Nevin Manimala

Clin Oral Investig. 2023 Aug 21. doi: 10.1007/s00784-023-05212-x. Online ahead of print.

ABSTRACT

OBJECTIVES: Different platelet-rich fibrin (PRF) protocols exist and are known to differ in resulting mechanical and bioactive properties. Centrifugation parameters may also influence drug release, in particular antibiotics, when using PRF as a bio-carrier. We thus evaluated three common protocols regarding effects on the bio-carrier properties.

MATERIALS AND METHODS: In a prospective trial comprising 33 patients, we compared different protocols for PRF as a bio-carrier for ampicillin/sulbactam (SAM). Blood samples were taken shortly after a single dose of ampicillin/sulbactam (2 g/1 g) was administered to patients intravenously. PRF was obtained by centrifugation and three protocols were used: protocol A (1300 rpm, 8 min, RCF-max = 208 g), B (2300 rpm, 12 min, RCF-max = 652 g), and C (1500 rpm, 14 min, RCF-max = 276 g). The antibacterial activity of PRF was investigated against five oral species in vitro, based on agar diffusion methodology.

RESULTS: The study demonstrates that a single dose of SAM is sufficient to reach high concentrations in PRF in all protocols (150 µg/ml), which is comparable to the plasma SAM concentration. Antibacterial activity was inferred from the diameter of inhibition zones seen in agar diffusion tests using PRF discs. Protocol B resulted in the largest inhibition zones. One-way ANOVA revealed statistically improved results for protocol B for some bacteria.

CONCLUSIONS: The study provides valuable data on PRF antibiotic enrichment, notably SAM. A single dose of SAM is sufficient to reach clinically relevant concentrations in PRF.

CLINICAL RELEVANCE: These findings potentially extend the application of PRF, for example in patients with osteonecrosis of the jaw or in oral surgery (e.g., stick bone).

PMID:37603167 | DOI:10.1007/s00784-023-05212-x

Ophthalmol Ther. 2023 Aug 21. doi: 10.1007/s40123-023-00781-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Measurement of the largest basal dimension (LBD) of intraocular tumors is important as a prognostic parameter. To evaluate the potential value of true color ultra-widefield fundus photography for measuring tumors, we compared LBD measurements of choroidal and retinal tumors using a color ultra-widefield fundus camera with clinical estimation based on indirect ophthalmoscopy and standardized ophthalmic ultrasound.

METHODS: The LBD of 148 choroidal and retinal tumors in 148 patients seen at Tongren Hospital were measured using ultra-widefield fundus photography and compared with measurements obtained using B-scan ultrasonography and clinical estimates based on indirect ophthalmoscopy.

RESULTS: Paired t-tests and Bland-Altman plots reveal that measurements from ultra-widefield fundus photographic images are not statistically different from clinical estimates and ultrasound measurements. The results also showed that, although not statistically significant, when the tumor boundary was clear, the height was < 3 mm, or the tumor was pigmented, measurement from ultra-widefield fundus photography tended to be greater than those obtained by ultrasound.

CONCLUSIONS: The LBD measurement using ultra-widefield fundus photography correlated well with ultrasonography and clinical estimation and could be used as a reliable tool for measuring the LBD of choroidal and retinal tumors.

PMID:37603161 | DOI:10.1007/s40123-023-00781-2

Int J Cardiovasc Imaging. 2023 Aug 21. doi: 10.1007/s10554-023-02875-1. Online ahead of print.

ABSTRACT

PURPOSE: Different non-invasive and invasive imaging modalities are used to determine carotid artery stenosis severity that remains a principal parameter in clinical decision-making. We compared stenosis degree obtained with different modalities against vascular imaging gold standard, intravascular ultrasound, IVUS.

METHODS: 300 consecutive patients (age 47-83 years, 192 men, 64% asymptomatic) with carotid artery stenosis of ” ≥ 50%” referred for potential revascularization received as per study protocol (i) duplex ultrasound (DUS), (ii) computed tomography angiography (CTA), (iii) intraarterial quantitative angiography (iQA) and (iv) and (iv) IVUS. Correlation of measurements with IVUS (r), proportion of those concordant (within 10%) and proportion of under/overestimated were calculated along with recipient-operating-characteristics (ROC).

RESULTS: For IVUS area stenosis (AS) and IVUS minimal lumen area (MLA), there was only a moderate correlation with DUS velocities (peak-systolic, PSV; end-diastolic, EDV; r values of 0.42-0.51, p < 0.001 for all). CTA systematically underestimated both reference area and MLA (80.4% and 92.3% cases) but CTA error was lesser for AS (proportion concordant-57.4%; CTA under/overestimation-12.5%/30.1%). iQA diameter stenosis (DS) was found concordant with IVUS in 41.1% measurements (iQA under/overestimation 7.9%/51.0%). By univariate model, PSV (ROC area-under-the-curve, AUC, 0.77, cutoff 2.6 m/s), EDV (AUC 0.72, cutoff 0.71 m/s) and CTA-DS (AUC 0.83, cutoff 59.6%) were predictors of ≥ 50% DS by IVUS (p < 0.001 for all). Best predictor, however, of ≥ 50% DS by IVUS was stenosis severity evaluation by automated contrast column density measurement on iQA (AUC 0.87, cutoff 68%, p < 0.001). Regarding non-invasive techniques, CTA was the only independent diagnostic modality against IVUS on multivariate model (p = 0.008).

CONCLUSION: IVUS validation shows significant imaging modality-dependent variations in carotid stenosis severity determination.

PMID:37603155 | DOI:10.1007/s10554-023-02875-1

Eur J Popul. 2023 Aug 21;39(1):28. doi: 10.1007/s10680-023-09676-1.

ABSTRACT

Studies show that the economic benefits of marriage carry over into old age and that widowhood and divorce have detrimental economic consequences, especially for women. This study asks how affluence and poverty are affected by the timing of widowhood and divorce and tests whether they operate in symmetry. The study draws on Israel’s annual Social Survey from multiple years (2013-2017), conducted by Israel’s Central Bureau of Statistics. The sample is limited to older individuals, aged 55+ (n = 4824 men, 5643 women). The findings show that married people are less likely to be poor than unmarried people, but they are not always more likely to be affluent. Widowed men and women, and divorced men are more likely to achieve affluence than continuously married couples. The explanation may be that, in the Israeli context, the widowed tend to inherit benefits accumulated by their late spouse, whereas the divorced tend to divide resources when the marriage dissolves. Women incur higher and longer-term penalties for their change in marital status than do men, so that previously married women tend to have higher rates of poverty and lower rates of affluence than previously married men. The findings show that affluence and poverty do not operate in symmetry and that affluence does not simply mirror poverty, especially among men. For example, early widowed and late divorced men have higher odds of both poverty and affluence than married men. These findings demonstrate that poverty and affluence operate differently and examining both leads to new insights.

PMID:37603138 | DOI:10.1007/s10680-023-09676-1

Glob Chang Biol. 2023 Aug 21. doi: 10.1111/gcb.16914. Online ahead of print.

ABSTRACT

The TreeGOER (Tree Globally Observed Environmental Ranges) database provides information for most known tree species of their environmental ranges for 38 bioclimatic, eight soil and three topographic variables. It is based on species distribution modelling analyses of more than 44 million occurrences. The database can be accessed from https://doi.org/10.5281/zenodo.7922927. Statistics that include 5% and 95% quantiles were estimated for a cleaned and taxonomically standardized occurrence data set with different methods of outlier detection, with estimates for roughly 45% of species being based on 20 or more observation records. Where sufficient representative observations are available, the ranges provide useful preliminary estimates of suitable conditions particularly for lesser-known species under climate change. Inferred core bioclimatic ranges of species along global temperature and moisture index gradients and across continents follow the known global distribution of tree diversity such as its highest levels in moist tropical forests and the ‘odd man out’ pattern of lower levels in Africa. To demonstrate how global analyses for large numbers of tree species can easily be done in R with TreeGOER, here I present two case studies. The first case study investigated latitudinal trends of tree vulnerability and compared these with previous results obtained for urban trees. The second case study focused on tropical areas, compared trends in different longitudinal zones and investigated patterns for the moisture index. TreeGOER is expected to benefit researchers conducting biogeographical and climate change research for a wide range of tree species at a variety of spatial and temporal scales.

PMID:37602408 | DOI:10.1111/gcb.16914

Nurs Ethics. 2023 Aug 21:9697330231174533. doi: 10.1177/09697330231174533. Online ahead of print.

ABSTRACT

BACKGROUND: Professional autonomy, which directly affects the quality of professional nursing in patient care, and cognitive flexibility, which is an important factor for adaptation to change and developing nursing roles, are important concepts for nursing.

RESEARCH OBJECTIVES: This research was carried out to determine the effect of cognitive flexibility on attitudes towards professional autonomy in nurses.

RESEARCH DESIGN: This was a descriptive study.

PARTICIPANTS AND RESEARCH CONTEXT: The research was conducted with 415 nurses working in a city hospital of a province, meeting the inclusion criteria and agreeing to participate in the study. A questionnaire form, The Cognitive Flexibility Inventory (CFI), and the Attitude Toward Professional Autonomy Scale for Nurses (APASN) were used to collect data.

ETHICAL CONSIDERATIONS: Ethical approval was obtained from the university ethics committee before starting the study. Institutional permission was obtained from the city hospital where the study was conducted. Electronic informed consent was obtained from the nurses included in the study.

FINDINGS: In the study, the mean CFI score was 80.62 ± 11.55 and the mean APASN score was 70.42 ± 18.79. There was a weak positive correlation (r = 0.270; p < 0.05) between CFI and APASN scores. Moreover, the effect of the CFI mean score on the APASN mean score was found to be statistically significant (β = 0.278; p < 0.001). Furthermore, CFI explains 7.7% of APASN.

CONCLUSION: In the study, nurses’ attitudes towards professional autonomy and cognitive flexibility scores were found to be at a good level. Cognitive flexibility has a positive effect on attitudes towards professional autonomy. Interventional studies that will increase the level of cognitive flexibility are recommended in the development of nurses’ attitudes towards professional autonomy.

PMID:37602374 | DOI:10.1177/09697330231174533

Future Oncol. 2023 Aug 21. doi: 10.2217/fon-2023-0315. Online ahead of print.

ABSTRACT

Aim: This study evaluated event-free survival (EFS) as a surrogate outcome for overall survival (OS) in neoadjuvant therapy for early-stage triple-negative breast cancer (eTNBC). Methods: Meta-regression analyses based on a targeted literature review were used to evaluate the individual- and trial-level associations between EFS and OS. Results: In the individual-level analyses, 3-year EFS was a significant predictor of 5-year OS (p < 0.01; coefficient of determinations [R²]: 0.82 [95% CI: 0.68-0.91]). Additionally, there was a statistically significant association between the treatment effect on EFS and OS at the trial level (p < 0.001; R²: 0.64 [95% CI: 0.45-0.82]). Conclusion: This study demonstrates significant associations between EFS and OS and suggests that EFS is a valid surrogate for OS following neoadjuvant therapy for eTNBC.

PMID:37602372 | DOI:10.2217/fon-2023-0315

Risk Manag Healthc Policy. 2023 Aug 15;16:1555-1566. doi: 10.2147/RMHP.S418892. eCollection 2023.

ABSTRACT

BACKGROUND: The presence and extent of severity of esophageal varices (EV) in patients with liver cirrhosis (LC) are predicted using noninvasive clinical, biochemical, and imaging parameters. The aim of this study was to investigate the accuracy of noninvasive predictors of EV, such as the platelet count-to-spleen diameter ratio (PSR), platelet count-to-spleen volume ratio (PSVR), spleen size (SZ), and a combination of these markers in determining the severity of EV in patients with cirrhosis.

METHODS: We recruited 82 inpatients with LC from the Department of Gastroenterology at the First Affiliated Hospital of Guangxi Medical University between January 2018 and December 2019 for this diagnostic investigation. All patients underwent endoscopy, ultrasound, computed tomography, and routine laboratory investigations. For the study, we evaluated and compared the diagnostic accuracy of PSR, PSVR, SZ, and their combinations.

RESULTS: There were significant differences in the area under the receiver operating characteristic (ROC) curve (AUC) in the prediction of severe and moderate/severe EV for all the variables. PSR+PSVR had the highest AUC at 0.735 (95% CI: 0.626-0.826) and 0.765 (95% CI: 0.659-0.852) for predicting severe and moderate/severe EV, respectively. There were statistically significant differences in the AUCs (95% CI) for PSR, PSVR, and PSR+PSVR in predicting the existence of EV. As per the overall model quality chart, the combination of PSR+PSVR was the best indicator for detecting the presence of EV (AUC, 0.696; 95% CI: 0.584-0.792).

CONCLUSION: In our study, we found that these noninvasive parameters could predict the extent of severity of EV in patients with LC. We anticipate the use of a combination of PSR + PSVR to emerge as the superior indicator as studies progress.

PMID:37602362 | PMC:PMC10439804 | DOI:10.2147/RMHP.S418892

Risk Manag Healthc Policy. 2023 Aug 15;16:1509-1520. doi: 10.2147/RMHP.S420330. eCollection 2023.

ABSTRACT

OBJECTIVE: To analyze the questionnaire of the validity and reliability of knowledge, attitudes and practices concerning Mpox.

METHODS: This was an instrumental, cross-sectional study. The sample consisted of 178 citizens from 3 sectors of Peru, who responded to a virtual questionnaire regarding knowledge, attitudes and practices concerning Mpox. The validity and reliability process of the questionnaire was carried out using Aiken’s V, Cronbach’s Alpha, McDonald’s Omega and principal component analysis.

RESULTS: After expert evaluation, the questionnaire was shown to have adequate content validity for measuring knowledge, attitudes and practices concerning Mpox, each in their respective dimensions, with Aiken’s V values above 0.90. For construct validity, exploratory factor analysis was used and the items were grouped into four dimensions for the level of knowledge, three dimensions for attitudes, and two for practices. With respect to the reliability analysis, the application of Cronbach’s α statistic and McDonald’s ω, obtained values above 0.70.

CONCLUSION: The results of the research enabled the attainment of a questionnaire that meets the adequate psychometric characteristics in order to be applied.

PMID:37602360 | PMC:PMC10439795 | DOI:10.2147/RMHP.S420330

Drugs Context. 2023 Aug 8;12:2022-10-5. doi: 10.7573/dic.2022-10-5. eCollection 2023.

ABSTRACT

BACKGROUND: This study investigates the efficiency of two different types of immunomodulators for the treatment of non-severe community-acquired pneumonia (CAP) and assesses their long-term effects.

METHODS: The study included 55 patients with non-severe CAP. Group 1 (control) received only standard CAP therapy; the other two groups received immunomodulators simultaneously with the standard therapy: bacterial lysate for group 2 and azoximer bromide (AzB) for group 3. TNF and IL-6 concentrations were determined on the day of hospitalization as well as on days 13 and 60 of follow-up. For 2 years, we monitored the incidence of low respiratory tract infections (LRTIs) in the same patients with CAP (n=55).

RESULTS: The overall duration of all symptoms was lower in the immunomodulator groups compared with the control group. During treatment, TNF and IL-6 concentrations decreased on days 13 and 60 in all patients; in patients who received immunomodulators, TNF and IL-6 were reliably lower than in control patients. IL-6 concentration decreased on day 60 in the bacterial lysate and AzB treatment groups and did not differ (p=0.72). The odds ratio for the development of LRTIs in the AzB group was 0.15 (0.02-0.93) (p=0.04), suggesting its protective effect.

CONCLUSION: Inclusion of immunomodulators in the basic treatment of non-severe CAP reduces the duration of symptoms and is associated with improvement of the pro-inflammatory cytokine profile. In 2 years of follow-up, the long-term effects of the immunomodulatory therapy showed a statistically significant lower incidence of LRTIs in the AzB group only. However, given the small sample size of this study, further clinical studies are needed.

PMID:37602358 | PMC:PMC10435266 | DOI:10.7573/dic.2022-10-5