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Medical Principles and Practice :... Apr 2024Finding a reliable preoperative predictor of complicated acute appendicitis (AA) has been a challenging diagnostic problem. The present study aimed to identify potential...
OBJECTIVE
Finding a reliable preoperative predictor of complicated acute appendicitis (AA) has been a challenging diagnostic problem. The present study aimed to identify potential factors that may predict complicated AA in the pediatric emergency department (ED) based on routine, widely available laboratory tests on admission to the ED, including plasma sodium concentration.
METHODS
We retrospectively reviewed clinical and laboratory data of pediatric patients with AA who underwent emergency surgery at our department between January 2020 and December 2022. The patients were divided into two groups: histopathologically proven complicated AA (n = 80), and non-complicated AA (n = 155).
RESULTS
Complicated AA was associated with reduced plasma sodium and chloride concentrations (p < 0.001, both), decreased values of lymphocytes (p = 0.002), elevated C-reactive protein (CRP) ( p < 0.001), elevated values of white blood cells (WBC) and neutrophils (p = 0.012 and 0.001, respectively). In binomial logistic regression, increased levels of CRP and WBC, and decreased levels of sodium were predictors of complicated AA. The area under the ROC curve was 0.825 (95% CI 0.764, 0.886).
CONCLUSION
We identified mild hyponatremia and elevated CRP and WBC values as potential markers for distinguishing complicated from uncomplicated pediatric AA with implications for surgical approaches for treating complicated AA and conservative approaches for treating uncomplicated AA.
PubMed: 38593764
DOI: 10.1159/000538778 -
Scientific Reports Nov 2023We aimed to investigate acute changes before and after low-intensity continuous and intermittent blood flow restriction (BFR) deep-squat training on thigh muscle...
We aimed to investigate acute changes before and after low-intensity continuous and intermittent blood flow restriction (BFR) deep-squat training on thigh muscle activation characteristics and fatigue level under suitable individual arterial occlusion pressure (AOP). Twelve elite male handball players were recruited. Continuous (Program 1) and intermittent (Program 2) BFR deep-squat training was performed with 30% one-repetition maximum load. Program 1 did not include decompression during the intervals, while Program 2 contained decompression during each interval. Electromyography (EMG) was performed before and after two BFR training programs in each period. EMG signals of the quadriceps femoris, posterior femoral muscles, and gluteus maximus, including the root mean square (RMS) and normalized RMS and median frequency (MF) values of each muscle group under maximum voluntary contraction (MVC), before and after training were calculated. The RMS value under MVC (RMS) of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and gluteus maximus (GM) decreased after continuous and intermittent BFR training programs, and those of the biceps femoris (BF) and semitendinosus (SEM) increased; The RMS standard values of the VL, BF, and SEM were significantly increased after continuous and intermittent BFR training (P < 0.05), The RMS value of GM significantly decreased after cuff inflating (P < 0.05). The MF values of RF, VM, VL, and GM decreased significantly after continuous BFR training (P < 0.05). Continuous BFR deep-squat training applied at 50% AOP was more effective than the intermittent BFR training program. Continuous application of BFR induces greater levels of acute fatigue than intermittent BFR that may translate into greater muscular training adaptations over time.
Topics: Male; Humans; Thigh; Muscle Fatigue; Muscle, Skeletal; Quadriceps Muscle; Electromyography
PubMed: 37932313
DOI: 10.1038/s41598-023-44523-7 -
Proceedings of the National Academy of... Oct 2023Cognitive scientists treat verification as a computation in which descriptions that match the relevant situation are true, but otherwise false. The claim is...
Cognitive scientists treat verification as a computation in which descriptions that match the relevant situation are true, but otherwise false. The claim is controversial: The logician Gödel and the physicist Penrose have argued that human verifications are not computable. In contrast, the theory of mental models treats verification as computable, but the two truth values of standard logics, and , as insufficient. Three online experiments (n = 208) examined participants' verifications of disjunctive assertions about a location of an individual or a journey, such as: 'You arrived at Exeter or Perth'. The results showed that their verifications depended on observation of a match with one of the locations but also on the status of other locations (Experiment 1). Likewise, when they reached one destination and the alternative one was impossible, their use of the truth value: increased (Experiment 2). And, when they reached one destination and the only alternative one was possible, they used the truth value, , and when the alternative one was impossible, they used the truth value: (Experiment 3). These truth values and those for falsity embody counterfactuals. We implemented a computer program that constructs models of disjunctions, represents possible destinations, and verifies the disjunctions using the truth values in our experiments. Whether an awareness of a verification's outcome is computable remains an open question.
Topics: Humans; Physicians; Software
PubMed: 37748054
DOI: 10.1073/pnas.2310488120 -
Foods (Basel, Switzerland) Dec 2023This study assessed edible oil industry byproducts, oil cakes (OC) based on hazelnuts and walnuts (HOC, WOC), to replace wheat flour dough (WD) based on farinograph and...
This study assessed edible oil industry byproducts, oil cakes (OC) based on hazelnuts and walnuts (HOC, WOC), to replace wheat flour dough (WD) based on farinograph and extensograph parameters and rheological measurements. The research hypothesis of this work is that replacing part of wheat flour with ground nut oil cakes modifies the rheological characteristics of the dough. WF was replaced at the level of 5%, 10% and 15%. It was shown that use of OC in flour mixtures at various levels significantly influenced the rheological properties of the dough. The water absorption of wheat flour and oil cake mixtures was higher than that of the control sample, and the average value of this indicator was 53.4%. The control sample had the lowest dough development time (DDT), and the presence of HOC or WOC in the system resulted in a significant increase in this parameter ( < 0.05). The average DDT of WDHOC cakes was 4.7 min and was lower compared to WDWOC which was 5.9 min. The WDWOC10% and WDWOC15% samples were characterized by the highest dough stability value and the lowest degree of softening ( < 0.05). The presence of OC in the flour mixtures increased the values of the storage and loss moduli, which was reflected in the K' and K″ values. The values of these parameters also increased as the level of OC addition increased. WDHOC doughs were characterized by higher values of the K' and K″ parameters compared to WDWOC. The results of the creep and recovery test showed that the dough with the addition of nut OC was less susceptible to deformation compared to the control dough ( < 0.05). The resistance to deformation increased with the increasing share of HOC or WOC in the mixtures. The average value of viscoelastic compliance (J) of this parameter for WDHOC dough was on average 1.8 × 10 Pa, and for WDWOC 2.0 × 10 Pa. Nut oil cakes are an interesting technological addition to the dough. Their use may have a positive impact on the characteristics of the finished product and expand their application possibilities in the food industry. This is because the dough with the addition of nut cakes was more stiff and less flexible and susceptible to deformation.
PubMed: 38201168
DOI: 10.3390/foods13010140 -
Frontiers in Psychology 2023Intentionally or not, humans produce rhythmic behaviors (e.g., walking, speaking, and clapping). In 1974, Paul Fraisse defined rhythmic behavior as a periodic movement... (Review)
Review
Intentionally or not, humans produce rhythmic behaviors (e.g., walking, speaking, and clapping). In 1974, Paul Fraisse defined rhythmic behavior as a periodic movement that obeys a temporal program specific to the subject and that depends less on the conditions of the action (p. 47). Among spontaneous rhythms, the spontaneous motor tempo (SMT) corresponds to the tempo at which someone produces movements in the absence of external stimuli, at the most regular, natural, and pleasant rhythm for him/her. However, intra- and inter-individual differences exist in the SMT values. Even if several factors have been suggested to influence the SMT (e.g., the age of participants), we do not yet know which factors actually modulate the value of the SMT. In this context, the objectives of the present systematic review are (1) to characterize the range of SMT values found in the literature in healthy human adults and (2) to identify all the factors modulating the SMT values in humans. Our results highlight that (1) the reference value of SMT is far from being a common value of 600 ms in healthy human adults, but a range of SMT values exists, and (2) many factors modulate the SMT values. We discuss our results in terms of intrinsic factors (in relation to personal characteristics) and extrinsic factors (in relation to environmental characteristics). Recommendations are proposed to assess the SMT in future research and in rehabilitative, educative, and sport interventions involving rhythmic behaviors.
PubMed: 37920737
DOI: 10.3389/fpsyg.2023.1161052 -
Clinical Nutrition ESPEN Oct 2023Children affected by Down syndrome (DS) have a higher prevalence of obesity, dyslipidemia, and altered liver enzymes. This study investigates a small sample of pediatric...
BACKGROUND & AIMS
Children affected by Down syndrome (DS) have a higher prevalence of obesity, dyslipidemia, and altered liver enzymes. This study investigates a small sample of pediatric patients with DS and possible associations among their anthropometric and laboratory data.
METHODS
Cross-sectional study involving 33 children (5-17 years old) affected by DS. Children underwent the measurement of anthropometric parameters through bioelectrical impedance analysis and a venous sampling to check their hepatic and lipid profiles.
RESULTS
54.6% of subjects were overweight or obese according to WHO (BMI z-score ≥1) and 42% of subjects were overweight or obese according to McCarthy et al. with a percentage of body fat (PBF) ≥ 85° centiles. 28% of subjects were dyslipidemic, showing an alteration of total, LDL, HDL cholesterol or triglycerides according to our laboratory reference values, and a low HDL value (under the normal range for gender and age) was the most frequent lipidic alteration (12.5%). An association was found between some values: lower HDL value was associated with higher PBF (p = 0.025); higher ALT value was associated with higher BMI z-score (p = 0.01) and higher PBF (p = 0.01); higher GGT value was associated with higher BMI z-score (p = 0.002) and higher PBF (p = 0.002).
CONCLUSIONS
Children with DS are at high risk for obesity and its complications. Our results show dyslipidemia and altered liver enzymes in obese subjects. Pediatricians should monitor children with DS for obesity and consider liver function testing and lipid profiles on children with DS and obesity.
Topics: Humans; Child; Child, Preschool; Adolescent; Down Syndrome; Overweight; Cross-Sectional Studies; Body Composition; Obesity; Cholesterol, HDL
PubMed: 37739665
DOI: 10.1016/j.clnesp.2023.07.003 -
Canadian Journal of Anaesthesia =... Sep 2023The primary objective of our study was to determine how lowering a P value threshold from 0.05 to 0.005 would affect the statistical significance of previously published...
PURPOSE
The primary objective of our study was to determine how lowering a P value threshold from 0.05 to 0.005 would affect the statistical significance of previously published randomized controlled trials (RCTs) in major anesthesiology journals.
METHODS
We searched the PubMed database for studies electronically published in 2020 within three major general anesthesiology journals as indexed by both Google Metrics and Scimago Journal & Country Rank. Studies included were RCTs published in 2020 in Anesthesiology, Anesthesia & Analgesia, and the British Journal of Anaesthesia; had a primary endpoint, and used a P value threshold to determine the effect of the intervention. We performed screening and data extraction in a masked duplicate fashion.
RESULTS
Ninety-one RCTs met inclusion criteria. The most frequently studied type of intervention was drugs (44/91, 48%). From the 91 trials, 99 primary endpoints, and thus P values, were obtained. Fifty-eight (59%) endpoints had a P value < 0.05 and 41 (41%) had a P value ≥ 0.05. Of the 58 primary endpoints previously considered statistically significant, 21 (36%) P values would maintain statistical significance at P < 0.005, and 37 (64%) would be reclassified as "suggestive."
CONCLUSIONS
Lowering a P value threshold of 0.05 to 0.005 would have altered one third of significance interpretations of RCTs in the surveyed anesthesiology literature. Thus, it is important for readers to consider post hoc probabilities when evaluating clinical trial results. Although the present study focused on the anesthesiology literature, we suggest that our results warrant further research within other fields of medicine to help avoid clinical misinterpretation of RCT findings and improve quality of care.
Topics: Humans; Anesthesiology; Randomized Controlled Trials as Topic; Periodicals as Topic; Anesthesia
PubMed: 37561351
DOI: 10.1007/s12630-023-02529-9 -
Skeletal Radiology Dec 2023To validate the subjective image quality and lesion detectability of deep learning-accelerated Dixon (DL-Dixon) imaging of the cervical spine compared with routine Dixon...
OBJECTIVES
To validate the subjective image quality and lesion detectability of deep learning-accelerated Dixon (DL-Dixon) imaging of the cervical spine compared with routine Dixon imaging.
MATERIALS AND METHODS
A total of 50 patients underwent sagittal routine Dixon and DL-Dixon imaging of the cervical spine. Acquisition parameters were compared and non-uniformity (NU) values were calculated. Two radiologists independently assessed the two imaging methods for subjective image quality and lesion detectability. Interreader and intermethod agreements were estimated with weighted kappa values.
RESULTS
Compared with the routine Dixon imaging, the DL-Dixon imaging reduced the acquisition time by 23.76%. The NU value is slightly higher in DL-Dixon imaging (p value: 0.015). DL-Dixon imaging showed superior visibility of all four anatomical structures (spinal cord, disc margin, dorsal root ganglion, and facet joint) for both readers (p value: < 0.001 ~ 0.002). The motion artifact scores were slightly higher in the DL-Dixon images than in routine Dixon images (p value = 0.785). Intermethod agreements were almost perfect for disc herniation, facet osteoarthritis, uncovertebral arthritis, central canal stenosis (κ range: 0.830 ~ 0.980, all p values < 0.001) and substantial to almost perfect for foraminal stenosis (κ = 0.955, 0.705 for each reader). There was an improvement in the interreader agreement of foraminal stenosis by DL-Dixon images, from moderate to substantial agreement.
CONCLUSION
The DLR sequence can substantially decrease the acquisition time of the Dixon sequence with subjective image quality at least as good as the conventional sequence. And no significant differences in lesion detectability were observed between the two sequence types.
Topics: Humans; Magnetic Resonance Imaging; Constriction, Pathologic; Deep Learning; Reproducibility of Results; Cervical Vertebrae
PubMed: 37233758
DOI: 10.1007/s00256-023-04364-x -
African Journal of Laboratory Medicine 2023Critical value notification (CVN) entails notifying doctors or other laboratory users of aberrant laboratory results that threaten the patient's life and of any values...
BACKGROUND
Critical value notification (CVN) entails notifying doctors or other laboratory users of aberrant laboratory results that threaten the patient's life and of any values for which reporting delays could negatively impact the patient's health. Critical value notification practices in clinical laboratories in Nigeria and sub-Saharan Africa are largely unknown.
OBJECTIVE
We conducted a nationwide survey to obtain baseline information on CVN practice by Nigeria's laboratories.
METHODS
This cross-sectional study was conducted among purposively selected secondary- and tertiary-tier, public and private clinical laboratories across northern and southern Nigeria between October 2015 and December 2015. Consenting senior laboratory staff completed and returned a structured questionnaire, that gathered data on respondents' demographics, designations, and institutional characteristics and practices regarding CVN.
RESULTS
One hundred and thirty-four laboratories responded to the questionnaires. Only 69 (51.5 %) laboratories practised CVN; only 23 (33.3%) had existing written policies guiding the practice. Most (43; 62.3%) laboratories use similar critical values (CVs) for adult and paediatric populations. Most laboratories (27; 39.1%) obtained their CVs by combining published literature and local opinions from stakeholders. Physical dispatch (42; 60.9%) followed by telephone calls (38; 55.1%) were the most common means of notification. Private laboratories, compared with public hospital laboratories, were likelier to have separate paediatric CV lists ( = 0.019) and practise telephone notifications ( < 0.001).
CONCLUSION
Critical value notification practices vary and are often suboptimal in many clinical laboratories in Nigeria, which is exacerbated by the absence of guiding policies and national recommendations for post-analytical procedures.
WHAT THIS STUDY ADDS
This study provides baseline information on CVN practice by Nigeria's laboratories. The study explores the causes of practice variations that can serve as a foundation for enhancing critical reporting and post-analytical services, particularly in clinical laboratories in sub-Saharan Africa.
PubMed: 38116517
DOI: 10.4102/ajlm.v12i1.2249 -
Advanced Biomedical Research 2023CA125 levels show a variation in premenopausal women during the menstrual cycle. Moreover, various modifiable and non-modifiable factors affect its value which needs to...
BACKGROUND
CA125 levels show a variation in premenopausal women during the menstrual cycle. Moreover, various modifiable and non-modifiable factors affect its value which needs to be taken into account while interpreting the results. The study was done with an objective (1) to determine differences in CA125 levels during the mid-cycle and menstrual phase of menstruation and (2) to determine the factors (demographic and clinical) that may affect CA125 values.
MATERIALS AND METHODS
An observational study was conducted from December 2017 to May 2019. Women of reproductive age group of 15-45 years with regular menstrual cycles were included in the study. The CA125 levels were compared among mid-cycle values and values during menstruation. A mean of the values was taken, and factors affecting it were determined by regression analysis. < 0.05 was considered statistically significant.
RESULTS
The mean age of the patients was 28.71 ± 6.14 years. The median day of sample collection during menses was day 2 and during mid-cycle was day 14. Compared to mid-cycle CA125 values, values during menses were significantly higher (24.74 ± 17.43 vs. 12.39 ± 7.3, < 0.0001) with a mean difference of 12.35 ± 15.04. Multivariate regression analysis showed that days of menses (beta coefficient 3.49, = 0.0001) and regular caffeine consumption (beta coefficient 7.074, = 0.007) were significant independent positive risk factors of CA125 levels.
CONCLUSION
In conclusion, CA125 levels are significantly higher during menstruation as compared to mid-cycle values in premenopausal women. The significant factors leading to higher CA125 levels are days of menses and caffeine consumption.
PubMed: 38073732
DOI: 10.4103/abr.abr_100_23