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Haarhaus M, Bratescu LO, Pana N, Gemene EM, Silva EM, Santos Araujo CAR, Macario F. Early referral to nephrological care improves long-term survival and hospitalization after dialysis initiation, independent of optimal dialysis start - a call for harmonization of reimbursement policies. Ren Fail 2024; 46:2313170. [PMID: 38357766 PMCID: PMC10877651 DOI: 10.1080/0886022x.2024.2313170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
Early treatment of kidney disease can slow disease progression and reduce the increased risk of mortality associated with end-stage kidney disease. However, uncertainty exists whether early referral (ER) to nephrological care per se or an optimal dialysis start impacts patient outcome after dialysis initiation. We determined the effect of ER and suboptimal dialysis start on the 3-year mortality and hospitalizations after dialysis initiation. Between January 2015 and July 2018, 349 patients with ≥1 month of follow-up started dialysis at nine Romanian dialysis clinics. After excluding patients with COVID-19 during follow-up, 254 patients (97 ER and 157 late referral) were included in this retrospective study. The observational period was truncated at 3 years, death, or loss to follow-up. Clinical and laboratory data were retrieved from the quality database of the nephrological care providers. Patients were followed for a median (25-75%) of 36 (16-36) months. At dialysis start, ER patients had higher hemoglobin, phosphate, and albumin levels and started dialysis less often via a central dialysis catheter (p < 0.001 for each). Logistic regression analysis demonstrated an independent lower risk for frequent hospitalizations for ER patients (odds ratio 0.22 (95% confidence interval 0.1-0.485), p < 0.001), and Cox regression analysis revealed an improved survival (hazard ratio 0.540 (95% confidence interval 0.325-0.899), p = 0.02), both independent of optimal dialysis start. In conclusion, early referral to nephrological care was associated with improved survival and lower hospitalization rates during the three years after dialysis initiation, independent of optimal dialysis start. These results strongly support the reimbursement of nephrological care before dialysis initiation.
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Affiliation(s)
- Mathias Haarhaus
- Diaverum, Malmö, Sweden
- Karolinska Institutet, Institutionen for klinisk vetenskap intervention och teknik, Stockholm, Sweden
| | | | - Nicolae Pana
- Diaverum Romania, Bucharest, Romania
- Universitatea de Medicina si Farmacie Carol Davila, Bucuresti, Romania
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Xie KY, Zhang CK, Lee S, He Y, Liu Y. Delay-dependent Lurie-Postnikov type Lyapunov-Krasovskii functionals for stability analysis of discrete-time delayed neural networks. Neural Netw 2024; 173:106195. [PMID: 38394998 DOI: 10.1016/j.neunet.2024.106195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/18/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
This paper addresses the influence of time-varying delay and nonlinear activation functions with sector restrictions on the stability of discrete-time neural networks. Compared to previous works that mainly focuses on the influence of delay information, this paper devotes to activation nonlinear functions information to help compensate the analysis technique based on Lyapunov-Krasovskii functional (LKF). A class of delay-dependent Lurie-Postnikov type integral terms involving sector constraints of nonlinear activation function is proposed to complement the LKF construction. The less conservative criteria for the stability analysis of discrete-time delayed networks is given by using improved LKF. Numerical examples show that conservatism can be reduced by the delay-dependent integral terms involving nonlinear activation functions.
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Affiliation(s)
- Ke-You Xie
- School of Automation, China University of Geosciences, Wuhan 430074, China; Hubei Key Laboratory of Advanced Control and Intelligent Automation for Complex Systems, Wuhan 430074, China; Engineering Research Center of Intelligent Technology for Geo-Exploration, Ministry of Education, Wuhan 430074, China
| | - Chuan-Ke Zhang
- School of Automation, China University of Geosciences, Wuhan 430074, China; Hubei Key Laboratory of Advanced Control and Intelligent Automation for Complex Systems, Wuhan 430074, China; Engineering Research Center of Intelligent Technology for Geo-Exploration, Ministry of Education, Wuhan 430074, China
| | - Sangmoon Lee
- School of Electronic and Electrical Engineering, Kyungpook National University, Daegu 41566, South Korea.
| | - Yong He
- School of Automation, China University of Geosciences, Wuhan 430074, China; Hubei Key Laboratory of Advanced Control and Intelligent Automation for Complex Systems, Wuhan 430074, China; Engineering Research Center of Intelligent Technology for Geo-Exploration, Ministry of Education, Wuhan 430074, China
| | - Yajuan Liu
- School of Control and Computer Engineering, North China Electric Power University, Beijing 102206, China
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Wei C, Wang X, Ren F, Zeng Z. Quasi-synchronization for variable-order fractional complex dynamical networks with hybrid delay-dependent impulses. Neural Netw 2024; 173:106161. [PMID: 38335795 DOI: 10.1016/j.neunet.2024.106161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/10/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
This paper focuses on addressing the problem of quasi-synchronization in heterogeneous variable-order fractional complex dynamical networks (VFCDNs) with hybrid delay-dependent impulses. Firstly, a mathematics model of VFCDNs with short memory is established under multi-weighted networks and mismatched parameters, which is more diverse and practical. Secondly, under the framework of variable-order fractional derivative, a novel fractional differential inequality has been proposed to handle the issue of quasi-synchronization with hybrid delay-dependent impulses. Additionally, the quasi-synchronization criterion for VFCDNs is developed using differential inclusion theory and Lyapunov method. Finally, the practicality and feasibility of this theoretical analysis are demonstrated through numerical examples.
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Affiliation(s)
- Chen Wei
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiaoping Wang
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Fangmin Ren
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Zhigang Zeng
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
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Wan J, Xia N, Yin Y, Pan X, Hu J, Yi J. TCDformer: A transformer framework for non-stationary time series forecasting based on trend and change-point detection. Neural Netw 2024; 173:106196. [PMID: 38412739 DOI: 10.1016/j.neunet.2024.106196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/25/2024] [Accepted: 02/18/2024] [Indexed: 02/29/2024]
Abstract
Although time series prediction models based on Transformer architecture have achieved significant advances, concerns have arisen regarding their performance with non-stationary real-world data. Traditional methods often use stabilization techniques to boost predictability, but this often results in the loss of non-stationarity, notably underperforming when tackling major events in practical applications. To address this challenge, this research introduces an innovative method named TCDformer (Trend and Change-point Detection Transformer). TCDformer employs a unique strategy, initially encoding abrupt changes in non-stationary time series using the local linear scaling approximation (LLSA) module. The reconstructed contextual time series is then decomposed into trend and seasonal components. The final prediction results are derived from the additive combination of a multilayer perceptron (MLP) for predicting trend components and wavelet attention mechanisms for seasonal components. Comprehensive experimental results show that on standard time series prediction datasets, TCDformer significantly surpasses existing benchmark models in terms of performance, reducing MSE by 47.36% and MAE by 31.12%. This approach offers an effective framework for managing non-stationary time series, achieving a balance between performance and interpretability, making it especially suitable for addressing non-stationarity challenges in real-world scenarios.
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Affiliation(s)
- Jiashan Wan
- College of Computer and Information Science, Hefei University of Technology, Hefei, 230601, Anhui, China; College of Big Data and Artificial Intelligence, Anhui Institute of Information Technology, Wuhu, 241000, Anhui, China.
| | - Na Xia
- College of Computer and Information Science, Hefei University of Technology, Hefei, 230601, Anhui, China
| | - Yutao Yin
- Shenzhen Hangsheng electronics Co., Ltd., Shenzhen, 518103, Guangdong, China
| | - Xulei Pan
- College of Big Data and Artificial Intelligence, Anhui Institute of Information Technology, Wuhu, 241000, Anhui, China
| | - Jin Hu
- Shenzhen Hangsheng electronics Co., Ltd., Shenzhen, 518103, Guangdong, China
| | - Jun Yi
- College of Computer and Information Science, Hefei University of Technology, Hefei, 230601, Anhui, China
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Lucas S, Portillo E. Methodology based on spiking neural networks for univariate time-series forecasting. Neural Netw 2024; 173:106171. [PMID: 38382399 DOI: 10.1016/j.neunet.2024.106171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 11/17/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
Spiking Neural Networks (SNN) are recognised as well-suited for processing spatiotemporal information with ultra-low energy consumption. However, proposals based on SNN for classification tasks are more common than for forecasting problems. In this sense, this paper presents a new general training methodology for univariate time-series forecasting based on SNN. The methodology is focused on one-step ahead forecasting problems and combines a PulseWidth Modulation based encoding-decoding algorithm with a Surrogate Gradient method as supervised training algorithm. In order to validate the generality of the presented methodology sine-wave, 3 UCI and 1 available real-world datasets are used. The results show very satisfactory forecasting results (MAE∈[0.0094,0.2891]) regardless of the characteristics of the dataset or the application field. In addition, weights can be initialised just once to achieve robust results, boosting the advantages of computational and energy cost of SNN.
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Affiliation(s)
- Sergio Lucas
- Department of Automatic Control and Systems Engineering, Faculty of Engineering of Bilbao, University of the Basque Country (UPV/EHU), Plaza Ingeniero Torres Quevedo, 1, Bilbao, 48013, Basque Country, Spain.
| | - Eva Portillo
- Department of Automatic Control and Systems Engineering, Faculty of Engineering of Bilbao, University of the Basque Country (UPV/EHU), Plaza Ingeniero Torres Quevedo, 1, Bilbao, 48013, Basque Country, Spain.
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Teixeira GP, da Cunha NB, Azeredo CM, Rinaldi AEM, Crispim CA. Eating time variation from weekdays to weekends and its association with dietary intake and BMI in different chronotypes: findings from National Health and Nutrition Examination Survey (NHANES) 2017-2018. Br J Nutr 2024; 131:1281-1288. [PMID: 38012849 DOI: 10.1017/s0007114523002738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Evidence suggests that differences in meal timing between weekends and weekdays can disrupt the body's circadian rhythm, leading to a higher BMI. We aimed to investigate the associations between mealtime variation from weekdays to weekends (eating midpoint jetlag), dietary intake and anthropometric parameters, based on individuals' chronotype. The study utilised data from National Health and Nutrition Examination Survey 2017-2018. Food consumption was estimated by weighted average of participants' food intake on weekdays and weekends. Eating midpoint jetlag, defined as the difference between the midpoint of the first and last mealtimes on weekends and weekdays, was calculated. Chronotype was assessed by participants' mid-sleep time on weekends, adjusted for sleep debt. Linear regression analysis was conducted to investigate the associations between variables. The sample was categorised into chronotype tertiles. Among individuals in the third chronotype tertile, there was a positive association between eating midpoint jetlag and BMI (β = 1·2; 95 % CI (1·13, 1·27)). Individuals in the first tertile showed a positive association between eating midpoint jetlag and energy (β = 96·9; 95 % CI (92·9, 101·7)), carbohydrate (β = 11·96; 95 % CI (11·2, 12·6)), fat (β = 3·69; 95 % CI (3·4, 3·8)), cholesterol (β = 32·75; 95 % CI (30·9, 34·6)) and sugar (β = 8·84; 95 % CI (8·3, 9·3)) intake on weekends. Among individuals with an evening tendency, delaying meals on weekends appears to be linked to a higher BMI. Conversely, among individuals with a morning tendency, eating meals later on weekends is associated with higher energetic intake on weekends.
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Affiliation(s)
- Gabriela Pereira Teixeira
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Nayara Bernardes da Cunha
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Catarina Machado Azeredo
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Ana Elisa Madalena Rinaldi
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Cibele Aparecida Crispim
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Wicki B, Flückiger B, Vienneau D, de Hoogh K, Röösli M, Ragettli MS. Socio-environmental modifiers of heat-related mortality in eight Swiss cities: A case time series analysis. Environ Res 2024; 246:118116. [PMID: 38184064 DOI: 10.1016/j.envres.2024.118116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/08/2024]
Abstract
In the light of growing urbanization and projected temperature increases due to climate change, heat-related mortality in urban areas is a pressing public health concern. Heat exposure and vulnerability to heat may vary within cities depending on structural features and socioeconomic factors. This study examined the effect modification of the temperature-mortality association of three socio-environmental factors in eight Swiss cities and population subgroups (<75 and ≥ 75 years, males, females): urban heat islands (UHI) based on within-city temperature contrasts, residential greenness measured as normalized difference vegetation index (NDVI) and neighborhood socioeconomic position (SEP). We used individual death records from the Swiss National Cohort occurring during the warm season (May to September) in the years 2003-2016. We performed a case time series analysis using conditional quasi-Poisson and distributed lag non-linear models with a lag of 0-3 days. As exposure variables, we used daily maximum temperatures (Tmax) and a binary indicator for warm nights (Tmin ≥20 °C). In total, 53,593 deaths occurred during the study period. Overall across the eight cities, the mortality risk increased by 31% (1.31 relative risk (95% confidence interval: 1.20-1.42)) between 22.5 °C (the minimum mortality temperature) and 35 °C (the 99th percentile) for warm-season Tmax. Stratified analysis suggested that the heat-related risk at 35 °C is 26% (95%CI: -4%, 67%) higher in UHI compared to non-UHI areas. Indications of smaller risk differences were observed between the low vs. high greenness strata (Relative risk difference = 13% (95%CI: -11%; 44%)). Living in low SEP neighborhoods was associated with an increased heat related risk in the non-elderly population (<75 years). Our results indicate that UHI are associated with increased heat-related mortality risk within Swiss cities, and that features beyond greenness are responsible for such spatial risk differences.
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Affiliation(s)
- Benedikt Wicki
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| | - Benjamin Flückiger
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland; University of Basel, Basel, Switzerland
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Golestani S, Cardenas T, Koepp K, Efird J, Teixeira PG, Mery M, Dubose J, Trust MD, Bach M, Ali S, Brown CVR. Barriers to Breastfeeding During Surgery Residency. J Surg Educ 2024; 81:551-555. [PMID: 38388308 DOI: 10.1016/j.jsurg.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/07/2023] [Accepted: 12/30/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Breastfeeding is a highly demanding experience, especially for surgical residents who pump after returning to work. We believe that there are obstacles to pumping and opportunities exist to improve support for this group. The objective of this study was to understand the experience of breastfeeding surgery residents and find opportunities for increased support. DESIGN Surveys were sent out through the Association of Program Directors in Surgery for distribution among current residents. A survey was also conducted in a private group of surgeon mothers to identify those who had previously been breastfeeding during residency. SETTING All surveys were performed online with results collected in a REDCap web-based application. PARTICIPANTS Participants were those who gave birth during their surgical residency. RESULTS 67% of the 246 survey respondents stated that they did not have adequate time for pumping and 56% rarely had access to a lactation room. 69% of mothers reported a reduction in milk supply and 64% stated that the time constraints of residency shortened the total duration they breastfed. 59% of women did not feel comfortable asking to pump. CONCLUSIONS Surgical residents reported a lack of space, resources, and dedicated time for pumping. These deficiencies contribute to shorter breastfeeding duration. It is crucial to provide lactation rooms and to foster a supportive culture.
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Affiliation(s)
- Simin Golestani
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas.
| | - Tatiana Cardenas
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Katherine Koepp
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Jessica Efird
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Pedro G Teixeira
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Marissa Mery
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Joseph Dubose
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Marc D Trust
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Michelle Bach
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Sadia Ali
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Carlos V R Brown
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
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Jammoul N, Dupasquier V, Akodad M, Meunier PA, Moulis L, Soltani S, Macia JC, Robert P, Schmutz L, Steinecker M, Piot C, Targosz F, Benkemoun H, Lattuca B, Roubille F, Cayla G, Leclercq F. Long-term follow-up of balloon-expandable valves according to the implantation strategy: insight from the DIRECTAVI trial. Am Heart J 2024; 270:13-22. [PMID: 38253304 DOI: 10.1016/j.ahj.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Safety and feasibility of transcatheter aortic valve replacement (TAVR) without balloon aortic valvuloplasty (BAV) using the SAPIEN 3 balloon-expandable device has been previously demonstrated. The impact on long-term valve hemodynamic performances and outcomes remains however unknown. We evaluate long-term clinical and hemodynamic results according to the implant strategy (direct TAVR vs BAV pre-TAVR) in patients included in the DIRECTAVI randomized trial (NCT02729519). METHODS Clinical and echocardiographic follow-up until January 2023 was performed for all patients included in the DIRECTAVI trial since 2016 (n = 228). The primary endpoint was incidence of moderate/severe hemodynamic valve deterioration (HVD), according to the Valve Academic Research defined Consortium-3 criteria (increase in mean gradient ≥10 mmHg resulting in a final mean gradient ≥20 mmHg, or new/worsening aortic regurgitation of 1 grade resulting in ≥ moderate aortic regurgitation). RESULTS Median follow-up was 3.8 (2.2-4.7) years. Mean age at follow-up was 87 ± 6.7 years. No difference in incidence of HVD in the direct implantation group compared to the BAV group was found (incidence of 1.97 per 100 person-years and 1.45 per 100 person-years, respectively, P = 0.6). Prevalence of predicted prothesis-patient mismatch was low (n = 13 [11.4%] in the direct TAVR group vs n = 15 [13.2%] in BAV group) and similar between both groups (P = .7). Major outcomes including death, stroke, hospitalization for heart failure and pacemaker implantation were similar between both groups, (P = .4, P = .7, P = .3, and P = .3 respectively). CONCLUSION Direct implantation of the balloon-expandable device in TAVR was not associated with an increased risk of moderate/severe HVD or major outcomes up to 6-year follow-up. These results guarantee wide use of direct balloon-expandable valve implantation, when feasible. CLINICAL TRIALS REGISTRATION NUMBER NCT05140317.
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Affiliation(s)
- Nidal Jammoul
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France
| | - Valentin Dupasquier
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France
| | - Mariama Akodad
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques-Cartier, Massy, France
| | - Pierre-Alain Meunier
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France
| | - Lionel Moulis
- Epidemiological and Clinical Research Unit, CHU Montpellier, Montpellier, France.
| | - Sonia Soltani
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France
| | - Jean-Christophe Macia
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France
| | - Pierre Robert
- Department of cardiology, CHU Nimes, Montpellier University, Nimes, France
| | - Laurent Schmutz
- Department of cardiology, CHU Nimes, Montpellier University, Nimes, France
| | - Matthieu Steinecker
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France
| | | | | | | | - Benoît Lattuca
- Department of cardiology, CHU Nimes, Montpellier University, Nimes, France
| | - François Roubille
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France; PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Guillaume Cayla
- Department of cardiology, CHU Nimes, Montpellier University, Nimes, France
| | - Florence Leclercq
- Department of Cardiology, CHU Montpellier, Montpellier University, Montpellier, France.
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Langley JO, Langley B. The effect of advanced footwear technology on elite male marathon race speed. Eur J Appl Physiol 2024; 124:1143-1149. [PMID: 37922023 DOI: 10.1007/s00421-023-05341-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/11/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE The aim of this study was to explore the ergogenic effect of advanced footwear technology (AFT) upon world-class male marathon running speed. METHOD A retrospective analysis of 99 world-class male marathon runners' performances between 2012 and 2021 was undertaken, providing a sample size of 971 performances, split into two footwear groups: AFT (n = 299) and traditional (n = 672). Additionally, details regarding the year of the marathon performance and racecourse were extracted. A mixed model for repeated measures (MMRM) analysis were undertaken identifying athlete (Wald Z = 2.821; p = .005) and course (Wald Z = 4.111; p < 0.001) as significant contributors to the variance in marathon running speed and as such were included as random factors with footwear type set as a fixed factor. RESULTS World-class male marathon running speeds were significantly faster (p < 0.001) when running in AFT (5.441 m.s-1) when compared with traditional shoes (5.386 m.s-1) with a mean difference of 0.055 m.s-1 (95% CI 0.039-0.071 m.s-1), translating to an improvement in marathon speed of 1.0% or a 79 s improvement in marathon race time. CONCLUSION Our findings demonstrate an improvement in world-class male marathon running speed of 1% when running in AFT, a near identical degree of improvement to the male marathon world record ran in AFT. Whilst a 1% improvement in marathon running times associated with AFT is smaller than previously predicted utilizing laboratory-based models, this still reflects a significant degree of improvement at the elite level.
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Affiliation(s)
- Jamie Oliver Langley
- Department of Higher Education Sport, Loughborough College, Radmoor Road, Loughborough, Leicestershire, LE11 3BT, UK.
| | - Ben Langley
- Sport and Physical Activity, Edge Hill University, Ormskirk, Lancashire, L39 4QP, UK
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11
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Yei KS, Janssen C, Elsayed N, Naazie I, Sedrakyan A, Malas MB. Long-term outcomes of carotid endarterectomy vs transfemoral carotid stenting in a Medicare-matched database. J Vasc Surg 2024; 79:826-834.e3. [PMID: 37634620 DOI: 10.1016/j.jvs.2023.08.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/14/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Carotid endarterectomy (CEA) is associated with lower risk of perioperative stroke compared with transfemoral carotid artery stenting (TFCAS) in the treatment of carotid artery stenosis. However, there is discrepancy in data regarding long-term outcomes. We aimed to compare long-term outcomes of CEA vs TFCAS using the Medicare-matched Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network database. METHODS We assessed patients undergoing first-time CEA or TFCAS in Vascular Quality Initiative Vascular-Vascular Implant Surveillance and Interventional Outcomes Network from January 2003 to December 2018. Patients with prior history of carotid revascularization, nontransfemoral stenting, stenting performed without distal embolic protection, multiple or nonatherosclerotic lesions, or concomitant procedures were excluded. The primary outcome of interest was all-cause mortality, any stroke, and a combined end point of death or stroke. We additionally performed propensity score matching and stratification based on symptomatic status. RESULTS A total of 80,146 carotid revascularizations were performed, of which 72,615 were CEA and 7531 were TFCAS. CEA was associated with significantly lower risk of death (57.8% vs 70.4%, adjusted hazard ratio [aHR], 0.46; 95% confidence interval [CI], 0.41-0.52; P < .001), stroke (21.3% vs 26.6%; aHR, 0.63; 95% CI, 0.57-0.69; P < .001) and combined end point of death and stroke (65.3% vs 76.5%; HR, 0.49; 95% CI, 0.44-0.55; P < .001) at 10 years. These findings were reflected in the propensity-matched cohort (combined end point: 34.6% vs 46.8%; HR, 0.53; 95% CI, 0.46-0.62) at 4 years, as well as stratified analyses of combined end point by symptomatic status (asymptomatic: 63.2% vs 74.9%; HR, 0.49; 95% CI, 0.43-0.58; P < .001; symptomatic: 69.9% vs 78.3%; HR, 0.51; 95% CI, 0.45-0.59; P < .001) at 10 years. CONCLUSIONS In this analysis of North American real-world data, CEA was associated with greater long-term survival and fewer strokes compared with TFCAS. These findings support the continued use of CEA as the first-line revascularization procedure.
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Affiliation(s)
- Kevin S Yei
- Division of Vascular and Endovascular Surgery, University of California San Diego, La Jolla, CA
| | - Claire Janssen
- Division of Vascular and Endovascular Surgery, University of California San Diego, La Jolla, CA
| | - Nadin Elsayed
- Division of Vascular and Endovascular Surgery, University of California San Diego, La Jolla, CA
| | - Isaac Naazie
- Division of Vascular and Endovascular Surgery, University of California San Diego, La Jolla, CA
| | - Art Sedrakyan
- Division of Vascular and Endovascular Surgery, Weill Cornell Medical College, New York, NY
| | - Mahmoud B Malas
- Division of Vascular and Endovascular Surgery, University of California San Diego, La Jolla, CA.
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12
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Ma SN, Liu XH, Cai WS. Preventive noninvasive vagal nerve stimulation reduces insufficient sleep-induced depression by improving the autonomic nervous system. Biomed Pharmacother 2024; 173:116344. [PMID: 38412716 DOI: 10.1016/j.biopha.2024.116344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Depression is closely linked to an imbalance in the autonomic nervous system (ANS). However, the role of this imbalance in mediating the effects of sleep deprivation (SD) and vagus nerve stimulation (VNS) on emotional well-being is not fully understood. METHODS A population-based analysis was conducted to explore the relationship between sleep duration, depression scores, and heart rate variability (HRV). Additionally, the chronic SD mouse model was established to assess the impact of preventive transcutaneous auricular VNS (taVNS) on pathological and behavioral changes. RESULTS Our study found a significant link between sleep duration, depression severity, and HRV. Shorter sleep duration was associated with higher depression scores and lower RMSSD (a measure of HRV). In our rat model, insufficient sleep consistently impaired HRV. This effect was mitigated by taVNS, accompanied by corresponding changes in levels of IL-1β and IL-6, astrocyte and microglia activation, and tail suspension times. CONCLUSIONS Using VNS as a preventive treatment for depression-risk individuals with insufficient sleep shows promise. It not only broadens the potential applications of VNS but also sheds light on its mechanism-particularly its role in enhancing vagal nerve function and balancing the ANS, as evidenced by HRV measurements.
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Affiliation(s)
- Sai-Nan Ma
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Hong Liu
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei-Song Cai
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China.
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13
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Roinesdottir S, Petursdottir S, Gudjonsdottir EM. [Where are the men? Increasing number of women in medicine at the University of Iceland]. LAEKNABLADID 2024; 110:187. [PMID: 38517404 DOI: 10.17992/lbl.2024.04.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
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14
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Zhang X, Zhang T, Chen X, Ni J, Xu S, Peng Y, Wang G, Sun W, Liu X, Pan F. The impact of short-term exposure to meteorological factors on the risk of death from hypertension and its major complications: a time series analysis based on Hefei, China. Int Arch Occup Environ Health 2024; 97:313-329. [PMID: 38403848 DOI: 10.1007/s00420-024-02046-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/16/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study aimed to reveal the short-term impact of meteorological factors on the mortality risk in hypertensive patients, providing a scientific foundation for formulating pertinent prevention and control policies. METHODS In this research, meteorological factor data and daily death data of hypertensive patients in Hefei City from 2015 to 2018 were integrated. Time series analysis was performed using distributed lag nonlinear model (DLNM) and generalized additive model (GAM). Furthermore, we conducted stratified analysis based on gender and age. Relative risk (RR) combined with 95% confidence interval (95% CI) was used to represent the mortality risk of single day and cumulative day in hypertensive patients. RESULTS Single-day lag results indicated that high daily mean temperature (T mean) (75th percentile, 24.9 °C) and low diurnal temperature range (DTR) (25th percentile, 4.20 °C) levels were identified as risk factors for death in hypertensive patients (maximum effective RR values were 1.144 and 1.122, respectively). Extremely high levels of relative humidity (RH) (95th percentile, 94.29%) reduced the risk of death (RR value was 0.893). The stratified results showed that the elderly and female populations are more susceptible to low DTR levels, whereas extremely high levels of RH have a more significant protective effect on both populations. CONCLUSION Overall, we found that exposure to low DTR and high T mean environments increases the risk of death for hypertensive patients, while exposure to extremely high RH environments significantly reduces the risk of death for hypertensive patients. These findings contribute valuable insights for shaping targeted prevention and control strategies.
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Affiliation(s)
- Xu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xuyang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Jianping Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Siwen Xu
- School of Medicine, Tongji University, 500 Zhennan Road, Shanghai, 200333, China
| | - Yongzhen Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Guosheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Wanqi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Murden R, Allan SM, Hodgekins J, Oduola S. The effectiveness of public health interventions, initiatives, and campaigns designed to improve pathways to care for individuals with psychotic disorders: A systematic review. Schizophr Res 2024; 266:165-179. [PMID: 38412687 DOI: 10.1016/j.schres.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/19/2024] [Accepted: 02/17/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Lengthy duration of untreated psychosis (DUP) and duration of untreated illness (DUI) in people at clinical high-risk for psychosis (CHR-P) and first episode psychosis (FEP) is associated with poorer outcomes. However, individuals with FEP often experience negative pathways to care involving contacts with police, crisis services and requiring compulsory admissions, and evidence suggests individuals with both FEP and CHR-P often experience lengthy delays to treatment. Early detection interventions, such as public health interventions, may be one way to reduce delays. This systematic review aimed to synthesise the available evidence on such interventions. METHODS The EMBASE, PsychINFO, CINAHL, and MEDLINE databases were searched. Studies were included if they compared an intervention designed to improve timely access to treatment for individuals with FEP or CHR-P to standard treatment provision. Interventions may be targeted at potential patients, their families, the general public, or non-healthcare professionals. Outcomes of interest were DUP or DUI, and/or characteristics of pathways to care. RESULTS Nineteen studies met the inclusion criteria. All consisted of FEP populations, none of CHR-P populations. Employing narrative synthesis, we found mixed results about the effectiveness of interventions at reducing DUP and interventions appeared to differentially impact groups. Pathways to care information was limited and mixed. CONCLUSION Findings on the effectiveness of interventions designed to improve timely access to treatment were inconclusive. More research is warranted to better understand where delays occur and factors which may influence this for both FEP and CHR-P populations which may help to develop targeted interventions to address delays.
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Affiliation(s)
- Rhiannon Murden
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; Birmingham and Solihull Mental Health NHS Foundation Trust, Uffculme Centre, 52 Queensbridge Road, Moseley, Birmingham B13 8QY, UK.
| | - Sophie M Allan
- Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn, Cambridgeshire CB21 5EF, UK; School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
| | - Jo Hodgekins
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
| | - Sheri Oduola
- Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn, Cambridgeshire CB21 5EF, UK; School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
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16
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Olson E. The First Fifteen Seconds. Acad Psychiatry 2024; 48:203-204. [PMID: 37386236 DOI: 10.1007/s40596-023-01812-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/13/2023] [Indexed: 07/01/2023]
Affiliation(s)
- Elizabeth Olson
- University of Maryland School of Medicine, Baltimore, MD, USA.
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17
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Abdelaziz A, Elsayed H, Atta K, Mechi A, Kadhim H, Aboutaleb AM, Elaraby A, Ellabban MH, Eid M, AboElfarh HE, Ibrahim RA, Zawaneh EA, Ezzat M, Abdelaziz M, Hafez A, Mahmoud A, Ghaith HS, Suppah M. A comprehensive guide on the optimal timing of PCI in the setting of acute coronary syndrome: An updated meta-analysis. Int J Cardiol 2024; 400:131774. [PMID: 38211674 DOI: 10.1016/j.ijcard.2024.131774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/19/2023] [Accepted: 01/07/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Invasive revascularization is recommended for cohorts of patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation acute coronary syndrome (NSTE-ACS). However, the optimal timing of invasive revascularization is still controversial and no defined consensus is established. We aim to give a comprehensive appraisal on the optimal timing of invasive strategy in the heterogenous population of ACS. METHODS Relevant studies were assessed through PubMed, Scopus, Web of science, and Cochrane Library from inception until April 2023. Major adverse cardiovascular events (MACE) and all-cause mortality were our primary outcomes of interest, other secondary outcomes were cardiac death, TVR, MI, repeat revascularization, recurrent ischemia, and major bleeding. The data was pooled as odds ratio (OR) with its 95% confidence interval (CI) in a random effect model using STATA 17 MP. RESULTS A total of 26 studies comprising 21,443 patients were included in the analysis. Early intervention was favor to decrease all-cause mortality (OR = 0.79, 95% CI: 0.64 to 0.98, p = 0.03), when compared to delayed intervention. Subgroup analysis showed that early intervention was significantly associated with all-cause mortality reduction in only NSTE-ACS (OR = 0.83, 95% CI [0.7 to 0.99], p = 0.04). However, there was no significant difference between early and delayed intervention in terms of MACE, cardiac death, TVR, MI, repeat revascularization, recurrent ischemia, and major bleeding. CONCLUSION An early intervention was associated with lower mortality rates compared to delayed intervention in NSTE-ACS with no significant difference in other clinical outcomes. PROSPERO registration: CRD42023415574.
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Affiliation(s)
- Ahmed Abdelaziz
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
| | - Hanaa Elsayed
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Karim Atta
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Institute of Medicine, National Research Mordovia State University, Saransk, Russia
| | - Ahmed Mechi
- University of Kufa, Medicine College, Internal Medicine Department, Najaf, Iraq
| | | | - Aya Moustafa Aboutaleb
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Elaraby
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Hatem Ellabban
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mahmoud Eid
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hadeer Elsaeed AboElfarh
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Mansoura Manchester Programme for Medical Education, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Rahma AbdElfattah Ibrahim
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt
| | - Emad Addin Zawaneh
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of medicine, Jordan university of science and technology, Irbid, Jordan
| | - Mahmoud Ezzat
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Mohamed Abdelaziz
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Abdelrahman Hafez
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Mahmoud
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hazem S Ghaith
- Medical Research group of Egypt (MRGE), Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mustafa Suppah
- Department of Cardiovascular Medicine, Mayo Clinic, 13400 E Shea Boulevard, Scottsdale, AZ 85259, USA
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Azimuddin A, Tzeng CWD, Prakash LR, Bruno ML, Arvide EM, Dewhurst WL, Newhook TE, Kim MP, Ikoma N, Snyder RA, Lee JE, Perrier ND, Katz MH, Maxwell JE. Postoperative Global Period Cost Reduction Using 3 Successive Risk-Stratified Pancreatectomy Clinical Pathways. J Am Coll Surg 2024; 238:451-459. [PMID: 38180055 DOI: 10.1097/xcs.0000000000000944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
BACKGROUND We hypothesized that iterative revisions of our original 2016 risk-stratified pancreatectomy clinical pathways would be associated with decreased 90-day perioperative costs. STUDY DESIGN From a single-institution retrospective cohort study of consecutive patients with 3 iterations: "version 1" (V1) (October 2016 to January 2019), V2 (February 2019 to October 2020), and V3 (November 2020 to February 2022), institutional data were aggregated using revenue codes and adjusted to constant 2022-dollar value. Grand total perioperative costs (primary endpoint) were the sum of pancreatectomy, inpatient care, readmission, and 90-day global outpatient care. Proprietary hospital-based costs were converted to ratios using the mean cost of all hospital operations as the denominator. RESULTS Of 814 patients, pathway V1 included 363, V2 229, and V3 222 patients. Accordion Grade 3+ complications decreased with each iteration (V1: 28.4%, V2: 22.7%, and V3: 15.3%). Median length of stay decreased (V1: 6 days, interquartile range [IQR] 5 to 8; V2: 5 [IQR 4 to 6]; and V3: 5 [IQR 4 to 6]) without an increase in readmissions. Ninety-day global perioperative costs decreased by 32% (V1 cost ratio 12.6, V2 10.9, and V3 8.6). Reduction of the index hospitalization cost was associated with the greatest savings (-31%: 9.4, 8.3, and 6.5). Outpatient care costs decreased consistently (1.58, 1.41, and 1.04). When combining readmission and all outpatient costs, total "postdischarge" costs decreased (3.17, 2.59, and 2.13). Component costs of the index hospitalization that were associated with the greatest savings were room or board costs (-55%: 1.74, 1.14, and 0.79) and pharmacy costs (-61%: 2.20, 1.61, and 0.87; all p < 0.001). CONCLUSIONS Three iterative risk-stratified pancreatectomy clinical pathway refinements were associated with a 32% global period cost savings, driven by reduced index hospitalization costs. This successful learning health system model could be externally validated at other institutions performing abdominal cancer surgery.
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Affiliation(s)
- Ahad Azimuddin
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
- Texas A&M School of Medicine, Houston, TX (Azimuddin)
| | - Ching-Wei D Tzeng
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Laura R Prakash
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Morgan L Bruno
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Elsa M Arvide
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Whitney L Dewhurst
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Timothy E Newhook
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Michael P Kim
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Naruhiko Ikoma
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Rebecca A Snyder
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Jeffrey E Lee
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Nancy D Perrier
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Matthew Hg Katz
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
| | - Jessica E Maxwell
- From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Azimuddin, Tzeng, Prakash, Bruno, Arvide, Dewhurst, Newhook, Kim, Ikoma, Snyder, Lee, Perrier, Katz, Maxwell)
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Tran BW, May KA, Pal N. Academic Anesthesiology: What Does It Mean for Most of Us? Anesth Analg 2024; 138:e15-e16. [PMID: 38489800 DOI: 10.1213/ane.0000000000006898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Bryant W Tran
- Department of Anesthesiology, Virginia Commonwealth University, Richmond, Virginia,
| | - Keith A May
- Department of Anesthesiology, University of Tennessee, Knoxville, Tennessee
| | - Nirvik Pal
- Department of Anesthesiology, Virginia Commonwealth University, Richmond, Virginia
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Xu M, Wen J, Li Z, Wang Z, Zhang J. Behavioral impulse and time pressure jointly influence intentional inhibition: evidence from the Free Two-Choice Oddball task. Psychol Res 2024; 88:936-949. [PMID: 38117321 DOI: 10.1007/s00426-023-01905-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
Intentional inhibition is a crucial component of self-regulation, yet it is under-researched, because it is difficult to study without external stimuli or overt behaviors. Although Free-Choice tasks have been developed, it remains unclear how two key design features (i.e., behavioral impulse and time pressure) affect their sensitivity to intentional inhibition. To investigate this, the present study developed a Free Two-Choice Oddball task, which generated both an inhibition rate index and a response time (RT) index. Two experiments were conducted to systematically manipulate the ratio of the reactive standard to oddball trials and reaction time limit, inducing diverse behavioral impulses and different time pressures. The following findings were obtained from the critical Free-Choice trials. In the equal ratio condition, participants demonstrated comparable RTs for both the standard and oddball responses. In the moderate-ratio condition, participants exhibited longer RTs for the oddball than standard responses under low- but not high-time pressure. In the high-ratio condition, while RTs for the oddball responses were longer than those for the standard responses under both the high- and low-time pressures, participants displayed a decreased inhibition rate under the high-time pressure compared to the low-time pressure. Finally, participants exhibited a reduced inhibition rate in the high-ratio condition compared to the moderate-ratio condition. Together, these findings suggest that Free-Choice tasks can reflect intentional inhibition under specific conditions, and intentional inhibition is susceptible to both behavioral impulse and time pressure, while also establishing the theoretical and methodological foundations for subsequent research.
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Affiliation(s)
- Mengsi Xu
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Yanta District, Xi'an, China.
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China.
| | - Jiayu Wen
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Yanta District, Xi'an, China
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China
| | - Zhiai Li
- Department of Applied Psychology, College of Public Administration, Guangdong University of Foreign Studies, Guangzhou, China
| | - Zhenhong Wang
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Yanta District, Xi'an, China.
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China.
| | - Junhua Zhang
- College of Eastern Languages and Cultures, Sichuan International Studies University, No. 33, Zhuangzhi Road, Shapingba District, Chongqing, China.
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21
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Tu Y, Li X, Lu ZL, Wang Y. Adaptive smoothing of retinotopic maps based on Teichmüller parametrization. Med Image Anal 2024; 93:103074. [PMID: 38160658 DOI: 10.1016/j.media.2023.103074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Retinotopic mapping, the mapping between visual inputs on the retina and neural responses on the cortical surface, is one of the fundamental topics in visual neuroscience. In human studies, retinotopic maps are conventionally constructed and processed by decoding blood oxygenation-level dependent (BOLD) functional magnetic resonance imaging (fMRI) responses to designed visual stimuli on the cortical surface. However, these methods frequently generate retinotopic maps that do not preserve topology, contradicting a fundamental property of retinotopic maps observed in neurophysiology. To address this problem, we propose an integrated approach to simultaneously refine the flattening from the 3D cortical surface to the 2D parametric space and adaptively smooth retinotopic perception centers in the visual space to make the retinotopic maps topological. One key element of the approach is the enhanced error tolerant Teichmüller mapping, which refines the parametrization by minimizing angle distortions and maximizing alignment to noisy landmarks. We validated our overall approach with synthetic and real retinotopic mapping datasets and applied it to compute cortical magnification factor (CMF). The results showed that the proposed approach was superior to other conventional retinotopic mapping methods in predicting BOLD fMRI time series and preserving topology.
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Affiliation(s)
- Yanshuai Tu
- School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, USA
| | - Xin Li
- School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, USA
| | - Zhong-Lin Lu
- Division of Arts and Sciences, New York University Shanghai, Shanghai, China; Center for Neural Science and Department of Psychology, New York University, New York, NY, USA; NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China.
| | - Yalin Wang
- School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, USA.
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Bauducco SV, Gardner LA, Champion K, Newton N, Gradisar M. It's past your bedtime, but does it matter anymore? How longitudinal changes in bedtime rules relate to adolescents' sleep. J Sleep Res 2024; 33:e13940. [PMID: 37192612 DOI: 10.1111/jsr.13940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023]
Abstract
This study investigated how changing or maintaining parent-set bedtimes over time relates to adolescents' sleep timing, latency, and duration. Adolescents (n = 2509; Mage = 12.6 [0.5] years; 47% m) self-reported their sleep patterns, and whether they had parent-set bedtimes on two separate occasions in 2019 (T1; 12.6 years) and 2020 (T2; 13.7 years). We identified four groups based on parent-set bedtimes: (1) bedtime rules at both T1 and T2 (46%, n = 1155), (2) no bedtime rules at T1 nor T2 (26%, n = 656), (3) bedtime rules at T1 but not T2 (19%, n = 472), (4) no bedtime rules at T1 but a parent-set bedtime at T2 (9%, n = 226). As expected, the entire sample showed that bedtimes generally became later and sleep duration shorter across adolescence, but the change differed among the groups. Adolescents whose parents introduced bedtime rules at T2 reported earlier bedtimes and longer sleep duration (~20 min) compared with adolescents with no bedtime rules at T2. Importantly, they no longer differed from adolescents who consistently had bedtimes across T1 and T2. There was no significant interaction for sleep latency, which declined at a similar rate for all groups. These results are the first to suggest that maintaining or re-introducing a parent-set bedtime may be possible and beneficial for adolescents' sleep.
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Affiliation(s)
- S V Bauducco
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden
- College of Education, Psychology & Social Work, Flinders University, Adelaide, South Australia, Australia
| | - L A Gardner
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - K Champion
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - N Newton
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - M Gradisar
- Sleep Cycle, Gothenburg, Sweden
- WINK Sleep, Adelaide, South Australia, Australia
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Azzam AY, Vaishnav D, Essibayi MA, Unda SR, Jabal MS, Liriano G, Fortunel A, Holland R, Khatri D, Haranhalli N, Altschul D. Prediction of delayed cerebral ischemia followed aneurysmal subarachnoid hemorrhage. A machine-learning based study. J Stroke Cerebrovasc Dis 2024; 33:107553. [PMID: 38340555 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/25/2023] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Delayed Cerebral Ischemia (DCI) is a significant complication following aneurysmal subarachnoid hemorrhage (aSAH) that can lead to poor outcomes. Machine learning techniques have shown promise in predicting DCI and improving risk stratification. METHODS In this study, we aimed to develop machine learning models to predict the occurrence of DCI in patients with aSAH. Patient data, including various clinical variables and co-factors, were collected. Six different machine learning models, including logistic regression, multilayer perceptron, decision tree, random forest, gradient boosting machine, and extreme gradient boosting (XGB), were trained and evaluated using performance metrics such as accuracy, area under the curve (AUC), precision, recall, and F1 score. RESULTS After data augmentation, the random forest model demonstrated the best performance, with an AUC of 0.85. The multilayer perceptron neural network model achieved an accuracy of 0.93 and an F1 score of 0.85, making it the best performing model. The presence of positive clinical vasospasm was identified as the most important feature for predicting DCI. CONCLUSIONS Our study highlights the potential of machine learning models in predicting the occurrence of DCI in patients with aSAH. The multilayer perceptron model showed excellent performance, indicating its utility in risk stratification and clinical decision-making. However, further validation and refinement of the models are necessary to ensure their generalizability and applicability in real-world settings. Machine learning techniques have the potential to enhance patient care and improve outcomes in aSAH, but their implementation should be accompanied by careful evaluation and validation.
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Affiliation(s)
- Ahmed Y Azzam
- Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dhrumil Vaishnav
- Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Muhammed Amir Essibayi
- Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Santiago R Unda
- Department of Neurological Surgery, Weill Cornell Medical College, Cornell University NY, NY, USA
| | | | - Genesis Liriano
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adisson Fortunel
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ryan Holland
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Deepak Khatri
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Neil Haranhalli
- Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Altschul
- Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
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Heining C, Ishii H, Cheung L, Clark M. Sick-leave duration after elective day case surgery in ENT: Is it affected by the type of employment? Surgeon 2024; 22:88-91. [PMID: 37923667 DOI: 10.1016/j.surge.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Many ENT day-case procedures are performed on otherwise healthy individuals in employment. We hypothesised patients' type of employment may affect the amount of time taken off work following such procedures. We aimed to disprove the hypothesis that there is no difference in time taken off between employees and self-employed individuals. MATERIALS AND METHODS We prospectively collected data on working adult patients undertaking elective day-case procedures at our department. Collected information included basic patient demographics and type of employment. A telephone call was made to collect data on actual period of time taken off work, 5-6 weeks later. RESULTS 23% of patients were self-employed, the rest were employees. 92% of self-employed patients received no pay during their time off. This compared with 10% of employed patients receiving no pay. 77% of employed patients received full pay. Although mean time taken off work was less if the patient was self-employed (9.5 days vs 10.63), this was not found to be statistically significant. DISCUSSION AND CONCLUSION Our study demonstrates time off work following day-case ENT procedures places a higher financial burden on self-employed patients. This should inform patient counselling prior to operations. We demonstrated no statistically significant difference in time off work post-surgery between the 2 groups. There was a possible trend towards less time off in self-employed individuals and we speculate that further research with more patients may demonstrate a statistically significant difference in time off work. Perhaps most importantly is for doctors to consider how long an individual needs off after a given procedure, after taking account of their individual patient needs, rather than defaulting to a standard 2-weeks.
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Affiliation(s)
- Christopher Heining
- ENT Department, University Hospitals Bristol and Weston NHS Foundation Trust, England.
| | - Hiro Ishii
- ENT Department, University Hospitals Bristol and Weston NHS Foundation Trust, England.
| | - Linnea Cheung
- ENT Department, University Hospitals Bristol and Weston NHS Foundation Trust, England.
| | - Matthew Clark
- ENT Department, Gloucestershire Hospitals NHS Foundation Trust, England.
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Moorthy GC, Craig JL, Ferrara E, Quinn RJ, Stavropoulos SW, Trerotola SO. Supply Costs in Complex and Routine Inferior Vena Cava Filter Retrieval: 10 Years' Data from a Single Center. J Vasc Interv Radiol 2024; 35:583-591.e1. [PMID: 38160750 DOI: 10.1016/j.jvir.2023.12.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/14/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE To characterize the medical supply costs associated with inferior vena cava filter retrieval (IVCFR) using endobronchial forceps (EFs), a snare, or Recovery Cone (RC). MATERIALS AND METHODS In total, 594 of 845 IVCFRs attempted at a tertiary referral hospital between October 1, 2012, and June 20, 2022 were categorized by intended retrieval strategy informed by, rotational cavography as follows: (a) EF (n = 312) for tilted or tip-embedded/strut-embedded filters and for long-dwelling closed-cell filters and (b) a snare (n = 255) or (c) RC (n = 27) for other well-positioned filters with or mostly without hooks, respectively. List prices of relevant supplies at time of retrieval were obtained or, rarely, estimated using a standard procedure. Contrast use, fluoroscopic time, filter type, dwell time, and patient age and sex were recorded. Mean between-group cost differences were estimated by linear regression, adjusting for date. Additional models evaluated filter type, dwell time, and patient-level effects. RESULTS Of the 594 IVCFRs, 591 were successful, whereas 2 EF and 1 snare retrievals failed. Moreover, 4 EF retrievals were successful with a snare and 2 with smaller EF, 12 snare retrievals were successful with EF, 1 RC retrieval was successful with a snare and 2 with EF. Principal model indicated a significantly lower mean cost of EF ($564.70, SE ± 9.75) than that of snare ($811.29, SE ± 10.83; P < .0001) and RC ($1,465.48, SE ± 47.12; P < .0001) retrievals. Adjusted models yielded consistent results. Had all retrievals been attempted with EF, estimated undiscounted full-period supplies savings would be $87,201.51. CONCLUSIONS EFs are affordable for complex IVCFR, and extending their use to routine IVCFR could lead to considerable cost savings.
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Affiliation(s)
- Gyan C Moorthy
- Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. https://twitter.com/HistoryonRecord
| | - Jason L Craig
- Endovascular Division, Abbott Laboratories, Santa Clara, California
| | - Edward Ferrara
- Biostatistics Consulting Unit, Office of Nursing Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Ryan J Quinn
- Biostatistics Consulting Unit, Office of Nursing Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - S William Stavropoulos
- Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Scott O Trerotola
- Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
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O'Donnell TFX, Dansey KD, Patel VI, Beck AW, Zettervall SL, Schermerhorn ML. Outcomes of Staged Repairs of Complex Endovascular Repairs of Thoracoabdominal Aortic Aneurysms. Ann Vasc Surg 2024; 101:62-71. [PMID: 38154495 DOI: 10.1016/j.avsg.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Endovascular treatment allows for the staging of thoracoabdominal aortic aneurysm repairs (eTAAAs) in an effort to decrease the risk of spinal cord ischemia (SCI), but data are limited. METHODS We studied all eTAAAs in the Vascular Quality Initiative from 2014 to 2021. Inverse probability weighting was used to compare perioperative and long-term outcomes of staged and single-stage repairs. Thoracoabdominal life-altering events (TALEs) are the composite endpoint consisting of death/stroke/permanent SCI/permanent dialysis. RESULTS There were 3,258 total operations during the study period. In total, 841 cases (26%) were staged repairs, and 2,417 (74%) were completed in a single stage, but in the cohort of patients with extensive aneurysms, 44% were staged. Staging methods included thoracic endograft (78%), branch (23%), and iliac (5%). Staged repairs were more often employed by high-volume surgeons at high-volume centers; for larger, more extensive aneurysms, with higher rates of prior aortic surgery. After adjustment, staged repair and single-stage treatment were associated with similar odds of all perioperative outcomes and including mortality, TALE, acute kidney injury, stroke, dialysis, and SCI, as well as long-term survival. This was consistent in the subgroups of patients with extensive aneurysms undergoing elective procedures. Of note, first-stage thoracic endografts were associated with 2.6% mortality, 7.3% TALE, 1.5% dialysis, and 4.1% SCI, and 25% of patients did not undergo a second stage. First-stage procedures accounted for one-third of perioperative complications including half of the deaths in the staged cohort. CONCLUSIONS Staged eTAAA repairs were associated with similar perioperative and long-term complications to single-stage treatments. However, first stage procedures are associated with significant morbidity and mortality, and one-quarter of patients never complete their repairs. These data demonstrate the necessity of evaluating the outcomes of all patients planned for staged procedures, not only those who make it to the final stage. More data are needed as to the optimal method of spinal cord protection for these challenging aneurysms.
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Affiliation(s)
- Thomas F X O'Donnell
- Division of Cardiac, Thoracic, and Vascular Surgery, New York-Presbyterian/Columbia University Irving Medical Center/Columbia University Vagelos College of Physicians & Surgeons, New York, NY.
| | - Kirsten D Dansey
- Division of Vascular and Endovascular Surgery, University of Washington, Seattle WA
| | - Virendra I Patel
- Division of Cardiac, Thoracic, and Vascular Surgery, New York-Presbyterian/Columbia University Irving Medical Center/Columbia University Vagelos College of Physicians & Surgeons, New York, NY
| | - Adam W Beck
- Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL
| | - Sara L Zettervall
- Division of Vascular and Endovascular Surgery, University of Washington, Seattle WA
| | - Marc L Schermerhorn
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Bickenbach J, Fritsch S, Cosler S, Simon Y, Dreher M, Theisen S, Kao J, Hildebrand F, Marx G, Simon TP. Effects of structured protocolized physical therapy on the duration of mechanical ventilation in patients with prolonged weaning. J Crit Care 2024; 80:154491. [PMID: 38042000 DOI: 10.1016/j.jcrc.2023.154491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 12/04/2023]
Abstract
PURPOSE 20% of patients with mechanical ventilation (MV) have a prolonged, complex weaning process, often experiencing a condition of ICU-acquired weakness (ICUAW), with a severe decrease in muscle function and restricted long-term prognosis. We aimed to analyze a protocolized, systematic approach of physiotherapy in prolonged weaning patients and hypothesized that the duration of weaning from MV would be shortened. METHODS ICU patients with prolonged weaning were included before (group 1) and after (group 2) introduction of a quality control measure of a structured and protocolized physiotherapy program. Primary endpoint was the tested dynamometric handgrip strength and the Surgical Intensive Care Unit Optimal Mobilization Score (SOMS). Secondary endpoints were weaning success rate, ventilator-free days, hospital mortality, the prevalence of ICUAW, infections and delirium. RESULTS 106 patients were included. Both the SOMS and the handgrip test were significantly improved after introducing the program. Despite no differences in weaning success rates at discharge, the total length of MV was significantly shorter in group 2, which also had lower prevalence of infection and higher probability of survival. CONCLUSIONS Protocolized, systematic physiotherapy resulted in an improvement of the clinical outcome in patients with prolonged weaning. Results were objectifiable with the SOMS and the handgrip test.
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Affiliation(s)
- Johannes Bickenbach
- Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Sebastian Fritsch
- Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Sophia Cosler
- Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Yvonne Simon
- Department of Physiotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Michael Dreher
- Department of Pneumology and Internal Intensive Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Silke Theisen
- Project Management, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Joyce Kao
- Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopedics, Trauma and Reconstructive Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany; Department of Physiotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Gernot Marx
- Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Tim Philipp Simon
- Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany
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Cai M, Bai D, Hou D, You Q, Wang W, Lu X, Gao J. Effectiveness of nonpharmacological multi-component intervention on depressive symptoms in patients with mild cognitive impairment and dementia: A systematic review and meta-analysis. Int J Ment Health Nurs 2024; 33:297-308. [PMID: 37937694 DOI: 10.1111/inm.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 09/06/2023] [Accepted: 10/13/2023] [Indexed: 11/09/2023]
Abstract
Patients with mild cognitive impairment (MCI) and dementia are more prone to depression than people without MCI or dementia. Some studies have found nonpharmacological multi-component intervention to be more effective than single-component intervention in improving the condition of patients with MCI and dementia; however, their effect on depressive symptoms is still inconsistent. Therefore, it is necessary to explore the effectiveness of nonpharmacological multi-component intervention in improving depressive symptoms in patients with MCI and dementia. This review retrieved papers from PubMed, Embase, Cochrane Library, CINAHL, PsycINFO and CNKI. The retrieval time limit was set from 1 January 1990 to 25 November 2022. The PRISMA 2020 guideline was used to report the included studies. The result showed that nonpharmacological multi-component intervention could improve depressive symptoms in patients with MCI and dementia. Among them, nonpharmacological multi-component intervention with a duration of <6 months, physical and cognitive activities, or other activities had significant effects. However, each study differed in terms of specific measures, duration and frequency of intervention methods. Accordingly, more randomized controlled trials with larger samples are required to discover the best scheme for nonpharmacological multi-component intervention.
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Affiliation(s)
- Mingjin Cai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dingxi Bai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongjiang Hou
- School of Medicine and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian You
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xianying Lu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Zhang Q, Zhang L, Wu J, Yang F. Effects of clinical nursing pathway on surgical site wound infection in patients undergoing acute appendicitis surgery: A meta-analysis. Int Wound J 2024; 21:e14600. [PMID: 38146201 PMCID: PMC10961861 DOI: 10.1111/iwj.14600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023] Open
Abstract
This study aimed to explore the impact of clinical nursing pathway applied to acute appendicitis surgery on patients' postoperative wound infections and complications. A computerised search of PubMed, Cochrane Library, Web of Science, EMBASE, Wanfang, Chinese Biomedical Literature Database and China National Knowledge Infrastructure was conducted and supplemented by a manual search, from database inception to October 2023, to collect randomised controlled trials (RCTs) on the application of clinical nursing pathways to acute appendicitis surgery. Literature screening, data extraction and quality assessment of the included literature were carried out independently by two researchers. RevMan 5.4 software was applied for data analysis. Twenty-one RCTs with a total of 2408 patients were finally included. The analysis revealed the implementation of clinical nursing pathway could effectively reduce the incidence of wound infection (OR = 0.26, 95% CI: 0.15-0.46, p < 0.001) and postoperative complications (OR = 0.20, 95% CI: 0.15-0.27, p < 0.001), as well as shorten the hospital length of stay (MD = -3.26, 95% CI: -3.74 to -2.79, p < 0.001) and accelerated the time to first ventilations (MD = -14.85, 95% CI: -21.56 to -8.13, p < 0.001), as well as significantly improved patient satisfaction (OR = 5.52, 95% CI: 3.52-8.65, p < 0.001) in patients undergoing surgery for acute appendicitis. The application of clinical nursing pathway in acute appendicitis surgery can significantly reduce postoperative wound infection and complications, and at the same time can shorten the hospital length of stay as well as improve the satisfaction of patients.
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Affiliation(s)
- Qin Zhang
- Department of EmergencyPeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Li‐Hua Zhang
- Department of ObstetricsPeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Jian‐Li Wu
- Department of OtolaryngologyPeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Feng‐Yong Yang
- Department of EmergencyPeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
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Yang W, Huang J, He X, Wen S. Fixed-time synchronization of complex-valued neural networks for image protection and 3D point cloud information protection. Neural Netw 2024; 172:106089. [PMID: 38181617 DOI: 10.1016/j.neunet.2023.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/19/2023] [Accepted: 12/22/2023] [Indexed: 01/07/2024]
Abstract
This paper studies the fixed-time synchronization (FDTS) of complex-valued neural networks (CVNNs) based on quantized intermittent control (QIC) and applies it to image protection and 3D point cloud information protection. A new controller was designed which achieved FDTS of the CVNNs, with the estimation of the convergence time not dependent on the initial state. Our approach divides the neural network into two real-valued systems and then combines the framework of the Lyapunov method to give criteria for FDTS. Applying synchronization to image protection, the image will be encrypted with a drive system sequence and decrypted with a response system sequence. The quality of image encryption and decryption depends on the synchronization error. Meanwhile, the depth image of the object is encrypted and then the 3D point cloud is reconstructed based on the decrypted depth image. This means that the 3D point cloud information is protected. Finally, simulation examples verify the efficacy of the controller and the synchronization criterion, giving results for applications in image protection and 3D point cloud information protection.
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Affiliation(s)
- Wenqiang Yang
- Chongqing Key Laboratory of Nonlinear Circuits and Intelligent Information Processing, College of Electronic and Information Engineering, Southwest University, Chongqing 400715, China.
| | - Junjian Huang
- Chongqing Key Laboratory of Nonlinear Circuits and Intelligent Information Processing, College of Electronic and Information Engineering, Southwest University, Chongqing 400715, China.
| | - Xing He
- Chongqing Key Laboratory of Nonlinear Circuits and Intelligent Information Processing, College of Electronic and Information Engineering, Southwest University, Chongqing 400715, China.
| | - Shiping Wen
- Faculty of Engineering and Information Technology, Australian Artificial Intelligence Institute (AAII), University of Technology at Sydney, Sydney, NSW 2007, Australia.
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Bulman JC, Ali H, Sikaria D, Ahmed M, Weinstein JL. The Impact of Implementation of a Commercial Inferior Vena Cava Filter Database Program on Filter Retrieval versus Physician Tracking over a 9-Year Period: A Retrospective, Observational Study. J Vasc Interv Radiol 2024; 35:576-582. [PMID: 38142888 DOI: 10.1016/j.jvir.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023] Open
Abstract
PURPOSE To compare the impact of a commercial tracking database on inferior vena cava filter retrievals with that of physician tracking and no tracking. MATERIALS AND METHODS From January 2013 to December 2021, 532 filters were placed at a single institution and followed in 3 phases: (a) Phase 1, pretracking (January 1, 2013, to February 28, 2015); (b) Phase 2, commercial database tracking (March 1, 2015, to June 30, 2019); and (c) Phase 3, commercial database tracking with separate tracking by an interventional radiologist (July 1, 2019, to December 31, 2021). Patients excluded from the commercial database due to human error served as a control group. Outcomes of commercial database entry, 2-year filter retrieval rates, dwell times, and factors contributing to retrieval candidacy were collected. RESULTS Two-year retrieval rates in Phases 1, 2 and 3 were 20%, 31%, and 46%, respectively (Phase 1 vs 2, P = .04; Phase 2 vs 3, P = .009). Median dwell times across Phases 1, 2, and 3 were 168 days (4-1,313 days), 140 days (3-1,988 days), and 188 days (13-734 days) (P = .33), respectively. There was no difference in retrieval rates (P = .86) and dwell times (P = .50) between patients enrolled in the database group and those enrolled in the control group. Across all phases, 48% of patients enrolled in the database were not successfully contacted, and only 6% were categorized as "likely to consult" filter retrieval. During Phase 3, 100% of patients achieved a retrieval disposition. CONCLUSIONS A commercial tracking database had low success rates of contacting patients and did not increase filter retrieval rates relative to those in the control group; however, physician tracking increased retrieval rates.
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Affiliation(s)
- Julie C Bulman
- Division of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts.
| | - Hamza Ali
- Division of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
| | - Dhiraj Sikaria
- Division of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
| | - Muneeb Ahmed
- Division of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
| | - Jeffrey L Weinstein
- Division of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
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Liu X, Chen L, Zhao Y, Li H. Event-triggered hybrid impulsive control for synchronization of fractional-order multilayer signed networks under cyber attacks. Neural Netw 2024; 172:106124. [PMID: 38286097 DOI: 10.1016/j.neunet.2024.106124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/28/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024]
Abstract
In this paper, we consider the exponential bipartite synchronization (EBS) problem of fractional-order multilayer signed networks with time-varying delays (FO-MSNT) under random cyber attacks. In contrast to the existing literature, the proposed hybrid event-triggered controller combines the advantages of feedback controller and impulsive controller, and the event-triggered condition is constructed by applying the network topology and the Lyapunov function of the subsystem, rather than the state function of the subsystem. Based on the Lyapunov-Razumikhin method and the graph theory, some sufficient conditions for achieving EBS of FO-MSNT under cyber attacks which are related to the topology of networks, the event-triggered parameters, the order of fractional derivative and the signal sent by the enemy are obtained. Furthermore, fractional-order coupled Chua's circuits model and fractional-order power systems built on MSNT are established and the EBS issues under cyber attacks are analyzed. Numerical examples and simulations are provided to show the validity of our theories.
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Affiliation(s)
- Xin Liu
- College of Mathematics and Systems Science, Shandong University of Science and Technology, Qingdao, 266590, China.
| | - Lili Chen
- College of Mathematics and Systems Science, Shandong University of Science and Technology, Qingdao, 266590, China.
| | - Yanfeng Zhao
- College of Mathematics and Systems Science, Shandong University of Science and Technology, Qingdao, 266590, China.
| | - Honglin Li
- College of Mathematics and Systems Science, Shandong University of Science and Technology, Qingdao, 266590, China.
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Kang Q, Ren G, Gan Q, Li R, Meng M. Tradeoff analysis between time cost and energy cost for fixed-time synchronization of discontinuous neural networks. Neural Netw 2024; 172:106118. [PMID: 38232421 DOI: 10.1016/j.neunet.2024.106118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/20/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
This article focuses on the tradeoff analysis between time and energy costs for fixed-time synchronization (FXTS) of discontinuous neural networks (DNNs) with time-varying delays and mismatched parameters. First, a more comprehensive lemma is systematically established to study fixed-time stability, which is less conservative than those in most current results. Besides, theoretical proof has proven that the upper bounds of the settling time (ST) in this article are more accurate compared to existing results. Second, on the grounds of the new fixed-time stability lemma, fixed-time synchronization problem for discontinuous neural networks with time-varying delays and mismatched parameters is explored, and sufficient conditions for fixed-time synchronization are obtained. Further, the upper bounds of energy cost during the synchronization process are estimated. Third, in order to achieve a balance between time cost and energy cost, the genetic algorithm is utilized to find the satisfactory control parameter. Finally, a numerical example is provided to verify the theoretical analysis's correctness and the control mechanism's feasibility.
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Affiliation(s)
- Qiaokun Kang
- Shijiazhuang Campus, Army Engineering University of PLA, Shijiazhuang 050003, China
| | - Guoquan Ren
- Shijiazhuang Campus, Army Engineering University of PLA, Shijiazhuang 050003, China
| | - Qintao Gan
- Shijiazhuang Campus, Army Engineering University of PLA, Shijiazhuang 050003, China.
| | - Ruihong Li
- Shijiazhuang Campus, Army Engineering University of PLA, Shijiazhuang 050003, China
| | - Mingqiang Meng
- Shijiazhuang Campus, Army Engineering University of PLA, Shijiazhuang 050003, China
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Abufarsakh B, Otachi JK, Wang T, Al-Mrayat Y, Okoli CTC. The Impact of a Nurse-Led Service on Tobacco Treatment Provision Within a Psychiatric Hospital: A Time Series Study. J Am Psychiatr Nurses Assoc 2024; 30:434-440. [PMID: 35549464 DOI: 10.1177/10783903221093582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Psychiatric hospitalization is an opportunity to provide evidence-based tobacco treatment to optimize cessation efforts among people living with mental illnesses (MI). The purpose of this study was to examine the effectiveness of nurse-driven initiatives to enhance tobacco treatment within an inpatient psychiatric setting. AIMS We assessed the 4-year impact of implementing a nurse-led tobacco treatment service offered to 11,314 inpatients at admissions in a tobacco-free psychiatric facility in Kentucky. METHOD Through a time-series design, we compared the differences in rates of screening for tobacco use and providing treatment from September to December 2015 (prior to implementing the nurse-led tobacco treatment services) to each subsequent year in a 4-year period (2016-2019). RESULTS Approximately 60.0% of inpatients were persons using tobacco during the assessment period. Although there were no changes in tobacco use prevalence over the 4-year evaluation duration, there were significant increases in the provision of practical counseling and Food and Drug Administration-approved nicotine replacement therapies for persons using tobacco. CONCLUSIONS Our findings support the effectiveness of implementing tobacco treatment programs at the organizational level. Psychiatric hospitalizations provide an opportunity to optimize nurse-driven efforts to deliver tobacco treatment to people with MI. Similar models of nurse-led tobacco treatment services can be adopted within inpatient and other mental and behavioral health settings.
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Affiliation(s)
- Bassema Abufarsakh
- Bassema Abufarsakh, PhD candidate, MSN, BSN, University of Kentucky College of Nursing, Lexington, KY, USA
| | - Janet K Otachi
- Janet K. Otachi, PhD, MSW, MA, University of Kentucky College of Social Work, Lexington, KY, USA
| | - Tianyi Wang
- Tianyi Wang, MS, BS, University of Kentucky College of Arts and Sciences, Lexington, KY, USA
| | - Yazan Al-Mrayat
- Yazan Al-Mrayat, PhD, MSN, RN, University of Kentucky College of Nursing, Lexington, KY, USA
| | - Chizimuzo T C Okoli
- Chizimuzo T. C. Okoli, PhD, MPH, MSN, PMHNP-BC, APRN, FAAN, Professor, University of Kentucky College of Nursing, Lexington, KY, USA
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Gimeno-García AZ, Hernández-Pérez A, Benítez F, Segura N, Nicolás-Pérez D, Quintero E, Hernández-Álvarez N, Betancor I, Salido E, Hernández-Guerra M. Postcolonoscopy colorectal cancer: Prevalence, categorization and root-cause analysis based on the World Endoscopic Organization system. Gastroenterol Hepatol 2024; 47:319-326. [PMID: 37285934 DOI: 10.1016/j.gastrohep.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/12/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023]
Abstract
AIMS The World Endoscopy Organization (WEO) recommends that endoscopy units implement a process to identify postcolonoscopy colorectal cancer (PCCRC). The aims of this study were to assess the 3-year PCCRC rate and to perform root-cause analyses and categorization in accordance with the WEO recommendations. PATIENTS AND METHODS Cases of colorectal cancers (CRCs) in a tertiary care center were retrospectively included from January 2018 to December 2019. The 3-year and 4-year PCCRC rates were calculated. A root-cause analysis and categorization of PCCRCs (interval and type A, B, C noninterval PCCRCs) were performed. The level of agreement between two expert endoscopists was assessed. RESULTS A total of 530 cases of CRC were included. A total of 33 were deemed PCCRCs (age 75.8±9.5 years; 51.5% women). The 3-year and 4-year PCCRC rates were 3.4% and 4.7%, respectively. The level of agreement between the two endoscopists was acceptable either for the root-cause analysis (k=0.958) or for the categorization (k=0.76). The most plausible explanations of the PCCRCs were 8 "likely new PCCRCs", 1 (4%) "detected, not resected", 3 (12%) "detected, incomplete resection", 8 (32%) "missed lesion, inadequate examination", and 13 (52%) "missed lesion, adequate examination". Most PCCRCs were deemed noninterval Type C PCCRCs (N=17, 51.5%). CONCLUSION WEO recommendations for root-cause analysis and categorization are useful to detect areas for improvement. Most PCCRCs were avoidable and were likely due to missed lesions during an otherwise adequate examination.
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Affiliation(s)
- Antonio Z Gimeno-García
- Servicio de Gastroenterología, Hospital Universitario de Canarias, Spain; Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Spain; Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, Tenerife, Spain.
| | | | - Federica Benítez
- Servicio de Gastroenterología, Hospital Universitario de Canarias, Spain
| | - Noemi Segura
- Servicio de Gastroenterología, Hospital Universitario de Canarias, Spain
| | | | - Enrique Quintero
- Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Spain; Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, Tenerife, Spain
| | | | - Isabel Betancor
- Servicio de Anatomía Patológica, Hospital Universitario de Canarias, Spain
| | - Eduardo Salido
- Servicio de Anatomía Patológica, Hospital Universitario de Canarias, Spain
| | - Manuel Hernández-Guerra
- Servicio de Gastroenterología, Hospital Universitario de Canarias, Spain; Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Spain; Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, Tenerife, Spain
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Lampridou S, Saghdaoui LB, Bicknell C, Kumlien C, Lear R. Health Related Quality of Life Following Intervention for Thoracoabdominal Aortic Aneurysm: A Systematic Review and Narrative Synthesis. Ann Vasc Surg 2024; 101:105-119. [PMID: 38160705 DOI: 10.1016/j.avsg.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Thoracoabdominal aortic aneurysms (TAAA) pose significant risks of morbidity and mortality. Considering the evolving techniques for TAAA intervention and the growing interest in quality of life (QoL) outcomes for decision-making, we aimed to evaluate the impact of patient and perioperative characteristics on short-term, medium-term, and long-term postoperative QoL in TAAA repair patients. METHODS A systematic search was conducted in CINAHL, APA PsycINFO, EMBASE, Medline and Cochrane to identify primary research studies evaluating QoL post TAAA surgery, published in English or Swedish between January 01, 2012 and September 26, 2022. A narrative synthesis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence was assessed using the Critical Appraisal Skills Program and Joanna Briggs Institute checklists. RESULTS Eight studies of low or moderate quality with 455 patients were included. Preoperative QoL in TAAA patients was lower compared to the general population. While there is an initial short-term improvement in postoperative QoL, patients fail to reach baseline levels even after 7 years, with physical activity and functioning domains being particularly affected. Experiencing postoperative complications, including paraplegia and cardiovascular events, negatively impacts postoperative QoL. Patients with uncomplicated postoperative status had improved QoL. Prolonged hospital stay negatively affects physical functioning. CONCLUSIONS Individuals with TAAA are likely to have lower baseline QoL compared to the general population. Following TAAA repair, postoperative QoL may remain lower than baseline levels, persisting over the long-term. Comorbidities, postoperative complications, and hospitalization duration appear to exert adverse effects on postoperative QoL.
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Affiliation(s)
- Smaragda Lampridou
- Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK.
| | - Layla Bolton Saghdaoui
- Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Colin Bicknell
- Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Christine Kumlien
- Department of Care Science, Malmö University, Malmö, Sweden; Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
| | - Rachael Lear
- Institute of Global Health Innovation, NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK
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Murakami T, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, Tamanaha Y, Kasahara T, Watanabe Y, Yamamoto K, Seguchi M, Wada H, Fujita H. Development of a simple prediction model for mechanical complication in ST-segment elevation myocardial infarction patients after primary percutaneous coronary intervention. Heart Vessels 2024; 39:288-298. [PMID: 38008806 DOI: 10.1007/s00380-023-02336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/01/2023] [Indexed: 11/28/2023]
Abstract
Mechanical complication (MC) is a rare but serious complication in patients with ST-segment elevation myocardial infarction (STEMI). Although several risk factors for MC have been reported, a prediction model for MC has not been established. This study aimed to develop a simple prediction model for MC after STEMI. We included 1717 patients with STEMI who underwent primary percutaneous coronary intervention (PCI). Of 1717 patients, 45 MCs occurred after primary PCI. Prespecified predictors were determined to develop a tentative prediction model for MC using multivariable regression analysis. Then, a simple prediction model for MC was generated. Age ≥ 70, Killip class ≥ 2, white blood cell ≥ 10,000/µl, and onset-to-visit time ≥ 8 h were included in a simple prediction model as "point 1" risk score, whereas initial thrombolysis in myocardial infarction (TIMI) flow grade ≤ 1 and final TIMI flow grade ≤ 2 were included as "point 2" risk score. The simple prediction model for MC showed good discrimination with the optimism-corrected area under the receiver-operating characteristic curve of 0.850 (95% CI: 0.798-0.902). The predicted probability for MC was 0-2% in patients with 0-4 points of risk score, whereas that was 6-50% in patients with 5-8 points. In conclusion, we developed a simple prediction model for MC. We may be able to predict the probability for MC by this simple prediction model.
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Affiliation(s)
- Tsukasa Murakami
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Kenichi Sakakura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan.
| | - Hiroyuki Jinnouchi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Yousuke Taniguchi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Takunori Tsukui
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Masashi Hatori
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Yusuke Tamanaha
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Taku Kasahara
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Yusuke Watanabe
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Kei Yamamoto
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Masaru Seguchi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Hiroshi Wada
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Hideo Fujita
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
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Dexter F, Hindman BJ. Narrative Review of Prolonged Times to Tracheal Extubation After General Anesthesia With Intubation and Extubation in the Operating Room. Anesth Analg 2024; 138:775-781. [PMID: 37788413 DOI: 10.1213/ane.0000000000006644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
This narrative review summarizes research about prolonged times to tracheal extubation after general anesthesia with both intubation and extubation occurring in the operating room or other anesthetizing location where the anesthetic was performed. The literature search was current through May 2023 and included prolonged extubations defined either as >15 minutes or at least 15 minutes. The studies showed that prolonged times to extubation can be measured accurately, are associated with reintubations and respiratory treatments, are rated poorly by anesthesiologists, are treated with flumazenil and naloxone, are associated with impaired operating room workflow, are associated with longer operating room times, are associated with tardiness of starts of to-follow cases and surgeons, and are associated with longer duration workdays. When observing prolonged extubations among all patients receiving general anesthesia, covariates accounting for most prolonged extubations are characteristics of the surgery, positioning, and anesthesia provider's familiarity with the surgeon. Anesthetic drugs and delivery systems routinely achieve substantial differences in the incidences of prolonged extubations. Occasional claims made that anesthesia drugs have unimportant differences in recovery times, based on medians and means of extubation times, are misleading, because benefits of different anesthetics are achieved principally by reducing the variability in extubation times, specifically by decreasing the incidence of extubation times sufficiently long to have economic impact (ie, the prolonged extubations). Collectively, the results show that when investigators in anesthesia pharmacology quantify the rate of patient recovery from general anesthesia, the incidence of prolonged times to tracheal extubation should be included as a study end point.
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Affiliation(s)
- Franklin Dexter
- From the Department of Anesthesia, University of Iowa, Iowa City, Iowa
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Han S, Kommuri SK, Jin Y. Novel criteria of sampled-data synchronization controller design for gated recurrent unit neural networks under mismatched parameters. Neural Netw 2024; 172:106081. [PMID: 38181615 DOI: 10.1016/j.neunet.2023.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
Synchronization between neural networks (NNs) has been intensively investigated to analyze stability, convergence properties, neuronal behaviors and response to various inputs. However, synchronization techniques of NNs with gated recurrent units (GRUs) have not been provided until now due to their complicated nonlinearity. In this paper, we address the sampled-data synchronization problems of GRUs for the first time, and propose controller design methods using discretely sampled control inputs to synchronize master and slave GRUs. The master and slave GRUs are mathematically modeled as a linear parameter varying (LPV) system in which the parameter of the slave GRUs is constructed independently of the master GRUs. This distinctive modeling feature provides flexibility to extend the existing master and slave NNs into a more general structure. Indeed, the sampled-data synchronization can be achieved by formulating the design condition in terms of linear matrix inequalities (LMIs). The novel sampled-data synchronization criteria are devised by combining the H∞ controller design with the looped-functional approach. The synthesized synchronization controllers guarantee not only asymptotic stability of the synchronization error system with aperiodic sampling, but also provides a satisfactory H∞ control performance. Moreover, the communication efficiency is improved by using the proposed method in which the sampled-data synchronization controller is combined with the event-triggered mechanism. Finally, the numerical example validates the proposed theoretical contributions via simulation results.
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Affiliation(s)
- Seungyong Han
- Korea Atomic Energy Research Institute (KAERI), Daejeon, 34057, Republic of Korea.
| | - Suneel Kumar Kommuri
- Department of Electrical and Electronic Engineering, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China.
| | - Yongsik Jin
- Robotics IT Convergence Research Section, Electronics and Telecommunications Research Institute (ETRI), Daegu, 42994, Republic of Korea.
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Wang L, Ma F, Li Z, Zhang Y. Immobilizing amyloglucosidase on inorganic hybrid nanoflowers to prepare time-temperature integrators for chilled pork quality monitoring. Food Chem 2024; 437:137876. [PMID: 37931448 DOI: 10.1016/j.foodchem.2023.137876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023]
Abstract
Time-temperature integrators (TTIs) based on amyloglucosidase@Cu3(PO4)2 nanoflowers (AMG@NFs) were developed to monitor the freshness of chilled pork. AMG@NFs were synthesized through biomineralization, resulting in enhanced activity and stability of amyloglucosidase. The TTI prototypes were constructed by hydrolyzing maltodextrin with AMG@NFs. The hue of the TTIs varied from burgundy to colorless, and the discoloration kinetics were investigated. The deterioration process of chilled pork was explored, and the activation energy (Ea) was calculated as 67.32 ± 5.13 kJ/mol. To optimize costs and match TTIs with food, 6#TTI was selected to predict the quality of chilled pork. The dynamic temperature test revealed that the cumulative effective temperatures of chilled pork and 6#TTI were 289.34 K and 290.05 K, respectively, which indicated that 6#TTI was highly reliable and suitable for monitoring the actual chilled pork system. This study offers a new approach for real-time and accurate visual monitoring of chilled pork quality.
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Affiliation(s)
- Lin Wang
- Henan University of Animal Husbandry and Economy, No. 6 Longzihu North Road, Zhengzhou, Henan 450046, China.
| | - Falai Ma
- Zhengzhou Golden Leaf Industrial Co., Ltd., No. 73 Longhai East Road, Zhengzhou, Henan 450002, China
| | - Zihan Li
- Henan University of Animal Husbandry and Economy, No. 6 Longzihu North Road, Zhengzhou, Henan 450046, China
| | - Yan Zhang
- Henan University of Animal Husbandry and Economy, No. 6 Longzihu North Road, Zhengzhou, Henan 450046, China.
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Jiang X, Li W, Li R, Ning J. Addressing subject heterogeneity in time-dependent discrimination for biomarker evaluation. Stat Med 2024; 43:1341-1353. [PMID: 38287471 DOI: 10.1002/sim.10024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/29/2023] [Accepted: 01/12/2024] [Indexed: 01/31/2024]
Abstract
Accurate discrimination has been the central goal in identifying biomarkers for monitoring disease progression and early detection. Acknowledging the fact that discrimination accuracy of biomarkers for a time-to-event outcome often changes over time, local measures such as the time-dependent receiver operating characteristic curve and its area under the curve (AUC) are used to assess time-dependent predictive discrimination. However, such measures do not address subject heterogeneity, although the impact of covariates including demographics, disease-related characteristics, and other clinical information on the discriminatory performance of biomarkers needs to be investigated before their clinical use. We propose the covariate-specific time-dependent AUC, a measure for covariate-adjusted discrimination. We develop a regression model on the covariate-specific time-dependent AUC to understand how and in what magnitude the covariates influence biomarker performance. Then we construct a pseudo partial-likelihood for estimation and inference. This is followed by our establishing the asymptotic properties of the proposed estimators and provide variance estimation. The simulation studies and application to the AIDS Clinical Trials Group 175 data demonstrate that the proposed method offers an informative tool for inferring covariate-specific and time-dependent predictive discrimination.
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Affiliation(s)
- Xinyang Jiang
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Wen Li
- Department of Internal Medicine, The University of Texas McGovern Medical School, Houston, Texas, USA
| | - Ruosha Li
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jing Ning
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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43
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Bailly R, Malfante M, Allier C, Paviolo C, Ghenim L, Padmanabhan K, Bardin S, Mars J. Detecting abnormal cell behaviors from dry mass time series. Sci Rep 2024; 14:7053. [PMID: 38528035 DOI: 10.1038/s41598-024-57684-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/20/2024] [Indexed: 03/27/2024] Open
Abstract
The prediction of pathological changes on single cell behaviour is a challenging task for deep learning models. Indeed, in self-supervised learning methods, no prior labels are used for the training and all of the information for event predictions are extracted from the data themselves. We present here a novel self-supervised learning model for the detection of anomalies in a given cell population, StArDusTS. Cells are monitored over time, and analysed to extract time-series of dry mass values. We assessed its performances on different cell lines, showing a precision of 96% in the automatic detection of anomalies. Additionally, anomaly detection was also associated with cell measurement errors inherent to the acquisition or analysis pipelines, leading to an improvement of the upstream methods for feature extraction. Our results pave the way to novel architectures for the continuous monitoring of cell cultures in applied research or bioproduction applications, and for the prediction of pathological cellular changes.
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Affiliation(s)
- Romain Bailly
- Univ. Grenoble Alpes, CEA, List, F-38000, Grenoble, France
- Univ. Grenoble Alpes, CNRS, Grenoble-INP, GIPSA-Lab, 38000, Grenoble, France
| | | | - Cédric Allier
- Univ. Grenoble Alpes, CEA, Leti, F-38000, Grenoble, France
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA, USA
| | - Chiara Paviolo
- Univ. Grenoble Alpes, CEA, Leti, F-38000, Grenoble, France
| | - Lamya Ghenim
- Univ. Grenoble Alpes, INSERM, CEA-IRIG, BGE, Biomics, F-38000, Grenoble, France
| | - Kiran Padmanabhan
- Institut de Génomique Fonctionnelle de Lyon, Univ. Lyon, CNRS/ENS, UMR 5242, Lyon, France
| | - Sabine Bardin
- Institut Curie, PSL Research University, CNRS, UMR 144, Molecular Mechanisms of Intracellular Transport, F-75005, Paris, France
| | - Jérôme Mars
- Univ. Grenoble Alpes, CNRS, Grenoble-INP, GIPSA-Lab, 38000, Grenoble, France
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44
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Xiao F, Yang S, Li X, Ni J. Branch error reduction criterion-based signal recursive decomposition and its application to wind power generation forecasting. PLoS One 2024; 19:e0299955. [PMID: 38517881 PMCID: PMC10959340 DOI: 10.1371/journal.pone.0299955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/14/2024] [Indexed: 03/24/2024] Open
Abstract
Due to the ability of sidestepping mode aliasing and endpoint effects, variational mode decomposition (VMD) is usually used as the forecasting module of a hybrid model in time-series forecasting. However, the forecast accuracy of the hybrid model is sensitive to the manually set mode number of VMD; neither underdecomposition (the mode number is too small) nor over-decomposition (the mode number is too large) improves forecasting accuracy. To address this issue, a branch error reduction (BER) criterion is proposed in this study that is based on which a mode number adaptive VMD-based recursive decomposition method is used. This decomposition method is combined with commonly used single forecasting models and applied to the wind power generation forecasting task. Experimental results validate the effectiveness of the proposed combination.
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Affiliation(s)
- Fen Xiao
- State Grid Fujian Electric Power Co., LTD., Fuzhou, China
| | - Siyu Yang
- State Grid Fujian Electric Power Co., LTD., Fuzhou, China
| | - Xiao Li
- North China Electric Power University, Baoding, China
| | - Junhong Ni
- North China Electric Power University, Baoding, China
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45
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Ragland A, Stevens C, Bai N, Ahuja C, Virk C. Retrieval of an inferior vena cava Greenfield filter 34 years after insertion. BMJ Case Rep 2024; 17:e259053. [PMID: 38514161 PMCID: PMC10961489 DOI: 10.1136/bcr-2023-259053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Inferior vena cava (IVC) filters are engineered medical devices deployed in the IVC primarily to prevent a pulmonary embolism from occurring. In this article, we present a case of an IVC filter that was successfully retrieved from a patient after being in place for 34 years. The patient presented to hospital for trauma in which subsequent imaging showed tines of an IVC filter protruding outside of the vessel with one of the tines penetrating the duodenal wall. The filter was successfully removed with no complications. This report adds to the existing literature by yielding an example of an adverse risk that can be associated with the placement of IVC filters. In addition, to the authors' best knowledge, this is the longest reported length of time that an IVC filter has stayed in a patient before being removed, thus adding another intriguing detail to the case.
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Affiliation(s)
- Amanda Ragland
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Christopher Stevens
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Nancy Bai
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Chaitanya Ahuja
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Chiranjiv Virk
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
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46
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Lundberg F, Robinson D, Bratt O, Fallara G, Lambe M, Johansson ALV. Time trends in the use of curative treatment in men 70 years and older with nonmetastatic prostate cancer. Acta Oncol 2024; 63:95-104. [PMID: 38505996 DOI: 10.2340/1651-226x.2024.26189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/17/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Undertreatment of otherwise healthy men in their seventies with prostate cancer has been reported previously. MATERIAL AND METHODS Using information in a Swedish prostate cancer research database, patterns of management and cancer-specific mortality were compared across age groups in over 70,000 men diagnosed with intermediate- or high-risk nonmetastatic prostate cancer between 2008 and 2020. Crude probabilities of death were estimated non-parametrically. Staging procedures, primary treatment, and cancer death were compared using regression models, adjusting for patient and tumor characteristics. RESULTS During the study period, the proportion of men treated with curative intent increased in ages 70-74 (intermediate-risk from 45% to 72% and high-risk from 49% to 84%), 75-79 (intermediate-risk from 11% to 52% and high-risk from 12% to 70%), and 80-84 years (intermediate-risk from < 1% to 14% and high-risk from < 1% to 30%). Older age was associated with lower likelihoods of staging investigations and curative treatment, also after adjustment for tumor characteristics and comorbidity. Men treated with curative intent and those initially managed conservatively had lower crude risks of prostate cancer death than men receiving androgen deprivation treatment (ADT). In adjusted analyses, ADT was associated with higher prostate cancer mortality than curative treatment across ages and risk groups. Among men managed conservatively, prostate cancer mortality was higher in ages 70 and above. INTERPRETATION Use of curative treatment increased substantially in older men with prostate cancer between 2008 and 2020. Our findings suggest reduced age-bias and under-treatment, likely reflecting improved individualized decision-making and adherence to guidelines recommending more active management of older men.
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Affiliation(s)
- Frida Lundberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
| | - David Robinson
- Department of Urology, Ryhov Hospital, Jönköping, Sweden
| | - Ola Bratt
- Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Giuseppe Fallara
- Department of Urology, IRCCS IEO European Institute of Urology, Milan, Italy
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Regional Cancer Center Central Sweden, Uppsala, Sweden
| | - Anna L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Oslo, Norway
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47
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Davoudkhani M, Rubino F, Creevey CJ, Ahvenjärvi S, Bayat AR, Tapio I, Belanche A, Muñoz-Tamayo R. Integrating microbial abundance time series with fermentation dynamics of the rumen microbiome via mathematical modelling. PLoS One 2024; 19:e0298930. [PMID: 38507436 PMCID: PMC10954177 DOI: 10.1371/journal.pone.0298930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/02/2024] [Indexed: 03/22/2024] Open
Abstract
The rumen represents a dynamic microbial ecosystem where fermentation metabolites and microbial concentrations change over time in response to dietary changes. The integration of microbial genomic knowledge and dynamic modelling can enhance our system-level understanding of rumen ecosystem's function. However, such an integration between dynamic models and rumen microbiota data is lacking. The objective of this work was to integrate rumen microbiota time series determined by 16S rRNA gene amplicon sequencing into a dynamic modelling framework to link microbial data to the dynamics of the volatile fatty acids (VFA) production during fermentation. For that, we used the theory of state observers to develop a model that estimates the dynamics of VFA from the data of microbial functional proxies associated with the specific production of each VFA. We determined the microbial proxies using CowPi to infer the functional potential of the rumen microbiota and extrapolate their functional modules from KEGG (Kyoto Encyclopedia of Genes and Genomes). The approach was challenged using data from an in vitro RUSITEC experiment and from an in vivo experiment with four cows. The model performance was evaluated by the coefficient of variation of the root mean square error (CRMSE). For the in vitro case study, the mean CVRMSE were 9.8% for acetate, 14% for butyrate and 14.5% for propionate. For the in vivo case study, the mean CVRMSE were 16.4% for acetate, 15.8% for butyrate and 19.8% for propionate. The mean CVRMSE for the VFA molar fractions were 3.1% for acetate, 3.8% for butyrate and 8.9% for propionate. Ours results show the promising application of state observers integrated with microbiota time series data for predicting rumen microbial metabolism.
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Affiliation(s)
- Mohsen Davoudkhani
- INRAE, AgroParisTech, UMR Modélisation Systémique Appliquée aux Ruminants, Université Paris-Saclay, Palaiseau, France
| | - Francesco Rubino
- Institute of Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | - Christopher J. Creevey
- Institute of Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | - Seppo Ahvenjärvi
- Animal Nutrition, Production Systems, Natural Resources Institute Finland (Luke), Jokioinen, Finland
| | - Ali R. Bayat
- Animal Nutrition, Production Systems, Natural Resources Institute Finland (Luke), Jokioinen, Finland
| | - Ilma Tapio
- Genomics and Breeding, Production Systems, Natural Resources Institute Finland (Luke), Jokioinen, Finland
| | - Alejandro Belanche
- Departamento de Producción Animal y Ciencia de los Alimentos, Universidad de Zaragoza, Zaragoza, Spain
| | - Rafael Muñoz-Tamayo
- INRAE, AgroParisTech, UMR Modélisation Systémique Appliquée aux Ruminants, Université Paris-Saclay, Palaiseau, France
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48
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Richer E, Solano MM, Cheriet F, Lesk MR, Costantino S. Denoising OCT videos based on temporal redundancy. Sci Rep 2024; 14:6605. [PMID: 38503804 PMCID: PMC10951312 DOI: 10.1038/s41598-024-56935-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
The identification of eye diseases and their progression often relies on a clear visualization of the anatomy and on different metrics extracted from Optical Coherence Tomography (OCT) B-scans. However, speckle noise hinders the quality of rapid OCT imaging, hampering the extraction and reliability of biomarkers that require time series. By synchronizing the acquisition of OCT images with the timing of the cardiac pulse, we transform a low-quality OCT video into a clear version by phase-wrapping each frame to the heart pulsation and averaging frames that correspond to the same instant in the cardiac cycle. Here, we compare the performance of our one-cycle denoising strategy with a deep-learning architecture, Noise2Noise, as well as classical denoising methods such as BM3D and Non-Local Means (NLM). We systematically analyze different image quality descriptors as well as region-specific metrics to assess the denoising performance based on the anatomy of the eye. The one-cycle method achieves the highest denoising performance, increases image quality and preserves the high-resolution structures within the eye tissues. The proposed workflow can be readily implemented in a clinical setting.
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Affiliation(s)
- Emmanuelle Richer
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, QC, H3T 1J4, Canada
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada
| | - Marissé Masís Solano
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, H3T 1P1, Canada
| | - Farida Cheriet
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, QC, H3T 1J4, Canada
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, H3T 1P1, Canada
| | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada.
- Department of Ophthalmology, Université de Montréal, Montreal, QC, H3T 1P1, Canada.
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49
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Darvall JN, Richards T. Cutting the queue: the need for evidence-driven surgery. Med J Aust 2024; 220:241-242. [PMID: 38379301 DOI: 10.5694/mja2.52239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024]
Affiliation(s)
- Jai N Darvall
- Royal Melbourne Hospital, Melbourne, VIC
- University of Melbourne, Melbourne, VIC
- Monash University, Melbourne, VIC
| | - Toby Richards
- Monash University, Melbourne, VIC
- Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
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50
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Zhang S, Xu H, Liu A, Qi S, Hu B, Huang M, Luo J. Mapping of secondary forest age in China using stacked generalization and Landsat time series. Sci Data 2024; 11:302. [PMID: 38493235 PMCID: PMC10944476 DOI: 10.1038/s41597-024-03133-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
A national distribution of secondary forest age (SFA) is essential for understanding the forest ecosystem and carbon stock in China. While past studies have mainly used various change detection algorithms to detect forest disturbance, which cannot adequately characterize the entire forest landscape. This study developed a data-driven approach for improving performances of the Vegetation Change Tracker (VCT) and Continuous Change Detection and Classification (CCDC) algorithms for detecting the establishment of forest stands. An ensemble method for mapping national-scale SFA by determining the establishment time of secondary forest stands using change detection algorithms and dense Landsat time series was proposed. A dataset of national secondary forest age for China (SFAC) for 1 to 34 and with a 30-m spatial resolution was produced from the optimal ensemble model. This dataset provides national, continuous spatial SFA information and can improve understanding of secondary forests and the estimation of forest carbon storage in China.
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Affiliation(s)
- Shaoyu Zhang
- Key Laboratory of Poyang Lake Wetland and Watershed Research (Ministry of Education), School of Geography and Environment, Jiangxi Normal University, Nanchang, 330022, China
| | - Hanzeyu Xu
- School of Geography, Nanjing Normal University, Nanjing, 210023, China
| | - Aixia Liu
- Land Satellite Remote Sensing Application Center, Ministry of Natural Resources, Beijing, 10048, China
| | - Shuhua Qi
- Key Laboratory of Poyang Lake Wetland and Watershed Research (Ministry of Education), School of Geography and Environment, Jiangxi Normal University, Nanchang, 330022, China.
| | - Bisong Hu
- Key Laboratory of Poyang Lake Wetland and Watershed Research (Ministry of Education), School of Geography and Environment, Jiangxi Normal University, Nanchang, 330022, China
| | - Min Huang
- Key Laboratory of Poyang Lake Wetland and Watershed Research (Ministry of Education), School of Geography and Environment, Jiangxi Normal University, Nanchang, 330022, China
| | - Jin Luo
- Key Laboratory of Poyang Lake Wetland and Watershed Research (Ministry of Education), School of Geography and Environment, Jiangxi Normal University, Nanchang, 330022, China
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