Category: Nevin Manimala

Euro Surveill. 2022 Jun;27(23). doi: 10.2807/1560-7917.ES.2022.27.23.2100497.

ABSTRACT

BackgroundNon-pharmaceutical interventions (NPIs) were implemented worldwide to control the spread of SARS-CoV-2.AimTo evaluate the impact of tiered NPIs and a nationwide lockdown on reduction of COVID-19 incidence during the second and third epidemic waves in Portugal.MethodsSurveillance data on laboratory-confirmed COVID-19 cases were used to conduct an interrupted time series analysis to estimate changes in daily incidence during a second wave tiered NPI period (9 November-18 December 2020), and a third wave lockdown period without (15-21 January 2021) and with school closure (22 January-10 February 2021).ResultsSignificant changes in trends were observed for the overall incidence rate; declining trends were observed for tiered NPIs (-1.9% per day; incidence rate ratio (IRR): 0.981; 95% confidence interval (CI): 0.973-0.989) and a lockdown period without (-3.4% per day; IRR: 0.966; 95% CI: 0.935-0.998) and with school closure (-10.3% per day, IRR: 0.897; 95% CI: 0.846-0.951). Absolute effects associated with tiered NPIs and a lockdown on a subsequent 14-day period yielded 137 cases and 437 cases per 100,000 population potentially averted, respectively.ConclusionOur results indicate that tiered NPIs implemented during the second wave caused a decline in COVID-19 incidence, although modest. Moreover, a third wave lockdown without school closure was effective in reducing COVID-19 incidence, but the addition of school closure provided the strongest effect. These findings emphasise the importance of early and assertive decision-making to control the pandemic.

PMID:35686568 | DOI:10.2807/1560-7917.ES.2022.27.23.2100497

Stroke. 2022 Jun 10:101161STROKEAHA121038374. doi: 10.1161/STROKEAHA.121.038374. Online ahead of print.

ABSTRACT

BACKGROUND: Randomized controlled trials for the use of alteplase in acute ischemic stroke have excluded or had little representation of patients with prestroke disability, and the benefit of alteplase in this population remains uncertain. We performed a systematic review and meta-analysis to examine the outcomes of thrombolysis in patients with premorbid disability.

METHODS: We performed a systematic review in accordance with the Meta-Analysis of Observational Studies in Epidemiology guidelines and retrieved studies reporting intravenous thrombolysis (IVT) in patients with prestroke disability (modified Rankin Scale score, 3-5) with acute ischemic stroke, either compared with untreated patients or treated patients without premorbid disability. The primary outcome was the return to premorbid disability at 90 days. Secondary outcomes included rate and odds ratio of favorable functional outcome at 90 days (modified Rankin Scale score 0-2 or return to premorbid modified Rankin Scale), symptomatic intracerebral hemorrhage (sICH), and 90-day mortality.

RESULTS: Eight articles were included involving 103 988 patients. Patients with disability treated with IVT had better odds of returning to baseline function compared with those who did not receive IVT (odds ratio, 7.26 [95% CI, 2.51-21.02]). Mortality and rates of sICH were not significantly different between patients with disability treated with IVT and those not treated, although there were numerically more sICHs in the IVT group. Return to baseline function was not significantly different between patients with and without prestroke disability (odds ratio, 1.46 [95% CI, 0.75-2.83]). The rates of sICH were not significantly different in patients with and without premorbid disability. However, mortality was 3× higher in patients with premorbid disability than in those without premorbid disability (38.2% versus 12.6%).

CONCLUSIONS: The use of IVT in patients with disability was associated with better outcomes compared with patients who did not receive IVT without statistically significant added risks of sICH or mortality. When compared with those without disability, there was no significant difference in the return to baseline function or sICH. High-quality data comparing treated versus untreated patients with premorbid disability are needed to clarify this issue.

REGISTRATION: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42021240499.

PMID:35686556 | DOI:10.1161/STROKEAHA.121.038374

Orthop Surg. 2022 Jun 10. doi: 10.1111/os.13351. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the incidence and risk factors of postoperative respiratory complications (PRCs) in children with early-onset scoliosis (EOS) following posterior spine deformity surgery (PSDS) based on growth-friendly techniques, so as to help improve the safety of surgery.

METHODS: A retrospective study of children with EOS admitted for PSDS based on growth-friendly techniques from October 2013 to October 2018 was reviewed at a single center. There were 73 children (30 boys, 43 girls) who fulfilled the criteria in this research. The mean age of the patients was 7 ± 6.2 years. Patients were divided into the groups with and without PRCs. Variables that might affect the PRCs during the perioperative period, including general factors, radiographic factors, laboratory factors and surgical factors, were analyzed using univariate analysis to evaluate the potential risk factors. The variables that were significantly different were further analyzed by binary logistic regression analysis to identify the independent factors of PRCs.

RESULTS: All the 73 children included 42 idiopathic scoliosis (57.5%), 12 congenital scoliosis (16.4%), 10 syndromic scoliosis (13.7%) and nine neuromuscular scoliosis (12.3%). PRCs were detected in 16 children (21.9%) with nine different PRCs. The total frequency of detected PRCs was 54, including pleural effusion (25.9%), postoperative pneumonia (20.4%), hypoxemia (18.5%), atelectasis (14.8%), prolonged intubation with mechanical positive pressure ventilatory support (PIMPPVS) (7.4%), bronchospasm (3.7%), reintubation (3.7%), delayed extubation (3.7%) and pneumothorax (1.9%). Results of univariate testing demonstrated that the following six variables were statistically different (P < 0.05): nonidiopathic scoliosis, combined with pulmonary comorbidities, pretransferrin < 200 mg/dL, prealbumin < 3.5 g/dL, anesthesia time ≥ 300 min and blood loss to total blood volume ratio (BL/TBV) ≥ 15%. Binary logistic regression analysis confirmed that BL/TBV≥15% (odd ratio OR = 29.188, P = 0.010), combined with pulmonary comorbidities (OR = 19.216, P = 0.012), pretransferrin < 200 mg/dL (OR = 11.503, p = 0.024), and nonidiopathic scoliosis (OR = 7.632, P = 0.046) were positively linear correlated with PRCs in children with EOS following PSDS.

CONCLUSION: PRCs has a higher incidence in children with EOS following PSDS. BL/TBV ≥15%, combined with pulmonary comorbidities, pre-transferrin < 200 mg/dL, and nonidiopathic scoliosis play an important role for the development of PRCs in this population.

PMID:35686538 | DOI:10.1111/os.13351

J Vasc Access. 2022 Jun 10:11297298221103201. doi: 10.1177/11297298221103201. Online ahead of print.

ABSTRACT

Venous access devices are used in health care. To prevent occlusions the evidence confirmed the need for routine catheter flushing before and after infusion as well as at the end of use. To date, the efficacy of heparin has not been demonstrated. The aim of this study was to evaluate the effectiveness of the locking of central venous catheters with heparin versus normal saline in adults to prevent occlusion, catheter-related infections and thrombosis in adults. A literature search using Medline, Embase, Cochrane Library and Cinahl was performed to identify all meta-analyses addressing the effectiveness of heparin versus normal saline in locking central venous catheters in adults. Four reviewers independently selected publications assessed quality and extracted data. Parameter estimates regarding occlusion, catheter- related infections and thrombosis were pooled using an umbrella review. We identified 6356 references. Seven systematic reviews were included in the study. Most of the studies included in the systematic reviews were conducted in oncohaematology departments, intensive care and cardiac surgery units among patients with multiple diseases and chronicity. Most studies report a heparin concentration of 10 to 5000 IU/ml versus normal saline and other solutions. There was no evidence that heparin was more effective than normal saline in reducing complications such as occlusion, catheter-related infections and thrombosis. No statistically significant difference was found between heparin and normal saline in reducing catheter occlusion. Heparin is not superior compared to normal saline.

PMID:35686498 | DOI:10.1177/11297298221103201

J Zhejiang Univ Sci B. 2022 Jun 15;23(6):528. doi: 10.1631/jzus.B17r0516.

ABSTRACT

The authors have retracted this article (Xiao et al., 2018). After publication, they became aware that a number of studies included in the meta-analysis did not meet the eligibility criteria and that errors were made in classification and statistical analysis. The conclusions presented are therefore unreliable. All authors agree with this retraction.

PMID:35686530 | DOI:10.1631/jzus.B17r0516

Plant Cell Environ. 2022 Jun 10. doi: 10.1111/pce.14377. Online ahead of print.

ABSTRACT

Circadian clocks confer adaptation to predictable 24-h fluctuations in the exogenous environment, but it has yet to be determined what ecological factors maintain natural genetic variation in endogenous circadian period outside of the hypothesized optimum of 24 h. We estimated quantitative genetic variation in circadian period in leaf movement in 30 natural populations of the Arabidopsis relative Boechera stricta sampled within only 1° of latitude but across an elevation gradient spanning 2460-3300 m in the Rocky Mountains. Measuring ~3800 plants from 473 maternal families (7-20 per population), we found that genetic variation was of similar magnitude among vs. within populations, with population means varying between 21.9-24.9 h and maternal family means within populations varying by up to ~6 h. After statistically accounting for spatial autocorrelation at a habitat extreme, we found that elevation explained a significant proportion of genetic variation in circadian period, such that higher-elevation populations had shorter mean period lengths and reduced intrapopulation ranges. Environmental data indicate that these spatial trends could be related to steep regional climatic gradients in temperature, precipitation, and their intra-annual variability. Our findings suggest that spatially fine-grained environmental heterogeneity contributes to naturally occurring genetic variation in circadian traits in wild populations. This article is protected by copyright. All rights reserved.

PMID:35686466 | DOI:10.1111/pce.14377

Microsc Microanal. 2022 Jun 10:1-11. doi: 10.1017/S1431927622012065. Online ahead of print.

ABSTRACT

Artificial intelligence (AI) promises to reshape scientific inquiry and enable breakthrough discoveries in areas such as energy storage, quantum computing, and biomedicine. Scanning transmission electron microscopy (STEM), a cornerstone of the study of chemical and materials systems, stands to benefit greatly from AI-driven automation. However, present barriers to low-level instrument control, as well as generalizable and interpretable feature detection, make truly automated microscopy impractical. Here, we discuss the design of a closed-loop instrument control platform guided by emerging sparse data analytics. We hypothesize that a centralized controller, informed by machine learning combining limited a priori knowledge and task-based discrimination, could drive on-the-fly experimental decision-making. This platform may unlock practical, automated analysis of a variety of material features, enabling new high-throughput and statistical studies.

PMID:35686442 | DOI:10.1017/S1431927622012065

J Coll Physicians Surg Pak. 2022 Jun;32(6):712-721. doi: 10.29271/jcpsp.2022.06.712.

ABSTRACT

OBJECTIVE: To screen and identify key genes as potential biomarkers of lung cancer using bioinformatics analysis.

STUDY DESIGN: Observational study.

PLACE AND DURATION OF STUDY: Department of Critical Care Medicine, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China, from August 2018 to April 2021.

METHODOLOGY: Independent microarray datasets (GSE85841 and GSE118370) were downloaded from the Gene Expression Omnibus (GEO) database and the differentially expressed genes (DEGs) were screened using GEO2R. Cytohubba was employed to identify the hub genes. Cellular component analysis, hierarchical clustering, and survival analyses of hub genes were performed via BiNGO, UCSC, and cBioPorta. A series of analyses of FGF2 and PIK3R1 were conducted using Oncomine.

RESULTS: A total of 463 DEGs were identified and 11 hub genes were determined. BDNF, FGF2, JAK2, NCAM1, CAV1, TJP1, and PIK3R1 may affect the survival probability and life expectancy of lung cancer patients, but the p-values were not statistically significant. FGF2 and PIK3R1 had the highest node degrees, 40 and 32 respectively. The expression of FGF2 and PIK3R1 were significantly lower in the 4 lung cancer data sets compared with non-lung cancer tissues. And the low expression of FGF2 and PIK3R1 is related to tumor grades, family history of cancer, multiple tumors present, and prior therapy of lung cancer.

CONCLUSION: Evaluation of FGF2 and PIK3R1 as potential biomarkers can contribute to the subsequent theoretical analysis of potential molecular mechanisms and development of lung cancer, so that the diagnosis of lung cancer may be more accurate, and it is possible to provide therapeutic and prognostic medicine targets.

KEY WORDS: Lung neoplasms, Differentially expressed genes, Bioinformatical analysis, Microarray analysis, biomarkers.

PMID:35686401 | DOI:10.29271/jcpsp.2022.06.712

J Coll Physicians Surg Pak. 2022 Jun;32(6):773-778. doi: 10.29271/jcpsp.2022.06.773.

ABSTRACT

OBJECTIVE: To assess the utility of systemic immune inflammation index (SII) in predicting disease activity in psoriatic arthritis (PsA) patients.

STUDY DESIGN: A descriptive study.

PLACE AND DURATION OF STUDY: Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey, from October 2020 to September 2021.

METHODOLOGY: This study included 106 PsA and 103 age and gender-matched healthy individuals. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), and SII were calculated from complete blood count parameters. The PsA disease activity was assessed by using disease activity score-ESR and DAS-CRP based on 28 joints and the Disease Activity in Psoriatic Arthritis (DAPSA) scores. The receiver operating characteristic (ROC) curve was performed to evaluate the utility of SII in determining disease activity in PsA patients.

RESULTS: The NLR, PLR, MLR, and SII were significantly higher in PsA patients compared to healthy control (p=0.013, p=0.019, p=0.012, and p=0.002, respectively). There were statistically significant positive correlations between the DAS28-ESR, DAS28-CRP, and DAPSA and SII (p<0.001, p<0.001, and p<0.001 respectively). The SII values were significantly higher in PsA patients with moderate to severe disease activity according to DAPSA scores when compared to patients with remission or low disease activity (p<0.001). The cut-off value of 800×109/L was found for predicting disease activity in PsA.

CONCLUSION: SII may be an easy, practical, economical, and readily accessible tool for monitoring disease activity and the efficacy of treatment in PsA patients.

KEY WORDS: Blood cell count, Psoriatic arthritis, Systematic immune inflammation index (SII).

PMID:35686411 | DOI:10.29271/jcpsp.2022.06.773

J Vet Diagn Invest. 2022 Jun 10:10406387221101547. doi: 10.1177/10406387221101547. Online ahead of print.

ABSTRACT

Serum protein electrophoresis (SPE) shows the distribution of protein fractions, helping clinicians to characterize some pathologic processes. Information is lacking in the literature about SPE alterations in dogs with chronic hepatitis (CH). Our aim was to describe SPE alterations in canine CH, to compare SPE results to histologic scores, and to study SPE trends during follow-up. We reviewed retrospectively case data from dogs with a histologic diagnosis of CH. Only cases with SPE, CBC, and serum chemistry results available were included. Dogs were divided into subgroups based on histologic necroinflammatory activity (A) and fibrosis (F) scores (groups A0-1 and A>1; groups F<2 and F≥2). We included 26 dogs; 15 had follow-up SPE. The most common SPE alterations at admission were hypoalbuminemia (n = 16), increases in α1-globulins (n = 11), γ-globulins (n = 11), α2-globulins (n = 8), β2-globulins (n = 7), and β1-globulins (n = 6), and decreased albumin:globulin (A:G) ratios (n = 20). Four of 11 dogs had β-γ bridging. Groups with higher A and F scores had higher β2-globulins. Eleven of 15 dogs with a post-treatment SPE had a decrease in γ-globulins and increase in A:G ratio compared to their T0, although there was no statistically significant difference. Although further studies are warranted, SPE may be useful for monitoring canine CH.

PMID:35686386 | DOI:10.1177/10406387221101547