Tag: pubmed

Am J Perinatol. 2021 Jun 14. doi: 10.1055/s-0041-1731277. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to evaluate the validity of transcutaneous bilirubin (TcB) measurements at three sites in premature infants born at 23^0/7 to 34^6/7 weeks’ gestational age (GA) compared with total serum bilirubin (TSB) measurements.

STUDY DESIGN: A prospective study was conducted at Banner – University Medical Center Phoenix, where informed consent was obtained from the infant’s parent or legally authorized representative. Cohort A was comprised of infants 23^0/7 to 28^6/7 weeks’ GA and Cohort B contained subjects 29^0/7 to 34^6/7 weeks’ GA. Baseline TSB measurements were collected at approximately 24 hours of life, as the standard of care and the TcB measurements were obtained from the sternum, interscapular, and buttock areas at approximately ± 30 minutes from collection of the TSB. Statistical analysis of measurements including sensitivity, specificity, positive, and negative predictive values, and the area under the receiver operator characteristic curve (AUROC) were performed.

RESULTS: A total of 166 infants were included in the study population. Cohort A consisted of 41 subjects and Cohort B contained 125 subjects. The results showed that baseline TcB measurements from the interscapular area were the most sensitive and specific with TSB levels >5.0 mg/dL in Cohort A. Baseline TcB measurements from the sternum demonstrated greatest sensitivity and specificity when the TSB level was >8.0 mg/dL in Cohort B. In general, each of the three sites in both cohorts demonstrated excellent AUROCs and negative predictive values.

CONCLUSION: The use of a TcB meter in preterm infants can be a reliable noninvasive screening tool for hyperbilirubinemia, and it may be beneficial in decreasing painful stimuli and iatrogenic blood loss when used as an adjunct to TSB monitoring.

KEY POINTS: · Interscapular TcB is sensitive/specific in 23 to 29 weeks’ GA.. · Sternal TcB is sensitive/specific in 29 to 35 weeks’ GA.. · TcB readings are reliable in preterm infants.. · TcB is reliable when serum bilirubin is >5.0 mg/dL..

PMID:34126648 | DOI:10.1055/s-0041-1731277

Stat Med. 2021 Jun 14. doi: 10.1002/sim.9098. Online ahead of print.

ABSTRACT

A reciprocal LASSO (rLASSO) regularization employs a decreasing penalty function as opposed to conventional penalization approaches that use increasing penalties on the coefficients, leading to stronger parsimony and superior model selection relative to traditional shrinkage methods. Here we consider a fully Bayesian formulation of the rLASSO problem, which is based on the observation that the rLASSO estimate for linear regression parameters can be interpreted as a Bayesian posterior mode estimate when the regression parameters are assigned independent inverse Laplace priors. Bayesian inference from this posterior is possible using an expanded hierarchy motivated by a scale mixture of double Pareto or truncated normal distributions. On simulated and real datasets, we show that the Bayesian formulation outperforms its classical cousin in estimation, prediction, and variable selection across a wide range of scenarios while offering the advantage of posterior inference. Finally, we discuss other variants of this new approach and provide a unified framework for variable selection using flexible reciprocal penalties. All methods described in this article are publicly available as an R package at: https://github.com/himelmallick/BayesRecipe.

PMID:34126655 | DOI:10.1002/sim.9098

Respir Med. 2021 Jun 8;185:106495. doi: 10.1016/j.rmed.2021.106495. Online ahead of print.

ABSTRACT

INTRODUCTION: Organ tropism of SARS-CoV-2 to the respiratory tract could potentially aggravate asthma. The susceptibility of patients with asthma to develop an exacerbation when they are infected with SARS-CoV-2 is unknown. We aimed to investigate the symptoms presented in patients with asthma who became infected with SARS-CoV-2.

METHODS AND RESULTS: All patients over 14 years of age who tested positive for SARS-CoV-2 (by RT-PCR) were included (n = 2995). In patients with asthma (n = 77, 2.6%; 44 females), symptoms, therapy and phenotype were recorded. Seventeen (22%) patients had mild asthma, 55 (71%) moderate and five severe (6%). Twenty-six patients with asthma (34%) were asymptomatic, 34 (44%) developed symptoms but did not require hospital admission, and 17 (22%) were hospitalised. One patient was admitted because of asthma exacerbation without pneumonia or other symptoms. Ten patients (13%) had wheezes (six with pneumonia). Comparison of wheezing between patients with non-T2 asthma and the rest of the patients was statistically significant, (p < 0.001).

CONCLUSIONS: SARS-CoV-2 infection is not a significant cause of asthma exacerbation, although some patients may present wheezing, especially in cases of pneumonia. The severity of asthma does not seem to be associated with symptoms of the disease.

PMID:34126579 | DOI:10.1016/j.rmed.2021.106495

J Phys Condens Matter. 2021 Jun 14. doi: 10.1088/1361-648X/ac0b20. Online ahead of print.

ABSTRACT

Self-affine rough interfaces are ubiquitous in experimental systems, and display characteristic scaling properties as a signature of the nature of disorder in their supporting medium, i.e. of the statistical features of its heterogeneities. Different methods have been used to extract roughness information from such self-affine structures, and in particular their scaling exponents and associated prefactors. Notably, for an experimental characterization of roughness features, it is of paramount importance to properly assess sample-to-sample fluctuations of roughness parameters. Here, by performing scaling analysis based on displacement correlation functions in real and reciprocal space, we compute statistical properties of the roughness parameters. As an ideal, artifact-free reference case study and particularly targeting finite-size systems, we consider three cases of numerically simulated one-dimensional interfaces: (i) elastic lines under thermal fluctuations and free of disorder, (ii) directed polymers in equilibrium with a disordered energy landscape, and (iii) elastic lines in the critical depinning state when the external applied driving force equals the depinning force set by disorder. Our results shows that sample-to-sample fluctuations are rather large when measuring the roughness exponent. These fluctuations are also relevant for roughness amplitudes. Therefore a minimum of independent interface realizations (at least a few tens in our numerical simulations) should be used to guarantee sufficient statistical averaging, an issue often overlooked in experimental reports.

PMID:34126604 | DOI:10.1088/1361-648X/ac0b20

Am J Emerg Med. 2021 Jun 3;49:189-194. doi: 10.1016/j.ajem.2021.05.080. Online ahead of print.

ABSTRACT

BACKGROUND: Prehospital emergency care of children is challenging. In the era of the COVID-19 pandemic, when medical personnel should use personal protective equipment against aerosol-generating procedures, the efficiency of medical procedures may decrease. The study objective was to evaluate the effectiveness of different intravascular access methods applied by nurses wearing biosafety Level-2 suits in simulated paediatric COVID-19 resuscitation.

METHODS: A prospective, randomized, crossover, single-blinded simulation trial was performed. Nursing staff attending Advanced Cardiovascular Life Support courses accredited by the American Heart Association participated in the study. A total of 65 nurses were recruited and randomly assigned to different study groups. They received standard training on intravascular access methods employing distinct devices. The participants wore biosafety Level-2 suits and performed vascular access with the following intraosseous devices: NIO-P, EZ-IO, and Jamshidi needle; intravenous (IV) access was used as a reference method. Both the order of participants and the access methods were random. Each participant performed intravascular access with each of the four methods tested. The effectiveness of the first attempt to obtain intravascular access and the following time parameters were analysed: the time between grasping the intravascular device out of the original packing until infusion line connection. The ease of the procedure was measured with a visual analogue scale (1 – easy; 10 – difficult).

RESULTS: The first attempt success rate of intravascular access by using NIO-P and EZ-IO equalled 100% and was statistically significantly higher than that with the Jamshidi needle (80.0%; p = 0.02) and with the IV method (69.2%; p = 0.005). The time required to connect the infusion line varied and amounted to 33 ± 4 s for NIO-P compared to 37 ± 6.7 s for EZ-IO (p<0.001), 43 ± 7 s for Jamshidi (p<0.001), and 98.5 ± 10 s for IV access (p<0.001). The procedure was easiest in the case of NIO-P and EZ-IO (2 ± 1 points; p=1.0) compared with Jamshidi (5 ± 3 points; p<0.001) and IV access (7 ± 2 points; p<0.001).

CONCLUSION: The study provides evidence that nurses wearing biosafety Level-2 suits were able to obtain intraosseous access faster and more effectively as compared with IV access during simulated COVID-19 paediatric resuscitation. The most effective method of intravascular access was the NIO-P intraosseous device. Further clinical trials are necessary to confirm the results.

PMID:34126564 | DOI:10.1016/j.ajem.2021.05.080

Gait Posture. 2021 Jun 8;88:240-246. doi: 10.1016/j.gaitpost.2021.06.005. Online ahead of print.

ABSTRACT

BACKGROUND: Barriers to successful return to previous level of activity following Anterior Cruciate Ligament Reconstruction (ACLR) are multifactorial and recent research suggests that athletic performance deficits persist after completion of the rehabilitation course in a large percentage of patients.

RESEARCH QUESTION: Do technology-based biomechanical assessments reveal underneath differences in both recreational and competitive athletes in Return to Play after ACL-Reconstruction?

METHODS: Thirty soccer athletes (26.9 ± 5.7 years old, male) with ACL injury were surgically treated with all-inside technique and semitendinosus tendon autograft. Before 2 years from surgery, they were called back for clinical examination, self-reported psychological scores, and biomechanical outcomes (balance, strength, agility and velocity, and symmetry). Athletes were classified into recreational (n = 15) and competitive (n = 15) according to the self-reported Return to Play Level based on the TALS post-injury. Nonparametric statistical tests have been adopted for group comparisons in terms of age, concomitant presence of meniscus tear, injury on dominant leg, presence of knee laxity, presence of varus/valgus, body sides, and return to different levels of sports.

RESULTS: Competitive athletes showed better in terms of strength (45.3 ± 5.4 W kg^-1 vs 39.3 ± 3.4 W kg^-1, P ≤ 0.01) associated with good self-reported outcomes (TLKS, CRSQ) and low fear of reinjury (TSK). However, all the athletes had a functional deficit in at least one subtest, and a safe return to sports could not have been recommended. Our findings confirmed that demographics, physical function, and psychological factors were related to playing the preinjury level sport at mean 2 years after surgery, supporting the notion that returning to sport after surgery is multifactorial.

SIGNIFICANCE: A strict qualitative and quantitative assessment of athletes’ status should be performed at different follow-ups after surgery to guarantee a safe and controlled RTP.

PMID:34126566 | DOI:10.1016/j.gaitpost.2021.06.005

Appl Ergon. 2021 Jun 11;96:103494. doi: 10.1016/j.apergo.2021.103494. Online ahead of print.

ABSTRACT

Industrial passive low-back exoskeletons have gained recent attention as ergonomic interventions to manual handling tasks. This research utilized a two-armed experimental approach (single vs dual-task paradigms) to quantify neural and biomechanical tradeoffs associated with short-term human-exoskeleton interaction (HEI) during asymmetrical lifting in twelve healthy adults balanced by gender. A dynamic, electromyography-assisted spine model was employed that indicated statistical, but marginal, biomechanical benefits of the tested exoskeleton, which diminished with the introduction of the cognitive dual-task. Using Near Infrared Spectroscopy (fNIRS)-based brain connectivity analyses, we found that the tested exoskeleton imposed greater neurocognitive and motor adaptation efforts by engaging action monitoring and error processing brain networks. Collectively, these findings indicate that a wearer’s biomechanical response to increased cognitive demands in the workplace may offset the mechanical advantages of exoskeletons. We also demonstrate the utility of ambulatory fNIRS to capture the neural cost of HEI without the need for elaborate dual-task manipulations.

PMID:34126572 | DOI:10.1016/j.apergo.2021.103494

Sci Total Environ. 2021 Jun 5;791:148309. doi: 10.1016/j.scitotenv.2021.148309. Online ahead of print.

ABSTRACT

This study explored the sources, transformations of suspended particulate organic matter (POM), and the influence of landscape patterns on POM within the Beiyun River Watershed by applying the stable carbon and nitrogen isotope technique combined with multiple statistical analyses. The POM variables showed great spatial fluctuations under different urban development gradients. Analysis of multiple isotopes revealed that assimilation of phytoplankton might exist in the rainy season, while nitrification occurs in the dry season. SIAR modeling results indicated that the sewage debris and phytoplankton were the main sources of POM in both seasons, accounting for 52.58% and 38.39% in the rainy season, 33.17% and 31.95% in the dry season, respectively. Spatiotemporal variations of POM sources existed in the study watershed, probably due to urbanization and human disturbance. The multiple linear stepwise regression and redundant analysis results indicated that landscape metrics reflecting contagion and fragmentation at the class level correlated well with the POM variables over seasons. Interspersion and juxtaposition indices of grassland and water were negatively related to POM variables in the rainy season, whereas the landscape division index of buildup land showed negative correlations with POM parameters in the dry season. Increasing the adjacency of grassland and water to other land uses, while reducing the aggregation of buildup lands would be an efficient way for urban river water quality improvement.

PMID:34126488 | DOI:10.1016/j.scitotenv.2021.148309

Sci Total Environ. 2021 Jun 8;791:148373. doi: 10.1016/j.scitotenv.2021.148373. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, many previous studies have examined the association between ambient temperature and mortality in different parts of the world. However, very few studies have explored the mortality burden attributable to temperature, especially those in developing countries. This study aimed to quantify the burden of mortality attributable to non-optimum temperature in Thailand and explore whether greenness, using normalized difference vegetation index (NDVI) as indicator, alleviates the mortality contributed by non-optimum ambient temperature.

METHODS: Daily number of mortality (i.e., all-cause, cardiovascular and respiratory diseases) and daily meteorological data were obtained over 65 provinces in Thailand during 2010 to 2017. The two-stage statistical approach was applied to estimate the association between temperature and mortality. First, the time-stratified case-crossover analysis was performed to examine province-specific temperature-mortality association. Second, province-specific association was pooled to derive national estimates using multivariate meta-regression. Mortality burden attributable to temperature was then estimated, and the association between attributed mortality and NDVI was explored using multivariate meta-regression models.

RESULTS: A total of 2,891,407 all-cause of death was included over the study period, in which 403,450 and 264,672 deaths were accounted for cardiovascular and respiratory diseases, respectively. The temperature-mortality association at cumulative lag 0-7 days was non-linear with J-shaped curve for all-cause and respiratory mortality, whereas V-shaped curve was observed for cardiovascular mortality. Using minimum mortality temperature (MMT) as optimum temperature, 3.72% (95% empirical CI: 2.18, 5.21) of all-cause, 2.92% (0.55, 5.10) of cardiovascular and 3.00% (0.27, 5.49) of respiratory mortality were attributable to non-optimum temperature (both hot and cold effects). Higher level of NDVI was associated with alleviated impacts of non-optimum temperature, especially hot temperature.

CONCLUSION: Exposure to non-optimum temperature was associated with increased risks of mortality in Thailand. This finding is useful for planning the public health interventions to reduce health effects of non-optimum ambient temperature.

PMID:34126499 | DOI:10.1016/j.scitotenv.2021.148373

J Environ Manage. 2021 Jun 11;294:113020. doi: 10.1016/j.jenvman.2021.113020. Online ahead of print.

ABSTRACT

Researches on the deforestation of the Amazon have gained prominence in the last recent years, mainly with the change in the policy regarding the facing of this phenomenon by the Brazilian government. Therefore, an understanding about the causes that pressure the occurrence of deforestation remains relevant and has a leading role in the world. Therefore, the aim of this study is to perform the analysis of the spatial variability of the reasons for the deforestation in the Amazon Biome, in Brazil, (2010-2019). To achieve this goal, 14 variables were selected, the choice and adjustment of the regression model were determined and a diagnosis was carried out in order to verify the most appropriate model. To achieve this purpose, a geographic database was structured in a geographic information system environment. The main results revealed that the adjusted R² of the Geographically Weighted Regression (GWR) was 0.96, that is, the GWR model explains 96% of the variations in deforestation. Therefore, it was observed a significant gain when using this model. In addition, it was also observed that the average variable of the number of oxen was, among those analyzed, the one that showed the highest correlation with deforestation. Thus, it was found that the livestock sector in southern Amazonia is the main economic agent that pressures large areas of deforestation, since stockfarming is practiced extensively. Finally, it was concluded that the municipalities with the largest areas of deforestation formed a cluster in the southern portion of the Amazon, in the arc of deforestation.

PMID:34126530 | DOI:10.1016/j.jenvman.2021.113020