Publications by authors named "Syed Hassan"

293 Publications

Associated Factors With Uremic Pruritus in Chronic Hemodialysis Patients: A Single-Center Observational Study.

Cureus 2021 Aug 30;13(8):e17559. Epub 2021 Aug 30.

Internal Medicine, Liaquat National Hospital and Medical College, Karachi, PAK.

Background and objectives Uremic pruritus is a recurrent and delicate manifestation in patients suffering from end-stage renal disease. It is a consequence of multiple factors, primarily comprising of metabolic factors and complement activation along with interleukins. The objective of our study was to find out the associated factors of uremic pruritus in chronic hemodialysis patients. The secondary aim was to obtain cut-off values of all the markers predicting pruritus. Materials and methods A cross-sectional observational study was conducted in the nephrology department of a tertiary care hospital including 135 patients. The current occurrence of pruritus was diagnosed on the basis of a validated and reliable scale of pruritus among chronic kidney disease (CKD) patients in the local language. Multivariate logistic regression and receiver operating characteristic analysis were conducted to decipher the required objectives. Results Study participants had a mean age of 56.29 ± 10.51 years with 56.3% males and 43.7% females. Hypertension was frequent comorbidity (75.6%) followed by diabetes (51.9%). Mean body mass index (BMI), duration of CKD diagnosis, and hemodialysis onset were 26.55 ± 5.37 kg/m, 6.58 ± 3.65 years, and 3.32 ± 2.09 years respectively. Pruritus was reported in 37.0% of the study participants. On multivariate logistic regression, presence of skin allergy (aOR: 8.100 [2.926-22.420], p<0.001), phosphate >4.5 mg/dL (aOR: 3.889 [1.118-15.532], p=0.033), female gender (aOR: 3.592 [1.337-9.655], p=0.011), albumin <3.5 g/dL (aOR: 2.987 [1.156-7.716], p=0.024) and potassium >5.1 mEq/L (aOR: 2.934 [1.030-8.355], p=0.044) were found significantly associated with pruritus. Conclusion Many factors were linked to pruritus in hemodialysis patients in the current study. The current study also significantly correlated certain factors with pruritus independently.
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http://dx.doi.org/10.7759/cureus.17559DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481143PMC
August 2021

Potential Role of Natural Products to Combat Radiotherapy and Their Future Perspectives.

Molecules 2021 Oct 2;26(19). Epub 2021 Oct 2.

Department of Botany, Abdul Wali Khan University Mardan, Mardan 23200, Pakistan.

Cancer is the second leading cause of death in the world. Chemotherapy and radiotherapy (RT) are the common cancer treatments. In addition to these limitations, the development of adverse effects from chemotherapy and RT reduces the quality of life for cancer patients. Cellular radiosensitivity, or the ability to resist and overcome cell damage caused by ionizing radiation (IR), is directly related to cancer cells' response to RT. Therefore, radiobiological research is emphasizing chemical compounds 'radiosensitization of cancer cells so that they are more reactive in the IR spectrum. Recent years researchers have seen an increase in interest in natural products that have antitumor effects with minimal side effects. Natural products, on the other hand, are easy to recover and therefore less expensive. There have been several scientific studies done based on these compounds that have tested their ability in vitro and in vivo to induce tumor radiosensitization. The role of natural products in RT, as well as their usefulness and potential applications, is the goal of this current review.
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http://dx.doi.org/10.3390/molecules26195997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8512367PMC
October 2021

Implant fracture of the TFNA femoral nail.

J Clin Orthop Trauma 2021 Nov 20;22:101598. Epub 2021 Sep 20.

Department of Trauma and Orthopaedic Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, UK.

Background: The TFNA (Trochanteric Fixation Nail Advanced) Proximal Femoral Nailing System (DePuy Synthes) is frequently used for intramedullary fixation of proximal femoral fractures. The aim of this study was to evaluate all TFNA implant fractures at a UK trauma unit to ascertain any patient or surgical factors associated with implant failure.

Methods: A retrospective study was carried out identifying all patients that sustained a TFNA implant fracture over a five-year period. Data was collected on demographic information, ASA, co-morbidities, mechanism of injury, fracture pattern according to the AO/OTA classification, procedure details and time to failure. Radiographs were assessed by two independent reviewers to identify tip-apex distance (TAD), calcar TAD, reduction quality and union status at time of implant failure.

Results: Six cases were identified, all with implant breakage at the aperture for the proximal screw. All femoral fractures were intertrochanteric reverse obliquity type (OA/OTA 31A3). Two were traumatic fragility fractures and the remainder atraumatic. Mean time from index surgery to revision was 441 days (104-963). Mean TAD was 20.5 mm (15-24) and mean calcar TAD 24 mm (18-32). All six cases displayed radiographic non-union at the time of implant fracture.

Conclusion: Pathological fractures resulting in reverse obliquity type fracture patterns and subsequent non-union appear to be contributory factors to TFNA breakage at the proximal screw aperture. This may be further exacerbated by alterations to the nail design from previous generations. In these patients, close follow up with clinical and radiographic surveillance should be employed. Further biomechanical and clinical studies are required to compare this finding against other nail designs.
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http://dx.doi.org/10.1016/j.jcot.2021.101598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473538PMC
November 2021

Synergetic contribution of fluorinated azide for high EQE and operational stability of top-illuminated, semitransparent, photomultiplication-type organic photodiodes.

Mater Horiz 2021 Sep 27. Epub 2021 Sep 27.

Department of Chemical Engineering, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea.

In this study, it is shown that fluorinated azide, employed as a functional additive to photomultiplication-type organic photodiodes (PM-OPDs), can not only enhance the operational stability by freezing the morphology consisting of matrix polymer/localized acceptor but also stabilize the trapped electron states such that the photomultiplication mechanism can be accelerated further, leading to exceptionally high external quantum efficiency (EQE). The consequent semitransparent OPD consisting of molybdenum oxide (MoO)/Au/MoO/photoactive layer/polyethyleneimine ethoxylated/indium tin oxide (ITO) rendered a maximum EQE of over 500 000% and 370 000% under bottom and top illumination, respectively. Owing to the remarkably high EQE, high specific detectivity of 5.6 × 10 Jones and low noise-equivalent power of 5.35 × 10 W Hz were also demonstrated. Furthermore, the OPD demonstrated stable performance during 20 h of continuous operation and minimal performance degradation even after the damp heat test. To fully visualize the advantages of the proposed high-EQE, top-illuminated, semitransparent OPD with spectral asymmetry between absorption and detection, a reflection-type fingerprint platform consisting of 1 OPD-1 oxide field-effect transistor complementary metal-oxide-semiconductor backplane (300 ppi) is designed and fabricated. The successful recognition of the fingerprint of one of the authors is demonstrated, which indicates the feasibility of the proposed PM-OPD for sensing weak light intensity.
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http://dx.doi.org/10.1039/d1mh01368hDOI Listing
September 2021

Loss of Pulmonary Vascular Volume as a Predictor of Right Ventricular Dysfunction and Mortality in Acute Pulmonary Embolism.

Circ Cardiovasc Imaging 2021 Sep 21;14(9):e012347. Epub 2021 Sep 21.

University of Pennsylvania, Philadelphia. Division of Pulmonary and Critical Care Medicine (S.M.H., E.H., S.A., S.M., A.B.W., G.R.W., F.N.R.), Brigham and Women's Hospital, Harvard Medical School, Boston.

Background: In acute pulmonary embolism, chest computed tomography angiography derived metrics, such as the right ventricle (RV): left ventricle ratio are routinely used for risk stratification. Paucity of intraparenchymal blood vessels has previously been described, but their association with clinical biomarkers and outcomes has not been studied. We sought to determine if small vascular volumes measured on computed tomography scans were associated with an abnormal RV on echocardiography and mortality. We hypothesized that decreased small venous volume would be associated with greater RV dysfunction and increased mortality.

Methods: A retrospective cohort of patients with intermediate risk pulmonary embolism admitted to Brigham and Women's Hospital between 2009 and 2017 was assembled, and clinical and radiographic data were obtained. We performed 3-dimensional reconstructions of vasculature to assess intraparenchymal vascular volumes. Statistical analyses were performed using multivariable regression and cox proportional hazards models, adjusting for age, sex, lung volume, and small arterial volume.

Results: Seven hundred twenty-two subjects were identified of whom 573 had documented echocardiography. A 50% reduction in small venous volume was associated with an increased risk of RV dilation (relative risk: 1.38 [95% CI, 1.18-1.63], <0.001), RV dysfunction (relative risk: 1.62 [95% CI, 1.36-1.95], <0.001), and RV strain (relative risk: 1.67 [95% CI, 1.37-2.04], <0.001); increased cardiac biomarkers, and higher 30-day and 90-day mortality (hazard ratio: 2.50 [95% CI, 1.33-4.67], =0.004 and hazard ratio: 1.84 [95% CI, 1.11-3.04], =0.019, respectively).

Conclusions: Loss of small venous volume quantified from computed tomography angiography is associated with increased risk of abnormal RV on echocardiography, abnormal cardiac biomarkers, and higher risk of 30- and 90-day mortality. Small venous volume may be a useful marker for assessing disease severity in acute pulmonary embolism.
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http://dx.doi.org/10.1161/CIRCIMAGING.120.012347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462092PMC
September 2021

Sublimation-doping with super bases for high-performance solution-processed heterojunction oxide thin film transistors.

Mater Horiz 2021 Sep 13. Epub 2021 Sep 13.

Department of Chemical Engineering, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea.

We elucidate how non-destructive sublimation-doping of InO/ZnO heterojunctions with various amidine-based organic dopants affects the degree of band bending of the heterojunction and thus the overall performance of solution-processed heterojunction oxide thin-film transistors (TFTs). Ultraviolet photoelectron spectroscopy and X-ray photoelectron spectroscopy analyses show that the stronger the basicity of the dopant, the smaller the - of ZnO that can be induced within a short doping time, resulting in a high electron mobility due to the increased electron density of the InO layer at the vicinity of the heterointerface. Mott-Schottky analysis combined with secondary ion mass spectroscopy shows the preferential modification of - selectively for the ZnO layer. The use of a super base with the highest basicity exhibits a high electron mobility of 17.8 cm V s for the SiO and 37.8 cm V s on average (46.6 cm V s maximum) for the ZrO dielectric layers and enhanced operational bias-stress stability sublimation-doping for 6 min, which can be attributed to the trap-filled, percolation-limited charge transport behavior. Reproducibility tests are conducted for more than 50 independently fabricated TFTs using the optimized doping technique, and electron mobility distributions with deviations <±10% are demonstrated. This study shows that sublimation doping with super bases can be a good solution for high mobility oxide TFTs with stability and reliability.
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http://dx.doi.org/10.1039/d1mh00929jDOI Listing
September 2021

A Meta-Analysis of Association between Remdesivir and Mortality among Critically-Ill COVID-19 Patients.

Infect Chemother 2021 Sep 30;53(3):512-518. Epub 2021 Aug 30.

Department of Internal Medicine, Dr. NTR University of Health Sciences, Vijayawada, India.

Background: The World Health Organization guidelines did not make a recommendation on use of remdesivir based on disease severity. Little is known regarding effectiveness of remdesivir in critically ill coronavirus disease 2019 (COVID-19) patients. This has led to a state of dilemma for doctors leaving them skeptical of whether they should continue to recommend the drug or not.

Materials And Methods: A systematic search adhering to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was conducted from inception until February 20, 2020. Electronic bibliographic databases (PubMed, Cochrane database, Scopus, Embase) were included. Using dichotomous data for select values, the unadjusted odds ratios (ORs) were calculated applying Mantel Haenszel (M-H) using random-effects model. The primary outcome of interest was all-cause mortality in ventilated and non-ventilated patients.

Results: The Remdesivir arm was associated with similar rates of 28-day all-cause mortality (OR: 0.93, 95% confidence interval [CI]: 0.80 - 1.08; = 0.33). Remdesivir was not found to be favorable for ventilated patients. Non ventilated COVID-19 patients showed a significant lower in-hospital mortality rate as compared with patients requiring mechanical ventilatory support (OR: 6.86, 95% CI: 5.39 - 268.74; <0.0001).

Conclusion: Non-ventilated patients were associated with significant lower all-cause mortality rates. Prudent use of remdesivir is recommended in critically ill COVID-19 patients.
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http://dx.doi.org/10.3947/ic.2021.0060DOI Listing
September 2021

Stroke in young adults: Current trends, opportunities for prevention and pathways forward.

Am J Prev Cardiol 2020 Sep 9;3:100085. Epub 2020 Sep 9.

Division of Cardiovascular Prevention & Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.

Cardiovascular disease remains a major contributor to morbidity and mortality in the US and elsewhere, and stroke is a leading cause of disability worldwide. Despite recent success in diminishing stroke incidence in the general US population, in parallel there is now a concerning propensity for strokes to happen at younger ages. Specifically, the incidence of stroke for US adults 20-44 years of age increased from 17 per 100,000 US adults in 1993 to 28 per 100,000 in 2015. Occurrence of strokes in young adults is particularly problematic as these patients are often affected by physical disability, depression, cognitive impairment and loss of productivity, all of which have vast personal, social and economic implications. These concerning trends among young adults are likely due to increasing trends in the prevalence of modifiable risk factors amongst this population including hypertension, hyperlipidemia, obesity and diabetes, highlighting the importance of early detection and aggressive prevention strategies in the general population at early ages. In parallel and compounding to the issue, troublesome trends are evident regarding increasing rates of substance abuse among young adults. Higher rates of strokes have been noted particularly among young African Americans, indicating the need for tailored prevention and social efforts targeting this and other vulnerable groups, including the primordial prevention of risk factors in the first place, reducing stroke rates in the presence of prevalent risk factors such as hypertension, and improving outcomes through enhanced healthcare access. In this narrative review we aim to emphasize the importance of stroke in young adults as a growing public health issue and increase awareness among clinicians and the public health sector. For this purpose, we summarize the available data on stroke in young adults and discuss the underlying epidemiology, etiology, risk factors, prognosis and opportunities for timely prevention of stroke specifically at young ages. Furthermore, this review highlights the gaps in knowledge and proposes future directions moving forward.
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http://dx.doi.org/10.1016/j.ajpc.2020.100085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315351PMC
September 2020

Clinical Presentations and Outcomes of Coronavirus Disease 2019 in Patients With Solid Tumors.

Cureus 2021 Jun 5;13(6):e15452. Epub 2021 Jun 5.

Internal Medicine, University of Louisville, Louisville, USA.

Background Coronavirus disease 2019 (COVID-19) is a global health crisis. The literature suggests that cancer patients are more prone to be affected by COVID-19 because cancer suppresses the immune system and such patients usually present poor results. The objective of this study is to present all clinical, laboratory, and demographic characteristics of COVID-19 patients with solid tumors. Methodology This study was conducted at the Dow University of Health Sciences for a period of six months from April 2020 to September 2020. In this study, we included a total of 1,519 confirmed patients diagnosed with solid tumors via polymerase chain reaction. The mortality timeline within 30 days of contracting the virus was considered, and the median age of the included individuals was 61 years, with a range of 20-95 years. Of the patients included in the study, 49.4% (750) were men; moreover, 3.15% of our study population had prostate cancer, 10.20% had colorectal cancer, 2.76% had breast cancer, and 10.46% had lung cancer. Of the patients, 25.93% presented with at least one comorbidity. For 73% of the patients, at least one direct therapy for COVID-19 was included in the treatment; 56.6% of the patients were hospitalized, and 11.32% were admitted to the intensive care unit. Results The mortality rate was 4.74% in the first 30 days after diagnosis, where 72 patients died. The findings of the first multi-variation model showed that males at older ages who were diabetic and going through cytotoxic therapy were prone to die within the first 30 days. However, the 30-day mortality rate was lower in patients diagnosed with prostate and breast cancer. The second set incorporated laboratory factors, where we found that higher values of leukocytosis, thrombocytopenia, and lymphocytopenia were correlated with higher rates of mortality within 30 days. Conclusions We conclude that there is a higher mortality rate of COVID-19 in patients with solid tumors than in the general population. However, it was found to be lower in the Pakistani population compared with the Chinese and Western populations. Intensive care can decrease mortality rates in COVID-19 and cancer patients.
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http://dx.doi.org/10.7759/cureus.15452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260216PMC
June 2021

Opportunistic Large Array Propagation Models: A Comprehensive Survey.

Sensors (Basel) 2021 Jun 19;21(12). Epub 2021 Jun 19.

Department of Information and Telecommunication Engineering, Incheon National University, Incheon 22012, Korea.

Enabled by the fifth-generation (5G) and beyond 5G communications, large-scale deployments of Internet-of-Things (IoT) networks are expected in various application fields to handle massive machine-type communication (mMTC) services. Device-to-device (D2D) communications can be an effective solution in massive IoT networks to overcome the inherent hardware limitations of small devices. In such D2D scenarios, given that a receiver can benefit from the signal-to-noise-ratio (SNR) advantage through diversity and array gains, cooperative transmission (CT) can be employed, so that multiple IoT nodes can create a virtual antenna array. In particular, Opportunistic Large Array (OLA), which is one type of CT technique, is known to provide fast, energy-efficient, and reliable broadcasting and unicasting without prior coordination, which can be exploited in future mMTC applications. However, OLA-based protocol design and operation are subject to network models to characterize the propagation behavior and evaluate the performance. Further, it has been shown through some experimental studies that the most widely-used model in prior studies on OLA is not accurate for networks with networks with low node density. Therefore, stochastic models using quasi-stationary Markov chain are introduced, which are more complex but more exact to estimate the key performance metrics of the OLA transmissions in practice. Considering the fact that such propagation models should be selected carefully depending on system parameters such as network topology and channel environments, we provide a comprehensive survey on the analytical models and framework of the OLA propagation in the literature, which is not available in the existing survey papers on OLA protocols. In addition, we introduce energy-efficient OLA techniques, which are of paramount importance in energy-limited IoT networks. Furthermore, we discuss future research directions to combine OLA with emerging technologies.
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http://dx.doi.org/10.3390/s21124206DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234782PMC
June 2021

Geopolymers and Fiber-Reinforced Concrete Composites in Civil Engineering.

Polymers (Basel) 2021 Jun 25;13(13). Epub 2021 Jun 25.

Department of Textile Engineering, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan.

This paper discusses the influence of fiber reinforcement on the properties of geopolymer concrete composites, based on fly ash, ground granulated blast furnace slag and metakaolin. Traditional concrete composites are brittle in nature due to low tensile strength. The inclusion of fibrous material alters brittle behavior of concrete along with a significant improvement in mechanical properties i.e., toughness, strain and flexural strength. Ordinary Portland cement (OPC) is mainly used as a binding agent in concrete composites. However, current environmental awareness promotes the use of alternative binders i.e., geopolymers, to replace OPC because in OPC production, significant quantity of CO is released that creates environmental pollution. Geopolymer concrete composites have been characterized using a wide range of analytical tools including scanning electron microscopy (SEM) and elemental detection X-ray spectroscopy (EDX). Insight into the physicochemical behavior of geopolymers, their constituents and reinforcement with natural polymeric fibers for the making of concrete composites has been gained. Focus has been given to the use of sisal, jute, basalt and glass fibers.
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http://dx.doi.org/10.3390/polym13132099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272018PMC
June 2021

Malformin-A1 (MA1) Sensitizes Chemoresistant Ovarian Cancer Cells to Cisplatin-Induced Apoptosis.

Molecules 2021 Jun 13;26(12). Epub 2021 Jun 13.

Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 50, Muscat P.C. 123, Oman.

High-grade epithelial ovarian cancer is a fatal disease in women frequently associated with drug resistance and poor outcomes. We previously demonstrated that a marine-derived compound MalforminA1 (MA1) was cytotoxic for the breast cancer cell line MCF-7. In this study, we aimed to examine the effect of MA1 on human ovarian cancer cells. The potential cytotoxicity of MA1was tested on cisplatin-sensitive (A2780S) and cisplatin-resistant (A2780CP) ovarian cancer cell lines using AlamarBlue assay, Hoechst dye, flow cytometry, Western blot, and RT-qPCR. MA1 had higher cytotoxic activity on A2780S (IC50 = 0.23 µM) and A2780CP (IC50 = 0.34 µM) cell lines when compared to cisplatin (IC50 = 31.4 µM and 76.9 µM, respectively). Flow cytometry analysis confirmed the cytotoxic effect of MA1. The synergistic effect of the two drugs was obvious, since only 13% of A2780S and 7% of A2780CP cells remained alive after 24 h of treatment with both MA1 and cisplatin. Moreover, we examined the expression of bcl2, p53, caspase3/9 genes at RNA and protein levels using RT-qPCR and Western blot, respectively, to figure out the cell death mechanism induced by MA1. A significant down-regulation in bcl2 and p53 genes was observed in treated cells compared to non-treated cells ( < 0.05), suggesting that MA1 may not follow the canonical pathway to induce apoptosis in ovarian cancer cell lines. MalforminA1 showed promising anticancer activity by inducing cytotoxicity in cisplatin-sensitive and cisplatin-resistant cancer cell lines. Interestingly, a synergistic effect was observed when MA1 was combined with cisplatin, leading to it overcoming its resistance to cisplatin.
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http://dx.doi.org/10.3390/molecules26123624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231817PMC
June 2021

Pancytopenia Resulting From Low-Dose Methotrexate Use: A Diagnostic Challenge.

Cureus 2021 May 23;13(5):e15193. Epub 2021 May 23.

Medical Intensive Care Unit, Darul Sehat Hospital, Karachi, PAK.

Rheumatoid arthritis (RA) is a common autoimmune disease primarily affecting small joints which leads to crippling erosion of the articular cartilage and bone. It is associated with complications related to both its disease course and treatment. Methotrexate (MTX) is a folate antagonist responsible for modulating cell-specific signaling pathways and inhibiting the proinflammatory properties of major cell lineages involved in the pathogenesis of RA. It is considered to be the first-line agent in RA because of its disease-modifying ability and safety profile at low doses. This case report discusses how a middle-aged female presented with severe bone marrow suppression secondary to MTX toxicity, an unusual presentation at the usual low-dose regimen. Her presentation overlapped with several other conditions, especially with Felty's syndrome, a rare complication of RA, characterized by the triad of splenomegaly, neutropenia, and RA. Other differentials included hemophagocytic lymphohistiocytosis, hematologic neoplasms, drug reaction, and infection. Therefore, it was essential to exclude all possible differentials before initiating therapy. We found the corrected reticulocyte count coupled with a good response to leucovorin to be an effective way to differentiate MTX-induced pancytopenia from other possible hematologic diagnoses without the use of a bone marrow biopsy. Additionally, our case incidentally demonstrated a potential interaction between piperacillin/tazobactam and MTX.
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http://dx.doi.org/10.7759/cureus.15193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221657PMC
May 2021

Cardiac Mesenchymal Cells Cultured at Physiologic Oxygen Tension Have Superior Therapeutic Efficacy in Heart Failure Caused by Myocardial Infarction.

Front Cell Dev Biol 2021 26;9:662415. Epub 2021 May 26.

Department of Medicine, Institute of Molecular Cardiology, University of Louisville, Louisville, KY, United States.

Stem/progenitor cells are usually cultured at atmospheric O tension (21%); however, since physiologic O tension in the heart is ∼5%, using 21% O may cause oxidative stress and toxicity. Cardiac mesenchymal cells (CMCs), a newly discovered and promising type of progenitor cells, are effective in improving left ventricle (LV) function after myocardial infarction (MI). We have previously shown that, compared with 21% O, culture at 5% O increases CMC proliferation, telomerase activity, telomere length, and resistance to severe hypoxia . However, it is unknown whether these beneficial effects of 5% O translate into greater therapeutic efficacy in the treatment of heart failure. Thus, murine CMCs were cultured at 21% or 5% O. Mice with heart failure caused by a 60-min coronary occlusion followed by 30 days of reperfusion received vehicle, 21% or 5% O CMCs via echocardiography-guided intraventricular injection. After 35 days, the improvement in LV ejection fraction effected by 5% O CMCs was > 3 times greater than that afforded by 21% O CMCs (5.2 vs. 1.5 units, < 0.01). Hemodynamic studies (Millar catheter) yielded similar results both for load-dependent (LV dP/dt) and load-independent (end-systolic elastance) indices. Thus, two independent approaches (echo and hemodynamics) demonstrated the therapeutic superiority of 5% O CMCs. Further, 5% O CMCs, but not 21% O CMCs, significantly decreased scar size, increased viable myocardium, reduced LV hypertrophy and dilatation, and limited myocardial fibrosis both in the risk and non-infarcted regions. Taken together, these results show, for the first time, that culturing CMCs at physiologic (5%) O tension provides superior therapeutic efficacy in promoting cardiac repair . This concept may enhance the therapeutic potential of CMCs. Further, culture at 5% O enables greater numbers of cells to be produced in a shorter time, thereby reducing costs and effort and limiting cell senescence. Thus, the present study has potentially vast implications for the field of cell therapy.
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http://dx.doi.org/10.3389/fcell.2021.662415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189180PMC
May 2021

Therapeutic potential of biogenic titanium dioxide nanoparticles: a review on mechanistic approaches.

Nanomedicine (Lond) 2021 07 4;16(16):1429-1446. Epub 2021 Jun 4.

Department of Botany, PMAS Arid Agriculture University, Rawalpindi, Punjab 46300, Pakistan.

Biogenic titanium dioxide nanoparticles have unique size, shape and biochemical functional corona that embellish them with the potential to perform therapeutic actions such as anticancer, antimicrobial, antioxidant, larvicidal and photocatalysis by adopting various mechanistic or physiological approaches at the molecular level. We have provided a detailed overview of some of these physiological mechanisms, including disruption of the electron transport chain, DNA fragmentation, mitochondrial damage, induction of apoptosis, disorganization of the plasma membrane, inhibition of ATP synthase activity, suspension of cellular signaling pathways and inhibition of enzymatic activity. The biogenic synthesis of customized titanium dioxide nanoparticles has future application potentials to do breakthroughs in the pharmaceutical sectors to advance precision medicine and to better explain the disease prognosis and treatment strategies.
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http://dx.doi.org/10.2217/nnm-2021-0020DOI Listing
July 2021

What are the Economic Costs to Society Attributable to Alcohol Use? A Systematic Review and Modelling Study.

Pharmacoeconomics 2021 07 10;39(7):809-822. Epub 2021 May 10.

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.

Background: Alcohol-attributable costs to society are captured by cost-of-illness studies, however estimates are often not comparable, e.g. due to the omission of relevant cost components. In this contribution we (1) summarize the societal costs attributable to alcohol use, and (2) estimate the total costs under the assumption that all cost components are considered.

Methods: A systematic review and meta-analyses were conducted for studies reporting costs from alcohol consumption for the years 2000 and later, using the EMBASE and MEDLINE databases. Cost estimates were converted into 2019 international dollars (Int$) per adult and into percentage of gross domestic product (GDP). For each study, weights were calculated to correct for the exclusion of cost indicators.

Results: Of 1708 studies identified, 29 were included, and the mean costs of alcohol use amounted to 817.6 Int$ per adult (95% confidence interval [CI] 601.8-1033.4), equivalent to 1.5% of the GDP (95% CI 1.2-1.7%). Adjusting for omission of cost components, the economic costs of alcohol consumption were estimated to amount to 1306 Int$ per adult (95% CI 873-1738), or 2.6% (95% CI 2.0-3.1%) of the GDP. About one-third of costs (38.8%) were incurred through direct costs, while the majority of costs were due to losses in productivity (61.2%).

Discussion: The identified cost studies were mainly conducted in high-income settings, with high heterogeneity in the employed methodology. Accounting for some methodological variations, our findings demonstrate that alcohol use continues to incur a high level of cost to many societies.

Registration: PROSPERO #CRD42020139594.
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http://dx.doi.org/10.1007/s40273-021-01031-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8200347PMC
July 2021

Three new guaiane-type sesquiterpenoids and a monoterpenoid from Merr.

Nat Prod Res 2020 Dec 1:1-14. Epub 2020 Dec 1.

Department of Natural Product Chemistry, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China.

Three undescribed guaiane-type sesquiterpenes (), and a monoterpenoid () along with eleven known compounds () were isolated from the crude extract of Merr. The structures of all the isolated compounds were extensively elucidated on the basis of comprehensive spectroscopic techniques (HRESIMS, 1 D NMR, and 2 D NMR). Their relative and absolute configurations were comprehensively established by NOESY spectroscopy, circular dichroism (ECD) and the calculated ECD analysis. All the isolates were tested for anti-inflammatory activity by measuring the amount of nitric oxide production. Amongst tested compounds, compounds exhibited moderate inhibitory activities against the production of nitric oxide with IC value of 35.5, 32.1, 46.7 M in RAW264.7 cells stimulated by LPS, respectively.
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http://dx.doi.org/10.1080/14786419.2020.1853727DOI Listing
December 2020

Color blindness in dental profession: An issue unexplored.

Indian J Ophthalmol 2021 05;69(5):1336-1337

Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-graduate Research Institute, Parbhani, Maharashtra, India.

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http://dx.doi.org/10.4103/ijo.IJO_357_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186567PMC
May 2021

Estimating the economic consequences of substance use and substance use disorders.

Expert Rev Pharmacoecon Outcomes Res 2021 Oct 26;21(5):869-876. Epub 2021 Apr 26.

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.

Introduction: This contribution gives an overview on estimating the economic impact of substance use (SU) and substance use disorders (SUDs) from a societal perspective.

Areas Covered: In this Expert Review, we first discuss the scope of the economic costs of SU to society and the methods used to estimate them. In general, cost studies should not be limited to SUDs, but should also include costs related to the consequences of any type of SU to achieve a comprehensive picture of the societal burden. Further, estimating potentially avoidable costs will increase the value of cost studies. Importantly, methodologically sound cost studies shed light on the magnitude of societal problems related to SU and can be used as a reference point to evaluate regulatory policies and other preventive measures. The area of estimating potential economic benefits of SU is understudied and lacks a theoretical and methodological framework.

Expert Opinion: Overall, economic studies on the impact of SU and SUDs can strongly contribute to better-informed decision-making in the creation of regulatory and control policies. The least developed area of research refers to a consensus methodology that could be used in studies which compare economic costs to potential economic benefits.
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http://dx.doi.org/10.1080/14737167.2021.1916470DOI Listing
October 2021

Exploring the impact of the COVID-19 pandemic on pediatric surgical services: a scoping review.

Minerva Pediatr (Torino) 2021 Apr 12. Epub 2021 Apr 12.

Department of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA.

Inevitably, along with other healthcare specializations, pediatric surgery was affected by the Coronavirus disease-19 (COVID-19) pandemic. Children were reported to manifest mild to moderate symptoms and mortality was primarily observed in patients aged <1 year and having underlying comorbidities. The majority of the cases were asymptomatic in children, hence, posing a challenge for pediatric surgery centers to take drastic measures to reduce the virus transmission. Telemedicine was introduced and outpatient consultations were conducted online as out-patient clinics were closed. Elective surgeries were postponed with delayed appointments while the healthcare sector was diverted towards tackling COVID-19. Case urgency was classified and triaged, leading to limited surgeries being performed only in COVID-19 negative patients following an extensive screening process. The screening process consisted of online history taking and RT-PCR tests. Newer practices such as mouth rinse, video laryngoscopy, and anesthesia were introduced to restrict patients from crying, coughing, and sneezing, as an attempt to avoid aerosolization of viral particles and safely conduct pediatric surgeries during the pandemic. Surgical trainees were also affected as the smaller number of surgeries conducted reduced the clinical experience available to medical enthusiasts. There is still room for advanced practices to be introduced in pediatric surgery, and restore all kinds of surgeries to improve the quality of life of the patient.
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http://dx.doi.org/10.23736/S2724-5276.21.06146-6DOI Listing
April 2021

Insight on the fractionations and structural characterizations of innovative antidiarrheal compounds screened from leaves of Psidium guajava of local origin in Pakistan.

Pak J Pharm Sci 2020 Sep;33(5(Supplementary)):2323-2329

Imran Adrees College of Pharmacy, 3Km Daska Road, Sialkot, Pakistan.

Numerous ailments have been effectively treated with natural plants for long time all over the world. Plants provided a back bone for the exploration of novel medicinal compounds. Therefore, chief focus of our study was to isolate the biologically active compounds from the plant source and evaluate their antidiarrheal potentials, as diarrhea is still the most dominant disease in developing countries. The isolation and structure elucidation of two new compounds were identified from methanolic and chloroform extracts of Psidium guajava (guava) leaves. Extracts of plants were acquired by successive maceration from dried powder. Castor oil induced diarrheal-model was used to evaluate the antidiarrheal activity and therapeutic response was endorsed to the suppression of normal and wet stools in Spraug Dawley rats. Through the series of fractionations, compound-A was obtained from methanolic extract and named 3-(4-amino 1,3,8-tri-OH 5,6-di-CH 7-propyl 1,2,3,4,4a,5,8,8a-octahydronaphthalen 2-yl) propanoic3-(4-NH3 7-butyl 1,3,8-tri-OH 5,6-di-CH 1,2,3,4,4a,5,8,8a-octahydronaphthalen 2-yl)propanoic anhydride. Compound-B was entitled 5-(3-hydroxy-1,4-di-CH3-1,2,3,4,4a,5,8,8a-octahydronaphthalen-2-yl)pent-3-enoic acid was acquired from the chloroform extract. The structure elucidations of both compounds were interpreted through spectroscopic data, including EI-MS, FTIR, HNMR and C-NMR. The significant antidiarrheal activities were determined with crude extracts and isolated compounds. In inference, present study revealed that substantial antidiarrheal feature of guava is confined to the identified compounds.
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September 2020

Comparison of Repeated Doses of C-kit-Positive Cardiac Cells versus a Single Equivalent Combined Dose in a Murine Model of Chronic Ischemic Cardiomyopathy.

Int J Mol Sci 2021 Mar 19;22(6). Epub 2021 Mar 19.

Division of Cardiovascular Medicine, Institute of Molecular Cardiology, University of Louisville, Louisville, KY 40292, USA.

Using a murine model of chronic ischemic cardiomyopathy caused by an old myocardial infarction (MI), we have previously found that three doses of 1 × 10 c-kit positive cardiac cells (CPCs) are more effective than a single dose of 1 × 10 cells. The goal of this study was to determine whether the beneficial effects of three doses of CPCs (1 × 10 cells each) can be fully replicated by a single combined dose of 3 × 10 CPCs. Mice underwent a 60-min coronary occlusion; after 90 days of reperfusion, they received three echo-guided intraventricular infusions at 5-week intervals: (1) vehicle × 3; (2) one combined dose of CPCs (3 × 10) and vehicle × 2; or (3) three doses of CPCs (1 × 10 each). In the combined-dose group, left ventricular ejection fraction (LVEF) improved after the 1st CPC infusion, but not after the 2nd and 3rd (vehicle) infusions. In contrast, in the multiple-dose group, LVEF increased after each CPC infusion; at the final echo, LVEF averaged 35.2 ± 0.6% ( < 0.001 vs. the vehicle group, 27.3 ± 0.2%). At the end of the study, the total cumulative change in EF from pretreatment values was numerically greater in the multiple-dose group (6.6 ± 0.6%) than in the combined-dose group (4.8 ± 0.8%), although the difference was not statistically significant ( = 0.08). Hemodynamic studies showed that several parameters of LV function in the multiple-dose group were numerically greater than in the combined-dose group ( = 0.08 for the difference in LVEF). Compared with vehicle, cardiomyocyte cross-sectional area was reduced only in the multiple-dose group (-32.7%, 182.6 ± 15.1 µm vs. 271.5 ± 27.2 µm, < 0.05, in the risk region and -28.5%, 148.5 ± 12.1 µm vs. 207.6 ± 20.5 µm, < 0.05, in the noninfarcted region). LV weight/body weight ratio and LV weight/tibia length ratios were significantly reduced in both cell treated groups vs. the vehicle group, indicating the attenuation of LV hypertrophy; however, the lung weight/body weight ratio was significantly reduced only in the multiple-dose group, suggesting decreased pulmonary congestion. Taken together, these results indicate that in mice with chronic ischemic cardiomyopathy, the beneficial effects of three doses of CPCs on LV function and hypertrophy cannot be fully replicated with a single dose, notwithstanding the fact that the total number of cells delivered with one or three doses is the same. Thus, it is the multiplicity of doses, and not the total number of cells, that accounts for the superiority of the repeated-dose paradigm. This study supports the idea that the efficacy of cell therapy in heart failure can be augmented by repeated administrations.
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http://dx.doi.org/10.3390/ijms22063145DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003463PMC
March 2021

The Impact of Door to Diuretic Time in Acute Heart Failure on Hospital Length of Stay and In-Patient Mortality.

Cureus 2021 Jan 16;13(1):e12742. Epub 2021 Jan 16.

Internal Medicine, University of South Florida Morsani College of Medicine Graduate Medical Education (GME) Oak Hill Hospital, Brooksville, USA.

Background Acute heart failure (AHF) can be life-threatening if not treated promptly and can significantly increase the number of annual emergency department (ED) encounters in the United States. Achieving adequate and prompt euvolemic state in AHF patients using intravenous (IV) diuretics is the cornerstone of treatment, which not only reduces in-hospital stay and mortality but also decreases healthcare expenditures. Surprisingly, the door to diuretic (D2D) time in AHF patients has always been a debatable issue among physicians worldwide, and so far, there are no set guidelines. This study examines a large cohort of AHF patients to determine the association between diuretics use within 90 minutes of ED admission and hospital length of stay (LOS) and patient mortality.  Methods Retrospective institutional data of AHF patients receiving IV diuretics following ED admission were extracted from 2016 to 2017. A total of 7,751 patients treated for AHF exacerbation were included, which were further divided into two groups based on the timing of diuretics administration (<90 minutes vs. ≥90 minutes). The primary outcomes were LOS between the two groups and hospital mortality. The standard statistical methodology was used for data analysis. Results  A total of 7,751 AHF cases receiving IV diuretics were identified. Almost 1,432 patients (18.5%) received IV diuretics within 90 minutes of ER admission (group 1) while 6,319 patients (81.5%) patients received IV diuretics after 90 minutes (group 2). Furthermore, among group 1 patients, average LOS was noted to be associated with shorter hospitalization (average of 1.423 days less as compared to group 2 patients (confidence interval (CI) =1.02-1.82; p<0.05). Finally, after controlling for other mortality risk factors, patients in group 2 were 1.435 times more likely to have died compared to patients in group 1 (CI=1.03-1.98; p<0.05). Conclusions  D2D time in AHF patients has always been a crucial judgmental decision. The current study successfully demonstrated the relation between IV diuretics administration within 90 minutes of ED admission, favorable clinical outcomes, and decreased mortality rates. More adequately powered studies are needed to validate the results of our current study further.
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http://dx.doi.org/10.7759/cureus.12742DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884126PMC
January 2021

Mechanistic elucidation of germination potential and growth of Sesbania sesban seedlings with Bacillus anthracis PM21 under heavy metals stress: An in vitro study.

Ecotoxicol Environ Saf 2021 Jan 10;208:111769. Epub 2020 Dec 10.

Department of Plant Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan. Electronic address:

Soils contaminated with heavy metals such as Chromium (Cr) and Cadmium (Cd) severely impede plant growth. Several rhizospheric microorganisms support plant growth under heavy metal stress. In this study, Cr and Cd stress was applied to in vitro germinating seedlings of a Legume plant species, Sesbania sesban, and investigated the plant growth potential in presence and absence of Bacillus anthracis PM21 bacterial strain under heavy metal stress. The seedlings were exposed to different concentrations of Cr (25-75 mg/L) and Cd (100-200 mg/L) in Petri plates. Growth curve analysis of B. anthracis PM21 revealed its potential to adapt Cr and Cd stress. The bacteria supported plant growth by exhibiting ACC-deaminase activity (1.57-1.75 μM of α-ketobutyrate/h/mg protein), producing Indole-3-acetic acid (99-119 μM/mL) and exopolysaccharides (2.74-2.98 mg/mL), under heavy metal stress condition. Analysis of variance revealed significant differences in growth parameters between the seedlings with and without bacterial inoculation in metal stress condition. The combined Cr+Cd stress (75 + 200 mg/L) significantly reduced root length (70%), shoot length (24%), dry weight (54%) and fresh weight (57%) as compared to control. Conversely, B. anthracis PM21 inoculation to seedlings significantly increased (p ≤ 0.05) seed germination percentage (5%), root length (31%), shoot length (23%) and photosynthetic pigments (Chlorophyll a: 20%; Chlorophyll b: 16% and total chlorophyll: 18%), as compared to control seedlings without B. anthracis PM21 inoculation. The B. anthracis PM21 inoculation also enhanced activities of antioxidant enzymes, including superoxide dismutase (52%), peroxidase (66%), and catalase (21%), and decreased proline content (56%), electrolyte leakage (50%), and malondialdehyde concentration (46%) in seedlings. The B. anthracis PM21 inoculated seedlings of S. sesban exhibited significantly high (p ≤ 0.05) tissue deposition of Cr (17%) and Cd (16%) as compared to their control counterparts. Findings of the study suggested that B. anthracis PM21 endured metal stress through homeostasis of antioxidant activities, and positively impacted S. sesban growth and biomass. Further experiments in controlled conditions are necessary for investigating phytoremediation potential of S. sesban in metal-contaminated soils in presence of B. anthracis PM21 bacterial strain.
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http://dx.doi.org/10.1016/j.ecoenv.2020.111769DOI Listing
January 2021

Conversion and transformation of N species during pyrolysis of wood-based panels: A review.

Environ Pollut 2021 Feb 1;270:116120. Epub 2020 Dec 1.

Joint International Research Laboratory of Biomass Energy and Materials, College of Materials Science and Engineering, Nanjing Forestry University, Nanjing, 210037, PR China. Electronic address:

Understanding the migration and conversion of nitrogen in wood-based panels (WBPs) during pyrolysis is fundamentally important for potentially transforming the N-containing species into valuable material-based products. This review firstly summarizes the commonly used methods for examining N evolution during the WBPs pyrolysis before probing into the association between the wood and adhesives.The potential effects of wood-adhesive interaction on the pyrolysis process are subsequently analyzed. Furthermore, the controversial statements from literature on the influence of adhesives on wood pyrolysis behavior are discussed, which is followed by the detailed investigation into the distribution and evolution of N-containing species in gas, liquid and char, respectively, during WBPs pyrolysis in recent studies. The differences in N species due to the heating sources (i.e. electrical heating vs microwave heating) are particularly compared. Finally, based on the characteristics of staged pyrolysis, co-pyrolysis and catalytic pyrolysis, the converting pathways for WBPs are proposed with an emphasis on the production of value-added chemicals and carbon materials, simultaneously mitigating NO emission.
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http://dx.doi.org/10.1016/j.envpol.2020.116120DOI Listing
February 2021

Linear and Decoupled Decoders for Dual-Polarized Antenna-Based MIMO Systems.

Sensors (Basel) 2020 Dec 13;20(24). Epub 2020 Dec 13.

School of Electrical Engineering & Computer Science (SEECS), National University of Sciences & Technology (NUST), Islamabad 44000, Pakistan.

Quaternion orthogonal designs (QODs) have been used to design STBCs that provide improved performance in terms of various design parameters. In this paper, we show that all QODs obtained from generic iterative construction techniques based on the Adams-Lax-Phillips approach have linear and decoupled decoders which significantly reduce the computational complexity at the receiver. Our result is based on the quaternionic description of communication channels among dual-polarized antennas. Another contribution of this work is the linear and decoupled decoder for quasi-orthogonal codes for non-square as well as square designs. The proposed solution promises diversity gains with the quaternionic channel model and the decoding solution is independent of the number of receive dual-polarized antennas. A brief comparison is presented at the end to demonstrate the effectiveness of quaternion designs in two dual-polarized antennas over available STBCs for four single-polarized antennas. Linear and decoupled decoding of two quasi-orthogonal designs is shown, which has failed to exit previously. In addition, a QOD for 2×1 dual-polarized antenna configuration using quaternionic channel model shows a 3 dB gain at 10-5 in comparison to the same code evaluated for 2×2 complex representation of the quaternionic channel. This gain is further enhanced when the received diversity for these the cases is matched i.e., 2×2. The code using the quaternionic channel model shows a further 13 dB improvement at 10-5 BER.
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http://dx.doi.org/10.3390/s20247141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763135PMC
December 2020

Remote Pain Monitoring Using Fog Computing for e-Healthcare: An Efficient Architecture.

Sensors (Basel) 2020 Nov 18;20(22). Epub 2020 Nov 18.

Department of Information and Communication Engineering, Yeungnam University, Gyeongsan 38541, Korea.

The integration of medical signal processing capabilities and advanced sensors into Internet of Things (IoT) devices plays a key role in providing comfort and convenience to human lives. As the number of patients is increasing gradually, providing healthcare facilities to each patient, particularly to the patients located in remote regions, not only has become challenging but also results in several issues, such as: (i) increase in workload on paramedics, (ii) wastage of time, and (iii) accommodation of patients. Therefore, the design of smart healthcare systems has become an important area of research to overcome these above-mentioned issues. Several healthcare applications have been designed using wireless sensor networks (WSNs), cloud computing, and fog computing. Most of the e-healthcare applications are designed using the cloud computing paradigm. Cloud-based architecture introduces high latency while processing huge amounts of data, thus restricting the large-scale implementation of latency-sensitive e-healthcare applications. Fog computing architecture offers processing and storage resources near to the edge of the network, thus, designing e-healthcare applications using the fog computing paradigm is of interest to meet the low latency requirement of such applications. Patients that are minors or are in intensive care units (ICUs) are unable to self-report their pain conditions. The remote healthcare monitoring applications deploy IoT devices with bio-sensors capable of sensing surface electromyogram (sEMG) and electrocardiogram (ECG) signals to monitor the pain condition of such patients. In this article, fog computing architecture is proposed for deploying a remote pain monitoring system. The key motivation for adopting the fog paradigm in our proposed approach is to reduce latency and network consumption. To validate the effectiveness of the proposed approach in minimizing delay and network utilization, simulations were carried out in iFogSim and the results were compared with the cloud-based systems. The results of the simulations carried out in this research indicate that a reduction in both latency and network consumption can be achieved by adopting the proposed approach for implementing a remote pain monitoring system.
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http://dx.doi.org/10.3390/s20226574DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698725PMC
November 2020

Do morbidity measures predict the decline of activities of daily living and instrumental activities of daily living amongst older inpatients? A systematic review.

Int J Clin Pract 2021 Apr 14;75(4):e13838. Epub 2020 Dec 14.

Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia.

Objectives: Older adults often suffer from multimorbidity, which results in hospitalisations. These are often associated with poor health outcomes such as functional dependence and mortality. The aim of this review was to summarise the current literature on the capacities of morbidity measures in predicting activities of daily living (ADL) and instrumental activities of daily living (IADL) amongst inpatients.

Methods: A systematic literature search was performed using four databases: Medline, Cochrane, Embase, and Cinahl Central from inception to 6th March 2019. Keywords included comorbidity, multimorbidity, ADL, and iADL, along with specific morbidity measures. Articles reporting on morbidity measures predicting ADL and IADL decline amongst inpatients aged 65 years or above were included.

Results: Out of 7334 unique articles, 12 articles were included reporting on 7826 inpatients (mean age 77.6 years, 52.7% females). Out of five morbidity measures, the Charlson Comorbidity Index was most often reported. Overall, morbidity measures were poorly associated with ADL and IADL decline amongst older inpatients.

Conclusion: Morbidity measures are poor predictors for ADL or IADL decline amongst older inpatients and follow-up duration does not alter the performance of morbidity measures.
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http://dx.doi.org/10.1111/ijcp.13838DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047900PMC
April 2021
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