Tag: pubmed

Neurosurgery. 2021 Oct 11:nyab360. doi: 10.1093/neuros/nyab360. Online ahead of print.

ABSTRACT

BACKGROUND: Few studies have assessed the impact of overlapping surgery during different timepoints of neurosurgical procedures.

OBJECTIVE: To evaluate the impact of overlap before the critical portion of surgery on short-term patient outcomes following lumbar fusion.

METHODS: In total, 3799 consecutive patients who underwent single-level, posterior-only lumbar fusion over 6 yr (2013-2019) at an academic hospital system were retrospectively studied. Outcomes included 30-d emergency department (ED) visit, readmission, reoperation, mortality, overall morbidity, and overall morbidity/surgical complications. Duration of overlap that occurred before the critical portion of surgery was calculated as a percentage of total beginning operative time. Univariate logistic regression was used to assess the impact of incremental 1% increases in the duration of overlap within the whole population and patients with beginning overlap. Subsequently, univariate analysis was used to compare exact matched patients with the least (bottom 40%) and most amounts of overlap (100% beginning overlap). Coarsened exact matching was used to match patients on key demographic factors, as well as attending surgeon. Significance was set at a P-value < .05.

RESULTS: Increased duration of beginning overlap was associated with a decrease in 30-d ED visit (P = .03) within all patients with beginning overlap, but not within the whole population undergoing lumbar fusion. Duration of beginning overlap was not associated with any other short-term morbidity or mortality outcome in either the whole population or patients with beginning overlap.

CONCLUSION: Increased duration of overlap before the critical step of surgery does not predict adverse short-term outcomes after single-level, posterior-only lumbar fusion.

PMID:34634816 | DOI:10.1093/neuros/nyab360

Ecotoxicol Environ Saf. 2021 Oct 8;226:112881. doi: 10.1016/j.ecoenv.2021.112881. Online ahead of print.

ABSTRACT

Geological disasters seriously threaten the safety of human life, property, ecological resources, and the environment. Effective control of geological disasters is the focus of achieving sustainable social development. The Helong City (Jilin Province, China) was selected as the case study. Combined with GIS technology, a new integrated prediction model of geological disaster susceptibility was developed to improve the accuracy of geological disaster assessment, reduce the cost of geological disaster treatment, and ensure the sustainable development of ecological environment. The research results showed that elevation and normalized difference vegetation index (NDVI) were the key factors affecting susceptibility. Compared with the conventional model, the accuracy of the developing integrated model FR-DT and FR-RF was improved by more than 6%, and the disaster points were more concentrated in the high susceptibility zone. Statistical results of disaster treatment cost estimation and gross domestic product (GDP) value showed that the integrated model can save about 10% of treatment cost, and the ratio of total GDP/disaster governance cost was higher. The performance of the integrated model FR-DT and FR-RF had obvious advantages over the conventional model in terms of prediction accuracy, prevention pertinence, and prevention cost. These research results promote the advancement of geological disaster prevention and control technology, ensure the safety of the geological environment, and are of great significance to the sustainable development of the regional economy.

PMID:34634737 | DOI:10.1016/j.ecoenv.2021.112881

Lung Cancer. 2021 Sep 30;162:1-8. doi: 10.1016/j.lungcan.2021.09.020. Online ahead of print.

ABSTRACT

OBJECTIVES: Patients with lung cancer have high symptom burden and diminished quality of life. Electronic patient-reported outcome (PRO) platforms deliver repeated longitudinal surveys via web or telephone to patients and alert clinicians about concerning symptoms. This study aims to determine feasibility of electronic PRO monitoring in lung cancer patients receiving treatment in community settings.

METHODS: Adults receiving treatment for advanced or metastatic lung cancer at 26 community sites were invited to participate in a prospective trial of weekly electronic PRO symptom monitoring for 12 months (NCT03249090). Surveys assessing patients’ satisfaction with the electronic PRO system were administered at 3 months. Descriptive statistics were generated for demographics, survey completion rates, symptom occurrence, and provider PRO alert management approaches. Pairwise relationships between symptom items were evaluated using intra-individual repeated-measures correlation coefficients.

RESULTS: Lung cancer patients (n = 118) participating in electronic PROs were older (mean 64.4 vs 61.9 years, p = 0.03), had worse performance status (p = 0.002), more comorbidities (p = 0.02), and less technology experience than patients with other cancers. Of delivered weekly PRO surveys over 12 months, 91% were completed. Nearly all (97%) patients reported concerning (i.e., severe or worsening) symptoms during participation, with 33% of surveys including concerning symptoms. Pain was the most frequent and longest lasting symptom and was associated with reduced activity level. More than half of alerts to clinicians for concerning symptoms led to intervention. The majority (87%) would recommend using electronic PRO monitoring to other lung cancer patients.

CONCLUSIONS: Remote longitudinal weekly monitoring of patients with lung cancer using validated electronic PRO surveys was feasible in a multicenter, community-based pragmatic study. A high symptom burden specific to lung cancer was detected and clinician outreach in response to alerts was frequent, suggesting electronic PROs may be a beneficial strategy for identifying actionable symptoms and allow opportunities to optimize well-being in this population.

PMID:34634754 | DOI:10.1016/j.lungcan.2021.09.020

Diagn Microbiol Infect Dis. 2021 Sep 4;101(4):115535. doi: 10.1016/j.diagmicrobio.2021.115535. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate a pharmacist-facilitated evidence-based bundle (EBB) initiative with infectious disease consultation (IDC) for Staphylococcus aureus bacteremia (SAB).

METHODS: This was a before-and-after quasi-experimental study of adult patients with SAB before and after the pharmacist-facilitated EBB initiative, which included IDC, timely definitive antibiotics, source control, echocardiography, and repeat blood cultures.

RESULTS: Ninety and 111 patients were included in pre- and post-intervention cohorts, respectively. We observed significant increases in adherence to all 5 (4.4% vs 68.5%, P < 0.001) and 4 (10.0% vs 76.6%, P < 0.001) EBB elements. Time to definitive antibiotics (48 vs 16 hours, P < 0.001), time to IDC (43.5 vs 32 hours, P < 0.001), SAB duration (95 vs 66 hours, P = 0.009), persistent SAB (18.9% vs 9.0%, P = 0.041), and length of stay (14 vs 13 days, P = 0.027) also improved. No statistically significant differences for SAB-related readmission or all-cause mortality were observed.

CONCLUSIONS: Our pharmacist-facilitated SAB initiative was associated with improved EBB adherence and clinical outcomes.

PMID:34634714 | DOI:10.1016/j.diagmicrobio.2021.115535

J Environ Manage. 2021 Oct 8;301:113893. doi: 10.1016/j.jenvman.2021.113893. Online ahead of print.

ABSTRACT

Amongst different climatic and anthropogenic drivers, water resources management can cause massive changes to the natural regime of a lake after its regulation, thereby affecting the quantity and quality of water intended for satisfying the multiple basin water requirements. Here, we investigate the multi-decadal variation of the water levels and outflows of Lake Garda, the largest in Italy, where the dam operational rules and the related basin water needs heavily altered the annual and seasonal trend of the lake regime since its regulation in 1951. Daily lake levels and outflows were first collected and digitized for the period 1888-2020, thus providing a unique database of 133 years that allowed a consistent comparison between natural and regulated periods. Statistical analyses highlighted a significant change of the inter-annual trend of the lake outflows, which passed from upward to downward after regulation, against a constant increasing trend of the water levels. Conversely, water levels showed a more remarkable shifts on a seasonal scale if compared to the outflows, revealing the influence of summer and winter basin water needs. Additional analyses on the inter-annual variation of the main downstream water demands regulated by the dam, i.e. the irrigation, hydropower and fluvial ecosystem requirements, outlined their relevance in changing the lake regime, influencing dam operational policies, which progressively limited the share of water released for ecosystem integrity. A comparison between the lake levels and outflows recorded for the pre-regulation and post-regulation periods of some selected European perialpine lakes finally highlighted different effects on the lake regime, drawing attention to the importance of defining the role of the dam operational policies within the current scenario of climate change and changing water demands.

PMID:34634725 | DOI:10.1016/j.jenvman.2021.113893

Forensic Sci Int. 2021 Oct 5;328:111035. doi: 10.1016/j.forsciint.2021.111035. Online ahead of print.

ABSTRACT

Forensic soil examination has a well-established foundation in forensic science, this is in part due to the widely varied and complex nature of soil. Within this domain, mineral suite studies are a commonly utilized tool in soil examination. However, statistical or probabilistic approaches towards the interpretation of results from such analysis are lacking and this study aims to fill that gap. Soil samples from four different locations in the city of Lausanne, Switzerland were sampled and their mineral fractions, light and heavy of size between 90 and 180 µm, were studied utilizing microscopical methods. First, the light minerals were identified and counted by employing scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM-EDS). Second, the heavy minerals were identified and counted manually under a polarized light microscope (PLM). The resulting count data were subjected to various multivariate statistical treatments such as principal components analysis (PCA), hierarchical clustering analysis (HCA), and linear discriminant analysis (LDA). These methods assist in identifying pertinent variables and subsequently in building various classification models. The validities of these models were then tested and evaluated using blind tests. Finally, these methods demonstrate how a probabilistic approach can be taken in the interpretation of the results to answer source level questions.

PMID:34634691 | DOI:10.1016/j.forsciint.2021.111035

Acta Histochem. 2021 Oct 8;123(7):151792. doi: 10.1016/j.acthis.2021.151792. Online ahead of print.

ABSTRACT

Prolonged inorganic arsenic (iAs) exposure is widely associated with brain damage particularly in the hippocampus via oxidative and apoptotic pathways. Resveratrol (RES) has gained considerable attention because of its benefits to human health. However, its neuroprotective potential against iAs-induced toxicity in CA1 region of hippocampus remains unexplored. Therefore, we investigated the neuroprotective efficacy of RES against arsenic trioxide (As₂O₃)-induced adverse effects on neuronal morphology, apoptotic markers and oxidative stress parameters in mouse CA1 region (hippocampus). Adult female Swiss albino mice of reproductive maturity were orally exposed to either As₂O₃ (2 and 4 mg/kg bw) alone or in combination with RES (40 mg/kg bw) for a period of 45 days. After animal sacrifice on day 46, the perfusion fixed brain samples were used for the observation of neuronal morphology and studying the morphometric features. While the freshly dissected hippocampi were processed for biochemical estimation of oxidative stress markers and western blotting of apoptosis-associated proteins. Chronic iAs exposure led to significant decrease in Stratum Pyramidale layer thickness along with reduction in cell density and area of Pyramidal neurons in contrast to the controls. Biochemical analysis showed reduced hippocampal GSH content but no change in total nitrite (NO) levels following iAs exposure. Western blotting showed apparent changes in the expression levels of Bax and Bcl-2 proteins following iAs exposure, however the change was statistically insignificant. Contrastingly, iAs +RES co-treatment exhibited substantial reversal in morphological and biochemical observations. Together, these findings provide preliminary evidence of neuroprotective role of RES on structural and biochemical alterations pertaining to mouse hippocampus following chronic iAs exposure.

PMID:34634674 | DOI:10.1016/j.acthis.2021.151792

Res Vet Sci. 2021 Sep 28;141:1-3. doi: 10.1016/j.rvsc.2021.09.012. Online ahead of print.

ABSTRACT

In Veterinary Forensic Medicine, determination of the degree of animal suffering is an essential element for the prosecution of perpetrators of animal abuse. The purpose of this study is to find a suitable immunohistochemical marker for the assessment of suffering to be routinely used in Veterinary Forensic Pathology, by analyzing the expression of Corticotropin-releasing factor (CRF) in formalin-fixed brains of dogs as a measurement of the agonic stress. CRF, a key peptide element in exogenous and endogenous stressors adaptation, can regulate endocrine-behavioral responses to stress stimulating pituitary ACTH release and consequent adrenal secretion of glucocorticoids. Since CRF acts in days or weeks, this study investigates its role as a potential distinctive marker between sudden death and death associated with a longer agonic period. The study used immunohistochemistry (IHC) to evaluate the CRF expression in the brain of dogs that suffered sudden death, as compared to dogs that died after long-term agonic stress. IHC labelling analysis was performed with machine-learning-based software and the results were statistically evaluated. Our results demonstrate for the first time that CRF is a promising marker of stress in abused patients also in Veterinary Medicine.

PMID:34634683 | DOI:10.1016/j.rvsc.2021.09.012

Comput Biol Med. 2021 Sep 29;138:104911. doi: 10.1016/j.compbiomed.2021.104911. Online ahead of print.

ABSTRACT

Transcriptomics and metabolomics data often contain missing values or outliers due to limitations of the data acquisition techniques. Most of the statistical methods require complete datasets for downstream analysis. A number of methods have been developed for missing value imputation using the classical mean and variance based on maximum likelihood estimators, which are not robust against outliers. Consequently, the performance of these methods deteriorates in the presence of outliers. Hence precise imputation of missing values and outliers handling are both concurrently important. Therefore, in this paper, we developed a robust iterative approach using robust estimators based on the minimum beta divergence method, which simultaneously impute missing values and outliers. We investigate the performance of the proposed method in a comparison with six frequently used missing value imputation methods such as Zero, KNN, robust SVD, EM, random forest (RF) and weighted least square approach (WLSA) through feature selection using both simulated and real datasets. Ten performance indices were used to explore the optimal method such as Frobenius norm (FOBN), accuracy (ACC), sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), detection rate (DR), misclassification error rate (MER), the area under the ROC curve (AUC) and computational runtime. Evaluation based on both simulated and real data suggests the superiority of the proposed method over the other traditional methods in terms of various rates of outliers and missing values. The suggested approach also keeps almost equal performance in absence of outliers with the other methods. The proposed method is accurate, simple, and consumes lower computational time compared to the other methods. Therefore, our recommendation is to apply the proposed procedure for large-scale transcriptomics and metabolomics data analysis. The computational tool has been implemented in an R package, which is publicly available from https://CRAN.R-project.org/package=rMisbeta.

PMID:34634637 | DOI:10.1016/j.compbiomed.2021.104911

Addict Behav. 2021 Sep 30;125:107127. doi: 10.1016/j.addbeh.2021.107127. Online ahead of print.

ABSTRACT

BACKGROUND: Gambling disorder (GD) is a global phenomenon affecting millions of people. GD can result in severe social and financial difficulties and efficacious treatments are warranted. Psychosocial treatments form the basis of treatment. Opioid antagonists (OAs) have however shown promise in previous studies. In a recent imaging study intranasal naloxone was found to rapidly and fully occupy brain μ-opioid receptors. This trial investigates the effect and safety of as needed naloxone in the treatment of gambling disorder.

METHODS: This was a 12-week double blind, randomised control trial comparing intranasal naloxone to placebo. The primary endpoint was gambling urge measured by the Gambling symptom Assessment Scale (G-SAS). Secondary outcome measures were gambling severity measures (PGSI) as well as quality of life (WHO:EUROHIS-8), alcohol consumption (AUDIT), depression (MARDS) and internet use (IDS-9SF). In addition, safety of treatment was assessed. Both treatment groups received psychosocial support.

RESULTS: 126 participants were randomised to treatment groups in a 1:1 ratio. 106 patients completed the study. Gambling urge (GSAS) and other gambling related measured improved in both groups, but no statistically significant difference could be found. Intranasal naloxone was well tolerated, no subjects discontinued the study due to adverse events. No serious adverse drug reactions were observed.

CONCLUSIONS: This study found no difference between the as-needed administration of intranasal naloxone and placebo in reducing gambling urge in persons with GD. Intranasal naloxone was safe and well tolerated.

PMID:34634640 | DOI:10.1016/j.addbeh.2021.107127