Occurrence Ratio Research Articles

Revealing the impacts of human activity on the aquatic environment of the Pearl River Estuary, South China, based on sedimentary nutrient records

Elucidating environmental evolution and its influencing factors in estuarine areas is essential to coastal and marine ecological management. In this study, the spatiotemporal distributions of organic carbon (OC), total nitrogen (TN), total phosphorus (including geochemical speciation), δ13C and nutrient ratios in sediments were explored to interpret changes in the aquatic environment of the Pearl River Estuary (PRE), and their sources in various periods were identified. Nutrients carried by surface runoff accumulated abundantly in the sediments of the northern and western shoals. Two dated sediment cores indicated a close relationship between environmental evolution in the PRE and the socioeconomic development of the Pearl River Delta (PRD). Rapid urbanization and population explosion in the PRD transformed the PRE from the pre-1970 low-impact state to a eutrophic state, which lasted until the end of the 1990s. After 2000, improvement of sewage treatment systems and environmental governance policies promoted the restoration of water quality, although inorganic nitrogen remained high in the coastal waters. Based on the threshold of sedimentary TN/OP ratio (5.60) of red-tide occurrence, the eastern shoal of the PRE exhibited high potential for red tides. Agricultural activities along the western coast lowered sedimentary OC/TN ratios (6.51 ± 1.54) near the river's outlets. The sedimentary δ13C of organic matter (OM) in surface and subsurface sediments fell into the range of soil OM (−25.46 ± 0.82‰), suggesting an expanding influence of eroded soil from land reclamation on Longxue Island. This research revealed the intense influence of human activities on the aquatic-environmental evolution and provides scientific basis for environmental restoration of the PRE in the future.

Shoulder stretching versus shoulder muscle strength training for the prevention of baseball-related arm injuries: a randomized, active-controlled, open-label, non-inferiority study

Glenohumeral internal rotation deficit (GIRD) and weakness in prone external rotation are risk factors for shoulder and elbow injuries in high school baseball pitchers. While a shoulder-stretching prevention program to improve GIRD decreases the injury rate, the effects of external rotation strength remain unclear. This non-inferiority (NI) study investigates the hypothesis that external rotation strength training is not inferior to sleeper stretching for shoulder and elbow injury prevention in high school baseball pitchers. Participants were randomly allocated to the stretching (n = 62; active control group) and muscle-training (n = 51) groups. Specific exercises were performed each night. Elbow and shoulder injuries were monitored for 150 days. Kaplan–Meier survival curves were generated, and the hazard ratios (HRs) for injury occurrence were calculated using multivariate Cox regression. The log-rank test was used to compare the injury-free time. A one-sided NI test using a fixed NI margin was performed (significance level, P = 0.025). The injury rates were 22.6% (n = 14) in the stretching group and 9.8% (n = 5) in the muscle-training group. The muscle-training group had a lower injury rate (P < 0.001) and a lower risk of injury than the stretching group (HR = 0.489). Therefore, external rotation muscle strength training is not inferior to stretching for preventing baseball-related arm injuries.

1957. Increased short-term vaccine effectiveness of BNT162b2 with same-arm vs. cross-arm administration of sequential doses

Abstract Background It is unknown whether administering the second BNT162B2 vaccine dose on the cross-arm or the same arm as the first dose creates a more robust local and systemic immune response leading to favorable clinical results. We used data from Israel’s largest healthcare provider (Clalit health services [CHS]) to assess the impact on vaccine effectiveness of contralateral vs. ipsilateral administration of BNT162b2. Methods A retrospective cohort study, conducted on all CHS members who received the BNT162b2 vaccine between December 2020 and December 2021. The primary endpoint was a positive RT-PCR test for SARS-CoV-2 between 10 days and 38 days after the administration of the second dose of bnt162b2. A logistic regression model was used to compare the likelihood of COVID-19 infection at different time intervals following vaccination. Results During the study, 2,678,226 CHS members received both doses of BNT162b and were eligible for analysis. Of these, 2,367,694 (88.41%) received the first two doses of the vaccine on the same arm (ipsilateral). The primary endpoint was observed in 2061 (0.077%) participants. The primary endpoint was observed more frequently in the contralateral vs. the ipsilateral group. The adjusted odds ratio for occurrence of the primary endpoint in the ipsilateral vs. the contralateral group was 0.83 (95% CI 0.73-0.94 P=0.004). Statistically significant reduction in OR was also observed in two of our secondary outcomes – hospitalization due to COVID-19 and all-cause mortality. Conclusion Our study suggests that administration of the first and second BNT162b doses in the same arm, might increase vaccine effectiveness in the short term, possibly due to more robust local lymph node activation. This intervention could have a dramatic effect on public health. Further studies are needed to assess the long-term effectiveness of our findings. Disclosures All Authors: No reported disclosures.

Multiyear ENSO Dynamics as Revealed in Observations, Climate Model Simulations, and the Linear Recharge Oscillator

Abstract El Niño–Southern Oscillation (ENSO) events occasionally recur one after the other in the same polarity, called multiyear ENSO. However, the dynamical processes are not well understood. This study aims to elucidate the unified mechanisms of multiyear ENSO using observations, phase 6 of the Coupled Model Intercomparison Project (CMIP6) models, and the theoretical linear recharge oscillator (RO) model. We found that multiyear El Niño and La Niña events are roughly symmetric except for cases of multiyear La Niña following strong El Niño. The composite multiyear ENSO reveals that anomalous ocean heat content (OHC) in the equatorial Pacific persists beyond the first peak, stimulating another event. This prolonged OHC anomaly is caused by meridional Ekman heat transport counteracting geostrophic transport-induced recharge–discharge process that otherwise acts to change the OHC anomaly. A meridionally wide pattern of sea surface temperature anomalies observed during multiyear ENSO is responsible for the Ekman heat transport and multiple factors such as decadal variability, subtropical processes, and ENSO diversity modulate the ENSO meridional structure. CMIP6 multimodel ensemble shows a significant correlation between the ENSO meridional width and the occurrence ratio of multiyear ENSO, supporting the aforementioned mechanism. A multiyear ENSO-like oscillation was simulated using the linear RO model that incorporates a seasonally varying Bjerknes growth rate and a weak recharge efficiency representing the effect of Ekman transport. When the recharge efficiency parameter was estimated using reanalysis data based on geostrophic transport alone, a multiyear ENSO rarely occurred, confirming the importance of Ekman transport in retarding the recharge–discharge process.

The hourly wind-bias-adjusted precipitation data set from the Environment and Climate Change Canada automated surface observation network (2001–2019)

Abstract. The measurement of precipitation in the Environment and Climate Change Canada (ECCC) surface network is a crucial component for climate and weather monitoring, flood and water resource forecasting, numerical weather prediction, and many other applications that impact the health and safety of Canadians. Through the late 1990s and early 2000s, the ECCC surface network modernization resulted in a shift from manual to automated precipitation measurements. Although many advantages to automation are realized, such as enhanced capabilities for monitoring in remote locations and a higher frequency of observations at lower cost, the increased reliance on automated precipitation gauges has also resulted in additional challenges, especially with data quality and homogenization. The automated weighing precipitation gauges used in the ECCC operational network have an increased propensity for wind-induced undercatch of solid precipitation. One outcome of the World Meteorological Organization (WMO) Solid Precipitation Intercomparison Experiment (SPICE) was the development of transfer functions for the adjustment of high-frequency solid precipitation measurements made with gauge/wind shield configurations used in the ECCC surface network. Using the SPICE universal transfer function (UTF), hourly precipitation measurements from 397 ECCC automated climate stations were retroactively adjusted for wind undercatch. The data format, quality control, and adjustment procedures are described here. The hourly adjusted data set (2001–2019; version v2019UTF) is available via the ECCC data catalogue at https://doi.org/10.18164/6b90d130-4e73-422a-9374-07a2437d7e52 (ECCC, 2021). A basic spatial impact assessment shows that the highest relative total precipitation adjustments occur in the Arctic, where solid precipitation has an overall higher annual occurrence ratio. The highest adjustments for solid precipitation are shared by the Arctic, Southern Prairies, and the coastal Maritimes, where stations tend to be more exposed and snowfall events occur at higher wind speeds.

Decadal variability and trends in extratropical Rossby wave packet amplitude, phase, and phase speed

Abstract. The ongoing global yet spatially inhomogeneous warming prompts the inspection of decadal variability in the extratropical upper-tropospheric circulation properties. This study provides observational evidence in this regard by utilizing reanalysis data to examine the past interannual-to-decadal variability and unveil trends in the probability distribution of Rossby wave packet (RWP) amplitude (E), phase (Φ), and phase speed (cp). First, a comparison between the NE Pacific and N Atlantic regions indicates that the 300 hPa E probability distribution exhibits a seasonally and regionally varying decadal variability. No apparent discrepancy arises between different reanalysis datasets, except from the JJA season where two historical reanalyses systematically underestimate E compared to three modern-era reanalyses. Further exploiting the local-in-space and local-in-time character of the employed diagnostics in ERA5 reveals that, while many areas experience pronounced RWP property variations at interannual and/or decadal timescales, patterns of statistically significant trends in the 1979–2019 period do emerge. Notably, the Northern Hemisphere E field exhibits positive trends in the N Pacific, the NE Atlantic, and S Asia in DJF, whereas negative trends are found in a substantial portion of the extratropics in JJA. In terms of cp, distinct patterns characterize MAM, with positive trends in parts of the N Atlantic and most of Europe and negative trends to the north of these regions and parts of the N Pacific. The Southern Hemisphere features a poleward shift in the band of climatologically maximum E values in DJF, widespread positive E trends in MAM, and positive cp trends in large parts of the extratropics in DJF and MAM. Assessing the decadal variability of RWP phase reveals zonally extended patterns of alternating trends in the trough–ridge occurrence ratio for MAM in the Northern Hemisphere and JJA in both hemispheres. Furthermore, no covariance is observed between area-averaged daily-mean E and cp at decadal timescales, as revealed by the bivariate probability distribution trends in the E–cp domains for the different regions and seasons. Finally, it is shown that many parts of the N Pacific and N America experience a shift to increasing occurrence of large-amplitude and/or quasi-stationary RWPs in DJF during 1999–2019, which is a manifestation of the pronounced interannual-to-decadal variability that characterizes the E and cp seasonal distributions in some areas and seasons. Overall, this study underscores that substantial seasonal and regional variations characterize the past decadal variability and trends that emerge in the seasonal probability distributions of key RWP properties.

Comparative Effectiveness of Fostamatinib Vs. Rituximab in Refractory Chronic Immune Thrombocytopenia: A Network Meta-Analysis

Introduction Immune thrombocytopenia (ITP) is an autoimmune condition characterised by platelet destruction and insufficient platelet production. The American Society of Hematology ITP guidelines recommend rituximab, splenectomy, and thrombopoietin receptor agonists (TPO-RAs) as primary treatment options in patients with chronic ITP (Neunert C, et al. 2019). Fostamatinib, a spleen tyrosine kinase inhibitor, is approved for the treatment of chronic ITP in patients who have had an insufficient response to a previous treatment (FDA 2018, EMA 2020). Recent real-world evidence suggests that fostamatinib is used after a previous TPO-RA line (Hughes DM, et al. 2021). The objective of this network meta-analysis (NMA) was to estimate the relative efficacy of fostamatinib compared with current standard treatments after TPO-RAs in patients with refractory chronic ITP for overall platelet response. Methods A systematic literature review was conducted in 2019 and updated in July 2021. Six identified studies informed the NMA, including 2 placebo-controlled trials of fostamatinib (Bussel J, et al. 2018), 2 placebo-controlled trials of rituximab (Arnold DM, et al. 2012, Ghanima W, et al. 2015), 1 randomised trial of 3 rituximab regimens (Zwaginga JJ, et al. 2015) and 1 non-randomised study of 2 rituximab regimens (Zaja F, et al. 2012) (Figure 1). No studies assessing additional comparators of interest were found that could inform the NMA. The outcome of interest was overall platelet response, however definitions varied across studies in terms of platelet count thresholds and assessment time points, and several analyses were therefore performed to investigate sensitivity in variation in outcome definition. Analysis 1 used the published definitions for each study. Analysis 2 used an alternative standardised definition (platelet count >30,000/µL by week 4) for the fostamatinib trials, and the published definitions for each of the remaining studies. Analysis 3 used the alternative standardised definition for all studies and was restricted to those with results available: Bussel 2018 and Ghanima 2015. Possible treatment effect modifiers were evaluated by 8 British haematologists via a Delphi panel. None were identified and it was assumed that the differing baseline characteristics between studies did not have a significant impact on the outcome of interest. Random-effect models were employed in the analyses. The Odds Ratio (OR) for outcome occurrence of each treatment compared to fostamatinib together with the 95% credible intervals (CrI), 95% prediction intervals (PrI), median rank and probability of being the best treatment were estimated and are displayed in forest plots for each analysis. ORs<1 indicate reduced response relative to fostamatinib. All analyses were performed following the guidance of the National Institute for Health and Care Excellence Decision Support Unit and were implemented with WinBUGS and R. Results In analysis 1, pairwise comparisons indicated that fostamatinib was statistically significantly more effective than placebo and all rituximab regimens with ORs for comparators vs. fostamatinib ranging from 0.11 to 0.20 (Figure 2A). In analysis 2, fostamatinib was associated with improved response vs. placebo and all rituximab regimens (OR range 0.14 - 0.25) but statistical significance was only reached vs. placebo and rituximab 4 x 100 mg/week (Figure 2B). In analysis 3, pairwise comparisons suggested increased efficacy of fostamatinib relative to placebo and rituximab 4 x 375 mg/m2/week with ORs of 0.25 and 0.34, respectively. However, OR was only statistically significant vs. placebo (Figure 2C). The probability of fostamatinib being the most effective treatment ranged 0.91 - 0.97 across analyses; median rank for fostamatinib was 1 in all analyses (Figure 2). The between study standard deviations indicated moderate heterogeneity in treatment effects between studies. Conclusions The results from all analyses indicate that fostamatinib was associated with improved overall platelet response relative to rituximab at all regimens evaluated (4 x 375 mg/m2/week, 2/4 x 375 mg/m2/week, 2 x 750 mg/m2/week, 4 x 100 mg/week), and placebo. The use of rituximab offered no additional benefit with regards to achieving a platelet response than being on placebo. Fostamatinib may be a better alternative than rituximab to increase platelet counts in patients with refractory chronic ITP. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Is electronic cigarette use a risk factor for stroke? A systematic review and meta-analysis.

Stroke, as a common cerebrovascular disease, has a high mortality and disability rate. Although many studies have reported that using e-cigarettes was associated with occurrence of stroke, some studies have concluded that e-cigarettes may help smokers stop using combustible cigarettes and reduce the risk of stroke. Therefore, we aimed to validate the hypothesis that e-cigarette use might be an independent risk factor for stroke occurrence by performing a systematic review and meta-analysis of clinical epidemiology studies. The pooled effect was calculated by the random effects model. I2 was used to test for heterogeneity. Sensitivity analysis was performed to evaluate the stability of the overall results. Funnel plot symmetry or Egger's regression was used to evaluate publication bias. All p values were two-sided with significance level at 0.05. Six cross-sectional studies with high quality were finally included in the meta-analysis, which included a total of 1134896 participants. Analysis with random effects model showed that the total pooled odds ratio (OR) of stroke occurrence in e-cigarette users was 1.25 (95% CI: 1.01-1.55) (I2=96.6%, p<0.001). A stable result was revealed by sensitivity analysis. There was no publication bias. Due to high heterogeneity, we performed subgroup analysis. Compared to neither e-cigarette nor combustible cigarette users, pooled OR of stroke occurrence in e-cigarette only users was 1.13 (95% CI: 0.99-1.29) (I2=45.9%, p=0.116). Compared to combustible cigarette only users, pooled OR of stroke occurrence in both of e-cigarette and combustible cigarette users was 1.39 (95% CI: 1.19-1.64) (I2=5.6%, p=0.303). In addition, pooled OR in currently e-cigarette only users who were formerly combustible cigarette only users was 1.59 (95% CI: 1.22-2.07) (I2=0.0%, p=0.989). The role of e-cigarette use in the development of stroke is inconclusive, due to the strong effect of prior tobacco use as a risk factor for stroke in the included studies.

Evaluation of Aerosol Typing with Combination of Remote Sensing Techniques with In Situ Data during the PANACEA Campaigns in Thessaloniki Station, Greece

Two measurement campaigns were conducted at Thessaloniki, an urban station, (40.5°N, 22.9°E; 60 m) in the frame of the PANhellenic infrastructure for Atmospheric Composition and climatEchAnge (PANACEA) project. The first one covers the period from July to August 2019 and the second one from January to February An overview of the aerosol optical properties (columnar and height resolved), acquired with the remote sensing infrastructure of the Laboratory of Atmospheric Physics (LAP) of the Aristotle University of Thessaloniki (AUTH), as well as the additional instrumentation that participated during the PANACEA campaigns is presented. The majority of the detected layers (16 out of 40, ranged between 0.8 and 4.5 km) are classified as biomass burning aerosols, attributed to either city sources or long range transport. Concerning the other aerosol types, the Clean Continental cluster has an occurrence ratio of 23%, while dust layers and mixtures with urban particles transported to Thessaloniki are also identified. Our findings are discussed along with the surface information, i.e., the particulate matter (PM2.5 and PM10) concentrations and the black carbon (BC) concentration, separated into fossil fuel (BCff) and biomass/wood burning (BCwb) fractions. This is the first time that collocated in situ and remote sensing instruments are deployed in Thessaloniki in order to assess the presence of aerosols and the predominant aerosol type both in situ and at elevated heights. Overall, our study showed that the BCwb contribution to the BC values in Thessaloniki is quite low (11%), whilst the majority of the biomass burning layers identified with the lidar system, are also linked with enhanced BC contribution and high Fine Mode Fraction values.

Sources and Biogeochemical Processes of Nitrate in the Laolongdong Karst Underground River Basin, Chongqing

Samples of sewage, well water, and underground river water of the urbanized Laolongdong karst underground river basin in Chongqing, China were collected during July 2019 and October 2020 and measured to determine the nitrate origin and biogeochemical processes based on geochemistry and dual nitrate isotope (δ15N-NO3- and δ18O-NO3-) data. The results showed that:① the isotopic nitrate compositions of sewage ranged from -3.3‰ to 14.6‰ for δ15N-NO3- and from -5.2‰ to 20.6‰ for δ18O-NO3-, which indicated that nitrate originated from manure and sewage, fertilizer, and soil organic nitrogen. The δ15N-NO3- and δ18O-NO3- of well water varied from 3.1‰ to 12.6‰ and 2.9‰ to 8.9‰, respectively, suggesting nitrate was mainly from soil organic nitrogen and manure and sewage. For the underground river water, the δ15N-NO3- and δ18O-NO3- ranged from 5.6‰ to 28.6‰ and from -2.0‰ to 15.7‰, respectively, suggesting that municipal sewage and manure were the dominate nitrate sources. ② Based on the MixSIAR model, manure and sewage were the primary nitrate source of the underground river water, accounting for 89.1% of the total contribution, whereas the contributions of soil organic nitrogen, fertilizer, and atmospheric precipitation were 4.4%, 3.4%, and 3.1%, respectively. ③ In the basin, the concentration ratios of COD:ρ(NO3-) from low to high were as follows:well water (0.14-5.15), underground river water (0.50-9.36), and sewage (4.08-89.50). Only 50% of well water samples with COD:ρ(NO3-) were slightly higher than 0.65, which is the minimum stoichiometric ratio for denitrification occurrence. This indicated that there were insufficient COD concentrations to support that denitrification occurred in the well water. This was further verified by no significant enrichment of nitrogen and oxygen isotopes. As much as 90% of underground river water samples had a COD:ρ(NO3-) higher than 0.65, and the dual nitrate isotopes were simultaneously enriched with a δ15N:δ18O of 1.8, which is within the ratios ranging from 1.3 to 2.1, indicating that denitrification occurred. The COD:ρ(NO3-) for all wastewater samples was much higher than 0.65, of which 25% were higher than the stoichiometric ratio (29.34) for the occurrence of dissimilation reduction nitrate to ammonium (DNRA). The δ15N-NO3- and ρ(NH4+):ρ(NO3-) of sewage increased simultaneously, indicating that DNRA may have occurred in the sewage.

Association of Higher Rates of Type 2 Diabetes (T2DM) Complications with Psychological and Demographic Variables: Results of a Cross-Sectional Study.

The aim of this study was to assess the relationship between the occurrence and number of T2DM complications with sociodemographic (age, sex, habitation, education), clinical (duration of diabetes, HbA1c (%), BMI) and psychological (well-being, sense of influence on the diabetes course, coping styles) variables. A total of 2574 adult patients were assessed using The Sense of Influence on the Diabetes Course Scale, WHO-5 Well-Being Index, and the Brief Method of Evaluating Coping with Disease. Hierarchical Regression Analysis was conducted with number of complications as the dependent variable and three sets of variables entered in sequential steps: (a) sociodemographic; (b) clinical and (c) psychological factors. Logistic regression analysis was used to examine the association of these variables with diabetes complications' occurrence. A higher number of complications and higher odds ratios of occurrence of complications were associated with sociodemographic and clinical variables, poor well-being, low perception of influence on the diabetes course, and an emotion-oriented coping style. The logistic regression indicated that participants with HbA1c >7% (in comparison with HbA1c ≤ 7%) and with high risk of depression (in comparison with no risk of depression) had respectively 68% and 86% higher odds of developing complications. The number of complications has weak but statistically significant relations with psychological and clinical factors. The results support the rationale of including the psychosocial factors in the context of diabetes management.

PNEUMOCYSTIS JIROVECI-ASSOCIATED PNEUMOMEDIASTINUM AND PNEUMOPERICARDIUM: A SYSTEMATIC REVIEW OF THE PUBLISHED CASE REPORTS

PNEUMOCYSTIS JIROVECI-ASSOCIATED PNEUMOMEDIASTINUM AND PNEUMOPERICARDIUM: A SYSTEMATIC REVIEW OF THE PUBLISHED CASE REPORTS

Phonological Error Patterns in Subgroups of Speech Sound Disorders

Objectives: The purpose of this study was to investigate phonological error patterns from multisyllable words in subgroups of speech sound disorders (SSDs) classified by linguistic symptomatology, and to examine whether underlying deficits of each subgroup of SSDs could be identified through phonological error patterns. Methods: The 2-5-syllable words, which a total of 120 children with SSDs from 3 years to 9 years 11 months produced, were analyzed; and phonological error patterns were determined. Phonological error patterns were categorized into whole word error patterns, segmental (consonants and vowels), and distortion error patterns, as well as into developmental and non-developmental error patterns. Statistical analyses were performed to determine whether the subgroups of SSDs show differences in the occurrence ratio of each category. Results: Children with articulation disorders showed a relatively higher ratio of distortions compared to children of other subgroups, which confirms that articulation disorders are related to deficits in motoric level. Children with inconsistent phonological disorders were characterized with higher ratio of whole word error patterns, which may indicate their sequencing difficulties. Children with consistent or inconsistent phonological disorders showed a higher ratio of non-developmental error patterns which may reflect their weakness in phonological representations. Conclusion: This study supported the position that phonological error pattern analysis could allow us to know the underlying deficits which children with SSDs show in speech processing levels and ultimately to understand subgroups of SSDs.

Nonnus niger (Brullé, 1846) (Hymenoptera: Ichneumonidae: Nesomesochorinae) en el este de Uruguay: nuevos registros y comentarios sobre su fenología

The genus Nonnus Cresson, 1874 (Hymenoptera: Ichneumonidae: Nesomesochorinae) contains 20 species distributed in the New World and so far, no species of this genus has been recorded for Uruguay. Thus, the objective of this work was to investigate the occurrence, abundance and sex ratio of Nonnus niger (Brullé, 1846) in three different phytophysiognomies in eastern Uruguay.

Effect of Remdesivir Administration on Occurrence of Major Adverse Cardiac Events in Critically Ill COVID-19 Pneumonia: A Retrospective Observational Study.

ABSTRACTBackground and objectivesMajor adverse cardiac events (MACE) are frequent in coronavirus disease-2019 (COVID-19). Remdesivir is used worldwide for treatment in COVID-19. In this retrospective observational study, our primary objective was to assess the impact of remdesivir administration on the incidence of MACE and associated 28 day survival in critically ill patients admitted for moderate to severe COVID-19 pneumonia.Patients and methodsWe analyzed the data of 437 patients admitted in intensive care unit (ICU) and divided them into two groups: R group (received remdesivir at ICU admission) and NR group (nonremdesivir) or based on the occurrence of MACE in ICU. We followed the data until discharge, death, or 28 days postadmission. Our primary objective was to investigate the log-odds of survival with remdesivir administration and a correlation/regression analysis of MACE with remdesivir administration in all included patients.ResultsThe incidence of MACE was 72 among 437 patients, with 17 (9.3%) patients in R group vs 55 (21.8%) in NR group (p <0.001). On performing correlation analysis between MACE and remdesivir administration, significant correlation coefficient of −0.168 (p = 0.004) was obtained. On regression analysis, the odds ratio for occurrence of MACE with remdesivir administration was 0.362 (regression coefficient: −1.014, p <0.001). It indicates a 64% decrease in the log-odds of MACE and a 16% increase in the log-odds of survival with remdesivir administration. All 72 patients with MACE had expired, suggesting a high mortality risk with cardiac complications. The odds ratio for mortality due to MACE with remdesivir administration was 0.216 (regression coefficient: −1.530, p −<0.001). It indicates a 79% decrease in the log-odds of death due to MACE with remdesivir administration.ConclusionOur study showed significant reduction in MACE and mortality benefit in patients who received remdesivir in comparison to standard treatment.How to cite this articlePanda R, Singh P, Jain G, Saigal S, Karna ST, Anand A, et al. Effect of Remdesivir Administration on Occurrence of Major Adverse Cardiac Events in Critically Ill COVID-19 Pneumonia: A Retrospective Observational Study. Indian J Crit Care Med 2022;26(9):993–999.

Prevention of Lower Extremity Musculoskeletal Injuries in Tactical and First Responder Populations: A Systematic Review and Meta-Analysis of Randomized Trials From 1955 to 2020.

Sinnott, AM, Krajewski, KT, LaGoy, AD, Beckner, ME, Proessl, F, Canino, MC, Nindl, BC, Turner, RL, Lovalekar, MT, Connaboy, C, and Flanagan, SD. Prevention of lower extremity musculoskeletal injuries in tactical and first responder populations: A systematic review and meta-analysis of randomized trials from 1955 to 2020. J Strength Cond Res 37(1): 239-252, 2023-Lower extremity musculoskeletal injuries (LEMSIs) impose a significant burden on tactical and first responder populations. To determine the effectiveness of LEMSI prevention strategies, we performed a systematic review and meta-analysis of randomized controlled trials published in English from 1955 to 2020 (PROSPERO: CRD42018081799). MEDLINE, EMBASE, Cochrane, CINAHL, ProQuest, and DTIC databases were searched for trials that assigned military service members, police, firefighters, or paramedics to LEMSI prevention interventions with a minimum surveillance period of 12 weeks. Evidence was synthesized as odds ratios (OR) for LEMSI occurrence between individuals assigned to interventions and those assigned to standard activities. Risk of bias was assessed with the Cochrane Risk of Bias tool 2.0. Random-effects meta-analyses were conducted for (a) physical training and (b) footwear modifications to reduce LEMSI and (c) footwear modifications to reduce stress fractures specifically. Certainty in the body of evidence was determined with the GRADE approach. Of 28,499 records, 18 trials comprised of more than 11,000 subjects were synthesized. Interventions included physical training (8, N = 6,838), footwear modifications (8, N = 3,792), nutritional supplementation (1, N = 324), and training modifications (1, N = 350). Overall risk of bias was generally moderate ( N = 7 of 18) or high ( N = 9 of 18). Physical training (OR = 0.87, 95% CI [0.71, 1.08], p = 0.22, I 2 = 58.4%) and footwear modification (OR = 1.13, 95% CI [0.85, 1.49], p = 0.42, I 2 = 0.0%) did not reduce LEMSI or stress fractures (OR = 0.76, 95% CI [0.45, 1.28], p = 0.30, I 2 = 70.7%). Our results indicate that there is weak evidence to support current LEMSI prevention strategies. Future efforts will benefit from longer surveillance periods, assessment of women and nonmilitary populations, improved methodological rigor, and a greater breadth of approaches.

Epileptic Seizure Classification and Prediction Model Using Fuzzy Logic-Based Augmented Learning

Epileptic Seizure (ES) is an abnormality associated with discharging of continues electric impulses from the instance of normal activity. The period and time interval of occurrence is a challenging task to record and validate. In this article, a focus is made to classify and predict the occurrence ratio of seizer based on augmented learning and fuzzy rules. The Epileptic Seizure datasets are acquired from pre-trained and validated approaches further re-trained using interdependent attributes based on augmented learning and training approach. The outcome of training is further used by fuzzy rules to classify and categorize the Epileptic Seizure based on occurrences series of patterns and time. The proposed technique is a hybrid approach and novel as segmented based learning is used to predict the seizer. The technique has recorded 92.23% accuracy in seizure classification and 89.91% in reliable prediction.

Impact of long lasting insecticidal nets on asymptomatic malaria during pregnancy, in a rural and urban setting in Cameroon

According to the world malaria report more malaria cases were reported in 2020 than in 2019, due to disruptions in the distribution of insecticide treated nets, caused by the COVID-19 pandemic. Consequently a projected 34.32% (11.6 million out of 33.8 million) pregnancies were exposed to malaria in the WHO African Region in 2020. This study was therefore designed to assess the impact of long lasting insecticidal nets (LLINs) on asymptomatic malaria in the pregnant women attending the Foumbot District Hospital (rural setting) and the Bamenda Regional Hospital (urban setting). This was a hospital based cross-sectional study done within three months from February to April 2021. A structured questionnaire and the CareStart™ Pf Malaria HRP2 qualitative rapid diagnostic test were used for data collection. Data were analysed using descriptive statistics, and Chi-square test. The relative risk, attributable risk, odds ratio, and likelihood ratio of malaria occurrence in exposed patients were determined by Chi-square (and Fisher's exact) test. The prevalence of asymptomatic malaria was 10.14% (63/621), with a higher prevalence among the pregnant women in the rural setting (12.21%; 37/303), than the urban setting (8.18%; 26/318). As indicated by the attributable risk, 21% of malaria incidence was attributed to absence of LLINs distribution in neighborhoods of the rural setting meanwhile 10% of malaria incidence is attributed to absence of LLINs distribution in neighborhoods of the urban setting. Regular screening for asymptomatic malaria in pregnancy and consistent free distribution of LLINs are recommended in endemic areas, especially in the rural settings.

풍기지역 6년근 홍삼의 등급별 외⋅내부 및 화학적 품질 비교

The purpose of this study was to analyze the correlation between the external, internal and chemical quality characteristics of 6-year-old red ginseng produced in punggi area. Red ginseng samples are graded as cheon (1st grade), ji (2nd grade), yang (3rd grade), gi (out of grade) by trained inspectors. External characteristics of red ginseng depend on weight, volume, density, length and color. Internal characteristics were expressed by length and occurrence ratio of inner white and inner cavity. Chemical characteristics were evaluated by crude saponin, ginsenoside (Rg1, Rb1, Rc), total sugar, acidic polysaccharide, and 50% ethanol extracts contents. Overall, this study showed that quality of external and internal characteristics was matched with grade, but chemical quality was not matched.

Association of low-dose glucocorticoid use and infection occurrence in systemic lupus erythematosus patients: a prospective cohort study

BackgroundInfection is a major cause of mortality in patients with systemic lupus erythematosus (SLE). Therefore, minimizing the risk of infection is an important clinical goal to improve the long-term prognosis of SLE patients. Treatment with ≥7.5 mg prednisolone (PSL) or equivalent has been reported to increase the risk of infections. However, it remains unclear whether <7.5 mg PSL or equivalent dose affects the risk of infection in SLE patients. This study evaluated the association between the occurrence of infection in patients with SLE and low-dose glucocorticoid (GC) usage, especially <7.5 mg PSL or equivalent, to explore the GC dose that could reduce infection occurrence.MethodsThis prospective cohort study included patients from the Japanese multicenter registry of patients with SLE (defined as ≥4 American College of Rheumatology 1997 revised criteria) over 20 years of age. The PSL dose was categorized as PSL 0–2.5, 2.6–5.0, 5.1–7.5, and 7.6–15.0 mg. The primary outcome was infection requiring hospitalization. We conducted a multivariable analysis using time-dependent Cox regression analysis to assess the hazard ratio of infection occurrence compared with a dose of 0–2.5 mg PSL or equivalent in the other three PSL dose groups. Based on previous reports and clinical importance, the covariates selected were age, sex, and concurrent use of immunosuppressants with GC. In addition, two sensitivity analyses were conducted.ResultsThe mean age of the 509 SLE patients was 46.7 years; 89.0% were female, and 77.2% used multiple immunosuppressants concomitantly. During the observation period, 52 infections requiring hospitalization occurred. The incidence of infection with a PSL dose of 5.0–7.5 mg was significantly higher than that in the PSL 0–2.5 mg group (adjusted hazard ratio: 6.80, 95% confidence interval: 2.17–21.27). The results of the two sensitivity analyses were similar.ConclusionsOur results suggested that the use of 5.0–7.5 mg PSL or equivalent could pose an infection risk in SLE patients. This finding indicates that PSL dose should be reduced to as low as possible in SLE patients to avoid infection.