Tag: nevin manimala

Health Serv Res. 2021 Oct 4. doi: 10.1111/1475-6773.13886. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop a screening tool to identify emergency department (ED) patients at risk of entering a homeless shelter, which could inform targeting of interventions to prevent future homelessness episodes.

DATA SOURCES: Linked data from: 1) ED patient baseline questionnaires; and, 2) citywide administrative homeless shelter database.

STUDY DESIGN: Stakeholder-informed predictive modeling utilizing ED patient questionnaires linked with prospective shelter administrative data. The outcome was shelter entry documented in administrative data within 6 months following the baseline ED visit. Exposures were responses to questions on homelessness risk factors from baseline questionnaires.

DATA COLLECTION/EXTRACTION METHODS: Research assistants completed questionnaires with randomly sampled ED patients who were medically stable, not in police/prison custody, and spoke English or Spanish. Questionnaires were linked to administrative data using deterministic and probabilistic matching.

PRINCIPAL FINDINGS: Of 1,993 ED patients who were not homeless at baseline, 5.6% entered a shelter in the next 6 months. A screening tool consisting of two measures of past shelter use and one of past criminal justice involvement had 83.0% sensitivity and 20.4% positive predictive value for future shelter entry.

CONCLUSIONS: Our study demonstrates the potential of using cross-sector data to improve hospital initiatives to address patients’ social needs.

PMID:34608999 | DOI:10.1111/1475-6773.13886

J Clin Ultrasound. 2021 Oct 5. doi: 10.1002/jcu.23075. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effect of the Q-Box size on liver stiffness (LS) measurement by two-dimensional shear wave elastography (2D SWE).

METHODS: Ninety-eight patients with chronic liver disease were enrolled. Each patient was continuously measured five times. The Q-Box diameter was adjusted to 10, 20, and 30 mm each time. The liver stiffness values (LSVs) at different diameters were compared in the following groups: LSVs ≤6.2 kPa, 6.2 kPa < LSVs ≤11 kPa, LSVs >11 kPa. The reliability and repeatability of LS measurement at different diameters were evaluated.

RESULTS: The differences in LSVs at different Q-Box diameters were statistically significant only when LSV ≤6.2 kPa (p = 0.004). There were no statistically significant differences in standard deviation (SD), SD/median, coefficient of variation (CV), and interquartile range (IQR)/median at different Q-Box diameters (p > 0.05). There were statistical differences in minimum LSVs and percentage of minimum LSVs ≤0.2 kPa as well as in stability index (SI) and percentage of SI <90% at different Q-Box diameters (p < 0.05). The intraclass correlation coefficients (ICCs) were up to 0.98 at Q-Box diameters of 10, 20, and 30 mm.

CONCLUSIONS: Our study showed that Q-Box size may lead to significant differences in LSVs, especially when LSVs ≤6.2 kPa. The Q-Box size had a large effect on the reliability of a single LS measurement but did not affect the repeatability of multiple measurements.

PMID:34609006 | DOI:10.1002/jcu.23075

Evolution. 2021 Oct 5. doi: 10.1111/evo.14365. Online ahead of print.

ABSTRACT

The altricial-precocial spectrum describes patterns of variation in avian developmental mode that greatly influence avian life histories. Appraising a given species’ position on this spectrum is therefore fundamental to understanding patterns of avian life history evolution. However, evaluating avian developmental mode remains a relatively subjective task reliant on untested assumptions, including the notion that developmental strategies are distributed along a single dimension of statistical variation. Here, we present a quantitative multivariate framework that objectively discriminates among meaningfully different modes of avian development. We gathered information on seven hatchling and post-hatching traits for up to 4,000 extant bird species, and find that most traits related to developmental mode show high phylogenetic signal and little intraclade variation, allowing unknown values to be reliably interpolated. Principal component analyses (PCAs) of these traits illustrate that most variation in hatchling state can be quantified along one dimension of trait space. However, our PCAs also reveal an important second dimension explaining variation in post-hatching behavior, enabling factors related to hatchling state and post-hatching behavior to be disentangled. In order to facilitate future macroevolutionary studies of variation in avian developmental strategies, as well as explorations of covariation between developmental mode and other aspects of avian biology, we present PC scores for 9,993 extant avian species. This article is protected by copyright. All rights reserved.

PMID:34608994 | DOI:10.1111/evo.14365

Biometrics. 2021 Oct 5. doi: 10.1111/biom.13575. Online ahead of print.

ABSTRACT

We propose inference procedures for general factorial designs with time-to-event endpoints. Similar to additive Aalen models, null hypotheses are formulated in terms of cumulative hazards. Deviations are measured in terms of quadratic forms in Nelson-Aalen-type integrals. Different from existing approaches, this allows to work without restrictive model assumptions as proportional hazards. In particular, crossing survival or hazard curves can be detected without a significant loss of power. For a distribution-free application of the method, a permutation strategy is suggested. The resulting procedures’ asymptotic validity is proven and small sample performances are analyzed in extensive simulations. The analysis of a data set on asthma illustrates the applicability.

PMID:34608996 | DOI:10.1111/biom.13575

Neuro Oncol. 2021 Oct 5;23(Supplement_3):iii1-iii105. doi: 10.1093/neuonc/noab200.

ABSTRACT

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the CDC and NCI, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy and is the first CBTRUS Report to provide the distribution of molecular markers for selected brain and CNS tumor histologies. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.25 (Malignant AAAIR=7.06, Non-malignant AAAIR=17.18). This overall rate was higher in females compared to males (26.95 versus 21.35) and non-Hispanics compared to Hispanics (24.68 versus 22.12). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.3% of all tumors and 49.1% of malignant tumors), and the most common non-malignant tumor was meningioma (39% of all tumors and 54.5% of non-malignant tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.21. An estimated 88,190 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US population in 2021 (25,690 malignant and 62,500 non-malignant). There were 83,029 deaths attributed to malignant brain and other CNS tumors between 2014 and 2018. This represents an average annual mortality rate of 4.43 per 100,000 and an average of 16,606 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 66.9%, for a non-malignant brain and other CNS tumors the five-year relative survival rate was 92.1%.

PMID:34608945 | DOI:10.1093/neuonc/noab200

Folia Morphol (Warsz). 2021 Oct 5. doi: 10.5603/FM.a2021.0080. Online ahead of print.

ABSTRACT

BACKGROUND: Piriform aperture is anterior opening of the nasal cavity formed by bones of the viscerocranium and knowledge about differences between genders is important for forensic scientists, anthropologists, orthopedists, neurosurgeons and vascular surgeons. The aim of this study was to examine gender differences of piriform aperture on 3D models of human skulls originating from Bosnian population using the geometric morphometric method.

MATERIALS AND METHODS: The study was conducted on 211 3D models of human skulls of known gender. 3D models were obtained by laser scanning. We analyzed the gender differences of piriform aperture using geometric morphometrics method. On 3D models we marked four landmarks on piriform aperture in the Landmark editor program, after which we analyzed its gender differences in MorphoJ program.

RESULTS: The first PCA axis described 40.398% of total variability of piriform aperture. The greatest gender variability was present in the position of the landmark rhinion. Discriminant functional analysis of the shape and size of the piriform aperture allowed the gender determination with 64.03% accuracy for male and 70.83% accuracy for female gender. The size of the piriform aperture showed a statistically significant difference between genders. Discriminant functional analysis of the shape of the piriform aperture without affecting size enabled gender determination with 59.71% accuracy for male and 62.5% accuracy for female.

CONCLUSIONS: Analysis showed statistically significant differences in the shape and size of piriform aperture between genders. The accuracy for gender determination based on piriform aperture was higher in females.

PMID:34608986 | DOI:10.5603/FM.a2021.0080

Nat Commun. 2021 Oct 4;12(1):5793. doi: 10.1038/s41467-021-26036-x.

ABSTRACT

Household air pollution generated from the use of polluting cooking fuels and technologies is a major source of disease and environmental degradation in low- and middle-income countries. Using a novel modelling approach, we provide detailed global, regional and country estimates of the percentages and populations mainly using 6 fuel categories (electricity, gaseous fuels, kerosene, biomass, charcoal, coal) and overall polluting/clean fuel use – from 1990-2020 and with urban/rural disaggregation. Here we show that 53% of the global population mainly used polluting cooking fuels in 1990, dropping to 36% in 2020. In urban areas, gaseous fuels currently dominate, with a growing reliance on electricity; in rural populations, high levels of biomass use persist alongside increasing use of gaseous fuels. Future projections of observed trends suggest 31% will still mainly use polluting fuels in 2030, including over 1 billion people in Sub-Saharan African by 2025.

PMID:34608147 | DOI:10.1038/s41467-021-26036-x

Transplantation. 2021 Oct 4. doi: 10.1097/TP.0000000000003970. Online ahead of print.

ABSTRACT

BACKGROUND: International travel for transplantation remains a global issue as countries continue to struggle in establishing self-sufficiency. In the United States (US), the United Network for Organ Sharing (UNOS) requires citizenship classification at time of waitlisting to remain transparent and understand to whom our organs are allocated. This study provides an assessment of patients who travel internationally for liver transplantation, and their outcomes, using the current citizenship classification employed by UNOS.

METHODS: Adult liver UNOS data from 2003-2019 was utilized. Patients were identified as citizens, noncitizen, nonresidents (NCNR), or noncitizen residents (NC-R) according to citizenship status. Descriptive statistics compared demographics among the waitlisted patients and demographics and donor characteristics among transplant recipients. A competing risks model was used to examine waitlist outcomes. The Kaplan-Meier method and Cox proportional hazards were used for posttransplant outcomes.

RESULTS: There were significant demographic differences according to citizenship group among waitlisted (n=125 652) and transplanted (n=71 536) patients. Compared with US citizens, NCNR was associated with a 9% increase in transplant (Subdistribution Hazard Ration (SHR) 1.09, 95% CI 1.00-1.18, p=0.04), and NC-R was associated with a 24% decrease transplant (SHR 0.76, 95% CI 0.72-0.79, p<0.0001) and 23% increase in death or removal for too sick (SHR 1.23, 95% CI 1.14-1.33, p<0.0001). US citizens had significantly inferior graft and patient survival (p-values <0.001).

CONCLUSIONS: Though the purpose of the citizenship classification system is transparency, the results of this study highlight significant disparities in access to, and outcomes following, liver transplantation according to citizenship status.

PMID:34608102 | DOI:10.1097/TP.0000000000003970

Retina. 2021 Sep 23. doi: 10.1097/IAE.0000000000003309. Online ahead of print.

ABSTRACT

PURPOSE: To determine the relationship between macular microvascular abnormalities on optical coherence tomography angiography (OCT-A) and silent cerebral infarctions (SCI) on cerebral magnetic resonance imaging (MRI) in sickle cell disease (SCD).

METHODS: Patients (age < 18 years old) from our previous pediatric SCD study cohort who had prior OCT-A and brain MRI were identified. Brain MRI images were compared to macular OCT-A scans to identify macular vascular density differences between patients with SCI and without SCI.

RESULTS: 68 eyes from 34 patients who underwent OCT-A were evaluated, of whom 28 eyes from 14 patients met inclusion criteria for this study. Eight (57%) patients with SCI and 6 (43%) patients without SCI were identified. The mean age (17 years in SCI, 16.3 years in non-SCI) was comparable between groups. There was no statistically significant difference in systemic complications. Deep capillary plexus (DCP) vessel density was lower in the temporal quadrant in patients with SCI (49.3% vs 53.7%, P = 0.014).

CONCLUSION: Patients with SCI were found to have lower vessel density in the DCP compared to those without SCI. This finding suggests that DCP vessel density may have utility as an imaging biomarker to predict the presence of SCI.

PMID:34608107 | DOI:10.1097/IAE.0000000000003309

Dermatol Surg. 2021 Sep 30. doi: 10.1097/DSS.0000000000003238. Online ahead of print.

ABSTRACT

BACKGROUND: The perioral region is highly mobile and subject to multifactorial changes during aging. Resilient Hyaluronic Acid Redensity (RHAR), an RHA filler, was developed with the aim of optimizing outcomes in dynamic facial areas.

OBJECTIVE: This randomized, blinded, multicenter clinical study aimed to demonstrate superiority of RHAR over no-treatment control for correction of moderate-to-severe dynamic perioral rhytides.

MATERIALS AND METHODS: Blinded live evaluator assessments of efficacy included improvement in perioral rhytides severity using a proprietary scale (Perioral Rhytids Severity Rating Scale [PR-SRS]) and the Global Aesthetic Improvement Scale. Subjects self-assessed their results with FACE-Q, a validated patient-reported outcome measure, and satisfaction scales. Safety was monitored throughout the study based on common treatment responses (CTRs) and adverse events (AEs).

RESULTS: The primary efficacy end point was achieved, with the treatment group showing statistically significant superiority over the control group at Week 8 (80.7% vs 7.8% responder rate by PR-SRS, p < .0001). Most patients (66%) were still responders at Week 52 (study completion). Most AEs were CTRs after perioral injection of a dermal filler, and none was a clinically significant treatment-related AE.

CONCLUSION: Resilient Hyaluronic Acid Redensity is effective and safe for the correction of dynamic perioral rhytides in all Fitzpatrick phototypes, with marked durability.

PMID:34608092 | DOI:10.1097/DSS.0000000000003238