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1.
Artif Organs ; 46(4): 688-696, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34694655

RESUMO

BACKGROUND: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) support is increasingly used in the management of COVID-19-related acute respiratory distress syndrome (ARDS). However, the clinical decision-making to initiate V-V ECMO for severe COVID-19 still remains unclear. In order to determine the optimal timing and patient selection, we investigated the outcomes of both COVID-19 and non-COVID-19 patients undergoing V-V ECMO support. METHODS: Overall, 138 patients were included in this study. Patients were stratified into two cohorts: those with COVID-19 and non-COVID-19 ARDS. RESULTS: The survival in patients with COVID-19 was statistically similar to non-COVID-19 patients (p = .16). However, the COVID-19 group demonstrated higher rates of bleeding (p = .03) and thrombotic complications (p < .001). The duration of V-V ECMO support was longer in COVID-19 patients compared to non-COVID-19 patients (29.0 ± 27.5 vs 15.9 ± 19.6 days, p < .01). Most notably, in contrast to the non-COVID-19 group, we found that COVID-19 patients who had been on a ventilator for longer than 7 days prior to ECMO had 100% mortality without a lung transplant. CONCLUSIONS: These findings suggest that COVID-19-associated ARDS was not associated with a higher post-ECMO mortality than non-COVID-19-associated ARDS patients, despite longer duration of extracorporeal support. Early initiation of V-V ECMO is important for improved ECMO outcomes in COVID-19 ARDS patients. Since late initiation of ECMO was associated with extremely high mortality related to lack of pulmonary recovery, it should be used judiciously or as a bridge to lung transplantation.


Assuntos
COVID-19 , Oxigenação por Membrana Extracorpórea , Síndrome do Desconforto Respiratório , COVID-19/complicações , COVID-19/terapia , Oxigenação por Membrana Extracorpórea/efeitos adversos , Hemorragia/etiologia , Humanos , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/terapia , Estudos Retrospectivos , Fatores de Tempo
2.
Forensic Sci Int Genet ; 57: 102661, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35063923

RESUMO

Non-self DNA is normally present on skin due to DNA transfer occurring during daily activities. The understanding of persistence and accumulation of foreign DNA on the neck can assist in the interpretation of DNA evidence collected from an assaulted victim. Establishing the composition and level of non-self DNA present is relevant, especially in cases where the victim cohabits with other individuals, such as partner and children. This study investigated the persistence and accumulation of non-self DNA on the neck, over the course of 24 h. DNA samples were collected from the neck of 20 adult volunteers at three time-points, on two days. The detection of a partner's DNA and DNA from unknown sources was studied in relation to the living arrangement and to the activities performed by each individual. An increased number of non-self alleles were detected over time. Partner's DNA was observed to accumulate during the day and to persist when an individual was absent from the shared home environment. DNA from unknown contributors was found on the neck of individuals that used public transport, attended public spaces and had social interactions. The data acquired from this study will help to increase knowledge on the composition of DNA present on an individual's neck in a daily situation.


Assuntos
Vítimas de Crime , DNA , Adulto , Alelos , Criança , DNA/genética , Humanos , Fatores de Tempo
3.
Braz. j. oral sci ; 21: e225757, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1366215

RESUMO

Aim: This study aimed to evaluate the effect of frozen storage on the physical properties of a silicone-based test food material, highly used to evaluate the masticatory performance in research settings. Methods: A total of 1,666 silicone cubes of Optosil Comfort® with 5.6-mm edges were shaped and stored at -18°C. The cubes were subsequently tested for flexural strength (maximum force, displacement, stress, and strain) before breaking (n = 136), changes in weight and size (n = 170), and masticatory performance (n = 1360) at eight timepoints: immediately after cube preparation (baseline, no freezing), and 1, 2, 3 and 4 weeks, and 2, 4 and 6 months after frozen storage. The cubes were thawed 8 h before each assessment. Results: The maximum force, stress, maximum displacement, and deformation values for the cubes were not affected by freezing (P > 0.05). At all of the time points, the cubes exhibited similar weight (P = 0.366) and size (identical values). The masticatory performance for the cubes also showed no differences from baseline through 6 months (P = 0.061). Conclusion: Freezing Optosil Comfort® silicone cubes did not alter the physical and mechanical properties of the material, being suitable to optimize the assessment of masticatory parameters for research purposes


Assuntos
Humanos , Masculino , Adulto , Elastômeros de Silicone , Teste de Materiais/métodos , Fenômenos Físicos , Congelamento , Resistência à Flexão , Mastigação , Fatores de Tempo
4.
Front Endocrinol (Lausanne) ; 13: 936573, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35909563

RESUMO

Background: The optimal break-in period (BI) of urgent-start peritoneal dialysis (USPD) initiation for patients with end-stage renal disease (ESRD) and diabetes is unclear. We aimed to explore the safety and applicability of a BI ≤24 h in patients with ESRD and diabetes. Methods: We used a retrospective cohort design wherein we recruited patients with ESRD and diabetes who underwent USPD at five institutions in China between January 2013 and August 2020. The enrolled patients were grouped according to BI. The primary outcomes were mechanical and infectious complication occurrences, whereas the secondary outcome was technique survival. Results: We enrolled 310 patients with diabetes, of whom 155 and 155 patients were in the BI ≤24 h and BI >24 h groups, respectively. The two groups showed a comparable incidence of infectious and mechanical complications within 6 months after catheter insertion (p>0.05). Logistic regression analysis revealed that a BI ≤24 h was not an independent risk factor for mechanical or infectious complications. Kaplan-Meier estimates showed no statistically significant between-group differences in technique survival rates (p>0.05). Cox multivariate regression analysis revealed that a BI ≤24 h was not an independent risk factor for technique failure. Conclusion: USPD initiation with a BI ≤24 h may be safe and feasible for patients with ESRD and diabetes.


Assuntos
Diabetes Mellitus , Falência Renal Crônica , Diálise Peritoneal , Humanos , Falência Renal Crônica/terapia , Diálise Peritoneal/efeitos adversos , Diálise Peritoneal/métodos , Estudos Retrospectivos , Fatores de Tempo
5.
J Coll Physicians Surg Pak ; 32(8): 1009-1013, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35932124

RESUMO

OBJECTIVE: To evaluate the outcomes of radiofrequency ablation (RFA) therapy performed on patients with great saphenous vein insufficiency. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Bahcelievler State Hospital, Istanbul, Turkey, between January 2018 and May 2021 Methodology: A total of 709 patients (382 females, 327 males), who were treated with radiofrequency ablation (RFA) in the clinic, were included in the study. The demographic, anthropometric, clinical, laboratory, and radiological data of the patients were obtained retrospectively from the medical records. Pre and post treatment clinical, etiologic, anatomical, pathophysiologic (CEAP) scores, the venous clinical severity score (VCSS), and the visual analog scale (VAS) were evaluated. RESULTS: The median age of the patients was 48 (19-65) years, and the median follow-up period was 36 (6-53) months. At follow-up, after treatment, 673 (94.9%) of the patients had a CEAP clinical score of C0. Postoperative complications were recorded in 56 (7.9%) patients. Significant improvement was observed in the patients' CEAP, VAS, and VCSS scores at the follow-up (p<0.001). CONCLUSION: There was a high success rate in achieving short- and long-term venous occlusion in varicose vein treatment with RFA. Characterized by a fast recovery, good perioperative and postoperative outcomes, and a low frequency of side effects, RFA is effective and safe in the treatment of varicose veins. KEY WORDS: Chronic venous insufficiency, Radiofrequency ablation, Patient-reported outcomes.


Assuntos
Ablação por Cateter , Ablação por Radiofrequência , Varizes , Idoso , Ablação por Cateter/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Veia Safena/cirurgia , Fatores de Tempo , Resultado do Tratamento , Varizes/cirurgia
6.
JAMA ; 328(5): 451-459, 2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35916847

RESUMO

Importance: Care of adults at profit vs nonprofit dialysis facilities has been associated with lower access to transplant. Whether profit status is associated with transplant access for pediatric patients with end-stage kidney disease is unknown. Objective: To determine whether profit status of dialysis facilities is associated with placement on the kidney transplant waiting list or receipt of kidney transplant among pediatric patients receiving maintenance dialysis. Design, Setting, and Participants: This retrospective cohort study reviewed the US Renal Data System records of 13 333 patients younger than 18 years who started dialysis from 2000 through 2018 in US dialysis facilities (followed up through June 30, 2019). Exposures: Time-updated profit status of dialysis facilities. Main Outcomes and Measures: Cox models, adjusted for clinical and demographic factors, were used to examine time to wait-listing and receipt of kidney transplant by profit status of dialysis facilities. Results: A total of 13 333 pediatric patients who started receiving maintenance dialysis were included in the analysis (median age, 12 years [IQR, 3-15 years]; 6054 females [45%]; 3321 non-Hispanic Black patients [25%]; 3695 Hispanic patients [28%]). During a median follow-up of 0.87 years (IQR, 0.39-1.85 years), the incidence of wait-listing was lower at profit facilities than at nonprofit facilities, 36.2 vs 49.8 per 100 person-years, respectively (absolute risk difference, -13.6 (95% CI, -15.4 to -11.8 per 100 person-years; adjusted hazard ratio [HR] for wait-listing at profit vs nonprofit facilities, 0.79; 95% CI, 0.75-0.83). During a median follow-up of 1.52 years (IQR, 0.75-2.87 years), the incidence of kidney transplant (living or deceased donor) was also lower at profit facilities than at nonprofit facilities, 21.5 vs 31.3 per 100 person-years, respectively; absolute risk difference, -9.8 (95% CI, -10.9 to -8.6 per 100 person-years) adjusted HR for kidney transplant at profit vs nonprofit facilities, 0.71 (95% CI, 0.67-0.74). Conclusions and Relevance: Among a cohort of pediatric patients receiving dialysis in the US from 2000 through 2018, profit facility status was associated with longer time to wait-listing and longer time to kidney transplant.


Assuntos
Instituições de Assistência Ambulatorial , Acesso aos Serviços de Saúde , Falência Renal Crônica , Transplante de Rim , Diálise Renal , Listas de Espera , Adolescente , Instituições de Assistência Ambulatorial/economia , Instituições de Assistência Ambulatorial/organização & administração , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Administração de Instituições de Saúde/economia , Administração de Instituições de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Falência Renal Crônica/economia , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Transplante de Rim/economia , Transplante de Rim/estatística & dados numéricos , Masculino , Organizações sem Fins Lucrativos/economia , Organizações sem Fins Lucrativos/organização & administração , Organizações sem Fins Lucrativos/estatística & dados numéricos , Propriedade/economia , Propriedade/estatística & dados numéricos , Diálise Renal/economia , Diálise Renal/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Tempo
7.
BMJ Open Qual ; 11(Suppl 1)2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35914815

RESUMO

BACKGROUND: ST-elevation myocardial infarction (STEMI) is a highly time-sensitive and life-threatening condition. Early recognition and timely management are challenging in a busy emergency department (ED), especially in low/middle-income countries where emergency systems are often fragmented. The aim of our quality improvement (QI) project was to increase the percentage of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) with door to balloon (D2B) time of <90 min by 30% over 12 months. METHODS: As part of the first step in QI, baseline data were collected at different points in the process of care. Using process maps and fishbone analysis, delays in patient registration, ECG and communication with cardiology were identified as some bottlenecks, and change ideas were tested using plan-do-study-act cycles using point-of-care QI methodology. The majority of the change ideas focused on interventions in the ED like strengthening triage, training frontline staff, early diagnosis and quick transportation of patients. RESULTS: During the baseline phase, 22.22% of patients were found to have a D2B time of <90 min. We achieved an increase of 47.78% in patients receiving PCI within 90 min and hence increased to 70% at the end of the intervention phase. Data collected for 4 months after the intervention phase were found to have sustained the effort. CONCLUSION: Significant improvement in the door to reperfusion time resulted from a meticulous assessment of emergency care processes by drawing process flow chart and implementation of change ideas like introduction of fast-track policy for patients with chest pain, reducing staff turnover in the triage area, formal training of staff, continuous engagement with cardiology team and by interchanging of processes which led to a reduction in time to ECG.


Assuntos
Serviços Médicos de Emergência , Infarto do Miocárdio , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Eletrocardiografia , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/terapia , Assistência ao Paciente , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Centros de Atenção Terciária , Fatores de Tempo
9.
Sci Rep ; 12(1): 13310, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922452

RESUMO

More than one billion people rely on livestock for income, nutrition, and social cohesion, however livestock keeping can facilitate disease transmission and contribute to climate change. While data on the distribution of livestock have broad utility across a range of applications, efforts to map the distribution of livestock on a large scale are limited to the Gridded Livestock of the World (GLW) project. We present a complimentary effort to map the distribution of cattle and pigs in Malawi, Uganda, Democratic Republic of Congo, and South Sudan. In contrast to GLW, which uses dasymmetric modeling applied to census data to produce time-stratified estimates of livestock counts and spatial density, our work uses complex survey data and distinct modeling methods to generate a time-series of livestock distribution, defining livestock density as the ratio of animals to humans. In addition to favorable cross-validation results and general agreement with national density estimates derived from external data on national human and livestock populations, our results demonstrate extremely good agreement with GLW-3 estimates, supporting the validity of both efforts. Our results furthermore offer a high-resolution time series result and employ a definition of density which is particularly well-suited to the study of livestock-origin zoonoses.


Assuntos
Renda , Gado , Animais , Bovinos , Humanos , Projetos de Pesquisa , Suínos , Fatores de Tempo , Zoonoses
10.
Parasit Vectors ; 15(1): 277, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922821

RESUMO

BACKGROUND: Dengue is a major public health problem in Sri Lanka. Aedes vector surveillance and monitoring of larval indices are routine, long-established public health practices in the country. However, the association between Aedes larval indices and dengue incidence is poorly understood. It is crucial to evaluate lagged effects and threshold values of Aedes larval indices to set pragmatic targets for sustainable vector control interventions. METHODS: Monthly Aedes larval indices and dengue cases in all 10 Medical Officer of Health (MOH) divisions in Kalutara district were obtained from 2010 to 2019. Using a novel statistical approach, a distributed lag non-linear model and a two-staged hierarchical meta-analysis, we estimated the overall non-linear and delayed effects of the Premise Index (PI), Breteau Index (BI) and Container Index (CI) on dengue incidence in Kalutara district. A set of MOH division-specific variables were evaluated within the same meta-analytical framework to determine their moderator effects on dengue risk. Using generalized additive models, we assessed the utility of Aedes larval indices in predicting dengue incidence. RESULTS: We found that all three larval indices were associated with dengue risk at a lag of 1 to 2 months. The relationship between PI and dengue was homogeneous across MOH divisions, whereas that with BI and CI was heterogeneous. The threshold values of BI, PI and CI associated with dengue risk were 2, 15 and 45, respectively. All three indices showed a low to moderate accuracy in predicting dengue risk in Kalutara district. CONCLUSIONS: This study showed the potential of vector surveillance information in Kalutara district in developing a threshold-based, location-specific early warning system with a lead time of 2 months. The estimated thresholds are nonetheless time-bound and may not be universally applicable. Whenever longitudinal vector surveillance data areavailable, the methodological framework we propose here can be used to estimate location-specific Aedes larval index thresholds in any other dengue-endemic setting.


Assuntos
Aedes , Dengue , Animais , Dengue/epidemiologia , Humanos , Larva , Mosquitos Vetores , Sri Lanka/epidemiologia , Fatores de Tempo
11.
Proc Natl Acad Sci U S A ; 119(32): e2112656119, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35921436

RESUMO

Since the beginning of the COVID-19 pandemic, many dashboards have emerged as useful tools to monitor its evolution, inform the public, and assist governments in decision-making. Here, we present a globally applicable method, integrated in a daily updated dashboard that provides an estimate of the trend in the evolution of the number of cases and deaths from reported data of more than 200 countries and territories, as well as 7-d forecasts. One of the significant difficulties in managing a quickly propagating epidemic is that the details of the dynamic needed to forecast its evolution are obscured by the delays in the identification of cases and deaths and by irregular reporting. Our forecasting methodology substantially relies on estimating the underlying trend in the observed time series using robust seasonal trend decomposition techniques. This allows us to obtain forecasts with simple yet effective extrapolation methods in linear or log scale. We present the results of an assessment of our forecasting methodology and discuss its application to the production of global and regional risk maps.


Assuntos
COVID-19 , COVID-19/epidemiologia , Previsões , Humanos , Pandemias , Fatores de Tempo
12.
Continuum (Minneap Minn) ; 28(4): 1083-1103, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35938658

RESUMO

PURPOSE OF REVIEW: This article provides an update on progressive forms of multiple sclerosis (MS) commonly referred to as primary progressive MS and secondary progressive MS. It discusses the importance of diagnosing and detecting progression early, the similarities between progressive forms, challenges in detecting progression, factors that could augment progression, and the importance of disease-modifying therapies in patients with evidence of active progressive MS. It also discusses the overall care of progressive MS. RECENT FINDINGS: The pathogenesis of primary progressive MS and secondary progressive MS is overlapping, and in both presentations, patients with relapses or focal MRI activity are classified as having active, progressive MS. All currently approved disease-modifying therapies are indicated for active secondary progressive MS. The therapeutic opportunity of anti-inflammatory drugs for the treatment of progressive MS is enhanced in those who are younger and have a shorter disease duration. Vascular comorbidities may contribute to progression in MS. SUMMARY: Several challenges remain in the diagnosis, follow-up, and treatment of progressive MS. Early identification of active progressive MS is needed to maximize treatment benefit. The advantages of optimal comorbidity management (eg, hypertension, hyperlipidemia) in delaying progression are uncertain. Clinical care guidelines for advanced, severe MS are lacking.


Assuntos
Esclerose Múltipla Crônica Progressiva , Esclerose Múltipla , Progressão da Doença , Humanos , Imageamento por Ressonância Magnética , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/terapia , Esclerose Múltipla Crônica Progressiva/diagnóstico , Esclerose Múltipla Crônica Progressiva/tratamento farmacológico , Recidiva , Fatores de Tempo
13.
PLoS One ; 17(8): e0272408, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35939502

RESUMO

Hyperspectral imaging (HSI) is a promising technology for environmental monitoring with a lot of undeveloped potential due to the high dimensionality and complexity of the data. If temporal effects are studied, such as in a monitoring context, the analysis becomes more challenging as time is added to the dimensions of space (image coordinates) and wavelengths. We conducted a series of laboratory experiments to investigate the impact of different stressor exposure patterns on the spectrum of the cold water coral Desmophyllum pertusum. 65 coral samples were divided into 12 groups, each group being exposed to different types and levels of particles. Hyperspectral images of the coral samples were collected at four time points from prior to exposure to 6 weeks after exposure. To investigate the relationships between the corals' spectral signatures and controlled experimental parameters, a new software tool for interactive visual exploration was developed and applied, the HypIX (Hyperspectral Image eXplorer) web tool. HypIX combines principles from exploratory data analysis, information visualization and machine learning-based dimension reduction. This combination enables users to select regions of interest (ROI) in all dimensions (2D space, time point and spectrum) for a flexible integrated inspection. We propose two HypIX workflows to find relationships in time series of hyperspectral datasets, namely morphology-based filtering workflow and embedded driven response analysis workflow. With these HypIX workflows three users identified different temporal and spatial patterns in the spectrum of corals exposed to different particle stressor conditions. Corals exposed to particles tended to have a larger change rate than control corals, which was evident as a shifted spectrum. The responses, however, were not uniform for coral samples undergoing the same exposure treatments, indicating individual tolerance levels. We also observed a good inter-observer agreement between the three HyPIX users, indicating that the proposed workflow can be applied to obtain reproducible HSI analysis results.


Assuntos
Antozoários , Animais , Antozoários/fisiologia , Monitoramento Ambiental , Aprendizado de Máquina , Fatores de Tempo , Água
14.
Sci Rep ; 12(1): 13531, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941225

RESUMO

The active cycling of carbon between soil organic matter and the atmosphere is of critical importance to global climate change. An extensive body of research exists documenting the capricious nature of soil organic matter (SOM) dynamics, which is symptomatic of an intricate network of interactions between diverse groups of heterotrophic microorganisms, complex organic substrates, and highly variable local environmental conditions. These attributes are consistent with elements of complex system theory and the temporal evolution of otherwise unpredictable patterns of behavior that emerge from long range dependency on initial conditions. Here we show that vertical depth profile of self-potential (SP) time series measurements responds in a quantitative manner to variations in soil moisture, SOM concentrations, and relative rates of microbial activity. Application of detrended fluctuation analysis (DFA) of self potential time series data is shown additionally to reveal the presence of long-range dependence and emergence of anomalous electrochemical diffusion behavior, both of which diminish with depth as SOM specific energy densities decline.


Assuntos
Carbono , Solo , Carbono/análise , Mudança Climática , Solo/química , Microbiologia do Solo , Fatores de Tempo
15.
Cardiovasc Diabetol ; 21(1): 149, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941586

RESUMO

BACKGROUND: Chronic total occlusion (CTO) of the coronary artery is a difficult problem in clinical practice. The triglyceride-glucose (TyG) index is an effective risk predictor of cardiovascular risk. However, the relationship between the TyG index and the prognosis of CTO patients remains unstudied. Thus, the present study aimed to investigate the relationship between the TyG index and cardiovascular risk in CTO patients. METHODS: This was a single-centre, retrospective cohort study. We retrospectively enrolled 652 patients with CTO lesions diagnosed by angiography and who underwent revascularization through PCI. Patients were routinely followed up for 24 months unless meeting the endpoint. The primary endpoint was the composite of all-cause death, nonfatal myocardial infarction, unplanned revascularization, and nonfatal ischaemic stroke. To test the association of the TyG index with cardiovascular risk, the categorized TyG index and Cox proportional hazards regression models were utilized. RESULTS: A total of 652 patients were enrolled in the final analysis (male: 83.7%, age: 58.2 ± 10.49 years). The average TyG index was 8.8 ± 0.57. CTO PCIs were procedurally successfully completed in 503 (77.15%) patients. During the follow-up period of 22.8 ± 3.84 months, 73 (11.19%) major adverse cardiovascular and cerebral events (MACCEs) occurred. When fully adjusted, there was a 2.09-fold risk for MACCEs among patients with the highest TyG index compared with those with the lowest TyG index [T2 vs. T1: hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.65-2.38, P = 0.057; T3 vs. T1: HR 2.09, 95% CI 1.14-3.86, P = 0.018; P for trend = 0.036]. The restricted cubic spline (RCS) analysis showed that the HR for MACCEs increased as the TyG index increased over 8.71 [HR per standard deviation (SD) 1.740, 95% CI 1.23-2.46, P = 0.002]. The risk of MACCEs increased with increasing tertiles of TyG index in successful CTO PCI patients and nondiabetes mellitus (DM) patients (P < 0.05) but not in patients with failed CTO PCI and DM patients. CONCLUSION: The study revealed that the TyG index had significant relevance to cardiovascular risk in CTO patients and suggests that the TyG index is feasible for predicting cardiovascular risk in CTO patients.


Assuntos
Isquemia Encefálica , Oclusão Coronária , Intervenção Coronária Percutânea , Acidente Vascular Cerebral , Idoso , Biomarcadores , Glicemia , Isquemia Encefálica/etiologia , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/terapia , Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/efeitos adversos , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Fatores de Tempo , Triglicerídeos
16.
PLoS One ; 17(8): e0272300, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35944045

RESUMO

Annual monitoring of the spatial distribution of cultivated land is important for maintaining the ecological environment, achieving a status quo of land resource management, and guaranteeing agricultural production. With the gradual development of remote sensing technology, it has become a common practice to obtain cultivated land boundary information on a large scale with the help of satellite Earth observation images. Traditional land use classification methods are affected by multiple types of land cover, which leads to a decrease in the accuracy of cultivated land mapping. In contrast, although the current advanced methods (such as deep learning) can obtain more accurate cultivated land mapping results than traditional methods, such methods often require the use of a massive amount of training samples, large computing power, and highly complex model tuning processes, increasing the cost of mapping and requiring the involvement of more professionals. This has hindered the promotion of related methods in mapping institutions. This paper proposes a method based on time series vector features (MTVF), which uses vector thinking to establish the features. The advantage of this method is that the introduction of vector features enlarges the differences between the different land cover types, which overcomes the loss of mapping accuracy caused by the influences of the spectra of different ground objects and ensures the calculation efficiency. Moreover, the MTVF uses a traditional method (random forest) as the classification core, which makes the MTVF less demanding than advanced methods in terms of the number of training samples. Sentinel-2 satellite images were used to carry out cultivated land mapping for 2020 in northern Henan Province, China. The results show that the MTVF has the potential to accurately identify cultivated land. Furthermore, the overall accuracy, producer accuracy, and user accuracy of the overall study area and four sub-study areas were all greater than 90%. In addition, the cultivated land mapping accuracy of the MTVF is significantly better than that of the maximum likelihood, support vector machine, and artificial neural network methods.


Assuntos
Agricultura , Tecnologia de Sensoriamento Remoto , China , Meio Ambiente , Tecnologia de Sensoriamento Remoto/métodos , Máquina de Vetores de Suporte , Fatores de Tempo
17.
BMC Public Health ; 22(1): 1484, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927638

RESUMO

BACKGROUND: Epidemiological studies have investigated the short-term effects of meteorological factors and air pollution on the incidence of hand, foot, and mouth disease (HFMD). Several meteorological indicators, such as relative humidity and the diurnal temperature range (DTR), significantly modify the relationship between short-term exposure to temperature and HFMD incidence. However, it remains unclear whether (and how) long-term air pollution levels modify the short-term relationships of HFMD incidence with meteorological factors and air pollution. METHODS: We obtained daily data on meteorological factors, air pollutants, and HFMD counts in children from 21 prefecture-level cities in Sichuan Province in Southwest China from 2015 to 2017. First, we constructed a distributed lag nonlinear model (DLNM) at each prefecture-level site to evaluate the short-term impacts of meteorological variables and air pollutants on HFMD incidence. Then, we assessed the pooled effects of the exposures and incorporated long-term city-specific air pollutant indicators as meta-predictors to examine their potential modification effects by performing multivariate meta-regression models. RESULTS: We found that long-term SO2 and CO concentrations significantly modified the short-term relationships between climatic variables and HFMD incidence. Specifically, high concentrations of CO (P = 0.027) and SO2 (P = 0.039) reduced the risk of HFMD at low temperatures. The relationship between relative humidity and HFMD incidence was weakened at high SO2 concentrations (P = 0.024), especially when the relative humidity was below the median level. When the minimum relative humidity (32%) was compared to the median relative humidity (77%), the risk ratio (RR) was 0.77 (95% CI: 0.51-1.17) in the 90th percentile of SO2 (19.6 µg/m3) and 0.41 (95% CI: 0.27-0.64) in the 10th percentile of SO2 (10.6 µg/m3). CONCLUSION: Our results indicated that long-term SO2 and CO levels modified the short-term associations between HFMD incidence in children and meteorological variables. These findings may inform health authorities to optimize targeted public health policies including reducing ambient air pollution and reinforcing self-protective actions to weaken the adverse health impacts of environmental factors on HFMD incidence.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doença de Mão, Pé e Boca , Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Criança , China/epidemiologia , Doença de Mão, Pé e Boca/epidemiologia , Humanos , Incidência , Conceitos Meteorológicos , Dinâmica não Linear , Temperatura , Fatores de Tempo
18.
J Prev Med Public Health ; 55(4): 351-359, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35940190

RESUMO

OBJECTIVES: The Regional CardioCerebroVascular Center (RCCVC) project was initiated to improve clinical outcomes for patients with acute myocardial infarction or stroke in non-capital areas of Korea. The purpose of this study was to evaluate the outcomes and issues identified by the Busan RCCVC project in the treatment of ST-segment elevation myocardial infarction (STEMI). METHODS: Among the patients who were registered in the Korean Registry of Acute Myocardial Infarction for the RCCVC project between 2007 and 2019, those who underwent percutaneous coronary intervention (PCI) for STEMI at the Busan RCCVC were selected, and their medical data were compared with a historical cohort. RESULTS: In total, 1161 patients were selected for the analysis. Ten years after the implementation of the Busan RCCVC project, the median door-to-balloon time was reduced from 86 (interquartile range [IQR], 64-116) to 54 (IQR, 44-61) minutes, and the median symptom-to-balloon time was reduced from 256 (IQR, 180-407) to 189 (IQR, 118-305) minutes (p<0.001). Inversely, the false-positive PCI team activation rate increased from 0.6% to 21.4% (p<0.001). However, the 1-year cardiovascular death and major adverse cardiac event rates did not change. Even after 10 years, approximately 75% of the patients had a symptom-to-balloon time over 120 minutes, and approximately 50% of the patients underwent inter-hospital transfer for primary PCI. CONCLUSIONS: A decade after the implementation of the Busan RCCVC project, although time parameters for early reperfusion therapy for STEMI improved, at the cost of an increased false-positive PCI team activation rate, survival outcomes were unchanged.


Assuntos
Infarto do Miocárdio , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Infarto do Miocárdio/terapia , Sistema de Registros , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Fatores de Tempo
19.
Vasc Health Risk Manag ; 18: 603-615, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35942041

RESUMO

Background: It is unknown at this time whether Jetstream atherectomy (JET) and paclitaxel-coated balloon (PCB) provides a superior outcome to balloon angioplasty (PTA) followed by PCB in treating femoropopliteal (FP) arterial disease. Methods: The JET-RANGER study was a multicenter (eleven US centers) randomized trial, core lab-adjudicated, designed to demonstrate the superiority of JET + PCB versus PTA + PCB in treating FP arterial disease. The study intended to enroll 255 patients, but was stopped early because of poor enrollment due to COVID-19 and concerns about the association of paclitaxel with mortality. The data are thus considered exploratory. A total of 47 patients (48 lesions) with claudication (80.9%) or rest pain/ulcerations (19.2%) were randomly assigned 2:1 to JET + PCB (n=31) or PTA + PCB (n=16). The In.PACT (Medtronic) and Ranger (Boston Scientific) PCBs were used. Freedom from target-lesion revascularization (TLR) was evaluated at 1 year. Analysis was performed on intention to treat. Results: Mean lesion length was 10.8±4.3 cm for JET + PCB and 11.2±7.6 cm for PTA + PCB (P=0.858). There were no other differences in demographic or angiographic variables between the two groups. Procedural success was superior with JET + PCB (87.1%) vs PTA + PCB alone (52.9%; P=0.0147). Overall bailout stenting rate was 17% (0 JET + DCB versus 50% PCB, P<0.0001). There was no distal embolization requiring treatment. There was no amputation or death in either group. Using KM analysis, the primary end point of freedom from TLR (bailout stent considered a TLR) at 1 year was 100% and 43.8% (P<0.0001) for JET + PCB versus PTA + PCB, respectively. When bailout stent was not considered a TLR, freedom from TLR was 100% and 93.7%, respectively (P=0.327). Conclusion: A high rate of freedom from TLR was seen in the JET + PCB arm and the PTA + DCB arm at 1-year follow-up, with a significant reduction in bailout stenting following vessel prepping with the Jetstream.


Assuntos
Angioplastia com Balão , COVID-19 , Doença Arterial Periférica , Angioplastia com Balão/efeitos adversos , Aterectomia , Materiais Revestidos Biocompatíveis , Humanos , Paclitaxel/efeitos adversos , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/terapia , Artéria Poplítea/diagnóstico por imagem , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular
20.
Sci Rep ; 12(1): 13197, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915102

RESUMO

We propose that technical analysis tools developed to give buy/sell signals in asset trading can be applied to analyze time series datasets in the natural sciences, and we show this explicitly for a study of WHO COVID-19 data. Notably, reliable short term forecasting can provide potentially lifesaving insights into logistical planning, and in particular, into the optimal allocation of resources such as hospital staff and equipment. By reinterpreting COVID-19 daily cases in terms of candlesticks, we are able to apply some of the most popular stock market technical indicators to obtain predictive power over the course of the pandemics. By providing a quantitative assessment of MACD, RSI, and candlestick analyses, we show their statistical significance in making predictions for both stock market data and WHO COVID-19 data. In particular, we show the utility of this novel approach by considering the identification of the beginnings of subsequent waves of the pandemic. Finally, our new methods are used to assess whether current health policies are impacting the growth in new COVID-19 cases.


Assuntos
COVID-19 , COVID-19/epidemiologia , Previsões , Humanos , Pandemias , Fatores de Tempo
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