Tag: nevin manimala

Glob Chang Biol. 2021 Jun 5. doi: 10.1111/gcb.15733. Online ahead of print.

ABSTRACT

The temporal trend of aboveground net primary production (ANPP) is frequently used to estimate the human effect on ecosystems. In water-limited ecosystems, like most grazing areas in the world, human effects act upon ANPP in combination with environmental variations. Our main objective was to quantify long-term (1981-2012) changes of ANPP and discriminate the causes of these changes between environmental and human at a subcontinental scale, across vast areas of Patagonia. We estimated ANPP through a radiative model based on remote sensing data. Then, we evaluated the relation between ANPP and environmental interannual variations of two hierarchically related factors: ENSO, through the Southern Oscillation Index, SOI, and precipitation. We described the human effect through the shape of the temporal trends of the residuals of the environmental model (RESTREND) and quantified human relative impact through the RESTREND: ANPP trend ratio. ANPP interannual variation was significantly explained by ENSO (through SOI) and precipitation in 65% of the study area. The Southern Oscillation Index had a positive association with annual precipitation. The association between ANPP and annual precipitation was positive. RESTREND analysis was statistically significant in 92% of the area where the tested environmental model worked, representing 60% of the study area, and it was mostly negative. However, its magnitude, revealed through the RESTREND: ANPP trend ratio, was relatively mild. Our analysis revealed that most of ANPP trends were associated with climate and that even when human density is low, its incidence seems to be mainly negative.

PMID:34091988 | DOI:10.1111/gcb.15733

Intern Med J. 2021 Jun 6. doi: 10.1111/imj.15404. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic non-malignant pain is a disabling condition that results in a reduction in function and quality of life when inadequately managed. Sub-lingual ketamine has been shown to be efficacious for use in chronic pain. Despite its use for decades in chronic non-malignant pain, there is no published long-term data on safety, side effects or adverse drug reactions. The aim of this case-series is to provide the initial evidence for safety and efficacy in this patient group.

METHODS: We present a retrospective review of twenty-nine patients (n=29) from a metropolitan tertiary pain service who have been receiving sub-lingual ketamine troches / lozenges between the period of 2012-2019. Patients were identified from the outpatient pain clinic, who had been admitted for inpatient subcutaneous ketamine infusions as part of opiate detoxification or management of central sensitisation due to a chronic neuropathic pain syndrome. An initial review was performed to check the patient started taking the ketamine troches. Each of these medical records was reviewed manually to extract information to a datasheet.

RESULTS: There was a wide range of dosages used from 25-600mg in divided doses. The duration of treatment ranged from 2-89 months. There was no association with either the dosage or duration of treatment and frequency of side effects. There was an overall reduction in the use of opioids, gabapentinoids or benzodiazepines in 59% of patients with 39% having a complete cessation of an analgesic agent. Side effects were reported in 24%, but only 7% discontinued the treatment due to the side effect (drowsiness). There were no reports of renal impairment, cystitis, or hepatotoxicity.

DISCUSSION: This retrospective case-series has demonstrated that sub-lingual ketamine is a safe and effective analgesic agent to use in chronic non-malignant pain management. It is indicated in a variety of chronic pain conditions and has an excellent safety profile, with no association between the frequency in side effects and duration of therapy or total daily dosages. The study has also shown that the “safe” dose may be higher than the previous consensus.

CONTRIBUTION STATEMENT: A.A and S.G. recruited the patients. A.A. & B.M. created the parameters for the data collection sheet. B.M Collected most of the data from the medical records, entered it into a datasheet, wrote the manuscript, ran the statistics, performed the data analysis, and generated the figures and tables. A.A. Edited the manuscript. S.G. and A.A were the research supervisors. This article is protected by copyright. All rights reserved.

PMID:34092024 | DOI:10.1111/imj.15404

J Esthet Restor Dent. 2021 Jun 6. doi: 10.1111/jerd.12794. Online ahead of print.

ABSTRACT

INTRODUCTION: The use of light sources during the application of bleaching can reduce the time and improve the results, but at the same time this can increase the dental temperature. The objective of this study was to evaluate the performance of two bleaching agents and the increase in dental temperature with the use of light emitted by diodes (LED)-unit.

MATERIALS AND METHODS: Forty third molars were obtained and randomized: the whiteness without lamp (WHN) and Pola office without lamp (PON) groups, two bleaching systems based on 35% hydrogen peroxide were used, according to manufacturer specifications. For the whiteness with lamp (WHL) and Pola office with lamp (POL) groups the same bleaching agents were light boosted. A spectrophotometer and ∆WI_D equation was used to record and analyzed teeth color. An infrared thermometer was used to record the external and internal temperature. A ∆T was obtained by the difference of the temperature of the groups with and without LED (WHN-WHL and PON-POL). For statistical analysis Kruskal-Wallis test and Anova test were performed.

RESULTS: The WHN, PON, WHL, and POL groups reported ∆WI_D values of 4.88 ± 1.08, 9.26 ± 3.27, 5.70 ± 2.48, 12.08 ± 5.44, respectively. The dates of internal temperature were 1.01 and 1.07°C, and for external temperature were 1.61 and 1.15°C respectively.

CONCLUSIONS: With the limitations of this study, both bleaching agents reported a significant increase in ∆WI_D with and without association of light. Significant temperature increases were also observed. The highest average temperature increase was approximately 1.61°C.

CLINICAL SIGNIFICANCE: Bleaching agents boosted with LED may improve the results of bleaching, but it is not essential to obtain good results.

PMID:34092026 | DOI:10.1111/jerd.12794

Acta Paediatr. 2021 Jun 6. doi: 10.1111/apa.15969. Online ahead of print.

ABSTRACT

Very preterm infants (≤ 32 weeks gestational age; GA) are at high risk of developing late-onset sepsis (LOS; onset after 72 hours of age), which is associated with increased mortality and short- and long-term morbidity. The early symptoms of suspected LOS are non-specific and are managed with empiric broad-spectrum antibiotics, with well-documented adverse effects, including mortality. Microbial blood culture, with adjunctive diagnostic biomarker(s) (e.g. C-reactive protein (CRP) and interleukin (IL)-6), are commonly used for LOS diagnosis, but have sub-optimal sensitivity and specificity, and median time to positivity of 12 – 36 hours for blood culture.

PMID:34091943 | DOI:10.1111/apa.15969

J Trauma Stress. 2021 Jun 6. doi: 10.1002/jts.22694. Online ahead of print.

ABSTRACT

The use of patient-reported measures in assessing mental health symptoms is common in both the research and clinical fields. With regard to assessing posttraumatic stress symptoms, there are specific versions of measures designed for child and adolescent populations in accordance with the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5, respectively). Different clinical thresholds, numbers of items, and score ranges may present obstacles for clinicians and researchers attempting to compare self-report ratings across different versions of a measure. The current study aimed to produce a score conversion crosswalk between two child/adolescent self-report measures of posttraumatic stress disorder (PTSD): the UCLA PTSD Reaction Index for DSM-IV (RI-IV) and DSM-5 (RI-5). Using item response theory (IRT), we calibrated both measures separately to derive scaled scores. The discrimination parameters ranged from 0.57 to 2.08 (SE = 0.09-0.17) for RI-IV and from 0.73 to 2.11 for RI-5 (SE = 0.07-0.13). The scaled scores were connected with equipercentile linking. Total scores based on common items between the two measures were used as anchors to enhance the linking results. A total of 1,486 children and adolescents completed the measure: 571 respondents filled out the RI-IV and 915 respondents filled out the RI-5. The results allow linked scores to be compared to establish recommended clinical cutoffs and help elucidate the implications of changes in the diagnostic criteria for the measurement of self-reported PTSD symptoms in children and adolescents.

PMID:34091976 | DOI:10.1002/jts.22694

Med J Aust. 2021 Jun 5. doi: 10.5694/mja2.51117. Online ahead of print.

ABSTRACT

OBJECTIVE: To quantify the burden of invasive group A Streptococcus (GAS) disease in Western Australia during 2000-2018.

DESIGN, SETTING: Population-based data linkage study: Hospital Morbidity Data Collection (HMDC; all WA public and private hospital records), PathWest pathology data (government-owned pathology services provider), and death registrations.

PARTICIPANTS: People with invasive GAS disease, defined by an isolate from a normally sterile site (PathWest) or a hospital-based principal ICD-10-AM diagnosis code (HMDC).

MAIN OUTCOME MEASURES: Incidence of invasive GAS disease; median length of hospital stay; all-cause mortality.

RESULTS: We identified 2237 cases of GAS disease during 2000-2018; 1283 were in male patients (57%). 1950 cases had been confirmed by GAS isolates from normally sterile tissues (87%; including 1089 from blood [56% of cases] and 750 from tissue [38%]). The age-standardised incidence increased from 2.0 (95% CI, 1.4-2.7) cases per 100 000 population in 2000 to 9.1 (95% CI, 7.9-10.2) cases per 100 000 in 2017 (by year, adjusted for age group and sex: incidence rate ratio [IRR], 1.09; 95% CI, 1.08-1.10). Incidence was consistently higher among Indigenous than non-Indigenous Australians (year-adjusted IRR, 13.1; 95% CI, 11.3-15.1). All-cause 30-day mortality was 5% (116 deaths), and 90-day mortality 7% (156 deaths); 30-day mortality, adjusted for age group and sex, was not statistically significantly different for cases involving Indigenous or non-Indigenous patients (adjusted odds ratio, 0.8; 95% CI, 0.6-1.1).

CONCLUSIONS: The incidence of invasive GAS disease in WA increased between 2000 and 2018, particularly among Indigenous Australians. Mandatory notification of invasive GAS disease would therefore be appropriate. The social determinants of differences in incidence should be addressed, and other relevant host, pathogen, and health system factors investigated.

PMID:34091892 | DOI:10.5694/mja2.51117

J Dent Educ. 2021 Jun 6. doi: 10.1002/jdd.12696. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess the impact of a full-day workshop on increasing cultural awareness among incoming first-year (DDS-I) and post-doctoral (PGY-I) dental students at the Columbia University College of Dental Medicine.

METHODS: The workshop focused on developing students’ cultural awareness regarding dimensions of identity, recognition of power and privilege, importance of cross-cultural understanding and communication, and the role of self-reflection through direct teaching, interactive discussions, and reflective writing. A convenience sample of 83 DDS-I and 30 PGY-I students from the 2019 enrollment class were recruited. Assessments included pre- and post-workshop surveys, facilitator interviews, and a formal workshop evaluation. Descriptive and bivariate analyses of students’ responses were performed to assess cultural awareness within and between student groups. Facilitator interviews and student feedback were analyzed qualitatively to identify emerging themes.

RESULTS: Global cultural awareness among both student groups was higher in the post-workshop survey (for DDS-I, mean = 3.46, SD = 0.38; for PGY-I, mean = 3.47, SD = 0.30) than in the pre-workshop survey (for DDS-I, mean = 2.98, SD = 0.34; for PGY-I, mean = 2.90, SD = 0.47), which represented a statistically significant difference (p < 0.001 for both comparisons). Quantitative analysis revealed that the workshop provided a platform to discuss sensitive topics, increased cultural awareness among students and faculty, and provided faculty with different perspectives about culture awareness.

CONCLUSIONS: The full-day workshop achieved its goals of increasing dental students’ self-perceived cultural awareness and capacity to establish cross-cultural professional relationships.

PMID:34091910 | DOI:10.1002/jdd.12696

Lett Appl Microbiol. 2021 Jun 5. doi: 10.1111/lam.13519. Online ahead of print.

ABSTRACT

The development of microalgae culture technology has been an integral part to produce biomass feedstock to biofuel production. Due to this, numerous attempts have been made to improve some operational parameters of microalgae production. Despite this, specialized research in cell growth monitoring, considered as a fundamental parameter to achieve profitable applications of microalgae for biofuels production, presents some opportunity areas mainly related to the development of specific and accurate methodologies for growth monitoring. In this work, predictive models were developed through statistical tools that correlate a specific microalgal absorbance with cell density measured by cell count (cells∙mL^-1 ), for three species of interest for biofuels production. The results allow the precise prediction of cell density through a logistic model based on spectrophotometry, valid for all the kinetics analyzed. The adjusted determination coefficients (r²_adj ) for the developed models were 0.993, 0.995 and 0.994 for Dunaliella tertiolecta, Nannochloropsis oculata and Chaetoceros muelleri, respectively. The results showed that the equations obtained here can be used with an extremely low error (≤ 2%) for all the cell growth ranges analyzed, with low operational cost and high potential of automation. Finally, a user-friendly software was designed to give practical use to the developed predictive models.

PMID:34091927 | DOI:10.1111/lam.13519

Ir J Med Sci. 2021 Jun 5. doi: 10.1007/s11845-021-02657-5. Online ahead of print.

ABSTRACT

AIM: To evaluate the nephro-ureteric stent (NUS) insertion and exchange practice in a tertiary referral cancer centre, and determine the safety and compliance with current guidelines. We also reviewed if increasing exchange time interval from 6 to 12 weeks was safe, and if this could be adopted into our local guidelines.

METHODS: A retrospective review was performed covering 24 months from January 2017 to December 2018. All NUS insertions and exchanges performed in that period were analysed, including the number of exchanges the patient underwent, the time between subsequent exchanges, and the screening time. We also reviewed the indications for stent insertion, possible causes for failed stent exchange, and factors which led to significant delays in stent exchanges for some patients. A scatterplot of screening time versus time in situ was derived and correlation analysis performed using the Pearson coefficient.

RESULTS: Thirty-two patients underwent de novo NUS insertion during the period, and 102 NUS exchanges were performed. The interval between stent exchanges ranged from 1 to 40 weeks, with a mean of 12.3 weeks (SD = 8.96 weeks). Screening time ranged from 33 s to 17 min, with a mean of 3 min 50 s (SD = 3 min 35 s). There were 100 successful exchanges, and two failed exchanges, accounting for 1.9% of total exchanges. In both failed cases, the reason for failed exchange was due to a prolonged period between exchanges (6 months in both cases). The reason for delay for stent exchange was due to non-attendance for scheduled appointments. There was a weakly positive correlation coefficient of 0.06 (screening time versus time period between insertions); however, this was not statistically significant (p = 0.81).

CONCLUSION: In this retrospective review, we have demonstrated that the recommended 6-week period between stent exchanges is unnecessary in the vast majority of cases, and that a longer interval between NUS exchanges, e.g. 8-12 weeks, is safe for the patient, and reduces screening time. This reduction in procedures also provides a significant potential saving to the radiology department in both monetary expense and limited angiography suite time.

PMID:34091859 | DOI:10.1007/s11845-021-02657-5

Biol Trace Elem Res. 2021 Jun 6. doi: 10.1007/s12011-021-02744-9. Online ahead of print.

ABSTRACT

Honey is a highly valued product due to its nutritional value, pro-health and healing properties. Pollutants from the environment penetrate into nectar, honeydew, pollen and next into bee products and can cause human exposure after ingestion. Mercury (Hg) is a toxic metal to living organisms. This is why it was important to determine the level of Hg in consumed honey.The aim of this manuscript is to analyse mercury concentration in honeys collected on the territory of Poland. A total of 108 samples of honey purchased in regional apiaries and hypermarkets were tested. The concentration of Hg was analysed in various types of honey (multifloral, honeydew, linden, goldenrod, acacia, buckwheat, rapeseed, sunflower, heather, dandelion, phacelia). The values of the Estimated Daily Intake (EDI), Estimated Weekly Intake (EWI) and % Provisional Tolerable Weekly Intake (% PTWI) were calculated. This allowed estimating the amount of Hg taken during consumption of the tested honeys.The concentration of Hg ranged from 0.01 to 1.71 µg/kg and was 0.43 µg/kg on average. A higher concentration of Hg, which was statistically significant, was recorded in honeydew honey, then in compound honeys. Honeys produced from one raw material had the lowest concentration of Hg. There were no significant differences in the concentration of Hg depending on the origin of honey. The calculations have shown that consumption of a portion (19 g) of the tested honey per week is safe for both adults and children according to the applicable standards.

PMID:34091870 | DOI:10.1007/s12011-021-02744-9