Tag: pubmed

Sci Rep. 2021 Sep 3;11(1):17684. doi: 10.1038/s41598-021-97150-5.

ABSTRACT

Positional brain shift (PBS), the sagging of the brain under the effect of gravity, is comparable in magnitude to the margin of error for the success of stereotactic interventions ([Formula: see text] 1 mm). This non-uniform shift due to slight differences in head orientation can lead to a significant discrepancy between the planned and the actual location of surgical targets. Accurate in-vivo measurements of this complex deformation are critical for the design and validation of an appropriate compensation to integrate into neuronavigational systems. PBS arising from prone-to-supine change of head orientation was measured with magnetic resonance imaging on 11 young adults. The full-field displacement was extracted on a voxel-basis via digital volume correlation and analysed in a standard reference space. Results showed the need for target-specific correction of surgical targets, as a significant displacement ranging from 0.52 to 0.77 mm was measured at surgically relevant structures. Strain analysis further revealed local variability in compressibility: anterior regions showed expansion (both volume and shape change), whereas posterior regions showed small compression, mostly dominated by shape change. Finally, analysis of correlation demonstrated the potential for further patient- and intervention-specific adjustments, as intra-cranial breadth and head tilt correlated with PBS reaching statistical significance.

PMID:34480073 | DOI:10.1038/s41598-021-97150-5

J Hum Hypertens. 2021 Sep 3. doi: 10.1038/s41371-021-00598-1. Online ahead of print.

ABSTRACT

The risk of cardiovascular disease (CVD) at currently defined normal systolic blood pressure (SBP) levels in individuals without CVD risk factors is not well examined. We evaluated whether higher systolic blood pressure within the range considered normal is associated with a higher CVD risk in Chinese without traditional CVD risk factors. The community-based study included 25,529 individuals (mean age:47.3 ± 12.3 years;range:18-95 years) with a baseline SBP of 90-129 mmHg, who were free of CVD and traditional CVD risk factors, and who were re-examined in biennial intervals. During a mean follow-up of 10.6 ± 1.49 years (maximum. 11.5 years), 847 CVD events occurred. CVD incidence per 1000 person-years increased with higher baseline SBP levels (SBP,90-99 mmHg:1.45;100-109 mmHg:2.15;110-119 mmHg:3.06; and 120-129 mmHg:3.80). After adjusting for CVD risk factors, the categorical Cox regression suggested that the CVD risk was not statistically significant for study participants with a baseline SBP level of 100-109 mmHg, 110-119 mmHg, and 120-129 mmHg compared with those with a baseline SBP level of 90-99 mmHg. If CVD risk factors including blood pressure categories which developed during follow-up were included in a time-dependent Cox regression analysis, the normal baseline SBP was still not associated with incident CVDs. A SBP between 90 and 129 mmHg was not associated with an increased CVD risk in a healthy population.

PMID:34480099 | DOI:10.1038/s41371-021-00598-1

Sci Rep. 2021 Sep 3;11(1):17681. doi: 10.1038/s41598-021-96975-4.

ABSTRACT

Although multiple myeloma (MM) is still considered as an incurable disease by current standards, the development of several combination therapies, and immunotherapy approaches has raised the hope towards transforming MM into an indolent, chronic disease, and possibly achieving a cure. We tried to shed light on the expression of PD1 and different Microparticles (MPs) in MM and their interplay as a mechanism of resistance to standardized treatments, in addition, find their associations with prognostic factors of symptomatic MM. Thirty patients with newly diagnosed and chemotherapy naïve active MM, along with 19 healthy participants of comparable age and sex were recruited, after diagnosis of MM; blood samples were collected from both patients and controls for flow cytometric detection of CD4+, CD8+, CD4+PD1+, and CD8+PD1+T cells, total MPs, CD138+ MPs, and platelet MPs. MM patients had statistically significant higher levels of TMPs, CD138+ MPs compared to their controls, while PMPs exhibited no significant difference between both groups. Statistically significant higher percentages of CD8+, PD1CD8+, PD1CD4+T cells were detected in patients compared to controls, while the latter group had a significantly higher percentage of CD4+T cells than MM patients, patients who did not achieve complete response, had significantly higher percentages of PMPs, CD138+MPs, PD1+CD8+, PD1+CD4+, and CD8+T cells (cutoff values = 61, 10.6, 13.5, 11.3 and 20.1 respectively), (p-values = 0.002, 0.003, 0.017, 0.001 and 0.008 respectively). Microparticles and PD1 expressions were associated with proliferative potential and resistance to Bortezomib-based treatments, our results suggested that they played a crucial role in myeloma progression.

PMID:34480060 | DOI:10.1038/s41598-021-96975-4

Sci Rep. 2021 Sep 3;11(1):17667. doi: 10.1038/s41598-021-96880-w.

ABSTRACT

The global sea-level budget is studied using the Gravity Recovery and Climate Experiment (GRACE) solutions, Satellite Altimetry and Argo observations based on the updated budget equation. When the global ocean mass change is estimated with the updated Tongji-Grace2018 solution, the misclosure of the global sea-level budget can be reduced by 0.11-0.22 mm/year compared to four other recent solutions (i.e. CSR RL06, GFZ RL06, JPL RL06 and ITSG-Grace2018) over the period January 2005 to December 2016. When the same missing months as the GRACE solution are deleted from altimetry and Argo data, the misclosure will be reduced by 0.06 mm/year. Once retained the GRACE C₂₀ term, the linear trends of Tongji-Grace2018 and ITSG-Grace2018 solutions are 2.60 ± 0.16 and 2.54 ± 0.16 mm/year, closer to 2.60 ± 0.14 mm/year from Altimetry-Argo than the three RL06 official solutions. Therefore, the Tongji-Grace2018 solution can reduce the misclosure between altimetry, Argo and GRACE data, regardless of whether the C₂₀ term is replaced or not, since the low-degree spherical harmonic coefficients of the Tongji-Grace2018 solution can capture more ocean signals, which are confirmed by the statistical results of the time series of global mean ocean mass change derived from five GRACE solutions with the spherical harmonic coefficients truncated to different degrees and orders.

PMID:34480069 | DOI:10.1038/s41598-021-96880-w

Tob Control. 2021 Sep 3:tobaccocontrol-2021-056717. doi: 10.1136/tobaccocontrol-2021-056717. Online ahead of print.

ABSTRACT

OBJECTIVE: We sought to conduct a systematic review and meta-analysis of evidence to inform policies that reduce density and proximity of tobacco retailers.

DATA SOURCES: Ten databases were searched on 16 October 2020: MEDLINE via PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus, plus grey literature searches using Google and the RAND Publication Database.

STUDY SELECTION: Included studies used inferential statistics about adult participants to examine associations between tobacco retailer density/proximity and tobacco use behaviours and health outcomes. Of 7373 studies reviewed by independent coders, 37 (0.5%) met inclusion criteria.

DATA EXTRACTION: Effect sizes were converted to a relative risk reduction (RRR) metric, indicating the presumed reduction in tobacco use outcomes based on reducing tobacco retailer density and decreasing proximity.

DATA SYNTHESIS: We conducted a random effects meta-analysis and examined heterogeneity across 27 studies through subgroup analyses and meta-regression. Tobacco retailer density (RRR=2.55, 95% CI 1.91 to 3.19, k=155) and proximity (RRR=2.38, 95% CI 1.39 to 3.37, k=100) were associated with tobacco use behaviours. Pooled results including both density and proximity found an estimated 2.48% reduction in risk of tobacco use from reductions in tobacco retailer density and proximity (RRR=2.48, 95% CI 1.95 to 3.02, k=255). Results for health outcomes came from just two studies and were not significant. Considerable heterogeneity existed.

CONCLUSIONS: Across studies, lower levels of tobacco retailer density and decreased proximity are associated with lower tobacco use. Reducing tobacco supply by limiting retailer density and proximity may lead to reductions in tobacco use. Policy evaluations are needed.

PMID:34479990 | DOI:10.1136/tobaccocontrol-2021-056717

Proc Natl Acad Sci U S A. 2021 Sep 7;118(36):e2105328118. doi: 10.1073/pnas.2105328118.

ABSTRACT

Brain microstructure plays a key role in driving the transport of drug molecules directly administered to the brain tissue, as in Convection-Enhanced Delivery procedures. The proposed research analyzes the hydraulic permeability of two white matter (WM) areas (corpus callosum and fornix) whose three-dimensional microstructure was reconstructed starting from the acquisition of electron microscopy images. We cut the two volumes with 20 equally spaced planes distributed along two perpendicular directions, and, on each plane, we computed the corresponding permeability vector. Then, we considered that the WM structure is mainly composed of elongated and parallel axons, and, using a principal component analysis, we defined two principal directions, parallel and perpendicular, with respect to the axons’ main direction. The latter were used to define a reference frame onto which the permeability vectors were projected to finally obtain the permeability along the parallel and perpendicular directions. The results show a statistically significant difference between parallel and perpendicular permeability, with a ratio of about two in both the WM structures analyzed, thus demonstrating their anisotropic behavior. Moreover, we find a significant difference between permeability in corpus callosum and fornix, which suggests that the WM heterogeneity should also be considered when modeling drug transport in the brain. Our findings, which demonstrate and quantify the anisotropic and heterogeneous character of the WM, represent a fundamental contribution not only for drug-delivery modeling, but also for shedding light on the interstitial transport mechanisms in the extracellular space.

PMID:34480003 | DOI:10.1073/pnas.2105328118

Cancer Epidemiol Biomarkers Prev. 2021 Sep 3:cebp.0476.2021. doi: 10.1158/1055-9965.EPI-21-0476. Online ahead of print.

ABSTRACT

BACKGROUND: Experimental studies suggest that iron overload might increase pancreatic cancer (PC) risk. We evaluated whether prediagnostic hemochromatosis and iron-overload diseases, including sideroblastic and congenital dyserythropoietic anemias and non-alcoholic related chronic liver disease (NACLD), were associated with PC risk in older adults.

METHODS: We conducted a population-based, case-control study within the United States’ Surveillance, Epidemiology, and End Results Program (SEER)-Medicare linked data. Incident primary PC cases were adults > 66 years. Controls were alive at the time cases were diagnosed and matched to cases (4:1 ratio) by age, sex, and calendar-year. Hemochromatosis, iron-overload anemias, and NACLD were reported 12 or more months before PC diagnosis or control selection using Medicare claims data. Adjusted unconditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) between hemochromatosis, sideroblastic and congenital dyserythropoietic anemias NACLD, and PC.

RESULTS: Between 1992-2015, 80,074 PC cases and 320,296 controls were identified. Overall, we did not observe statistically significant associations between hemochromatosis, sideroblastic anemia, or congenital dyserythropoietic anemia and PC; however, sideroblastic anemia was associated with later primary PC (OR: 1.30, 95% CI: 1.03-1.64). NACLD was associated with first (OR: 1.10, 95% CI: 1.01-1.19), later (OR: 1.17, 95% CI: 1.02-1.35), and all (OR: 1.12, 95% CI: 1.04-1.20) PC.

CONCLUSION: Overall hemochromatosis and iron-overload anemias were not associated with PC, whereas NACLD was associated with increased risk in this large study of older adults.

IMPACT: These results partly support the hypothesis that iron-overload diseases increases PC risk.

PMID:34479949 | DOI:10.1158/1055-9965.EPI-21-0476

Postgrad Med J. 2021 Sep 3:postgradmedj-2021-141014. doi: 10.1136/postgradmedj-2021-141014. Online ahead of print.

ABSTRACT

Surveys are quick and easy to produce. This paper outlines some of the many problems that should be anticipated.

PMID:34479976 | DOI:10.1136/postgradmedj-2021-141014

Postgrad Med J. 2021 Sep 3:postgradmedj-2020-139382. doi: 10.1136/postgradmedj-2020-139382. Online ahead of print.

ABSTRACT

BACKGROUND: Postpartum haemorrhage is one of the direct and the leading causes of maternal morbidity and mortality. There are many risk factors of postpartum haemorrhage, which vary in different settings. Therefore, the purpose of this study was to assess postpartum haemorrhage and associated factors among mothers who gave birth in public health facilities.

METHODS: A cross-sectional study was employed from 17 November 2019 to 15 February 2020. The study participants were selected using a systematic sampling technique. The data were entered and cleaned using EpiData V.3.1 then exported to SPSS V.20 for analysis. Factors associated with postpartum haemorrhage were selected for multiple logistic regression at the probability value (p value) of less than 0.2 in the χ² analysis. Statistically significant associated factors were identified at probability value (p value) less than 0.05 and adjusted OR (AOR) with a 95% CI.

RESULTS: The mean age of participants was 31.3 (SD ±5.7) years. This study found that the prevalence of postpartum haemorrhage was 13.6% (67). Age of participants (AOR 12.5, 95% CI 4.0 to 38.6), disrespectful maternity care (AOR 8.4, 95% CI 3.2 to 22.0), labour induction and augmentation (AOR 6.97, 95% CI 2.34 to 20.8), the prolonged second stage of labour (AOR 9.9, 95% CI 2.6 to 37.1) and no antenatal care visit (AOR 10.1, 95% CI 3.4 to 29.7) were statistically significant associated factors of postpartum haemorrhage.

CONCLUSIONS: The prevalence of postpartum haemorrhage is high. The age of the participants, disrespectful maternity care, labour induction and augmentation, the prolonged second stage of labour and no antenatal care visit were independent predictors of postpartum haemorrhage.

PMID:34479977 | DOI:10.1136/postgradmedj-2020-139382

BMJ Open. 2021 Sep 3;11(9):e051003. doi: 10.1136/bmjopen-2021-051003.

ABSTRACT

INTRODUCTION: Acute traumatic coagulopathy (ATC) in bleeding trauma patients increase in-hospital mortality. Fibrinogen concentrate (FC) and prothrombin complex concentrate (PCC) are two purified concentrates of clotting factors that have been used to treat ATC. However, there is a knowledge gap on their use compared with the standard of care, the transfusion of plasma.

METHODS AND ANALYSIS: The factors in the initial resuscitation of severe trauma 2 trial is a multicentre, randomised, parallel-control, single-blinded, phase IV superiority trial. The study aims to address efficacy and safety of the early use of FC and PCC compared with a plasma-based resuscitation. Adult trauma patients requiring massive haemorrhage protocol activation on hospital arrival will receive FC 4 g and PCC 2000 IU or plasma 4 U, based on random allocation. The primary outcome is a composite of the cumulative number of all units of red cells, plasma and platelets transfused within 24 hours following admission. Secondary outcomes include measures of efficacy and safety of the intervention. Enrolment of 350 patients will provide an initial power >80% to demonstrate superiority for the primary outcome. After enrolment of 120 patients, a preplanned adaptive interim analysis will be conducted to reassess assumptions, check for early superiority demonstration or reassess the sample size for remainder of the study.

ETHICS AND DISSEMINATION: The study has been approved by local and provincial research ethics boards and will be conducted according to the Declaration of Helsinki, Good Clinical Practice guidelines and regulatory requirements. As per the Tri-Council Policy Statement, patient consent will be deferred due to the emergency nature of the interventions. If superiority is established, results will have a major impact on clinical practice by reducing exposure to non-virally inactivated blood products, shortening the time for administration of clotting factors, correct coagulopathy more efficaciously and reduce the reliance on AB plasma.

TRIAL REGISTRATION NUMBER: NCT04534751, pre results.

PMID:34479938 | DOI:10.1136/bmjopen-2021-051003