Tag: nevin manimala

Physiol Meas. 2021 Apr 22. doi: 10.1088/1361-6579/abfae5. Online ahead of print.

ABSTRACT

OBJECTIVE: Disease may cause changes in the individual’s respiratory pattern, which can be measured as parameters for evaluating disease, usually through manually annotated polysomnographic recordings. In this study, a machine learning model based on nasal airflow and respiratory effort of chest and abdomen is proposed to automatically identify respiratory events, including normal breathing event, hypopnea event and apnea event.

APPROACH: The nasal airflow and chest-abdominal respiratory effort signals were collected from Polysomnography (PSG). Time/frequency domain features, fractional fourier transform features and sample entropy were calculated to obtain feature sets. And selected features through statistical analysis were used as input variables of the machine learning model. The performance of different input combinations on different models was studied and cross-validated.

MAIN RESULTS: The dataset included PSG sleep records of 60 patients provided by the Chinese People’s Liberation Army General Hospital. The eXtreme Gradient Boosting (XGBoost)-based model performed best in several models with an accuracy of 0.807 and an f1-score of 0.807, depending on the combination of nasal airflow and two respiratory effort signals. The precision for normal breathing, hypopnea and apnea event were 0.764, 0.789 and 0.871 respectively. In addition, the recall score were 0.833, 0.768 and 0.823 for normal breathing, hypopnea and apnea event, respectively. Moreover, it was found that the standard deviation and kurtosis of nasal airflow were the most important features of respiratory event detection model.

SIGNIFICANCE: Since nasal airflow and respiratory effort of chest and abdomen contain the characteristics of respiratory events, their combined use can improve the classification performance in identifying respiratory events. With this method, respiratory events can be automatically detected and labeled from the PSG records, which can be used to screen for patients with Sleep Apnea Hypopnea Syndrome (SAHS).

PMID:33887711 | DOI:10.1088/1361-6579/abfae5

Ann Nutr Metab. 2021 Apr 22:1-10. doi: 10.1159/000515057. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Parenteral nutrition (PN) has become an efficient, safe, and convenient treatment over years for patients suffering from intestinal failure. Home PN (HPN) enables the patients to have a high quality of life in their own environment. The therapy management however implies many restrictions and potentially severe lethal complications. Prevention and therapy of the latter are therefore of utmost importance. This study aims to assess and characterize the situation of patients with HPN focusing on prevalence of catheter-related complications and mortality.

METHODS: Swiss multicentre prospective observational study collecting demographic, anthropometric, and catheter-related data by means of questionnaires every sixth month from 2017 to 2019 (24 months), focusing on survival and complications. Data were analysed using descriptive statistics. Logistic regression models were fitted to investigate association between infection and potential co-factors.

RESULTS: Seventy adult patients (50% women) on HPN were included (≈5 patients/million adult inhabitants/year). The most common underlying diseases were cancer (23%), bariatric surgery (11%), and Crohn’s disease (10%). The most prevalent indication was short bowel syndrome (30%). During the study period, 47% of the patients were weaned off PN; mortality rate reached 7% for a median treatment duration of 1.31 years. The rate of catheter-related infection was 0.66/1,000 catheter-days (0.28/catheter-year) while the rate of central venous thrombosis was 0.13/1,000 catheter-days (0.05/catheter-year).

CONCLUSION: This prospective study gives a comprehensive overview of the adult Swiss HPN patient population. The collected data are prerequisite for evaluation, comparison, and improvement of recommendations to ensure best treatment quality and safety.

PMID:33887736 | DOI:10.1159/000515057

Lung Cancer. 2021 Apr 19;156:31-40. doi: 10.1016/j.lungcan.2021.04.005. Online ahead of print.

ABSTRACT

INTRODUCTION: Randomized controlled trials have shown that screening with computed tomography reduces lung cancer mortality but is most effective when applied to high-risk individuals. Accurate lung cancer risk prediction models effectively select individuals for screening. Few pilots or programs have implemented risk models for enrolling individuals for screening in real-world, population-based settings. This report describes implementation of the PLCOm2012 risk prediction model in the Ontario Health (Cancer Care Ontario) lung cancer screening Pilot.

METHODS: In the Pilot’s Health Technology Assessment, 576 categorical age/pack-years/quit-years scenarios were evaluated using MISCAN microsimulation modeling and cost-effectiveness analyses. A preferred model was selected which provided the most life-years gained per cost. The PLCOm2012 was compared to the preferred MISCAN scenario at a threshold that yielded the same number eligible (risk ≥2.0 %/6-years).

RESULTS: The PLCOm2012 had significantly higher sensitivity and predictive value (68.1 % vs 59.6 %, p < 0.0001; 4.90 % vs 4.29 %, p = 0.044), and an Expert Panel selected it for use in the Pilot. The Pilot cancer detection rate was significantly higher than in the NLST (p = 0.009) or NELSON (p = 0.003) and there was a significant shift to early stage compared to historical Ontario Cancer Registry statistics (p < 0.0001). Pre- and post-Pilot evaluations found that conducting quality risk assessments were not excessively time consuming or difficult, and participants’ satisfaction was high.

CONCLUSIONS: The PLCOm2012 was efficiently implemented in the Pilot in a real-world setting and is being used to transition into a provincial program. Compared to categorical age/pack-years/quit-years criteria, risk assessment using the PLCOm2012 can lead to effective and efficient screening.

PMID:33887677 | DOI:10.1016/j.lungcan.2021.04.005

J Environ Manage. 2021 Apr 19;290:112610. doi: 10.1016/j.jenvman.2021.112610. Online ahead of print.

ABSTRACT

River sediments have the capability to accumulate and absorb traces of anthropic environmental degradation. In this work, we investigated the effects of urban land use on the composition of physical sediment. For this purpose, sediment profiles were collected in the wet and dry seasons and in locations with mixed land-use. For the sediment analysis, particle size separation, organic matter degradation, visual analysis of the thickest fraction using a magnifying glass and stereomicroscope analysis of the particle size material corresponding to the sands were performed. It was observed that the sedimentation of synthetic materials and plastics (fragments and fibres) were the most frequently found materials. More intense urban occupation areas and with less riparian vegetation suffer more from this degradation than rural areas or areas with preserved riparian vegetation. The dam in the basin accumulates more materials (macro and microplastics) and has the role of containing and preventing these residues from being transported downstream. The importance of investing in environmental management measures is emphasized, and based on the sampled sites assessed, the restoration of riparian vegetation, greater inspection of inadequate waste disposal and public cleaning actions are suggested, including actions in the Tibiriçá dam.

PMID:33887637 | DOI:10.1016/j.jenvman.2021.112610

J Stroke Cerebrovasc Dis. 2021 Apr 19;30(7):105794. doi: 10.1016/j.jstrokecerebrovasdis.2021.105794. Online ahead of print.

ABSTRACT

INTRODUCTION: Flow diversion of the distal anterior circulation cerebral vasculature may be used for management of wide necked aneurysms not amenable to other endovascular approaches. Follow-up angiography sometimes demonstrates neo-intimal hyperplasia within or adjacent to the stent, however there is limited evidence in the literature examining the incidence in MCA and ACA aneurysms. We present our experience with flow diversion of the distal vasculature and evaluate the incidence of neo-intimal hyperplasia.

MATERIALS AND METHODS: Retrospective review of patients who underwent Pipeline embolization device (PED) treatment for ruptured and unruptured anterior circulation aneurysms.

RESULTS: A total of 251 anterior circulation aneurysms were treated by pipeline flow diversion, of which 175 were ICA aneurysms, 14 were ACA aneurysms and 18 were MCA aneurysms. 6-month follow-up angiography was available in 207 patients. The incidence of neo-intimal hyperplasia was 15.9%, 21.4%, and 61.1% in ICA, ACA, and MCA aneurysms, respectively. MCA-territory aneurysms developed neo-intimal hyperplasia at a significantly higher rate than aneurysms in other vessel territories. Rates of aneurysmal occlusion did not significantly differ from those patients who did not exhibit intimal hyperplasia on follow-up angiography.

CONCLUSION: In our experience, flow diversion of distal wide-necked MCA and ACA aneurysms is a safe and effective treatment strategy. The presence of neo-intimal hyperplasia at 6-month angiography is typically clinically asymptomatic. Given the statistically higher rate of neo-intimal hyperplasia in MCA aneurysms at 6-month angiography, we propose delaying initial follow-up angiography to 12-months and maintaining dual antiplatelet therapy during that time.

PMID:33887663 | DOI:10.1016/j.jstrokecerebrovasdis.2021.105794

J Mech Behav Biomed Mater. 2021 Mar 19;119:104474. doi: 10.1016/j.jmbbm.2021.104474. Online ahead of print.

ABSTRACT

Three-point bending is often used during the mechanical determination of tissue material properties. When taken to failure, the test samples often experience high deformations. The objective of this study was to present beam and plate theories as analytical tools for determining tensile and compressive elastic moduli during the transition from flexure to membrane stress states. Samples of cartilage, a highly flexible connective tissue having differing tensile and compressive moduli, were tested. Three-point bending tests were conducted on auricular (ear) and costal (rib) cartilage harvested from pigs. The influence of span length variation and Poisson’s ratio assumptions were statistically assessed. Tensile elastic moduli of the ear (3.886 MPa) and rib (6.131 MPa) were derived from high-deformation bending tests. The functional assessment described here can be applied as a design input approach for tissue reconstruction and tissue engineering, considering both hard and soft tissue applications.

PMID:33887626 | DOI:10.1016/j.jmbbm.2021.104474

Health Place. 2021 Apr 19;69:102571. doi: 10.1016/j.healthplace.2021.102571. Online ahead of print.

ABSTRACT

BACKGROUND: Population ageing and air pollution have become two major public health concerns in China. Longitudinal evidence on the body weight impacts of air pollution among older adults is rare. This study aims to investigate the impacts of ambient particulate matter with aerodynamic diameters ≤2.5 μm (PM_2.5) on weight status of older adults in China and the potential behavioral and metabolic pathways through which PM_2.5 influences weight status.

METHODS: The longitudinal data from the China Health and Retirement Longitudinal Study (body mass index-BMI, n = 9053; waist/height ratio-WHR, n = 9064) were linked to the air pollution data at the city-level with a rural-urban distinction. We used mixed-effects linear models to evaluate the impacts of PM_2.5 on individual weight status and multiple mediation analysis to examine potential pathways.

RESULTS: After adjusting for relevant socioeconomic and city-level risk factors, significant and robust positive impacts of PM_2.5 on BMI (0.025, 95%CI: 0.018, 0.031) and WHR*100 (0.058, 95%CI: 0.044, 0.072) were found among older adults in China. The PM_2.5-weight status relationship among older adults may be mediated through metabolic and inflammatory dysfunction pathways particularly HbA1c and C-reactive protein (CRP). As PM_2.5 deteriorates, the detrimental impacts tend to be more severe for rural-urban migrants and rural residents, compared to their urban counterparts. The worsening rural PM_2.5 profiles in some areas, such as the northern parts of the Central and the Eastern, may leave them particularly vulnerable to air pollution air .

CONCLUSIONS: PM_2.5 has an independent and significant detrimental impact on weight status including BMI and WHR of older adults in China, especially among rural adults and rural-urban migrants. PM_2.5 may affect weight status of older adults through biomarkers such as HbA1c and CRP. More research is needed to confirm our findings.

PMID:33887573 | DOI:10.1016/j.healthplace.2021.102571

Int J Med Inform. 2021 Apr 15;150:104465. doi: 10.1016/j.ijmedinf.2021.104465. Online ahead of print.

ABSTRACT

BACKGROUND: The plethora of information in the contemporary digital age is enormous and beyond the capability of the average person to process all the information received. During the COVID-19 pandemic outbreak, huge amount of information is increasingly available in digital information sources and overwhelms the average person. The purpose of this research was to investigate public’s information seeking behavior on COVID-19 in Greece.

METHOD: The study was conducted through a web-based survey, facilitated by the use of questionnaire posted on the Google Forms platform. The questionnaire consisted of closed-ended, 7-point Likert scale questions and multiple choice questions and was distributed to all over Greek Regions to almost 3.000 recipients, during the implementation of restrictive measures against the COVID-19 outbreak in Spring 2020. The data collected were subjected to a descriptive statistical analysis. The median was used to present the results. In order to perform analysis between genders, as well as age groups, the non-parametric criteria Mann-Whitney U and Kruskal-Wallis were applied to determine the existence of differences in participants’ beliefs.

RESULTS: Responses by 776 individuals were obtained. Individuals dedicated up to 2 h per day to be informed on COVID-19. Television, electronic press and news websites were reported by the participants as more reliable than social media, in obtaining information on COVID-19. Respondents paid attention to official sources of information (Ministry of Health, Civil Protection etc.). Family and friends played an additional role in the participants’ information on COVID-19, while the personal doctor, other health workers and pharmacists did not appear to be most preferred sources of information on COVID-19. Participants’ most common information seeking strategy in digital environment was keyword searching. Unreliable information, fake news and information overload were the most common difficulties that the participants encountered seeking information on COVID-19. The respondents’ views seemed to differ significantly among age groups. The older the participants, the more often they were informed by television (p < 0.001) and the less often by the internet (p < 0.001). Females appear to use more frequently internet (p < 0.001) and social media (p = 0.001) out of habit and visit more often the Ministry of Health (p < 0.001) and the Civil Protection (p=0.005) websites, compared to males. Most of the participants seemed to worry about the fake news phenomenon and agreed that fake news on COVID-19 is being spread in the media and especially social networks.

CONCLUSION: The study revealed that, during the COVID-19 pandemic in Greece, participants obtained information about the disease mainly by television, electronic press and news websites. On the contrary, the limited use of social media demonstrates the participants awareness of the spread of fake news on social media. This observed information seeking behavior might has contributed to individuals’ acceptance of the necessary behavioral changes that had led to the Greek success story in preventing spread of the disease.

PMID:33887589 | DOI:10.1016/j.ijmedinf.2021.104465

Public Health. 2021 Apr 19;194:127-134. doi: 10.1016/j.puhe.2021.03.001. Online ahead of print.

ABSTRACT

OBJECTIVES: To map district-level tobacco hot spots and understand the Sociodemographic Indices (SDI) influencing tobacco consumption in Indian men and women.

STUDY DESIGN: Cross-sectional study.

METHODS: Tobacco use data from 640 districts of India were extracted from National Family Health Survey-4, carried out from 2015 to 2016 with a sample size of 103,411 men and 699,686 women. Geographic Information System was used to map the tobacco prevalence, and hot spots were identified by spatial statistics (Getis-OrdGi∗). SDI were studied by bivariate analyses and binary logistic regression.

RESULTS: India has two major tobacco hot spots; one comprising the districts of North-Eastern states, excluding Sikkim, and the second cluster is formed by the districts of Central-Eastern states. These hot spots coincide well with demographic determinants: North-East (adjusted odds ratio [aOR] men, 5.74; aOR women, 13.54) and Central India (aOR men, 4.5; aOR women, 3.5) have higher odds of Tobacco consumption. In men, respondents with no education (aOR 2.52; 95% confidence interval [CI]: 2.26-2.81) and Muslims (aOR 3.53; 95% CI: 2.93-4.26) have higher odds of tobacco consumption. The poorest (men aOR, 2.06; 95% CI: 1.87-2.27; women aOR, 3.36: 95% CI: 2.69-4.19) and ST women (aOR 1.89; 95% CI: 1.68-2.13) have higher odds of tobacco consumption.

CONCLUSIONS: We have identified tobacco hot spots and detailed the SDI affecting tobacco use separately in men and women to guide public health policies for targeted intervention of tobacco consumption.

PMID:33887600 | DOI:10.1016/j.puhe.2021.03.001

J Biomech. 2021 Apr 11;121:110432. doi: 10.1016/j.jbiomech.2021.110432. Online ahead of print.

ABSTRACT

The purpose of this study was to examine the association of breast cancer-related lymphedema on shoulder girdle kinematics and upper extremity function. The study included 67 breast cancer survivors with and without unilateral lymphedema. Individuals were divided into non-lymphedema, moderate and severe lymphedema groups according to the volumetric measurement difference between the affected and unaffected upper extremities. A three-dimensional motion monitor-electromagnetic system was used to analyze scapular movements during the elevation and depression phases of the upper extremity elevation in the scapular plane. Shoulder range of motion was assessed with a digital inclinometer. Upper extremity function was assessed with the ‘Disabilities of the Arm, Shoulder, and Hand Questionnaire-Short Form (Quick-DASH)’. The scapular upward rotation was lower for the severe lymphedema group than for the non-lymphedema group in the 90-60-30° depression phases of arm elevation (p < .05). The scapular anterior tilt was higher for the severe lymphedema group than for the non-lymphedema group in the 30° depression phase of arm elevation (p < .05). Shoulder abduction range of motion was the lowest in the severe lymphedema group (p < .05). The non-lymphedema group had the lowest quick-DASH score and the severe lymphedema group had the highest score (p < .05). There were statistically significant moderate associations between the quick-DASH scores and scapular movements in all groups (p < .05). The development, presence and/or severity of lymphedema were associated with impaired shoulder-girdle kinematics and decreased upper extremity function. However, a need exists for longitudinal studies comparing individuals with and without lymphedema and healthy controls.

PMID:33887538 | DOI:10.1016/j.jbiomech.2021.110432