Tag: nevin manimala

Int J Clin Pharm. 2023 May 9. doi: 10.1007/s11096-023-01563-3. Online ahead of print.

ABSTRACT

BACKGROUND: When prescriptions are being processed in pharmacies, ‘rework’ is a phenomenon where an activity occurs that requires the return to a prior procedural step in the process for correction. To date, little is known regarding rework prevalence in community pharmacies or how this might be minimised.

AIM: To evaluate the cause and frequency of prescription rework in community pharmacies.

METHOD: A list of reworks was designed for community pharmacists to self-record prescription rework instances and causes in their workplace across a two-week period. Community pharmacists in Ireland were recruited via convenience sampling and snowballing. Descriptive statistics were used to assess rework frequency according to the various causes, as well as the pharmacist and pharmacy characteristics.

RESULTS: Eight pharmacists participated, recording 325 reworks across 92.9% of the 65 study days (mean 5 reworks/day). The pharmacists’ mean ranged from 1.82 to 15 reworks/day. Pharmacists and pharmacy technicians alone or together were involved in 72.3% of reworks. The three most common rework categories were involving labelling errors (22.8%), prepared prescriptions which necessitated opening and repackaging (15.1%), and medication owings to patients (13.9%).

CONCLUSION: This study reveals that prescription rework occurs frequently in community pharmacies and has provided an indication of some of the main causes. These findings demonstrate areas where pharmacy staff can address rework and should aid the development of approaches to minimise rework in future – thus decreasing workload and facilitating more time for community pharmacy staff to focus on providing patient care.

PMID:37160551 | DOI:10.1007/s11096-023-01563-3

Phys Eng Sci Med. 2023 May 9. doi: 10.1007/s13246-023-01274-z. Online ahead of print.

ABSTRACT

Examining P-wave morphological changes in Electrocardiogram (ECG) is essential for characterizing atrial arrhythmias. However, standard 12-lead ECGsuffer from diagnostic redundancy due to low signal-to-noise ratio of P-waves. To address this issue, various optimal leads have been proposed for improved atrial activity recording, but the right selection among these leads is crucial for enhancing diagnostic efficacy. This study proposes an automated lead selection technique using the CatBoost machine learning (ML) model to improve the detection of P-wave changes among optimal bipolar leads under different heart rates. ECGs were obtained from healthy participants with a mean age of 25 ± 3.81 years (34% women), including 114 in sinus rhythm (SR) and 38 in sinus tachycardia (ST). The recordings were made using a newly designed atrial lead system (ALS), standard limb lead (SLL), modified limb lead (MLL), modified Lewis lead (LLM) and P-lead. P-wave features and Atrioventricular (AV) ratio were extracted for statistical analysis and ML classification. The optimum ML model was chosen to identify the best-performing optimal lead, which was selected based on the SLL metrics among different ML classifiers. CatBoost was found to outperform the other ML models in SLL-II with the highest accuracy and sensitivity of 0.82 and 0.90, respectively. The CatBoost model, amid other optimal leads, gave the best results for AL-I and AL-II (0.86 and 0.83 in accuracy and 0.91 and 0.93 in sensitivity). The developed CatBoost model selected AL-I and AL-II as the top two best-performing optimal leads for the enhanced acquisition of P-wave changes, which may be useful for diagnosing atrial arrhythmias.

PMID:37160538 | DOI:10.1007/s13246-023-01274-z

Environ Sci Pollut Res Int. 2023 May 9. doi: 10.1007/s11356-023-27387-2. Online ahead of print.

ABSTRACT

This study examined the modelling and optimisation of the electrocoagulation-flocculation (ECF) recovery of aquaculture effluent (AQE) using aluminium electrodes. The response surface methodology (RSM), artificial neural network (ANN), and adaptive neuro-fuzzy inference system (ANFIS) were used for the modelling, while the optimisation tools were the numerical RSM and genetic algorithm (GA). Furthermore, the kinetics of the ECF process was studied to provide insight into the mechanism governing the ECF of AQE. The experimental design was performed using the central composite design (CCD) of the RSM. The ANFIS modelling was accomplished via the Grid Partition (GP) of the data set, while the ANN used the multi-layer perceptron (MLP) based feed-forward system. Statistically, the prediction accuracy of the models followed the order: ANFIS (R²: 0.9990), ANN (R²: 0.9807), and RSM (R²: 0.9790). The process optimisation gave optimal turbidity (TD) removal efficiencies of 98.98, 97.81, and 96.01% for ANFIS-GA, ANN-GA, and RSM optimisation techniques, respectively. The ANFIS-GA gave the best optimization result at optimum conditions of pH 4, current intensity (3 A), electrolysis time (7.2 min), settling time (23 min), and temperature (43.8 °C). In the kinetics study, the experimental data was analysed using pseudo-first-order (0.8787), pseudo-second-order (0.9395), and Elovich (R²: 0.9979) kinetic models; the Elovich model gave the best correlation with the experimental data showing that the process is governed by electrostatic interaction mechanism. This study effectively demonstrated that ECF recovery of AQE can effectively be modelled using RSM, ANN, and ANFIS and be optimised using RSM, ANN-GA, and ANFIS-GA techniques, and the order of performance is ANFIS > ANN > RSM and ANFIS-GA > ANN-GA > RSM, respectively.

PMID:37160520 | DOI:10.1007/s11356-023-27387-2

Lasers Med Sci. 2023 May 9;38(1):121. doi: 10.1007/s10103-023-03775-5.

ABSTRACT

The aim of this study was to evaluate the effects of photobiomodulation (PBM) on cell migration and alkaline phosphatase (ALP), type I collagen (Col-1), runt-related transcription factor 2 (RUNX-2), and Osterix (OSX) gene expression in a cementoblast culture (OCCM-30), in a microenvironment mimicking an injury on the cementoblast layer, such as it occurs during root resorption. For this, OCCM-30 cells were cultured in 6-well plates and the following parameters were assayed: (1) migration by scratch assay and ALP, Col-1, Runx2, and Osx by real-time PCR. PBM was performed in two protocols using a LED device emitting light at 660 nm (± 30 nm). OCCM-30 cementoblasts were grown and divided into four groups: (1) negative control; (2) positive control (scratch); (3) scratch + PBM with a total energy of 36 J and energy density 1.6 J/cm²; and (4) scratch + PBM with a total energy of 72 J and energy density of 3.2 J/cm². Data were statistically analyzed, with the level of significance set at 5%. Cementoblasts migrated from the edge of the scratch toward the center, and the wound closed after 24 h, with the PBM3.2J/cm² group showing the higher cell migration compared with the other groups at 2 h, 6 h, 8 h, and 13 h (p < 0.05). The control and PBM1.6J/cm² groups showed similar levels of cell migration, with no significant differences (p > 0.05). PBM3.2J/cm² group exhibited greater ALP, Col-1, OSX, and RUNX2 in comparison with the other experimental groups (p < 0.05). Similar levels of all genes evaluated were observed between the PBM1.6J/cm² group and the positive control group (p > 0.05). In conclusion, our findings support the effectiveness of photobiomodulation on cementoblast migration and gene expression, which may contribute to the formation of a new cementum layer.

PMID:37160506 | DOI:10.1007/s10103-023-03775-5

Cardiovasc Drugs Ther. 2023 May 9. doi: 10.1007/s10557-023-07450-3. Online ahead of print.

ABSTRACT

CONTEXT: A nomogram model affecting the activated clotting time (ACT) targeting rate during radiofrequency ablation of atrial fibrillation (RFCA) in China.

PURPOSE: The aim of this study is to develop and validate a nomogram model for predicting the activated clotting time targeting rate after the initial bolus heparin dosages during the radiofrequency catheter ablation of atrial fibrillation in China.

METHODS AND RESULTS: A retrospective observational study was conducted on the data of 465 patients with atrial fibrillation who underwent radiofrequency catheter ablation (RFCA) from October 2019 to June 2022. All patients were randomized into a training cohort (70%; n = 325) and a validation cohort (30%; n = 140). Independent risk factors were identified using univariate and multifactorial logistic regression analysis. The predictive nomogram model was established using R software. The nomogram was developed and evaluated based on differentiation, calibration, and clinical efficacy using concordance statistic (C-statistic), calibration plots, and decision curve analysis (DCA), respectively. The nomogram was established using three variables, including sex (OR 1.01, 95% CI 0.29-1.76, P = 0.007), heparin dose (OR 0.04; 95%CI 0.02-0.05, P < 0.001), and the baseline ACT (OR 0.03; 95%CI 0.02-0.04, P < 0.001). The C-statistic of the nomogram was 0.736 (95%CI 0.675-0.732) in the training cohort and 0.700 (95%CI 0.622-0.721) in the validation cohort. The calibration plots showed good agreement between the predictions and observations in the training and validation cohorts. The clinical decision curve also proves that the map is useful in clinical settings.

CONCLUSION: The nomogram model has good discrimination and accuracy, which can screen attainment groups intuitively and individually, and has a certain predictive value for the probability of ACT reaching the target after the adequate dosage of initial heparin in Chinese patients with atrial fibrillation.

PMID:37160503 | DOI:10.1007/s10557-023-07450-3

Graefes Arch Clin Exp Ophthalmol. 2023 May 9. doi: 10.1007/s00417-023-06085-2. Online ahead of print.

ABSTRACT

PURPOSE: Anti-retinal autoantibodies are assumed to be associated with age-related macular degeneration (AMD). To our knowledge, this is the first evaluation of autoantibodies in human sera of participants with different stages of AMD in a large population-based, observational cohort study in Germany.

METHODS: The Gutenberg Health Study (GHS) is a population-based, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. Amongst others, non-mydriatic fundus photography (Visucam PRO NM™, Carl Zeiss Meditec AG, Jena, Germany) was performed. Fundus images of the first 5000 participants were graded based on the Rotterdam Eye Study classification. Sera of participants with AMD (n=541) and sera of age-matched participants without AMD (n=490) were analyzed by antigen-microarrays. Besides descriptive statistics, autoantibody-levels were compared by Mann-Whitney-U test and the associations of level of autoantibodies with AMD were calculated by logistic regression analysis. Likewise, possible associations of the autoantibodies and both clinical and laboratory parameters on AMD subjects were analyzed.

RESULTS: Autoantibodies against transferrin (p<0.001) were significantly downregulated in participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only compared to Controls. Mitogen-activated protein kinase 3 (p=0.041), glutathione peroxidase 4 (p=0.048), clusterin (p=0.045), lysozyme (p=0.19), protein kinase C substrate 80K-H (p=0.02), heat shock 70 kDa protein 1A (p=0.04) and insulin (p=0.018) show a trend between Control and participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only.

CONCLUSIONS: This study contributes to a growing knowledge of autoantibodies in association with different AMD stages compared to controls in the context of a large population-based study in Germany. Especially autoantibodies against inflammatory proteins were downregulated in participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only.

PMID:37160502 | DOI:10.1007/s00417-023-06085-2

Sleep Breath. 2023 May 9. doi: 10.1007/s11325-023-02841-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the correlation between sleep duration and type II diabetes in adults.

METHOD: Computer databases searches were carried out through October 1, 2022, including PubMed, Cochrane Library, Embase, and Web of Science. Relevant literature was collected, and the Newcastle-Ottawa Scale (NOS) and extracted data were used to exclude studies and evaluate quality on the basis of inclusion and exclusion criteria. Meta-analysis was conducted using RevMan 5.4.1 software with random/fixed effects models.

RESULTS: A total of 5 studies with 74,226 subjects (31,611 in the male study group, 42,615 in the female study group) were included. The meta-analysis revealed that women with long sleep duration (LSD) have a higher risk for developing type II diabetes than men, OR = 0.70; 95% CI 0.59-0.84, Z = 4.00 and P < 0.001. Men with short sleep duration (SSD) tended to have a higher risk in developing type II diabetes than women though the difference between men and women did not reach statistical significance, OR = 1.09, 95% CI 0.73-1.62, Z = 0.42 and P = 0.68. Further subgroup analysis by regional populations suggested that men in Europe and America with SSD had a higher risk of type II diabetes OR = 1.52, 95% CI 1.04-2.21, Z = 2.18 and P = 0.03.

CONCLUSION: Women with LSD may have a higher risk for type II diabetes, and men in Europe and America with SSD may have a higher risk for type II diabetes than men of other regions.

PMID:37160494 | DOI:10.1007/s11325-023-02841-0

Int J Hyg Environ Health. 2023 May 7;251:114184. doi: 10.1016/j.ijheh.2023.114184. Online ahead of print.

ABSTRACT

Human breast milk is an optimally balanced infant food and a suitable tool for assessing the burden of humans with lipophilic persistent organic pollutants. The aim of this study was to investigate the accumulation profile of polychlorinated biphenyls in breast milk of women living in Bulgaria and to assess the health risk to infants. Breast milk samples were obtained from 72 healthy primiparae and multiparae mothers, living in two regions in northeastern Bulgaria – Varna region and Dobrich region, in the period October 2019-July 2021. Important information for the study, such as age, body mass, smoking and dietary habits, was collected through a questionnaire. Fifteen congeners of PCBs, including six indicator congeners, were determined by capillary gas chromatography system with mass spectrometry detection. The lipid content of the tested samples was in the range from 0.5% to 6.7%, with average value 3.25%. The six indicator PCBs in human milk samples formed up to 89% of the total PCBs levels. The most abundant congener was PCB 153, followed by PCB 138 and PCB 180. Five of the 15 PCB congeners (77, 126, 128, 156, 169) were not detected in any of the milk samples. The arithmetic mean PCB levels in milk samples from Varna (32.7 ng/g lw) were found higher than PCB levels in breast milk of mothers from Dobrich (22.5 ng/g lw). The highest PCB levels were found in milk samples from primiparae mothers in 36-40 age group (for both regions). Infant exposure to PCBs present in human milk was estimated using toxic equivalents (TEQ). The health risk to infants was assessed and was compared to the tolerable daily intake (TDI). Positive correlation was found between the arithmetic mean PCBs levels and two important factors – the age and body mass index of the primiparae group. The mean values of the analyzed PCB congeners in breast milk samples from multiparae were lower than in those from primiparae mothers. The regional differences in PCB concentrations were small, suggesting similar exposures in the studied regions. The levels of PCBs in breast milk were found lower than levels from studies in other European countries. Statistical data does not show any association between PCB levels in milk and dietary habits. The results showed that infants are not at risk of any adverse effects caused by PCBs through breast milk.

PMID:37159972 | DOI:10.1016/j.ijheh.2023.114184

J Osteopath Med. 2023 May 10. doi: 10.1515/jom-2022-0232. Online ahead of print.

ABSTRACT

CONTEXT: Osteopathic manipulative treatment (OMT) is utilized by clinicians to diagnose and treat a variety of musculoskeletal conditions including acute and chronic pain, and other medical conditions. Previous studies have examined attitudes of allopathic (MD) residents toward OMT and have implemented residency-based curricula; however, literature is lacking on the attitudes of MD students toward OMT.

OBJECTIVES: The objective of this study was to determine MD students’ familiarity with OMT and to evaluate their interest in an elective osteopathic curriculum.

METHODS: A 15-item online survey was electronically sent to 600 MD students at a large allopathic academic medical center. The survey assessed familiarity with OMT, interest in OMT and in participating in an OMT elective, educational format preference, and interest in pursuing primary care. Educational demographics were also collected. Descriptive statistics and Fisher’s exact test were utilized for categorical variables, and nonparametric tests were utilized for the ordinal and continuous variables.

RESULTS: A total of 313 MD students submitted responses (response rate=52.1 %), of which 296 (49.3 %) responses were complete and utilized for analysis. A total of 92 (31.1 %) students were aware of OMT as a modality in treating musculoskeletal disorders. Among the respondents who indicated “very interested” in learning a new pain treatment modality, the majority: (1) observed OMT in a prior clinical or educational setting (85 [59.9 %], p=0.02); (2) had a friend or family member treated by a DO physician (42 [71.2 %], p=0.01); (3) were pursuing a primary care specialty (43 [60.6 %], p=0.02); or (4) interviewed at an osteopathic medical school (47 [62.7 %], p=0.01). Among those interested in developing some OMT competency, the majority: (1) were pursuing a primary care specialty (36 [51.4 %], p=0.01); (2) applied to osteopathic schools (47 [54.0], p=0.002); or (3) interviewed at an osteopathic medical school (42 [56.8 %], p=0.001). A total of 230 (82.1 %) students were somewhat or very interested in a 2-week elective course in OMT; among all respondents, hands-on labs were the preferred method for delivery of OMT education (272 [94.1 %]).

CONCLUSIONS: The study found a strong interest in an OMT elective by MD students. These results will inform OMT curriculum development aimed at interested MD students and residents in order to provide them with OMT-specific theoretical and practical knowledge.

PMID:37159913 | DOI:10.1515/jom-2022-0232

J Infect Dev Ctries. 2023 Apr 30;17(4):542-549. doi: 10.3855/jidc.17478.

ABSTRACT

INTRODUCTION: Entamoeba histolytica, a protozoan parasite, is the third major contributor to human mortality and morbidity outside of malaria and schistosomiasis. The purpose of this cross-sectional study was to estimate the prevalence of Entamoeba spp. among outpatients of two teaching hospitals in Duhok city who agreed to participate in the study from April 2021 to March 2022 to assess the impact of associated risk variables on the infection rate.

METHODOLOGY: Stool specimens were collected from outpatients suffering from diarrhea and other gastrointestinal symptoms in two teaching hospitals: Azadi and Heevi Pediatric in Duhok city, Kurdistan Region- Iraq. The collected stool specimens were examined macroscopically, followed by microscopic examination using the direct wet mount and zinc sulfate flotation methods, respectively.

RESULT: Infection with Entamoeba species was recorded in 21.68% (562/2592) of the analyzed specimens. Males had a significantly higher infection rate than females (67.43% vs. 32.56%). This difference was statistically significant (p < 0.000). The highest rate was seen in the age group 1-10 years (p < 0.001). Lower levels of education, low incomes, eating unwashed fruits and vegetables, drinking well water, eating frequently outside of homes, not using antidiarrheal medications and living in overcrowded families were risk factors that showed high levels of infection (p < 0.0001).

CONCLUSIONS: The present study concluded that improving living conditions, providing clean water, and promoting health education programs are essential to reduce the rate of this disease among the population.

PMID:37159899 | DOI:10.3855/jidc.17478