Tag: pubmed

Opt Lett. 2021 Sep 1;46(17):4386-4389. doi: 10.1364/OL.435799.

ABSTRACT

Nitrogen-vacancy color centers (NVs) in diamond have several potential applications ranging from quantum computing to data storage. However, artificial NVs are often close to the surface, which limits their spatial density and applicability. Here we demonstrate an effective and precise method for preparing deep single NVs in diamond. The method is based on a spatial-shaped femtosecond laser to overcome laser defocus in high-refractive materials, and realizes the preparation of single NVs at 95 µm. In addition, owing to the good energy distribution of the shaped laser focus, the single NVs exhibit a statistic yield of 56%±11% with excellent qualities. This processing method will contribute to the integration of color centers with emerging optical elements and high-density data storage.

PMID:34470022 | DOI:10.1364/OL.435799

J Healthc Qual. 2021 Aug 31. doi: 10.1097/JHQ.0000000000000322. Online ahead of print.

ABSTRACT

BACKGROUND: Opioid-induced respiratory depression (OIRD) is a serious complication that can lead to negative outcomes. There are known risk factors for OIRD; however, a lack of national guidelines for the prevention and early detection of OIRD exists.

METHODS: An evidence-based practice study was conducted to create an enhanced monitoring (EM) program. The EM program consisted of risk stratification of surgical spine patients, including the use of STOP-BANG screening for obstructive sleep apnea, capnography monitoring, use of home positive airway pressure therapy, capnography alarm optimization, hospitalist consultation, nursing education, and patient education.

RESULTS: Approximately 17% (N = 937/5,462) of surgical spine patients were enrolled in the EM program. Fifty-six percent of EM patients were monitored with capnography and had out of range end-tidal carbon dioxide levels 17% of the time. The rate of transfers to the intensive care unit (ICU) for OIRD decreased, though not statistically significant (p = .151).

CONCLUSIONS: The EM program with risk stratification was found to reduce transfers to the ICU for OIRD. Although not statistically significant, the decreased number of transfers was clinically significant. Engagement of the interprofessional team and capnography alarm parameter optimization helped to reduce nonactionable alarms.

PMID:34469926 | DOI:10.1097/JHQ.0000000000000322

Menopause. 2021 Aug 30. doi: 10.1097/GME.0000000000001847. Online ahead of print.

ABSTRACT

OBJECTIVE: This study explored the clinical management practices of healthcare providers who treat menopausal women in an urban Mid-South area. The study specifically examined their knowledge of prescribing and counseling related to the care of women who present with complaints or clinical findings of genitourinary syndrome of menopause.

METHODS: An electronic questionnaire was distributed to healthcare providers involved in the care of women undergoing menopausal transition spanning a variety of medical specialties. The questionnaire was distributed to academic program directors, coordinators, and ListServ administrators to forward to targeted respondents. Items included demographic questions, clinical knowledge, management practices, and preferences. Statistical analysis for associations between demographics was performed using Chi-squared tests and between age groups with Kruskal Wallis tests.

RESULTS: The final sample contained 106 healthcare providers. Respondents were demographically diverse and encompassed multiple levels of professional training including Attendings, Trainees (Residents and Fellows), as well as Advanced Practice Registered Nurses. Significant differences were noted in many areas examined in our questionnaire, comprising knowledge, management, counseling, and prescribing practices surrounding the treatment of genitourinary syndrome of menopause when accounting for training level, specialty, and years in practice. Among all respondents, 10.4% reported rarely or never discussing menopausal symptoms with their patients. Most respondents (76.4%) stated they had prescribed topical therapies for genitourinary syndrome of menopause, with over 90% of practitioners prescribing lubricants/moisturizers and estradiol cream; however, only 55% reported being familiar with the US Food and Drug Administration’s boxed warning on low-dose vaginal estrogen. Nearly half of the respondents (49%) reported being uncomfortable counseling about the boxed warning on low-dose vaginal estrogen.

CONCLUSION: This study identifies gaps in Mid-South healthcare providers’ awareness of the boxed warning on low-dose vaginal estrogen as well as their comfort level in providing counseling regarding the risks, benefits, and alternatives to vaginal estrogen. Integrated practice between physicians and Advanced Practice Registered Nurses can lead to a significant benefit to patients experiencing menopause as shared experience and knowledge are shared between each group. Our survey does reveal gaps in knowledge and practice for optimal outcomes for patients experiencing genitourinary syndrome of menopause. These results will be useful in providing continuing education to providers and more effective communication, evaluation, and treatment to patients.

PMID:34469937 | DOI:10.1097/GME.0000000000001847

Phys Med Biol. 2021 Sep 1. doi: 10.1088/1361-6560/ac22dc. Online ahead of print.

ABSTRACT

Brain-shift during neurosurgery compromises the accuracy of tracking the boundaries of the tumor to be resected. Although several studies have used various finite element models (FEMs) to predict inward brain-shift, evaluation of their accuracy and efficiency based on public benchmark data has been limited. This study evaluates several FEMs proposed in the literature (various boundary conditions, mesh sizes, and material properties) by using intraoperative imaging data (the public REtroSpective Evaluation of Cerebral Tumors [RESECT] database). Four patients with low-grade gliomas were identified as having inward brain-shifts. We computed the accuracy (using target registration error) of several FEM-based brain-shift predictions and compared our findings. Since information on head orientation during craniotomy is not included in this database, we tested various plausible angles of head rotation. We analyzed the effects of brain tissue viscoelastic properties, mesh size, craniotomy position, cerebrospinal fluid drainage level, and rigidity of meninges and then quantitatively evaluated the trade-off between accuracy and central processing unit time in predicting inward brain-shift across all models with second-order tetrahedral FEMs. The mean initial Target Registration Error (TRE) was 5.78±3.78 mm with rigid registration. FEM prediction (edge-length, 5 mm) with non-rigid meninges led to a mean TRE correction of 1.84±0.83 mm assuming heterogeneous material. Results show that, for the low-grade glioma patients in the study, including non-rigid modeling of the meninges was significant statistically. In contrast including heterogeneity was not significant. To estimate the optimal head orientation and CSF drainage, an angle step of 5° and an CSF height step of 5 mm were enough leading to <0.26mm TRE fluctuation.

PMID:34469879 | DOI:10.1088/1361-6560/ac22dc

Am J Ther. 2021 Aug 19. doi: 10.1097/MJT.0000000000001422. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to compare the poisoned patients who could not be administered activated charcoal because of its unavailability with the poisoned patients who were administered charcoal in the later period and to reveal the results about its effectiveness.

STUDY QUESTION: Is the use of activated charcoal effective against poisoning caused by oral medication?

STUDY DESIGN: This retrospective cohort study with historical control was planned at a tertiary hospital. Patients older than 18 years were admitted to the emergency department because of oral drug poisoning during the study periods. A total of 1159 patients who were not given activated charcoal and 877 patients who were given activated charcoal were included in this study.

MEASURES AND OUTCOMES: The frequency of clinical findings secondary to the drug taken, the frequency of antidote use, the frequency of intubation, and the hospitalization length were determined as clinical outcome parameters.

RESULTS: There was no statistically significant difference in the development of central nervous system findings, cardiovascular system findings, frequency of intubation, and blood gas disorders, as well as the length of hospitalization periods according to the activated charcoal application. Hepatobiliary system findings and electrolyte disturbances were found to be less common in patients given activated charcoal. The frequency of tachycardia, speech impairment, coma, and respiratory acidosis was found to be statistically higher in patients who were administered activated charcoal. The hospitalization period of the patients who were given activated charcoal was longer in patients with drug findings; however, there was no difference in the hospitalization periods of the patients who were given an antidote.

CONCLUSIONS: The use of activated charcoal in poisoned patients may not provide sufficient clinical benefits. However, clinical studies with strong evidence levels are needed to determine activated charcoal’s clinical efficacy, which is still used as a universal antidote.

PMID:34469920 | DOI:10.1097/MJT.0000000000001422

J Affect Disord. 2021 Aug 24;295:183-191. doi: 10.1016/j.jad.2021.08.025. Online ahead of print.

ABSTRACT

BACKGROUND: Rhythms And You (RAY) is an online intervention for bipolar disorders (BD) based on Interpersonal and Social Rhythm Therapy. We examined RAY’s feasibility and acceptability for individuals with BD recruited from primary care. Because online interventions may be more effective when paired with human support, we evaluated RAY with and without weekly brief (∼5 min) calls from clinical helpers (CH).

METHODS: Participants (n = 47) meeting criteria for BD I, II or other specified BD, presenting for primary care, were randomly assigned to RAY, RAY-CH, or Adjunctive Reading Material (ARM) control. RAY consisted of 12 weekly online modules. ARM consisted of 12 weekly emails. Participants were assessed at baseline, 4, 8, and 12 weeks.

RESULTS: RAY showed high completion rates and Client Satisfaction Questionnaire scores (36/47, 77% and 25.1 ± 5.5, respectively; no group differences). Effect sizes for RAY- CH ranged from small [Internal State Scale-Activation Subscale (ISS-ACT); d = 0.3] to large [SF-12 Mental Health Composite Score (SF-12 MHC); d = 1.3]. ARM also showed moderate effects (ISS-ACT d = 0.7; Quick Inventory of Depressive Symptoms, d = 0.8). SF-12 MHC scores showed a time*group interaction (F = 2.38, df = 6,32, p = 0.05) favoring RAY-CH. Number of logins trended toward significant association with improved social rhythm regularity (F = 4.09, df = 1, 17, p = 0.06).

LIMITATIONS: Sample size is small, limiting conclusions that can be drawn.

CONCLUSIONS: Remote delivery of RAY for individuals with BD is feasible and acceptable. More time spent engaged in RAY was associated with greater improvement in social rhythm regularity. Preliminary evidence suggests adding brief human support to RAY may yield better outcomes.

PMID:34469857 | DOI:10.1016/j.jad.2021.08.025

Neurosurg Focus. 2021 Sep;51(3):E9. doi: 10.3171/2021.6.FOCUS21112.

ABSTRACT

OBJECTIVE: This prospective study was designed to confirm the role of atorvastatin in collateral circulation formation induced by encephaloduroarteriosynangiosis (EDAS) in patients with moyamoya disease (MMD).

METHODS: Patients who were diagnosed with MMD at the Department of Neurosurgery in the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China, between June 2017 and May 2018 were included. Blood samples were obtained from an antecubital vein and were analyzed using flow cytometry. Endothelial progenitor cells (EPCs) were defined as CD34brCD133+CD45dimKDR+. All patients included in the study underwent EDAS. Patients voluntarily chose whether to undergo atorvastatin treatment after EDAS. The correlation between atorvastatin and good postoperative collateral circulation was evaluated.

RESULTS: A total of 106 patients with MMD were included in this study. Fifty-three patients (50%) received atorvastatin treatment. The baseline characteristics did not display statistically significant differences between the atorvastatin-treated and non-atorvastatin groups. Seventy-eight (42.9%) of the 182 hemispheres investigated postoperatively were classified as grade A collateral circulation, 47 (25.8%) as grade B, and 57 (31.3%) as grade C. Multivariate analysis revealed that only atorvastatin was significantly correlated with good collateral circulation after EDAS (p = 0.041).

CONCLUSIONS: The results of this prospective clinical trial have indicated that atorvastatin administered at 20 mg daily is safe and effective for the formation of postoperative collateral induced by EDAS.

PMID:34469867 | DOI:10.3171/2021.6.FOCUS21112

Neuroimage. 2021 Aug 29;243:118518. doi: 10.1016/j.neuroimage.2021.118518. Online ahead of print.

ABSTRACT

Null models are useful for assessing whether a dataset exhibits a non-trivial property of interest. These models have recently gained interest in the neuroimaging community as means to explore dynamic properties of functional Magnetic Resonance Imaging (fMRI) time series. Interpretation of null-model testing in this context may not be straightforward because (i) null hypotheses associated to different null models are sometimes unclear and (ii) fMRI metrics might be ‘trivial’, i.e. preserved under the null hypothesis, and still be useful in neuroimaging applications. In this commentary, we review several commonly used null models of fMRI time series and discuss the interpretation of the corresponding tests. We argue that, while null-model testing allows for a better characterization of the statistical properties of fMRI time series and associated metrics, it should not be considered as a mandatory validation step to assess their relevance in representing brain functional dynamics.

PMID:34469853 | DOI:10.1016/j.neuroimage.2021.118518

Psychiatry Res. 2021 Aug 21;305:114173. doi: 10.1016/j.psychres.2021.114173. Online ahead of print.

ABSTRACT

Using daily vital statistics data from the Japanese Ministry of Health, Labour and Welfare, we provide the first weekly and age-group-specific estimates of the additional suicide burden during the COVID-19 pandemic in Japan by gender, from January through November 2020. Our results indicate that compared with the previous five years, suicide cases in 2020 in Japan have increased from late July to November for women in all age groups and for men in the 20-29 and 80+ years age group. Targeted interventions based on age and gender might be more effective in reducing suicide during the COVID-19 pandemic in Japan.

PMID:34469804 | DOI:10.1016/j.psychres.2021.114173

J Minim Invasive Gynecol. 2021 Aug 29:S1553-4650(21)00404-0. doi: 10.1016/j.jmig.2021.08.018. Online ahead of print.

ABSTRACT

STUDY OBJECTIVE: To investigate the therapeutic efficacy of catheter-directed ethanol sclerotherapy (CDS) and its effect on ovarian reserve in patients with endometrioma at risk of decreased ovarian reserve.

DESIGN: A retrospective study.

SETTING: A teaching hospital.

PATIENTS: We evaluated 18 patients with ovarian endometrioma measuring ≥3 cm and pre-procedural serum anti-Müllerian hormone (AMH) levels of <2 ng/mL.

INTERVENTIONS: An 8.5-F catheter was inserted either transabdominally or transvaginally into the endometrioma. Following aspiration, sclerotherapy with 99% ethanol was performed, with subsequent 20-minute ethanol retention.

MEASUREMENTS AND MAIN RESULTS: Ultrasonography (US) was performed pre-procedurally and 6 months following CDS to evaluate any recurrence or changes in cyst size. Further, serum AMH levels, CA-125 levels, and the visual analog scale (VAS) scores for dysmenorrhea were obtained to analyze the ovarian reserve and treatment efficacy, pre-procedurally and at 6 months after CDS. The mean cyst size on US and serum CA-125 levels decreased 6 months after CDS (p < .001, and p = .001, respectively). All patients reported a decreased VAS score for dysmenorrhea (p < .001). However, the difference in serum AMH levels before and after CDS was statistically insignificant (p = .875).

CONCLUSION: CDS was efficacious in reducing pain and serum CA-125 levels in patients with low AMH levels without adversely affecting their ovarian reserve.

PMID:34469826 | DOI:10.1016/j.jmig.2021.08.018