Tag: pubmed

Neurosurg Focus. 2021 Jul;51(1):E2. doi: 10.3171/2021.4.FOCUS21117.

ABSTRACT

OBJECTIVE: The establishment of mechanical thrombectomy (MT) as a first-line treatment for select patients with acute ischemic stroke (AIS) and the expansion of stroke systems of care have been major advancements in the care of patients with AIS. In this study, the authors aimed to identify temporal trends in the usage of tissue-type plasminogen activator (tPA) and MT within the AIS population from 2012 to 2018, and the relationship to mortality.

METHODS: Using a nationwide private health insurance database, 117,834 patients who presented with a primary AIS between 2012 and 2018 in the United States were identified. The authors evaluated temporal trends in tPA and MT usage and clinical outcomes stratified by treatment and age using descriptive statistics.

RESULTS: Among patients presenting with AIS in this population, the mean age was 69.1 years (SD ± 12.3 years), and 51.7% were female. Between 2012 and 2018, the use of tPA and MT increased significantly (tPA, 6.3% to 11.8%, p < 0.0001; MT, 1.6% to 5.7%, p < 0.0001). Mortality at 90 days decreased significantly in the overall AIS population (8.7% to 6.7%, p < 0.0001). The largest reduction in 90-day mortality was seen in patients treated with MT (21.4% to 14.1%, p = 0.0414) versus tPA (11.8% to 7.0%, p < 0.0001) versus no treatment (8.3% to 6.3%, p < 0.0001). Age-standardized mortality at 90 days decreased significantly only in patients aged 71-80 years (11.4% to 7.8%, p < 0.0001) and > 81 years (17.8% to 11.6%, p < 0.0001). Mortality at 90 days stagnated in patients aged 18 to 50 years (3.0% to 2.2%, p = 0.4919), 51 to 60 years (3.8% to 3.9%, p = 0.7632), and 61 to 70 years (5.5% to 5.2%, p = 0.2448).

CONCLUSIONS: From 2012 to 2018, use of tPA and MT increased significantly, irrespective of age, while mortality decreased in the entire AIS population. The most dramatic decrease in mortality was seen in the MT-treated population. Age-standardized mortality improved only in patients older than 70 years, with no change in younger patients.

PMID:34198248 | DOI:10.3171/2021.4.FOCUS21117

Neurosurg Focus. 2021 Jul;51(1):E12. doi: 10.3171/2021.4.FOCUS21125.

ABSTRACT

OBJECTIVE: In symptomatic patients with cerebrovascular steno-occlusive disease, impaired blood oxygenation level-dependent cerebrovascular reactivity (BOLD-CVR) and increased flow velocity of the P2 segment of the posterior cerebral artery (PCA-P2) on transcranial Doppler (TCD) ultrasonography have been introduced as emerging clinical imaging parameters to identify patients at high risk for recurrent ischemic events. Since hemodynamic physiology differs between the acute and chronic stages of ischemic stroke, the authors sought to investigate whether those parameters have merit for both the acute and chronic stages of ischemic stroke.

METHODS: From a prospective database, patients who underwent BOLD-CVR and TCD examinations in the acute stroke stage (< 10 days) were matched to patients in the chronic stroke stage (> 3 months). A linear regression analysis for both groups was performed between ipsilateral PCA-P2 systolic flow velocity and BOLD-CVR of the ipsilateral (affected) hemisphere, the ipsilateral middle cerebral artery (MCA) territory, and the ipsilateral steal volume (i.e., paradoxical BOLD-CVR response). The resulting slopes and intercepts were statistically compared to evaluate differences between groups.

RESULTS: Forty matched patient pairs were included. Regression analysis showed no significant difference for either the intercept (p = 0.84) or the slope (p = 0.85) between PCA-P2 flow velocity and BOLD-CVR as measured for the ipsilateral (affected) hemisphere. Similarly, no significant difference was seen between PCA-P2 flow velocity and BOLD-CVR of the ipsilateral MCA territory (intercept, p = 0.72; slope, p = 0.36) or between PCA-P2 flow velocity and steal volume (intercept, p = 0.59; slope, p = 0.34).

CONCLUSIONS: The study results indicated that the relationship between ipsilateral PCA-P2 systolic flow velocity and BOLD-CVR remains the same during the acute and chronic stages of ischemic stroke. This provides further support that these novel hemodynamic imaging parameters may have merit to assess the risk for recurrent ischemic events for a wide ischemic stroke population. PCA-P2 systolic flow velocity, in particular, may be a highly practical screening tool, independent of ischemic stroke stage.

PMID:34198249 | DOI:10.3171/2021.4.FOCUS21125

Aging (Albany NY). 2021 Jul 1;13. doi: 10.18632/aging.203228. Online ahead of print.

ABSTRACT

The present study aimed to investigate the associations between the trajectory of blood pressure (BP) change and the risk of subsequent dementia and to explore the differences in age, gender, and hypertension subgroups. We included 10,660 participants aged ≥ 60 years from 1998 to 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Latent growth mixture models were used to estimate BP trajectories. Cox-proportional hazard models were used to analyze the effects of BP trajectories on the risk of dementia. According to the results, stabilized systolic BP (SBP) was found to be associated with a higher risk of dementia compared with normal SBP [adjusted hazard ratio (aHR): 1.62; 95% confidence interval (CI): 1.27-2.07] and elevated SBP (aHR: 2.22; 95% CI: 1.51-3.28) in and only in the subgroups of the oldest-old, women, and subjects without hypertension at baseline. Similarly, stabilized pulse pressure (PP) was associated with a higher risk of dementia compared with normal PP (aHR: 1.52; 95% CI: 1.24-1.88) and elevated PP (aHR: 2.12; 95% CI: 1.48-3.04) in and only in the subgroups of the oldest-old, women, and subjects with hypertension at baseline. These findings suggest that stabilized SBP and PP have predictive significance for the occurrence of dementia in late life, and the factors of age, gender, and late-life hypertension should be considered when estimating the risk of BP decline on dementia.

PMID:34198262 | DOI:10.18632/aging.203228

Psychiatry Res. 2021 Jun 22;303:114073. doi: 10.1016/j.psychres.2021.114073. Online ahead of print.

ABSTRACT

Our manuscript aims to: 1) assess physical health in a sample of patients with severe mental disorders; and 2) identify the psychopathological and psychosocial characteristics associated with an increased likelihood of having a poor physical health. The study, funded by the Italian Ministry of Education, has been carried out in psychiatric outpatient units of six Italian University sites. All recruited patients have been assessed through standardized assessment instruments. Moreover, anthropometric parameters have been obtained at recruitment and a blood samples have been collected to assess cardiometabolic parameters. Four-hundred and two patients with a primary diagnosis of bipolar disorder (43.3%), schizophrenia or other psychotic disorder (29.9%), or major depression (26.9%) were recruited. Internalized stigma, psychosocial functioning, quality of life, psychiatric hospitalizations, depressive/anxiety and manic symptoms and cognition were those domains more strongly associated with poor metabolic parameters, including high body mass index, HOMA and Framingham indexes and waist circumference. There were no statistically significant differences among the three diagnostic groups. Our findings highlight the importance of perceived stigma and quality of life on patients’ physical health. This should be taken into account when developing plans for reducing the mortality rate in patients with severe mental disorders.

PMID:34198214 | DOI:10.1016/j.psychres.2021.114073

Int J Pediatr Otorhinolaryngol. 2021 Jun 26;148:110816. doi: 10.1016/j.ijporl.2021.110816. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to document the observation of the Crista Fenestra’s morphological types (CF) of the round window and to detect its impact during cochlear implant operation.

STUDY DESIGN: A prospective descriptive cohort study.

SETTINGS: We conducted this study at tertiary referral institutions in Egypt.

PATIENTS: This study included 140 children who underwent cochlear implantation.

INTERVENTION: We observed the CF’s morphological type during the operation according to (Baki-Elzayat) novel classification of CF anatomy, and the need for drilling in each CI operation.

MAIN OUTCOME MEASURES: CF has two main types. Type A, in which CF was present at the same level of round window membrane and attached to it. Type B, in which CF was medial to the Round window membrane.

RESULTS: Type (A) CF was detected in 125 cases (89.28%), while 25 cases (10.71%) showed type (B) CF. Drilling was needed in 10 cases (7.14%), including CF types A.3 and B2. Drilling was not needed in 130 cases (92.85%), including CF type A.1, A.2, and B.1. There was a statistically significant difference in the need for drilling (P-value <0.001).

CONCLUSIONS: According to this prospective study, CF had complicated anatomy. Baki-Elzayat classified the CF into two main types. In type A, CF was at the same level of RWM and attached to it. In type B, CF was medial to RWM. We recommended drilling for partial removal of massive CF types (A.3 and B.2) for atraumatic safe insertion of the electrode without deflection. This classification can offer an easy language system for CI surgeons to describe and register CF during their operations and in the surgical files.

PMID:34198228 | DOI:10.1016/j.ijporl.2021.110816

Behav Res Ther. 2021 Jun 24;144:103918. doi: 10.1016/j.brat.2021.103918. Online ahead of print.

ABSTRACT

We examined whether extinction or changes negative trauma-related beliefs occur either prior to or concurrently with changes in posttraumatic stress symptoms among individuals who received either Cognitive Processing Therapy (CPT) or Written Exposure Therapy (WET) using statistical methods that permit proper discernment of temporal sequence. Community participants with PTSD (N = 126) were evenly randomized to 12 sessions of CPT or 5 sessions of WET. We assessed within- and between-session changes in arousal and valence and changes in trauma-related beliefs 6-, 12-, 24-, 36- and 60-weeks following the first treatment session. Between-session change in post-session emotional valence temporally preceded PTSD symptom reduction among participants who received WET but did not predict subsequent symptom reduction. Although negative trauma-related beliefs changed in parallel with and correlated with PTSD symptom reduction in both conditions, this change did not temporally precede symptom reduction. Our results are inconsistent with those from prior studies and suggest these constructs may more appropriately be characterized as correlates, rather than mediators, of symptom reduction. These results highlight the value of discernment of the temporal sequence of change between hypothesized mediators and symptoms and underscore that we still have much to learn about how evidence-based treatments reduce PTSD symptoms.

PMID:34198230 | DOI:10.1016/j.brat.2021.103918

Water Res. 2021 Jun 21;201:117380. doi: 10.1016/j.watres.2021.117380. Online ahead of print.

ABSTRACT

Investigation of seasonal variations of water quality parameters is essential for understanding the mechanisms of structural changes in aquatic ecosystems and their pollution control. Despite the ongoing rise in scientific production on spatiotemporal distribution characteristics of water quality parameters, such as total nitrogen (TN) in reservoirs, attempts to use published data and incorporate them into a large-scale comparison and trends analyses are lacking. Here, we propose a framework of Data extraction, Data grouping and Statistical analysis (DDS) and illustrate application of this DDS framework with the example of TN in reservoirs. Among 1722 publications related to TN in reservoirs, 58 TN time-series data from 19 reservoirs met the analysis requirements and were extracted using the DDS framework. We performed statistical analysis on these time-series data using Dynamic Time Warping (DTW) combined with agglomerative hierarchical clustering as well as Generalized Additive Models for Location, Scale, and Shape (GAMLSS). Three patterns of seasonal TN dynamics were identified. In Pattern V-Sum, TN concentrations change in a “V” shape, dropping to its lowest value in summer; in Pattern P-Sum, TN increases in late summer/early fall before decreasing again; and in Pattern P-Spr, TN peaks in spring. Identified patterns were driven by phytoplankton growth and precipitation (Pattern V-Sum), nitrate wet deposition and agricultural runoff (Pattern P-Sum), and anthropogenic discharges (Pattern P-Spr). Application of the DDS framework has identified a key bottleneck in assessing the dynamics of TN – low data accessibility and availability. Providing an easily accessible data sharing platform and increasing the accessibility and availability of raw data for research will facilitate improvements and expand the applicability of the DDS framework. Identification of additional spatiotemporal patterns of water quality parameters can provide new insights for more comprehensive pollution control and management of aquatic ecosystems.

PMID:34198201 | DOI:10.1016/j.watres.2021.117380

Adv Colloid Interface Sci. 2021 Jun 17;294:102468. doi: 10.1016/j.cis.2021.102468. Online ahead of print.

ABSTRACT

The dynamic uptake of adsorbate onto the porous adsorbent plays a crucial role in determining the performance of the adsorption-based cooling system. Therefore, it is imperative to know the kinetics parameters of an adsorbate – adsorbent pair to design a system to be operated at variable working conditions. The kinetics models of adsorption, used to simulate the adsorption rate of different pairs, are derived and presented in this paper. Besides, the limitations and advantages of the models are also mentioned. Moreover, the dynamic performance of different adsorption pairs is analyzed, and the values of kinetics parameters, determined through experimental procedures and fitting of kinetics models, are also summarized. It is opined that during the initial unsaturated condition of adsorption, the semi-infinite model can be preferred to determine the diffusion time constant. The modification of different models, e.g., Langmuir and linear driving force models, can significantly overcome the drawbacks of the models, as shown by several researchers. However, research may be carried out to investigate different models’ fitting errors from a statistical perspective. Furthermore, to evaluate the dynamic performance of different adsorbates, a lot of research needs to be done, specifically, on the adsorption of the newly developed environment-friendly refrigerants, onto the promising composite adsorbents possessing high thermal conductivity and significantly improved adsorption uptakes.

PMID:34198212 | DOI:10.1016/j.cis.2021.102468

Semin Arthritis Rheum. 2021 Jun 20;51(4):888-894. doi: 10.1016/j.semarthrit.2021.06.008. Online ahead of print.

ABSTRACT

INTRODUCTION: Psoriatic arthritis (PsA) is a multidimensional inflammatory disease for which multiple outcome measures can be used to assess disease activity. In 2006, the OMERACT has proposed the first core domain set in PsA. Since 2006, much work has been performed on outcome measures in PsA.

OBJECTIVES: The purpose of this study was to assess outcome measures collected in recent PsA registries or longitudinal cohorts.

METHODS: A systematic literature review was performed in Pubmed Medline (PROSPERO CRD42020175745) to identify all articles reporting on either registries or longitudinal cohorts in PsA, published between 2010 and March 2020. Registries centered on drugs or not PsA-specific, trials and long-term extension studies were excluded. The data collection comprised patient characteristics and the clinical outcome measures reported, including composite scores and patient reported outcomes (PROs). Statistics were descriptive.

RESULTS: Of 673 articles, 73 were analysed, reporting on 27 registries/cohorts. Overall, 16,183 patients were included, with a mean of 599 per study; 51% were men, weighted mean age was 49.7 ± 9.3 years and weighted mean disease duration was 6.8 ± 0.2 years. Overall, 58 different outcome measures were collected. Disease activity composite scores were used in 20/27 (74%) registries through 8 different scores (most frequently Minimal Disease Activity: 41%, DAS28: 33% and DAPSA: 30%). Among the domains of PsA, joint involvement was reported in 26/27 (96%) registries (through the 66/68 joint count: 85%) and skin psoriasis in 93% (through PASI: 72%), whereas enthesitis, dactylitis and axial involvement were less often reported (respectively, 77%, 74% and 52%). Furthermore, 22/27 (82%) studies reported HAQ; the other frequently reported PROs were patient global assessment (70%) and pain (63%).

CONCLUSIONS: Data collection in PsA is very heterogeneous, reflecting the need for international consensus on outcome measures.

PMID:34198147 | DOI:10.1016/j.semarthrit.2021.06.008

Int J Pediatr Otorhinolaryngol. 2021 Jun 26;147:110819. doi: 10.1016/j.ijporl.2021.110819. Online ahead of print.

ABSTRACT

INTRODUCTION: The assessment of the integrity of the neural responses with ABR, aims to assist in the differential diagnosis of retrocochlear alterations. The gold standard stimulus for this assessment is Click. However, the CE-Chirp® Level Specific was developed to optimize the triggering of neural responses.

OBJECTIVE: to compare neural responses obtained with CE-Chirp® LS stimulus to those obtained with Clicks at 70 dB nHL in hearing infants, in order to analyze advantages in using CE-Chirp® LS.

METHODS: Eighteen infants with normal hearing were evaluated with Eclipse EP25 ABR System. Clicks and CE-Chirp® LS stimuli were presented using ER-3A insert earphones at 70 dB nHL, rate 45.1/s, and alternating polarity. A 30 Hz high-pass and 1500 Hz low-pass filter was applied, and ±40 μV artifact rejection level. Absolute latency of waves I, III and V and their interpeak intervals I-III, III-V and I-V were measured, as well as interaural difference for wave V and interpeak I-V, and wave V amplitude.

RESULTS: Although 18 infants were included in the study, it was possible to collect data only in 30 ears for Click stimulus, and 33 ears for CE-Chirp® LS, according to exclusion criteria. It was possible to record waves I, III, and V for both stimuli at 70 dB nHL in all normal-hearing infants. CE-Chirp® LS stimulus evoked a higher wave V amplitude than Click (p < 0.001). Wave I absolute latency was statistically different between stimuli (p < 0.001), being delayed for CE-Chirp® LS. Wave III absolute latency was statistically different between stimuli only for the right ear (p = 0.021), and wave V absolute latency was similar in both stimuli (p = 0.210). Interpeak intervals I-III and I-V were statistically different between stimuli (p < 0.001), being reduced for CE-Chirp® LS. Interpeak interval III-V was different between the stimuli only for right ears (p = 0.006). There was no difference between stimuli for interaural difference wave V (p = 1.33) and interaural difference interpeak I-V (p = 0.409).

CONCLUSION: It is possible to use CE-Chirp® LS stimulus in order to analyze neural synchrony in infants at 70 dB nHL, since better morphology waveforms were observed, and higher wave V amplitudes could be recorded. We suggest that new studies with infants with neurological disabilities and various hearing status, to observe how CE-Chirp® LS stimulus evokes neural responses in these conditions.

PMID:34198155 | DOI:10.1016/j.ijporl.2021.110819