Aims
Endothelial‐derived epoxyeicosatrienoic acids may regulate vascular tone and are metabolized by soluble epoxide hydrolase enzymes (sEH). GSK2256294 is a potent and selective sEH inhibitor that ...was tested in two phase I studies.
Methods
Single escalating doses of GSK2256294 2–20 mg or placebo were administered in a randomized crossover design to healthy male subjects or obese smokers. Once daily doses of 6 or 18 mg or placebo were administered for 14 days to obese smokers. Data were collected on safety, pharmacokinetics, sEH enzyme inhibition and blood biomarkers. Single doses of GSK2256294 10 mg were also administered to healthy younger males or healthy elderly males and females with and without food. Data on safety, pharmacokinetics and biliary metabolites were collected.
Results
GSK2256294 was well‐tolerated with no serious adverse events (AEs) attributable to the drug. The most frequent AEs were headache and contact dermatitis. Plasma concentrations of GSK2256294 increased with single doses, with a half‐life averaging 25–43 h. There was no significant effect of age, food or gender on pharmacokinetic parameters. Inhibition of sEH enzyme activity was dose‐dependent, from an average of 41.9% on 2 mg (95% confidence interval CI –51.8, 77.7) to 99.8% on 20 mg (95% CI 99.3, 100.0) and sustained for up to 24 h. There were no significant changes in serum VEGF or plasma fibrinogen.
Conclusions
GSK2256294 was well‐tolerated and demonstrated sustained inhibition of sEH enzyme activity. These data support further investigation in patients with endothelial dysfunction or abnormal tissue repair, such as diabetes, wound healing or COPD.
Cloud computing has become increasingly popular for data storage and processing, but security and privacy remain major concerns due to the potential for malicious attacks on wireless and mobile ...communication networks. In order to address these issues, researchers have proposed an IAS protocol that incorporates identity, access control, and secure authentication. To ensure the authenticity and security of data transmission in cloud computing, the proposed IAS protocol is implemented on top of blockchain technology. This allows for decentralized key management for recovery and revocation, as well as identity verification. To evaluate the effectiveness of this approach, the proposed model using Block Chain based Identity Management, Access Control and Secure Sharing (BC-IAS) is simulated on the cloud environment. The simulation assesses primary performance key metrics, including Data Access Rate, Message Delivery Ratio, End to End Delay and Energy consumption. Overall, the proposed BC-IAS protocol on top of blockchain technology shows promise for enhancing security and privacy in cloud computing. The proposed BC-IAS protocol on top of blockchain technology presents a promising solution for enhancing the security and privacy of cloud computing. The decentralized nature of blockchain technology ensures that data is stored in a tamper-proof and transparent manner, while the use of smart contracts allows for automated enforcement of access control policies. Moreover, the incorporation of identity verification and secure authentication ensures that only authorized users can access sensitive data, reducing the risk of data breaches and cyber-attacks.
Dens in dente is a developmental dental anomaly which poses a challenge for the endodontist due to its complex pulpal anatomy. In this case report, a class 2 dens in dente was managed nonsurgically. ...A 32-year-old female reported with a palatal swelling and pain in the upper front region of the jaw. On examination, #7 was observed to be malformed and showed a negative pulpal sensibility test. Radiographic and CBCT analysis revealed Ohler’s type 2 dens in dente with a periapical radiolucency. In the first visit, invagination was removed using diamond-coated ultrasonic tips, the canal was minimally instrumented, and premixed calcium hydroxide was injected in the canal which accidentally extruded periapically. After two weeks, a draining sinus was observed on the palatal side which when traced, lead to #7. Intracanal dressing was replaced with a mix of powdered calcium hydroxide and saline. The dressing was replaced every two weeks, and radiographs were taken, which revealed the resorption of extruded calcium hydroxide and reduction in the osseous defect. Biodentine was used to obturate the entire canal space. Subsequent follow-up radiographs till 24 months showed significant periapical healing and resorption of extruded calcium hydroxide.
Introduction: Temporomandibular Joint (TMJ) has been a controversial topic in Oral and Maxillofacial Surgery speciality especially regarding temporomandibular joint disorders and internal derangement ...of articular disc. The aetiology behind it has been related to the anatomic variations of the disc and its impact on the functioning of the articular disc. To understand such anatomic variation, the study has been conducted that will help future maxillofacial surgeon’s in designing accurate prosthetic articular disc that will improve the overall mechanics of the functioning of the prosthetic disc. Aim: To analyse the morphometric variations of the intra-articular disc in terms of circumference of the disc, perforations and their thickness within the disc in cadavers. Materials and Methods: The present observational study was carried out on cadavers in the Department of Anatomy. SBKS Medical College and Research Centre, Sumandeep Vidyapeeth University, Gujarat, India. The study was done from January 2017 to October 2018. Temporomandibular joints were dissected bilaterally from 10 human cadavers, i.e., 20 articular discs. The disc was removed and was measured with the help of thread, vernier callipers and standardised metallic scale and the circumference and thickness in the disc were evaluated. Descriptive statistical test was used and Chi-square test was applied. Results: Mean thickness of disc, both in males as well as females ranged from 1.4-2.0 mm in the Posterio-Medial (PM) and Posterio- Lateral (PL) region, while in Anterio-Medial (AM) and Anterio- Lateral (AL) region it ranged from 1.6-1.8 mm. Maximum length of disc ranged from 12-13 mm in anterio-posterio dimension while in Medio-Lateral (ML) it was 22-23 mm. Conclusion: The study gives an indepth knowledge about the various morphometric variations of articular disc and also shows its impact on the functioning of the disc. The study also directs maxillofacial surgeons to design prosthetic articular disc with greater accuracy and anatomical knowledge so that the procedures like surgical replacement of the disc can be carried out with greater potency and efficacy for the betterment of the patient.
Gastric cancer is one of the leading cancers in Southern India. Data regarding the gastric cancers among the Indian population is sparse. Most patients in our country have locally advanced gastric ...cancers due to delayed presentation. In this article, we present our data regarding the presentation patterns, epidemiological demographics, surgical outcomes, and survival patterns from a tertiary care center in South India. This is a retrospective analysis of gastric cancer patients who underwent gastrectomy in our institution between January 2015 and November 2021 (
n
= 102). The data regarding patient characteristics, histopathology, and perioperative outcomes were analysed from medical records. The adjuvant treatment received and survival details were collected from the follow-up records and by telephonic interviews. A total of 128 patients were assessable, 102 patients underwent gastrectomy in a period of 6 years. The median age of presentation was 60 years and males were more commonly affected (70.6%). Most common presentation was pain abdomen followed by gastric outlet obstruction. Adenocarcinoma NOS (93%) was the most common histological type. Most of the Patients had antropyloric growths (79.4%) and subtotal gastrectomy with D2 lymphadenectomy was the most common surgery performed. Majority of the tumors were T4 tumors (55.9%) and nodal metastases were detected in 74% of the specimens. Predominant morbidity was wound infection (6.1%) followed by anastomotic leak (5.9%) with a combined overall morbidity of 16.7% and 30-day mortality of 2.9%. Seventy five (80.5%) patients were able to complete all planned 6 cycles of adjuvant chemotherapy. The median time of survival calculated by Kaplan–Meier method was 23 months with 2-year and 3-year overall survival rates of 31% and 22%, respectively. Lymphovascular invasion (LVSI) and lymph nodal burden were the risk factors associated with recurrences and deaths. The patient characteristics, histological factors, and perioperative outcomes revealed most of our patients presented in locally advanced stages with poor risk histological types and increased nodal burden contributing to the lower survival in our population. Inferior survival outcomes suggest the need to explore perioperative and neoadjuvant chemotherapy options in our population.
A scaly eruption on the body Kwan, Julia; Hoverson, Kara; Arora, Navin S.
International journal of dermatology,
January 2016, Letnik:
55, Številka:
1
Journal Article
Abstract A clinical decision support system is a computer-based system that is designed to assist healthcare providers with clinical decision-making by analyzing electronic health records and other ...healthcare information systems to provide real-time support to clinicians at the point of care. A novel classification framework for clinical datasets in which the relevant features are selected by ranking them based on Fisher’s Score and a wrapper-based Satin Bower Bird Optimization algorithm with the combination of accuracy, G-mean and F-Score measured by support vector machine (SVM) as the fitness function is proposed. The classification is performed using an SVM classifier in which the hyperparameters of the SVM classifier are optimized using the Satin Bower Bird Optimization that improves the classification performance. In the context of statistical analysis, the research undergoes a non-parametric Friedman Test. This study selects relevant attributes from three clinical datasets from the Machine Learning Repository maintained by the University of California Irvine and achieved an accuracy of 86% for the Breast Cancer Wisconsin (Diagnostic) dataset, 89% for the Diabetic Retinopathy Debrecen dataset, and 91% for the EEG Eye State dataset respectively. When compared with other machine learning classifiers the proposed approach performed well with feature selection compared with other machine learning classifiers.
Objective
Mental health treatment is often initiated in primary care settings, but many primary care providers (PCPs), residents, and medical students report discomfort in managing psychiatric ...conditions. This study evaluated the effect of an educational workshop that featured an evidence-based psychopharmacology clinical decision support tool (CDST) on trainee confidence and willingness to treat psychiatric conditions.
Methods
Participants completed pre- and post-workshop surveys. Nine months after the workshop, a subset of trainees participated in a focus group.
Results
Of the participants, 62.5% of the obstetrics-gynecology (OB-GYN) resident physicians (10/16) and 100% of the medical students (18/18) completed both pre- and post-surveys. Following the workshop, OB-GYN resident physicians reported significantly improved confidence in treating psychiatric disorders (
p
< 0.001), sense of having psychiatric support tools (
p
< 0.001), and knowledge of treating psychiatric disorders (
p
= 0.021). Medical students reported significantly improved confidence in treating psychiatric disorders (
p
< 0.001), willingness to devise treatment plans for psychiatric disorders (
p
= 0.024), sense of having psychiatric support tools (
p
< 0.001), knowledge of treating psychiatric disorders (
p
< 0.001), and comfort in presenting a psychiatric treatment plan to an attending (
p
= 0.003). Most focus group participants (93.75%; 15/16) reported that they continued to use the CDST, and it increased their confidence in formulating psychiatric treatment plans.
Conclusions
These findings suggest that educational workshops that introduce high-quality psychopharmacology CDSTs may be an effective method for improving provider comfort in treating psychiatric disorders.
Background: Dental extraction is the removal of a tooth from the oral cavity and is the most common procedure performed in oral surgery. Conventional exodontia tends to cause unnecessary trauma ...leading to postoperative pain, loss of tissue and stress for the patient. ‘Atraumatic’ dental extraction techniques have nowadays gained popularity and in such case, physics forceps can be helpful in achieving such results. The aim of the study was to evaluate and compare efficacy of physics forceps versus conventional forceps in therapeutic extraction of premolars.Methods: A total of 35 patients requiring extraction of premolars in maxillary or mandibular arch or both arches for orthodontic treatment purpose were included and divided into groups A and B wherein right sided extractions performed with physics forceps were compared with left sided extractions carried out using conventional forceps in terms of time taken for extraction, bone and soft tissue injury, success score and pain assessment.Results: The present study suggested statistically significant difference between both the groups. Time taken for extraction, trauma to gingival tissue, bone loss, and visual analogue scale (VAS) score was significantly lesser with physics forceps group, when compared to conventional forceps group. Moreover no significant difference in success score was noted between both the groups.Conclusions: Physics forceps are comparatively superior to conventional extraction forceps in terms of lesser time taken for the procedure, lesser tendency to induce trauma to both hard and soft tissue and have been found to induce comparatively lesser pain post extraction.
Dental treatment of young pediatric patients can be confounded by lack of cooperation for dental rehabilitation procedures and even examination and/or radiographs. With the recent US Food and Drug ...Administration warning applied to many anesthetic/sedative agents for children less than 3 years old, a retrospective review of general anesthesia (GA) cases from 1 private pediatric dental practice was studied for age, gender, body mass index, anesthetic duration, airway management used, extent of dental surgical treatment, recovery time, and cardiac/pulmonary complications. For the 2016 calendar year, 351 consecutive GA cases were identified with patients aged 2-13 years. Of these, 336 underwent nasal endotracheal intubation. Forty-six of 351 patients (13%) were younger than 3 years. Median anesthesia duration was approximately 1.7 hours for all age groups. Dental treatment consisting of 8-9 teeth including crowns, fillings, and extractions was most frequently encountered. One hundred sixty-eight patients (48%), however, required care for 10-18 teeth. There were no episodes of significant oxygen desaturation. The overall complication rate was 1.1%, with 2 cases of postextubation croup, 1 case of mild intraoperative bronchospasm, and 1 case of intraoperative bradycardia. Complications did not correlate with children being overweight or obese.
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