Tag: nevin manimala

Angew Chem Int Ed Engl. 2023 May 9:e202304943. doi: 10.1002/anie.202304943. Online ahead of print.

ABSTRACT

The statistical terpolymerization of epoxides, CO2 and cyclic anhydrides remains challenging, mainly because epoxide/CO2 and epoxide/anhydride copolymerizations typically proceed at considerably different rates. Herein, we report the syntheses of novel chiral terpolymers with unprecedented statistical distributions of carbonate and ester units (up to 50% junction units) via the one-pot reaction of cyclohexene oxide, phthalic anhydride, and CO2 under mild conditions using enantiopure bimetallic aluminum-complex-based catalyst systems. Notably, all resulting terpolymers exhibited excellent enantioselectivities (≥96% ee) that were independent of the carbonate-ester distribution. The statistical compositions of the carbonate and ester units in the resulting terpolymers were determined via 1H and 13C NMR spectroscopies. Furthermore, thermal properties were tuned by altering the ester content of the chiral terpolymer without influencing the enantioselective ring-opening step involving the meso-epoxide. This asymmetric terpolymerization methodology is also compatible with a variety of meso-epoxides to afford the corresponding terpolymers with 17%-25% junction units and excellent enantioselectivities (94%-99% ee). The present study is expected to provide new guidelines for preparing a broad range of biodegradable polymers with excellent enantioselectivities and adjustable properties.

PMID:37159107 | DOI:10.1002/anie.202304943

Acta Orthop Traumatol Turc. 2023 May 9. doi: 10.5152/j.aott.2023.22013. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to present a new modification of the modified Kessler tendon repair technique and share results of an animal study scrutinizing mainly the biomechanical properties and comparing it to other techniques.

METHODS: Eighteen New Zealand rabbits were used and divided into 3 groups: 1 experiment and 2 control groups. Four-strand modified Kessler and 6-strand Tang repairs were used for the control groups. The new modification was used in the experiment group. Two surgeries were conducted 8 weeks apart, repairing 1 Achilles tendon in the first, repairing the contralateral tendon and harvesting specimens in the second. The repair times were recorded. In addition, biomechanical tests were conducted to determine mechanical strength.

RESULTS: There was a statistically significant difference between the 3 groups in load-to-failure values for the strength after repair model, with the experiment group superior to the other 2 (P = .002; P < .05). Although there was a noticeable difference between the mean loadto- failure values of each group in the healing model, we could not demonstrate a statistically significant difference(P > .05). The new modification took significantly less time than the other 2 techniques (P = .001).

CONCLUSION: Our new modification was biomechanically stronger and faster than the other 2 techniques. The technique offers a new, suitable, practical option for human flexor tendon repair.

PMID:37159026 | DOI:10.5152/j.aott.2023.22013

J Healthc Manag. 2023 May-Jun 01;68(3):198-214. doi: 10.1097/JHM-D-22-00115.

ABSTRACT

GOAL: We explored how readmissions may result from patients’ lack of access to aftercare services, failure to adhere to psychotropic medication plans, and inability to understand and follow hospital discharge recommendations. We also investigated whether insurance status, demographics, and socioeconomic status are associated with hospital readmissions. This study is important because readmissions contribute to increased personal and hospital expenses and decreased community tenure (the ability to maintain stability between hospital admissions). Addressing hospital readmissions will promote optimal discharge practices beginning on day one of hospital admission.

METHODS: The study examined the differences in hospital readmission rates for patients with a primary psychotic disorder diagnosis. Discharge data were drawn in 2017 from the Nationwide Readmissions Database. Inclusion criteria included patients aged 0-89 years who were readmitted to a hospital between less than 24 hr and up to 30 days from discharge. Exclusion criteria were principal medical diagnoses, unplanned 30-day readmissions, and discharges against medical advice. The sampling frame included 269,906 weighted number of patients diagnosed with a psychotic disorder treated at one of 2,355 U.S. community hospitals. The sample size was 148,529 unweighted numbers of patients discharged.

PRINCIPAL FINDINGS: In a logistic regression model, weighted variables were calculated and used to determine an association between the discharge dispositions and readmissions. After controlling for hospital characteristics and patient demographics, we found that the odds for readmission for routine and short-term hospital discharge dispositions decreased for home health care discharges, which indicated that home health care can prevent readmissions. The finding was statistically significant when controlling for payer type and patient age and gender.

PRACTICAL APPLICATIONS: The findings support home health care as an effective option for patients with severe psychosis. Home health care reduces readmissions and is recommended, when appropriate, as an aftercare service following inpatient hospitalization and may enhance the quality of patient care. Improving healthcare quality involves optimizing, streamlining, and promoting standardized processes in discharge planning and direct transitions to aftercare services.

PMID:37159018 | DOI:10.1097/JHM-D-22-00115

J Healthc Manag. 2023 May-Jun 01;68(3):174-186. doi: 10.1097/JHM-D-22-00170.

ABSTRACT

GOAL: The purpose of this study was to examine nurse staffing while describing the relationships that exist in staffing and quality associated with nursing care during the COVID-19 pandemic, a significantly challenging time for nurse staffing. We examined the relationship between permanent registered nurse (RN) and travel RN staffing during the pandemic and the nursing-sensitive outcomes of catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), falls, and hospital-acquired pressure injuries (HAPIs) and length of stay and compared the cost of CAUTIs, CLABSIs, falls, and HAPIs in fiscal years 2021 and 2022.

METHODS: We used a descriptive, observational design to retrospectively examine permanent nurse staffing volume and CAUTI, CLABSI, HAPI, and fall counts from October 1, 2019, to February 28, 2022, and travel nurse volume for the most current 12 months, April 1, 2021, to March 31, 2022. Descriptive statistics, Pearson correlation, and statistical process control analyses were completed.

PRINCIPAL FINDINGS: Pearson correlation showed a statistically significant, moderately strong negative correlation (r = -0.568, p = .001) between the active registered nurse full-time equivalents (RN FTEs) and average length of stay (ALOS), and a moderately strong positive correlation (r = 0.688, p = .013) between the travel RN FTEs and ALOS. Pearson correlations were not statistically significant, with low to moderate negative correlations for CAUTIs (r = -0.052, p = .786), CLABSIs (r = -0.207, p = .273), and falls (r = -0.056, p = .769). Pearson correlation for active RN and HAPI showed a moderately strong, statistically significant positive correlation (r = 0.499, p = .003). We observed common cause variation in CAUTIs and CLABSIs, with HAPIs and falls showing special cause variation via statistical process control.

PRACTICAL APPLICATIONS: Despite the challenges associated with the lack of available nurse staffing accompanied by increasing responsibilities including unlicensed tasks, positive clinical outcomes can be maintained by staff adherence to evidence-based quality improvement.

PMID:37159016 | DOI:10.1097/JHM-D-22-00170

Cardiol Rev. 2023 May 4. doi: 10.1097/CRD.0000000000000533. Online ahead of print.

ABSTRACT

Influenza vaccination has shown great promise in terms of its cardioprotective effects. The aim of our analysis is to provide evidence regarding the protective effects of influenza vaccination in patients with cardiovascular disease. We conducted a systematic literature search to identify trials assessing the cardiovascular outcomes of influenza vaccination. Summary effects were calculated using a DerSimonian and Laird fixed effects and random effects model as odds ratio with 95% confidence intervals (CIs) for all the clinical endpoints. Fifteen studies with a total of 745,001 patients were included in our analysis. There was lower rates of all-cause mortality [odds ratio (OR) = 0.74, 95% CI 0.64-0.86], cardiovascular death (OR = 0.73, 95% CI 0.59-0.92), and stroke (OR = 0.71, 95% CI 0.57-0.89) in patients who received the influenza vaccine compared to placebo. There was no significant statistical difference in rates of myocardial infarction (OR = 0.91, 95% CI 0.69-1.21) or heart failure hospitalizations (OR = 1.06, 95% CI 0.85-1.31) in the 2 cohorts. In patients with cardiovascular disease, influenza vaccination is associated with lower all-cause mortality, cardiovascular death, and stroke.

PMID:37158999 | DOI:10.1097/CRD.0000000000000533

Epilepsia Open. 2023 May 9. doi: 10.1002/epi4.12758. Online ahead of print.

ABSTRACT

OBJECTIVE: Observational studies have shown an association between 25-hydroxyvitamin D (25(OH)D) and epilepsy, but it is unclear whether the association is causal. Therefore, we applied Mendelian randomization (MR) analysis to determine the causal relationship between serum 25(OH)D levels and epilepsy.

METHODS: We conducted a two-sample Mendelian randomization (TSMR) study to investigate the association between serum 25(OH)D levels and epilepsy using pooled statistics from genome-wide association studies (GWAS). Data for 25(OH)D came from a GWAS comprising 417,580 participants, and data for epilepsy were obtained from the International League Against Epilepsy (ILAE) consortium. Five methods were used to analyze TSMR, including the inverse variance weighting method, MR Egger method, weighted median method, simple model, and weighted model. In the sensitivity analysis, MR Egger and MR PRESSO methods were used to test for pleiotropy, inverse variance weighting and MR Egger in Cochran’s Q statistics were used to test for heterogeneity.

RESULTS: MR analyzed the relationship between 25(OH)D and different types of epilepsy, and the results showed that a 1 standard deviation increase in natural log-transformed serum 25(OH)D levels was associated with reduced risk for juvenile absence epilepsy (IVW OR = 0.985; 95% confidence interval (CI): 0.971-0.999; P-value = 0.038). There was no apparent heterogeneity and horizontal gene pleiotropy.

SIGNIFICANCE: Higher serum levels of 25(OH)D were a protective factor for adolescent absence epilepsy, but had no effect on other types of epilepsy.

PMID:37158995 | DOI:10.1002/epi4.12758

Arch Public Health. 2023 May 8;81(1):84. doi: 10.1186/s13690-023-01100-8.

ABSTRACT

BACKGROUND: Neuromotor rehabilitation and improvement of upper limb functions are necessary to improve the life quality of patients who have experienced injuries or have pathological outcomes. Modern approaches, such as robotic-assisted rehabilitation can help to improve rehabilitation processes and thus improve upper limb functions. Therefore, the aim of this study was to investigate the role of robots in upper limb disability improvement and rehabilitation.

METHODS: This scoping review was conducted by search in PubMed, Web of Science, Scopus, and IEEE (January 2012- February 2022). Articles related to upper limb rehabilitation robots were selected. The methodological quality of all the included studies will be appraised using the Mixed Methods Appraisal Tool (MMAT). We used an 18-field data extraction form to extract data from articles and extracted the information such as study year, country, type of study, purpose, illness or accident leading to disability, level of disability, assistive technologies, number of participants in the study, sex, age, rehabilitated part of the upper limb using a robot, duration and frequency of treatment, methods of performing rehabilitation exercises, type of evaluation, number of participants in the evaluation process, duration of intervention, study outcomes, and study conclusions. The selection of articles and data extraction was made by three authors based on inclusion and exclusion criteria. Disagreements were resolved through consultation with the fifth author. Inclusion criteria were articles involving upper limb rehabilitation robots, articles about upper limb disability caused by any illness or injury, and articles published in English. Also, articles involving other than upper limb rehabilitation robots, robots related to rehabilitation of diseases other than upper limb, systematic reviews, reviews, and meta-analyses, books, book chapters, letters to the editor, and conference papers were also excluded. Descriptive statistics methods (frequency and percentage) were used to analyses the data.

RESULTS: We finally included 55 relevant articles. Most of the studies were done in Italy (33.82%). Most robots were used to rehabilitate stroke patients (80%). About 60.52% of the studies used games and virtual reality rehabilitate the upper limb disabilities using robots. Among the 14 types of applied evaluation methods, “evaluation and measurement of upper limb function and dexterity” was the most applied evaluation method. “Improvement in musculoskeletal functions”, “no adverse effect on patients”, and “Safe and reliable treatment” were the most cited outcomes, respectively.

CONCLUSIONS: Our findings show that robots can improve musculoskeletal functions (musculoskeletal strength, sensation, perception, vibration, muscle coordination, less spasticity, flexibility, and range of motion) and empower people by providing a variety of rehabilitation capabilities.

PMID:37158979 | DOI:10.1186/s13690-023-01100-8

J Chromatogr Sci. 2023 May 8:bmad034. doi: 10.1093/chromsci/bmad034. Online ahead of print.

ABSTRACT

Amiodarone-induced thyrotoxicosis (AIT) is a common condition in patients who are receiving amiodarone for cardiac arrhythmia. This risk is elevated in iodine-deficient regions. Levothyroxine is the standard treatment for patients with hypothyroidism. This investigation is concerned with the evaluation of the possible pharmacokinetic interaction between amiodarone and levothyroxine upon co-therapy in rats and to investigate the cause of thyrotoxicosis. A selective, sensitive and precise RP-HPLC method was developed for the simultaneous determination of levothyroxine and amiodarone in rat plasma. A stationary phase of C18 Xterra RP column and a mobile phase consisting of acetonitrile: acidified water with 0.1% trifluoracetic acid (pH = 4.8) with gradient elution were used. The experiment was conducted at ambient temperature with flow rate of 1.5 mL/min for the chromatographic separation and quantitation of the investigated drugs. Protein precipitation with methanol was applied for the analysis of the two drugs in rat plasma. The method was linear over concentration range of 5-200 μg/mL for both levothyroxine and amiodarone. The European Medicines Agency guideline was applied for the validation of the developed bioanalytical method. The method was successfully applied to in vivo pharmacokinetic study in which levothyroxine and amiodarone were quantified in plasma of rats after receiving an oral dose of levothyroxine and amiodarone. After the calculation of the pharmacokinetic parameters, a statistical analysis was performed to elucidate the existence of significant difference between test and control groups in rats. The combination of levothyroxine and amiodarone significantly decreased levothyroxine bioavailability in rats, making the therapeutic drug monitoring mandatory in patients receiving levothyroxine and amiodarone. In addition, the increased clearance of levothyroxine upon the co-administration with amiodarone may explain the reported hypothyroidism.

PMID:37158185 | DOI:10.1093/chromsci/bmad034

Echocardiography. 2023 May 9. doi: 10.1111/echo.15587. Online ahead of print.

ABSTRACT

BACKGROUND: Left atrial (LA) volume is related to LA reservoir strain (LAS_R ), but the relationship is not fully resolved. We sought to model the relationship between LA end-diastolic and end-systolic volumes (LAEDV and LAESV) and LAS_R based on a geometrical approach to exploit the relationship between LAS_R and volume.

METHODS: Modeling the LA as a hemisphere with radius r, LAS_R was recognized to vary linearly with r and LA volume with r³ . Expanding this cubic relation as a Taylor series resulted in a simple linear equation: LAESV/LAEDV = 1 + 3 × LAS_R . To validate this, 52 transthoracic echocardiograms were analyzed from 18 patients who underwent transcatheter edge-to-edge repair (TEER) with MitraClip with serial assessment pre-procedure, 1 month post-clip, and 12 months post-TEER. Linear regression was performed to compare the geometric equation to a statistical model created by a line of best fit to relate LAESV/LAEDV to LAS_R .

RESULTS: The statistical and geometric model both resulted in a strong correlation (r = .8, p < .001, respectively). The slope of the line in the statistical model was 3.3, which was statistically indistinguishable from the expected slope of 3 based on the geometric model (Figure 2A). Using the geometric model to compare the measured versus calculated LAESV/LAEDV also resulted in a strong correlation (r = .8, p < .001)(Figure 2B).

CONCLUSION: We describe the relationship between LA volume and strain mathematically by considering the geometry of the LA. This model enhances our understanding of the interaction between atrial strain and volume. Further research is necessary to validate this using 3D atrial volumes in a broader cohort of subjects.

PMID:37158184 | DOI:10.1111/echo.15587

Brief Funct Genomics. 2023 May 8:elad016. doi: 10.1093/bfgp/elad016. Online ahead of print.

ABSTRACT

RNA-binding proteins (RBPs) are essential for post-transcriptional gene regulation in eukaryotes, including splicing control, mRNA transport and decay. Thus, accurate identification of RBPs is important to understand gene expression and regulation of cell state. In order to detect RBPs, a number of computational models have been developed. These methods made use of datasets from several eukaryotic species, specifically from mice and humans. Although some models have been tested on Arabidopsis, these techniques fall short of correctly identifying RBPs for other plant species. Therefore, the development of a powerful computational model for identifying plant-specific RBPs is needed. In this study, we presented a novel computational model for locating RBPs in plants. Five deep learning models and ten shallow learning algorithms were utilized for prediction with 20 sequence-derived and 20 evolutionary feature sets. The highest repeated five-fold cross-validation accuracy, 91.24% AU-ROC and 91.91% AU-PRC, was achieved by light gradient boosting machine. While evaluated using an independent dataset, the developed approach achieved 94.00% AU-ROC and 94.50% AU-PRC. The proposed model achieved significantly higher accuracy for predicting plant-specific RBPs as compared to the currently available state-of-art RBP prediction models. Despite the fact that certain models have already been trained and assessed on the model organism Arabidopsis, this is the first comprehensive computer model for the discovery of plant-specific RBPs. The web server RBPLight was also developed, which is publicly accessible at https://iasri-sg.icar.gov.in/rbplight/, for the convenience of researchers to identify RBPs in plants.

PMID:37158175 | DOI:10.1093/bfgp/elad016