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Nevin Manimala Statistics

Efficacy of Sesame (Sesamum indicum L.) in the Management of Incomplete Abortion: An Open-Label Randomized Controlled Clinical Trial

Complement Med Res. 2021 Jun 30:1-7. doi: 10.1159/000510901. Online ahead of print.

ABSTRACT

BACKGROUND: Incomplete abortion is a common complication of pregnancy. Sesamum indicum L. is a widely used emmenagogue herb.

OBJECTIVES: We designed a clinical trial to evaluate the efficacy of sesame for the removal of retained products of conception (RPOC).

METHODS: In this randomized, open-label, and controlled trial, 45 patients received sesame powder as an intervention group and 45 patients received expectant management as a control group for 5 days. The primary outcome measure was complete resolution of RPOC assessed by sonography. Secondary outcome measures were severity of patients’ vaginal bleeding and pain.

RESULTS: 84.1% had complete resolution of RPOC in the sesame group, while 26.2% had complete resolution of RPOC in the control group, which was statistically significant (p < 0.001). Moreover, patients in the sesame group showed a significantly more decreasing trend in pain and vaginal bleeding compared to the control group (p < 0.001).

CONCLUSION: Sesame had a significant effect on the removal of RPOC and the reduction of pain and vaginal bleeding.

PMID:34192691 | DOI:10.1159/000510901

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Effect and Safety of Remifentanil Patient-Controlled Analgesia Compared with Epidural Analgesia in Labor: An Updated Meta-Analysis of Randomized Controlled Trials

Gynecol Obstet Invest. 2021 Jun 30:1-8. doi: 10.1159/000515531. Online ahead of print.

ABSTRACT

PURPOSE: The study was aimed to systematically assess the effect and safety of remifentanil patient-controlled analgesia (rPCA) versus epidural analgesia (EA) during labor.

METHODS: Eligible trials were retrieved from PubMed, EMBASE, ScienceDirect, and Cochrane Library before April 2020. The primary outcomes were patient satisfaction with pain relief and average visual analog scale (VAS) pain scores during labor; the secondary outcomes were rate of spontaneous delivery, oxygen desaturation, maternal hyperthermia, and neonatal Apgar scores <7 at 1 and 5 min.

RESULTS: Eleven studies involving 3,039 parturients were included. We found that parturients receiving rPCA were similarly satisfied with pain relief compared to those receiving EA (standardized mean difference: -0.19; 95% confidence interval [CI]: -0.57, 0.18), though had significantly higher VAS pain scores during labor (weighted mean difference: 1.41; 95% CI: 0.32, 2.50). The rate of spontaneous delivery was comparable. rPCA increased the risk of maternal oxygen desaturation (risk ratio [RR]:3.23, 95% CI: 1.98, 5.30). There was no statistical significance regarding hyperthermia (RR: 0.49, 95% CI: 0.24, 1.01). No significant difference was found for neonatal Apgar scores <7 at 1 and 5 min.

CONCLUSION: rPCA could be an optional alternative for pain relief to EA without worsening maternal satisfaction with pain relief, delivery modes, or neonatal morbidity. However, rPCA was associated with higher pain intensity during labor and higher incidence of maternal oxygen desaturation. The routine use of rPCA in labor must be armed with close respiratory monitoring. Continued well-designed studies are required to provide more robust evidence.

PMID:34192701 | DOI:10.1159/000515531

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Phase I clinical trial of an antithrombotic drug protocol combining apixaban and clopidogrel in dogs

J Vet Cardiol. 2021 Jun 5;36:105-114. doi: 10.1016/j.jvc.2021.05.010. Online ahead of print.

ABSTRACT

INTRODUCTION: Combining an antiplatelet drug, clopidogrel, with the direct oral Factor Xa inhibitor, apixaban, could provide an effective antithrombotic strategy in dogs. Thus, a limited 3 + 3 phase I dose-escalation clinical trial in healthy dogs was conducted to evaluate bleeding (primary end-point) and pharmacodynamic (PD)/pharmacokinetic (PK) parameters (secondary end-point).

ANIMALS: Eleven beagle dogs, median body weight 10.2 kg (9.7-10.9 kg), were enrolled.

METHODS: Four doses of apixaban (three dogs/dose) administered for eight days. Clopidogrel dose was fixed at 18.75 mg per os (PO) q 24 h with escalation of apixaban dose at 5 mg PO q 12 h, 5 mg PO q 8 h, 10 mg PO q 12 h, and 10 mg PO q 8 h. Laboratory testing included fecal occult blood, coagulation parameters, Factor X activity, apixaban concentration, platelet aggregometry, and thromboelastography on days 1, 3, and 8.

RESULTS: Evidence of bleeding was not observed at any dosage. Dose-dependent changes in PD/PK parameters between baseline and 3 h post-medication were observed including a prolongation of prothrombin time, a prolongation of activated partial thromboplastin time, a decrease of Factor X activity level, and increased apixaban concentration.

CONCLUSIONS: The combination of apixaban at a dosage range of approximately 0.5 mg/kg PO q 12 h to 1 mg/kg PO q 8 h and clopidogrel at approximately 1.8 mg/kg PO q 24 h did not cause bleeding over a one-week period in healthy dogs. Clinically relevant changes in PD/PK data occur at all dosage levels. This study provides a starting point for longer-term clinical trials to determine safety and efficacy.

PMID:34192609 | DOI:10.1016/j.jvc.2021.05.010

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Altered gray matter structural covariance networks in postpartum depression: a graph theoretical analysis

J Affect Disord. 2021 Jun 12;293:159-167. doi: 10.1016/j.jad.2021.05.018. Online ahead of print.

ABSTRACT

BACKGROUND: Postpartum depression (PPD) is a serious postpartum mental health problem worldwide. To date, minimal is known about the alteration of topographical organization in the brain structural covariance network of patients with PPD. This study investigates the brain structural covariance networks of patients with PPD by using graph theoretical analysis.

METHODS: High-resolution 3D T1 structural images were acquired from 21 drug-naive patients with PPD and 18 healthy postpartum women. Cortical thickness was extracted from 64 brain regions to construct the whole-brain structural covariance networks by calculating the Pearson correlation coefficients, and their topological properties (e.g., small-worldness, efficiency, and nodal centrality) were analyzed by using graph theory. Nonparametric permutation tests were further used for group comparisons of topological metrics. A node was set as a hub if its betweenness centrality (BC) was at least two standard deviations higher than the mean nodal centrality. Network-based statistic (NBS) was used to determine the connected subnetwork.

RESULTS: The PPD and control groups showed small-worldness of group networks, but the small-world network was more evidently in the PPD group. Moreover, the PPD group showed increased network local efficiency and almost similar network global efficiency. However, the difference of the network metrics was not significant across the range of network densities. The hub nodes of the patients with PPD were right inferior parietal lobule (BC = 13.69) and right supramarginal gyrus (BC = 13.15), whereas those for the HCs were left cuneus (BC = 14.96), right caudal anterior-cingulate cortex (BC = 15.51), and right precuneus gyrus (BC = 15.74). NBS demonstrated two disrupted subnetworks that are present in PPD: the first subnetwork with decreased internodal connections is mainly involved in the cognitive-control network and visual network, and the second subnetwork with increased internodal connections is mainly involved in the default mode network, cognitive-control network and visual network.

CONCLUSIONS: This study demonstrates the alteration of topographical organization in the brain structural covariance network of patients with PPD, providing in sight on the notion that PPD could be characterized as a systems-level disorder.

PMID:34192630 | DOI:10.1016/j.jad.2021.05.018

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Nevin Manimala Statistics

Collective particle dynamics of molten NaCl by inelastic x-ray scattering

J Phys Condens Matter. 2021 Jun 30. doi: 10.1088/1361-648X/ac101c. Online ahead of print.

ABSTRACT

An inelastic x-ray scattering experiment has been performed on molten NaCl over wide wave vector and energy transfer ranges. Data of high statistical quality are analyzed using a memory function approach within a generalized Langevin equation. The approach with two relaxation times for the memory function provides a very good data description over the whole wave vector range beyond the hydrodynamic regime. A slow thermal and a fast structural relaxation process in the memory function completely define the density fluctuations in molten NaCl and evidences the thermal-viscoelastic model as the minimal description for collective particle dynamics in molten alkali halides. The obtained excitation frequencies demonstrate a large positive dispersion effect, which can be related to the viscoelastic reaction of the molten salt. A transition from the viscoelastic to a hydrodynamic response of the molten salt at small wave vectors is observed. In the hydrodynamic regime the resulting thermal diffusivity agrees well with values obtained through light scattering. The modeling indicates some deficiencies at small wave vectors and large energy transfers and the spectra of the current correlation function evidences additional intensity at high frequency. The frequency of these additional modes approach a non-zero value at zero wave vector and indicates a non-acoustic character of these excitations. The frequency center of this additional inelastic intensity coincides with optic-type modes in molten NaCl predicted by simulations.

PMID:34192684 | DOI:10.1088/1361-648X/ac101c

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Soluble total antigen derived from Toxoplasma gondii tachyzoites increased the expression levels of NLRP1, NLRP3, NLRC4, AIM2, and the release of mature form of IL1β, but downregulated the expression of IL1β and IL18 genes in THP-1 cell line

Microb Pathog. 2021 Jun 27:105072. doi: 10.1016/j.micpath.2021.105072. Online ahead of print.

ABSTRACT

Toxoplasma gondii (T. gondii) is an intracellular parasitic protozoan infecting homoeothermic animals and about a third of the world’s population. Inflammasomes are intracellular multi-protein complex, which are activated by many factors. Inflammasomes are activated during toxoplasmosis; however, there are a lot of obscure aspects. THP-1 monocyte cells were converted to M0 macrophages by PMA and treated by 100 μg/mL soluble total Ag (STAg) derived from T. gondii strain RH for two time points 3 h and 24 h. After total RNA extraction and cDNA synthesis, the expression pattern of NLRP1, NLRP3, NLRC4, AIM2, IL1β, and IL18 was evaluated by relative real-time PCR. In addition, the cytokine release of IL1β and TNFα were evaluated in supernatant of each well. The results showed statistically significant time-dependent overexpression of inflammasomes. NLRP1 and NLRP3 showed the higher and lower expression, respectively, during 3 h and 24 h after exposure. Both IL1β and IL18 downregulated 3 h after exposure. IL18 presented statistically significant upregulation after 24 h, but IL1β showed statistically significant downregulation after 24 h. The release of IL1β increased after 3 h, but it slightly decreased during 24 h after exposure. The concentration of TNFα showed an insignificant decrease compared to control, while it increased during 24 h after exposure. Taken together, this study suggested that T. gondii STAg induces NLRP1 more than NLRP3, NLRC4, and AIM2. Our findings also proposed that T. gondii STAg downregulates the gene expression of IL1β, but increases the release of this cytokine. It seems that Toxoplasma STAg probably increase the release of IL1β via activating NLRPs and AIM2 to cleave pro-caspase 1 to caspase 1 that leads to conversion of pro IL1β to mature IL1β.

PMID:34192597 | DOI:10.1016/j.micpath.2021.105072

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Nevin Manimala Statistics

Effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients

Anat Rec (Hoboken). 2021 Jun 30. doi: 10.1002/ar.24700. Online ahead of print.

ABSTRACT

The aim of the study was to explore the effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients. All patients were divided into Group A and Group B based on different interventions (Group A: acupuncture + conventional rehabilitation, Group B: conventional rehabilitation alone). Acupuncture was conducted once a day, five times a week for 8 weeks, and rehabilitation (including physical therapy and occupational therapy) was conducted for 2 hr per session, once a day, five times a week for 8 weeks. Mini-mental State Examination (MMSE) and Fugl-Meyer Assessment (FMA) were used to assess the motor and cognitive functions at baseline and the end of 8 weeks. After the intervention, FMA and MMSE scores were improved significantly in the two groups (p <.05), compared with the scores prior to intervention. After 8 weeks of intervention, a statistically significant difference in the FMA and MMSE scores was observed between the Group A and the Group B. The results suggested that the combined intervention is more effective than the conventional rehabilitation alone in improving cognitive and motor functions in poststroke patients.

PMID:34192418 | DOI:10.1002/ar.24700

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Visual abstracts do not increase some impact scores more than conventional abstracts of clinical research: A retrospective cohort study

Health Info Libr J. 2021 Jun 30. doi: 10.1111/hir.12376. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: We examined whether the use of visual abstracts on social media platforms can improve comprehensive social media and conventional metrics such as total altmetric attention score, full text page views and citation counts (study outcomes) through retrospective cohort study.

METHODS: We included all original research articles (Total 307 articles: N = 69 in visual abstract group and N = 238 in control group) published between July 2018 and January 2019 in the JAMA, BMJ and the NEJM and used negative binomial regression to adjust for article characteristics.

RESULTS: Adjusted analysis showed no significant differences between articles with and without visual abstracts in the altmetric attention score (p = 0.37) and in number of page views (p = 0.44). Citations in the Web of Science core collection were found to be statistically significant favouring control group (p = 0.028). We also found no significant differences in altmetric attention score and page views after stratification for article type [randomised controlled trial (RCT) vs. non-RCT]. Citations counts were found to be borderline significant for RCT (p = 0.04) and non-significant for non-RCT.

CONCLUSION: Visual abstracts might not be effective in disseminating scientific research. We should look at other innovative ways to improve the visibility of the research.

PMID:34192421 | DOI:10.1111/hir.12376

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Rising healthcare expenditure on tuberculosis in India: Can India achieve the End-Tb goal?

Trop Med Int Health. 2021 Jun 30. doi: 10.1111/tmi.13648. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the out-of-pocket expenditure, health care burden , catastrophic health expenditure, hardship financing, and impoverishment effects of TB treatment in India.

METHODS: ata of three rounds of National Statistic Surveys 60th 2004-05, 71st 2013-14 and 75th 2017-18. Descriptive statistics, bivariate estimates and multivariate models were performed to calculate the out-of-pocket expenditure, health care burden, catastrophic health expenditure, hardship financing and impoverishment using standard definitions at December 2019 price values.

RESULTS: More than two-thirds of the TB cases are seen in the economically productive age group (14-59 years). Illiterate patients had a higher healthcare burden and out-of-pocket expenditure. The healthcare burden, hardship financing and catastrophic health expenditure are considerably higher for those utilising private hospitals. Male patients have a higher exposure to hardship financing than female patients. Impoverishment effects are higher among Hindus and illiterate populations due to utilization of hospitalization services.

CONCLUSION: The present analysis helps understand the trends in the financial burden of TB on households over last 15 years, thus providing evidence to policymakers for more effective channeling of resources in order to achieve a TB-free India by 2025.

PMID:34192385 | DOI:10.1111/tmi.13648

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Does self-monitoring diet and physical activity behaviors using digital technology support adults with obesity or overweight to lose weight? A systematic literature review with meta-analysis

Obes Rev. 2021 Jun 30:e13306. doi: 10.1111/obr.13306. Online ahead of print.

ABSTRACT

Establish whether digital self-monitoring of diet and physical activity is effective at supporting weight loss, increasing physical activity and improving eating behavior in adults with obesity or overweight, and determine the intervention components that might explain variations in its effectiveness. A systematic search of MEDLINE, Embase, PsycINFO, Web of Science, Scopus, Cinahl, and CENTRAL identified 4068 studies, of which 12 randomized controlled trials were eligible and included in the review. A random-effect meta-analysis evaluated intervention effectiveness and subgroup analyses tested for effective intervention content. Twelve studies were included in the review and meta-analysis. Digital self-monitoring of both diet and physical activity had a statistically significant effect at supporting weight loss (mean difference [MD] = -2.87 [95% CI -3.78, -1.96], P < 0.001, I2 = 69%), improving moderate physical activity (standardized mean difference [SMD] = 0.44 [95% CI 0.26, 0.62], P < 0.001, I2 = 0%), and reducing calorie intake (MD = -181.71 [95% CI -304.72, -58.70], P < 0.01, I2 = 0%). Tailored interventions were significantly more effective than nontailored interventions (x2 = 12.92, P < 0.001). Digital self-monitoring of physical activity and diet is an effective intervention to support weight loss in adults with obesity or overweight. This effect is significantly associated with tailored advice. Future studies should use rigorous designs to explore intervention effectiveness to support weight loss as an adjunct to weight management services.

PMID:34192411 | DOI:10.1111/obr.13306