Category: Nevin Manimala

J Cataract Refract Surg. 2021 Aug 4. doi: 10.1097/j.jcrs.0000000000000768. Online ahead of print.

ABSTRACT

PURPOSE: To quantify the damage to the corneal endothelium from the flow of balanced salt solution during phacoemulsification.

SETTING: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

DESIGN: Experimental Study.

METHODS: Twelve New Zealand white rabbits received bilateral surgery. Six eyes served as controls with no irrigation (incision only). In 18 eyes, the Intrepid Balanced tip of the Centurion (Alcon) Ozil handpiece was inserted into the anterior chamber for continuous irrigation at 50mL/minute with either 250 mL or 500 mL of balanced salt solution (BSS). After euthanasia and enucleation, the corneas were removed, stained with trypan blue/alizarin red, and photographed in a standardized manner (X400 photographs from 5 specific areas, and 1 overview photograph from each corneal button). The ImageJ program was used to evaluate cell damage and loss in the photographs obtained from each cornea.

RESULTS: Analysis of the X400 photographs showed no statistical differences between control, 250 mL, and 500 mL groups in the percentage of intact, damaged, or lost cells (P= 0.896, 0.851, and 0.972 respectively). For the overview photos, the differences in areas of intact and damaged cells among the groups were statistically significant, likely due to the peripheral areas of damage related to touches between the phaco tip and the endothelium during irrigation.

CONCLUSION: The volume of BSS flow alone does not appear to be a major contributing source of endothelial cell damage and loss, providing further insight on mechanisms of corneal endothelium damage during phacoemulsification.

PMID:34371510 | DOI:10.1097/j.jcrs.0000000000000768

Br J Clin Pharmacol. 2021 Aug 9. doi: 10.1111/bcp.15028. Online ahead of print.

ABSTRACT

AIM: This study aimed to evaluate the association between opioid-related deaths and persistent opioid utilisation in the United Kingdom (UK).

METHODS: This nested case-control study used the UK Clinical Practice Research Datalink, linking the Office for National Statistics death registration. Adult opioid users with recorded opioid-related death between 2000 and 2015 were included and matched to four opioid users (controls) based on a disease risk score. Persistent opioid utilisation (opioid prescriptions ≥3 quarters/year and oral morphine equivalent dose ≥4500 mg/year) and psychotropic prescriptions were identified annually during the three patient-years before the date of opioid-related death. Conditional logistic regression was used to assess the association between persistent opioid utilisation and opioid-related death, and the results were reported as adjusted odds ratios (aOR) and 95% confidence intervals (95%CI).

RESULTS: Of the 902,149 opioid users, 230 opioid-related deaths (cases) and 920 controls were identified. Persistent opioid utilisation was significantly associated with an increased risk of opioid-related deaths (aOR: 1.9; 95%CI: 1.2, 2.9) when persistent opioid utilisation was defined by both annual dose and number of quarters. Concurrent prescription of opioids and tricyclic antidepressants (aOR: 2.0; 95%CI: 1.2, 3.5) or higher dose of benzodiazepine (aOR: 6.5; 95%CI: 4.0, 10.4) or gabapentinoids (aOR: 6.2; 95%CI: 2.9, 13.5) were associated with opioid-related death.

CONCLUSION: Persistent opioid prescribing and concurrent prescribing of psychotropics were associated with a higher risk of opioid-related death and should be avoided in clinical practice. An evidence-based indicator to monitor the safety of prescribed opioids during opioid de-prescribing is needed.

PMID:34371521 | DOI:10.1111/bcp.15028

J Water Health. 2021 Aug;19(4):575-591. doi: 10.2166/wh.2021.269.

ABSTRACT

Tropical communities in the developing world depend heavily on riverine systems for their socioeconomic development. However, these resources are poorly protected from diffuse pollution, and there is a lack of quantitative information regarding the microbial pollution characteristics of riverine water, despite frequently reported gastrointestinal diseases. The aim of our study was to apply faecal taxation (i.e., faecal pellet counting in representative test areas to estimate the potential availability of diffuse pollution sources) in combination with a detailed microbiological faecal pollution analysis in a riverine environment to elucidate the importance of diffuse pollution. To realize this approach, ambient faecal pellets, a multiparametric data set for standard faecal indicator bacteria (SFIB), including Escherichia coli, Clostridium perfringens spores and enterococci from catchment soil and river water, and a number of riverine water physicochemical variables were analysed during a one-year cycle. We demonstrated that the abundance of ambient faecal pellets, which were consistently counted at reference sites in the catchment, was associated with faecal pollution in the river water. Water SFIB, dissolved oxygen, nutrients, conductivity and total suspended solids were strongly linked with the abundance of ambient faecal pellets in the river catchment, as demonstrated by principal component analysis (PCA). Elevated concentrations of SFIB in the riverine water in the absence of rainfall also suggested the direct input of faecal bacteria into the riverine water by livestock (e.g., during watering) and humans (e.g., during bathing). Statistical analyses further revealed that the microbiological water quality of the investigated riverine water was not influenced by SFIB potentially occurring in the soil. This study demonstrates the importance of diffuse faecal pollution sources as major drivers of the microbiological quality of riverine water in the Ethiopian highlands. In addition, the new successfully applied integrated approach could be very useful for developing predictive models, which would aid in forecasting riverine microbiological quality in tropical developing countries.

PMID:34371495 | DOI:10.2166/wh.2021.269

J Water Health. 2021 Aug;19(4):671-681. doi: 10.2166/wh.2021.074.

ABSTRACT

Adequate hydration is an essential component of health at every stage of life. Although many factors such as age, gender, physical activity, drug use, and illness affect hydration status, it is vital to maintain water balance, especially in infectious diseases. This study was conducted to estimate the hydration status of young adults living in Turkey during the COVID-19 pandemic. The total water intake (TWI) and total water loss of the individuals were determined using the Water Balance Questionnaire (WBQ), which consists of questions about physical activity status, frequency of food and beverage consumption, water consumption, and water loss with urine and feces. The TWI of men and women was found to be 4,776.1 and 4,777.3 mL/day, respectively (p > 0.05). It was determined that 29% of the total water was obtained from drinking water, 49% from other beverages, and 22% from food. A positive net water balance was found in all body mass index (BMI) groups, men, and women. The net water balance was statistically lower in men (2,230.6 mL) than women (2,783.8 mL) (p < 0.05). As the COVID-19 pandemic continues, studies should be done on hydration status in the more balanced populations in terms of BMI and age groups.

PMID:34371502 | DOI:10.2166/wh.2021.074

Nurse Educ Pract. 2021 Jul 23;55:103164. doi: 10.1016/j.nepr.2021.103164. Online ahead of print.

ABSTRACT

AIM: The number of online graduate nursing programs across the United States has increased to address a critical shortage of nurse educators. Web-based learning appeals to nurses returning to school as a means of gaining an education at their convenience. More schools are offering compressed courses to meet this demand. Although students have a preference toward shorter intensive online courses, it is unclear how that affects the quality of the learning experience such as student engagement. The study explored the effect of course length on the student learning experience in a graduate online nurse educator course.

DESIGN: Using the community of inquiry framework, this study examined the effect of course duration (8-week versus traditional 16-week timeframes) on student engagement, student perceptions of the learning experience and self-reported learning behaviors. Study participants were enrolled in an online graduate nurse educator program located in the northwest United States.

METHODS: Data were collected using a background information form, a course evaluation form and the Community of Inquiry Questionnaire which measured teaching presence, social presence and cognitive presence. Data were analyzed using descriptive and inferential statistics.

RESULTS: High mean scores on the questionnaire showed that a community of inquiry was established regardless of course duration. However, there were differences in terms of the social and teaching presence subscales but not in the cognitive presence subscale suggesting that students in the traditional course were better able to establish the type of rapport with each other that increased comfort and engagement with peer interactions. Independent t-tests revealed statistically significant differences in perceptions of time to complete course activities. Students in the 16-week course were more likely to report that they had adequate time to complete course teachings, think critically about course content, complete course assignments and thoughtfully engage in course discussion and that they performed their best on assignments.

CONCLUSIONS: The findings support the traditional course duration over an intensive 8-week format because it allows for students to build a better rapport and greater student engagement with the course materials and peers. The study reinforces previous work on distance education noting social presence and connectedness as essential to optimal online learning. Using the community of inquiry framework and best-practice pedagogies for online education in the design and development of online courses can contribute to greater collaboration and deeper learning.

PMID:34371480 | DOI:10.1016/j.nepr.2021.103164

Aging (Albany NY). 2021 Aug 9;13(undefined). doi: 10.18632/aging.203374. Online ahead of print.

ABSTRACT

To map the magnitudes and temporal trends of blindness and vision loss (BVL) due to common eye diseases along with its attributable risk factors at the national, regional, and global levels. The annual burden of BVL in 204 countries and territories was extracted from the Global Burden of Disease Study 2019. The estimated annual percentage change (EAPC) and causes composition change were calculated to quantify the temporal trends of BVL-related disease burden by sex, region, and eye disease. The global disability-adjusted life years (DALYs) of BVL increased from 12.44 million in 1990 to 22.56 million in 2019, with a slightly decreased rate from 3.03 to 2.78 per 1000 population (EAPC = -0.30). About 29.6% of BVL-related DALYs worldwide were caused by cataract, followed by refraction disorders (29.1%), near vision loss (21.7%), other vision loss (13.7%), glaucoma (3.3%), and age-related macular degeneration (2.5%) in 2019. The age-standardized DALYs rates due to each eye disease type in most regions were decreased, especially in countries with high burden and high-middle socio-demographic index. Moreover, the contribution of smoking and air pollution from solid fuels to BVL burden decreased, however, the age-standardized burden of BVL attributed to high body-mass index and high fasting plasma glucose elevated gradually across almost all regions. The temporal trend of BVL burden due to specific eye diseases varies remarkably by region, sex and age. Understanding the real-time patterns of BVL burden is crucial for formulating more effective and targeted prevention and healthcare strategies to decrease the BVL burden.

PMID:34371482 | DOI:10.18632/aging.203374

J Pharm Biomed Anal. 2021 Aug 4;205:114304. doi: 10.1016/j.jpba.2021.114304. Online ahead of print.

ABSTRACT

Fluorescence, especially laser induced fluorescence (LIF), is a powerful detection technique thanks to its specificity and high sensitivity. The use of fluorescence detection hyphenated to separation technique often requires the labeling of analytes with suitable fluorescent dye, such as FITC for the labeling of molecules presenting amino groups. Nevertheless, the labeling of analytes could be a tedious, time consuming and a non-robust step of the analytical workflow. In this context, the objective of the present work was to propose a robust and reliable FITC labeling process. Primary and secondary amino compounds (i.e. synthetic cathinones) were selected as model compounds because they are representative of a large proportion of pharmaceutical small molecules. Based on prior knowledge, DoE combined with multivariate statistical modeling was performed to optimize the process. Reaction time and pH of reaction buffer were highlighted as the most critical parameters to control the process. The study showed also the benefit of short reaction time to maximize the labeling efficiency. Indeed, optimal condition was defined as reaction time of 32 min with ratio between FITC and analytes of 40.4 and the buffer reaction pH of 9.7. In addition, variance component analysis was integrated to the DoE to estimate the variability of process and to evaluate its applicability for quantitative purpose. These chemometric approaches helped to develop an efficient labeling process able to reach high sensitivity for CE-LIF analysis (i.e. 10 nM) with good precision (i.e. intermediate precision values lower or close to 5 %).

PMID:34371450 | DOI:10.1016/j.jpba.2021.114304

J Biomech. 2021 Jul 29;127:110657. doi: 10.1016/j.jbiomech.2021.110657. Online ahead of print.

ABSTRACT

Various methods have been suggested for estimating the variability in biomechanical variables during gait. However, all current measures of variability are performed on discrete measurements extracted from the kinematic or kinetic waveforms, which provide no temporal information on where differences in variability occur. This study used a variance equality test to compare temporal differences in group variance along the entire ground reaction force waveform. The variance equality test used an F-statistic whose critical value was determined using the random field theory function within the one-dimensional statistical parametric mapping package. Twenty healthy younger and twenty older adults were included in the study and completed gait analysis as they walked along a level walkway at a self-selected pace. Variance for each group was calculated and compared at each interval along the waveform to produce the F-value. The F-value was compared against a calculated F-critical value to determine where in the waveform significant differences in ground reaction force variance occurred. Results suggest that younger individuals may exhibit greater ground reaction force variance during heel contact in the vertical and posterior directions, and that older individuals may exhibit greater variability in the mediolateral direction at toe-off. This study was able to identify differences in ground reaction force variance within the gait cycle between younger and older adults. The findings of this study warrant the use of the function as a suitable method to compare variance along the entire waveform between two groups.

PMID:34371475 | DOI:10.1016/j.jbiomech.2021.110657

Eur J Cancer. 2021 Aug 6;155:97-105. doi: 10.1016/j.ejca.2021.06.052. Online ahead of print.

ABSTRACT

OBJECTIVE: It is unknown whether persistent metabolic syndrome (MetS) is associated with an increased risk of cholangiocarcinoma (CCA). Therefore, we investigated the risk of CCA according to changes in MetS status.

RESEARCH DESIGN AND METHODS: This nationwide cohort study included 8,581,407 adults who underwent anthropometric measurements and laboratory tests in two consecutive national health screenings during 2009-2012 and observed the subjects until 2017. Individuals with cancer, or follow-up duration <1 year were excluded (n = 377,915). Subjects were classified into the MetS-free, MetS-developed, MetS-improved, and MetS-persistent groups. The outcome was the incidence of CCA, identified using the claims database. Multivariable Cox proportional hazards regression models were used.

RESULTS: Among the 8,203,492 subjects (mean age 48.9 ± 12.8 years; 56.7% male), 7506 CCA patients were newly identified during a median follow-up of 5.1 years. The probability of CCA was consistently higher in the MetS-persistent group than in the MetS-free group (P < 0.001). MetS-persistent status was significantly associated with an increased risk of CCA compared with the MetS-free status (unadjusted hazard ratio [HR] 2.8, 95% confidence interval [CI] 2.66-2.95), even after adjusting for multiple covariates (adjusted HR 1.07, 95% CI 1.01-1.13). Improved or newly developed MetS was not associated with CCA risk in the fully adjusted model (aHR 1.02, 95% CI 0.94-1.10 and aHR 0.99, 95% CI 0.92-1.06, respectively).

CONCLUSIONS: MetS was associated with an increased risk of CCA if it persisted for ≥2 years. Our finding suggests that MetS may be a potentially modifiable risk factor for CCA.

PMID:34371446 | DOI:10.1016/j.ejca.2021.06.052

Sci Total Environ. 2021 Jul 31;799:149351. doi: 10.1016/j.scitotenv.2021.149351. Online ahead of print.

ABSTRACT

Climate change and particularly warming are significantly impacting marine ecosystems and the services they provided. Temperature, as the main factor driving all biological processes, may influence ectotherms metabolism, thermal tolerance limits and distribution species patterns. The joining action of climate change and local stressors (including the increasing human marine use) may facilitate the spread of non-indigenous and native outbreak forming species, leading to associated economic consequences for marine coastal economies. Marine aquaculture is one among the most economic anthropogenic activities threatened by multiple stressors and in turn, by increasing hard artificial substrates at sea would facilitate the expansion of these problematic organisms and face negative consequences regarding facilities management and farmed organisms’ welfare. Species Distribution Models (SDMs) are considered powerful tools for forecasting the future occurrences and distributions of problematic species used to preventively aware stakeholders. In the current study, we propose the use of combined correlative SDMs and mechanistic models, based on individual thermal performance curve models calculated through non-linear least squares regression and Bayesian statistics (functional-SDM), as an ecological relevant tool to increase our ability to investigate the potential indirect effect of climate change on the distributions of harmful species for human activities at sea, taking aquaculture as a food productive example and the benthic cnidarian Pennaria disticha (one of the most pernicious fouling species in aquaculture) as model species. Our combined approach was able to improve the prediction ability of both mechanistic and correlative models to get more ecologically informed “whole” niche of the studied species. Incorporating the mechanistic links between the organisms’ functional traits and their environments into SDMs through the use of a Bayesian functional-SDM approach would be a useful and reliable tool in early warning ecological systems, risk assessment and management actions focused on important economic activities and natural ecosystems conservation.

PMID:34371417 | DOI:10.1016/j.scitotenv.2021.149351