Tag: nevin manimala

Hepatol Commun. 2023 Apr 14;7(5):e0109. doi: 10.1097/HC9.0000000000000109. eCollection 2023 May 1.

ABSTRACT

BACKGROUND: In children with biliary atresia (BA), pathologic structural changes within the heart, which define cirrhotic cardiomyopathy, are associated with adverse perioperative outcomes. Despite their clinical relevance, little is known about the pathogenesis and triggers of pathologic remodeling. Bile acid excess causes cardiomyopathy in experimental cirrhosis, but its role in BA is poorly understood.

METHODS: Echocardiographic parameters of left ventricular (LV) geometry [LV mass (LVM), LVM indexed to height, left atrial volume indexed to BSA (LAVI), and LV internal diameter (LVID)] were correlated with circulating serum bile acid concentrations in 40 children (52% female) with BA listed for transplantation. A receiver-operating characteristic curve was generated to determine optimal threshold values of bile acids to detect pathologic changes in LV geometry using Youden index. Paraffin-embedded human heart tissue was separately analyzed by immunohistochemistry for the presence of bile acid-sensing Takeda G-protein-coupled membrane receptor type 5.

RESULTS: In the cohort, 52% (21/40) of children had abnormal LV geometry; the optimal bile acid concentration to detect this abnormality with 70% sensitivity and 64% specificity was 152 µmol/L (C-statistics=0.68). Children with bile acid concentrations >152 µmol/L had ∼8-fold increased odds of detecting abnormalities in LVM, LVM index, left atrial volume index, and LV internal diameter. Serum bile acids positively correlated with LVM, LVM index, and LV internal diameter. Separately, Takeda G-protein-coupled membrane receptor type 5 protein was detected in myocardial vasculature and cardiomyocytes on immunohistochemistry.

CONCLUSION: This association highlights the unique role of bile acids as one of the targetable potential triggers for myocardial structural changes in BA.

PMID:37058680 | DOI:10.1097/HC9.0000000000000109

Opt Lett. 2023 Apr 15;48(8):2206-2209. doi: 10.1364/OL.489165.

ABSTRACT

We investigate the statistical mechanics of the photonic Ablowitz-Ladik lattice, the integrable version of the discrete nonlinear Schrödinger equation. In this regard, we demonstrate that in the presence of perturbations, the complex response of this system can be accurately captured within the framework of optical thermodynamics. Along these lines, we shed light on the true relevance of chaos in the thermalization of the Ablowitz-Ladik system. Our results indicate that when linear and nonlinear perturbations are incorporated, this weakly nonlinear lattice will thermalize into a proper Rayleigh-Jeans distribution with a well-defined temperature and chemical potential, in spite of the fact that the underlying nonlinearity is non-local and hence does not have a multi-wave mixing representation. This result illustrates that in the supermode basis, a non-local and non-Hermitian nonlinearity can in fact properly thermalize this periodic array in the presence of two quasi-conserved quantities.

PMID:37058678 | DOI:10.1364/OL.489165

Opt Lett. 2023 Apr 15;48(8):2150-2153. doi: 10.1364/OL.485215.

ABSTRACT

Hopfield networks are iterative procedures able to solve combinatorial optimization problems. New studies regarding algorithm-architecture adequacy are fostered by the re-emergence of hardware implementations of such methods in the form of Ising machines. In this work, we propose an optoelectronic architecture suitable for fast processing and low energy consumption. We show that our approach allows effective optimization relevant to statistical image denoising.

PMID:37058664 | DOI:10.1364/OL.485215

Cancer Nurs. 2023 Apr 13. doi: 10.1097/NCC.0000000000001235. Online ahead of print.

ABSTRACT

BACKGROUND: There is no consensus on the best intervention for topical management of bleeding in malignant wounds. Although surgical hemostatic dressings are recommended, the use of calcium alginate (CA) is frequent among practitioners.

OBJECTIVE: The aim of this study was to evaluate the hemostatic efficacy of oxidized regenerated cellulose (ORC) and CA dressing in the management of bleeding from malignant wounds resulting from breast cancer.

METHODS: This was a randomized open clinical trial. The outcomes measured were total time to hemostasis and the number of hemostatic products used.

RESULTS: Sixty-one patients were potentially eligible for the study, 1 did not consent, and 32 were assessed to be ineligible, resulting in a sample of 28 who were randomized to 2 study groups. Total time to hemostasis was 93.8 seconds in the ORC group, with an average of 30.1 seconds (95% confidence interval, 18.6-189 seconds), and 67 seconds in the CA group, with an average of 30.4 seconds (confidence interval, 21.7 seconds to imprecise upper limit). The main difference was 26.8 seconds. Kaplan-Meier log-rank test, and Cox model showed no statistical significance (P = 0.894). A total of 18 hemostatic products were used in the CA group and 34 in the ORC group. No adverse effects were identified.

CONCLUSIONS: Although no significant differences were identified in terms of time, more hemostatic products were used in the ORC group, highlighting the effectiveness of CA.

IMPLICATIONS FOR PRACTICE: Calcium alginate may be the first choice in the management of bleeding in malignant wounds, favoring nursing in the most immediate hemostatic actions.

PMID:37058598 | DOI:10.1097/NCC.0000000000001235

Rev Esc Enferm USP. 2023 Apr 14;57:e20220309. doi: 10.1590/1980-220X-REEUSP-2022-0309en. eCollection 2023.

ABSTRACT

OBJECTIVE: To analyze the association between time of arrival at a reference hospital and mortality of people with ischemic stroke.

METHOD: Descriptive and inferential statistics were used. Modifying and confounding variables between time of arrival and mortality were observed in the multivariate analysis. The Akaike Information Criterion was used to choose the model. Statistical significance of 5% and risk correction using the Poisson Model were adopted.

RESULTS: Most participants arrived within 4.5 hours of symptom onset or wake up stroke to the referral hospital and 19.4% died. The score of the National Institute of Health Stroke Scale was a modifier. In the multivariate model stratified by scale score ≥14, arrival time >4.5h was associated with lower mortality; and age ≥60 years and having Atrial Fibrillation, to higher mortality. In the model stratified by score ≤13, previous Rankin ≥3, and presence of atrial fibrillation were predictors of mortality.

CONCLUSION: The relationship between time of arrival and mortality up to 90 days was modified by the National Institute of Health Stroke Scale. Prior Rankin ≥3, atrial fibrillation, time to arrival ≤4.5h, and age ≥60 years contributed to higher mortality.

PMID:37058593 | DOI:10.1590/1980-220X-REEUSP-2022-0309en

Sleep. 2023 Apr 14:zsad111. doi: 10.1093/sleep/zsad111. Online ahead of print.

ABSTRACT

The frequent appearance of newly learned information in dreams suggests that dream content is influenced by memory consolidation. Many studies have tested this hypothesis by asking whether dreaming about a learning task is associated with improved memory, but results have been inconsistent. We conducted a meta-analysis to determine the strength of the association between learning-related dreams and post-sleep memory improvement. We searched the literature for studies that 1) trained participants on a pre-sleep learning task and then tested their memory after sleep and 2) associated post-sleep memory improvement with the extent to which dreams incorporated learning task content. Sixteen studies qualified for inclusion, which together reported 45 effects. Integrating across effects, we report a strong and statistically significant association between task-related dreaming and memory performance (SMD = 0.51 [95% CI 0.28 0.74], p < 0.001). Among studies using polysomnography, this relationship was statistically significant for dreams collected from NREM sleep (n = 10) but not for dreams collected from REM sleep (n = 12). There was a significant association between dreaming and memory for all types of learning tasks studied. This meta-analysis provides further evidence that dreaming about a learning task is associated with improved memory performance, suggesting that dream content may be an indication of memory consolidation. Furthermore, we report preliminary evidence that the relationship between dreaming and memory may be stronger in NREM sleep compared to REM.

PMID:37058584 | DOI:10.1093/sleep/zsad111

PLoS One. 2023 Apr 14;18(4):e0283482. doi: 10.1371/journal.pone.0283482. eCollection 2023.

ABSTRACT

BACKGROUND: Epicardial fat represents visceral adiposity. Many observational studies have reported that increased epicardial is associated with adverse metabolic profile, cardiovascular risk factors, and coronary atherosclerosis in patients with cardiovascular diseases and in general population. We and others have previously reported the association of increased epicardial fat with left ventricular (LV) hypertrophy and diastolic dysfunction as well as the development of heart failure (HF) and coronary artery disease in these populations. In some studies, however, the association did not reach statistical significance. The inconsistent results may be due to limited power, different imaging modalities for quantifying epicardial fat volume, and different outcome definitions. Accordingly, we aim to perform the systematic review and meta-analysis of studies on the association of epicardial fat with cardiac structure and function and cardiovascular outcomes.

METHODS: This systematic review and meta-analysis will include observational studies examining the association of epicardial fat with cardiac structure and function or the cardiovascular outcomes. Relevant studies will be identified by searching electronic databases including PubMed, Web of Science, and Scopus and by manual screening of reference lists of relevant reviews and retrieved studies. The primary outcome will be cardiac structure and function. The secondary outcome will be cardiovascular events including death from cardiovascular causes, hospitalization for HF, nonfatal myocardial infarction, and unstable angina.

DISCUSSION: The results of our systematic review and meta-analysis will provide evidence regarding the clinical usefulness of epicardial fat assessment.

SYSTEMATIC REVIEW REGISTRATION: INPLASY 202280109.

PMID:37058546 | DOI:10.1371/journal.pone.0283482

PLoS One. 2023 Apr 14;18(4):e0284248. doi: 10.1371/journal.pone.0284248. eCollection 2023.

ABSTRACT

This study describes the incidence, evolution and prognosis of acute kidney injury (AKI) in critical COVID-19 during the first pandemic wave. We performed a prospective, observational, multicenter study of confirmed COVID-19 patients admitted to 19 intensive care units (ICUs) in Catalonia (Spain). Data regarding demographics, comorbidities, drug and medical treatment, physiological and laboratory results, AKI development, need for renal replacement therapy (RRT) and clinical outcomes were collected. Descriptive statistics and logistic regression analysis for AKI development and mortality were used. A total of 1,642 patients were enrolled (mean age 63 (15.95) years, 67.5% male). Mechanical ventilation (MV) was required for 80.8% and 64.4% of these patients, who were in prone position, while 67.7% received vasopressors. AKI at ICU admission was 28.4% and increased to 40.1% during ICU stay. A total of 172 (10.9%) patients required RRT, which represents 27.8% of the patients who developed AKI. AKI was more frequent in severe acute respiratory distress syndrome (ARDS) ARDS patients (68% vs 53.6%, p<0.001) and in MV patients (91.9% vs 77.7%, p<0.001), who required the prone position more frequently (74.8 vs 61%, p<0.001) and developed more infections. ICU and hospital mortality were increased in AKI patients (48.2% vs 17.7% and 51.1% vs 19%, p <0.001) respectively). AKI was an independent factor associated with mortality (IC 1.587-3.190). Mortality was higher in AKI patients who required RRT (55.8% vs 48.2%, p <0.04). Conclusions There is a high incidence of AKI in critically ill patients with COVID-19 disease and it is associated with higher mortality, increased organ failure, nosocomial infections and prolonged ICU stay.

PMID:37058544 | DOI:10.1371/journal.pone.0284248

PLoS One. 2023 Apr 14;18(4):e0282633. doi: 10.1371/journal.pone.0282633. eCollection 2023.

ABSTRACT

BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) is prevalent and may affect cognitive function. We studied associations of NAFLD with risk of cognitive impairment. Secondarily we evaluated liver biomarkers (alanine aminotransferase (ALT), aspartate aminotransferase (AST), their ratio, and gamma-glutamyl transpeptidase).

METHODS: In a prospective cohort study, the REasons for Geographic and Racial Differences in Stroke, among 30,239 black and white adults aged ≥45,495 cases of incident cognitive impairment were identified over 3.4 years follow up. Cognitive impairment was identified as new impairment in two of three cognitive tests administered every two years during follow up; word list learning and recall, and verbal fluency. 587 controls were selected from an age, race, sex-stratified sample of the cohort. The fatty liver index was used to define baseline NAFLD. Liver biomarkers were measured using baseline blood samples.

RESULTS: NAFLD at baseline was associated with a 2.01-fold increased risk of incident cognitive impairment in a minimally adjusted model (95% CI 1.42, 2.85). The association was largest in those aged 45-65 (p interaction by age = 0.03), with the risk 2.95-fold increased (95% CI 1.05, 8.34) adjusting for cardiovascular, stroke and metabolic risk factors. Liver biomarkers were not associated with cognitive impairment, except AST/ALT >2, with an adjusted OR 1.86 (95% CI 0.81, 4.25) that did not differ by age.

CONCLUSIONS: A laboratory-based estimate of NAFLD was associated with development of cognitive impairment, particularly in mid-life, with a tripling in risk. Given its high prevalence, NAFLD may be a major reversible determinant of cognitive health.

PMID:37058527 | DOI:10.1371/journal.pone.0282633

PLoS One. 2023 Apr 14;18(4):e0279323. doi: 10.1371/journal.pone.0279323. eCollection 2023.

ABSTRACT

BACKGROUND: The differentiation of minimal-fat-or low-fat-angiomyolipomas from other renal lesions is clinically challenging in conventional computed tomography. In this work, we have assessed the potential of grating-based x-ray phase-contrast computed tomography (GBPC-CT) for visualization and quantitative differentiation of minimal-fat angiomyolipomas (mfAMLs) and oncocytomas from renal cell carcinomas (RCCs) on ex vivo renal samples.

MATERIALS AND METHODS: Laboratory GBPC-CT was performed at 40 kVp on 28 ex vivo kidney specimens including five angiomyolipomas with three minimal-fat (mfAMLs) and two high-fat (hfAMLs) subtypes as well as three oncocytomas and 20 RCCs with eight clear cell (ccRCCs), seven papillary (pRCCs) and five chromophobe RCC (chrRCC) subtypes. Quantitative values of conventional Hounsfield units (HU) and phase-contrast Hounsfield units (HUp) were determined and histogram analysis was performed on GBPC-CT and grating-based attenuation-contrast computed tomography (GBAC-CT) slices for each specimen. For comparison, the same specimens were imaged at a 3T magnetic resonance imaging (MRI) scanner.

RESULTS: We have successfully matched GBPC-CT images with clinical MRI and histology, as GBPC-CT presented with increased soft tissue contrast compared to absorption-based images. GBPC-CT images revealed a qualitative and quantitative difference between mfAML samples (58±4 HUp) and oncocytomas (44±10 HUp, p = 0.057) and RCCs (ccRCCs: 40±12 HUp, p = 0.012; pRCCs: 43±9 HUp, p = 0.017; chrRCCs: 40±7 HUp, p = 0.057) in contrast to corresponding laboratory attenuation-contrast CT and clinical MRI, although not all differences were statistically significant. Due to the heterogeneity and lower signal of oncocytomas, quantitative differentiation of the samples based on HUp or in combination with HUs was not possible.

CONCLUSIONS: GBPC-CT allows quantitative differentiation of minimal-fat angiomyolipomas from pRCCs and ccRCCs in contrast to absorption-based imaging and clinical MRI.

PMID:37058505 | DOI:10.1371/journal.pone.0279323