Tag: nevin manimala

Langmuir. 2023 Jul 10. doi: 10.1021/acs.langmuir.3c01070. Online ahead of print.

ABSTRACT

Titanium dioxide (TiO₂) nanoparticles have been extensively used to modify the optical properties of various types of materials. In particular, they have been intensively loaded onto polymer fibers to quench the light reflection. In situ polymerization and online addition are two common strategies for fabricating TiO₂-loaded polymer nanocomposite fibers. The former does not require separate preparation of masterbatches as the latter does and therefore has its advantages in terms of decreasing the fabrication steps and economic costs. Moreover, it has been found that in situ-polymerized TiO₂-loaded polymer nanocomposite fibers (e.g., TiO₂/poly(ethylene terephthalate) fibers) usually have enhanced light-extinction properties over those prepared by the online addition process. Intuitively, there should be a difference in the filler particle dispersion for the two fabrication processes. This hypothesis has not yet been tackled due to the technical difficulty in acquiring the three-dimensional (3D) filler morphology inside the fiber matrix. In this paper, we report a study using the powerful focused ion beam-scanning electron microscopy (FIB-SEM) with a resolution of 20 nm to directly acquire the 3D microstructure of TiO₂/poly(ethylene terephthalate) nanocomposite (TiO₂/PET) fibers. This microscopy technique allows us to characterize the particle size statistics and the dispersion inside TiO₂/PET fibers. We have found that the particle size of TiO₂ inside the fiber matrix can be well modeled by Weibull statistics. Surprisingly, we find that TiO₂ nanoparticles form more significant agglomeration in the in situ-polymerized TiO₂/PET fibers. This observation is contrary to our common understanding of the two fabrication processes. Namely, slightly altering the particle dispersion with increased TiO₂ filler size helps improve the light-extinction properties. The slightly increased filler size may have altered the Mie scattering between the nanoparticles and the incident visible light, leading to enhanced light-extinction properties of in situ-polymerized TiO₂/PET nanocomposite fibers.

PMID:37427414 | DOI:10.1021/acs.langmuir.3c01070

HCA Healthc J Med. 2021 Dec 29;2(6):423-431. doi: 10.36518/2689-0216.1306. eCollection 2021.

ABSTRACT

BACKGROUND: Patients with syncope often undergo costly testing, despite current guidelines and data supporting the contrary.

OBJECTIVE: To determine the diagnostic value through positivity rate of electrocardiogram (EKG), computed tomography (CT) of the brain, magnetic resonance imaging (MRI) of the brain, transthoracic echocardiogram, nuclear and pharmacologic cardiac stress test, tilt table test and carotid ultrasound in patients diagnosed with syncope.

METHODS: This is a retrospective study of 10,036 adults presenting to the emergency department or hospitalized with a primary diagnosis of syncope at 8 acute care facilities in the southwest United States from January 1, 2019, to December 31, 2019. A chi-square analysis was performed for each testing modality to evaluate for a statistically significant difference. The cost of each test was estimated based on published national averages per Medicare.

RESULTS: Of our sample, 903 patients (9%) received a test that yielded any positive finding. The results in the order of highest percent positivity rate to lowest were EKG (5.7%), carotid ultrasound (4.84%), transthoracic echocardiogram (2.56%), tilt table test (1%), MRI brain (0.99%), CT brain (0.82%) and cardiac stress test (0.09%). The total sum spent on testing was estimated at $43,347,332. Only $489,170 of this total was spent on a positive test. If this data is expanded to the 6,146 hospitals across the United States, a yearly $33 billion are wasted on syncope workups.

CONCLUSION: Costly testing continues to be performed on syncope patients despite guidelines discouraging testing. The necessity of these tests should be carefully evaluated for each patient based on diagnostic value.

PMID:37427395 | PMC:PMC10324800 | DOI:10.36518/2689-0216.1306

HCA Healthc J Med. 2021 Dec 29;2(6):411-421. doi: 10.36518/2689-0216.1295. eCollection 2021.

ABSTRACT

BACKGROUND: Pharmacy-led medication reconciliation identifies and corrects medication errors that can potentially cause moderate to severe harm. This research sought to identify the impact of pharmacy-led medication reconciliation on patient outcomes and describe the changes in healthcare workers’ perceptions of the program.

METHODS: A pharmacy-led admission medication reconciliation program pilot started in July 2019, and a discharge medication reconciliation proof of concept was tested in September 2020 at a 432-bed hospital. The following periods were compared: August 2018 to February 2019 (pre-program implementation) and August 2019 to February 2020 (post-program implementation). Endpoints included patient outcomes, workforce productivity and interdisciplinary healthcare team satisfaction through program surveys. Patient outcomes were assessed with chisquared tests. Survey responses were assessed using the Likert scale. Descriptive statistics were used for productivity outcomes and the number of discharge medication reconciliations completed.

RESULTS: Approximately 18,000 admissions were recorded for each period. The adverse drug event (ADE) rate decreased 49% (p < 0.001), and the complication rate decreased 29.7% (p = 0.001). During post-pilot implementation, 6,530 medication histories were completed, and 70,050 medications were reviewed. Of medication histories completed, 22.6% of patient allergies/adverse drug reactions were updated, 52.3% of medications were clarified, and 54.7% of preferred outpatient pharmacies were updated. Pharmacy services completed medication histories in 38.8% of inpatients. In the proof of concept, 168 discharge medication lists were drafted. Survey results showed statistically significant improvement in healthcare team satisfaction.

CONCLUSION: A pharmacy-led medication reconciliation program involving designated pharmacists and pharmacy technicians has shown to decrease ADEs and complications while improving interdisciplinary healthcare team satisfaction.

PMID:37427394 | PMC:PMC10324798 | DOI:10.36518/2689-0216.1295

Acta Stomatol Croat. 2023 Jun;57(2):177-189. doi: 10.15644/asc57/2/8.

ABSTRACT

OBJECTIVES: The primary aim was to compare the amount of bone height change that occurs around the tooth and the implant when having tooth-implant-supported prosthetic restorations versus bone height change that appears around implants in only implant-supported prosthetic restorations. The secondary aim was to examine the influence of various factors such as the number of teeth involved in the construction, their endodontic treatment, number of implants, the type of implantology construction, the jaw in which the construction is located, the condition of the opposite jaw, gender, age, and working time, as well as to examine whether the initial bone level influenced the amount of change in bone height itself.

MATERIALS AND METHODS: With a total of 50 respondents, 25 X-ray panoramic images were representing tooth-implant-supported prosthetic restorations, while the other 25 were representing implant-supported prosthetic restorations. Bone measures were taken (from enamel-cement junction/implant neck to the most apical bone point) from 2 panoramic radiographs. The first one is immediately after the implant placement and the second and the last one again in half a year up to seven years after, depending on the time when the photo was taken for each patient. The obtained difference represented the bone resorption, the bone formation, or a state without change. Influence of different factors, such as sex, age of the patient, working time, the number of teeth involved in the construction, endodontic treatment, number of implants, the type of implant construction, the jaw where the construction is located, the condition of the opposite jaw, as well as the initial bone condition, was examined. During the statistical analysis, frequency tables, basic statistical parameters, the Mann-Whitney U test, the Kruskal-Wallis Anova, Wilcoxon test, and regression analysis were used, and the results were presented in tabular form and the form of the Pareto diagram of t-values.

RESULTS: No statistically significant difference in bone change (whether we are talking about the place of the implant (-0.359±1.009 and median value 0.000), the place of a tooth (-0.428±0.746 and median value -0,150) in tooth-implant supported restorations, or the place of the implant in case of implant-supported structures (-0,059±0,200 and median value -0,120)) was proven. When talking about the influence of other factors, by regression analysis, the number of implants was shown to be the only factor with a statistically significant influence (β=0.54; P=0.019) in a change of bone level, but only when talking about implant-supported restorations.

CONCLUSION: No significant difference was proven between bone height change, neither around the tooth nor the implant in tooth-implant-supported prosthetic restorations compared to the bone height changes around the implant in only implant-supported prosthetic restorations. Among all the examined factors, the number of implants has shown to have statistically significant contribution to the amount of bone height change in implant-supported prosthetic restorations.

PMID:37427363 | PMC:PMC10323935 | DOI:10.15644/asc57/2/8

Acta Stomatol Croat. 2023 Jun;57(2):145-154. doi: 10.15644/asc57/2/5.

ABSTRACT

OBJECTIVE: Due to the consideration that oral/dental health is an important part of general health, well-being, and an individual’s quality of life, the need for appropriate instruments assessing oral health-related quality of life is emphasized. This study aimed to evaluate the psychometric properties of the Oral health-related quality of life questionnaire consisting of 14 questions among the Macedonian language-speaking adults (OHIP-MAC 14).

MATERIAL AND METHODS: A total of 270 adults participated in the study. The reliability of the questionnaire was examined by testing the internal consistency and reproducibility (test-retest). The responsiveness of the instrument was tested by computing the pre-intervention and post-intervention OHIP-14 scores using the paired t-test followed by the determination of the effect-size. The two aspects of the construct validity were evaluated: concurrent validity and discriminative validity.

RESULTS: A concurrent validity analysis confirmed that the instrument performed well. Discriminative validity also confirmed good psychometric properties (P<0.01). The ICC statistics and the Cronbach alpha coefficients indicated the appropriate reliability of the instrument for the included groups of participants. The responsiveness of the questionnaire was also acceptable (P<0.01) demonstrating the large effect-size of 1.43.

CONCLUSION: The OHIP 14 MAC showed acceptable psychometric properties and can be recommended as a valuable instrument in assessments of the Oral health-related quality of life in the Republic of North Macedonia.

PMID:37427359 | PMC:PMC10323931 | DOI:10.15644/asc57/2/5

Acta Stomatol Croat. 2023 Jun;57(2):167-176. doi: 10.15644/asc57/2/7.

ABSTRACT

OBJECTIVES: The study aimed to determine the relationship between the mandibular asymmetry index according to Kjellberg between patients with painful unilateral anterior disc displacement (DD) and asymptomatic volunteers without disc displacement. Vertical measurements were performed on a panoramic single-image radiograph, and the disc status was confirmed by magnetic resonance imaging (MRI).

MATERIAL AND METHODS: Two groups of subjects were retrospectively selected, 40 patients (the overall mean age was 35.5 years; 75% female) with temporomandibular disorder symptoms confirmed by RDC/TMD axis I and manual functional analysis. Unilateral DD was determined by MRI. A comparative group of asymptomatic volunteers (20 dental students with a mean age of 23.4 years; 72% female) had the physiological position of the disc determined by MRI. The vertical asymmetry of the condyle was determined by the method of Kjellberg et al. The symmetry of the gonial angle of the mandible was also measured.

RESULTS: A comparison of the mean of the asymmetry index between patients (average 90.89±7.08%) and asymptomatic volunteers (mean 95.86±4.44%) showed a statistically significant difference (p=0.0029). There was no difference (p=0.088) in gonial angle symmetry between the patients (mean 96.48±2.96°) and the asymptomatic volunteers (mean 97.52±2.31°). The distribution of the presence of individual DD diagnoses (partial and total displacement with reduction, displacement without reduction) in patients diagnosed with asymmetry of the mandible was without statistical significance (p>0.05).

CONCLUSION: This study actually points to the asymmetry of the mandible as a potential morphological risk of anterior DD.

PMID:37427358 | PMC:PMC10323934 | DOI:10.15644/asc57/2/7

Eur Heart J Open. 2023 Jun 20;3(4):oead065. doi: 10.1093/ehjopen/oead065. eCollection 2023 Jul.

ABSTRACT

AIMS: In patients undergoing catheter ablation for atrial fibrillation (AF), direct oral anticoagulants (DOACs) are as effective and safe as the vitamin K antagonist (VKA) warfarin. Phenprocoumon has a different pharmacokinetic profile compared with warfarin and is the most used VKA in Germany. The aim of the study was to compare DOAC with phenprocoumon.

METHODS AND RESULTS: In this retrospective single-centre cohort study, 1735 patients who underwent 2219 consecutive catheter ablations for AF between January 2011 and May 2017 were included. All patients were in-hospital for at least 48 h after catheter ablation. The primary outcome was defined as peri-procedural thrombo-embolic events. The secondary outcome was any bleeding according to the International Society on Thrombosis and Haemostasis (ISTH). The mean age of the patients was 63.3 years. Phenprocoumon was prescribed in 929 (42%) of the cases, and in 697 (31%) dabigatran, 399 (18%) rivaroxaban, and 194 (9%) apixaban. During hospitalization, 37 (1.6%) thrombo-embolic events occurred, including 23 transient ischaemic attacks (TIAs). Compared with the use of phenoprocoumon, the use of DOAC was significantly associated with a lower thrombo-embolic risk [16 (1.2%) vs. 21 (2.2%), odds ratio (OR)], 0.5 [95% confidence interval (CI) 0.2-0.9], P = 0.04. No statistically significant association with bleeding risk was observed [phenprocomoun: 122 (13%); DOAC: 163 (12.6%); OR 0.9 (95% CI 0.7-1.2); P = 0.70]. Interruption of oral anticoagulation (OAC) was associated with an increased risk for thrombo-embolic complications [OR 2.2 (1.1-4.3); P = 0.031], and bleeding [OR 2.5 (95% CI 1.8-3.2), P = 0.001].

CONCLUSION: In patients undergoing catheter ablation for AF, the use of DOAC was associated with a reduced risk of thrombo-embolic events compared with phenprocoumon. Non-interrupted oral anticoagulation (OAC) therapy was associated with a reduced risk of peri-procedural thrombo-embolic and any bleeding complications.

PMID:37427356 | PMC:PMC10329261 | DOI:10.1093/ehjopen/oead065

Oncol Lett. 2023 Jun 22;26(2):343. doi: 10.3892/ol.2023.13929. eCollection 2023 Aug.

ABSTRACT

Triple-negative breast cancer (TNBC) is an aggressive subtype of BC characterized by extensive intratumoral heterogeneity. Compared with other types of BC, TNBC is more prone to invasion and metastasis. The aim of the present study was to determine whether adenovirus-mediated clustered regulatory interspaced short palindromic repeats (CRISPR)/Cas9 system is capable of effectively targeting enhancer of zeste homolog 2 (EZH2) in TNBC cells and lay an experimental basis for the investigation of the CRISPR/Cas9 system as a gene therapy for BC. In the present study, EZH2 was knocked out in MDA-MB-231 cells using the CRISPR/Cas9 gene editing tool to create EZH2-knockout (KO) group (EZH2-KO group). Moreover, the GFP knockout group (control group), and a blank group (Blank group), were employed. The success of vector construction and EZH2-KO were verified by T7 endonuclease I (T7EI) restriction enzyme digestion, mRNA detection and western blotting. Changes in proliferation and migration ability of MDA-MB-231 cells following gene editing were detected by MTT, wound healing, Transwell and in vivo tumor biology assays. As indicated by the results of mRNA and protein detection, the mRNA and protein expression of EZH2 were significantly downregulated in the EZH2-KO group. The difference in EZH2 mRNA and protein between the EZH2-KO and the two control groups was statistically significant. MTT, wound healing and transwell assay suggested that the proliferation and migration ability of MDA-MB-231 cells in the EZH2-KO group were significantly decreased after EZH2 knockout. In vivo, the tumor growth rate in the EZH2-KO group was significantly lower than that in the control groups. In brief, the present study revealed that the biological functions of tumor cells were inhibited after EZH2 knockout in MDA-MB-231 cells. The aforementioned findings suggested that EZH2 can have a key role in the development of TNBC.

PMID:37427349 | PMC:PMC10326815 | DOI:10.3892/ol.2023.13929

Oncol Lett. 2023 Jun 28;26(2):350. doi: 10.3892/ol.2023.13936. eCollection 2023 Aug.

ABSTRACT

Intracranial meningiomas are the most common tumors of the central nervous system (CNS). Meningiomas account for up to 36% of all brain tumors. The incidence of metastatic brain lesions has not been determined. Up to 30% of adult patients with cancer of one localization or another suffer from a secondary tumor lesion of the brain. The vast majority of meningiomas have meningeal localization; >90% are solitary. The incidence of intracranial dural metastases (IDM) is 8-9% of cases, while in 10% of cases, the brain is the only localization, and in 50% of cases the metastases are solitary. Typically, the task of distinguishing between meningioma and dural metastasis does not involve difficulties. Periodically, there is a situation when the differential diagnosis between these tumors is ambiguous, since meningiomas and solitary IDM may have similar characteristics, in particular, a cavity-less solid structure, limited diffusion of water molecules, the presence of extensive peritumoral edema, and an identical contrast pattern. The present study included 100 patients with newly diagnosed tumors of the CNS, who subsequently underwent examination and neurosurgical treatment at the Federal Center for Neurosurgery with histological verification between May 2019 and October 2022. Depending on the histological conclusion, two study groups of patients were distinguished: The first group consisted of patients diagnosed with intracranial meningiomas (n=50) and the second group of patients were diagnosed with IDM (n=50). The study was performed using a magnetic resonance imaging (MRI) General Electric Discovery W750 3T before and after contrast enhancement. The diagnostic value of this study was estimated using Receiver Operating Characteristic curve and area under the curve analysis. Based on the results of the study, it was found that the use of multiparametric MRI (mpMRI) in the differential diagnosis of intracranial meningiomas and IDM was limited by the similarity of the values of the measured diffusion coefficient. The assumption, previously put forward in the literature, regarding the presence of a statistically significant difference in the apparent diffusion coefficient values, which make it possible to differentiate tumors, was not confirmed. When analyzing perfusion data, IDM showed higher cerebral blood flow (CBF) values compared with intracranial meningiomas (P≤0.001). A threshold value of the CBF index was revealed, which was 217.9 ml/100 g/min, above which it is possible to predict IDM with a sensitivity and specificity of 80.0 and 86.0%, respectively. Diffusion-weighted images are not reliable criteria for differentiating intracranial meningiomas from IDM and should not influence the diagnosis suggested by imaging. The technique for assessing the perfusion of a meningeal lesion makes it possible to predict metastases with a sensitivity and specificity close to 80-90% and deserves attention when making a diagnosis. In the future, in order to reduce the number of false negative and false positive results, mpMRI would require additional criteria to be included in the protocol. Since IDM differs from intracranial meningiomas in the severity of neoangiogenesis and, accordingly, in greater vascular permeability, the technique for assessing vascular permeability (wash-in parameter with dynamic contrast enhancement) may serve as a refining criterion for distinguishing between dural lesions.

PMID:37427340 | PMC:PMC10326821 | DOI:10.3892/ol.2023.13936

Indian J Psychol Med. 2023 Jul;45(4):338-344. doi: 10.1177/02537176221130252. Epub 2022 Oct 27.

ABSTRACT

BACKGROUND: Patients with dementia usually have multiple comorbidities. The presence of comorbidities may exacerbate the progression of dementia and decreases the patient’s ability to participate in health maintenance activities. However, there is hardly any meta-analysis estimating the magnitude of comorbidities among patients with dementia in the Indian context.

METHODS: We searched PubMed, Scopus, and Google Scholar, and relevant studies conducted in India were included. The risk of bias was assessed and a random-effects meta-analysis model was used in which I² statistics were calculated to measure heterogeneity among studies.

RESULTS: Fourteen studies were included in the meta-analysis based on the inclusion and exclusion criteria. Altogether, we found the coexistence of comorbid conditions such as hypertension (51.10%), diabetes (27.58%), stroke (15.99%), and factors like tobacco use (26.81 %) and alcohol use (9.19%) among patients with dementia in this setting. The level of heterogeneity was high due to differences in the methodologies in the included studies.

CONCLUSIONS: Our study found hypertension as the most common comorbid condition among patients with dementia in India. The observed lacuna of methodological limitations in the studies included in the current meta-analysis provides the urgent need for good quality research to successfully meet the challenges ahead while devising appropriate strategies to treat the comorbidities among patients with dementia.

PMID:37427307 | PMC:PMC7614734 | DOI:10.1177/02537176221130252