Tag: pubmed

J Am Heart Assoc. 2022 Apr 12:e024325. doi: 10.1161/JAHA.121.024325. Online ahead of print.

ABSTRACT

Background Cardiac complications are associated with perioperative mortality, but perioperative adverse cardiac events (PACEs) that are associated with long-term mortality have not been clearly defined. We identified PACE as a composite of myocardial infarction, coronary revascularization, congestive heart failure, arrhythmic attack, acute pulmonary embolism, cardiac arrest, or stroke during the 30-day postoperative period and we compared mortality according to PACE occurrence. Methods and Results From January 2011 to June 2019, a total of 203 787 consecutive adult patients underwent noncardiac surgery at our institution. After excluding those with 30-day mortality, mortality during a 1-year follow-up was compared. Machine learning with the extreme gradient boosting algorithm was also used to evaluate whether PACE was associated with 1-year mortality. After excluding 1203 patients with 30-day mortality, 202 584 patients were divided into 7994 (3.9%) patients with PACE and 194 590 (96.1%) without PACE. After an adjustment, the mortality was higher in the PACE group (2.1% versus 7.7%; hazard ratio [HR], 1.90; 95% CI, 1.74-2.09; P<0.001). Results were similar for 7839 pairs of propensity-score-matched patients (4.9% versus 7.9%; HR, 1.64; 95% CI, 1.44-1.87; P<0.001). PACE was significantly associated with mortality in the extreme gradient boostingmodel. Conclusions PACE as a composite outcome was associated with 1-year mortality. Further studies are needed for PACE to be accepted as an end point in clinical studies of noncardiac surgery.

PMID:35411778 | DOI:10.1161/JAHA.121.024325

Zhongguo Yi Liao Qi Xie Za Zhi. 2022 Mar 30;46(2):219-224. doi: 10.3969/j.issn.1671-7104.2022.02.022.

ABSTRACT

Objective The study aims to investigate the effects of different adaptive statistical iterative reconstruction-V（ ASiR-V） and convolution kernel parameters on stability of CT auto-segmentation which is based on deep learning. Method Twenty patients who have received pelvic radiotherapy were selected and different reconstruction parameters were used to establish CT images dataset. Then structures including three soft tissue organs (bladder, bowelbag, small intestine) and five bone organs (left and right femoral head, left and right femur, pelvic) were segmented automatically by deep learning neural network. Performance was evaluated by dice similarity coefficient（ DSC） and Hausdorff distance, using filter back projection(FBP) as the reference. Results Auto-segmentation of deep learning is greatly affected by ASIR-V, but less affected by convolution kernel, especially in soft tissues. Conclusion The stability of auto-segmentation is affected by parameter selection of reconstruction algorithm. In practical application, it is necessary to find a balance between image quality and segmentation quality, or improve segmentation network to enhance the stability of auto-segmentation.

PMID:35411755 | DOI:10.3969/j.issn.1671-7104.2022.02.022

Zhongguo Yi Liao Qi Xie Za Zhi. 2022 Mar 30;46(2):233-236. doi: 10.3969/j.issn.1671-7104.2022.02.025.

ABSTRACT

OBJECTIVE: Analyze and conclude the new quality control process, so as to improve the quality control efficiency.

METHODS: Statistical analysis was conducted on the flow rate quality control data of infusion pump in 2020, with a total of 330 times of quality control data.

RESULTS: The pump with qualified flow rate entered and maintained the qualified state from the third minute, while the pump with unqualified flow rate entered and maintained the unqualified state from the second minute.

CONCLUSIONS: Take the third minute to enter the qualified range and continue for 2 minutes to judge that the flow rate quality control is qualified. The accuracy of this new rule is as high as 100%, and the time of flow rate quality control can be reduced from 60 minutes to 10 minutes, which greatly improves the work efficiency.

PMID:35411758 | DOI:10.3969/j.issn.1671-7104.2022.02.025

Zhongguo Yi Liao Qi Xie Za Zhi. 2022 Mar 30;46(2):172-175. doi: 10.3969/j.issn.1671-7104.2022.02.012.

ABSTRACT

According to the characteristics of short time and large amount of samples for out of hospital emergency nucleic acid detection, this study introduces an out of hospital emergency nucleic acid detection cloud platform system, which realizes the functions of rapid identification of the detected person and one-to-one correspondence with the samples, and real-time upload of the detection results to Zhejiang Government service network for quick viewing and statistics, so as to complete the task of national nucleic acid screening efficiently and accurately that we must provide information support.

PMID:35411745 | DOI:10.3969/j.issn.1671-7104.2022.02.012

Zhongguo Yi Liao Qi Xie Za Zhi. 2022 Mar 30;46(2):147-151. doi: 10.3969/j.issn.1671-7104.2022.02.006.

ABSTRACT

A novel and portable device is proposed to monitor motor rehabilitation equipment, which can be mounted on most equipment with rotor shaft. The software of the device, whose main functions include equipment configuration, monitoring and statistical computation, is developed based on available sensor. The data collected by the device serve both department managers to learn the efficiency of the equipment, and physicians and therapists to understand the physical conditions of the patients who perform training exercises with the monitored rehabilitation equipment. About 2000 hours’ monitoring has been carried out, and the experimental result indicates that the monitoring device is applicable to many types of motor rehabilitation equipment and achieves good monitoring accuracy. The data aggregated by the device can be used to evaluate the motor functions of the patients and make rehabilitation training plan. Besides, it is agreed by physicians and therapists that the device is easy-to-use, robust and has good real-time performance. The monitoring device thus holds the promise of boosting the development of digitalized rehabilitation medicine.

PMID:35411739 | DOI:10.3969/j.issn.1671-7104.2022.02.006

J Korean Med Sci. 2022 Apr 11;37(14):e117. doi: 10.3346/jkms.2022.37.e117.

ABSTRACT

BACKGROUND: This study aimed to perform meta-analyses to update a previous systematic review (SR) conducted by the US Preventive Services Task Force (USPSTF) to evaluate the benefits and harms of screening for chronic obstructive pulmonary disease (COPD) in asymptomatic adults.

METHODS: MEDLINE, EMBASE, Cochrane Library, and regional databases were searched from their inception to January 2020. Studies for diagnostic accuracy, preventive services effect, treatment efficacy, and treatment harms were included.

RESULTS: Eighteen studies were included, and twelve of these were newly added in this update. In meta-analyses, the pooled sensitivity and specificity for COPD diagnosis using spirometry were 73.4% and 89.0%, respectively. The relative effect of smoking cessation intervention with screening spirometry, presented as abstinence rate, was not statistically significant (risk ratio [RR], 1.21; 95% confidence interval [CI], 0.87-1.67) when all selected studies were pooled, but screening on smoking cessation was effective (RR, 1.58; 95% CI, 1.14-2.19) when limited to studies with smoking cessation programs that provided smoking cessation medicines or intensive counseling at public health centers or medical institutions.

CONCLUSION: In this study, no direct evidence for the impact on health outcomes of screening asymptomatic adults for COPD was identified similar to the previous SR. Further research is necessary to confirm the benefits of COPD screening.

PMID:35411733 | DOI:10.3346/jkms.2022.37.e117

J Korean Med Sci. 2022 Apr 11;37(14):e108. doi: 10.3346/jkms.2022.37.e108.

ABSTRACT

BACKGROUND: The effect of coronavirus disease 2019 (COVID-19) pandemic on public mental health has been increasing. Additionally, the underlying psychological stressors remain unexplored, and few studies have been conducted nationally on the social distancing measures. Therefore, the present study aimed to identify the psychological impacts of the implementation of social distancing measures by analyzing the Internet search trends of major depressive disorder (MDD) symptoms.

METHODS: Using Naver^® Trends’ relative search volumes (RSVs), we analyzed the average search volumes and trend changes of 16 terms, adopted from the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for diagnosing MDD. An interrupted time-series analysis was performed using the data from January 1, 2016 to December 31, 2020. Furthermore, changes in RSVs, according to the intensity of the social distancing measures implemented from January 1 to December 31, 2020, were determined using Wilcoxon rank sum tests.

RESULTS: Of the 16 terms, the search trends of ‘feeling guilty’ (P < 0.001) and ‘wanting to die’ (P = 0.002) showed a significant increase as of February 29, 2020, when the social distancing measures were officially implemented. Additionally, the average search volumes for ‘hopelessness’ (P = 0.003), ‘sexual desire’ (P < 0.001), ‘insomnia’ (P = 0.002), ‘hypersomnia’ (P < 0.001), ‘restlessness’ (P < 0.001), and ‘feeling lethargic’ (P < 0.001) increased significantly. Moreover, gender analysis showed that the average search volume of ‘depressed mood’ (P = 0.033) and the trend of ‘impaired concentration’ (P < 0.001) increased in males only. However, the average search volume of ‘feeling lethargic’ (P = 0.001) and the trend of ‘feeling guilty’ (P = 0.001) increased in females only. The average search volumes for ‘depressed mood’ (P < 0.001), ‘impaired concentration’ (P = 0.038), and ‘indecisiveness’ (P < 0.001) were significantly higher during the enforcement of level 2 or higher social distancing measures.

CONCLUSION: Our results reported the negative effect of COVID-19 preventive measures on public mental health in South Korea, especially for MDD symptoms. Moreover, the findings suggested the utility of Naver Trends as a feasible big data source to assess future mental health crises.

PMID:35411728 | DOI:10.3346/jkms.2022.37.e108

Neuropsychopharmacol Rep. 2022 Apr 12. doi: 10.1002/npr2.12250. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to examine the effectiveness of vaccination to improve mental health among employees in Japan based on a prospective study.

METHODS: The data were retrieved from the Employee Cohort Study conducted during the COVID-19 pandemic in Japan (E- COCO-J) at T1 (4-10 February 2021) and T2 (22-29 June 2021). Psychological distress was measured by using an 18-item scale of the Brief Job Stress Questionnaire (BJSQ). The analytic sample was limited to individuals employed at both T1 and T2 without missing covariates. Vaccination status was measured at T2. Statistical analysis was conducted to test the differential change in the psychological distress at T1 and T2 with the time × group interactions by using repeated ANOVA, adjusting for the covariates (gender, age, marital status, education, chronic disease, company size, industry, and occupation).

RESULTS: Of the total sample (N = 948), 105 (11.1%) were vaccinated at least once at T2. The crude mean scores of psychological distress at T1 and T2 were 41.8 and 42.0 for vaccinated participants and 41.2 and 41.2 for nonvaccinated participants, respectively, with no significant effect of having been vaccinated (Cohen’s d = 0.02, P = 0.833). After adjusting the covariates, there was no significance (P = 0.446).

CONCLUSIONS: The COVID-19 vaccination was supposed to have a limited effect on mental health among Japanese employees in an early phase of vaccination. To keep providing mental health care for employees is important even after starting the vaccination program.

PMID:35411665 | DOI:10.1002/npr2.12250

CPT Pharmacometrics Syst Pharmacol. 2022 Apr 11. doi: 10.1002/psp4.12795. Online ahead of print.

ABSTRACT

The coronavirus disease 2019 (COVID-19) has presented unprecedented challenges to the generic drug development including interruptions in bioequivalence (BE) studies. Per guidance published by the US Food and Drug Administration (FDA) during the COVID-19 public health emergency, any protocol changes or alternative statistical analysis plan for COVID-19-interrupted BE study should be accompanied with adequate justifications and not lead to biased equivalence determination. In this study, we used a modeling and simulation approach to assess the potential impact of study outcomes when two different batches of a Reference Standard (RS) were to be used in an in vivo pharmacokinetic (PK) BE study due to the RS expiration during the COVID-19 pandemic. Simulations were performed with hypothetical drugs under two scenarios: 1) uninterrupted study using a single batch of an RS, and 2) interrupted study using two batches of an RS. The acceptability of BE outcomes was evaluated by comparing the results obtained from interrupted studies with those from uninterrupted studies. The simulation results demonstrated that using a conventional statistical approach to evaluate BE for COVID-19-interrupted studies may be acceptable based on the pooled data from two batches. An alternative statistical method which includes a “batch” effect to the mixed effects model may be used when a significant “batch” effect was found in interrupted 4-way crossover studies. However, such alternative method is not applicable for interrupted 2-way crossover studies. Overall, the simulated scenarios are only for demonstration purpose, the acceptability of BE outcomes for the COVID19-interrupted studies could be case-specific.

PMID:35411692 | DOI:10.1002/psp4.12795

J Paediatr Child Health. 2022 Apr 12. doi: 10.1111/jpc.15975. Online ahead of print.

ABSTRACT

AIM: To determine if the delivery mode has a causal effect on neonatal serum C-reactive protein (CRP) levels. If such a causal effect exists, we aim to quantify its magnitude.

METHODS: We investigated the causal effect of the delivery mode on serum CRP levels 6-8 h after delivery, with appropriate statistical tools for retrospective studies, combining classical and machine-learning methods. The statistical inference is followed by sensitivity analysis to quantify the magnitude of unobserved bias required in order to alter the study’s conclusion.

RESULTS: This retrospective study reviewed laboratory records of neonates after birth who underwent blood tests due to suspected sepsis. A total of 440 newborns were included, 324 of which underwent a vaginal delivery, 59 an urgent caesarean delivery, and 57 an elective caesarean delivery. Our results revealed that serum CRP values following elective caesarean deliveries were 50% less than those following a vaginal delivery (P = 0.030; -0.907; 95% CI [-1.545, -0.268] in log-CRP units). No significant effect was found for urgent caesarean deliveries compared to vaginal deliveries (P = 0.887). Those results were strengthened by (1) a sensitivity magnitude of 1.6 to unobserved bias and (2) non-significant effects when analysis is repeated on blood collected 12-24 h after birth.

CONCLUSION: CRP concentrations in neonatal blood during the first 6-8 h of life are higher following vaginal deliveries compared to elective caesarean deliveries. Further studies with the intent of improving EONS detection should include information on the delivery mode.

PMID:35411656 | DOI:10.1111/jpc.15975