Nevin Manimala

Ren Fail. 2022 Dec;44(1):1090-1097. doi: 10.1080/0886022X.2022.2094805.

ABSTRACT

INTRODUCTION: Abnormalities in blood bicarbonates (HCO₃^–) concentration are a common finding in patients with chronic kidney disease, especially at the end-stage renal failure. Initiating of hemodialysis does not completely solve this problem. The recommendations only formulate the target concentration of ≥22 mmol/L before hemodialysis but do not guide how to achieve it. The aim of the study was to assess the acid-base balance in everyday practice, the effect of hemodialysis session and possible correlations with clinical and biochemical parameters in stable hemodialysis patients.

MATERIAL AND METHODS: We enrolled 75 stable hemodialysis patients (mean age 65.5 years, 34 women), from a single Department of Nephrology. We assessed blood pressure, and acid-base balance parameters before and after mid-week hemodialysis session.

RESULTS: We found significant differences in pH, HCO₃^– pCO₂, lactate before and after HD session in whole group (p < 0.001; p < 0.001; p < 0.001; p = 0.001, respectively). Buffer bicarbonate concentration had only statistically significant effect on the bicarbonate concentration after dialysis (p < 0.001). Both pre-HD acid-base parameters and post-HD pH were independent from buffer bicarbonate content. We observed significant inverse correlations between change in the serum bicarbonates and only two parameters: pH and HCO₃^– before hemodialysis (p = 0.013; p < 0.001, respectively).

CONCLUSIONS: Despite the improvement in hemodialysis techniques, acid-base balance still remains a challenge. The individual selection of bicarbonate in bath, based on previous single tests, does not improve permanently the acid-base balance in the population of hemodialysis patients. New guidelines how to correct acid-base disorders in hemodialysis patients are needed to have less ‘acidotic’ patients before hemodialysis and less ‘alkalotic’ patients after the session.

PMID:35793495 | DOI:10.1080/0886022X.2022.2094805

J Am Anim Hosp Assoc. 2022 Jul 1;58(4):180-188. doi: 10.5326/JAAHA-MS-7230.

ABSTRACT

Diabetes mellitus is a common endocrinopathy in dogs that has been associated with various biochemical changes and comorbid diseases, but hematologic abnormalities have been rarely reported. The aim of this retrospective study was to evaluate complete blood count and blood smear alterations and to describe their relationship with, and incidence of comorbid diseases in, diabetic dogs. Three-hundred twelve diabetic dogs, 286 dogs diagnosed with systemic, nondiabetic illnesses, and 506 healthy dogs were identified during the study period. Groups were compared using contingency tables and logistic regression. Associations between statistically significant complete blood count and blood smear alterations and comorbidities were evaluated using multivariable analysis. High-grade codocytosis and anisocytosis were identified more frequently in diabetic dogs, whereas high-grade reactive lymphocytosis and keratocytosis were identified less frequently (P < .001). Diabetic dogs with high-grade codocytosis had lower red blood cell, hemoglobin, hematocrit and higher white blood cell counts (P < .001). Diabetic ketoacidosis was diagnosed more frequently in diabetic dogs with high-grade codocytosis when compared with those with low-grade codocytosis (P < .001) or when compared with any other cell morphologic alterations. This study suggests that blood smear analysis should be a routine part of the evaluation of diabetic dogs.

PMID:35793489 | DOI:10.5326/JAAHA-MS-7230

Biometrics. 2022 Jul 6. doi: 10.1111/biom.13711. Online ahead of print.

ABSTRACT

Recent statistical methodology for precision medicine has focused on either identification of subgroups with enhanced treatment effects or estimating optimal treatment decision rules so that treatment is allocated in a way that maximizes, on average, predefined patient outcomes. Less attention has been given to subgroup testing, which involves evaluation of whether at least a subgroup of the population benefits from an investigative treatment, compared to some control or standard of care. In this work, we propose a general framework for testing for the existence of a subgroup with enhanced treatment effects based on the difference of the estimated value functions under an estimated optimal treatment regime and a fixed regime that assigns everyone to the same treatment. Our proposed test does not require specification of the parametric form of the subgroup and allows heterogeneous treatment effects within the subgroup. The test applies to cases when the outcome of interest is either a time-to-event or a (uncensored) scalar, and is valid at the exceptional law. To demonstrate the empirical performance of the proposed test, we study the type I error and power of the test statistics in simulations and also apply our test to data from a Phase III trial in patients with hematological malignancies.

PMID:35793474 | DOI:10.1111/biom.13711

J Eur Acad Dermatol Venereol. 2022 Jul 6. doi: 10.1111/jdv.18407. Online ahead of print.

ABSTRACT

Tumor necrosis factor inhibitors (TNFis) are commonly used for treating psoriatic diseases; however, the risk of infection while receiving TNFis remains uncertain. The aim of this study was to investigate the infection risk in patients with psoriatic disease receiving TNFis. A prospectively registered systematic literature search was conducted in Medline (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, and the ClinicalTrials.gov databases from inception to December 31, 2021. We included double-blind randomized controlled trials that compared TNFis or other biologics with placebo in adults with psoriasis or psoriatic arthritis. The primary outcomes included overall and serious infection risks, and secondary outcomes included upper respiratory infections and nasopharyngitis risks. The risk ratio of the dichotomous outcome was calculated using the Mantel-Haenszel method with random effects, and heterogeneity was assessed using Cochran’s Q statistic and quantified using the I-squared statistic. A total of 48 studies with 15464 patients with psoriatic diseases were included. The meta-analysis demonstrated a slightly increased overall infection risk (risk ratio =1.09; 95% confidence interval,1.02 to 1.15) but not serious infection risk (risk ratio =0.95; 95% confidence interval, 0.61 to 1.49) among patients receiving TNFis. There was also no increased risks of upper respiratory infections (risk ratio =1.10; 95% confidence interval, 0.94 to 1.28) or nasopharyngitis (risk ratio =1.14; 95% confidence interval, 1.00 to 1.30). In subgroup analyses using the fixed effects model, only etanercept and certolizumab pegol were respectively associated with an increased risk of overall infection (RR = 1.14, 95% CI, 1.03 to 1.27) and upper respiratory infections (RR=1.42, 95% CI, 1.02 to 1.98). In conclusion, evidence to date suggests an increased overall infection risk that is generally tolerable in patients with psoriatic diseases receiving TNFis. There are no increased risks of serious infections, upper respiratory infections, or nasopharyngitis.

PMID:35793472 | DOI:10.1111/jdv.18407

J Am Chem Soc. 2022 Jul 6. doi: 10.1021/jacs.2c02001. Online ahead of print.

ABSTRACT

The conversion of CO₂ into value-added products is a compelling way of storing energy derived from intermittent renewable sources and can bring us closer to a closed-loop anthropogenic carbon cycle. The ability to synthesize nanocrystals of well-defined structure and composition has invigorated catalysis science with the promise of nanocrystals that selectively express the most favorable sites for efficient catalysis. The performance of nanocrystal catalysts for the CO₂ reduction reaction (CO₂RR) is typically evaluated with nanocrystal ensembles, which returns an averaged system-level response of complex catalyst-modified electrodes with each nanocrystal likely contributing a different (unknown) amount. Measurements at single nanocrystals, taken in the context of statistical analysis of a population, and comparison to macroscale measurements are necessary to untangle the complexity of the ever-present heterogeneity in nanocrystal catalysts, achieve true structure-property correlation, and potentially identify nanocrystals with outlier performance. Here, we employ environment-controlled scanning electrochemical cell microscopy to isolate and investigate the electrocatalytic CO₂RR response of individual facet-defined gold nanocrystals. Using correlative microscopy approaches, we conclusively demonstrate that {110}-terminated gold rhombohedra possess superior activity and selectivity for CO₂RR compared with {111}-terminated octahedra and high-index {310}-terminated truncated ditetragonal prisms, especially at low overpotentials where electrode kinetics is anticipated to dominate the current response. The methodology framework described here could inform future studies of complex electrocatalytic processes through correlative single-entity and macroscale measurement techniques.

PMID:35793438 | DOI:10.1021/jacs.2c02001

Psychooncology. 2022 Jul 6. doi: 10.1002/pon.5995. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has had a complex and profound impact on the provision of palliative care globally. To support learning from palliative care providers and researchers worldwide, the Education Subcommittee of International Psycho-Oncology Society (IPOS) Palliative Care Special Interest Group developed a webinar with presentations by and discussion with eight international palliative care leaders. Presentations were content rich; the speakers used both quantitative (e.g., sharing recent statistical findings) and qualitative (e.g., narrative storytelling, anecdotal experiences) approaches to portray the effect of COVID-19 in their region. Subsequent to the webinar, the committee collectively identified five themes conveyed by the presenters through consensus. The themes included: 1) altered accessibility to palliative care, with socio-economic status impacting virtual health availability; 2) reduced opportunities to preserve dignity, as survival has been prioritized over preserving the humanity of patients and their loved ones; 3) complicated grief and bereavement arising from social distancing requirements; 4) greater awareness of the importance of sustaining health provider well-being; and 5) the development of valuable innovations across nations, institutions, disciplines, and communities. Overall, the webinar facilitated valuable connection for global learning and identified opportunities for research and clinical interventions. This article is protected by copyright. All rights reserved.

PMID:35793431 | DOI:10.1002/pon.5995

Disabil Rehabil Assist Technol. 2022 Jul 5:1-10. doi: 10.1080/17483107.2022.2091670. Online ahead of print.

ABSTRACT

PURPOSE: to investigate long-term effects of SmartDrive on mobility, everyday activity, and shoulder pain among spinal cord injured manual wheelchairs users.

MATERIAL AND METHODS: A prospective pilot intervention study was conducted at Spinalis/Aleris Rehab Station, Sweden. Participants were consecutively invited when evaluated for SmartDrive prescription. Assessments were done at baseline, intervention (use of SmartDrive), and after six months. A smartwatch registered wheelchair utilization including push intensity and pushes/day. Wheelchair Outcome Measure, pain rating instruments including Wheelchair User’s Shoulder Pain Index, a wheelchair test, and semi-structured interviews were used. Descriptive statistics and content analysis approach were used.

RESULTS: Twenty-five persons were screened, six of 14 included completed the study. Drop-out reasons were not related to SmartDrive for five of the eight persons. After intervention, there was a tendency of decreased pain (median (IQR) 5/10 (2.6-6.6) vs 2.5 (2-3.2). All participants reported increased satisfaction of performance when “taking a walk”, from median (IQR) 45/100 (27-70) at baseline to 95 (80-100) at 6 months. Two persons who could not ascend a slope at baseline could manage using the SmartDrive. Interviews revealed that the in general positive response persisted at six months. Also, with the SmartDrive the participants could go out despite pain, providing a sense of freedom and independence. Three incidents were reported.

CONCLUSION: This long-term pilot study indicates that a SmartDrive might be a valuable assistive device to promote mobility despite of shoulder pain. All participants considered it easy to use and experienced increased independence, however skills training and follow-ups are necessary. IMPLICATIONS FOR REHABILITATIONA Rear Drive Power Assist Device (RD-PAD) could increase satisfaction with self-selected activities.A RD-PAD could increase functional mobility by facilitating propelling longer distances and steeper slopes.A RD-PAD could improve perseverance of daily activities in spite of shoulder pain.A RD-PAD could be a valuable assistive aid for persons with paraplegia with different level of wheelchair skills but with good self-awareness regarding their abilities.Thorough assessment of initial wheelchair skills, training, and follow-up are important to enhance safety and maximize performance when using the RD-PAD.

PMID:35793399 | DOI:10.1080/17483107.2022.2091670

PLoS One. 2022 Jul 6;17(7):e0270761. doi: 10.1371/journal.pone.0270761. eCollection 2022.

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-1), notoriously known as COVID-19, emerged in 2019 and was responsible for causing acute respiratory collapse. Moreover, in September 2020, new variant cases of severe acute respiratory syndrome coronavirus 2 were reported in the United Kingdom, with many patients and deaths. This study aimed to see knowledge, perception, and fear among the global population towards a new variant of severe acute respiratory syndrome coronavirus 2, known as Omicron (B.1.1.529). This online cross-sectional global study was conducted during the emergence of the B.1.1.529 variant, also known as the Omicron variant. The survey was carried out from 2nd December 2021 to 3rd January 2022. The descriptive analysis was presented as frequencies (N), percentages (%), and mean ± standard deviation (m ± SD). The association between dependent and categorical independent variables was determined using the Chi-square test (x2). Statistical analysis was performed by using SPSS version 23. Of 353 respondents, approximately 61% were females. One hundred fifty-four respondents were in the age group of 18-27 years. The average age was 31.53±10.3 (mean± SD). The majority of respondents (43.9%) were from Indonesia. The mean knowledge score about the Omicron variant was 3.18±1.14. Our study suggests that people have some knowledge about the new variant, Omicron (B.1.1.529). Besides, there was a significant association (p = 0.05) for the perception of the fatality rate of Omicron among the respondents from different countries. However, there is still an ample research gap in enlightening people about this infection (B.1.1.529).

PMID:35793377 | DOI:10.1371/journal.pone.0270761

PLoS One. 2022 Jul 6;17(7):e0270553. doi: 10.1371/journal.pone.0270553. eCollection 2022.

ABSTRACT

BACKGROUND: Price forecasting of perishable crop like vegetables has importance implications to the farmers, traders as well as consumers. Timely and accurate forecast of the price helps the farmers switch between the alternative nearby markets to sale their produce and getting good prices. The farmers can use the information to make choices around the timing of marketing. For forecasting price of agricultural commodities, several statistical models have been applied in past but those models have their own limitations in terms of assumptions.

METHODS: In recent times, Machine Learning (ML) techniques have been much successful in modeling time series data. Though, numerous empirical studies have shown that ML approaches outperform time series models in forecasting time series, but their application in forecasting vegetables prices in India is scared. In the present investigation, an attempt has been made to explore efficient ML algorithms e.g. Generalized Neural Network (GRNN), Support Vector Regression (SVR), Random Forest (RF) and Gradient Boosting Machine (GBM) for forecasting wholesale price of Brinjal in seventeen major markets of Odisha, India.

RESULTS: An empirical comparison of the predictive accuracies of different models with that of the usual stochastic model i.e. Autoregressive integrated moving average (ARIMA) model is carried out and it is observed that ML techniques particularly GRNN performs better in most of the cases. The superiority of the models is established by means of Model Confidence Set (MCS), and other accuracy measures such as Mean Error (ME), Root Mean Square Error (RMSE), Mean Absolute Error (MAE) and Mean Absolute Prediction Error (MAPE). To this end, Diebold-Mariano test is performed to test for the significant differences in predictive accuracy of different models.

CONCLUSIONS: Among the machine learning techniques, GRNN performs better in all the seventeen markets as compared to other techniques. RF performs at par with GRNN in four markets. The accuracies of other techniques such as SVR, GBM and ARIMA are not up to the mark.

PMID:35793366 | DOI:10.1371/journal.pone.0270553

PLoS One. 2022 Jul 6;17(7):e0267627. doi: 10.1371/journal.pone.0267627. eCollection 2022.

ABSTRACT

Agricultural water salvation is the lifeblood of the national economy and is of great significance to the high-quality development of the region. In order to maximize the economic assistances of agricultural water salvation investment, this article focuses on panel data from 2005 to 2019 in 14 provinces in Eastern China, this research constructs an economic development evaluation index system from five dimensions: innovative development, coordinated development, green development, open development and shared development, and uses dynamic panel model to explore the influence relationship and path of Eastern Agricultural water salvation investment on economic development. The results represent that: there is a significant non-linear effect between agricultural water salvation investment and economic growth, showing an inverted U-shaped relationship. Which means that with the expansion of agricultural water salvation investment; economic growth has risen first and then declined. At present, the impact of agricultural water salvation investment in the Eastern region on economic development is in the promotion stage of positive and sustained growth. The recommendation of this research will help the state control in the amount of agricultural water salvation investment in the Eastern region, improve the efficiency of agricultural water salvation investment, and provide support in decision making.

PMID:35793363 | DOI:10.1371/journal.pone.0267627