Tag: nevin manimala

Chemosphere. 2021 Jun 4;282:131104. doi: 10.1016/j.chemosphere.2021.131104. Online ahead of print.

ABSTRACT

River biofilm communities are the first ones to be exposed to all toxic discharges received via run off from agricultural fields. Hence, changes in river biofilm community structure and growth pattern are considered as indicator of overall health of lotic ecosystem. Toxicants have effect on biofilm biomass, photosynthetic efficiency and chlorophyll a concentrations. Mathematical models may be applied to estimate the overall vigor of riverine ecosystems considering biofilms as indicators. Herein, previous empirical data of Ricart et al. (2009) on long term effects of environmentally relevant concentrations of diuron on biofilm communities of the River Llobregat, Spain was considered as our model inputs. Our objective is to understand the influence of diuron, chlorophyll a concentrations and photosynthetic efficiency on biovolume using a statistical model. The non-linear relationships between biovolume (dependent variable) and diuron, chlorophyll a concentrations and photosynthetic efficiency (independent variables) were represented by constructing three separate basis functions based on day 8 empirical data. Biovolume, due to nonlinear influence as yielded by the basis functions were used in a multiple linear regression model to estimate the net biovolume. Model validation was done based on day 29 empirical data. The experimentally determined biovolume and our model estimated biovolume showed similar trends. Also, diuron and photosynthetic efficiency had significant (p < 0.05) influence on biovolume. Since, the predominance of diatoms as biofilms within periphytic layers is very common in lotic systems, estimation of changes in diatom biovolume will be significant to assess the effect of herbicides. Diatom biovolume of any day (for example day 22) mentioned in the experimental study may be determined by this model, without the requirement of tedious manual biovolume calculation. Our model will be useful in numerous other studies undertaken on the toxic effect of pollutants on biofilms to quickly and accurately estimate the biofilm biovolume.

PMID:34118626 | DOI:10.1016/j.chemosphere.2021.131104

Mult Scler Relat Disord. 2021 May 7;52:103003. doi: 10.1016/j.msard.2021.103003. Online ahead of print.

ABSTRACT

BACKGROUND: Relapsing-remitting multiple sclerosis (RRMS) is an autoimmune disorder of the central nervous system. Dimethyl Fumarate is a disease-modifying medication used to treat RRMS patients that can induce lymphopenia. We aimed to immunophenotype peripheral blood mononuclear cells (PBMC) in RRMS patients cross-sectionally and examine the characteristics and modifications of lymphopenia over time.

METHODS: Characterization of PBMC was done by multiparametric flow cytometry. Patients had been on treatment for up to 4 years and were grouped into lymphopenic (DMF-L) and non-lymphopenic (DMF-N) patients.

RESULTS: Lymphopenia affected the cell population changes over time, with other patient characteristics (gender, age, and previous treatment status) also having significant effects. In both lymphopenic and non-lymphopenic patients, PBMC percentages were reduced over time. While overall T and B cells frequencies were not affected, males, older patients and untreated patients had significant changes in B cell subpopulations over time. CD4⁺ to CD8⁺T cell ratio increased significantly in lymphopenic patients over time. CD4^–CD8^–T cell population was similarly reduced in both lymphopenic and non-lymphopenic patients, over time. While the monocyte and NK overall populations were not changed, non-classical monocyte subpopulation decreased over time in lymphopenic patients. We also found CD56^–CD16⁺ and CD56^–CD16^– NK cells frequencies changed over time in lymphopenic patients. Immune populations showed correlations with clinical outcomes measured by EDSS and relapse rate. Analysis of the overall immunophenotype showed that, while groups divided by other patient characteristics showed differences, the lymphopenia status overrode these differences, resulting in similar immunophenotype within DMF-L.

CONCLUSIONS: Our data provide evidence that under the same therapy, lymphopenia affects how the immunophenotype changes over time and can override the differences associated with other patient characteristics and possibly mask other significant changes in the immune profile of patients.

PMID:34118574 | DOI:10.1016/j.msard.2021.103003

Knee. 2021 Jun 9;31:64-76. doi: 10.1016/j.knee.2021.05.009. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the present study was to compare the accuracy of prosthetic alignment with three-dimensional computed tomography (3DCT) measurements following total knee arthroplasty (TKA) performed using a robotic-assisted surgical technique versus a conventional TKA.

METHODS: 41 TKAs were performed with a handheld robotic-assisted surgical procedure (Robot group) between 2019 and 2020. Another 41 patients underwent TKA with a conventional manual surgical procedure (Manual group) using the same prosthesis. The operation durations between both groups were investigated. 3DCT scans of the entire lower extremities were taken before and after the surgery and femoral and tibial alignments in the coronal, sagittal, and axial planes were measured using computer software. The differences in prosthetic alignment and translation between the preoperative 3DCT plan and postoperative 3DCT image were also measured.

RESULTS: There were no statistically significant differences in the post-operative outliers of the femorotibial angle between the groups. In the tibial-axial plane, the mean of prosthetic alignment in the anteroposterior plane was 4.0° in the Robot group and 6.7° in the Manual group (p < 0.01). The rate of outliers for tibial-axial alignment in the Robot group was significantly less than in the Manual group (p < 0.01). There were no statistically significant differences in prosthetic translation in the proximal-distal, anterior-posterior and medial-lateral orientations between the groups.

CONCLUSIONS: In a radiologic study using 3DCT, robotic-assisted TKA reduced the outliers for rotational alignment of the tibial prosthesis in comparison to conventional TKA, which can lead to improved tracking of the femoral-tibial bearing surfaces.

PMID:34118583 | DOI:10.1016/j.knee.2021.05.009

J Vet Cardiol. 2021 May 13;36:89-98. doi: 10.1016/j.jvc.2021.05.001. Online ahead of print.

ABSTRACT

INTRODUCTION: The objective of this retrospective study was to describe the indications, complications, and long-term outcomes in a group of cats that received an epicardial pacing (EP) system.

ANIMALS: Twenty client-owned cats.

MATERIALS AND METHODS: Medical records were reviewed for signalment, presenting complaint, primary electrocardiogram (ECG) diagnosis, presence of structural heart disease, presence of congestive heart failure (CHF), presence of major or minor complications, and survival time.

RESULTS: The majority of cats were presented for syncope (n = 11), and the most common ECG diagnosis was advanced second-degree atrioventricular block (n = 9). Fifteen cats (15/20, 75%) had one or more major or minor complications. One cat died in the perioperative period as a result of a major complication. None of the variables evaluated were associated with a statistically significant increase in the occurrence of major or minor complications. The most common major complication was loss of ventricular capture (seven instances in six cats), which was successfully treated in all cases by increasing pacemaker output or replacing both the lead and the pulse generator. The most common minor complications were arrhythmias (n = 7) and sensing issues (n = 8). The overall median survival time (MST) was 948 days. No statistical difference in survival time was identified between cats that experienced a major complication and those that did not.

CONCLUSIONS: Although complications were common in this feline population after EP, major and minor complications were successfully treated.

PMID:34118563 | DOI:10.1016/j.jvc.2021.05.001

Health Place. 2021 Jun 9;70:102600. doi: 10.1016/j.healthplace.2021.102600. Online ahead of print.

ABSTRACT

The use of planning policy to manage and create a healthy food environment has become a popular policy tool for local governments in England. To date there has been no evaluation of their short-term impact on the built environment. We assess if planning guidance restricting new fast food outlets within 400 m of a secondary school, influences the food environment in the local authority of Newcastle Upon Tyne, UK. We have administrative data on all food outlets in Newcastle 3 years pre-intervention 2012-2015, the intervention year 2016, and three years’ post-intervention 2016-2019. We employ a difference-in-difference approach comparing postcodes within the school fast food outlet exclusion zone to those outside the fast-food exclusion zones. In the short term (3 years), planning guidance to limit the number of new fast-food outlets in a school exclusion zone did not have a statistically significant impact on the food environment when compared with a control zone.

PMID:34118573 | DOI:10.1016/j.healthplace.2021.102600

Colloids Surf B Biointerfaces. 2021 Jun 2;205:111897. doi: 10.1016/j.colsurfb.2021.111897. Online ahead of print.

ABSTRACT

Polydopamine (PDA), also known as synthetic melanin, is widely used as a biomimetic anchoring layer for the modification of various solid substrates. PDA is utilized for a wide range of biomedical, sensing and tribological applications, even though the polymer’s precise covalent structure has not been completely revealed yet. Even more, it is not evident to which extent the chemical nature of the substrate, on which the layer is formed, influences and predetermines the covalent structure of resulting PDA. In this contribution, we have studied the growth of PDA using various surface-sensitive techniques such as spectroscopic ellipsometry, atomic force microscopy and X-ray photoelectron spectroscopy. We supplemented grazing angle attenuated total reflection FTIR spectroscopy with multivariate statistical analysis to further gain analytical power. We have particularly focused on the effects of polymerization time and substrate on the PDA structure. We found notable differences in the chemical composition of PDA formed on gold and on surfaces terminated with oxides/reactive hydroxides such as silicon and N-dopped-TiO₂ in the early stages of the layer formation. At the later stages of layer formation, a merely unified chemical structure was observed independently on the type of substrate.

PMID:34118533 | DOI:10.1016/j.colsurfb.2021.111897

Liver Transpl. 2021 Jun 12. doi: 10.1002/lt.26205. Online ahead of print.

ABSTRACT

BACKGROUND: Computed tomography (CT) derived body metrics such as skeletal muscle index (SMI), psoas muscle index (PMI), and subcutaneous fat index (ScFI) are measurable components of sarcopenia, frailty, and nutrition. While these body metrics are advocated in adults for predicting postoperative outcomes after liver transplantation (LT), little is known about the value in pediatric populations. This study assessed the relation between preoperative CT-based body metrics and postoperative short-term outcomes in pediatric LT recipients.

METHODS: Patients aged 0-18 years who underwent a primary LT were retrospectively included (N=101, median age 0.5 years, range 0.2-17.1). SMI, PMI, and ScFI were derived from preoperative axial CT slices. Postoperative outcomes and complications within 90 days were correlated with the CT-based body metrics. To classify postoperative infections, the Clavien-Dindo (CD) classification was used. Subgroup analyses were performed for age groups (<1, 1-10, and >10 years old). An optimal threshold for test performance was defined using Youden’s J-statistic and receiver operating characteristic curve as appropriate.

RESULTS: ScFI was significantly (P=0.001) correlated with moderate to severe postoperative infections (CD grade 3-5) in children <1 year old, with the optimal ScFI threshold being ≤27.1 cm² /m² (sensitivity 80.4% and specificity 77.8%). A weak negative correlation between SMI and the total duration of hospital stay (R=-0.33, P=0.010) and intensive care unit stay (R=-0.32, P 0.013) was observed in children <1 year old. No other associations between CT-based body metrics and postoperative outcomes were shown.

CONCLUSIONS: In children <1 year old with cirrhotic liver disease undergoing LT, pre-operative CT-based body metrics were correlated with moderate to severe postoperative infections (ScFI), and with longer duration of hospital and ICU stay (SMI), and thus can be considered important tools for pre-LT risk assessment.

PMID:34118133 | DOI:10.1002/lt.26205

J Adv Nurs. 2021 Jun 12. doi: 10.1111/jan.14920. Online ahead of print.

ABSTRACT

AIM: This study aims to provide economic evidence of the cost-effectiveness of employing specialist Parkinson’s nurses in a regional community in Australia.

STUDY DESIGN: This retrospective study utilized hospital service usage data to compare outcomes for people with Parkinson’s disease before and after the employment of a specialist Parkinson’s nurse in a regional community.

METHODS: A representative sample was drawn from the target population of people with a diagnosis of Parkinson’s admitted to a regional hospital over a 4-year period (2013-2014 and 2016-2017). A multiple regression approach and cost-benefit analysis were used to examine hospital costs related to length of stay based on hospital records. All costs were attributed to resource allocation according to service category and the national funding system. Quantitative data were analysed using Strata Analytics.

RESULTS: Statistical findings demonstrated a reduction in hospital length of stay ranging from 0.37 (AUD$1924) to 0.755 day (AUD$3926) after the establishment of the specialist Parkinson’s nurse. The cost-benefit analysis showed a net dollar benefit, or savings in hospital costs, of up to $8600.00 per person over a 3-year period, as a result of the specialist Parkinson’s nurse intervention.

CONCLUSION: The statistical results show significant cost benefits associated with reduced length of hospital stay following introduction of the specialist Parkinson’s nurse. These findings support advocacy for sustainable specialist Parkinson’s nurse positions and have the potential to inform and influence policy and systemic changes within the health care system.

IMPACT: The benefits of embedding specialist nursing services for people with Parkinson’s disease in primary health settings include the direct impact on the potential to avoid hospital admissions due to worsening symptoms, improving quality of life for the person with Parkinson’s and slowing the trajectory of the disease. Additional benefits are increased access to specialist services and reduced family caregiver burden.

PMID:34118161 | DOI:10.1111/jan.14920

J Adv Nurs. 2021 Jun 12. doi: 10.1111/jan.14915. Online ahead of print.

ABSTRACT

AIMS: This study systematically reviews the literature regarding preoperative stoma site marking and discusses the effectiveness of the procedure on complication rates, self-care deficits and health-related quality of life (HRQOL).

DESIGN: Systematic review and meta-analysis.

DATA SOURCE: Our review was conducted following the PRISMA guidelines. PubMed, EMBASE, Cochrane and CINAHL databases were searched to obtain articles published in English. Articles were also retrieved from Korean databases as well. Our last search was conducted on 2 June 2019.

REVIEW METHODS: Two reviewers independently selected relevant studies, evaluated their methodological quality and extracted data. Experimental and observational studies were included. Our main focus was on complication rates, self-care deficits and HRQOL. We conducted meta-analysis using the statistical software spss 25.0 and Stata 13.0.

RESULTS: Of the 1,039 articles reviewed, 20 were included for review, and 19 were used for quantitative synthesis. Preoperative stoma site marking reduced complication rates (odds ratio [OR]: 0.47; 95% confidence interval [CI]: 0.36-0.62; I² : 70.6%), lowered self-care deficits (OR: 0.34; 95% CI: 0.18-0.64; I² : 0%), and increased HRQOL (standardized mean difference, 1.05; 95% CI: 0.70-1.40; I² : 0%). Quality appraisal results for both the individual studies and the studies overall were excellent. The possibility of publication bias was low.

CONCLUSIONS: Our findings indicate that preoperative stoma site marking improves patient outcomes: stoma-related complication rates and self-care deficits decrease and HRQOL rises. For this reason, preoperative stoma site marking should be a mandatory procedure in clinical settings. The practice should also be supported by policymakers and healthcare expert associations.

IMPACT: Preoperative stoma site marking reduces overall complication rates by 53% and skin problems by 59%. Preoperative stoma site marking also improves self-care and health-related quality of life. We recommend that preoperative stoma site marking should be a mandatory procedure in clinical settings.

PMID:34118170 | DOI:10.1111/jan.14915

Liver Transpl. 2021 Jun 12. doi: 10.1002/lt.26209. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The Affordable Care Act (ACA) expanded Medicaid around the same time that direct-acting antivirals (DAAs) became widely available for the treatment of hepatitis C virus (HCV). However, there is significant variation in Medicaid HCV treatment eligibility criteria between states. We explored the combined effects of Medicaid expansion and leniency of HCV coverage under Medicaid on liver outcomes.

METHODS: We assessed state-level end-stage liver disease (ESLD) mortality, listings for liver transplant (LT), and listing-to-death ratio (LDR) for adults 25-64 years old using data from UNOS and CDC WONDER. States were divided into four nonoverlapping groups based on expansion status on January 1, 2014 (expansion versus non-expansion) and leniency of Medicaid HCV coverage (lenient versus restrictive coverage). Joinpoint regression analysis evaluated for significant changes in slope over time (joinpoints) during the pre-expansion (2009-2013) and post-expansion (2014-2018) time periods.

RESULTS: We found significant changes in annual percent change (APC) for population-adjusted ESLD deaths between 2014-2015 in all cohorts except for the non-expansion/restrictive cohort, in which deaths increased at the same APC from 2009-2018 (APC +2.5% [95% CI 1.8, 3.3]). In the expansion/lenient coverage cohort, deaths increased at an APC of +2.6% (95% CI 1.8, 3.5) until 2014 and then tended to decrease at an APC of -0.4% (95% CI -1.5, 0.8). LT listings tended to decrease over time for all cohorts. For LDR, only the expansion/lenient and expansion/restrictive cohorts had statistically significant joinpoints.

CONCLUSION: Improvements in ESLD mortality and LDR were associated with both Medicaid expansion and leniency of HCV coverage under Medicaid. These findings argue for the implementation of more lenient and widespread public health insurance to improve liver disease outcomes, including mortality.

PMID:34118120 | DOI:10.1002/lt.26209