Tag: nevin manimala

Front Physiol. 2024 Nov 14;15:1258175. doi: 10.3389/fphys.2024.1258175. eCollection 2024.

ABSTRACT

OBJECTS: Anterograde renal pelvis perfusion manometry is an effective method to assist in the diagnosis of upper urinary tract obstruction.

METHODS: To established a rat model of partial ureteral obstruction to explore the perfusion rate, renal pelvis volume, obstruction sites, contralateral upper urinary tract, and lower urinary tract functions, which may affect anterograde renal pelvis perfusion manometry. To measure the renal pelvis volume using ultrasound. Depending on whether clamped the contralateral ureter and it continuously emptied the bladder, perfused the renal pelvis at rate of 15, 30, 60, 90, or 120 mL/h to measure the pressure synchronously.

RESULTS: The research showed the renal pelvis volume of UPJ and UVJ at 1, 2, 3, and 4 weeks respectively, significantly increased compared with the control group. Comparison of the renal pelvis volume between the UPJ and UVJ groups was not statistically significant. The renal pelvis pressure of UPJ and UVJ was significantly increased compared with the control group, and the UVJ group was greater than the UPJ group. The renal pelvic pressure increased as the perfusion rate increased. Comparing the renal pelvis pressure measured using synchronous bladder emptying with the renal pelvis pressure measured singly, the difference was statistically significant. Comparing the renal pelvis pressure measured using synchronous bladder emptying with measured with a clamped contralateral ureter, the difference was not statistically significant; however, in some groups, the difference was statistically significant. Measuring the renal pelvis pressure singly and clamping the contralateral ureter, the difference was not statistically significant, except in some groups, the difference was significant.

CONCLUSION: The study suggested that ureter obstruction sites, perfusion rates, renal pelvis volumes, and synchronous bladder emptying affects the renal pelvis pressure. The function of the contralateral upper urinary tract did not affect renal pelvis pressure in the short term.

PMID:39611076 | PMC:PMC11602502 | DOI:10.3389/fphys.2024.1258175

Cureus. 2024 Nov 21;16(11):e74171. doi: 10.7759/cureus.74171. eCollection 2024 Nov.

ABSTRACT

This study evaluated the comparative efficacy of different beta blockers bisoprolol, carvedilol, and metoprolol in reducing mortality and hospitalizations among 120 heart-failure (HF) patients. The sample had an equal gender distribution (50% male, 50% female) with a mean age of 69.28 years. Baseline characteristics, such as systolic blood pressure (mean: 134.36 mmHg) and left ventricular ejection fraction (LVEF) (mean: 40.24%), were comparable across the treatment groups. Patients were treated with either bisoprolol (30%), carvedilol (30%), or metoprolol (40%) for an average of 27.54 weeks. The study utilized Poisson and negative binomial regression models to assess hospitalization rates, and chi-square tests to compare mortality outcomes. Results revealed that mortality was 44.2% across the entire cohort, with no significant differences between the three beta-blocker groups (p = 0.301). Similarly, no significant differences were observed in hospitalizations (p = 0.276) or ICU admissions (p = 0.797). However, patients on bisoprolol and carvedilol exhibited a slight improvement in New York Heart Association (NYHA) class and LVEF, though this was not statistically significant (p = 0.145 and p = 0.477, respectively). Side effects, including bradycardia, fatigue, and hypotension, were noted in 32.5%, 21.7%, and 23.3% of patients, respectively. These findings suggest that all three beta blockers are similarly effective in reducing mortality, though bisoprolol and carvedilol may offer better control of HF symptoms.

PMID:39611070 | PMC:PMC11604132 | DOI:10.7759/cureus.74171

Front Clin Diabetes Healthc. 2024 Nov 14;5:1464365. doi: 10.3389/fcdhc.2024.1464365. eCollection 2024.

ABSTRACT

The purpose of the study is to investigate the importance of education and re-education for the proper use of the insulin pump (IP) in order to maintain stable glycemic control over an extended period.

METHODS: The study was designed as a cross-sectional retrospective study. A total of 168 patients participated in a five-day structured education program in a small group. Following the initial education, 42 patients who met the criteria for continuation of IP treatment continued to be monitored every six months (period I). After six years of follow-up (period II) data from 36 patients were taken and analyzed. The data from the IP were downloaded from the IP Paradigm 754 “VEO” (Medtronic Inc., Illinois, USA) on the personal computer via the CareLink Pro software (Medtronic, Inc., Illinois).

RESULTS: The number of patients using the bolus calculator (BC+) for at least 50% of all administered boluses remained high in both periods. However, BC+ patients statistically significantly increased their A1C value in period II. The average number of hypoglycemias was statistically significantly increased in the group of BC+ patients in period II compared to period I (p=0.009). The continuous glucose monitors (CGM) were used only in period II, so the number of hypoglycemias in period I were roughly estimated.

CONCLUSIONS: The long-term success of IP therapy primary depends on the proper use of the device, highlighting the importance of good education and regular re-education for both patients and health professionals. Advanced hybrid technology systems could be particularly in settings with poorly organized healthcare, where re-education is not routinely provided and diabetes control relies heavily on the patient engagement.

PMID:39611060 | PMC:PMC11602451 | DOI:10.3389/fcdhc.2024.1464365

Front Clin Diabetes Healthc. 2024 Nov 14;5:1432551. doi: 10.3389/fcdhc.2024.1432551. eCollection 2024.

ABSTRACT

INTRODUCTION: Diabetic retinopathy (DR) is a highly prevalent microvascular disease among diabetic patients, resulting in irreversible blindness. However, there is a dearth of evidence on diabetic retinopathy (DR) and its associated factors in eastern Ethiopia. The study aimed to determine the prevalence of diabetic retinopathy (DR) and its associated factors among type 1 and type 2 diabetic patients at public hospitals in eastern Ethiopia.

METHOD: A hospital-based comparative cross-sectional was conducted among 520 diabetic patients. Epidata software was used for data entry, and STATA version 17 was used for statistical analysis. Multivariate binary logistic regression was computed to identify factors associated with DR. The Hosmer and Lemeshow chi-square test assessed goodness of fit.

RESULTS: The overall prevalence of DR was 43.5%. The prevalence of diabetic retinopathy among type 1 DM was 38.5%, and the prevalence of DR among type 2 DM was 48.5%. Age >60 [AOR = 4.64 95% CI (1.60, 13.51)], being male [AOR = 4.05 95% CI (1.51, 10.97)], and having complications [AOR = 0.01 95% CI (0.003, 0.04)] were significantly associated with DR among type 1 diabetes. Having a family history of DM [AOR = 1.57 95% CI (1.76, 3.24)], poor glycemic status [AOR = 1.91 95% CI (1.56, 2.83)], and having complications [AOR = 11.07 95% CI (4.89, 25.13)] were significantly associated with DR among type 2 diabetes.

CONCLUSIONS: In the current study, the prevalence of DR was 43.5%. The prevalence was higher among type 2 diabetes compared to type 1 diabetes. Factors such as poor glycemic control, older age, male sex, a family history of diabetes, and complications related to diabetes were significantly associated with DR. To minimize the impact of diabetics, it requires regular screening programs for diabetic patients, especially those with poor glycemic control and other identified risk factors.

PMID:39611059 | PMC:PMC11602483 | DOI:10.3389/fcdhc.2024.1432551

Health Sci Rep. 2024 Nov 26;7(12):e70207. doi: 10.1002/hsr2.70207. eCollection 2024 Dec.

ABSTRACT

BACKGROUND AND AIMS: Due to the increasing use of imaging services, this study aimed to estimate the number of unnecessary imaging services, normal and abnormal imaging examinations, and their determinant factors.

METHODS: This cross-sectional study was conducted at a district hospital in East Azerbaijan, Iran. Retrospective data were collected from the electronic medical records of patients referred to the Imaging Department between March and August 2022, using the Hospital Information System (HIS). Descriptive statistics and χ ² tests were performed, followed by hierarchical logistic regression with AOR, 95% CI, using SPSS-24 for analysis.

RESULTS: About 28% of imaging examinations with abnormal results and 21% of the examinations with normal results were unnecessary. The probability of ultrasound abnormal imaging results was 67% lower than computed tomography (CT) scan (CT-scan) (adjusted odds ratio (AOR) = 0.33 (0.212-0.50); p < 0.001). One year increase of patient age is associated with a 1% lower likelihood of having normal imaging (AOR = 0.99 (0.98-0.99); p < 0/001). Women were 20% less likely than men to have abnormal imaging results (AOR = 0.80 (0.65-0.98); p = 0.035). The probability of necessary imaging decreases by 1% for 1 year increase in patient age (p = 0.017), on the other hand, the probability of unnecessary chest radiography was 5% higher than a brain CT-scan imaging (AOR = 2.05 (1.19-3.51); p = 0.009).

CONCLUSIONS: Unnecessary imaging were more frequently performed on the older patients. Additionally, ultrasound was less likely than CT-scans to show abnormal findings, while chest radiography was more frequently deemed unnecessary compared to brain CT-scans. These insights highlight the need for age- and modality-specific guidelines to reduce unnecessary imaging and improve diagnostic efficiency.

PMID:39611021 | PMC:PMC11599613 | DOI:10.1002/hsr2.70207

PeerJ. 2024 Nov 25;12:e18542. doi: 10.7717/peerj.18542. eCollection 2024.

ABSTRACT

BACKGROUND: This study provides new information on long non-coding RNA (lncRNA) and messenger RNA (mRNA) expression profiles in the hair follicles of Hetian sheep via the sequencing and analysis of the transcriptome of skin hair follicles during three periods of periodicity change. This is important for improving the quality of carpet wool, providing a preliminary basis for further research on the targeting relationship of these mRNAs and their target genes, and providing a scientific basis for marker-assisted selection of Hetian sheep.

METHODS: The periodic variation of anagen (P I, May, n = 3), catagen (p II, October, n = 3), and telogen (p III, January, n = 3) of the skin hair follicle tissue of three Hetian sheep ewes were selected. Skin samples were collected from the right mid-side of each sampled sheep at three hair follicle developmental stages. The three sheep were used for each developmental stage as biological and technical replicates for transcriptome sequencing and analysis.

RESULTS: The statistical power of this experimental design, calculated in RNASeqPower, was 0.92. Differential expression analysis revealed 81 lncRNAs that were differentially expressed (46 up-regulated and 35 down-regulated) and 129 mRNAs that were differentially expressed (46 up-regulated and 83 down-regulated) during the PI and PII periods. Between the PI and PIII periods, a total of 144 differentially expressed lncRNAs and 693 differentially expressed mRNAs were identified. Of these, 73 lncRNAs were significantly up-regulated and 71 were significantly down-regulated, while 474 mRNAs were significantly up-regulated and 219 were down-regulated. Additionally, a total of 87 lncRNAs were found to be differentially expressed, with 40 up-regulated and 47 down-regulated, along with 39 differentially expressed mRNAs (23 up-regulated and 16 down-regulated), between the PII and PIII stages. The functional assessment revealed that the mRNA expressed in the cells is related to the membrane, cell processes, metabolism, extracellular region, and other GO items. It is enriched in thyroid hormone synthesis, choline metabolism, cancer, AMPK, Hedgehog, and other signaling pathways.

CONCLUSION: A total of 2,286 lncRNAs (including 965 known and 1,321 novel lncRNAs) and 20,879 mRNAs were identified. These co-expressed differentially expressed genes could be used as candidate genes for studying the periodic changes of the hair follicles in Hetian sheep.

PMID:39611017 | PMC:PMC11604043 | DOI:10.7717/peerj.18542

Int J Nanomedicine. 2024 Nov 23;19:12461-12481. doi: 10.2147/IJN.S479937. eCollection 2024.

ABSTRACT

INTRODUCTION: Given the increasing frequency of drug-resistant bacteria and the limited progress in developing new antibiotics, it is necessary to explore new methods of combating microbial infections. Nanoparticles, particularly silver nanoparticles (Ag-NPs), have shown exceptional antibacterial characteristics; however, elevated concentrations of Ag-NPs can produce noticeable levels of toxicity in mammalian cells.

AIM: This study examined the potential synergistic effect of combining a low dosage of Ag-NPs and anti-pseudomonas drugs against Pseudomonas aeruginosa (ATCC strain) and eleven clinical isolates from cystic fibrosis patients.

METHODS: The Ag-NPs were chemically produced by utilizing a seed extract from Peganum Harmala and characterized via ultraviolet-visible spectroscopy and scanning electron microscopy. The broth microdilution technique was utilized to investigate the minimum inhibitory concentration (MIC) of Ag-NPs and eight antibiotics (Piperacillin, Ciprofloxacin, Levofloxacin, Meropenem, Amikacin, Ceftazidime, Gentamicin, Aztreonam). The fractional inhibitory concentration index (FICI) was determined via the checkerboard method to evaluate the synergistic effects of Ag-NPs and various antibiotics.

RESULTS: The biosynthesized Ag-NPs were uniformly spherical and measured around 15 nm in size. When combined with antibiotics, Ag-NP produced statistically significant reductions in the amount of antibiotics required to completely prevent P. aeruginosa growth for all strains. The findings revealed that the MIC of Ag-NPs was 15 ug/mL for all strains which decreased substantially when administered with antibiotics at a dose of 1.875-7.5 ug/mL. The majority of Ag-NP and antibiotic combinations exhibited a synergistic or partially synergistic impact. This was particularly noticeable in combinations containing Meropenem, Ciprofloxacin, and Aztreonam (in which the FIC index was less than or equal to 0.5).

CONCLUSION: The findings revealed that combining Ag-NPs with antibiotics was more effective than using Ag-NPs or antibiotics in isolation and that combinations of Ag-NPs and antimicrobial agents displayed synergistic activity against the majority of strains assessed.

PMID:39611007 | PMC:PMC11602434 | DOI:10.2147/IJN.S479937

Contemp Clin Trials Commun. 2024 Nov 4;42:101388. doi: 10.1016/j.conctc.2024.101388. eCollection 2024 Dec.

ABSTRACT

This paper proposes a platform trial for conducting A/B tests with multiple arms and interim monitoring to investigate the impact of several factors on the expected sample size and probability of early stopping. We examined the performance of three stopping boundaries: O’Brien Fleming (OBF) stopping for either futility or difference (both), Pocock stopping for futility only, and fixed sample size design. We simulated twelve scenarios of different orders of arms based on various effect sizes, as well as considered 1 or 3 interim looks. The overall findings are summarizing in a flowchart to provide intuitive guidance for the design of the platform based on the simulation. We found that it is better to use OBF stopping for both if there is any effective variant and the trial is sufficiently powered to detect the expected effect size. If the study is underpowered to detect a difference, we recommend fixed sample size design to gather as much information as possible, however if the expected sample size is important to minimize, we recommend using Pocock boundaries with futility monitoring. Our results aimed at helping high-tech companies conduct their own studies without requiring extensive knowledge of clinical trial design and statistical methodology.

PMID:39611005 | PMC:PMC11602995 | DOI:10.1016/j.conctc.2024.101388

J Med Internet Res. 2024 Nov 11. doi: 10.2196/59921. Online ahead of print.

ABSTRACT

BACKGROUND: An increasing aging population, accompanied by a shortage of residential aged care homes and workforce, and consumer feedback, has driven a growing interest in enabling older people to age in place through home-based care. In this context, smart home technologies for remote health monitoring have gained popularity in supporting older people to live in their own homes.

OBJECTIVE: This study aims to investigate the impact of smart home monitoring on multiple outcomes, including quality of life, activities of daily living, and depressive symptoms among older people living in their own homes over a 12-month period.

METHODS: We conducted an open-label parallel-group randomized controlled trial. The control group continued to receive their existing care from aged care service providers. Meanwhile the intervention group, in addition to receiving their usual aged care services, had their activities of daily living monitored using a smart home platform. Surveys including Adult Social Care Outcomes Toolkit (ASCOT), EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), Katz Index of Independence in Activities of Daily Living (Katz ADL), Lawton Instrumental Activities of Daily Living Scale (IADL), and Geriatric Depression Scale (GDS) were conducted at baseline, 6 and 12 months from baseline. Linear mixed-effects models were used to compare the difference between the intervention and control groups, with the ASCOT as the primary outcome measure.

RESULTS: The data from 130 participants were used in the analysis, with no significant differences in baseline characteristics between the control group (n = 61) and the intervention group (n = 69). In comparison to the control group, the intervention group had a higher ASCOT score at the 6-month assessment (mean difference: 0.045; 95% CI: 0.001 to 0.089; Cohen d: 0.377). However, this difference did not persist at the 12-month assessment (mean difference: 0.031; 95% CI: -0.014 to 0.076; Cohen d: 0.259). There were no significant differences in EQ-5D-5L, Katz ADL, IADL, and GDS observed between the intervention and control groups at the 6-month and 12-month assessments.

CONCLUSIONS: The study demonstrates that smart home monitoring can improve social care-related quality of life for older people living in their own homes. However, the improvement was not sustained over the long term. The lack of statistically significant findings and diminished long-term improvements may be attributed to the influence of the COVID-19 pandemic during the later stage of the trial. Further research with a larger sample size is needed to evaluate the effect of smart home monitoring on broader quality of life measures.

CLINICALTRIAL: Australian New Zealand Clinical Trials Registry ACTRN12618000829213; https://tinyurl.com/2n6a75em.

INTERNATIONAL REGISTERED REPORT: RR2-10.2196/31970.

PMID:39608020 | DOI:10.2196/59921

Hum Factors. 2024 Nov 28:187208241302475. doi: 10.1177/00187208241302475. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to compare the relative sensitivity between scene-independent and scene-dependent eye metrics in assessing trainees’ performance in simulated psychomotor tasks.

BACKGROUND: Eye metrics have been extensively studied for skill assessment and training in psychomotor tasks, including aviation, driving, and surgery. These metrics can be categorized as scene-independent or scene-dependent, based on whether predefined areas of interest are considered. There is a paucity of direct comparisons between these metric types, particularly in their ability to assess performance during early training.

METHOD: Thirteen medical students practiced the peg transfer task in the Fundamentals of Laparoscopic Surgery. Scene-independent and scene-dependent eye metrics, completion time, and tool motion metrics were derived from eye-tracking data and task videos. K-means clustering of nine eye metrics identified three groups of practice trials with similar gaze behaviors, corresponding to three performance levels verified by completion time and tool motion metrics. A random forest model using eye metrics estimated classification accuracy and determined the feature importance of the eye metrics.

RESULTS: Scene-dependent eye metrics demonstrated a clearer linear trend with performance levels than scene-independent metrics. The random forest model achieved 88.59% accuracy, identifying the top four predictors of performance as scene-dependent metrics, whereas the two least effective predictors were scene-independent metrics.

CONCLUSION: Scene-dependent eye metrics are overall more sensitive than scene-independent ones for assessing trainee performance in simulated psychomotor tasks.

APPLICATION: The study’s findings are significant for advancing eye metrics in psychomotor skill assessment and training, enhancing operator competency, and promoting safe operations.

PMID:39608016 | DOI:10.1177/00187208241302475