Tag: nevin manimala

Huan Jing Ke Xue. 2021 Aug 8;42(8):3695-3708. doi: 10.13227/j.hjkx.202012229.

ABSTRACT

To explore the isotopic distribution and differentiation of water along the hydraulic flow gradients and plant-bed/ditch systems in constructed root-channel wetlands, surface and subsurface water samples were collected from four ecological wetlands, namely Shijiuyang and Guanjinggang in Jiaxing, as well as Changshuitang and Taishangang in Haining. All samples were collected along water flow pathways during the wet and rainy summer season in August 2019, except for those from Taishangang, which were collected within the plant-bed/ditch system during the dry and cold winter season in January 2020. The abundance of deuterium (δD) and δ¹⁸ O was determined in each functional area of the wetlands to assess the influence of wetlands on water differentiation. Stable isotope technology and mathematical statistics were used to analyze the distribution of δD and δ¹⁸ O in constructed root-channel wetlands and to reveal the influence of plant-bed/ditch systems on stable isotopes of water. A variety of data mining methods were used to examine the differentiation of stable isotopes of water, at various dimensions and scales, including nonparametric Kendall’s tau-b correlation, stepwise regression, gray relational analysis, and machine learning (random forest) combined with scatter diagrams and model hypothesis diagnosis analysis. The main results were as follows:① The spatiotemporal variations in water isotopes of stream networks were largely affected by different water supply and evaporation enrichment effects. The slope and intercept of the wetland water line in Jiaxing were both significantly lower than the regional precipitation line of the adjacent Changshu Station (CHNIP). This showed that the wetlands area had undergone hydrogen and oxygen isotope enrichment. The δD values in Shijiuyang wetland water ranged from -52.2‰ to -49.4‰, and δ¹⁸ O values ranged from -7.6‰ to -6.9‰. In Guanjinggang wetland water samples, δD ranged from -48.1‰ to -45.1‰, and δ¹⁸ O ranged from -6.8‰ to -5.8‰. The δD values in Changshuitang wetland water ranged from -49.8‰ to -48.4‰, and δ¹⁸ O ranged from -7.2‰ to -6.6‰. The δD values in Taishangang wetland water ranged from -55.3‰ to -51.6‰, and δ¹⁸ O ranged from -7.8‰ to -7.2‰. ② Hydrogen and oxygen isotope abundance and composition of water showed complex nonlinear changes in the vertical and horizontal dimensions at different scales. At the regional scale, water level elevation in the vertical dimension had a greater impact on water isotope distribution than the length of the hydraulic flow pathway in the horizontal dimension. Water isotopes tended to be enriched in low-lying areas with low water levels. At the local scale, the influence of hydraulic process often played a greater role in determining water isotope distributions. The spatial variations of water isotopes were comprehensively determined by the evaporation of regional water and meandering hydraulic processes inside the wetland. ③ Compared with other wetland functional areas, the central constructed root-channel area (middle treatment zone) was more enriched in water isotopes. ④ The underground macropore network formed by plants with developed rhizomes or roots (e.g., Phragmites communis Trin. and Typha orientalis Presl), mineral-rich substrate soil, and aquatic plants in the plant bed had a significant influence on the abundance of hydrogen and oxygen isotopes in the plant-bed/ditch system. Therefore, when water passed through the plant-bed/ditch system, the values of δD and δ¹⁸ O in the lower ditch (outlet) were lower than those in the higher ditch (inlet). ⑤ The abrupt change in isotopic contents of the plant-bed/ditch system might indicate an inflection point in water quality purification. ⑥ The deuterium excess (d-excess) in subsurface water of the plant-bed/ditch system was significantly higher than that in ditch water, and the coefficient of variation in subsurface water was considerably greater than that in ditch water. The d-excess in the wetland root-channel ecological purification zone showed significant temporal differences and was negative in the summer and positive in the winter, which reflected the seasonal variation in water vapor sources and the spatial variation in isotope fractionation behavior in wetlands. These results provide some understanding of the distribution of water isotopes in constructed wetlands, which will strengthen their operation and management. This study also provides some ideas regarding new technologies for water quality improvement and shows that water isotope technology may be a reliable method for analyzing wetland hydrology.

PMID:34309256 | DOI:10.13227/j.hjkx.202012229

Mol Oncol. 2021 Jul 26. doi: 10.1002/1878-0261.13067. Online ahead of print.

ABSTRACT

We aimed to examine the associations of a genome-wide set of single-nucleotide polymorphisms (SNPs) and 254 copy number variations (CNVs) and/or insertion/deletions (INDELs) with clinical outcomes in colorectal cancer patients (n=505). We also aimed to investigate whether their associations changed (e.g. appeared, diminished) over time. Multivariable Cox proportional hazards and piece-wise Cox regression models were used to examine the associations. The Cancer Genome Atlas (TCGA) datasets were used for replication purposes and to examine the gene expression differences between tumor and non-tumor tissue samples. A common SNP (WBP11-rs7314075) was associated with disease-specific survival with p-value of 3.2×10^-8 . Association of this region with disease-specific survival was also detected in the TCGA patient cohort. Two expression quantitative trait loci (eQTLs) were identified in this locus that were implicated in the regulation of ERP27 expression. Interestingly, expression levels of ERP27 and WBP11 were significantly different between colorectal tumors and non-tumor tissues. Three SNPs predicted the risk of recurrent disease only after 5-years post-diagnosis. Overall, our study identified novel variants, one of which also showed an association in the TCGA dataset, but no CNVs/INDELs, that associated with outcomes in colorectal cancer. Three SNPs were candidate predictors of long-term recurrence/metastasis risk.

PMID:34309201 | DOI:10.1002/1878-0261.13067

Plant Genome. 2021 Jul 26:e20122. doi: 10.1002/tpg2.20122. Online ahead of print.

ABSTRACT

Deep learning (DL) is revolutionizing the development of artificial intelligence systems. For example, before 2015, humans were better than artificial machines at classifying images and solving many problems of computer vision (related to object localization and detection using images), but nowadays, artificial machines have surpassed the ability of humans in this specific task. This is just one example of how the application of these models has surpassed human abilities and the performance of other machine-learning algorithms. For this reason, DL models have been adopted for genomic selection (GS). In this article we provide insight about the power of DL in solving complex prediction tasks and how combining GS and DL models can accelerate the revolution provoked by GS methodology in plant breeding. Furthermore, we will mention some trends of DL methods, emphasizing some areas of opportunity to really exploit the DL methodology in GS; however, we are aware that considerable research is required to be able not only to use the existing DL in conjunction with GS, but to adapt and develop DL methods that take the peculiarities of breeding inputs and GS into consideration.

PMID:34309215 | DOI:10.1002/tpg2.20122

Oral Dis. 2021 Jul 26. doi: 10.1111/odi.13976. Online ahead of print.

ABSTRACT

BACKGROUND: Self-perceived oral health has been extensively investigated, but studies on homeless people are scarce, and there is currently no evidence from Latin America.

OBJECTIVE: To investigate the prevalence and factors associated with satisfaction with the oral health of homeless individuals in one Brazilian capital of the Midwest region.

SUBJECT AND METHODS: A cross-sectional study was carried out with 351 adult individuals attending a temporary public shelter who were interviewed about sociodemographic and psychosocial aspects, drugs use and oral health. The outcome was satisfaction with oral health (satisfied/dissatisfied). Pearson’s Chi-square test and Poisson regression with robust variance were used for statistical analysis.

RESULTS: The prevalence of dissatisfaction with oral health was 68.9% (95%CI= 63.9-73.6). After adjusting for covariates, dissatisfaction was more frequent among individuals who were married/in a stable relationship (PR= 1.18; 95%CI= 1.02-1.36), with felt need for treatment (PR= 2.27; 95%CI= 1.23-4.17) or complete prosthesis (PR= 1.35; 95%CI= 1.18-1.55); and those who used illicit drugs in the past six months (PR= 1.22; 95%CI = 1.06-1.39).

CONCLUSION: The prevalence of dissatisfaction with oral health in the homeless individuals studied was high and associated with their marital status, use of illicit drugs and self-reported need for dental treatment and complete prosthesis.

PMID:34309141 | DOI:10.1111/odi.13976

Pharm Stat. 2021 Jul 26. doi: 10.1002/pst.2154. Online ahead of print.

ABSTRACT

This paper discusses the design of clinical trials where the primary endpoint is a recurrent event with the focus on the sample size calculation. For the problem, a few methods have been proposed but most of them assume a multiplicative treatment effect on the rate or mean number of recurrent events. In practice, sometimes the additive treatment effect may be preferred or more appealing because of its intuitive clinical meaning and straightforward interpretation compared to a multiplicative relationship. In this paper, new methods are presented and investigated for the sample size calculation based on the additive rates model for superiority, non-inferiority, and equivalence trials. They allow for flexible baseline rate function, staggered entry, random dropout, and overdispersion in event numbers, and simulation studies show that the proposed methods perform well in a variety of settings. We also illustrate how to use the proposed methods to design a clinical trial based on real data.

PMID:34309179 | DOI:10.1002/pst.2154

Acad Emerg Med. 2021 Jul 26. doi: 10.1111/acem.14353. Online ahead of print.

ABSTRACT

BACKGROUND: Delayed diagnosis of cerebrovascular disease (CVD) among patients can result in substantial harm. If diagnostic process failures can be identified at Emergency Department (ED) visits that precede CVD hospitalization, interventions to improve diagnostic accuracy can be developed.

METHODS: We conducted a nested case-control study using a cohort of adult ED patients discharged from a single medical center with a benign headache diagnosis from 10/1/2015-3/31/2018. Hospitalizations for CVD within 1 year of index ED visit were identified using a regional health information exchange. Patients with subsequent CVD hospitalization (cases) were individually matched to patients without subsequent hospitalization (controls) using patient’s age and visit date. Demographic, clinical, and ED processes characteristics were assessed via detailed chart review. McNemar’s test for categorical and paired t-test for continuous variables were used with statistical significance set at ≤0.05.

RESULTS: Of the 9,157 patients with ED headache visits, 57 (0.6%; 95% CI:0.5-0.8) had a subsequent CVD hospitalization. Median time from ED visit to hospitalization was 107 days. In twenty-five patients (43.9%; 25/57) the CVD hospitalization and the index ED visit were at different hospitals. Fifty-three cases and 53 matched controls were included in the final study analysis. Cases and controls had similar baseline demographic and headache characteristics. Cases more often had a history of stroke (32.1% vs. 13.2%, p=0.02) and neurosurgery (13.2% vs. 1.9%, p=0.03) prior to the index ED visit. Cases more often had <2 components of the neurological exam documented (30.2% vs. 11.3%, p=0.03).

CONCLUSION: We found that 0.6% of patients with an ED headache visit had subsequent CVD hospitalization, often at another medical center. ED visits for headache complaints among patients with prior stroke or neurosurgical procedures may be important opportunities for CVD prevention. Documented neurological examinations were poorer among cases, which may represent an opportunity for ED process improvement.

PMID:34309135 | DOI:10.1111/acem.14353

J Magn Reson Imaging. 2021 Jul 26. doi: 10.1002/jmri.27852. Online ahead of print.

ABSTRACT

BACKGROUND: Recent studies have utilized MRI to determine the extent to which COVID-19 survivors may experience cardiac sequels after recovery.

PURPOSE: To systematically review the main cardiac MRI findings in COVID-19 adult survivors.

STUDY TYPE: Systematic review.

SUBJECTS: A total of 2954 COVID-19 adult survivors from 16 studies.

FIELD STRENGTH/SEQUENCE: Late gadolinium enhancement (LGE), parametric mapping (T1-native, T2, T1-post (extracellular volume fraction [ECV]), T2-weighted sequences (myocardium/pericardium), at 1.5 T and 3 T.

ASSESSMENT: A systematic search was performed on PubMed, Embase, and Google scholar databases using Boolean operators and the relevant key terms covering COVID-19, cardiac injury, CMR, and follow-up. MRI data, including (if available) T1, T2, extra cellular volume, presence of myocardial or pericardial late gadolinium enhancement (LGE) and left and right ventricular ejection fraction were extracted.

STATISTICAL TESTS: The main results of the included studies are summarized. No additional statistical analysis was performed.

RESULTS: Of 1601 articles retrieved from the initial search, 12 cohorts and 10 case series met our eligibility criteria. The rate of raised T1 in COVID-19 adult survivors varied across studies from 0% to 73%. Raised T2 was detected in none of patients in 4 out of 15 studies, and in the remaining studies, its rate ranged from 2% to 60%. In most studies, LGE (myocardial or pericardial) was observed in COVID-19 survivors, the rate ranging from 4% to 100%. Myocardial LGE mainly had nonischemic patterns. None of the cohort studies observed myocardial LGE in “healthy” controls. Most studies found that patients who recovered from COVID-19 had a significantly greater T1 and T2 compared to participants in the corresponding control group.

DATA CONCLUSION: Findings of MRI studies suggest the presence of myocardial and pericardial involvement in a notable number of patients recovered from COVID-19.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 3.

PMID:34309139 | DOI:10.1002/jmri.27852

Int J Nurs Pract. 2021 Jul 26:e12996. doi: 10.1111/ijn.12996. Online ahead of print.

ABSTRACT

AIM: This study aimed to explore the level and influencing factors of fatigue in patients with rheumatoid arthritis.

METHODS: This cross-sectional study was conducted in 243 patients with rheumatoid arthritis from April 2016 to March 2017. The Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, Arthritis Self-Efficacy Scale-8, Visual Analogue Scale for pain, physical function subscale of Short Form 36-Item Health Survey, Hospital Anxiety and Depression Scale, Perceived Social Support Scale, Pittsburgh Sleep Quality Index and a self-designed demographic and disease-related information questionnaire were used to collect the data. Stepwise linear multiple regression was used to clarify the impact of statistically significant variables (P < 0.05) in the independent sample t test, one-way ANOVA and correlation analysis on the level of fatigue.

RESULTS: Stepwise linear multiple regression analyses showed that disease activity, self-efficacy, physical function, pain, depression, duration of morning stiffness and anxiety were major factors influencing fatigue in patients with rheumatoid arthritis, which explained 59.5% of the total variance.

CONCLUSION: Our study demonstrated a moderate level of fatigue in Chinese patients with rheumatoid arthritis. In clinical practice, nurses should explore individualized intervention programmes based on related predictors of fatigue to help patients relieve fatigue.

PMID:34309127 | DOI:10.1111/ijn.12996

J Magn Reson Imaging. 2021 Jul 26. doi: 10.1002/jmri.27860. Online ahead of print.

ABSTRACT

BACKGROUND: MRI is the most effective diagnostic tool of osteonecrosis of the femoral head (ONFH), especially for early diagnosis, but its detection of subchondral or cortical fractures is less accurate than CT. Therefore, it is difficult to accurately stage ONFH in the peri-collapse period by MRI.

PURPOSE: To improve the accuracy of MR for distinguishing between Association Research Circulation Osseous (ARCO) stages 2 and 3A in ONFH.

STUDY TYPE: Retrospective.

SUBJECTS: One hundred and fifty five cases of ARCO stage 2/3A of ONFH underwent MR examinations, M/F = 72/83. CT was used as reference standard for collapse, which was decided by an orthopedist and a radiologist in consultation.

FIELD STRENGTH/SEQUENCE: 3 T/axial and coronal T₁ -weighted Turbo Spin Echo (T₁ W TSE) sequence, axial T₂ -weighted fat-saturated (T₂ W FS) TSE sequence, and coronal proton density-weighted imaging (PDWI)-FS-Dixon fat/water image.

ASSESSMENT: Five potential MR signs (the maximum width of the necrotic-viable interface, bone marrow edema (BME), irregular articular surface of the femoral head, T₂ heterogeneous high signal, and the absence of a necrotic-viable interface with the morphology of closed loop) were evaluated blindly by five radiologists independently and the total scores of different combinations of MR signs were calculated.

STATISTICAL TESTS: Mann-Whitney U test and Chi-square test were used to evaluate age, gender, and MR signs differences between the two groups. ROC curve was used to access the distinguishing value of MR signs. The consistency of the five radiologists was analyzed by intraclass correlation coefficient.

RESULTS: The area under the curve of the combined MR signs 2 for distinguishing between ARCO stages 2 and 3A was the greatest (0.967), sensitivity and specificity were 100.00% and 88.71% respectively, and greater than 1 was the threshold.

DATA CONCLUSION: Combined MR signs 2 has great values in distinguishing between ARCO stages 2 and 3A in ONFH, thus helping clinical therapy.

LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 2.

PMID:34309130 | DOI:10.1002/jmri.27860

Neuromodulation. 2021 Jul 26. doi: 10.1111/ner.13498. Online ahead of print.

ABSTRACT

INTRODUCTION: Dorsal root ganglion (DRG) stimulation is a form of neuromodulation used to treat neuropathic pain due to a myriad of etiologies. Though this relatively new therapy has been shown to be quite effective, complications associated with the implantation of this therapy have not been well documented.

OBJECTIVES: The primary objective of this study was to describe the device-related complications associated with DRG stimulator implantations.

MATERIALS AND METHODS: This was a single-center retrospective analysis of 31 patients who underwent full implantation of neuromodulation hardware marketed for DRG stimulation. The predefined endpoints included device-related complications associated with DRG implantations, such as hardware failure, explantation procedures, and revision surgery. Additional endpoints included percentage of patients receiving therapy and pain as measured using the visual analog scale (VAS) pain scale at initial, six-month, and 12-month follow-up after hardware implantation.

RESULTS: Thirty-one patients were included out of 42 patients trialed. Baseline VAS in patients was 7.7 (31 patients). At initial follow-up, six-month follow-up, and one-year follow-up, VAS scores were 4.7 (31 patients), 5.3 (20 patients), and 5.5 (13 patients), respectively. Paired t-test between preoperative VAS (mean 7.3) and one-year follow-up VAS (5.5) demonstrated statistical significance (p = 0.027). At initial, six-month, and one-year follow-up, 30/31 (97%), 19/24 (79%), and 18/23 (78%) patients were confirmed to be receiving DRG stimulation therapy after permanent implant. Of the 31 patients who were implanted with a permanent system, 8 (26%) were explanted and an additional 10 (29%) required revision surgery.

CONCLUSION: In this study, we examine the various device-related complications associated with DRG stimulation requiring repeat surgery. High rates of hardware failure, revision surgery, and explantation of stimulators illustrate the need for hardware optimization to improve patient outcomes.

PMID:34309131 | DOI:10.1111/ner.13498