Nevin Manimala

Ann Vasc Surg. 2021 Oct 20:S0890-5096(21)00747-0. doi: 10.1016/j.avsg.2021.08.039. Online ahead of print.

ABSTRACT

OBJECTIVE: Recent literature and societal recommendations support early revascularization of symptomatic carotid patients over the traditional six-week period. Nonetheless, the timing of these interventions can vary widely among populations. The goal of this study is to identify any factors influencing carotid revascularization during the index hospitalization for patients with symptomatic disease.

METHODS: The Texas Department of State Health Services database was queried to identify all patients >45 years old admitted to non-federal Texas Hospitals between 2009 to 2013 with an admission diagnosis of carotid artery stenosis and either transient ischemic attack (TIA), cerebrovascular accident (CVA), or amaurosis fugax. Diagnoses codes and demographic data were also used to adjust for clinical, social, and demographic factors (including area of residence and treatment). Descriptive statistics and multivariable logistic regression were used to identify significant factors for index admission revascularization.

RESULTS: A total of 29,046 symptomatic patients were identified among the 153,484 patients who had an eligible admission diagnosis. This included 16,244 (55.9%) males and 12,802 (44.1%) females. Only 4,594 (15.8%) patients were revascularized during the index hospitalization. The majority of these patients presented with amaurosis (OR 5.58; 95% CI 4.84-6.44) instead of CVAs (OR 0.48; 95% CI 0.45-0.51) or TIAs (Table 2). Adjusting for hospital volume, insurance coverage, residence, and other clinical factors, rates of index admission carotid intervention remained significantly lower for women (OR 0.85; 95% CI 0.79-0.91), persons categorized as black (OR 0.60; 95% CI 0.53-0.69), and persons categorized as Hispanic (OR 0.77; 95% CI 0.70-0.86).

CONCLUSION: Gender, race and ethnicity appear to correlate with rates of carotid intervention at index hospitalization despite thorough risk adjustment for clinical, social and demographic factors. Efforts should be directed towards reducing these disparities.

PMID:34687890 | DOI:10.1016/j.avsg.2021.08.039

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2021 Jan;37(1):96-103. doi: 10.12047/j.cjap.0091.2021.111.

ABSTRACT

Objective: Subjects used upper limb (arm dynamometer) and lower limb precision electromagnetic power meter (cycle ergometer) to perform symptom-restricted limit cardiopulmonary exercise testing (CPET). Then we analyzed the clinical value of arm ergometer CPET. Methods: The upper limb and lower limb precision electromagnetic power meters were used to complete the CPET in two different days for 6 normal people and 9 chronic patients. We analyzed CPET data, calculated related core indicators, and compared normal subjects and chronic patients to analyze the similarities and differences between upper and lower extremities and their correlations. Results: ①Compared with 9 patients with chronic diseases, there were significant differences in age ((33.2±12.7) vs (53.6±8.5) years) and diagnosis in 6 normal people. ②The Peak HR ((131.0±19.0) vs (153.0±22.0) bpm,P<0.05) of upper limb CPET of 15 subjects were lower than lower limb CPET, but the difference in blood pressure was not statistically significant (P>0.05). The Peak V_T ((1.3±0.4) vs (1.8±0.4) L) and Peak VE ((51.4±21.1) vs (67.9±22.1) L/min) of lower limb CPET were significantly higher than that of upper limb (all P<0.05), and there was no significant difference in Peak BF When upper limb CPET was used, EX-time ((6.4±0.6) vs (8.5±1.2) min) was shorter than lower limb CPET; Peak Work Rate((73.2±19.6) vs (158.5±40.3) W/min), Peak VO₂ ((1.1±0.4) vs (1.7±0.4) L/min), AT ((0.6±0.2) vs (0.9±0.2) L/min), Peak VO₂/HR ((8.6±2.3) vs (10.9±2.6) ml/beat), OUEP (34.7±4.3 vs 39.8±5.3)were lower, and the Lowest VE/VCO₂(32.6±3.8 vs 28.7±4.9), VE/VCO₂ Slope (33.9±4.3 vs 28.3±6.2)were higher than those of lower limb CPET (all P<0.05). The comparison results of the two subgroups of normal and chronic patients were the same as the holistic comparison results. ③EX-time, Peak HR, Peak BF, Peak VT and Peak VE of upper limb CPET had good correlation with the results of lower limb CPET. Besides, the measured value and percentage of the projected value of Peak Work Rate, the measured value, kilogram weight value of Peak VO₂ and AT, and percentage of the projected value of Peak VO₂, the measured value of Peak VO₂/HR also had good correlation. The measured value of OUEP, the measured value and percentage of the projected value of Lowest VE/VCO₂ and VE/VCO₂ Slope were also the same, when the other indicators had no significant correlation. Conclusion: As a supplement to lower limb CPET, upper limb CPET is highly feasible and safe for holistic functional status assessment. It provides an important supplement to guide the implementation of the holistic plan of individualized precision exercise, which is worthy of our further exploration.

PMID:34672469 | DOI:10.12047/j.cjap.0091.2021.111

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2021 Jan;37(1):72-78. doi: 10.12047/j.cjap.0090.2021.108.

ABSTRACT

Objective: To evaluate the value of cardiopulmonary exercise testing in diagnosing coronary atherosclerotic heart disease（CHD). Methods: A total of 156 patients with suspected CHD（The patient’s condition is relatively stable, aged 18 to 80 years）were performed for cardiopulmonary exercise testing, ECG exercise test and coronary angiography. Based on the results of coronary angiography, the sensitivity, specificity and diagnostic value of relevant indicators of cardiopulmonary exercise testing (CPET) parameters (Peak VO₂%pred、Peak O₂ pulse%pred、ΔVO₂/ΔWR) in diagnosing CHD were analyzed by statistical methods based on the results of coronary angiography. Results: Useing the best cut-off point of Peak VO₂ ≤69%pred for detecting CHD, the sensitivity was 55.1%, the specificity was 77.0%, and the AUC was 0.698. The sensitivity, specificity and AUC of peak O₂ pulse%pred were 50.7%, 72.4% and 0.58 respectively. ΔVO₂/ΔWR sensitivity in diagnosing CHD was 44.9%, specificity was 87.4%, AUC was 0.647. The sensitivity of peak O₂ pulse%pred and ΔVO₂/ΔWR were much higher than the ECG exercise test, the difference was statistically significant (P<0.01). Conclusion: The sensitivity of some indexes of CPET in diagnosing CHD was better than ECG exercise test, the specificity and diagnostic value of the optimal cut-off point are high. CPET has predictive value for the diagnosis of CHD, it can diagnose CHD early and accurately.

PMID:34672466 | DOI:10.12047/j.cjap.0090.2021.108

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2021 Jan;37(1):40-44. doi: 10.12047/j.cjap.0078.2021.103.

ABSTRACT

Objective: The objective is to find the characteristics of arterial blood sample waveform in different respiration models. Methods: Six post-operative patients with normal heart function and negative Allen test, were 4 male and 2 female, (59.00±16.64)year, (71.67±0.37)kg, left ventricular ejection fraction(LVEF) (61.33±2.16)%, had been placed the arterial catheterization and central venous catheterization for continuous collecting arterial in 3 different kinds of respiration models: normal breathing, no breathing and deep breathing. We selected two breaths cycles of waveform from each patient for data calculations of magnitudes and time interval. Compare the adjacent highest and lowest values of patients to verify whether there are periodic wave-like signal changes in arterial and venous blood gas in the three breathing states. In addition, statistical t-test analysis was performed on the change amplitude of the periodic wave-like signal of the patient’s arterial and venous blood gas to compare whether there is a difference. Results: The heart beat numbers for drawing blood into pipe were 15-16, and all covered more than 2 breathing cycles. There were significant changes of arterial PaO₂ (i.e. the highest high values compare to the next lowest values, P<0.05) in three different breathing models(normal, no breathing and high breathing), the magnitudes of which were (9.96±5.18)mmHg, (5.33±1.55)mmHg and (13.13±7.55)mmHg, with (8.09±2.43)%, (5.29±2.19)% and (10.40±2.68)% from their mean respectively. PO₂ in venous blood gas did not show wavy changes under normal breathing, 20 s breath holding and high tidal volume ventilation. The amplitudes were (1.63 ± 0.41) mmHg, (1.13 ± 0.41) mmHg and (1.31 ± 0.67) mmHg, which were (3.91 ± 1.22)%, (2.92 ± 1.12)%, (3.33 ± 1.81)%, respectively, which were significantly lower than that of arterial blood gas under the same state, but there was no significant difference between groups. Conclusion: With continuous beat-by-beat arterial blood sampling and ABG analyzing method in three different breathing models, We obtain a clear evidence of the biggest periodic parameters ABG waveform in high breathing models, which followed by normal breathing models, no breathing was the smallest, and the wave variation amplitude of venous oxygen partial pressure was not obvious in the three respiratory states, which implies the oscillatory information of the arterial blood with comes from the gas exchanging in the lung.

PMID:34672461 | DOI:10.12047/j.cjap.0078.2021.103

Isr Med Assoc J. 2021 Oct;23(10):646-650.

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory and destructive joint disease with the presence of autoantibodies, rheumatoid factor (RF), and anti-citrullinated protein antibodies (ACPA). The presence of RF or ACPA predicts RA severity. Data on the influence of ACPA titer on RA course are limited.

OBJECTIVES: To determine the correlation between ACPA titers at the time of RA diagnosis to RA features and severity during 3 years of follow-up.

METHODS: We performed a retrospective study of RA patients treated at our institution during the years 2006-2015 with known ACPA titers at RA diagnosis who completed at least 3 years of follow-up. Patients (N=133) were divided according to ACPA titer: seronegative (< 15 U/ml, n=55), weakly positive (15-49 U/ml, n=18), moderately positive (50-300 U/ml, n=29), and strongly positive (> 300 U/ml, n=31). Patient data, including disease activity score (DAS28), bone erosion on hand and/or foot X-rays, treatments with corticosteroids and disease-modifying-anti-rheumatic drugs (DMARDs), and hospitalizations, were recorded. Chi-square and Mann-Whitney method were used for statistical analysis. P < 0.05 was considered as statistically significant.

RESULTS: Male gender, smoking, and RF positivity correlated with ACPA positivity and higher ACPA titers. There was no correlation between ACPA titer and the variables defined as representing RA severity: higher DAS28, bone erosions, hospitalizations, need for corticosteroids, and conventional and biological DMARDs.

CONCLUSIONS: Titer of ACPA was not identified as a predictive factor for RA severity.

PMID:34672447

Isr Med Assoc J. 2021 Oct;23(10):635-638.

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) is a serious disease, which demands a fast accurate diagnosis to begin suitable treatment. It presents a major problem in the emergency department (ED), and its confirmation requires adequate evaluation.

OBJECTIVES: To evaluate a potential role of mean platelet volume (MPV) in differentiating VTE from other potential diagnosis in patients with suspected VTE.

METHODS: We conducted a retrospective case-controlled study of 440 consecutive patients who presented to the ED of our hospital with clinical VTE, but only 316 with proven VTE. A control group was composed of patients (124) who presented with clinical VTE but without proven VTE. We checked the MPV value in all 440 patients and the correlation with VTE occurrence in the study group vs. control group.

RESULTS: Statistical analysis of the acquired results indicated that MPV value could not aid in determining the difference of real VTE vs. patients with VTE-like clinical picture presenting to the ED. We found an inverse correlation between MPV value and proven VTE, in contrast to most researchers who have studied the same issue.

CONCLUSIONS: Although MPV can be a useful diagnostic marker in many diseases, we found no definite association between low MPV and VTE.

PMID:34672445

J Comput Chem. 2021 Oct 21. doi: 10.1002/jcc.26770. Online ahead of print.

ABSTRACT

In order to quantitatively predict nano- as well as other particle-size distributions, one needs to have both a mathematical model and estimates of the parameters that appear in these models. Here, we show how one can use Bayesian inversion to obtain statistical estimates for the parameters that appear in recently derived mechanism-enabled population balance models (ME-PBM) of nanoparticle growth. The Bayesian approach addresses the question of “how well do we know our parameters, along with their uncertainties?.” The results reveal that Bayesian inversion statistical analysis on an example, prototype Ir0n nanoparticle formation system allows one to estimate not just the most likely rate constants and other parameter values, but also their SDs, confidence intervals, and other statistical information. Moreover, knowing the reliability of the mechanistic model’s parameters in turn helps inform one about the reliability of the proposed mechanism, as well as the reliability of its predictions. The paper can also be seen as a tutorial with the additional goal of achieving a “Gold Standard” Bayesian inversion ME-PBM benchmark that others can use as a control to check their own use of this methodology for other systems of interest throughout nature. Overall, the results provide strong support for the hypothesis that there is substantial value in using a Bayesian inversion methodology for parameter estimation in particle formation systems.

PMID:34672375 | DOI:10.1002/jcc.26770

Syst Biol. 2021 Oct 21:syab085. doi: 10.1093/sysbio/syab085. Online ahead of print.

ABSTRACT

Although molecular mechanisms associated with the generation of mutations are highly conserved across taxa, there is widespread variation in mutation rates between evolutionary lineages. When phylogenies are reconstructed based on nucleotide sequences, such variation is typically accounted for by the assumption of a relaxed molecular clock, which is a statistical distribution of mutation rates without much underlying biological mechanism. Here, we propose that variation in accumulated mutations may be partly explained by an elevated mutation rate during speciation. Using simulations, we show how shifting mutations from branches to speciation events impacts inference of branching times in phylogenetic reconstruction. Furthermore, the resulting nucleotide alignments are better described by a relaxed than by a strict molecular clock. Thus, elevated mutation rates during speciation potentially explain part of the variation in substitution rates that is observed across the tree of life.

PMID:34672354 | DOI:10.1093/sysbio/syab085

Bioinformatics. 2021 Oct 21:btab728. doi: 10.1093/bioinformatics/btab728. Online ahead of print.

ABSTRACT

SUMMARY: Eukaryotic gene expression requires coordination among hundreds of transcriptional regulators. To characterize a specific transcriptional regulator, identifying how it shares genomic-binding profiles with others can generate important insights into its action. As genomic data such as ChIP-Seq are being rapidly generated from individual labs, there is a demand for timely integration and analysis of these new data. We have developed an R package, GPSmatch (Genomic-binding Profile Similarity match), for calculating the Jaccard index to compare ChIP-Seq peaks from one experiment to the peaks of other ChIP-Seq experiments stored in a user-supplied customizable database. GPSmatch also evaluates the statistical significance of the calculated Jaccard index using a nonparametric Monte Carlo procedure. We show that GPSmatch is suitable for identifying transcriptional regulators that share similar genomic-binding profiles, which may unravel potential mechanistic actions of gene regulation.

AVAILABILITY: The software is freely available at https://github.com/Bao-Lab/GPSmatch.

PMID:34672337 | DOI:10.1093/bioinformatics/btab728

Psychiatr Danub. 2021 Sep;33(Suppl 10):155-160.

ABSTRACT

BACGROUND: This study aimed to examine the relationship between COVID-19 perceived risk and attitudes towards COVID-19 vaccination in healthcare professionals.

SUBJECTS AND METHODS: This cross-sectional descriptive study included a total of 580 healthcare professionals.

RESULTS: The healthcare professionals’ COVID-19 Perceived Risk Scale (CPRS) and Attitudes towards COVID-19 Vaccine Scale (ATV-COVID-19) mean scores were 31.36±5.16 and 3.00±0.61, respectively. A statistically significant negative correlation was found between their CPRS and ATV-COVID-19 mean scores.

CONCLUSIONS: The healthcare professionals had a high COVID-19 perceived risk and moderately positive attitudes towards COVID-19 vaccine.

PMID:34672290