Tag: nevin manimala

JAMA Netw Open. 2022 May 2;5(5):e2210192. doi: 10.1001/jamanetworkopen.2022.10192.

ABSTRACT

IMPORTANCE: Residents of long-term care facilities (LTCFs) experience high hospitalization rates, yet little is known about the effects of transitional care interventions for these residents.

OBJECTIVE: To assess the association of transitional care interventions with readmission rates and other outcomes for residents of LTCFs who are 65 years and older and LTCF staff and to explore factors that potentially mitigate the association.

DATA SOURCES: MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature were searched for English-language studies published until July 21, 2021. Associated qualitative studies were identified using aspects of the CLUSTER (citations, lead authors, unpublished materials, searched Google Scholar, tracked theories, ancestry search for early examples, and follow-up of related projects) methodology.

STUDY SELECTION: Controlled design studies evaluating transitional care interventions for residents of LTCFs 65 years and older were included. Records were independently screened by 2 reviewers; disagreements were resolved through discussion and involvement of a third reviewer. From 14 538 records identified, 15 quantitative and 4 qualitative studies met the eligibility criteria.

DATA EXTRACTION AND SYNTHESIS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data were extracted by one reviewer and checked by a second reviewer. Fixed-effect and random-effects models were used according to the number of studies reporting the outcomes of interest.

MAIN OUTCOMES AND MEASURES: The primary outcome consisted of 30-, 60-, and 90-day readmission rates (hospital and emergency department [ED]). Other outcomes included length of stay, functional independence (Barthel score), and quality of life. The I2 statistic was used to quantify heterogeneity.

RESULTS: Of 14 538 records identified from searches, 15 quantitative studies (totaling 32 722 participants or records) and 4 qualitative studies were included. People allocated to transitional care interventions were 1.7 times less likely to be readmitted to the hospital or ED compared with those in control groups (14 studies; odds ratio, 1.66 [95% CI, 1.18-2.35]; I2 = 81% [95% CI, 70%-88%]). Length of stay in the ED was significantly decreased for intervention groups (3 studies; standardized mean difference, -3.00 [95% CI, -3.61 to -2.39]; I2 = 99% [95% CI, 98%-99%]). There were no significant differences for other outcomes. Factors associated with outcomes included communication and referral processes between health care professionals.

CONCLUSIONS AND RELEVANCE: Emerging evidence suggests that transitional care interventions are associated with lower readmissions for residents of LTCFs 65 years and older. Despite this and with aging populations, investment in such interventions has been remarkably low across most countries.

PMID:35507344 | DOI:10.1001/jamanetworkopen.2022.10192

JAMA Netw Open. 2022 May 2;5(5):e2210450. doi: 10.1001/jamanetworkopen.2022.10450.

ABSTRACT

IMPORTANCE: Rotating night shift work is associated with higher mortality. Whether it is also associated with overall health among those who survive to older ages remains unclear.

OBJECTIVE: To examine whether rotating night shift work is associated with healthy aging after 24 years of follow-up in the Nurses’ Health Study, a cohort study among registered female nurses.

DESIGN, SETTING, AND PARTICIPANTS: For this cohort study, a composite healthy aging phenotype was ascertained among 46 318 participants who were aged 46 to 68 years and free of major chronic diseases in 1988 when the history of night shift work was assessed. In a secondary analysis in which cognitive function decline was considered in the healthy aging definition, 14 273 nurses were involved. Data were analyzed from March 1 to September 30, 2021.

EXPOSURES: Duration of rotating night shift work.

MAIN OUTCOMES AND MEASURES: Healthy aging was defined as reaching at least 70 years of age and being free of 11 major chronic diseases, memory impairment, physical limitation, or deteriorated mental health.

RESULTS: Of 46 318 female nurses (mean [SD] age at baseline, 55.4 [6.1] years), 3695 (8.0%) achieved healthy aging after 24 years of follow-up. After adjusting for established and potential confounders, compared with women who never worked rotating night shifts, the odds of achieving healthy aging decreased significantly with increasing duration of night shift work. The odds ratios were 0.96 (95% CI, 0.89-1.03) for 1 to 5 years, 0.92 (95% CI, 0.79-1.07) for 6 to 9 years, and 0.79 (95% CI, 0.69-0.91) for 10 or more years of night shift work (P = .001 for trend). This association did not differ substantially by age and lifestyles and was consistent for 4 individual dimensions of healthy aging. Results were similar in a secondary analysis, with an odds ratio of 0.73 (95% CI, 0.60-0.89; P < .001 for trend) comparing 10 or more years of night shift work vs no night shift work.

CONCLUSIONS AND RELEVANCE: In this cohort study, rotating night shift work was associated with decreased probability of healthy aging among US female nurses. These data support the notion that excess night shift work is a significant health concern that may also lead to deteriorated overall health among older individuals.

PMID:35507343 | DOI:10.1001/jamanetworkopen.2022.10450

Methods Mol Biol. 2022;2449:349-386. doi: 10.1007/978-1-0716-2095-3_15.

ABSTRACT

Since the advent of high-throughput omics technologies, various molecular data such as genes, transcripts, proteins, and metabolites have been made widely available to researchers. This has afforded clinicians, bioinformaticians, statisticians, and data scientists the opportunity to apply their innovations in feature mining and predictive modeling to a rich data resource to develop a wide range of generalizable prediction models. What has become apparent over the last 10 years is that researchers have adopted deep neural networks (or “deep nets”) as their preferred paradigm of choice for complex data modeling due to the superiority of performance over more traditional statistical machine learning approaches, such as support vector machines. A key stumbling block, however, is that deep nets inherently lack transparency and are considered to be a “black box” approach. This naturally makes it very difficult for clinicians and other stakeholders to trust their deep learning models even though the model predictions appear to be highly accurate. In this chapter, we therefore provide a detailed summary of the deep net architectures typically used in omics research, together with a comprehensive summary of the notable “deep feature mining” techniques researchers have applied to open up this black box and provide some insights into the salient input features and why these models behave as they do. We group these techniques into the following three categories: (a) hidden layer visualization and interpretation; (b) input feature importance and impact evaluation; and (c) output layer gradient analysis. While we find that omics researchers have made some considerable gains in opening up the black box through interpretation of the hidden layer weights and node activations to identify salient input features, we highlight other approaches for omics researchers, such as employing deconvolutional network-based approaches and development of bespoke attribute impact measures to enable researchers to better understand the relationships between the input data and hidden layer representations formed and thus the output behavior of their deep nets.

PMID:35507271 | DOI:10.1007/978-1-0716-2095-3_15

J Am Chem Soc. 2022 May 4. doi: 10.1021/jacs.2c02456. Online ahead of print.

ABSTRACT

This manuscript introduces geometry as a means to program the tile-based DNA self-assembly in two and three dimensions. This strategy complements the sequence-focused programmable assembly. DNA crystal assembly critically relies on intermotif, sticky-end cohesion, which requires complementarity not only in sequence but also in geometry. For DNA motifs to assemble into crystals, they must be associated with each other in the proper geometry and orientation to ensure that geometric hindrance does not prevent sticky ends from associating. For DNA motifs with exactly the same pair of sticky-end sequences, by adjusting the length (thus, helical twisting phase) of the motif branches, it is possible to program the assembly of these distinct motifs to either mix with one another, to self-sort and consequently separate from one another, or to be alternatingly arranged. We demonstrate the ability to program homogeneous crystals, DNA “alloy” crystals, and definable grain boundaries through self-assembly. We believe that the integration of this strategy and conventional sequence-focused assembly strategy could further expand the programming versatility of DNA self-assembly.

PMID:35507317 | DOI:10.1021/jacs.2c02456

Methods Mol Biol. 2022;2449:263-280. doi: 10.1007/978-1-0716-2095-3_11.

ABSTRACT

The multilevel organization of nature is self-evident: proteins do interact among them to give rise to an organized metabolism and the same hierarchical organization is in action for gene expression, tissue and organ architectures, and ecological systems.The still more common approach to such state of affairs is to think that causally relevant events originate from the lower level in the form of perturbations, that climb up the hierarchy reaching the ultimate layer of macroscopic behavior (e.g., causing a specific disease). Such rigid bottom-up causative model is unable to offer realistic models of many biological phenomena.Complex network approach allows to uncover the nature of multilevel organization, but in order to operationally define the organization principles of biological systems, we need to go further and complement network approach with sensible measures of order and organization. These measures, while keeping their original physical meaning, must not impose theoretical premises not verifiable in biological frameworks. We will show here how relatively simple and largely hypothesis-free multidimensional statistics tools can satisfactorily meet these criteria.

PMID:35507267 | DOI:10.1007/978-1-0716-2095-3_11

J Ultrasound. 2022 May 4. doi: 10.1007/s40477-022-00674-3. Online ahead of print.

ABSTRACT

AIMS: lymphadenopathy can occur after COVID-19 vaccination and when encountered at ultrasound examinations performed for other reasons might pose a diagnostic challenge. Purpose of the study was to evaluate the incidence, course and ultrasound imaging features of vaccine-induced lymphadenopathy.

METHODS: 89 healthy volunteers (median age 30, 76 females) were prospectively enrolled. Vaccine-related clinical side effects (e.g., fever, fatigue, palpable or painful lymphadenopathy) were recorded. Participants underwent bilateral axillary, supraclavicular and cervical lymph node stations ultrasound 1-4 weeks after the second dose and then again after 4-12 weeks in those who showed lymphadenopathy at the first ultrasound. B-mode, color-Doppler assessment, and shear-wave elastography (SWE) evaluation were performed. The correlation between lymphadenopathy and vaccine-related side effects was assessed using the Fisher’s exact test.

RESULTS: Post-vaccine lymphadenopathy were found in 69/89 (78%) participants (37 single and 32 multiple lymphadenopathy). Among them, 60 presented vaccine-related side effects, but no statistically significant difference was observed between post-vaccine side effect and lymphadenopathy. Ultrasound features of vaccine-related lymphadenopathy consisted of absence of fatty hilum, round shape and diffuse or asymmetric cortical thickness (median cortical thickness of 5 mm). Vascular signal was mainly found to be increased, localized in both central and peripheral regions. SWE showed a soft cortical consistence in all cases (median value 11 Kpa). At follow-up, lymph-node morphology was completely restored in most cases (54/69, 78%) and in no case lymphadenopathy had worsened.

CONCLUSION: A high incidence of vaccine-induced lymphadenopathy was found in a population of healthy subjects, with nearly complete regression within 4-12 weeks.

PMID:35507248 | DOI:10.1007/s40477-022-00674-3

Ann Biomed Eng. 2022 May 4. doi: 10.1007/s10439-022-02974-5. Online ahead of print.

ABSTRACT

The relationship between head impact and subsequent brain injury for American football players is not well-defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multi-season study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9-14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs 61.9; 95th percentile PLA practice: 42.6 vs 58.8; 95th percentile peak rotational acceleration (PRA, rad·s^-2) competition: 2262 vs 4422; 95th percentile PRA practice: 2081 vs 4052; 95th percentile HITsp competition: 25.4 vs 32.8; 95th percentile HITsp practice: 23.9 vs 30.2). Impacts during competition were more frequent and of greater magnitude than during practice at both levels. Quantified comparisons of head impact frequency and magnitude between youth and collegiate athletes reveal HIE differences as a function of age, and expanded insight better informs the development of age-appropriate guidelines for helmet design, prevention measures, standardized testing, brain injury diagnosis, and recovery management.

PMID:35507229 | DOI:10.1007/s10439-022-02974-5

Environ Sci Pollut Res Int. 2022 May 4. doi: 10.1007/s11356-022-20460-2. Online ahead of print.

ABSTRACT

The focus of this study is to evaluate the influence of intertropical discontinuity (ITD) on the variation of total column ozone (TCO). Relevant information is supplied on the temporal and spatial variability of TCO along the ITD zone, which is an important factor influencing the earth’s atmosphere. Several studies over the years have established the relationship and have influence several atmospheric processes on TCO. However, the relationship between intertropical discontinuity and TCO over West Africa has a gap. This study tends to examine the influence ITD has on TCO variation using the West African region as a case study. The study used wind, ozone, and dewpoint temperature data for the period between 1980 and 2019. To assess the variability and trend over the study region, several statistical methods were used, including Pearson correlation, Mann-Kendall, and linear regression model. The Mann-Kendall test shows an increasing trend throughout the months over the study region. Spatial analysis also revealed that regions north of the ITD have a higher concentration of TCO than the southern region of the ITD between April and September. However, ITD influence was more visible during the wet months of June to August (JJA) as the highest concentration of TCO was observed during this period across all latitude, but more deviation was observed between latitude 10 to 18° N, while the least occurrence is observed when ITD is at its minimum position in the month of December to February (DJF). The ACRV shows that 14° N exhibit the highest variation with a value of 4.84, while the deviation is also at its highest with value of 13.65. The monthly position of ITD for 40 years was also analysed to observe the monthly deviation along the ITD region 40 years, and the spatial distribution of TCO was analysed from January to December. It is of note that during the cause of this study, low-ozone values of 220DU are not found in the study region. The highest and the lowest value of TCO is 295 DU and 227 DU, respectively, with an average range of 68DU.

PMID:35507220 | DOI:10.1007/s11356-022-20460-2

Environ Sci Pollut Res Int. 2022 May 4. doi: 10.1007/s11356-022-20363-2. Online ahead of print.

ABSTRACT

The genotoxicity of biogenic silver nanoparticles (AgNPs) obtained from three microbial mediators was assessed using the Allium cepa assay. Three clusters were differentiated for the highest frequency of end points of clastogenicity (stick-ends, fragments and bridges), end points of missegregation (C-metaphases and disorder anaphases), and lowest frequency of all the end points. In these clusters, the treatments were grouped respectively as I) positive control (GSF); II) silver nanoparticles form Aspergillus niger (AgNPs-An); and III) silver nanoparticles from both Cryptococcus laurentii (AgNPs-Cl) and Rhodotorula glutinis (AgNPs-Rg), Ag + , and negative control (NC). These results were in according to the principal component analisys (PCA) where treatments were associated to each component of the genotoxic effects. The statistical comparative analysis of the mitotic index (IM) and the abnormal mitosis frequency (AM) indicated that both GSF and AgNPsAn induce significant genotoxic effect. Low genotoxic effects were attributed to AgNPs-Cl and AgNPs-Rg, but mitogenic stimuli, similar to that obtained by the silver ions Ag + , were observed. Results suggested that different features of biogenic nanoparticles such as composition, size, and coating may be involved in the different cytological responses of the meristematic cells.

PMID:35507223 | DOI:10.1007/s11356-022-20363-2

Biol Trace Elem Res. 2022 May 4. doi: 10.1007/s12011-022-03196-5. Online ahead of print.

ABSTRACT

The traceability of different cultivation modes is critical for ensuring the commercial viability of high-value Dendrobium officinale. In this study, by means of polarizing microscopy, SEM-EDX, ICP-MS and ICP-AES, the possibility of combining microscopic characteristics, multielemental analysis and multivariate statistical authenticity analysis was realized to determine the origins of the fresh stem and dried stem powder of D. officinale derived from three different cultivation modes from six provinces of China. The microscopic structure, chemical elements on the surface of the main microstructures and concentrations of Ca, K, Ba, Cs, As and Cu varied among specimens derived from different cultivation modes. The fresh stems of D. officinale derived from different cultivation modes can be effectively and quickly identified by various microscopic characteristics and different contents of Ca on the surface of the parenchyma, phloem and xylem. Meanwhile, linear discriminant analysis showed that 98.1% of the dried stem powder samples were correctly classified, and the accuracy of cross-validation was 95.3%. This study facilitated an effective integrated method for determining the traceability of the fresh stem and dried stem powder of D. officinale derived from three different cultivation modes. This approach offers a potential method for identifying the origins of medicinal plants derived from different cultivation modes.

PMID:35507137 | DOI:10.1007/s12011-022-03196-5