Tag: pubmed

Pediatr Transplant. 2022 Jun 1:e14324. doi: 10.1111/petr.14324. Online ahead of print.

ABSTRACT

BACKGROUND: Cytomegalovirus infection represents a significant cause of morbidity and mortality after hematopoietic stem cell transplantation. This study aimed to evaluate the incidence of viremia and disease due to cytomegalovirus and the risk factors in pediatric patients with hematopoietic stem cell transplantation in our institution.

METHODS: This was a retrospective cohort of patients under 19 years of age who underwent allogeneic hematopoietic stem cell transplantation due to any indication between 2012 and 2019. The analysis included the diagnosis of cytomegalovirus viremia or disease during post-transplant follow-up, evaluation of risk factors, and outcomes. The statistical analysis included univariate and multivariate analyses, and the cumulative incidence of cytomegalovirus viremia was determined by the Kaplan-Meier method using STATA 14 statistical software.

RESULTS: A total of 182 transplants were included. At 100 days, the cumulative incidence of cytomegalovirus viremia was 70.5%, and that of cytomegalovirus disease was 4.7%. Overall survival at 2 years was 74%, and event-free survival was 64%. The remaining demographic characteristics were not predictors of infection. There was no association between viremia and relapse or survival of the patients. Higher mortality was noted in cytomegalovirus disease.

CONCLUSIONS: During the study period, the incidence of cytomegalovirus disease was similar to that of other pediatric reports, but the incidence of viremia was higher. Pre-emptive therapy has diminished disease rates and death due to infection. Viral load cutoff points should be standardized to guide treatment and avoid myelotoxicity.

PMID:35647735 | DOI:10.1111/petr.14324

J Appl Behav Anal. 2022 Jun 1. doi: 10.1002/jaba.935. Online ahead of print.

ABSTRACT

Children with autism spectrum disorder (ASD) have been shown to exhibit fewer instances of social referencing compared to their typically developing peers. The current study evaluated the effectiveness of multiple-exemplar training, prompting, and social reinforcement to teach social referencing. We used a single-blind randomized control trial with a multiple-baseline design nested within the experimental group to evaluate treatment effects. Twenty-five children with ASD participated. Participants in the treatment group showed significantly higher social referencing scores. However, there were no statistically significant differences between the groups in the posttraining initiating and responding to joint attention scores. The clinical implications of our findings are discussed.

PMID:35647715 | DOI:10.1002/jaba.935

Mol Biol Evol. 2022 Jun 1:msac119. doi: 10.1093/molbev/msac119. Online ahead of print.

ABSTRACT

Commonly used methods for inferring phylogenies were designed before the emergence of high throughput sequencing and can generally not accommodate the challenges associated with noisy, diploid sequencing data. In many applications, diploid genomes are still treated as haploid through the use of ambiguity characters; while the uncertainty in genotype calling – arising as a consequence of the sequencing technology – is ignored. In order to address this problem we describe two new probabilistic approaches for estimating genetic distances: distAngsd-geno and distAngsd-nuc, both implemented in a software suite named distAngsd. These methods are specifically designed for next generation sequencing data, utilize the full information from the data, and take uncertainty in genotype calling into account. Through extensive simulations, we show that these new methods are markedly more accurate and have more stable statistical behaviors than other currently available methods for estimating genetic distances – even for very low depth data with high error rates.

PMID:35647675 | DOI:10.1093/molbev/msac119

Ophthalmol Sci. 2022 Jun;2(2):100144. doi: 10.1016/j.xops.2022.100144. Epub 2022 Mar 18.

ABSTRACT

PURPOSE: To study the wider field swept-source optical coherence tomography angiography (WF SS-OCTA) metrics, especially non-perfusion area (NPA), in the diagnosing and staging of DR.

DESIGN: Cross-sectional observational study (November 2018-September 2020).

PARTICIPANTS: 473 eyes of 286 patients (69 eyes of 49 control patients and 404 eyes of 237 diabetic patients).

METHODS: We imaged using 6mm×6mm and 12mm×12mm angiograms on WF SS-OCTA. Images were analyzed using the ARI Network and FIJI ImageJ. Mixed effects multiple regression models and receiver operator characteristic analysis was used for statistical analyses.

MAIN OUTCOME MEASURES: Quantitative metrics such as vessel density (VD); vessel skeletonized density (VSD); foveal avascular zone (FAZ) area, circularity, and perimeter; and NPA in DR and their relative performance for its diagnosis and grading.

RESULTS: Among patients with diabetes (median age 59 years), 51 eyes had no DR, 185 eyes (88 mild, 97 moderate-severe) had non-proliferative DR (NPDR); and 168 eyes had proliferative DR (PDR). Trend analysis revealed a progressive decline in superficial capillary plexus (SCP) VD and VSD, and increased NPA with increasing DR severity. Additionally, there was a significant reduction in deep capillary plexus (DCP) VD and VSD in early DR (mild NPDR), but the progressive reduction in advanced DR stages was not significant. NPA was the best parameter to diagnose DR (AUC:0.96), whereas all parameters combined on both angiograms efficiently diagnosed (AUC:0.97) and differentiated between DR stages (AUC range:0.83-0.97). The presence of diabetic macular edema was associated with reduced SCP and DCP VD and VSD within mild NPDR eyes, whereas an increased VD and VSD in SCP among moderate-severe NPDR group.

CONCLUSIONS: Our work highlights the importance of NPA, which can be more readily and easily measured with WF SS-OCTA compared to fluorescein angiography. It is additionally quick and non-invasive, and hence can be an important adjunct for DR diagnosis and management. In our study, a combination of all OCTA metrics on both 6mm×6mm and 12mm×12mm angiograms had the best diagnostic accuracy for DR and its severity. Further longitudinal studies are needed to assess NPA as a biomarker for progression or regression of DR severity.

PMID:35647573 | PMC:PMC9137369 | DOI:10.1016/j.xops.2022.100144

J Contin Educ Nurs. 2022 Jun;53(6):273-278. doi: 10.3928/00220124-20220505-09. Epub 2022 Jun 1.

ABSTRACT

An RN refresher program can be a valuable tool to mobilize nurses back into practice, but there are limited data regarding how much it increases students’ confidence. Bandura’s (1997) theory defines self-efficacy as a construct of one’s belief in obtaining control over behavior and environment to achieve a goal. In this study, the validated Clinical Skills Self-Efficacy Scale (CSES) was used to measure the difference in a student’s reported perception of self-efficacy after completing a refresher program. The CSES survey was distributed to two groups of RN students: 59 accelerated students who finished the course in 3 months and 57 traditional students who had 9 months to complete the course. The accelerated students had recent nursing experience, but were responding to the COVID-19 pandemic. A mixed model was used to analyze the CSES scores between the accelerated students and the traditional students. A pretest-posttest design was used for each item of the scale. Both groups of students had a statistically significant difference in their CSES scores from pretest to posttest (p < .05). [J Contin Educ Nurs. 2022;53(6):273-278.].

PMID:35647623 | DOI:10.3928/00220124-20220505-09

Resusc Plus. 2022 May 24;10:100250. doi: 10.1016/j.resplu.2022.100250. eCollection 2022 Jun.

ABSTRACT

BACKGROUND: If adolescents can teach each other cardiopulmonary resuscitation (CPR) during school hours, this may be a cost-effective approach to CPR training. The aim of this study was to evaluate CPR quality among students trained by student instructors in CPR.

MATERIAL AND METHODS: Three high schools participated. Recruited student instructors (SIs) were given a two-day course by professional instructors. Theoretic knowledge was acquired through an e-learning program. The SIs then trained fellow students in a 90-minute practical CPR session during physical education classes. All participants performed a 4-minutes test of CPR performance. Data was collected using Little Anne QCPR manikins with QCPR classroom software (Laerdal Medical Inc, Norway). Statistical equivalence in CPR performance was assessed applying the two one-sided tests (TOST)-procedure.

RESULTS: Eight professional instructors trained 76 SIs who trained approximately 2650 students in CPR. The number of available tests for analysis of student performance was 982. The compression rates were within guideline recommendations for SIs (mean 110.6, SD 5.4) and students (mean 118.6, SD 8.6). The corresponding numbers for mean compression depth were 7.2 cm (SD 0.7) and 7 cm (SD 1.0). Students demonstrated greater variation in mouth-to-mouth (MTM) skills, with only 41% performing at least 15 successful ventilations during the test. Except for the total number of MTM ventilations (mean difference -5.6), CPR performance was deemed statistically equivalent between professional instructors, SIs and students.

CONCLUSIONS: High school students can be trained as CPR instructors and teach fellow students CPR with good quality, with some variation in MTM-ventilation skills.

PMID:35647568 | PMC:PMC9130223 | DOI:10.1016/j.resplu.2022.100250

Brain Behav Immun Health. 2022 May 2;23:100458. doi: 10.1016/j.bbih.2022.100458. eCollection 2022 Aug.

ABSTRACT

Systemic and cerebral inflammation following antenatal infection (e.g. chorioamnionitis) and dysregulation of the blood brain barrier (BBB) are major risk factors for abnormal neonatal brain development. Administration of multipotent adult progenitor cells (MAPCs) represents an interesting pharmacological strategy as modulator of the peripheral and cerebral immune response and protector of BBB integrity. We studied the immunomodulatory and protective cerebrovascular potential of prenatally administered MAPCs in a preclinical ovine model for antenatal inflammation. Ovine fetuses were intra-amniotically (i.a.) exposed to lipopolysaccharide (LPS) or saline at gestational day 125, followed by the intravenous administration of 1*10⁷ MAPCs or saline at gestational day 127. Circulating inflammation markers were measured. Fetal brains were examined immuno-histochemically post-mortem at gestational day 132. Fetal plasma IL-6 levels were elevated significantly 24 h after LPS administration. In utero systemic MAPC treatment after LPS exposure increased Annexin A1 (ANXA1) expression in the cerebrovascular endothelium, indicating enforcement of BBB integrity, and increased the number of leukocytes at brain barriers throughout the brain. Further characterisation of brain barrier-associated leukocytes showed that monocyte/choroid plexus macrophage (IBA-1⁺/CD206⁺) and neutrophil (MPO⁺) populations predominantly contributed to the LPS-MAPC-induced increase of CD45⁺cells. In the choroid plexus, the percentage of leukocytes expressing the proresolving mediator ANXA1 tended to be decreased after LPS-induced antenatal inflammation, an effect reversed by systemic MAPC treatment. Accordingly, expression levels of ANXA1 per leukocyte were decreased after LPS and restored after subsequent MAPC treatment. Increased expression of ANXA1 by the cerebrovasculature and immune cells at brain barriers following MAPC treatment in an infectious setting indicate a MAPC driven early defence mechanism to protect the neonatal brain against infection-driven inflammation and potential additional pro-inflammatory insults in the neonatal period.

PMID:35647567 | PMC:PMC9136278 | DOI:10.1016/j.bbih.2022.100458

SN Comput Sci. 2022;3(4):300. doi: 10.1007/s42979-022-01186-x. Epub 2022 May 21.

ABSTRACT

Gaussian process models (GPMs) are widely regarded as a prominent tool for learning statistical data models that enable interpolation, regression, and classification. These models are typically instantiated by a Gaussian Process with a zero-mean function and a radial basis covariance function. While these default instantiations yield acceptable analytical quality in terms of model accuracy, GPM inference algorithms automatically search for an application-specific model fitting a particular dataset. State-of-the-art methods for automated inference of GPMs are searching the space of possible models in a rather intricate way and thus result in super-quadratic computation time complexity for model selection and evaluation. Since these properties only enable processing small datasets with low statistical versatility, various methods and algorithms using global as well as local approximations have been proposed for efficient inference of large-scale GPMs. While the latter approximation relies on representing data via local sub-models, global approaches capture data’s inherent characteristics by means of an educated sample. In this paper, we investigate the current state-of-the-art in automated model inference for Gaussian processes and outline strengths and shortcomings of the respective approaches. A performance analysis backs our theoretical findings and provides further empirical evidence. It indicates that approximated inference algorithms, especially locally approximating ones, deliver superior runtime performance, while maintaining the quality level of those using non-approximative Gaussian processes.

PMID:35647556 | PMC:PMC9123926 | DOI:10.1007/s42979-022-01186-x

Eur J Obstet Gynecol Reprod Biol X. 2022 May 20;15:100155. doi: 10.1016/j.eurox.2022.100155. eCollection 2022 Aug.

ABSTRACT

BACKGROUND: The level of activity in women who have given birth is very low despite the great benefits of exercise on their physical and mental health. There are some contradictories between the results of several preliminary studies on the effects of exercise on post-partum fatigue reduction. Therefore, the aim of this study was to assess the effects of exercise on decreasing postpartum fatigue in general and, specifically, in Iran using meta-analysis.

METHODS: In this study, the articles printed in international and national centres of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed and Web of Science (WoS), were used to find the studies electronically published up to 2021. The studies’ heterogeneity was examined using the I² index, and subsequently, a random-effects model was applied. Data analysis was performed within the Comprehensive Meta-Analysis software (version 2).

RESULTS: Finally, nine articles met the inclusion criteria in this systematic and meta-analysis review. The included samples were 456 patients in the intervention group and 446 in the control group. The mean score of fatigue after the intervention was 8.1 ± 1.1 lower than before intervention in the experimental group, and this difference was statistically significant (p ≤ 0.001).

CONCLUSION: The results of this study indicate that exercise reduces postpartum fatigue, which can be used for counseling and treatment by gynecologists. Reduce postpartum problems in women and increase the quality of life after childbirth.

PMID:35647520 | PMC:PMC9136263 | DOI:10.1016/j.eurox.2022.100155

Res Pract Thromb Haemost. 2022 May 25;6(4):e12733. doi: 10.1002/rth2.12733. eCollection 2022 May.

ABSTRACT

BACKGROUND: Research on venous thromboembolism (VTE) that relies only on the International Classification of Diseases (ICD) can misclassify outcomes. Our study aims to discover and validate an improved VTE computable phenotype for people with cancer.

METHODS: We used a cancer registry electronic health record (EHR)-linked longitudinal database. We derived three algorithms that were ICD/medication based, natural language processing (NLP) based, or all combined. We then randomly sampled 400 patients from patients with VTE codes (n = 1111) and 400 from those without VTE codes (n = 7396). Weighted sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated on the entire sample using inverse probability weighting, followed by bootstrapped receiver operating curve analysis to calculate the concordance statistic (c statistic).

RESULTS: Among 800 patients sampled, 280 had a confirmed acute VTE during the first year after cancer diagnosis. The ICD/medication algorithm had a weighted PPV of 95% and a weighted sensitivity of 81%, with a c statistic of 0.90 (95% confidence interval [CI], 0.89-0.91). Adding Current Procedural Terminology codes for inferior vena cava filter removal or early death did not improve the performance. The NLP algorithm had a weighted PPV of 80% and a weighted sensitivity of 90%, with a c statistic of 0.93 (95% CI, 0.92-0.94). The combined algorithm had a weighted PPV of 98% at the higher cutoff and a weighted sensitivity of 96% at the lower cutoff, with a c statistic of 0.98 (95% CI, 0.97-0.98).

CONCLUSIONS: Our ICD/medication-based algorithm can accurately identify VTE phenotype among patients with cancer with a high PPV of 95%. The combined algorithm should be considered in EHR databases that have access to such capabilities.

PMID:35647478 | PMC:PMC9130880 | DOI:10.1002/rth2.12733