Tag: nevin manimala

J Infect Dis. 2021 Apr 15:jiab205. doi: 10.1093/infdis/jiab205. Online ahead of print.

ABSTRACT

BACKGROUND: Respiratory viral infections are common and potentially devastating to patients with underlying lung disease. Diagnosing viral infections often requires invasive sampling, and interpretation often requires specialized laboratory equipment. Here, we test the hypothesis that a breath test could diagnose influenza and rhinovirus infections using an in vitro model of the human airway.

METHODS: Cultured primary human tracheobronchial epithelial cells were infected with either Influenza A H1N1 or Rhinovirus 1B and compared with healthy control cells. Headspace volatile metabolite measurements of cell cultures were made at 12 h timepoints post-infection using a thermal desorption-gas chromatography-mass spectrometry method.

RESULTS: Based on 54 compounds, statistical models distinguished VOC profiles of influenza- and rhinovirus-infected cells from healthy counterparts. Area under the curve values were 0.94 for influenza, 0.90 for rhinovirus, and 0.75 for controls. A regression analysis predicted how many hours prior cells became infected with a root mean square error of 6.35 h for influenza- and 3.32 h for rhinovirus-infected cells.

CONCLUSIONS: Volatile biomarkers released by bronchial epithelial cells could not only be used to diagnose whether cells were infected, but also the timing of infection. Our model supports the hypothesis that a breath test could serve to diagnose viral infections.

PMID:33858010 | DOI:10.1093/infdis/jiab205

Anaesthesia. 2021 Apr 15. doi: 10.1111/anae.15481. Online ahead of print.

NO ABSTRACT

PMID:33858027 | DOI:10.1111/anae.15481

Menopause. 2021 Apr 12. doi: 10.1097/GME.0000000000001774. Online ahead of print.

ABSTRACT

OBJECTIVE: To predict the age at natural menopause (ANM).

METHODS: Cox models with time-dependent covariates were utilized for ANM prediction using longitudinal data from 47 to 55-year-old women (n = 279) participating in the Estrogenic Regulation of Muscle Apoptosis study. The ANM was assessed retrospectively for 105 women using bleeding diaries. The predictors were chosen from the set of 32 covariates by using the lasso regression (model 1). Another easy-to-access model (model 2) was created by using a subset of 16 self-reported covariates. The predictive performance was quantified with c-indices and by studying the means and standard deviations of absolute errors (MAE ± SD) between the predicted and observed ANM.

RESULTS: Both models included alcohol consumption, vasomotor symptoms, self-reported physical activity, and relationship status as predictors. Model 1 also included estradiol and follicle-stimulating hormone levels as well as SD of menstrual cycle length, while model 2 included smoking, education, and the use of hormonal contraception as additional predictors. The mean c-indices of 0.76 (95% CI 0.71-0.81) for model 1 and 0.70 (95% CI 0.65-0.75) for model 2 indicated good concordance between the predicted and observed values. MAEs of 0.56 ± 0.49 and 0.62 ± 0.54 years respectively for model 1 and 2 were clearly smaller than the MAE for predicted sample mean (1.58 ± 1.02).

CONCLUSIONS: In addition to sex hormone levels, irregularity of menstrual cycle, and menopausal symptoms, also life habits and socioeconomic factors may provide useful information for ANM prediction. The suggested approach could add value for clinicians’ decision making related to the use of contraception and treatments for menopausal symptoms in perimenopausal women.

Video Summary:http://links.lww.com/MENO/A743.

PMID:33857956 | DOI:10.1097/GME.0000000000001774

J Nerv Ment Dis. 2021 Apr 15. doi: 10.1097/NMD.0000000000001348. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with psychiatric disorders (as well as general medical conditions) often describe their lives in terms of suffering. Although suffering is honored as a central focus of physicians’ concerns, it is not even indexed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Generally connoting severe, prolonged distress, suffering can be distinguished from pain, depression, and anxiety. The aims of this article are to consider whether attending to suffering per se in psychiatric patients merits attention independent of other commonly assessed psychiatric symptoms such as anxiety, depression, and conventional distress, and how targeting suffering per se might add value to psychiatric patient care.

METHODS: Sources for this article were obtained via a selective literature search in PubMed using the terms “suffering” in the title and the terms “psychiatric disorder,” “mental illness,” “assessment,” “measurement,” “scale,” “existential suffering,” and “unbearable suffering.” Articles of interest were followed up using a snowball technique to examine “similar articles” and “cited by” titles to find additional pertinent articles.

RESULTS: Definitions of suffering in the medical literature stress its subjectivity, particularity, complexity, and connection to a wide variety of noxious sensations, as well as real and anticipated deficits, losses, and thwarted motivations. These can affect the entire spectrum of universal human needs, from basic biological issues through intrapsychic, interpersonal, and social issues, encompassing existential concerns of meaning, purpose, and transcendence. Based on these factors, a definition of suffering in patients with psychiatric disorders is proposed. Although efforts to measure suffering have been limited and numerous gaps in the literature are evident, several scales may offer suitable bases for the study of suffering in patients with psychiatric disorders.

CONCLUSIONS AND IMPLICATIONS: Ascertaining sources of suffering may require new types of inquiry and additional time. Well-described, evidence-informed strategies and time-honored psychotherapy techniques are available for addressing the numerous concerns that contribute to suffering. Patients with psychiatric disorders whose distinct, multidimensional sources of suffering are identified, acknowledged, and addressed may experience better treatment quality, greater treatment satisfaction, and possibly better outcomes than those whose clinicians’ attention is limited to conventional psychiatric signs and symptoms.

PMID:33857957 | DOI:10.1097/NMD.0000000000001348

Anesth Analg. 2021 May 1;132(5):1223-1230. doi: 10.1213/ANE.0000000000005446.

ABSTRACT

BACKGROUND: Sleep disorders affect up to 25% of the general population and are associated with increased risk of adverse perioperative events. The key sleep medicine topics that are most important for the practice of anesthesiology have not been well-defined. The objective of this study was to determine the high-priority sleep medicine topics that should be included in the education of anesthesia residents based on the insight of experts in the fields of anesthesia and sleep medicine.

METHODS: We conducted a prospective cross-sectional survey of experts in the fields of sleep medicine and anesthesia based on the Delphi technique to establish consensus on the sleep medicine topics that should be incorporated into anesthesia residency curricula. Consensus for inclusion of a topic was defined as >80% of all experts selecting “agree” or “strongly agree” on a 5-point Likert scale. Responses to the survey questions were analyzed with descriptive statistical methods and presented as percentages or weighted mean values with standard deviations (SD) for Likert scale data.

RESULTS: The topics that were found to have 100% agreement among experts were the influence of opioids and anesthetics on control of breathing and upper airway obstruction; potential interactions of wake-promoting/hypnotic medications with anesthetic agents; effects of sleep and anesthesia on upper airway patency; and anesthetic management of sleep apnea. Less than 80% agreement was found for topics on the anesthetic implications of other sleep disorders and future pathways in sleep medicine and anesthesia.

CONCLUSIONS: We identify key topics of sleep medicine that can be included in the future design of anesthesia residency training curricula.

PMID:33857964 | DOI:10.1213/ANE.0000000000005446

Rep Prog Phys. 2021 Apr 15. doi: 10.1088/1361-6633/abf893. Online ahead of print.

ABSTRACT

Charles Richter’s observation that “only fools and charlatans predict earthquakes,” reflects the fact that despite more than 100 years of effort, seismologists remain unable to do so with reliable and accurate results. Meaningful prediction involves specifying the location, time, and size of an earthquake before it occurs to greater precision than expected purely by chance from the known statistics of earthquakes in an area. In this context, “forecasting” implies a prediction with a specification of a probability of the time, location, and magnitude. Two general approaches have been used. In one, the rate of motion accumulating across faults and the amount of slip in past earthquakes is used to infer where and when future earthquakes will occur and the shaking that would be expected. Because the intervals between earthquakes are highly variable, these long-term forecasts are accurate to no better than a hundred years. They are thus valuable for earthquake hazard mitigation, given the long lives of structures, but have clear limitations. The second approach is to identify potentially observable changes in the earth that precede earthquakes. Various precursors have been suggested, and may have been real in certain cases, but none have yet proved to be a general feature preceding all earthquakes or to stand out convincingly from the normal variability of the earth’s behavior. However, new types of data, models, and computational power may provide avenues for progress using machine learning that were not previously available. At present, it is unclear whether deterministic earthquake prediction is possible. The frustrations of this search have led to the observation that (echoing Yogi Berra) “it is difficult to predict earthquakes, especially before they happen.” However, because success would be of enormous societal benefit, the search for methods of earthquake prediction and forecasting will likely continue.

PMID:33857928 | DOI:10.1088/1361-6633/abf893

Complement Med Res. 2021 Apr 15:1-10. doi: 10.1159/000516026. Online ahead of print.

ABSTRACT

INTRODUCTION: Individualized homeopathy (IH) in atopic dermatitis (AD) remained under-researched.

OBJECTIVE: We aimed at evaluating efficacy of IH in AD.

METHODS: A double-blind, randomized, placebo-controlled, short-term, preliminary trial was conducted in an Indian homeopathy hospital. Patients were randomized to either IH (n = 30) or identical-looking placebo (n = 30) using computerized randomization and allocation. Outcomes were patient-oriented scoring of AD (PO-SCORAD; primary end point), Dermatological Life Quality Index (DLQI) score, and AD burden score for adults (ADBSA; secondary end points), measured monthly for 3 months. An intention-to-treat sample was analyzed after adjusting baseline differences.

RESULTS: On PO-SCORAD, improvement was higher in IH against placebo, but nonsignificant statistically (pmonth 1 = 0.433, pmonth 2 = 0.442, pmonth 3 = 0.229). Secondary outcomes were also nonsignificant – both DLQI and ADBSA (p > 0.05). Four adverse events (diarrhea, injury, common cold) were recorded.

CONCLUSIONS: There was a small, but nonsignificant direction of effect towards homeopathy, which renders the trial inconclusive. A properly powered robust trial is indicated.

PMID:33857943 | DOI:10.1159/000516026

Urol Int. 2021 Apr 15:1-8. doi: 10.1159/000506652. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this article is to evaluate the efficacy and safety of prestenting (PS) versus non-PS (NPS) of flexible ureteroscopy (fURS) to treat large upper urinary stones.

METHODS: We conducted a systematic literature research of PubMed, Ovid, Scopus (up to August 2019), and citation lists to identify eligible studies. All studies comparing PS versus NPS of fURS were included. Data were analyzed using the Cochrane Collaboration’s Review Manager (RevMan) 5.3 software.

RESULTS: Overall, 7 studies including 3,145 patients (PS 1,408; NPS 1,737) were included in this article. PS group was associated with older age (weighted mean difference [WMD] 0.91 year; p < 0.001) and more male patients (odds ratio [OR] 1.34; p < 0.001). There were no statistical differences between PS and NPS in BMI (WMD 0.34 kg/m2; p = 0.13), stone size (WMD 0.13 mm; p = 0.77), and operative time (WMD 0.44 min; p = 0.86). Compared with NPS, PS showed better initial success rate (OR 4.04; p < 0.001) and higher SFR (OR 1.64; p < 0.001). There were no statistical differences for complications (OR 0.84; p = 0.42) and Clavien-Dindo score ≥3 complications (OR 1.04; p = 0.93).

CONCLUSION: PS could improve initial success rate and avoid secondary general anesthesia for first ureteral access sheath failed patients. PS could provide better SFR than NPS in the treatment of large upper urinary stones with fURS.

PMID:33857952 | DOI:10.1159/000506652

Epidemics. 2021 Mar 19;35:100457. doi: 10.1016/j.epidem.2021.100457. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had an unprecedented impact on citizens and health care systems globally. Valid near-term projections of cases are required to inform the escalation, maintenance and de-escalation of public health measures, and for short-term health care resource planning.

METHODS: Near-term case and epidemic growth rate projections for Canada were estimated using three phenomenological models: the logistic model, Generalized Richard’s model (GRM) and a modified Incidence Decay and Exponential Adjustment (m-IDEA) model. Throughout the COVID-19 epidemic in Canada, these models have been validated against official national epidemiological data on an ongoing basis.

RESULTS: The best-fit models estimated that the number of COVID-19 cases predicted to be reported in Canada as of April 1, 2020 and May 1, 2020 would be 11,156 (90 % prediction interval: 9,156-13,905) and 54,745 (90 % prediction interval: 54,252-55,239). The three models varied in their projections and their performance over the first seven weeks of their implementation. Both the logistic model and GRM under-predicted cases reported a week following the projection date in nearly all instances. The logistic model performed best at the early stages, the m-IDEA model performed best at the later stages, and the GRM performed most consistently during the full period assessed.

CONCLUSIONS: All three models have yielded qualitatively comparable near-term forecasts of cases and epidemic growth for Canada. Under or over-estimation of projected cases and epidemic growth by these models could be associated with changes in testing policies and/or public health measures. Simple forecasting models can be invaluable in projecting the changes in trajectory of subsequent waves of cases to provide timely information to support the pandemic response.

PMID:33857889 | DOI:10.1016/j.epidem.2021.100457

Water Res. 2021 Apr 5;197:117109. doi: 10.1016/j.watres.2021.117109. Online ahead of print.

ABSTRACT

Tracer tests represent a well-established method for delineating key environmental processes in various media and engineered systems. Tracers like Rhodamine B and WT are frequently applied due to their strong fluorescence even at low concentrations.. However, due to a lack of ecotoxicological data, limit values for these tracers cannot be determined. This study fills this critical data gap by providing ecotoxicity data for Rhodamine B and WT using a battery of short-term standardized tests, including growth rate inhibition tests with algae (Raphidocelis subcapitata) and lethality tests using crustaceans (Daphnia magna) and zebrafish (Danio rerio) embryos, and estimating EQS for surface water. For Rhodamine B, the effective and lethal concentration (EC₅₀ and LC₅₀) -causing 50% toxicity were in the range of 14-24 mg/L. For Rhodamine WT, no statistically significant effects were observed (p<0.05) at the tsted concentrations (up to 91, 100 and 200 mg/L for algae, crustaceans and fish embryos, respectively). Thus for all tested organisms, Rhodamine B was more toxic than Rhodamine WT (more than 14 times more toxic for R. subcapitata, 5.6 times for D. magna, 15 times for D. rerio embryos,based on EC₁₀ and LC₁₀ values). These results signify that read-across assessments using ecotoxicity data obtained with Rhodamine B is not advisable for estimating the ecotoxicity of Rhodamine WT. The annual-average quality standard (AA-QS) and maximum allowable concentration quality standard (MAC-QS) for Rhodamine B were found to be 14 and 140 µg/L, respectively. For Rhodamine WT, the corresponding values were estimated to >91 µg/L (AA-QS) and >910 µg/L (MAC-QS). Hence, concentrations below 140 µg/L or 910 µg/L for Rhodamine B and WT, respectively, are not expected to pose a risk to aquatic freshwater life in the case of intermittent discharges, e.g. tracer experiments released in streams.

PMID:33857893 | DOI:10.1016/j.watres.2021.117109