Tag: nevin manimala

J Dermatolog Treat. 2023 Dec;34(1):2245080. doi: 10.1080/09546634.2023.2245080.

ABSTRACT

Hand eczema is one of the most frequent dermatological diseases, with an incidence increased during the COVID-19 pandemic. The impact on life quality is considerable, giving rise to the need for a psycho-dermatological approach. This is a Randomized Control Trial (RCT) evaluating, either by the dermatological or psychological point of view, the effectiveness of an emollient and rehydrating topical product (Rilastil Difesa Sterile® cream) versus a standard treatment (i.e. moisturizing basic cream) in a group of 51 healthcare workers suffering from hand eczema during the COVID-19 pandemic. The enrolled subjects were randomized into a treatment or a control arm, treated for 8 weeks, and monitored through a clinical score (HECSI) and questionnaires evaluating the impact of the pathology and treatment on quality of life (DLQI and QOLHEQ). A psychometric evaluation was performed using the SCL-90 R, OCI-R, and CPDI scales. Our data, despite not reaching the statistical significance, demonstrated that both the clinical and psychological scores decreased mostly in patients treated with Rilastil Difesa Sterile^® cream when compared to those treated with simple topical emollients. Moreover, we observed a high level of psychic suffering in dermatological patients and a parallel change in dermatological and psychological indicators, thus confirming their connection.

PMID:37558217 | DOI:10.1080/09546634.2023.2245080

Aust J Prim Health. 2023 Aug 10. doi: 10.1071/PY22227. Online ahead of print.

ABSTRACT

BACKGROUND: The 75+ health assessment has been identified as a suitable trigger to introduce advance care planning (ACP) to general practice patients. Australian general practitioners (GPs) were surveyed to explore their perceptions, attitudes and practices in introducing ACP during 75+ health assessments.

METHODS: A cross-sectional postal survey of Australian GPs covering their personal, professional and workplace characteristics, their current practice regarding ACP within a 75+ health assessment, and their attitude towards ACP. Multivariate logistic regression was used to analyse the factors associated with routinely discussing ACP as part of the 75+ health assessment.

RESULTS: A total of 185 (19.2%) out of 964 eligible GPs returned a completed survey. Most GPs reported that patients interested in ACP were supported by the GPs or the practice nurse. Two factors, (1) attitude that ACP is an essential component of the 75+ health assessment, and (2) regional or rural location of the practice, had a statistically and clinically significant association with the GP’s self-reported discussion of ACP during 75+ health assessments.

CONCLUSIONS: GPs showed a high level of support and involvement in discussing ACP during 75+ health assessments. ACP support during 75+ health assessments was often provided directly by the GP or via the practice nurse. Given the international evidence that ACP training programs improve skills and knowledge, and foster positive attitudes towards ACP, there is an important need to continue funding ACP training programs for GPs and practice nurses.

PMID:37558212 | DOI:10.1071/PY22227

Exp Parasitol. 2023 Aug 7:108591. doi: 10.1016/j.exppara.2023.108591. Online ahead of print.

ABSTRACT

Mass rearing of mosquitoes as required to fulfil research studies is a technically challenging endeavor. Blood meal source has been recognized as a key consideration in mass rearing of mosquitoes that affects colony health and fecundity. Four species of laboratory-colonized mosquitoes from the Department of Entomology, US Army Medical Directorate – Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS); Anopheles cracens, An. dirus, An. minimus and An. sawadwongporni were fed blood meals from human and rhesus macaque sources using an artificial membrane feeder. The effects of different blood meal sources were evaluated concerning blood-feeding, survival and reproduction (fecundity and hatching rates). Adult survival was monitored at days 7, 14 and 21 post blood-feeding. Although the mosquitoes fed on human blood exhibited higher rates of engorgement, there were no significant differences in blood-feeding rates in An. cracens (P = 0.08) and An. dirus (P = 0.91) between rhesus macaque and human blood sources. Twenty-one days post-feeding, no significant differences were observed in the survival rates of mosquitoes fed on human versus rhesus macaque blood. Except for An. dirus, which had better survival rates with human blood (97.5%) than after feeding on rhesus macaque blood (95.4%). All mosquito species fed on human blood produced significantly more eggs when compared to those fed on rhesus macaque blood. However, there was no statistical difference in hatching rates between blood sources, except for An. dirus, which had better hatching rates with human blood. These results indicate that human and rhesus macaque blood may be a viable alternative for maintaining Anopheles mosquitoes in colony.

PMID:37558194 | DOI:10.1016/j.exppara.2023.108591

J Endod. 2023 Aug 7:S0099-2399(23)00471-5. doi: 10.1016/j.joen.2023.07.026. Online ahead of print.

ABSTRACT

INTRODUCTION: A combination labial infiltration (1.8 mL) plus lingual infiltration (1.8 mL) of 4% articaine with 1:100,000 epinephrine in the mandibular lateral incisor was found superior to a labial infiltration of 1.8 mL of the same solution. However, it is not known whether the volume or the location had the greatest effect. Therefore, the purpose of this prospective, randomized crossover study was to determine the anesthetic efficacy of a labial infiltration of a 3.6 mL volume of 4% articaine with 1:100,000 epinephrine compared to labial infiltration (1.8 mL) plus lingual infiltration (1.8 mL) of 4% articaine with 1:100,000 epinephrine in the mandibular lateral incisor.

METHODS: One hundred subjects randomly received two sets of injections, using 4% articaine with 1:100,000 epinephrine, consisting of labial and lingual infiltrations of 1.8 mL (3.6 mL total) and two labial infiltrations of 1.8 mL (3.6 mL total) of the mandibular lateral incisor in two separate appointments. Electric pulp testing was used to determine anesthetic success (highest 80/80 reading). The data were analyzed statistically.

RESULTS: The labial and lingual combination exhibited a significantly higher anesthetic success rate (97%) when compared to the two labial infiltrations (74%) and had significantly higher 80/80s readings from 1 minute to 58 minutes.

CONCLUSIONS: Within the limitations of this clinical study, a combination labial plus lingual infiltration using a 3.6 mL volume of 4% articaine with 1:100,000 epinephrine significantly increased pulpal anesthetic success for the mandibular lateral incisor when compared to a labial infiltration using a 3.6 mL volume of articaine. Therefore, location of the infiltrations was more important than volume.

PMID:37558177 | DOI:10.1016/j.joen.2023.07.026

J Obstet Gynaecol Can. 2023 Aug 7:S1701-2163(23)00498-X. doi: 10.1016/j.jogc.2023.08.001. Online ahead of print.

ABSTRACT

OBJECTIVE: Our objective was to explore the workforce and clinical care of first and second trimester surgical abortion (FTSA, STSA) providers following the publication of updated Society of Obstetricians and Gynaecologists of Canada (SOGC) surgical abortion guidelines.

METHODS: We conducted a national, cross-sectional, online, self-administered survey of physicians who provided abortion care in 2019. This anonymized survey collected participant demographics, types of abortion services, and characteristics of FTSA and STSA clinical care. Through health care organizations using a modified Dillman technique, we recruited from July to December 2020. Descriptive statistics were generated by R Statistical Software.

RESULTS: We present the data of 222 surgical abortion provider respondents, of whom 219 provided FTSA, 109 STSA, and 106 both. Respondents practiced in every Canadian province and territory. Most were obstetrician-gynaecologists (56.8%) and family physicians (36.0%). The majority of FTSA and STSA respondents were located in urban settings, 64.8% and 79.8% respectively, and more than 80% practiced in hospitals. More than 1 in 4 respondents reported <5 years’ experience with surgical abortion care and 93.2% followed SOGC guidelines. Noted guideline deviations included that prophylactic antibiotic use was not universal, and more than half of respondents used sharp curettage in addition to suction. Fewer than 5% of STSA respondents used mifepristone for cervical preparation.

CONCLUSIONS: The surgical abortion workforce is multidisciplinary and rejuvenating. Education, training, and practice supports, including SOGC guideline implementation, are required to optimize care and to ensure equitable FTSA and STSA access in both rural and urban regions.

PMID:37558165 | DOI:10.1016/j.jogc.2023.08.001

J Sport Health Sci. 2023 Aug 7:S2095-2546(23)00074-1. doi: 10.1016/j.jshs.2023.08.001. Online ahead of print.

ABSTRACT

BACKGROUND: One of the pathological hallmarks distinguishing Alzheimer’s disease from other dementias is the accumulation of amyloid beta (Aβ). Higher physical activity is associated with decreased dementia risk, and one potential path could be through Aβ levels modulation. We aimed to explore the relationship between physical activity and Aβ in middle-aged and older adults.

METHODS: A systematic search of PubMed, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, and SportDiscuss was performed from inception to the 28^th of April 2022. Studies were eligible if they included physical activity and Aβ data in adults aged 45 years or older. Multi-level meta-analyses of intervention and observational studies were performed to examine the role of physical activity in modulating Aβ levels.

RESULTS: In total, 37 articles were included (8 randomized controlled trials (RCTs), 3 non-RCTs, 4 prospective longitudinal studies, and 22 cross-sectional studies). The overall effect size of physical activity interventions on changes in blood Aβ was medium (pooled standardized mean difference (SMD) = -0.69, 95% confidence interval (95%CI): -1.41 to 0.03; I² = 74.6%). However, these results were not statistically significant, and there were not enough studies to explore the effects of physical activity on cerebrospinal fluid (CSF) and brain Aβ. Data from observational studies were examined based on measurements of Aβ in the brain using positron emission tomography scans, CSF, and blood. Higher physical activity was positively associated with Aβ only in the CSF (Estimate r = 0.12; 95%CI: 0.05 to 0.18; I² = 38%).

CONCLUSION: Physical activity might moderately reduce blood Aβ in middle-aged and older adults. However, results were only near statistical significance and might be interpreted with caution given the methodological limitations observed in some of the included studies. In observational studies, higher levels of physical activity were positively associated with Aβ only in CSF. Therefore, further research is needed to understand the modulating role of physical activity in the brain, CSF, and blood Aβ, as well as its implication for cognitive health.

PMID:37558161 | DOI:10.1016/j.jshs.2023.08.001

J Theor Biol. 2023 Aug 7:111592. doi: 10.1016/j.jtbi.2023.111592. Online ahead of print.

ABSTRACT

There has been an increasing recognition of the utility of models of the spatial dynamics of viral spread within tissues. Multicellular models, where cells are represented as discrete regions of space coupled to a virus density surface, are a popular approach to capture these dynamics. Conventionally, such models are simulated by discretising the viral surface and depending on the rate of viral diffusion and other considerations, a finer or coarser discretisation may be used. The impact that this choice may have on the behaviour of the system has not been studied. Here we demonstrate that under realistic parameter regimes – where viral diffusion is small enough to support the formation of familiar ring-shaped infection plaques – the choice of spatial discretisation of the viral surface can qualitatively change key model outcomes including the time scale of infection. Importantly, we show that the choice between implementing viral spread as a cell-scale process, or as a high-resolution converged PDE can generate distinct model outcomes, which raises important conceptual questions about the strength of assumptions underpinning the spatial structure of the model. We investigate the mechanisms driving these discretisation artefacts, the impacts they may have on model predictions, and provide guidance on the design and implementation of spatial and especially multicellular models of viral dynamics. We obtain our results using the simplest TIV construct for the viral dynamics, and therefore anticipate that the important effects we describe will also influence model predictions in more complex models of virus-cell-immune system interactions. This analysis will aid in the construction of models for robust and biologically realistic modelling and inference.

PMID:37558160 | DOI:10.1016/j.jtbi.2023.111592

Swiss Med Wkly. 2023 Aug 9;153:40098. doi: 10.57187/smw.2023.40098.

ABSTRACT

BACKGROUND: Addressing the current demographic development, the efficacy and safety of kidney transplantations from very senior donors needs to be carefully evaluated. The aim of this study was to analyse patient and graft outcomes of kidney allograft recipients stratified by donor age.

METHODS: We retrospectively investigated n = 491 patients from a prospective, observational renal transplant cohort. Patients with kidneys from very old donors (n = 75, aged >70 years), elderly donors (n = 158, between 60-70 years), and regular donors (n = 258, aged <60 years) were investigated. The primary outcome was death-censored graft survival within the predefined donor age groups.

RESULTS: Overall, n = 57 death-censored graft losses occurred. Graft loss was proportionally highest in the very old donor group (n = 11/75), but this did not reach statistical significance when compared to the elderly (14/158) and regular donor groups (32/258); (p = 0.37). Kaplan-Meier analysis demonstrated that 3-year/5-year death-censored graft survival in the very old donor group was 96%/86% and did not differ from the other age groups (p = 0.44). Median estimated glomerular filtration rate (eGFR), calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula (in ml/min/1.73 m2 of body surface) 12 months post-transplant did not differ between the elderly donor and very old donor groups (p = 0.53). However, patients who received regular donor kidneys had higher median eGFR compared to recipients in both the elderly and very old donor groups (p <0.0001). During follow-up, 31% of patients developed at least one acute rejection episode. Time-to-event analysis demonstrated no difference in occurrence of any acute rejection event across all three groups (p = 0.11).

CONCLUSIONS: This study demonstrates that kidney transplantation from carefully selected very old donors seems a valid option with reasonable short- and mid-term outcomes.

PMID:37556837 | DOI:10.57187/smw.2023.40098

Aesthet Surg J. 2023 Aug 10:sjad251. doi: 10.1093/asj/sjad251. Online ahead of print.

ABSTRACT

BACKGROUND: People of color (POC) are often underrepresented in clinical studies evaluating the safety and effectiveness of aesthetic products, including hyaluronic acid (HA) fillers, which to date have limited clinical data in POC.

OBJECTIVE: To assess the safety and effectiveness of a new line of dynamic HA fillers (RHA®, Revance, Nashville TN) for treating moderate-to-severe nasolabial folds (NLF) in POC versus non-POC.

METHODS: Post hoc subgroup analyses compared the efficacy and safety of POC versus non-POC subjects treated with RHA2, RHA3, or RHA4 for correction of moderate-to-severe nasolabial folds in the pooled Per Protocol population (N=217) in two clinical trials. Evaluated population cohorts were classified by Fitzpatrick Skin Type (FST) [high FST (IV-VI) versus low FST (I-III)] and by subject-reported race (non-White versus White) relative to baseline at 6, 9, 12, and 15 months.

RESULTS: POC consistently showed greater improvement in wrinkle severity and higher responder rates compared to non-POC, which reached statistical significance at several measured time points. Global aesthetic improvement scores (GAIS) and subject satisfaction were similar for POC and non-POC and remained high throughout the course of the study. Treatment-related adverse event rates were generally lower for high FSTs versus low FSTs, with no reported cases of keloidal scarring.

CONCLUSION: The RHA line of dynamic fillers is well tolerated and effective for the correction of moderate-to-severe nasolabial folds in POC and can be confidently used in this important and growing patient population.

PMID:37556827 | DOI:10.1093/asj/sjad251

Nurse Educ. 2023 Aug 9. doi: 10.1097/NNE.0000000000001486. Online ahead of print.

ABSTRACT

BACKGROUND: Although just culture is reportedly integrated across education and practice, little is known about how perceptions may change across time as students transition from prelicensure education to registered nurse in the practice setting.

PURPOSE: The purpose of this study was to describe and compare just culture perceptions of registered nurses at 2 time points: (1) as prelicensure students and (2) as new graduate nurses with a minimum of 6 months of experience.

METHODS: Utilizing the Just Culture Assessment Tool for Nursing Education (JCAT-NE) and the Just Culture Assessment Tool (JCAT), this within-subject, longitudinal study measured just culture perceptions across time.

RESULTS: Although there was no statistically significant change in total scores across time, 8 individual items demonstrated statistically significant change.

CONCLUSIONS: Students use the knowledge, skills, and attitudes about just culture taught in prelicensure education as new graduate nurses. However, findings reveal areas where the practice environment has altered perceptions of just culture.

PMID:37556826 | DOI:10.1097/NNE.0000000000001486