Tag: pubmed

J Neural Eng. 2021 Jul 8. doi: 10.1088/1741-2552/ac127f. Online ahead of print.

ABSTRACT

OBJECTIVE: Asynchronous brain-computer interfaces (BCIs) show significant advantages in many practical application scenarios. Compared with the rapid development of synchronous BCIs technology, the progress of asynchronous BCI research, in terms of containing multiple targets and training-free detection, is still relatively slow. In order to improve the practicability of the brain-computer interface, a spatio-temporal equalization multi-window algorithm (STE-MW) was proposed for asynchronous detection of steady-state visual evoked potential (SSVEP) without the need for acquiring calibration data.

APPROACH: The algorithm used spatio-temporal equalization strategy to intercept EEG signals of different lengths through multiple stacked time windows and statistical decisions-making based on Bayesian risk decision-making. Different from the traditional asynchronous algorithms based on the “non-control state detection” methods, this algorithm was based on the “statistical inspection-rejection decision” mode and did not require a separate classification of non-control states, so it can be effectively applied to detections for large-scale candidates.

MAIN RESULTS: Online experimental results involving fourteen healthy subjects showed that, in the continuously input experiments of 40 targets, the algorithm achieved the average recognition accuracy of 97.2%±2.6% and the average information transfer rate of 106.3±32.0 bits/min. At the same time, the average false alarm rate in the 240-seconds resting state test was 0.607±0.602 min^(-1). In the free spelling experiments involving patients with severe amyotrophic lateral sclerosis, the subjects achieved an accuracy of 92.7% and an average information transfer rate of 43.65 bits/min in two free spelling experiments.

SIGNIFICANCE: This algorithm can achieve high-performance, high-precision, and asynchronous detection of SSVEP signals with low algorithm complexity and false alarm rate under multi-targets and training-free conditions, which is helpful for the development of asynchronous BCI systems.

PMID:34237711 | DOI:10.1088/1741-2552/ac127f

Phys Med Biol. 2021 Jul 8. doi: 10.1088/1361-6560/ac127d. Online ahead of print.

ABSTRACT

We try to develop an atlas-guided automatic planning (AGAP) approach and evaluate its feasibility and performance in rectal cancer intensity-modulated radiotherapy. The developed AGAP approach consisted of four independent modules: patient atlas, similar patient retrieval, beam morphing, and plan fine-tuning modules. The atlas was setup using anatomy and plan data from Pinnacle auto-planning (P-auto) plans. Given a new patient, the retrieval function searched the top similar patient by a generic Fourier descriptor algorithm and retrieved its plan information. The beam morphing function generated an initial plan for the new patient by morphing the beam aperture from the top similar patient plan. The beam aperture and calculated dose of the initial plan were used to guide the new plan optimization in the plan fine-tuning function. The AGAP approach was tested on 96 patients by the leave-one-out validation and plan quality was compared with the P-auto plans. The AGAP and P-auto plans had no statistical difference for target coverage and dose homogeneity in terms of V100%(p=0.76) and homogeneity index (HI)(p=0.073), respectively. The CI index showed they had a statistically significant difference. but the ΔCI was both 0.02 compared to the perfect CI index of 1. The AGAP approach reduced the bladder mean dose by 152.1cGy (p<0.05) and V50 by 0.9% (p<0.05), and slightly increased the left and right femoral head mean dose by 70.1cGy (p<0.05) and 69.7cGy (p<0.05), respectively. This work developed an efficient and automatic approach that could fully automate the IMRT planning process in rectal cancer radiotherapy. It reduced the plan quality dependence on the planner experience and maintained the comparable plan quality with P-auto plans.

PMID:34237715 | DOI:10.1088/1361-6560/ac127d

Eur Neuropsychopharmacol. 2021 Jul 5;52:18-30. doi: 10.1016/j.euroneuro.2021.06.003. Online ahead of print.

ABSTRACT

Sodium oxybate (SMO) has been approved in Italy and Austria for the maintenance of abstinence in alcohol dependent (AD) patients. Although SMO is well tolerated in AD patients, cases of abuse and misuse have been reported outside the therapeutic setting. Here we report on a phase IIb double-blind, randomized, placebo-controlled trial for the maintenance of abstinence in AD patients with a new abuse and misuse deterrent formulation of SMO. A total of 509 AD patients were randomized to 12 weeks of placebo or one of four SMO doses (0.75, 1.25, 1.75 or 2.25 g t.i.d.) followed by a one-week medication-free period. The primary endpoint was the percentage of days abstinent (PDA) at end of treatment. An unexpectedly high placebo response (mean 73%, median 92%) was observed. This probably compromised the demonstration of efficacy in the PDA, but several secondary endpoints showed statistically significant improvements. A post-hoc subgroup analysis based on baseline severity showed no improvements in the mild group, but statistically significant improvements in the severe group: PDA: mean difference +15%, Cohen’s d = 0.42; abstinence: risk difference +18%, risk ratio = 2.22. No safety concerns were reported. Although the primary endpoint was not significant in the overall population, several secondary endpoints were significant in the intent-to-treat population and post-hoc results showed that treatment with SMO was associated with a significant improvement in severe AD patients which is consistent with previous findings. New trials are warranted that take baseline severity into consideration.

PMID:34237655 | DOI:10.1016/j.euroneuro.2021.06.003

Clin Nutr. 2021 Jun 5;40(7):4644-4652. doi: 10.1016/j.clnu.2021.05.026. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the linear and nonlinear dose-response associations of animal-based dietary protein intake and risk of developing rheumatoid arthritis (RA).

METHODS: A systematic search of MEDLINE, Scopus and Embase was conducted up to October 2020. Observational studies that report risk estimates of RA for animal-based protein consumption were included. We calculated pooled relative risks (RRs) by using a random-effects model. Linear and non-linear dose-response analyses were performed to examine the dose-response relations between animal-based protein consumption and RA.

RESULTS: Seven cohort studies (n = 457,554) with 3545 incident cases and six case-control studies with 3994 cases and 5252 controls were identified. Highest compared with the lowest category of fish consumption was inversely associated with risk of RA (RR: 0.89; 95% CI, 0.80 to 0.99; I² = 0%, n = 10). Also, a 100 g/day increment in fish intake was associated with a 15% decreased risk of RA. Dose-response analysis showed a modest U-shaped association between fish consumption and incidence of RA, with the lowest risk at a fish intake of 20-30 g/day (P_{non-linearity} = 0.04). We found no significant association between consumption of red meat, poultry or dairy and the risk of RA.

CONCLUSION: The present study revealed a significant reverse association between fish consumption and risk of RA. While we observed no association between red meat, dairy or poultry consumption and risk of RA. Further well-designed prospective studies are needed to support our findings.

PMID:34237693 | DOI:10.1016/j.clnu.2021.05.026

Drug Alcohol Depend. 2021 Jun 30;226:108868. doi: 10.1016/j.drugalcdep.2021.108868. Online ahead of print.

ABSTRACT

BACKGROUND: The American Society of Addiction Medicine (ASAM) criteria were developed to provide a systematic, evidence-based, and transparent approach to addiction treatment assessment and level-of-care recommendations. In 2017, California began a Medicaid demonstration that required that providers in participating counties to adopt ASAM-based intake assessments and level-of-care criteria. We hypothesized that ASAM implementation would increase the proportion of patients retained in addiction treatment and successfully completing their treatment plan.

METHODS: We implemented a comparative interrupted time series analysis with 407,792 treatment episodes by Medicaid beneficiaries in specialty addiction treatment settings from 2015 to mid-2019. We compared the change in retention rates and successful completion rates in counties that adopted ASAM-based assessments relative to counties that did not adopt ASAM-based assessments and used only clinical judgment for level-of-care decisions. Treatment retention was defined as staying in addiction treatment for at least 30 days. Successful completion of the treatment plan was determined by the patient’s clinician.

RESULTS: After one year, ASAM implementation was associated with a 9% increase in 30-day retention among treatment episodes that started in a residential setting, but no change in retention among episodes starting in outpatient settings. We found no statistically significant association between ASAM adoption and successful treatment completion.

CONCLUSIONS: Implementation of ASAM-based assessment may lead to improved retention for individuals who begin treatment in residential treatment, which may be encouraging to the many state Medicaid programs that are adopting ASAM-based criteria. More research is needed to clarify the mechanism by which ASAM leads to improved outcomes and to clarify how to maximize the potential benefits of ASAM, such as through patient-centered implementation.

PMID:34237614 | DOI:10.1016/j.drugalcdep.2021.108868

J Surg Res. 2021 Jul 5;267:443-451. doi: 10.1016/j.jss.2021.06.001. Online ahead of print.

ABSTRACT

BACKGROUND: Previous studies have suggested that large preoperative AAA size may impact late survival after elective EVAR. It is unclear, however, whether this association applies to patients with smaller AAA between 5.0-5.5 cm, who constitute a substantial portion of patients undergoing elective EVAR. The purpose of this study was to delineate the effect of AAA size between 5.0 and 5.5 cm on mid-term mortality after EVAR by analyzing a large national cohort, the Vascular Quality Initiative (VQI) database.

METHODS: Using the Vascular Quality Initiative (VQI) national database, patients who underwent EVAR for intact AAA between 2003 and 2018 were identified and stratified based on maximal AAA diameter into 3 groups: Group 1 (4.0 cm ≤ AAA <5.0 cm); Group 2 (5.0 cm ≤ AAA < 5.5 cm); and Group 3 (AAA ≥ 5.5 cm). Cox proportional hazard model and propensity score matching method were used to estimate AAA size effect on all-cause mortality at 1, 3, and 5 years after EVAR while adjusting for potential confounders.

RESULTS: The study included 32,398 patients, of whom 81% were men with a mean age of 74. The most common group who underwent EVAR was Group 2 (5.0 cm ≤ AAA < 5.5 cm). Larger AAA size was associated with male sex (75% versus 79% versus 84%, for Groups 1, 2, and 3 respectively; P < 0.0001) and with coronary artery disease (27% versus 29% versus 31%, for Groups 1, 2, and 3 respectively, P< 0.0001); but was negatively associated with active smoking (33% versus 31% versus 30%, for Groups 1, 2, and 3, respectively, P< 0.001). While 10% of the largest and smallest AAA groups (Groups 3 and 1, respectively) were symptomatic, only 5% of patients in Group 2 were symptomatic (P < 0.01). Adjusted Cox proportional hazard modeling revealed that patients in Group 2 were at significantly lower risk of 5-year mortality when compared to patients in Group 3 (HR 0.66, 95% CI 0.61-0.72, P< 0.01), while similar in risk when compared to patients in Group 1 (HR 1.11, 95% CI 0.93-1.32, P= 0.26).

CONCLUSION: Our analysis found that over 40% of EVAR in the national VQI cohort were performed for AAA < 5.5 cm, with the greatest number of patients undergoing EVAR at AAA size 5.0-5.5cm. Patients with AAA size 5.0-5.5 cm had better 5-year survival outcomes than patients with AAA ≥ 5.5 cm, and similar survival to patients with small AAA between 4.0-5.0 cm.

PMID:34237629 | DOI:10.1016/j.jss.2021.06.001

Environ Pollut. 2021 Jul 3;288:117683. doi: 10.1016/j.envpol.2021.117683. Online ahead of print.

ABSTRACT

Reservoirs are an important type of drinking water source for megacities, while lots of reservoirs are threatened by odor problems during certain seasons. The influencing factors of odor compounds in reservoirs are still unclear. During August 2019, a nationwide survey investigating the distribution of odor compounds in reservoirs used as drinking water sources was conducted on seven reservoirs. 2-methylisoborneol (2-MIB) and geosmin were detected in almost every reservoir, and some odor compound concentrations even exceeded the odor threshold concentration. The average concentration of 2-MIB was 2.68 ng/L, and geosmin was 3.63 ng/L. The average chlorophyll a concentration was 8.25 μg/L. The dominant genera of phytoplankton in these reservoirs belonged to cyanobacteria and diatom. Statistical analysis showed that odor compound concentration was significantly related to the chlorophyll a concentration and indicated that the odor compounds mainly came from phytoplankton. The concentration of odor compounds in the euphotic zone was significantly related to phytoplankton species and biomass. Therefore, the odor compound concentrations in the subsurface chlorophyll maxima layer was generally higher than in the surface layer. However, the odor compounds in the hypolimnion layer were related to the density current. This research suggests that both phytoplankton proliferation events and heavy storm events are important risk factors increasing odor compounds in reservoirs. Control of algal bloom, in-situ profile monitoring system and depth-adjustable pumping system will greatly reduce the risk of odor problems in reservoirs using as water supplies for large cities.

PMID:34237652 | DOI:10.1016/j.envpol.2021.117683

Diabetes Metab Syndr. 2021 Jun 27;15(4):102186. doi: 10.1016/j.dsx.2021.102186. Online ahead of print.

ABSTRACT

AIMS: This systematic review and meta-analysis aims to investigate the effect of ivermectin on mortality in patients with COVID-19.

METHODS: A comprehensive systematic literature search was performed using PubMed, Scopus, Embase, and Clinicaltrials.gov from the inception of databases up until April 9, 2021. The intervention group was ivermectin and the control group was standard of care or placebo. The primary outcome was mortality reported as risk ratio (RR).

RESULTS: There were 9 RCTs comprising of 1788 patients included in this meta-analysis. Ivermectin was associated with decreased mortality (RR 0.39 [95% 0.20-0.74], p = 0.004; I²: 58.2%, p = 0.051). Subgroup analysis in patients with severe COVID-19 showed borderline statistical significance towards mortality reduction (RR 0.42 [95% 0.18-1.00], p = 0.052; I²: 68.3, p = 0.013). The benefit of ivermectin and mortality was reduced by hypertension (RR 1.08 [95% CI 1.03-1.13], p = 0.001); but was not influenced by age (p = 0.657), sex (p = 0.466), diabetes (p = 0.429). Sensitivity analysis using fixed-effect model showed that ivermectin decreased mortality in general (RR 0.43 [95% CI 0.29-0.62], p < 0.001) and severe COVID-19 subgroup (RR 0.48 [95% CI 0.32-0.72], p < 0.001).

CONCLUSIONS: Ivermectin was associated with decreased mortality in COVID-19 with a low certainty of evidence. Further adequately powered double-blinded placebo-controlled RCTs are required for definite conclusion.

PMID:34237554 | DOI:10.1016/j.dsx.2021.102186

Mult Scler Relat Disord. 2021 Jun 23;54:103109. doi: 10.1016/j.msard.2021.103109. Online ahead of print.

ABSTRACT

BACKGROUND: Fatigue is one of the most prevalent and impactful symptoms for people with multiple sclerosis (MS). Yet, fatigue is less understood in progressive forms of MS, and few studies have explored the extent to which MS disease course is associated with fatigue. The current study aimed to (1) describe fatigue severity and fatigue interference (the extent to which fatigue interferes with individuals’ physical, mental, and social activities) in people with progressive MS (primary progressive MS and secondary progressive MS); (2) compare fatigue severity and fatigue interference in people with progressive forms of MS to people with relapsing-remitting MS (RRMS); and (3) identify factors associated with fatigue severity and fatigue interference in people with progressive forms of MS and RRMS.

METHODS: Secondary analysis of baseline data from participants with MS (N = 573; progressive forms of MS n = 142; RRMS n = 431) in a survey-based longitudinal study on healthy aging in people with a physical disability. Primary outcomes were average fatigue severity (0-10 Numerical Rating Scale), and fatigue interference (PROMIS Fatigue Short Form). Correlates were variables across the demographic and biopsychosocial domains, collected with validated self-reported measures. Statistical methods included t-test and chi-square analyses to compare fatigue severity and fatigue interference in people with progressive MS to those with RRMS, and multiple regression analyses to examine the association of variables with fatigue severity and fatigue interference.

RESULTS: Participants with progressive forms of MS reported moderate to severe levels of average fatigue severity (5.9 ± 2.8) and elevated levels of fatigue interference (T-Score of 58.2 ± 7.9). There were no group differences between people with progressive MS and RRMS in average fatigue severity or fatigue interference. Common factors associated with greater fatigue severity were lower income, being unemployed, shorter disease duration, greater disability, and greater sleep disturbance. Common factors associated with fatigue interference were younger age, lower income, being unemployed, greater disability, lower alcohol consumption, being a smoker, and greater sleep disturbance. For those with progressive forms of MS, longer MS disease duration was associated with lower average fatigue severity (b = -0.08, t(532) = -3.69, p < .001) and having a college degree or higher was associated with higher fatigue interference (b = 2.84, t(520) = 2.23, p = .026).

CONCLUSION: In this sample, fatigue severity and fatigue interference were similar for progressive forms of MS and RRMS. Future research should consider if interventions that work for fatigue management in people with relapsing forms of MS work similarly for people with progressive forms of MS.

PMID:34237561 | DOI:10.1016/j.msard.2021.103109

J Environ Radioact. 2021 Jul 5;237:106692. doi: 10.1016/j.jenvrad.2021.106692. Online ahead of print.

ABSTRACT

The use of nuclear power as an environmentally friendly, and sustainable means for energy production is heavily under discussion. Despite this recently several countries with a predominantly arid climate have sought to develop or deploy nuclear energy production systems. However, there is little information on how radionuclides behave in different, especially arid, climates. Members of the IUR task group for arid environment and of the IAEA MODARIA II working group 4 contributed to such a supplement to the International Atomic Energy Agency (IAEA) Technical Report Series No. 472 (IAEA, 2010) Handbook of Parameter Values for the Prediction of Radionuclides Transfer in Terrestrial and Freshwater Environments under the IAEA Modelling and Data for Radiological Impact Assessments (MODARIA II) programme (2016-2019) to close this knowledge gap. Data on concentration ratios for plant and soil (CR) in arid environments following the Köppen-Geiger classification of climates were collated, summarised and quality assured. The combination of this data with transfer parameter data for root uptake of radionuclides by food crops in tropical environments (this issue) aimed to compare all data with those in TRS 472 recommended for use in dose assessment models. Therefore, a databank has been started based on an intensive literature research on published concentration ratio (CR) data in selected arid environments. After quality check data have been formatted to comply with TRS 472 and with the tropical data base criteria. Due to the scarcity of published information and the high uncertainty of the estimated mean values for individual plant and soil groups in arid environments no statistically relevant conclusions could be drawn, although some differences were notable. Nevertheless, despite its limitations and high uncertainties, this work presents the first reported comprehensive data collation on CR soil-plant values in arid environments.

PMID:34237508 | DOI:10.1016/j.jenvrad.2021.106692