Nevin ManimalaPLoS Med. 2022 Feb 3;19(2):e1003898. doi: 10.1371/journal.pmed.1003898. eCollection 2022 Feb.
ABSTRACT
Dipender Gill and Stephen Burgess discuss the accompanying study by James Yarmolinsky and colleagues investigating the associations between genetically-proxied inhibition of antihypertensive drug targets and risk of common cancer subtypes using Mendelian randomization.
PMID:35113864 | DOI:10.1371/journal.pmed.1003898
PLoS One. 2022 Feb 3;17(2):e0261134. doi: 10.1371/journal.pone.0261134. eCollection 2022.
ABSTRACT
On the basis of numerous fluid simulation experiences, researchers have discovered that many common operations can be abstracted to form a general fluid simulation framework. These operations include the discretization of equations and variables, the computation of the coefficients, the assembly of the linear or nonlinear systems, the solving of the systems, etc. Furthermore, all of the operations can be attributed to the operations “in the field”, which is an abstract concept derived from the equations and variables. Thus, fluid simulations can be performed under a field-based general framework. Moreover, in response to the urgent need for large-scale fluid simulations, parallelism is integrated into the framework. Due to the convenience of the field operations, parallelization of the framework can be realized on both the OpenMP and MPI levels. In other words, because of the newly defined “fields”, a series of operations in fluid simulations can be simplified and unified. However, very few studies have noted this advantage, and therefore, this work attempts to fill the void. With the help of a field-based general framework, it is anticipated that the parallel codes of fluid simulations can be generated easily and quickly. As an application of the general framework, a parallel 3D simulator for matrix acidization called Masor is developed. The simulation results are regarded as physically reasonable by many studies, which verifies the correctness and effectiveness of the general framework. In addition, it is noteworthy that the parallel performance of Masor is decided by a solver.
PMID:35113859 | DOI:10.1371/journal.pone.0261134
PLoS One. 2022 Feb 3;17(2):e0260018. doi: 10.1371/journal.pone.0260018. eCollection 2022.
ABSTRACT
BACKGROUND: The variations in ABO blood groups are reported to be associated with multiple disorders, including ulcerative colitis (UC). We aimed to investigate the distribution of ABO blood groups in UC patients and explore its impact on disease severity.
METHODS: We retrospectively collected 129 UC patients diagnosed at our hospital between January 2000 and November 2019. Clinical characteristics, ABO blood groups, and operation rates were analyzed.
RESULTS: The mean diagnostic age of patients was 38.97 years. Males accounted for the majority of all patients (62.8%). Of 129 patients, 43 (33.3%) were blood type O, 41 (31.8%) were blood type A, 38 (29.5%) were blood type B, and 7 (5.4%) were blood type AB. Although our patients had higher ratio of blood type A comparing our general population, there was no statistically significant association of ABO blood types distribution between these two groups (p = 0.1906). In the subgroup analysis, there were no significant difference of disease locations and operation rates between different ABO blood groups. Furthermore, blood type A patients had higher serum hemoglobin (Hb) levels compared to blood type O patients (13.31 g/dL vs. 12.30 g/dL, p = 0.0347). Blood type A patients had lower serum erythrocyte sedimentation rate (ESR) levels compared to blood type O patients (12.46 mm/hour vs. 21.5 mm/hour, p = 0.0288). Blood type O had higher serum ESR levels compared to non-O groups (p = 0.0228). In the ABO blood groups and mean diagnostic age (≤ 40 years or > 40 years), there were no statistically significant difference between these two age groups, p = 0.5515.
CONCLUSIONS: Our results showed ABO blood groups are not associated with UC in spite of a higher ratio of blood type A in our patients. Blood type O patients had higher serum ESR levels; however, blood type A patients had higher Hb levels.
PMID:35113863 | DOI:10.1371/journal.pone.0260018
Int Angiol. 2022 Feb 3. doi: 10.23736/S0392-9590.22.04799-X. Online ahead of print.
ABSTRACT
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) is becoming increasingly popular due to fewer access-related complications, shorter procedural times and length of stay (LOS). Our aim was to explore factors associated with access-related complications and their impact on procedural time and LOS.
METHODS: We retrospectively analysed consecutive aorto-iliac endovascular procedures in a tertiary hub comprising 2 institutions and 18 consultant vascular surgeons and interventional radiologists between 2016 – 2017. Access-related complications were defined as: bleeding requiring cutdown or return to theatre, acute limb ischaemia or common femoral artery (CFA) pseudoaneurysm requiring intervention and wound infection or dehiscence needing hospitalization.
RESULTS: Of 511 patients, 354 (69%) had a percutaneous approach via 589 CFA access sites. In this percutaneous group, access-related complications occurred in 11% of sites (65/589); Their rate varied with procedure type ranging between 3.6% to 17.6%. The most common complication was bleeding due to closure device failure in 8.5% (50/589) of access sites. When uncomplicated, percutaneous interventions were faster compared to open surgical access (p<0.0001). Operation time and median LOS (3 vs. 2 days) were longer for elective standard EVAR patients experiencing access-related complications (p=0.033). In the percutaneous group, multivariate regression analysis demonstrated significant associations between accessrelated complications and eGFR (odds ratio (OR) 0.984 [0.972-0.997], p=0.014), CFA depth (OR 1.026 [1.008-1.045], p=0.005), device used (Prostar vs. Proglide (OR 2.177 [1.236-3.832], p=0.007) and procedural type (complex vs. standard EVAR) (OR 2.017 [1.122-3.627], p=0.019). We developed a risk score which had reasonably good predictive power (C-statistic 0.716 [0.646-0.787],p<0.0001) for avoiding access complications.
CONCLUSIONS: Physiological (low eGFR level), anatomical (increased CFA depth) and technical factors (choice of device and complex procedures) were identified as predictors of access-related complications in this large retrospective series. These are important for safe selection of patients that would benefit from percutaneous access.
PMID:35112825 | DOI:10.23736/S0392-9590.22.04799-X
Intern Med J. 2022 Feb 3. doi: 10.1111/imj.15707. Online ahead of print.
ABSTRACT
BACKGROUND: Hospitalisation provides an opportunity for medication review and deprescribing. Patient-reported experience measures (PREM) for deprescribing in older patients in-hospital are not well-described.
AIM: To pilot test and describe PREM for deprescribing in older patients, compare PREM by patient characteristics, and investigate patients’ awareness of medication changes on hospital discharge.
METHODS: This prospective, multicentre, observational cohort study at two tertiary hospitals in Sydney, Australia, evaluated the PREM questionnaire developed by the NSW Therapeutic Advisory Group. It was completed by patients (or their next of kin) recruited from acute geriatric medicine and orthogeriatric services. Association with nine patient characteristics was analysed using the chi-square test and multivariable regression. Awareness of medication changes and test-retest reliability were analysed using descriptive statistics.
RESULTS: Overall, 201 participants completed the questionnaire, with 170 eligible for analysis; 34/170 (20%) were aware of reduction or cessation of their usual medications on discharge and reported involvement in decision making and receiving enough information to reduce or stop one or more of their usual medications (positive PREM). Independent predictors of positive PREM included respondent (next of kin), hospital (Hospital 1), language (English), and specialty (acute geriatric medicine). Overall, 92 of 155 (59.4%) patients with medication changes were aware of those changes on hospital discharge.
CONCLUSIONS: These PREMs are a feasible tool to examine older patients’ experiences of deprescribing in-hospital and may be applied to evaluate interventions to improve awareness, shared decision making, and provision of information when deprescribing for older patients. This article is protected by copyright. All rights reserved.
PMID:35112777 | DOI:10.1111/imj.15707
J Sports Med Phys Fitness. 2022 Feb 3. doi: 10.23736/S0022-4707.22.13495-X. Online ahead of print.
ABSTRACT
BACKGROUND: The experiment tested the effect of non-contact boxing training on the frequency and timing of anticipatory postural adjustments (APAs) resulting from self-induced postural perturbations in healthy adults.
METHODS: The 8-week non-contact boxing intervention study involved 33 healthy adults between 18 and 27 years of age who had no boxing experience (control group = 17 participants, boxing group = 16 participants). Pretests and posttests utilized rapid bilateral arm raising as a focal movement to elicit APAs. EMG in the anterior deltoid, thoracic and lumbar erector spinae, semitendinosus and soleus muscles was recorded. The boxing group completed twenty 90-min non-contact boxing training sessions over 8 weeks, whereas the control group kept physical activity consistent during the intervention period.
RESULTS: Non-contact boxing training caused APAs to become more frequent during the focal movement, in comparison to the control group, in the soleus and also in the semitendinosus after an outlier was removed. Non-contact boxing training caused earlier APA onset during the focal movement, in comparison to the control group, in the lumbar erector spinae after an outlier was removed.
CONCLUSIONS: Non-contact boxing training had a modest positive effect on the frequency and timing of APAs resulting from self-induced postural perturbations in healthy adults.
PMID:35112818 | DOI:10.23736/S0022-4707.22.13495-X
Biom J. 2022 Feb 3. doi: 10.1002/bimj.202100077. Online ahead of print.
ABSTRACT
The wide-scale adoption of electronic health records (EHRs) provides extensive information to support precision medicine and personalized health care. In addition to structured EHRs, we leverage free-text clinical information extraction (IE) techniques to estimate optimal dynamic treatment regimes (DTRs), a sequence of decision rules that dictate how to individualize treatments to patients based on treatment and covariate history. The proposed IE of patient characteristics closely resembles “The clinical Text Analysis and Knowledge Extraction System” and employs named entity recognition, boundary detection, and negation annotation. It also utilizes regular expressions to extract numerical information. Combining the proposed IE with optimal DTR estimation, we extract derived patient characteristics and use tree-based reinforcement learning (T-RL) to estimate multistage optimal DTRs. IE significantly improved the estimation in counterfactual outcome models compared to using structured EHR data alone, which often include incomplete data, data entry errors, and other potentially unobserved risk factors. Moreover, including IE in optimal DTR estimation provides larger study cohorts and a broader pool of candidate tailoring variables. We demonstrate the performance of our proposed method via simulations and an application using clinical records to guide blood pressure control treatments among critically ill patients with severe acute hypertension. This joint estimation approach improves the accuracy of identifying the optimal treatment sequence by 14-24% compared to traditional inference without using IE, based on our simulations over various scenarios. In the blood pressure control application, we successfully extracted significant blood pressure predictors that are unobserved or partially missing from structured EHR.
PMID:35112726 | DOI:10.1002/bimj.202100077
J Clin Sleep Med. 2022 Feb 4. doi: 10.5664/jcsm.9930. Online ahead of print.
ABSTRACT
STUDY OBJECTIVES: Chronic pain is associated with insomnia. The objective of this clinical study is to compare the efficacy and safety of different prescribed doses of zopiclone and clonidine; for the management of insomnia in patients with chronic pain.
METHODS: A prospective observational crossover study of 160 consenting adult patients who underwent pain management. For insomnia treatment, each patient ingested different prescribed doses of zopiclone or clonidine on alternate nights. Each patient used a special validated sleep diary to collect data including pain score, sleep scores, sleep duration, sleep medication dose, and adverse effects. Each patient completed the diary for 3 continuous weeks. Pain was measured using the numeric pain rating scale. Sleep score was measured using the Likert sleep scale. A change in the pain or sleep scores by 2-points was considered significant. Of the 160 study participants, 150 (93.8%) completed the study successfully; and their data were analyzed. Data were analyzed with IBM SPSS Statistics 25 (IBM Corp, Armonk, NY); using Student’s t-test, ANOVA, Pearson Chi-square test, and regression analysis. P-value <0.05 was considered significant.
RESULTS: Pain score was lower with clonidine than zopiclone (p=0.025). Time to fall asleep was shorter with clonidine than zopiclone (p=0.001). Feeling rested on waking in the morning was better with clonidine than zopiclone (p=0.015). Overall sleep quality was better with clonidine than zopiclone (p=0.015). Total Likert sleep score was better with clonidine than zopiclone (p=0.005). Total sleep duration was better with clonidine than zopiclone (p=0.013). Adverse effects were commoner with zopiclone; including collapse, fall, confusion, amnesia, mood disorder, hallucination, nightmare, nocturnal restlessness, locomotor dysfunction, hunger, nausea and headache. Minor adverse effect of dry mouth was commoner with clonidine.
CONCLUSIONS: Clonidine is significantly better than zopiclone regarding sleep quality, analgesia, tolerability profile, and patient safety. Further studies will be beneficial to compare clonidine with other insomnia medications.
PMID:35112665 | DOI:10.5664/jcsm.9930
Rev Esc Enferm USP. 2022 Jan 28;56:e20210249. doi: 10.1590/1980-220X-REEUSP-2021-0249. eCollection 2022.
ABSTRACT
OBJECTIVE: To identify factors related to tissue complications resulting from insulin therapy.
METHOD: This is a descriptive, cross-sectional study carried out in a capital of northeastern Brazil. A semi-structured form and an observation guide were applied to assess the performance of insulin preparation and administration techniques. Descriptive statistics, association test, and multivariate logistic regression were used for data analysis.
RESULTS: Most participants were female (74.2%), aged between 51 and 70 years (50.0%), and had nine to eleven years of education (36.7%). The presence of some type of local complication in 73.5% of the participants and the failure to rotate the injection sites in 82.3% are highlighted. Being single/widowed and not rotating insulin application sites were related to local complications and increased the chances of their occurrence by 3.51 and 6.70 times, respectively.
CONCLUSION: Marital status and nonrotation of injection site were related to the increased chances of tissue complications resulting from insulin therapy.
PMID:35112702 | DOI:10.1590/1980-220X-REEUSP-2021-0249
Curr Med Res Opin. 2022 Feb 3:1-14. doi: 10.1080/03007995.2022.2037847. Online ahead of print.
ABSTRACT
BACKGROUND: Histamine 2 receptor antagonists (H2RA) are amongst the most entrenched antacid therapies available including over-the-counter. They have an excellent safety profile including no known teratogenic risk. Fracture risk is generally recognized with chronic proton pump inhibitor (PPI) therapy in adults and children although the related mechanism is poorly understood. The analogous risk in H2RAs, including in children, is unclear. We studied the fracture risk and characteristics among hospitalized pediatric patients exposed to H2RA compared to an untreated cohort.
METHODS: The Pediatric Health Information System (PHIS) multicenter database was queried for hospital encounters of children aged 6 months – 15.5 years and between 7/2016 – 8/2017. Patients with comorbidities and medications including PPI that predispose for fractures were excluded from the cohort and a propensity matched control was identified. The subjects and controls were followed for 2 years for hospitalization with a fracture diagnoses.
RESULTS: Our cohort included 3,526 patients with exposure to H2RA and matched controls. Fractures were reported in 1% of patients (67) with no statistical difference between the groups. Upper, then lower extremity fractures were the most common in both groups. Axial skeleton fractures were the least frequently encountered fractures among both groups.
CONCLUSION: H2RA exposure is not associated with an increased risk of fracture in hospitalized children exposed to H2RA when compared with a matched untreated cohort, further studies are needed to determine if long-term exposure to H2RA may be associated with fracture risk in both those with and without comorbidities or on fracture predisposing medication.What is known Histamine-2-receptor antagonists (H2RA) are amongst the most widely used acid suppression therapy in children.H2RA therapy is regarded as safe in children including infants.Fracture risk associated with proton pump inhibitor (PPI) therapy in children has not been adequately studied in children.What is new The incidence of fractures in children aged 6 months through 15.5 years followed for 2 years after H2RA therapy was not increased when compared to a matched controlUse of H2RA therapy is safer than PPI therapy with respect to fracture risk in children with no other risk factors.Further studies are needed to assess the association of long-term exposure to H2RA with fracture risk in children without predisposing risk for fracture.
PMID:35112645 | DOI:10.1080/03007995.2022.2037847