Nevin Manimala

Int J Biol Macromol. 2021 Oct 29;193(Pt A):915-922. doi: 10.1016/j.ijbiomac.2021.10.155. Online ahead of print.

ABSTRACT

This research work is a contribution to understand the olfaction mechanism at a molecular level of vanillin, ethyl vanillin, coumarin and quinoline molecules using a modeling of a putative adsorption process by analytical model established by statistical physics formalism. A statistical physics modeling using the monolayer model with identical and independent binding sites of the responses of the two human olfactory receptors OR10G4 and OR2B11 showed that vanillin and quinoline were adsorbed with a mixed non-parallel and parallel orientation on OR10G4 and on OR2B11, respectively. However, ethyl vanillin and coumarin were anchored with a total non-parallel orientation. The adsorption energy values collected from data analysis, which were ranged from 12.51 to 20.91 kJ/mol, confirmed that the adsorption of vanillin and ethyl vanillin on OR10G4 and the adsorption of coumarin and quinoline on OR2B11were exothermic and were based on physical interactions. Furthermore, the dose-olfactory response curves of vanillin, ethyl vanillin, coumarin and quinoline provided access to OR10G4 and OR2B11 steric characterization via the calculation of the studied olfactory receptors site size distributions (RSDs). Indeed, vanillin, ethyl vanillin, coumarin and quinoline RSDs are spread from 0.3 to 12 nm, from 0.5 to 12 nm, from 0.40 to 12 nm and from 0.14 to 12 nm, respectively, with a maximum at 1.55 nm, 2.11 nm, 2.50 and 1.13 nm, respectively. Lastly, the physico-chemical model parameters can be used for the energetic characterization to confirm the physical nature of the vanillin/ethyl vanillin-OR10G4 and the coumarin/quinoline-OR2B11 interactions and to determine an olfactory band of order of 12 kJ/mol [11-23 kJ/mol], 10 kJ/mol [14-24 kJ/mol], 7 kJ/mol [9-16 kJ/mol], 15 kJ/mol [13-28 kJ/mol] for vanillin, ethyl vanillin, coumarin and quinoline, respectively, through the determination of the adsorption energy distributions (AEDs).

PMID:34743943 | DOI:10.1016/j.ijbiomac.2021.10.155

Indian Heart J. 2021 Oct 29:S0019-4832(21)00231-5. doi: 10.1016/j.ihj.2021.10.012. Online ahead of print.

ABSTRACT

BACKGROUND: Over the last 20 years various techniques have been developed striving for safer and more durable pulmonary vein isolation (PVI). The three most commonly used tools are pulmonary vein ablation catheter (PVAC) and cryoballoon (‘single-shot’ techniques), and point-by-point (PBP) radiofrequency ablation using 3D electroanatomical mapping (EAM).

OBJECTIVE: Evaluate the safety and efficacy of the different techniques in an unselected population undergoing de-novo ablation for persistent or paroxysmal atrial fibrillation (AF) at Royal Papworth Hospital (RPH).

METHOD: Retrospective, single-centre study of consecutive AF ablations at RPH between March 2017 and April 2018. Demographic, procedural and outcome data were analysed.

RESULTS: Over the study period 329 first-time PVI procedures were performed. 37.4% were performed using PBP, 39.8% using cryoballoon and 22.8% using PVAC. There was no significant difference in age or sex between different ablation technique groups. 238 procedures were performed for paroxysmal AF and 91 for persistent AF. A higher proportion of the persistent cases were performed using point-by-point techniques compared to paroxysmal cases (58.2% vs 29.0%, p < 0.05). Procedural times were significantly longer in the group undergoing PBP ablation compared to cryoballoon or PVAC. However, there was no statistically significant difference in 12-month freedom from symptomatic AF or procedural complications between the groups.

CONCLUSIONS: PBP, PVAC and cryoballoon AF ablation all appeared equally efficacious in an unselected population, though PVAC and cryoballoon procedures were shorter. All procedures were associated with a low adverse event rate. Prospective examination is required to substantiate this finding.

PMID:34743897 | DOI:10.1016/j.ihj.2021.10.012

Clin Chim Acta. 2021 Oct 28:S0009-8981(21)00378-8. doi: 10.1016/j.cca.2021.10.034. Online ahead of print.

NO ABSTRACT

PMID:34743811 | DOI:10.1016/j.cca.2021.10.034

Clin Chim Acta. 2021 Oct 29:S0009-8981(21)00380-6. doi: 10.1016/j.cca.2021.10.036. Online ahead of print.

NO ABSTRACT

PMID:34743810 | DOI:10.1016/j.cca.2021.10.036

J Clin Sleep Med. 2021 Sep 1;17(9):1895-1945. doi: 10.5664/jcsm.9326.

ABSTRACT

INTRODUCTION: This systematic review provides supporting evidence for the accompanying clinical practice guideline on the treatment of central disorders of hypersomnolence in adults and children. The review focuses on prescription medications with U.S. Food & Drug Administration approval and nonpharmacologic interventions studied for the treatment of symptoms caused by central disorders of hypersomnolence.

METHODS: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine to perform a systematic review. Randomized controlled trials and observational studies addressing pharmacological and nonpharmacological interventions for central disorders of hypersomnolence were identified. Statistical analyses were performed to determine the clinical significance of all outcomes. Finally, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process was used to assess the evidence for the purpose of making specific treatment recommendations.

RESULTS: The literature search identified 678 studies; 144 met the inclusion criteria and 108 provided data suitable for statistical analyses. Evidence for the following interventions is presented: armodafinil, clarithromycin, clomipramine, dextroamphetamine, flumazenil, intravenous immune globulin (IVIG), light therapy, lithium, l-carnitine, liraglutide, methylphenidate, methylprednisolone, modafinil, naps, pitolisant, selegiline, sodium oxybate, solriamfetol, and triazolam. The task force provided a detailed summary of the evidence along with the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.

CITATION: Maski K, Trotti LM, Kotagal S, et al. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17(9):1895-1945.

PMID:34743790 | DOI:10.5664/jcsm.9326

Can J Aging. 2021 Nov 8:1-17. doi: 10.1017/S0714980821000349. Online ahead of print.

ABSTRACT

A palliative approach to care aims to meet the needs of patients and caregivers throughout a chronic disease trajectory and can be delivered by non-palliative specialists. There is an important gap in understanding the perspectives and experiences of primary care providers on an integrated palliative approach in dementia care and the impact of existing programs and models to this end. To address these, we undertook a scoping review. We searched five databases; and used descriptive numerical summary and narrative synthesizing approaches for data analysis. We found that: (1) difficulty with prognostication and a lack of interdisciplinary and intersectoral collaboration are obstacles to using a palliative approach in primary care; and (2) a palliative approach results in statistically and clinically significant impacts on community-dwelling individuals, specifically those with later stages of dementia. There is a need for high-quality research studies examining the integrated palliative approach models and initiation of these models sooner in the care trajectory for persons living with mild and moderate stages of dementia in the community.

PMID:34743774 | DOI:10.1017/S0714980821000349

Br J Nutr. 2021 Oct 7:1-8. doi: 10.1017/S0007114521004049. Online ahead of print.

ABSTRACT

This study aims to evaluate the interaction effect of socio-economic environment (SEE) in the relationship between the eating location (EL) and diet quality, in children and adolescents. Data included Portuguese children and adolescents (3-17 years) from a National Dietary Survey Sample (IAN-AF 2015/2016, n 987). Dietary intake was obtained by 2-d food diaries (children) or 2-24-h-recall (adolescents). Participants were classified into four groups of EL: ‘Home’, ‘Other homes’, ‘School’ and ‘Restaurants’. Diet quality was measured as a higher adherence to a healthy eating pattern. A previous developed socio-economic classification was used, and participants were grouped as belonging to a low socio-economic environment (LSE) or middle-high socio-economic environment (MHSE). Linear regression models were used to evaluate the association between EL and diet quality, stratified by the SEE. A statistically significant interaction effect was found (P < 0·01) for the SEE in the association between EL and diet quality. After adjustment for potential confounders, in LSE, participants belonging to ‘Other homes’ (β = -2·07; 95 % CI:-3·70, -0·44) and ‘Restaurants’ (β = -3·31; 95 % CI: -5·08, -1·54) had lower scores in the diet quality score, comparing to ‘Home’. In MHSE, comparing with ‘Home’, ‘Restaurants’ showed lower diet quality (β = -1·56; 95 % CI:-2·65, -0·48), while the ‘School’ had better diet quality (β = 0·90; 95 % CI: 0·16, 1·64). The SEE influences the association between EL and diet quality and, belonging to more disadvantaged SEE, might represent a higher risk of unhealthy eating habits when eating out-of-home.

PMID:34743770 | DOI:10.1017/S0007114521004049

Trials. 2021 Nov 7;22(1):780. doi: 10.1186/s13063-021-05755-y.

ABSTRACT

Non-pharmaceutical interventions (NPI) for infectious diseases such as COVID-19 are particularly challenging given the complexities of what is both practical and ethical to randomize. We are often faced with the difficult decision between having weak trials or not having a trial at all. In a recent article, Dr. Atle Fretheim argues that statistically underpowered studies are still valuable, particularly in conjunction with other similar studies in meta-analysis in the context of the DANMASK-19 trial, asking “Surely, some trial evidence must be better than no trial evidence?” However, informative trials are not always feasible, and feasible trials are not always informative. In some cases, even a well-conducted but weakly designed and/or underpowered trial such as DANMASK-19 may be uninformative or worse, both individually and in a body of literature. Meta-analysis, for example, can only resolve issues of statistical power if there is a reasonable expectation of compatible well-designed trials. Uninformative designs may also invite misinformation. Here, we make the case that-when considering informativeness, ethics, and opportunity costs in addition to statistical power-“nothing” is often the better choice.

PMID:34743755 | DOI:10.1186/s13063-021-05755-y

Orphanet J Rare Dis. 2021 Nov 7;16(1):472. doi: 10.1186/s13023-021-02098-4.

ABSTRACT

BACKGROUND: Individuals with Williams syndrome (WS) have an elevated risk for anxiety disorders throughout the life span, making it a research priority to identify the individual factors associated with anxiety. Most of the existing literature is based on questionnaire data and suggests that impaired executive functions (EF) increase the risk for anxiety in WS. The aim of this study was to use direct measures by trained clinicians to investigate the effects of general intelligence, inhibition, sustained attention, and working memory on anxiety in WS, to further elucidate potential underlying mechanisms.

METHOD: Twenty-four individuals with WS participated in the study (mean age: 29 years, range: 9-53 years), together with at least one of their parents. The MINI international neuropsychiatric interview for DSM-5 was completed to establish clinical diagnosis of anxiety, and the Clinical Global Impression Scale – Severity was used for an expert rating of symptom severity. Intellectual abilities were measured using the Wechsler scales, and attention and inhibition using the Conner’s Continuous Performance Test. In addition, a parent-report questionnaire measuring EF, learning and memory was collected.

RESULTS: In contrast to the apriori hypothesis, there was no significant association between anxiety and core elements of EF such as working memory, sustained attention, and inhibition (i.e. the process of restraining one’s impulses or behaviour). Using ordinal logistic regression analyses, we showed that decreasing intelligence quotient (IQ) and age are associated with elevated anxiety. We confirmed these results in between-groups analyses (anxiety disorder vs no current anxiety disorder), and low IQ was associated with higher risk of having an anxiety diagnosis. In addition, Bayesian statistics gave substantial evidence for no significant association between anxiety and inhibition.

CONCLUSION: By using direct measures of psychological pathology and functioning, the current results provide a deeper characterisation of the WS phenotype and provide novel insights into the potential mechanisms underpinning anxiety.

PMID:34743752 | DOI:10.1186/s13023-021-02098-4

J Orthop Surg Res. 2021 Nov 7;16(1):662. doi: 10.1186/s13018-021-02814-7.

ABSTRACT

OBJECTIVE: To investigate the relationship between the infection rate and the timing of replacement of temporary external fixators with internal fixation, and the timing of immediate or delayed internal fixation after removal of temporary external fixation in the staging treatment modality of open fractures of extremities.

METHODS: A retrospective analysis was performed on 122 cases of open fractures of extremities. External fixators were applied at the early stage and replaced with internal fixation when the condition of soft tissues improved and inflammatory indexes dropped to the normal range or showed a steady downward trend. Depending on the carrying time of external fixators after wound closure or healing, the patients were divided into three groups; the carrying time of groups A, B, and C was ≤ 14 days, 15-28 days, and > 28 days, respectively. Depending on the immediate or delayed internal fixation after removal of external fixator, patients were divided into group a (immediate internal fixation after removal of external fixator) and group b (delayed internal fixation after removal of external fixator, 5-7 days later).

RESULTS: The infection rates of groups A, B, and C were 6.5%, 5.9%, and 23.3%, respectively. The differences among the three groups were statistically significant (P < 0.05). The infection rates of different Gustilo-Anderson fractures were as follows: no cases of infection out of 10 cases with type I fracture (0%); two cases of infection out of 35 cases with type II fracture (5.7%); three cases of infection out of 36 cases with IIIa fracture (8.3%); five cases of infection out of 28 cases with IIIB fracture (17.9%); and five cases of infection out of 13 cases with IIIC fracture (38.5%). The differences among the five groups were statistically significant.

CONCLUSIONS: The occurrence of infection of open fractures of extremities is associated with the fracture severity (Gustilo classification). For open fractures of Gustilo types I and II, the final internal fixation should be placed as soon as possible when the recovery of general and local conditions is good and the infection is controlled.

PMID:34743751 | DOI:10.1186/s13018-021-02814-7