Nevin Manimala

Soft Matter. 2023 Jul 20. doi: 10.1039/d3sm00835e. Online ahead of print.

ABSTRACT

Soft condensed matter structures often challenge us with complex many-body phenomena governed by collective modes spanning wide spatial and temporal domains. In order to successfully tackle such problems, mesoscopic coarse-grained (CG) statistical models are being developed, providing a dramatic reduction in computational complexity. CG models provide an intermediate step in the complex statistical framework of linking the thermodynamics of condensed phases with the properties of their constituent atoms and molecules. These allow us to offload part of the problem to the CG model itself and reformulate the remainder in terms of reduced CG phase space. However, such exchange of pawns to chess pieces, or ‘Hamiltonian renormalization’, is a radical step and the thermodynamics of the primary atomic and CG models could be quite distinct. Here, we present a comprehensive study of the phase diagram including binodal and interfacial properties of a dissipative particle dynamics (DPD) model, extended to include finite-range attraction to support the liquid-gas equilibrium. Despite the similarities with the atomic model potentials, its phase envelope is markedly different featuring several anomalies such as an unusually broad liquid range, change in concavity of the liquid coexistence branch with variation of the model parameters, volume contraction on fusion, temperature of maximum density in the liquid phase and negative thermal expansion in the solid phase. These results provide new insight into the connection between simple potential models and complex emergent condensed matter phenomena.

PMID:37470164 | DOI:10.1039/d3sm00835e

BJU Int. 2023 Jul 20. doi: 10.1111/bju.16134. Online ahead of print.

ABSTRACT

OBJECTIVES: to compare USC pentafecta and trifecta achievement comparing open radical cystectomy (ORC) vs robot-assisted RC (RARC) with totally intracorporeal UD (i-UD) from a randomised controlled trial (RCT) MATERIALS AND METHODS: Patients were eligible for randomization if they had a diagnostic TURBt with cT2-4, cN0, cM0, or recurrent HG NMIBC and no anesthesiologic contraindications to robotic surgery. Patients were enrolled with a covariate adaptive randomization process based on the following variables: BMI, ASA score, preoperative haemoglobin, planned UD, neoadjuvant chemotherapy and cT-stage. USC pentafecta was defined as the combination, 1-yr after surgery, of negative soft tissue surgical margins, ≥ 16 lymph node (LN) yield, absence of major (Clavien≥3) complications at 90 days, absence of UD-related long-term sequalae and absence of clinical recurrence. Trifecta was defined as the coexistence of daytime urinary continence, absence of major complications and recurrence-free status, all assessed at 1 year. Continuous and categorical variables were compared using Student t and Chi-Square tests, respectively. Univariable logistic regression analysis was performed to assess the role of USC pentafecta and trifecta achievement on HRQoL.

RESULTS: No statistically significant difference was observed in USC pentafecta and trifecta achievement between groups. Among secondary outcomes, univariable logistic regression analysis was performed and both 1yr USC Pentafecta and trifecta achievement were predictors of 2yrs unmodified global QoL.

CONCLUSIONS: This study supports equivalence of RARC-iUD and ORC with regard to surgical quality as described by USC pentafecta and trifecta. We described a significant impact of USC pentafecta and trifecta achievement on global health status/QoL, providing a strict correlation between objective evaluation of surgical outcomes and self-reported HRQoL.

PMID:37470132 | DOI:10.1111/bju.16134

J Prosthodont. 2023 Jul 20. doi: 10.1111/jopr.13738. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this cross-sectional clinical study was to determine and compare alveolar ridge mucosa thickness at crestal, buccal, and lingual locations of the maxillary and mandibular arches in completely edentulous patients using a dedicated, ultrasonic gingival scanner.

MATERIALS AND METHODS: Thirty-eight completely edentulous subjects were included in the study. In each subject, soft tissue thickness was measured at 28 sites of the edentulous ridge by a single calibrated examiner. Intra-observer reliability was calculated with Intraclass Correlation Coefficients by measuring 10 subjects twice, after 1 week. Measurements (mm) were taken at the buccal, lingual, and crestal aspects of the ridge with a dedicated ultrasonic scanner. Repeated measures ANOVA and paired t-tests were used to compare the mean buccal, lingual, and crestal soft tissue thicknesses at each site. The Generalized Estimating Equations model was used to study the effects of age, gender, and race. Confidence level was set to 95%.

RESULTS: Mean tissue thickness ranged from 0.96 mm to 1.98 mm with a mean of 1.63 ± 0.25 mm. Intraclass Correlation Coefficients were >0.97. No significant differences between buccal, crestal, and lingual sites were noted for the mandibular arch as well as at 4 sites on the maxillary arch (maxillary right second molar, maxillary right canine, maxillary left first premolar, maxillary left second molar). However, significant differences in soft tissue thickness were noted for all remaining maxillary sites. Race was found to be positively correlated with tissue thickness, with black individuals showing a significantly greater thickness than whites at four sites (maxillary right first molar, maxillary left canine, mandibular right second premolar, mandibular right first molar). Age was found to be positively correlated with tissue thickness at 4 sites (maxillary left central incisor, maxillary left first molar, maxillary left second molar, mandibular left second premolar) and negatively correlated at 2 sites (mandibul0ar right canine, mandibular right second molar). Female gender was positively (maxillary left second premolar, maxillary left second molar) and negatively (mandibular right canine) correlated, respectively, with tissue thickness at 3 sites. When data for anterior and posterior sites was respectively pooled, tissue thickness was significantly less at anterior sextant lingual and crestal sites, while no difference was seen for buccal sites.

CONCLUSION: Statistically significant differences for alveolar ridge mucosa thickness were found at several sites in the maxilla and between anterior and posterior sextants for lingual and crestal sites in the maxillary and mandibular arches. Tissue thickness differences were also noted for race with black individuals showing greater tissue thickness at some sites. Age and gender did not show a clear effect on tissue thickness. Recorded differences in tissue thickness were however small and appear of uncertain clinical significance. This article is protected by copyright. All rights reserved.

PMID:37470112 | DOI:10.1111/jopr.13738

Eur J Heart Fail. 2023 Jul 20. doi: 10.1002/ejhf.2977. Online ahead of print.

ABSTRACT

AIMS: Mitiperstat (formerly AZD4831) is a novel selective myeloperoxidase inhibitor. Currently, no effective therapies target comorbidity-induced systemic inflammation, which may be a key mechanism underlying heart failure with preserved or mildly reduced ejection fraction (HFpEF/HFmrEF). Circulating neutrophils secrete myeloperoxidase, causing oxidative stress, microvascular endothelial dysfunction, interstitial fibrosis, cardiomyocyte remodelling and diastolic dysfunction. Mitiperstat may therefore improve function of the heart and other organs, and ameliorate heart failure symptoms and exercise intolerance. ENDEAVOR is a combined, seamless phase 2b-3 study of the efficacy and safety of mitiperstat in patients with HFpEF/HFmrEF.

METHODS: In phase 2b, approximately 660 patients with heart failure and ejection fraction >40% are being randomized 1:1:1 to mitiperstat 2.5 mg, 5 mg or placebo for 48 weeks. Eligible patients have baseline 6-min walk distance (6MWD) of 30-400 m with a < 50 m difference between screening and randomization and Kansas City Cardiomyopathy Questionnaire – total symptom score (KCCQ-TSS) ≤90 points at screening and randomization. The dual primary endpoints are change from baseline to week 16 in 6MWD and KCCQ-TSS. The sample size provides 85% power to detect placebo-adjusted improvements of 21 m in 6MWD and 6.0 points in KCCQ-TSS at overall two-sided alpha of 0.05. Safety is monitored throughout treatment, with a focus on maculopapular rash. In phase 3 of ENDEAVOR, approximately 820 patients will be randomized 1:1 to mitiperstat or placebo.

CONCLUSION: ENDEAVOR is the first phase 2b-3 study to evaluate whether myeloperoxidase inhibition can improve symptoms and exercise capacity in patients with HFpEF/HFmrEF. Clincaltrials.gov: NCT04986202 This article is protected by copyright. All rights reserved.

PMID:37470101 | DOI:10.1002/ejhf.2977

J Pediatr Orthop. 2023 Jul 20. doi: 10.1097/BPO.0000000000002471. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric physeal ankle fractures carry a high risk of complications. This study aimed to (1) investigate the effect of anatomic reduction of the physis on mid to long-term functional outcomes in Salter-Harris type II and triplane distal tibial physeal fractures (DTPFs) and (2) compare the outcomes of 3 different surgical techniques applied in these fractures.

METHODS: The database of a single level-I trauma center was retrospectively reviewed for DTPFs between 2012 and 2022. A total of 39 eligible patients with operative Salter-Harris type II and triplane fractures between 2012 and 2022 were included. Surgical treatment methods were closed reduction-percutaneous fixation (CR-PF), open reduction-screw fixation, or open reduction-plate fixation. Patients were further divided into subgroups for fractures reduced anatomically (<1 mm) or nonanatomically (1 to 3 mm). The primary outcome measures were the American Orthopaedic Foot and Ankle Society Score, ankle range of motion, presence of premature physeal closure and angular deformities, and Takakura ankle osteoarthritis grade.

RESULTS: A total of 39 patients were included, with an average age of 12.9 ± 2.2 years. The mean follow-up time was 68.9±38.0 months. The CR-PF group had higher postoperative fracture displacement (P = 0.011). American Orthopaedic Foot and Ankle Society scores were excellent in all groups, statistically similar between surgical techniques, and similar between anatomic and nonanatomic reduction groups. The CR-PF group (P =0.030) and nonanatomic reduction (P = 0.030) provided a significantly lower ankle osteoarthritis rate. All 4 patients with premature physeal closure were observed in patients treated with open techniques.

CONCLUSIONS: CR-PF for the treatment of DTPFs should be preferred in suitable cases as it is less invasive and provides satisfactory mid to long-term functional outcomes without increasing complications compared with anatomic reduction and open techniques.

LEVEL OF EVIDENCE: Level III.

PMID:37470086 | DOI:10.1097/BPO.0000000000002471

BJOG. 2023 Jul 20. doi: 10.1111/1471-0528.17581. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore potential reasons for differences in preterm neonatal mortality in neonatal intensive care units (NICUs) in India and Pakistan.

DESIGN: A prospective observational study, the Project to Understand and Research Stillbirth and Preterms in Southeast Asia (PURPOSe) was conducted July 2018 to February 2020.

SETTING: Three hospitals in Davangere, India, and a large public hospital in Karachi, Pakistan.

POPULATION: Of a total of 3,202 preterm infants enrolled, 1,512 were admitted to a study NICU.

METHODS: We collected data for neonates, including length of stay, diagnoses, and diagnostic tests.

MAIN OUTCOME MEASURES: Neonatal mortality, tests performed, diagnoses ascertained.

RESULTS: For infants of equivalent weights and gestational ages, neonatal mortality in Pakistan was twice that in the Indian NICU. The mean newborn length of stay in Pakistan was 2 days compared with 10 days for India. Fewer diagnostics and other investigations were used to determine neonatal condition or guide treatment in the Pakistani NICU. Because of limited information from testing in Pakistan concerning clinical respiratory distress, respiratory distress syndrome appeared to be over-diagnosed, whereas other conditions including pneumonia, sepsis, necrotising entercolitis and intraventricular haemorrhage were rarely diagnosed.

CONCLUSION: In the Pakistani site, the limited resources available to the NICU appeared related to a shorter length of stay and decreased diagnostic testing, likely explaining the higher mortality. With improved care, reduction in mortality among preterm neonates should be achievable.

PMID:37470084 | DOI:10.1111/1471-0528.17581

Front Allergy. 2023 Jul 4;4:1126012. doi: 10.3389/falgy.2023.1126012. eCollection 2023.

ABSTRACT

INTRODUCTION: Immunophenotyping, which is the identification of immune cell subsets based on antigen expression, is an integral technique used to determine changes of cell composition and activation in various disease states or as a response to different stimuli. As nanoparticles are increasingly utilized for diagnostic and therapeutic applications, it is important to develop methodology that allows for the evaluation of their immunological impact. Therefore, the development of techniques such as immunophenotyping are desirable. Currently, the most common technique used to perform immunophenotyping is multicolor flow cytometry.

METHODS: We developed two distinct multicolor flow cytometry immunophenotyping panels which allow for the evaluation of the effects of nanoparticles on the composition and activation status of treated human peripheral blood mononuclear cells. These two panels assess the presence of various lymphoid and myeloid-derived cell populations as well as aspects of their activation statuses-including proliferation, adhesion, co-stimulation/presentation, and early activation-after treatment with controls or nanoparticles. To conduct assay performance qualification and determine the applicability of this method to preclinical characterization of nanoparticles, we used clinical-grade nanoformulations (AmBisome, Doxil and Feraheme) and research-grade PAMAM dendrimers of different sizes (G3, G4 and G5) and surface functionalities (amine-, carboxy- and hydroxy-).

RESULTS AND DISCUSSION: We found that formulations possessing intrinsic fluorescent properties (e.g., Doxil and AmBisome) interfere with accurate immunophenotyping; such interference may be partially overcome by dilution. In the absence of interference (e.g., in the case of dendrimers), nanoparticle size and surface functionalities determine their effects on the cells with large amine-terminated dendrimers being the most reactive.

PMID:37470031 | PMC:PMC10353541 | DOI:10.3389/falgy.2023.1126012

Ecol Evol. 2023 Jul 17;13(7):e10298. doi: 10.1002/ece3.10298. eCollection 2023 Jul.

ABSTRACT

Most marine invertebrate larvae either obligately feed or depend on maternally provided reserves during planktonic development. A small number of species have the capacity to do both, in a mode of development known as facultative planktotrophy. We describe facultative feeding in a larva from the Oregon coast, and identify it as being an undescribed species in the genus Amphiodia, which we refer to as Amphiodia sp. opaque. We quantified the effects of food on larval and juvenile quality by culturing larvae, collected as embryos, with and without microalgal food at 15°C. The resulting juveniles were monitored under conditions of starvation. A cohort of juveniles of larvae caught as plankton was subjected to the same starvation treatment for comparison with our laboratory-reared larvae. We observed benefits to offspring that received food: larvae provided with microalgae developed more quickly and metamorphosed at higher rates. Furthermore, juveniles resulting from fed larvae were larger and were able to avoid starvation for longer after metamorphosis. Our results varied across two experimental years, suggesting that provisions provided by parents vary between populations and years. Juveniles from planktonic larvae exhibited sizes not statistically different from larvae cultured in the absence of food, but died from starvation more quickly.

PMID:37470028 | PMC:PMC10352130 | DOI:10.1002/ece3.10298

J Nutr Metab. 2023 Jul 11;2023:9998499. doi: 10.1155/2023/9998499. eCollection 2023.

ABSTRACT

BACKGROUND: The microwave body remodeling system is indicated for people who want to improve their physical appearance as it can penetrate deep tissues, causing thermic stress on adipocytes to produce adipolysis while in superficial tissues, it dissolves fibrous tracts and stimulates new collagen.

OBJECTIVES: The aim of this study was to assess the localized adiposity reduction in Latin American patients using a microwave system.

METHODS: A total of 35 patients with a mean age of 47.5 (±9.0) years received body remodeling treatment, using the microwave system between the years 2019-2022 in a Bogota, Colombia reference center. Data descriptive analysis was made as well as single-factor repeated measures ANOVA to show pre- and post-treatment difference, and mixed ANOVA for body mass index (BMI) subgroup analysis was performed.

RESULTS: In all patients examined, statistical significant differences were found in pre- and post-treatment skinfold test for each body area: superior abdomen (F(1,27) = 63.13; p=0.001), iliac crest (F(1, 23) = 114.33; p < 0.001), posterior waist (F(1, 20) = 27.36; p < 0.001), trochanter (F(1, 17) = 26.94; p < 0.001), among others.

CONCLUSIONS: According to the study’s findings, this microwave system is an innovative and effective technique for body remodeling and cellulite and localized fat reduction.

PMID:37469997 | PMC:PMC10353896 | DOI:10.1155/2023/9998499

Belitung Nurs J. 2021 Apr 29;7(2):98-106. doi: 10.33546/bnj.1322. eCollection 2021.

ABSTRACT

BACKGROUND: The condition of the Indonesians’ unpreparedness for the COVID-19 pandemic has caused anxiety and fear. The public’s fears of COVID-19 cases have led to a negative stigma. As part of health workers in disaster management’s main pillars in health services, nurses are most vulnerable to infection and not free from the stigma.

OBJECTIVE: This study aimed to describe the social stigma against nurses taking care of patients with COVID-19 and experiencing suspected or probable or confirmed COVID-19 cases in Indonesia.

METHODS: This study was a mixed-method study using a sequential explanatory design-participant selection model. The selection of respondents used the convenience sampling technique. The number of respondents in the quantitative stage was 118 respondents. For qualitative data, selected participants were respondents with a stigma score of more than 21 nurses and willing to continue the interview process. There were 11 participants in the qualitative stage. This study used the modified Stigma Scale of the Explanatory Model Interview Catalog for quantitative data and four semi-structured questions to obtain qualitative data. Quantitative data were processed in descriptive statistics, and a thematic analysis was performed to analyze the qualitative data.

RESULTS: The highest stigma score of 118 respondents was 37, and the lowest score was zero. The stigma score had a mean of 12.28 (SD ± 7.9). The higher the score obtained leads to a higher level of stigma received. From a total of 11 participants interviewed, four main themes emerged: rejection, feeling down and afraid, sources of support, and professional vigilance.

CONCLUSION: The social stigma experienced by nurses comes from colleagues and society and impacts psychological distress. Support from families and colleagues strengthens nurses in facing social stigma. Nevertheless, nurses uphold the values to remain grateful and carry out professional responsibilities in taking care of patients. Nurses should be provided with psychological support and be prepared for disasters to provide excellent health services and reduce adverse mental health.

PMID:37469947 | PMC:PMC10353578 | DOI:10.33546/bnj.1322