiparous woman is at high risk of an unplanned cesarean delivery would be a major advance in obstetrics.

PURPOSE: To develop and validate a predictive model assessing the risk of cesarean delivery in primiparous women based on MRI findings.

STUDY TYPE: Prospective.

POPULATION: A total of 150 primiparous women with clinical findings suggestive of CPD.

FIELD STRENGTH/SEQUENCE: T1-weighted fast spin-echo sequences, single-shot fast spin-echo (SSFSE) T2-weighted sequences at 1.5 T.

ASSESSMENT: Pelvimetry and fetal biometry were assessed independently by two radiologists. A nomogram model combined that the clinical and MRI characteristics was constructed.

STATISTICAL TESTS: Univariable and multivariable logistic regression analyses were applied to select independent variables. Receiver operating characteristic (ROC) analysis was performed, and the discrimination of the model was assessed by the area under the curve (AUC). Calibration was assessed by calibration plots. Decision curve analysis was applied to evaluate the net clinical benefit. A P value below 0.05 was considered to be statistically significant.

RESULTS: In multivariable modeling, the maternal body mass index (BMI) before delivery, bilateral femoral head distance, obstetric conjugate, fetal head circumference, and fetal abdominal circumference was significantly associated with the likelihood of cesarean delivery. The discrimination calculated as the AUC was 0.838 (95% confidence interval [CI]: 0.774-0.902). The sensitivity and specificity of the nomogram model were 0.787 and 0.764, and the positive predictive and negative predictive values were 0.696 and 0.840, respectively. The model demonstrated satisfactory calibration (calibration slope = 0.945). Moreover, the decision curve analysis proved the superior net benefit of the model compared with each factor included.

DATA CONCLUSION: Our study might provide a nomogram model that could identify primiparous women at risk of cesarean delivery caused by CPD based on MRI measurements.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.

PMID:35302271 | DOI:10.1002/jmri.28164

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Are we aware of COVID-19-related acute kidney injury in intensive care units?

Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1753-1760. doi: 10.26355/eurrev_202203_28245.

ABSTRACT

OBJECTIVE: Coronavirus disease-19 (COVID-19) primarily affects the respiratory system. In some cases, the heart, kidney, liver, circulatory system, and nervous system are also affected. COVID-19-related acute kidney injury (AKI) occurs in more than 20% of hospitalized patients and more than 50% of patients in the intensive care unit (ICU). In this study, we aimed to review the prevalence of COVID-19-related acute kidney injury, risk factors, hospital and ICU length of stay, the need for renal replacement therapy. We also examined the effect of AKI on mortality in patients in the ICU that we treated during a 1-year period.

PATIENTS AND METHODS: The files of patients with COVID-19 (n=220) who were treated in our ICU between March 21st, 2020, and June 1st, 2021, were analyzed retrospectively. Demographic data of the patients, laboratory data, and treatments were examined. Patients were divided into two groups, group I patients without AKI and, group II patients with AKI. The patients with AKI were evaluated according to the theKidney Disease Improving Global Outcomes (KDIGO) classification and were graded.

RESULTS: Of the 220 patients included in the study, 89 were female and 131 were male. The mean age of patients with AKI (70.92±11.28 years) was statistically significantly higher than among those without AKI (58.87±13.63 years) (p<0.001). In patients with AKI, ICU length of stay, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, initial lactate levels, need for mechanical ventilation, duration of mechanical ventilation, and secondary infection rates were found to be statistically significantly higher. Discharge rates from the ICU in patients without AKI were statistically higher (75.3% vs. 26.6%), and mortality rates were significantly higher in patients with AKI (67.8% vs. 14.3%).

CONCLUSIONS: Various studies conducted have shown that patients with COVID-19 are at risk for AKI, and this is closely related to age, sex, and disease severity. The presence of AKI in patients with COVID-19 increases mortality, and this is more evident in patients hospitalized in the ICU. In our study, the prevalence of AKI was higher in older patients with high APACHE II scores and initial lactate levels. Comorbidities such as hypertension, chronic kidney disease, and coronary artery disease in patients with AKI were higher than in those without AKI.

PMID:35302225 | DOI:10.26355/eurrev_202203_28245

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Indications and outcomes for elective dissection of level V in primary parotid cancer

Head Neck. 2022 Mar 18. doi: 10.1002/hed.27030. Online ahead of print.

ABSTRACT

BACKGROUND: The extent of cervical lymphadenectomy required for primary parotid cancer is not well-established.

METHODS: In this retrospective case-control study, 84 patients who underwent primary parotidectomy and neck dissection for primary parotid cancer between 2010 and 2019 were identified and analyzed.

RESULTS: Of the 84 patients, 37 underwent elective level V neck dissection. All six (16.0%) who had occult level V nodes had clinically evident, preoperative anterior cervical metastases, a statistically significant finding. No other clinical factors are correlated with posterior neck involvement. There was no significant difference in disease-free or overall survival for patients with occult level V disease relative to positive lymph nodes in other levels.

CONCLUSIONS: Patients with clinically evident anterolateral cervical lymphatic metastases from parotid cancer preoperatively have high rates of occult level V nodes. Level V neck dissection can be avoided in cN0 patients and offered no survival advantage.

PMID:35302270 | DOI:10.1002/hed.27030

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Local anesthesia with sedation and general anesthesia for the treatment of chronic subdural hematoma: a systematic review and meta-analysis

Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1625-1631. doi: 10.26355/eurrev_202203_28230.

ABSTRACT

OBJECTIVE: Drilling and drainage is the main treatment for chronic subdural hematoma (cSDH). However, anesthesia methods also have an important effect on patients’ postoperative outcomes. The clinical effect of drainage of cSDH under local anesthesia with sedation (LAS) and general anesthesia (GA) was systematically evaluated.

MATERIALS AND METHODS: A literature study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies that compare LAS and GA for cSDH. The following treatment outcomes were compared between LAS and GA: total duration of surgery, postoperative complications, mortality, recurrence rate, and hospital length of stay (LOS).

RESULTS: Four papers (n = 391, LAS: 196, GA: 195) met the inclusion criteria. Although there was no statistically significant difference between the two groups in mortality (OR: 0.47, 95% CI: 0.06-3.84, p = 0.48; p = 0.2, I2 = 39%), recurrence rate (OR: 0.82, 95% CI: 0.33-2.04, p = 0.66; p = 0.69, I2 = 0%), LOS (ratio of means: 0.86, 95% CI: 0.71-1.05, p = 0.14; p = 0.02, I2 = 75%). The total duration of surgery (MD: -26.71 min, 95% CI: -37.29 to -16.13, p < 0.00001; p = 0.65, I2 = 0%) was significantly shorter and the number of postoperative complications was significantly lower in the LAS group compared with the GA group (OR: 0.25, 95% CI: 0.13-0.50, p < 0.0001; p= 0.62, I2 = 0%).

CONCLUSIONS: A systematic review and meta-analysis of the existing literature showed that LAS reduces the total duration of surgery and postoperative complications compared to GA. No significant difference in mortality, recurrence rate, and LOS was observed between the two groups.

PMID:35302209 | DOI:10.26355/eurrev_202203_28230

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Effect of human adipose-derived mesenchymal stem cell conditioned medium on musculoskeletal pain

Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1570-1578. doi: 10.26355/eurrev_202203_28223.

ABSTRACT

OBJECTIVE: Several studies in animal models have shown the safety and effectiveness of mesenchymal stem cell conditioned medium (MSC-CM) in inflammatory lesions involving muscles and joints.

PATIENTS AND METHODS: In this report, we retrospectively evaluated 16 patients who received local administration of the human adipose-derived mesenchymal stem cells conditioned medium (hAMSC-CM) for musculoskeletal chronic pain. Overall, 27 body locations expressing pain have been treated. The local administrated dose was 5 ml in the joint cavity and/or 2 ml in the other locations. The patients were asked to conduct self-evaluation of the degree of pain using a numeric rating scale (NRS) questionnaire and record the severity of pain before administration and at 15 min, 1 day, 1 week, and 4 weeks after administration. A second administration has been performed in 7 locations. The analysis was done considering two conditions: the “current pain status” and the “worst pain status in a week.”

RESULTS: The results showed statistically significant differences between before and after administration at each time point for “current pain status” and at 1-week and 4-week time points for “worst pain status in a week” after first administration (Tukey-Kramer test). After second administration, significant differences were found at 1-week and 4-week time points for “current pain status”. No serious adverse effect was found.

CONCLUSIONS: It was concluded that local administration of hAMSC-CM appears to be safe and could be expected to have effective therapeutic value against musculoskeletal chronic pain. Further studies are needed to clarify analgesic effects of hAMSC-CM and its underlying mechanism(s).

PMID:35302202 | DOI:10.26355/eurrev_202203_28223