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Nevin Manimala Statistics

Feasibility of T2 relaxation time in predicting the technical outcome of MR-guided high-intensity focused ultrasound treatment of uterine fibroids

Int J Hyperthermia. 2021;38(1):1384-1393. doi: 10.1080/02656736.2021.1976850.

ABSTRACT

PURPOSE: The aim of this study was to assess the feasibility of T2 relaxation time in predicting the immediate technical outcome i.e., nonperfused volume ratio (NPVr) of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) treatment of symptomatic uterine fibroids and to compare it with existing T2-weighted imaging methods (Funaki classification and scaled signal intensity, SSI).

MATERIALS AND METHODS: 30 patients with 32 uterine fibroids underwent an MRI study including a quantitative T2 relaxation time measurement prior to MRgHIFU treatment. T2 relaxation times were measured with a multi-echo fast imaging-based technique with 16 echoes. The correlation between pretreatment values of the uterine fibroids and treatment outcomes, that is nonperfused volume ratios (NPVr), was assessed with nonparametric statistical measures. T2 relaxation time-based method was compared to existing T2-weighted imaging-based methods using receiver-operating-characteristics (ROC) curve analysis and Chi-square test.

RESULTS: Nonparametric measures of association revealed a statistically significant negative correlation between T2 relaxation time values and NPVr. The T2 relaxation time classification (T2 I, T2 II, and T2 III) resulted in the whole model p-value of 0.0019, whereas the Funaki classification resulted in a p-value of 0.56. The T2 relaxation time classification (T2 I and T2 II) achieved a whole model of a p-value of 0.0024, whereas the SSI classification had a p-value of 0.0749.

CONCLUSIONS: A longer T2 relaxation time of the fibroid prior to treatment correlated with a lower NPVr. Based on our results, the T2 relaxation time classifications seem to outperform the Funaki classification and the SSI method.

PMID:34542013 | DOI:10.1080/02656736.2021.1976850

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Nevin Manimala Statistics

Effect of bio-banding on physiological and technical-tactical key performance indicators in youth elite soccer

Eur J Sport Sci. 2021 Sep 19:1-9. doi: 10.1080/17461391.2021.1974100. Online ahead of print.

ABSTRACT

Bio-banding has been introduced to reduce the impact of inter-individual differences due to biological maturation among youth athletes. Existing studies in youth soccer have generally examined the pilot-testing application of bio-banding. This is the first study that investigated whether bio-banded (BB) versus chronological age (CA) competition affects reliable physiological and technical-tactical in-game key performance indicators (KPIs) using a randomized cross-over repeated measures design. Sixty-five youth elite soccer players from the under-13 (U13) and under-14 (U14) age category and with maturity offsets (MO) between -2.5 and 0.5 years, competed in both a BB and CA game. For statistical analysis, players were divided into four sub-groups according to CA and MO: U13MOlow (CA ≤ 12.7, MO ≤ -1.4), U13MOhigh (CA ≤ 12.7, MO > -1.4), U14MOlow (CA > 12.7, MO ≤ -1.4), U14MOhigh (CA > 12.7, MO > -1.4). The two-factor mixed ANOVA revealed significant (p < .05) interactions between competition format and sub-group for the KPIs high accelerations (ηp2 = .176), conquered balls (ηp2 = .227) and attack balls (ηp2 = .146). Especially, U13MOhigh (i.e. early maturing players) faced a higher physiological challenge by having more high accelerations (|d| = 0.6) in BB games. Notably, U14MOlow (i.e. late maturing players) had more opportunities to show their technical-tactical abilities during BB games with more conquered balls (|d| = 1.1) and attack balls (|d| = 1.6). Affected KPIs indicate new challenges and learning opportunities during BB competition depending on a player’s individual maturity status. Bio-banding can beneficially be applied to enhance the talent development of youth elite soccer players.

PMID:34542017 | DOI:10.1080/17461391.2021.1974100

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Nevin Manimala Statistics

Assessment of medical and pharmaceutical waste flows during the coronavirus pandemic in the Rabat-Sale-Kenitra region, Morocco

Waste Manag Res. 2021 Sep 18:734242X211046853. doi: 10.1177/0734242X211046853. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has created unprecedented difficulties for health care institutions, which are required to manage not only the flow of patients with COVID-19, but also the management of medical and pharmaceutical waste (MPW). At the level of Morocco, the waste produced by hospitals has risen sharply in the regions most affected by the virus, such as the Rabat-Sale-Kenitra region (15.05% of recorded cases). The objective of this study is to perform a descriptive statistical analysis and to evaluate the generation rates of MPW generated during the treatment of the coronavirus pandemic, with reference to a large health care hospital in the region, in order to enable decision-makers to adopt responses in terms of regular and continuous management of MPW. The Moulay Abdellah hospital in Sale has a bedding capacity allocated to the COVID-19 patient of 110 beds with a Average Occupation Rate (AOR) of 100% and an average production of 13tons per month. The study showed that the average rate of MPW generated is 4 kg per bed per day, which is twice as high as the average generation rate during normal operation in 2019. As well, frequency analysis of the data revealed that MPW generation follows a log normal distribution with a correlation coefficient of 0.9. The distribution is skewed to the right and flatter than the normal distribution curve as judged by the skewness coefficient which is 0.87 and kurtosis coefficient which has a value of 1.286, indicating a deviation from normality.

PMID:34541985 | DOI:10.1177/0734242X211046853

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Nevin Manimala Statistics

A statistical fix for archaeology’s dating problem

Archaeologists have long had a dating problem. The radiocarbon analysis typically used to reconstruct past human demographic changes relies on a method easily skewed by radiocarbon calibration curves and measurement uncertainty. And there’s never been a statistical fix that works — until now.
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Nevin Manimala Statistics

Safety and efficacy of urethroplasty based on age groups

Actas Urol Esp (Engl Ed). 2021 Sep 12:S2173-5786(21)00090-1. doi: 10.1016/j.acuroe.2021.07.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the results and complications after urethroplasty based on patient age groups. As secondary objective, we analyzed the impact of operative complexity on each age group.

MATERIAL AND METHODS: This is a retrospective cohort study that include male patients who underwent urethroplasty between January 2011 and December 2018. Data was obtained from the patients’ electronic health records. Patients were grouped as follows: <60 years, 60-79 years and >80 years. Variables evaluated were history, comorbidities, previous surgeries and operative complexity. Restenosis-free survival and complications presented in each group were determined according to the Clavien-Dindo classification system. The SPSS® program was used for statistical analysis.

RESULTS: A total of 783 patients were included, and the mean follow-up was 19 months. The estimated 2-year restenosis-free survival in the population under 60, 60-79 and over 80 years was 87, 87 and 93.9% (IC 95%), respectively. Univariate analysis showed that the age group was not a predictor of restenosis. Complex surgery is the only predictor of recurrence, increasing the risk by 60% (HR 1.64, 95% CI 1.05-2.56, p = 0.029). There was an overall complication rate of 30.8%, and 62% of these were Clavien ≤ II. We found no association between the frequency of complications and age.

CONCLUSIONS: Urethroplasty is safe and effective regardless of age group. There are no statistically significant differences in outcomes and complications shown by the age group comparison. There were no significant differences when analyzing the impact of complex surgeries among the different age groups. The data indicate that age alone should not be taken as an absolute exclusion criterion for patients needing urethral reconstruction.

PMID:34526253 | DOI:10.1016/j.acuroe.2021.07.004

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Endoscopic treatment of primary vesicoureteral reflux in children with two different bulking agents, high success and low complication rates: Comparison of Dexell and Vantris

Actas Urol Esp (Engl Ed). 2021 Sep 12:S2173-5786(21)00088-3. doi: 10.1016/j.acuroe.2021.07.002. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVES: To compare the results in terms of efficacy and safety of the endoscopic management for vesicoureteral reflux (VUR) in two different standardized primary VUR cohorts treated with Dexell and Vantris.

PATIENTS: 128 refluxing renal units (RRU) in 87 patients with primary VUR (64 females, 23 males). Patients with secondary VUR and severe bladder and bowel dysfunction were excluded. A total of 22 continent children with mild bladder-bowel dysfunction underwent bladder-bowel training before the implantation. All procedures were performed in the presence of sterile urine using a conventional subureteral transurethral injection technique.

RESULTS: There were no statistically significant differences between groups in terms of mean age, sex, RRU side, 99mTc-DMSA uptake, and reflux grade. The overall resolution rates based on the number of RRUs for up to three endoscopic treatments were 80% (56/70) in Dexell group and 94.8% (55/58) in Vantris group (P = .012). No postoperative recurrences or vesicoureteral junction obstructions were seen in any group.

CONCLUSIONS: Dexell and Vantris provided an effective and safe endoscopic VUR treatment in the early and mid-term follow up of children with primary VUR. The effectiveness of these substances, which can produce different mass effects with different particle sizes, in safe VUR resolution, needs further investigations.

PMID:34526255 | DOI:10.1016/j.acuroe.2021.07.002

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Nevin Manimala Statistics

Perioperative Two-Dimensional Left Ventricular Global Longitudinal Strain in Coronary Artery Bypass Surgery: A Prospective Observational Pilot Study

J Cardiothorac Vasc Anesth. 2021 Aug 25:S1053-0770(21)00640-6. doi: 10.1053/j.jvca.2021.08.004. Online ahead of print.

ABSTRACT

OBJECTIVES: There are limited data on perioperative left ventricular strain. The authors aimed to describe the entire perioperative course of two-dimensional left ventricular global longitudinal strain in patients undergoing coronary artery bypass graft (CABG) surgery and compare to common parameters of LV function assessment.

DESIGN: Prospective observational study.

SETTING: Single university hospital.

PARTICIPANTS: Forty patients scheduled for isolated on-pump CABG surgery with preserved left and right ventricular function with an unremarkable, complication-free perioperative course.

INTERVENTIONS: Two-dimensional strain analysis and standard echocardiographic assessment of left ventricular function were performed pre- (T1) and postoperatively (T4) by transthoracic echocardiography (TTE) and intraoperatively pre- (T2) and poststernotomy (T3) by transesophageal echocardiography (TEE). Echocardiography was performed under stable hemodynamics and predefined fluid management, in sinus rhythm without any vasoactive support.

MEASUREMENTS AND MAIN RESULTS: Analysis of two-dimensional LV global longitudinal strain (2D-LV GLS) was performed using Tomtec 2D Cardiac Performance Analysis software. Philips QLAB 10.8 was used to analyze left ventricular ejection fraction (LV EF) and tissue velocity of the lateral mitral annulus (LV S ́). There were no significant differences (median with interquartile range [IQR]) after induction of anesthesia in values of LV EF and 2D-LV GLS (T1 v T2; 59% [IQR, 52 to 64] v 56% [IQR, 51.75 to 63] and -15.2 [IQR, -18.05 to -13.08] v -15.6 [IQR, -17.65 to -13.88]; both not significant [ns]), while LV S´ declined (T1 v T2, 7 cm/s [IQR, 5.25 to 8] v 5.25 cm/s [IQR, 4.6 to 6.83]; p < 0.001). Bland-Altman analysis for this comparison of 2D-LV GLS (T1 v T2) showed that bias was not significant between both techniques; however, there were limits of agreement. After sternotomy (T2 v T3) neither LV EF nor 2D-LV GLS or LV S´ declined. 2D-LV GLS deteriorated significantly after CABG (T1 v T4; -15.2 [IQR, -18.05 to -13.08] v -11.3 [IQR, -15.8 to -9.78]; p < 0.001). In contrast, LV EF and LV S´ did not change significantly in the perioperative interval (T1 v T4; 59% [IQR, 52 to 64] v 56% [IQR, 51.5 to 64.25] and 7 cm/s [IQR, 5.25 to 8] v 7 cm/s [IQR, 6 to 8]; both ns).

CONCLUSION: Values of 2D-LV GLS did not differ in awake, spontaneously breathing patients assessed by TTE and in anesthetized and ventilated patients with stable hemodynamics measured by TEE. 2D-LV GLS did not change after sternotomy; however, it declined significantly after on-pump CABG, while LV EF and LV S´ remained unchanged.

PMID:34526240 | DOI:10.1053/j.jvca.2021.08.004

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Dosing of Opioid Medications During and After Pediatric Cardiac Surgery for Children With Down Syndrome

J Cardiothorac Vasc Anesth. 2021 Aug 15:S1053-0770(21)00691-1. doi: 10.1053/j.jvca.2021.08.019. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether children with Down syndrome (DS) receive higher doses of opioid medications compared with children without DS for repair of complete atrioventricular canal (CAVC).

DESIGN: A retrospective chart review of children with and without DS who underwent primary repair of CAVC. The exclusion criteria included unbalanced CAVC and patients undergoing biventricular staging procedures. The primary outcome was oral morphine equivalents (OME) received in the first 24 hours after surgery. The secondary outcomes included intraoperative OME, OME at 48 and 72 hours, nonopioid analgesic and sedative medications received, pain scores, time to extubation, and length of stay.

SETTING: A pediatric academic medical center in the United States.

PARTICIPANTS: One hundred thirty-one patients with DS and 24 without, all <two years old, who underwent a CAVC repair.

INTERVENTIONS: Not applicable.

MEASUREMENTS AND MAIN RESULTS: Patients with DS were older than patients without DS (median 96.3 days [interquartile range {IQR} 70.7-128.2] v 75.9 days [IQR 49.8-107.3], p = 0.033) but otherwise not statistically different in the baseline characteristics. There was no difference in OME received in the first 24 hours postoperatively between groups (3.01 mg/kg [IQR 1.23-5.43] v 3.57 mg/kg [IQR 1.54-7.06], p = 0.202). OME at 48 and 72 hours was lower in the DS group compared with the control group. Similar amounts of opioid and non-opioid analgesics and sedatives were otherwise given to both groups of patients. Median pain scores did not differ between groups.

CONCLUSIONS: These results suggested that patients with DS undergoing CAVC repair do not have increased opioid requirements compared with a similar control group.

PMID:34526241 | DOI:10.1053/j.jvca.2021.08.019

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Predictors of academic performance during the covid-19 outbreak: impact of distance education on mental health, social cognition and memory abilities in an Italian university student sample

BMC Psychol. 2021 Sep 15;9(1):142. doi: 10.1186/s40359-021-00649-9.

ABSTRACT

BACKGROUND: This study aimed to investigate the impact of distance education (DE) on mental health, social cognition, and memory abilities in a sample of university students during the national COVID-19 lockdown in Italy and to identify the predictors of academic performance.

METHODS: Two hundred and three students (76.4% women, mean age 24.3, SD ± 4.9) responded to an anonymous online cross-sectional survey between July 15 and September 30, 2020, on DE experience and cognitive and social-cognitive variables. A short version of the Beck Depression Inventory-II, ten images from the Eyes Task, and five memory vignette stimuli were included in the survey. Descriptive, one-way ANOVA, correlation, and logistic regression analyses were conducted.

RESULTS: Half of the student sample reported significant impairment in concentration and learning abilities during DE. Regarding psychological health, 19.7%, 27.1%, and 23.6% of the sample reported mild, moderate, and severe depressive symptoms, respectively. Correlation analyses showed a statistically significant negative association between depression and the overall subjective evaluation of DE (r = – 0.359; p < 0.000). Changes in one’s study context and habits, i.e., studying alone at one’s parents’ home instead of studying with colleagues or alone in a university “social place” (e.g., the university library), seemed to increase the likelihood of poor academic performance by almost 3 times (O.R. 3.918; p = 0.032). This predictor was no longer statistically significant in the subsequent step when the individual impairment predictors were entered. Learning concentration impairment during DE (O.R. 8.350; p = 0.014), anxiety about COVID-19 contagion for oneself or others (O.R. 3.363; p = 0.022), female gender (O.R. 3.141; p = 0.045), and depressive symptomatology (O.R. 1.093; p = 0.047) were ultimately determined to be the strongest predictors of poor academic performance, whereas the appreciation of DE represented a protective variable (O.R. 0.610; p < 0.000).

CONCLUSIONS: The study showed a negative impact of DE on the mental health of students presenting depressive symptoms and impairment in concentration and learning, the latter identified as the strongest predictors of poor academic performances. The study confirms the emerging need to monitor the impact of DE, which occurred during the 2019/2020 academic year and will continue in the coming months, to refine educational offerings and meet students’ psychological needs by implementing psychological interventions based on the modifiable variables that seem to compromise students’ psychological well-being and academic outcomes.

PMID:34526153 | DOI:10.1186/s40359-021-00649-9

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Pseudo-Random Mating with Multiple Alleles

Twin Res Hum Genet. 2021 Sep 16:1-4. doi: 10.1017/thg.2021.35. Online ahead of print.

ABSTRACT

The conditions on the mating matrix associated with a stable equilibrium are specified for an autosomal locus with four alleles. An example illustrates how Hardy-Weinberg proportions are maintained with nonrandom mating. The ABO blood group provides an illustration.

PMID:34526157 | DOI:10.1017/thg.2021.35