Category: Nevin Manimala

Cardiol Young. 2024 Apr 17:1-13. doi: 10.1017/S1047951124000453. Online ahead of print.

ABSTRACT

OBJECTIVES: The aims of this study were to evaluate the 16-year experience with arterial switch operation at Beijing Children’s Hospital and to determine early and late mortality and late morbidity, to explore risk factors for late complications and reintervention, and finally to evaluate whether the neoaortic sinotubular junction reconstruction technique reduces late complications of arterial switch operation.

METHODS: The clinical data of 185 patients with transposition of the great arteries who underwent arterial switch operation in Beijing Children’s Hospital from January 2006 to January 2022 and 30 patients who underwent modified arterial switch operation with neoaortic sinotubular junction reconstruction technique in Fuwai Hospital during the same period were retrospectively analysed. Propensity score matching was also used to match the neoaortic sinotubular junction reconstruction patients in Fuwai Hospital with 30 non-neoaortic sinotubular junction reconstruction patients in Beijing Children’s Hospital.

RESULTS: There were 13 early deaths (7.03%) and five late deaths (3.01%). Nineteen patients (11.45%) developed new aortic valve regurgitation and 28 patients (16.87%) developed aortic root dilation. Late right ventricular outflow tract obstruction occurred in 33 patients (19.88%). Late reintervention occurred in 18 cases (10.84%). Multivariate analysis showed that aorto-pulmonary diameter mismatch, previous pulmonary artery banding, and mild moderate or above new aortic valve regurgitation at discharge were independent risk factors for late new aortic valve regurgitation and aortic root dilation. Low surgical weight was an independent risk factor specific to new aortic valve regurgitation, and bicuspid native pulmonary valve was an independent risk factor specific to aortic root dilation. Older surgical age and aortic root dilation were independent risk factors for late right ventricular outflow tract obstruction. Older surgical age, operation before 2014, late right ventricular outflow tract obstruction, and late aortic root dilation were independent risk factors for late intervention. Propensity score matching showed that new aortic valve regurgitation and aortic root dilation were not followed up in the neoaortic sinotubular junction reconstruction group, while seven cases of aortic root dilation and five cases of new aortic valve regurgitation occurred in the non-neoaortic sinotubular junction reconstruction group, respectively, and the differences were statistically significant (P = 0.003; P = 0.015).

CONCLUSIONS: The increased incidence of new aortic valve regurgitation, aortic root dilation, and right ventricular outflow tract obstruction as children age is a major concern outcome in the future and may mean more late reintervention. neoaortic sinotubular junction reconstruction technique may reduce the incidence of new aortic valve regurgitation and aortic root dilation, and improve the late prognosis of arterial switch operation. Careful follow-up of neo-aortic valve and root function is imperative, especially in patients with aorto-pulmonary diameter mismatch, previous pulmonary artery banding, mild new aortic valve regurgitation at discharge, low surgical weight, and bicuspid native pulmonary valve structures.

PMID:38629195 | DOI:10.1017/S1047951124000453

Environ Sci Technol. 2024 Apr 17. doi: 10.1021/acs.est.3c08990. Online ahead of print.

ABSTRACT

Understanding microplastic exposure and effects is critical to understanding risk. Here, we used large, in-lake closed-bottom mesocosms to investigate exposure and effects on pelagic freshwater ecosystems. This article provides details about the experimental design and results on the transport of microplastics and exposure to pelagic organisms. Our experiment included three polymers of microplastics (PE, PS, and PET) ranging in density and size. Nominal concentrations ranged from 0 to 29,240 microplastics per liter on a log scale. Mesocosms enclosed natural microbial, phytoplankton, and zooplankton communities and yellow perch (Perca flavescens). We quantified and characterized microplastics in the water column and in components of the food web (biofilm on the walls, zooplankton, and fish). The microplastics in the water stratified vertically according to size and density. After 10 weeks, about 1% of the microplastics added were in the water column, 0.4% attached to biofilm on the walls, 0.01% within zooplankton, and 0.0001% in fish. Visual observations suggest the remaining >98% were in a surface slick and on the bottom. Our study suggests organisms that feed at the surface and in the benthos are likely most at risk, and demonstrates the value of measuring exposure and transport to inform experimental designs and achieve target concentrations in different matrices within toxicity tests.

PMID:38629179 | DOI:10.1021/acs.est.3c08990

J Intensive Care Med. 2024 Apr 17:8850666241247516. doi: 10.1177/08850666241247516. Online ahead of print.

ABSTRACT

Purpose/Background: Recent studies have shown improved outcomes with the initiation of earlier subcutaneous (SQ) basal insulin. The purpose of this study was to examine the effects of early SQ basal insulin administration on hospital length of stay in patients with mild to moderate diabetic ketoacidosis (DKA). Methods: This was a retrospective, single-center study from a large community teaching hospital that included patients 18 years or older with mild to moderate DKA, identified using ICD-10 codes, who received intravenous (IV) insulin. Patients who received SQ basal insulin prior to a documented anion gap ≤12 mmol/L were considered to have received early SQ basal insulin and were compared to patients who received SQ basal insulin after closure of their anion gap (AG). The primary outcome was hospital length of stay. Secondary outcomes included intensive care unit length of stay, duration of IV insulin, time to anion gap closure, and incidences of rebound hyperglycemia. Safety outcomes included incidences of hypoglycemia, and hypokalemia. Results: Of 301 patients screened, 108 patients were included in the final analysis. Forty patients received early SQ basal insulin and 68 did not. Median hospital length of stay in the nonearly group was 71 h, compared to 62 h in the early group (P = .57). Secondary and safety outcomes were similar between groups. Conclusions: In this study, there was no statistically significant difference in length of stay in patients that received early SQ basal insulin. Larger trials are needed to determine the significance of earlier SQ basal insulin in DKA.

PMID:38629164 | DOI:10.1177/08850666241247516

Anal Methods. 2024 Apr 17. doi: 10.1039/d4ay00171k. Online ahead of print.

ABSTRACT

In this research, Raman imaging was employed to map various samples, and the resulting data were analyzed using a suite of automated tools to extract critical information, including intensity and signal-to-noise ratio. The acquired spectra were further processed to identify similarities and investigate patterns using principal component analysis. The objective of this study was to establish guidelines for investigating Raman imaging results, particularly when dealing with large datasets comprising thousands of relatively low-intensity spectra. The overall quality of the results was assessed, and representative locations were determined based on the main Raman bands. While automated software solutions are insufficient for removing baselines and fitting the data, statistical analysis proved to be a powerful tool for extracting valuable information directly from the raw spectral data. This approach enables the extraction of as much information as possible from large arrays of spectral data, even in complex cases where automated software may fall short. The findings of this study contribute to enhancing the analysis and interpretation of Raman imaging results, providing researchers with a robust methodology for extracting meaningful insights from complex datasets, reducing the amount of effort required during data interpretation and analysis.

PMID:38629136 | DOI:10.1039/d4ay00171k

Ergonomics. 2024 Apr 17:1-13. doi: 10.1080/00140139.2024.2339439. Online ahead of print.

ABSTRACT

New type desktop head-up display (HUD) can reduce visual fatigue and protect vision through long viewing distance. In this study, participants evaluated visual performance, fatigue, and discomfort of desktop HUD under two contrast polarity (N = 36) and five display luminance levels (N = 21). A positive polarity advantage was found over negative in visual fatigue and discomfort (p < .05). Statistically significant effect of luminance was found on visual performance, fatigue, and discomfort (p < .05). The calculated optimum display luminance by the proposed inverted-U fitted model was 153 cd/m² under 300 lx, higher than that of traditional desktop displays. It is speculated that higher luminance is required to offset the reduction in contrast sensitivity due to smaller target angular size, which caused by longer viewing distance. These findings suggest that positive polarity and 153 cd/m² can be used to improve performance and avoid fatigue and discomfort when utilising desktop HUD under 300 lx.

PMID:38629123 | DOI:10.1080/00140139.2024.2339439

Glob Adv Integr Med Health. 2024 Apr 14;13:27536130241246788. doi: 10.1177/27536130241246788. eCollection 2024 Jan-Dec.

ABSTRACT

BACKGROUND: There is a growing, global awareness and recognition of the important, interdependent relationships between our natural world and human health. Several contemporary health organizations have placed calls to action and emphasize an urgent need for collaboration and interdisciplinary research, education, and clinical work to address the increasing degradation of our planetary and human health. With more research dedicated to nature’s health impacts, health professions schools would benefit by including such training in their programs while also cultivating a comprehensive mind-body health perspective to support both the health of student practitioners and their future patients.

OBJECTIVE: The present program evaluation investigates a five-day outdoor mini-course covering nature-based health techniques at a medical and dental school in the American Northeast. This unique outdoor course combines nature, creativity, and reflection within the context of modern medicine.

METHODS: A concurrent mixed-method design using descriptive statistics, quantitative and qualitative data from students’ anonymous final course evaluations and final reflection projects are evaluated.

RESULTS: Data suggests that students benefitted from their experience during this five-day course. Students provided feedback reinforcing the enjoyment and transformative outcomes gleaned from the course experiences. Students entered the course describing feeling stressed, overwhelmed, and overextended, not uncommon for learners in medical and dental school, and completed the course describing the acquisition of applicable skills, increased attention and mindfulness, creativity, and connection to the natural world.

CONCLUSIONS: Students described a positive experience of the course. Several areas of personal and professional development were also described, such as improvements within cognitive domains, enhanced connection with nature, others, and themselves, increased mindfulness, and overall improved well-being. Findings have implications for medical and dental programs on how such innovative training may lean into the work of nature-based care to provide for the whole person.

PMID:38629109 | PMC:PMC11020736 | DOI:10.1177/27536130241246788

Genome Res. 2024 Apr 16. doi: 10.1101/gr.278268.123. Online ahead of print.

ABSTRACT

Reference-free genome phasing is vital for understanding allele inheritance and the impact of single-molecule DNA variation on phenotypes. To achieve thorough phasing across homozygous or repetitive regions of the genome, long-read sequencing technologies are often used to perform phased de novo assembly. As a step toward reducing the cost and complexity of this type of analysis, we describe new methods for accurately phasing Oxford Nanopore Technologies (ONT) sequence data with the Shasta genome assembler and a modular tool for extending phasing to the chromosome scale called GFAse. We test using new variants of ONT PromethION sequencing, including those using proximity ligation, and show that newer, higher accuracy ONT reads substantially improve assembly quality.

PMID:38627094 | DOI:10.1101/gr.278268.123

Clin Psychopharmacol Neurosci. 2024 May 31;22(2):364-369. doi: 10.9758/cpn.24.1183.

ABSTRACT

OBJECTIVE: This study determined the threshold for recurrent depressive episodes that predicted conversion from major depressive disorder (MDD) to bipolar disorder (BD).

METHODS: We retrospectively reviewed the medical records of 296 patients diagnosed with MDD for a minimum of 5 years in two university hospitals. We examined their the Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnoses and detailed clinical information at the initial admission and yearly assessments after discharge to establish the threshold for recurrent depressive episodes indicating a risk of diagnostic conversion from MDD to BD. Optimal cut-offs were derived using receiver operating characteristic (ROC) curves.

RESULTS: ROC curve analysis revealed that more than four recurrent depressive episodes was indicative of potential diagnostic conversion from MDD to BD (area under the curve, 0.604; sensitivity, 0.353; specificity, 0.855; positive predictive value, 0.421; negative predictive value, 0.816).

CONCLUSION: These findings suggest that the best predictor of conversion from MDD to BD is more than four recurrent depressive episodes. Our findings have the potential to enhance diagnostic accuracy and treatment efficiency. To validate our results, longitudinal prospective studies are necessary.

PMID:38627083 | DOI:10.9758/cpn.24.1183

Clin Psychopharmacol Neurosci. 2024 May 31;22(2):285-294. doi: 10.9758/cpn.23.1091. Epub 2023 Jul 17.

ABSTRACT

OBJECTIVE: Many psychiatric disorders are linked to low grade systemic inflammation as measured by systemic cytokine levels. Exploration of cytokines and immune activity and their role in psychiatric symptoms may inform pathobiology and treatment opportunities. The aim of this study is to explore if there are associations between cytokines and psychiatric symptom clusters. Comparison between patients regularly using and those not using psychotropic medication is also conducted.

METHODS: This was a cross sectional naturalistic study with 132 participants from a general open inpatient psychiatric ward at the Nordland Hospital Trust, Norway. Serum levels of 28 different cytokines were assessed. Psychiatric symptoms the last week were assessed by a self-rating scale (Symptom check list, SCL-90-R) and grouped in defined clusters. Multiple linear regression model was used for statistical analyses of associations between levels of cytokines and symptoms, adjusting for possible confounding factors.

RESULTS: We found a positive association (p = 0.009) between the chemokine interferon-gamma inducible protein 10 (CXCL 10; IP-10) and the anger hostility cluster. No associations were found between the other symptom clusters and cytokines. IP-10 and the anger hostility cluster were positively associated (p = 0.002) in the subgroup of patients using psychotropic medication, not in the subgroup not using psychotropic medication.

CONCLUSION: Our analyses revealed a significant positive association between the symptom cluster anger hostility in SCL-90-R and the chemokine IP-10 in the subgroup of patients using psychotropic medications.

PMID:38627075 | DOI:10.9758/cpn.23.1091

BMJ Paediatr Open. 2024 Apr 16;8(1):e002502. doi: 10.1136/bmjpo-2024-002502.

ABSTRACT

BACKGROUND: With the increasing survival rate of smaller newborns and twins, previous growth curves may not accurately assess the growth of extremely preterm infants (EPIs). Our study aimed to establish birth weight percentile curves for singletons and twins in EPIs from China and the USA and compare the differences between them.

METHODS: In China, EPIs were from 31 provinces, from 2010 to 2021. The collected information was sex, gestational age, birth weight, singletons and twins. We used the generalised additive models for location scale and shape method to construct the birth weight percentile curves by gestational age and sex for EPIs. The National Vital Statistics System database from 2016 to 2021 was also analysed. We compared the differences between the 50th birth weight percentile curves of the two databases.

RESULTS: We identified 8768 neonates in China (5536 singletons and 3232 twins) and 121 933 neonates in the USA (97 329 singletons and 24 604 twins). We established the 3rd, 10th, 25th, 50th, 75th, 90th and 97th birth weight reference curves for China and the USA. The results showed that males had higher birth weights than females. In China, for the same gestational age and sex, birth weights in singletons and twins were found to be similar, though singleton males born in China had slightly higher birth weights than male twins. In the USA, birth weights were also similar for females and males, with the same gestational age in singletons and twins.

CONCLUSION: We established birth weight reference percentile curves by gestational age and sex for singletons and twins among EPIs in China and the USA.

PMID:38627060 | DOI:10.1136/bmjpo-2024-002502