Tag: pubmed

Ann Intensive Care. 2022 Jun 21;12(1):56. doi: 10.1186/s13613-022-01030-8.

ABSTRACT

BACKGROUND: Previous studies have found an increase in cardiac troponins (cTns) and echocardiographic abnormalities in patients with COVID-19 and reported their association with poor clinical outcomes. Whether acute injury occurs during the course of critical care and if it is associated with cardiac function is unknown. The purpose of this study was to document the incidence of acute myocardial injury (AMInj) and echocardiographically defined left ventricular (LV) and right ventricular (RV) systolic dysfunction in consecutive patients admitted to an intensive care unit (ICU) for COVID-19. The relationship between AMInj and echocardiographic abnormalities during the first 14 days of ICU admission was studied. Finally, the association between echocardiographic findings, AMInj and clinical outcome was evaluated.

METHODS: Seventy-four consecutive patients (≥18 years) admitted to the ICU at Linköping University Hospital between 19 Mar 2020 and 31 Dec 2020 for COVID-19 were included. High-sensitivity troponin-T (hsTnT) was measured daily for up to 14 days. Transthoracic echocardiography was conducted within 72 h of ICU admission. Acute myocardial injury was defined as an increased hsTnT > 14ng/l and a > 20% absolute change with or without ischaemic symptoms. LV and RV systolic dysfunction was defined as at least 2 abnormal indicators of systolic function specified by consensus guidelines.

RESULTS: Increased hsTnT was observed in 59% of patients at ICU admission, and 82% developed AMInj with peak levels at 8 (3-13) days after ICU admission. AMInj was not statistically significantly associated with 30-day mortality but was associated with an increased duration of invasive mechanical ventilation (10 (3-13) vs. 5 days (0-9), p=0.001) as well as ICU length of stay (LOS) (19.5 (11-28) vs. 7 days (5-13), p=0.015). After adjustment for SAPS-3 and admission SOFA score, the effect of AMInj was significant only for the duration of mechanical ventilation (p=0.030). The incidence of LV and RV dysfunction was 28% and 22%, respectively. Only indices of LV and RV longitudinal contractility (mitral and tricuspid annular plane systolic excursion) were associated with AMInj. Echocardiographic parameters were not associated with clinical outcome.

CONCLUSIONS: Myocardial injury is common in critically ill patients with COVID-19, with AMInj developing in more than 80% after ICU admission. In contrast, LV and RV dysfunction occurred in approximately one-quarter of patients. AMInj was associated with an increased need for mechanical ventilation and ICU LOS but neither AMInj nor ventricular dysfunction was significantly associated with mortality.

PMID:35727386 | DOI:10.1186/s13613-022-01030-8

Breast Cancer Res Treat. 2022 Jun 21. doi: 10.1007/s10549-022-06642-z. Online ahead of print.

ABSTRACT

PURPOSE: Accumulating evidence has shown that microRNAs (miRNAs) are promising biomarkers of neoadjuvant chemotherapy (NAC) response in breast cancer (BC). However, their predictive roles remain controversial. Thus, this systematic review and meta-analysis aimed to describe the role of miRNA expression in NAC response and prognosis in BC to increase statistical power and improve translation.

METHODS: A systematic review of electronic databases for relevant studies was conducted following PRISMA guidelines. Data were extracted, collated, and combined by odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) to estimate the strength of the associations.

RESULTS: Of the 560 articles screened, 59 studies were included in our systematic review, and 5 studies were included in the subsequent meta-analysis. Sixty of 123 miRNAs were found to be related with NAC response and an elevated baseline miR-7 level in tissues was associated with a higher pathological complete response rate (OR 5.63; 95% CI 2.15-14.79; P = 0.0004). The prognostic value of 39 miRNAs was also studied. Of them, 26 miRNAs were found to be associated with survival. Pooled HRs indicated that patients with increased levels of serum miR-21 from baseline to the end of the second NAC cycle and from baseline to the end of NAC had a worse disease-free survival than those with decreased levels.

CONCLUSION: Our results highlight that a large number of miRNAs have possible associations with NAC response and prognosis in BC patients. Further well-designed studies are needed to elucidate the molecular mechanisms underlying these associations.

PMID:35727379 | DOI:10.1007/s10549-022-06642-z

J Cancer Res Clin Oncol. 2022 Jun 21. doi: 10.1007/s00432-022-04137-4. Online ahead of print.

ABSTRACT

BACKGROUND: The use of immune checkpoint inhibitors (ICI) has transformed cancer treatment. Subsequent ICI use has become increasingly common following disease progression. We aim to evaluate the safety and tolerability of the sequential ICI treatment modality.

METHODS: Retrospective review of confirmed carcinoma from January 2014 to December 2018. Patients were categorized into “initial ICI arm” and “sequential ICI arm” defined as patients receiving single, dual or chemo-immunotherapy ICI following an initial ICI regimen. Primary outcome was the development of a new or recurrent immune related adverse event (irAE) during sequential therapy. Secondary outcomes were the number of cycles prior to the development of irAE and grade of irAE.

RESULTS: A total of 483 patients received ICI during the timeframe. Of those, 22 patients received sequential ICI. The diagnoses included ten lung cancer, seven melanoma, four renal cell carcinoma and one bladder cancer. 16 patients received single agent ICI following the initial ICI, three patients received dual ICI following the initial ICI, one patient received chemotherapy-immunotherapy following initial ICI, and two patients received chemo-immunotherapy after dual ICI. Four patients developed new irAE and one patient developed the same irAE on sequential treatment. A higher proportion of patients experienced grade 3 irAE in the sequential arm compared to the initial ICI arm (p = 0.03). No statistical difference was found between the development of irAE and the number of cycles prior to development of irAE in either treatment groups (p = 0.5).

CONCLUSION: Our data shows overall safety of sequencing ICI when close monitoring was employed.

PMID:35727369 | DOI:10.1007/s00432-022-04137-4

Exp Brain Res. 2022 Jun 21. doi: 10.1007/s00221-022-06394-8. Online ahead of print.

ABSTRACT

Cognitive flexibility is a core component of executive function and supports the ability to ‘switch’ between different tasks. Our group has examined the cost associated with switching between a prosaccade (i.e., a standard task requiring a saccade to veridical target location) and an antisaccade (i.e., a non-standard task requiring a saccade mirror-symmetrical to veridical target) in predictable (i.e., AABB) and unpredictable (e.g., AABAB…) switching paradigms. Results have shown that reaction times (RTs) for a prosaccade preceded by an antisaccade (i.e., task-switch trial) are longer than when preceded by its same task-type (i.e., task-repeat trial), whereas RTs for antisaccade task-switch and task-repeat trials do not differ. The asymmetrical switch-cost has been attributed to an antisaccade task-set inertia that proactively delays a subsequent prosaccade (i.e., the unidirectional prosaccade switch-cost). A salient question arising from previous work is whether the antisaccade task-set inertia passively dissipates or persistently influences prosaccade RTs. Accordingly, participants completed separate AABB (i.e., A = prosaccade, B = antisaccade) task-switching conditions wherein the preparation interval for each trial was ‘short’ (1000-2000 ms; i.e., the timeframe used in previous work), ‘medium’ (3000-4000 ms) and ‘long’ (5000-6000 ms). Results demonstrated a reliable prosaccade switch-cost for each condition (ps < 0.02) and two one-sided test statistics indicated that switch cost magnitudes were within an equivalence boundary (ps < 0.05). Hence, null and equivalence tests demonstrate that an antisaccade task-set inertia does not passively dissipate and represents a temporally persistent feature of oculomotor control.

PMID:35727365 | DOI:10.1007/s00221-022-06394-8

Biol Cybern. 2022 Jun 21. doi: 10.1007/s00422-022-00937-6. Online ahead of print.

ABSTRACT

In Bourlard and Kamp (Biol Cybern 59(4):291-294, 1998), it was theoretically proven that autoencoders (AE) with single hidden layer (previously called “auto-associative multilayer perceptrons”) were, in the best case, implementing singular value decomposition (SVD) Golub and Reinsch (Linear algebra, Singular value decomposition and least squares solutions, pp 134-151. Springer, 1971), equivalent to principal component analysis (PCA) Hotelling (Educ Psychol 24(6/7):417-441, 1993); Jolliffe (Principal component analysis, springer series in statistics, 2nd edn. Springer, New York ). That is, AE are able to derive the eigenvalues that represent the amount of variance covered by each component even with the presence of the nonlinear function (sigmoid-like, or any other nonlinear functions) present on their hidden units. Today, with the renewed interest in “deep neural networks” (DNN), multiple types of (deep) AE are being investigated as an alternative to manifold learning Cayton (Univ California San Diego Tech Rep 12(1-17):1, 2005) for conducting nonlinear feature extraction or fusion, each with its own specific (expected) properties. Many of those AE are currently being developed as powerful, nonlinear encoder-decoder models, or used to generate reduced and discriminant feature sets that are more amenable to different modeling and classification tasks. In this paper, we start by recalling and further clarifying the main conclusions of Bourlard and Kamp (Biol Cybern 59(4):291-294, 1998), supporting them by extensive empirical evidences, which were not possible to be provided previously (in 1988), due to the dataset and processing limitations. Upon full understanding of the underlying mechanisms, we show that it remains hard (although feasible) to go beyond the state-of-the-art PCA/SVD techniques for auto-association. Finally, we present a brief overview on different autoencoder models that are mainly in use today and discuss their rationale, relations and application areas.

PMID:35727351 | DOI:10.1007/s00422-022-00937-6

Psychol Rev. 2022 Apr;129(3):438-456. doi: 10.1037/rev0000351.

ABSTRACT

Many psychological experiments have subjects repeat a task to gain the statistical precision required to test quantitative theories of psychological performance. In such experiments, time-on-task can have sizable effects on performance, changing the psychological processes under investigation. Most research has either ignored these changes, treating the underlying process as static, or sacrificed some psychological content of the models for statistical simplicity. We use particle Markov chain Monte-Carlo methods to study psychologically plausible time-varying changes in model parameters. Using data from three highly cited experiments, we find strong evidence in favor of a hidden Markov switching process as an explanation of time-varying effects. This embodies the psychological assumption of “regime switching,” with subjects alternating between different cognitive states representing different modes of decision-making. The switching model explains key long- and short-term dynamic effects in the data. The central idea of our approach can be applied quite generally to quantitative psychological theories, beyond the models and datasets that we investigate. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

PMID:35727307 | DOI:10.1037/rev0000351

Perspect Psychiatr Care. 2022 Jun 21. doi: 10.1111/ppc.13128. Online ahead of print.

ABSTRACT

PURPOSE: To find out whether psychological capital has a mediating role in the relationship between job satisfaction and turnover intention on nurses.

DESIGN AND METHODS: This study is a cross-sectional descriptive study. 466 nurses participated in this study. Data were collected via paper-and-pencil format using Minnesota Satisfaction Questionnaire, Psychological Capital Questionnaire and Turnover Intention Scale.

CONCLUSIONS: Our findings revealed effects of poor psychological capital among nurses. The effect of psychological capital was statistically significant and it partially mediated job satisfaction and turnover intention.

PRACTICE IMPLICATIONS: Initiative sand training programs should be planned to improve nurses’ attitudes towards psychological capital levels.

PMID:35726709 | DOI:10.1111/ppc.13128

Nurs Forum. 2022 Jun 21. doi: 10.1111/nuf.12770. Online ahead of print.

ABSTRACT

BACKGROUND: Oral anticoagulation is the most common method to decrease the risk of stroke in people with atrial fibrillation.

PURPOSE: To assess the knowledge of Jordanian nurses about anticoagulation therapy, the effectiveness of educational courses in increasing their knowledge, and the factors that affect nurses’ changing knowledge following completion of an educational course.

METHOD: A pre/posttest quasi-experimental design was used. A total of 123 nurses participated in the study, identified by convenience sampling and recruited from five governmental hospitals in Jordan. To assess changes in knowledge between pre-and posttest, a questionnaire based on European cardiovascular nurses’ knowledge of anticoagulation therapy was used. An educational course was given to improve participants’ knowledge of anticoagulation therapy. The participants’ knowledge was assessed before and after the educational course. For data analysis, Statistical Package for the Social Sciences version 23 was used.

RESULTS: Nurses’ knowledge of anticoagulants was poor; however, a significant improvement was achieved following the educational course (M = 25.5, SD = 3.41), as compared to before conducting it (M = 12.2, SD = 5.3, t = 42.54, p < 0.001). Having an academic degree was found to affect the change in knowledge scores among participants (t = -3.52, p = 0.001).

CONCLUSION: The educational course was effective in improving the nurses’ knowledge. Baccalaureate degree holders achieved more improvement in their knowledge scores. Post-graduate education for nurses would help to improve their knowledge of anticoagulants. Revision of nursing curricula may be deemed necessary to improve the quality of education for nurses during their degree work, especially regarding anticoagulants.

PMID:35726697 | DOI:10.1111/nuf.12770

J Diabetes Investig. 2022 Jun 21. doi: 10.1111/jdi.13862. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was conducted to assess the association of Dehydroepiandrosterone (DHEA) with diabetic nephropathy in patients with T2DM to better predict the progression of diabetic nephropathy.

METHODS: A total of 1082 patients with T2DM in the Department of Endocrinology and Metabolism of Tianjin Medical University General Hospital were inrolled in this study，and grouped for comparison.The effect of serum DHEA on DN was evaluated by multivariate Logistic regression analysis, and receiver operating characteristiccurves (ROC) were established to explore the optimal concentration of DHEA in patients with DN and non-DN.

RESULTS: DHEA was significantly decreased in patients with diabetic nephropathy (P < 0.001). The prevalence of diabetic nephropathy was significantly higher in the low DHEA quartile than in the other quartiles (P < 0.001).Spearman-related analysis showed that DHEA levels were negatively correlated with patient age, course of diabetes, systolic blood pressure, blood creatinine(Cr), uric acid(Ur), urine albumin-to-creatinine ratio (ACR), 24-hour urine microalbumin(24 h UMA), 24-hour urine protein quantification(24hUAER), and glomerular fltration rate(GFR), positively correlated with Body mass index (BMI) , total cholesterol(TC), and low density lipoprotein (LDL).Logistic regression analysis showed that the effect of DHEA on diabetic nephropathy was statistically significant (P< 0.001).The ROC curve showed that the sensitivity was 81.4%, the specificity was 70%, and the area under the curve was 0.812 when the optimal cut-off value was 1640 (pg/mL).

CONCLUSION: DHEA is significantly associated with DN and may be a protective factor for DN and is important for the prediction of DN.

PMID:35726691 | DOI:10.1111/jdi.13862

J Card Surg. 2022 Jun 21. doi: 10.1111/jocs.16699. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the study was to analyze the surgical outcome of patients with total anomalous pulmonary venous connection (TAPVC) who underwent cardiac surgery.

METHODS: A retrospective study was carried out. Patients with diagnosis of TAPVC undergoing cardiac surgery at the National Institute of Cardiology Ignacio Chávez, from January 1, 2003 and June 30, 2019 were included. Descriptive statistics were calculated, as well as a bivariate analysis of the variables associated with mortality. A logistic regression model was included to determine risk factors associated with the main outcome and survival was analyzed using the Kaplan-Meier method.

RESULTS: A total of 5314 patients diagnosed with congenital heart disease (CHD) underwent surgery, 414 (7.8%) were patients with TAPVC, with an average age of 17.1 ± 34.6 months, 58.2% were male. It was frequent in infants (61.6%) and preschool (19.6%). Predominant type was supracardiac TAPVC (47.4%). Pulmonary venous obstruction (PVO) occurred in 32.1%. Risk factors associated with mortality were infracardiac TAPVC (odds ratio [OR]: 3.26; 95% confidence interval [CI]: 1.17-9.03; p = .02), PVO (OR: 2.56; 95% CI: 1.05-6.22; p = .03) and postoperative mechanical ventilation (OR: 1.005; 95% CI: 1.002-1.008; p = .01). Overall survival was 87.2%, with better outcomes in adolescents (100%), children (94.1%), mixed TAPVC (96%), and cardiac TAPVC (91.9%; p < .001).

CONCLUSIONS: The survival of our institution after surgical correction of TAPVC is similar to that of other referral centers, where patients with infracardiac TAPVC and newborns worse outcomes. All patients must undergo a rigorous evaluation to determine an adequate repair strategy.

PMID:35726661 | DOI:10.1111/jocs.16699