Tag: pubmed

Sci Rep. 2022 Apr 15;12(1):6352. doi: 10.1038/s41598-022-09949-5.

ABSTRACT

Disease-free survival (DFS) comprises both breast cancer and non-breast cancer events. DFS has not been validated as a surrogate endpoint for overall survival (OS) in most breast cancer subtypes. We assessed changes to the type of events contributing to DFS over time. We identified adjuvant studies in breast cancer (BC) from 2000 to 2020 where the endpoint was DFS. We examined change in distant DFS events and the BC-related DFS using univariable and multivariable linear regression. Data were reported quantitatively using the Burnand criteria irrespective of statistical significance. We included 84 studies (88 cohorts), comprising 212,191 participants, 41,604 DFS events and 23,205 distant DFS events. The DFS event rate/100 participants/year has declined modestly over time (ß – 0.34, p = 0.001). Start year was negatively associated with distant DFS events (ß – 0.58, p < 0.0001); however, the effect was lost after adjusting for follow-up time (ß – 0.18, p = 0.096). The average number of BC-related events/100 participants/year also declined over time (ß – 0.28, p = 0.009). In multivariable analysis, start year and ER expression were quantitatively associated with distant DFS events and BC-related DFS events. DFS events have declined over time driven by a reduction in BC related events. As DFS events are increasingly defined by non-BC events, there will be limited surrogacy between DFS and OS.

PMID:35428842 | DOI:10.1038/s41598-022-09949-5

Sci Rep. 2022 Apr 15;12(1):6262. doi: 10.1038/s41598-022-10346-1.

ABSTRACT

An accurate prediction of major adverse events after percutaneous coronary intervention (PCI) improves clinical decisions and specific interventions. To determine whether machine learning (ML) techniques predict peri-PCI adverse events [acute kidney injury (AKI), bleeding, and in-hospital mortality] with better discrimination or calibration than the National Cardiovascular Data Registry (NCDR-CathPCI) risk scores, we developed logistic regression and gradient descent boosting (XGBoost) models for each outcome using data from a prospective, all-comer, multicenter registry that enrolled consecutive coronary artery disease patients undergoing PCI in Japan between 2008 and 2020. The NCDR-CathPCI risk scores demonstrated good discrimination for each outcome (C-statistics of 0.82, 0.76, and 0.95 for AKI, bleeding, and in-hospital mortality) with considerable calibration. Compared with the NCDR-CathPCI risk scores, the XGBoost models modestly improved discrimination for AKI and bleeding (C-statistics of 0.84 in AKI, and 0.79 in bleeding) but not for in-hospital mortality (C-statistics of 0.96). The calibration plot demonstrated that the XGBoost model overestimated the risk for in-hospital mortality in low-risk patients. All of the original NCDR-CathPCI risk scores for adverse periprocedural events showed adequate discrimination and calibration within our cohort. When using the ML-based technique, however, the improvement in the overall risk prediction was minimal.

PMID:35428765 | DOI:10.1038/s41598-022-10346-1

Sci Rep. 2022 Apr 15;12(1):6298. doi: 10.1038/s41598-022-10245-5.

ABSTRACT

The static and fatigue tensile properties of high-strength polyacrylonitrile (PAN)-based carbon (IMS60) and electronic (E)-class glass (E-glass) hybrid fiber-reinforced epoxy matrix composites (HFRPs) were investigated. The fiber orientations of the HFRP specimens were set to unidirectional with [(0_(IMS60))/(0_(E-glass))]_S (subscript S means symmetry and [(0_(IMS60))/(0_(E-glass))/(0_(E-glass))/(0_(IMS60))]), [(0_(E-glass))/(0_(IMS60))]_S, [(0_(E-glass))/(0_(IMS60))₂]_S, [(0_(E-glass))/(0_(IMS60))₃]_S, [(0_(E-glass))/(0_(IMS60))₅]_S, [(0_(E-glass))₂/(0_(IMS60))]_S, [(0_(E-glass))₃/(0_(IMS60))]_S, and [(0_(E-glass))₅/(0_(IMS60))]_S. Under static loading for the [(0_(IMS60))/(0_(E-glass))]_S, [(0_(E-glass))/(0_(IMS60))]_S, [(0_(E-glass))/(0_(IMS60))₂]_S, [(0_(E-glass))/(0_(IMS60))₃]_S, and [(0_(E-glass))/(0_(IMS60))₅]_S HFRP specimens, the stress applied to the specimen was almost linearly proportional to the strain until failure. However, the tensile stress-strain curves of the [(0_(E-glass))₂/(0_(IMS60))]_S, [(0_(E-glass))₃/(0_(IMS60))]_S, and [(0_(E-glass))₅/(0_(IMS60))]_S HFRP specimens had a complicated shape (jagged trace). The Weibull statistical distributions of the tensile strength values were also examined. The Weibull moduli for the [(0_(E-glass))/(0_(IMS60))]_S, [(0_(E-glass))/(0_(IMS60))₂]_S, [(0_(E-glass))/(0_(IMS60))₃]_S, [(0_(E-glass))/(0_(IMS60))₅]_S, [(0_(E-glass))₂/(0_(IMS60))]_S, [(0_(E-glass))₃/(0_(IMS60))]_S, and [(0_(E-glass))₅/(0_(IMS60))]_S HFRP specimens were higher than those for the mono carbon fiber-reinforced epoxy (CFRP) and glass fiber-reinforced epoxy (GFRP) specimens. Under fatigue loading, the fatigue properties of the HFRP specimens showed CFRP-dominant behaviour at high stress levels and GFRP-dominant behaviour at low stress levels. The fatigue properties of the HFRP specimens increased with increasing volume fraction of CFRP in the following order: ([(0_(E-glass))/(0_(IMS60))₅]_S > [(0_(E-glass))/(0_(IMS60))₃]_S > [(0_(E-glass))/(0_(IMS60))₂]_S > [(0_(IMS60))/(0_(E-glass))]_S > [(0_(E-glass))/(0_(IMS60))]_S > [(0_(E-glass))₂/(0_(IMS60))]_S > [(0_(E-glass))₃/(0_(IMS60))]_S > [(0_(E-glass))₅/(0_(IMS60))]_S).

PMID:35428749 | DOI:10.1038/s41598-022-10245-5

Postgrad Med J. 2022 Apr 15:postgradmedj-2022-141642. doi: 10.1136/postgradmedj-2022-141642. Online ahead of print.

ABSTRACT

BACKGROUND: Various complications have been reported in patients with COVID-19 including pneumomediastinum.

METHODS: The primary objective of the study was to determine the incidence of pneumomediastinum in COVID-19 positive patients who underwent CT pulmonary angiography (CTPA). The secondary objectives were to analyse if the incidence of pneumomediastinum changed between March and May 2020 (peak of the first wave in the UK) and January 2021 (peak of the second wave in the UK) and to determine the mortality rate in patients with pneumomediastinum. We undertook an observational, retrospective, single-centre, cohort study of patients with COVID-19 admitted to Northwick Park Hospital.

RESULTS: 74 patients in the first wave and 220 patients in the second wave met the study criteria. Two patients during the first wave and eleven patients during the second wave developed pneumomediastinum.

CONCLUSIONS: The incidence of pneumomediastinum changed from 2.7% during the first wave to 5% during the second wave and this change was not statistically significant (p value 0.4057). The difference in mortality rates of patients with pneumomediastinum in both waves of COVID-19 (69.23%) versus patients without pneumomediastinum in both waves of COVID-19 (25.62%) was statistically significant (p value 0.0005). Many patients with pneumomediastinum were ventilated, which could be a confounding factor. When controlling for ventilation, there was no statistically significant difference in the mortality rates of ventilated patients with pneumomediastinum (81.81%) versus ventilated patients without pneumomediastinum (59.30%) (p value 0.14).

PMID:35428734 | DOI:10.1136/postgradmedj-2022-141642

Neurology. 2022 Apr 15:10.1212/WNL.0000000000200349. doi: 10.1212/WNL.0000000000200349. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Individuals with cerebellar ataxia (CA) can develop impulsive behavioral symptoms, often resulting in negative interpersonal consequences, detrimentally impacting their quality of life. Limited evidence exists concerning impulsivity in CA and its associated behavioral changes. We assessed impulsive traits in CA using the Barratt impulsivity scale (BIS-11) and compared them with those of Parkinson disease (PD), in order to investigate the differences in the impulsive trait profiles between CA and PD.

METHODS: We conducted a dual-center cross-sectional study with CA and PD subjects enrolled through consecutive sampling from movement disorders clinics at Columbia University Medical Center and Vanderbilt University Medical Center, respectively. Age-matched controls were recruited at the respective institutions. Participants were excluded if they had prior or comorbid neurological and psychiatric diseases known to be associated with impulsivity. All subjects completed the BIS-11 questionnaire as a measure of impulsive traits. We used a general linear model and a least absolute shrinkage and selection operation regression to compare the total, subscale, and individual items of the BIS-11 scores between groups. Subgroup analyses were performed to isolate cerebellar contributions to impulsivity from potential effects of extracerebellar pathology and dopaminergic dysfunction or medications.

RESULTS: A total of 190 participants: 90 age-matched controls, 50 CA, and 50 PD participants completed the assessments. Persons with CA reported 9.7% greater BIS-11 scores than controls (p < 0.001), while persons with PD participants reported 24.9% higher than controls (p < 0.001). In CA, the most impacted domain of impulsivity was non-planning. In contrast, persons with PD noted greater impulsivity across the non-planning, attentional, and motor domains.

DISCUSSION: Impulsivity in CA is uniquely driven by the non-planning trait, unlike in PD. This suggests that the cerebellum and basal ganglia may differentially govern impulsive behaviors with the cerebellum contributing to the brain circuitry of impulsivity in a domain-specific manner.

PMID:35428731 | DOI:10.1212/WNL.0000000000200349

Horm Mol Biol Clin Investig. 2022 Apr 15. doi: 10.1515/hmbci-2021-0090. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to evaluate the levels of serum lipoprotein a, LP (a), in Jordanian patients with type 2 diabetes mellitus (DM); and to examine its relation to glycemic control, metabolic syndrome (MS) and duration of DM. The LP (a) is considered one of the independent risk factors for coronary artery disease (CAD) in the general population.

METHODS: Fasting blood samples were drawn from 51 diabetic patients with type 2 DM and 31 non-diabetic age and sex control subjects. Serum LP (a) was measured along with other parameters, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c) and glycosylated haemoglobin (HbA_1c). Correlation analyses were performed between LP (a) and the various variables measured.

RESULTS: LP (a) measurement showed a skewed distribution towards the lower levels in both groups. Mean LP (a) levels showed a statistically insignificant difference between the two groups. No correlations of LP (a) were observed with age, sex or body mass index (BMI). No correlations of LP (a) with LDL-c, HDL-c, TG, TC, MS, DM duration or HbA_1c were observed. The LP (a) serum levels were significantly higher in type 2 diabetic patients with retinopathy.

CONCLUSIONS: LP (a) serum levels are not increased in type 2 diabetic patients; so, LP (a) may not be a reliable marker for early therapeutic interventions in DM patients, even in high-risk for thrombosis groups.

PMID:35427448 | DOI:10.1515/hmbci-2021-0090

J Thromb Haemost. 2022 Apr 15. doi: 10.1111/jth.15730. Online ahead of print.

ABSTRACT

BACKGROUND: The ISTH SSC Subcommittee on Pediatric and Neonatal Thrombosis and Hemostasis convened a working group on medication adherence to begin to understand the current state of clinical practice to inform priority areas for efforts to improve adherence for children, and adolescents and young adults (AYA) prescribed anticoagulants.

OBJECTIVES: We sought to survey an international group of clinicians involved in anticoagulation management in children and/or AYA about perceptions of medication on health outcomes, clinical practice related to medication adherence, and barriers to assessing and improving medication adherence.

METHODS: Clinicians involved in anticoagulation management in children and/or AYA were surveyed via REDCap^® . Descriptive statistics were used to summarize demographic and clinical characteristics and responses to multiple choice and Likert-type questions. Free-text answers were coded based on the Behavior Change Technique Taxonomy and the Expert Recommendations for Implement Change project.

RESULTS AND CONCLUSIONS: There were 200 participants, 90% of whom were pediatric hematology/oncology physicians. Based on the results which demonstrate that clinicians are concerned about impact of poor medication adherence and have limited resources to identify and improve adherence, the working group has identified next steps to further understand impact of medication adherence on anticoagulation-related health outcomes, address the need for validated measures to assess medication adherence for all anticoagulants prescribed to this population, and develop an intervention and implementation research agenda to improve outcomes.

PMID:35427434 | DOI:10.1111/jth.15730

PLoS One. 2022 Apr 15;17(4):e0266881. doi: 10.1371/journal.pone.0266881. eCollection 2022.

ABSTRACT

The purpose of this study was to evaluate the strength of the knee flexors and extensors and hip abductor and adductor muscles in young soccer players. Twenty-three male under-19 soccer players participated in this study (age: 17.7 ± 0.2 years; height: 173.0 ± 1.1 cm; body mass: 66.1 ± 1.3 kg). Body composition was measured using a bioelectrical impedance (InBody770), and the dynamometry was performed by an isokinetic dynamometer (Biodex System 3) for knee flexion and extension, and by an isometric dynamometer (Smart Groin Trainer), for hip adduction and abduction. Comparisons were made between dominant members (D) vs. non-dominant members (ND) and adductors vs. abductors (ADD:ABD) using the Wilcoxon test. There were statistically significant differences in the peak torques between the dominant and non-dominant members in the flexion function (Z = -4.198, p < 0.01) and in the extension function (Z = -4.197, p < 0.01) of the knee in concentric muscular action, and the flexion (Z = -4.198, p < 0.01) and in the extension (Z = -4.198, p < 0.01) of the knee in eccentric muscular action. No statistically significant differences were obtained in the conventional ratio (Z = -0.456, p = 0.648) nor the functional ratio (Z = -0.335, p = 0.738) between D and ND members. There were no statistically significant differences between adductors and abductors at the moment of strength for absolute values (N). The reference absolute and normalized to the weight values and the ADD:ABD can be used as a guideline for classifying players in screening and comparison in return tests to sports practice after an injury.

PMID:35427407 | DOI:10.1371/journal.pone.0266881

PLoS One. 2022 Apr 15;17(4):e0267182. doi: 10.1371/journal.pone.0267182. eCollection 2022.

ABSTRACT

INTRODUCTION: There is scarcity of data on children with disabilities living in low-and-middle-income countries, including Uganda. This study describes disability prevalence and explores factors associated with different disability categories. It highlights the value of using a standardized, easy-to-use tool to determine disability in children and contextualizing disability in children in light of their developmental needs.

METHODS: A cross-sectional study was conducted between September 2018-January 2019 at the Iganga-Mayuge Health and Demographic Surveillance Site in Uganda. Respondents were caregivers of children between 5-17 years and were administered an in-depth Child Functioning Module (CFM). The outcome variable, disability, was defined as an ordered categorical variable with three categories-mild, moderate, and severe. Generalized ordered logit model was applied to explore factors associated with disability categories.

RESULTS: Out of 1,842 caregivers approached for the study, 1,439 (response: 78.1%) agreed to participate in the study. Out of these 1,439, some level of disability was reported by 67.89% (n = 977) of caregivers. Of these 977 children with disability, 48.01% (n = 692) had mild disability and 15.84% (n = 228) had moderate disability, while 3.96% (n = 57) had severe disability. The mean (SD) score for mild disability was 2.22±1.17, with a median of 2. The mean and median for moderate disability was 5.26±3.28 and 4 (IQR:3-6), and for severe disability was 14.23±9.51 and 12 (IQR:6-22). The most common disabilities reported were depression (54.83%) and anxiety (50.87%). Statistically significant association was found for completion of immunization status and school enrollment when controlled for a child’s age, sex, having a primary caregiver, age of mother at child’s birth, family system, family size and household wealth quintile.

CONCLUSION: This study suggests association between incomplete immunization status and school enrollment for children with disability. These are areas for further exploration to ensure inclusive health and inclusive education of children with disabilities in Uganda.

PMID:35427403 | DOI:10.1371/journal.pone.0267182

PLoS One. 2022 Apr 15;17(4):e0267168. doi: 10.1371/journal.pone.0267168. eCollection 2022.

ABSTRACT

Photography and photogrammetry have recently become among the most widespread and preferred visualisation methods for the representation of small objects and artefacts. People want to see the past, not only know about it; and the ability to visualise objects into virtually realistic representations is fundamental for researchers, students and educators. Here, we present two new methods, the ‘Small Object and Artefact Photography’ (‘SOAP’) and the ‘High Resolution “DIY” Photogrammetry’ (‘HRP’) protocols. The ‘SOAP’ protocol involves the photographic application of modern digital techniques for the representation of any small object. The ‘HRP’ protocol involves the photographic capturing, digital reconstruction and three-dimensional representation of small objects. These protocols follow optimised step-by-step explanations for the production of high-resolution two- and three-dimensional object imaging, achievable with minimal practice and access to basic equipment and softwares. These methods were developed to allow anyone to easily and inexpensively produce high-quality images and models for any use, from simple graphic visualisations to complex analytical, statistical and spatial analyses.

PMID:35427405 | DOI:10.1371/journal.pone.0267168