Category: Nevin Manimala

Phys Chem Chem Phys. 2022 Jun 1. doi: 10.1039/d2cp01699k. Online ahead of print.

ABSTRACT

Nitration of benzene is a representative aromatic substitution reaction related to the σ-complex (arenium ion or “Wheland” intermediate) concept. This reaction is typically carried out in a mixed acid solution to generate nitronium ions, and how solvent molecules play roles in the reaction has been of great interest. Here we will shed new light on the reaction, namely the electronic structure and the microscopic insights of the solvation, which have been rarely discussed so far. We studied this process using the reference interaction site model-self consistent field with constrained spatial electron density distribution (RISM-SCF-cSED) method, considering sulfuric acid or water molecules as a solvent. In this method, the electronic structure of the solute and the solvation structure are self-consistently determined based on quantum chemistry and statistical mechanics of molecular liquids. The solvation free energy surfaces in solution and solvation structures were verified. In the bond formation process of benzene and nitronium ions, the solvation structure by sulfuric acid molecules drastically changes and the solvation effect on the free energy is quite large. We revealed largely contributing resonance structures in the π-electron system of the σ-complex in gas and solution phases by analysing the valence electronic structures.

PMID:35647764 | DOI:10.1039/d2cp01699k

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3444-3449. doi: 10.26355/eurrev_202205_28838.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of 0.2% hyaluronic acid gel and 0.01% hyaluronic acid (HA) spray in the healing of extraction wounds using the ruler and digital planimetry method.

PATIENTS AND METHODS: 30 systemically healthy female participants aged between 20-60 years requiring extraction were selected. Extraction sockets receiving 0.2% HA gel Gengigel®, 0.01% HA spray Gengigel®, and where hyaluronic acid was excluded were allocated into three groups as test group A (HA gel group), test group B (HA spray group) and control group (without HA). Socket wound closure was measured post-operative on the day of extraction and 1-week post extraction using digital planimetry and ruler method. Patient satisfaction rate was evaluated for both the gel and spray.

RESULTS: The wound closure with the ruler method was 43.01% for the control group, 67.01%, and 65.82% for the gel group and spray group respectively. The wound closure with the digital planimetry method was 47.97% for the control group, 69.08% for the gel group, and 66.94% for the spray group. The gel showed better results of wound closure as compared to the spray. However, the results were not statistically significant.

CONCLUSIONS: Hyaluronic acid offers a beneficial effect in early post-operative healing after extraction.

PMID:35647824 | DOI:10.26355/eurrev_202205_28838

Nurs Crit Care. 2022 Jun 1. doi: 10.1111/nicc.12781. Online ahead of print.

ABSTRACT

BACKGROUND: A spontaneous breathing trial (SBT) is recommended to help patients to liberate themselves from mechanical ventilation as soon as possible in the ICU. The respiratory workload in SBT, which depends on being with or without respiratory support and a specific time, is more accurate to reflect how much support the weaning patients need compared with only considering SBT technologies.

AIM: To compare and rank the effectiveness of different respiratory workloads during SBT via differing technologies (Pressure Support Ventilation and T-piece) and differing duration (30 and 120 min) in SBTs.

STUDY DESIGN: A comprehensive literature search was performed in six English electronic databases to identify eligible randomized controlled trials (RCTs) published before September 2020. The pooled risk ratio (RR) with 95% confidence interval (CI) was calculated by Markov chain Monte Carlo methods. A Bayesian network meta-analysis was conducted using “gemtc” version 0.8.2 of R software. Each intervention’s ranking possibilities were calculated using the surface under the cumulative ranking analysis (SUCRA).

RESULTS: A total of nine RCTs including 3115 participants were eligible for this network meta-analysis involving four different commonly used SBT strategies and four outcomes. The only statistically significant difference was between Pressure Support Ventilation (PSV) 30 min and T-piece 120 min in the outcome of the rate of success in SBTs (RR = 0.91; 95% CI, 0.84-0.98). The cumulative rank probability showed that the rate of success in SBT from best to worst was PSV 30 min, PSV 120 min, T-piece 30 min and T-piece 120 min. PSV 30 min and PSV 120 min are more likely to have a higher rate of extubation (SUCRA values of 82.5% for 30 min PSV, 70.7% for 120 min PSV, 36.4% for T-piece 30 min, 10.4% for T-piece 120). Meanwhile, T-piece 120 min (SUCRA, 62.9%) and PSV 120 min (SUCRA, 60.9%) may result in lower reintubation rates, followed by T-piece 30 min (SUCRA, 41.8%) and PSV 30 min (SUCRA, 34.4%).

CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: In comprehensive consideration of four outcomes, regarding SBT strategies, 30-min PSV was superior in simple-to-wean patients. Besides, 120-min T-piece and 120-min PSV are more likely to achieve a lower reintubation rate. Thus, the impact of duration is more significant among patients who have a high risk of reintubation. It is still unclear whether the SBTs affect the outcome of mortality; further studies may need to explore the underlying mechanism.

PMID:35647738 | DOI:10.1111/nicc.12781

Pediatr Transplant. 2022 Jun 1:e14324. doi: 10.1111/petr.14324. Online ahead of print.

ABSTRACT

BACKGROUND: Cytomegalovirus infection represents a significant cause of morbidity and mortality after hematopoietic stem cell transplantation. This study aimed to evaluate the incidence of viremia and disease due to cytomegalovirus and the risk factors in pediatric patients with hematopoietic stem cell transplantation in our institution.

METHODS: This was a retrospective cohort of patients under 19 years of age who underwent allogeneic hematopoietic stem cell transplantation due to any indication between 2012 and 2019. The analysis included the diagnosis of cytomegalovirus viremia or disease during post-transplant follow-up, evaluation of risk factors, and outcomes. The statistical analysis included univariate and multivariate analyses, and the cumulative incidence of cytomegalovirus viremia was determined by the Kaplan-Meier method using STATA 14 statistical software.

RESULTS: A total of 182 transplants were included. At 100 days, the cumulative incidence of cytomegalovirus viremia was 70.5%, and that of cytomegalovirus disease was 4.7%. Overall survival at 2 years was 74%, and event-free survival was 64%. The remaining demographic characteristics were not predictors of infection. There was no association between viremia and relapse or survival of the patients. Higher mortality was noted in cytomegalovirus disease.

CONCLUSIONS: During the study period, the incidence of cytomegalovirus disease was similar to that of other pediatric reports, but the incidence of viremia was higher. Pre-emptive therapy has diminished disease rates and death due to infection. Viral load cutoff points should be standardized to guide treatment and avoid myelotoxicity.

PMID:35647735 | DOI:10.1111/petr.14324

J Appl Behav Anal. 2022 Jun 1. doi: 10.1002/jaba.935. Online ahead of print.

ABSTRACT

Children with autism spectrum disorder (ASD) have been shown to exhibit fewer instances of social referencing compared to their typically developing peers. The current study evaluated the effectiveness of multiple-exemplar training, prompting, and social reinforcement to teach social referencing. We used a single-blind randomized control trial with a multiple-baseline design nested within the experimental group to evaluate treatment effects. Twenty-five children with ASD participated. Participants in the treatment group showed significantly higher social referencing scores. However, there were no statistically significant differences between the groups in the posttraining initiating and responding to joint attention scores. The clinical implications of our findings are discussed.

PMID:35647715 | DOI:10.1002/jaba.935

Mol Biol Evol. 2022 Jun 1:msac119. doi: 10.1093/molbev/msac119. Online ahead of print.

ABSTRACT

Commonly used methods for inferring phylogenies were designed before the emergence of high throughput sequencing and can generally not accommodate the challenges associated with noisy, diploid sequencing data. In many applications, diploid genomes are still treated as haploid through the use of ambiguity characters; while the uncertainty in genotype calling – arising as a consequence of the sequencing technology – is ignored. In order to address this problem we describe two new probabilistic approaches for estimating genetic distances: distAngsd-geno and distAngsd-nuc, both implemented in a software suite named distAngsd. These methods are specifically designed for next generation sequencing data, utilize the full information from the data, and take uncertainty in genotype calling into account. Through extensive simulations, we show that these new methods are markedly more accurate and have more stable statistical behaviors than other currently available methods for estimating genetic distances – even for very low depth data with high error rates.

PMID:35647675 | DOI:10.1093/molbev/msac119

Ophthalmol Sci. 2022 Jun;2(2):100144. doi: 10.1016/j.xops.2022.100144. Epub 2022 Mar 18.

ABSTRACT

PURPOSE: To study the wider field swept-source optical coherence tomography angiography (WF SS-OCTA) metrics, especially non-perfusion area (NPA), in the diagnosing and staging of DR.

DESIGN: Cross-sectional observational study (November 2018-September 2020).

PARTICIPANTS: 473 eyes of 286 patients (69 eyes of 49 control patients and 404 eyes of 237 diabetic patients).

METHODS: We imaged using 6mm×6mm and 12mm×12mm angiograms on WF SS-OCTA. Images were analyzed using the ARI Network and FIJI ImageJ. Mixed effects multiple regression models and receiver operator characteristic analysis was used for statistical analyses.

MAIN OUTCOME MEASURES: Quantitative metrics such as vessel density (VD); vessel skeletonized density (VSD); foveal avascular zone (FAZ) area, circularity, and perimeter; and NPA in DR and their relative performance for its diagnosis and grading.

RESULTS: Among patients with diabetes (median age 59 years), 51 eyes had no DR, 185 eyes (88 mild, 97 moderate-severe) had non-proliferative DR (NPDR); and 168 eyes had proliferative DR (PDR). Trend analysis revealed a progressive decline in superficial capillary plexus (SCP) VD and VSD, and increased NPA with increasing DR severity. Additionally, there was a significant reduction in deep capillary plexus (DCP) VD and VSD in early DR (mild NPDR), but the progressive reduction in advanced DR stages was not significant. NPA was the best parameter to diagnose DR (AUC:0.96), whereas all parameters combined on both angiograms efficiently diagnosed (AUC:0.97) and differentiated between DR stages (AUC range:0.83-0.97). The presence of diabetic macular edema was associated with reduced SCP and DCP VD and VSD within mild NPDR eyes, whereas an increased VD and VSD in SCP among moderate-severe NPDR group.

CONCLUSIONS: Our work highlights the importance of NPA, which can be more readily and easily measured with WF SS-OCTA compared to fluorescein angiography. It is additionally quick and non-invasive, and hence can be an important adjunct for DR diagnosis and management. In our study, a combination of all OCTA metrics on both 6mm×6mm and 12mm×12mm angiograms had the best diagnostic accuracy for DR and its severity. Further longitudinal studies are needed to assess NPA as a biomarker for progression or regression of DR severity.

PMID:35647573 | PMC:PMC9137369 | DOI:10.1016/j.xops.2022.100144

J Contin Educ Nurs. 2022 Jun;53(6):273-278. doi: 10.3928/00220124-20220505-09. Epub 2022 Jun 1.

ABSTRACT

An RN refresher program can be a valuable tool to mobilize nurses back into practice, but there are limited data regarding how much it increases students’ confidence. Bandura’s (1997) theory defines self-efficacy as a construct of one’s belief in obtaining control over behavior and environment to achieve a goal. In this study, the validated Clinical Skills Self-Efficacy Scale (CSES) was used to measure the difference in a student’s reported perception of self-efficacy after completing a refresher program. The CSES survey was distributed to two groups of RN students: 59 accelerated students who finished the course in 3 months and 57 traditional students who had 9 months to complete the course. The accelerated students had recent nursing experience, but were responding to the COVID-19 pandemic. A mixed model was used to analyze the CSES scores between the accelerated students and the traditional students. A pretest-posttest design was used for each item of the scale. Both groups of students had a statistically significant difference in their CSES scores from pretest to posttest (p < .05). [J Contin Educ Nurs. 2022;53(6):273-278.].

PMID:35647623 | DOI:10.3928/00220124-20220505-09

Resusc Plus. 2022 May 24;10:100250. doi: 10.1016/j.resplu.2022.100250. eCollection 2022 Jun.

ABSTRACT

BACKGROUND: If adolescents can teach each other cardiopulmonary resuscitation (CPR) during school hours, this may be a cost-effective approach to CPR training. The aim of this study was to evaluate CPR quality among students trained by student instructors in CPR.

MATERIAL AND METHODS: Three high schools participated. Recruited student instructors (SIs) were given a two-day course by professional instructors. Theoretic knowledge was acquired through an e-learning program. The SIs then trained fellow students in a 90-minute practical CPR session during physical education classes. All participants performed a 4-minutes test of CPR performance. Data was collected using Little Anne QCPR manikins with QCPR classroom software (Laerdal Medical Inc, Norway). Statistical equivalence in CPR performance was assessed applying the two one-sided tests (TOST)-procedure.

RESULTS: Eight professional instructors trained 76 SIs who trained approximately 2650 students in CPR. The number of available tests for analysis of student performance was 982. The compression rates were within guideline recommendations for SIs (mean 110.6, SD 5.4) and students (mean 118.6, SD 8.6). The corresponding numbers for mean compression depth were 7.2 cm (SD 0.7) and 7 cm (SD 1.0). Students demonstrated greater variation in mouth-to-mouth (MTM) skills, with only 41% performing at least 15 successful ventilations during the test. Except for the total number of MTM ventilations (mean difference -5.6), CPR performance was deemed statistically equivalent between professional instructors, SIs and students.

CONCLUSIONS: High school students can be trained as CPR instructors and teach fellow students CPR with good quality, with some variation in MTM-ventilation skills.

PMID:35647568 | PMC:PMC9130223 | DOI:10.1016/j.resplu.2022.100250

Brain Behav Immun Health. 2022 May 2;23:100458. doi: 10.1016/j.bbih.2022.100458. eCollection 2022 Aug.

ABSTRACT

Systemic and cerebral inflammation following antenatal infection (e.g. chorioamnionitis) and dysregulation of the blood brain barrier (BBB) are major risk factors for abnormal neonatal brain development. Administration of multipotent adult progenitor cells (MAPCs) represents an interesting pharmacological strategy as modulator of the peripheral and cerebral immune response and protector of BBB integrity. We studied the immunomodulatory and protective cerebrovascular potential of prenatally administered MAPCs in a preclinical ovine model for antenatal inflammation. Ovine fetuses were intra-amniotically (i.a.) exposed to lipopolysaccharide (LPS) or saline at gestational day 125, followed by the intravenous administration of 1*10⁷ MAPCs or saline at gestational day 127. Circulating inflammation markers were measured. Fetal brains were examined immuno-histochemically post-mortem at gestational day 132. Fetal plasma IL-6 levels were elevated significantly 24 h after LPS administration. In utero systemic MAPC treatment after LPS exposure increased Annexin A1 (ANXA1) expression in the cerebrovascular endothelium, indicating enforcement of BBB integrity, and increased the number of leukocytes at brain barriers throughout the brain. Further characterisation of brain barrier-associated leukocytes showed that monocyte/choroid plexus macrophage (IBA-1⁺/CD206⁺) and neutrophil (MPO⁺) populations predominantly contributed to the LPS-MAPC-induced increase of CD45⁺cells. In the choroid plexus, the percentage of leukocytes expressing the proresolving mediator ANXA1 tended to be decreased after LPS-induced antenatal inflammation, an effect reversed by systemic MAPC treatment. Accordingly, expression levels of ANXA1 per leukocyte were decreased after LPS and restored after subsequent MAPC treatment. Increased expression of ANXA1 by the cerebrovasculature and immune cells at brain barriers following MAPC treatment in an infectious setting indicate a MAPC driven early defence mechanism to protect the neonatal brain against infection-driven inflammation and potential additional pro-inflammatory insults in the neonatal period.

PMID:35647567 | PMC:PMC9136278 | DOI:10.1016/j.bbih.2022.100458