Category: Nevin Manimala

J Pediatr Orthop. 2023 Jul 20. doi: 10.1097/BPO.0000000000002471. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric physeal ankle fractures carry a high risk of complications. This study aimed to (1) investigate the effect of anatomic reduction of the physis on mid to long-term functional outcomes in Salter-Harris type II and triplane distal tibial physeal fractures (DTPFs) and (2) compare the outcomes of 3 different surgical techniques applied in these fractures.

METHODS: The database of a single level-I trauma center was retrospectively reviewed for DTPFs between 2012 and 2022. A total of 39 eligible patients with operative Salter-Harris type II and triplane fractures between 2012 and 2022 were included. Surgical treatment methods were closed reduction-percutaneous fixation (CR-PF), open reduction-screw fixation, or open reduction-plate fixation. Patients were further divided into subgroups for fractures reduced anatomically (<1 mm) or nonanatomically (1 to 3 mm). The primary outcome measures were the American Orthopaedic Foot and Ankle Society Score, ankle range of motion, presence of premature physeal closure and angular deformities, and Takakura ankle osteoarthritis grade.

RESULTS: A total of 39 patients were included, with an average age of 12.9 ± 2.2 years. The mean follow-up time was 68.9±38.0 months. The CR-PF group had higher postoperative fracture displacement (P = 0.011). American Orthopaedic Foot and Ankle Society scores were excellent in all groups, statistically similar between surgical techniques, and similar between anatomic and nonanatomic reduction groups. The CR-PF group (P =0.030) and nonanatomic reduction (P = 0.030) provided a significantly lower ankle osteoarthritis rate. All 4 patients with premature physeal closure were observed in patients treated with open techniques.

CONCLUSIONS: CR-PF for the treatment of DTPFs should be preferred in suitable cases as it is less invasive and provides satisfactory mid to long-term functional outcomes without increasing complications compared with anatomic reduction and open techniques.

LEVEL OF EVIDENCE: Level III.

PMID:37470086 | DOI:10.1097/BPO.0000000000002471

BJOG. 2023 Jul 20. doi: 10.1111/1471-0528.17581. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore potential reasons for differences in preterm neonatal mortality in neonatal intensive care units (NICUs) in India and Pakistan.

DESIGN: A prospective observational study, the Project to Understand and Research Stillbirth and Preterms in Southeast Asia (PURPOSe) was conducted July 2018 to February 2020.

SETTING: Three hospitals in Davangere, India, and a large public hospital in Karachi, Pakistan.

POPULATION: Of a total of 3,202 preterm infants enrolled, 1,512 were admitted to a study NICU.

METHODS: We collected data for neonates, including length of stay, diagnoses, and diagnostic tests.

MAIN OUTCOME MEASURES: Neonatal mortality, tests performed, diagnoses ascertained.

RESULTS: For infants of equivalent weights and gestational ages, neonatal mortality in Pakistan was twice that in the Indian NICU. The mean newborn length of stay in Pakistan was 2 days compared with 10 days for India. Fewer diagnostics and other investigations were used to determine neonatal condition or guide treatment in the Pakistani NICU. Because of limited information from testing in Pakistan concerning clinical respiratory distress, respiratory distress syndrome appeared to be over-diagnosed, whereas other conditions including pneumonia, sepsis, necrotising entercolitis and intraventricular haemorrhage were rarely diagnosed.

CONCLUSION: In the Pakistani site, the limited resources available to the NICU appeared related to a shorter length of stay and decreased diagnostic testing, likely explaining the higher mortality. With improved care, reduction in mortality among preterm neonates should be achievable.

PMID:37470084 | DOI:10.1111/1471-0528.17581

Front Allergy. 2023 Jul 4;4:1126012. doi: 10.3389/falgy.2023.1126012. eCollection 2023.

ABSTRACT

INTRODUCTION: Immunophenotyping, which is the identification of immune cell subsets based on antigen expression, is an integral technique used to determine changes of cell composition and activation in various disease states or as a response to different stimuli. As nanoparticles are increasingly utilized for diagnostic and therapeutic applications, it is important to develop methodology that allows for the evaluation of their immunological impact. Therefore, the development of techniques such as immunophenotyping are desirable. Currently, the most common technique used to perform immunophenotyping is multicolor flow cytometry.

METHODS: We developed two distinct multicolor flow cytometry immunophenotyping panels which allow for the evaluation of the effects of nanoparticles on the composition and activation status of treated human peripheral blood mononuclear cells. These two panels assess the presence of various lymphoid and myeloid-derived cell populations as well as aspects of their activation statuses-including proliferation, adhesion, co-stimulation/presentation, and early activation-after treatment with controls or nanoparticles. To conduct assay performance qualification and determine the applicability of this method to preclinical characterization of nanoparticles, we used clinical-grade nanoformulations (AmBisome, Doxil and Feraheme) and research-grade PAMAM dendrimers of different sizes (G3, G4 and G5) and surface functionalities (amine-, carboxy- and hydroxy-).

RESULTS AND DISCUSSION: We found that formulations possessing intrinsic fluorescent properties (e.g., Doxil and AmBisome) interfere with accurate immunophenotyping; such interference may be partially overcome by dilution. In the absence of interference (e.g., in the case of dendrimers), nanoparticle size and surface functionalities determine their effects on the cells with large amine-terminated dendrimers being the most reactive.

PMID:37470031 | PMC:PMC10353541 | DOI:10.3389/falgy.2023.1126012

Ecol Evol. 2023 Jul 17;13(7):e10298. doi: 10.1002/ece3.10298. eCollection 2023 Jul.

ABSTRACT

Most marine invertebrate larvae either obligately feed or depend on maternally provided reserves during planktonic development. A small number of species have the capacity to do both, in a mode of development known as facultative planktotrophy. We describe facultative feeding in a larva from the Oregon coast, and identify it as being an undescribed species in the genus Amphiodia, which we refer to as Amphiodia sp. opaque. We quantified the effects of food on larval and juvenile quality by culturing larvae, collected as embryos, with and without microalgal food at 15°C. The resulting juveniles were monitored under conditions of starvation. A cohort of juveniles of larvae caught as plankton was subjected to the same starvation treatment for comparison with our laboratory-reared larvae. We observed benefits to offspring that received food: larvae provided with microalgae developed more quickly and metamorphosed at higher rates. Furthermore, juveniles resulting from fed larvae were larger and were able to avoid starvation for longer after metamorphosis. Our results varied across two experimental years, suggesting that provisions provided by parents vary between populations and years. Juveniles from planktonic larvae exhibited sizes not statistically different from larvae cultured in the absence of food, but died from starvation more quickly.

PMID:37470028 | PMC:PMC10352130 | DOI:10.1002/ece3.10298

J Nutr Metab. 2023 Jul 11;2023:9998499. doi: 10.1155/2023/9998499. eCollection 2023.

ABSTRACT

BACKGROUND: The microwave body remodeling system is indicated for people who want to improve their physical appearance as it can penetrate deep tissues, causing thermic stress on adipocytes to produce adipolysis while in superficial tissues, it dissolves fibrous tracts and stimulates new collagen.

OBJECTIVES: The aim of this study was to assess the localized adiposity reduction in Latin American patients using a microwave system.

METHODS: A total of 35 patients with a mean age of 47.5 (±9.0) years received body remodeling treatment, using the microwave system between the years 2019-2022 in a Bogota, Colombia reference center. Data descriptive analysis was made as well as single-factor repeated measures ANOVA to show pre- and post-treatment difference, and mixed ANOVA for body mass index (BMI) subgroup analysis was performed.

RESULTS: In all patients examined, statistical significant differences were found in pre- and post-treatment skinfold test for each body area: superior abdomen (F(1,27) = 63.13; p=0.001), iliac crest (F(1, 23) = 114.33; p < 0.001), posterior waist (F(1, 20) = 27.36; p < 0.001), trochanter (F(1, 17) = 26.94; p < 0.001), among others.

CONCLUSIONS: According to the study’s findings, this microwave system is an innovative and effective technique for body remodeling and cellulite and localized fat reduction.

PMID:37469997 | PMC:PMC10353896 | DOI:10.1155/2023/9998499

Belitung Nurs J. 2021 Apr 29;7(2):98-106. doi: 10.33546/bnj.1322. eCollection 2021.

ABSTRACT

BACKGROUND: The condition of the Indonesians’ unpreparedness for the COVID-19 pandemic has caused anxiety and fear. The public’s fears of COVID-19 cases have led to a negative stigma. As part of health workers in disaster management’s main pillars in health services, nurses are most vulnerable to infection and not free from the stigma.

OBJECTIVE: This study aimed to describe the social stigma against nurses taking care of patients with COVID-19 and experiencing suspected or probable or confirmed COVID-19 cases in Indonesia.

METHODS: This study was a mixed-method study using a sequential explanatory design-participant selection model. The selection of respondents used the convenience sampling technique. The number of respondents in the quantitative stage was 118 respondents. For qualitative data, selected participants were respondents with a stigma score of more than 21 nurses and willing to continue the interview process. There were 11 participants in the qualitative stage. This study used the modified Stigma Scale of the Explanatory Model Interview Catalog for quantitative data and four semi-structured questions to obtain qualitative data. Quantitative data were processed in descriptive statistics, and a thematic analysis was performed to analyze the qualitative data.

RESULTS: The highest stigma score of 118 respondents was 37, and the lowest score was zero. The stigma score had a mean of 12.28 (SD ± 7.9). The higher the score obtained leads to a higher level of stigma received. From a total of 11 participants interviewed, four main themes emerged: rejection, feeling down and afraid, sources of support, and professional vigilance.

CONCLUSION: The social stigma experienced by nurses comes from colleagues and society and impacts psychological distress. Support from families and colleagues strengthens nurses in facing social stigma. Nevertheless, nurses uphold the values to remain grateful and carry out professional responsibilities in taking care of patients. Nurses should be provided with psychological support and be prepared for disasters to provide excellent health services and reduce adverse mental health.

PMID:37469947 | PMC:PMC10353578 | DOI:10.33546/bnj.1322

Belitung Nurs J. 2021 Apr 29;7(2):88-97. doi: 10.33546/bnj.1298. eCollection 2021.

ABSTRACT

BACKGROUND: Diabetes risk assessment is an essential preboarding tool before implementing health literacy programs to change an adult’s health behavior positively. Research has shown an association between health literacy and health behaviors, but there is a dearth of literature that delineates the difference between the health literacy and health behaviors of adults according to their diabetes risks; high risk vs. low risk.

OBJECTIVE: This study aimed to determine the difference between the health literacy and health behaviors of adults and establish the relationship between the two variables when classified according to their diabetes risks.

METHODS: This study utilized a descriptive cross-sectional design with 400 adults in a remote Filipino community in November 2019. Data were gathered using the Health Promoting Lifestyle Profile II (HPLP II) and Health Literacy Survey-Short Form 12 (HLS-SF12) questionnaires. Descriptive statistics, independent t-test, and Pearson’s r were used to analyze the data.

RESULTS: There is a significant difference between the health literacy index scores (p < .05); but no significant difference between the health behavior mean scores (p > .05) of adults when grouped according to their diabetes risks. Health literacy is significantly (p < .05) correlated with health behaviors of adults, with a moderate positive correlation in the high-risk group (r = .43), and both weak positive correlation in the low-risk group (r = .13) and entire group (r = .17).

CONCLUSION: All adult inclusion efforts in promoting health literacy, with emphasis on the high-risk group, are needed to improve awareness of the degree of diabetes risks. Nurses should take an active role in the assessment of diabetes risks, evaluation of results, and implementation of interventions that could increase health literacy to facilitate the development of healthy behaviors. Stakeholders are urged to advance the availability of evidence-based lifestyle interventions to reduce the growth in new cases of diabetes.

PMID:37469942 | PMC:PMC10353656 | DOI:10.33546/bnj.1298

Belitung Nurs J. 2021 Apr 29;7(2):78-87. doi: 10.33546/bnj.1359. eCollection 2021.

ABSTRACT

BACKGROUND: Symptom cluster management is in its early stages in many chronic and debilitating illnesses. The development of a proposed theory should be an initial step in advancing this area of interest.

OBJECTIVE: This article presents the development of a Proposed Theory of Symptom Cluster Management.

METHODS: The concept analysis, statement synthesis, and theory synthesis by Walker and Avant were used in the development of this proposed theory. A search from July to September 2020 for published empirical and theoretical articles was conducted in scientific databases, expanded on the web, and secondary references from identified articles.

RESULTS: The Proposed Theory of Symptom Cluster Management is both a descriptive and explanatory theory. The defining characteristics of symptom cluster management include the basic and effectiveness components. Antecedents for symptom cluster management include socio-demographic characteristics, symptom cluster characteristics, individual clinical characteristics, individual illness factors, and situational factors or symptom experience. The consequences are clustered as personal-related, health-related, social-related outcomes, and existential outcomes. Measurement tools for the antecedents and outcomes in symptom cluster management and the analytical and statistical strategies were considered. Relational statements were also identified. Theoretical assertions were advanced.

CONCLUSION: The Proposed Theory of Symptom Cluster Management may provide a holistic approach because it integrates both the symptom cluster and management strategies. The concepts, statements including the complete representation of the proposed theory identified in this article, may provide cues to policymakers and clinical researchers towards the development of tailored interventions and programs.

PMID:37469941 | PMC:PMC10353591 | DOI:10.33546/bnj.1359

Front Artif Intell. 2023 Jul 4;6:1060879. doi: 10.3389/frai.2023.1060879. eCollection 2023.

ABSTRACT

INTRODUCTION: The Cancer Field Effect describes an area of pre-cancerous cells that results from continued exposure to carcinogens. Cells in the cancer field can easily develop into cancer. Removal of the main tumor mass might leave the cancer field behind, increasing risk of recurrence.

METHODS: The model we propose for the cancer field effect is a hybrid cellular automaton (CA), which includes a multi-layer perceptron (MLP) to compute the effects of the carcinogens on the gene expression of the genes related to cancer development. We use carcinogen interactions that are typically associated with smoking and alcohol consumption and their effect on cancer fields of the tongue.

RESULTS: Using simulations we support the understanding that tobacco smoking is a potent carcinogen, which can be reinforced by alcohol consumption. The effect of alcohol alone is significantly less than the effect of tobacco. We further observe that pairing tumor excision with field removal delays recurrence compared to tumor excision alone. We track cell lineages and find that, in most cases, a polyclonal field develops, where the number of distinct cell lineages decreases over time as some lineages become dominant over others. Finally, we find tumor masses rarely form via monoclonal origin.

PMID:37469932 | PMC:PMC10352683 | DOI:10.3389/frai.2023.1060879

Indian J Community Med. 2023 May-Jun;48(3):401-406. doi: 10.4103/ijcm.ijcm_282_22. Epub 2023 May 30.

ABSTRACT

BACKGROUND: Across the globe, people are seeking integrative and holistic measures to prevent coronavirus (COVID-19) infection in the form of complementary and alternative medicines (CAM) with or without conventional medicines. This study was done to know the extent of CAM use for COVID-19 prophylaxis and to know beliefs and attitudes of people related to CAM use in India.

METHODOLOGY: A pretested and prevalidated questionnaire was circulated on social media. Participants, who completed the online form and gave voluntary consent, were included. The questionnaire included demographic details and questions related to CAM use, preferences with reasons, preparations used, perceived role of CAM in prevention, immunity boosting and side effects, sources of information, etc.

RESULTS: Out of 514 responses, 495 were analyzed. 47.07% of respondents were males and 52.93% were females. 66.9% were using CAM for COVID-19 prophylaxis. The association between age, gender, and profession with CAM use was statistically significant (P < 0.05). 41.1% reported CAM use in the past. 36.6% of CAM users were taking “Kadha” and 33% were using ayurvedic medicines. Other frequently used CAM preparations were chyavanprash, giloy, tulsi, ginger, pepper, cloves, honey, sudarshanghanvati, arsenic-30, lemon juice, cinnamon, steam inhalation, ashwagandha, swasarivati, coronil, and warm saline water gargles. 46.9% of the CAM users were on self-medication and 52.3% preferred CAM over allopathy.

CONCLUSION: Complementary and alternative medicine utilization for COVID-19 prophylaxis is widespread and self-medication is prevalent. As no specific cure is available in conventional systems, people believe in traditional medicines more than conventional, yet confusion exists. There is a need of increasing awareness regarding side effects, drug-drug interactions, and self-medication.

PMID:37469923 | PMC:PMC10353683 | DOI:10.4103/ijcm.ijcm_282_22