Tag: nevin manimala

BMC Anesthesiol. 2023 May 31;23(1):188. doi: 10.1186/s12871-023-02151-8.

ABSTRACT

BACKGROUND: By continually monitoring end-tidal carbon dioxide concentrations, capnography can detect abnormal ventilation or apnoea early. This randomized, controlled study explored the effect of early intervention with capnography on the incidence of hypoxia in mildly obese patients undergoing sedation for esophagogastroduodenoscopy (EGD) and colonoscopy.

METHODS: This is a single-center, randomized, single-blind, parallel-assignment, controlled trial. Mildly obese patients (28 kg/m² ≤ BMI < 40 kg/m²) undergoing sedation for EGD and colonoscopy were randomly assigned to either the standard or capnography group. Standard cardiopulmonary monitoring equipment was used in both groups, and additional capnography was performed in the capnography group. In the event of inadequate alveolar ventilation during sedation, five interventions were administered in sequence (a-e) : a: increasing oxygen flow (5 L/min); b: a chin lift or jaw thrust maneuver; c: placement of the nasopharyngeal airway and chin lift; d: mask positive-pressure ventilation, and e: ventilator-assisted ventilation with tube insertion. The primary outcome was the incidence of hypoxia (SpO₂ < 90%, ≥ 10 s) in each group. The secondary outcomes included the incidence of severe hypoxia (SpO₂ ≤ 85%), subclinical respiratory depression (90% ≤ SpO₂ < 95%), interventions, minimum SpO₂ during operation, patient satisfaction, endoscopist satisfaction, and other adverse events of anesthesia sedation.

RESULTS: 228 patients were included (capnography group = 112; standard group = 113; three patients were excluded) in this study. The incidence of hypoxia was significantly lower in the capnography group than in the standard group (13.4% vs. 30.1%, P = 0.002). Subclinical respiratory depression in the capnography group was higher than that of the standard group (30.4% vs. 17.7%, P = 0.026). There was only a 5.4% incidence of severe hypoxia in the capnography group compared with 14.2% in the standard group (P = 0.026). During sedation, 96 and 34 individuals in the capnography and standard groups, respectively, underwent the intervention. There was a statistically significant difference (P < 0.0001) in the number of the last intraoperative intervention between the two groups ( a:47 vs. 1, b:46 vs. 26, c:2 vs. 5, d:1 vs. 2, e:0 vs. 0 ). No significant differences were found between the two groups in terms of minimum SpO₂ during operation, patient satisfaction, or endoscopist satisfaction rating. There was no statistically significant difference in adverse events of anesthesia sedation between the two groups.

CONCLUSION: Capnography during sedation for EGD and colonoscopy allows for the detection of apnea and altered breathing patterns in mildly obese patients before SpO₂ is reduced. Effective intervention measures are given to patients within this time frame, which reduces the incidence of hypoxia and severe hypoxia in patients.

TRIAL REGISTRATION: Ethical approval was granted by the Medical Ethics Committee (Chairperson Professor Tian Hui) of Qilu Hospital, Shandong University ((Ke) Lun Audit 2021 (186)) on 15/07/2021. The study was registered ( https://www.chictr.org.cn ) on 23/10/2021(ChiCTR2100052234). Designed and reported using CONSORT statements.

PMID:37259022 | DOI:10.1186/s12871-023-02151-8

J Gastrointest Surg. 2023 May 31. doi: 10.1007/s11605-023-05718-5. Online ahead of print.

ABSTRACT

BACKGROUND: Malrotation in children presents with bilious emesis and can be life threatening. Data on adults is lacking.

METHODS: Single institution, retrospective 20-year data collection on adult (>18 years) and adolescent patients (12-18) with symptomatic malrotation. We evaluated demographics, surgical approach, hospital stay, time to feed, and type of surgeon with descriptive statistics to analyze each group.

RESULTS: Adult (n=17) and adolescent patients (n=8) primarily presented with acute abdominal pain (82% adult, 100% adolescent), and non-bilious emesis (0%), and had elective repair. CT scan was diagnostic for 82% adults and 71% adolescents. Overall, 88% had improvement in symptoms.

CONCLUSION: In this single institution series comparing adults and adolescent patients with malrotation, 88% have resolution of pain after repair, despite atypical presentations. CT scan is diagnostic and laparoscopic approach should be considered.

PMID:37259017 | DOI:10.1007/s11605-023-05718-5

J Racial Ethn Health Disparities. 2023 May 31. doi: 10.1007/s40615-023-01638-x. Online ahead of print.

ABSTRACT

BACKGROUND: While previous studies have identified a range of factors associated with mask wearing in the US, little is known about drivers of mask-wearing among racial and ethnic minority groups. This analysis assessed whether factors positively associated with wearing a mask early in the pandemic differed between participants grouped by race/ethnicity (Hispanic, non-Hispanic Black, non-Hispanic Asian, and non-Hispanic White).

METHOD: Data were obtained from a US internet panel survey of 3217 respondents during May-November 2020 (weighted by race/ethnicity, age, gender, and education to the US national population). Within each of the four available racial/ethnic groups, crude and adjusted odds ratios (COR and AOR) were calculated using logistic regression to assess factors positively associated with wearing a mask. Adjusted models were controlled for age, gender, education, county COVID-19 case count, presence of a state-issued mask mandate, and interview month.

RESULTS: The following variables were most strongly positively associated with mask wearing (p<0.05) in each racial/ethnic group: Hispanic-seeing others wearing masks (AOR: 6.7), importance of wearing a mask combined with social distancing (AOR: 3.0); non-Hispanic Black-belief that wearing a mask would protect others from coronavirus (AOR: 5.1), reporting hearing that one should wear a mask (AOR: 3.6); non-Hispanic Asian-belief that people important to them believe they should wear a mask (COR: 5.1, not statistically significant); and non-Hispanic White-seeing others wearing masks (AOR: 3.1), importance of wearing a mask (AOR: 2.3).

CONCLUSION: Public health efforts to encourage mask wearing should consider the diversity of behavioral influences within different population groups.

PMID:37258995 | DOI:10.1007/s40615-023-01638-x

Methods Mol Biol. 2023;2674:87-99. doi: 10.1007/978-1-0716-3243-7_6.

ABSTRACT

The development of high-throughput sequencing technology has led to a significant reduction in the time and cost of sequencing whole genomes of bacterial pathogens. Studies can sequence and compare hundreds or even thousands of genomes within a given bacterial population. A phylogenetic tree is the most frequently used method of depicting the relationships between these bacterial pathogen genomes. However, the presence of homologous recombination in most bacterial pathogen species can invalidate the application of standard phylogenetic tools. Here we describe a method to produce phylogenetic analyses that accounts for the disruptive effect of recombination. This allows users to investigate the recombination events that have occurred, as well as to produce more meaningful phylogenetic analyses which recover the clonal genealogy representing the clonal relationships between genomes.

PMID:37258962 | DOI:10.1007/978-1-0716-3243-7_6

Arch Gerontol Geriatr. 2023 May 23;114:105068. doi: 10.1016/j.archger.2023.105068. Online ahead of print.

ABSTRACT

This systematic review and meta-analysis explored the effects of structured exercise regimens on brain-derived neurotrophic factor (BDNF) levels, a proxy for cognitive function, in older women. In this study, we collated evidence from the available clinical trials that reported BDNF levels and other outcomes following structured exercise regimens. Adhering to PRISMA Statement 2020 guidelines. PubMed/MEDLINE, Scopus, CINAHL Plus, and Cochrane were systematically searched using a combination of the following keywords: brain-derived neurotrophic factor, women, exercise, older, cognition, and/or cognitive. A random-effects model was applied; the statistical analysis was conducted in RevMan 5.4 (Cochrane). The risk of bias in the included trials was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Across 12 trials, 994 older women were included that were enrolled in different exercise regimens globally. Exercise regimens were categorized as aerobic, resistance/power training, aquatic, taekwondo, and multimodal and ranging from 30 to 60 min, 1-5 times per week across 5-24 weeks. Moderate improvement (Cohen’s d: 0.44, 95% CI: 0.04-0.84, p = 0.03) was found in BDNF levels across all trials. There was a small yet insignificant improvement in mini-mental state examination (MMSE) scores (Cohen’s d: 0.17, 95% CI: -0.79-1.13, p = 0.73). Aerobic exercise, aquatic exercise, and multimodal regimens showed significant association with improved BDNF levels but the sample size for individual exercise regimens was small A main limitation was the inclusion of 114 (10.3%) males in the data, introducing gender bias. This study provides novel insight into the association between various exercise regimens and BDNF levels among older women.

PMID:37257214 | DOI:10.1016/j.archger.2023.105068

Am J Speech Lang Pathol. 2023 May 31:1-13. doi: 10.1044/2023_AJSLP-22-00264. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to determine normative values for cepstral peak prominence measures across the life span as a function of sex using clinically relevant stimuli (/ɑ/, /i/, and two sentences of The Rainbow Passage) and two commonly used software types: Praat (Version 6.0.50) and Analysis of Dysphonia in Speech and Voice (ADSV).

METHOD: One hundred fifty speakers (75 men, 75 women; evenly distributed into three age groups) without voice disorders aged 18-91 years were recorded via headset microphone in a sound-treated booth. Cepstral measures were analyzed using common analysis methods in Praat and ADSV by sex, stimuli, and software type. Kruskal-Wallis tests and post hoc Mood’s Median tests for significant factors were performed on cepstral measures to assess the effects of age group, sex, stimuli, and software type.

RESULTS: The results revealed statistically significant effects of sex, stimuli, and software type on cepstral measures, but no statistical effect of age group on cepstral values. Women had lower average cepstral values compared to men. Across stimuli, the highest average cepstral measure was found for sustained /ɑ/, followed by sustained /i/, and then of the two sentences of The Rainbow Passage. Average cepstral measures in Praat were higher than those from ADSV.

CONCLUSIONS: The current work did not find a statistical effect of age group on cepstral values; thus, normative cepstral values were reported by sex, stimuli, and software type. Future work should examine the applicability of these normative values for discriminating speakers with and without voice disorders.

PMID:37257202 | DOI:10.1044/2023_AJSLP-22-00264

Cancer Epidemiol Biomarkers Prev. 2023 May 31:EPI-23-0154. doi: 10.1158/1055-9965.EPI-23-0154. Online ahead of print.

ABSTRACT

Spatial modelling of cancer survival is an important tool for identifying geographic disparities and providing an evidence base for resource allocation. Many different approaches have attempted to understand how survival varies geographically. This is the first scoping review to describe different methods and visualization techniques and to assess temporal trends in publications. The review was carried out using the PRISMA guideline using PubMed and Web of Science databases. Two authors independently screened articles. Articles were eligible for review if they measured cancer survival outcomes in small geographical areas by using spatial regression and/or mapping. Thirty-two articles were included, and the number increased over time. Most articles have been conducted in high-income countries using cancer registry databases. Eight different methods of modelling spatial survival were identified, and there were seven different ways of visualizing the results. Increasing the use of spatial modelling through enhanced data availability and knowledge sharing could help inform and motivate efforts to improve cancer outcomes and reduce excess deaths due to geographical inequalities. Efforts to improve the coverage and completeness of population-based cancer registries should continue to be a priority, in addition to encouraging the open sharing of relevant statistical programming syntax and international collaborations.

PMID:37257201 | DOI:10.1158/1055-9965.EPI-23-0154

J Comput Biol. 2023 May 31. doi: 10.1089/cmb.2022.0388. Online ahead of print.

ABSTRACT

The stochastic susceptible-infected-vaccinated (SIV) epidemic model includes a nonlinear term, making it difficult to obtain analytical solutions. Thus, numerical approximation schemes are an important tool for predicting the dynamics of infectious diseases and establishing optimal control strategies. However, the convergence rate of the existing numerical methods [e.g., Euler-Maruyama (EM) and truncated EM scheme] is only 1/2 order of the time step $\Delta t$. This article describes the construction of a logarithmic truncated EM scheme that achieves order-1 convergence and ensures positive numerical solutions of the stochastic SIV epidemic model. The existence of an invariant measure is proved for the stochastic SIV epidemic model with Markov switching. In addition, relaxed controls for the stochastic SIV epidemic model are investigated by using the Markov chain approximation method. It is demonstrated that the approximation schemes converge to the optimal strategy as the mesh size goes to zero. Finally, the results of numerical examples are presented to illustrate the theoretical results derived in this article.

PMID:37257191 | DOI:10.1089/cmb.2022.0388

Genet Test Mol Biomarkers. 2023 May;27(5):149-156. doi: 10.1089/gtmb.2022.0201.

ABSTRACT

Objectives: This study was designed to analyze the association between the SLC2A2 rs1499821 polymorphism and caries susceptibility in the Chinese Han, Zhuang, and Baikuyao populations. Materials and Methods: The present case-control study included 1067 12-year-old children: 481 with caries (142 Han, 166 Zhuang and 173 Baikuyao) and 586 who were caries-free (135 Han, 178 Zhuang and 273 Baikuyao). Questionnaires about diet and oral habits were obtained from all subjects. All of the children received dental examinations and DNA collection. The SLC2A2 rs1499821 SNP was genotyped using the SNPscan technique. Results: The rs1499821 T polymorphism was significantly associated with caries susceptibility in both the Han population and the combined populations of the three ethnic subgroups. SLC2A2 rs1499821 was associated with caries susceptibility in the dominant model in the Han (p = 0.045) population and the combined (p = 0.038) group. The CT+TT genotypes at rs1499821 were associated with a higher risk of caries in the Han (OR = 1.69, adjusted 95% CI: 1.01-2.81) and combined (OR = 1.33, adjusted 95% CI: 1.02-1.74) populations. In both Han (p = 0.009) and the combined populations (p = 0.004), there were statistically significant associations between the frequency of sweet food intake and dental caries. However, the rs1499821 polymorphisms did not associate with the frequency of sweet food intake in these ethnic subgroups. Conclusion: In the Han population, the SLC2A2 rs1499821 T allele and the frequency of sweet food intake may be regarded as risk factors for caries susceptibility. The SLC2A2 rs1499821 T allele had no association with the frequency of sweet food intake in any of the three ethnic groups.

PMID:37257183 | DOI:10.1089/gtmb.2022.0201

Biostatistics. 2023 May 31:kxad010. doi: 10.1093/biostatistics/kxad010. Online ahead of print.

ABSTRACT

In complex tissues containing cells that are difficult to dissociate, single-nucleus RNA-sequencing (snRNA-seq) has become the preferred experimental technology over single-cell RNA-sequencing (scRNA-seq) to measure gene expression. To accurately model these data in downstream analyses, previous work has shown that droplet-based scRNA-seq data are not zero-inflated, but whether droplet-based snRNA-seq data follow the same probability distributions has not been systematically evaluated. Using pseudonegative control data from nuclei in mouse cortex sequenced with the 10x Genomics Chromium system and mouse kidney sequenced with the DropSeq system, we found that droplet-based snRNA-seq data follow a negative binomial distribution, suggesting that parametric statistical models applied to scRNA-seq are transferable to snRNA-seq. Furthermore, we found that the quantification choices in adapting quantification mapping strategies from scRNA-seq to snRNA-seq can play a significant role in downstream analyses and biological interpretation. In particular, reference transcriptomes that do not include intronic regions result in significantly smaller library sizes and incongruous cell type classifications. We also confirmed the presence of a gene length bias in snRNA-seq data, which we show is present in both exonic and intronic reads, and investigate potential causes for the bias.

PMID:37257175 | DOI:10.1093/biostatistics/kxad010