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Although several previous studies have focused on pedestrian safety, most of the studies have focused on urban roads. This study investigated accident data among 1358 pedestrians from 2012 to 2018 on urban, suburban, and rural roads in 16 cities in the Gilan province of Iran using structural equation modelling (SEM). Factor analysis showed that four exogenous latent variables had a significant relationship with fatal accidents among pedestrians. Factors related to roads (coefficient 0.968), vehicles (coefficient 0.632), humans (coefficient 0.306), and the environment (coefficient 0.194) were respectively the most important for pedestrian safety status. The main findings also proclaim that the poor quality of cars manufactured in Iran in addition to the poor design of intersections and major roads (urban) and ring roads (suburban) may be important reasons of the increased fatal accidents in the studied areas. A potential cause for these accidents may be rooted in less attention towards giving behavioural instructions to road users, and underdeveloped driver education procedures. Finally, the data-model fit of the SEM was validated using different indicators, and suggestions to improve safety were pointed out.Statins, ezetimibe, and PCSK9 inhibitors are currently the standard of care for the prevention and treatment of coronary artery disease. Despite their widespread use, coronary artery disease remains the leading cause of death worldwide, a fact that pleads for the development of new protective therapies. In no small part due to advances in the field of human genetics, many new therapies targeting various lipid traits or inflammation have recently received approval from regulatory agencies such as the US Food and Drug Administration or fared favorably in clinical trials. This wave of new therapies promises to transform the care of patients at risk for life-threatening coronary events.Herbal therapies are used worldwide to treat a variety of health conditions, including dental conditions in veterinary medicine. In this context, the use of medicinal plant-based formulations as potential therapeutics and preventatives in veterinary dentistry is worth highlighting. The objective of the present study was to develop a mucoadhesive ointment formulation, named orabase, that contained pomegranate extract for use in the oral cavity of dogs, with the aim of improving their oral hygiene. The hydroalcoholic extracts of pomegranate peels was incorporated into the orabase in 3 different concentrations. The formulations were subjected to in vitro microbiological testing by a modified disc-diffusion method to study the susceptibility of microorganisms collected from the oral cavities of the dogs. The samples were taken from the buccal mucosa of dogs having the same management and diet. MPP antagonist in vivo The most effective formulation was submitted to physicochemical tests to evaluate the functionality of the product, namely pH, swelling index, spreadability, and mechanical properties (hardness, cohesiveness, and adhesiveness). The formulation containing 25.0% w/w of the extract was considered most suitable for the intended use as it showed antiseptic activity and demonstrated a swelling index of approximately 35% in the first 20 minutes of the test, high spreadability, and suitable mechanical properties. The results suggest that the product obtained from pomegranate peel extract is a viable option for use to improve oral hygiene, helping to reduce the bacterial component of dental plaque in dogs.I would like to welcome our readers to volume 11 of Pain Management. Since the launch of the journal in 2011, the title has gone from strength to strength, and we are delighted to bring you a new year of content. We are starting off this issue with a look back on some of our article highlights from 2020, alongside some of this month's key content.
The survivorship of peripheral intravenous catheters (PIVCs) placed in hospitalized patients is shockingly poor and leads to frequent reinsertions. We aimed to evaluate differences in failure rates and IV insertion practices for PIVCs that are placed in the emergency department (ED) compared to those placed in the inpatient (IP) setting.
We conducted a retrospective electronic medical record review of PIVC survival at a single-site suburban, academic tertiary care referral center with 130,000 annual ED visits and 1100 inpatient beds. Adult patients admitted requiring at least one PIVC were included. The primary outcome was incidence of premature failure of PIVCs. Secondary outcomes included dwell time, completion of therapy, catheter diameter, and site of insertion as they relate to PIVC survival.
Between January 2018 and July 2019, 90,743 IV catheters were included from 47,272 unique patient encounters in which 35,798 and 54,945 catheters were placed in the ED and IP units, respectively. There was no sy used. Smaller diameter (22G) catheters have highest complications and poorest survival regardless of site of insertion. Larger diameter catheters (18 or 20 gauge) may offer improved outcomes.
The procedure for the captopril challenge test (CCT) in diagnosing primary aldosteronism (PA) is not standardized. We performed a meta-analysis to evaluate the controversial diagnostic value and influential factors of the post-captopril aldosterone/renin ratio (ARR).
We searched literature in databases for eligible studies (until October 1, 2020). We extracted information regarding study and patient characteristics, CCT methods, outcome data. We pooled studies using the random-effect model. We performed meta-regression and six pre-specified subgroup analyses to explore heterogeneity.
Nineteen studies involving 4568 subjects were included. The pooled sensitivity and specificity were 0.825 (95% CI 0.804-0.844) and 0.919 (95% CI 0.908-0.928). The area under the summary receiver operating characteristic curve was 0.9487 (95% CI 0.9207-0.9767). Meta-regression revealed that heterogeneity might derive from time interval (
= 0.0117) and study population (
= 0.0033). Subgroup analyses showed significant differences between the subgroups stratified by the dose, posture, study region, time interval, cut-off value and study population for sensitivity and/or specificity (
< 0.05).
Post-captopril ARR is comparably valuable for diagnosing PA at cut-offs from 12.0 to 50.0. Conducting the CCT in the supine position with 25 mg of captopril may attain greater sensitivity. Conducting the CCT in the seated position with 50 mg of captopril may attain greater specificity. A 90-min time interval may perform best in both the sensitivity and specificity.
Post-captopril ARR is comparably valuable for diagnosing PA at cut-offs from 12.0 to 50.0. Conducting the CCT in the supine position with 25 mg of captopril may attain greater sensitivity. Conducting the CCT in the seated position with 50 mg of captopril may attain greater specificity. A 90-min time interval may perform best in both the sensitivity and specificity.
