Tag: nevin manimala

J Clin Monit Comput. 2024 Apr 25. doi: 10.1007/s10877-024-01163-0. Online ahead of print.

ABSTRACT

PURPOSE: New-generation anesthesia machines administer inhalation anesthetics and automatically control the fresh gas flow (FGF) rate. This study compared the administration of minimal flow anesthesia (MFA) using the automatically controlled anesthesia (ACA) module of the Mindray A9 (Shenzhen, China) anesthesia machine versus manual control by an anesthesiologist.

METHODS: We randomly divided 76 patients undergoing gynecological surgery into an ACA group (Group ACA) and a manually controlled anesthesia group (Group MCA). In Group MCA, induction was performed with a mixture of 40-60% O₂ and air with a 4 L/min FGF until the minimum alveolar concentration (MAC) reached 1. Next, MFA was initiated with 0.5 L/min FGF. The target fraction of inspired oxygen (FiO₂) value was 35-40%. In Group ACA, the MAC was defined as 1, and the FiO₂ was adjusted to 35%. Depth of anesthesia, anesthetic agent (AA) consumption, time to achieve target end-tidal AA concentration, awakening times, and number of ventilator adjustments were analyzed.

RESULTS: The two groups showed no statistically significant differences in depth of anesthesia or AA consumption (Group ACA: 19.1 ± 4.9 ml; Group MCA: 17.2 ± 4.5; p-value = 0.076). The ACA mode achieved the MAC target of 1 significantly faster (Group ACA: 218 ± 51 s; Group MCA: 314 ± 169 s). The number of vaporizer adjustments was 15 in the ACA group and 217 in the MCA group.

CONCLUSION: The ACA mode was more advantageous than the MCA mode, reaching target AA concentrations faster and requiring fewer adjustments to achieve a constant depth of anesthesia.

PMID:38662297 | DOI:10.1007/s10877-024-01163-0

Environ Sci Pollut Res Int. 2024 Apr 25. doi: 10.1007/s11356-024-33305-x. Online ahead of print.

ABSTRACT

Forest fires are sudden, destructive, hazardous, and challenging to manage and rescue, earning them a place on UNESCO’s list of the world’s eight major natural disasters. Currently, amid global warming, all countries worldwide have entered a period of high forest fire incidence. Due to global warming, the frequency of forest fires has accelerated, the likelihood of large fires has increased, and the spatial and temporal dynamics of forest fires have shown different trends. Therefore, the impact of climate change on the spatiotemporal dynamics of forest fires has become a hot issue in the field of forest fire research in recent years. Therefore, it is of great significance and necessity to conduct a review of the research in this area. This review delves into the interactions and impacts between climate change and the spatiotemporal dynamics of forest fires. To address this issue, scholars have mainly adopted the following research methods: first, statistical analysis methods, second, the establishment of spatiotemporal prediction models for meteorology and forest fires, and third, the coupling of climate models with forest fire risk forecasting models. The statistical analysis method relies on the analysis of historical meteorological and fire-related data to study the effects of climate change and meteorological factors on fire occurrence. Meanwhile, forest fire prediction models utilize technical tools such as remote sensing. These models synthesize historical meteorological and fire-related data, incorporating key meteorological factors such as temperature, rainfall, relative humidity, and wind. The models revealed the spatial and temporal distribution patterns of fires, identified key drivers, and explored the interactions between climate change and forest fire dynamics, culminating in the construction of predictive models. With the deepening of the study, the coupling of climate models and fire risk ranking systems became a trend in the prediction of forest fire risk trends. Moreover, as the climate warms, the increased frequency of extreme weather events like heatwaves, droughts, snow and ice storms, and El Niño-Southern Oscillation (ENSO) has accelerated forest fire occurrences and raised the risk of major fires. This review offers valuable technical insights by comprehensively analyzing the spatial and temporal characteristics of forest fires, elucidating key meteorological drivers, and exploring potential mechanisms. These insights serve as a scientific foundation for preventive measures and effective forest fire management. In the face of a changing climate, this synthesis contributes to the development of informed strategies to mitigate the escalating threat of forest fires.

PMID:38662294 | DOI:10.1007/s11356-024-33305-x

Environ Monit Assess. 2024 Apr 25;196(5):473. doi: 10.1007/s10661-024-12631-0.

ABSTRACT

Aerosol optical depth (AOD) serves as a crucial indicator for assessing regional air quality. To address regional and urban pollution issues, there is a requirement for high-resolution AOD products, as the existing data is of very coarse resolution. To address this issue, we retrieved high-resolution AOD over Kanpur (26.4499°N, 80.3319°E), located in the Indo-Gangetic Plain (IGP) region using Landsat 8 imageries and implemented the algorithm SEMARA, which combines SARA (Simplified Aerosol Retrieval Algorithm) and SREM (Simplified and Robust Surface Reflectance Estimation). Our approach leveraged the green band of the Landsat 8, resulting in an impressive spatial resolution of 30 m of AOD and rigorously validated with available AERONET observations. The retrieved AOD is in good agreement with high correlation coefficients (r) of 0.997, a low root mean squared error of 0.035, and root mean bias of – 4.91%. We evaluated the retrieved AOD with downscaled MODIS (MCD19A2) AOD products across various land classes for cropped and harvested period of agriculture cycle over the study region. It is noticed that over the built-up region of Kanpur, the SEMARA algorithm exhibits a stronger correlation with the MODIS AOD product compared to vegetation, barren areas and water bodies. The SEMARA approach proved to be more effective for AOD retrieval over the barren and built-up land categories for harvested period compared with the cropping period. This study offers a first comparative examination of SEMARA-retrieved high-resolution AOD and MODIS AOD product over a station of IGP.

PMID:38662282 | DOI:10.1007/s10661-024-12631-0

AIDS Behav. 2024 Apr 25. doi: 10.1007/s10461-024-04342-x. Online ahead of print.

ABSTRACT

The coronavirus disease of 2019 (COVID-19) pandemic exacerbated barriers to care for people living with human immunodeficiency virus (HIV) (PLWH). The quick uptake of telemedicine in the outpatient setting provided promise for care continuity. In this study, we compared appointment and laboratory no-show rates in an urban outpatient HIV clinic during three time periods: (1) Pre-COVID-19: 9/15/2019-3/14/2020 (predominately in-person), (2) “Early” COVID-19: 3/15/2020-9/14/2020 (predominately telemedicine), and (3) “Later” COVID-19: 9/15/2020-3/14/2021 (mixed in-person/telemedicine). Multivariable logistic regression models evaluated the two study hypotheses: (i) equivalence of Period 2 with Period 1 and of Period 3 with Period 1 and (ii) improved outcomes with telemedicine over in-person visits. No-show rates were 1% in Period 1, 4% in Period 2, and 18% in Period 3. Compared to the pre-pandemic period, individuals had a higher rate of appointment no-shows during Period 2 [OR (90% CI): 7.67 (2.68, 21.93)] and 3 [OR (90% CI): 30.91 (12.83 to 75.06). During the total study period, those with telemedicine appointments were less likely to no-show than those with in-person appointments [OR (95% CI): 0.36 (0.16-0.80), p = 0.012]. There was no statistical difference between telemedicine and in-person appointments for laboratory completion rates. Our study failed to prove that no-show rates before and during the pandemic were similar; in fact, no-show rates were higher during both the early and later pandemic. Overall, telemedicine was associated with lower no-show rates compared to in-person appointments. In future pandemics, telemedicine may be a valuable component to maintain care in PLWH.

PMID:38662279 | DOI:10.1007/s10461-024-04342-x

Arch Dermatol Res. 2024 Apr 25;316(5):128. doi: 10.1007/s00403-024-02867-8.

NO ABSTRACT

PMID:38662244 | DOI:10.1007/s00403-024-02867-8

Cogn Sci. 2024 Apr;48(4):e13447. doi: 10.1111/cogs.13447.

ABSTRACT

One of the most prominent social influences on human decision making is conformity, which is even more prominent when the perceptual information is ambiguous. The Bayes optimal solution to this problem entails weighting the relative reliability of cognitive information and perceptual signals in constructing the percept from self-sourced/endogenous and social sources, respectively. The current study investigated whether humans integrate the statistics (i.e., mean and variance) of endogenous perceptual and social information in a Bayes optimal way while estimating numerosities. Our results demonstrated adjustment of initial estimations toward group means only when group estimations were more reliable (or “certain”), compared to participants’ endogenous metric uncertainty. Our results support Bayes optimal social conformity while also pointing to an implicit form of metacognition.

PMID:38659095 | DOI:10.1111/cogs.13447

J Hepatobiliary Pancreat Sci. 2024 Apr 24. doi: 10.1002/jhbp.1433. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic papillectomy (EP) is less invasive than surgery but procedure-related adverse events (AEs) still frequently occur. This study compared the benefits of EP using a new optimal endoCUT setting on the VIO (Erbe) electrosurgical unit (VIO-EP) with those using the conventional electrosurgical unit setting (ICC-EP, Erbe).

METHODS: This multicenter, retrospective, comparative cohort study included 57 patients who underwent VIO-EP and 91 who underwent ICC-EP. The primary outcome was occurrence of EP-related AEs. Secondary outcomes were pathological findings (the resection margins, the R0 resection, and residual lesions).

RESULTS: Pancreatitis tended to be less common in the VIO-EP group (5.3% vs. 9.9%, p = .248). Evaluation of computed tomography images showed that pancreatitis was confined to the pancreatic head in 77.8% of cases in the ICC-EP group and in 33.3% of those in the VIO-EP group. After exclusion of cases of delayed bleeding, pancreatitis tended to be less common in the VIO-EP group; this finding was not statistically significant (2.3% vs. 8.2%, p = .184). In pathological findings, residual lesions were significantly less common in the VIO-EP group.

CONCLUSIONS: The risks of pancreatitis and residual lesions after EP may be lower when the VIO electrosurgical unit is used with the optimal setting.

PMID:38659092 | DOI:10.1002/jhbp.1433

J Vasc Access. 2024 Apr 24:11297298241246300. doi: 10.1177/11297298241246300. Online ahead of print.

ABSTRACT

BACKGROUND: There is little information regarding complications of arterial catheterization in modern clinical care. We aimed to determine the incidence of abnormal duplex vascular ultrasound and catheter related infections following perioperative arterial catheterization.

METHODS: Patients requiring arterial catheterization for elective surgery were included and insertion details collected prospectively. Duplex ultrasound evaluation was performed 24 h after catheter removal. Symptomatic patients were identified by self-reported questionnaire. On Day 7, patients answered questions by telephone, related to the insertion site, pain, and function. Results of catheter tip and blood culture analyses were sought. Univariate associations of patient and surgical characteristics with abnormal ultrasound were assessed with p < 0.05 considered significant.

RESULTS: Of 339 catheterizations, 105 (40%) had ultrasound evaluation. Catheters were indwelling for median (IQR, range) duration of 6.0 h (4.4-8.2, 1.8-28) with no catheter-related infections. There were 16 (15.2%, 95% CI 9.0%-23.6%) abnormal results, including 14 radial artery thromboses, one radial artery dissection, and one radial vein thrombosis. Those with abnormal ultrasound results were more likely to have had Arrow catheters inserted (68.8% vs 27%, p = 0.023) and more than one skin puncture (37.5% vs 26.8%, p = 0.031). Two of the 16 (12.5%) patients with abnormal ultrasound results reported new symptoms related to the hand compared with nine of the 88 (10.2%) with normal results (p = 0.1). No patients required urgent referral for management.

CONCLUSIONS: Thrombosis was the most common abnormality and was usually asymptomatic. There were no infections, few post-operative symptoms, and minimal functional impairment following arterial catheterization.

PMID:38659089 | DOI:10.1177/11297298241246300

Clin Epigenetics. 2024 Apr 24;16(1):57. doi: 10.1186/s13148-024-01668-0.

ABSTRACT

BACKGROUND: Heart failure (HF) is a disease that poses a serious threat to individual health, and DNA methylation is an important mechanism in epigenetics, and its role in the occurrence and development of the disease has attracted more and more attention. The aim of this study was to evaluate the link between iodothyronine deiodinase 3 promoter region fragment FA27 (DIO3-FA27) methylation levels, biochemical indices, and HF.

RESULTS: The methylation levels of DIO3-FA27_CpG_11.12 and DIO3-FA27_CpG_23.24 significantly differed in HF patients with different degrees. Multivariate logistic regression analysis indicated that the relative HF risk in the third and fourth quartiles of activated partial thromboplastin time and fibrin degradation products. The results of the restricted cubic spline model showed that the methylation levels of DIO3-FA 27_CpG_11.12 and DIO3-FA 27_CpG_23.24 were associated with coagulation indicators, liver function, renal function, and blood routine.

CONCLUSIONS: Based on the differential analysis of CpG methylation levels based on DIO3-FA27, it was found that biochemical indicators combined with DIO3-FA27 promoter DNA methylation levels could increase the risk of worsening the severity classification of HF patients, which provided a solid foundation and new insights for the study of epigenetic regulation mechanisms in patients with HF.

PMID:38659084 | DOI:10.1186/s13148-024-01668-0

Clin Diabetes Endocrinol. 2024 Apr 25;10(1):9. doi: 10.1186/s40842-023-00163-4.

ABSTRACT

BACKGROUND & AIMS: Despite its high prevalence in the western world metabolic dysfunction-associated steatotic liver disease (MASLD) does not benefit from targeted pharmacological therapy. We measured healthcare utilisation and identified factors associated with high-cost MASLD patients in France.

METHODS: The prevalent population with MASLD (including non-alcoholic steatohepatitis) in the CONSTANCES cohort, a nationally representative sample of 200,000 adults aged between 18 and 69, was linked to the French centralised national claims database (SNDS). Study participants were identified by the fatty liver index (FLI) over the period 2015-2019. MASLD individuals were classified according as “high-cost” (above 90th percentile) or “non-high cost” (below 90th percentile). Factors significantly associated with high costs were identified using a multivariate logistic regression model.

RESULTS: A total of 14,437 predominantly male (69%) participants with an average age of 53 ± SD 12 years were included. They mainly belonged to socially deprived population groups with co-morbidities such as diabetes, high blood pressure, mental health disorders and cardiovascular complications. The average expenditure was €1860 ± SD 4634 per year. High-cost MASLD cost €10,863 ± SD 10,859 per year. Conditions associated with high-cost were mental health disorders OR 1.79 (1.44-2.22), cardiovascular diseases OR 1.54 (1.21-1.95), metabolic comorbidities OR 1.50 (1.25-1.81), and respiratory disease OR 1.50 (1.11-2.00). The 10% high-cost participants accounted for 58% of the total national health care expenditures for MASLD.

CONCLUSION: Our results emphasize the need for comprehensive management of the comorbid conditions which were the major cost drivers of MASLD.

PMID:38659082 | DOI:10.1186/s40842-023-00163-4