Tag: nevin manimala

Comput Methods Biomech Biomed Engin. 2022 Jan 5:1-13. doi: 10.1080/10255842.2021.2021194. Online ahead of print.

ABSTRACT

The hydrothermal features of unsteady, incompressible, and laminar hybrid nanofluid motion through a porous capillary are analytically studied in the magnetic field presence. The hybrid nanofluid (GO + ZnO + Blood) is synthesized by blending nanomaterials of graphene oxide and zinc oxide with blood acting as the host fluid. The mathematical model of the flow comprises of a coupled nonlinear set of partial differential equations (PDEs) satisfying appropriate boundary conditions. These equations are reduced to ordinary differential equations (ODEs) by using similarity transformations and then solved with homotopy analysis method (HAM). The impacts of various pertinent physical parameters over the hybrid nanofluid state functions are examined by displaying 2 D graphs. It has been observed that the fluid velocity mitigates with the varying strength of M, A₀, N₀, and N₁. The enhancing buoyancy parameter ϵ augments the fluid velocity. The increasing Prandtl number causes to reduce, while the enhancing A₀, B, and N₂ augment the hybrid nanofluid temperature. The fluid concentration mitigates with the higher Schmidt number values and A₀, and augments with the increasing Soret number strength. The augmenting magnetic field strength causes to enhance the fluid friction, whereas the convective heat transfer increases with the Prandtl number rising values. The rising Sherwood number drops the mass transfer rate of the fluid. The achieved results are validated due to the agreement with the published results. The results of this computation will find applications in biomedicine, nanotechnology, and fluid dynamics.

PMID:34986079 | DOI:10.1080/10255842.2021.2021194

Acta Med Port. 2021 Nov 2;34(11):724-732. doi: 10.20344/amp.14004. Epub 2021 Nov 2.

ABSTRACT

INTRODUCTION: Urinary incontinence affects up to one third of women in Portugal. Exercise can be a precipitating/aggravating factor but also protective, if appropriate. The aim of this study was to determine the prevalence of urinary incontinence in women who practice recreational exercise, to assess its relationship with the type of exercise and other coexisting risk factors, and assess whether the topic is addressed in gyms.

MATERIAL AND METHODS: Cross-sectional study using self-reported questionnaires in gyms in Porto and Vila Nova de Gaia, Portugal.

RESULTS: Two hundred and ninety women completed the questionnaires. From these, 67.6% were under 40 years old, 25.2% reported incontinence, and 53.4% had at least one risk factor unrelated to exercise. There was a statistically significant association (p < 0.05) between incontinence, obesity and constipation. High impact exercises were included in the training of 62.1% continent and 50.9% incontinent women. The topic of incontinence and strengthening of the pelvic floor muscles was addressed in only 5.5% in the initial assessment, 9.7% in collective training, and in 13.5% of the 37 women with individualized training.

DISCUSSION: The higher proportion of continent women – compared to incontinent – who practiced strenuous exercise suggests that this might be a provocative factor for some, although there was no statistically significant association between incontinence and type of exercise.

CONCLUSION: Urinary incontinence affects women who practice recreational exercise, regardless of age and exercise characteristics. It is rarely addressed in gyms, and it is necessary to raise the awareness of professionals to enhance the preventive/therapeutic effects of exercise on the function of the pelvic floor and in the control of modifiable risk factors.

PMID:34986083 | DOI:10.20344/amp.14004

Physiol Biochem Zool. 2022 Mar-Apr;95(2):113-121. doi: 10.1086/717938.

ABSTRACT

AbstractAlthough climate warming poses a grave threat to amphibians, little is known about the capacity of this group to evolve in response to warming. The capacity of key traits to evolve depends on the presence of genetic variation on which selection can act. Here, we use repeatability estimates to estimate the potential upper bounds of heritable genetic variation in voluntary and critical thermal maxima of gray-cheeked salamanders (Plethodon metcalfi). Increases in thermal tolerance may also require concordant increases in resistance to water loss because hotter temperatures incur greater evaporative risk. Therefore, we also tested for a correlation between voluntary thermal maxima and resistance to water loss and conducted an acclimation study to test for covariation between these traits in response to warming. Voluntary thermal maxima exhibited low to moderate levels of repeatability (R=0.32, P=0.045), while critical thermal maxima exhibited no statistically significant repeatability (R=0.10, P=0.57). Voluntary thermal maxima also correlated positively with resistance to water loss (R=0.31, P=0.025) but only when controlling for body mass. Voluntary thermal maxima and resistance to water loss also exhibited different acclimatory responses across control (12°C-18°C) and warm (18°C-24°C) temperature regimes, indicating a potential decoupling of traits in different thermal environments. By addressing the repeatability of thermal tolerance and the potential for covariation with resistance to water loss, we begin to address some of the key requirements of amphibians to evolve in warming climates.

PMID:34986078 | DOI:10.1086/717938

Birth Defects Res. 2022 Jan 4. doi: 10.1002/bdr2.1973. Online ahead of print.

ABSTRACT

BACKGROUND: In 2016, Zika virus (ZIKV) was recognized as a human teratogen. North Carolina (NC) had no local transmission of ZIKV but infants with relevant birth defects, including severe brain anomalies, microcephaly, and eye abnormalities, require specialized care and services, the costs of which have not yet been quantified. The objective of this study is to examine NC Medicaid healthcare expenditures for infants with defects potentially related to ZIKV compared to infants with no reported defects.

METHODS: Data sources for this retrospective cohort study include NC birth certificates, Birth Defects Monitoring Program data, and Medicaid enrollment and paid claims files. Infants with relevant defects were identified and expenditure ratios were calculated to compare distributions of estimated expenditures during the first year of life for infants with relevant defects and infants with no reported defects.

RESULTS: This analysis included 551 infants with relevant defects and 365,318 infants with no reported defects born 2011-2016. Mean total expenditure per infant with defects was $69,244 (median $30,544) for the first year. The ratio of these expenditures relative to infants with no reported defects was 14.5. Expenditures for infants with select brain anomalies were greater than those for infants with select eye abnormalities only.

CONCLUSIONS: Infants with defects potentially related to ZIKV had substantially higher Medicaid expenditures than infants with no reported defects. These results may be informative in the event of a future outbreak and are a resource for program planning related to care for infants in NC.

PMID:34984857 | DOI:10.1002/bdr2.1973

Dermatol Ther. 2022 Jan 4:e15303. doi: 10.1111/dth.15303. Online ahead of print.

ABSTRACT

Chronic spontaneous urticaria (CSU) is characterized by the spontaneous development of wheals, itching, and/or angioedema, for ≥6 weeks. In China, non-sedating H1-antihistamines (H1AH) are the recommended first-line treatment, with escalation up to 4× the standard dose in symptomatic patients to achieve control. Treatment options for Chinese patients who remain symptomatic on H1AH treatment are limited. This 20-week randomized, double-blind, placebo-controlled, parallel-group study investigated the efficacy and safety of omalizumab as an add-on therapy for the treatment of patients with CSU who remained symptomatic despite H1AH treatment in China. Adult patients (N = 418) diagnosed with refractory CSU for ≥6 months were randomized (2:2:1) to receive omalizumab 300 mg (OMA300), omalizumab 150 mg (OMA150) or placebo, subcutaneously, every 4 weeks. Primary outcome was change from baseline to Week 12 in weekly itch severity score (ISS7). Safety was assessed by rates of adverse events (AEs). Demographic and disease characteristics at baseline were comparable across treatment groups. At week 12, statistically significant greater decreases from baseline were observed in ISS7 with OMA300 (least square mean difference [LSM]: -4.23; 95% confidence interval [CI]: -5.70, -2.77; P < 0.001) and OMA150 (LSM: -3.79; 95% CI: -5.24, -2.33; P < 0.001) vs. placebo. Incidence of treatment-emergent AEs over 20 weeks was slightly higher with OMA300 (71.3%) compared to OMA150 and placebo groups (64.7% and 63.9%, respectively). The incidences of serious AEs were balanced between groups. This study demonstrated the efficacy and safety of omalizumab in Chinese adult patients with CSU who remained symptomatic despite H1AH therapy. Trials registered at clinicaltrials.gov NCT03328897 Date of registration: 1 November 2017.

PMID:34984792 | DOI:10.1111/dth.15303

Musculoskeletal Care. 2022 Jan 4. doi: 10.1002/msc.1615. Online ahead of print.

ABSTRACT

INTRODUCTION/OBJECTIVES: Therapeutic alliance (TA) is an integral part of building a patient and clinician relationship. TA begins at the initial encounter; however, the specific TA behavioural practices that are most impactful and linked to pain reduction and improved function remain unclear. The primary objective of this study was to explore physical therapist behaviours and interactions during the initial physical therapy evaluation and how they related to the patient’s perception of TA. A secondary objective was to explore the relationship between TA, pain intensity, and function.

METHODS: A mixed methods study was conducted. Pain intensity, TA and self-reported function were assessed at three time points. Spearman’s Rho (ρ) was used to quantify if there was an association between increased TA and function and reduced pain intensity, while a checklist of TA themes and behavioural practices was used for the qualitative analysis.

RESULTS: There was a statistically significant negative correlation between patient-perceived TA and pain intensity immediately after the initial evaluation (ρ = -0.39 [p = 0.048]). Behavioural practices associated with higher TA included information gathering, pausing to listen, using humour and transitions, and use of clarifying questions. Behavioural practices associated with patient-perceived lower TA interactions were lack of touch, the absence of pain neuroscience education, and not restating what the patient said during the interview.

CONCLUSION: This study highlights a relationship between TA and reduction of pain intensity after the initial evaluation and identifies key behavioural practices that could positively and negatively impact TA during the clinical encounter.

PMID:34984781 | DOI:10.1002/msc.1615

ANZ J Surg. 2022 Jan 4. doi: 10.1111/ans.17448. Online ahead of print.

ABSTRACT

BACKGROUND: Maxillofacial trauma accounts for ~10% of trauma presentations to most centres, with massive haemorrhage occurring in 1.2-4.5% of cases. Despite its infrequent presentation, there is significant associated morbidity and mortality. Transcatheter arterial embolization (TAE) is playing an increasingly prominent role in trauma presentations. The aim of this article was to compare outcomes of TAE with more traditional management methods for the treatment of massive facial haemorrhage following maxillofacial trauma.

METHODS: A database and Google Scholar search was performed, with articles discussing massive facial haemorrhage secondary to maxillofacial trauma and its management included.

RESULTS: Twenty-seven articles were found that met inclusion criteria, encompassing 384 patients. Statistical testing comparing mortality between TAE and non-TAE groups did not find a significant difference, with a mortality rate of 30.2% in the TAE group and 38.9% in the non-TAE group. Assessment of morbidity directly related to interventions was difficult, as many of the included participants had significant associated injuries which contributed an indeterminate degree to morbidity. There was a 10% rate of adverse events associated with TAE, most commonly puncture site haematomas and soft tissue swelling, with more significant adverse events including cerebrovascular accidents and blindness.

CONCLUSION: Embolization was correlated with increased rates of haemorrhage control when compared with other interventions. Overall, despite no significant impact on mortality, embolization is recommended in the management of massive haemorrhage following maxillofacial trauma due to improved success rates at haemorrhage control and a low rate of significant adverse events.

PMID:34984779 | DOI:10.1111/ans.17448

Paediatr Anaesth. 2022 Jan 5. doi: 10.1111/pan.14392. Online ahead of print.

ABSTRACT

BACKGROUND: The goal of the present study was to investigate intraoperative factors associated with major neurological complications at 1 year following surgery for necrotizing enterocolitis.

MATERIAL AND METHODS: the study consisted of a retrospective review of medical charts of patients operated for over one calendar year in one institution. Data collected included demographic data, cardiac resuscitation at birth, Bell classification, antibiotics usage, time of day of surgery, surgical technique, surgical duration, type of ventilation, intraoperative vasoactive agents and albumin use, nadir cerebral saturation, the decrease in cerebral saturation from baseline, the time period when cerebral saturation was at least 20% below baseline, and the mean arterial pressure at nadir cerebral saturation. Reported follow up complications were assessed during formal neonatologist consultation and additional imaging exploration as needed. Analyses included descriptive statistics and, univariable and multivariable statistics.

RESULTS: The study included 32 patients with no prior clinical neurological complications, of which 25 had normal cerebral imaging. Severe neurological complications occurred in 9 patients at one year: Intraventricular hemorrhage (N=2) and Periventricular leukomalacia (N=7). However, preoperative cerebral imaging was lacking in 7 patients. Consequently, the observed neurological complications at one year might be present before the surgery. Multivariable analysis found the decrease in cerebral saturation ≥ 36% from baseline as the only factor associated with the occurrence of those complications.

CONCLUSION: Intraoperative decrease of cerebral oxygen saturation below ≥ 36% from baseline is associated with severe neurological complications in neonates undergoing surgery for necrotizing enterocolitis.

PMID:34984774 | DOI:10.1111/pan.14392

Paediatr Perinat Epidemiol. 2022 Jan 4. doi: 10.1111/ppe.12857. Online ahead of print.

ABSTRACT

BACKGROUND: Ischaemic placental disease (IPD) affects 16%-23% of pregnancies in the United States. In vitro fertilisation (IVF) is a risk factor for IPD, and the magnitude of increase in risk differs for individuals using donor oocytes (donor IVF) versus their own oocytes (autologous IVF). In addition, multifoetal gestations, which are more common in IVF than non-IVF pregnancies, also are a risk factor for IPD.

OBJECTIVE: To quantify the contribution of multifoetal gestations to the association between IVF and IPD.

METHODS: We conducted a retrospective cohort study at a tertiary hospital from 1 January, 2000 to 1 August 2018 using electronic medical records and state vital statistics data. IPD was defined as preeclampsia, placental abruption, small for gestational age (SGA) birth or an intrauterine foetal demise due to placental insufficiency. We used mediation analysis to decompose the total effect of IVF on IPD into a natural direct effect and an indirect effect through multifoetal gestations. We repeated the analyses separately for donor and autologous IVF. All models were adjusted for maternal age, race, parity, insurance, year of delivery and account for multiple pregnancies per person.

RESULTS: We identified 86,514 deliveries, of which 281 resulted from donor IVF and 4173 resulted from autologous IVF. IVF pregnancies had 1.99 (95% CI 1.88, 2.10) times the risk of IPD compared to non-IVF pregnancies, and 75.5% of this increased risk was mediated by multifoetal gestations. Autologous IVF pregnancies had 1.95 (95% CI 1.84, 2.07) times the risk of IPD compared to non-IVF pregnancies, and the per cent mediated was 78.8%. Donor IVF pregnancies had 2.50 (95% CI 2.09, 2.92) times the risk of IPD, but the per cent mediated was 37.5%.

CONCLUSION: The majority of the association between autologous IVF and IPD was mediated through multifoetal gestations; however, this was not the case for donor IVF pregnancies.

PMID:34984737 | DOI:10.1111/ppe.12857

Int J Health Plann Manage. 2022 Jan 4. doi: 10.1002/hpm.3413. Online ahead of print.

ABSTRACT

This work investigates the performance and inter-sectoral interaction mechanism of China’s largest vertically integrated care network, the national medical alliance (NMA). The data collected derive from the China Health Statistics Bulletin and the China Health Statistical Yearbook for the period 2009-2018. The data include 64 observation indicators for five medical sectors in the NMA, namely, tertiary hospitals (THS), secondary hospitals (SHS), community health centres (CHCS), township hospitals (TsHS) and professional public health institutions (PPHIS). This research combines complex systems theory with a multilevel structural dynamic factor model, and yields two main results. First, although the trend for the NMA’s global factor is increasing, the evolutionary paths for sectoral factors differ substantially. Among the sectoral factors, the sectoral factor of THS continued to decline, and neither the sectoral factor of CHCS nor the sectoral factor of TsHS has significantly improved. Then, the interaction mechanism between the various NMA sectors is investigated. While a close relationship has been formed between THS and CHCS and between SHS and CHCS, there remains no close two-way relationship between either THS and TsHS or THS and SHS. Thus, going forward, to reach the policy expectations, China’s NMA implementation must consider the interaction between different constituent sectors.

PMID:34984751 | DOI:10.1002/hpm.3413