Nevin Manimala

Int Wound J. 2023 Jan 18. doi: 10.1111/iwj.14093. Online ahead of print.

ABSTRACT

Pain and anxiety were considered the most common complications of treatment procedures in burn patients. Non-pharmacological drugs, including aromatherapy, can decrease these issues. This systematic review and meta-analysis aim to summarise the effects of aromatherapy with Rosa damascene (RD) and lavender on the pain and anxiety of burn patients. A systematic search was performed on international electronic databases such as Scopus, PubMed, and Web of Science, as well as on Iranian electronic databases such as Iranmedex and Scientific Information Database (SID) with keywords extracted from Medical Subject Headings such as “Burns”, “Pain”, “Pain management”, “Anxiety”, and “Aromatherapy” were performed from the earliest to November 1, 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist assessed the quality of randomised control trials (RCTs) and quasi-experimental studies. STATA v.14 software was used to estimate pooled effect size. Heterogeneity was assessed with I² value. Random effect model and inverse-variance method using sample size, mean, and standard deviation changes were applied to determine standard mean differences (SMD). The confidence interval of 95% was considered to determine the confidence level. A total of 586 burn patients participated in six studies, including three RCT studies and three quasi-experimental studies. The results based on RCT studies showed RD significantly decreased the dressing pain average when compared to the control group (SMD: -1.61, 95%CI: -2.32 to -0.99, Z = 5.09, I² : 66.2%, P < 0.001). Aromatherapy with lavender decreased the average pain in the interventional group more than in the control group (SMD: -1.78, 95%CI: -3.62 to 0.07, Z = 1.89, I² : 97.2%, P = 0.06). Using aromatherapy with RD and lavender significantly decreased pain average in the interventional group than the control group (SMD: -1.68, 95%CI: -2.64 to -0.72, Z = 3.42, I² : 94.2%, P = 0.001). The results showed RD significantly decreased the anxiety average in the interventional group than the control group (SMD: -2.49, 95%CI: -2.98 to -2.0, Z = 9.94, I² : 51.6%, P < 0.001). Overall, this study showed that aromatherapy with RD decreased pain and anxiety of dressing procedures in burn patients. Although aromatherapy with lavender decreased pain in the patients, it was not statistically significant. More RCTs studies are required to be able to better judge the effects of aromatherapy with RD and lavender on the pain and anxiety of burn patients.

PMID:36651329 | DOI:10.1111/iwj.14093

Oral Health Prev Dent. 2023 Jan 18;21(1):17-24. doi: 10.3290/j.ohpd.b3818041.

ABSTRACT

PURPOSE: The present study systematically reviewed randomised controlled trials (RCT) to investigate the efficacy of Er:YAG laser (ERL) as a debridement method in surgical treatment of advanced peri-implantitis.

MATERIALS AND METHODS: An electronic database search and a manual search were performed until March 2022. Outcome measures were clinical attachment level (CAL) gain, probing depth (PD) reduction, plaque index (PI) and bleeding on probing (BOP). The addressed PICO question was: Is ERL an effective debridement tool in the surgical treatment of advanced peri-implantitis?

RESULTS: Five eligible randomised clinical trials (RCTs) were included in the qualitative analysis, one of which had unclear risk of bias. One study reported a statistically significant difference in terms of implant CAL gain and PD reduction in favour of the experimental group vs the control group, while four studies did not report any difference between the two groups.

CONCLUSION: Due to methodological heterogeneity, such as non-standard control groups and laser parameters, this systematic review demonstrated inconclusive findings in terms of the efficacy of Er:YAG laser as a debridement method in surgical treatment of advanced peri-implantitis. The results of this review should be considered preliminary and further, well-designed studies with standardised comparators with laser parameters are warranted.

PMID:36651312 | DOI:10.3290/j.ohpd.b3818041

Oral Health Prev Dent. 2023 Jan 18;21(1):1-6. doi: 10.3290/j.ohpd.b3818027.

ABSTRACT

PURPOSE: This study aimed to compare insulin status and dysglycemia (prediabetes/diabetes) of patients with chronic (stage III, grade B) or aggressive periodontitis (stage III, grade C) to that of a healthy population.

MATERIALS AND METHODS: Patients with chronic (CP, n = 16) or aggressive periodontitis (AP, n = 15) and periodontally healthy controls (n = 32) were recruited. Body mass index was calculated. Glycemia, plasma insulin, glycated hemoglobin, C-reactive protein, and lipid levels were measured in fasting. The Homeostasis Model Assessment was used to calculate the insulin sensitivity (HOMA-%S), the beta-cell function (HOMA-%B), and their hyperbolic product (HOMA-%BxS).

RESULTS: The CP group showed statistically significantly insulin resistance with a lower HOMA-%S (p = 0.0003) and a reduced HOMA-%BxS (p = 0.049) despite a higher insulin level (p = 0.01) vs the control group, even after BMI adjustment. There was also a trend to dysglycemia (prediabetes/diabetes) in the chronic group. In patients with AP, no abnormalities in insulin status were observed and glycemic levels were comparable with controls. Additionally, patients in both AP and CP groups presented significantly higher CRP levels compared to those of the control group (p = 0.02).

CONCLUSION: Patients with CP showed reduced insulin sensitivity, increased insulin levels but a reduced %BxS product and a trend to dysglycemia. These abnormalities were not observed in AP.

PMID:36651310 | DOI:10.3290/j.ohpd.b3818027

Nan Fang Yi Ke Da Xue Xue Bao. 2022 Dec 20;42(12):1882-1888. doi: 10.12122/j.issn.1673-4254.2022.12.18.

ABSTRACT

OBJECTIVE: To investigate the effect of aldehyde dehydrogenase 2 (ALDH2) on lipopolysaccharide (LPS)- induced damage of mouse brain microvascular endothelial barrier and explore the role of mitochondrial fusion and fission in maintaining the integrity of endothelial barrier.

METHODS: Mouse brain microvascular endothelial cells were treated with 1 μg/ mL LPS for 24 h with or without pretreatment with 20 μmol/mL Alda-1 (a ALDH2 agonist) for 1 h. The changes in cell viability were assessed using cell counting Kit-8 (CCK8) assay, and the cell permeability was evaluated using transendothelial cell resistance (TEER) and FITC-Dextran assay. The level of oxidative stress in the cells was assessed by detecting the levels of malondialdehyde (MDA) and superoxide dismutase (SOD), and the content of reactive oxygen species (ROS) was detected using a superoxide anion fluorescent probe (DHE). Western blotting was performed to detect the expressions of ALDH2, tight junction proteins ZO-1 and occludin, and mitochondrial fusion- and division-related proteins Mfn2, OPA1, Drp1 and Fis1.

RESULTS: Compared with the untreated cells, the cells treated with LPS showed significantly decreased TEER, increased FITC-dextran leakage, MDA content and ROS production, decreased SOD activity expressions of ALDH2, ZO-1, occludin, Mfn2 and OPA1, and increased expressions of Drp1 and Fis1 (P < 0.05). Pretreatment with Alda-1 prior to LPS exposure strongly suppressed the increase of endothelial cell membrane permeability, reduced ROS production, increased the expressions of ALDH2, ZO-1, occludin, OPA1 and Mfn2, and lowered the expressions of Drp1 and Fis1 (P < 0.05).

CONCLUSION: ALDH2 can alleviate LPS-induced damage of brain microvascular endothelial cell barrier by inhibiting the mitochondrial ROS production and promoting mitochondrial fusion and inhibiting mitochondrial fission.

PMID:36651258 | DOI:10.12122/j.issn.1673-4254.2022.12.18

J Glob Health. 2023 Jan 30;13:04002. doi: 10.7189/jogh.13.04002.

ABSTRACT

BACKGROUND: Interviewer effects can have consequential impacts on survey data, particularly for reporting sensitive attitudes and behaviours such as sexual activity and drug use, yet these effects remain understudied in low- and middle-income countries. The Demographic and Health Surveys (DHS) present a unique opportunity to study interviewer effects on the self-report of sensitive topics in low- and middle-income countries by including interviewer characteristics data. This paper aims to narrow the gap in research on interviewer effects by studying the effects that age difference between interviewer and respondent and interviewer survey experience have on the reporting of ever having sexual intercourse.

METHODS: We used DHS data from 91 066 women and 56 336 men in 21 countries where the standard DHS was implemented among all women of reproductive age, and interviewer characteristics were included in the data set. Using a Bayesian cross-classified model with random intercepts for interviewer and cluster, we assessed whether the effect of an age difference of 10 years or greater was associated with a difference in self-report of ever having sexual intercourse, adjusting for respondent demographics.

RESULTS: There was a meaningful association between an age difference of greater than ten years and reporting of ever having had sexual intercourse in most countries for both genders after adjusting for interviewer age and experience, rural or urban cluster, and individual-level characteristics. Among women, the marginal posterior probability of reporting ever having sexual intercourse if the interviewer was ten years or more years older was lower for 17 of 19 countries (countries ranged from -12.50 to 3.90 percentage points). Among men, the marginal posterior probability was lower for 16 of 20 countries, ranging from -18.30 to 17.10 percentage points.

CONCLUSIONS: In most countries, women and men were less likely to report ever having sexual activity if the interviewer was ten or more years older than them, adjusting for potential confounders. These findings have important implications for interpreting numerous sexual health indicators, such as unmet family planning needs and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) risk. Survey administrators may consider more careful interviewer-respondent characteristic matching or novel approaches like Audio Computer Assisted Self Interview to minimize interviewer-induced variance.

PMID:36651233 | DOI:10.7189/jogh.13.04002

J Appl Clin Med Phys. 2023 Jan 18:e13880. doi: 10.1002/acm2.13880. Online ahead of print.

ABSTRACT

The multi-leaf collimator (MLC)-equipped CyberKnife^® M6 radiosurgery system (CKM6) (Accuray Inc., Sunnyvale, CA) has been increasingly employed for stereotactic radiosurgery (SRS) to treat relatively small lesions. However, achieving an accurate dose distribution in such cases is usually challenging due to the combination of numerous small fields ≤ (30 × 30) mm² . In this study, we developed a new Monte Carlo (MC) dose model for the CKM6 system using the EGSnrc to investigate dose variations in the small fields. The dose model was verified for the static MLC fields ranging from (53.8 × 53.9) to (7.6 × 7.7) mm² at 800 mm source to axis distance in a water phantom, based on the computed doses of Accuray Precision^® (Accuray Inc.) treatment planning system (TPS). We achieved a statistical uncertainty of ≤4% by simulating 30-50 million incident particles/histories. Then, the treatment plans were created for the same fields in the TPS, and the corresponding measurements were performed with MapCHECK2 (Sun Nuclear Corporation), a standard device for patient-specific quality assurance (PSQA). Results of the MC simulations, TPS, and MapCHECK2 measurements were inter-compared. An overall difference in dosimetric parameters such as profiles, tissue maximum ratio (TMR), and output factors (OF) between the MC simulations and the TPS results was found ≤3% for (53.8 × 53.9-15.4 × 15.4) mm² MLC fields, and it rose to 4.5% for the smallest (7.6 mm × 7.7 mm) MLC field. The MapCHECK2 results showed a deviation ranging from -1.5% to + 4.5% compared to the TPS results, whereas the deviation was within ±2.5% compared with the MC results. Overall, our MC dose model for the CKM6 system showed better agreement with measurements and it could serve as a secondary dose verification tool for the patient-specific QA in small fields.

PMID:36651219 | DOI:10.1002/acm2.13880

J R Soc Interface. 2023 Jan;20(198):20220758. doi: 10.1098/rsif.2022.0758. Epub 2023 Jan 18.

ABSTRACT

Modern human feet are considered unique among primates in their capacity to transmit propulsive forces and re-use elastic energy. Considered central to both these capabilities are their arched configuration and the plantar aponeurosis (PA). However, recent evidence has shown that their interactions are not as simple as proposed by the theoretical and mechanical models that established their significance. Using three-dimensional foot scans and statistical shape and deformation modelling, we show that the shape of the longitudinal and transverse arches varies widely among the healthy adult population, and that the former is subject to load-induced arch flattening, whereas the latter is not. However, longitudinal arch shape and flattening are only one of the various foot shape-deformation relationships. PA stiffness was also found to vary widely. Yet only a small amount of this variability (approx. 10-18%) was explained by variations in foot shape, deformation and their combination. These findings add to the mounting evidence showing that foot mechanics are complex and cannot be accurately represented by simple models. Especially the interactions between longitudinal arch and PA appear to be far less constrained than originally proposed, most likely due to the many degrees of freedom provided by the structural complexity of our feet.

PMID:36651181 | DOI:10.1098/rsif.2022.0758

Open Biol. 2023 Jan;13(1):220314. doi: 10.1098/rsob.220314. Epub 2023 Jan 18.

ABSTRACT

p38 kinases are key elements of the cellular stress response in animals. They mediate the cell response to a multitude of stress stimuli, from osmotic shock to inflammation and oncogenes. However, it is unknown how such diversity of function in stress evolved in this kinase subfamily. Here, we show that the p38 kinase was already present in a common ancestor of animals and fungi. Later, in animals, it diversified into three JNK kinases and four p38 kinases. Moreover, we identified a fifth p38 paralog in fishes and amphibians. Our analysis shows that each p38 paralog has specific amino acid substitutions around the hinge point, a region between the N-terminal and C-terminal protein domains. We showed that this region can be used to distinguish between individual paralogs and predict their specificity. Finally, we showed that the response to hyperosmotic stress in Capsaspora owczarzaki, a close unicellular relative of animals, follows a phosphorylation-dephosphorylation pattern typical of p38 kinases. At the same time, Capsaspora‘s cells upregulate the expression of GPD1 protein resembling an osmotic stress response in yeasts. Overall, our results show that the ancestral p38 stress pathway originated in the root of opisthokonts, most likely as a cell’s reaction to salinity change in the environment. In animals, the pathway became more complex and incorporated more stimuli and downstream targets due to the p38 sequence evolution in the docking and substrate binding sites around the hinge region. This study improves our understanding of p38 evolution and opens new perspectives for p38 research.

PMID:36651171 | DOI:10.1098/rsob.220314

Hepatology. 2023 Jan 19. doi: 10.1097/HEP.0000000000000286. Online ahead of print.

ABSTRACT

BACKGROUND AIMS: Nonalcoholic fatty liver disease (NAFLD) strongly associates with cardiovascular disease (CVD) risk factors; however, the association between NAFLD and incident CVD, CVD-related mortality, incident cancer, and all-cause mortality is unclear.

APPROACH RESULTS: We included 10,040 participants from the Framingham Heart Study, the Coronary Artery Risk Development in Young Adults (CARDIA) Study, and the Multi-Ethnic Study of Atherosclerosis (MESA) to assess the longitudinal association between liver fat (defined on computed tomography [CT]) and incident CVD, CVD-related mortality, incident cancer, and all-cause mortality. We performed multivariable-adjusted Cox regression models including age, sex, diabetes, systolic blood pressure, alcohol use, smoking, high-density lipoprotein, triglycerides, and body mass index (BMI) at baseline or time-varying covariates. The average age was 51.3±3.3 years and 50.6% were women. Hepatic steatosis was associated with all-cause mortality after 12.7 years of mean follow-up when adjusting for baseline CVD risk factors, including BMI [hazard ratio (HR) 1.21, 1.04-1.40]; however, results were attenuated when utilizing time-varying covariates. The association between hepatic steatosis and incident CVD was not statistically significant after we accounted for BMI in models considering baseline covariates or time-varying covariates. We observed no association between hepatic steatosis and CVD-related mortality or incident cancer.

CONCLUSIONS: In this large, multi-cohort study of participants with CT-defined hepatic steatosis, accounting for change in CVD risk factors over time attenuated associations between liver fat and overall mortality or incident CVD. Our work highlights the need to consider concurrent cardiometabolic disease when determining associations between NAFLD and CVD and mortality outcomes.

PMID:36651168 | DOI:10.1097/HEP.0000000000000286

Arch Esp Urol. 2022 Dec;75(10):867-872. doi: 10.56434/j.arch.esp.urol.20227510.126.

ABSTRACT

BACKGROUND: To investigate the influencing factors of health-related quality of life (HRQOL) in children and adolescents with congenital adrenal hyperplasia (CAH).

METHODS: Pediatric Quality of Life Inventory 4.0 (PedsQL4.0) and 8-item Morisky medication adherence scale (MMAS-8) were used to survey eighty-seven children and adolescents with CAH (5-18 years), as well as their parents. SPSS 26.0 software was utilized for statistical analysis.

RESULTS: The scores of social functions, school performance, social psychological function and total scores of CAH girls aged 13-18 years were lower than those of boys (p < 0.05). CAH children with older age, longer course of disease, older than 3 years old at first diagnosis, living in rural areas, lower education level of caregivers and lower family monthly income had lower scores. CAH patients with poor compliance and complications had significantly lower scores in each single domain, social psychological function, and total scores than those with good compliance and no complications (p < 0.05).

CONCLUSIONS: Age, age at initial diagnosis, course of disease, complications, compliance, residence, education level of caregivers and family income were important factors affecting HRQOL of CAH children and adolescents, among which complications and compliance were independent key influencing factors.

PMID:36651098 | DOI:10.56434/j.arch.esp.urol.20227510.126