Nevin Manimala

Int Emerg Nurs. 2021 Jul 28;58:101035. doi: 10.1016/j.ienj.2021.101035. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency departments are faced with a high influx of patients presenting for various complaints. The aim of the present study was to assess the basic characteristics of elderly patients presenting to a rural hospital emergency department in inland Croatia in 2017.

METHODS: Retrospective data collected from the Hospital Information System and by analysis of medical records on patients presenting to emergency department in 2017 were used in the study.

RESULTS: Study results indicated that a lower proportion of elderly individuals aged 65-74 were hospitalized following emergency department workup. A statistically significantly higher proportion of patients older than 74 years was presented to ED due to various discomforts and diseases (ICD-10 group I; χ2 = 324.85; p < 0.01) than due to cardiorespiratory diseases and acute abdomen (χ2 = 285.04; p < 0.01).

CONCLUSION: Our findings highlight the need for a complex approach in care for elderly people, given that they are a fragile population with multiple comorbidities, chronic diseases, atypical symptoms, and often with cognitive and functional impairments.

PMID:34332452 | DOI:10.1016/j.ienj.2021.101035

J Mech Behav Biomed Mater. 2021 Jul 13;122:104699. doi: 10.1016/j.jmbbm.2021.104699. Online ahead of print.

ABSTRACT

Elastic arteries are idealised as being incompressible orthotropic nonlinearly elastic cylinders. They are further idealised as being membranes in order to analyse the effect of the experimentally observed pre-stressing of arterial tissue on inflation. The pre-stress is modelled here using the opening-angle method. It is shown that there can be multiple unloaded states of arterial segments of Fung materials, suggesting the corresponding set of material parameters will not yield reliable predictions of arterial stress in three dimensions as there is no experimental evidence to support this non-uniqueness. It is also shown that the circumferential pre-strain has a simple magnifying scaling effect on the pressure-radial strain relation and on the axial force needed to maintain the membrane length during inflation; the effect of the axial pre-strain is more nuanced.

PMID:34332451 | DOI:10.1016/j.jmbbm.2021.104699

Psychiatry Res. 2021 Jul 19;304:114131. doi: 10.1016/j.psychres.2021.114131. Online ahead of print.

ABSTRACT

Neurocognitive symptoms exert the most influence on treatment outcomes over the course of schizophrenia, starting from the first-episode of psychosis (FEP) onwards. Our aim was to analyze the neurocognitive status of FEP compared to healthy controls (HC), and its change after 18 months of treatment. We performed a study in a sample of 159 patients with FEP and 100 HC. We followed the patients up for 18 months after initial assessment with a battery of neurocognitive tests. We observed statistically significant improvement in the majority of neurocognitive tests after 18 months, but several tests of specific neurocognitive domains (verbal memory, language functions, executive functions) did not show significant differences between the two assessments. The results for the majority of tests obtained from patients with FEP after 18 months of treatment showed significant deterioration compared with HC. Although our study showed significant improvement of baseline neurocognitive deficits in FEP with treatment, this varied across domains and overall performance remained below that of HC. Thus, while it seems that treatment of FEP may help to delay or restore neurocognitive deterioration, it is unclear whether specific areas of neurocognitive deterioration (e.g. verbal domain) would benefit from more time or specific treatment approaches.

PMID:34332430 | DOI:10.1016/j.psychres.2021.114131

Res Vet Sci. 2021 Jul 25;139:166-171. doi: 10.1016/j.rvsc.2021.07.026. Online ahead of print.

ABSTRACT

There are currently no vaccines or effective drugs to prevent the disorders caused by avian leukosis virus subgroup J (ALV-J). Hence, it is critical to identify potential biomarkers in ALV-J-infected chickens to prevent ALV-J-induced disorders. We hypothesized that ALV-J infection alters metabolic profile in chickens. In the present study, a nontargeted metabolomics approach based on liquid chromatography coupled with mass spectrometry (LC-MS) was used to find differential metabolites in plasma samples from ALV-J-infected chickens and healthy controls. The parametric statistical test (Student’s t-test) and fold change analysis were used for univariate analysis. Multivariate statistical analyses included principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). The levels of methyl bromide, pyraclonil, hexaflumuron, lythidathion, 3-phosphoglycerol-glutathione, bis-4-nitrophenyl phosphate, 4-ketocyclophosphamide, oxidized photinus luciferin, phenyl sulfate, and aryl sulfate significantly decreased, whereas the levels of 2-methylthiobenzothiazole, irinotecan, methadone, 3-o-ethyl-l-ascorbic acid, and o-acetylneuraminic acid markedly increased in ALV-J-infected chickens as compared to those in healthy controls. These data provide metabolic evidence and potential biomarkers for ALV-J-induced alterations in plasma metabolism.

PMID:34332419 | DOI:10.1016/j.rvsc.2021.07.026

J Psychiatr Res. 2021 Jul 22;142:110-116. doi: 10.1016/j.jpsychires.2021.07.042. Online ahead of print.

ABSTRACT

Apathy is present at the onset in nearly half the patients with schizophrenia. Current therapies lack the efficiency to improve apathy in patients. The presence of apathy is also associated with poorer outcomes. Despite its clinical importance, the underlying mechanism of apathy in schizophrenia is unclear, but it seems frontostriatal connections play a role. In this study, we investigated whole-brain white matter microstructural properties associated with the severity of apathy-avolition in schizophrenia. We included 80 schizophrenia patients (60 Male, 20 Female) from the Mind Clinical Imaging Consortium database and associated Apathy-Avolition score of “Scale for Assessment of Negative Symptoms” with fiber integrity measures derived from diffusion-weighted imaging using Tract-Based Spatial Statistics (TBSS). We also did tractography on eight tracts, including bilateral superior longitudinal fasciculus, uncinate fasciculus, cingulum, genu and splenium of the corpus callosum. Age, gender, years of education, chlorpromazine equivalent cumulative dose, and acquisition site were inserted as covariates. We showed a widespread association between lower fiber integrity (by measures of increased mean diffusivity and decreased fractional anisotropy) and increased apathy-avolition in TBSS, which we also validated in tractography. Moreover, mean diffusivity, and not fractional anisotropy, was associated with apathy independent of disease severity. In conclusion, we propose diffuse white-matter pathology, within the corpus callosum, limbic system, and the frontostriatal circuit is involved in apathy-avolition in schizophrenia. Also, we suggest that diffuse neuroinflammatory processes may play a part in apathy-avolition, independent of disease severity.

PMID:34332375 | DOI:10.1016/j.jpsychires.2021.07.042

J Affect Disord. 2021 Jul 16;294:628-637. doi: 10.1016/j.jad.2021.07.007. Online ahead of print.

ABSTRACT

BACKGROUND: There is a lack of research and consensus with respect to long-term effective treatments for trauma-affected refugees. The purpose of this follow-up study of a randomised clinical trial was to investigate the effectiveness of Stress Management (SM) versus Cognitive Restructuring (CR) in treating trauma-affected refugees, six and 18 months post-treatment, respectively.

METHODS: From a total of 126 refugees with PTSD, the intention-to-treat sample in the original trial, 74 patients were present at the six-month follow-up (SM; n = 37, CR; n = 37) and 34 patients at the 18-month follow-up (SM; n = 14, CR; n = 20). During the trial, the patients had been offered a total of 16 psychotherapy sessions and 10 sessions with a medical doctor.

RESULTS: Mixed regression analyses at six and 18-month follow-up showed a non-significant small reduction in PTSD symptoms at both follow-up points with no significant between-group differences between the two psychotherapeutic interventions. Statistically significant between-group treatment effects were, however, observed with the patients receiving SM having significantly reduced symptoms of somatisation measured by the Symptom Checklist (β = 0.40), depression (β = 0.29) and anxiety (β = 0.37) (measured by the Hamilton Depression and Anxiety ratings) at 18 months post-treatment compared to the CR group.

LIMITATIONS: Limitations to the present study include the dropout rate at follow-up(s).

CONCLUSIONS: The findings suggest that the consolidation of coping strategies including relaxation, attention-diversion and behavioural activation in SM appears to be more beneficial than CR in reducing long-term somatisation, depression and anxiety symptoms for this population.

PMID:34332363 | DOI:10.1016/j.jad.2021.07.007

Comput Biol Med. 2021 Jul 27;136:104684. doi: 10.1016/j.compbiomed.2021.104684. Online ahead of print.

ABSTRACT

In this paper, we detect the occurrence of epileptic seizures in patients as well as activities namely stand, walk, and exercise in healthy persons, leveraging EEG (electroencephalogram) signals. Using Hilbert vibration decomposition (HVD) on non-linear and non-stationary EEG signal, we obtain multiple monocomponents varying in terms of amplitude and frequency. After decomposition, we extract features from the monocomponent matrix of the EEG signals. The instantaneous amplitude of the HVD monocomponents varies because of the motion artifacts present in EEG signals. Hence, the acquired statistical features from the instantaneous amplitude help in identifying the epileptic seizures and the normal human activities. The features selected by correlation-based Q-score are classified using an LSTM (Long Short Term Memory) based deep learning model in which the feature-based weight update maximizes the classification accuracy. For epilepsy diagnosis using the Bonn dataset and activity recognition leveraging our Sensor Networks Research Lab (SNRL) data, we achieve testing classification accuracies of 96.00% and 83.30% respectively through our proposed method.

PMID:34332352 | DOI:10.1016/j.compbiomed.2021.104684

J Pharm Biomed Anal. 2021 Jul 20;204:114270. doi: 10.1016/j.jpba.2021.114270. Online ahead of print.

ABSTRACT

An original, innovative, high-throughput method based on attenuated total reflectance – Fourier’s transform infrared (ATR-FTIR) spectroscopy has been developed for the proof-of-concept discrimination of fibre-type from drug-type Cannabissativa L. inflorescences. The cannabis sample is placed on the instrument plate and analysed without any previous sample pretreatment step. In this way, a complete analysis lasts just a few seconds, the time needed to record an ATR-FTIR spectrum. The method was calibrated and cross-validated using data provided by liquid chromatography – tandem mass spectrometry (LC-MS/MS) analysis of the different cannabis samples and carried out the statistical assays for quantitation. During cross-validation, complete agreement was obtained between ATR-FTIR and LC-MS/MS identification of the cannabis chemotype. Moreover, the method has proved to be capable of quantifying with excellent accuracy (75-103 % vs. LC-MS/MS) seven neutral and acidic cannabinoids (THC, THCA, CBD, CBDA, CBG, CBGA, CBN) in inflorescences from different sources. The extreme feasibility and speed of execution make this ATR-FTIR method highly attractive as a proof-of-concept for a possible application to quality controls during pharmaceutical product manufacturing, as well as on-the-street cannabis controls and user counselling.

PMID:34332310 | DOI:10.1016/j.jpba.2021.114270

Cancer Treat Rev. 2021 Jul 22;99:102261. doi: 10.1016/j.ctrv.2021.102261. Online ahead of print.

ABSTRACT

BACKGROUND: Temozolomide (TEM) is an active treatment in metastatic neuroendocrine tumors (NETs). Patients affected by glioblastoma multiforme or advanced melanoma treated with TEM who have deficiency of O⁶-methylguanine DNA methyltransferase (MGMT) have a better responses and survival. However, the predictive role of MGMT in patients with NETs treated with TEM is still debated.

METHODS: We conducted a systematic review of the literature and meta-analysis, based on PRISMA methodology, searching in the main databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library and clinical trial.gov) and the proceedings of the main international congresses, until April 26, 2021.

RESULTS: Twelve out of 616 articles were selected for our analysis, regarding a total of 858 NET patients treated with TEM-based chemotherapy. The status of MGMT had been tested in 513 (60%) patients, using various methods. The pooled overall response rate (ORR) was higher in MGMT-deficient compared with MGMT-proficient NETs, with a risk difference of 0.31 (95% confidence interval, CI: 0.13-0.50; p < 0.001; I²: 73%) and risk ratio of 2.29 (95% CI: 1.34-3.91; p < 0.001; I²: 55%). The pooled progression free survival (PFS) (hazard ratio, HR = 0.56; 95% CI: 0.43-0.74; p < 0.001) and overall survival (OS) (HR = 0.41; 95% CI: 0.20-0.62; p = 0.011) were longer in MGMT-deficient versus MGMT-proficient NETs.

CONCLUSIONS: Our meta-analysis suggested that MGMT status may be predictive of TEM efficacy. However, due to the high heterogeneity of the evaluated studies the risk of biases should be considered. On this hypothesis future homogeneous prospective studies are warranted.

PMID:34332293 | DOI:10.1016/j.ctrv.2021.102261

J Psychosom Res. 2021 Jul 16;149:110572. doi: 10.1016/j.jpsychores.2021.110572. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine if there is a synergistic effect between clinically relevant depressive symptoms and cardiovascular risk factors that disproportionately increases the risk of cardiovascular disease (CVD) among older adults with depressive symptoms.

METHODS: Data were obtained from the Longitudinal Aging Study Amsterdam, a longitudinal cohort study. N = 3091 respondents with up to seven years of follow-up were included. Incident CVD was based on self-report, medication use, general practitioners’ diagnoses and causes of death. A score of ≥16 points on the Center for Epidemiological Studies Depression Scale indicated clinically relevant depressive symptoms. Risk factors included were sex, education, obesity, smoking, alcohol use, physical inactivity and diabetes mellitus. Data were analysed with Cox regression models. Measures of multiplicative and additive interaction were calculated to determine if the presence of both depressive symptoms and a risk factor amplified the risk of CVD.

RESULTS: Of all participants, 12.6% had clinically relevant depressive symptoms and, after a median follow-up of six years, 15.7% developed CVD. Only the additive interaction between physical inactivity and depressive symptoms was statistically significant and explained 40.6% of the CVD risk among inactive persons with depressive symptoms.

CONCLUSION: In the general population, we did not detect synergistic effects for most risk factors. However, older adults with clinically relevant depressive symptoms and a physically inactive lifestyle appeared to be at a particularly high risk to develop CVD and may represent an important target for cardiovascular prevention.

PMID:34332270 | DOI:10.1016/j.jpsychores.2021.110572