Tag: nevin manimala

Acta Anaesthesiol Scand. 2021 Apr 18. doi: 10.1111/aas.13832. Online ahead of print.

ABSTRACT

BACKGROUND: Life-sustaining treatment limitation (LSTL) on the intensive care unit (ICU) may affect the rate of organ donation after brain death (DBD). The primary aim of this study was to examine whether there is a relationship between LSTL and DBD. Furthermore, we aimed to determine the rate of LSTL involved in ICU deaths, and to describe technical and procedural characteristics of LSTL on Swedish ICUs.

METHODS: This was an observational cohort study on all ICU deaths (n=13,156) in Sweden between 2014 and 2017. We analysed differences in DBD rates between deaths in ICU with and those without LSTL, using descriptive statistics and logistic regression.

RESULTS: After excluding 1084 deaths on specialised ICUs and units not registering goals of treatment, the study population comprised 12,072 deaths including 615 DBDs, of which 7865 had LSTL, 1706 had no LSTL, and 2501 had no stated goals of treatment. The final cohort on which the relationship between DBD and LSTL was analysed comprised 9571 deaths including 419 DBDs. When no LSTL was documented, the rate of organ donation was 9.5 % compared to 3.3 % when LSTL was documented (P<0.001). LSTL was associated with a lower DBD rate after adjusting for patient- and ICU-related factors (OR 0.41, 95% CI 0.31-0.53, P <0.001).

CONCLUSION: There was an inverse relationship between LSTL and DBD among patients who died on the ICU. This relationship remained after adjusting for factors known to influence organ donation. The reason remains to be determined.

PMID:33866543 | DOI:10.1111/aas.13832

J Surg Oncol. 2021 Apr 18. doi: 10.1002/jso.26499. Online ahead of print.

ABSTRACT

BACKGROUND: Patients undergoing an orthopedic surgery for bone or soft tissue sarcoma are at increased venous thromboembolism (VTE) risk. Unfortunately, there is a lack of thromboprophylaxis guidelines in this population. The purpose of this systematic review was to determine the soft tissue and bone sarcoma VTE rate and to explore the thromboprophylaxis regimens used.

METHODS: The databases MEDLINE, EMBASE, and CENTRAL were queried using keywords related to VTE and long bone malignancy requiring surgical intervention to 2020. Included studied reported VTE rate in patients with surgically managed extremity sarcoma. Descriptive statistics and weighted mean totals were calculated.

RESULTS: A total of 2082 studies were screened and 23 studies were included. The overall VTE rate was 2.9%, with a rate of 3.7% and 1.4% in patients with bone and soft tissue sarcomas, respectively. Low-molecular-weight heparin was the most commonly used chemoprophylaxis.

CONCLUSIONS: There is a high VTE rate following sarcoma surgery. The VTE rate is higher in bone sarcoma surgery, which may be attributed to differences in surgery and postoperative recovery. There was no consensus on the duration or type of thromboprophylaxis used. Future research is needed to determine the most effective thromboprophylaxis regimen in patients with sarcoma and whether individualized thromboprophylaxis is required.

PMID:33866561 | DOI:10.1002/jso.26499

J Pers. 2021 Apr 18. doi: 10.1111/jopy.12639. Online ahead of print.

ABSTRACT

INTRO: Need for Cognition (NFC) refers to a personality trait describing the relatively stable intrinsic motivation of individuals to invest cognitive effort in cognitive endeavors. Higher NFC is associated with a more elaborated, central information processing style and increased recruitment of resources in cognitively demanding situations. To further clarify the association between cognitive resources and NFC, we examined in two studies how NFC relates to executive functions as basic cognitive abilities.

METHODS: In Study 1, 189 healthy young adults completed a NFC scale and a battery of six commonly used inhibitory control tasks (Stroop, antisaccade, stop-signal, flanker, shape-matching, word-naming). In Study 2, 102 healthy young adults completed the NFC scale and two tasks for each of the three executive functions inhibitory control (go-nogo, stop-signal), shifting (number-letter, color-shape) and working memory updating (two-back, letter-memory).

RESULTS: Using a Bayesian approach to correlation analysis, we found no conclusive evidence that NFC was related to any executive function measure. Instead, we obtained even moderate evidence for the null hypothesis.

CONCLUSION: Both studies add to more recent findings that shape the understanding of NFC as a trait that is less characterized by increased cognitive control abilities but rather by increased willingness to invest effort and exert self-control via motivational processes.

PMID:33866562 | DOI:10.1111/jopy.12639

J Autism Dev Disord. 2021 Apr 18. doi: 10.1007/s10803-021-04990-1. Online ahead of print.

ABSTRACT

Commemorating the 40 th anniversary of the Diagnostic and Statistical Manual (DSM) III, the purpose of this commentary is to describe school-based and school-relevant interventions and instructional approaches for children and youth with autism that have been developed and employed during that time period. The commentary begins with a brief description of foundational research that provides an historical context. Research themes shaped by science, ethics, social policy, and the changes in the DSM provide an organization for describing the evolution of intervention and instructional practices over the four previous decades. The commentary concludes with a discussion of school-contextual variables that influence implementation and the promise of the “iSciences” for closing the research to practice gap in the future.

PMID:33866461 | DOI:10.1007/s10803-021-04990-1

Hepatol Int. 2021 Apr 17. doi: 10.1007/s12072-021-10180-z. Online ahead of print.

ABSTRACT

BACKGROUND: Human fascioliasis, caused by the liver flukes F. hepatica, and F. gigantica, is a neglected tropical disease that causes health problems in many regions of the world. This disease can be classified as either acute or chronic based depending on the clinical manifestations and laboratory findings.

METHODS: We retrospectively reviewed the demographic data, clinical features, radiologic manifestations, and the response to specific treatment of patients diagnosed with hepatic fascioliasis as well as fasciola liver abscess in Thailand.

RESULTS: A total of 175 patients were included in the study, 126 patients were females (72%), while the mean age was 47.8 years (16-84 years). The most common symptoms were abdominal pain (74.9%), weight loss (29.1%) and fever (28%). Peripheral eosinophilia was observed in 92% of patients. The typical radiologic findings discovered conglomerated hypodensity which are rim-enhancing lesions located in the subcapsular and peripheral region of the liver. Most of patients were improved after a single dose of triclabendazole treatment. Adding antibiotic had no statistical impact on treatment outcome (p = 0.78).

CONCLUSIONS: Human fascioliasis presents with a wide clinical spectrum; therefore, a high index of suspicion is required to establish a correct diagnosis. Clinicians need to be aware of hepatic fascioliasis when patients in such endemic areas present as hypereosinophilia and typical liver imaging. Prompt specific treatments will contribute towards a satisfactory outcome in patients.

PMID:33866512 | DOI:10.1007/s12072-021-10180-z

Adv Ther. 2021 Apr 17. doi: 10.1007/s12325-021-01657-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Substantial unmet needs exist among patients with metastatic renal cell carcinoma (mRCC). This retrospective study evaluated treatment patterns as well as clinical and economic outcomes associated with first-line monotherapy among patients with mRCC in the USA.

METHODS: Newly diagnosed patients with mRCC initiating at least one first-line therapy (1L) from 1 October 2013 to 31 March 2018 (index date = 1L start date) were identified from the US Veterans Health Administration database. Treatment patterns, clinical outcomes (time to next treatment [TNT] defined by earliest of switch to non-index therapy or re-initiation of index therapy after a more than 90-day gap, time to treatment discontinuation [TTD], overall survival [OS]), and costs were evaluated among patients treated with tyrosine kinase inhibitors (TKI), mammalian target of rapamycin inhibitors (mTOR), immune checkpoint inhibitors (ICI), and other monotherapies. Standard descriptive statistics were presented. The Kaplan-Meier method was used to evaluate clinical outcomes.

RESULTS: Of 759 patients (median age 68.0 years), 85.0%, 8.0%, 4.3%, and 2.6% were treated with TKI, mTOR, ICI, or other therapy in 1L, respectively. Advancement rates (to second-line [2L] therapy) ranged from 10.0 (ICI) to 45.1 per 100 person years (TKI). The 12-month OS rates ranged from 47.4% (TKI) to 67.7% (mTOR). The median TNT ranged from 3.8 (mTOR) to 9.6 months (ICI), and median TTD ranged from 2.3 (mTOR) to 4.7 months (TKI). Total all-cause mean costs per patient per month ranged from $12,466 (mTOR) to $19,812 (ICI).

CONCLUSION: These results indicate high unmet medical needs among patients with mRCC treated with 1L monotherapies. Novel combination therapies (e.g., ICI + ICI, ICI + TKI) may improve front-line outcomes for patients with poor prognoses.

PMID:33866526 | DOI:10.1007/s12325-021-01657-2

Oral Maxillofac Surg. 2021 Apr 17. doi: 10.1007/s10006-021-00962-y. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Oral submucous fibrosis is a scourge of Southeastern Asia since a long time resulting in significant health and social problems. Mainstay of the treatment is concentrated on attempts to improve mouth opening and relieve the symptoms by medicinal or surgical means. In moderate to severe cases, release of fibrous bands is advocated followed by placement of graft. The present study was conducted to evaluate the use of collagen-silicone bilayer membrane as a mucosal substitute in its management.

METHODOLOGY: Study consisted of 12 clinically and histologically proven cases of OSMF. After the incision and release of fibrous bands, a collagen membrane was placed and secured over the raw area by placement of a silicone sheet of adequate thickness. Parameters were assessed pre-operatively, intra-operatively, and post-operatively at 1 week, 1 month, and 3 months. The data was recorded and statistical analysis was done.

RESULTS: Pre-operatively, the mean values of inter-incisal opening, cheek flexibility, and width of oral commissure were 16.92, 24.58, and 53.17 mm respectively whereas at 3 months post-operatively, it was 27.67, 26.58, and 55.00 mm, which was statistically significant. No incidence of infection was noted.

CONCLUSION: The study concludes that the use of collagen membrane along with silicone sheet can be an alternative to other graft materials in context of reduced donor site morbidity as well as significant increase in inter-incisal opening. However, study with more sample size is needed to assess the long-term efficiency and surgical outcome of this material.

PMID:33866454 | DOI:10.1007/s10006-021-00962-y

Eur Phys J E Soft Matter. 2021 Apr 18;44(4):54. doi: 10.1140/epje/s10189-021-00070-5.

ABSTRACT

We investigate the standard deviation [Formula: see text] of the variance [Formula: see text] of time series [Formula: see text] measured over a finite sampling time [Formula: see text] focusing on non-ergodic systems where independent “configurations” c get trapped in meta-basins of a generalized phase space. It is thus relevant in which order averages over the configurations c and over time series k of a configuration c are performed. Three variances of [Formula: see text] must be distinguished: the total variance [Formula: see text] and its contributions [Formula: see text], the typical internal variance within the meta-basins, and [Formula: see text], characterizing the dispersion between the different basins. We discuss simplifications for physical systems where the stochastic variable x(t) is due to a density field averaged over a large system volume V. The relations are illustrated for the shear-stress fluctuations in quenched elastic networks and low-temperature glasses formed by polydisperse particles and free-standing polymer films. The different statistics of [Formula: see text] and [Formula: see text] are manifested by their different system-size dependences.

PMID:33866449 | DOI:10.1140/epje/s10189-021-00070-5

Abdom Radiol (NY). 2021 Apr 18. doi: 10.1007/s00261-021-03068-x. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to analyze the change of quantitative intra-tumoral metabolic heterogeneity consisting of texture features and conventional metabolic parameters of pancreatic cancer (PC) in dual-time 2-deoxy-2(¹⁸F) fluoro-D-glucose (¹⁸F-FDG) positron emission tomography-computed tomography (PET/CT).

METHODS: A retrospective analysis was conducted considering the texture features and conventional metabolic parameters in dual-time ¹⁸F-FDG PET/CT scans of PC patients. Features were extracted based on spatial distribution of ¹⁸F-FDG uptake in image. Firstly, the texture features and the conventional metabolic parameters of the delayed scan were both compared with that of the early scan. Statistically different data was defined among them. Secondly, the study evaluated the correlations between retention index (RI) of the texture features and the conventional metabolic parameters. Finally, the variation of texture features in dual-time PET/CT of resectable PC patients and unresectable PC patients was calculated separately.

RESULTS: In total, 183 PC patients were analyzed retrospectively in this research. The conventional metabolic parameters were all statistically different between the early and delayed scans except for metabolic tumor volume (MTV). In the radiomics, there were 59 textural features. Nineteen of 59 texture features were statistically different between the early and delayed scans. Features that were more than 10% different during two scans were observed in a substantial percentage of patients. Weak correlations were only found between MTV, TLG (Total lesion glycolysis), SUVpeak and the RI of some texture features in early or delayed scans. There were obviously fewer features with significant difference in resectable PC group than in unresectable PC group. Most features showing the difference in unresectable group while no significant difference in resectable group.

CONCLUSIONS: This study investigated the change and inner correlations of quantitative tumoral metabolic heterogeneity in the dual-time ¹⁸F-FDG-PET/CT scan of PC patients. Some features displayed the difference between dual-time scans. Conventional metabolic parameters were weakly related to the change of texture feature. The change of texture feature in resectable PC group was different from that in unresectable PC group. This result is potential to provide more information for the image evaluation of PC.

PMID:33866381 | DOI:10.1007/s00261-021-03068-x

Rev Environ Contam Toxicol. 2021 Apr 19. doi: 10.1007/398_2020_58. Online ahead of print.

ABSTRACT

Health risks at population level may be investigated with different types of environmental studies depending on access to data and funds. Options include ecological studies, case-control studies with individual interviews and human sample analysis, risk assessment or cohort studies. Most public health projects use data and methodologies already available due to the cost of ad-hoc data collection. The aim of the article is to perform a literature review of environmental exposure and health outcomes with main focus on methodologies for assessing an association between water and/or soil pollutants and cancer. A systematic literature search was performed in May 2019 using PubMed. Articles were assessed by four independent reviewers. Forty articles were identified and divided into four groups, according to the data and methods they used, i.e.: (1) regression models with data by geographical area; (2) regression models with data at individual level; (3) exposure intensity threshold values for evaluating health outcome trends; (4) analyses of distance between source of pollutant and health outcome clusters. The issue of exposure assessment has been investigated for over 40 years and the most important innovations regard technologies developed to measure pollutants, statistical methodologies to assess exposure, and software development. Thanks to these changes, it has been possible to develop and apply geo-coding and statistical methods to reduce the ecological bias when considering the relationship between humans, geographic areas, pollutants, and health outcomes. The results of the present review may contribute to optimize the use of public health resources.

PMID:33866420 | DOI:10.1007/398_2020_58