Tag: pubmed

Ecology. 2024 Nov 27:e4490. doi: 10.1002/ecy.4490. Online ahead of print.

ABSTRACT

Although herbivory and allelopathy play important roles in plant invasions, their roles in mediating the effect of plant diversity on invasion resistance remain unknown. In a 2-year field experiment, we constructed native plant communities with four levels of species richness (one, two, four, and eight species) and used a factorial combination of insecticide and activated carbon applications to reduce herbivory and allelopathy, respectively. We then invaded the communities with the introduced plant Solidago canadensis L. One year after the start of the experiment, there was no statistically significant net effect of species richness on biomass of the invader. However, a structural equation model showed that species richness had a positive direct effect on invader biomass that was partially balanced out by a negative indirect effect of species richness via increased light interception. In the second year, the relationship between invader biomass and species richness was negative when we analyzed the treatment combination with herbivory and allelopathy separately. Therefore, we conclude that joint effects of herbivory and allelopathy may play major roles in driving the diversity-invasibility relationship and should be considered in future studies.

PMID:39604040 | DOI:10.1002/ecy.4490

Anaesthesia. 2024 Nov 27. doi: 10.1111/anae.16491. Online ahead of print.

ABSTRACT

INTRODUCTION: The number of tracheal intubation attempts required to reach proficiency in videolaryngoscopy with hyperangulated blades is unknown. Understanding this training requirement might guide training for clinicians who perform laryngoscopy. We therefore performed a planned sub-analysis of a randomised controlled trial comparing tracheal intubation success with videolaryngoscopy vs. direct laryngoscopy to determine the number of tracheal intubations with a hyperangulated videolaryngoscope blade needed to provide an acceptable first-attempt success rate.

METHODS: We included clinicians from a randomised controlled trial who were familiar with direct laryngoscopy and Macintosh-blade videolaryngoscopy but inexperienced with hyperangulated videolaryngoscopy. Cumulative sum statistics were used to generate learning curves with acceptable success rates of 85% and unacceptable success rates of 70% for the primary outcome of first-attempt tracheal intubation success.

RESULTS: We included 223 clinicians (25 consultants; 35 certified registered nurse anaesthetists; 36 student registered nurse anaesthetists; 46 fellows; and 81 residents) who attempted tracheal intubation in 4312 procedures. The median (IQR [range]) number of tracheal intubations per clinician was 15 (8-25 [1-77]). First-attempt failure was low, with only 72 failed first attempts overall, and was comparable across clinician groups. In total, 133 (60%) clinicians crossed the acceptable success rate boundary while the remaining 90 (40%) clinicians crossed neither the acceptable nor unacceptable success rate boundaries. Among clinicians who crossed the acceptance boundary, the median (IQR [range]) number of attempts for learning was 12 (12-12 [12-26]).

DISCUSSION: Clinicians experienced in tracheal intubation with direct laryngoscopy but unfamiliar with hyperangulated-blade videolaryngoscopy can achieve proficiency after approximately 12 attempts.

PMID:39604038 | DOI:10.1111/anae.16491

J Am Heart Assoc. 2024 Nov 27:e036046. doi: 10.1161/JAHA.124.036046. Online ahead of print.

ABSTRACT

BACKGROUND: Hypertension is a global health issue causing increased cardiovascular morbidity and mortality. Adherence to prescribed medication is a crucial factor in obtaining targeted outcomes, and fixed-dose combined antihypertensive pills (FCAPs) have been shown to help combat difficulties associated with polypharmacy management. This study investigated the influence of combination antihypertensives on blood pressure (BP) management.

METHODS AND RESULTS: Data from the 2013 to 2020 NHANES (National Health and Nutrition Examination Survey) were analyzed. Participants were included if between 18 and 79 years of age and were prescribed 2 antihypertensive classes. BP was deemed controlled if <140/<90 mm Hg. Examiner documentation and questionnaire data determined prescription antihypertensive medication usage and the presence of an FCAP. Descriptive statistics and multivariate regression analyses were used to compare the 2 groups. Subgroup analysis was performed for stricter BP goals of <130/<80 mm Hg. A total of 15 927 747 weighted participants met the inclusion criteria, 32.7% of whom were undergoing management with an FCAP. Participants with an FCAP were 1.78 (95% CI, 1.28-2.47, P=0.001) times more likely to have controlled BP (76.4% versus 67.3%) than those without an FCAP. Subgroup analysis revealed that FCAPs were associated with stricter BP goals (odds ratio [OR], 1.65, P=0.008; 87.6% versus 71.2%) compared with those without.

CONCLUSIONS: Participants with an FCAP were more likely to exhibit controlled BP, including participants with clinical atherosclerotic cardiovascular disease and those targeting stricter control. Clinicians can immediately and meaningfully affect their patient’s BP by opting for FCAPs.

PMID:39604035 | DOI:10.1161/JAHA.124.036046

J Am Heart Assoc. 2024 Nov 27:e036596. doi: 10.1161/JAHA.124.036596. Online ahead of print.

ABSTRACT

BACKGROUND: The prognostic value of 3-dimensional (3D)-left ventricular global longitudinal strain (LVGLS) in recipients of heart transplant (HT) reremains unknown. This study aimed to determine whether 3D-LVGLS was the more powerful predictor of poor outcomes in recipients of HT compared with 2-dimensional (2D)-LVGLS.

METHODS AND RESULTS: All consecutive adult patients who received HT and underwent at least 1 comprehensive 2D and 3D transthoracic echocardiographic examination for clinical surveillance were retrospectively enrolled. The end point was all-cause mortality. Prognostic model performance was assessed according to the C-statistic. The 3D-LVGLS measurements were feasible in 294 of 342 patients with HT (86%). The median follow-up time was 53 months, and 44 HT redied. Receiver operating characteristic curves revealed that the area under the curve for predicting all-cause mortality was greater for 3D-LVGLS than 2D-LVGLS (0.77 versus 0.67, P=0.012). When HT stratified patients with HT into tertiles according to 3D-LVGLS values, patients with lower 3D-LVGLS had worse outcome (P<0.001). The multivariable Cox analysis showed that the model with 3D-LVGLS (hazard ratio [HR],1.44 [95% CI,1.24-1.68]; P<0.001; C-statistic=0.814) was better in predicting death than the model with 2D-LVGLS (HR, 1.19 [95% CI, 1.06-1.32]; P=0.002; C-statistic=0.772). The best cutoff value of 3D-LVGLS for detecting all-cause mortality was -16.1%, with a sensitivity of 63.6% and a specificity of 84.0%.

CONCLUSIONS: The 3D-LVGLS was a powerful predictor of all-cause mortality in patients receiving HT and provided greater prognostic value than 2D-LVGLS. Our study highlighted the potential of evaluating 3D-LVGLS for risk stratification in recipients of HT.

PMID:39604024 | DOI:10.1161/JAHA.124.036596

J Am Heart Assoc. 2024 Nov 27:e036637. doi: 10.1161/JAHA.124.036637. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with chronic heart failure (HF) show an increased risk for the occurrence of chronic kidney disease and cardiorenal syndrome. Urinary Dickkopf-3 (uDKK3), a stress-induced, tubular profibrotic glycoprotein, may be elevated in HF as early as in New York Heart Association class I HF and may indicate subsequent decline in estimated glomerular filtration rate (eGFR).

METHODS AND RESULTS: uDKK3 levels in patients with HF and controls were measured by enzyme-linked immunosorbent assay. eGFR was determined up to 5 years in HF. Change in eGFR was assessed with respect to baseline uDKK3 using (mixed-effect) linear and logistic regression models. A total of 488 patients with chronic HF and 45 control patients were included. Patients with HF showed higher median uDKK3 levels than controls (259.6 pg/mg creatinine [interquartile range (IQR), 119.2-509.4 pg/mg creatinine] versus 107.5 pg/mg creatinine [IQR, 60.5-181.2 pg/mg creatinine], P<0.001). Regression models demonstrated a significant association between log uDKK3 and the decline in eGFR during a median of 13 months (IQR, 12-59 months) (estimated higher eGFR loss, 0.8039 mL/min per 1.73 m²/year [95% CI, 0.002-1.606 mL/min per 1.73 m²/year], P=0.049; odds ratio, 1.345 [95% CI, 1.049-1.741], P=0.021). uDKK3 levels ≥354 pg/mg creatinine were associated with a significantly higher risk for eGFR decline at 1-year follow-up (estimated higher eGFR loss, 4.538 mL/min per 1.73 m² [95% CI, 1.482-9.593 mL/min per 1.73 m²]), P=0.004). Even patients with HF without chronic kidney disease (n=334) had higher uDKK3 levels compared with controls (233.4 [IQR, 109.0-436.9 pg/mg creatinine] versus 107.5 [IQR, 60.5-181.2 pg/mg creatinine], P<0.001).

CONCLUSIONS: The present findings indicate that uDKK3 is a promising prognostic biomarker for subsequent eGFR decline in patients with HF, irrespective of the presence of chronic kidney disease and even in the early stages of HF. This potential allows for early intervention to mitigate the deterioration of kidney function. Further investigation is warranted to validate its clinical utility.

PMID:39604022 | DOI:10.1161/JAHA.124.036637

Am J Epidemiol. 2024 Nov 26:kwae442. doi: 10.1093/aje/kwae442. Online ahead of print.

ABSTRACT

Although 1990-1991 Gulf War deployment has been linked to worse health outcomes such as chronic multisymptom illness (CMI), often referred to as Gulf War Illness, among deployed Gulf War Veterans, less is known regarding Gulf War service and mortality. Using 20 years of longitudinal data from Gulf War Veteran and Era personnel from the Millennium Cohort Study (2001-2021; n=45381), Cox proportional hazard models estimated the relative effects of Gulf War service status, CMI, and their corresponding interaction on all-cause mortality. Although age- and sex-adjusted mortality ratios suggested that Gulf War Veterans had higher mortality rates than Era personnel, no association was observed between Gulf War service status and mortality risk. Screening positive for CMI was associated with greater risk of all-cause mortality compared with those who did not screen positive across both GWV and Era personnel; interactions between CMI and Gulf War status were not statistically significant. This finding suggests that CMI increases mortality risk regardless of whether the symptomology is associated with Gulf War deployment. Future research is necessary to examine specific occupational and environmental exposures experienced during deployments and service in support of the 1990-1991 Gulf War and their association with mortality in this population.

PMID:39604006 | DOI:10.1093/aje/kwae442

Transpl Infect Dis. 2024 Nov 27:e14407. doi: 10.1111/tid.14407. Online ahead of print.

ABSTRACT

BACKGROUND: Donor screening and antimicrobial management processes are inconsistent across organ procurement organizations (OPOs) and transplant centers. As part of a Controversies Conference addressing the evaluation and management of infectious diseases (ID) in deceased donors sponsored by the American Society of Transplantation (AST), two online pre-meeting surveys were developed to inform conference proceedings and assess current practices and opinions on donor screening and antimicrobial management.

METHODS: Survey 1 addressed the current state of deceased donor ID testing, culture data communication, antimicrobial utilization, and involvement of transplant ID during donor management and was distributed to all 56 United States OPOs. Survey 2 evaluated transplant professionals’ opinions regarding donor antimicrobial use and was sent to the AST Infectious Disease, Kidney Pancreas, Liver and Intestinal, and Thoracic and Critical Care Community of Practice listservs. Descriptive statistics were performed.

RESULTS: Thirty-five (63%) unique responses were received from OPOs for Survey 1. Findings included variability in the timing of donor culture collection, frequent sampling of indwelling catheters, wide variation in the location of culture processing, and availability of additional susceptibility testing. Eighty-eight unique responses were received from approximately 1552 (6%) transplant providers for Survey 2. Of the respondents, 37% would not recommend standard antibiotics prior to organ recovery in the absence of suspected or confirmed infection.

CONCLUSIONS: These surveys demonstrate variability in donor testing, donor antimicrobial utilization, and transplant provider opinions regarding the need for and selection of antimicrobial agents. Findings highlight opportunities for standardized approaches to donor testing and management.

PMID:39603978 | DOI:10.1111/tid.14407

J Prosthet Dent. 2024 Nov 26:S0022-3913(24)00732-7. doi: 10.1016/j.prosdent.2024.10.033. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Challenges persist with conventional polymethyl methacrylate (PMMA) prosthetic materials and conversion protocols for immediate implant-supported interim restorations. Advances, such as the use of fiber-reinforced composites (FRCs), and novel conversion protocols, such as the Smart Denture Conversion (SDC), may mitigate existing prosthetic complications, yet their impact on flexural strength and mode of failure remains unclear.

PURPOSE: The purpose of this in vitro study was to better understand the effect of the conversion method and to characterize the relevance of reinforcing interim implant-supported fixed prosthetics with FRCs. The effect of SDC, compared with a conventional conversion (CC) protocol, and the influence of FRC polymer was assessed on prosthesis flexural strength and mode of failure.

MATERIAL AND METHODS: A total of 100 computer-aided design and computer-aided manufacturing (CAD-CAM) conversion matrices were divided into 4 groups: CC, SDC, SDC with FRC arch bar reinforcement (SDC-FRC bar), and SDC with FRC framework reinforcement (SDC-FRC framework). Flexural strength testing was conducted with a universal testing machine. Modes of failure were qualitatively analyzed. Statistical analysis was performed with 1-way ANOVA and the Tukey multiple comparison test (α=.05).

RESULTS: SDC and SDC-FRC bar specimens demonstrated flexural strength comparable with that of CC (P=.995 and P=.907, respectively), while FRC framework reinforcement significantly increased strength (P<.001). The SDC-FRC framework specimens exhibited the highest flexural strength (144.7 MPa).

CONCLUSIONS: SDC offers a clinically convenient conversion technique with flexural strength comparable with that of conventional conversion methods. FRC framework reinforcement significantly enhances strength and reduces catastrophic prosthetic failure risk. These findings underscore the positive impact of reinforcement materials in interim implant-supported prosthesis fabrication.

PMID:39603970 | DOI:10.1016/j.prosdent.2024.10.033

Farm Hosp. 2024 Nov 26:S1130-6343(24)00173-9. doi: 10.1016/j.farma.2024.10.013. Online ahead of print.

ABSTRACT

OBJECTIVE: To study medication adherence and persistence among heart failure patients, assess the methods utilized for estimating medication adherence, and identify optimal adherence thresholds and their impact on clinical outcomes.

METHODS: A systematic search will be conducted in PubMed, Embase, CINAHL, Web of Science, and Scopus databases. Observational studies assessing medication adherence or persistence among heart failure patients via electronic healthcare databases will be included. A narrative synthesis will describe medication adherence and persistence reported and methods used to measure it. A meta-analysis will be attempted to evaluate the impact of secondary medication adherence (multiple and by drug class) on clinical outcomes, including hospitalization, emergency visits, and mortality. The I statistic will be employed to study heterogeneity and the GRADE framework to evaluate evidence certainty. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with the Prospective Register of Ongoing Systematic Reviews (PROSPERO) CRD42024509542.

DISCUSSION: This study aims to evaluate medication adherence and persistence in heart failure management through electronic health databases, intending to explore widely used measurement methods and their limitations, and to identify adherence thresholds associated with improved clinical outcomes. By examining these aspects, we anticipate proposing enhancements for future research and establishing desired adherence goals. This approach highlights the expected significance of our findings in advancing patient care and research methodologies.

PMID:39603950 | DOI:10.1016/j.farma.2024.10.013

J Plast Reconstr Aesthet Surg. 2024 Oct 28:S1748-6815(24)00668-5. doi: 10.1016/j.bjps.2024.10.028. Online ahead of print.

ABSTRACT

BACKGROUND: Reduction mammaplasties are among the plastic surgery procedures with the highest rates of patient satisfaction. However, the loss of postoperative sensation in the breast and nipple-areolar complex remains a concern. In light of increasing interest in nerve-preservation techniques, we sought to investigate the relationship between retained sensation with overall satisfaction in reduction mammaplasty in current literature.

METHODS: The authors systematically reviewed all studies that reported postoperative sensation and satisfaction in patients who underwent reduction mammaplasty, using the MEDLINE, Embase, Cochrane, CINAHL, and Scopus databases in October 2023. Studies were evaluated for methodological quality using an NIH Quality Assessment Tool. Meta-analyses of proportions were conducted.

RESULTS: A total of 48 studies met the eligibility criteria. The median quality assessment score was 8/10. For 28 studies eligible for statistical analysis, random effects pooled proportion for patients that retained preoperative sensation was 0.78 (95% CI: 0.67-0.87), and for patients that report postoperative satisfaction was 0.94 (95% CI: 0.91-0.97). Overall, the studies reported a relatively wide range of sensation outcomes with consistently high satisfaction scores.

CONCLUSION: The results of this systematic review suggest that other surgical factors (e.g., relief of macromastia symptoms, aesthetic appearance) play a greater role in patient satisfaction compared to sensation retention in reduction mammaplasty. Wide variability in assessment methodologies for both sensation and satisfaction was noted. Standardizing and objectifying measurement techniques, particularly for sensation, will help further characterize the relationship between sensation and satisfaction in future studies.

PMID:39603925 | DOI:10.1016/j.bjps.2024.10.028