Tag: pubmed

Int J Older People Nurs. 2021 Aug 26:e12419. doi: 10.1111/opn.12419. Online ahead of print.

ABSTRACT

BACKGROUND: Older adults and their caregivers often believe it is either too late or too difficult to make health-focused lifestyle changes. However, this is inaccurate, as older adults can make health promotion focused lifestyle changes thereby improving their health. This study developed and evaluated a self-care education program using Pender’s Health Promotion Model and its influence on health-focused behaviour changes among older Iranians.

METHOD: This was a quasi-experimental study with a convenience sample of 136 community-living older adults from Tabriz, Iran. The participants were randomly assigned to either an intervention (n = 69) or control (n = 67) group. Chi-square test, independent t tests and Analysis of covariance (ANCOVA) statistical methods were used to compare pre- and post-intervention data, control and intervention groups and changes over time. The intervention was an eight-week educational program with pre- and post-intervention data collected using the Health Promoting Lifestyle Profile II (HPLP II) questionnaire.

RESULTS: The mean difference and confidence limits of the older adults’ health behaviours pre- and post-intervention scores were 2.228 (-5.450 – 9.916) and – 35.820 (-32.051 – 39.588). The covariance analysis adjusting for the baseline values showed significant differences post-intervention (p<0.0001) in the areas of interpersonal communication, physical activity, nutrition, stress management and spiritual growth.

CONCLUSION: The health promotion education intervention illustrated that older Iranians could improve their health outcomes in several areas. Thus, culturally tailored intervention programs can be successful in challenging the opinion that older adults cannot make behaviour changes supporting their health.

PMID:34435738 | DOI:10.1111/opn.12419

J Chem Inf Model. 2021 Aug 26. doi: 10.1021/acs.jcim.1c00718. Online ahead of print.

ABSTRACT

The ability to predict the thermodynamic properties of amine species in CO₂-loaded aqueous solutions, including their deprotonation (pK_a) and carbamate to bicarbonate reversion (pK_c) equilibrium constants and their corresponding standard reaction enthalpies, is of critical importance for the design of improved carbon capture solvents. In this study, we used isocoulombic forms of both reactions to determine these quantities for a large set of aqueous alkanolamine solvent systems. Our hybrid approach involves using classical molecular dynamics simulations with the general amber force field (GAFF) and semi-empirical AM1-BCC charges (GAFF/AM1-BCC) in the solution phase, combined with high-level composite quantum chemical ideal-gas calculations. We first determined a new force field (FF) for the hydronium ion (H₃O⁺) by matching to the single experimental pK_a data point for the well-known monoethanolamine system at 298.15 K. We then used this FF to predict the pK_a values for 76 other amines at 298.15 K and for all 77 amines at elevated temperatures. Additionally, we indirectly relate the H₃O⁺ hydration free energy to that of H⁺ and provide expressions for intrinsic hydration free energy and enthalpy of the proton. Using the derived H₃O⁺ FF, we predicted the pK_a values of a diverse set of alkanolamines with an overall average absolute deviation of less than 0.72 pK_a units. Furthermore, the derived H₃O⁺ FF is able to predict the protonation enthalpy of these amines when used with the GAFF. We also predicted the carbamate reversion constants of the primary and secondary amine species in the data set and their corresponding standard heats of reaction, which we compared with the scarcely available experimental data, which are often subject to significant uncertainty. Finally, we also described the influence of electronic and steric effects of different molecular fragments/groups on the stabilities of the carbamates.

PMID:34435774 | DOI:10.1021/acs.jcim.1c00718

J Dermatol. 2021 Aug 26. doi: 10.1111/1346-8138.16120. Online ahead of print.

ABSTRACT

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritus, xerosis, and eczematous lesions. In Japan, treatment options, such as topical corticosteroids and tacrolimus, are associated with efficacy and safety concerns. Crisaborole ointment, 2%, is a topical non-steroidal anti-inflammatory agent approved in several countries for the treatment of mild-to-moderate AD. This phase 2b, randomized, double-blind study (NCT03954158) assessed the efficacy and safety of two crisaborole regimens versus vehicle in the treatment of Japanese patients aged ≥2 years with mild-to-moderate AD. Each patient was assigned to one of two age cohorts (≥12 or 2-11 years) and randomized to crisaborole once daily (QD) or twice daily (BID). All patients had two target lesions that were each randomly assigned to crisaborole or vehicle at baseline and treated for 2 weeks. The primary endpoint was change from baseline in total sign score (TSS) in crisaborole- or vehicle-treated target lesions on day 15, and secondary endpoints included change from baseline in Investigator’s Static Global Assessment (ISGA) and pruritic assessments (Cohort 1: peak pruritus numeric rating scale [NRS]; Cohort 2: Itch Severity Scale Self-Report and Caregiver-Reported Itch Severity NRS) and incidence of treatment-emergent adverse events (TEAEs). This study comprised 81 patients (Cohort 1: n = 41; Cohort 2: n = 40). Crisaborole-treated lesions showed statistically significant reductions in TSS versus vehicle-treated lesions at day 15 (p < 0.01), and numerically larger decreases in TSS were observed with crisaborole BID versus crisaborole QD in both cohorts. Furthermore, crisaborole-treated lesions generally demonstrated greater decreases in ISGA, peak pruritus NRS, Itch Severity Scale, and Caregiver-Reported Itch Severity NRS versus vehicle-treated lesions irrespective of regimen or cohort. Overall, TEAEs were mild; the most frequently reported TEAEs was application site irritation. In summary, both crisaborole regimens, particularly crisaborole BID, demonstrated efficacy and were well tolerated.

PMID:34435694 | DOI:10.1111/1346-8138.16120

Microsc Res Tech. 2021 Aug 26. doi: 10.1002/jemt.23917. Online ahead of print.

ABSTRACT

Thin films of two alloys (chromel and alumel), with thickness less than 100 nm, were obtained by plasma deposition technique, namely filtered cathodic vacuum arc (FCVA). The elemental analyses were performed by quantitative energy dispersive spectroscopy (EDS) microanalysis and Rutherford backscattering spectrometry (RBS). The applicability of EDS to such thin films as these was established by analysis of films deposited on substrates of different atomic numbers, specifically vitreous carbon, silicon, copper, and tin. We found that a substrate with atomic number similar to the mean atomic number of the film constituents is best for reliable EDS results, when compared to RBS. The compatibility between quantitative EDS measurements and RBS measurements, as well as comparison between the thin film elemental composition and the bulk material composition, was assessed by statistical analysis. Good consistency between EDS and RBS measurements was found for both chromel and alumel thin films when copper was used as substrate material. We observed severely overlapping peaks in the RBS output for the case of alumel films so that EDS analysis was crucial. We also compared thickness measurements determined by EDS and RBS, and we found good agreement for the case of alumel film on copper substrate, and 15% agreement for chromel film on copper substrate.

PMID:34435712 | DOI:10.1002/jemt.23917

Infect Dis Ther. 2021 Aug 26. doi: 10.1007/s40121-021-00520-9. Online ahead of print.

ABSTRACT

Pertussis (whooping cough) epidemics persist globally despite high vaccine coverage among infants and young children. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity, resulting in a pool of unprotected adolescents and adults. However, pertussis is generally less severe in adolescents and adults, and this difference in presentation means it can often be unrecognised by healthcare professionals, meaning that it is largely under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology and mortality in school-aged children, adolescents and adults in Europe. A formal statistical comparison (e.g. using meta-analyses) was not possible because of the mix of methodologies reported. There were 69 epidemiological studies and 19 mortality studies identified for review. Over the past decade, the reported incidence of notified pertussis cases varied widely between European countries, which is likely associated with differences in surveillance systems, diagnostic techniques and reporting regulations. However, several studies show that pertussis is circulating among adolescents and adults in Europe, and although pertussis-related morbidity and mortality are highest in infants, there is evidence that adults aged > 50 years are at increased risk. For example, in a hospital-based surveillance study in Portugal, between 2000 and 2015, 94% of hospitalised pertussis cases were infants aged < 1 year, with a case fatality rate (CFR) of 0.8%; however, among hospitalised adult cases of pertussis, the CFRs were 11.5% (aged 18-64 years) and 17.4% (aged > 65 years). Very few European countries currently include pertussis boosters for adults in the national immunisation strategy. In addition to increasing pertussis vaccination coverage in adolescents and adults, mitigation strategies in European countries should include improved diagnosis and treatment in these populations.

PMID:34435338 | DOI:10.1007/s40121-021-00520-9

Drugs Real World Outcomes. 2021 Aug 25. doi: 10.1007/s40801-021-00273-4. Online ahead of print.

ABSTRACT

BACKGROUND: Fondaparinux is the first approved anticoagulant drug among factor Xa inhibitors, with proven effectiveness and safety in preventing deep vein thrombosis. However, limited data are available supporting the benefit-risk profile of fondaparinux vs enoxaparin in a real-world group of Indian patients with deep vein thrombosis.

OBJECTIVE: To compare the effectiveness and tolerability of fondaparinux vs enoxaparin in patients with symptomatic deep vein thrombosis in a long-term real-world setting.

METHODS: Data from the electronic medical records of adult patients diagnosed with deep vein thrombosis prescribed fondaparinux (n = 503) or enoxaparin (n = 508) as monotherapy were analyzed. Effectiveness was analyzed in terms of recurrence, duration, and type of deep vein thrombosis event, and tolerability as bleeding events at initial hospitalization and follow-up visits up to 3 months duration. Appropriate statistical methods were used to determine the significance (p < 0.05) between the two groups.

RESULTS: The deep vein thrombosis recurrence in the fondaparinux group was non-inferior (2.78%) when compared with enoxaparin (3.76%), with a mean duration of 47 and 48 days, respectively. The number of events and mean duration of events (in days) were not significant (p > 0.05). Major bleeding events were higher in the enoxaparin group at 3.17% than the fondaparinux group at 2.19%, and the difference was not statistically significant (p > 0.05).

CONCLUSIONS: The weight-based, once-daily subcutaneous fondaparinux dose showed non-inferior effectiveness and a comparable tolerability profile when compared with the twice-daily enoxaparin dose for the management of symptomatic deep vein thrombosis.

PMID:34435340 | DOI:10.1007/s40801-021-00273-4

J Robot Surg. 2021 Aug 26. doi: 10.1007/s11701-021-01291-8. Online ahead of print.

ABSTRACT

Since 2000, robotic-assisted surgery has rapidly expanded into almost every surgical sub-specialty. Despite the popularity of robotic surgery across the United States, a national consensus for standardized training and education of robotic surgeons or surgical teams remains absent. In this quality improvement initiative, a novel, stepwise iterative Robotic Assistant Surgical Training (RAST) curriculum was developed to broaden and standardize robotic bedside assistant training. Thirteen voluntary participants, capable of fulfilling the bedside assistant role, were evaluated to determine if RAST enhanced the learner’s self-perceived level of confidence and comfort in their role as bedside assistant. A pre- and post-RAST training survey and a between-stages repeated-measures survey were conducted. All learner participants reported statistically significant increases in confidence and comfort after RAST training, (p = < 0.001), and between each stage, F (2, 24 = 60.47, p < .001; [Formula: see text] = 0.834). Participant feedback regarding curriculum improvement was obtained, suggesting the desire for more training and practice, in smaller groups of 2-3 participants. One hundred percent of participants felt RAST was beneficial and that it should be implemented as standardized training during onboarding for all robotic bedside assistants. Thus, a standardized, stepwise iterative robotic bedside assistant curriculum increases learner preparedness, comfort, and confidence, safely away from the patient bedside.

PMID:34435279 | DOI:10.1007/s11701-021-01291-8

Atten Percept Psychophys. 2021 Aug 25. doi: 10.3758/s13414-021-02354-6. Online ahead of print.

ABSTRACT

Attention is dynamic, constantly shifting between different locations – sometimes imperfectly. How do goal-driven expectations impact dynamic spatial attention? A previous study (Dowd & Golomb, Psychological Science, 30(3), 343-361, 2019) explored object-feature binding when covert attention needed to be either maintained at a single location or shifted from one location to another. In addition to revealing feature-binding errors during dynamic shifts of attention, this study unexpectedly found that participants sometimes made correlated errors on trials when they did not have to shift attention, mistakenly reporting the features and location of an object at a different location. The authors posited that these errors represent “spatial lapses” attention, which are perhaps driven by the implicit sampling of other locations in anticipation of having to shift attention. To investigate whether these spatial lapses are indeed anticipatory, we conducted a series of four experiments. We first replicated in Psychological Science, 30(3), the original finding of spatial lapses, and then showed that these spatial lapses were not observed in contexts where participants are not expecting to have to shift attention. We then tested contexts where the direction of attentional shifts was spatially predictable, and found that participants lapse preferentially to more likely shift locations. Finally, we found that spatial lapses do not seem to be driven by explicit knowledge of likely shift locations. Combined, these results suggest that spatial lapses of attention are induced by the implicit anticipation of making an attentional shift, providing further insight into the interplay between implicit expectations, dynamic spatial attention, and visual perception.

PMID:34435320 | DOI:10.3758/s13414-021-02354-6

Clin Oral Investig. 2021 Aug 25. doi: 10.1007/s00784-021-04148-4. Online ahead of print.

ABSTRACT

OBJECTIVES: To make an in vitro assessment of fracture resistance of weakened and non-weakened teeth receiving intraradicular reinforcement using Rebilda bundled glass fiber-reinforced composite posts (GT), Rebilda conventional glass fiber posts (RP), or both systems combined (GT + RP).

MATERIALS AND METHODS: Eighty sound bovine incisors were prepared and divided randomly into eight groups as follows: (a) nWnR: without simulating weakness, and without intraradicular reinforcement; (b) WnR: simulating weakness, but without intraradicular reinforcement; (c) nWGT: without simulating weakness, but with GT; (d) WGT: simulating weakness, and with GT; (e) nWRP: without simulating weakness, but with RP; (f) WRP: simulating weakness, and with RP; (g) nWGTRP: without simulating weakness, but with GT + RP; (h) WGTRP: simulating weakness, and with GT + RP. The specimens were subjected to the load-to-fracture test using the DL-2000MF universal testing machine. The finite element method assessed the mechanical behavior and stress distribution in endodontically treated teeth.

RESULTS: The groups nWGTRP and WGTRP presented the best results in the load-to-fracture test, with the former being better than the latter, but with no statistically significant difference (P > 0.05). However, there was a significant difference between these and the other groups (P < 0.05), except for nWRP. Stress distribution inside the canal wall was different among the groups, with promising mechanical behavior for nWGTRP and nWRP.

CONCLUSIONS: The Rebilda conventional fiber post (RP), combined with the Rebilda bundled glass fiber-reinforced composite post (GT) improves the resistance and stress distribution of immature teeth.

CLINICAL RELEVANCE: Longitudinal fracture is less frequent in teeth restored with GT and RP posts.

PMID:34435252 | DOI:10.1007/s00784-021-04148-4

Dig Dis Sci. 2021 Aug 25. doi: 10.1007/s10620-021-07215-8. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Inadequate bowel preparation leads to poor outcomes in colonoscopy. Prior investigations have demonstrated improved bowel preparation with pre-procedural educational videos. We aimed to determine whether an interactive, online educational video could improve bowel preparation scores in an outpatient population.

METHODS: We performed a prospective, endoscopist-blinded, randomized controlled trial at our hospital-based outpatient endoscopy center. Eligible patients were randomized to two groups. Both groups received standard verbal and written instructions, while the intervention group also received access to an interactive, online video. The primary outcome was improvement in the bowel preparation scores graded using the Boston bowel prep score (BBPS). Secondary outcomes included adenoma detection rate, total number of polyps detected, patient satisfaction, pre-procedure anxiety, and complication rates.

RESULTS: The difference in BBPS in the intervention group (8) compared to the control group (7.6) did not meet statistical significance in our primary outcome of improvement in BBPS (p = 0.076). However, on subgroup analysis, there was a statistically significant improvement in BBPS in the intervention group among African Americans (p = 0.007) and patients older than 65 (p = 0.026). Those in the intervention arm rated pre-procedural materials “very easy” to understand significantly more often than in the control arm (p = 0.018).

CONCLUSIONS: Use of an interactive, online educational video for bowel preparation did not lead to improvement in overall BBPS. However, among patients at higher risk for inadequate bowel preparation, such as African Americans and elderly patients, there may be a benefit.

PMID:34435269 | DOI:10.1007/s10620-021-07215-8