Tag: nevin manimala

Thromb Res. 2023 May 13;228:54-60. doi: 10.1016/j.thromres.2023.05.008. Online ahead of print.

ABSTRACT

BACKGROUND: Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs.

METHODS: The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe.

RESULTS: SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life.

CONCLUSIONS: We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers.

PMID:37276718 | DOI:10.1016/j.thromres.2023.05.008

J Infect Public Health. 2023 May 30;16(8):1220-1229. doi: 10.1016/j.jiph.2023.05.032. Online ahead of print.

ABSTRACT

BACKGROUND: Institutions must have access to antibiograms to monitor changes in antimicrobial resistance and direct empirical antibiotic therapy. The first facility-specific cumulative antibiogram was launched in the ICU in 2019. Consequently, many antibiogram-operation-related actions have been adopted in the institution based on reported data. This study aimed to analyze the cumulative antibiogram reports for multiple intensive care units (ICUs) for 2020, and compare the antimicrobial susceptibility testing (AST) patterns between the 2019 and 2020 years in an academic medical center.

METHODS: This cross-sectional study was performed of routine bacterial culture and AST data extracted from a laboratory information system in a 2252-bed capacity hospital. Only the first diagnostic isolate of a given species per patient per year was included in the study. Interpretation and reporting were done in accordance with the applicable Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing guidelines.

RESULTS: Of the 46,791 clinical isolates, the Gram-negative bacilli isolation rate witnessed a significant increase: 35,670 isolates in 2020 versus. 33,652 isolates in 2019. Klebsiella pneumoniae showed a statistically significant increase, mainly in pediatric, emergency, and cardiothoracic ICUs (p < 0.001). Neonatal and pediatric ICUs showed statistically significant increases in Pseudomonas aeruginosa and Proteus mirabilis isolates (p < 0.001). A statistically significant decrease was noted in the prevalence of Acinetobacter, Escherichia coli, Burkholderia cepacia, and Enterobacter cloacae. The sensitivities of K. pneumoniae and E. coli to imipenem and tigecycline significantly improved (p < 0.001). The sensitivity to colistin was significantly decreased (p < 0.001). The sensitivity of P. aeruginosa isolates to colistin and carbapenems was improved (p < 0.001). We reported a statistically significant decrease in all Gram-positive cocci (11,121 in 2020 versus. 11,528 in 2019). Staphylococcus aureus showed a statistically significant increase (p < 0.001), particularly in the medical ICU.

CONCLUSION: The high susceptibility rates of Enterobacteriaceae toward colistin and tigecycline, should be cautiously considered in empiric therapy while looking for alternatives. The majority of isolates of Gram-positive cocci were coagulase negative staphylococci (CONS), we still need to confirm whether they are true pathogens or commensals before considering anti-staphylococcal agents in the empirical therapy. We underscored some corrective actions that might have improved the susceptibility rates, such as antibiotic cycling.

PMID:37276716 | DOI:10.1016/j.jiph.2023.05.032

Mar Pollut Bull. 2023 Jun 3;192:115103. doi: 10.1016/j.marpolbul.2023.115103. Online ahead of print.

ABSTRACT

Elemental composition, multivariate statistical analyses with the absolute principal component score-multiple linear regression (APCS-MLR) model, and different pollution indices in Upper and Lower Southwestern Ganges-Brahmaputra-Meghna (GBM) delta sediments were studied to characterize pollution, ecological risk and quantify potential toxic element sources of the area. Toxic metals concentrations were higher in Lower Delta and individual pollution indices showed Upper Delta was moderately polluted by arsenic, chromium, cobalt, copper and lead, and Lower Delta was moderately-strongly polluted by the same metals. Synergistic indices include Potential Ecological, Toxic, Nemerow, and Pollution Risk indices in Upper and Lower Delta sediment ranged from 47.17-128.07, 2.03-12.19, 29.92-65.42, 0.28-1.62, and 69.17-246.90, 8.00-13.47, 20.53-152.92, 1.18-1.58, indicated low and moderate risk pollution, respectively. Statistical models represent the metals dominantly originated from nature for Upper Delta, and both natural and anthropogenic activities contributed to Lower Delta sediment. The study found that the modern deposit in Lower Delta became more contaminated and thus enhanced ecological risk.

PMID:37276710 | DOI:10.1016/j.marpolbul.2023.115103

Hear Res. 2023 Jun 1;435:108820. doi: 10.1016/j.heares.2023.108820. Online ahead of print.

ABSTRACT

Optical coherence tomography has become the most popular approach to experimental measures of sound-induced vibrations within the mammalian cochlea. Because it is relatively easy to use and works in the unopened cochlea, the measurement of vibratory tuning curves has become highly reliable, and averaging data from multiple animals in different experimental cohorts is now possible. Here I tested a modern statistical approach to compare cohorts for differences in the magnitude and phase of vibration. A linear mixed-effect approach with first, second, third, and fourth-order models to fit the data was tested. The third-order model best fit both the magnitude and phase data without having terms that did not contribute substantively to improving the R² or the p-value for the independent variables. It identified a difference between cohorts of mice that were different and no difference between cohorts that should not be different. Thus, this approach provides a way to simply compare a full set of tuning curves between cohorts. While further analyses by the investigator will always be needed to study specific details related to the study hypothesis, this statistical technique provides a simple way for the cochlear physiologist to perform an initial assessment of whether the cohorts are same or different.

PMID:37276685 | DOI:10.1016/j.heares.2023.108820

J Biomech. 2023 May 26;155:111658. doi: 10.1016/j.jbiomech.2023.111658. Online ahead of print.

ABSTRACT

People with unilateral transfemoral amputation using socket prostheses are at increased risk for developing osteoarthritis in both the residual hip and intact lower-limb joints. Osseointegrated prostheses are a surgical alternative to socket prostheses that directly attach to the residual femur via a bone-anchored implant, however their multi-joint loading effect is largely unknown. Our objective was to establish how osseointegrated prostheses influence joint loading during walking. Motion capture data (kinematics, ground reaction forces) were collected from 12 participants at baseline, with socket prostheses, and 12-months after prosthesis osseointegration during overground walking at self-selected speeds. Subject-specific musculoskeletal models were developed at each timepoint relative to osseointegration. Internal joint moments were calculated using inverse dynamics, muscle and joint reaction forces (JRFs) were estimated with static optimization. Changes in internal joint moments, JRFs, and joint loading-symmetry were compared using statistical parametric mapping (p≤ 0.05) before and after osseointegration. Amputated limb hip flexion moments and anterior JRFs decreased during terminal stance (p = 0.002, <0.001; respectively), while amputated limb hip abduction moments increased during mid-stance (p < 0.001), amputated hip rotation moment changed from internal to external throughout early stance (p < 0.001). Intact limb hip extension and knee flexion moments (p = 0.028, 0.032; respectively), superior and resultant knee JRFs (p = 0.046, 0.049; respectively) decreased during the loading response following prosthesis osseointegration. These results may indicate that the direct loading transmission of these novel prostheses create a more typical mechanical environment in bilateral joints, which is comparable with loading observed in able-bodied individuals and could decrease the risk of development or progression of osteoarthritis.

PMID:37276681 | DOI:10.1016/j.jbiomech.2023.111658

Food Chem. 2023 May 30;425:136489. doi: 10.1016/j.foodchem.2023.136489. Online ahead of print.

ABSTRACT

Melons (Cucumis melo L.) are highly popular due to its delicate and delightful flavor in the worldwide. However, the flavor of the melon juice was easily affected by thermal treatments and unpleasant cooking smell during production process. Sugarcane (Saccharum officinarum) juice is a proven nutritious beverage with high levels of antioxidants, polyphenols, and other beneficial nutrients. Due to its low sugar content, combined with sugarcane, muskmelon-sugarcane blend juice gives an appealing and exotic drink. The research was planned to evaluate the effect of thermo-sonication (20 kHz, 70% amplitude, 5, 10 and 15 min) and microwave (90 °C, 400 W, 120 sec) on physicochemical parameters including pH, titratable acidity, total soluble solids (TSS), total phenolic contents (TPC), total flavonoid contents (TFC) and antioxidant capacity of muskmelon and sugarcane juice blend, during storage of 90 days at refrigeration (4±1 °C). The statistical results showed that synergism of sonication and microwave treatments had a significant (p ≤ 0.05) influence on pH, TSS, titratable acidity, TPC, TFC and antioxidant capacity. T₃ (15 min of sonication and 120 s of microwave) showed the maximum TSS (12.00±0.40 °B), pH (5.07±0.02), TPC (484.33±10.41 mg GAE/100 mL), TFC (261.73±11.32 mg CE/100 mL), and antioxidant activity (381.62±17.72 µg AAE/100 mL), as compared to untreated samples. Thermosonication for 15 min caused maximum retention of TPC, TFC and antioxidant capacity of blend juice during 90 days of storage, whereas in untreated samples these parameters were found highly decreased during storage. Thus, sonication and microwave can be recommended as an alternative to both conventional pasteurization processes and chemical preservatives.

PMID:37276674 | DOI:10.1016/j.foodchem.2023.136489

Chaos. 2023 Jun 1;33(6):063121. doi: 10.1063/5.0138150.

ABSTRACT

The May-Leonard model was introduced to examine the behavior of three competing populations where rich dynamics, such as limit cycles and nonperiodic cyclic solutions, arise. In this work, we perturb the system by adding the capability of global mutations, allowing one species to evolve to the other two in a linear manner. We find that for small mutation rates, the perturbed system not only retains some of the dynamics seen in the classical model, such as the three-species equal-population equilibrium bifurcating to a limit cycle, but also exhibits new behavior. For instance, we capture curves of fold bifurcations where pairs of equilibria emerge and then coalesce. As a result, we uncover parameter regimes with new types of stable fixed points that are distinct from the single- and dual-population equilibria characteristic of the original model. On the contrary, the linearly perturbed system fails to maintain heteroclinic connections that exist in the original system. In short, a linear perturbation proves to be significant enough to substantially influence the dynamics, even with small mutation rates.

PMID:37276577 | DOI:10.1063/5.0138150

Chaos. 2023 Jun 1;33(6):063117. doi: 10.1063/5.0126559.

ABSTRACT

Seasonal effects powerfully shape the population dynamics with periodic climate changes because species naturally adjust their dynamics with seasonal variations. In response to these effects, sometimes population dynamics exhibit synchrony or generate chaos. However, synchronized dynamics enhance species’ persistence in naturally unstable environments; thus, it is imperative to identify parameters that alter the dynamics of an ecosystem and bring it into synchrony. This study examines how ecological parameters enable species to adapt their dynamics to seasonal changes and achieve phase synchrony within ecosystems. For this, we incorporate seasonal effects as a periodic sinusoidal function into a tri-trophic food chain system where two crucial bio-controlling parameters, Allee and refugia effects, are already present. First, it is shown that the seasonal effects disrupt the limit cycle and bring chaos to the system. Further, we perform rigorous mathematical analysis to perform the dynamical and analytical properties of the nonautonomous version of the system. These properties include sensitive dependence on initial condition (SDIC), sensitivity analysis, bifurcation results, the positivity and boundedness of the solution, permanence, ultimate boundedness, and extinction scenarios of species. The SDIC characterizes the presence of chaotic oscillations in the system. Sensitivity analysis determines the parameters that significantly affect the outcome of numerical simulations. The bifurcation study concerning seasonal parameters shows a higher dependency of species on the frequency of seasonal changes than the severity of the season. The bifurcation study also examines the bio-controlling parameters and reveals various dynamic states within the system, such as fold, transcritical branch points, and Hopf points. Moreover, the mathematical analysis of our seasonally perturbed system reveals the periodic coexistence of all species and a globally attractive solution under certain parametric constraints. Finally, we examine the role of essential parameters that contribute to phase synchrony. For this, we numerically investigate the defining role of the coupling dimension coefficient, bio-controlling parameters, and other parameters associated with seasonality. This study infers that species can tune their dynamics to seasonal effects with low seasonal frequency, whereas the species’ tolerance for the severity of seasonal effects is relatively high. The research also sheds light on the correlation between the degree of phase synchrony, prey biomass levels, and the severity of seasonal forcing. This study offers valuable insights into the dynamics of ecosystems affected by seasonal perturbations, with implications for conservation and management strategies.

PMID:37276576 | DOI:10.1063/5.0126559

Chaos. 2023 Jun 1;33(6):063110. doi: 10.1063/5.0147847.

ABSTRACT

This paper designs an algorithm to distill the piecewise non-linear dynamical system from the data without prior knowledge. The system to be identified does not have to be written as a known model term or be thoroughly understood. We exploit the fact that an unknown piecewise non-linear system can be decomposed into the Fourier series as long as its equations of motion are Riemann integrable. Based on this property, we reduce the challenge of finding the correct model to discovering the Fourier series approximation. However, the Fourier series approximation of the piecewise function is inaccurate. The new method takes advantage of this weakness to determine whether the model has piecewise features and to find a way to discover the discontinuity set. Then, the dynamical system on each segment is identified as a pure Fourier series. Identification of intricate models can be achieved in simple steps. The results show that the method can accurately discover the equation of motion and precisely capture the non-smooth characteristic. Next, the prediction and further detailed analysis can be carried out.

PMID:37276571 | DOI:10.1063/5.0147847

Chaos. 2023 Jun 1;33(6):063114. doi: 10.1063/5.0146649.

ABSTRACT

We reinvestigate a paradigmatic model of nonequilibrium statistical physics consisting of an inertial Brownian particle in a symmetric periodic potential subjected to both a time-periodic force and a static bias. In doing so, we focus on the negative mobility phenomenon in which the average velocity of the particle is opposite to the constant force acting on it. Surprisingly, we find that in the weak dissipation regime, thermal fluctuations induce negative mobility much more frequently than it happens if dissipation is stronger. In particular, for the very first time, we report a parameter set in which thermal noise causes this effect in the nonlinear response regime. Moreover, we show that the coexistence of deterministic negative mobility and chaos is routinely encountered when approaching the overdamped limit in which chaos does not emerge rather than near the Hamiltonian regime of which chaos is one of the hallmarks. On the other hand, at non-zero temperature, the negative mobility in the weak dissipation regime is typically affected by weak ergodicity breaking. Our findings can be corroborated experimentally in a multitude of physical realizations, including, e.g., Josephson junctions and cold atoms dwelling in optical lattices.

PMID:37276563 | DOI:10.1063/5.0146649