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Nevin Manimala Statistics

Investigation of the effect of thyroid collar, radiation safety glasses and lead apron on radiation dose in cone beam computed tomography

Dentomaxillofac Radiol. 2025 Jan 20:twaf007. doi: 10.1093/dmfr/twaf007. Online ahead of print.

ABSTRACT

OBJECTIVES: Due to the increasing use of cone-beam computed tomography (CBCT) in dentistry and considering the effects of radiation on radiosensitive organs, the aim of this study was to investigate the effect of shielding on absorbed dose of eyes, thyroid and breasts in scans conducted with different parameters using two different fields of view (FOV).

METHODS: Dose measurements were calculated on a tissue-equivalent female phantom by repeating each scanning parameter three times and placing at least two thermoluminescent dosimeters (TLD) on each organ, with the averages then taken. The same CBCT scans were performed in two different FOV with shielding including thyroid collar, radiation safety glasses and lead apron and without shielding. The differences between them were analyzed statistically. Descriptive statistics and the Wilcoxon test were used for data analysis.

RESULTS: The difference between measurements with and without shielding was statistically significant for all scans (p < 0.001). The dose reduction associated with the use of shielding ranged from 26.81% to 52.95%. The dose related to the FOV has shown a significant increase, ranging from 8.30% to 623.54%, due to both the variation in the area affected by the primary beam on the organs and changes in the amount of radiation.

CONCLUSION: There are significant differences in the absorbed dose depending on shielding and FOV usage. Therefore, the CBCT imaging protocol should be optimized by the operator, and special attention should be paid to the use of thyroid collars and radiation safety glasses, considering their effects on image quality.

PMID:39832266 | DOI:10.1093/dmfr/twaf007

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Factors Influencing Nursing Interns’ Engagement in Fall Prevention Activities in Saudi Arabia

Nurs Open. 2025 Jan;12(1):e70131. doi: 10.1002/nop2.70131.

ABSTRACT

AIM: To assess the knowledge, attitudes and engagement of nursing interns regarding fall prevention activities during their internship within hospital settings.

DESIGN: This study used a cross-sectional design.

METHODS: This was a cross-sectional, descriptive, correlational study. A convenience sample of 187 nursing interns was recruited from three hospitals in Riyadh, Saudi Arabia. A questionnaire was administered to the participants to collect data on their demographics, knowledge, attitudes and engagement in fall prevention. The collected data were analysed using descriptive and inferential statistics.

RESULTS: The participants exhibited insufficient knowledge, relatively negative attitudes and acceptable fall prevention engagement. There was a low-to-moderate positive association only between attitude and fall prevention engagement. Moreover, hierarchical multiple regression analysis showed that attitude was the only predictor for fall prevention engagement.

CONCLUSION: Fall prevention is an important subject that needs more attention from nursing programmes in universities and preceptorship programmes in hospitals to enhance nursing interns’ attitudes, knowledge and practices in this regard.

RELEVANCE TO CLINICAL PRACTICE: The findings of this research could be beneficial for clinical coordinators and faculty members to enhance nursing interns’ engagement in preventing falls among at-risk patients.

PATIENT OR PUBLIC CONTRIBUTION: Participants were not involved in the design, conduct, reporting or dissemination of this research.

PMID:39832264 | DOI:10.1002/nop2.70131

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Assessment of the rational use of the most commonly prescribed antibiotics at the Department of Health of Ramallah in Palestine

J Infect Dev Ctries. 2024 Dec 30;18(12):1909-1915. doi: 10.3855/jidc.19794.

ABSTRACT

INTRODUCTION: Appropriate antibiotic use requires using the right antibiotic, at the right dose, for the right duration, and at the right time. Drug-resistant diseases cause numerous deaths globally a year, and antibiotic stewardship is a cornerstone in fighting antibiotic resistance. This study focuses on tracking the antibiotic prescribing practices in Palestine and improving future antibiotic prescribing.

METHODOLOGY: Data from prescriptions of the most commonly prescribed antibiotics was collected from the Health Department of Ramallah and Al-Bireh clinics between January 1 to March 31, 2020. The prescriptions were divided into three categories according to the diagnosis status: unwritten, unspecific, and precise diagnosis. The precise prescriptions were further divided into two categories: appropriate or inappropriate indication. Only appropriate prescriptions were candidates for the assessment of dose and duration appropriateness.

RESULTS: The percentages of the three categories of diagnosis precise, unspecific, and unwritten were 23.4%, 20.4%, and 56.2%, respectively. The percentage of appropriate prescriptions was 16.2%. Azithromycin was the most over-utilized antibiotic, followed by co-amoxiclav (amoxicillin/clavulanic acid). Amoxicillin and co-trimoxazole (trimethoprim/sulfamethoxazole) were under-prescribed. All the prescriptions indicated for urinary tract infections (UTIs) were inappropriate.

CONCLUSIONS: Most prescriptions were not candidates for analysis due to missing diagnosis. Amoxicillin, co-amoxiclav, cefuroxime, azithromycin, and ciprofloxacin were the most commonly prescribed antibiotics and were mostly indicated for pharyngitis. The duration of all sinusitis regimens was inappropriate. More rational antibiotic use in the Department of Health could be achieved by improving documentation, following updated guidelines, choosing cost-effective agents, and keeping track of local resistance patterns and antibiograms.

PMID:39832250 | DOI:10.3855/jidc.19794

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Antibiotic Resistance Trends in ESKAPE Pathogens Isolated at a Health Practice and Research Hospital: A Five-Year Retrospective Study

J Infect Dev Ctries. 2024 Dec 30;18(12):1899-1908. doi: 10.3855/jidc.19592.

ABSTRACT

INTRODUCTION: Antimicrobial resistance remains a global threat with increasing morbidity and mortality rates. The aim of this study was to identify the antimicrobial resistance trends among ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) isolated from clinical samples at a Health Practice and Research Hospital over five years.

METHODOLOGY: Microbiological diagnosis utilized classical culture methods and automated systems. Antimicrobial susceptibility analysis was conducted using BD Phoenix, adhering to European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards.

RESULTS: A total of 15,272 clinical strains of ESKAPE pathogens were identified in this study. The most frequently isolated pathogens among ESKAPE were K. pneumoniae (3.938, 27.79%), Acinetobacter baumannii (3,013, 19.73%) and Enterococcus faecium (2,966, 19.24%). Bacterial strains were isolated predominantly from urine (3,263, 21.37%), followed by blood cultures (3,099, 20.29%). ESKAPE pathogens were most commonly found in internal intensive care units (4,758, 31.16%), followed by surgical intensive care units (4,000, 26.19%). Reduced resistance rates were observed for most antibiotics against Enterococcus faecium and Staphylococcus aureus. The vancomycin resistance rate for Enterococcus faecium was 18.48%, and the methicillin resistance rate for Staphylococcus aureus was 44.87%. A concerning trend of increasing antimicrobial resistance was noted in Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.

CONCLUSIONS: The alarming rise in antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae is a significant concern. The high rates of antimicrobial resistance observed in ESKAPE pathogens underscore the urgent need for improvement in antimicrobial stewardship and infection prevention and control programs.

PMID:39832249 | DOI:10.3855/jidc.19592

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Ongoing post-COVID-19 symptoms and complaints among healthcare professionals

J Infect Dev Ctries. 2024 Dec 30;18(12):1846-1854. doi: 10.3855/jidc.19368.

ABSTRACT

INTRODUCTION: Post-COVID-19 syndrome refers to the occurrence of symptoms lasting more than 4 weeks in individuals who have recovered from COVID-19. This study aims to investigate the post-COVID-19 symptoms in healthcare professionals.

METHODOLOGY: This descriptive study included 166 healthcare professionals who had tested positive for COVID-19 via PCR at least four weeks prior and subsequently presented to the Family Medicine Clinic at Pamukkale University Training and Research Hospital. Participants` demographic data, medical history, COVID-19 history and ongoing or newly emerged complaints and symptoms were evaluated, and physical examinations were carried out and recorded on a patient information form. Blood tests were conducted, and the results were analyzed.

RESULTS: The most common post-COVID-19 symptoms and complaints observed in our study were difficulty in performing daily activities (32.5%; n = 54), fatigue (26.5%; n = 44), forgetfulness (25.9%; n = 43) and weakness (24.1%; n = 40), respectively. Smoking, alcohol use, hospitalization, the need for oxygen support and having comorbidities such as asthma, diabetes, hypertension and rheumatism were found to be associated with various post-acute symptoms. Post-acute symptoms were most frequently observed in individuals vaccinated with Sinovac (38.5%), followed by those who were unvaccinated (35.7%). Least symptoms were seen in individuals vaccinated with only Biontech (15.4%).

CONCLUSIONS: The most common post-COVID-19 symptoms observed in our study were difficulty in performing daily activities, fatigue, forgetfulness and weakness. Having comorbidities was found to be associated with various post-COVID-19 symptoms.

PMID:39832242 | DOI:10.3855/jidc.19368

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Fecal fatty acid profile reveals the therapeutic effect of red ginseng acidic polysaccharide on type 2 diabetes mellitus in rats

J Food Sci. 2025 Jan;90(1):e70015. doi: 10.1111/1750-3841.70015.

ABSTRACT

This study aimed to investigate the potential hypoglycemic mechanism of red ginseng acidic polysaccharides (RGAP) from the perspective of fatty acid (FA) regulation. A high-glucose/high-fat diet in conjunction with streptozotocin administration was employed to establish type 2 diabetes mellitus (T2DM) rat models, and their fecal FAs were detected using the liquid chromatography-mass spectrometry (LC-MS) method. RGAP treatment alleviated the polyphagia, polydipsia, weight loss, and hyperglycemia observed in T2DM rats. FA profile was disturbed by T2DM modeling, and 11 marker FAs were selected from statistical analysis, whose intensities were reversely changed by RGAP administration. Among these marker FAs, short-chain FAs were negatively correlated with the fasting blood glucose (FBG) level, while positive correlations were observed between long-chain FA and the FBG level. Combined with the metabolite-enzyme-gene network analysis, we inferred that the mechanistic mechanism RGAP on T2DM may be associated with the regulation of FA metabolism and inflammation-related signaling pathways. This study confirmed the regulatory effect of RGAP on fecal FA, which can provide a scientific basis and new ideas for developing red ginseng as a functional food for supplementary treatment of T2DM.

PMID:39832227 | DOI:10.1111/1750-3841.70015

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Effect of targeted education of patients with atrial fibrillation on unplanned cardiovascular outcomes: results of the multicentre randomized AF-EduCare trial

Europace. 2024 Dec 26;27(1):euae211. doi: 10.1093/europace/euae211.

ABSTRACT

AIMS: Trials on integrated care for atrial fibrillation (AF) showed mixed results in different AF populations using various approaches. The multicentre, randomized AF-EduCare trial evaluated the effect of targeted patient education on unplanned cardiovascular outcomes.

METHODS AND RESULTS: Patients willing to participate were randomly assigned to in-person education, online education, or standard care (SC) and followed for minimum 18 months. Education focused on four aspects of integrated AF care: (i) knowledge on AF and oral anticoagulation; (ii) reinforcement of medication adherence; (iii) awareness about risk factors; and (iv) reachability for AF-related questions. The primary endpoint was the composite of cumulative events of unplanned cardiovascular hospitalizations and consultations, emergency department visits for cardiovascular reasons, and cardiovascular death. A total of 1038 patients (69.8 ± 9.2 years) were followed up for 26.9 ± 9.4 months. Education (both in-person and online) significantly improved AF-related knowledge compared to SC (P < 0.001), increased patient awareness about risk factors, led to high medication adherence, and encouraged patients to ask health-related questions. However, in-person education did not show an effect on the primary outcome compared to SC [HR 1.02 (0.91-1.14); P = 0.80] that was also not the case when comparing online education vs. SC [HR 1.18 (0.95-1.46), P = 0.65]. Exploratory subgroup analyses showed a heterogeneous effect over the centres, but a positive impact of in-person education in patients with asymptomatic AF, being 70 years old or younger, and without a history of heart failure.

CONCLUSION: AF-EduCare showed that intensive targeted patient education did not lead to less unplanned cardiovascular events in the AF patient population as a whole, although subgroups might benefit.

PMID:39832209 | DOI:10.1093/europace/euae211

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The Effect of Colchicine on Platelet Function Profiles in Patients with Stable Coronary Artery Disease: The ECLIPSE Pilot Study

Cardiol Ther. 2025 Jan 18. doi: 10.1007/s40119-024-00393-2. Online ahead of print.

ABSTRACT

INTRODUCTION: This prospective, single-arm pharmacodynamic study assessed the effect of colchicine (COLC) [Strides Pharma UK Ltd, Watford, Hertfordshire, England] 0.5 mg administered orally once daily for 14 days on platelet reactivity with respect to aspirin reaction units (ARUs) and P2Y12 reaction units (PRUs).

METHODS: Twenty-two patients with stable coronary artery disease (CAD) on dual antiplatelet therapy (DAPT) with daily maintenance aspirin and clopidogrel were recruited. Baseline platelet function was evaluated with the VerifyNow™ ARU and PRU assays (Werfen, Bedford, MA, USA) and assessed post-completion of COLC 0.5 mg once daily for 14 days.

RESULTS: In this study, the median ARU baseline score was 463, and post-COLC it was 436, which was not statistically significant (p = 0.485). The mean difference in scores was -18.31 (95% confidence interval [CI] -74.34 to 37.71, p = 0.504). At baseline, 27.3% of the patients had “aspirin resistance” or were non-responders, compared to 13.6% post-COLC (p = 0.423). The median baseline PRU score was 210, and post-COLC it was 199, which was also not statistically significant (p = 0.581). The mean difference in scores was -7.31 (95% CI -31.1 to 16.5, p = 0.530). At baseline, 50% of the patients had “clopidogrel resistance” or were non-responders, compared to 45.5% post-COLC (p = 0.999). Two patients experienced mild gastrointestinal upset during the trial without interruption of COLC, and there were no serious adverse events or treatment-emergent adverse events.

CONCLUSIONS: There were no significant differences in ARUs and PRUs post-COLC trial in patients with stable CAD. This pilot pharmacodynamic study could be clinically informative in patients on DAPT. Further studies are required to confirm these exploratory findings.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT06567678, prospectively registered 20/8/2024.

PMID:39826082 | DOI:10.1007/s40119-024-00393-2

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A prediction model for electrical strength of gaseous medium based on molecular reactivity descriptors and machine learning method

J Mol Model. 2025 Jan 18;31(2):53. doi: 10.1007/s00894-024-06254-y.

ABSTRACT

CONTEXT: Ionization and adsorption in gas discharge are similar to electrophilic and nucleophilic reactions. The molecular descriptors characterizing reactions such as electrostatic potential descriptors are useful in predicting the electrical strength of environmentally friendly gases. In this study, descriptors of 73 molecules are employed for correlation analysis with electrical strength. These molecular descriptors are categorized into two types: area-related descriptors and reactivity-related descriptors. Furthermore, the predictive performance between statistical models and machine learning models is compared. The statistical models include multiple linear regression, and polynomial regression, while machine learning models consist of K-nearest neighbors, random forest, and gradient boosting decision trees. The results indicate that machine learning models are generally better than statistical models in terms of predictive accuracy and stability, with gradient boosting decision trees demonstrating the best performance. Specifically, the coefficient of determination and mean squared error on the testing set after 1000 training iterations are 0.864 and 0.105, respectively. Therefore, the application of molecular reactivity descriptors and machine learning methods can effectively predict the electrical strength of gaseous medium.

METHODS: The Gaussian 16 software is employed to optimize the molecular structure with the M06-2X functional and def2 series basis sets in this study. Then, the Multiwfn is utilized for wavefunction analysis to obtain molecular surface descriptors.

PMID:39826053 | DOI:10.1007/s00894-024-06254-y

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Pancreas-guided C-shaped surgical procedure: a safer and more efficient procedure for laparoscopic left hemicolectomy in obese patients

Updates Surg. 2025 Jan 18. doi: 10.1007/s13304-025-02071-x. Online ahead of print.

ABSTRACT

The surgical risk is higher for obese patients undergoing laparoscopic left hemicolectomy. To enhance the surgical safety and efficacy for obese patients, we have innovatively integrated the advantages of various surgical approaches to modify a pancreas-guided C-shaped surgical procedure. The safety and quality were assessed through a retrospective analysis. Colon cancer patients who underwent laparoscopic left hemicolectomy were categorized into two groups, C-shaped group and Medial-to-lateral group. Baseline data, operative safety indices, operative quality indices and learning curve were subjected to statistical analysis. The complete mesocolic excision rate and R0 resection rate were 100% in both groups. In terms of surgical safety, C-shaped group experienced significantly less blood loss (50(20) mL vs. 50(50) mL, p = 0.002), shorter total operative time (252.65 ± 50.43 min vs. 280.12 ± 70.45 min, p = 0.004) and no organ damage occurred. All patients were classified into four BMI grades (I: BMI < 18.5 kg/m2; II: 18.5 ≤ BMI < 24 kg/m2; III: 24 ≤ BMI < 28 kg/m2; IV: BMI ≥ 28 kg/m2). The total operative time and estimated blood loss were significantly lower in obese patients (BMI grade III and IV) of C-shaped group. In addition, intra-group analysis further confirmed that this modified surgical technique could effectively enhance safety and efficiency for obese patients. Learning curve analysis revealed a significant reduction in total operative time after the completion of 20 surgeries. Utilization of the pancreas-guided C-shaped surgical procedure in obese patients ensures reliable surgical outcomes and significantly increases safety and efficiency. In addition, it is easier to learn and master.

PMID:39826041 | DOI:10.1007/s13304-025-02071-x