Venous thromboembolism in tropical Australia and in Indigenous Australians.

There is a paucity of data on the incidence of venous thromboembolism (VTE) in Australia, particularly amongst Indigenous Australians. We have therefore conducted a retrospective review of all cases of deep vein thrombosis and pulmonary embolism over a 24 months' period in two major hospitals of the Northern Territory (NT). A total of 429 VTE diagnoses were recorded over a 2-year period and 71 of 429 (17%) patients were Indigenous Australians. The overall incidence rate was 0.9 per 1,000 person-year for the population of the NT with a rate of 0.5 per 1,000 person-year for Indigenous Australians versus 1 per 1,000 person-year for non-Indigenous Australians. Of the 71, 39 (55%) of the VTE cases in the Indigenous group occurred in patients younger than 50 years and almost half of these (n = 18) were younger than 29 years. Hospitalization was found to be a major risk factor for VTE in 20 (38%) of the 54 Indigenous Australians of whom 10 (26%) patients were younger than 50 years. Although the rate of VTE in Indigenous Australians was low, its onset was significantly earlier in life and it was often triggered by prolonged hospitalization. VTE therefore should be added to the list of adverse outcomes of poor health and chronic diseases, which cause disproportional high rates of hospitalization amongst Indigenous Australians. The low number of VTE observed in older Indigenous patients in our study possibly reflects on the lower life expectancy and ongoing wide gap in life expectancy between Indigenous and non-Indigenous Australians.

A serial risk score approach to disease classification that accounts for accuracy and cost.

The performance of diagnostic tests for disease classification is often measured by accuracy (e.g., sensitivity or specificity); however, costs of the diagnostic test are a concern as well. Combinations of multiple diagnostic tests may improve accuracy, but incur additional costs. Here, we consider serial testing approaches that maintain accuracy while controlling costs of the diagnostic tests. We present a serial risk score classification approach. The basic idea is to sequentially test with additional diagnostic tests just until persons are classified. In this way, it is not necessary to test all persons with all tests. The methods are studied in simulations and compared with logistic regression. We applied the methods to data from HIV cohort studies to identify HIV infected individuals who are recently infected (<1 year) by testing with assays for multiple biomarkers. We find that the serial risk score classification approach can maintain accuracy while achieving a reduction in cost compared to testing all individuals with all assays.

Vitamin B12 deficiency in diabetic patients treated with metformin: A cross-sectional study.

Metformin is a cornerstone medication in the management of type 2 diabetes. Metformin is safe, effective, and inexpensive; however, it is associated with vitamin B12 deficiency. This study set out to evaluate the rate of vitamin B12 deficiency in Vietnamese patients with type 2 diabetes who were treated with metformin and to investigate factors associated with vitamin B12 deficiency. This is a cross-sectional study that was conducted in Vinmec Central Park Hospital from February to June 2023. The clinical and paraclinical characteristics of the participants were recorded, and the levels of vitamin B12 and folate were measured. The rate of vitamin B12 deficiency in patients treated with metformin was found to be 18.6%. Further, the duration of diabetes, duration of metformin use, metformin dose, and hemoglobin levels were statistically associated with vitamin B12 deficiency with OR (95% CI) = 1.12 (1.03-1.19), 1.01 (1.00-1.02), 1.002 (1.001-1.002), 0.74 (0.55-0.99), respectively. After adjusting for covariates, a metformin dose greater than the median dose remained the only parameter associated with vitamin B12 deficiency, with OR (95% CI) = 4.10 (1.62-10.36). Moreover, when combining both long-term use of metformin and a metformin dose greater than the median dose, the OR increased to 5.25 (95% CI: 2.11-13.15). These results demonstrate that vitamin B12 deficiency in patients treated with metformin is quite prevalent in Vietnam and that those with long-term use of metformin (48 months or more) and high metformin dose (1000 mg/day or more) are at high risk of experiencing this adverse effect and so require screening.

Cellulose-based aerogels from sugarcane bagasse for oil spill-cleaning and heat insulation applications.

A promising and economic material for various applications, such as thermal insulation in construction building and oil clean-up in marine ecosystems, is successfully developed from the by-product of the sugarcane industry. Biodegradable sugarcane bagasse aerogels are produced using polyvinyl alcohol (PVA) binder, followed by a freeze-drying method. This environmental-friendly recycled aerogel has an ultra-low density ([0.016-0.112] g/cm3), a high porosity ([91.9-98.9]%), and a very low thermal conductivity ([0.031-0.042] W/mK). Its superhydrophobicity properties and its maximum oil absorption capacity (up to 25 g/g) are measured after coating aerogel samples with methyltrimethoxysilane (MTMS). The biodegradable aerogel has a Young's modulus of 88 K Pa and can be bent without breaking, demonstrating its high flexibility.

Utilization of multiple spinal cord stimulation (SCS) waveforms in chronic pain patients.

BACKGROUND: Advances in spinal cord stimulation (SCS) have improved patient outcomes, leading to its increased utilization for chronic pain. Chronic pain is dynamic showing exacerbations, variable severity, and evolving pain patterns. Given this complexity, SCS systems that provide a broad range of stimulation waveforms may be valuable. METHODS: The aim of this research was to characterize the usage pattern of stimulation waveforms and field shapes in chronic pain patients implanted with the Spectra System. A review of daily device usage in a cohort of 250 patients implanted for a minimum duration of one month was conducted. RESULTS: With follow-ups ranging between 1 month and 1 year post-implant, 72.8% of patients used Standard Rate, 34.8% Anode Intensification, 23.2% Higher Rate, and 8.4% Burst stimulation waveforms. Collectively, 60% used 1 or more advanced waveforms, either exclusively or along with Standard Rate. A trend showed patients continuing to use up to 3 programs one year post-implant. CONCLUSION: When given a choice, SCS patients often utilize a variety of waveforms, suggesting that patients may benefit from a single system that provides multiple waveforms and field shapes to customize therapy and improve efficacy.