Category: Nevin Manimala

J Biomater Appl. 2023 Feb 5:8853282231155570. doi: 10.1177/08853282231155570. Online ahead of print.

ABSTRACT

The aim of this paper was to synthesize and characterize polymeric scaffolds of Chitosan/Xanthan/Hydroxyapatite-Graphene Oxide nanocomposite associated with mesenchymal stem cells for regenerative dentistry application. The chitosan-xanthan gum (CX) complex was associated with Hydroxyapatite-Graphene Oxide (HA-GO) nanocomposite with different Graphene Oxides (GO) concentration (0.5 wt%; 1.0 wt%; 1.5 wt%). The scaffolds characterizations were performed by X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Raman spectroscopy, thermogravimetric analysis (TGA), scanning electron microscopy (SEM) and contact angle. The mechanical properties were assessed by compressive strength. The in vitro bioactivity and the in vitro cytotoxicity test (MTT test) were analyzed as well. The data was submitted to the Normality and Homogeneity tests. In vitro Indirect Cytotoxicity assay data was statistically analyzed by ANOVA two-way, followed by Tukey’s test (α = 0.05). Compressive strength and contact angle data were statistically analyzed by one-way ANOVA, followed by Tukey’s test (α = 0.05). XRD showed the presence of Hydroxyapatite (HA) peaks in the structures CXHA, CXHAGO 0.5%,1.0% and 1.5%. FT-IR showed amino and carboxylic bands characteristic of CX. Raman spectroscopy analysis evidenced a high quality of the GO. In the TGA it was observed the mass loss associated with the CX degradation by depolymerization. SEM analysis showed pores in the scaffolds, in addition to HA incorporated and adhered to the polymer. Contact angle test showed that scaffolds have a hydrophilic characteristic, with the CX group the highest contact angle and CXHA the lowest (p < 0.05). 1.0 wt% GO significantly increased the compressive strength compared to other compositions. In the bioactivity test, the apatite crystals precipitation on the scaffold surface was observed. MTT test showed high cell viability in CXHAGO 1.0% and CXHAGO 1.5% scaffold. CXHAGO scaffolds are promising for regenerative dentistry application because they have morphological characteristics, mechanical and biological properties favorable for the regeneration process.

PMID:36740600 | DOI:10.1177/08853282231155570

Nurs Crit Care. 2023 Feb 5. doi: 10.1111/nicc.12889. Online ahead of print.

ABSTRACT

BACKGROUND: The combination of prone positioning and extracorporeal membrane oxygenation (ECMO) in patients with acute respiratory distress syndrome (ARDS) is recognized as safe but its use has been limited due to potential complications.

OBJECTIVE: To report the prevalence of pressure ulcers and other complications due to prone positioning in adult patients receiving veno-venous ECMO.

METHODS: This cross-sectional study was conducted in a tertiary level intensive care unit (ICU) in Milan (Italy), between January 2015 and December 2019. The study population was critically ill adult patients undergoing veno-venous ECMO. Statistical association between pressure ulcers and the type of body positioning (prone versus supine) was explored fitting a logistic model.

RESULTS: In the study period, 114 patients were treated with veno-venous ECMO and 62 (54.4%) patients were placed prone for a total of 130 prone position cycles. ECMO cannulation was performed via femoro-femoral configuration in the majority of patients (82.4%, 94/114). Pressure ulcers developed in 57.0% of patients (95%CI: 44.0%-72.6%), most often arising on the face and the chin (37.1%, 23/62), particularly in those placed prone. The main reason of prone positioning interruption was the decrease of ECMO blood flow (8.1%, 5/62). The fitted model showed no association between body position during ECMO and occurrence of pressure ulcers (OR 1.3, 95%CI: 0.5-3.6, p = .532).

CONCLUSION: Facial pressure ulcers were the most frequent complications of prone positioning. Nurses should plan and implement evidence-based care to prevent such pressure injuries in patients undergoing ECMO.

RELEVANCE TO CLINICAL PRACTICE: The combination of prone positioning and ECMO shows few life-threating complications. This manoeuvre during ECMO is feasible and safe when performed by experienced ICU staff.

PMID:36740588 | DOI:10.1111/nicc.12889

Epilepsia. 2023 Feb 5. doi: 10.1111/epi.17532. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to determine the contribution of comorbidly to excess PNES mortality.

METHODS: Retrospective cohort study of tertiary epilepsy outpatients from St Vincent’s Hospital Melbourne, Australia with 8:1 comparison cohort, matched by age, sex and socioeconomic status (SES) to national administrative databases between 2007-2017. Privacy-preserving data-linkage was undertaken with the national prescription, National Death Index and National Coronial Information System. 45 comorbid disease classes were derived by applying an Australian validated RxRisk-V to all dispensed prescriptions. We fitted Cox proportional hazard models controlling for age, sex, SES, comorbidity, disease duration and number of concomitant antiseizure medications (ASM), as a marker of disease severity. We also performed a parallel forward-selection change in estimate strategy to explore which specific comorbidities contributed to the largest changes in the hazards ratio.

RESULTS: 13,488 participants were followed for a median 3.2 years (IQR 2.4-4.0 years). 1,628 tertiary epilepsy outpatients. 1,384 patients with epilepsy, 176 PNES and 59 with both. 82% of epileptic seizures and 92% of typical PNES events were captured in an epilepsy monitoring unit. The age-sex-SES-adjusted hazards ratio (95% confidence interval) was elevated for epilepsy 4.74 (3.36, 6.68) and PNES 3.46 (1.38, 8.68) and remained elevated for epilepsy 3.21 (2.22, 4.63) but not PNES 2.15 (0.77, 6.04), after comorbidity adjustment. PNES had more pre-existing comorbidities (p=0.0007) with a three times greater median weighted Rx-RiskV score. Psychotic illness, opioid analgesia, malignancies and non-opioid analgesia had the greatest influence on PNES comorbid risk.

SIGNIFICANCE: Higher comorbidity appears to explain the excess PNES mortality and may either represent a wider under recognised somatoform disorder or a psychological response to physical illness. Better understanding and management of the bidirectional relationship of these wider somatic treatments in PNES could potentially reduce the risk of death.

PMID:36740578 | DOI:10.1111/epi.17532

Nutr Metab Cardiovasc Dis. 2023 Jan 24:S0939-4753(23)00025-X. doi: 10.1016/j.numecd.2023.01.014. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: NT-proBNP has been hypothesized as a possible explanation for the paradoxical association between adiponectin and cardiovascular and all-cause mortality. We examined the heterogeneities by NT-proBNP, sex, BMI, smoking status, hypertension and diabetes status in the association between adiponectin and cardiovascular disease risk and mortality.

METHODS AND RESULTS: We used a case-cohort design nested within the EPIC-Heidelberg cohort, including 1387 incident cases of myocardial infarction or stroke, 582 deaths from cardiovascular causes and 2352 total deaths. We estimated hazard ratios for the association between 1SD increase in log-transformed total adiponectin levels and cardiovascular disease risk, cardiovascular mortality and mortality using Prentice-weighted Cox-proportional hazard models and assessed heterogeneity of the associations across strata of covariates. Overall, adiponectin was significantly associated with all-cause mortality [HR = 1.09, 95% CI: 1.03-1.16, p = 0.004]. The association with cardiovascular mortality did not reach statistical significance [1.10 (0.99-1.37), p = 0.073]. There was significant heterogeneity by NT-proBNP in the association between total adiponectin and all-cause mortality (phet = 0.019) such that significant increase in hazards of mortality were restricted to participants in the highest tertile of NT-proBNP. Among these participants, adiponectin showed a dose-response relationship with total mortality such that; compared to participants in the lowest quintile, those in the third, fourth and fifth were at 1.22 (0.87-1.70), 1.50 (1.07-2.11), and 1.59 (1.15-2.21) higher hazards of mortality respectively.

CONCLUSIONS: Significant association between adiponectin and mortality was only observed in the context of high NT-proBNP. Our findings provide further support for hypothesis that NT-proBNP may explain the adiponectin paradox.

PMID:36740561 | DOI:10.1016/j.numecd.2023.01.014

Neurobiol Aging. 2022 Dec 31:S0197-4580(22)00275-5. doi: 10.1016/j.neurobiolaging.2022.12.012. Online ahead of print.

ABSTRACT

Recent genome-wide association studies suggested shared genetic components between neurodegenerative diseases. However, pleiotropic association patterns among them remain poorly understood. We here analyzed 4 major neurodegenerative diseases including Alzheimer’s disease (AD), Parkinson’s disease (PD), frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), and found suggestively positive genetic correlation. We next implemented a gene-centric pleiotropy analysis with a powerful method called PLACO and detected 280 pleiotropic associations (226 unique genes) with these diseases. Functional analyses demonstrated that these genes were enriched in the pancreas, liver, heart, blood, brain, and muscle tissues; and that 42 pleiotropic genes exhibited drug-gene interactions with 341 drugs. Using Mendelian randomization, we discovered that AD and PD can increase the risk of developing ALS, and that AD and ALS can also increase the risk of developing FTD, respectively. Overall, this study provides in-depth insights into shared genetic components and causal relationship among the 4 major neurodegenerative diseases, indicating genetic overlap and causality commonly drive their co-occurrence. It also has important implications on the etiology understanding, drug development and therapeutic targets for neurodegenerative diseases.

PMID:36740554 | DOI:10.1016/j.neurobiolaging.2022.12.012

Explore (NY). 2023 Jan 25:S1550-8307(23)00028-9. doi: 10.1016/j.explore.2023.01.005. Online ahead of print.

ABSTRACT

OBJECTIVE: Tinea Corporis is the most frequent form of dermatophytosis reported as the commonest presentation. Majoon Ushba (MU) a polyherbal preparation in a semisolid oral dosage form and Marham Raal (MR) an ointment made up of herbal and animal drugs are used for skin disorders in Unai medicine. Considering the biologically active substances with antioxidant, antimicrobial, antifungal, anti-inflammatory, and wound-healing properties of their ingredients, this study aimed to evaluate the clinical and mycological efficacy and safety of MU and MR in tinea corporis.

METHODS: This randomized open-labeled active-controlled clinical trial was conducted on 42 patients of tinea corporis. Patients were randomly assigned via a computer-generated list to the test group (n=21) receiving oral MU (6 gm) with topical MR and the control group (n=21) topical terbinafine hydrochloride (1%) for 40 days. The severity scores of clinical symptoms; erythema, scaling, itching, margins, and size were the primary outcome and the mycological cure (negative KOH microscopy), total score, and dermatology life quality index (DLQI) were the secondary outcomes were analyzed at baseline and at 40 days.

RESULTS: A significant reduction was observed in clinical severity scores of erythema, scaling, and itching (P ≤ 0.05) in both groups except for margins, and size of the lesion (P ≥ 0.05). The mycological cure (P = .001) and the total score (P = 0.0002) and DLQI (P = 0.002) were statistically significant in both groups when analyzed from baseline to the end of the treatment within groups, however, the differences in these outcomes were statistically insignificant (P ≥ 0.05) on the inter-group comparison. All the safety parameters (clinical and laboratory) were in the normal range in both groups.

CONCLUSION: The results demonstrated that traditional and conventional treatments were equally effective and MU and MR can be prescribed as alternative or complementary treatments for tinea corporis.

PMID:36740535 | DOI:10.1016/j.explore.2023.01.005

Res Social Adm Pharm. 2023 Jan 31:S1551-7411(23)00034-7. doi: 10.1016/j.sapharm.2023.01.014. Online ahead of print.

ABSTRACT

BACKGROUND: Non-medical medication switches, a change to another medicine or medication label not motivated by medical reasons, occur frequently. Switches often lead to negative patient emotions, such as confusion and anger. Pharmacy staff’s communication, i.e. delivering the message and addressing patients’ emotions is crucial, but experienced as difficult.

OBJECTIVE: To develop and test a communication training for the pharmacy team to facilitate medication switch conversations.

METHODS: A communication training was developed based on the ‘breaking bad news model’ and ‘positive message framing’ strategies, and incorporating needs and preferences from practice. The training consisted of an e-learning with theory and reflective exercises, a half-day live training session, and an online reflection session. The Kirkpatrick training evaluation model (levels one ‘reaction’ and two ‘learning’) was used to evaluate the training. Quantitative data were analyzed using descriptive statistics and interview data was transcribed verbatim and analyzed thematically.

RESULTS: Twelve pharmacists and 27 pharmacy technicians from 15 Dutch pharmacies participated in the training. According to Kirkpatrick’s model level one, the major learning outcome was to give space to patients to express their emotions and/or concerns (e.g. more silences in the conversations). For level two, most participants valued practicing the conversations, role-playing, and receiving feedback. The majority of the participants indicated that they had sufficient tools and practice during the live training to apply the strategies in daily practice. A few participants still needed time and practice, or missed examples to apply the strategies.

CONCLUSION: The communication training based on the two strategies was well-received and participants felt well-equipped post-training. The take-away for participants was to give space to patients to express their emotions. Using these strategies and skills, pharmacy teams can tailor their medication counseling to patients’ emotions and concerns during non-medical medication switches to better support patients in proper medication use.

PMID:36740526 | DOI:10.1016/j.sapharm.2023.01.014

Surg Obes Relat Dis. 2022 Dec 30:S1550-7289(22)00830-9. doi: 10.1016/j.soard.2022.12.034. Online ahead of print.

ABSTRACT

BACKGROUND: Male obesity secondary hypogonadism (MOSH) is a common disease among men with obesity and can be associated with metabolic syndrome and a variety of metabolic problems ultimately leading to androgen deficiency. Metabolic and bariatric surgery is a well-established treatment option associated with significant weight loss and reduction in metabolic co-morbidities.

OBJECTIVES: To evaluate the impact of surgery on plasma levels of sexual hormones and their effect on weight loss comparing 2 surgical methods (one-anastomosis gastric bypass [OAGB] and Roux-en-Y gastric bypass [RYGB]) in male patients with obesity.

SETTING: University hospital, Austria.

METHODS: Patients undergoing OAGB and RYGB between 2012 and 2017 were analyzed retrospectively. Follow-up in this study was up to 24 months. Systemic levels of sexual hormones (luteinizing hormone [LH]), follicle stimulating hormone [FSH], total testosterone [TT], sexual hormone binding globin [SHBG], 17 beta-estradiol [17bE], androstenedione [AS]) were retrieved at each visit. A linear mixed model was used to assess the correlation between changes in testosterone levels and percent excess weight loss (%EWL).

RESULTS: In 30.8% of all patients, MOSH was present preoperatively. A significant increase of TT was observed postoperatively that led to a complete resolution of hypogonadism within the period observed. Bioavailable testosterone (bTT) and FSH levels significantly increased each month of follow-up after surgery (all P < .01). Levels of 17bE did not change significantly after surgery. The overall change of TT, comparing preoperative and 1-year postoperative TT levels (ΔTT), significantly correlated with %EWL. Changes in TT levels were not affected by the choice of surgical method.

CONCLUSIONS: Serum plasma testosterone levels rise significantly after metabolic and bariatric surgery in male patients. The change of testosterone levels seems to play a role in continued weight loss after surgery. This is true irrespective of the surgical method used.

PMID:36740523 | DOI:10.1016/j.soard.2022.12.034

Genet Epidemiol. 2023 Feb 5. doi: 10.1002/gepi.22517. Online ahead of print.

ABSTRACT

Currently, the only effect size prior that is routinely implemented in a Bayesian fine-mapping multi-single-nucleotide polymorphism (SNP) analysis is the Gaussian prior. Here, we show how the Laplace prior can be deployed in Bayesian multi-SNP fine mapping studies. We compare the ranking performance of the posterior inclusion probability (PIP) using a Laplace prior with the ranking performance of the corresponding Gaussian prior and FINEMAP. Our results indicate that, for the simulation scenarios we consider here, the Laplace prior can lead to higher PIPs than either the Gaussian prior or FINEMAP, particularly for moderately sized fine-mapping studies. The Laplace prior also appears to have better worst-case scenario properties. We reanalyse the iCOGS case-control data from the CASP8 region on Chromosome 2. Even though this study has a total sample size of nearly 90,000 individuals, there are still some differences in the top few ranked SNPs if the Laplace prior is used rather than the Gaussian prior. R code to implement the Laplace (and Gaussian) prior is available at https://github.com/Kevin-walters/lapmapr.

PMID:36739616 | DOI:10.1002/gepi.22517

J Sep Sci. 2023 Feb 5:e2200826. doi: 10.1002/jssc.202200826. Online ahead of print.

ABSTRACT

Goji berries are now becoming increasingly popular in the human diet due to their potential health benefits. Unscrupulous traders deliberately mislabel with certain origins to gain illegal profits, which seriously affected the consumers’ benefits. In this study, an on-line ultra performance liquid chromatography-2,2-diphenyl-1 -picrylhydrazyl-photodiode array detector-electrospray ionization-quadrupole time of flight mass was developed for rapid screening and identification of the antioxidants from Goji berry; then, the antioxidants characteristic fingerprint was established and explored in the origins discrimination of Goji berries from China combined with multivariate statistics analysis. As a result, twenty-eight compounds were screened from Goji berry extract, 19 of which were identified by accurate molecular and ultraviolet information according references. Principal components analysis and partial least squares discrimination analysis achieved the accurate classification from the four regions, eight compounds were selected as origin-related antioxidant markers with variable importance in projection >1 and one-way analysis of variance (P<0.05), including rutin, rutin di-hexose, P-coumaric acid tri-hexose, dicaffeoylquinic acid isomer, Quercetin-rhamno-di-hexoside, peak14, peak16, and peak27. This study provides a feasible strategy for the geographical origins discrimination of Goji berries based on antioxidant ingredients difference, and will be helpful for improving the quality control level of Goji berry. This article is protected by copyright. All rights reserved.

PMID:36739594 | DOI:10.1002/jssc.202200826