- Prospective, multi-centric benchmark study assessing delirium: prevalence, incidence and its correlates in hospitalized elderly Lebanese patients. [Journal Article]
- ACAging Clin Exp Res 2019 Jun 15
- CONCLUSIONS: Secondary to the burden of delirium and its impact on mortality among elderly population, trying to understand and adjust modifiable factors would promote more appropriate prevention strategies.
- Opportunities for the prevention of mental disorders by reducing general psychopathology in early childhood. [Journal Article]
- BRBehav Res Ther 2019 May 25; 119:103411
- This paper explores the concept that reducing general psychopathology early in the life course provides unprecedented opportunities to prevent the development of all forms of psychopathology later in…
This paper explores the concept that reducing general psychopathology early in the life course provides unprecedented opportunities to prevent the development of all forms of psychopathology later in life. We review empirical evidence for the existence of the general factor of psychopathology and theories regarding the psychological nature of the factor. We then highlight specific examples of environmental risk factors for general psychopathology and discuss translational implications for the transdiagnostic prevention of psychopathology beginning in early childhood. Ultimately, we propose a developmentally informed and transdiagnostic stepped care approach to intervention in which reduction of general psychopathology in early childhood represents the foundational step for prevention and intervention of subsequent psychopathology. This model heralds three key benefits over the current treatment zeitgeist: (1) Reducing the burden and confusion in healthcare and education systems by providing a coherent and systematic structure for early intervention across a child's development, (2) maximising the breadth of the impact of intervention by focusing on common shared risks across psychopathology, and (3) increasing the efficiency of intervention by corresponding with the development of psychopathology and leveraging the emergence of general psychopathology in early childhood.
- On the realistic contribution of European forests to reach climate objectives. [Editorial]
- CBCarbon Balance Manag 2019 Jun 14; 14(1):8
- A recent article by Luyssaert et al. (Nature 562:259-262, 2018) analyses the climate impact of forest management in the European Union, considering both biogeochemical (i.e., greenhouse gases, GHG) a…
A recent article by Luyssaert et al. (Nature 562:259-262, 2018) analyses the climate impact of forest management in the European Union, considering both biogeochemical (i.e., greenhouse gases, GHG) and biophysical (e.g., albedo, transpiration, etc.) effects. Based on their findings, i.e. that additional net overall climate benefits from forest management would be modest, the authors conclude that the EU "should not rely on forest management to mitigate climate change". We first explain that most of the additional EU GHG mitigation effort by 2030 is expected to come from emission reductions and only a very small part from forestry, even when forest bioenergy is allowed for. Nevertheless, the inclusion of forest management in climate change mitigation strategies is key to identifying the country-specific optimal mix, in terms of overall GHG balance, between strategies focused on conserving and/or enhancing the sink and strategies focused on using more wood to reduce emissions in other GHG sectors. Then, while acknowledging the importance that biophysical effects have on the climate, especially at the local and seasonal scale, we argue that the net annual biophysical climate impact of forest management in Europe remains more uncertain than the net CO2 impact. This has not been adequately emphasized by Luyssaert et al. (2018), leading to conclusions on the net overall climate impact of forest management that we consider premature and applied to a partially biased perception of European policy towards forestry and climate change. To avoid further confusion in the debate on how forestry may contribute to mitigating climate change, a more constructive dialogue between the scientific community and policy makers is needed.
- Cephalosporin-related neurotoxicity: Metabolic encephalopathy or non-convulsive status epilepticus? [Journal Article]
- JCJ Clin Neurosci 2019 Jun 11
- Metabolic encephalopathy and Non-Convulsive Status Epilepticus (NCSE) have been reported with cephalosporin use, particularly cefepime. We aimed to analyze the clinical and EEG findings in patients w…
Metabolic encephalopathy and Non-Convulsive Status Epilepticus (NCSE) have been reported with cephalosporin use, particularly cefepime. We aimed to analyze the clinical and EEG findings in patients with cephalosporin-related neurotoxicity (CRN) at our hospital identified via the hospital EEG database, and to critically review CRN case reports in the literature. A Medline search was performed to identify CRN cases where a representative sample of EEG was provided. EEGs were analyzed using published criteria differentiating NCSE from triphasic waves (TW). Eleven patients at our hospital were identified with CRN (9 cefepime, 2 ceftriaxone): all had an encephalopathy with decreased consciousness and/or confusion. One patient had clinical seizures and 6 had multifocal myoclonus. All patients had abnormal EEGs, all with moderate to severe generalized slowing and 10 also with TW. Recovery was related to cephalosporin withdrawal rather than antiepileptic therapy. Analysis of 37 EEG samples of CRN patients reported in the literature as NCSE (30) or TW (7) revealed that most did not meet criteria for NCSE, with 33 showing TW, 1 showing generalised epileptiform discharges and 3 being uninterpretable. CRN usually produces a toxic encephalopathy rather than NCSE, and is commonly associated with triphasic waves on EEG. In most patients anti-epileptic and/or sedative drugs do not hasten clinical improvement.
- Mandarin Electrolaryngeal Speech Recognition Based on WaveNet-CTC. [Journal Article]
- JSJ Speech Lang Hear Res 2019 Jun 14; :1-10
- Purpose The application of Chinese Mandarin electrolaryngeal (EL) speech for laryngectomees has been limited by its drawbacks such as single fundamental frequency, mechanical sound, and large radiati…
Purpose The application of Chinese Mandarin electrolaryngeal (EL) speech for laryngectomees has been limited by its drawbacks such as single fundamental frequency, mechanical sound, and large radiation noise. To improve the intelligibility of Chinese Mandarin EL speech, a new perspective using the automatic speech recognition (ASR) system was proposed, which can convert EL speech into healthy speech, if combined with text-to-speech. Method An ASR system was designed to recognize EL speech based on a deep learning model WaveNet and the connectionist temporal classification (WaveNet-CTC). This system mainly consists of 3 parts: the acoustic model, the language model, and the decoding model. The acoustic features are extracted during speech preprocessing, and 3,230 utterances of EL speech mixed with 10,000 utterances of healthy speech are used to train the ASR system. Comparative experiment was designed to evaluate the performance of the proposed method. Results The results show that the proposed ASR system has higher stability and generalizability compared with the traditional methods, manifesting superiority in terms of Chinese characters, Chinese words, short sentences, and long sentences. Phoneme confusion occurs more easily in the stop and affricate of EL speech than the healthy speech. However, the highest accuracy of the ASR could reach 83.24% when 3,230 utterances of EL speech were used to train the ASR system. Conclusions This study indicates that EL speech could be recognized effectively by the ASR based on WaveNet-CTC. This proposed method has a higher generalization performance and better stability than the traditional methods. A higher accuracy of the ASR system based on WaveNet-CTC can be obtained, which means that EL speech can be converted into healthy speech. Supplemental Material https://doi.org/10.23641/asha.8250830.
- Assessment of Machine Learning Detection of Environmental Enteropathy and Celiac Disease in Children. [Journal Article]
- JNJAMA Netw Open 2019 Jun 05; 2(6):e195822
- CONCLUSIONS: A machine learning-based histopathological analysis model demonstrating 93.4% classification accuracy was developed for identifying and differentiating between duodenal biopsies from children with EE and CD. The combination of the CNN with a deconvolutional network enabled feature recognition and highlighted secretory cells' role in the model's ability to differentiate between these histologically similar diseases.
- Singapore SPICE: Sedation Practices in Intensive Care Evaluation in Singapore - a prospective cohort study of the public healthcare system. [Journal Article]
- SMSingapore Med J 2019 Jun 14
- CONCLUSIONS: Sedation practices in Singapore ICUs are characterised by light sedation depth and low incidence of delirium. This may be due to the drugs used.
- Factors influencing treatment recommendations for base of 5th metatarsal fractures in orthopaedic residency programs. [Journal Article]
- FAFoot Ankle Surg 2019 May 30
- CONCLUSIONS: Our data demonstrated no significant concordance between resident level in training regarding proximal 5th metatarsal fracture treatment decisions, nor between residents and subspecialty-trained foot and ankle surgeons. Increased rotations with foot and ankle fellowship-trained surgeons throughout residency may be desirable to improve the quality of residency training.
- Multimodal prehabilitation to reduce the incidence of delirium and other adverse events in elderly patients undergoing elective major abdominal surgery: An uncontrolled before-and-after study. [Journal Article]
- PlosPLoS One 2019; 14(6):e0218152
- CONCLUSIONS: Current prehabilitation program is feasible and safe, and can reduce delirium incidence in elderly patients undergoing elective major abdominal surgery. This program merits further evaluation.
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- Clinicopathological features and prognosis of AFP-producing colorectal cancer: a single-center analysis of 20 cases. [Journal Article]
- CMCancer Manag Res 2019; 11:4557-4567
- CONCLUSIONS: AFP-producing CRC has unique clinical and histopathological characteristics, showing an aggressive biological behavior and worse prognosis than traditional CRC.