Tag: pubmed

AANA J. 2022 Aug;90(4):263-270.

ABSTRACT

The effectiveness of propofol infusion on postoperative nausea and vomiting (PONV) is poorly understood in relation to various patient and procedure characteristics. This retrospective cohort study aimed to quantify the effectiveness of propofol infusion when administered either via total intravenous administration (TIVA) or combined intravenous anesthesia (CIVA) with inhalational agents on PONV. The relationship between propofol infusion and PONV was characterized controlling for patient demographics, procedure characteristics, PONV risk factors, and antiemetic drugs in adult patients (age ≥18 years) undergoing general anesthesia. Learned coefficients from multivariate regression models were reported as “lift” which represents the percentage change in the base likelihood of observing PONV if a variable is present versus absent. In a total of 41,490 patients, models showed that propofol infusion has a naive effect on PONV with a lift of -41% (P < .001) when using TIVA and -17% (P < .001) when using CIVA. Adding interaction terms to the model resulted in the loss of statistical significance in these relationships (lift of -30%, P = .23, when using TIVA, and -42%, P = .36, when using CIVA). It was further found that CIVA/TIVA are ineffective in short cases (CIVA * short surgery duration: lift = 49%, P < .001 and TIVA * short surgery duration: lift = 56%, P < .001).

PMID:35943751

J Chem Inf Model. 2022 Aug 9. doi: 10.1021/acs.jcim.2c00144. Online ahead of print.

ABSTRACT

A fast and accurate operational model of electron density is crucial in many scientific disciplines including crystallography, molecular biology, pharmaceutical, and structural chemistry. In quantum crystallography, the aspherical refinement of crystal structures is becoming increasingly popular because of its accurate description in terms of physically meaningful properties. The transferable aspherical atom model (TAAM) is quick and precise, though it requires a robust algorithm for atom typing and coverage of the most popular atom types present in small organic molecules. Thus, the University at Buffalo Databank (UBDB) has been renamed to the Multipolar Atom Types from Theory and Statistical clustering (MATTS) data bank, broadened, restructured, and implemented into the software DiSCaMB with 651 atom types obtained from 2316 small-molecule crystal structures containing C, H, N, O, P, S, F, Cl, and Br atoms. MATTS2021 data bank now covers most of the small molecules, peptides, RNA, DNA, and some frequently occurring cations and anions in biological, pharmaceutical, and organic materials, including the majority of known crystal structures composed of the above elements. The multipole model parameters (P_val, κ, κ’, P_lm) obtained for different atom types were greatly influenced by neighboring atom types, hybridization, geometrical strain in the ring system, and charges on the molecule. Contrary to previous findings, the atoms showing variable oxidation states and ions deviate from the linear dependence of monopole-derived charges on the expansion-contraction κ parameter.

PMID:35943747 | DOI:10.1021/acs.jcim.2c00144

J Chem Inf Model. 2022 Aug 9. doi: 10.1021/acs.jcim.2c00145. Online ahead of print.

ABSTRACT

The multipole model (MM) uses an aspherical approach to describe electron density and can be used to interpret data from X-ray diffraction in a more accurate manner than using the spherical approximation. The MATTS (multipolar atom types from theory and statistical clustering) data bank gathers MM parameters specific for atom types in proteins, nucleic acids, and organic molecules. However, it was not fully understood how the electron density of particular atoms responds to their surroundings and which factors describe the electron density in molecules within the MM. In this work, by applying clustering using descriptors available in the MATTS data bank, that is, topology and multipole parameters, we found the topology features with the biggest impact on the multipole parameters: the element of the central atom, the number of first neighbors, and planarity of the group. The similarities in the spatial distribution of electron density between and within atom type classes revealed distinct and unique atom types. The quality of existing types can be improved by adding better parametrization, definitions, and local coordinate systems. Future development of the MATTS data bank should lead to a wider range of atom types necessary to construct the electron density of any molecule.

PMID:35943739 | DOI:10.1021/acs.jcim.2c00145

Evol Comput. 2022 Aug 9:1-21. doi: 10.1162/evco_a_00314. Online ahead of print.

ABSTRACT

In the traffic light scheduling problem the evaluation of candidate solutions requires the simulation of a process under various (traffic) scenarios. Thus, good solutions should not only achieve good objective function values, but they must be robust (low variance) across all different scenarios. Previous work has shown that combining IRACE with evolutionary operators is effective for this task due to the power of evolutionary operators in numerical optimization. In this paper, we further explore the hybridization of evolutionary operators and the elitist iterated racing of IRACE for the simulation-optimization of traffic light programs. We review previous works from the literature to find the evolutionary operators performing the best when facing this problem to propose new hybrid algorithms. We evaluate our approach over a realistic case study derived from the traffic network of Málaga (Spain) with 275 traffic lights that should be scheduled optimally. The experimental analysis reveals that the hybrid algorithm comprising IRACE plus differential evolution offers statistically better results than the other algorithms when the budget of simulations is low. In contrast, IRACE performs better than the hybrids for high simulations budget, although the optimization time is much longer.

PMID:35943729 | DOI:10.1162/evco_a_00314

Am J Physiol Lung Cell Mol Physiol. 2022 Aug 9. doi: 10.1152/ajplung.00126.2022. Online ahead of print.

ABSTRACT

^99mTc-hexamethylpropyleneamine oxime (HMPAO) and ^99mTc-duramycin in vivo imaging detects pulmonary oxidative stress and cell death, respectively, in rats exposed to >95% O₂ (hyperoxia) as a model of Acute Respiratory Distress Syndrome (ARDS). Pre-exposure to hyperoxia for 48 h followed by 24 h in room air (H-T) is protective against hyperoxia-induced lung injury. This study’s objective was to determine the ability of ^99mTc-HMPAO and ^99mTc-duramycin to track this protection and to elucidate underlying mechanisms. Rats were exposed to normoxia, hyperoxia for 60 h, H-T, or H-T followed by 60 h of hyperoxia (H-T+60). Imaging was performed 20 minutes post intravenous injection of either ^99mTc-HMPAO or ^99mTc-duramycin. ^99mTc-HMPAO and ^99mTc-duramycin lung uptake was 200% and 167% greater (p <0.01) in hyperoxia compared to normoxia rats, respectively. On the other hand, uptake of ^99mTc-HMPAO in H-T+60 was 24% greater (p <0.01) than in H-T rats, but ^99mTc-duramycin uptake was not significantly different (p=0.09). Lung wet-to-dry weight ratio, pleural effusion, endothelial filtration coefficient, and histological indices all showed evidence of protection and paralleled imaging results. Additional results indicate higher mitochondrial complex IV activity in H-T versus normoxia rats, suggesting that mitochondria of H-T lungs may be more tolerant of oxidative stress. A pattern of increasing lung uptake of ^99mTc-HMPAO and ^99mTc-duramycin correlates with advancing oxidative stress and cell death and worsening injury, whereas stable or decreasing ^99mTc-HMPAO and stable ^99mTc-duramycin reflects hyperoxia tolerance, suggesting the potential utility of molecular imaging for identifying at-risk hosts that are more or less susceptible to progressing to ARDS.

PMID:35943727 | DOI:10.1152/ajplung.00126.2022

J Endocrinol Invest. 2022 Aug 9. doi: 10.1007/s40618-022-01885-5. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the association of cytochrome P450 2E1 (CYP2E1) C-1054T (rs2031920) and 96-bp I/D genetic variations with the risk of polycystic ovary syndrome (PCOS), and to estimate the effects of genotypes on the clinical, metabolic, hormonal, and oxidative stress indicators.

METHODS: This case-control study included 762 control women and 1034 patients with PCOS. Genotypes were determined using polymerase chain reaction and/or restriction fragment length polymorphism analysis. Clinical and biochemical parameters were also analyzed.

RESULTS: Frequencies of the TT + CT genotype (35.4 vs. 28.9%) and T allele (19.6 vs. 16.0%) of the CYP2E1 C-1054T polymorphism were significantly higher in the PCOS group than in the control group (OR = 1.350, 95% CI 1.103-1.652, P = 0.004 for the dominant model). Genotype TT + CT remained a significant predictor of PCOS in a logistic regression model including age, body mass index (BMI), and recruitment year of participants (OR = 1.345, 95% CI 1.071-1.688, P = 0.011). No statistical differences were found in the genotype and allele frequencies of CYP2E1 96-bp I/D polymorphism. However, the combined genotype DD/TT + CT was related to an increased risk of PCOS when the DD/CC wild-type combined genotype was used as a reference. Patients with the I allele of 96-bp I/D polymorphism had a lower BMI but higher plasma apolipoprotein B and oxidized low-density lipoprotein cholesterol levels than those with the DD genotype.

CONCLUSION: CYP2E1 C-1054T, but not 96-bp I/D, genetic polymorphism is associated with an increased risk of PCOS in Chinese women.

PMID:35943720 | DOI:10.1007/s40618-022-01885-5

Transpl Infect Dis. 2022 Aug 9:e13920. doi: 10.1111/tid.13920. Online ahead of print.

ABSTRACT

BACKGROUND: Carbapenem-resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients’ survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres.

AIMS: This study aimed to identify risk factors for CRE colonisation at LT in order to build a predictive model.

METHODS: Retrospective multicentre study including consecutive adult patients who underwent LT, from 2010 to 2019, at two large teaching hospitals. We excluded patients who had CRE infections within 90 days before LT. CRE screening was performed in all patients on the day of LT. Exposure variables were considered within 90 days before LT and included cirrhosis complications, underlying disease, time on the waiting list, MELD and CLIF-SOFA scores, antibiotic use, intensive care unit and hospital stay, and infections. A machine learning model was trained to detect the probability of a patient being colonized with CRE at LT.

RESULTS: A total of 1544 patients were analyzed, 116 (7.5%) patients were colonized by CRE at LT. The median time from CRE isolation to LT was 5 days. Use of antibiotics, hepato-renal syndrome, worst CLIF sofa score, and use of beta-lactam/beta-lactamase inhibitor increased the probability of a patient having pre-LT CRE. The proposed algorithm had a sensitivity of 66% and a specificity of 83% with a negative predictive value of 97%.

CONCLUSIONS: We created a model able to predict CRE colonization at LT based on easy-to-obtain features that could guide antibiotic prophylaxis.

PMID:35942941 | DOI:10.1111/tid.13920

Biometrics. 2022 Aug 9. doi: 10.1111/biom.13732. Online ahead of print.

ABSTRACT

Mendelian randomization (MR) utilizes genetic variants as instrumental variables (IVs) to estimate the causal effect of an exposure variable on an outcome of interest even in the presence of unmeasured confounders. However, the popular inverse-variance weighted (IVW) estimator could be biased in the presence of weak IVs, a common challenge in MR studies. In this article, we develop a novel penalized inverse-variance weighted (pIVW) estimator, which adjusts the original IVW estimator to account for the weak IV issue by using a penalization approach to prevent the denominator of the pIVW estimator from being close to zero. Moreover, we adjust the variance estimation of the pIVW estimator to account for the presence of balanced horizontal pleiotropy. We show that the recently proposed debiased IVW (dIVW) estimator is a special case of our proposed pIVW estimator. We further prove that the pIVW estimator has smaller bias and variance than the dIVW estimator under some regularity conditions. We also conduct extensive simulation studies to demonstrate the performance of the proposed pIVW estimator. Furthermore, we apply the pIVW estimator to estimate the causal effects of five obesity-related exposures on three coronavirus disease 2019 (COVID-19) outcomes. Notably, we find that hypertensive disease is associated with an increased risk of hospitalized COVID-19; and peripheral vascular disease and higher body mass index are associated with increased risks of COVID-19 infection, hospitalized COVID-19 and critically ill COVID-19. This article is protected by copyright. All rights reserved.

PMID:35942938 | DOI:10.1111/biom.13732

Pflege. 2022 Aug 9. doi: 10.1024/1012-5302/a000904. Online ahead of print.

ABSTRACT

Nursing interventions by school nurses in Germany: A cross-sectional study Abstract. Background: The internationally established professional profile of school nursing has not yet been implemented across the board in Germany. In model projects and some international schools the feasibility of the concept and the daily work of school nurses in Germany can already be observed. Urgent and currently often unsolved issues in the school setting are the inclusion of chronically ill students and health promotion in the living environment. Aim: The aim of this paper is to describe the interventions of school nurses in everyday school life. Method: Using a standardized online questionnaire, school nurses in Germany were surveyed regarding the activities they performed and their frequency. The data on the activities were collected based on the Nursing Intervention Classification (NIC). Data were analyzed using descriptive statistics. Results: Respondents (n = 25) focused on acute care and health education/promotion. Nursing interventions that have a family or population-based approach are performed only “every 2-3 months” or less by the average respondent. Conclusions: The daily intensive implementation of diverse nursing interventions indicates an urgent need for nursing expertise in schools.

PMID:35942890 | DOI:10.1024/1012-5302/a000904

Stroke. 2022 Aug 9:101161STROKEAHA122038673. doi: 10.1161/STROKEAHA.122.038673. Online ahead of print.

ABSTRACT

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) can cause short-term cerebrovascular complications, such as brain infarction and hemorrhage. We hypothesized that PRES is also associated with an increased long-term risk of stroke.

METHODS: We performed a retrospective cohort study in the United States using statewide all-payer claims data from 2016 to 2018 on all admissions to nonfederal hospitals in 11 states. Adults with PRES were compared with adults with renal colic (negative control) and transient ischemic attack (TIA; positive control). Any stroke and the secondary outcomes of ischemic and hemorrhagic stroke were ascertained using International Classification of Diseases, Tenth Revision, Clinical Modification codes. We excluded prevalent stroke. We used time-to-event statistics to calculate incidence rates and Cox proportional hazards analyses to evaluate the association between PRES and stroke, adjusting for demographics and stroke risk factors. In a sensitivity analysis, outcomes within 2 weeks of index admission were excluded.

RESULTS: We identified 1606 patients with PRES, 1192 with renal colic, and 38 216 with TIA. Patients with PRES had a mean age of 56±17 years; 72% were women. Over a median follow-up of 0.9 years, the stroke incidence per 100 person-years was 6.1 (95% CI, 5.0-7.4) after PRES, 1.0 (95% CI, 0.62-1.8) after renal colic, and 9.7 (95% CI, 9.4-10.0) after TIA. After statistical adjustment for patient characteristics and risk factors, patients with PRES had an elevated risk of stroke compared with renal colic (hazard ratio [HR], 2.3 [95% CI, 1.7-3.0]), but lower risk than patients with TIA (HR, 0.67 [95% CI, 0.54-0.82]). In secondary analyses, compared with TIA, PRES was associated with hemorrhagic stroke (HR, 2.0 [95% CI, 1.4-2.9]). PRES was associated with ischemic stroke when compared with renal colic (HR, 1.9 [95% CI, 1.4-2.7]) but not when compared with TIA (HR, 0.49 [95% CI, 0.38-0.63]). Results were similar with 2-week washout.

CONCLUSIONS: Patients with PRES had an elevated risk of incident stroke.

PMID:35942880 | DOI:10.1161/STROKEAHA.122.038673