Tag: pubmed

AAPS PharmSciTech. 2022 Apr 19;23(5):116. doi: 10.1208/s12249-022-02269-x.

ABSTRACT

Topical drug delivery systems are interesting and popular dosage forms for formulation development. Thai herbs are used in alternative medicine to treat patients suffering from severe illnesses. They have significant economic and cultural value in Thailand. This work prepared Thai herbal topical patches of Lysiphyllum strychnifolium stem extracts using pectin and Eudragit^® NM 30D, and glycerin as a plasticizer. Astilbin was selected as a chemical marker in L. strychnifolium stem extracts. The L. strychnifolium stem extracts showed a statistically significant decrease in nitrate accumulation. The various properties of Thai herbal topical patches were not significantly different from blank patches. However, the trends of the properties depended on the amount of Eudragit^® NM 30D. All ingredients were homogeneously mixed in Thai herbal topical patches and showed a smooth and compact film. The astilbin content was found in a range of 52.72-63.36 μg/cm². The in vitro release of astilbin depended on the amount of Eudragit^® NM 30D. The kinetics of astilbin release were fitted to the Korsmeyer-Peppas model. The astilbin showed low permeation; thus, polyethylene glycol 400 was used as a permeation enhancer. Polyethylene glycol 400 could increase the permeation rates of astilbin and the cumulative amount of astilbin in pig skin. This would be suitable for preparing the Thai herbal topical patches and could be developed for pharmaceutical and herbal products.

PMID:35441285 | DOI:10.1208/s12249-022-02269-x

Res Synth Methods. 2022 Apr 19. doi: 10.1002/jrsm.1561. Online ahead of print.

ABSTRACT

The meta-analytic-predictive (MAP) approach is a Bayesian meta-analytic method to synthesize and incorporate information from historical controls in the analysis of a new trial. Classically, only a single parameter, typically the intercept or rate, is assumed to vary across studies, which may not be realistic in more complex models. Analysis of covariance (ANCOVA) is often used to analyze trials with a pretest-posttest design, where both the intercept and the baseline effect (coefficient of the outcome at baseline) affect the estimated treatment effect. We extended the MAP approach to ANCOVA, to allow for variation in the intercept and the baseline effect across studies, and possibly also correlation between these parameters. The method was illustrated using data from the Alzheimer’s Disease Cooperative Study (ADCS) and assessed with a simulation study. In the ADCS data, the proposed multivariate MAP approach yielded a prior effective sample size of 79 and 58 for the intercept and the baseline effect respectively and reduced the posterior standard deviation of the treatment effect by 12.6%. The result was robust to the choice of prior for the between-study variation. In the simulations, the proposed approach yielded power gains with a good control of the type I error rate. Ignoring the between-study correlation of the parameters or assuming no variation in the baseline effect generally led to less power gain. In conclusion, the MAP approach can be extended to a multivariate version for ANCOVA, which may improve the estimation of the treatment effect. This article is protected by copyright. All rights reserved.

PMID:35439840 | DOI:10.1002/jrsm.1561

J Neurol Surg A Cent Eur Neurosurg. 2022 Apr 19. doi: 10.1055/s-0042-1743531. Online ahead of print.

ABSTRACT

BACKGROUND: In this study, we analyze our institutional experience and personal impressions using minimally invasive spine surgery (MISS) to describe our learning curve and how experience influenced different parameters of the surgical procedure.

METHODS: The study was conducted prospectively and included the first consecutive 152 patients treated with MISS techniques. Patient demographics, surgical data, length of hospital stay, and clinical outcome were reviewed. The cohort was divided into consecutive quarters. Comparison between the quarters and timeline analysis were made to assess the learning curve.

RESULTS: Only percutaneous transpedicular screw fixation was performed in 65 cases, minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) in 70 cases, and vertebral body replacement in 4 cases. The average blood loss was 113.3, 115, 106.6, and 107.1 mL for each quarter. The average operative time was 155.0, 143.2, 134.5, and 133.8 minutes for the four quarters, whereas the average radiation exposure time was 105.4, 85.3, 46.2, and 45.2 seconds. Differences in the operative time and radiation exposure time between the first to third and the first to fourth quarters were statistically significant.

CONCLUSIONS: Some advantages of MISS techniques could be observed with the very first cases and were not related significantly with the surgeon’s experience with MISS. With the acquisition of more experience, some disadvantages of MISS techniques such as longer operative time and longer X-ray exposure can be substantially reduced. Surgical experience, familiarity of the team with the MISS instrumentation, and good patient selection are crucial for achieving all the benefits of MISS.

PMID:35439828 | DOI:10.1055/s-0042-1743531

Pain. 2022 Mar 7. doi: 10.1097/j.pain.0000000000002623. Online ahead of print.

ABSTRACT

showed that ACPs were not less popular than adolescents without chronic pain. Second, ACPs nominated each other more often as being part of the same peer group. Third, results regarding friendship quality showed that adolescents with more pain problems perceived the relationship with their friends as less positive (e.g., support) and more negative (e.g., conflict) than adolescents with less pain problems. Finally, positive and negative friendship quality moderated the relationship between pain and emotional distress.The current study contributes to the literature on the importance of ACPs’ peer relationships. Clinical implications and directions for future research are discussed.

PMID:35439797 | DOI:10.1097/j.pain.0000000000002623

Nicotine Tob Res. 2022 Apr 19:ntac108. doi: 10.1093/ntr/ntac108. Online ahead of print.

ABSTRACT

INTRODUCTION: Differential reasons for e-cigarette use for men and women have seldom been examined, and there is no systematic overview of this research literature. The aim for this review is to conduct a systematic review of the literature to identify gender differences in the reasons for e-cigarette use.

METHODS: Systematic searches covered in three databases found 866 unique articles: Web of Science, Pubmed and PsycInfo. Twenty six studies met the inclusion criteria and were reviewed. Reasons for e-cigarette use were sorted into 17 distinct categories.

RESULTS AND CONCLUSIONS: Fifteen studies identified statistically significant differences in reasons between men and women. Frequently assessed reasons for e-cigarette use across studies included Health/Smoking Cessation, Experimentation/Curiosity, Enjoyment/Pleasure, Use in Specific Locations, Acceptable to Others, and Cost. Of those that identified statistically significant differences in reasons between men and women, the findings varied considerably, and some reasons for e-cigarette use were found to be significant in only one or two studies. Most of the reasons identified were only measured in a small number of studies, complicating our ability to make intervention recommendations based on gender. Additionally, we limited our literature search to peer-reviewed studies. Of the reason categories that did find significant differences between gender, such as reasons related to Health/Smoking Cessation, the outcomes were not consistent across studies. Future studies are needed to identify potentially important differences in the reasons for e-cigarette use among men and women.

IMPLICATION: This systematic review aims to uncover gender differences in e-cigarette use to understand important differences in motivation for use that may help us better understand strategies for prevention and treatment of tobacco use disorder. This review is the first on this topic and could provide further insight on patterns of e-cigarette use across gender.

PMID:35439816 | DOI:10.1093/ntr/ntac108

J Glaucoma. 2022 Apr 14. doi: 10.1097/IJG.0000000000002037. Online ahead of print.

ABSTRACT

PRCIS: Using an intracanalicular dexamethasone insert or topical prednisolone following iStent and Hydrus surgery provided similar short-term control of post-operative inflammation.

PURPOSE: To compare post-operative inflammation in patients who received an intracanalicular dexamethasone insert or topical prednisolone after iStent or Hydrus surgery.

PATIENTS AND METHODS: Patients receiving a dexamethasone insert after iStent or Hydrus insertion were included and compared to age-matched controls who received topical prednisolone. Pre-operative data were recorded. Post-operative inflammatory cell and the proportion of patients with zero anterior chamber cells was recorded at month 1. Post-operative IOP and rate of cystoid macular edema (CME) were recorded at months 1 and 3.

RESULTS: 40 eyes receiving topical prednisolone were compared to 35 eyes receiving a dexamethasone insert after iStent or Hydrus insertion. Mean post-operative inflammatory cell for the topical group at month 1 was 0.2±0.3, and the dexamethasone group, 0.3±0.5;P=0.816. 70% of patients in the topical group had zero anterior chamber cell at post-operative month 1 compared to 75.8% in the dexamethasone group,P=0.583. Mean pre-operative IOP for the topical group was 18.8±5.5 and the dexamethasone group was 17.1±4.1,P=0.064. Mean post-operative IOP for the topical group at months 1 and 3 was 17.6±6.4 and 15.1±3.1, respectively and the dexamethasone group, 17.5±4.8 and 15.0±3.4, respectively;P=0.772 and 0.884. One patient developed CME in each group.

CONCLUSIONS: There was no statistically significant difference in the proportion of patients who had zero anterior chamber cell at post-operative month 1 between groups.

PMID:35439795 | DOI:10.1097/IJG.0000000000002037

J Contin Educ Health Prof. 2022 Apr 18. doi: 10.1097/CEH.0000000000000428. Online ahead of print.

ABSTRACT

INTRODUCTION: Sickness absence remains a major challenge globally. Primary care physicians often find it challenging to deny patients’ requests for sick leaves, making the gatekeeping role uneasy among doctors.

METHODS: Twenty-one PCPs participated in this non-randomized intervention study. The educational intervention consisted of an interactive presentation, a 20-minute video screening, and 3 text message reminders. The average number for sickness certificates (SCs), sickness absence rate per patient, and causes for sickness absence spells were measured one year before and one year after the intervention.

RESULTS: The average number of SC one year before and after the intervention was 0.44 and 0.47, respectively. The sickness absence rate was 0.63% one year before and 0.75% one year after the intervention with no statistical significance. The mean number of sickness absence days did not significantly change. Causes for sickness absence spells significantly increased for diarrhea and back pain but decreased for upper respiratory infections with no statistical significance.

DISCUSSION: Implementation of a multifaceted intervention to train PCPs on the process of sickness certification did not affect the sickness absence rate. Further research is needed to assess the knowledge and understanding of physicians’ sickness certification process and the underlying factors that govern it to better develop tailored and effective interventions.

PMID:35439792 | DOI:10.1097/CEH.0000000000000428

Cornea. 2022 Apr 14. doi: 10.1097/ICO.0000000000003041. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to report the long-term surgical and visual outcomes of patients with mucopolysaccharidoses (MPS) after big bubble deep anterior lamellar keratoplasty (BB-DALK).

METHODS: This was a retrospective case series of patients with MPS who underwent BB-DALK at a single academic institution. All patients had corneal clouding secondary to MPS limiting visual acuity for which keratoplasty was indicated. Each patient was evaluated and underwent surgery by a single surgeon. Reported data included age at keratoplasty, sex, MPS type, best spectacle-corrected visual acuity, change in pachymetry, ocular comorbidities, surgical complications, and MPS-related medication use.

RESULTS: Outcomes of 12 eyes from 7 patients with MPS type I (Hurler, Scheie, and Hurler-Scheie) are reported using the newest nomenclature. The mean follow-up was 5.58 years (range: 1-10 years). All cases underwent BB-DALK with a type 1 big bubble during the surgery. Two cases (16.6%) required rebubbling because of partial Descemet membrane detachment. One case was complicated by a suture abscess and required a penetrating keratoplasty. No episodes of rejection occurred. Statistically significant improvement in the best spectacle-corrected visual acuity (from a mean 0.85-0.33 logarithm of the minimum angle of resolution, P = logarithm of the minimum angle of resolution 0.0054) and pachymetry (mean reduction of -145.4 μm, P = 0.0018) was observed.

CONCLUSIONS: BB-DALK seems to be an acceptable long-term surgical option in patients with MPS. Our findings suggest that this technique is reproducible and can achieve clear corneal grafts with good visual results on a long-term follow-up.

PMID:35439776 | DOI:10.1097/ICO.0000000000003041

J Glaucoma. 2022 Apr 14. doi: 10.1097/IJG.0000000000002039. Online ahead of print.

ABSTRACT

PRCIS: Pupillary dilation with 0.5% tropicamide and 2.5% phenylephrine resulted in a statistically significant decrease in foveal avascular zone (FAZ) metrics in glaucoma eyes. This observation emphasizes the critical role of pupillary status in interpreting glaucomatous vascular alterations detected by OCTA.

PURPOSE: To evaluate the influence of mydriatic eye drops on optical coherence tomography angiography (OCTA) parameters in patients with primary open-angle glaucoma (POAG).

METHODS: A total of 20 POAG eyes and 20 control eyes were recruited in the study. The imaging area on the fundus was visualized by AngioPlex (Cirrus 5000 HD-OCT; Carl Zeiss Meditec) using en face view of 3×3▒mm and 6×6▒mm preview scans. Images were generated before and after the instillation of topical 0.5% tropicamide and 2.5% phenylephrine. Optic nerve head (ONH) perfusion, ONH flux index, macular perfusion density, macular vessel density, and foveal avascular zone (FAZ) measurements were consecutively obtained for each session. Differences between the pre-and post-dilation measurements were evaluated in POAG patients and controls.

RESULTS: POAG eyes showed a statistically significant decrease in the FAZ area from a mean of 0.29▒mm2to 0.25▒mm2(P=0.037) and FAZ perimeter from a mean of 2.27▒mm to 2.09▒mm (P=0.045) in the OCTA 6×6▒mm scan area after tropicamide/phenylephrine instillation. Pre-and post-dilation measurements of ONH perfusion and ONH flux index were significantly lower in the glaucoma group compared to controls (P<0.05, for all).

CONCLUSION: Topical pupillary dilation with 0.5% tropicamide and 2.5% phenylephrine results in a statistically significant reduction in the FAZ area and FAZ perimeter in POAG eyes. Further OCTA studies are needed for the diagnostic value of vascular changes due to pupil dilation in glaucoma.

PMID:35439783 | DOI:10.1097/IJG.0000000000002039

Bioinspir Biomim. 2022 Apr 19. doi: 10.1088/1748-3190/ac6849. Online ahead of print.

ABSTRACT

Individual insects flying in crowded assemblies perform complex aerial maneuvers by sensing and feeding back neighbor measurements to small changes in their wing motions. To understand the individual feedback rules that permit these fast, adaptive behaviors in group flight, both experimental preparations inducing crowded flight and high-speed tracking systems capable of tracking both body motions and more subtle wing motion changes for multiple insects in simultaneous flight are needed. This measurement capability extends tracking beyond the previous focus on individual insects to multiple insects. This paper describes an experimental preparation that induces crowded insect flight in more naturalistic conditions (a laboratory-outdoor transition tunnel) and directly compares the resulting flight performance to traditional flight enclosures. Measurements are made possible via the introduction of a multi-agent high speed insect tracker called Hi-VISTA, which provides a capability to track wing and body motions of multiple insects using high speed cameras (9000-12,500 fps). Processing steps consist of automatic background identification, data association, hull reconstruction, segmentation, and feature measurement. To improve the biological relevance of laboratory experiments and develop a platform for interaction studies, this paper applies the Hi-VISTA measurement system toApis melliferaforagers habituated to transit flights through the transparent transition environment. Binary statistical analysis (Welch’s t-test, Cohen’s d effect size) of 95 flight trajectories is presented, quantifying the differences between flights in an unobstructed environment and in a confined tunnel volume. The results indicate that body pitch angle, heading rate, flapping frequency, and vertical speed (heave) are each affected by confinement, and other flight variables show minor or statistically insignificant changes. These results form a baseline as swarm tracking and analysis begins to isolate the effects of neighbors from environmental enclosures, and improve the connection of high speed insect laboratory experiments to outdoor field experiments.

PMID:35439741 | DOI:10.1088/1748-3190/ac6849