Tag: nevin manimala

Anal Chem. 2021 Apr 22. doi: 10.1021/acs.analchem.1c00438. Online ahead of print.

ABSTRACT

This paper compares static (i.e., temporally unchanging) thermal gradient gas chromatography (GC) to isothermal GC using a stochastic transport model to simulate peak characteristics for the separation of C12-C14 hydrocarbons resulting from variations in injection bandwidth. All comparisons are made using chromatographic conditions that give approximately equal analyte retention times so that the resolution and number of theoretical plates can be clearly compared between simulations. Simulations show that resolution can be significantly improved using a linear thermal gradient along the entire column length. This is mainly achieved by partially compensating for loss in resolution from the increase in mobile phase velocity, which approximates an ideal, basic separation. The slope of the linear thermal gradient required to maximize resolution is a function of the retention parameters, which are specific to each analyte pair; a single static, thermal gradient will not affect all analytes equally. A static, non-linear thermal gradient that creates constant analyte velocities at all column locations provides the largest observed gains in resolution. From the simulations performed in this study, optimized linear thermal gradient conditions are shown to improve the resolution by as much as 8.8% over comparative isothermal conditions, even with a perfect injection (i.e., zero initial bandwidth).

PMID:33885280 | DOI:10.1021/acs.analchem.1c00438

Kardiol Pol. 2021 Apr 16. doi: 10.33963/KP.15956. Online ahead of print.

ABSTRACT

BACKGROUND: Ionizing radiation constitutes a well-known risk factor of carotid artery stenosis. The survival rates of head and neck cancer patients undergoing radiotherapy have risen owing to medical advancements in the field. As a consequence, the incidence of carotid artery stenosis in these high-risk patients has increased.

AIMS: In this study we sought to compare the outcomes of carotid endarterectomy (CEA) versus carotid artery stenting (CAS) for radiation-induced carotid artery stenosis.

METHODS: This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eligible studies were identified through a comprehensive search of PubMed, Scopus and Cochrane Central until July 2020. A random-effects model meta-analysis was conducted, and odds ratios (ORs) were calculated. The I-square statistic was used to assess for heterogeneity.

RESULTS: Seven studies and 201 patients were included. Periprocedural stroke, myocardial infarction (MI) and death rates were similar between the two revascularization approaches. However, the risk for cranial nerve (CN) injury was higher in the CEA group (OR: 7.40; 95% CI: 1.58-34.59; I2 = 0%). Analysis revealed no significant difference in terms of long-term mortality (OR: 0.41; 95%CI: 0.14-1.16; I2 = 0%) and restenosis (OR: 0.69; 95%CI: 0.29-1.66; I2 = 0%) rates between CEA and CAS after a mean follow up of 40.5 months.

CONCLUSIONS: CAS and CEA appear to have a similar safety and efficacy profile in patients with radiation-induced carotid artery stenosis. Patients treated with CEA have a higher risk for periprocedural CN injuries. Future prospective studies are warranted to validate these results.

PMID:33885270 | DOI:10.33963/KP.15956

Clin Nucl Med. 2021 Apr 21. doi: 10.1097/RLU.0000000000003704. Online ahead of print.

NO ABSTRACT

PMID:33883481 | DOI:10.1097/RLU.0000000000003704

Nurs Res. 2021 Mar 22. doi: 10.1097/NNR.0000000000000513. Online ahead of print.

ABSTRACT

BACKGROUND: Despite numerous efforts to create more equitable health care systems, minority populations face long-standing health disparities compared to White populations. Health care research is the necessary foundation for creating equitable health systems and providing patient-centered care. Significant challenges exist, however, with recruiting and engaging underrepresented populations in clinical research.

OBJECTIVES: The purpose of this analysis was to determine how research participant race, trust, and level of education influence participation barriers in clinical research.

METHODS: The study used secondary, cross-sectional survey data that were collected between 2014 and 2016 through the former Mid-South Clinical Data Research Network (CDRN), currently known as the STAR-CRN. Descriptive statistics and Spearman rank correlations were performed between level of education, level of trust, and each attitude statement for each racial category.

RESULTS: A total of 2,190 survey responses were used in the data analysis. The mean age of respondents was 52 years with majority being female, White, insured, and working full time. Overall, the respondents had favorable attitudes towards research participation. Trust was correlated with agreement in many attitude statements for both White and African American respondents, while correlations with education level were more variable depending on racial grouping. Trust level was negatively associated with agreement towards the statement “researchers don’t care about me” in White and Native American respondents.

DISCUSSION: The results support the importance of trust to research participation. Generally, education level was not strongly predictive of research participation, although prediction was influenced by race and attitude.

PMID:33883501 | DOI:10.1097/NNR.0000000000000513

J Clin Gastroenterol. 2021 Apr 21. doi: 10.1097/MCG.0000000000001546. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer and cancer-related mortality worldwide. Studies have suggested that aspirin (ASA) and statins may be associated with a decrease in incident HCC.

GOALS: We aimed to evaluate the effect of ASA and statin use on the incidence of HCC in a prospective cohort of patients with liver cirrhosis and to identify if there was an increased risk of esophageal variceal hemorrhage (VH) in patients with ASA use.

STUDY: We conducted a retrospective study of 521 patients with data collected from July 1, 2012 to December 31, 2017. We used competing risk analysis to assess the association between risk factors and HCC; and the association between ASA and VH.

RESULTS: ASA use alone was associated with a decreased incidence of HCC in the univariate and multivariate models; [hazard ratio (HR) confidence interval (CI): 0.348 (0.124-0.976); P=0.0448] and [HR (CI): 0.266 (0.094-0.755); P=0.0129, respectively]. The combination of ASA and statin use was associated with a decreased hazard of HCC [HR (CI): 0.15 (0.036-0.624); P=0.0090] and this remained statistically significant in the multivariable model [HR (CI): 0.113 (0.026-0.483); P=0.0033]. Among daily ASA users compared with non-users, there was not a significant increase in risk of VH.

CONCLUSIONS: Daily ASA use was associated with a decrease risk of incident HCC. The combination of daily ASA use and statin use decreased the risk of incident HCC suggesting there is beneficial interaction. Finally, no excess VH was observed in daily ASA users compared with non-users.

PMID:33883511 | DOI:10.1097/MCG.0000000000001546

J Neurosci Nurs. 2021 Apr 20. doi: 10.1097/JNN.0000000000000590. Online ahead of print.

ABSTRACT

BACKGROUND: There is growing importance on discovering factors that delay time to intervention for acute ischemic stroke (AIS) patients, as rapid intervention is essential for better patient outcomes. The management of these patients involves a multidisciplinary effort and quality improvement initiatives to safely increase treatment with intravenous (IV) thrombolytic. The objective of this pilot study is to evaluate factors of acute stroke care in the emergency department (ED) and their impact on IV alteplase administration. METHODS: A sample of 89 AIS patients who received IV alteplase from a single academic medical institution was selected for retrospective analysis. System characteristics (presence of a stroke nurse and time of day) and patient characteristics (mode of arrival and National Institutes of Health Stroke Scale score on arrival) were analyzed using descriptive statistics and multiple regression to address the study question. RESULTS: The mean door-to-needle time is 53.74 (38.06) minutes, with 74.2% of patients arriving to the ED via emergency medical services and 25.8% having a stroke nurse present during IV alteplase administration. Mode of arrival (P = .001) and having a stroke nurse present (P = .022) are significant predictors of door-to-needle time in the ED. CONCLUSION: Although many factors can influence door-to-needle times in the ED, we did not find National Institutes of Health Stroke Scale score on arrival and time of day to be significant factors. Patients arriving to the ED by personal vehicle will have a significant delay in IV alteplase administration, therefore emphasizing the importance of using emergency medical services. Perhaps more importantly, collaborative efforts including the addition of a specialized stroke nurse significantly decreased time to IV alteplase administration for AIS patients. With this dedicated role, accelerated triage and more effective management of AIS patients is accomplished, leading to decreased intervention times and improving patient outcomes.

PMID:33883535 | DOI:10.1097/JNN.0000000000000590

Shokuhin Eiseigaku Zasshi. 2021;62(2):56-64. doi: 10.3358/shokueishi.62.56.

ABSTRACT

Benchmark dose (BMD) method have been used in the toxicological assessment of chemical substances so that the point of departure can be derived, as an alternative to the use of no observable adverse effect level (NOAEL), and the method is often applied to the incidence data of histopathological findings in the toxicity studies. In the present study, the BMD method was applied to various patterns of incidence data derived from some toxicity studies as case studies, and the validity of each application was discussed. Five independent applications including toxicity studies of madder color or semicarbazide hydrochloride were prepared and model averaging over the three models with the lowest three AIC (Akaike information criteria) values (MA-3), a recently proposed model averaging method, was employed. The series of case studies indicated, for the better application of the BMD method to histopathological findings, the following points:(i) If there are incidence data with severity grading of pathologically significant lesions, we must discuss whether the BMD method should be applied to the total incidence data or the incidence data above certain grade with or without data aggregation.(ii) If a lesion of interest had higher toxicological significance rather than the secondary lesions with higher severity, the BMD method should be applied to the incidence data of the lesion of interest.(iii) If it is highly necessary to apply the BMD method to obtained incidence data without toxicological and statistical validity, toxicological pathologists are advised to review individual datasets of histopathology and associated data, and provide new incidence data of comprehensive findings (diagnostic name) such as hepatocellular injury or nephropathy, if possible. In all cases, toxicological significance and mechanism of a lesion of interest need to be considered in light of the dose-dependence. In view of both toxicology and statistics, sufficient discussions must be made on the validity of applying BMD method and its estimate.

PMID:33883337 | DOI:10.3358/shokueishi.62.56

Ann Plast Surg. 2021 Apr 21. doi: 10.1097/SAP.0000000000002857. Online ahead of print.

ABSTRACT

INTRODUCTION: In the last decade, we have seen a steady increase in the incidence of frontal sinus trauma due to gunshot wounds and a decrease in motor vehicle trauma. Penetrating gunshot wounds to the frontal sinus present a unique challenge to the reconstructive surgeon because they require careful consideration of the management principles of plastic surgery. Despite previous reviews on frontal sinus trauma, there are no studies examining the management techniques of frontal sinus fractures due specifically to gunshot wounds. In this study, we aim to retrospectively evaluate the use of a variety of tissue flaps in intervention and associated outcomes.

METHODS: A retrospective chart review was completed on all patients with gunshot wound(s) to the frontal sinus from January 2010 to January 2018 at a single institution. The patients were classified based on the fracture pattern (anterior vs posterior table vs both), degree of displacement, presence of nasofrontal outflow tract injury, and evidence of cerebrospinal fluid leak. Patients were then stratified according to the type of reconstruction performed (cranialization, obliteration and need for free flap) and evaluated for major and minor complications after reconstruction.

RESULTS: In this study, we present outcome data from 28 cases of frontal sinus trauma due to gunshot wounds. There was a statistically significant difference (P = 0.049) in the type reconstructive strategy employed with each type of flap, with pericranial flaps primarily used in cranialization, temporal grafts were more likely to be used in obliteration, and free flaps were more likely to be used in cranialization. The overall major complication rate was 52% (P = 0.248), with the most common acute major complication was cerebrospinal fluid leak (39%) and major chronic was abscess (23.5%).

CONCLUSIONS: This report explores the management of frontal sinus trauma and presents short-term outcomes of treatment for penetrating gunshot wounds at a tertiary referral center.

PMID:33883442 | DOI:10.1097/SAP.0000000000002857

Cancer Nurs. 2021 Apr 21. doi: 10.1097/NCC.0000000000000932. Online ahead of print.

ABSTRACT

BACKGROUND: Sleep disturbance is common among adolescent and young adult (AYA) cancer survivors. Physical activity (PA) and behavioral activation (BA) therapy have been reported as enhancing sleep quality, but few studies exist on the effects of such interventions combined with technology to promote sleep quality in AYA cancer patients.

OBJECTIVE: The aim of this study was to investigate the feasibility and effects of intelligent wearable device-based PA therapy and internet-based modified BA therapy to improve sleep quality among AYA cancer patients.

METHODS: A randomized controlled trial with 143 AYA cancer patients was conducted. Participants were randomly assigned to a control group (n = 48), which performed routine care, a PA group (n = 47), which received 8-week PA therapy based on intelligent wearable devices, and a BA group (n = 48), which participated in internet-based modified BA therapy for 8 weeks.

RESULTS: At 1 week and 3 months after the intervention for sleep quality, there were statistically significant differences between the PA group and the control group (P = .020), but no statistically significant difference between the BA group and the control group.

CONCLUSIONS: The intelligent wearable device-based PA therapy has more advantages than internet-based modified BA therapy in improving the overall state of AYA cancer patients, and the intervention effect was sustained for at least 3 months.

IMPLICATIONS FOR PRACTICE: Developing and implementing PA plans for AYA cancer survivors can improve their sleep quality. Social media, intelligent wearable devices, and mobile health applications have unique advantages in promoting sleep quality for AYA cancer survivors.

PMID:33883477 | DOI:10.1097/NCC.0000000000000932

Neurology. 2021 Apr 21:10.1212/WNL.0000000000011986. doi: 10.1212/WNL.0000000000011986. Online ahead of print.

ABSTRACT

OBJECTIVE: Migraine has been identified as a potential risk-factor for hypertension in prospective studies. In women, migraine prevalence decreases after menopause, but no studies have determined if migraine is associated with hypertension after menopause. This study sought to determine if history of migraine was associated with an increased risk of hypertension among menopausal women.

METHODS: We assessed associations between migraine and hypertension in a longitudinal cohort study of 56,202 menopausal women participating in the French E3N cohort, with follow-up beginning in 1993. We included women who did not have hypertension or cardiovascular disease at the age of their menopause. Migraine was classified as ever or never at each questionnaire cycle. Cox proportional hazards models were used to investigate relations between migraine and hypertension, controlling for potential confounding. A secondary analysis with baseline in 2011 considered aura status, grouping participants reporting migraine as migraine with aura, migraine without aura, or unknown migraine type.

RESULTS: During 826,419 person years, 12,501 cases of incident hypertension were identified, including 3100 among women with migraine, and 9401 among women without migraine. Migraine was associated with an increased risk of hypertension in menopausal women (HR _migraine = 1.29 [1.24: 1.35]), and were consistent in post-hoc sensitivity analyses, such as when controlling for common migraine medications. Associations between migraine and hypertension were similar whether or not women reported aura (HR _{migraine aura} = 1.54 [1.04: 2.30], HR _{migraine no aura} = 1.32 [0.87: 2.02], p-heterogeneity = 0.60). Associations were slightly stronger among ever users of menopausal hormone therapy (HR _migraine = 1.34 [1.27: 1.41]), than among never users (HR _migraine = 1.19 [1.11: 1.28]).

CONCLUSION: Migraine was associated with an increased risk of hypertension amongst menopausal women. In secondary analysis, we didn’t observe a significant difference between migraine with aura and migraine without aura.

PMID:33883242 | DOI:10.1212/WNL.0000000000011986