Tag: pubmed

Wound Manag Prev. 2022 Mar;68(3):12-18.

ABSTRACT

BACKGROUND: Skin conditions and dermatological diseases (eg, intertrigo) in older patients are common in clinical practice. In addition to the negative impact on the patient’s health, diseases such as intertrigo place a financial burden on the health care system.

PURPOSE: The purpose of this secondary data analysis was to compare the prevalence, anatomical locations, and applied interventions of intertrigo in patients in hospitals and geriatric institutions.

METHODS: The authors report the outcome of a secondary data analysis of data collected from 2012 to 2016 from the Nursing Quality Measurement 2.0. This is an annually conducted cross-sectional multicenter study. Descriptive statistics and statistical tests were used to analyze the data.

RESULTS: Of patients in the hospital, 2.4% (n = 15,152) had intertrigo compared with 3.4% (n = 3743) of patients in geriatric institutions. In general, expert consultation was the least used intervention for the treatment of intertrigo in hospitals (6.1%, n = 359) and geriatric institutions (9.8%, n = 122).

CONCLUSION: Independent of the setting, considering the worldwide climate change, the authors expect that the number of patients with intertrigo will be increasing. Therefore, they highly recommend implementing standardized skin assessments for moisture-associated skin damage to identify intertrigo as early as possible. Moreover, as the consultation of experts was seldom used in both settings, advances in the interdisciplinary and interprofessional management of moisture-associated skin damages are needed.

PMID:35344504

Proc Natl Acad Sci U S A. 2022 Apr 5;119(14):e2111372119. doi: 10.1073/pnas.2111372119. Epub 2022 Mar 28.

ABSTRACT

SignificanceRecord-setting fires in the western United States over the last decade caused severe air pollution, loss of human life, and property damage. Enhanced drought and increased biomass in a warmer climate may fuel larger and more frequent wildfires in the coming decades. Applying an empirical statistical model to fires projected by Earth System Models including climate-ecosystem-socioeconomic interactions, we show that fine particulate pollution over the US Pacific Northwest could double to triple during late summer to fall by the late 21st century under intermediate- and low-mitigation scenarios. The historic fires and resulting pollution extremes of 2017-2020 could occur every 3 to 5 y under 21st-century climate change, posing challenges for air quality management and threatening public health.

PMID:35344431 | DOI:10.1073/pnas.2111372119

Global Spine J. 2022 Mar 28:21925682221083913. doi: 10.1177/21925682221083913. Online ahead of print.

ABSTRACT

STUDY DESIGN: Prospective observational study.

OBJECTIVE: The population of patients with advanced stages of cancer, including metastatic spinal disease, is growing because of better treatment options allowing for longer control of disease. The main goal of treatment for these patients is to improve or maintain their health-related quality of life (HRQOL). A spine oncology-specific outcome measure has been developed by the Spine Oncology Study Group and validated through international studies. We proposed to translate and validate the questionnaire in Italian language.

METHODS: The cross-cultural adaptation of the questionnaire has been performed according to guidelines previously proposed. After this process, an observational prospective study has been conducted to validate the efficacy of SOSGOQ in Italian language. SOSGOQ has been compared to SF-36 (Short Form Health Survey-36), a generic validated questionnaire to assess HRQOL. Starting from January 2020, SOSGOQ and SF-36 questionnaires were auto-administered to 150 patients affected by spinal metastases who provided written informed consent for study participation.

RESULTS: The confirmatory factor analysis on the 4 domains examined showed a good model fit (comparative fit index, .95; RMSEA .07 (90% CI, .05-.09) and SRMR, .05), endorsing construct validity. The analysis of concurrent validity demonstrated strong correlation for physical function, pain and mental health domains with the corresponding domain scores of SF-36. The reliability across item was high with a Cronbach’s alpha coefficient of .91.

CONCLUSIONS: The statistical analysis of the results will allow to accept the Italian version of SOSGOQ as a specific and efficient tool to measure HRQOL in Italian-speaking patients affected by spinal metastases.

PMID:35344384 | DOI:10.1177/21925682221083913

Am J Speech Lang Pathol. 2022 Mar 28:1-7. doi: 10.1044/2022_AJSLP-21-00269. Online ahead of print.

ABSTRACT

PURPOSE: The external validity of aphasia treatment research relies on diverse and representative participants. The purposes of this study were (a) to examine whether reporting of patient-reported age, sex, and race/ethnicity has improved since Ellis (2009) and (b) to evaluate whether these demographic variables were consistent with population-level estimates of stroke survivor demographics in the United States.

METHOD: A scoping review examined U.S.-based aphasia treatment studies published between 2009 and 2019 and characterized the percentage of studies reporting age, sex, and race/ethnicity. Summary statistics for these variables were calculated and compared statistically with a population-based study of stroke survivors.

RESULTS: It was found out that 97.1% of studies reported age, 93.5% reported sex, and 28.1% reported race and/or ethnicity. Within reporting studies, participant mean age was 58.04 years, 61.6% of participants were men, and 38.4% were women; 86.5% of participants were White, 11.0% were Black, 2.0% were Hispanic/Latino, and 0.5% fell in other racial categories. All three variables were statistically different from the study of Kissela et al. (2012).

DISCUSSION: Despite being highlighted as an issue by Ellis (2009), less than 30% of recent aphasia treatment studies reported race or ethnicity, and participants do not appear to be demographically representative compared with estimates of stroke survivors living in the United States. These issues may negatively impact the ecological validity of aphasia treatment research. Aphasia researchers should more consistently report participant race and ethnicity and follow current guidelines for increasing the demographic representation of women and minorities.

PMID:35344392 | DOI:10.1044/2022_AJSLP-21-00269

Ann Intern Med. 2022 Mar 29. doi: 10.7326/M21-3128. Online ahead of print.

ABSTRACT

BACKGROUND: Motivational interviewing (MI) is potentially useful in management of overweight and obesity, but staff training and increased delivery time are barriers, and its effectiveness independent of other behavioral components is unclear.

PURPOSE: To assess the independent contribution of MI as part of a behavioral weight management program (BWMP) in controlling weight and improving psychological well-being.

DATA SOURCES: 6 electronic databases and 2 trial registries, searched from database inception through 24 September 2021.

STUDY SELECTION: Randomized controlled trials in adults or adolescents aimed at weight loss or maintenance and comparing programs incorporating MI versus interventions without MI.

DATA EXTRACTION: Two reviewers independently screened studies, extracted data, and assessed risk of bias. Outcomes included weight, anxiety, depression, quality of life, and other aspects of psychological well-being. Pooled mean differences or standardized mean differences were obtained using random- and fixed-effects meta-analyses.

DATA SYNTHESIS: Forty-six studies involving 11 077 participants, predominantly with obesity, were included. At 6 months, BWMPs using MI were more effective than no/minimal intervention (-0.88 [95% CI, -1.27 to -0.48] kg; I ² = 0%) but were not statistically significantly more effective than lower-intensity (-0.88 [CI, -2.39 to 0.62] kg; I ² = 55.8%) or similar-intensity (-1.36 [CI, -2.80 to 0.07] kg; I ² = 18.8%) BWMPs. At 1 year, data were too sparse to pool comparisons with no/minimal intervention, but MI did not produce statistically significantly greater weight change compared with lower-intensity (-1.16 [CI, -2.49 to 0.17] kg; I ² = 88.7%) or similar-intensity (-0.18 [CI, -2.40 to 2.04] kg; I ² = 72.7%) BWMPs without MI. Studies with 18-month follow-up were also sparse; MI did not produce statistically significant benefit in any of the comparator categories. There was no evidence of subgroup differences based on study, participant, or intervention characteristics. Too few studies assessed effects on psychological well-being to pool, but data did not suggest that MI was independently effective.

LIMITATIONS: High statistical heterogeneity among studies, largely unexplained by sensitivity and subgroup analyses; stratification by comparator intensity and follow-up duration resulted in pooling of few studies.

CONCLUSION: There is no evidence that MI increases effectiveness of BWMPs in controlling weight. Given the intensive training required for its delivery, MI may not be a worthwhile addition to BWMPs.

PRIMARY FUNDING SOURCE: National Institute for Health Research Biomedical Research Centre. (PROSPERO: CRD42020177259).

PMID:35344379 | DOI:10.7326/M21-3128

Anal Chem. 2022 Mar 28. doi: 10.1021/acs.analchem.1c03237. Online ahead of print.

ABSTRACT

Non-targeted metabolomics via high-resolution mass spectrometry methods, such as direct infusion Fourier transform-ion cyclotron resonance mass spectrometry (DI-FT-ICR MS), produces data sets with thousands of features. By contrast, the number of samples is in general substantially lower. This disparity presents challenges when analyzing non-targeted metabolomics data sets and often requires custom methods to uncover information not always accessible via classical statistical techniques. In this work, we present a pipeline that combines a convolutional neural network with traditional statistical approaches and an adaptation of a genetic algorithm. The developed method was applied to a lifestyle intervention cohort data set, where subjects at risk of type 2 diabetes underwent an oral glucose tolerance test. Feature selection is the final result of the pipeline, achieved through classification of the data set via a neural network, with a precision-recall score of over 0.9 on the test set. The features most relevant for the described classification were then chosen via a genetic algorithm. The output of the developed pipeline encompasses approximately 200 features with high predictive scores, providing a fingerprint of the metabolic changes in the prediabetic class on the data set. Our framework presents a new approach which allows to apply complex modeling based on convolutional neural networks for the analysis of high-resolution mass spectrometric data.

PMID:35344349 | DOI:10.1021/acs.analchem.1c03237

J Magn Reson Imaging. 2022 Mar 28. doi: 10.1002/jmri.28163. Online ahead of print.

ABSTRACT

BACKGROUND: Stress cardiac MRI permits comprehensive evaluation of patients with known or suspected chronic coronary syndromes (CCS). The impact of sex on the use of invasive cardiac angiography (ICA) after vasodilator stress cardiac MRI is unclear.

PURPOSE: To evaluate the impact of sex on ICA use after vasodilator stress cardiac MRI.

STUDY TYPE: Retrospective.

POPULATION: A total of 6229 consecutive patients (age [mean ± standard deviation] 65.2 ± 11.5 years, 38.1% women).

FIELD STRENGTH/SEQUENCE: A 5-T; a steady-state free-precession cine sequence; stress first-pass perfusion imaging; late enhancement imaging.

ASSESSMENT: Patients underwent vasodilator stress cardiac MRI for known or suspected CCS. The ischemic burden (at stress first-pass perfusion imaging) was computed (17-segment model).

STATISTICAL TESTS: Multivariate logistic regression was used to evaluate the potential differential association between ischemic burden and use of cardiac MRI-related ICA across sex.

RESULTS: A total of 1109 (17.8%) patients were referred to ICA, among which there were significantly more men (762, 19.7%) than women (347, 14.6%). Overall, after multivariate adjustment, female sex was not associated with lower use of ICA (odds ratio [OR] = 0.99; confidence interval [CI] 95%: 0.84-1.18, P = 0.934). However, significant sex differences were detected across ischemic burden. Whereas women with nonischemic vasodilator stress cardiac MRI (0 ischemic segments) were less commonly submitted to ICA (OR = 0.49; CI 95%: 0.35-0.69) in patients with ischemia (>1 ischemic segment), adjusted use of ICA was more frequent in women than men (OR = 1.27; CI 95%: 1.1-1.5).

DATA CONCLUSIONS: In patients with known or suspected CCS submitted to undergo vasodilator stress cardiac MRI, cardiac MRI-related ICA may be overused in men without ischemia. Furthermore, ICA referral in patients with negative ischemia resulted in greater odds of revascularization in men.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 5.

PMID:35344231 | DOI:10.1002/jmri.28163

Ecol Appl. 2022 Mar 28:e2595. doi: 10.1002/eap.2595. Online ahead of print.

ABSTRACT

Introduction of pests and diseases through trade is one of the main socio-ecological challenges worldwide. Although Binomial sampling inspection at the border can reduce pest entry risk, it is common for consignments to fail inspection, wasting resources for both exporter and importer. Outsourcing the inspection to the exporting country could reduce the cost of inspection for both parties. However, there is then a need to assess the quality of the offshore inspection. In this paper, we develop an inverse method combining past inspection data on the pathway, an onshore inspection sample, and the Beta-Binomial model to infer the sample size of the offshore inspection. We illustrate the method on two case studies: the importation of live plants through germplasm into Australia and the importation of pelleted seeds in New Zealand. In these case studies, we found that detecting 4-5 infested units in a single onshore inspection was typically sufficient to significantly doubt the presence of a compliant offshore inspection. We also ran a simulation experiment to quantify the statistical power to reject or accept the presence of compliant offshore inspection in practice: In highly infested pathways, we could detect the absence of offshore inspections after inspecting five consignments onshore. Less infested pathways required inspecting 20 to 60 consignments onshore. Our study demonstrates that Binomial sampling onshore can be used to assess the quality of offshore inspections.

PMID:35344236 | DOI:10.1002/eap.2595

Adv Biol (Weinh). 2022 Mar 27:e2101319. doi: 10.1002/adbi.202101319. Online ahead of print.

ABSTRACT

Immune checkpoint inhibitors (ICIs), as a novel class of anticancer therapy, can be more efficacious and less toxic than chemotherapy, but their clinical success is confined to certain tumor types. Elucidating their targets, mechanisms and scope of action, and potential synergism with chemotherapy and/or targeted therapies are critical to widen their clinical indications. Treatment response to an ICI targeting programmed death-1 (anti-PD-1) is sought to be understood here by conducting a preplanned correlative analysis of a phase II clinical trial in patients with small bowel adenocarcinoma (SBA). The cytolytic capacity of circulating immune cells in cancer patients using a novel ex vivo cytotoxicity assay is evaluated, and the utility of circulating biomarkers is investigated to predict and monitor the treatment effect of anti-PD-1. Baseline expression of Bim and NKG7 and upregulation of CX3CR1 in circulating T cells are associated with the clinical benefit of anti-PD-1 in patients with SBA. Overall, these findings suggest that the frequency and cytolytic capacity of circulating, effector immune cells may differentiate clinical response to ICIs, providing a strong rationale to support immune monitoring using patient peripheral blood.

PMID:35343107 | DOI:10.1002/adbi.202101319

Cancer Med. 2022 Mar 27. doi: 10.1002/cam4.4664. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) is the second cause of cancer death worldwide. The role of circulating microvesicles as a screening tool is a novel, yet effective approach that warrants prioritised research.

METHODS: In a two-gate diagnostic accuracy study, 35 patients with benign colorectal polyps (BCRP) (n = 16) and colorectal cancer (CRC) (n = 19) were compared to 17 age-matched healthy controls. Total annexin-V positive microvesicles and sub-populations positive for selected biomarkers relevant to bowel neoplasm were evaluated in patients’ plasma using flow cytometry. Statistical methods including factor analysis utilising two component factors were performed to obtain optimal diagnostic accuracy of microvesicles in identifying patients with colorectal neoplasms.

RESULTS: Total plasma microvesicles, and sub-populations positive for CD31, CD42a, CD31+/CD42a-, EPHB2, ICAM and LGR5 (component factor-1) were able to identify patients with BCRP and CRC with a receiver operator curve (AUC) accuracy of a 100% (95% CI: 100%-100%) and 95% (95% CI: 88%-100%), respectively. To identify patients with BCRP, a cut-off point value of component factor-1761 microvesicles/μl demonstrated a 100% sensitivity, specificity and negative predictive value (NPV) and a 93% positive predictive value (PPV). To identify patients with CRC, a cut-off value of component factor-1 ³ 439 microvesicles/μl demonstrated a 100% sensitivity, specificity and NPV and a 65% PPV. CEA+ microvesicles sub-population were significantly (p < 0.02) higher in CRC in comparison to BCRP.

CONCLUSIONS: Microvesicles as biomarkers for the early and accurate detection of CRC is a simple and effective tool that yields a potential breakthrough in clinical management.

PMID:35343093 | DOI:10.1002/cam4.4664