Nevin Manimala

J Korean Med Sci. 2022 Feb 28;37(8):e65. doi: 10.3346/jkms.2022.37.e65.

ABSTRACT

BACKGROUND: Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2) are key proteins mediating viral entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although gene expressions of ACE2 and TMPRSS2 have been analyzed in various organs and diseases, their soluble forms have been less studied, particularly in asthma. Therefore, we aimed to measure circulating ACE2 and TMPRSS2 in the serum of asthmatics and examine their relationship with clinical characteristics.

METHODS: Clinical data and serum samples of 400 participants were obtained from an asthma cohort. The soluble ACE2 (sACE2) and soluble TMPRSS2 (sTMPRSS2) level was measured by enzyme-linked immunosorbent assay, and the values underwent a natural log transformation. Associations between sACE2 and TMPRSS2 levels and various clinical variables were analyzed.

RESULTS: The patients younger than 70 years old, those with eosinophilic asthma (eosinophils ≥ 200 cells/µL), and inhaled corticosteroids (ICS) non-users were associated with higher levels of sACE2. Blood eosinophils and fractionated exhaled nitric oxide levels were positively correlated with serum ACE2. In contrast, lower levels of sTMPRSS2 were noted in patients below 70 years and those with eosinophilic asthma, while no association was noted between ICS use and sTMPRSS2. The level of sTMPRSS2 also differed according to sex, smoking history, coexisting hypertension, and forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio. The proportion of sputum neutrophils was positively correlated with sTMPRSS2, while the FEV1/FVC ratio reported a negative correlation with sTMPRSS2.

CONCLUSION: The levels of ACE2 and TMPRSS2 were differently expressed according to age, ICS use, and several inflammatory markers. These findings suggest variable susceptibility and prognosis of SARS-CoV-2 infection among asthmatic patients.

PMID:35226423 | DOI:10.3346/jkms.2022.37.e65

J Korean Med Sci. 2022 Feb 28;37(8):e62. doi: 10.3346/jkms.2022.37.e62.

ABSTRACT

BACKGROUND: Reduced exercise capacity reflects symptom severity and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM). The present study aimed to identify factors that may affect exercise capacity in patients with HCM.

METHODS: In 294 patients with HCM and preserved left ventricular (LV) ejection fraction, we compared peak oxygen consumption (peak VO₂) evaluated by cardiopulmonary exercise testing as a representative parameter of exercise tolerance with clinical and laboratory data, including N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP), diastolic parameters on echocardiography, and the grade of myocardial fibrosis on cardiac magnetic resonance imaging (CMR).

RESULTS: Median peak VO₂, was 29.0 mL/kg/min (interquartile range [IQR], 25.0-34.0). Age (estimated β = -0.140, P < 0.001), female sex (β = -5.362, P < 0.001), NT-proBNP (β = -1.256, P < 0.001), and E/e’ ratio on echocardiography (β = -0.209, P = 0.019) were significantly associated with exercise capacity. Peak VO₂ was not associated with the amount of myocardial fibrosis on CMR (mean of late gadolinium enhancement 12.25 ± 9.67%LV).

CONCLUSION: Decreased exercise capacity was associated with age, female sex, increased NT-proBNP level, and E/e’ ratio on echocardiography. Hemodynamic changes and increased filling pressure on echocardiography should be monitored in this population for improved outcomes.

PMID:35226420 | DOI:10.3346/jkms.2022.37.e62

J Korean Med Sci. 2022 Feb 28;37(8):e60. doi: 10.3346/jkms.2022.37.e60.

ABSTRACT

BACKGROUND: Intussusception refers to the invagination of a part of the intestine into itself. The exact cause for this condition is unknown in most cases. The active implementation of coronavirus disease 2019 (COVID-19) infection control guidelines has reduced the spread of COVID-19 and the incidence of other infectious diseases in children. The current study aimed to identify changes in pediatric intussusception and infectious diseases after the implementation of infection control guidelines and confirm the association between intussusception and contagious diseases.

METHODS: We analyzed the electronic medical records of pediatric patients diagnosed with intussusception from seven hospitals in Korea between January 2017 and December 2020. We used open data from the Korea Disease Control and Prevention Agency to investigate changes in infectious diseases over the same period.

RESULTS: Altogether, we evaluated 390 children with intussusception. There was a statistically significant decrease in the incidence of monthly visits with intussusception in the COVID-19 period group (9.0 vs. 3.5, P < 0.001). When the monthly incidence of infectious diseases was compared between the pre-COVID-19 and the COVID-19 periods, a statistically significant decrease in respiratory viruses (7979.0 vs. 815.2, P < 0.001), enterovirus infection (262.2 vs. 6.6, P < 0.001), and viral enteritis (916.2 vs. 197.8, P < 0.001) were confirmed in the COVID-19 period. Through interrupted time series analysis, it was confirmed that the incidence of intussusception and viral infectious diseases have drastically decreased since March 2020, when COVID-19 infection control guidelines were actively implemented.

CONCLUSION: We confirmed that implementing infection control guidelines during the COVID-19 pandemic resulted in a decrease in intussusception and viral infectious diseases. Through this result, it was possible to indirectly confirm the existing hypothesis that viral infections play a significant role in the pathophysiologic mechanism of intussusception.

PMID:35226418 | DOI:10.3346/jkms.2022.37.e60

Am J Addict. 2022 Feb 28. doi: 10.1111/ajad.13267. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Clinical studies examining once-daily versus multiple-daily dosing of buprenorphine/naloxone in patients with opioid use disorder (OUD) in the absence of comorbid pain are lacking.

METHODS: This retrospective chart review aimed to compare 100 patients prescribed single-daily buprenorphine/naloxone (n = 50) to those prescribed multiple-daily buprenorphine/naloxone (n = 50) to elucidate the impact that dosing frequency has on negative urine drug screens (UDS) and the number of relapses in OUD.

RESULTS: The once-daily cohort produced 84% negative UDSs compared with 74% in the multiple-daily cohort which was statistically significant (p = .034). There were a total of 43 relapses reported in the once-daily cohort, compared with 141 relapses in the multiple-daily cohort (p < .001). The average number of relapses per patient in the single-daily cohort was 0.68 compared with the multiple-daily cohort average of 2.16 (p < .001). In the once-daily cohort, 14% of patients experienced at least one relapse throughout the study, compared with 31% in the multiple-daily cohort (p < .002). There were no significant differences between time to relapse, adherence to treatment, or treatment retention. Statistically significantly more patients in the multiple-daily cohort were using methamphetamines (p = .005); there were no significant differences between groups with the use of any other illicit or non-prescribed substances.

DISCUSSION AND CONCLUSIONS: Once-daily dosing was associated with more negative UDSs and fewer opioid relapses compared with multiple-daily dosing.

SCIENTIFIC SIGNIFICANCE: This was the first study to evaluate buprenorphine/naloxone dosing frequency for opioid use disorder, in the absence of chronic pain. Additional studies evaluating optimal dosing schedules for relapse prevention are warranted.

PMID:35226393 | DOI:10.1111/ajad.13267

Ying Yong Sheng Tai Xue Bao. 2022 Jan;33(1):210-218. doi: 10.13287/j.1001-9332.202201.018.

ABSTRACT

Understanding the responses of lake sediment carbon process to climate change is an important part of a comprehensive understanding of lake carbon budget. To explore the effects of future rainfall increase on sediment carbon flux, undisturbed sediment samples were collected from the bottom of dry lake Barikun in Hami, Xinjiang for the incubation experiment. Based on the increase rate of precipitation (4 mm·10 a^-1) and the distribution characteristics of rainfall in the plant growing season in Hami, Xinjiang since 1960, five rainfall treatments were set (86 mm, T₀; 94 mm, T₁; 102 mm, T₂; 110 mm, T₃; 126 mm, T₄) based on the rainfall in growing season of 2016 (86 mm). We analyzed the effects of rainfall increase on sediment CO₂ flux. Results showed that compared with that before rainfall, the sediment CO₂ flux increased after 1 day of rainfall in the study area. Compared with that during May to July, the CO₂ flux of sediments in August to October decreased. There was no variation of CO₂ accumulative emission among the T₀-T₃ treatments from May to October. However, the average CO₂ emission rate under the T₃ treatment (0.22 μmol·m^-2·s^-1) was significantly higher than that under the T₄ treatment (0.14 μmol·m^-2·s^-1). All treatments showed CO₂ sink at the first day of rainfall (1 d), with T₄ treatment (-0.13 μmol·m^-2·s^-1) having the highest “carbon sink” capacity. After 1 day, the CO₂ sink converted to CO₂ source under the five rainfall treatments, with the CO₂ emission rate under T₃ treatment (0.34 μmol·m^-2·s^-1) being significantly higher than those under other treatments. Compared with May, the CO₂ emission fluxes of T₂-T₄ treatments were significantly higher than those at the time from August to October. Under the condition with relatively stable temperature, the CO₂ flux of sediments was significantly correlated with the sediment moisture and air humidity. In the next 60 years, the continuous increase of future rainfall may be an important factor promoting CO₂ emission from lake sediment in arid regions, and thus affecting global warming.

PMID:35224943 | DOI:10.13287/j.1001-9332.202201.018

Ying Yong Sheng Tai Xue Bao. 2022 Jan;33(1):9-16. doi: 10.13287/j.1001-9332.202201.001.

ABSTRACT

Forest biomass is an important index in forest development planning and forest resource monitoring. In order to provide a more efficient and low-biased method for estimating individual tree biomass, we introduced artificial neural network here. We used the data of aboveground biomass of 101 Larix olgensis trees harvested from the Dongzhelenghe Forest Farm in Heilongjiang Province to develop four aggregation model systems (AMS), based on different combination of the variables (diameter at breast height, tree height, crown width). The weighted functions were used to eliminate heteroscedasticity. Then, we trained artificial neural network (ANN) biomass model based on the optimal combination. The models were tested by the leave-one-out cross-validation method to compare the accuracy of the two biomass estimation methods. The results showed that biomass model based on only one variable, diameter at breast height, could accurately estimate the biomass of L. olgensis. Adding two indices, tree height and crown width, could improve the fitting performance of models, with AMS4 performing the best among the four addictive model systems. The biomass models developed by the two methods both could estimate biomass at tree level accurately, with the coefficient of determination (R²) of each component was higher than 0.87. Compared with the AMS4, R² of leaf biomass model was about 0.05 higher, and that of other organs were also about 0.01 higher in artificial neural network model system. In addition, the root mean square error (RMSE) and other indicators were also significantly smaller. For example, the RMSE of tree stem and aboveground biomass were smaller by 2.135 kg and 3.908 kg, respectively. The model’s validation statistics mean relative error (MRE) performed better. In general, ANN was a flexible and reliable biomass estimation method, which was worthy consideration when predicting tree component biomass or aboveground biomass.

PMID:35224920 | DOI:10.13287/j.1001-9332.202201.001

Rev Med Suisse. 2022 Feb 23;18(770):343-346. doi: 10.53738/REVMED.2022.18.770.343.

ABSTRACT

Takotsubo cardiomyopathy (TK-CM) is a reversible acute left ventricular dysfunction that cannot be explained by an obstructive coronary lesion. The aim of our study was to explore the possible correlation between the incidence of TK-CM in summer and the average temperature, number of heat waves or number of days hotter than 30°C. 482 patients presented an acute coronary syndrome in the summers of 2012 until 2017 in our region. 15 patients met the inclusion and exclusion criteria and were diagnosed as TK-CM. The study analysis showed a statistically correlation between the number of heatwaves and the incidence of TK-CM (coefficient of correlation: 0.77; p = 0.04). This comforts the hypothesis of climatic influence on this pathology.

PMID:35224911 | DOI:10.53738/REVMED.2022.18.770.343

Int Forum Allergy Rhinol. 2022 Feb 27. doi: 10.1002/alr.22992. Online ahead of print.

ABSTRACT

BACKGROUND: There are major challenges in olfactory measurements in clinical practice; therefore, a handheld digital scent device (DSD; Noar MultiScent 20^® ) was developed as a tablet with an integrated storage system for odors. The DSD is a self-administered, handheld device that controls the duration of odor release to the nasal cavity through a touchscreen digital interface with automatic database generation. This study aimed to determine the feasibility of this DSD as an olfactory assessment test.

METHODS: We recruited 180 participants (mean ± standard deviation age: 34.58 ± 9.71 years; 114 women and 66 men) to participate in smell tests using both the DSD and the 40-item Smell Identification Test (SIT-40), which contained the same type and order of odors and the same multiple-choice answers. The scores were compared and evaluated for correlation between the tests, and test-retest reliability was calculated.

RESULTS: The DSD test scores were higher than the SIT-40 scores (median [interquartile range] = 32 [5.0] vs. 31 [7.0], p = 0.005). The completion time was lower for the DSD test than for the SIT-40 (12.5 [5.0] vs. 16 [6.0] min, p < 0.001). The tests were strongly correlated (Spearman’s rho: 0.74; p < 0.001) and exhibited a high level of agreement (Bland-Altman regression coefficient: 0.672; p = 0.003). The DSD test-retest reliability coefficient was 0.820.

CONCLUSIONS: The DSD is feasible as an olfactory assessment test. The digitalization of olfactory assessment combined with data science may enable new research perspectives in the field of olfaction. This article is protected by copyright. All rights reserved.

PMID:35224885 | DOI:10.1002/alr.22992

Emerg Med Australas. 2022 Feb 27. doi: 10.1111/1742-6723.13936. Online ahead of print.

ABSTRACT

E-learning (EL) has been developing as a medical education resource since the arrival of the internet. The COVID-19 pandemic has minimised clinical exposure for medical trainees and forced educators to use EL to replace traditional learning (TL) resources. The aim of this review was to determine the impact of EL versus TL on emergency medicine (EM) learning outcomes of medical trainees. A systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement using articles sourced from CINAHL, Embase, OVID Medline and PubMed. Articles were independently reviewed by two reviewers following strict inclusion and exclusion criteria. Bias was assessed using the Cochrane Risk of Bias tool. The search yielded a total of 1586 non-duplicate studies. A total of 19 studies were included for data extraction. Fifteen of the included studies assessed knowledge gain of participants using multiple-choice questions as an outcome measure. Eleven of the 15 demonstrated no statistically significant difference while two studies favoured EL with statistical significance and two favoured TL with statistical significance. Six of the included studies assessed practical skill gain of participants. Five of the six demonstrated no statistical significance while one study favoured EL with statistical significance. This systematic review suggests that EL may be comparable to TL for the teaching of EM. The authors encourage the integration of EL as an adjunct to face-to-face teaching where possible in EM curricula; however, the overall low quality of evidence precludes definitive conclusions from being drawn.

PMID:35224870 | DOI:10.1111/1742-6723.13936

Int Wound J. 2022 Feb 28. doi: 10.1111/iwj.13779. Online ahead of print.

ABSTRACT

The aim of this study was to describe pressure ulcer prevalence and prevention interventions in hospital care in Sweden based on nationwide surveys conducted over a 10-year period. All Swedish hospitals were invited to participate in annual pressure ulcer prevalence surveys during the period 2011-2020. The data collection protocols included gender, age, skin assessment, risk assessment, and preventive interventions. In total, more than 130,000 patients were included in the ten prevalence surveys. The prevalence of pressure ulcers in Swedish hospital patients decreased significantly from 17.0 %to 11.4% between 2011 and 2020 and hospital-acquired pressure ulcers decreased from 8.1% to 6.4% between 2018 and 2020. There was no significant decline in medicaldevice-related pressure ulcers during the same period. The proportion of patients who were risk and skin assessed increased, as did the use of pressure-reducing mattresses, sliding sheets, heel protection, and nrepositioning plans. This study shows that the implementation of a national patient safety program has had an impact on the nationwide prevalence of pressure ulcers in hospital care and the occurrence of prevention strategies. However, one in ten patients in Swedish hospitals still suffers from pressure ulcers. Further improvements can be made.

PMID:35224868 | DOI:10.1111/iwj.13779