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Journal of Children's Orthopaedics Feb 2020Spinal sagittal alignment restoration has been associated with improved functional outcomes and with reduced complications rates. Several limitations exist for... (Review)
Review
PURPOSE
Spinal sagittal alignment restoration has been associated with improved functional outcomes and with reduced complications rates. Several limitations exist for radiological analysis in cerebral palsy (CP) patients. The goal of this study was to summarize the existing literature and report the important considerations to evaluate in a CP patient undergoing spinal surgery.
METHODS
A retrospective radiological analysis was performed, including non-ambulant CP children with progressive scoliosis. Full-spine sitting radiographs performed pre-and postoperatively were required to measure spino-pelvic sagittal parameters.
RESULT
A total of 23 non-ambulating CP patients were included, mean age 16.0 years (standard error of the mean 0.5). Two distinct groups of patients were identified. Group 1 (61%) were patients with less trunk control (lumbar lordosis (LL) < 50°), retroverted and vertical pelvis (mean sacral slope (SS) 11.4° and pelvic tilt (PT) 38.1°) and anterior imbalance (mean sagittal vertical axis (SVA) 5.9 cm) and Group 2 (39%) were patients with better trunk control (LL > 60°, anteverted and horizontal pelvis (mean SS 49.3°, PT 9.7°) and posterior imbalance (mean SVA 5.8 cm). Postoperative measures showed significant impact of surgery with a PT reduction of 19° (p = 0.007), a mean SS increase of 15° (p = 0.04) and a LL gained of 10° (p = 0.2).
CONCLUSION
Sagittal spino-pelvic alignment in non-ambulating CP patients remains difficult to assess. The current literature is poor but our radiological study was able to define two distinct groups among Gross Motor Function Classification System (GMFCS) level V patients, based on the quality of their trunk control. All possible factors that may influence head and trunk posture should be systematically considered and optimized.
LEVEL OF EVIDENCE
Level IV.
PubMed: 32165977
DOI: 10.1302/1863-2548.14.190160 -
Respiratory Care Apr 2022Blood gas quality control (QC) is an essential and mandatory part of a laboratory's quality plan. The acceptable QC range should be 2 SD from the mean value. The use of...
BACKGROUND
Blood gas quality control (QC) is an essential and mandatory part of a laboratory's quality plan. The acceptable QC range should be 2 SD from the mean value. The use of assayed QC material does not negate the responsibility of the laboratory to calculate the mean and 2 SD ranges of QC measurements for verification. Verifying assayed QC ranges is a Clinical Laboratory Improvement Amendment (CLIA) requirement. This study shows the results of assayed QC mean and 2 SD range verification from a blood gas analyzer.
METHODS
QC data from a blood gas analyzer were compared to manufacturer-provided mean and ranges. The percent difference between the measured mean and the manufacturer-provided mean was calculated to assess agreement. The measured SD was used to determine how many SD the manufacturer-provided ranges were from the measured mean.
RESULTS
The largest difference in mean values was 2.27% > the manufacturer-provided mean. Forty-eight percent of all mean value comparisons showed a difference of 0%, and 71% were < 1%. The manufacturer-provided ranges were considerably wider than the measured 2 SD range, ranging from 2.4-75 SD. None of the manufacturer-provided ranges were deemed acceptable for clinical use.
CONCLUSIONS
Our analysis validates the CLIA mandate and American Association for Respiratory Care Clinical Practice Guideline recommendation that laboratories must verify manufacturer-provided QC means and ranges and adjust QC means and ranges to match the performance of their blood gas analyzer.
Topics: Humans; Laboratories; Quality Control
PubMed: 35078931
DOI: 10.4187/respcare.09342 -
The Journal of Neuroscience : the... Feb 2022It is clear that humans can extract statistical information from streams of visual input, yet how our brain processes sequential images into the abstract representation...
It is clear that humans can extract statistical information from streams of visual input, yet how our brain processes sequential images into the abstract representation of the mean feature value remains poorly explored. Using multivariate pattern analyses of electroencephalography recorded while human observers viewed 10 sequentially presented Gabors of different orientations to estimate their mean orientation at the end, we investigated sequential averaging mechanism by tracking the quality of individual and mean orientation as a function of sequential position. Critically, we varied the sequential variance of Gabor orientations to understand the neural basis of perceptual mean errors occurring during a sequential averaging task. We found that the mean-orientation representation emerged at specific delays from each sequential stimulus onset and became increasingly accurate as additional Gabors were viewed. Especially in frontocentral electrodes, the neural representation of mean orientation improved more rapidly and to a greater degree in less volatile environments, whereas individual orientation information was encoded precisely regardless of environmental volatility. The computational analysis of behavioral data also showed that perceptual mean errors arise from the cumulative construction of the mean orientation rather than the low-level encoding of individual stimulus orientation. Thus, our findings provide neural mechanisms to differentially accumulate increasingly abstract features from a concrete piece of information across the cortical hierarchy depending on environmental volatility. The visual system extracts behaviorally relevant summary statistical representation by exploiting statistical regularity of the visual stream over time. However, how the neural representation of the abstract mean feature value develops in a temporally changing environment remains poorly identified. Here, we directly recover the mean orientation information of sequentially delivered Gabor stimuli with different orientations as a function of their positions in time. The mean orientation representation, which is regularly updated, becomes increasingly accurate with increasing sequential position especially in the frontocentral region. Further, perceptual mean errors arise from the cumulative process rather than the low-level stimulus encoding. Overall, our study reveals a role of higher cortical areas in integrating stimulus-specific information into increasingly abstract task-oriented information.
Topics: Brain; Electroencephalography; Female; Humans; Male; Orientation; Photic Stimulation; Visual Perception
PubMed: 34903571
DOI: 10.1523/JNEUROSCI.0628-21.2021 -
BMJ Open Ophthalmology 2020To validate the extrapolated norms or e-norms methodology in establishing a reference range for the biometric data used for intraocular lens power calculation.
OBJECTIVE
To validate the extrapolated norms or e-norms methodology in establishing a reference range for the biometric data used for intraocular lens power calculation.
METHODS AND ANALYSIS
All measurements were performed with an optical low-coherence reflectometer. A novel technique, the e-norms methodology, was used to determine the normative values of measurements.
RESULTS
Eyes (n=500) were measured to evaluate the axial length (AL), K readings (Ks), anterior chamber depth (ACD) and lens thickness (LT). Using the e-norms methodology, the normal AL ranged from 22.50 to 24.50 mm (mean=23.50 mm), with medium-long eyes between 24.51 and 24.99 mm and the long eyes measuring 25.00 mm and longer; the medium-short eyes ranged from 22.01 and 22.49 mm, with the short eyes measuring 22.00 mm and shorter. Normal values ranged from 2.50 to 3.50 mm for ACD (mean=3.00 mm), from 4.40 to 5.44 mm for LT (mean=4.92 mm), and from 42.50 to 44.82 dioptres for Ks (mean=43.66 dioptres).
CONCLUSION
Measurements of the biometric mean values compared favourably with published data. The e-norms methodology assisted in establishing a biometric reference range. Furthermore, it allowed us to cluster patients into groups based on AL differences.
PubMed: 33024826
DOI: 10.1136/bmjophth-2020-000500 -
Attention, Perception & Psychophysics Apr 2021Research on ensemble perception has shown that people can extract both mean and variance information, but much less is understand how these two different types of...
Research on ensemble perception has shown that people can extract both mean and variance information, but much less is understand how these two different types of summaries interact with one another. Some research has argued that people are more erroneous in extracting the mean of displays that have greater variability. In all three experiments, we manipulated the variability in the displays. Participants reported the mean size of a set of circles (Experiment 1) and mean length of horizontally placed (Experiment 2a) and randomly oriented lines (Experiment 2b). In all experiments, we found that mean size estimations were more erroneous for higher than smaller variance displays. More critically, there was a tendency to overestimate the mean, driven by variance in both task-relevant and task-irrelevant features. We discuss these findings in relation to limitations in concurrent summarization ability and outlier discounting in ensemble perception.
Topics: Humans; Orientation, Spatial
PubMed: 33772448
DOI: 10.3758/s13414-021-02269-2 -
Andrology Nov 2019The correlation between the increased mean platelet volume and varicocele is controversial.
BACKGROUND
The correlation between the increased mean platelet volume and varicocele is controversial.
OBJECTIVES
We designed this research to demonstrate the correlation relationship between varicocele and mean platelet volume by studying the changes of mean platelet volume in patients with varicocele before and after operation.
MATERIALS AND METHODS
A total of 317 patients with left unilateral varicocele underwent operation, and 293 healthy adult males were enrolled in the study. We collected diagnostic data for preoperative patients through physical examination, color Doppler ultrasonography, and blood routine, and recorded the follow-up data at 6 months after operation for varicocele. Platelet indices and the degree of varicocele or the diameter of spermatic vein correlation analysis were performed. Mean platelet volume values of preoperative and 6-month postoperative were statistically evaluated.
RESULTS
We found that the degree of varicocele and the diameter of spermatic vein were positively correlated with mean platelet volume (p = 0.001 or p < 0.001). When the left unilateral varicocele patients and healthy subjects were compared, there was a significant increase in mean platelet volume (p = 0.003). Mean platelet volume values of 96 varicocele patients who were cured by operation for varicocele after 6 months were decreased significantly more than preoperative (p = 0.039), but 32 varicocele patients of 6-month postoperative recurrence could not prove this change (p = 0.930).
DISCUSSION AND CONCLUSION
Our research proves that mean platelet volume was positively correlated with the degree of varicocele and the diameter of spermatic vein and varicocele patients showed significantly higher mean platelet volume than healthy subjects. The mean platelet volume of varicocele patients cured by operation for varicocele after 6 months was lower than before, but there was no difference in mean platelet volume between 6-month postoperative recurrent patients with preoperative.
Topics: Adult; Blood Platelets; Cross-Sectional Studies; Humans; Male; Mean Platelet Volume; Sperm Count; Sperm Motility; Spermatozoa; Ultrasonography, Doppler, Color; Varicocele; Veins; Young Adult
PubMed: 30969016
DOI: 10.1111/andr.12605 -
Psycho-oncology Dec 2022Demoralization is a prevalent psychological problem among cancer patients and reflects a sense of subjective incompetence. This systematic review aims to identify... (Review)
Review
OBJECTIVE
Demoralization is a prevalent psychological problem among cancer patients and reflects a sense of subjective incompetence. This systematic review aims to identify factors influencing demoralization among cancer patients.
METHODS
Eleven databases were systematically searched from database inception to 31 December 2020. Google Scholar and relevant reference lists were supplementarily searched. Studies reporting demoralization measured by Demoralization Scale and its influencing factors among cancer patients were included. A qualitative synthesis was conducted owing to the heterogeneity of the study outcome.
RESULTS
A total of 49 studies involving 10,712 participants were included in this review. The results showed substantial effect size variation, but the psychological factors showed the strongest magnitude of association. Among the biological factors, the number of physical symptoms (mean r values [rs]: 0.331) was associated with increased demoralization. Among the psychological factors, negative psychological factors include hopelessness (mean rs: 0.633), desire for death (mean rs: 0.620), dignity-related distress (mean rs: 0.595), depression (mean rs: 0.593), anxiety (mean rs: 0.589), psychological distress (mean rs: 0.465), and suicidal ideation (mean rs: 0.460) were related to increased demoralization; whereas positive psychological factors including hope (mean rs: -0.565), attachment security (mean rs: -0.530), and sense of coherence (mean rs: -0.453) were related to decreased demoralization. Among the social factors, social support (mean rs: -0.330) was negatively related to demoralization, and the demographic factors were still controversial. Quality of life was considered to be at the intersection of biopsychosocial factors and negatively associated with demoralization (mean rs: -0.599).
CONCLUSIONS
Demoralization is a consequence of the interaction of physical, psychological, and social factors among cancer patients. Factors with a significant effect should not be overlooked when designing an intervention to reduce demoralization. It is necessary to distinguish demoralization from other negative psychological states and further explore positive psychological factors influencing demoralization among cancer patients.
Topics: Humans; Demoralization; Quality of Life; Stress, Psychological; Anxiety; Neoplasms
PubMed: 36016470
DOI: 10.1002/pon.6023 -
Sensors (Basel, Switzerland) Jan 2022This study evaluates the progression of visual fatigue induced by visual display terminal (VDT) using automatically detected blink features. A total of 23 subjects were...
This study evaluates the progression of visual fatigue induced by visual display terminal (VDT) using automatically detected blink features. A total of 23 subjects were recruited to participate in a VDT task, during which they were required to watch a 120-min video on a laptop and answer a questionnaire every 30 min. Face video recordings were captured by a camera. The blinking and incomplete blinking images were recognized by automatic detection of the parameters of the eyes. Then, the blink features were extracted including blink number (BN), mean blink interval (Mean_BI), mean blink duration (Mean_BD), group blink number (GBN), mean group blink interval (Mean_GBI), incomplete blink number (IBN), and mean incomplete blink interval (Mean_IBI). The results showed that BN and GBN increased significantly, and that Mean_BI and Mean_GBI decreased significantly over time. Mean_BD and Mean_IBI increased and IBN decreased significantly only in the last 30 min. The blink features automatically detected in this study can be used to evaluate the progression of visual fatigue.
Topics: Asthenopia; Blinking; Humans; Surveys and Questionnaires; Video Recording
PubMed: 35161662
DOI: 10.3390/s22030916 -
Obesity Surgery Apr 2022Metabolic dysfunction-associated fatty liver disease-related cirrhosis is possible at the time of bariatric surgery, complicated by further liver decompensation. Hepatic...
PURPOSE
Metabolic dysfunction-associated fatty liver disease-related cirrhosis is possible at the time of bariatric surgery, complicated by further liver decompensation. Hepatic decompensation can also occur in the absence of cirrhosis but the presentation is less clear.
METHODS
We analyze the clinical characteristics, histological findings, and management of patients without cirrhosis who developed hepatic decompensation after bariatric surgery in our single tertiary-care hospital.
RESULTS
From 2014 to 2019, 6 patients underwent a transvenous liver biopsy for liver decompensation after bariatric surgery. Mean age at diagnosis was 44 years. The time between bariatric surgery and the onset of symptoms varied widely (min. 8 months, max. 17 years). Mean % of weight loss was high at 43%. The clinical presentation was as follows: fatigue and jaundice (5/6), leg edema (3/6), and ascites (1/6). Blood test showed increased transaminases (mean ALT 53 UI/L, mean AST 130 UI/L), bilirubin (mean 6 mg/dL), and INR (mean 1.5) with a low albumin level (mean 27 mg/dL). The hepatic venous pressure gradient was high (mean 10 mmHg). Histology revealed steatosis, hepatocyte ballooning but also portal inflammation with polymorphonuclear cells, and bile duct alterations. Mean fibrosis score was 2. The clinical course was favorable with nutritional support with a mean follow-up of 36 months.
CONCLUSION
Liver decompensation in the absence of cirrhosis can occur after bariatric surgery with a highly variable delay. A special histological signature is present with the coexistence of steatosis, bile duct alterations, and portal inflammation. Substantial clinical improvement with appropriate nutritional support seems to be effective.
Topics: Bariatric Surgery; Fatty Liver; Humans; Inflammation; Liver; Liver Cirrhosis; Liver Failure; Obesity, Morbid
PubMed: 35138516
DOI: 10.1007/s11695-022-05930-3 -
International Journal of Environmental... Dec 2022The concept of caring is fundamental to nursing practice. The aim of this study was to investigate patients' and nurses' caring behaviors and the possible differences...
The concept of caring is fundamental to nursing practice. The aim of this study was to investigate patients' and nurses' caring behaviors and the possible differences between the two groups. In this descriptive and comparative study, 310 patients and 329 nurses from six general hospitals from Greece completed the Caring Behaviors Inventory-16. The mean score of Caring Behaviors Inventory-16 for patients was 78.94 (±17.85) and for nurses 80.27 (±9.36). The items "Demonstrating professional knowledge and skills" (Mean: 5.45 ± 3.62) and "Treating my information confidentially" (Mean: 5.34 ± 1.06) were the most important caring behaviors while the items "Including me in planning care" (Mean: 4.36 ± 1.56), and "Treating me as an individual" (Mean: 4.55 ± 1.46) were the least important caring behaviors for patients. For nurses, the most important caring behavior was "Treating patients" information confidentially" (Mean: 5.43 ± 0.94) and the least important was "Returning to the patient voluntarily" (Mean: 4.57 ± 3.68). Significant differences were observed in items: "Attentively listening to me/the patient" ( = -2.05, = 0.04), "Treating me/the patient as an individual" ( = -7.82, = 0.00), "Being empathetic or identifying with me/the patient" ( = -2.80, = 0.00), and "Responding quickly when I/the patient call ( = -2.01, = 0.04). Respect, privacy, and dignity were the most important caring behaviors for nurses while for patients they were knowledge, skills, and safety.
Topics: Humans; Nurse-Patient Relations; Patients; Greece; Auditory Perception; Nurses; Attitude of Health Personnel; Surveys and Questionnaires
PubMed: 36612719
DOI: 10.3390/ijerph20010396