Nevin Manimala

Perspect Psychiatr Care. 2021 Apr 6. doi: 10.1111/ppc.12790. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine the status of spiritual caregiving education in nursing students belonging to two different state universities in Turkey.

DESIGN AND METHODS: The descriptive, cross-sectional study was completed with 326 students.

FINDINGS: Turkey’s western regions in mean scale scores of students (147.27 ± 19.40) in central Anatolia (140.83 ± 18.82) was higher than the students and the difference was statistically significant. A statistically significant difference was found between the total score averages of the Spiritual Caregiving Scale and their year of study, self-perception of spirituality, and relating their profession to spirituality (p < 0.05).

PRACTICE IMPLICATIONS: It is recommended to include spiritual care issues and principles in the nursing education curriculum.

PMID:33821478 | DOI:10.1111/ppc.12790

Hastings Cent Rep. 2021 Apr 6. doi: 10.1002/hast.1248. Online ahead of print.

ABSTRACT

The use of opaque, uninterpretable artificial intelligence systems in health care can be medically beneficial, but it is often viewed as potentially morally problematic on account of this opacity-because the systems are black boxes. Alex John London has recently argued that opacity is not generally problematic, given that many standard therapies are explanatorily opaque and that we can rely on statistical validation of the systems in deciding whether to implement them. But is statistical validation sufficient to justify implementation of these AI systems in health care, or is it merely one of the necessary criteria? I argue that accountability, which holds an important role in preserving the patient-physician trust that allows the institution of medicine to function, contributes further to an account of AI system justification. Hence, I endorse the vanishing accountability principle: accountability in medicine, in addition to statistical validation, must be preserved. AI systems that introduce problematic gaps in accountability should not be implemented.

PMID:33821471 | DOI:10.1002/hast.1248

J Fluoresc. 2021 Apr 5. doi: 10.1007/s10895-021-02708-1. Online ahead of print.

ABSTRACT

To utilize the nanomaterials as an effective carrier for the drug delivery applications, it is important to study the interaction between nanomaterials and drug or biomolecules. In this study GSH functionalized Mn²⁺-doped CdTe/ZnS QDs has been utilized as a model nanomaterial due to its high luminescence property. Folic acid (FA) gradually quenches the FL of GSH functionalized Mn²⁺ – doped CdTe/ZnS QDs. The Stern-Volmer quenching constant (K_sv), binding constant (K_s) and effective quenching constant (Ka) for the FA-QDs system is calculated to be 1.32 × 10⁵ M^-1, 1.92 × 10⁵ and 0.27 × 10⁵ M^-1, respectively under optimized condition (Temp. 300 K, pH 8.0, incubation time 40 min.). The effects of temperature, pH, and incubation time on FA-QDs system have also been studied. Statistical analysis of the quenched FL intensity versus FA concentration revealed a linear range from 1 × 10^-7 to 5.0 × 10^-5 for FA detection. The LOD of the current nano-sensor for FA was calculated to be 0.2 μM. The effect of common interfering metal ions and other relevant biomolecules on the detection of FA (12.0 μM) have also been investigated. L-cysteine and glutathione displayed moderate effect on FA detection. Similarly, the common metal ions (Na⁺, K⁺, Ca²⁺ and Mg²⁺) produced minute interference while Zn²⁺ Cu²⁺ and Fe³⁺ exert moderate interference. Toxic metal ions (Hg²⁺ and Pb²⁺) produced severe interferences in FA detection.Graphical abstract GSH-Mn²⁺ CdTe/ZnS QDs based Fluorescence Nanosensor for Folic acid.

PMID:33821436 | DOI:10.1007/s10895-021-02708-1

J Assist Reprod Genet. 2021 Apr 5. doi: 10.1007/s10815-021-02162-9. Online ahead of print.

ABSTRACT

PURPOSE: To study embryo morphokinetics in relation to release in spent media of molecules with possible roles in development and implantation (miR-20a, miR-30c, and sHLA-G).

METHODS: Data were obtained from embryos generated in standard IVF and ICSI cycles. The Eeva system was used for embryo assessment, based on early morphokinetic parameters and producing a score (1-5, best-worst) corresponding to higher/medium/lower chances of development to blastocyst. miRNAs – mm miR-20a-5p and miR-30c-5p – and sHLA-G were quantified in 25 μl of spent blastocyst media (SBM) collected before vitrification or transfer. Statistical analyses were performed applying Kolmogorov-Smirnov, Shapiro-Wilk, and Spearman’s correlation coefficient tests, where appropriate.

RESULTS: SBM were collected from a total of 172 viable blastocysts. Their analysis showed that concentration of miR-20a was progressively lower as Eeva score increased and probability of development to blastocyst decreased (P = 0.016). The opposite trend was observed in the case of miR-30c, i.e., concentration was higher as score increased and chances of development to blastocyst decreased (P = 0.004). Analysis of sHLA-G revealed a negative correlation with Eeva score, i.e., levels were progressively lower as Eeva score increased and probability of development to blastocyst decreased (R = – 0.388, N = 141, P = 0.001).

CONCLUSION: Our data suggest that morphokinetic algorithms that predict development to blastocyst stage, in fact, also identify embryos with molecular and cellular profiles more consistent with developmental functions.

PMID:33821429 | DOI:10.1007/s10815-021-02162-9

Qual Life Res. 2021 Apr 5. doi: 10.1007/s11136-021-02786-5. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to compare the measurement properties of two versions of EQ-5D (i.e.EQ-5D-3L and EQ-5D-5L) in hypertensive patients in rural China.

METHODS: A cross-sectional survey was carried out in hypertensive patients in rural China. We compared the ceiling effects, redistribution properties, informativity, known-groups validity, and relative efficiency of the 3L and 5L and examined their agreement.

RESULTS: A total of 11,412 patients were enrolled in our study. The mean EQ-5D index score was 0.84 (SD 0.21) according to the 5L and 0.86 (SD 0.17) according to the 3L. A good agreement was observed between the 3L and 5L. The overall ceiling effect decreased from 46.4% (3L) to 29.4% (5L). The Shannon index, H’ improved in all dimensions when used 5L. When used 3L, the median responses of all groups were consistent with 5L across the three dimensions of ‘mobility’, ‘self-care’, ‘usual activities’, while the median responses were inconsistent for the ‘pain/discomfort’ and ‘anxiety/depression’ dimensions. The 3L performed better in eight comorbidities in terms of F-statistics and six comorbidities in terms of the area under the receiver operating characteristic curves (AUROCs). The 5L performed better both in terms of the F-statistics and AUROCs in age, education level, anti-hypertensive medication use.

CONCLUSION: Taking all comparisons into account, we recommend the EQ-5D-5L for use in patients with hypertension in rural China.

PMID:33821418 | DOI:10.1007/s11136-021-02786-5

Trop Anim Health Prod. 2021 Apr 6;53(2):248. doi: 10.1007/s11250-021-02700-8.

ABSTRACT

Five non-linear functions, i.e. Gompertz, Logistic, Negative exponential, Brody and Bertalanffy, and multivariate adaptive regression splines (MARS) data mining algorithm were implemented with the objective to describe the body weight-age relationship of Harnai sheep of Balochistan, Pakistan. The data comprised of 1317 records of body weight from birth to 1 year were provided from Multi-Purpose Sheep Research Station Loralai, Balochistan. Each non-linear function and MARS algorithm were fitted to the data of male and female, single and twin and all lambs. Comparison among different non-linear models was based using the adjusted coefficient of determination ([Formula: see text]), Durbin-Watson statistic (DW), root mean square error (RMSE), Akaike’s and Bayesian information criteria (AIC and BIC) and the coefficient of correlation (r) between observed and fitted live body weight. The best fit was provided by the Brody model in terms of the highest [Formula: see text] and r values and lowest RMSE, AIC and BIC values in male and female, single and twin and all lambs followed by Bertalanffy, Gompertz, Negative exponential and Logistic model in order of their goodness. The negative correlation between asymptotic weight and maturing rate inferred that animals with smaller mature weight mature fast. Though males and singles were found heavier at mature weight than females and twins, respectively, they mature more slowly. The results of the study suggested the use of the Brody model to accurately describe the weight-age relationship of Harnai sheep. The present study also showed a very high predictive performance of the MARS data mining algorithm for describing the growth of sheep. In conclusion, MARS algorithm may be a good alternative for breeders aiming at describing the weight-age relationship of Harnai sheep.

PMID:33821400 | DOI:10.1007/s11250-021-02700-8

Obes Surg. 2021 Apr 5. doi: 10.1007/s11695-021-05380-3. Online ahead of print.

ABSTRACT

PURPOSE: In our centre, specialized high dose multivitamin supplementation designed to meet the needs of patients after gastric bypass surgery is routinely recommended in the early postoperative period. The aim of the present study was to analyse whether iron supplementation prescribed in clinical practice is sufficient in both sexes and whether multivitamin supplementation standardized for women might potentially lead to iron overload in men.

MATERIALS/METHODS: This was a retrospective study covering the period up to 36 months after bariatric surgery. Three groups were compared (men, premenopausal and postmenopausal women). The iron status was evaluated employing serum ferritin concentrations.

RESULTS: A total of 283 patients who had at least one follow-up visit between January 2015 and April 2018 at a specialized academic outpatient centre were included (71 men, 130 premenopausal women, 82 postmenopausal women). Thirty-six months after surgery, 33.3%, 68.4% and 54.5% of the men, pre- and postmenopausal women, respectively, were iron deficient. The preoperative prevalence of excess ferritin levels was 13.7% in premenopausal, 3.0% in postmenopausal women, 5.7% in men and declined in the following months.

CONCLUSION: Iron deficiency is very common after gastric bypass surgery, and even high dosages of multivitamin and mineral supplements might not be sufficient to prevent the development of iron deficiency. Men, pre- and postmenopausal women differ in their prevalence of iron deficiency which demands adapted iron dosage regimens based on the sex and the age. Iron overload is rare in all observed groups and highest in premenopausal women.

PMID:33821393 | DOI:10.1007/s11695-021-05380-3

Endocrine. 2021 Apr 5. doi: 10.1007/s12020-021-02696-z. Online ahead of print.

ABSTRACT

PURPOSE: High-fidelity simulation calls heavily upon cognitive capacities and generates stress and anxiety. The objective of this prospective, observational study was to evaluate the degree of stress in medical students by measuring hormone levels during critical care classes.

METHODS: Overall, 55 students (senior years of medical faculty) of both sexes were divided into 5-person teams. Demographic data and information on diagnosed diseases, stimulants used, and previous experience in the field of medical simulation were collected with a personal questionnaire. Before starting the scenario (T0), after the end of the scenario (T1), and 120 min thereafter (T2), stress level was measured. For this purpose, systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate and blood oxygen saturation were evaluated. In addition, saliva was collected to determine alpha-amylase activity and the concentrations of secretory immunoglobulin class A, cortisol, and testosterone.

RESULTS: Among hemodynamic parameters, systolic and mean blood pressure and heart rate were significantly higher in T1 than in T0 and T2 time points (p < 0.05). Cortisol concentration was higher at T2 compared with T0 and T1. Alpha-amylase activity was highest at T1. Secretory immunoglobulin class A concentration was highest at T0, followed by T1 and then T2. These differences were not statistically significant. Testosterone concentration showed significantly higher values at T2 compared with T0 and T1 (p < 0.05). The analysis of team leaders vs. other members revealed significantly lower cortisol and alpha-amylase values in leaders (p < 0.05).

CONCLUSIONS: High-fidelity simulation is a useful education method in medical subjects, especially in cases where a mistake could produce serious or irreversible consequences. It can increase stress hormone concentrations and thus can be assumed effective as a learning aid even in senior-year students of medical faculty.

PMID:33821392 | DOI:10.1007/s12020-021-02696-z

Ecotoxicology. 2021 Apr 5. doi: 10.1007/s10646-021-02400-x. Online ahead of print.

ABSTRACT

Atrazine was banned by the European Union in 2004, but is still used in many countries. Agricultural research employing nanotechnology has been developed in order to reduce the impacts to the environment and nontarget organisms. Nanoatrazine was developed as a carrier system and have been considered efficient in weed control. However, its toxicity must be verified with nontarget organisms. In this context, the aim of the present study was to investigate ecotoxicological effects of solid lipid nanoparticles (empty and loaded with atrazine) and atrazine on Chironomus sancticaroli larvae, evaluating the endpoints: mortality, mentum deformity, development rate and biochemical biomarkers. The contaminant concentrations used were 2, 470, 950, and 1900 μg L^-1 in acute (96 h) and 2 μg L^-1 in subchronic (10 days) bioassays. An environmentally relevant concentration of atrazine (2 μg L^-1) presented toxic and lethal effects towards the larvae. The nanoparticles loaded with atrazine showed toxic effects similar to free atrazine, causing mortality and biochemical alterations on the larvae. The nanoparticle without atrazine caused biochemical alterations and mortality, indicating a possible toxic effect of the formulation on the larvae. In the acute bioassay, most concentrations of nanoparticles loaded with atrazine were not dose dependent for the endpoint mortality. Only the atrazine concentration of 470 μg L^-1 was statistically significant to endpoint mentum deformity. The atrazine and nanoparticles (with and without atrazine) did not affect larval development. The results indicate that Chironomus sancticaroli was sensitive to monitor nanoatrazine, presenting potential to be used in studies of toxicity of nanopesticides.

PMID:33821358 | DOI:10.1007/s10646-021-02400-x

Ann Surg Oncol. 2021 Apr 5. doi: 10.1245/s10434-021-09897-w. Online ahead of print.

ABSTRACT

BACKGROUND: De-escalation of axillary surgery after neoadjuvant chemotherapy (NAC) requires careful patient selection. We seek to determine predictors of nodal pathologic complete response (ypN0) among patients treated on CALGB 40601 or 40603, which tested NAC regimens in HER2+ and triple-negative breast cancer (TNBC), respectively.

PATIENTS AND METHODS: A total of 760 patients with stage II-III HER2+ or TNBC were analyzed. Those who had axillary surgery before NAC (N = 122), or who had missing pretreatment clinical nodal status (cN) (N = 58) or ypN status (N = 41) were excluded. The proportion of patients with ypN0 disease was estimated for those with and without breast pathologic complete response (pCR) according to pretreatment nodal status.

RESULTS: In 539 patients, the overall ypN0 rate was 76.3% (411/539) to 93.2% (245/263) in patients with breast pCR and 60.1% (166/276) with residual breast disease (RD) (P < 0.0001). For patients who were cN0 pretreatment, the ypN0 rate was 88.8% (214/241), 96.3% (104/108) with breast pCR, and 82.7% (110/133) with RD. For patients who were cN1, 66.2% (157/237) converted to ypN0, 91.7% (111/121) with breast pCR and 39.7% (46/116) with RD. For patients who were cN2/3, 65.6% (40/61) converted to ypN0, 88.2% (30/34) with breast pCR and 37.0% (10/27) with RD. On multivariable analysis, only pretreatment clinical nodal status and breast pCR/RD were associated with ypN0 status (both P < 0.0001).

CONCLUSIONS: Breast pCR and pretreatment nodal status are predictive of ypN0 axillary nodal involvement, with < 5% residual nodal disease among cN0 patients who experience breast pCR. These findings support the incorporation of axillary surgery de-escalation strategies into NAC trials.

PMID:33821344 | DOI:10.1245/s10434-021-09897-w