Tag: nevin manimala

Food Chem Toxicol. 2021 Mar 11:112109. doi: 10.1016/j.fct.2021.112109. Online ahead of print.

ABSTRACT

In this work, a colorimetric sensor array has been designed for the identification and discrimination of thiometon (TM) and phosalone (PS) as organophosphate pesticides and prothioconazole (PC) as a triazole pesticide. For this purpose, two different plasmonic nanoparticles including unmodified gold nanoparticles (AuNPs) and unmodified silver nanoparticles (AgNPs) were used as sensing elements. The principle of the proposed strategy relied on the aggregation AuNPs and AgNPs through the cross-reactive interaction between the target pesticides and plasmonic nanoparticles. Therefore, these aggregation-induced UV-Vis spectra changes were utilized to discriminate the target pesticides with the help of linear discriminant analysis (LDA). Besides, we have employed the bar plots and the heat maps as visual non-statistical methods to differentiate the pesticides in a wide range of concentrations (i.e., 20 to 5000 ng mL^-1). Multivariate calibration plots from partial least squares (PLS)- regression indicated that the responses linearly depend on the pesticide concentrations in the range of 100-1000 ng mL^-1 with the limit of detections (LOD) of 66.8, 68.3, and 41.4 ng mL^-1, for TM, PS, and PC, respectively. Finally, the potential applicability of the proposed sensor array has been evaluated for the detection and identification of the pesticides in the mixtures, water samples, and cucumber fruit.

PMID:33716053 | DOI:10.1016/j.fct.2021.112109

J Cyst Fibros. 2021 Mar 11:S1569-1993(21)00046-1. doi: 10.1016/j.jcf.2021.02.011. Online ahead of print.

ABSTRACT

BACKGROUND: Mannitol is a mucoactive hyperosmotic agent used as add-on therapy in patients with cystic fibrosis (CF), administered twice-daily (BID) via a small, portable, breath-actuated dry-powder inhaler. This study was conducted to provide confirmatory evidence of mannitol’s efficacy and safety in adults.

METHODS: This multicenter, double-blind, randomized, parallel-group, controlled clinical trial recruited adults (aged ≥18 years) with CF, and forced expiratory volume in 1 second (FEV₁) 40-90% predicted. Subjects received either mannitol 400 mg or mannitol 50 mg (control), BID via dry-powder inhaler for 26 weeks. Primary endpoint: FEV₁ averaged over the 26-week treatment period.

RESULTS: Of 423 subjects randomized (209 or 214 receiving mannitol 400 mg BID or control, respectively), 373 (88.2%) completed the study, with a similar proportion completing in the two groups. For FEV₁ averaged over 26 weeks, mannitol 400 mg BID was statistically superior to control (adjusted mean difference 54 mL [95% CI 8, 100 mL]; p = 0.020). This was supported by sensitivity analyses of the primary endpoint, and by observed improvements in secondary pulmonary function endpoints (eg, absolute adjusted mean difference in percent predicted FEV₁ averaged over 26 weeks 1.21% [0.07%, 2.36%]; p = 0.037). Adverse events were mainly mild or moderate in severity, with treatment-related adverse events in 15.5 and 12.2% of subjects receiving mannitol 400 mg BID and control, respectively.

CONCLUSIONS: In adults with CF, mannitol 400 mg BID inhaled as a dry-powder statistically significantly improved lung function (FEV₁) compared with control, with this improvement supported by sensitivity analyses and secondary pulmonary function endpoints. Mannitol had a good overall safety and tolerability profile. ClinicalTrials.gov: NCT02134353.

PMID:33715994 | DOI:10.1016/j.jcf.2021.02.011

J Oral Maxillofac Surg. 2021 Feb 11:S0278-2391(21)00113-0. doi: 10.1016/j.joms.2021.02.006. Online ahead of print.

ABSTRACT

PURPOSE: We investigated the confidence levels of undergraduate dental students who used dental anesthesia simulators and patient reports of undergraduate dental students’ confidence levels in delivering anesthesia injections, in comparison with undergraduate dental students who did not use dental anesthesia simulators. We also investigated application success rates.

MATERIALS AND METHODS: The study was carried out in the dental anesthesia simulator laboratory and in the faculty clinics of the Faculty of Dentistry of Ankara University. One-hundred volunteer undergraduate dental students who had completed the third year of the 5-year undergraduate education program and who had not performed local anesthesia on a patient participated in the study. Seventy and 30 undergraduate dental students did and did not receive training on dental anesthesia simulators, respectively, before performing procedures on patients. Using a questionnaire, undergraduate dental students conducted a self-assessment of preparedness and confidence, educators assessed the application success rates, and patients evaluated the undergraduate dental students’ confidence levels.

RESULTS: Patients reported that the undergraduate dental students trained using the simulators were more confident. The self-reported confidence and success rates in providing anesthesia did not differ significantly as per the use of dental anesthesia simulators.

CONCLUSIONS: Although use of simulators did not enhance self-reported confidence, patients reported that undergraduate dental students who used the simulators were more confident and reassuring. Use of simulators did not increase the undergraduate dental students’ self-reported confidence or preparedness. However, we recommend using such simulators to overcome the ethical and moral issues associated with other teaching methods.

PMID:33716007 | DOI:10.1016/j.joms.2021.02.006

Environ Res. 2021 Mar 11:111014. doi: 10.1016/j.envres.2021.111014. Online ahead of print.

ABSTRACT

Congenital heart disease (CHD) is the most common congenital anomaly and one of the leading causes of newborn death. Few studies analyze multiple ambient air pollutants and different congenital heart disease subtypes at the same time. We conducted a meta-analysis to explore the association between gestational air pollution exposure and CHD subtype. We searched PubMed, Embase, Web of Science from inception till July 31, 2020. Newcastle Ottawa Scale (NOS) was used to evaluate the quality of the literature. Funnel plots and Egger’s regression were used to estimate publication bias. Heterogeneity was evaluated by the chi-square test and the coefficient of inconsistency I² in this study. Finally, we performed a subgroup analysis to find reasons for heterogeneity. In the preliminary analysis, the result shows that the association between air pollutants and congenital heart diseases was not statistically significant, except for CO and SO₂. There is a positive association between air pollutants and ventricular septal defect (VSD) in our subtype analysis, the OR (95%CI) for PM₁₀, PM_2.5, and O₃ was 1.057(1.005-1.109), 1.208(1.080-1.337), and 1.205(1.101-1.310), respectively. In addition, we also observed a negative association between SO₂ and atrial septal defect (ASD) (OR: 0.817, 95%CI: 0.743-0.890) in subgroup analysis. The source of heterogeneity in our study mainly included study area and exposure time. These findings have implications for researchers to further study the relationship between air pollution and congenital heart disease.

PMID:33716027 | DOI:10.1016/j.envres.2021.111014

Rev Esp Cir Ortop Traumatol. 2021 Mar 11:S1888-4415(21)00015-1. doi: 10.1016/j.recot.2020.10.010. Online ahead of print.

ABSTRACT

INTRODUCTION: Diaphyseal forearm fractures in skeletally immature patients are common injuries that account for 30% of upper extremity fractures in this age group. There are cases with unstable injuries or unacceptable reductions, in which surgical resolution by reduction and stabilisation with percutaneous elastic endomedullary nailing is indicated. One of the advantages of this system is that it avoids an approach to the fracture site, allowing closed reduction in the vast majority of fractures. However, it is not always possible to achieve an acceptable closed reduction and opening of the fracture site is necessary. The aim of this study was to determine whether there are preoperative factors to predict the difficulty of performing closed reduction in these patients.

METHODS: A retrospective study of skeletally immature patients with acute diaphyseal forearm fractures treated with elastic endomedullary nailing by the same paediatric surgeon was performed. The primary outcome variable was defined as the need for open reduction; considered as a direct surgical approach to the fracture site. Demographic characteristics of the included patients and radiographic characteristics of the fracture were analysed.

RESULTS: We found that the median percentage of preoperative radial shortening in the closed reduction and open reduction groups was 1 and 5%, respectively; resulting in a statistically significant difference (p = 0.04).

CONCLUSION: Radial shortening on preoperative radiographs predicts an increased risk of requiring an open reduction of the fracture (39% association); thus we understand that this variable should be considered by the general traumatologist as a prognostic factor in defining the referral of these patients.

PMID:33715982 | DOI:10.1016/j.recot.2020.10.010

Disabil Health J. 2021 Mar 5:101090. doi: 10.1016/j.dhjo.2021.101090. Online ahead of print.

ABSTRACT

BACKGROUND: People with disabilities and chronic health conditions rely on a range of services and supports to complete daily tasks, maintain health, and participate in the community. Preliminary research suggests the COVID-19 pandemic greatly disrupted these services and this population may be particularly susceptible to unemployment.

OBJECTIVE: Describe employment and service disruptions for individuals with disabilities and chronic health conditions during the onset of community-based spread of COVID-19 in the United States.

METHODS: Adults with disabilities and chronic health conditions completed online surveys to report employment and service changes via multiple choice and open-ended questions. Multiple choice questions were analyzed using descriptive statistics; open-ended responses were coded using content analysis.

RESULTS: Participants (n = 109): 79.8% female, 88.1% white, 77.121% completed a 4-year college degree or greater, 61.4% had annual income ≥$45,000. Only 14.9% of survey respondents reported disruptions in employment. On average, 54.0% of service changes were due to discontinuation, including loss of physical therapy, job coaching, community organizations, transportation, and peer supports. Other changes included a shift to virtual service delivery and family members taking the role of service providers.

CONCLUSIONS: Individuals with chronic health conditions and disabilities experienced service disruptions, even in a sample with considerably more economic, social, and educational privilege than the general population of people with chronic health conditions and disabilities in the United States.

PMID:33715986 | DOI:10.1016/j.dhjo.2021.101090

Surg Obes Relat Dis. 2021 Feb 6:S1550-7289(21)00081-2. doi: 10.1016/j.soard.2021.01.042. Online ahead of print.

ABSTRACT

BACKGROUND: Studies on early postoperative readmissions after bariatric surgery (BS) have examined readmissions as a single entity, regardless of urgency. Strategies to lower nonurgent readmissions would reduce unnecessary hospital utilization.

OBJECTIVES: To identify predictors of urgent readmissions (UR) versus nonurgent readmissions (NUR) at 30 days post-BS.

SETTING: Single academic institution.

METHODS: Patients undergoing primary BS over 2 years (n = 589) were retrospectively reviewed. Baseline demographic, medical, and hospitalization data were compared between readmitted patients, stratified by urgency, and nonreadmitted patients. Multivariate regression models of UR and NUR were created using variables with a P value ≤ .2 on univariate analyses. A P value ≤ .05 was considered statistically significant.

RESULTS: There were 39 documented instances of 30-day readmissions, of which 44% (n = 17) were NUR; NUR patients were more likely to be female (100% versus 78.2% male; P = .03) and trended toward being younger, experiencing ≥2 perioperative complications, and having a longer index hospital length of stay (LOS). Patients with URs had a higher baseline BMI (52.5 ± 11.4 kg/m² versus 48.7 ± 8.3 kg/m², respectively; P = .04), were more likely to have sleep apnea (77.3% versus 56.1%, respectively; P = .05), had a longer LOS (3 versus 2 d, respectively; P = .007), and were more likely to have ≥2 postoperative complications (46% versus 17.0%, respectively; P = .003) compared with those with an NUR. Independent predictors of NUR included public insurance (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.17-11.67; P = .03), younger age (OR = 1.05; 95% CI, 1-1.01; P = .04), and female sex, while URs were independently predicted by LOS (OR = 1.3; 95% CI, 1.04-1.5; P = .02).

CONCLUSIONS: Public insurance appears to be associated with NURs, while LOS predicts URs after BS. This suggests an important dichotomy within readmissions based on urgency, which has important implications for targeted quality initiatives.

PMID:33715991 | DOI:10.1016/j.soard.2021.01.042

J Cyst Fibros. 2021 Mar 11:S1569-1993(21)00049-7. doi: 10.1016/j.jcf.2021.02.014. Online ahead of print.

ABSTRACT

BACKGROUND: Home spirometry with regular symptom assessment is one strategy to track lung health to intervene early in episodes of pulmonary exacerbations (PE). In a multi-center randomized controlled trial home spirometry and symptom tracking demonstrated no significant differences regarding the primary clinical endpoint, FEV₁, compared to usual care, but did identify differences in healthcare utilization. We used data from the Early Intervention in Cystic Fibrosis Exacerbation (eICE) study to evaluate whether home monitoring of PE is a cost-minimizing intervention in the context of this randomized trial.

METHODS: We reviewed healthcare resource utilization of all 267 eICE participants, including outpatient visits, antibiotics and hospitalizations. Prices were identified in the IBM/Watson MarketScan^Ⓡ Commercial Claims and Encounters Databases and averaged over the 2014-2017 period. Using total healthcare utilization costs, we generated summary statistics by intervention and protocol arm (total cost, mean cost, standard deviation). We performed Welch Two Sample t-tests to determine if total costs and cost by type of utilization differed significantly between groups.

RESULTS: Outpatient visit costs were significantly higher by 13% in the Early Intervention (EI) than in the usual care (UC) arm ($3,345 vs. $2,966). We found no significant differences in outpatient antibiotic, hospitalization, or total health care costs between the arms.

CONCLUSIONS: Within the context of the eICE trial, outpatient visits were significantly higher in those with experimental home spirometry care, but that did not translate into statistically significant differences of overall health care costs between the two arms.

PMID:33715993 | DOI:10.1016/j.jcf.2021.02.014

J Craniomaxillofac Surg. 2021 Feb 27:S1010-5182(21)00078-0. doi: 10.1016/j.jcms.2021.02.021. Online ahead of print.

ABSTRACT

The aim of this study was to determine whether patients benefit from a secondary reconstruction since it carries the risks of no improvement or worsening of their current situation. Patients treated with individual computer-aided-design/computer-aided-manufacturing (CAD/CAM) ceramic implants were reviewed. To ascertain changes throughout the secondary reconstruction, the study investigators reviewed ophthalmological examinations, took volumetric measurements of the orbits and asked the patients for evaluation of their situation before and after the reconstruction. Points addressed were double vision, visual acuity, field of vision, limitations in daily life and aesthetic considerations. A total of 14 patients were reviewed and 11 answered the questionnaire. Ophthalmological examinations showed that the physical integrity of the eye was maintained. Volumetric measurements preopeatively (33.94 ± 3.24 cm³) and postoperatively (30.67 ± 2.07 cm³) showed that a statistically significant overcorrection of orbital volume leads to good functional and aesthetic outcomes. Patients’ subjective opinions were that they greatly benefitted, especially concerning limitations in daily life, which improved by 4.4 ± 2.8 points out of 10 possible points, and aesthetics, with an improvement of 5.9 ± 1.78 points. Based on these findings, we conclude that secondary reconstructions contribute to improvement of the patients’ quality of life and therefore should be considered as an option to improve patients’ condition.

PMID:33715966 | DOI:10.1016/j.jcms.2021.02.021

J Am Pharm Assoc (2003). 2021 Feb 19:S1544-3191(21)00075-3. doi: 10.1016/j.japh.2021.02.007. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study is to evaluate the incidence of glycemic relapse in patients who attained their glycosylated hemoglobin (A1C) goal through a health system-wide collaborative primary care-based pharmacist- and Certified Diabetes Care and Education Specialist (CDCES)-led type 2 diabetes (T2D) management program and to identify relapse risk factors.

METHODS: This retrospective cohort study examined patients with T2D in the diabetes management program with a baseline A1C of at least 9% who attained their A1C goal. The primary outcome was incidence of glycemic relapse. Time to relapse was estimated using Kaplan-Meier curve, and a cox proportional hazards model was fitted to identify the risk factors for glycemic relapse.

RESULTS: Three hundred sixty-two patients were followed-up for a median of 10.5 (interquartile range 12.1) months after program completion; 38 patients (10.5%) experienced a glycemic relapse. Kaplan-Meier analysis estimated a 12-month relapse rate of 8.3%. The presence of a medication adherence barrier, presence of a higher number of chronic medications at baseline, presence of a baseline body mass index (BMI) of 30-39.9, and use of insulin at program completion increased risk for glycemic relapse in a univariate model. In multivariate regression, baseline BMI of 30-39.9 remained statistically significant. Older age at baseline was associated with a statistically significantly decreased relapse risk in both models.

CONCLUSION: This study highlights a low incidence of glycemic relapse for patients with T2D who reach their A1C goal through a collaborative primary care-based pharmacist- and CDCES-led T2D management program. The presence of risk factors for glycemic relapse may indicate a need for ongoing intensive care despite achieving A1C goal.

PMID:33715974 | DOI:10.1016/j.japh.2021.02.007