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Predictors of Patient-Reported Pain and Functional Outcomes Over 10 Years After Primary Total Knee Arthroplasty: A Prospective Cohort Study
No full textAbstractBackgroundThis study aimed at identifying preoperative predictors of patient-reported outcomes after total knee arthroplasty (TKA) and at investigating their association with the outcomes over time.MethodsWe used data from 2080 patients from the Knee Arthroplasty Trial who received primary TKA in the United Kingdom between July 1999 and January 2003. The primary outcome measure was the Oxford knee score (OKS) collected annually over 10 years after TKA. Preoperative predictors included a range of patient characteristics and clinical conditions. Mixed-effects linear regression model analysis of repeated measurements was used to identify predictors of overall OKS, and pain and function subscale scores over 10 years, separately.ResultsWorse preoperative OKS, worse mental well-being, body mass index greater than 35 kg/m2, living in the most deprived areas, higher American Society of Anesthesiologists grade, presence of comorbidities, and history of previous knee surgery were associated with worse overall OKS over 10 years after surgery. The same predictors were identified for pain and function subscale scores, and for both long-term (10 years) and short-to-medium-term outcomes (1 and 5 years). However, fitted models explained more variations in function and shorter-term outcomes than in pain and longer-term outcomes, respectively.ConclusionThe same predictors were identified for pain and functional outcomes over both short-to-medium term and long term after TKA. Within the factors identified, functional and shorter-term outcomes were more predictable than pain and longer-term outcomes, respectively. Regardless of their preoperative characteristics, on average, patients achieved substantial improvement in pain over time, although improvement for function was less prominent
L-cysteine capped ZnS:Mn quantum dots for room-temperature detection of dopamine with high sensitivity and selectivity
No full textAbstractDopamine (DA) is one of the most important catecholamine neurotransmitters of the human central nervous system, and is involved in many behavioral responses and brain functions. Below normal DA levels in biological fluids can lead to different neurodegenerative conditions. For excess DA levels, a failure in energy metabolism is indicated. In this study, a facile room-temperature phosphorescence sensor is developed to detect DA based on l-cysteine capped Mn doped ZnS quantum dots (l-cys ZnS:Mn QDs). The QDs display a prominent orange emission band peaking at ~598nm, which is strongly quenched upon addition of DA in alkaline medium. The sensor exhibits a linear working range of ~0.15–3.00μM, and a limit of detection of ~7.80nM. These results are explained in terms of a pH-dependent electron transfer process, in which the oxidized dopamine quinone functions as an efficient electron acceptor. The QDs-based sensor shows a high selectivity to DA over common interfering biomolecules (including some amino acids, ascorbic acid, chloride and glucose). The sensor has been successfully applied for the detection of DA in urine samples, yielding recoveries as high as 93%. Our findings indicate that our developed sensor exhibits high sensitivity and reproducibility to determine DA even in biological fluids where DA is at low levels, e.g., in the central nervous system, which is the usual clinical profile of a neurodegenerative disorder associated to the Parkinson's disease
Impact of diurnal variability and meteorological factors on the PM2.5 - AOD relationship: Implications for PM2.5 remote sensing
No full textAbstractPM2.5 retrieval from space is still challenging due to the elusive relationship between PM2.5 and aerosol optical depth (AOD), which is further complicated by meteorological factors. In this work, we investigated the diurnal cycle of PM2.5 in China, using ground-based PM measurements obtained at 226 sites of China Atmosphere Watch Network during the period of January 2013 to December 2015. Results showed that nearly half of the sites witnessed a PM2.5 maximum in the morning, in contrast to the least frequent occurrence (5%) in the afternoon when strong solar radiation received at the surface results in rapid vertical diffusion of aerosols and thus lower mass concentration. PM2.5 tends to peak equally in the morning and evening in North China Plain (NCP) with an amplitude of nearly twice or three times that in the Pearl River Delta (PRD), whereas the morning PM2.5 peak dominates in Yangtze River Delta (YRD) with a magnitude lying between those of NCP and PRD. The gridded correlation maps reveal varying correlations around each PM2.5 site, depending on the locations and seasons. Concerning the impact of aerosol diurnal variation on the correlation, the averaging schemes of PM2.5 using 3-h, 5-h, and 24-h time windows tend to have larger R biases, compared with the scheme of 1-h time window, indicating diurnal variation of aerosols plays a significant role in the establishment of explicit correlation between PM2.5 and AOD. In addition, high cloud fraction and relative humidity tend to weaken the correlation, regardless of geographical location. Therefore, the impact of meteorology could be one of the most plausible alternatives in explaining the varying R values observed, due to its non-negligible effect on MODIS AOD retrievals. Our findings have implications for PM2.5 remote sensing, as long as the aerosol diurnal cycle, along with meteorology, are explicitly considered in the future
The relationship between green supply chain management and performance: A meta-analysis of empirical evidences in Asian emerging economies
No full textAbstractThe purpose of this study is to understand the relationship between green supply chain management (GSCM) practices and firm performance in the manufacturing sector in Asian emerging economies (AEE) based on empirical evidence. Through a systematic literature review, we identified 50 articles that surveyed 11,127 manufacturing companies in the AEE and were published between 1996 and 2015. Subsequently, a conceptual framework was developed and analyzed through a meta-analysis of 130 effects from 25,680 effect sizes. The findings revealed that the GSCM practices lead to better performance in four aspects: economic, environmental, operational, and social performance. Moreover, the results indicate that industry type, firm size, ISO certification, and export orientation moderate several of the GSCM practice-performance relationships. Moreover, the findings of this research help managers and policy makers to have more confidence in the adoption of GSCM practices to improve firm performance. Such results also help researchers to better channel their efforts in studying the GSCM practices in AEE. In addition, as meta-analysis has not been widely used in the supply chain management literature, our study is an important step in maturing the academic field by adopting this technique for confirming GSCM practice-performance relationships in the manufacturing sector of AEE
Development and validation of new analytical methods for simultaneous estimation of Drotaverine hydrochloride in combination with Omeprazole in a pharmaceutical dosage form
No full textAbstractA rapid and precise method (in accordance with ICH guidelines) is developed for the quantitative simultaneous determination of Drotaverine hydrochloride and Omeprazole in a combined pharmaceutical dosage form. Three methods are described for the simultaneous determination of Drotaverine hydrochloride and Omeprazole in a binary mixture. The first method was based on UV-Spectrophotometric determination of two drugs, using Vierordt!s simultaneous equation method. It involves absorbance measurement at 226.8nm (λmax of Drotaverine hydrochloride) and 269.4nm (λmax of Omeprazole) in methanol; linearity was obtained in the range of 5–30μgml−1 for both the drugs. The second method was based on HPLC separation of the two drugs using potassium dihydrogen phosphate buffer pH 5.0: Acetonitrile: Triethylamine (60:40:0.5, v/v) as a mobile phase. Areas were recorded at 260nm for both the drugs and retention time was found to be 2.71min. and 3.87min for Drotaverine hydrochloride and Omeprazole, respectively at 1.0mL/min flow rate. The selected chromatographic conditions were found to determine Drotaverine hydrochloride and Omeprazole quantitatively in a combined dosage form without any physical separation. The method has been validated for linearity, accuracy and precision. Linearity was found over the range of 5–30μgmL−1 for both drugs. The third method was based on HPTLC method for simultaneous quantification of these compounds in pharmaceutical dosage forms. Precoated silica gel 60 F254 plate was used as stationary phase. The separation was carried out using Glacial acetic acid:Cyclohexane:Methanol:(80:15:5 v/v/v) as mobile phase. The proposed method was found to be fast, accurate, precise, reproducible and rugged and can be used for a simultaneous analysis of these drugs in combined formulations
Intra-ring haptotropic rearrangements of Mn(CO)3 in fluorenyl ligands
No full textAbstractGeometric parameters, and intra-ring haptotropic rearrangements π–π (intra-ring-HRs) ŋ5⇌ŋ3 of the manganesetricarbonyl complexes (ŋ5-9-R-C13H8)Mn(CO)3, R=But and Ph in 18e zero-valence are carried out using density functional theory DFT at PBE/TZP level. The calculated activation barriers to ŋ5⇌ŋ3 intra-ring HR in (ŋ5-9-R-C13H8)Mn(CO)3, R=But and Ph are (28.5 and 69.5kcal.mol−1 respectively). The compute of HOMA and FLU indexes indicates the reduction of aromaticity when going from free to coordinated complex. The energy decomposition analysis reveals the dominant ionic character in manganese–Cp bond in the presence of covalent contribution
Pharmacophore modeling and 3D QSAR studies of aryl amine derivatives as potential lumazine synthase inhibitors
No full textAbstractDesign and discovery of novel antifungal compounds is the need of time, more than ever before due to the unavailability of effective antifungal therapy to treat resistant fungal infections. Due to morphological and functional similarities of fungi both with plant cell and human cell, the search for effective targets leading to specificity of antifungal drug action becomes all that more difficult. For the design of novel antifungal agents, it is necessary to comprehend the life cycle, morphology, metabolic pathways, etc. of fungi scientifically and systematically to identify critical targets for antifungal drug design. Fungi specific riboflavin metabolism involves lumazine synthase catalyzed synthesis of 6,7-dimethyl-8-D-ribityl lumazine which is converted to riboflavin by a riboflavin synthase. Therefore lumazine synthase has been targeted for the design of newer antifungal agents. The pharmacophore modeling and 3D QSAR studies were carried out on 32 N-substituted aryl amine derivatives as fungal lumazine synthase inhibitors. The selected model of 3D QSAR showed positive correlation of electronic descriptors with antifungal activity while steric and hydrophobic descriptors showed negative correlation with antifungal activity. The resulting model exhibited good q2 and r2 values up to 0.9109 and 0.845 respectively
Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures
No full textBackground and AimsSedation for GI endoscopy directed by anesthesia professionals (ADS) is used with the intention of improving throughput and patient satisfaction. However, data on its safety are sparse because of the lack of adequately powered, randomized controlled trials comparing it with endoscopist-directed sedation (EDS). This study was intended to determine whether ADS provides a safety advantage when compared with EDS for EGD and colonoscopy.MethodsThis retrospective, nonrandomized, observational cohort study used the Clinical Outcomes Research Initiative National Endoscopic Database, a network of 84 sites in the United States composed of academic, community, health maintenance organization, military, and Veterans Affairs practices. Serious adverse events (SAEs) were defined as any event requiring administration of cardiopulmonary resuscitation, hospital or emergency department admission, administration of rescue/reversal medication, emergency surgery, procedure termination because of an adverse event, intraprocedural adverse events requiring intervention, or blood transfusion.ResultsThere were 1,388,235 patients in this study that included 880,182 colonoscopy procedures (21% ADS) and 508,053 EGD procedures (23% ADS) between 2002 and 2013. When compared with EDS, the propensity-adjusted SAE risk for patients receiving ADS was similar for colonoscopy (OR, .93; 95% CI, .82-1.06) but higher for EGD (OR, 1.33; 95% CI, 1.18-1.50). Additionally, with further stratification by American Society of Anesthesiologists (ASA) class, the use of ADS was associated with a higher SAE risk for ASA I/II and ASA III subjects undergoing EGD and showed no difference for either group undergoing colonoscopy. The sample size was not sufficient to make a conclusion regarding ASA IV/V patients.ConclusionsWithin the confines of the SAE definitions used, use of anesthesia professionals does not appear to bring a safety benefit to patients receiving colonoscopy and is associated with an increased SAE risk for ASA I, II, and III patients undergoing EGD
A case of secondary amenorrhea caused by uterine myoma successfully treated by a combined laparoscopic and hysteroscopic approach
No full textPreparation, characterization and catalytic properties of nickel aluminate nanoparticles: A comparison between conventional and microwave method
No full textAbstractIn the present work, synthesis of nickel aluminate using Opuntia dilenii haw as plant extract by a microwave combustion method (MCM) and its comparison with the conventional combustion method (CCM) is investigated. O. dilenii haw plant extract simplifies the process, provides an alternative process for a simple and an economical synthesis. The absence of surfactant has led to a simple, cheap and fast method of synthesis of NiAl2O4 nanoparticles. The as-synthesized NiAl2O4 nanoparticles were characterized by X-ray diffraction (XRD) studies, Fourier transform infrared spectroscopy (FT-IR) studies, high resolution scanning electron microscopy (HR-SEM), energy dispersive X-ray analysis (EDX), high resolution transmission electron microscopy (HR-TEM), diffuses reflectance spectroscopy (DRS), and Brunauer Emmett Teller (BET) surface area analysis. The XRD results confirmed the formation of the cubic phase NiAl2O4. The formation of pure nickel aluminate phase was confirmed by FT-IR. The formation of NiAl2O4 nanoparticles was confirmed by HR-SEM and HR-TEM and their possible formation mechanisms were also proposed. MCM could produce NiAl2O4 with uniform size and well-defined shape with crystallinity. The optical property was determined by DRS. NiAl2O4 prepared by the microwave combustion method was found to possess a higher surface area, lower crystallite size than the NiAl2O4 nanoparticles prepared by the conventional combustion method, which in turn has led to the improved performance toward the selective oxidation of benzyl alcohol to benzaldehyde