Tag: nevin manimala

Environ Pollut. 2021 Jul 7;288:117715. doi: 10.1016/j.envpol.2021.117715. Online ahead of print.

ABSTRACT

Maricultured organisms are chronically exposed to water containing antibiotics but the bioaccumulative behavior of antibiotics in exposed organisms at different growth stages has received little attention. Here, we investigated the concentrations and tissue-specific bioaccumulation characteristics of 19 antibiotics during three growth stages (youth stage, growth stage, and adult stage) of various organisms (Scophthalmus maximus, Penaeus vannamei, Penaeus japonicus, and Apostichopus japonicus) cultivated in typical marine aquaculture regions, and explored the factors that could affect the bioaccumulation of antibiotics. Tetracyclines (TCs) and fluoroquinolones (FQs) were the dominant antibiotics in all organisms, and the total concentrations of the target antibiotics in fish (S. maximus) were significantly higher than those in shrimp (P. vannamei and P. japonicus) and sea cucumber (A. japonicus) (p < 0.01). The bioaccumulation capacity of a class of statistically significant antibiotics in most samples was strongest during the youth stage and weakest during the adult stage. The antibiotics exhibited higher bioaccumulation capacity in lipid-rich tissues (fish liver and shrimp head) or respiratory organs (fish gill) than muscle. Our results also reveal significant metabolic transformation of enrofloxacin in fish. Different from previous studies, the logarithm bioaccumulation factor (log BAF) was positively correlated with log D_lipw in low-biotransformation tissues (fish gill and muscle) rather than lipid-rich tissues (fish liver). Based on the calculated hazard quotients (HQ), doxycycline in fish muscle may pose a distinct risk to human health, which deserves special attention. Overall, these results provide insight into the bioaccumulation patterns of antibiotics during different growth stages and tissues of maricultured organisms.

PMID:34256288 | DOI:10.1016/j.envpol.2021.117715

Arch Gerontol Geriatr. 2021 Jul 2;96:104474. doi: 10.1016/j.archger.2021.104474. Online ahead of print.

ABSTRACT

INTRODUCTION: We investigated the efficacy and acceptability of pharmacotherapy for dementia with Lewy bodies (DLB) while simultaneously considering the neuropsychiatric symptoms (NPS), cognitive function, motor symptoms, and acceptability.

METHODS: Electronic databases were searched from inception through June 5, 2019, for randomized controlled trials (RCTs) and open-label trials (OLTs) in patients with DLB. We performed a pairwise conventional meta-analysis (PWMA) and network meta-analysis (NMA) within a frequentist framework. The main outcomes were mean change scores in NPS, general cognition, motor symptoms and acceptability. The effect sizes and odds ratios with 95% confidence intervals (CIs) were calculated. This study was registered with PROSPERO (CRD42018096996).

RESULTS: In total, we included 29 studies (9 RCTs and 20 OLTs). In the NMA with 9 RCTs, both high- (mean difference [MD] 2.00, 95% CIs, 0.69 to 3.31) and low-dose (1.86, 0.58 to 3.15) donepezil were associated with a greater cognitive improvement than placebo. High-dose zonisamide was associated with greater motor symptom improvement ( -4.10, -7.03 to -1.17]). No medications reached statistical significance regarding improving neuropsychiatric symptoms or developing intolerable adverse effects as compared to placebo. In the second NMA, with 29 studies as an exploratory analysis, aripiprazole and yokukansan may be effective for neuropsychiatric symptoms, while levodopa may be associated with cognitive impairment.

CONCLUSIONS: We report the most comprehensive evidence for the selection of pharmacotherapy for treating different clusters of DLB-related symptoms. Due to the limited availability of RCTs on DLB, more well-conducted RCTs are needed for MMA to warrant clinical efficacy in the future.

PMID:34256210 | DOI:10.1016/j.archger.2021.104474

Nurse Educ Today. 2021 Jul 3;105:105052. doi: 10.1016/j.nedt.2021.105052. Online ahead of print.

ABSTRACT

BACKGROUND: Transferring what has been learned in the classroom to clinical application is the main goal of nursing education. Our previous intervention study, in which a web-based interactive situational teaching strategy in a nursing ethic course was conducted as an experimental group, and the students in the class who were taught using a traditional teaching strategy was treated as the comparative group. The results, which were evaluated immediately after the class, showed that the web-based interactive situational teaching enhanced the students’ competency in ethical reasoning and problem solving compared to traditional teaching.

PURPOSE: This study followed the previous study and aimed to compare the effects of the learning transfer between the two groups in clinical performance as reflected in their internship scores, clinical practice, and self-efficacy assessment. It also explored the factors influencing this transfer.

METHOD: A predictive correlation-based research design was adopted to compare the students’ internship scores, clinical judgment abilities, and self-efficacy in clinical internships between two groups. The students’ self-efficacy was measured using a self-administered structured questionnaire, while their internship scores and clinical judgment abilities were evaluated by their clinical instructors. The data obtained were statistically analyzed using SPSS 23 software.

RESULTS: The nursing students who participated in the web-based interactive situational teaching course did not significantly outperform those who received traditional teaching in their clinical judgment and internship scores. The main variable that significantly affected the clinical self-efficacy of nursing students was the degree of support from the internship instructors.

CONCLUSION: Nursing students’ clinical performance is affected by multiple factors and is not solely determined by the curriculum or teaching strategies. The degree of instructor support during the internship process significantly affected the students’ self-efficacy in clinical performance.

PMID:34256216 | DOI:10.1016/j.nedt.2021.105052

Adv Med Sci. 2021 Jul 10;66(2):315-320. doi: 10.1016/j.advms.2021.07.002. Online ahead of print.

ABSTRACT

PURPOSE: Graves’ orbitopathy (GO) is an important problem in endocrinology. Currently used methods of assessing the degree of activity of the autoimmune process are not satisfactory. Therefore, there is a need to establish indicators of greater utility.

PATIENTS AND METHODS: The study included 35 patients: 15 with GO, 10 with Graves’ disease (GD) without GO and 10 controls. Patients with GO received methylprednisolone (MP) for 12 weeks. Concentrations of thyrotropin receptor antibodies (TSHRab), interleukin 17 (IL-17) and 23 (IL-23) were obtained before administering the first dose of MP, after 6 and 12 weeks of therapy, and 3 months after treatment cessation. Patients were classified as responders (n ​= ​11) if a reduction of ≥2 points in the Clinical Activity Score (CAS) was observed.

RESULTS: A significant decrease in exophthalmos, muscles’ thickness and CAS value was demonstrated after MP treatment in responders group. Significantly higher concentrations were found in baseline IL-23 between the GD and GO groups compared to controls. No statistically significant differences in serum concentrations of IL-17 and IL-23 were observed during treatment with MP and 3 months after treatment cessation. A statistically significant reduction in TSHRab concentration was demonstrated 3 months after treatment cessation compared to baseline values in responders group.

CONCLUSIONS: Low baseline IL-17 concentration, in addition to high TSHRab titre, serves as marker of disease activity. Although, we expect that low IL-23 concentration, in addition to high TSHRab titre, could be used as predictors of disease activity and a prognostic factor of response to immunosuppressive therapy in GO.

PMID:34256242 | DOI:10.1016/j.advms.2021.07.002

Neurotoxicol Teratol. 2021 Jul 10:107018. doi: 10.1016/j.ntt.2021.107018. Online ahead of print.

ABSTRACT

Developmental neurotoxicity (DNT) studies could benefit from revisions to study design, data analysis, and some behavioral test methods to enhance reproducibility. The Environmental Protection Agency (EPA) reviewed 69 studies submitted to the Office of Pesticide Program. Two of the behavioral tests identified the lowest observable adverse effect level (LOAEL) 20 and 13 times, respectively, while the other two tests identified the LOAEL only 3 and 4 times, respectively. The EPA review showed that the functional observational battery (FOB) was least effective at detecting the LOAEL, whereas tests of learning and memory (L&M) had methodological shortcomings. Human neurodevelopmental toxicity studies over the past 30 years show that most of the adverse effects are on higher cognitive functions such as L&M. The results of human studies together with structure-function relationships from neuroscience, suggest that tests of working memory, spatial navigation/memory, and egocentric navigation/memory should be added to guideline studies. Collectively, the above suggest that EPA and EU DNT studies would better reflect human findings and be more relevant to children by aligning L&M tests to the same domains that are affected in children, removing less useful methods (FOB), and using newer statistical models to better account for random factors of litter and litter × sex. Common issues in study design and data analyses are discussed: sample size, random group assignment, blinding, elimination of subjective rating methods, avoiding confirmation bias, more complete reporting of species, housing, test protocols, age, test order, and litter effects. Litter in DNT studies should at least be included as a random factor in ANOVA models and may benefit from inclusion of litter × sex as random factors.

PMID:34256163 | DOI:10.1016/j.ntt.2021.107018

Photodiagnosis Photodyn Ther. 2021 Jul 10:102433. doi: 10.1016/j.pdpdt.2021.102433. Online ahead of print.

ABSTRACT

This study evaluated the action of Antimicrobial Photodynamic Therapy (aPDT) on Enterococcus faecalis and Actinomyces israelii. Samples were taken from the root canal system, at different stages of treatment and bacteria were identified through qPCR. Fifty teeth (incisors, canines, and premolars) with pulp necrosis and periapical lesion diagnosis were randomly selected and divided into 2 groups: Group 1 (G1) – Endodontic Therapy with Mechanical Chemical Preparation (MPQ) and intracanal medication; Group 2 (G2) – Endodontic therapy with MPQ, intracanal medication, and 2 applications of aPDT. APDT was performed with application of 0.005% methylene blue, wavelength of 660 nm, and 90 seconds. Follow-up was performed with an initial x-ray and an x-ray 60 days after the end of treatment. The radiographs were scored evaluated by two examiners to classify periapical repair: total repair, partial repair, doubtful repair, or no repair. Enterococcus faecalis was found more frequently in G1 than G2. Actinomyces israelii was found equally in G1 and G2. Evaluation of the two bacteria between collections 1, 2 and 3, showed that there was no difference, both in G1 and in G2. There was association between the variables group and repair classification in radiographs evaluation. APDT did not promote better results in endodontic treatment, being similar to conventional treatment. However, this study pointed out that molecular methods may not be efficient in detecting bacteria after treatment, and colony-forming units may complement, being an effective quantifying method. Therefore, new studies must be carried out to show the possible effectiveness of aPDT.

PMID:34256171 | DOI:10.1016/j.pdpdt.2021.102433

Geriatr Nurs. 2021 Jul 10;42(5):1006-1011. doi: 10.1016/j.gerinurse.2021.06.010. Online ahead of print.

ABSTRACT

This study aimed to examine the relationship between fear of falling in elderly patients who underwent spinal surgery and pain, kinesiophobia, anxiety, depression, and associated factors. The study was a descriptive, cross-sectional design. The research sample consisted of 211 elderly patients who had undergone spinal surgery. The average age of the patients was 66.68 ± 5.57. Of the sample, 83.4% were afraid of falling, and 21.3% were severely afraid of falling. In the study, age (β = 0.115, p = 0.005), being a woman (β = -0.182, p < 0.001), pain (β = 0.269, p < 0.001), risk of falling (β = 0.084, p = 0.49), Hospital Anxiety and Depression Scale-Anxiety (HADS-A) (β = 0.135, p = 0.044), Hospital Anxiety and Depression Scale Anxiety-Depression (HADS-D) (β = 0.382, p < 0.001), and kinesiophobia (β = 0.722, p < 0.001) were statistically significant predictors of fear of falling. This study provided important information about the variables that surgical nurses should pay attention to while evaluating the fear of falling in elderly patients who underwent spinal surgery.

PMID:34256148 | DOI:10.1016/j.gerinurse.2021.06.010

Geriatr Nurs. 2021 Jun 12;42(5):983-992. doi: 10.1016/j.gerinurse.2021.06.003. Online ahead of print.

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused the coronavirus diseases 2019 (COVID-19) pandemic, continues to spread rapidly worldwide and is associated with high rates of mortality among older adults, those with comorbidities, and those in poor physiological states. This paper aimed to systematically identify the impact of frailty on overall mortality among older adults with COVID-19. We conducted a systematic review of the literature indexed in 4 databases. A random-effects model with inverse variance-weighted meta-analysis using the odds ratio was used to study the association of frailty levels with clinical outcomes among older adults with COVID-19. Heterogeneity was measured using the I² statistic and Egger’s test. We identified 22 studies that met our inclusion criteria, including 924,520 total patients. Overall, frailty among older adults was associated with high rates of COVID-19-related mortality compared with non-frail older adults (OR [odds ratio]:5.76; 95% confidence interval [95% CI]: 3.85-8.61, I²: 40.5%). Our results show that physical limitations, such as those associated with frailty among older adults, are associated with higher rates of COVID-19-related mortality.

PMID:34256158 | DOI:10.1016/j.gerinurse.2021.06.003

Geriatr Nurs. 2021 Jun 21;42(5):998-1005. doi: 10.1016/j.gerinurse.2021.06.020. Online ahead of print.

ABSTRACT

The purpose of this study was to examine the mental health of community-dwelling older adults as they adapted their everyday health behaviors during the COVID-19 pandemic. In response to a telephone survey, 126 older adults described perceived changes in physical and mental health, and adaptations in their everyday health behaviors. Descriptive statistics, bivariate correlations, and multiple regressions revealed that participants experienced changes in mental and physical health, reduced health service access, lower social engagement, and increased coping behaviors. Greater negative social impact of the pandemic was associated with higher levels of COVID-19 distress. Reduced mental health was significantly related to reductions in health service access, health changes, and fewer adaptive coping behaviors. Adaptive coping behaviors were helpful, just as reduced health access and social contact added risk for mental health problems. Suggestions were provided for alleviating mental health needs by increasing social contact and engaging in adaptive coping behaviors.

PMID:34256160 | DOI:10.1016/j.gerinurse.2021.06.020

J Vasc Interv Radiol. 2021 Jul 10:S1051-0443(21)01199-4. doi: 10.1016/j.jvir.2021.06.019. Online ahead of print.

ABSTRACT

PURPOSE: To review and compare outcomes of prostatic artery embolization (PAE) with three other minimally-invasive surgical treatments for benign prostatic hyperplasia (BPH), including photo selective vaporization (PVP), prostatic urethral lift (PUL), and water vapor thermal therapy (WV) for the treatment of benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS: A literature review identified 35 publications, which included 2653 patients (studies, patients): PVP (13, 949), PUL (9, 577), WV (3, 330), PAE (10, 728). International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and Quality of Life (QOL) were recorded at baseline, 6, and 12 months. Meta-analyses, pooling the standardized mean difference between pre and post-treatment scores, were conducted for each modality and time-point to assess the magnitude of a therapy’s effect to yield Pooled Effect Sizes. A negative score indicates IPSS and QOL improvement. A positive score indicates IIEF-5 improvement.

RESULTS: At 6 and 12 months, IPSS and QOL were most improved after PVP, then PAE, PUL, and lastly WV (measured only at 12 months). Between 6 and 12 months, IPSS and QOL improved with PAE, and worsened with PVP and PUL. Only PAE demonstrated statistical improvement of IIEF-5, which improved from 6 to 12 months.

CONCLUSION: PVP and PAE resulted in the largest improvements in IPSS and QOL. Only PAE resulted in improvement of IIEF-5.

PMID:34256123 | DOI:10.1016/j.jvir.2021.06.019