Tag: nevin manimala

P R Health Sci J. 2021 Mar;40(1):12-18.

ABSTRACT

OBJECTIVE: There have been significant successes in the fight against HIV/AIDS due to the access to rapid HIV testing, interventions to reduce the mother-to-child transmission (MTCT) risk, potent and effective antiviral medications, and other biomedical prevention strategies. The purpose of this work is to demonstrate that Puerto Rico eliminated Mother-to-Child Transmission of HIV (MTCT) following the 2017 World Health Organization (WHO) criteria for validating the elimination of MTCT and Syphilis.

METHODS: Existing epidemiological data from Puerto Rico was used to document the elimination of MTCT and Syphilis. Data to calculate the indicators was obtained from the various divisions of the Puerto Rico Department of Health, including vital statistics, surveillance data, and programmatic outcomes.

RESULTS: Puerto Rico eliminated MTCT and syphilis, according to the WHO indicators, earlier than other countries. We can trace the outcomes to 1994 using the incidence rate of perinatally-acquired HIV of <50/100,000; to 2007 using HIV perinatal transmission rates for non-breastfeeding countries (<2%), to 2008 using 90% of women receiving ART at delivery, and to 2005 using the incidence rate of congenital syphilis of <50/100,000.

CONCLUSION: Not only have we eliminated the MTCT of HIV and syphilis, but the efforts have been sustained since 2000. The elimination of transmission of infectious diseases requires the intersection of scientific feasibility, coordinated interventions, and political will, successfully attained in Puerto Rico.

PMID:33876913

Can J Diet Pract Res. 2021 Apr 20:1-9. doi: 10.3148/cjdpr-2021-005. Online ahead of print.

ABSTRACT

Despite the widespread use of statistical techniques in quantitative research, methodological flaws and inadequate statistical reporting persist. The objective of this study is to evaluate the quality of statistical reporting and procedures in all original, quantitative articles published in the Canadian Journal of Dietetic Practice and Research (CJDPR) from 2010 to 2019 using a checklist created by our research team. In total, 107 articles were independently evaluated by 2 raters. The hypothesis or objective(s) was clearly stated in 97.2% of the studies. Over half (51.4%) of the articles reported the study design and 57.9% adequately described the statistical techniques used. Only 21.2% of the studies that required a prestudy sample size calculation reported one. Of the 281 statistical tests conducted, 88.3% of them were correct. P values >0.05-0.10 were reported as “statistically significant” and/or a “trend” in 11.4% of studies. While this evaluation reveals both strengths and areas for improvement in the quality of statistical reporting in CJDPR, we encourage dietitians to pursue additional statistical training and/or seek the assistance of a statistician. Future research should consider validating this new checklist and using it to evaluate the statistical quality of studies published in other nutrition journals and disciplines.

PMID:33876983 | DOI:10.3148/cjdpr-2021-005

Stem Cells Transl Med. 2021 Apr 20. doi: 10.1002/sctm.20-0330. Online ahead of print.

ABSTRACT

We previously demonstrated the safety and feasibility of mesenchymal stem cell (MSC) transplantation for bronchopulmonary dysplasia (BPD) in preterm infants in a phase I clinical trial. We thus investigated the therapeutic efficacy of MSCs for BPD in premature infants. A phase II double-blind, randomized, placebo-controlled clinical trial was conducted on preterm infants at 23 to 28 gestational weeks (GW) receiving mechanical ventilator support with respiratory deterioration between postnatal days 5 and 14. Infants were stratified by 23 to 24 GW and 25 to 28 GW and randomly allocated (1:1) to receive stem cells (1 × 10⁷ cells/kg, n = 33) or placebo (n = 33). Although the inflammatory cytokines in the tracheal aspirate fluid were significantly reduced with MSCs, the primary outcome of death or severe/moderate BPD in the control group (18/33, 55%) was not significantly improved with MSC transplantation (17/33, 52%). In the subgroup analysis, the secondary outcome of severe BPD was significantly improved from 53% (8/15) to 19% (3/16) with MSC transplantation in the 23 to 24 GW group but not in the 25 to 28 GW subgroup. In summary, although MSC transplantation might be safe and feasible, this small study was underpowered to detect its therapeutic efficacy in preterm infants at 23 to 28 GW. Accordingly, we are now conducting an additional larger and controlled phase II clinical trial focusing on infants at 23 to 24 GW (NCT03392467). ClinicalTrials.gov identifier: NCT01828957.

PMID:33876883 | DOI:10.1002/sctm.20-0330

J Nurs Scholarsh. 2021 Apr 20. doi: 10.1111/jnu.12649. Online ahead of print.

ABSTRACT

PURPOSE: To identify which patient and hospital characteristics are related to nurse staffing levels in acute care hospital settings.

DESIGN: A cross-sectional design was used for this study.

METHODS: The sample comprised 1,004 patients across 10 hospitals in the Andalucian Health Care System (southern Spain) in 2015. The sampling was carried out in a stratified, consecutive manner on the basis of (a) hospital size by geographical location, (b) type of hospital unit, and (c) patients’ sex and age group. Random criteria were used to select patients based on their user identification in the electronic health record system. The variables were grouped into two categories, patient and hospital characteristics. Multilevel linear regression models (MLMs) with random intercepts were used. Two models were fitted: the first was the null model, which contained no explanatory variables except the intercepts (fixed and random), and the second (explanatory) model included selected independent variables. Independent variables were allowed to enter the explanatory model if their univariate association with the nurse staffing level in the MLM was significant at p < .05.

RESULTS: Two hierarchical levels were established to control variance (patients and hospital). The model variables explained 63.4% of the variance at level 1 (patients) and 71.8% at level 2 (hospital). Statistically significant factors were the type of hospital unit (p = .002), shift (p < .001), and season (p < .001). None of the variables associated with patient characteristics obtained statistical significance in the model.

CONCLUSIONS: Nurse staffing levels were associated with hospital characteristics rather than patient characteristics.

CLINICAL RELEVANCE: This study provides evidence about factors that impact on nurse staffing levels in the settings studied. Further studies should determine the influence of patient characteristics in determining optimal nurse staffing levels.

PMID:33876892 | DOI:10.1111/jnu.12649

Minerva Obstet Gynecol. 2021 Apr 20. doi: 10.23736/S2724-606X.21.04731-X. Online ahead of print.

ABSTRACT

BACKGROUND: Uterine fibroids are the most common benign tumor in women. According to literature, submucosal myomas have a negative effect on reproductive outcomes in women undergoing assisted reproductive techniques (ART) but there are fewer data concerning intramural fibroids. During last years, Ulipristal acetate (UPA) 5 mg was widely used as medical option of fibroid’s treatment, but from 2020, the Pharmacovigilance Risk Assessment Committee (PRAC) has revoked the marketing authorisation after some cases of liver toxiciy.

METHODS: In this observational, retrospective study we collected data from a sample of 23 women affected by symptomatic uterine fibroids (from Type 1 to Type 7 according FIGO classification) followed in our center for assisted reproduction from 2016-2019. All patients received 5 mg/day UPA for three months, followed by two months of wash-out therapy. A group of 13 women treated with UPA, with intramural fibroid not distorting the uterine cavity, after wash-out therapy, affected by tubal or idiopathic factors of infertility too, underwent ART. We also evaluated a control group of women, not affected by fibroids, randomly selected from a general group of our ART patients, similar by age, BMI, and cause of infertility only idiopathic or tubal factors. We evaluated the impact of UPA on reduction of fibroid volume, symptomatology and distortion of the cavity in all the women treated, and the IVF (In Vitro Fertilization) outcome between the fibroid group of women affected by intramural fibroids who underwent ART, and the control group.

RESULTS: In all the women treated with UPA the overall median fibroid volume pre-treatment was 45.168±35.360 mm3, that decreased to a mean value of 22.592±22.116 mm3 post one cycle of UPA, with an overall mean decrease of -22.586 mm3 (of 49%) statistically significant (p=0.00001). After treatment, the distortion of the uterine cavity reduced in high percentage of cases: 85,71% (type 1-2), χ squared difference in respect to the value pre-treatment of 0,3941, and 86.96% of patients subjectively referred an improvement in the symptomatology. In the group of 13 women that undergone ART, after one IVF cycle for each patient, we obtained 61% of positivity of dosage of beta human chorionic gonadotropin (hCG) after UPA treatment, and we obtained a similar value in the control group.

CONCLUSIONS: In our little sample we have observed that UPA represented a valid non-invasive medical treatment strategy for fibroids in women candidate for (IVF, not only in women affected by submucosal, but also by intramural fibroids not distorting uterine cavity. After a single, three months course of treatment, we obtained good results in terms of reduction of fibroid’s volume and improvement of symptomatology, without side effects, preparing a more favorable environment for ART.

PMID:33876897 | DOI:10.23736/S2724-606X.21.04731-X

Acta Paediatr. 2021 Apr 20. doi: 10.1111/apa.15881. Online ahead of print.

ABSTRACT

AIM: Treatment of childhood obesity is often insufficient and may be aggravated by high co-occurrence of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate whether children with overweight or obesity normalised in weight when receiving stimulant treatment for ADHD.

METHODS: Growth data of 118 children were obtained from medical records at outpatient paediatric and children’s psychiatric services in the Gothenburg area, Sweden. The children were diagnosed with ADHD and were between 6-17 years at the start of stimulant treatment. The pre-treatment data act as an internal control where every child is their own control.

RESULTS: At the start of treatment 74 children had normal weight and 44 had either overweight or obesity. During the year with stimulants, the mean (SD) body mass index (BMI) in standard deviation score (SDS) decreased significantly: -0.72 (0.66) compared to 0.17 (0.43) during the year before treatment (p<0.01). After one year with treatment 43% of those with overweight or obesity had reached normal weight.

CONCLUSIONS: Stimulant treatment for ADHD yield significant weight loss. In children with overweight or obesity and ADHD, this is an important finding showing additional benefit in terms of weight management.

PMID:33876865 | DOI:10.1111/apa.15881

Australas J Ageing. 2021 Apr 20. doi: 10.1111/ajag.12951. Online ahead of print.

ABSTRACT

OBJECTIVE: To summarise frailty measures and outcomes reported in trials involving frail older inpatients.

METHODS: Databases were searched for randomised controlled trials enrolling frail older inpatients.

RESULTS: Twenty-four articles describing twelve trials were included. Seven trials applied six tools to measure frailty, whilst five trials employed ad hoc measures. Eighty outcomes were examined with survival and functional status reported most commonly. Nine studies trialled multidisciplinary, geriatrician-led interventions. Statistically significant between-group differences were detected for at least one outcome in ten trials. All studies represented high risk of bias within at least one domain.

CONCLUSIONS: Heterogeneity of interventions, measurement of frailty and outcomes reported limit generalisability of findings. Many articles purport to study frail patients, yet do not enrol patients using any frailty measurement tool. Utilising validated instruments to measure frailty and a standard set of health outcomes relevant to older people would assist consistent reporting and evaluation of future studies.

PMID:33876880 | DOI:10.1111/ajag.12951

Chemistry. 2021 Apr 20. doi: 10.1002/chem.202100922. Online ahead of print.

ABSTRACT

Heavy-atom-free sensitizers forming long-living triplet excited states via the spin-orbit charge transfer intersystem crossing (SOCT-ISC) process have potential to replace transition metal complexes in photonic applications. The efficiency of SOCT-ISC in BODIPY donor-acceptor dyads can be tuned by structural modification. Predicting the triplet state yields and reactive oxygen species generation quantum yields in a particular solvent is challenging due to a lack of quantitative structure-property relationship (QSPR) models. We analyzed data on 1 O 2 generation quantum yields (Φ Δ ) for >70 heavy-atom-free BODIPY in toluene, acetonitrile, and THF. To build reliable QSPR models, we synthesized new BODIPYs containing different electron donating groups, studied their optical and structural properties and the solvent dependence of 1 O2 , which confirmed the formation of triplet states via SOCT-ISC. More than 5000 quantum-chemical descriptors were calculated including descriptors using DFT, namely M06-2X functional. QSPR models predicting ΦΔ values were developed using multiple linear regression (MLR), which perform significantly better than other machine learning methods and show sufficient statistical parameters (R = 0.88 ̶ 0.91 and q 2 = 0.62 ̶ 0.69) for all three solvents. A small root mean squared error of 8.2% was obtained for ΦΔ values predicted using MLR model in toluene. QSPR and machine learning techniques can be useful for predicting ΦΔ values in different media and virtual screening of new heavy-atom-free BODIPYs with improved photosensitizing ability.

PMID:33876842 | DOI:10.1002/chem.202100922

J Cosmet Dermatol. 2021 Apr 20. doi: 10.1111/jocd.14163. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the effectiveness of injection of autologous keratin gel and fibroblast for static forehead rhytides rectification as new soft tissue filler.

MATERIALS AND METHODS: Totally 48 volunteers suffering static forehead rhytides received the injection of autologous keratin and fibroblast and 6 volunteers received botulinum toxin type A (BTX-A) and hyaluronic acid(HA) treatment as parallel control. The follow-up study was carried out 1,3, 6, 12 and 24 months after treatment, photographs and satisfactions questionnaire were collected and assessed. All volunteers were independently assessed by blinded evaluators using global aesthetic improvement scores(GAIS). One-way-Anova was used for statistical analysis, and the significant level was α=0.05).

RESULTS: The static forehead rhytides was improved observably after the treatment. It still showed good result even at month 24 after the injection. There is no severe adverse effects observed in the whole procedure.

CONCLUSION: Autologous fibroblast and keratin combined injection might be an ideal therapy in mini-invasiveplastic injection area, which is safe and effective for static forehead rhytides correction, and has a long-term efficacy.

PMID:33876856 | DOI:10.1111/jocd.14163

J Prosthodont. 2021 Apr 20. doi: 10.1111/jopr.13366. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the trueness and precision of virtual facebow records using a smartphone as a 3D face scanner.

MATERIAL AND METHODS: Twenty repeated virtual facebow records were performed on two subjects using a smartphone as a 3D face scanner. For each subject, a virtual facebow was attached to his/her maxillary arch, and a face scan was performed using a smartphone with a 3D scan application. The subject’s maxillary arch intraoral scan was aligned to the face scan by the virtual facebow fork. This procedure was repeated 10 times for each subject. To investigate if the maxillary scan is located at the right position to the face, these virtual facebow records were superimposed to a cone-beam computed tomography (CBCT) head scan from the same subject by matching the face scan to the face 3D reconstruction from CBCT images. The location of maxillary arch in virtual facebow records was compared with its position in CBCT. The “trueness” of the proposed procedure is defined as the deviation between maxilla arch position in virtual facebow records and the CBCT images. The “precision” is defined as the deviation between each virtual facebow record. The linear deviation at left central incisor (#9), left first molar (#14), and right first molar (#3), as well as angular deviation of occlusal plane were analyzed with descriptive statistics. Differences between two objects were also explored with Mann Whitney U test.

RESULTS: The 20 virtual facebow records using the smartphone 3D scanner deviated from the CBCT measurements (trueness) by 1.14 ±0.40 mm at #9, 1.20 ±0.50 mm at #14, 1.12 ±0.51 mm at the #3, and 1.48 ±0.56° in the occlusal plane. The VFTs deviated from each other by 1.06 ±0.50 mm at #9, 1.09 ±0.49 mm at #14, 1.11 ±0.58 mm at #3, and 0.81 ±0.58° in the occlusal plane. When all sites combined, the trueness was 1.14 ±0.40 mm, and the precision was 1.08 ±0.52 mm. Out of eight measurements, three measurements were significantly different between subjects. Nevertheless, the mean difference was small.

CONCLUSIONS: Virtual facebow records made using smartphone-based face scan can capture the maxilla position with high trueness and precision. The deviation can be anticipated as around 1 mm in linear distance and 1° in angulation. This article is protected by copyright. All rights reserved.

PMID:33876857 | DOI:10.1111/jopr.13366