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1.
Small ; 20(27): e2308796, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38363026

RESUMEN

A race to achieve a crossover from positive to negative magnetoresistance is intense in the field of nanostructured materials to reduce the size of memory devices. Here, the unusual complex magnetoresistance in nonmagnetic sulfur-doped Sb2Se3 nanowires is demonstrated. Intentionally, sulfur is doped in such a way to nearly achieve the charge neutrality point that is evident from switching of carrier type from p-type to n-type at 13 K as inferred from the low-temperature thermoelectric power measurements. A change from 3D variable range hopping (VRH) to power law transport with α = 0.18  in resistivity measurement signifies a Luttinger liquid transport with weak links through the nanowires. Interestingly, high magnetic field induced negative magnetoresistance (NMR) occurring in hole dominated temperature regimes can only be explained by invoking the concept of charge puddles. Spot energy dispersive spectroscopy (EDS), magnetic force microscopy (MFM) measurements, Tmott and Regel plot indicate an enhanced disorder in these sulfurized nanowires that are found to be the precursor for the formation of these charge puddles. Tunability of conducting states in these nanowires is investigated in the light of interplay of carrier type, magnetic field, temperature, and intricate intra-inter wire transport that makes this nanowires potential for large scale spintronic devices.

2.
Environ Monit Assess ; 196(4): 352, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38466376

RESUMEN

With characterized for complex and maximum substance (suspended solids, broke up oil, a mixture of inorganic and chromium sulfides), tannery wastewater was subjected to a treatment process on removal of chemical oxygen demand (COD) via upstream anaerobic sludge blanket reactor where we found reduced departure efficiencies and that process limits were affected by the assortments in regular stacking rates, closeness of chromium, and sulfides. Hence, a combination of the aerobic-anaerobic hybrid reactor was set up for sequential treatment to determine possible COD reduction. This study investigated the biological degradation of tannery wastewater in a laboratory-scale sequential up-flow aerobic-anaerobic reactor. The aerobic zone at the top was packed with spherical ball-shaped polyhedral polypropylene, and the anaerobic zone at the bottom was packed medium with granular media. The aeration flow rate varied by 2 L/min, 4 L/min, and 6 L/min in the aerobic zone, and the reactor maintained an organic loading rate (OLR) of 5 kg COD/m3/d. Parameters like COD and gas yield assess the performance of the reactor. The maximum COD of 86% is removed in the anaerobic zone with an aeration rate of 6 L/min, and the 1800-mL methane gas yield is measured by the 29th day.


Asunto(s)
Reactores Biológicos , Aguas Residuales , Anaerobiosis , Análisis de la Demanda Biológica de Oxígeno , Monitoreo del Ambiente , Cromo , Sulfuros , Eliminación de Residuos Líquidos , Oxígeno
3.
Small ; 19(39): e2302676, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37263985

RESUMEN

Polymer nanocomposites with high loadings of nanoparticles (NPs) exhibit exceptional mechanical and transport properties. Separation of polymers and NPs from such nanocomposites is a critical step in enabling the recycling of these components and reducing the potential environmental hazards that can be caused by the accumulation of nanocomposite wastes in landfills. However, the separation typically requires the use of organic solvents or energy-intensive processes. Using polydimethylsiloxane (PDMS)-infiltrated SiO2 NP films, we demonstrate that the polymers can be separated from the SiO2 NP packings when these nanocomposites are exposed to high humidity and water. The findings indicate that the charge state of the NPs plays a significant role in the propensity of water to undergo capillary condensation within the PDMS-filled interstitial pores. We also show that the size of NPs has a crucial impact on the kinetics and extent of PDMS expulsion, illustrating the importance of capillary forces in inducing PDMS expulsion. We demonstrate that the separated polymer can be collected and reused to produce a new nanocomposite film. The work provides insightful guidelines on how to design and fabricate end-of-life recyclable high-performance nanocomposites.

4.
Am J Emerg Med ; 74: 84-89, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37797399

RESUMEN

BACKGROUND: Narratives are effective tools for communicating with patients about opioid prescribing for acute pain and improving patient satisfaction with pain management. It remains unclear, however, whether specific narrative elements may be particularly effective at influencing patient perspectives. METHODS: This study was a secondary analysis of data collected for Life STORRIED, a multicenter RCT. Participants included 433 patients between 18 and 70 years-old presenting to the emergency department (ED) with renal colic or musculoskeletal back pain. Participants were instructed to view one or more narrative videos during their ED visit in which a patient storyteller discussed their experiences with opioids. We examined associations between exposure to individual narrative features and patients' 1) preference for opioids, 2) recall of opioid-related risks and 3) perspectives about the care they received. RESULTS: Participants were more likely to watch videos featuring storytellers who shared their race or gender. We found that participants who watched videos that contained specific narrative elements, for example mention of prescribed opioids, were more likely to recall having received information about pain treatment options on the day after discharge (86.3% versus 72.9%, p = 0.02). Participants who watched a video that discussed family history of addiction reported more participation in their treatment decision than those who did not (7.6 versus 6.8 on a ten-point scale, p = 0.04). CONCLUSIONS: Participants preferentially view narratives featuring storytellers who share their race or gender. Narrative elements were not meaningfully associated with patient-centered outcomes. These findings have implications for the design of narrative communication tools.


Asunto(s)
Dolor Agudo , Dolor Musculoesquelético , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Manejo del Dolor , Dolor Agudo/tratamiento farmacológico , Analgésicos Opioides/uso terapéutico , Pautas de la Práctica en Medicina , Servicio de Urgencia en Hospital
5.
Langmuir ; 38(10): 3122-3128, 2022 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-35245077

RESUMEN

Nanostructured topological crystalline insulators (TCIs) in the presence of exotic surface states with spin momentum locking reported in individual nanostructures are predicted to hold a great promise for spintronics and quantum computing applications. However, practical application demands a strategy with large-scale production and integration for device applications. In this work, we demonstrate through prominent signatures of weak antilocalization (WAL), arising predominantly from destructive quantum interference on robust surface states, that a correlated TCI phase is possible in the nanobulk assembly of carefully nanostructured quasi-two-dimensional SnTe (edge-to-edge length ∼ 382 nm) synthesized by a simple, rapid, and scalable microwave-assisted solvothermal method. Hikami-Larkin-Nagaoka analysis (T-0.71), as well as the temperature dependence of resistivity, illustrates an interplay of both conductions from 2D channels and 3D EEI effects as the precursor for the observed WAL at low temperatures (2-6 K). Interestingly, the enhanced thermoelectric power of the sample of ∼45 µV/K, with a p-type carrier concentration of ∼1018/cm3 at 300 K, makes this SnTe nanocrystalline assembly more attractive as a multifunctional material for large-scale technological applications.

6.
Am J Public Health ; 112(S1): S45-S55, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35143273

RESUMEN

Objectives. To compare the effectiveness of 3 approaches for communicating opioid risk during an emergency department visit for a common painful condition. Methods. This parallel, multicenter randomized controlled trial was conducted at 6 geographically disparate emergency department sites in the United States. Participants included adult patients between 18 and 70 years of age presenting with kidney stone or musculoskeletal back pain. Participants were randomly assigned to 1 of 3 risk communication strategies: (1) a personalized probabilistic risk visual aid, (2) a visual aid and a video narrative, or 3) general risk information. The primary outcomes were accuracy of risk recall, reported opioid use, and treatment preference at time of discharge. Results. A total of 1301 participants were enrolled between June 2017 and August 2019. There was no difference in risk recall at 14 days between the narrative and probabilistic groups (43.7% vs 38.8%; absolute risk reduction = 4.9%; 95% confidence interval [CI] = -2.98, 12.75). The narrative group had lower rates of preference for opioids at discharge than the general risk information group (25.9% vs 33.0%; difference = 7.1%; 95% CI = 0.64, 0.97). There were no differences in reported opioid use at 14 days between the narrative, probabilistic, and general risk groups (10.5%, 10.3%, and 13.3%, respectively; P = .44). Conclusions. An emergency medicine communication tool incorporating probabilistic risk and patient narratives was more effective than general information in mitigating preferences for opioids in the treatment of pain but was not more effective with respect to opioid use or risk recall. Trial Registration. Clinical Trials.gov identifier: NCT03134092. (Am J Public Health. 2022;112(S1):S45-S55. https://doi.org/10.2105/AJPH.2021.306511).


Asunto(s)
Alfabetización en Salud/métodos , Cálculos Renales/tratamiento farmacológico , Dolor Musculoesquelético/tratamiento farmacológico , Manejo del Dolor/métodos , Educación del Paciente como Asunto/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
7.
Network ; 33(1-2): 95-123, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35465830

RESUMEN

Cardiac disease is the predominant cause of global death mainly due to its hidden symptoms and late diagnosis. Hence, early detection is important to improve quality of life. Though traditional researches attempted to predict heart disease, most of them lacked with respect to accuracy. To solve this, the present study proposes a hybridized Ant Lion Crow Search Optimization Genetic Algorithm (ALCSOGA) to perform effective feature selection. This hybrid optimization encompasses Ant Lion, Crow Search and Genetic Algorithm. Ant lion algorithm determines the elite position. While, the Crow Search Algorithm utilizes the phenomenon of position and memory of each crow for evaluating the objective function. Both these algorithms are fed into Genetic Algorithm to improve the performance of feature selection process. Then, Stochastic Learning rate optimized Long Short Term Memory (LSTM) is proposed to classify the extracted optimized features. Finally, comparative analysis is performed in terms of accuracy, recall, F1-score, and precision. Moreover, statistical analysis is performed with respect to Sum of Squares (SS), degree of freedom (df), F Critical (F crit), F Statistics (F), p, and Mean Square (MS) value. Analytical results revealed the efficiency of proposed system over conventional methods and thereby confirming its efficiency for predicting heart disease.


Asunto(s)
Cardiopatías , Calidad de Vida , Algoritmos , Humanos
8.
J Emerg Med ; 63(2): 192-199, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-36038438

RESUMEN

BACKGROUND: Drug-related problems (DRPs) are common among patients seen in the emergency department (ED), but the true incidence is not clear. OBJECTIVES: The primary objective of this study was to determine the prevalence of DRPs among patients seen in a U.S. ED. The secondary objective was to categorize these DRPs by problem type and by medication class. METHODS: This was a prospective observational cohort study of a random sample of ED patients between December 2011 and March 2013. ED pharmacists screened randomly selected patients for the presence of a DRP contributing to the ED visit. Four independent auditors evaluated the results to achieve consensus for the presence or absence of DRPs and categorization of the DRPs. RESULTS: Among 1039 patients screened for DRPs, 308 (29.6%) were found to have at least 1 DRP contributing to the ED visit. Among a total of 443 DRPs, the most commonly identified categories were adverse drug reaction (n = 193 [43.6%]), ineffective medication (n = 69 [15.6%]), and subtherapeutic dosage (n = 68 [15.3%]). The most commonly implicated drug classes were cardiovascular medications (n = 113 [26.5%]), anti-infective medications (n = 52 [12.2%]), and analgesic medications (n = 58 [13.6%]). CONCLUSIONS: A substantial proportion of ED visits are associated in part or in total with DRPs. Adverse drug reactions and cardiovascular medications are the most common category and medication class implicated, respectively.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Farmacéuticos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Servicio de Urgencia en Hospital , Humanos , Prevalencia , Estudios Prospectivos
9.
Am J Emerg Med ; 49: 178-184, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34119812

RESUMEN

OBJECTIVE: Numerous studies have demonstrated evidence of obesity bias in healthcare settings, however, little is known about obesity bias in the Emergency Department (ED). The objective of this study was to investigate obesity bias in an ED setting by assessing the association between body mass index (BMI) and door-to-room (DTR) or door-to-provider (DTP) times among ED patients. METHODS: We conducted an observational cohort study of all adult patient (age ≥ 18 years of age) visits to 21 Mayo Clinic and Mayo Clinic Health System EDs between November 1, 2018 and March 31, 2020. We compared DTR and DTP times based on BMI category. RESULTS: We found that median DTR and DTP times for adults with class 3 obesity are significantly shorter than patients in the normal weight category. For men with class 3 obesity, median DTR and DTP times were 7.5% and 5.4% shorter than men in the normal weight category. Relative to women in the normal weight category, the median DTR and DTP times were 4.6% and 3.8% faster for women in obesity class 1, 4.9% and 5.1% faster for women in obesity class 2, and DTR was 4.4% faster for women in obesity class 3. These percentage differences translated to slightly shorter wait times of 0.4-1.2 min compared to median wait times for patients with normal BMI. CONCLUSION: We did not find evidence of longer wait times experienced by people with obesity. Rather, patients with obesity often experienced wait times that were shorter than patients of normal weight.


Asunto(s)
Índice de Masa Corporal , Accesibilidad a los Servicios de Salud/normas , Disparidades en el Estado de Salud , Adulto , Anciano , Estudios de Cohortes , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Distribución de Poisson , Factores de Tiempo
10.
J Clin Ultrasound ; 49(4): 328-333, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32984964

RESUMEN

BACKGROUND: Given that abdominal aorta is a retroperitoneal structure, increased body mass index (BMI) may have an adverse effect upon the quality of aortic ultrasonographic imaging. PURPOSE: To assess the hypothesis that increased BMI is associated with worsening point-of-care abdominal aortic ultrasonographic image quality. METHODS: This is a retrospective single-center study of point-of-care abdominal aortic ultrasound examinations performed in an academic emergency department (ED) with fellowship-trained emergency ultrasonography faculty performing quality assurance review. RESULTS: Mean ± SD BMI was 27.4 ± 6.2, among the 221 included records. The overall quality rating decreased as BMI increased (correlation coefficient - 0.24; P < .001) and this persisted after adjustment for age and sex (P < .001). Although BMI was higher on average in the records that were of insufficient quality for clinical decisions when compared with those of sufficient quality (mean BMI 28.7 vs 27.0), this did not reach statistical significance in a univariable setting (P = .11) or after adjusting for age and sex (P = .14). CONCLUSION: This study data shows a decrease in point-of-care abdominal aorta ultrasound imaging quality as BMI increases, though this difference did not result in a statistically significant impairment in achieving the minimum quality for clinical decisions. This finding may help ameliorate some clinician concerns about ultrasonography for patients with high BMI.


Asunto(s)
Aorta Abdominal/diagnóstico por imagen , Índice de Masa Corporal , Ultrasonografía/normas , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Examen Físico , Pruebas en el Punto de Atención/normas , Estudios Retrospectivos , Ultrasonografía/métodos
11.
J Clin Ultrasound ; 48(8): 452-456, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32557626

RESUMEN

BACKGROUND: Many clinicians believe that a patient's body mass index (BMI) affects the likelihood of obtaining high quality ultrasound images. OBJECTIVES: To assess the hypothesis that increased BMI is associated with worsening focused assessment with sonography in trauma (FAST) image quality. METHODS: We conducted a retrospective single-center study of FAST examinations performed in a large academic emergency department (ED) with fellowship-trained emergency ultrasonography faculty performing quality assurance review. RESULTS: Mean (SD) BMI was 28.0 (6.6) among the 302 included studies. The overall quality rating tended to decrease as BMI increased but did not achieve statistical significance in a univariable setting (P = .06) or after adjustment for age and sex (P = .06). Operators perception of image adequacy was largely unaffected by BMI, with the exception of the pericardial view. CONCLUSION: This study did not identify a statistically significant difference in FAST quality with increased BMI. This result may help assuage clinician concerns about ultrasonography for patients in the ED.


Asunto(s)
Índice de Masa Corporal , Heridas y Lesiones/diagnóstico por imagen , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Ultrasonografía/métodos
12.
J Med Syst ; 43(8): 272, 2019 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-31278468

RESUMEN

Now days, health prediction in modern life becomesvery much essential. Big data analysis plays a crucial role to predict future status of healthand offerspreeminenthealth outcome to people. Heart disease is a prevalent disease cause's death around the world. A lotof research is going onpredictive analytics using machine learning techniques to reveal better decision making. Big data analysis fosters great opportunities to predict future health status from health parameters and provide best outcomes. WeusedBig Data Predictive Analytics Model for Disease Prediction using Naive Bayes Technique (BPA-NB). It providesprobabilistic classification based on Bayes' theorem with independence assumptions between the features. Naive Bayes approach suitable for huge data sets especially for bigdata. The Naive Bayes approachtrain the heart disease data taken from UCI machine learning repository. Then, it was making predictions on the test data to predict the classification. The results reveal that the proposed BPA-NB scheme providesbetter accuracy about 97.12% to predict the disease rate. The proposed BPA-NB scheme used Hadoop-spark as big data computing tool to obtain significant insight on healthcare data. The experiments are done to predict different patients' future health condition. It takes the training dataset to estimate the health parameters necessary for classification. The results show the early disease detection to figure out future health of patients.


Asunto(s)
Macrodatos , Enfermedad , Predicción , Aprendizaje Automático , Anciano , Teorema de Bayes , Femenino , Humanos , Masculino , Persona de Mediana Edad
13.
Oral Dis ; 23(8): 1066-1071, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28513913

RESUMEN

OBJECTIVES: In the process of carcinogenesis, lipid peroxidation and increased oxidative stress lead to changes in certain antioxidants. This study was aimed to assess and co-relate serum levels of ceruloplasmin in oral premalignancies and oral cancer so as to gauge its possible association with the process of carcinogenesis and to determine its role as tumor marker. MATERIAL AND METHODS: The study population comprised of 300 participants, equally divided into six study groups, that is, oral submucous fibrosis (OSMF), oral leukoplakia (OL), nicotina stomatitis (NS), oral malignancy (OM), controls (C), and healthy controls (HC); 5 ml of blood was collected from ante cubital vein from each participant. The serum was analyzed for ceruloplasmin levels using ERBA CHEM 5 PLUS semiautomated chemistry analyzer and diagnostic kit by turbidimetric immunoassay. RESULTS: There were total 242 males and 58 females, who were between 18 and 82 years of age, with a mean of 45.31 ± 13.97 years. The serum ceruloplasmin levels were significantly increased in OM, OSMF, OL, and NS groups as compared to C and HC groups (p < .001). No statistically significant difference was found in intragroup analysis of the disease groups (p > .05). CONCLUSION: Serum ceruloplasmin can be used as diagnostic marker for oral premalignant and malignant lesions.


Asunto(s)
Ceruloplasmina/metabolismo , Neoplasias de la Boca/sangre , Lesiones Precancerosas/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/sangre , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Leucoplasia Bucal/sangre , Masculino , Persona de Mediana Edad , Fibrosis de la Submucosa Bucal/sangre , Estomatitis/sangre , Estomatitis/etiología , Fumar Tabaco/efectos adversos , Adulto Joven
14.
Am J Emerg Med ; 35(5): 769-772, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28258839

RESUMEN

OBJECTIVE: A wide variety of spinal needles are used in clinical practice. Little is currently known regarding the impact of needle length, gauge, and tip type on the needle's ability to measure spinal canal opening pressure. This study aimed to investigate the relationship between these factors and the opening-pressure measurement or time to obtain an opening pressure. METHODS: Thirteen distinct spinal needles, chosen to isolate the effects of length, gauge, and needle-point type, were prospectively tested on a lumbar puncture simulator. The key outcomes were the opening-pressure measurement and the time required to obtain that measure. Pressures were recorded at 10-s intervals until 3 consecutive, identical readings were observed. RESULTS: Time to measure opening pressure increased with increasing spinal needle length, increasing gauge, and the Quincke-type (cutting) point (P<0.001 for all). The time to measurement ranged from 30s to 530s, yet all needle types were able to obtain a consistent opening pressure measure. CONCLUSION: Although opening pressure estimates are unlikely to vary markedly by needle type, the time required to obtain the measurement increased with increasing needle length and gauge and with Quincke-type needles.


Asunto(s)
Presión del Líquido Cefalorraquídeo , Punción Espinal/instrumentación , Humanos , Maniquíes
15.
Ann Emerg Med ; 68(5): 553-561, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27125817

RESUMEN

STUDY OBJECTIVE: We describe the use of the Kano Attractive Quality analytic tool to improve an identified patient experience gap in perceived compassion by emergency department (ED) providers. METHODS: In phase 1, point-of-service surveying assessed baseline patient perception of ED provider compassion. Phase 2 deployed Kano surveys to predict the effect of 4 proposed interventions on patient perception. Finally, phase 3 compared patients receiving standard care versus the Kano-identified intervention to assess the actual effect on patient experience. RESULTS: In phase 1, 193 of 200 surveys (97%) were completed, showing a baseline median score of 4 out of 5 (interquartile range [IQR] 3 to 5), with top box percentage of 33% for patients' perception of receiving compassionate care. In phase 2, 158 of 180 surveys (88%) using Kano-formatted questions were completed, and the data predicted that increasing shared decisionmaking would cause the greatest improvement in the patient experience. Finally, in phase 3, 45 of 49 surveys (92%) were returned and demonstrated a significant improvement in perceived concern and sensitivity, 5 (IQR 5 to 5) versus 4 (IQR 3 to 5) with a difference of 1 (95% CI 0.1-1.9) and a top box rating of 79% versus 35% with a difference of 44% (95% CI 12-66) by patients who received dedicated shared decisionmaking interventions versus those receiving standard of care. CONCLUSION: Kano analysis is likely predictive of change in patient experience. Kano methods may prove as useful in changing management of the health care industry as it has been in other industries.


Asunto(s)
Servicio de Urgencia en Hospital/organización & administración , Mejoramiento de la Calidad , Humanos , Innovación Organizacional , Satisfacción del Paciente , Proyectos Piloto , Mejoramiento de la Calidad/organización & administración , Encuestas y Cuestionarios
16.
Langmuir ; 31(33): 9246-52, 2015 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-26255906

RESUMEN

Ultrathin Au nanowires (∼2 nm diameter) are interesting from a fundamental point of view to study structure and electronic transport and also hold promise in the field of nanoelectronics, particularly for sensing applications. Device fabrication by direct growth on various substrates has been useful in demonstrating some of the potential applications. However, the realization of practical devices requires device fabrication strategies that are fast, inexpensive, and efficient. Herein, we demonstrate directed assembly of ultrathin Au nanowires over large areas across electrodes using ac dielectrophoresis with a mechanistic understanding of the process. On the basis of the voltage and frequency, the wires either align in between or across the contact pads. We exploit this assembly to produce an array of contacting wires for statistical estimation of electrical transport with important implications for future nanoelectronic/sensor applications.

17.
Spinal Cord ; 53(5): 353-7, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25224600

RESUMEN

OBJECTIVE: This study aims to understand the demographics, mode of trauma, hospital stay, complications, neurological improvement, mortality and expenditure incurred by Indian patients with spinal trauma and ankylosing spondylitis (AS). METHODS: Retrospective analysis of the patient data admitted to a tertiary referral hospital from 2008 to 2013 with the diagnosis of AS and spinal trauma was carried out. The variables studied were demographics, mode of trauma, neurological status, neurological improvement, involved vertebral level, duration of hospital stay, comorbid factors, expenditure and complications during the stay. RESULTS: Forty-six patients with diagnosis of AS with spine trauma were admitted over the last 5 years with a total of 52 fractures. All were male patients; 58.6% had injury because of trivial trauma and 78.2% patients presented with neurological injury. C5 C6, C6 C7, C7 D1 and D12 were the most common injured level. Fractures through intervertebral disc were most common in cervical spine. Of the patients, 52.7% had shown neurological improvement of at least grade 1(AIS). Mean expenditure of patient admitted with spinal cord injury (SCI) with AS is 7957 USD (United States dollar), which is around five times the per capita income in India (as per year 2013). CONCLUSION: Males with AS are much more prone to spinal fractures than females and its incidence may be higher than previously reported. Domestic falls are the most common mechanism of spinal trauma in this population. High velocity injuries are associated with complete SCI. The study reinforces the need for development of subsidized spinal care services for SCI management.


Asunto(s)
Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/epidemiología , Espondilitis Anquilosante/complicaciones , Espondilitis Anquilosante/epidemiología , Adulto , Anciano , Comorbilidad , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , India/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Traumatismos de la Médula Espinal/economía , Traumatismos de la Médula Espinal/mortalidad , Espondilitis Anquilosante/economía , Espondilitis Anquilosante/mortalidad
18.
Emerg Med J ; 32(10): 804-8, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25612763

RESUMEN

OBJECTIVE: To describe the credentialing systems of North American emergency department systems (EDS) with emergency ultrasound (EUS) fellowship programmes. METHODS: This is a prospective, cross-sectional, survey-based study of North American EUS fellowships using a 62-item, pilot-tested, web-based survey instrument assessing credentialing and training systems. The American College of Emergency Physicians (ACEP) distributed the surveys using SNAP survey (Snap Surveys Ltd, Portsmouth, New Hampshire, USA). RESULTS: Over 6 months, 75 eligible programmes were surveyed, 55 responded (73% response rate); 1 declined to participate leaving 54 participating programmes. Less than 20% of EDS credential nurses, physician assistants, nurse practitioners and students in EUS. Respondent EDS reported having an average of 4.2 ± 3.3 ultrasound faculty members (faculty identifying their career focus as EUS). The median number of annual point-of-care ultrasounds reported was 5000 (IQR 3000-8000). 30 EDS (56%) credential each examination individually and 48 EDS (89%) use ACEP credentialing criteria. 61% of fellowship leadership believe their credentialing system is either satisfactory or very satisfactory (Cronbach's coefficient α=0.84). CONCLUSIONS: The data show heterogeneity among North American EDS with EUS fellowship programmes with regard to credentialing systems despite published guidelines from the ACEP and Canadian Emergency Ultrasound Society.


Asunto(s)
Habilitación Profesional/normas , Medicina de Emergencia/educación , Servicio de Urgencia en Hospital/estadística & datos numéricos , Becas , Ultrasonografía , Actitud del Personal de Salud , Canadá , Competencia Clínica/estadística & datos numéricos , Estudios Transversales , Humanos , Estudios Prospectivos , Estados Unidos
19.
Inflammopharmacology ; 23(1): 65-70, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25490949

RESUMEN

The present work investigates the anti-inflammatory, analgesic and antipyretic activity of methanolic extract of mulberry leaves of variety S-1, S-13 and S-146. The S-146 extract was further evaluated for its efficacy against adjuvant arthritis in albino rats followed by inhibitory potential for COX 1, COX 2 and 5 LOX. The HPLC analysis enumerated the presence of morin, reversterol, scopoletin and 7-hydroxy coumarin as the major constituents. The anti-inflammatory, antipyretic and analgesic activity observed in the present experiment could be accredited to the dual inhibition in the AA pathway. The inhibition of COX and LOX enzymes could be imparted to the presence of resveraterol, morin, scopoletin and 7-hydroxy coumarin.


Asunto(s)
Ácido Araquidónico/antagonistas & inhibidores , Morus , Extractos Vegetales/farmacología , Hojas de la Planta , Transducción de Señal/efectos de los fármacos , Animales , Ácido Araquidónico/metabolismo , Femenino , Masculino , Ratones , Extractos Vegetales/aislamiento & purificación , Ratas , Ratas Wistar , Transducción de Señal/fisiología
20.
Am J Emerg Med ; 32(4): 346-8, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24512887

RESUMEN

INTRODUCTION: Despite a relatively high frequency of appendix nonvisualization when using ultrasound to diagnose appendicitis, many studies either fail to report these results or inconsistently analyze outcomes. OBJECTIVES: The objective of this study is to determine the most transparent and accurate way of reporting and analyzing ultrasound results for the diagnosis of appendicitis. METHODS: This was an observational cohort study of emergency department patients age 18 years or older who underwent right lower quadrant ultrasonography from September 2010 to October 2011. Patient characteristics, imaging, pathology, and follow-up data were analyzed. Test characteristics were calculated using conventional 2 × 2 contingency table analysis excluding inconclusive ultrasound results and an intention-to-diagnose approach with a 3 × 2 table. RESULTS: Sixty-five patients were included. Forty-four (68%) patients had a nonvisualized appendix resulting in an overall diagnostic yield of 32%. Twenty-one patients had a visualized appendix (14 [22%] negative and 7 [11%] positive for appendicitis). Using 2 × 2 contingency table analysis, sensitivity and specificity were 100%. Using the 3 × 2 table with and the intention-to-diagnose principle, sensitivity was 70% and specificity was 25%. Three (7%) of 44 patients with a nonvisualized appendix had appendicitis (likelihood ratio = 0.40). DISCUSSION: We suggest reporting ultrasound results using a 3 × 2 table (including nonvisualized findings) but using the traditional 2 × 2 type of analysis for test characteristic calculations. This approach allows for the determination of diagnostic yield and calculation of likelihood ratios when the appendix is not visualized. This approach to reporting should be considered for all types of diagnostic ultrasound studies.


Asunto(s)
Apendicitis/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Ultrasonografía
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