This study compares the effectiveness of pharmacological treatments to develop guidelines for the management of acute pain after tooth extraction. We searched Medline, EMBASE, CENTRAL, and US ...Clinical Trials registry on November 21, 2020. We included randomized clinical trials (RCTs) of participants undergoing dental extractions comparing 10 interventions, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and combinations to placebo. After duplicate screening and data abstraction, we conducted a frequentist network meta-analysis for each outcome at 6 h (i.e., pain relief, total pain relief TOTPAR, summed pain intensity difference SPID, global efficacy rating, rescue analgesia, and adverse effects). We assessed the risk of bias using a modified Cochrane RoB 2.0 tool and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We implemented the analyses in RStudio version 3.5.3 and classified interventions from most to least beneficial or harmful. We included 82 RCTs. Fifty-six RCTs enrolling 9,095 participants found moderate- and high-certainty evidence that ibuprofen 200 to 400 mg plus acetaminophen 500 to 1,000 mg (mean difference compared to placebo MDp, 1.68; 95% confidence interval CI, 1.06–2.31), acetaminophen 650 mg plus oxycodone 10 mg (MDp, 1.19; 95% CI, 0.85–1.54), ibuprofen 400 mg (MDp, 1.31; 95% CI, 1.17–1.45), and naproxen 400–440 mg (MDp, 1.44; 95% CI, 1.07–1.80) were most effective for pain relief on a 0 to 4 scale. Oxycodone 5 mg, codeine 60 mg, and tramadol 37.5 mg plus acetaminophen 325 mg were no better than placebo. The results for TOTPAR, SPID, global efficacy rating, and rescue analgesia were similar. Based on low- and very low-certainty evidence, most interventions were classified as no more harmful than placebo for most adverse effects. Based on moderate- and high-certainty evidence, NSAIDs with or without acetaminophen result in better pain-related outcomes than opioids with or without acetaminophen (except acetaminophen 650 mg plus oxycodone 10 mg) or placebo.
Objective
The aim of this study was to examine internal responsiveness and estimate minimally important differences (MIDs) for CLEFT-Q scales.
Design
In this prospective cohort study, participants ...completed the CLEFT-Q appearance and health-related quality of life (HRQL) scales before and six months after cleft-related surgery.
Setting
Seven cleft centres in Canada, USA and UK participated.
Patients/Participants
Patients were ages 8–29 years with CL/P.
Interventions
Patients underwent rhinoplasty, orthognathic or cleft lip scar revision surgery.
Main Outcome Measure(s)
Internal responsiveness was examined using Cohen's d effect sizes (ESs) based on the following interpretation: 0.20–0.49 small, 0.50–0.79 moderate and ≥ 0.80 large. MIDs were estimated using two distribution-based approaches.
Results
Participants had a rhinoplasty (n = 31), orthognathic (n = 21) or cleft lip scar revision (n = 18) surgery. Most participants were males (56%) and aged 8–11 years (41%). Following rhinoplasty, ESs were larger for the nose (0.92, p = 0.001) and nostrils (0.94, p < 0.001) scales than for the face scale (0.51, p = 0.003). MIDs ranged between 6.2–10.4. For orthognathic surgery, larger ES was observed for the jaws scale (1.80, p < 0.001) compared with the teeth (1.16, p < 0.001), face (1.15, p = 0.001) and lips (0.94, p < 0.001) scales. MIDs ranged between 5.9–14.4. In the cleft lip scar revision sample, the largest ES was observed for the nose scale (0.76, p = 0.03), followed by lips (0.58, p = 0.009) and cleft lip scar (0.50, p = 0.043) scales. MIDs ranged between 6.4–12.3.
Conclusions
CLEFT-Q detected change in key outcomes for three cleft-specific surgeries, providing evidence of its responsiveness. Estimated MIDs will aid in interpreting this PROM.
The relevance of the article stems from the fact that every year for 26 years, the expedition of winterers goes to the Ukrainian Antarctic Station “Vernadsky Research Base” to carry out scientific ...research. Their effective adaptation to extreme conditions of life provides qualitative psychological diagnostics and psychological recommendations. The purpose of this article is to provide a theoretical justification and empirical evidence of the specific features of Ukrainian winterers’ age in the process of adaptation to the Antarctica conditions. To achieve the results of the study, the article uses the method of sociometric measurement J. Moreno, method of distributing topics by rank, questionnaire. The authors of the article analysed scientific works on the research problem, clarified the concept of “adaptation” and “adaptability” and age limits of the groups of winterers, described methodological tools and conducted empirical research on the specific features of the age of winterers groups during the adaptation. The article justifies the distribution and identifies groups of high, medium and low adaptability to life under extreme conditions in Antarctica. The authors analysed both the data from the empirical study and the interviews with the surveyed winterers. The study’s conclusions are: senior winterers have more experience adapting to extreme conditions than younger generations. They can build better interpersonal relationships in a closed community and easily carry distance from home and homesickness. The study revealed that senior persons (especially representatives of the “Generation of winners’ children”) motivate wintering in Antarctica with a desire for self-fulfilment, being worthy representatives of Ukraine on a distant continent, and feeling responsible for discharging their duties. After all, they are governed by more professional and social motivations that help to better adapt to extreme conditions. The practical value of the work is to develop tools for psychological diagnosis and to provide guidance on the selection of winterers among candidates for wintering
Extension of the effective range of vaned diffusers is one of the promising ways to improve the centrifugal compressor's stages which are used in numerous fields of industry. The new method of ...profiling of the diffuser vanes has been developed using Stratford's results and boundary layer theory by Loytsanskiy. The developed method is based on the solution of the inverse task of gas-dynamic using given velocity distribution along the vane's surface. Comparison of the results of numerical simulations for different diffusers has shown that the performance of the diffuser designed with the resulting velocity distribution are better. Influence of the vane profile, number of the vanes, diffuser outlet diameter and the diffuser width on diffuser characteristics has been investigated. The results of the simulations have been used to formulate recommendations on the design of high-effectiveness vaned diffusers for centrifugal stages of different types.
Background
Antarctica is a unique place to study the health condition under the influence of environmental factors on the organism in pure form. Since the very beginning of the scientific presence of ...Ukraine in the Antarctic, biomedical research has been developed for the monitoring of individual biomarkers of winterers and medical accompaniment in Antarctic expeditions.
The aim
of the study was to analyze and discuss the retrospective data of long-term monitoring and observations in Ukrainian Antarctica station “Akademik Vernadsky,” providing multi-scale biomedical information with regard to conditions of a perfect isolation from technological and social influences and under extreme environmental factors.
Methods
Medical and biological studies have been performed with the participation of all 20 Ukrainian wintering expeditions. We surveyed 200 males aged 20–60 years (mean age 37 years). Extensive medical examinations were carried out before the expedition, during the selection of candidates, and after returning, and particular functions were monitored during the entire stay in Antarctica. The medical records were analyzed to study the reaction of the human organism on phenomena like “Antarctic syndrome,” dysadaptation, anxiety, desynchronosis, photoperiodism, influence of climatic and meteofactors like “Schumann resonance,” infrasound, “ozone hole,” and “sterile” environment; important aspects of its role on human health were precisely studied and discussed.
Results
The examinations showed the multi-level symptoms of the processes of dysregulation and dysadaptation, as functional tension in the sympathetic-adrenal system rights, especially during urgent adaptation to the Antarctic (1-month stay at the station) and, to a lesser extent, after returning from an expedition to Kyiv. At the initial, adaptation to the conditions of the Antarctic levels of urinary catecholamines (epinephrine, norepinephrine, dopamine, DOPA) increased compared with the start of the expedition (23.2 ± 4.3 and 53.3 ± 5 2 mmol/l,
p
< 0.001; 67.1 ± 12.3 and 138.3 ± 16.9 mmol/l,
p
< 0.01; 1749.6 ± 476.5 vs 7094.6 ± 918.3 mmol/l,
p
< 0.001; 129.6 ± 12.3 and 349.9 ± 40.6 mmol/l,
p
< 0.001, respectively). In the blood serum of 100 % of the expedition, we found an increase of oxidative stress markers—the level of TBARS increased by 41.2 %, i.e., the activation of free radical peroxidation. Thus, in 80 % of the participants, we observed a reduction in the activity of the SOD antiradical enzyme vs 58 % in the controls. Changes in brain electrical activity after a long stay at the Antarctic stations showed increasing delta rhythms, signs of CNS protective inhibition, likely due to hypoxia. We found changes in the concentrations of microelements (iron, copper, zinc, etc.) in the blood of winterers after the expedition. The polychrome-adaptive method of correcting the changes of the psycho-emotional state in a monochrome Antarctic environment was successfully applied.
Conclusions
The preliminary results of the retrospective study and our own observations of the fundamental physiological mechanisms of the negative influence of extreme environmental factors on an organism in the absence of man-made origin factors allow the determination of many mechanisms of “pre-pathology” processes which promise to develop the pathogenetically based pro-active prevention methods for a number of common diseases to set prospective interdisciplinary research in predictive, preventive, and personalized medicine.
We identified, synthesized, and field-tested the sex pheromone of female red cedar cone midge Mayetiola thujae (Hedlin) (Diptera: Cecidomyiidae), a pest insect in red cedar Thuja plicata seed ...orchards. Coupled gas chromatographic (GC)-electroantennographic detection analyses of pheromone extract revealed three components (A, B, C) that elicited responses from antennae of males, all of which occurred below the detection threshold of the mass spectrometer and thus had to be identified without spectroscopic data. Taking into account (1) their retention indices (RI) on three GC columns (DB-5, DB-23, and DB-210), (2) intercolumn RI differentials, and (3) the molecular structures of known cecidomyiid pheromones, we synthesized seven candidate pheromone components: 2,10-, 2,11-, 2,12-, 2,13-, 2,14-, 2,15- and 2,16-diacetoxyheptadecanes. Of these, 2,12-, 2,13-, and 2,14-diacetoxyheptadecane had RIs on all columns consistent with those of A, B, and C and elicited strong antennal responses when tested at picogram levels. In field experiments with the twelve stereoselectively synthesized stereoisomers, only the SS-stereoisomers of 2,12-, 2,13-, and 2,14-diacetoxyheptadecane attracted male M. thujae. The three-component SS-stereoisomer blend was more attractive than the 12-component blend of all stereoisomers, suggesting that one or several nonnatural stereoisomers are inhibitory. One-, two-, and three-component lures of the SS-stereoisomers were equally effective in attracting male M. thujae, indicating redundancy in the pheromone. Identification of the M. thujae sex pheromone will allow development of pheromone-based monitoring, and possibly control, of M. thujae populations in T. plicata seed orchards.
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