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The Use of Lidocaine Spray and Paracervical Nerve Block in Pain Management During Intrauterine Device Insertion: A Literature Review
Get PDFIntroduction: An intrauterine device (IUD) is an extremely reliable form of contraception with
one of the highest satisfaction rates among users. Yet, in Canada the use of IUDs as primary
contraception remains low. Women report that pain during IUD insertion dissuades them from
selecting this form of contraception. Despite evidence that women experience discomfort during
IUD insertions, standard pain control options remain unavailable.
Objective: This literature review aims to evaluate the evidence for lidocaine spray and lidocaine
paracervical nerve block in the management of pain during IUD insertion. A second objective is
to assess if these techniques are suitable for outpatient visits.
Methods: A search on PubMed was performed with key words and inclusion criteria to obtain
articles pertaining to the use of both topical and injected lidocaine as pain management
techniques during IUD insertion.
Results: Three studies explored the benefits of lidocaine spray during IUD insertion and two
studies assessed the effects of a lidocaine paracervical nerve block. Not only were both topical
and injected forms of lidocaine effective in reducing pain during IUD insertion, these techniques
were also effective in reducing pain during other procedural steps. Additionally, all participants
in the studies tolerated the procedure well on an outpatient basis.
Conclusion: Two effective pain management techniques have been identified in the literature.
Lidocaine spray was found to be effective in reducing pain in parous women during multiple
steps of IUD insertion. While a paracervical block was effective in reducing pain during IUD
insertion in nulliparous women. Further, these interventions were tolerated well and suitable for
outpatient clinics
Acceptability and preliminary effects of the volunteer-supported Meaningful Moments program to engage older adults with advanced dementia on a hospital-based specialized dementia care unit: a mixed methods study
Get PDFBackground
Namaste Care offers practical skills for healthcare providers, volunteers, and families to meaningfully engage individuals with dementia in activities (e.g., music, massage, reminiscing, socialization, aromatherapy, snacks). A hospital-based specialized dementia care unit for patients with mid- to late-stage dementia offered an adapted version of the Namaste Care program, which was called Meaningful Moments. The aim of this study was to assess the acceptability and preliminary effects of this novel approach using trained volunteers for older adults with mid- to late-stage dementia.
Methods
A mixed methods multiphase design was used. Qualitative description was used to explore acceptability of the Meaningful Moments program delivered over 6 months through focus groups (e.g., charge nurses, therapeutic recreationists, nurses, social workers) and individual interviews with one volunteer and two family members. A prospective pre-post-test study design was used to evaluate the preliminary effects of the program for patients with dementia and family members. Outcomes included quality of life, neuropsychiatric symptoms, and pain for patients with dementia and family carer role stress and the quality of visits for families. Data were collected from June 2018 to April 2019. Descriptive analyses of participants’ characteristics were expressed as a mean (standard deviation [SD]) for continuous variables and count (percent) for categorical variables. Focus group and individual interview data were analyzed using thematic analysis. The generalized estimating equations (GEE) method was used to assess change in the repeated measures outcome data.
Results
A total of 15 patients received the Meaningful Moments interventions. Families, staff, and volunteers perceived that patients experienced benefits from Meaningful Moments. Staff, volunteers, and families felt fulfilled in their role of engaging patients in the Meaningful Moments program. Individualized activities provided by volunteers were perceived as necessary for the patient population. There were no statistically significant improvements in patient outcomes. There was a statistically significant decline in family carer role stress.
Conclusions
Using a one-on-one approach by volunteers, patients experienced perceived benefits such as improved mood and opportunities for social interactions. There is a need for tailored activities for older adults with advanced dementia through practical strategies that can offer benefit to patients
Une analyse de la masculinité et de l’homosexualité masculine dans En finir avec Eddy Bellegueule et Querelle de Roberval
Get PDFDepuis longtemps, mais surtout depuis le début du XXIe siècle, il y a un intérêt pour les représentations de l’homosexualité et des homosexuels dans la littérature. Si de nos jours les portraits des personnages homosexuels sont assez variés et nuancés, ce n’était pas toujours le cas ; en fait, elles reflètent les valeurs de l’époque durant laquelle l’ouvrage est écrit. À cause du cliché de l’homme frivole et efféminé, les homosexuels ont souvent été perçus comme étant aux antipodes de la masculinité. Cette idée surgit également dans la littérature. Notre étude cherche donc à analyser la relation entre l’homosexualité masculine et la masculinité dans la littérature francophone du XXIe siècle. Pour ce faire, notre thèse portera sur la représentation des homosexuels et leurs liens avec d’autres hommes dans la littérature contemporaine. Nous nous focaliserons sur les romans intitulés En finir avec Eddy Bellegueule d’Édouard Louis et Querelle de Roberval de Kevin Lambert, deux ouvrages qui mettent en scène les expériences des homosexuels à travers les personnages principaux. Nous explorerons les effets de la masculinité hégémonique et l’hétéronormativité sur les hommes ainsi que les réactions des protagonistes face à ces influences. Puisque ces personnages vont à l’encontre des normes de leurs alentours, nous souhaitons également déterminer si ces romans à l’étude font partie de la littérature queer.October 202
Comparison of the phenolic components and their antioxidant activities in five common edible mushroom species in Manitoba
Get PDFBackground: Bioactive compounds found in mushrooms, particularly phenolic compounds, have demonstrated promising attributes such as anti-proliferative and antioxidant properties. However, until now, no comparative study between commercial and locally sourced fresh mushrooms has been undertaken.
Objectives: The objectives were i) to assess the differences in phenolic contents among different mushroom species supplied in Manitoba (Agaricus bisporus, Cantharellus cibarius, Lentinus edodes, Inonotus obliquus) and commercial mushrooms and how phenolic contents may contribute to antioxidant effects and potential antihypertensive efficacy in vitro; ii) to determine the impact of storage duration of Inonotus obliquus on phenolic content and their antioxidant properties.
Methods: The study used total phenolic content (TPC) and total flavonoid content (TFC) assays to determine the phenolic content in different mushrooms. Antioxidant activities were assessed using four antioxidant capacity assays. Potential anti-hypertensive effects were assessed in vitro by thiobarbituric acid reactive substances (TBARS) and angiotensin-converting enzyme (ACE) inhibition assays.
Results: Inonotus obliquus (Chaga) had the highest TPC of 6.98 mg GAE/g (dry wt.), which is six times higher than those obtained for other fresh mushrooms. The TPC in fresh Chaga mushrooms was four times higher than that of the corresponding commercial mushrooms. Chaga mushrooms also showed the highest antioxidant activity among different species of mushrooms, especially their total antioxidant activity level of 192.01 ± 14.67 mM TE/g DW, which was eight times higher than the total antioxidant activity level of other mushrooms. However, the ACE value of shiitake capsulated mushrooms was three times higher than corresponding fresh mushrooms, which had 47.03 ± 0.06%.
Conclusion:
This study showed varied phenolic content among the five mushrooms, with Chaga showing the highest content. However, phenolic content did not directly correlate with antioxidant properties and antihypertensive effects. More studies are required to understand how to connection between antioxidant and antihypertensive properties.February 202
Exploring metabolic syndrome and dietary quality in Iranian adults: a cross-sectional study
Get PDFAbstract Background Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors affecting a quarter of the global population, with diet playing a significant role in its progression. The aim of this study is to compare the effectiveness of the Dietary Diabetes Risk Reduction Score (DDRRS) and the Macronutrient Quality Index (MQI) scoring systems in assessing the diet-related risk of metabolic syndrome. Methods In this cross-sectional study, data from 7431 individuals aged between 30 and 70 years, obtained from the Mashhad Cohort Study, were utilized to evaluate the risk factors of metabolic syndrome. A valid semi-quantitative food frequency questionnaire was used to assess participants’ dietary intake. The MQI was calculated based on carbohydrate, fat, and healthy protein components, while the DDRRS was also computed. Anthropometric measurements and blood samples were taken to determine the presence of metabolic syndrome. Logistic regression analyses were conducted to assess the association between MQI and DDRRS with metabolic syndrome and its components. Results According to the crude model, we observed lower odds of MetS in the highest quartile of DDRRS and MQI compared to the lowest quartile (P-trend < 0.001). This trend persisted in the fully adjusted models, revealing odds ratios of 0.399 (95% CI: 0.319-0.500) and 0.597 (95% CI: 0.476–0.749) for DDRRS and MQI, respectively. After controlling for all potential confounders, we observed lower odds of central obesity in the highest quartile of MQI (OR: 0.818, 95% CI: 0.676–0.989, P-trend = 0.027). Furthermore, we found that the odds of high triglyceride levels were lower in the highest quartile of DDRRS compared to the lowest quartile (OR: 0.633, 95% CI: 0.521, 0.770, P-trend < 0.001). Conclusion In conclusion, our study indicates that greater adherence to both DDRRS and MQI is linked to a decreased risk of metabolic syndrome and its components. These findings hold significant implications for public health and the development of personalized nutrition strategies
Inhibition of nitrification and effects on N2O and CO2 emissions estimated using the flux gradient method from agricultural soils in Southern Manitoba
Get PDFNitrification inhibitors reduce the emissions of nitrous oxide (N2O) from agricultural soils treated with ammoniacal nitrogen fertilizers. Most studies to date, and all for Manitoba, have examined the benefits of nitrification inhibitors on N2O emissions using soil chambers. Here, N2O emissions were monitored using the flux gradient method, and the effect of nitrification inhibition of spring-applied nitrogen fertilizers on clay and loam farm fields near Glenlea and Clearwater, Manitoba, respectively, was examined. Established since 2005, the Trace Gas Manitoba (TGAS-MAN) research site on a clay field was used to examine the effect of the nitrification inhibitor, eNtrenchTM, coated urea in 2022 and the nitrification and urease inhibitor, SuperUTM, in 2023. The TGAS-MAN site utilized two 4-ha fields for each inhibited and uninhibited fertilizer treatment, all seeded to spring wheat (Triticum aestivum L.) in 2022 and canola (Brassica napus L.) in 2023. A new flux gradient installation was established on the loam field, Trace Gas Harvest Moon (TGAS-HM). This site utilized one 4-ha field of anhydrous ammonia treated with the nitrification inhibitor, Centuro®, and one of uninhibited anhydrous ammonia planted to grain corn (Zea mays L.). In 2022, soil moisture and high air temperature and humidity challenged fertilizer flow through operational machinery and an evaluation on the inhibition of nitrification and N2O emissions. In 2023, SuperU reduced cumulative (Jan 1st – Dec 31st) N2O emissions by 1,786.1 kg CO2-eq ha-1 compared to conventional urea. Both treatments lost approximately 6,200 kg CO2-eq ha-1 in 2022, compared to 2023 where SuperU lost 1,774 kg CO2-eq ha-1 and conventional urea lost 4,224 kg CO2-eq ha-1. Growing season (May 1st – Oct 13th) cumulative N2O emissions for anhydrous ammonia was 1.4 kg N2O-N ha-1 and, contrary to expectation, 1.8 kg N2O-N ha-1 for the Centuro® treatment. Across both research sites and study years, differences in treatment grain yield were not statistically significant. Study findings highlight greater N2O emissions for clay than loam soils in Manitoba, the challenges of coating urea with nitrification inhibitors for commercial purposes, employing the flux gradient method to observe a reduction in N2O emissions using SuperUTM, and the surprising ineffectiveness of a new nitrification inhibition product, Centuro®, to reduce N2O emissions.This project would not have been completed without funding from NSERC Discovery, Western Grains Research Foundation, Fertilizer Canada, and CREATE-CSS.October 202
Impact of bread waste inclusion in feedlot diets on the environmental footprint of growing and finishing beef cattle
No full textThe objective of this research was to examine the impact of including bread waste in feedlot diets on the environmental footprint of beef cattle. Existing data including diet composition and animal performance metrics (body weight, average daily gain, dry matter intake, feed:gain ratio) were obtained from two previous feeding trials in which steers were fed bread by-product (BBy) at rates of 40% (growing steers) and 55% DM (finishing steers). Environmental footprint metrics were estimated through modeling approaches and included land use requirements, greenhouse gas (GHG) emissions, ammonia (NH3) emissions, and water use requirements. Including bread waste in the diets of growing steers resulted in a 45% decrease in land use (ha hd-1) for feed crops, a 14% decrease in GHG emission intensity (kg CO2e hd-1), a 4% decrease in NH3 emission intensity (kg NH3 hd-1), and a 37% decrease in water use intensity (L kg-1 live weight) compared to steers fed a conventional corn-based diet. Finishing steers fed a BBy-based diet had a 63% reduction in land use (ha hd-1) for feed production, a 19% reduction in GHG emission intensity (kg CO2e hd-1), 1% reduction in NH3 emissions (kg NH3 hd-1), and a 61% reduction in water use intensity (L kg-1 live weight). Furthermore, GHG emissions associated with BBy from production to waste management were 24% and 53% lower when diverting BBy from landfill to growing and finishing diets, respectively. Utilizing bread waste in feedlot diets not only reduces the environmental footprint of growing and finishing cattle but makes use of land, water and fertilizer resources that have already been expended. Furthermore, as bread waste is priced lower than conventional feedstuffs, its inclusion in feedlot diets is expected to reduce the cost of production for growing and finishing cattle. Despite the benefits, current challenges that must be considered include availability and proximity of bread waste to feedlots, short shelf life, and regulatory restrictions.Beef Cattle Research CouncilOctober 202
Multifunctional structural panel for enhanced orbital debris and radiation protection of spacecraft
No full textGiven the space environment’s inherent threats, including space radiation and the rising potential for micrometeoroid and orbital debris (MMOD) impacts, spacecraft designs should aim to attain acceptable performance, reliability, and resilience in response to these challenges. In modern spacecraft design, there is an emerging trend to incorporate protective measures as an integral aspect of the spacecraft’s structural function. The foam-core sandwich panel, or FCSP, is a novel shield with the potential to overcome the limitations imposed by traditional honeycomb sandwich panels (HCSP). Previous numerical analysis and empirical investigations confirm FCSP’s ballistics protection capability. However, like with other sandwich structures, as the size of the threat rises, ballistic performance diminishes, weakening the multifunctional benefits of sandwiches like FCSPs. Therefore, replacing traditional HCSP with FCSP is futile without improving FCSP’s protection against larger MMOD threats.
The goal of this Ph.D. research was to devise a multifunctional, weight-efficient FCSP to address dual challenges in space exploration: protection against MMOD and extreme radiation environments. Three core objectives were delineated to fulfill this goal: 1) Develop highly accurate numerical models to represent FCSPs, 2) Enhance the FCSP design to improve its shielding performance against escalating MMOD threats while maintaining structural functions, and 3) Develop an implementable strategy to incorporate the refined FCSP designs in real-world spacecraft applications, including a review of their performance in extreme conditions such as Molniya radiation and Low Earth Orbit (LEO) debris.
The research methodology integrated physical testing with numerical simulations, leading to the creation of a detailed FCSP model that accurately simulates hypervelocity impacts. Validation of this model through physical tests confirmed FCSP’s shielding capabilities. Nevertheless, the study identified limitations in shielding against larger MMOD particles, and proposed appropriate solutions, and their practical applications. In pursuit of multifunctionality, the research explored the incorporation of radiation-attenuating materials like polyethylene (PE) and carbon-fibre reinforced composite (CFC), examining their impact on radiation shielding and the influence of composite microstructure on the total ionizing dose (TID). Additionally, the research outlined a practical application of the proposed FCSP design for spacecraft, emphasizing its relevance in enhancing spacecraft design for various orbital scenarios.Natural Science and Engineering Research Council of Canada (Discovery Grant no. 402115–2012)October 202
Simulation of agricultural air seeding systems using the discrete element method and computational fluid dynamics
No full textThe Discrete Element Method (DEM) and Computational Fluid Dynamics (CFD) were applied to simulate seed dynamic attributes as affected by air seeding equipment features. The air seeding equipment features in this work included a fluted roller seed meter, a horizontal distributor tube, a horizontal-vertical tube transition, and a vertical seed manifold. Each simulation was validated through a combination of theoretical calculations and experimental measurements. Fluted roller seed meter simulations using DEM demonstrated that varying inputs for mechanical energy dissipation (i.e. damping) did not affect mass flow rate at roller speeds between 10 and 50 rpm. The predicted mass flow rate values of the seed metering simulations were within 10 g/s of the experimental results with the largest relative error as 16.5 %. Coupled CFD-DEM simulations for the horizontal distributor tube showed that solids loading ratios between 0.5 and 3.0 did not have a significant effect on average seed velocity. The horizontal and horizontal-vertical tubing simulations generated average seed velocity data and flow patterns that corresponded well with values calculated from pneumatic conveying theory. Furthermore, simulated seed trajectory and contact force data identified the seed feeding point (horizontal distributor tube) and bend area (horizontal-vertical transition) as the locations with the highest contact forces inside the air seeder distribution system. Comparison of one-way and two-way coupled CFD-DEM simulation for the horizontal-vertical tube indicated that one-way coupling was a suitable option to represent seed dynamic attributes at low solids loading ratios. Seed manifold simulations using one-way CFD-DEM coupling were complementary to experimental observations (R2=0.90) but the accuracy in determining the actual number of seeds per manifold outlet needs improvement. Generally, increasing inlet air velocity promoted more uniform seed distributions but increased seed contact forces within the seed manifold. Median seed contact force was affected by location within the simulated manifold areas (elbow, vertical tube, and manifold head) and was highest at the elbow. The results of this study highlighted the predictive potential of DEM and CFD as well as potential limitations. Overall, simulated seed dynamic attributes provided important seed-seed and seed-machine interaction details to assist the future design of air seeder systems.May 202
DNA methylation signatures of youth-onset type 2 diabetes and exposure to maternal diabetes
No full textObjective
Youth-onset type 2 diabetes (T2D) is physiologically distinct from adult-onset, but it is not clear how the two diseases differ at a molecular level. In utero exposure to maternal type 2 diabetes (T2D) is known to be a specific risk factor for youth-onset T2D. DNA methylation (DNAm) changes associated with T2D but which differ between youth- and adult-onset might delineate the impacts of T2D development at different ages and could also determine the contribution of exposure to in utero diabetes.
Methods
We performed an epigenome-wide analysis of DNAm on whole blood from 218 youth with T2D and 77 normoglycemic controls from the iCARE (improving renal Complications in Adolescents with type 2 diabetes through REsearch) cohort. Associations were tested using multiple linear regression models while adjusting for maternal diabetes, sex, age, BMI, smoking status, second-hand smoking exposure, cell-type proportions and genetic ancestry.
Results
We identified 3830 differentially methylated sites associated with youth T2D onset, of which 3794 were moderately (adjusted p-value 0.01) associated and 36 were strongly (adjusted p-value 0.05) associated. A total of 3725 of these sites were not previously reported in the EWAS Atlas as associated with T2D, adult obesity or youth obesity. Moreover, three CpGs associated with youth-onset T2D in the PFKFB3 gene were also associated with maternal T2D exposure (FDR 0.01). This is the first study to link PFKFB3 and T2D in youth.
Conclusion
Our findings support that T2D in youth has different impacts on DNAm than adult-onset, and suggests that changes in DNAm could provide an important link between in utero exposure to maternal diabetes and the onset of T2D