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A new evaluation framework for nature-based solutions (NBS) projects based on the application of performance questions and indicators approach.

Sci Total Environ 2021 May 7;787:147615. Epub 2021 May 7.

GEMMA-Group of Environmental Engineering and Microbiology, Department of Civil and Environmental Engineering, Universitat Politècnica de Catalunya-BarcelonaTech, c/ Jordi Girona 1-3, Building D1, E-08034 Barcelona, Spain. Electronic address:

One of the key features of nature-based solutions (NBSs) is their high effectiveness and economic and resource efficiency in solving problems compared to traditional grey interventions. These aspects, however, have so far attracted little attention in the literature but should be considered, as the evaluation of NBS projects before implementation provides an opportunity to use them as practical tools. This paper aims to present a new evaluation framework of NBS projects (at the stage of solution selection) based on the application of performance questions and the indicators approach. Read More

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Smartphone-Acquired Image Photogrammetry for Detection of Shallow Anterior Chamber.

Clin Ophthalmol 2021 6;15:1875-1885. Epub 2021 May 6.

Department of Ophthalmology, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, 576104, India.

Purpose: This study aimed to explore the role of smartphone imaging of the eye using two perspectives - anterior and temporal - in the detection of a shallow anterior chamber (AC). The AC depth (ACD) of an eye can be used as a surrogate marker for identification of eyes at risk of developing angle-closure disease.

Methods: A prospective observational study was conducted at a university teaching hospital in South India. Read More

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The Effect of Footwear, Running Speed, and Location on the Validity of Two Commercially Available Inertial Measurement Units During Running.

Front Sports Act Living 2021 26;3:643385. Epub 2021 Apr 26.

Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Metro Vancouver, BC, Canada.

Most running-related injuries are believed to be caused by abrupt changes in training load, compounded by biomechanical movement patterns. Wearable technology has made it possible for runners to quantify biomechanical loads (e.g. Read More

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Complications of Intraosseous Access: Two Case Reports From a Single Center.

JBJS Case Connect 2021 04 20;11(2). Epub 2021 Apr 20.

Department of Orthopaedics & Rehabilitation, Oregon Health and Science University, Portland, Oregon.

Cases: Intraosseous (IO) access is an effective surrogate for intravascular access in critically ill patients. We present 2 cases of IO complications. The first patient is a 44-year-old man with deep peroneal nerve sensorimotor dysfunction due to possible missed acute compartment syndrome from improper placement of a tibial IO needle. Read More

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African Americans With p16+ and p16- Oropharyngeal Squamous Cell Carcinomas Have Distinctly Poor Treatment Outcomes Independent of Medical Care Access.

JCO Oncol Pract 2021 May;17(5):e695-e702

Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.

Purpose: Human papilloma virus-positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC), diagnosed with p16 immunohistochemistry, is associated with favorable prognosis; however, this connection was established using European American (EA)-skewed populations. The impact of p16/human papillomavirus status on outcomes in African American (AA) OPSCC patients remains to be settled. In this study, we determine the association between cancer disparity and p16 status in an OPSCC cohort controlling for time to treatment initiation (TTI), a surrogate for medical care access. Read More

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Bone Mineral Density Measurements and Association With Brain Structure and Cognitive Function: The Framingham Offspring Cohort.

Alzheimer Dis Assoc Disord 2021 May 11. Epub 2021 May 11.

The Framingham Heart Study, Framingham Department of Neurology, Boston University School of Medicine Department of Biostatistics, Boston University School of Public Health, Boston, MA Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX Department of Neurology, University of California, Davis Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, CA.

Background: Bone mineral density (BMD) is a potential surrogate marker of lifetime estrogen exposure previously linked to increased risk of Alzheimer dementia among elderly women. We examine the association between BMD in the "young old" with imaging biomarkers of brain aging and cognitive performance.

Methods: Offspring participants (N=1905, mean age 66) of a population-based cohort who had BMD, brain imaging and detailed cognitive assessment were included in the study. Read More

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Clinical significance of diabetes control before metabolic surgery.

Surg Obes Relat Dis 2021 Apr 9. Epub 2021 Apr 9.

Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Background: Even though observational studies have suggested that poor preoperative diabetes control increases risk after major abdominal surgery, it is unclear whether this effect is seen in metabolic surgery patients.

Objectives: To determine whether poor preoperative diabetes control is associated with worse outcomes in patients with obesity and diabetes undergoing metabolic surgery.

Setting: Metabolic and Bariatric Surgery Quality Improvement Project (MBSAQIP) database. Read More

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Polypharmacy prior to in-hospital cardiac arrest among patients with cardiopulmonary diseases: A pilot study.

Resusc Plus 2020 Dec 9;4. Epub 2020 Oct 9.

University of Rode Island, College of Nursing, NY, USA.

Background: Patterns of medication administration prior to in-hospital cardiac arrest (I-HCA) and the potential impact of these on patient outcomes is not well-established. Accordingly, types of medications administered in the 72 h prior to I-HCA were examined in relation to initial rhythms of I-HCA and survival.

Methods: A retrospective, pilot study was conducted among 96 patients who experienced I-HCA. Read More

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December 2020

Surrogate markers of mucosal healing in inflammatory bowel disease: A systematic review.

World J Gastroenterol 2021 Apr;27(16):1828-1840

Department of Gastroenterology, Colentina Clinical Hospital, Bucharest 020125, Romania.

Background: Mucosal healing (MH) has emerged as a key therapeutic target in inflammatory bowel disease (IBD), and achievement of this goal is documented by endoscopy with biopsy. However, colonoscopy is burdensome and invasive, and substitution with an accurate noninvasive biomarker is desirable.

Aim: To summarize published data regarding the performance of noninvasive biomarkers in assessing MH in IBD patients. Read More

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Coronavirus disease 2019 severity in obesity: Metabolic dysfunction-associated fatty liver disease in the spotlight.

World J Gastroenterol 2021 Apr;27(16):1738-1750

Anatomy, Rio de Janeiro State University, Rio de Janeiro 20551030, Brazil.

The coronavirus disease 2019 (COVID-19) outbreak has drawn the scientific community's attention to pre-existing metabolic conditions that could aggravate the infection, causing extended viral shedding, prolonged hospitalization, and high death rates. Metabolic dysfunction-associated fatty liver disease (MAFLD) emerges as a surrogate for COVID-19 severity due to the constellation of metabolic alterations it entails. This review outlines the impact MAFLD exerts on COVID-19 severity in obese subjects, besides the possible mechanistic links to the poor outcomes. Read More

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Guidance on validation of lethal control measures for foodborne pathogens in foods.

Compr Rev Food Sci Food Saf 2021 May 7;20(3):2825-2881. Epub 2021 May 7.

Laboratory of Food Microbiology, Wageningen University, Wageningen, The Netherlands.

Food manufacturers are required to obtain scientific and technical evidence that a control measure or combination of control measures is capable of reducing a significant hazard to an acceptable level that does not pose a public health risk under normal conditions of distribution and storage. A validation study provides evidence that a control measure is capable of controlling the identified hazard under a worst-case scenario for process and product parameters tested. It also defines the critical parameters that must be controlled, monitored, and verified during processing. Read More

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Biomarkers and Surrogate End points in Multiple Sclerosis Trials: Regulatory Issues.

J Clin Neurophysiol 2021 May;38(3):181-185

Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, Florida, U.S.A.

Summary: Evoked potentials have assisted in the diagnosis of multiple sclerosis for years, but the potential to demonstrate pathophysiologic change has prompted a reconsideration of their potential role as outcome measures in clinical trials of multiple sclerosis. The use of any surrogate end point or biomarker in clinical trials requires a thorough understanding of that end point's performance characteristics and utility in a particular setting. This article explores regulatory issues regarding the use of biomarkers and surrogate end points in clinical trials of multiple sclerosis with particular emphasis on challenges faced by evoked potential studies. Read More

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Determination of tetrabromobisphenol-A/S and their eight derivatives in abiotic (soil/dust) samples using ultra-high performance liquid chromatography-tandem mass spectrometry.

J Chromatogr A 2021 Apr 20;1647:462152. Epub 2021 Apr 20.

State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China; Guangdong-Hong Kong-Macao Joint Laboratory for Environmental Pollution and Control, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, People's Republic of China; CAS Center for Excellence in Deep Earth Science, Guangzhou, 510640, China.

Tetrabromobisphenol-A and Tetrabromobisphenol-S (TBBPA/S) and their derivatives have attracted widespread attention owing to their environmental risks and adverse effects on human health. In this study, we developed an analytical method based on ultra-high performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UPLC-MS/MS) for the simultaneous determination of TBBPA/S and their eight derivatives in soil samples. After ultrasonic extraction, TBBPA/S and their derivatives were purified using an LC-Si cartridge with 1 mL acetone and 30 mL dichloromethane/n-hexane (1/1, v/v) as the eluent. Read More

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Impact of Sarcopenia on Two-Year Mortality in Patients with HCV-Associated Hepatocellular Carcinoma After Radiofrequency Ablation.

J Hepatocell Carcinoma 2021 29;8:313-320. Epub 2021 Apr 29.

Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Purpose: Radiofrequency ablation (RFA) appears effective for the treatment of hepatocellular carcinoma (HCC). Evaluation of prognostic factors is imperative for patient selection and improving treatment efficacy. This study aimed to assess sarcopenia as a predictor of the outcome of RFA in patients with HCC. Read More

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Addition of Nimotuzumab to Standard TPF Regimen in Locally Advanced Head and Neck Cancer: A Single Institutional Study.

J Oncol 2021 16;2021:6641963. Epub 2021 Apr 16.

Department of Medical Oncology, Healthcare Global Enterprises Limited, Bengaluru, Karnataka, India.

Background: Induction docetaxel, cisplatin, and 5-fluorouracil (TPF) chemotherapy followed by definitive concurrent chemoradiation remains the standard of care in locally advanced squamous cell carcinoma of head and neck cancers despite which the survival remains low. So, we analyzed the efficacy and adverse effect profile of the addition of nimotuzumab to standard TPF induction chemotherapy. Methods. Read More

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Early Exposure to High-Sucrose Diet Leads to Deteriorated Ovarian Health.

Front Endocrinol (Lausanne) 2021 19;12:656831. Epub 2021 Apr 19.

Laboratory of Experimental Physiology, Department of Physiological Sciences, Biological and Health Sciences Centre, Federal University of Maranhão, São Luís, Brazil.

Background: The metabolic syndrome (MetS) is correlated with disorders of the reproductive system, such as the polycystic ovary syndrome (PCOS). While consumption of a diet rich in carbohydrates is linked to the development of MetS, it is still unclear if this diet leads to ovarian dysfunction and PCOS.

Objectives: We investigated the influence of a high-sucrose diet (HSD) on the ovarian milieu of Wistar rats and studied the correlation between high consumption of sugary drinks and the prevalence of PCOS in women. Read More

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Predictive Markers of Bronchial Hyperreactivity in a Large Cohort of Young Adults With Cough Variant Asthma.

Front Pharmacol 2021 19;12:630334. Epub 2021 Apr 19.

ASST Spedali Civili di Brescia, Department of Emergency, Brescia, Italy.

Cough variant asthma (CVA), a common asthma phenotype characterized by nonproductive cough and bronchial hyperreactivity (BHR), is usually detected by bronchial provocation tests (BPTs) which are timeconsuming, expensive, and unsafe. The primary study objective was to provide proof of concept for the use of fractional exhaled nitric oxide (FNO), eosinophil count percentage in induced sputum (sEOS%), forced expiratory flow between 25 and 75% of forced vital capacity (FEF) % predicted value, and FEF z-scores as surrogate markers predicting BHR in young adults with suspected CVA; the secondary objective was to compare the diagnostic performance of the various techniques. Three hundred and ten subjects (median age 24 years) were included in a cross-sectional study. Read More

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Advance care planning by proxy in German nursing homes: Descriptive analysis and policy implications.

J Am Geriatr Soc 2021 May 5. Epub 2021 May 5.

Institute of Ethics, History and Theory of Medicine, Ludwig Maximilian University of Munich, Munich, Germany.

Background: Legally recognized advance directives (ADs) have to be signed by the person to whom the decisions apply. In practice, however, there are also ADs written and signed by legal proxies (surrogates) on behalf of patients who lack decision-making capacity. Given their practical relevance and substantial ethical and legal implications, ADs by proxy (AD-Ps) have received surprisingly little scientific attention so far. Read More

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Clinical endpoints in oncology - a primer.

Am J Cancer Res 2021 15;11(4):1121-1131. Epub 2021 Apr 15.

Division of Hematology/Oncology, Georgia Cancer Center, Augusta University GA 30912, Augusta.

Clinical endpoints are essential for assessing the safety and efficacy of new cancer therapies. They are used by oncologists to help guide clinical decision making. While overall survival (OS) has frequently been regarded as the "gold standard" primary clinical endpoint, it's utility is constrained by several disadvantages. Read More

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Pretreatment CT and PET radiomics predicting rectal cancer patients in response to neoadjuvant chemoradiotherapy.

Rep Pract Oncol Radiother 2021 25;26(1):29-34. Epub 2021 Feb 25.

Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, United States.

Background: The purpose of this study was to characterize pre-treatment non-contrast computed tomography (CT) and F-fluorodeoxyglucose positron emission tomography (PET) based radiomics signatures predictive of pathological response and clinical outcomes in rectal cancer patients treated with neoadjuvant chemoradiotherapy (NACR T).

Materials And Methods: An exploratory analysis was performed using pre-treatment non-contrast CT and PET imaging dataset. The association of tumor regression grade (TRG) and neoadjuvant rectal (NAR) score with pre-treatment CT and PET features was assessed using machine learning algorithms. Read More

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February 2021

Doctor when can I drive? Braking response after knee arthroplasty: A systematic review & meta-analysis of brake reaction time.

Knee 2021 May 1;30:214-240. Epub 2021 May 1.

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, United Kingdom. Electronic address:

Background: There is limited evidence available on return to driving for patients undergoing knee arthroplasty (KA). Primarily, surgeons have used brake reaction time as a surrogate measure of safe return to driving. The purpose of this study was to review existing literature and provide guidance on the recovery of braking performance following knee arthroplasty. Read More

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How common is add-on use and how do patients decide whether to use them? A national survey of IVF patients.

Hum Reprod 2021 May 4. Epub 2021 May 4.

Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia.

Study Question: What is the prevalence and pattern of IVF add-on use in Australia?

Summary Answer: Among women having IVF in the last 3 years, 82% had used one or more IVF add-on, most commonly acupuncture, preimplantation genetic testing for aneuploidy and Chinese herbal medicine.

What Is Known Already: IVF add-ons are procedures, techniques or medicines which may be considered nonessential to IVF, but usually used in attempts to improve the probability of conception and live birth. The use of IVF add-ons is believed to be widespread; however, there is little information about the prevalence and patterns of use in different settings. Read More

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Role of endogenous melatonin in pathophysiologic and oxidative stress responses to personal air pollutant exposures in asthmatic children.

Sci Total Environ 2021 Jun 6;773:145709. Epub 2021 Feb 6.

Nicholas School of the Environment, Duke University, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA; Duke Kunshan University, Kunshan, Jiangsu Province, China. Electronic address:

Background: Heightening oxidative stress and inflammation is an important pathophysiological mechanism underlying air pollution health effects in people with asthma. Melatonin can suppress oxidative stress and inflammation in pulmonary and circulatory systems. However, the role of melatonin in the oxidative stress and physiological responses to air pollution exposure has not been examined in children with asthma. Read More

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Right Atrial Strain as a Surrogate Marker for Right Ventricular Function in Patients with Heart Failure.

Authors:
Min Kyung Kang

J Cardiovasc Imaging 2021 Apr;29(2):144-146

Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.

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Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions.

Front Nutr 2021 16;8:661170. Epub 2021 Apr 16.

Health Sciences and Sport, University of Stirling, Stirling, United Kingdom.

This perspective aims to highlight the lack of current knowledge on sarcopenic obesity in Africa and to call for diagnostic methods and appropriate interventions. Sarcopenic obesity has been defined as obesity that occurs in combination with low muscle mass and function, which is typically evident in older adults. However, there has been no clear consensus on population-specific diagnostic criterion, which includes both gold-standard measures that can be used in a more advanced health care system, and surrogate measures that can be used in low-income settings with limited resources and funding. Read More

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Pathological Complete Response in Locally Advanced Breast Cancer after Neoadjuvant Chemotherapy: Survival Outcome and Its Relevance as a Surrogate End Point.

South Asian J Cancer 2020 Jul 14;9(3):136-140. Epub 2020 Dec 14.

Department of Breast and Gynecology Oncology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

 Pathological complete response (pCR) to neoadjuvant chemotherapy has emerged as a reliable surrogate marker for improved survival in breast cancer (BC), but its role as a surrogate end point is still controversial.  The aim of the study is to investigate the clinical course of BC patients with pCR and to evaluate the relevance of pCR as a surrogate end point for survival.  This was a single-institution retrospective analysis done at Amrita Institute of Medical Sciences. Read More

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Small Fibre Neuropathy Is Associated With Impaired Vascular Endothelial Function in Patients With Type 2 Diabetes.

Front Endocrinol (Lausanne) 2021 14;12:653277. Epub 2021 Apr 14.

Diabetes and Vascular Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom.

Diabetic polyneuropathy (DPN) and endothelial dysfunction are prevalent complications of diabetes mellitus. Currently, there are two non-invasive markers for endothelial dysfunction: flow-mediated dilation and reactive hyperaemia peripheral arterial tonometry (RH-PAT). However, the relationship between diabetic small fibre neuropathy and macroangiopathy remains obscure thus far. Read More

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Multifractal Dynamics in Executive Control When Adapting to Concurrent Motor Tasks.

Authors:
Laurent M Arsac

Front Physiol 2021 16;12:662076. Epub 2021 Apr 16.

Université de Bordeaux, CNRS, Laboratoire IMS, UMR 5218, Talence, France.

There is some evidence that an improved understanding of executive control in the human movement system could be gained from explorations based on scale-free, fractal analysis of cyclic motor time series. Such analyses capture non-linear fractal dynamics in temporal fluctuations of motor instances that are believed to reflect how executive control enlist a coordination of multiple interactions across temporal scales between the brain, the body and the task environment, an essential architecture for adaptation. Here by recruiting elite rugby players with high motor skills and submitting them to the execution of rhythmic motor tasks involving legs and arms concurrently, the main attempt was to build on the multifractal formalism of movement control to show a marginal need of effective adaptation in concurrent tasks, and a preserved adaptability despite complexified motor execution. Read More

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The Association of Workload and Outcomes in the Pediatric Cardiac ICU.

Pediatr Crit Care Med 2021 May 3. Epub 2021 May 3.

Division of Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA. Goizueta Business School, Emory University, Atlanta, GA. Children's Healthcare of Atlanta, Emory University, Nell Hodgson School of Nursing, Atlanta, GA.

Objectives: Healthcare workload has emerged as an important metric associated with poor outcomes. To measure workload, studies have used bed occupancy as a surrogate. However, few studies have examined frontline provider (fellows, nurse practitioners, physician assistants) workload and outcomes. Read More

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Effect of Daily Dosage of Morphine Milligram Equivalents on Free Flap Complications: A Single-Institution Retrospective Study.

J Plast Reconstr Aesthet Surg 2021 Apr 8. Epub 2021 Apr 8.

Department of Surgery, Cooper University Hospital, Camden NJ.

Introduction: There appears to be an association between preoperative opioid use and postoperative complications. We sought to determine whether patients with a history of chronic opiate use (defined as 3 months or more of sustained use) prior to undergoing free flap surgery have higher rates of 30-day complications.

Methods: A retrospective review of patients undergoing free flaps from 2015 to 2020 was performed. Read More

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