Peak Ventilation Reference Standards from Exercise Testing: From the FRIEND Registry

Peak Ventilation Reference Standards from Exercise Testing: From the FRIEND Registry. Med. Sci. Sports Exerc., Vol. 50, No. 12, pp. 2603–2608, 2018. Purpose: Cardiopulmonary exercise testing (CPX) provides valuable clinical information, including peak ventilation (V˙ Epeak), which has been shown to have diagnostic and prognostic value in the assessment of patients with underlying pulmonary disease. This report provides reference standards for V˙ Epeak derived from CPX on treadmills in apparently healthy individuals. Methods: Nine laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the Fitness Registry and the Importance of Exercise National Database from 2014 to 2017. Data from 5232 maximal exercise tests from men and women without cardiovascular or pulmonary disease were used to create percentiles ofV˙ Epeak for both men and women by decade between 20 and 79 yr. Additionally, prediction equations were developed for V˙ Epeak using descriptive information. Results: V˙ Epeak was found to be significantly different between men and women and across age groups (P G 0.05). The rate of decline in V˙ Epeak was 8.0% per decade for both men and women. A stepwise regression model of 70% of the sample revealed that sex, age, and height were significant predictors ofV˙ Epeak. The equation was cross-validated with data from the remaining 30% of the sample with a final equation developed from the full sample (r = 0.73). Additionally, a linear regression model revealed forced expiratory volume in 1 s significantly predicted V˙ Epeak (r = 0.73). Conclusions: Reference standards were developed for V˙ Epeak for the United States population. Cardiopulmonary exercise testing laboratories will be able to provide interpretation of V˙ Epeak from these age and sex-specific percentile reference values or alternatively can use these nonexercise prediction equations incorporating sex, age, and height or with a single predictor of forced expiratory volume in 1 s

Impulsivity in Parkinson’s disease is associated with alterations in affective and sensorimotor striatal networks

A subset of patients with Parkinson’s disease (PD) experiences problems with impulse control, characterized by a loss of voluntary control over impulses, drives, or temptations regarding excessive hedonic behavior. The present study aimed to better understand the neural basis of such impulse control disorders (ICDs) in PD. We collected resting-state functional connectivity and structural MRI data from 21 PD patients with ICDs and 30 patients without such disorders. To assess impulsivity, all patients completed the Barratt Impulsiveness Scale and performed an information-gathering task. MRI results demonstrated substantial differences in neural characteristics between PD patients with and without ICDs. Results showed that impulsivity was linked to alterations in affective basal ganglia circuitries. Specifically, reduced frontal–striatal connectivity and GPe volume were associated with more impulsivity. We suggest that these changes affect decision making and result in a preference for risky or inappropriate actions. Results further showed that impulsivity was linked to alterations in sensorimotor striatal networks. Enhanced connectivity within this network and larger putamen volume were associated with more impulsivity. We propose that these changes affect sensorimotor processing such that patients have a greater propensity to act. Our findings suggest that the two mechanisms jointly contribute to impulsive behaviors in PD

Improving the neutrino mass hierarchy identification with inelasticity measurement in PINGU and ORCA

Multi-megaton scale under ice and underwater detectors of atmospheric neutrinos with few GeV's energy threshold (PINGU, ORCA) open up new possibilities in the determination of neutrino properties, and in particular the neutrino mass hierarchy. With a dense array of optical modules it will be possible to determine the inelasticity, $y$, of the charged current $\nu_\mu$ events in addition to the neutrino energy $E_\nu$ and the muon zenith angle $\theta_\mu$. The discovery potential of the detectors will substantially increase with the measurement of $y$. It will enable (i) a partial separation of the neutrino and antineutrino signals; (ii) a better reconstruction of the neutrino direction; (iii) the reduction of the neutrino parameters degeneracy; (iv) a better control of systematic uncertainties; (v) a better identification of the $\nu_\mu$ events. It will improve the sensitivity to the CP-violation phase. The three dimensional, $(E_\nu, \theta_\mu, y)$, $\nu_\mu-$oscillograms with the kinematical as well as the experimental smearing are computed. We present the asymmetry distributions in the $E_\nu - \theta_\mu$ plane for different intervals of $y$ and study their properties. We show that the inelasticity information reduces the effect of degeneracy of parameters by 30%. With the inelasticity, the total significance of establishing mass hierarchy may increase by 20% - 50%, thus effectively increasing the volume of the detector by factor 1.5 - 2.Comment: 19 pages, 10 figure

Intraoperative Neuromonitoring (IONM) and Hospital Outcome Metrics for Lower Risk Spinal Procedures: A Retrospective Analysis of Length of Stay and 30-day Readmission Rates for High and Low Users of IONM

Objective: To explore the relationship between the utilization rates of Intraoperative Neuromonitoring (IONM) across hospitals, and the impact on surgical outcomes of 30- day readmission (30DRR) and length of stay (LoS) for lower risk, non-complex spinal procedures. The following questions will be addressed: 1) Will hospitals with a high rate (\u3e 67th percentile) of IONM use for low risk spinal surgeries have lower LoS than hospitals with low use (\u3c 33rd percentile) of IONM?; 2) Will hospitals with a high rate (\u3e 67th percentile) of IONM use for low risk spinal surgeries have lower 30DRR than hospitals with low use (\u3c 33rd percentile) of IONM?; 3) High surgical volume hospitals with high IONM use rate (\u3e67th) during low risk will have lower 30-day readmission rates than similar high volume hospitals with low IONM use; and, 4) Will high surgical volume hospitals with high IONM use rate (\u3e67th) during low risk will have lower 30-day readmission rates than similar high volume hospitals with low IONM use? Methods: A retrospective analysis of multi-state hospital billing data was conducted utilizing the 2012 Agency for Healthcare Quality and Research (AHRQ), Healthcare Cost and Utilization Project (HCUP) Statewide Inpatient Databases (SID) for Florida, Massachusetts, New York, and Washington. Multivariable and gamma distributed, generalized linear log linked, regression models were used to test the association between hospital IONM utilization and hospital outcomes of 30DRR and LoS, respectively. Results: Hospitals in the top thirtile of IONM utilization had a 14.9% lower chance (OR of .851, p value .001) of a 30-day readmission and no significant difference in LoS, when compared to the bottom thirtile of IONM hospitals users, for surgeries within the Diagnostic Related Groups (DRGs) of 460 and 473. Hospitals in the subgroup of top 50th percentile of hospitals in the state by surgical volume had 8.3% lower chance (OR of .917, p value .023) of 30-day readmission when compared to the subgroup of bottom 50th percentile of all surgeries, and a small difference in mean LoS, 0.3 days (95% CI 3.04-3.09, 2.74-2.78). Discussion: Comparing the top thirtile of IONM utilizing hospitals to the bottom third of utilization hospitals reduced the chances of 30-day readmission by 14.9% for less complex and lower risk spinal procedures (DRGs 460 and 473). Additionally, this 14.9% lower chance of a 30-day readmission were further supported by the findings that surgical volume made no significant difference in this result. The top 50th percentile subgroup of all hospital spine surgeries was analyzed and yielded an 8.3% lower chance of incurring a 30-day readmission when compared to the bottom 50th percentile subgroup. Ultimately, the significant difference in 30DRR for the top thirtile of hospital IONM utilizers should not be attributed to organizational surgical volume alone, thus further supporting IONM’s influence in reducing 30DRR. Additional research is warranted to further assess the association between IONM and LoS. In general, adjusted estimations of mean LoS did not yield any differences for high or low IONM utilizing hospitals across lower risk, less complex procedures. For the top and bottom 50th percentile subgroups, there was a moderate increase in LoS for the top 50th percentile (0.3days) Further exploration of IONM’s utility is warranted, and ideally these analyses will be based on prospective, longitudinal datasets and registries with more detailed documentation. This expanded information would allow for more analytical and clinical control for the largely unstandardized practice of IONM

EVALUATING MINE SOIL PREPARED BY SCRAPER PANS FOR HERBACEOUS PLANTS AND PINE SEEDLINGS AT AN EAST TEXAS LIGNITE SURFACE MINE

Since 1974, Luminant Mining Company, LLC (Luminant) has planted over 38.7 million trees on its reclaimed lignite surface mine operations in Texas. For decades, the use of improved reclamation techniques on Luminant’s mined lands have resulted in over 31,160 ha reclaimed to forests, wildlife habitat, and pastures with productivity levels similar to those found on unmined lands. The development of new reclamation methodologies offers opportunities to further improve productivity of planted trees at Luminant’s Martin Lake Oak Hill Mine in east Texas. The conventional haulback or ‘truck shovel’ reclamation method uses haul trucks for the selective transport and placement of oxidized overburden to serve as the reforestation growth medium. Transport and placement of overburden can also be accomplished using scraper pans. Operating scraper pans is more cost effective than the truck shovel method; thus, there is a desire to institute scraper pans as the primary method of reclamation. However, given a lack of information, there are concerns of the effects of scraper pans on mine soil compaction and vegetative establishment. To address the potential compacting effects of scraper pans, four soil tillage treatments replicated five times were implemented at the Oak Hill Mine in August 2015 using a randomized complete block design: 1) No Tillage (control); 2) Disking (30-35 cm depth); 3) Single-Ripping (90 cm depth)/Disking (30-35 cm depth); and, 4) Cross-Ripping (90 cm depth)/Disking (30-35 cm depth). Soil physical and chemical properties were investigated at 0-30, 30-60, and 60-90 cm depth intervals. After one growing season, vegetative response was measured for an herbaceous winter cover crop in May 2016 and for loblolly pine (Pinus taeda L.) tree seedlings in October 2016. Aboveground biomass production of the winter cover crop was highest on the ripped treatments. The untilled control resulted in the lowest herbaceous establishment and growth. Loblolly pine tree seedling survival across all treatments exceeded the standard for mined lands in this region. Highest survival occurred on the tilled plots (\u3e 90%) compared to the control (85%) (p \u3c 0.10). Cross-ripping was superior in terms of lowering soil bulk density (1.36 Mg m-3) and soil strength (2,220 kPa), and increasing tree seedling relative volume index growth (32 cm3) (p \u3c 0.10). Above and belowground biomass of loblolly pine seedlings showed significant treatment effects (p \u3c 0.10) and followed similar trends to seedling volume growth. In summary, disking alone improved herbaceous cover and pine seedling survival, while cross-ripping coupled with disking provided the most favorable responses in mine soil physical properties and vegetative growth

Blood profile of implantation stainless steel 316L local implant material on rat femoral bone

This study was aimed to obtain information regarding complete blood count (CBC) profile of post implantation of stainless steel (SS) 316L as an Indonesian local product of non-degradable metal implant. Thirty adult male rat, aged approximately 12 weeks were divided into 3 groups, i.e. control group without implantation, implant group with import SS316L and implant group with Indonesian national local SS316L that developed by Agency for the Assessment and Application of Technology (BPPT). The implant groups were given implants by inserting it between femoral bone and biceps femoris muscle. On the control group, defect was made on bone without inserting an implants material. Examination of the systemic response was done with CBC before and 30 days after implantation. The analysis of red blood cells amount, haemoglobin level, haematocrite value, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), total white blood cell and its differentiation from each group did not show significant differences. In conclusion, stainless steel 316L of import and national local product showed non-negative effects on blood profile

Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare

BACKGROUND: The effectiveness of hand rubbing with alcohol-based handrub (ABHR) is impacted by several factors. To investigate these, World Health Organization (WHO) commissioned a systematic review. AIM: To evaluate the impact of ABHR volume, application time, rubbing friction and hand size on microbiological load reduction, hand surface coverage or drying time. METHODS: Medline, CINAHL, Web of Science and ScienceDirect databases were searched for healthcare or laboratory-based primary studies, published in English, (1980- February 2021), investigating the impact of ABHR volume, application time, rubbing friction or hand size on bacterial load reduction, hand coverage or drying time. Two reviewers independently performed data extraction and quality assessment. The results are presented narratively. FINDINGS: Twenty studies were included in the review. Categories included: ABHR volume, application time and rubbing friction. Sub-categories: bacterial load reduction, hand size, drying time or hand surface coverage. All used experimental or quasi-experimental designs. Findings showed as ABHR volume increased, bacterial load reduced, and drying times increased. Furthermore, one study showed that the application of sprayed ABHR without hand rubbing resulted in significantly lower bacterial load reduction than poured or sprayed ABHR with hand rubbing (− 0.70; 95%CI: − 1.13 to − 0.28). Evidence was heterogeneous in application time, volume, technique, and product. All studies were assessed as high risk of bias. CONCLUSIONS: There is insufficient evidence to change WHO recommendation of a palmful of ABHR in a cupped hand applied for 20–30 s or manufacturer-recommended volume applied for about 20 s (Centers for Disease Control and Prevention). Future hand hygiene research should standardise volume, application time, and consider hand size. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13756-021-01049-9

Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years

The Child Cancer Foundation in Denmark, The Novo Nordisk Foundation and the EU interregional project ReproHigh/ReproUnion are thanked for having funded this study.Objective: To study the impact of first-line antineoplastic treatment on the ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse. Design: Retrospective case-control study. Setting: University hospitals. Patients: Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment. Intervention(s): None. Main Outcome Measure(s): Follicular densities (follicles/mm3) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored. Result(s):There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm3 vs. 327 ± 756/mm3). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10% to 20% in children to around 30% in adolescent girls (>10 years). Conclusion(s): Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment.PostprintPeer reviewe