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A randomized controlled trial to compare the effectiveness and safety of adsorbent lotion containing tapioca starch, spent grain wax, Butyrospermum parkii extract, argania spinosa kernel oil, aloe barbadensis, rosehip oil, and allantoin with a low-potency topical corticosteroid in the treatment of intertrigo

J Cosmet Dermatol. 2021 Apr 3. doi: 10.1111/jocd.14125. Online ahead of print.

ABSTRACT

BACKGROUND: Intertrigo is an inflammatory skin-fold condition. Candida infections may occur concurrently or afterwards. Topical corticosteroids may reduce inflammation but exacerbate Candida infections. The treatment is contentious.

OBJECTIVE: To evaluate the efficacies and safety of adsorbent lotion containing tapioca starch, spent grain wax, Butyrospermum parkii extract, argania spinosa kernel oil, aloe barbadensis, rosehip oil, and allantoin for the treatment of mild-to-moderate intertrigo, relative to 1% hydrocortisone cream.

METHODS: This randomized, double-blinded study enrolled 40 intertrigo patients. Twice daily, 20 patients applied adsorbent lotion while the remainder used 1% hydrocortisone cream. Efficacy evaluation, skin biophysical measurements, skin tolerability, safety and visual analog scale (VAS) patient-satisfaction scores were evaluated at baseline and Week 2.

RESULTS: The adsorbent lotion showed higher complete cure rates for color, partial epidermal loss, papules/pustules/vesicles/patches, dryness, and scaling than the corticosteroid without statistical significance. Adsorbent lotion demonstrated significantly higher reduction in pruritus than the corticosteroid treatment. Reduction of erythema level using Mexameter and VAS patient-satisfaction scores were not statistically different between adsorbent lotion and hydrocortisone cream. No adverse effects or superimposed infections were reported.

CONCLUSIONS: The anti-inflammatory efficacies of adsorbent lotion and low-potency steroid were equivalent. The lotion was safe and produced excellent pruritus reduction. Patient satisfaction was high.

PMID:33811776 | DOI:10.1111/jocd.14125

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Reasons for Discontinuation of Acute Postoperative Pain Ketamine Infusions: A Retrospective Case-Control Study

Pain Pract. 2021 Apr 3. doi: 10.1111/papr.13012. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to investigate factors associated with early discontinuation of low-dose ketamine infusions due to adverse drug events (ADEs).

METHODS: A retrospective, matched case-control study of surgical patients who received low-dose ketamine infusions for postoperative pain over 6 years was conducted. Forty-seven study patients, who required early discontinuation of their infusion due to ADEs, were included and matched 1:1 with 47 controls, who did not experience ADEs, for a total of 94 patients. The two groups were compared based on surgery type, ASA classification, administration of specific perioperative anxiolytic, anesthetic, and analgesic medications, and use of regional anesthesia.

RESULTS: Of the study patients, 44.7% underwent spine procedures (vs 34% of controls), 27.6% underwent abdominal procedures (vs 8.5% of controls), 19.2% underwent orthopedic procedures (vs 46.8% of controls), and 8.5% underwent thoracic procedures (vs 6.4% of controls). There were no statistically significant differences in ASA classification, preoperative gabapentinoid and antidepressant use, average ketamine infusion dose, or postoperative use of peripheral nerve catheters, NSAIDs, acetaminophen, muscle relaxants and non-benzodiazepine sleep aides. Study patients had higher rates of intraoperative volatile anesthetic use (78.7% vs 57.7%, p=0.03) and more postoperative opioid PCA use (53.2% vs 29.8%, p=0.02) than controls. Control patients had higher rates of preoperative opioid use (76.7% vs 53.2%, p=0.02) and premedication with midazolam (89.4% vs 70.2%, p=0.02) than study patients.

CONCLUSION: Patients who required discontinuation of their low-dose ketamine infusion due to ADEs were more likely to be opioid naïve, received less preoperative benzodiazepines, and had greater postoperative opioid PCA requirements. Control patients, on the other hand, had higher rates of preoperative opioid use and experienced fewer ADEs despite greater total ketamine doses.

PMID:33811788 | DOI:10.1111/papr.13012

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Differential Substrate Use in EGF- and Oncogenic KRAS-Stimulated Human Mammary Epithelial Cells

FEBS J. 2021 Apr 3. doi: 10.1111/febs.15858. Online ahead of print.

ABSTRACT

Many metabolic phenotypes in cancer cells are also characteristic of proliferating non-transformed mammalian cells, and attempts to distinguish between phenotypes resulting from oncogenic perturbation from those associated with increased proliferation are limited. Here, we examined the extent to which metabolic changes corresponding to oncogenic KRAS expression differed from those corresponding to epidermal growth factor (EGF)-driven proliferation in human mammary epithelial cells (HMECs). Removal of EGF from culture medium reduced growth rates and glucose/glutamine consumption in control HMECs despite limited changes in respiration and fatty acid synthesis, while the relative contribution of branched-chain amino acids to the TCA cycle and lipogenesis increased in the near-quiescent conditions. Most metabolic phenotypes measured in HMECs expressing mutant KRAS were similar to those observed in EGF-stimulated control HMECs that were growing at comparable rates. However, glucose and glutamine consumption as well as lactate and glutamate production were lower in KRAS-expressing cells cultured in media without added EGF, and these changes correlated with reduced sensitivity to GLUT1 inhibitor and phenformin treatment. Our results demonstrate the strong dependence of metabolic behavior on growth rate, and provide a model to distinguish the metabolic influences of oncogenic mutations and non-oncogenic growth.

PMID:33811729 | DOI:10.1111/febs.15858

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Clinical outcomes after permanent polymer or polymer-free stent implantation in patients with diabetes mellitus: The ReCre8 diabetes substudy

Catheter Cardiovasc Interv. 2021 Apr 3. doi: 10.1002/ccd.29685. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this analysis was to compare target-lesion failure (TLF) of a permanent polymer zotarolimus-eluting stent (PP-ZES) versus a polymer-free amphilimus-eluting stent (PF-AES) in diabetics.

BACKGROUND: The improvement of outcomes with new-generation drug-eluting stent as seen in the general population is less pronounced among diabetics. The PF-AES introduces an elution-technology with potential enhanced performance in diabetics.

METHODS: In this subanalysis of the ReCre8 trial, patients were randomized to either a PP-ZES or PF-AES after stratification for diabetes and troponin status. The primary device-oriented endpoint was TLF, a composite of cardiac death, target-vessel myocardial infarction and target-lesion revascularization.

RESULTS: In the ReCre8 trial, 304 (20%) patients were diabetic and 96 (6%) had insulin-dependent diabetes mellitus. There was no statistically significant difference between the two study arms regarding the primary endpoint (PP-ZES 7.2% vs. PF-AES 4.0%; p = .21), although the composite of net adverse clinical events was higher in the PP-ZES arm (15.7 vs. 8.0%; p = .035). Stent thrombosis was low in both groups with no cases in the PP-ZES arm and 1 case in the PF-AES arm (p = .32). Regarding insulin-treated diabetics, TLF was higher in the PP-ZES arm (14.9 vs. 2.1%; p = .022).

CONCLUSIONS: Diabetics could potentially benefit from a dedicated stent, releasing sirolimus with a lipophilic carrier (amphilimus-formulation). Future trials should confirm the potential benefit of a PF-AES in this population.

PMID:33811730 | DOI:10.1002/ccd.29685

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Influence of ultraconservative access cavities on instrumentation efficacy with XP-endo Shaper and Reciproc, filling ability and load capacity of mandibular molars subjected to thermomechanical cycling

Int Endod J. 2021 Apr 3. doi: 10.1111/iej.13525. Online ahead of print.

ABSTRACT

AIM: To evaluate the influence of ultraconservative access cavities (UltraAC) on canal shaping and filling ability and load capacity of mandibular molars after root canal preparation with XP-endo Shaper (XP) or Reciproc (RC), under simulated clinical conditions. Traditional access cavities (TradAC) were used for comparison.

METHODOLOGY: Forty mandibular molars were scanned by micro-computed tomographic and, based on similar anatomical features, were divided into four groups (n=10), according to the type of access cavity and canal instrumentation protocol: TradAC/RC, TradAC/XP, UltraAC/RC and UltraAC/XP. All root canal procedures were performed on a dental mannequin. Teeth were scanned after root canal instrumentation and filling. Unprepared area, dentine removed, accumulated hard tissue debris (AHTD), canal transportation, presence of voids and filling material remnants within the pulp chamber were analyzed. After restorative procedures, the teeth were subjected to thermomechanical cycling and to a load capacity test. Statistical analyses were performed using two-way ANOVA test, considering the randomized blocks design (P<0.05).

RESULTS: The percentage of unprepared canal area was significantly lower in TradAC groups when compared to UltraAC groups (P<0.05), regardless of the instrument used. The UltraAC/XP group had significantly lower percentage of radicular dentine removed when compared to other groups (P<0.05). UltraAC/XP and TradAC/XP groups had significantly lower percentage of AHTD than UltraAC/RC and TradAC/RC groups (P<0.05). Regarding canal transportation, in the MB root canals, the TradAC/XP group had significantly lower values than other groups (P<0.05). In general, in ML and distal root canals, TradAC/XP and UltraAC/XP groups had significantly lower values of canal transportation when compared to other groups (P<0.05). Moreover, the UltraAC/RC had the highest canal transportation values in MB and distal canals. The UltraAC groups had significantly greater percentage of voids and volume of remaining root filling material within the pulp chamber after cleaning procedures than TradAC groups (P<0.05). There was no difference in the load capacity among groups (P<0.05).

CONCLUSION: The UltraAC/XP and UltraAC/RC groups had significantly more unprepared canal area, significantly more voids and volume of root filling material remnants within the pulp chamber after canal filling. UltraAC/XP had been associated with a significantly less amount of dentine removal and a significantly AHTD while TradAC/XP had overall significantly less canal transportation. No differences were observed in the load capacity among groups.

PMID:33811762 | DOI:10.1111/iej.13525

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The music video therapy in postoperative analgesia in preschool children after cardiothoracic surgery

J Card Surg. 2021 Apr 3. doi: 10.1111/jocs.15551. Online ahead of print.

ABSTRACT

OBJECTIVES: To observe the effect of music video (MV) therapy on early postoperative pain in preschool children after cardiothoracic surgery.

METHODS: 116 preschool children undergoing cardiothoracic surgery were randomly divided into the MV and control groups from June 2019 to March 2020. The related vital signs parameters, the Wong-Baker FACES pain rating scale, the FLACC scale, the number of postoperative PCA press and the cumulants of sufentanil use were recorded and analyzed.

RESULTS: There were no statistically significant differences in general characteristics and preintervention data between the two groups. However, there were significantly lower in the heart rate, mean arterial pressure, respiratory rate, the number of postoperative PCA press, and the dosage of sufentanil in the MV group than those in the control group after the intervention. The Wong-Baker FACES and FLACC scales in the MV group were significantly lower than those in the control group at the time point of immediately after the first intervention, 1 day, and 2 days after the intervention. The two pain scores showed a downward trend over time, and the corresponding scores in the MV group were better than those in the control group.

CONCLUSION: MV therapy can be an effective nonpharmaceutical intervention in the clinical to relieve children’s postoperative pain after cardiothoracic surgery.

PMID:33811684 | DOI:10.1111/jocs.15551

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Eating habits of children and adolescents during the COVID-19 pandemic: the impact of social isolation

J Hum Nutr Diet. 2021 Apr 3. doi: 10.1111/jhn.12901. Online ahead of print.

ABSTRACT

BACKGROUND: The social isolation enforced due to the new coronavirus (COVID-19) pandemic may impact families’ lifestyle and eating habits.

OBJECTIVE: To assess the behavior and dietary patterns of Brazilian children and adolescents during the social isolation imposed by the COVID-19 pandemic.

METHODS: This study was conducted using an online, anonymous cross-sectional survey with 589 children and 720 adolescents from Brazil during a nationwide social isolation policy. The Mann-Whitney U test or the Kruskal-Wallis with Dunn post-hoc method and a radar chart were used to compare the weekly consumption of each food by age group and isolation status. Statistical significance was set at p < 0.05, and analyses were conducted using R statistical software, version 4.0.2.

RESULTS: We found isolated families to show breakfast eating habits and consumption of raw salad, vegetables, beans, and soft drinks. Lower-class isolated families and those from the Northeast region consumed fruits, juices, vegetables, and beans less frequently. When compared to children, adolescents were less isolated (p = 0.016), less active (p < 0.001), exposed to longer screen time (p < 0.001), showed inadequate sleeping pattern (p = 0.002), and were from lower-class families (p < 0.001).

CONCLUSION: Social isolation affect the eating habits of children and adolescents. Non-isolated families present lower consumption of healthy food, especially those among the lower class, from Northeast Brazil, and adolescents.

PMID:33811690 | DOI:10.1111/jhn.12901

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Exploring Large Community- and Clinically-Generated Datasets to Understand Resilience Before and During the COVID-19 Pandemic

J Nurs Scholarsh. 2021 Apr 3. doi: 10.1111/jnu.12634. Online ahead of print.

ABSTRACT

PURPOSE: To explore resilience in the context of whole-person health and the social determinants of health at the individual and community levels using large, standardized nursing datasets.

DESIGN: A retrospective, observational, correlational study of existing deidentified Health Insurance Portability and Accountability Act (HIPAA)-compliant data using the Omaha System and its equivalent, Simplified Omaha System Terms.

METHODS: We used three samples to explore for patterns of resilience: pre-COVID-19 community-generated data (N = 383), pre-COVID-19 clinical documentation data (N = 50,509), and during-COVID-19 community-generated data (N = 102). Community participants used the My Strengths + My Health (MSMH) app to generate the two community datasets. The clinical data were obtained from the Omaha System Data Collaborative. We operationalized resilience as Omaha System Status scores of 4 (minimal signs or symptoms) or 5 (no signs or symptoms) as a discrete strengths measure for each of 42 Omaha System problem concepts. We used visualization techniques and standard descriptive and inferential statistics for analysis.

FINDINGS: It was feasible to examine resilience, operationalized as strengths by problem concept, within existing Omaha System or Simplified Omaha System Terms (MSMH) data. We identified several patterns indicating strengths and resilience that were consistent with literature related to community connectedness for community participants, and sleep for individuals in the clinical data.

CONCLUSIONS: When used consistently, the Omaha System within MSMH enabled robust data collection for a comprehensive, holistic assessment, resulting in better whole-person data including strengths, and enabled us to discover a potentially useful approach for defining resilience in new ways using standardized nursing data.

CLINICAL RELEVANCE: The notion that how we assess individuals and communities (i.e., the completeness of our assessments in relation to whole-person health) determines what we can know about resilience is seemingly in opposition to the critical need to decrease documentation burden, despite the potential to shift from a problem deficit-based assessment to one of strengths and resilience. However, a patient-facing comprehensive assessment that includes resilience and the social determinants of health can provide a transformative, whole-person platform for strengths-based care and population management.

PMID:33811723 | DOI:10.1111/jnu.12634

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Revisiting the determinants of carbon emissions for Turkey: the role of construction sector

Environ Sci Pollut Res Int. 2021 Apr 3. doi: 10.1007/s11356-021-13722-y. Online ahead of print.

ABSTRACT

This study intends to consider the link among carbon dioxide (CO2) emissions, real GDP, energy usage, trade, financial development, and construction sector activities in Turkey within the Environmental Kuznets Curve (EKC) framework by employing an autoregressive distributed lag (ARDL) bounds test procedure. The analysis includes the period of 1970-2015 in keeping with available data. The findings of the study show that an increase in construction sector activities plays a positive role in CO2 emissions. The results also argue that CO2 emissions have risen statistically significantly with real GDP and energy usage increases. Furthermore, trade openness positively contributes to carbon emissions, while financial development does not explain environmental pollution in the long term. The study also reveals that the EKC hypothesis holds for Turkey both in the long term and short term. The long-run findings of the study are supported through robustness analysis by applying the dynamic ordinary least square (DOLS), the fully modified ordinary least square (FMOLS), and the canonical cointegrating regression (CCR) methods. The study suggests that the government should take action against environmental deterioration with efficient policies that save energy and reduce emissions regarding the construction and residential sectors’ activities, such as providing financial support and tax cuts for relevant companies.

PMID:33811633 | DOI:10.1007/s11356-021-13722-y

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Online Betting Intensity is Linked with Extraversion and Conscientiousness

J Pers. 2021 Apr 3. doi: 10.1111/jopy.12637. Online ahead of print.

ABSTRACT

INTRODUCTION: Extraversion and conscientiousness are well-studied personality traits associated with reward processing and goal prioritization, respectively, and bear on individual differences in financial risk-taking. Using unique large datasets, we investigated the link between these traits and male online gamblers’ actual betting participation and intensity.

METHODS: We combined datasets containing online horse betting data (during 2015-2016) from the Finnish monopoly betting company; administrative registry data from Statistics Finland; and personality trait measures from the Finnish Defence Forces corresponding to extraversion and conscientiousness as defined in the five-factor model. We modelled associations between these traits and betting participation (n=471,968) and intensity (n=11,217) among male horse bettors (age=36-53).

RESULTS: Controlling for demographics and IQ, individuals scoring high on conscientiousness (or extraversion) were less (or more) likely to bet, and less (or more) intensive bettors – even when personality was measured 16-34 years before betting occurred. One SD personality score increase represented an annual decrease (conscientiousness) or increase (extraversion) of €570-754 in spending.

CONCLUSION: Extraversion and conscientiousness are implicated in real-life financial behavior with tangible consequences for individuals. These effects are stronger than for many known demographic variables used in gambling studies, and persist up to 34 years after personality has been measured.

PMID:33811638 | DOI:10.1111/jopy.12637