1.Polygenic Risk Score for Cardiovascular Diseases in Artificial Intelligence Paradigm: A Review
Narendra N KHANNA ; Manasvi SINGH ; Mahesh MAINDARKAR ; Ashish KUMAR ; Amer M. JOHRI ; Laura MENTELLA ; John R LAIRD ; Kosmas I. PARASKEVAS ; Zoltan RUZSA ; Narpinder SINGH ; Mannudeep K. KALRA ; Jose Fernandes E. FERNANDES ; Seemant CHATURVEDI ; Andrew NICOLAIDES ; Vijay RATHORE ; Inder SINGH ; Jagjit S. TEJI ; Mostafa AL-MAINI ; Esma R. ISENOVIC ; Vijay VISWANATHAN ; Puneet KHANNA ; Mostafa M. FOUDA ; Luca SABA ; Jasjit S. SURI
Journal of Korean Medical Science 2023;38(46):e395-
Cardiovascular disease (CVD) related mortality and morbidity heavily strain society. The relationship between external risk factors and our genetics have not been well established.It is widely acknowledged that environmental influence and individual behaviours play a significant role in CVD vulnerability, leading to the development of polygenic risk scores (PRS). We employed the PRISMA search method to locate pertinent research and literature to extensively review artificial intelligence (AI)-based PRS models for CVD risk prediction.Furthermore, we analyzed and compared conventional vs. AI-based solutions for PRS. We summarized the recent advances in our understanding of the use of AI-based PRS for risk prediction of CVD. Our study proposes three hypotheses: i) Multiple genetic variations and risk factors can be incorporated into AI-based PRS to improve the accuracy of CVD risk predicting. ii) AI-based PRS for CVD circumvents the drawbacks of conventional PRS calculators by incorporating a larger variety of genetic and non-genetic components, allowing for more precise and individualised risk estimations. iii) Using AI approaches, it is possible to significantly reduce the dimensionality of huge genomic datasets, resulting in more accurate and effective disease risk prediction models. Our study highlighted that the AI-PRS model outperformed traditional PRS calculators in predicting CVD risk. Furthermore, using AI-based methods to calculate PRS may increase the precision of risk predictions for CVD and have significant ramifications for individualized prevention and treatment plans.
2.Validation of Neck Disability Index Severity among Patients Receiving One or Two-Level Anterior Cervical Surgery
Cara E. GEOGHEGAN ; Shruthi MOHAN ; Conor P. LYNCH ; Elliot D. K. CHA ; Kevin C. JACOB ; Madhav R. PATEL ; Michael C. PRABHU ; Nisheka N. VANJANI ; Hanna PAWLOWSKI ; Kern SINGH
Asian Spine Journal 2023;17(1):86-95
Methods:
A surgical database was reviewed to identify patients undergoing cervical spine procedures. Demographics, operative characteristics, comorbidities, NDI, Visual Analog Scale (VAS), and 12-item Short Form (SF-12) physical and mental composite scores (PCS and MCS) were recorded. NDI severity was categorized using previously established threshold values. Improvement from preoperative scores at each postoperative timepoint and convergent validity of NDI was evaluated. Discriminant validity of NDI was evaluated against VAS neck and arm and SF-12 PCS and MCS.
Results:
All 290 patients included in the study demonstrated significant improvements from baseline values for all patient-reported outcome measures (PROMs) at all postoperative timepoints (p<0.001) except SF-12 MCS at 2 years (p =0.393). NDI showed a moderate- to-strong correlation (r≥0.419) at most timepoints for VAS neck, VAS arm, SF-12 PCS, and SF-12 MCS (p<0.001, all). NDI severity categories demonstrated significant differences in mean VAS neck, VAS arm, SF-12 PCS, and SF-12 MCS at all timepoints (p<0.001, all). Differences between NDI severity groups were not uniform for all PROMs. VAS neck values demonstrated significant intergroup differences at most timepoints, whereas SF-12 MCS showed significantly different values between most severity groups.
Conclusions
Neck disability is strongly correlated with neck and arm pain, physical function, and mental health and demonstrates worse outcomes with increasing severity. Previously established severity categories may be more applicable to pain than physical function or mental health and may be more uniformly applied preoperatively for cervical spine patients.
3.The Influence of Preoperative Narcotic Consumption on Patient-Reported Outcomes of Lumbar Decompression
Conor P. LYNCH ; Elliot D. K. CHA ; Shruthi MOHAN ; Cara E. GEOGHEGAN ; Caroline N. JADCZAK ; Kern SINGH
Asian Spine Journal 2022;16(2):195-203
Methods:
A surgical database was retrospectively reviewed for patients undergoing primary, single-level MIS LD from 2013 to 2020. Patients lacking preoperative narcotic consumption data were excluded. Demographics, spinal pathologies, and operative characteristics were collected. Patients were grouped based on preoperative narcotic consumption. Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) for back and leg, Oswestry Disability Index (ODI), 12-item Short Form Physical Component Summary, and Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF) were collected preoperatively and postoperatively. Preestablished values were used to calculate achievement of minimum clinically important difference (MCID). Differences in mean PROs and MCID achievement between groups were evaluated.
Results:
The cohort was 453 patients; 184 used preoperative narcotics and 269 did not. Significant differences were found in American Society of Anesthesiologists classification, ethnicity, insurance type, and estimated blood loss between groups. Significant differences were also found in preoperative PHQ-9, VAS leg, ODI, and PROMIS-PF between groups (all p<0.05). Mean postoperative PROs did not differ by group (p>0.05). A higher rate of MCID achievement was associated with the narcotic group for PHQ-9 and PROMIS-PF at 6 weeks (both p≤0.050), VAS leg at 1 year (p=0.009), and overall for ODI and PHQ-9 (both p≤0.050).
Conclusions
Preoperative narcotic consumption was associated with worse preoperative depression, leg pain, disability, and physical function. In patients consuming preoperative narcotics, a higher proportion achieved an overall MCID for disability and depressive symptoms. Patients taking preoperative narcotic medications may report significantly worse preoperative PROs but demonstrate greater improvements in postoperative disability and mental health.
4.Meeting Patient Expectations or Achieving a Minimum Clinically Important Difference: Predictors of Satisfaction among Lumbar Fusion Patients
Elliot D. K. CHA ; Conor P. LYNCH ; Caroline N. JADCZAK ; Shruthi MOHAN ; Cara E. GEOGHEGAN ; Kern SINGH
Asian Spine Journal 2022;16(4):478-485
Methods:
A surgical database was reviewed for eligible patients who underwent lumbar fusion. Patient satisfaction and Visual Analog Scale (VAS) for back and leg pain were the outcomes of interest. Meeting expectations was calculated as a difference of ≤0 between preoperative expectations and postoperative VAS scores. MCID achievement was calculated by comparing changes in VAS scores with established values. Meeting preoperative expectations or MCID achievement as predictors of patient satisfaction was evaluated using regression analysis.
Results:
A total of 134 patients were included in this study. Patients demonstrated significant improvements in VAS back and VAS leg (p<0.001). At 1 year, 56.4% of patients had their VAS back expectations met compared with 59.5% for VAS leg. Similarly, at 1 year, 77.3% and 71.3% of patients achieved MCID for VAS back and leg, respectively. Meeting expectations for VAS back was significantly associated with patient satisfaction at all postoperative timepoints; however, MCID achievement only demonstrated a significant association with patient satisfaction at 6 and 12 weeks (all, p≤0.024). Meeting VAS leg expectations and MCID achievement both demonstrated a significant association with patient satisfaction at all postoperative timepoints (all, p≤0.02). No differences between MCID achievement and meeting expectations as predictors of satisfaction were noted.
Conclusions
The majority of patients achieved MCID and had their back and leg pain expectations met by 1 year. Both measures were significant predictors of patient satisfaction and suggest that MCID achievement may act as a suitable substitute for patient satisfaction.
5.Erratum to: Dual Pathologies of Parathyroid Adenoma and Papillary Thyroid Cancer on Fluorocholine and Fluorodeoxyglucose PET/CT
N. T K THANSEER ; Sanjay Kumar BHADADA ; Ashwani SOOD ; Ashwin Singh PARIHAR ; Divya DAHIYA ; Priyanka SINGH ; Rajender Kumar BASHER ; Ashim DAS ; Bhagwant R MITTAL
Nuclear Medicine and Molecular Imaging 2018;52(1):85-85
Owing to an oversight in manuscript preparation, the name of the fifth author was rendered incorrectly. The correct spelling is Divya Dahiya.
6.Dual Pathologies of Parathyroid Adenoma and Papillary Thyroid Cancer on Fluorocholine and Fluorodeoxyglucose PET/CT
N T K THANSEER ; Sanjay Kumar BHADADA ; Ashwani SOOD ; Ashwin Singh PARIHAR ; Divya DAHIYA ; Priyanka SINGH ; Rajender Kumar BASHER ; Ashim DAS ; Bhagwant R MITTAL
Nuclear Medicine and Molecular Imaging 2018;52(2):154-158
¹â¸F-Fluorocholine (FCH) PET/CT is evolving as a functional imaging modality for the preoperative imaging of abnormal parathyroid tissue(s) helping to localize eutopic and ectopic parathyroid tissue and limit the extent of surgery. FCH PET/CT may show incidental uptake in various thyroid lesions necessitating further evaluation, whereas the role of ¹â¸F-fluorodeoxyglucose (FDG) PET/CT in the detection of incidental thyroid nodules is well documented. The case of a middle-aged woman with dual pathology of parathyroid adenoma and papillary thyroid cancer detected on FCH and FDG PET/CT is presented.
7.Erratum to: Dual Pathologies of Parathyroid Adenoma and Papillary Thyroid Cancer on Fluorocholine and Fluorodeoxyglucose PET/CT
N. T K THANSEER ; Sanjay Kumar BHADADA ; Ashwani SOOD ; Ashwin Singh PARIHAR ; Divya DAHIYA ; Priyanka SINGH ; Rajender Kumar BASHER ; Ashim DAS ; Bhagwant R MITTAL
Nuclear Medicine and Molecular Imaging 2018;52(1):85-85
Owing to an oversight in manuscript preparation, the name of the fifth author was rendered incorrectly. The correct spelling is Divya Dahiya.
8.Interleukin-1B (IL-1B-31 and IL-1B-511) and interleukin-1 receptor antagonist (IL-1Ra) gene polymorphisms in primary immune thrombocytopenia.
Deependra Kumar YADAV ; Anil Kumar TRIPATHI ; Divya GUPTA ; Saurabh SHUKLA ; Aloukick Kumar SINGH ; Ashutosh KUMAR ; Jyotsna AGARWAL ; K N PRASAD
Blood Research 2017;52(4):264-269
BACKGROUND: Immune thrombocytopenia (ITP) is an immune-mediated disease caused by autoantibodies against platelets membrane glycoproteins GPIIb/IIIa and GPIb/IX. The etiology of ITP remains unclear. This study evaluated the association of polymorphisms in interleukin (IL)-1B-31, IL-1B-511, and IL-1Ra with ITP. METHODS: Genotyping of IL-1B-31, IL-1B-511, and IL-1Ra was performed in 118 ITP patients and 100 controls by polymerase chain reaction restriction fragment length polymorphism and detection of variable number tandem repeats. RESULTS: Genotype differences in IL-1B-31 and IL-1Ra were significantly associated with ITP. Patients showed a higher frequency of the IL-1B-31 variant allele (T) and a 1.52-fold greater risk of susceptibility to ITP (odds ratio [OR]=1.52, 95% confidence interval [CI]=1.04–2.22, P=0.034). The frequencies of both homozygous and heterozygous variant genotypes of IL-1B-31 were higher (OR=2.33, 95% CI=1.069–5.09, P=0.033 and OR=2.044, 95% CI=1.068–39, P=0.034) among patients and were significantly associated with ITP susceptibility. Both homozygous and heterozygous variant genotypes of IL-1Ra were also more frequent (OR=4.48, 95% CI=1.17–17.05, P=0.0230 and OR=1.80, 95% CI=1.03–3.14, P=0.0494) among patients and were associated with ITP risk. IL-1B-31 and IL-1Ra also showed significant association with severe ITP. However, IL-1B-511 was not associated with ITP. CONCLUSION: IL-1B-31 and IL-1Ra polymorphisms may significantly impact ITP risk, and they could be associated with disease severity, which may contribute to the pathogenesis of ITP.
Alleles
;
Autoantibodies
;
Genotype
;
Humans
;
Interleukin 1 Receptor Antagonist Protein
;
Interleukin-1*
;
Interleukins
;
Membrane Glycoproteins
;
Minisatellite Repeats
;
Polymerase Chain Reaction
;
Polymorphism, Restriction Fragment Length
;
Purpura, Thrombocytopenic, Idiopathic*
9.A review of temporomandibular joint-related papers published between 2014–2015.
Vaibhav SINGH ; K N V SUDHAKAR ; Kiran Kumar MALLELA ; Rajat MOHANTY
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2017;43(6):368-372
We conducted a retrospective study and reviewed the temporomandibular joint (TMJ)-related papers published in a leading international journal, Journal of Oral and Maxillofacial Surgery, between January 2014 and December 2015. The study was conducted to ascertain and compare the trends of articles being published in the years 2014 and 2015. A total of 28 articles were reviewed, of which most of the full-length articles were on clinical management and outcomes and the role of radiology. The bulk of the studies were prospective, and less interest was shown in experimental research. A thorough review and analysis thus gives the impression that there is a great need for well-designed clinical studies on TMJ.
Ankylosis
;
Prospective Studies
;
Retrospective Studies
;
Surgery, Oral
;
Temporomandibular Joint
;
Temporomandibular Joint Disorders
10.Acute Onset Polyarthritis with Pitting Edema: Is it RS3PE?
Ankur N VARSHNEY ; Nilesh KUMAR ; Nand K SINGH
Annals of the Academy of Medicine, Singapore 2015;44(3):112-113
Acute Disease
;
Arthritis
;
diagnosis
;
Edema
;
diagnosis
;
Female
;
Humans
;
Middle Aged
;
Skin Diseases
;
diagnosis
;
Syndrome
;
Synovitis
;
diagnosis

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