Category: Nevin Manimala

J Surg Res. 2021 May 14;266:160-167. doi: 10.1016/j.jss.2021.03.051. Online ahead of print.

ABSTRACT

BACKGROUND: The incidence of thyroid cancer is increasing at a rapid rate. Prior studies have demonstrated financial burden and decreased quality of life in patients with thyroid cancer. Here, we characterize patient-reported financial burden in patients with thyroid cancer over a 28y period.

MATERIALS AND METHODS: Patients who underwent thyroidectomy for thyroid cancer from 1990-2018 completed a phone survey assessing financial burden and its related psychological financial hardship. Descriptive statistics were performed to characterize these outcomes and correlation with sociodemographic data was assessed.

RESULTS: Respondents (N = 147) were 73% female, 75% white, and had a median follow up of 7 y. The majority had a full-time job (59%) and private insurance (81%) at the time of diagnosis. Overall, 16% of respondents reported financial burden and 50% reported psychological financial hardship. Those reporting financial burden were disproportionately impacted by psychological financial hardship (87% versus 43%, P < 0.001). One in four (25%) respondents reported not being adequately informed about costs.

CONCLUSIONS: Financial burdens are important outcomes of thyroid cancer which occur even among patients with protective financial factors, suggesting an even greater impact on the general population of patients with thyroid cancer. Further research is needed to explore the intersection of financial burden, cost, and quality of life.

PMID:34000639 | DOI:10.1016/j.jss.2021.03.051

EBioMedicine. 2021 May 14;67:103371. doi: 10.1016/j.ebiom.2021.103371. Online ahead of print.

ABSTRACT

BACKGROUND: Prognostic implications of blood cholesterol may differ at different stages of life. This cohort study compares the value of total cholesterol (TC) readings earlier versus later in life for the prediction of coronary atherosclerosis, cardiovascular events, and cardiovascular death.

METHODS: In a cardiovascular observation study (CVOS) we performed coronary angiography and prospectively recorded cardiovascular events in 1090 patients over up to 19 years. These patients had participated in a health survey (HS) 15 years prior to the CVOS baseline. TC was measured twice, first at the earlier HS and then later at CVOS recruiting.

FINDINGS: Patients in the highest versus the lowest TC-category of the HS had an OR of 4.30 [2.41-7.65] for significant CAD at angiography, a HR of 1.74 [1.10-2.76] for cardiovascular events, and a HR of 7.55 [1.05-54.49] for cardiovascular death after multivariate adjustment. In contrast, TC as measured at the baseline of the CVOS was neither significantly associated with significant CAD (OR= 0.75 [0.49-1.13]) nor with cardiovascular events or death during follow-up (HR= 0.86 [0.62-1.18] and 0.79 [0.41-1.53], respectively). Moreover, the ESC/EAS-SCORE was found to be more powerful in predicting cardiovascular mortality when using earlier instead of later TC, with a continuous net reclassification improvement of 0.301 (p<0.001).

INTERPRETATION: Early measurement not only enables early intervention in keeping with the concept of lifelong exposure to atherogenic lipoproteins. These data also suggest that cardiovascular risk prediction is more accurate if using earlier in life TC readings.

FUNDING: The present study did not receive any particular funding.

PMID:34000625 | DOI:10.1016/j.ebiom.2021.103371

Food Chem. 2021 Apr 29;360:129978. doi: 10.1016/j.foodchem.2021.129978. Online ahead of print.

ABSTRACT

Qualitative and quantitative composition of non-structural carbohydrates comprising glucose, fructose, sucrose and fructooligosaccharides (FOS) is one of the key determinants of market suitability, storability and technological processability of onions. To develop a cost-effective and rapid tool for carbohydrate profiling, applicability of attenuated total reflectance Fourier-transform infrared (ATR-FTIR) spectroscopy of onion juice was investigated with special regard to FOS patterns. As reference, detailed carbohydrate profiles of onion juices were generated by high-performance liquid chromatography coupled with evaporative light scattering detection (HPLC-ELSD). Hierarchical cluster analysis (HCA) of ATR-FTIR spectra was successfully applied for classifying onions into fresh market, storage and dehydrator type according to HPLC-ELSD profiles. A bootstrapping method for automatized test-set validation by projection to latent structures (PLS) algorithms using HPLC and ATR-FTIR spectroscopy data was developed. Model statistics showed promising perspectives for reliable quantification of individual saccharides and sum parameters. The presented methodology allows estimating the nutritional and pre-biotic value directly during cultivation and processing.

PMID:34000635 | DOI:10.1016/j.foodchem.2021.129978

Eur J Radiol. 2021 Apr 30;140:109747. doi: 10.1016/j.ejrad.2021.109747. Online ahead of print.

ABSTRACT

PURPOSE: The primary aim was to develop and validate a novel mammography positioning measure, specifically incorporating parameters which might relate to mammography pain. We then explored relationships between the new adverse positioning score and (1) pain; (2) patient and technique factors.

METHODS: A 15-item instrument incorporating positioning features with potential to relate to mammography pain was developed. Participants’ mammograms (n = 310) were reviewed for presence of these features. Validity was investigated using the Rasch model. Scores produced by the resultant measure were investigated for associations with patients’ pain scores and relevant patient and technique factors, using Pearson correlation, analysis of variance, and multiple linear regression.

RESULTS: Statistical indices within the Rasch measurement framework provided good evidence that the measure reflected a coherent construct of adverse positioning. Thus, the scores produced with the measurement instrument were valid for use in further statistical analysis. There is, however, scope for improvement of the measure’s discriminatory properties. Adverse positioning scores were higher for greater breast volumes (r = 0.12, p=.0391) and body mass index (BMI) (r = 0.13, p=.0349), and varied by mammographer (F(11,298) 2.38, p = .0078). The relationships with BMI and mammographer persisted in regression modelling. No relationship was found between adverse positioning and pain.

CONCLUSIONS: Evidence from Rasch analysis suggests that this novel measure is valid for quantifying a coherent “adverse positioning” construct in mammography. Adverse positioning scores varied by mammographer and were related to higher patient BMI but not to mammography pain. The measure warrants expansion, further refinement, and testing in larger studies.

PMID:34000597 | DOI:10.1016/j.ejrad.2021.109747

Prim Care Companion CNS Disord. 2021 Apr 8;23(2):19m02493. doi: 10.4088/PCC.19m02493.

ABSTRACT

OBJECTIVE: To define sex differences in cardiometabolic indice changes over 12 months in patients on antipsychotics and to describe treatment complexity, interventions, and patient satisfaction of pharmacist comprehensive medication management (CMM) services.

METHODS: Secondary analyses of time effect-associated sex differences in cardiometabolic indices within and between study groups were done at baseline and 12 months. Each group consisted of 60 subjects who received full pharmacist CMM services (PCS) and 60 subjects who received either modified or no CMM services (NCS). Pharmacist CMM services are a team-based practice of providing direct patient care.

RESULTS: Significant sex differences in mean change score were observed from baseline to 12 months in the combined PCS and NCS subjects. Compared to men, women had greater body weight (P = .003) and waist measurement (P = .02) reductions and increased serum level of high-density lipoproteins (P < .001). In contrast, men had greater systolic (P < .001) and diastolic (P = .005) blood pressure levels, more hypertension diagnoses (P = .01), and less dyslipidemia diagnoses (P = .001) compared to women at 12 months. Significant sex differences were observed in combined PCS and NCS groups for glycated hemoglobin (HgbA_1c) (women: -0.33%, P = .02) and low-density lipoprotein (men: -21.63 mg/dL, P = .04) at 12 months. In PCS women, a significant (P = .02) reduction in mean HgbA_1c percentages (-0.46%) compared to PCS men (0.28%) was observed at 12 months. A higher percentage (62%, n = 28/45) of PCS women compared to PCS men (38%, n = 17/45) at 12 months continued to receive CMM services. Satisfaction survey results positively favored CMM services; however, the response rate was only 25% (n = 18/72).

CONCLUSIONS: Women on antipsychotics appear more likely to keep follow-up visits, return satisfaction surveys, reduce abdominal weight, and improve both HgbA_1c percentages and high-density lipid levels compared to men over 12 months. Women were satisfied overall with CMM services. Recognition of sex differences can promote a more personalized patient-centered care approach among patients prescribed antipsychotics.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02029989.

PMID:34000112 | DOI:10.4088/PCC.19m02493

J Sci Food Agric. 2021 May 17. doi: 10.1002/jsfa.11320. Online ahead of print.

ABSTRACT

BACKGROUND: Stevia leaves were subjected to convective hot-air, infrared, and vacuum drying at 40, 60, and 80 °C, followed by an assessment of thermophysical properties and microstructure, along with drying kinetics modelling and evaluation of energy features for all drying operations.

RESULTS: Effective moisture diffusivity (D_eff ) showed dependency on temperature with values ranging from 1.08×10^-12 to 7.43×10^-12 m² s^-1 for convective drying, from 0.71×10^-12 to 6.60×10^-12 m² s^-1 for infrared drying, and from 1.29×10^-12 to 5.39×10^-12 m² s^-1 for vacuum drying. The thermal properties of the dried Stevia leaves under different drying conditions, showed values of density, specific heat, thermal diffusivity, thermal conductivity, and thermal effusivity ranging from 95.6 to 116.2 kg m^-3 , 3050 to 3900 J kg^-1 K^-1 , 4.28×10^-7 to 5.60×10^-7 m² s^-1 , 0.16 to 0.23 W m^-1 K^-1 and 244 to 305 W s^0.5 m^-2 K^-1 respectively. As for microstructure, the convective hot-air drying showed better preserved leaves characteristics, compared to infrared- and vacuum-drying, whereby SEM image analysis also revealed noticeable differences at higher temperatures. Statistical analysis showed that the Midilli-Kuçuk model fitted best the experimental data of drying curves (0.961<r² <0.999, 0.000064<SSE<0.005359, and 0.000074<χ² <0.006278). Comparison of the drying methods with respect to energy features, showed that convective drying at 80 °C led to lowest specific energy consumption (61.86 kWh kg^-1 ) with highest efficiency (8.5%).

CONCLUSION: The results of this study contribute to a better understanding of the drying behaviour and showed that thermophysical properties of dried Stevia leaves and energy features are affected by drying methods. This article is protected by copyright. All rights reserved.

PMID:34000065 | DOI:10.1002/jsfa.11320

Am J Hematol. 2021 May 17. doi: 10.1002/ajh.26239. Online ahead of print.

NO ABSTRACT

PMID:34000073 | DOI:10.1002/ajh.26239

Catheter Cardiovasc Interv. 2021 May 17. doi: 10.1002/ccd.29772. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess the predictive ability of the Global Registry of Acute Coronary Events (GRACE) risk score 2.0 in contemporary acute coronary syndrome (ACS) patients, and its relation to antiplatelet strategies.

BACKGROUND: The predictive value of the GRACE risk score in the contemporary ACS cohort and the appropriate antiplatelet regimen according to the risk remain unclear.

METHODS: This is a subgroup analysis of the all-comers, randomized GLOBAL LEADERS trial, comparing ticagrelor monotherapy versus conventional dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). The GRACE risk score 2.0 with 1-year mortality prediction was implemented. The randomized antiplatelet effect was assessed in predefined three GRACE risk-groups; low-risk (GRACE <109), moderate-risk (GRACE 109-140), and high-risk (GRACE >140).

RESULTS: The GRACE risk score was available in 6,594 out of 7,487 ACS patients among whom 1,743, 2,823, and 2,028 patients were classified as low-risk, moderate-risk, and high-risk, respectively. At 1 year, all-cause mortality occurred in 120 patients (1.8%). The discrimination ability of the GRACE model was moderate (C-statistic = 0.742), whereas 1-year mortality risk was overestimated (mean predicted mortality rate: 3.9%; the Hosmer-Lemeshow chi-square: 21.47; p = 0.006). There were no significant interactions between the GRACE risk strata and effects of the ticagrelor monotherapy on ischemic or bleeding outcomes at 1 year compared to the reference strategy.

CONCLUSION: The GRACE risk score 2.0 is valuable in discriminating high risk ACS patients, however, the recalibration of the score is recommended for better risk stratification. There is no significant differences in efficacy and safety of ticagrelor monotherapy across the three GRACE risk strata.

PMID:34000088 | DOI:10.1002/ccd.29772

Interact Cardiovasc Thorac Surg. 2021 May 17:ivab119. doi: 10.1093/icvts/ivab119. Online ahead of print.

ABSTRACT

OBJECTIVES: The newly proposed N subclassification (new-N) was compared with the combined anatomical location and ratio of the number of metastatic lymph nodes to the total number of resected lymph nodes (anatomic-LNR) in terms of prognosis in resected lung cancer patients.

METHODS: Between 2005 and 2018, 961 patients who underwent lung cancer resection were catergorized into the pN1-single (N1a; n = 281), pN1-multiple (N1b; n = 182), pN2-single with skip metastasis (N2a1; n = 116), pN2-single with N1 metastasis (N2a2; n = 222) and pN2-multiple (N2b; n = 160) groups based on new-N. The optimal cut-off points for survival in pN1 and pN2 patients were determined using the best sensitivity and specificity scores, calculated using receiver operating characteristic analysis.

RESULTS: The difference in survival between N1a and N1b patients was statistically significant (P = 0.001), but there was no significant difference in the survival rates of N1b and N2a1 (P = 0.52). The survival curves for N2a1 and N2a2 patients almost overlapped (P = 0.143). N2a2 patients showed a better survival rate than N2b patients, with no significant difference (P = 0.132). The cut-off points for LNR were 0.10 and 0.25 for pN1 and pN2 patients, respectively, according to receiver operating characteristic analysis for survival. Based on receiver operating characteristic analysis, pN patients were categorized into the N1-lowLNR (n = 232), N1-highLNR (n = 231), N2-lowLNR (n = 266) and N2-highLNR (n = 232) groups. The 5-year survival rate was 62.9%, 49.8%, 41.1% and 27.1% for N1-lowLNR, N1-highLNR, N2-lowLNR and N2-highLNR, respectively (P < 0.001).

CONCLUSIONS: LowLNR is associated with better survival than highLNR in resected lung cancer patients. Anatomic-LNR shows a high discriminatory power for prognosis.

PMID:34000035 | DOI:10.1093/icvts/ivab119

J Sci Food Agric. 2021 May 17. doi: 10.1002/jsfa.11323. Online ahead of print.

ABSTRACT

BACKGROUND: Multilayer perceptron (MLP) feed-forward artificial neural networks (ANN) and first order Takagi-Sugeno type adaptive neuro-fuzzy inference systems (ANFIS) are utilized to model the fluidized bed drying process of Echium amoenum Fisch. & C. A. Mey. The moisture ratio evolution is calculated based on the drying temperature, airflow velocity and process time. Different ANN topologies are examined by evaluating the neuron number (3 to 20), the activation functions and the addition of a second hidden layer. Respectively, different number (2 to 5) and shapes of membership functions are examined for the ANFIS, using the grid partitioning method. The models with the best performance in terms of prediction accuracy as evaluated by the statistical indices, are compared with the best fit thin-layer model and the available data from the experimental cases of 40, 50 and 60°C temperatures at 0.5, 0.75 and 1 ms^-1 airflow velocity.

RESULTS: The best performed ANFIS model, comprised by 5-2-2 of π-shaped and triangular membership functions for time, temperature and airflow velocity inputs respectively, was able to describe the moisture ratio evolution of Echium amoenum more precisely than the best ANN topology with R² =0.9992, RMSE=0.0078 and SSE=1.06·10^-2 . Best thin-layer model involving six adjustable parameters, managed to describe experimental data with R² =0.9996, RMSE=0.0057 and SSE=7.3·10^-4 .

CONCLUSION: The results of the comparative study indicate that empirical regression models with increased number of adjustable parameters, constitute a simpler and more accurate modeling approach for estimating the moisture ratio of Echium amoenum Fisch. & C. A. Mey under fluidized bed drying. This article is protected by copyright. All rights reserved.

PMID:34000064 | DOI:10.1002/jsfa.11323