Category: Nevin Manimala

Dement Geriatr Cogn Disord. 2021 Jul 22:1-5. doi: 10.1159/000517580. Online ahead of print.

ABSTRACT

INTRODUCTION: Mild cognitive impairment (MCI) represents a target for early detection and intervention in dementia, yet there is a shortage of validated screening tools in Arabic to diagnose MCI. The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition.

OBJECTIVE: We aimed to validate the m-ACE in Arabic speakers in Egypt with MCI to provide cut-off scores.

METHODS: We included 24 patients with MCI and 52 controls and administered the Arabic version of the m-ACE.

RESULTS: There was a statistically significant difference (p < 0.0001) on the total m-ACE score between MCI patients (mean 18.54, SD 3.05) and controls (mean 24.54, SD 2.68). There was also a statistically significant difference between MCI patients and controls on the total score and the fluency, visuospatial, and memory recall sub-scores of the m-ACE (p < 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cut-off score for MCI on the m-ACE total score was 21 out of 30 (87.5% sensitivity, 84.6% specificity, and 85.5% accuracy).

CONCLUSIONS: We validated the Arabic m-ACE in Egyptian patients with MCI and provided objective validation of it as a screening tool for MCI, with good sensitivity, specificity, and accuracy that is comparable to other translated versions of the m-ACE in MCI.

PMID:34293741 | DOI:10.1159/000517580

Ophthalmic Plast Reconstr Surg. 2021 Jul 21. doi: 10.1097/IOP.0000000000002027. Online ahead of print.

ABSTRACT

PURPOSE: To describe the efficacy of tocilizumab in the treatment of a cohort of patients with active thyroid-associated orbitopathy.

METHODS: Patients were identified with active thyroid-associated orbitopathy who were intolerant of or had progression of disease despite systemic corticosteroids and subsequently were treated with tocilizumab between January 2015 and December 2020. Clinical Activity Score, Thyroid-Associated Ophthalmopathy Scale score, and thyroid-stimulating immunoglobulin levels were assessed prior to initiation of tocilizumab, following the first dose, and after the completion of treatment.

RESULTS: Eleven patients were candidates for and underwent treatment with tocilizumab, 9 of which met criteria for analysis. Average age was 55.6 years. Average time between onset of active thyroid-associated orbitopathy and completion of tocilizumab was 6.5 months. Average number of infusions was 4.2. There was a statistically significant reduction in Clinical Activity Score, Thyroid-Associated Ophthalmopathy Scale score, and thyroid-stimulating immunoglobulin levels when comparing pre-treatment values (mean Clinical Activity Score 6.78 ± 1.09, mean Thyroid-Associated Ophthalmopathy Scale score 10.2 ± 1.92, mean thyroid-stimulating immunoglobulin level 440.6 [%]) to values immediately following completion of treatment (mean Clinical Activity Score 0.44 ± 0.53, mean difference 6.3 points, p < 0.001 [95% CI, 5.5-7.2]; mean Thyroid-Associated Ophthalmopathy Scale score 1.2 ± 1.09, mean difference 9.0 points, p < 0.001 [95% CI, 7.2-10.8]; mean thyroid-stimulating immunoglobulin level 200.7 [%], mean difference 239.9 [%], p = 0.001 [95% CI, 124.3-355.4]). One patient had elevation of cholesterol following therapy induction. Patients were followed for an average of 23.6 months after treatment. No patients had recurrence of active disease after completion of tocilizumab.

CONCLUSIONS: This study supports the use of tocilizumab as a therapy for the inflammatory phase of thyroid-associated orbitopathy.

PMID:34293786 | DOI:10.1097/IOP.0000000000002027

Nutrition. 2021 Jun 7;91-92:111386. doi: 10.1016/j.nut.2021.111386. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to investigate the correlation between dietary patterns and the risk of sarcopenic obesity (SO) in community-dwelling elderly people.

METHODS: SO was defined as the coexistence of sarcopenia and obesity. Participants with low skeletal muscle index, low muscle strength, or low physical performance were diagnosed with sarcopenia, whereas obesity was defined as waist circumference ≥85 cm in men and ≥80 cm in women. Dietary patterns were determined by principal component analysis. Multinomial logistic regression analysis was used to evaluate the relationship between dietary patterns and SO.

RESULTS: Among 3795 Chinese participants, 112 (3.0%) were diagnosed with SO. After adjustment for confounding variables, lacto-ovo-vegetarian dietary pattern was negatively associated with risk of SO. The odds ratio for SO was 0.79 (95% confidence interval, 0.65-0.97; P = 0.027) for the lacto-ovo-vegetarian dietary pattern, whereas meat-fish and junk food dietary patterns were not associated with the risk of SO.

CONCLUSIONS: We suggest that older people should have a balanced daily diet such as a lacto-ovo-vegetarian dietary pattern to prevent the occurrence and progression of SO.

PMID:34293713 | DOI:10.1016/j.nut.2021.111386

Arch Gerontol Geriatr. 2021 Jul 15;97:104485. doi: 10.1016/j.archger.2021.104485. Online ahead of print.

ABSTRACT

PURPOSE: To compare the effects of exergames versus conventional physical training on the cognitive skills of older adults.

MATERIALS AND METHODS: Scientific studies published in PubMed, Web of Science, and Cochrane Library databases were searched. Individual studies were assessed using the Cochrane Risk-of-bias tool for randomized trials (RoB 2). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE Pro). The cognitive outcomes were Trail Making Test (TMT)-A, TMT-B, Stroop Word-Color test, Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA).

RESULTS: We identified 256 studies, in which 13 studies were included in the systematic review and 11 in the meta-analysis. The majority of the exergame interventions were based on the Xbox 360’s Kinect, followed by the Impact Dance Platform, Nintendo Wii, and the Bike Labyrinth. We observed heterogeneity in the conventional exercise group and in the duration of training, which ranged from 12 to 52 sessions. There was no statistically significant difference between groups in TMT-A (p=0.083), TMT-B (p=0.122), and Stroop (p=0.191). There were differences in favor of exergames in MMSE (raw mean difference=-1.58, 95% CI: -2.87 to -0.28, p<0.001) and MoCA (raw mean difference=-1.22, 95% CI: -2.24 to -0.20, p=0.019).

CONCLUSIONS: Despite statistical differences in MMSE and MoCA, these results should be interpreted with caution due to methodological heterogeneity. Some studies reported possible neurophysiological benefits induced by exergames, which should be explored in future investigations.

PMID:34293715 | DOI:10.1016/j.archger.2021.104485

J Mech Behav Biomed Mater. 2021 Jul 13;122:104695. doi: 10.1016/j.jmbbm.2021.104695. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to optimize the crystallization process and the microstructure of a new bioactive glass-ceramic (GC) previously developed by our research group to obtain machinable glass-ceramics.

METHODS: Differential scanning calorimetry (DSC) analyses were conducted to explore the characteristic temperatures and construct a semi-quantitative nucleation curve. The GC specimens were characterized by X-ray diffraction (XRD) and Rietveld refinement. Their brittleness index (B) and machinability were characterized and compared with IPS e.max-CAD®. Their Young’s modulus, fracture toughness, and hardness were assessed.

RESULTS: We found that the maximum crystal nucleation rate temperature of this GC is ~470 °C. Treatments were designed based on the 1st DSC peak onset (570 °C), 1st peak offset (650 °C), and 2nd peak offset (705 °C) crystallization temperatures of lithium metasilicate (LS, LiSi₂O₃) and lithium disilicate (LS2, Li₂Si₂O₅). Rietveld refinement indicated an increase in LS2 and a reduction in LS and amorphous phase for increased temperatures and longer treatment times. Their B values indicate good machinability compared with that of the control group based on statistical analyses. As expected, lower levels of LS2 increase the machinability regardless of the rotation speed adopted, leading to a greater depth of cut and reduced Edge Chipping Damage Depth (ECDD).

CONCLUSION: This bioactive GC with optimized microstructure presents high machinability. For treatment temperatures above 570 °C, the number of elongated LS2 crystals increases and decreases the amorphous phase content, which reduce the machinability of the GC, and should therefore be avoided. The best results were obtained using heat treatment at 570 °C, which produces LS crystals embedded in a glassy matrix (67%) with small contents of secondary phases.

PMID:34293695 | DOI:10.1016/j.jmbbm.2021.104695

Nurse Educ Pract. 2021 Jul 14;55:103150. doi: 10.1016/j.nepr.2021.103150. Online ahead of print.

ABSTRACT

AIM/OBJECTIVE: This paper sought to investigate the influence of the supernumerary clinical nurse educator role on the newly qualified graduate nurses’ professional development and successful transition to competent and confident practitioners in the acute care hospital environment.

BACKGROUND: The novice nurses learning in the inpatient clinical environment is affected by increasing patient acuity, complex conditions and organisational expectations. The supernumerary clinical nurse educator is uniquely positioned to prioritise these nurses’ education through protected and available time to support adaption in the workplace culture and retention in the organisation.

DESIGN: A convergent mixed methods design was used to investigate the relationship between the supernumerary clinical nurse educator role through the opinions and experiences of the graduate nurse.

METHODS: Data were collected in February – July 2015 from graduate nurses from three hospital sites in a healthcare organisation in Western Australia. The research used online questionnaires (n = 39) and face to face interviews (n = 10). Analysis of quantitative data used descriptive statistics and qualitative data used thematic analysis.

RESULTS: Four main themes were identified. These were: acknowledges new and challenging experiences, available to provide constructive responses, sympathises with anxiety and missing in action.

CONCLUSION: The graduate registered nurses perceived that clinical sympathy provided by the clinical nurse educator was essential to their new role of frontline nurses influencing their delivery of quality patient care and as a practical solution to champion the graduate nurses’ longevity in the future nursing workforce.

PMID:34293705 | DOI:10.1016/j.nepr.2021.103150

Clin Neurol Neurosurg. 2021 Jul 10;207:106808. doi: 10.1016/j.clineuro.2021.106808. Online ahead of print.

ABSTRACT

INTRODUCTION: Meningiomas are usually considered benign lesions, however a proportion of them shows a more aggressive behavior, defined high-grade meningiomas (HGM). Effective medical treatments are lacking, especially at the time of recurrence.

METHODS: Through a retrospective analysis, we examined epidemiological, diagnostic, therapeutic, recurrence information and survival data of HGM treated at our institution between 2010 and 2018.

RESULTS: 183 patients (105 females and 78 males), with median age of 58 years (25-88), were included; 168 were atypical, 12 anaplastic, 3 rhabdoid. Overall, m-PFS was 4.2 years, and m-OS was 10.3 years. Gross-total resection had a 5-year survival rate of 95% compared with subtotal/partial resection (86% and 67%) (p = 0.002). Higher expression of Ki-67/MIB-1 seems associated with higher risk of death (HR:1.06 with 95% CI, 1.00-1.12, p = 0.03). No statistically significant differences were seen in survival between the group managed with a wait-and-see strategy vs the group treated with RT while a difference on PFS was seen (4.1 years vs 5.2 years p = 0.03). After second recurrence, the most employed treatments were systemic therapies with a very limited effect on disease control.

CONCLUSIONS: Data confirmed the aggressive behavior of HGM. The extent of resection seems to correlate with a favorable outcome regardless histological subtypes. The role of RT remains controversial, with no statistically significant impact on OS but a possible role on PFS. Recurrent HGM remains the real challenge, to date no chemotherapies are able to achieve disease control. Future research should focus on biological/molecular predictors in order to achieve a patient-tailored treatment.

PMID:34293659 | DOI:10.1016/j.clineuro.2021.106808

J Environ Manage. 2021 Jul 19;297:113316. doi: 10.1016/j.jenvman.2021.113316. Online ahead of print.

ABSTRACT

Agriculture and the food system emit a considerable amount of Greenhouse Gas (GHG) emissions in the atmosphere. Hence, current researchers, policymakers, and other stakeholders are calling for improving the environmental performance of agriculture. This study utilizes the countries of The Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) to investigate the effect of agriculture value-added, pesticide use, renewable energy adoption, human capital, and economic growth on greenhouse gas emissions. The moderation effect of renewable energy use and human capital is also introduced to see whether they can offset agriculture’s emissions in these BIMSTEC economies. Having reported a state-of-the-art literature review, the econometric procedure applies the second-generation unit root tests, panel cointegration and panel quantile regression for three preferred model specifications. The result from the Panel quantile regression method reveals a U-shaped relationship between agriculture value-added and greenhouse gas emissions, suggesting the significance of a small farming system. Human capital has a negative effect, whereas pesticide use has a positive effect on greenhouse gas emissions. Furthermore, the moderation effect of human capital and pesticide use suggests that human capital is not significant enough to offset the effect of pesticide use on the greenhouse gas emissions, whereas the interaction of renewable and pesticide use suggests that renewable energy adoption in the agriculture sector can mitigate the effect of pesticide use on GHG emissions. Finally, the conclusions of the study support the achievement of few sustainable development goals.

PMID:34293673 | DOI:10.1016/j.jenvman.2021.113316

J Mech Behav Biomed Mater. 2021 May 23;122:104521. doi: 10.1016/j.jmbbm.2021.104521. Online ahead of print.

ABSTRACT

A solution is obtained for incompressible non-linearly elastic membranes that describes the bending of a cylindrical sector to form a perfect cylinder for a wide class of materials that includes isotropic materials and orthotropic materials reinforced by two families of mechanically equivalent fibres that are wound helically about the axial direction. Despite the relative simplicity of the physical problem, the solution of the corresponding boundary value problem for thick cylinders requires a numerical solution for even the simplest models. It is shown, however, that the thin shell solution provides an excellent approximation to the solution of the problem for cylindrical sectors whose thicknesses are an order of magnitude greater than that assumed for membranes. The approximate stress distribution in such thin shells is obtained. In these residually stressed cylinders, the radial stress is approximately zero but the hoop and axial stresses are finite. Estimates of the residual stresses in the unloaded state are obtained. A closed-form solution for the bending moment necessary to effect the deformation is also obtained.

PMID:34293693 | DOI:10.1016/j.jmbbm.2021.104521

Curr Opin Biotechnol. 2021 Jul 19;71:91-97. doi: 10.1016/j.copbio.2021.06.024. Online ahead of print.

ABSTRACT

Microbial organisms engage in a variety of metabolic interactions. A crucial part of these interactions is the exchange of molecules between different organelles, cells, and the environment. The main forces mediating this metabolic exchange are transporters. This transport can be difficult to measure experimentally because several transport mechanisms remain opaque. However, theoretical calculations about the inputs and outputs of cells via metabolic exchanges have enabled the successful inference of the workings of intra-organismal and inter-organismal systems. Kinetic, metabolic, and statistical modeling approaches in combination with omics data are enhancing our knowledge and understanding about metabolic exchange and mass resource allocation. This model-driven analytics approach can guide effective experimental design and yield new insights into biological function and control.

PMID:34293631 | DOI:10.1016/j.copbio.2021.06.024