Tag: nevin manimala

Nano Lett. 2022 Jul 8. doi: 10.1021/acs.nanolett.2c01473. Online ahead of print.

ABSTRACT

Single-walled carbon nanotubes (SWCNT) have long attracted attention due to their distinct physical properties, depending on their chiral structures (chiralities). Clarifying their growth mechanism is important toward perfect chirality-controlled bulk synthesis. Although a correlation between the chirality distribution and the carbon atom configuration at an open tube edge has been predicted theoretically, lack of sufficient statistical data on metallic and semiconducting SWCNTs prohibited its verification. Here, we report statistical verification of the chirality distribution of 413 as-grown individual air-suspended SWCNTs with a length of over 20 μm using broadband Rayleigh spectroscopy. After excluding the impact of the difference in the number of possible SWCNT structures per chiral angle interval, the abundance profile with chiral angle exhibits an increasing trend with a distinct anomaly at a chiral angle of approximately 20°. These results are well explained considering the growth rate depending on armchair-shaped site configurations at the catalyst-nanotube interface.

PMID:35802861 | DOI:10.1021/acs.nanolett.2c01473

J Neurosci Nurs. 2022 Jun 30. doi: 10.1097/JNN.0000000000000667. Online ahead of print.

ABSTRACT

AIM: The purpose of this study was to explore the perceived value of certification among those with a neuroscience or stroke nursing certification. METHODS: The Perceived Value of Certification Tool-12 (PVCT-12) consists of 12 value statements related to the benefits of certification, using a 4-point Likert scale ranging from strongly disagree to strongly agree. Descriptive statistics were used to determine the percentage of agreement among respondents with each of the PVCT-12 items. A generalized linear model approach was then used to estimate the associations between age, sex, race, experience, certification, highest degree earned, primary responsibility, and primary work setting with intrinsic and extrinsic values. An exploratory factor analysis was performed to identify factors on which related variables were found. RESULTS: The 632 certificants were predominantly female (90%) with a mean age of 54 years. Approximately 80% were White, followed by Asian (11%), Hispanic (4%), and Black (3%). Certification included certified neuroscience registered nurse (34%), stroke certified registered nurse (47%), or both (20%). Approximately 57% of the certificants work in critical care/medical-surgical units. Work setting included academic (46%) and community (42%). Responses indicated lower levels of agreement with the value statements regarding certification challenges, professional autonomy, being listened to, and monetary gain. Those in administration had statistically significant higher intrinsic and extrinsic value scores (P = .005) as compared with those in nonadministrative roles. There was no significant difference on perceived intrinsic or extrinsic values for those who work in an academic environment versus those who work in a community environment (P = .25). After factor analysis, the PVCT-12 was found to have 3 factors that accounted for 53.4% of the total variation in the data: recognition of specialization, personal achievement, and professional accomplishment. CONCLUSION: The PVCT-12 incorporated a Likert-type scale to provide levels of agreement for intrinsic and extrinsic values among stroke certified registered nurses and certified neuroscience registered nurses. To complement these findings, further research using open-ended questions is needed to improve our understanding of participant responses regarding complex values such as “autonomy” and the “extent of being listened to.”

PMID:35802890 | DOI:10.1097/JNN.0000000000000667

Dent Traumatol. 2022 Jul 8. doi: 10.1111/edt.12775. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: No studies have characterized the morbidity and mortality of maxillary & malar fractures on a national scale. The aim of this study was to examine the risk factors for mortality in pediatric patients who had sustained maxillary and malar fractures by using a national pediatric hospital inpatient care database.

MATERIALS AND METHODS: This retrospective cohort study was conducted using the Kids’ Inpatient Database (KID). The primary predictor variable was the cause of injury. The primary outcome variable was mortality rate. Additional predictor variables included age, gender, race, income, payer information, year and place of injury, number of facial fractures, concomitant facial fractures, other fractures of the body, and intracranial/internal organ injury. Univariate and multivariate regression models were performed to assess risk factors for mortality. Statistical significance was set to a p-value <.05.

RESULTS: A total of 5859 patients met the inclusion criteria. The most common age group was 13-17 years of age (n = 3816, 65.1%). Motor vehicle accidents were the most common mechanism of injury (n = 2172, 37.1%). The presence of cranial vault (OR = 2.81, p = .017), skull base (OR = 2.72, p < .001), and vertebral column fractures (OR = 2.13, p = .016), as well as sub-arachnoid hemorrhage (OR = 4.75, p = .005), traumatic pneumothorax/hemothorax (OR = 2.16, p = .015), and heart/lung injury (OR = 3.37, p < .001) were each independently associated with increased odds of mortality.

CONCLUSIONS: Patients in their late teens most commonly sustained malar and maxillary fractures, likely due to general trends in craniomaxillofacial development. The presence of other fractures located in close proximity to the mid-face increased the risk of mortality among pediatric patients with malar and maxillary fractures. This may be explained by the anatomical approximation of the mid-face to vital neurovascular structures of the head, which, when damaged, may prove fatal.

PMID:35802839 | DOI:10.1111/edt.12775

JCO Clin Cancer Inform. 2022 Jun;6:e2200019. doi: 10.1200/CCI.22.00019.

ABSTRACT

PURPOSE: For real-world evidence, it is convenient to use routinely collected data from the electronic medical record (EMR) to measure survival outcomes. However, patients can become lost to follow-up, causing incomplete data and biased survival time estimates. We quantified this issue for patients with metastatic cancer seen in an academic health system by comparing survival estimates from EMR data only and from EMR data combined with high-quality cancer registry data.

MATERIALS AND METHODS: Patients diagnosed with metastatic cancer from 2008 to 2014 were included in this retrospective study. Patients who were diagnosed with cancer or received their initial treatment within our system were included in the institutional cancer registry and this study. Overall survival was calculated using the Kaplan-Meier method. Survival curves were generated in two ways: using EMR follow-up data alone and using EMR data supplemented with data from the Stanford Cancer Registry/California Cancer Registry.

RESULTS: Four thousand seventy-seven patients were included. The median follow-up using EMR + Cancer Registry data was 19.9 months, and the median follow-up in surviving patients was 67.6 months. There were 1,301 deaths recorded in the EMR and 3,140 deaths recorded in the Cancer Registry. The median overall survival from the date of cancer diagnosis using EMR data was 58.7 months (95% CI, 54.2 to 63.2); using EMR + Cancer Registry data, it was 20.8 months (95% CI, 19.6 to 22.3). A similar pattern was seen using the date of first systemic therapy or date of first hospital admission as the baseline date.

CONCLUSION: Using EMR data alone, survival time was overestimated compared with EMR + Cancer Registry data.

PMID:35802836 | DOI:10.1200/CCI.22.00019

Ann Am Thorac Soc. 2022 Jul 8. doi: 10.1513/AnnalsATS.202206-544LE. Online ahead of print.

NO ABSTRACT

PMID:35802823 | DOI:10.1513/AnnalsATS.202206-544LE

J Orthop Sports Phys Ther. 2022 Jul 8:1-29. doi: 10.2519/jospt.2022.10989. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the effectiveness of patient education with ‘myths and facts’ versus ‘facts only’ on recall of back pain information and fear-avoidance beliefs in patients with chronic low back pain (LBP).

DESIGN: Randomized Study Within A Trial (SWAT).

METHODS: 152 participants with chronic LBP were included. Participants allocated to the ‘facts only’ group received an information sheet with six low back pain facts, whereas those allocated to the ‘myths and facts’ group received the same information sheet, with each myth refuted by its respective fact. The primary outcome was ‘correct recall’ of back pain facts, and the secondary outcome was ‘physical activity component’ of the Fear-avoidance Avoidance Beliefs Questionnaire (FABQ-pa), two weeks after the provision of the information sheet.

RESULTS: There was no evidence of a difference in the proportion of participants with correct recall between ‘myths and facts’ and ‘facts only’ groups (OR 0.98, 95% CI: 0.48, 1.99) and no significant difference in FABQ-pa mean scores between groups (-1.58, 95% CI: -3.77, 0.61). Sensitivity analyses adjusted for prognostic factors showed no difference in information recall but a larger difference in FABQ-pa score (-2.3, 95% CI: – 4.56, -0.04).

CONCLUSIONS: We found no overall difference in recall of back pain information for patients provided ‘myths and facts’ compared with ‘facts only’ and a slight reduction in fear-avoidance beliefs for physical activity using ‘myths and facts’ compared to ‘facts only’, but the meaningfulness of this result is uncertain.

PMID:35802818 | DOI:10.2519/jospt.2022.10989

J Orthop Sports Phys Ther. 2022 Jul 8:1-42. doi: 10.2519/jospt.2022.11072. Online ahead of print.

ABSTRACT

OBJECTIVE: to 1) evaluate an injury risk model that included modifiable and non-modifiable factors into an arm injury risk prediction model in Minor League Baseball (MiLB) pitchers; and 2) compare model performance separately for predicting the incidence of elbow and shoulder injuries.

DESIGN: Prospective cohort.

METHODS: A 10-year MiLB injury risk study was conducted. Pitchers were evaluated during preseason and pitches and arm injuries were documented prospectively. Non-modifiable variables included: arm injury history, professional experience, arm dominance, year, humeral torsion. Modifiable variables included: BMI, pitch count, total range of motion, and horizontal adduction. We compared modifiable, non-modifiable, and combined model performance by R², calibration (Best = 1.00), and discrimination (Area Under the Curve (AUC); Higher number is better). Sensitivity analysis included only arm injuries sustained in the first 90 days.

RESULTS: 407 MiLB pitchers (141 arm injuries) were included. Arm injury incidence was 0.27 injuries per 1000 pitches. The arm injury model (Calibration 1.05 (0.81-1.30); AUC: 0.74 (0.69-0.80)) had improved performance compared to only using modifiable predictors (Calibration: 0.91 (0.68-1.14); AUC: 0.67 (0.62-0.73) and only shoulder ROM (Calibration: 0.52 (0.29, 0.75); AUC: 0.52 (0.46, 58)). Elbow injury model demonstrated improved performance (Calibration: 1.03 (0.76-1.33); AUC: 0.76 (0.69-0.83)) compared to the shoulder injury model (Calibration: 0.46 (0.22-0.69); AUC: 0.62 (95% CI: 0.55, 0.69)). The sensitivity analysis demonstrated improved model performance compared to the arm injury model.

CONCLUSIONS: Arm injury risk is influenced by modifiable and non-modifiable risk factors. The most accurate way to identify professional pitchers who are at risk for arm injury is to use a model that includes modifiable and non-modifiable risk factors.

PMID:35802817 | DOI:10.2519/jospt.2022.11072

Ann Noninvasive Electrocardiol. 2022 Jul 8:e12989. doi: 10.1111/anec.12989. Online ahead of print.

ABSTRACT

BACKGROUND: One of the most catastrophic complications of Atrial fibrillation (AF) is thromboembolic stroke. Current guidelines recommend that 3 weeks of anticoagulation is adequate prior to direct current cardioversion (DCCV) to prevent thromboembolism. Here we present data regarding, which anticoagulant is most likely to show a presence of an Left atrial appendage thrombus (LAAT) on trans esophageal echocardiogram (TEE) for DCCV despite 3 weeks of anticoagulation.

OBJECTIVE: To investigate the effectiveness of both vitamin k antagonist (VKA) and direct oral anticoagulants (DOAC) in patients with AF as an anticoagulant for LAAT after 3 weeks of medication.

METHODS: This is a single-high volume tertiary center, where TEE precardioversion is the standard practice. We reviewed data over 10 months where DCCV was intended on individuals with AF who were fully anticoagulated for at least 3 weeks with either a VKA or taking a DOAC.

RESULTS: The data showed a statistical difference between patients who were fully anticoagulated for at least 3 weeks with VKA in comparison to DOACs. Patients on DOACs are significantly less likely to have an LAAT after at least 3 weeks of anticoagulation. OR = 0.04 (CI 95% 0.005-0.42; p-value < .05). Despite anticoagulation for at least 3 weeks, 40% of our patients still had a LAAT.

CONCLUSION: Our data indicates that all patients should be required to undergo a TEE prior to DCCV. This data also adds to the current evidence and supports the use of DOAC in AF to prevent LAAT.

PMID:35802810 | DOI:10.1111/anec.12989

Scand J Gastroenterol. 2022 Jul 8:1-5. doi: 10.1080/00365521.2022.2094723. Online ahead of print.

ABSTRACT

OBJECTIVES: ERCP is essential in managing pancreaticobiliary disease, with well-documented complications. Rates of clinically significant complications are about 10%, approximately half of which is related to post-ERCP pancreatitis (PEP). We aimed to quantify the effect of previous sphincterotomy on post-endoiscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).

MATERIALS AND METHODS: Data were collated from a contemporaneously collected database of 2876 consecutive ERCP procedures of a single operator in a tertiary referral centre. Analysis was conducted using R software, and logistic regression models.

RESULTS: Of 2876 procedures (mean age 63 years, 56% female), 120 (4.2%) developed PEP and 268 (9.3%) had prolonged/unplanned hospital admission. Univariate analysis showed patients with previous sphincterotomy 28/1054 (2.7%) had decreased risk of PEP compared with those without sphincterotomy 92/1822 (5.0%) (OR 0.52, p = .0021). This difference was not evident when multivariate analysis for age, sex and indication was undertaken due to a particularly low risk of PEP in stent change patients (1.4%), which were disproportionately represented in the previous sphincterotomy group. The rate of prolonged/unplanned hospital admission was recorded for a total of 2876 patients, occurring in 184/1802 (10.1%) in the native ampulla group, versus 84/1045 (8.0%) in the previous sphincterotomy group.

CONCLUSIONS: The risk of PEP is halved by prior sphincterotomy. The presence of a biliary stent conferred an even lower risk of PEP (1.4%), but those without an in situ stent at the time of ERCP had a similar risk of PEP (4.6%) of prolonged/unplanned hospitalisation to those with a native ampulla.

PMID:35802803 | DOI:10.1080/00365521.2022.2094723

Qual Manag Health Care. 2022 Jul 8. doi: 10.1097/QMH.0000000000000368. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Patient misidentification errors continue to represent a significant risk to patients, health care staff, and hospitals. The study’s purpose was to present a successful quality improvement project implemented in a public hospital in Saudi Arabia. The project focused on increasing staff’s compliance with and awareness of the hospital’s patient identification policy to thus reducing the number of patient misidentification-related incidents.

METHODS: Through a quality improvement project, we employed FOCUS PDSA to address the issue of patient misidentification at outpatient departments. A total of 640 staff members participated in the educational program including physicians, nurses, receptionists, radiologists, physiotherapists, and laboratory staff. Collected data included measures of compliance and awareness levels as well as patient misidentification incidents, before and after the project. Statistical analysis was conducted to measure significant differences in the study indicators before and after the project.

RESULTS: Results from the post-project assessment revealed that the project was successful in achieving its objectives. The overall compliance rate and awareness level increased from 59% to 78% and from 75% to 90%, respectively. Improvement in the levels of compliance and awareness was statistically significant. The average number of patient misidentification errors also reduced after the project’s implementation with an average of 3 errors per month. The mean difference of patient misidentification errors before and after the project was significant (P < .01).

CONCLUSION: This project demonstrated how quality improvement projects can be used to address a critical issue such as patient misidentification. The project furthers efforts made by national and international agencies to improve patient safety. It also highlights the importance of continuous education and training to ensure compliance with patient identification policies that ultimately contributes to a safer hospital environment.

PMID:35802801 | DOI:10.1097/QMH.0000000000000368