Tag: pubmed

Dig Dis. 2022 Feb 7. doi: 10.1159/000522328. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic therapy with ERCP is considered the first line treatment in the management of post-cholecystectomy bile leak (PCBL). Currently there is no consensus on the most effective endoscopic intervention for PCBL. Hence, we performed a systematic review and meta-analysis to compare the effectiveness and safety of the two interventional groups (biliary sphincterotomy [BS] alone vs biliary stent ± BS) in management of PCBL.

METHODS: We conducted a comprehensive search of multiple electronic databases and conference proceedings (from inception through January 2021). The primary outcome was to compare the pooled rate of clinical success between the 2 groups. The secondary outcome was to estimate the pooled rate of adverse events.

RESULTS: The pooled rate of clinical success with BS alone (5 studies, 299 patients) was 88% (95% CI: 84%- 92%, I2: 0%) and for biliary stent ± BS (5 studies, 864 patients) was 97% (CI: 93%-100%, I2: 79%). The rate of clinical success in biliary stent ± BS group was significantly higher than BS alone group (OR: 3.91 95% CI: 2.29-6.69, p<0.001, I2: 13%). The rate of adverse events was numerically lower in biliary stent ± BS group compared to BS alone (3 studies; OR: 0.65 95% CI: 0.41-1.03, p=0.07) without statistical significance. Low heterogeneity was noted in the analysis.

CONCLUSIONS: Biliary stent ± BS is more effective in endoscopic management of PCBL compared to BS alone. This may be related to inter-endoscopist variation in completeness of sphincterotomy and post sphincterotomy edema, which can influence the preferential trans-papillary flow of bile.

PMID:35130543 | DOI:10.1159/000522328

Nanotechnology. 2022 Feb 7. doi: 10.1088/1361-6528/ac5283. Online ahead of print.

ABSTRACT

Two-dimensional hexagonal boron nitride (h-BN) materials have garnered increasing attention due to its ability of hosting intrinsic quantum point defects. This paper presents a photoluminescence (PL) mapping study related to sub-bandgap-level emission in bulk-like multilayer h-BN films. Spatial PL intensity distributions were carefully analyzed with 500-nm spatial resolution in terms of zero phonon line (ZPL) and phonon sideband (PSB) emission-peaks, and their linewidths, thereby identifying the potential quantum point defects within the films. Two types of ZPL, and PSB emissions were confirmed from the point defects located at non-edge- and at the edge of the films. Our statistical PL data revealed consistent broad and relatively narrow emission from the non-edge and edge area of the sample, respectively. The measured optical properties of these defects and the associated ZPL peak shift and line broadening as a function of temperature between 77° and 300°K are qualitatively and quantitatively explained. Moreover, an enhancement of the photostable PL emission by at least a factor of ×3 is observed when our pristine h-BN was irradiated with a 532 nm laser.

PMID:35130530 | DOI:10.1088/1361-6528/ac5283

J Neural Eng. 2022 Feb 7. doi: 10.1088/1741-2552/ac5266. Online ahead of print.

ABSTRACT

OBJECTIVE: Cognitive impairment is one of the core symptoms of schizophrenia, with an emphasis on dysfunctional information processing. Sensory gating deficits have consistently been reported in schizophrenia, but the underlying physiological mechanism is not well-understood. We report the discovery and characterization of P50 dynamic brain connections based on microstate analysis.

APPROACH: We identify five main microstates associated with the P50 response and the difference between the first and second click presentation (S1-S2-P50) in first-episode schizophrenia patients (FESZ), ultra-high-risk individuals (UHR) and healthy controls (HC). The we used the signal segments composed of consecutive time points with the same microstate label to construct brain functional networks.

MAIN RESULTS: The microstate with a prefrontal extreme location during the response to the S1 of P50 are statistically different in duration, occurrence and coverage among the FESZ, UHR and HC groups. In addition, a microstate with anterior-posterior orientation was found to be associated with S1-S2-P50 and its coverage was found to differ among the FESZ, UHR and HC groups. Source location of microstates showed that activated brain regions were mainly concentrated in the right temporal lobe. Furthermore, the connectivities between brain regions involved in P50 processing of HC were widely different from those of FESZ and UHR.

SIGNIFICANCE: Our results indicate that P50 suppression deficits in schizophrenia may be due to both aberrant baseline sensory perception and adaptation to repeated stimulus. Our findings provide new insight into the mechanisms of P50 suppression in the early stage of schizophrenia.

PMID:35130537 | DOI:10.1088/1741-2552/ac5266

Phys Med Biol. 2022 Feb 7. doi: 10.1088/1361-6560/ac5299. Online ahead of print.

ABSTRACT

OBJECTIVE: Extended treatment session times are an operational limitation in magnetic resonance imaging guided adaptive radiotherapy (MRIgRT). In this study a novel leaf sequencing algorithm called optimal fluence levels (OFL) and an optimization algorithm called pseudo gradient descent (PGD) are evaluated with respect to plan quality, beam complexity, and the ability to reduce treatment session times on the Elekta Unity MRIgRT system.

APPROACH: Ten total patients were evaluated on this Institutional Review Board approved study: three with prostate cancer, three with oligometastases, two with pancreatic cancer, and two with liver cancer. Plans were generated using the clinical Monaco Hyperion optimizer and leaf sequencer and then re-optimized using OFL and PGD (OFL+PGD) while holding all IMRT constraints and planning parameters constant. All plans were normalized to ensure 95% of the PTV received the prescription dose. A paired t-test was used to evaluate statistical significance.

MAIN RESULTS: Plan quality in terms of dosimetric OAR sparing was found to be equivalent between the OFL+PGD and conventional Monaco Hyperion optimizer plans. The OFL+PGD plans had a reduction in optimization time of 51.4% ± 5.0% (p = 0.002) and reduction in treatment delivery time of 10.6% ± 7.5% (p = 0.005). OFL+PGD generated plans had on average 13.2% ± 12.6% fewer multi-leaf collimator (MLC) segments (p = 0.009) and 0.1 ± 0.1 lower plan averaged beam modulation (PM) (p = 0.004) relative to the Monaco Hyperion plans.

SIGNIFICANCE: The OFL+PGD algorithms more quickly generate Unity treatment plans that are faster to deliver than with the conventional approach and without compromising dosimetric plan quality. This is likely due to a delivery complexity reduction enabled by OFL+PGD relative to the Monaco Hyperion plans.

PMID:35130528 | DOI:10.1088/1361-6560/ac5299

Prep Biochem Biotechnol. 2022 Feb 7:1-9. doi: 10.1080/10826068.2022.2028637. Online ahead of print.

ABSTRACT

Trichosporon yeasts are widely employed to produce lipids, lipases, and aspartic peptidases, but there are no previous studies on collagenase production. This work aimed to select the best collagenase producing Amazonian Trichosporon strains. Moreover, a 2³-full factorial design (FFD) and a 2²-central composite design combined with Response Surface Methodology were applied to optimize production and find the best conditions for hydrolysis of type I bovine collagen. Most of the studied strains had some collagenolytic activity, but the selected one achieved the highest value (44.02 U) and a biomass concentration of 2.31 g/L. The best collagenase production conditions were 160 rpm of agitation, pH 5.5 and a substrate concentration of 4.0 g/L. The former experimental design showed that substrate concentration was the only statistically significant factor on both biomass concentration and collagenase activity, while the latter showed simultaneous effects of substrate concentration and pH on collagenolytic activity, which peaked at pH 5.5-6.4 and substrate concentration of 3.0-3.4 g/L. An additional 2³-FFD was finally used to optimize the conditions collagen hydrolysis, and pH 6, 25 °C and a substrate concentration of 7.5 (g/L) ensured the highest hydrolysis degree. This study is the first that describes optimized conditions of collagenase production by Trichosporon strains.

PMID:35130473 | DOI:10.1080/10826068.2022.2028637

Am J Trop Med Hyg. 2022 Feb 7:tpmd211014. doi: 10.4269/ajtmh.21-1014. Online ahead of print.

ABSTRACT

Global health education is offered increasingly during residency training. The University of Minnesota has offered a global pediatrics track to residents since 2005. This study aimed to understand the impacts of a global pediatrics track on graduates’ career choices, skills, and current engagement in global health. An electronic survey was sent to 110 track graduates in February to April 2020. Data were analyzed with descriptive statistics and paired t-tests. Content analysis of written comments was conducted. The response rate was 62% overall, varying by question. Overall, 75% of responding graduates reported global pediatrics track participation affected their career choices. Eighty-four percent recalled plans to work in global health after graduation and 64% of respondents reported working in global health abroad or at home at the time of the survey. Incorporation of public health and global research represented the greatest percentage change in career plans from the time of enrollment to graduation (24% and 27%, respectively). Ninety-five percent of respondents reported that track participation improved their ability to elicit information about cultural beliefs and practices, and 86% reported improvement in cost-conscious care. An increase in global health knowledge and skills was the most common category of impact cited by respondents. Neonatal resuscitation, bubble continuous positive airway pressure, and homemade spacers for metered-dose inhalers were the most used global health-adapted skills. Our study found that graduates of the global pediatrics track perceive their participation affected their knowledge, skills, and attitudes positively, with the potential to improve clinical care and promote health equity locally and globally.

PMID:35130486 | DOI:10.4269/ajtmh.21-1014

Risk Anal. 2022 Feb 7. doi: 10.1111/risa.13890. Online ahead of print.

ABSTRACT

Despite persistent record-breaking flood losses from tropical cyclones (TCs), the United States continues to be inadequately prepared for TC flood events, with the deficiency in residential flood insurance being a prime representation of this. One way to address this is through a better quantification of TC flood risk including variations associated with freshwater versus storm surge flood hazard and damage. We analyze actual residential flood claim data from the National Flood Insurance Program (NFIP) for the full set of all 28 significant US landfalling TC-related flood events from 2001 to 2014 which we split by storm surge and freshwater. We illustrate key differences between the numbers of claims, paid claim amounts, and damage for freshwater and surge claims, as well as evaluate differences associated with flood zone, state, TC event, and flood depth. Despite the typical focus on surge TC flooding, freshwater flooding accounts for over 60% of TC paid claim and damage amounts. Surge flooding often occurs outside of high-velocity flood zones, which is not reflected in the NFIP premiums. Statistical analysis indicates that depth-damage ratios vary significantly by surge versus freshwater and by geography. State-level analysis shows that land-use policies and building codes likely affect differences in damage along with storm characteristics and geography. The findings highlight the need to mitigate and manage both freshwater and surge TC flood risk and for more individualized flood insurance premiums less tied to flood zone. It appears that the latter need may be addressed by the Federal Emergency Management Agency (FEMA)’s Risk Rating 2.0.

PMID:35129843 | DOI:10.1111/risa.13890

Eur J Cancer Care (Engl). 2022 Feb 7:e13554. doi: 10.1111/ecc.13554. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this work is to compare posttraumatic stress symptoms (PTSS) between families of children on cancer treatment and families of healthy children in China and to analyse the association among child PTSS, parent PTSS, and depression in the cancer group.

METHODS: Participants were children on cancer treatment (n = 91) and their parents (n = 91), and healthy children (n = 114) and their parents (n = 96). The children were asked to self-report PTSS, and the parents completed self-reported measures of PTSS and depression.

RESULTS: Although the prevalence of probable PTSD in children on cancer treatment was higher than that in comparisons (8.79% vs. 0.88%, P < 0.01), no statistic differences in PTSS levels were found between the two groups (P > 0.05). However, significant differences in PTSS levels and the prevalence of severe PTSS (21.98% vs. 1.04%) between parents of children with cancer and comparisons were observed (P < 0.001). Parent PTSS and depression were positively associated with child PTSS in the cancer group (P < 0.01).

CONCLUSION: The prevalence of probable PTSD in Chinese children with cancer was low, but PTSS was remarkably prevalent in their parents. Greater parent PTSS and depression were related to greater child PTSS. Results underline the importance to provide supportive psychological care for Chinese parents of children undergoing cancer treatment.

PMID:35129840 | DOI:10.1111/ecc.13554

Braz J Microbiol. 2022 Feb 7. doi: 10.1007/s42770-022-00691-8. Online ahead of print.

ABSTRACT

The study’s objective was to develop a co-fermentation process with appropriate fermentation parameters to produce a sour beer (similar to a Belgium sour beer) with an ethanol content of 6-8% (v/v) using a coculture of Saccharomyces pastorianus and Lactobacillus plantarum. Statistical optimization was conducted to determine fermentation conditions to produce a sour beer with ~ 3 mg/mL of lactic acid, similar to the traditional sour beer levels. Studies were conducted on the microbial dynamics and volatile compounds produced during this fermentation and aging process. GC-MS studies revealed the generation of novel bioactive compounds as well as the depletion of some volatile compounds during co-fermentation. The study detailed a 5-day co-fermentation process of S. pastorianus and L. plantarum and a 21-day aging process to prepare a sour beer with biochemical properties along the lines of traditional lambic beers. The interrelationship between the two microorganisms and the biochemical changes in the sour beer fermentation process was elucidated and the sensorial attributes have been described.

PMID:35129817 | DOI:10.1007/s42770-022-00691-8

Diabetes Ther. 2022 Feb 7. doi: 10.1007/s13300-022-01212-4. Online ahead of print.

ABSTRACT

INTRODUCTION: The American Diabetes Association (ADA) has identified a target hemoglobin A1c (HbA1c) < 7% as appropriate for most adults with type 2 diabetes (T2D). This research examines US diabetes-related healthcare costs for adults with T2D for individuals with glycemic control (HbA1c < 7%) compared to poor glycemic control (HbA1c ≥ 7%).

METHODS: The Optum Clinformatics^® Data Mart database from 2016 to 2020 was used to identify a cohort of adults with T2D who had a recorded HbA1c test (with first such date identified as the index date) and continuous insurance from 1 year prior through 1 year post index date. Patients with glycemic control were propensity matched to patients with poor glycemic control. Generalized linear models and two-part models examined diabetes-related outpatient, drug, acute care, and total costs over the 1-year post-period.

RESULTS: There were 34,538 propensity matched individuals included in the study. Results indicate that glycemic control (HbA1c < 7%), compared to poor glycemic control (HbA1c ≥ 7%) ,was associated with statistically significantly lower annual diabetes-related acute ($5671 ± $4216 vs $6138 ± $4211), outpatient ($6051 ± $4216 vs $7259 ± $7771), drug ($3739 ± $4581 vs $4288 ± $4788), and total costs care ($13,704 ± $10,635 vs $16,460 ± $10,885) (all P < 0.0001). Sensitivity analyses also examined results based upon alternative HbA1c thresholds which were chosen on the basis of expert guidelines and prior clinical trial thresholds (< 6%, ≤ 6.5%, < 8%, and ≤ 9%). In all cases, being below threshold was associated with statistically significantly lower diabetes-related total costs and component costs. Results also illustrate that, in general, higher HbA1c thresholds are associated with higher diabetes-related costs.

CONCLUSION: Glycemic control was found to be associated with significantly lower annual diabetes-related component and total costs. Results suggest economic benefits associated with having HbA1c at or below target.

PMID:35129822 | DOI:10.1007/s13300-022-01212-4