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Ultrasonic-assisted nanofiltration separation recovering salvianolic acid B from ethanol wastewater.Ultrasonics Sonochemistry Jun 2024The transformation of salvianolic acid B brought on by heat treatment recovery of ethanol eluent, which is a difficult problem in pharmaceutical technology, affects the...
The transformation of salvianolic acid B brought on by heat treatment recovery of ethanol eluent, which is a difficult problem in pharmaceutical technology, affects the purity of raw material when the medicinal raw material salvianolic acid B is purified by resin. Ultrasonic-assisted nanofiltration separation (UANS) was first employed to improve efficiency of resource utilization by regulating rejection and separating salvianolic acid B and rosmarinic acid from organic pharmaceutical wastewater. The rejection was related to three variables: ultrasonic power, pH, and ethanol concentration. But there were differences in the effects of variables on the rejections of salvianolic acid B and rosmarinic acid. The rejections of rosmarinic acid and salvianolic acid B showed a decreasing trend with an increase in ultrasonic power or a decrease in pH; however, when the concentration of ethanol was increased from 5 % to 35 %, the salvianolic acid B rejection increased from 84.96 % to 96.60 % and the rosmarinic acid rejection decreased from 35.09 % to 17.51 %. On the basis of response surface methodology (RSM), the optimal UANS parameters for solution conditions involving different ethanol concentrations are as follows: 10 % ethanol solution (ultrasonic power 500 W and pH 6.15), 20 % ethanol solution (ultrasonic power 500 W and pH 6.54), and 30 % ethanol solution (ultrasonic power 460 W and pH 6.34). The molecular proportions of salvianolic acid B were 10.75 %, 7.13 %, and 8.27 % in 10 %, 20 %, and 30 % ethanol wastewater, while the molecular proportions of rosmarinic acid were 40.52 %, 33.83 %, and 69.87 %, respectively. And the recoveries of salvianolic acid B in 10 %, 20 %, and 30 % ethanol wastewater were 93.56 %, 95.04 %, and 97.30 %, respectively, while the recoveries of rosmarinic acid were 3.19 %, 2.27 %, and 0.56 %. The molecular proportion and the rejection are correlated exponentially. In comparison with conventional nanofiltration separation (CNS), UANS is able to resolve the conflict between rosmarinic acid and salvianolic acid B in pharmaceutical wastewater, as well as enhance resource recycling and separation efficiency to prevent pollution of the environment from pharmaceutical wastewater. Experiments using UANS at different power intensities suggest that the ultrasonic at a power intensity of 46-50 W/L and the power density of 0.92-1.00 W/cm may resolve the separation conflict between rosmarinic acid and salvianolic acid B. This work suggests that UANS may be a significant advancement in the field of ultrasonic separation and has several potential uses in the water treatment industry.
PubMed: 38917596
DOI: 10.1016/j.ultsonch.2024.106967 -
PloS One 2024Advanced maternal-age pregnancy has become a serious public health problem in both developed and developing countries due to adverse birth outcomes for the mother,...
BACKGROUND
Advanced maternal-age pregnancy has become a serious public health problem in both developed and developing countries due to adverse birth outcomes for the mother, fetus, or newborn. However, there are limited studies conducted to identify determinants of advanced-age pregnancy in Ethiopia. Therefore, this study aimed to assess individual and community-level determinants of advanced age pregnancy in Ethiopia.
METHODS
This study was based on 2016 Ethiopian Demographic and Health Survey data. Three thousand two hundred ninety-two weighted samples of pregnant women were included in this analysis. A multilevel logistic regression model was conducted to assess the determinants of advanced-age pregnancy among the study participants in Ethiopia.
RESULTS
maternal age at first birth (AOR = 4.05, 95% CI: 1.77-9.22), level of maternal education [primary education 2.72 times (AOR = 2.27, 95 CI: 1.55-4.76) and secondary and above education (AOR = 5.65, 95% CI: 1.77-17.70)], having a history of alcohol (AOR = 11.8, 95% CI: 5.71-24.42), parity (AOR = 3.22, 95% CI: 2.69-3.84), number of household member (AOR = 1.22, 95% CI: 1.05-1.41), family planning unmet need for spacing of pregnancy (AOR = 4.79, 95% CI: 2.63-8.74), having sons/daughters elsewhere (AOR = 1.89, 95% CI: 1.22-2.94), had higher community poverty level (AOR = 2.37, 95% CI: 1.16-4.85), those had higher community unmet need for family planning (AOR = 5.19, 95% CI: 2.72-9.92) were more likely to have advanced age pregnancy. Whereas Living in an Emerging region (AOR = 0.29, 95% CI: 0.14-0.59) and living in a metropolitan city (AOR = 0.03, 95% CI: 0.03-0.38), were less likely to have advanced age pregnancy.
CONCLUSIONS
increased Maternal age at first birth, level of maternal education, history of alcohol drinking, increased number of parity and household members, family planning unmet need for spacing, had sons/daughters elsewhere, had higher community poverty level, those had higher community unmet need for family planning positively, whereas living in the emerging region and living in metropolitan's city was negatively affect advanced age pregnancy. Help women to have informed decision-making and create platforms to women have special care during this age of pregnancy. Empower women on family planning and socioeconomic status.
Topics: Humans; Female; Ethiopia; Pregnancy; Adult; Maternal Age; Health Surveys; Young Adult; Adolescent; Middle Aged; Socioeconomic Factors; Educational Status; Demography; Logistic Models; Parity
PubMed: 38917226
DOI: 10.1371/journal.pone.0304954 -
PloS One 2024Preterm birth is the leading cause of both infant and neonatal mortality. It also had long-term consequences for the physical and neurological development of a growing...
INTRODUCTION
Preterm birth is the leading cause of both infant and neonatal mortality. It also had long-term consequences for the physical and neurological development of a growing child. The majority of these and related problems occur in low- and middle-income countries, particularly in sub-Saharan Africa, due to resource scarcity to sustain the lives of premature babies. Despite this, there is a paucity of recent information on the pooled prevalence and factors associated with preterm birth in sub-Saharan Africa. Therefore, this study aimed to update the pooled prevalence and determinants of preterm birth in sub-Saharan Africa based on the most recent Demographic and Health Survey data.
METHODS
A cross-sectional study design using the most recent demographic and health survey data from eight sub-Saharan African countries was used. We included a total weighted sample of 74,871 reproductive-aged women who gave birth in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors of preterm birth in sub-Saharan Africa. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant.
RESULTS
In this study, the pooled prevalence of preterm birth among reproductive-aged women in eight sub-Saharan African countries was 3.11% (95% CI: 2.98-3.25). Working mothers (AOR = 0.61; 95% CI: 0.38-0.97), being married (AOR = 0.63; 95% CI: 0.40-0.99), and having media exposure (AOR = 0.59; 95% CI: 0.36-0.96) decrease the odds of preterm birth. On the other hand, being low birth weight (AOR = 17.7; 95% CI: 10.7-29.3), having multiple pregnancies (AOR = 3.43; 95% CI: 1.82-6.45), having a history of terminated pregnancies (AOR = 1.56; 95% CI: 1.01-2.41), being un-educated (AOR = 3.16; 95% CI: 1.12-8.93), being of a maternal age above 35 (AOR = 1.63; 95% CI: 1.08-2.45), maternal alcohol use (AOR = 19.18; 95% CI: 13.6-38.8), and being in the low socio-economic status (AOR = 1.85; 95% CI: 1.11-3.07) of the community increase the odds of preterm birth.
CONCLUSION
The burden of preterm birth among reproductive-age women in sub-Saharan Africa showed improvements as compared to previous findings. To further lessen the burden, policymakers and other pertinent organizations must prioritize maternal health, expand media access, educate and empower women, and promote a healthy lifestyle for reproductive-age women.
Topics: Humans; Female; Africa South of the Sahara; Premature Birth; Adult; Cross-Sectional Studies; Health Surveys; Pregnancy; Young Adult; Adolescent; Prevalence; Risk Factors; Infant, Newborn; Middle Aged
PubMed: 38917208
DOI: 10.1371/journal.pone.0305810 -
PloS One 2024Alcohol use disorder (AUD) is a major economic and healthcare burden in the United States. While there is evidence-based medication-assisted treatment (MAT) for AUD, few...
BACKGROUND
Alcohol use disorder (AUD) is a major economic and healthcare burden in the United States. While there is evidence-based medication-assisted treatment (MAT) for AUD, few physicians implement these therapies on a regular basis.
OBJECTIVE
To determine the impact of a pharmacy-guided AUD discharge planning workflow on the rate of MAT prescriptions and inpatient readmissions.
METHODS
This was a single-centered pre-and-post intervention study over a 6-month period, with a 90-day pre-intervention period and a 90-day post-intervention period. The study included all patients over the age of 18 years admitted to a medicine or surgery floor bed who presented with alcohol withdrawal at any point during their hospital course. The intervention involved a pharmacy workflow, in which a list of patients admitted with alcohol withdrawal was automatically generated and referred to pharmacists, who then provided recommendations to the primary physician regarding prescriptions for naltrexone, acamprosate, and/or gabapentin. The patients were then contacted within 30 days after discharge for post-hospitalization follow-up. Our outcome measures were change in prescription rate of MATs, change in total and alcohol-related 90-day readmission rates, and change in total and alcohol-related 90-day emergency department (ED) visit rates.
RESULTS
The pre-intervention period consisted of 49 patients and the post-intervention period consisted of 41 patients. Our workflow demonstrated a 195% increase in the prescription rate of MATs at discharge (p < 0.001), 61% reduction in 90-day total readmission rate (p < 0.05), 40% reduction in 90-day total ED visit rate (p = 0.09), 92% reduction in 90-day alcohol-related readmission rate (p < 0.05), and 88% reduction in 90-day alcohol-related ED visit rate (p < 0.05).
CONCLUSIONS
Our intervention demonstrated that a pharmacy-based AUD discharge planning workflow has the potential to reduce inpatient readmissions and ED visits for patients with AUD, thus demonstrating improved patient outcomes with the potential to reduce healthcare costs.
Topics: Humans; Male; Female; Patient Discharge; Workflow; Middle Aged; Alcoholism; Adult; Patient Readmission; Patient Care Team; Inpatients; Aged
PubMed: 38917202
DOI: 10.1371/journal.pone.0306066 -
PloS One 2024The aim of this study was to evaluate the impact of intravenous palonosetron compared to ondansetron on hypotension induced by spinal anesthesia in women undergoing... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The aim of this study was to evaluate the impact of intravenous palonosetron compared to ondansetron on hypotension induced by spinal anesthesia in women undergoing cesarean section.
METHODS
Fifty-four women scheduled for elective cesarean section were, randomly allocated to ondansetron group (n = 27) or palonosetron group (n = 27). Ten minutes prior to the administration of spinal anesthesia, participants received an intravenous injection of either ondansetron or palonosetron. A prophylactic phenylephrine infusion was initiated immediately following the intrathecal administration of bupivacaine and fentanyl. The infusion rate was titrated to maintain adequate blood pressure until the time of fetal delivery. The primary outcome was total dose of phenylephrine administered. The secondary outcomes were nausea or vomiting, the need for rescue antiemetics, hypotension, bradycardia, and shivering. Complete response rate, defined as the absence of postoperative nausea and vomiting and no need for additional antiemetics, were assessed for up to 24 hours post-surgery.
RESULTS
No significant differences were observed in the total dose of phenylephrine used between the ondansetron and palonosetron groups (387.5 μg [interquartile range, 291.3-507.8 μg versus 428.0 μg [interquartile range, 305.0-507.0 μg], P = 0.42). Complete response rates also showed no significant differences between the groups both within two hours post-spinal anesthesia (88.9% in the ondansetron group versus 100% in the palonosetron group; P = 0.24) and at 24 hours post-surgery (81.5% in the ondansetron group versus 88.8% in the palonosetron group; P = 0.7). In addition, there was no difference in other secondary outcomes.
CONCLUSION
Prophylactic administration of palonosetron did not demonstrate a superior effect over ondansetron in mitigating hemodynamic changes or reducing phenylephrine requirements in patients undergoing spinal anesthesia with bupivacaine and fentanyl for cesarean section.
Topics: Humans; Female; Anesthesia, Spinal; Cesarean Section; Palonosetron; Adult; Hypotension; Pregnancy; Ondansetron; Antiemetics; Postoperative Nausea and Vomiting; Phenylephrine; Anesthesia, Obstetrical
PubMed: 38917195
DOI: 10.1371/journal.pone.0305913 -
PloS One 2024To evaluate the association between psoriasis (PSO), psoriatic arthritis (PsA) and periodontitis (PE), and the Oral Health-Related Quality of Life (OHRQoL) impacts on...
OBJECTIVE
To evaluate the association between psoriasis (PSO), psoriatic arthritis (PsA) and periodontitis (PE), and the Oral Health-Related Quality of Life (OHRQoL) impacts on individuals with psoriatic disease's daily activities compared to the non-psoriatic ones.
MATERIALS & METHODS
296 individuals with psoriatic disease (PSO n = 210, APS n = 86) (cases) and 359 without these diseases (controls) were included. Complete periodontal examinations and collection of variables of interest were performed. The Brazilian version of the Oral Impacts on Daily Performance (OIDP) instrument was applied.
RESULTS
The prevalence of PE was higher in PsA (57.0%; OR = 2.67 95%CI 1.65-4.32; p<0.001) than in PSO (34.3%; OR = 1.05 95% CI 0.73-1.51; p<0.001) compared to controls (33.1%). Both PsA and PSO groups showed more sites and teeth with 4-6mm probing depth (PD) and had higher OIDP scores than controls (p<0.001), thus indicating worse self-reported quality of life. PE, PSO+PE and consumption of alcohol/anxiolytics significantly influenced OHRQoL (p<0.05). The influence of periodontal parameters on OHRQoL was observed for the presence of PE; PD >6 mm; clinical attachment level >6 mm; higher plaque index, % sites and teeth with bleeding on probing (p<0.05).
CONCLUSION
Negative impacts of PE on the OHRQoL were demonstrated. The ones having PSO and especially PsA and PE presented significantly worse indicators.
Topics: Humans; Quality of Life; Arthritis, Psoriatic; Oral Health; Male; Female; Middle Aged; Psoriasis; Adult; Periodontitis; Brazil; Case-Control Studies
PubMed: 38917108
DOI: 10.1371/journal.pone.0301158 -
PloS One 2024Post-induction hypotension (PIH) often occurs during general anesthesia induction. This study aimed to investigate blood catecholamine levels during induction of general...
Changes in blood catecholamines during induction of general anesthesia in patients with post-induction hypotension undergoing laparoscopic cholecystectomy: A single-center prospective cohort study.
BACKGROUND
Post-induction hypotension (PIH) often occurs during general anesthesia induction. This study aimed to investigate blood catecholamine levels during induction of general anesthesia in patients with PIH undergoing laparoscopic cholecystectomy.
METHODS
This prospective study included 557 adult patients who underwent laparoscopic cholecystectomy under general anesthesia. PIH was defined as a greater than 20% decrease in systolic blood pressure from the pre-induction value, a systolic arterial pressure of less than 90 mmHg, or both. Plasma concentrations of epinephrine and norepinephrine during the induction of general anesthesia were determined using enzyme-linked immunosorbent assay. Multivariate logistic regression analysis evaluated the association between the clinical factors and PIH.
RESULTS
Of the 557 patients, 390 had PIH, and the remaining 167 were allocated to the non-PIH group. Changes in blood adrenaline, noradrenaline levels, or both were more pronounced in the PIH than in the non-PIH group (p<0.05). Age, body mass index, a history of hypertension, preoperative systolic blood pressure, and propofol or sufentanil dose were independent predictors of PIH.
CONCLUSION
The changes of blood catecholamines in patients with more stable hemodynamics during the induction of general anesthesia are smaller than that in patients with post-induction hypotension.
TRIAL REGISTRATION
ChiCTR2200055549, 12/01/2022.
Topics: Humans; Cholecystectomy, Laparoscopic; Male; Female; Anesthesia, General; Middle Aged; Prospective Studies; Hypotension; Adult; Catecholamines; Blood Pressure; Aged; Norepinephrine; Epinephrine
PubMed: 38917102
DOI: 10.1371/journal.pone.0305980 -
PloS One 2024Social media data provide unprecedented access to discussions of active, naturalistic, and often real-time cannabis use in an era of cannabis policy liberalization. The...
The Reddit cannabis subjective highness rating scale: Applying computational social science to explore psychological and environmental correlates of naturalistic cannabis use.
Social media data provide unprecedented access to discussions of active, naturalistic, and often real-time cannabis use in an era of cannabis policy liberalization. The aim of this study was to explore psychological and environmental correlates of cannabis effects by applying computational social science approaches to a large dataset of unprompted reports of naturalistic cannabis use with corresponding self-reported numerical ratings of subjective highness. Post title text was extracted via the Pushshift dataset from N = 328,865 posts to the r/trees Reddit community, where posters self-assess and disclose how high they feel on a scale from 1 to 10 (M = 6.9, SD = 1.8). Structural topic modelling and Linguistic Inquiry and Word Count (LIWC) dictionary-based approaches were applied to identify (1) frequently discussed topics and (2) text indicative of 5 psychological processes (affective, social, cognitive, perceptual, biological), respectively, as well as to examine relationships between subjective highness and (1) topic prevalence and (2) psychological process word counts. A 40-topic model was selected for interpretation based on semantic coherence and exclusivity. The most discussed topics in a 40-topic model were characterized by references to smoking places, social contexts, positive affect, cognitive states, as well as food and media consumed. In LIWC dictionary analyses, words mentioning affective, social, and cognitive processes were referenced more often than perceptual or body processes. Posters reported greater subjective highness when using language that referred to in-person social environments and lower subjective highness when using language that referred to online social environments and positive affect psychological states. This examination of unprompted online reports of naturalistic cannabis use identified textual content referring to affect and to other people as being associated with perceived effects of cannabis. These affective and social aspects of the cannabis use experience were salient to active posters in this online community and should be integrated into experience sampling methods and behavioral pharmacology research, as well as public health messaging.
Topics: Humans; Social Media; Cannabis; Social Sciences; Marijuana Use; Male; Self Report; Female
PubMed: 38917066
DOI: 10.1371/journal.pone.0300290 -
The Journal of Clinical Investigation Jun 2024Neutrophil infiltration occurs in a variety of liver diseases, but it is unclear how neutrophils and hepatocytes interact. Neutrophils generally use granule proteases to...
Neutrophil infiltration occurs in a variety of liver diseases, but it is unclear how neutrophils and hepatocytes interact. Neutrophils generally use granule proteases to digest phagocytosed bacteria and foreign substances or neutralize them in neutrophil extracellular traps. In certain pathological states, granule proteases play a destructive role against the host as well. More recently, non-destructive actions of neutrophil granule proteins have been reported, such as modulation of tissue remodeling and metabolism. Here we report a completely different mechanism by which neutrophils act non-destructively, by inserting granules directly into hepatocytes. Specifically, elastase-containing granules were transferred to hepatocytes where elastase selectively degraded intracellular calcium channels to reduce cell proliferation without cytotoxicity. In response, hepatocytes increased expression of serpin E2 and A3, which inhibited elastase activity. Elastase insertion was seen in patient specimens of alcohol-associated hepatitis, and the relationship between elastase-mediated ITPR2 degradation and reduced cell proliferation was confirmed in mouse models. Moreover, neutrophils from patients with alcohol-associated hepatitis were more prone to degranulation and more potent in reducing calcium channel expression than neutrophils from healthy subjects. This non-destructive and reversible action on hepatocytes defines a previously unrecognized role for neutrophils in the transient regulation of epithelial calcium signaling mechanisms.
PubMed: 38916955
DOI: 10.1172/JCI171691 -
JMIR Formative Research Jun 2024Measurement-based care in behavioral health uses patient-reported outcome measures (PROMs) to screen for mental health symptoms and substance use and to assess symptom...
BACKGROUND
Measurement-based care in behavioral health uses patient-reported outcome measures (PROMs) to screen for mental health symptoms and substance use and to assess symptom change over time. While PROMs are increasingly being integrated into electronic health record systems and administered electronically, paper-based PROMs continue to be used. It is unclear if it is feasible to administer a PROM on paper when the PROM was initially developed for electronic administration.
OBJECTIVE
This study aimed to examine the feasibility of patient self-administration of a 2-part substance use screener-the Tobacco, Alcohol, Prescription medications, and other Substances (TAPS)-on paper. This screener was originally developed for electronic administration. It begins with a limited number of questions and branches to either skip or reflex to additional questions based on an individual's responses. In this study, the TAPS was adapted for paper use due to barriers to electronic administration within an urgent care behavioral health clinic at an urban health safety net hospital.
METHODS
From August 2021 to March 2022, research staff collected deidentified paper TAPS responses and tracked TAPS completion rates and adherence to questionnaire instructions. A retrospective chart review was subsequently conducted to obtain demographic information for the patients who presented to the clinic between August 2021 and March 2022. Since the initial information collected from TAPS responses was deidentified, demographic information was not linked to the individual TAPS screeners that were tracked by research staff.
RESULTS
A total of 507 new patients were seen in the clinic with a mean age of 38.7 (SD 16.6) years. In all, 258 (50.9%) patients were male. They were predominantly Black (n=212, 41.8%), White (n=152, 30%), and non-Hispanic or non-Latino (n=403, 79.5%). Most of the patients were publicly insured (n=411, 81.1%). Among these 507 patients, 313 (61.7%) completed the TAPS screener. Of these 313 patients, 76 (24.3%) adhered to the instructions and 237 (75.7%) did not follow the instructions correctly. Of the 237 respondents who did not follow the instructions correctly, 166 (70%) answered more questions and 71 (30%) answered fewer questions than required in TAPS part 2. Among the 237 patients who did not adhere to questionnaire instructions, 44 (18.6%) responded in a way that contradicted their response in part 1 of the screener and ultimately affected their overall TAPS score.
CONCLUSIONS
It was challenging for patients to adhere to questionnaire instructions when completing a substance use screener on paper that was originally developed for electronic use. When selecting PROMs for measurement-based care, it is important to consider the structure of the questionnaire and how the PROM will be administered to determine if additional support for PROM self-administration needs to be implemented.
PubMed: 38916950
DOI: 10.2196/52801