Tag: pubmed

J Stroke Cerebrovasc Dis. 2021 Jun 19;30(8):105931. doi: 10.1016/j.jstrokecerebrovasdis.2021.105931. Online ahead of print.

ABSTRACT

OBJECTIVES: The Quality in Acute Stroke Care (QASC) protocol is a multidisciplinary approach to implement evidence-based treatment after acute stroke that reduces death and disability. This study sought to evaluate the cost-effectiveness of implementing the QASC protocol across Australia, from a healthcare and a societal perspective.

MATERIALS AND METHODS: A decision-analytic model was constructed to reflect one-year outcomes post-stroke, aligned with the stroke severity categories of the modified Rankin scale (mRS). Decision analysis compared outcomes following implementation of the QASC protocol versus no implementation. Population data were extracted from Australian databases and data inputs regarding stroke incidence, costs, and utilities were drawn from published sources. The analysis assumed a progressive uptake and efficacy of the QASC protocol over five years. Health benefits and costs were discounted by 5% annually. The cost of each year lived by an Australian, from a societal perspective, was based on the Australian Government’s ‘value of statistical life year’ (AUD 213,000).

RESULTS: Over five years, the model predicted 263,722 strokes among the Australian population. The implementation of the QASC protocol was predicted to prevent 1,154 deaths and yield a gain of 876 years of life (0.003 per stroke), and 3,180 quality-adjusted life years (QALYs) (0.012 per stroke). There was an estimated net saving of AUD 65.2 million in healthcare costs (AUD 247 per stroke) and AUD 251.7 million in societal costs (AUD 955 per stroke).

CONCLUSIONS: Implementation of the QASC protocol in Australia represents both a dominant (cost-saving) strategy, from a healthcare and a societal perspective.

PMID:34157669 | DOI:10.1016/j.jstrokecerebrovasdis.2021.105931

Eur J Radiol. 2021 Jun 11;141:109816. doi: 10.1016/j.ejrad.2021.109816. Online ahead of print.

ABSTRACT

OBJECTIVES: Rapid communication of CT exams positive for pulmonary embolism (PE) is crucial for timely initiation of anticoagulation and patient outcome. It is unknown if deep learning automated detection of PE on CT Pulmonary Angiograms (CTPA) in combination with worklist prioritization and an electronic notification system (ENS) can improve communication times and patient turnaround in the Emergency Department (ED).

METHODS: In 01/2019, an ENS allowing direct communication between radiology and ED was installed. Starting in 10/2019, CTPAs were processed by a deep learning (DL)-powered algorithm for detection of PE. CTPAs acquired between 04/2018 and 06/2020 (n = 1808) were analysed. To assess the impact of the ENS and the DL-algorithm, radiology report reading times (RRT), radiology report communication time (RCT), time to anticoagulation (TTA), and patient turnaround times (TAT) in the ED were compared for three consecutive time periods. Performance measures of the algorithm were calculated on a per exam level (sensitivity, specificity, PPV, NPV, F1-score), with written reports and exam review as ground truth.

RESULTS: Sensitivity of the algorithm was 79.6 % (95 %CI:70.8-87.2%), specificity 95.0 % (95 %CI:92.0-97.1%), PPV 82.2 % (95 %CI:73.9-88.3), and NPV 94.1 % (95 %CI:91.4-96 %). There was no statistically significant reduction of any of the observed times (RRT, RCT, TTA, TAT).

CONCLUSION: DL-assisted detection of PE in CTPAs and ENS-assisted communication of results to referring physicians technically work. However, the mere clinical introduction of these tools, even if they exhibit a good performance, is not sufficient to achieve significant effects on clinical performance measures.

PMID:34157638 | DOI:10.1016/j.ejrad.2021.109816

Neural Netw. 2021 Jun 15;143:230-245. doi: 10.1016/j.neunet.2021.06.013. Online ahead of print.

ABSTRACT

This paper discusses the periodicity and multi-periodicity in delayed Cohen-Grossberg-type neural networks (CGNNs) possessing impulsive effects, whose activation functions possess discontinuities and are allowed to be unbounded or nonmonotonic. Based on differential inclusion and cone expansion-compression fixed-point theory of set-valued mapping, several improved criteria are given to derive the positive solution with ω-periodicity and ω-multi-periodicity for delayed CGNNs under impulsive control. These ω-periodicity/ω-multi-periodicity orbits are produced by impulses control. The analytical method and theoretical results presented in this paper are of certain significance to the design of neural network models or circuits possessing discontinuous neuron activation and impulsive effects in periodic environment.

PMID:34157647 | DOI:10.1016/j.neunet.2021.06.013

Food Chem. 2021 Jun 16;364:130381. doi: 10.1016/j.foodchem.2021.130381. Online ahead of print.

ABSTRACT

The objective of this study was to explore the potentiality and mechanism of visible and near-infrared (Vis-NIR) spectroscopy in estimating the freshness of komatsuna. We monitored the cumulative CO₂ production of komatsuna stored under different conditions as a freshness indicator and measured the Vis-NIR spectra of komatsuna as the predictor. Using the informative wavelengths (IW) selected using the stepwise selectivity ratio method, we constructed an accurate freshness prediction model through PLSR analysis. The IW in the visible region were attributed to pigments such as chlorophyll. In the NIR region, ten amino acids were identified as directly or indirectly contributing to the IW and were highly related to freshness. They were confirmed on the basis of the strong correlations between the informative NIR signals and NMR signals, which were determined using statistical heterospectroscopy. The results demonstrate the feasibility of Vis-NIR spectroscopy in estimating the freshness of komatsuna using the IW.

PMID:34157592 | DOI:10.1016/j.foodchem.2021.130381

Plant Physiol Biochem. 2021 Jun 16;166:427-436. doi: 10.1016/j.plaphy.2021.06.012. Online ahead of print.

ABSTRACT

Hotness or pungency is the major trait of genetically diverse and economically valuable chili (Capsicum sp.) cultivars. However, little is known about the influence of soil characteristics on genetic regulation of pungency vis-à-vis capsaicin formation in endemic chilies. Hence, the present work was conducted by growing two endemic chili cultivars in two types (alluvial and lateritic) of soil. Capsaicin content, pungency, and capsaicin synthase activity were significantly greater in chilies grown in alluvial soil than in lateritic soil. Correspondingly, Csy1, the gene that encodes capsaicin synthase, was significantly upregulated in alluvial soil grown plants. Interestingly, upregulation of Pun1, the gene responsible for capsaicin accumulation in fruits, was more in lateritic soil than in alluvial soil; but pungency was inhibited in lateritic soil by the overexpression of Pun1², a recessive allele of Pun1 locus. Statistical analyses revealed that high organic C, microbial activity, and NPK status in alluvial soil were responsible for high pungency, capsaicin synthase activity, capsaicin accumulation, and suppression of Pun1². Fruit yield, dry matter, crude protein, titratable acidity, and soluble solids were also significantly high in chilies grown in alluvial soil. Therefore, we postulate that soil quality attributes play vital roles in genetic regulation of pungency, capsaicin biosynthesis, fruit yield, and produce quality of endemic chili cultivars.

PMID:34157605 | DOI:10.1016/j.plaphy.2021.06.012

Eur J Cancer. 2021 Jun 19;153:142-152. doi: 10.1016/j.ejca.2021.05.023. Online ahead of print.

ABSTRACT

BACKGROUND: This phase 1 study evaluated safety, pharmacokinetics (PK), maximum tolerated dose (MTD), and antitumour activity of regorafenib in paediatric patients with solid tumours.

PATIENTS AND METHODS: Patients (aged 6 months to <18 years) with recurrent/refractory solid tumours received oral regorafenib once daily for 3 weeks on/1 week off. The starting dose (60 mg/m²) was derived from an adult physiology-based PK model and scaled to children; dose escalation was followed by safety expansion of the MTD cohort. Treatment-emergent adverse events (TEAEs) were evaluated using National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Regorafenib PK was evaluated using a population PK model.

RESULTS: Forty-one patients (median age 13 years) received regorafenib (four cohorts: 60-93 mg/m²). Five of 23 evaluable patients experienced dose-limiting toxicities (Grade 4 thrombocytopenia, Grade 3 maculopapular rash, pyrexia, hypertension, and exfoliative dermatitis [each n = 1]). The MTD was defined as 82 mg/m². The most common Grade ≥3 drug-related TEAE was thrombocytopenia (10%). The incidence and severity of hypertension, diarrhoea, fatigue, hypothyroidism, and hand-foot skin reaction were lower than reported in adults. Regorafenib exposure increased with dose, with substantial overlap because of moderate-to-high interpatient variability. One patient with rhabdomyosarcoma experienced an unconfirmed partial response; 15 patients had stable disease, five for >16 weeks.

CONCLUSIONS: The recommended phase 2 dose of single-agent regorafenib in paediatric patients with solid malignancies is 82 mg/m². Regorafenib demonstrated acceptable tolerability and preliminary antitumour activity, supporting further investigation in paediatric patients.

CLINICAL TRIAL NUMBER: NCT02085148.

PMID:34157616 | DOI:10.1016/j.ejca.2021.05.023

Sci Total Environ. 2021 Jun 10;792:148406. doi: 10.1016/j.scitotenv.2021.148406. Online ahead of print.

ABSTRACT

BACKGROUND: Dengue is an endemic vector-borne disease influenced by environmental factors such as landscape and climate. Previous studies separately assessed the effects of landscape and climate factors on mosquito occurrence and dengue incidence. However, both factors concurrently coexist in time and space and can interact, affecting mosquito development and dengue disease transmission. For example, eggs laid in a suitable environment can hatch after being submerged in rain water. It has been difficult for conventional statistical modeling approaches to demonstrate these combined influences due to mathematical constraints.

OBJECTIVES: To investigate the combined influences of landscape and climate factors on mosquito occurrence and dengue incidence.

METHODS: Entomological, epidemiological, and landscape data from the rainy season (July-December) were obtained from respective government agencies in Metropolitan Manila, Philippines, from 2012 to 2014. Temperature, precipitation and vegetation data were obtained through remote sensing. A random forest algorithm was used to select the landscape and climate variables. Afterward, using the identified key variables, a model-based (MOB) recursive partitioning was implemented to test the combined influences of landscape and climate factors on ovitrap index (vector mosquito occurrence) and dengue incidence.

RESULTS: The MOB recursive partitioning for ovitrap index indicated a high sensitivity of vector mosquito occurrence on environmental conditions generated by a combination of high residential density areas with low precipitation. Moreover, the MOB recursive partitioning indicated high sensitivity of dengue incidence to the effects of precipitation in areas with high proportions of residential density and commercial areas.

CONCLUSIONS: Dengue dynamics are not solely influenced by individual effects of either climate or landscape, but rather by their synergistic or combined effects. The presented findings have the potential to target vector surveillance in areas identified as suitable for mosquito occurrence under specific climatic conditions and may be relevant as part of urban planning strategies to control dengue.

PMID:34157535 | DOI:10.1016/j.scitotenv.2021.148406

J Environ Manage. 2021 Jun 19;295:113019. doi: 10.1016/j.jenvman.2021.113019. Online ahead of print.

ABSTRACT

Urban soils’ health is important to the community because of the soils’ potential use for recreational activities. A data quality-oriented approach to sampling design is proposed for performing soil representative surveys that gives support to defensible and statistically-based decisions. Krowoderski park in Cracow (Poland) was selected as a study case to investigate heavy metals (HMs) accumulation and to assess human risk exposure according to simulated scenarios. Statistical power was computed for optimizing the number of samples to compare HMs concentration against legal upper tolerance levels (LUTL). The samples’ location was iteratively designed as random spatial distribution throughout the study area, followed by K Ripley’s test for selecting the best sampling scheme and avoiding points of clustering or dispersion at several ranges. The total content of Cd, Cu, Pb, Zn, coarse size particles fraction and fine size particles texture, bulk density, pH, total C and S were measured in topsoil at each location using composite sampling. The hydraulic properties were estimated using pedotransfer functions. Statistical analysis of topsoil data shows low correlation between heavy metals, whereas high correlation was found between total S with Cu and Pb as well as total C with Cu and Pb. The concentration of all the HMs analysed was found to be under LUTL in all locations in the park, except for one point that is an outlier for Pb, although the values of several indexes for pooled HMs categorize the park as medium to highly polluted. Spatial autocorrelation was explored for every heavy metal and for elaborated pollution indexes, then maps were drawn using geostatistics. A human health risk assessment (HHRA) was computed for several simulated scenarios finding that risk exists for children from Pb through high ingestion of soil particles.

PMID:34157543 | DOI:10.1016/j.jenvman.2021.113019

Hum Mov Sci. 2021 Jun 19;78:102832. doi: 10.1016/j.humov.2021.102832. Online ahead of print.

ABSTRACT

Among adults, persons in control of a vehicle (i.e., drivers) are less likely to experience motion sickness compared to persons in the same vehicle who do not control it (i.e., passengers). This “driver-passenger effect” is well-known in adults, but has not been evaluated in children. Using a yoked-control design with seated pre-adolescent children, we exposed dyads to a driving video game. In each dyad, one child (the driver) drove the virtual vehicle. Their performance was recorded, and later shown to the other child (the passenger). Thus, visual motion stimuli were identical for the members of each dyad. During exposure to the video game, we monitored the quantitative kinematics of head and torso movements. Participants were instructed to discontinue participation immediately if they experienced any symptoms of motion sickness, however mild. Accordingly, the movements that we recorded preceded the onset of motion sickness. Results revealed that Passengers (73.08%) were more likely than Drivers (42.31%) to state that they were motion sick. Drivers tended to move more than passengers, and with a greater degree of multifractality. The magnitude of movement was greater among participants who later reported motion sickness than among those who did not. In addition, for the multifractality of movement a statistically significant interaction revealed that postural precursors of motion sickness differed qualitatively between Drivers and Passengers. Overall, the results reveal that control of a virtual vehicle reduces the risk of motion sickness among pre-adolescent children.

PMID:34157576 | DOI:10.1016/j.humov.2021.102832

J Stomatol Oral Maxillofac Surg. 2021 Jun 19:S2468-7855(21)00131-2. doi: 10.1016/j.jormas.2021.04.014. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to evaluate effects of extended maxillary advancement osteotomy on pharyngeal airway space (PAS) in mid-facial deficient cleft lip and palate (CLP) patients and mid-facial deficient non-CLP patients.

METHODS: Pharyngeal airway space (PAS) of 10 CLP and 10 non-CLP patients with the mean age of 19 years 10 months was measured on digitized lateral cephalograms taken shortly before maxillary advancement operation with Quadrangular Le Fort I osteotomy (QLF-I) (T0), early post-operative, (T1) and long term post-operative (T2). Two way repeated analysis of variance, independent samples t-test and correlations tests were used for statistical analysis of airway and skeletal changes.

RESULTS: Total PAS depth and area was significantly increased after the advancement and was stable in long term post-operative period for CLP and non-CLP patients. Nasopharyngeal and velopharyngeal airway space depth and area was statistically increased at T1 and T2 for both groups. Oropharyngeal airway depth and area showed no significant statistical difference at any of the time points. The effect of QLF-I osteotomy on (PAS) was similar in both CLP and non-CLP patients CONCLUSIONS: Nasopharyngeal, velopharyngeal, and total pharyngeal airway space depth and area increased after maxillary advancement with the QLF-I osteotomy; this increase was stable in long term follow up. Maxillary advancement with the QLF-I technique had no significant effect on oropharyngeal airway space depth and area in both CLP and non-cleft patients.

PMID:34157445 | DOI:10.1016/j.jormas.2021.04.014