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Esterov D, Pradhan S, Driver S, Whyte J, Bell KR, Barber J, Temkin N, Bombardier CH. The Temporal Relationship Between Moderate to Vigorous Physical Activity and Secondary Conditions During the First Year After Moderate to Severe Traumatic Brain Injury. Arch Phys Med Rehabil 2024; 105:506-513. [PMID: 37827487 DOI: 10.1016/j.apmr.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/07/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To determine the cross-sectional and temporal relationships between minutes per week of moderate to vigorous physical activity (MVPA) as measured by a wrist-worn accelerometer and secondary conditions in the first year after moderate to severe traumatic brain injury (TBI). DESIGN Prospective longitudinal cohort study. SETTING Four inpatient rehabilitation centers. PARTICIPANTS Individuals (N = 180) with moderate-severe TBI enrolled in the TBI Model Systems Study. INTERVENTIONS Participants wore a wrist accelerometer for 7 days immediately post discharge, and for 7 consecutive days at 6- and 12-months post injury. MAIN OUTCOME MEASURES Minutes per week of MVPA from daily averages based on wrist worn accelerometer. Secondary conditions included depression (Patient Health Questionnaire-9), fatigue (PROMIS Fatigue), Pain (Numeric Rating Scale), Sleep (Pittsburgh Sleep Quality Index), and cognition (Brief Test of Adult Cognition by Telephone). RESULTS At baseline, 6 and 12 months, 61%, 70% and 79% of the sample achieved at least 150 minutes per week of MVPA. The correlations between minutes of MVPA between baseline, 6 and 12 months were significant (r = 0.53-0.73), as were secondary conditions over these time points. However, no significant correlations were observed between minutes of MVPA and any secondary outcomes cross-sectionally or longitudinally at any time point. CONCLUSIONS Given the robust relationships physical activity has with outcomes in the general population, further research is needed to understand the effect of physical activity in individuals with moderate-severe TBI.
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Affiliation(s)
- Dmitry Esterov
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - Sujata Pradhan
- Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, WA
| | - Simon Driver
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Research Institute, Dallax, TX
| | - John Whyte
- Department of Physical Medicine and Rehabilitation, Moss Rehabilitation Research Institute, Elkins Park, PA
| | - Kathleen R Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jason Barber
- Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, WA
| | - Nancy Temkin
- Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, WA
| | - Charles H Bombardier
- Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, WA.
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Alt Murphy M, Pradhan S, Levin MF, Hancock NJ. Uptake of Technology for Neurorehabilitation in Clinical Practice: A Scoping Review. Phys Ther 2024; 104:pzad140. [PMID: 37856528 PMCID: PMC10851848 DOI: 10.1093/ptj/pzad140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Technology-based interventions offer many opportunities to enhance neurorehabilitation, with associated research activity gathering pace. Despite this fact, translation for use in clinical practice has lagged research innovation. An overview of the current "state of play" regarding the extent of clinical uptake and factors that might influence use of technologies is required. This scoping review explored the uptake of technologies as neurorehabilitation interventions in clinical practice and factors that are reported to influence their uptake. METHODS This systematic scoping review was conducted with narrative synthesis and evidence mapping. Studies of any design reporting uptake or implementation of technology (wearable devices, virtual reality, robotics, and exergaming) for movement neurorehabilitation after stroke and other neurological conditions were sought via a formal search strategy in MEDLINE (Ovid), CINAHL, AMED, and Embase. Full-text screening and data extraction were completed independently by 2 reviewers. RESULTS Of 609 studies returned, 25 studies were included after title, abstract, and full-text screening. Studies investigated a range of technologies at various stages of development. Only 4 of the included studies explored the sustained use of technology in practice. The following 5 themes representing experiences of technology use emerged: perceived usefulness, technology design, social interaction, integration with services, and suggested improvements to enhance uptake. CONCLUSION Reporting of uptake and use of neurorehabilitation technologies in clinical practice is limited. The synthesis provided comprehensive knowledge of barriers to and facilitators of uptake to be considered in future protocols, including a steep learning curve required to engage with technology, a need for a supportive organizational culture, and a need for user involvement in both design and development. IMPACT This scoping review has provided indicators from current evidence of important factors to consider in the planning of research into and clinical implementation of technologies for neurorehabilitation. It serves to support an evidence-based, user-centered platform for improved research on and translation of technologies in neurorehabilitation clinical practice.
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Affiliation(s)
- Margit Alt Murphy
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sujata Pradhan
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Mindy F Levin
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Nicola J Hancock
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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Prusynski RA, Frogner BK, Rundell SD, Pradhan S, Mroz TM. Is More Always Better? Financially Motivated Therapy and Patient Outcomes in Skilled Nursing Facilities. Arch Phys Med Rehabil 2024; 105:287-294. [PMID: 37541357 PMCID: PMC10837324 DOI: 10.1016/j.apmr.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To determine if financially motivated therapy in Skilled Nursing Facilities (SNFs) is associated with patient outcomes. DESIGN Cohort study using 2018 Medicare administrative data. SETTING AND PARTICIPANTS 13,949 SNFs in the United States. PARTICIPANTS 934,677 Medicare Part A patients admitted to SNF for post-acute rehabilitation (N=934,677). INTERVENTIONS The primary independent variable was an indicator of financially motivated therapy, separate from intensive therapy, known as thresholding, defined as when SNFs provide 10 or fewer minutes of therapy above weekly reimbursement thresholds. MAIN OUTCOME MEASURES Dichotomous indicators of successful discharge to the community vs institution and functional improvement on measures of transfers, ambulation, or locomotion. Mixed effects models estimated relations between thresholding and community discharge and functional improvement, adjusted for therapy intensity, patient, and facility characteristics. Sensitivity analyses estimated associations between thresholding and outcomes when patients were stratified by therapy volume. RESULTS Thresholding was associated with a small positive effect on functional improvement (odds ratio 1.07; 95% CI 1.06-1.09) and community discharge (odds ratio 1.03, 95% CI 1.02-1.05). Effect sizes for functional improvement were consistent across patients receiving different volumes of therapy. However, effect sizes for community discharge were largest for patients in low-volume therapy groups (odds ratio 1.27, 95% CI 1.18-1.35). CONCLUSIONS Patients who experienced thresholding during post-acute SNF stays were slightly more likely to improve in function and successfully discharge to the community, especially for patients receiving lower volumes of therapy. While thresholding is an inefficient and financially motivated practice, results suggest that even small amounts of extra therapy time may have contributed positively to outcomes for patients receiving lower-volume therapy. As therapy volumes decline in SNFs, these results emphasize the importance of Medicare payment policy designed to promote, not disincentivize, potentially beneficial rehabilitation services for patients.
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Affiliation(s)
- Rachel A Prusynski
- Department of Rehabilitation Medicine, University of Washington, Seattle WA; Center for Health Workforce Studies, Department of Family Medicine, University of Washington, Seattle WA.
| | - Bianca K Frogner
- Center for Health Workforce Studies, Department of Family Medicine, University of Washington, Seattle WA
| | - Sean D Rundell
- Department of Rehabilitation Medicine, University of Washington, Seattle WA
| | - Sujata Pradhan
- Department of Rehabilitation Medicine, University of Washington, Seattle WA
| | - Tracy M Mroz
- Department of Rehabilitation Medicine, University of Washington, Seattle WA; Center for Health Workforce Studies, Department of Family Medicine, University of Washington, Seattle WA
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Prusynski RA, Rundell SD, Pradhan S, Mroz TM. Some But Not Too Much: Multiparticipant Therapy and Positive Patient Outcomes in Skilled Nursing Facilities. J Geriatr Phys Ther 2023; 46:185-195. [PMID: 36103147 PMCID: PMC10008750 DOI: 10.1519/jpt.0000000000000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND PURPOSE Physical and occupational therapy practices in skilled nursing facilities (SNFs) were greatly impacted by the 2019 Medicare Patient-Driven Payment Model (PDPM). Under the PDPM, the practice of multiparticipant therapy-treating more than one patient per therapy provider per session-increased in SNFs, but it is unknown how substituting multiparticipant therapy for individualized therapy may impact patient outcomes. This cross-sectional study establishes baseline relationships between multiparticipant therapy and patient outcomes using pre-PDPM data. METHODS We used Minimum Data Set assessments from all short-term Medicare fee-for-service SNF stays in 2018. Using generalized mixed-effects logistic regression adjusted for therapy volume and patient factors, we examined associations between the proportion of minutes of physical and occupational therapy that were received as multiparticipant sessions during the SNF stay and 2 outcomes: community discharge and functional improvement. Multiparticipant therapy minutes as a proportion of total therapy time were categorized as none, low (below the median of 5%), medium (median to <25%), and high (≥25%) to reflect the 25% multiparticipant therapy limit required by the PDPM. RESULTS AND DISCUSSION We included 901 544 patients with complete data for functional improvement and 912 996 for the discharge outcome. Compared with patients receiving no multiparticipant therapy, adjusted models found small positive associations between low and medium multiparticipant therapy levels and outcomes. Patients receiving low levels of multiparticipant therapy had 14% higher odds of improving in function (95% CI 1.09-1.19) and 10% higher odds of community discharge (95% CI 1.05-1.15). Patients receiving medium levels of multiparticipant therapy had 18% higher odds of functional improvement (95% CI 1.13-1.24) and 44% higher odds of community discharge (95% CI 1.34-1.55). However, associations disappeared with high levels of multiparticipant therapy. CONCLUSIONS Prior to the PDPM, providing up to 25% multiparticipant therapy was an efficient strategy for SNFs that may have also benefitted patients. As positive associations disappeared with high levels (≥25%) of multiparticipant therapy, it may be best to continue delivering the majority of therapy in SNFs as individualized treatment.
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Affiliation(s)
- Rachel A Prusynski
- Department of Rehabilitation Medicine, University of Washington, Seattle
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Pivot X, Manikhas A, Shamrai V, Dzagnidze G, Soo H, Kaewkangsadan V, Petrelli F, Villanueva C, Kim J, Pradhan S, Jaison L, Feyaerts P, Kaufman L, Derde MP, Deforce F, Cox D. 2MO Final analysis of the phase III randomized clinical trial, comparing HD201 vs referent trastuzumab in patients with ERBB2-positive breast cancer treated in the neoadjuvant setting. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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6
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Agrawal S, Pradhan S. Treatment of Infrabony Defects by Open Flap Debridement with or without Diode Laser. Kathmandu Univ Med J (KUMJ) 2022; 20:461-466. [PMID: 37795725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Periodontitis is the common oral condition which affects the periodontium of the teeth that leads to destruction of periodontal ligaments and alveolar bone. Open flap debridement is the surgical procedure which provides access and visibility of the site, application of laser as an adjunct has various advantanges. Objective To compare clinical outcomes after open flap debridement with or without diode laser. Method Patients aged 25-45 years diagnosed with infrabony defect ≥ 5 mm visiting Department of Dental Surgery, Bir Hospital. Control group sites were treated with open flap debridement alone, whereas test-groups were treated with Open flap debridement with diode laser. Various parameters like Plaque index, Gingival index, Pocket depth and Clinical attachment level were assessed and compared between groups at baseline, 3 and 6 months. Result The mean plaque and gingival scores improved in both the control and test groups at 3 and 6 months follow up as compared to baseline and was statistically nonsignificant between two groups. Open flap debridement with or without diode laser in the treatment of periodontal intrabony defects did not produce significant reduction in pocket depth and gain in clinical attachment level. Conclusion There was no significant differences in the clinical parameters were seen in the surgical flap debridement of infrabony pocket with and without diode laser. Diode laser can be used safely as an adjunct. However, long-term, multicentric, histologic and microbial studies are required.
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Affiliation(s)
- S Agrawal
- Department of Periodontology and oral Implantology, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - S Pradhan
- Periodontology and Oral Implantology Unit, Department of Dental Surgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
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Prusynski RA, Kelly VE, Fogelberg DJ, Pradhan S. The association between sleep deficits and sedentary behavior in people with mild Parkinson disease. Disabil Rehabil 2022; 44:5585-5591. [PMID: 34218729 PMCID: PMC10659136 DOI: 10.1080/09638288.2021.1940320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
Purpose: Sleep deficits are a common nonmotor symptom of Parkinson disease (PD). People with mild PD also achieve less physical activity (PA) than healthy older adults (HOA), but the relationship between sleep and PA in PD is unclear. This study examined associations between sleep and PA in participants with PD and HOA.Materials and Methods: Secondary analysis of a prospective observational study. Participants wore a commercially available activity monitor for two weeks. Wilcoxon Rank-Sum tests compared nighttime sleep, wakenings after sleep onset, number of wakenings, naps, step count, and PA intensity between PD and HOA groups. Age-adjusted regression models calculated associations between nighttime sleep and PA.Results: Per day, participants with PD slept 75 fewer minutes (p < 0.01), took 5,792 fewer steps (p < 0.001), achieved less PA at all intensities, and had 32% more sedentary time (p < 0.001) compared to HOA. Thirty minutes more sleep was associated with 26 fewer sedentary minutes for HOA (p = 0.01) and 25 fewer sedentary minutes for the PD group (p < 0.001).Conclusions: Sleep and PA are reduced in mild PD compared to HOA. Both groups demonstrated similar associations between reduced sleep and increased sedentary behavior. Results may encourage providers to screen for sleep deficits when promoting PA.IMPLICATIONS FOR REHABILITATIONThe use of a wrist-worn commercial activity and sleep monitor was well tolerated by both healthy older adults and people with mild Parkinson Disease in this study.People with mild Parkinson Disease slept less and were less active than a group of healthy older adults.Less sleep was associated with more sedentary behavior in both groups.The relationship between poor sleep and sedentary behavior in mild Parkinson Disease suggests that rehabilitation interventions may be optimized by targeting both physical activity and sleep deficits.
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Affiliation(s)
- Rachel A Prusynski
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Valerie E Kelly
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Donald J Fogelberg
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Sujata Pradhan
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
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Osborne JA, Botkin R, Colon-Semenza C, DeAngelis TR, Gallardo OG, Kosakowski H, Martello J, Pradhan S, Rafferty M, Readinger JL, Whitt AL, Ellis TD. Correction to: Osborne JA, Botkin R, Colon-Semenza C, et al. Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association. Phys Ther. 2022;102:pzab302. https://doi.org/10.1093/ptj/pzab302. Phys Ther 2022; 102:6677117. [PMID: 36029042 PMCID: PMC9418923 DOI: 10.1093/ptj/pzac098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/04/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Jacqueline A Osborne
- Brooks Rehabilitation Hospital, Brooks Institute of Higher Learning, Jacksonville, Florida, USA
| | - Rachel Botkin
- Botkin Rehab Services, Physical Therapy, Columbus, Ohio, USA
| | - Cristina Colon-Semenza
- Department of Kinesiology, Doctor of Physical Therapy Program, University of Connecticut, Storrs, Connecticut, USA
| | - Tamara R DeAngelis
- Boston University Sargent College of Health and Rehabilitation Services, Physical Therapy and Athletic Training, Boston, Massachusetts, USA
| | - Oscar G Gallardo
- Rancho Los Amigos National Rehabilitation Center, Physical Therapy, Downey, California, USA
| | - Heidi Kosakowski
- Address all correspondence to Dr Kosakowski care of the Department of Practice of the American Physical Therapy Association at:
| | | | - Sujata Pradhan
- University of Washington, Rehabilitation Medicine, Seattle, Washington, USA
| | - Miriam Rafferty
- Northwestern University, Center for Education in Health Sciences, Chicago, Illinois, USA
| | | | | | - Terry D Ellis
- Boston University Sargent College of Health and Rehabilitation Services, Physical Therapy and Athletic Training, Boston, Massachusetts, USA
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Shrestha R, Pradhan S, Baral G. Prevalence of Gingivitis in Second Trimester of Pregnancy. Kathmandu Univ Med J (KUMJ) 2022; 20:301-306. [PMID: 37042370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Gingivitis simply means the inflammation of gingiva. It is a reversible state but can lead to periodontitis. The final result could be the exfoliation of the tooth causing decreased masticatory function leading to a compromised quality of life. Gingivitis in the pregnant woman should be carefully assessed and treated and given special attention. There is rare documentation on the prevalence of gingivitis in pregnancy in the least developed countries. Objective To evaluate the prevalence of gingivitis in the second trimester of pregnancy and assess its relationship with age, parity, education, occupation, gravidity, oral hygiene habit and frequency of brushing. Method An observational descriptive study was conducted among 384 pregnant females in their second trimester in Kathmandu, Nepal. Demographic variables and general information including those related to oral hygiene practices and habits were collected during an interview. Plaque index and Gingival Index was recorded among the patients through full mouth examination at four sites. Result The prevalence of gingivitis in the second trimester of pregnancy was 76.3%. Statistically significant relationship was found between gingivitis and gravida and parity. A relation could not be established between gingivitis with age, education, occupation, oral hygiene habit and frequency of brushing. Conclusion The prevalence of gingivitis is found to be high in Nepalese pregnant women. Special strategies should be introduced targeting the pregnant women of least developed countries to uplift their periodontal health.
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Affiliation(s)
- R Shrestha
- Department of Periodontology and Oral Implantology, Bir Hospital, Mahaboudha, Kathmandu, Nepal
| | - S Pradhan
- Department of Periodontology and Oral Implantology, Bir Hospital, Mahaboudha, Kathmandu, Nepal
| | - G Baral
- Department of Obstetrics and Gynecology, Nobel Medical College, Biratnagar, Nepal
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gv A, Choubey A, Nanda S, Mukherji A, Pradhan S, Kapoor A, Mishra A, S D, Devalla A. PO-1101 Early NGT insertion prevents weight loss & treatment breaks in post-op CTRT and QoL assessment. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pradhan S, Ranjan R, Verma A, Singh T, Aggarwal L, Singh R, Shahi U. PD-0906 Functional MRI as an Assessment Tool in Carcinoma Cervix Patients Undergoing Chemoradiation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02985-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Prusynski RA, Pradhan S, Mroz TM. Skilled Nursing Facility Organizational Characteristics Are More Strongly Associated With Multiparticipant Therapy Provision Than Patient Characteristics. Phys Ther 2022; 102:pzab292. [PMID: 34972865 PMCID: PMC9097255 DOI: 10.1093/ptj/pzab292] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/25/2021] [Accepted: 11/19/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Multiparticipant physical and occupational therapy provision has fluctuated significantly in skilled nursing facilities (SNFs) under shifts in Medicare reimbursement policy. Multiparticipant therapy includes group (2-6 individuals per therapist) and concurrent therapy (2 individuals per therapist). This study uses recent patient-level data to characterize multiparticipant therapy provision in SNFs to help anticipate shifts under new Medicare policy and the COVID-19 pandemic. METHODS This secondary analysis used data on 1,016,984 post-acute rehabilitation stays in SNFs in 2018. This analysis identified patient predictors (eg, demographic, clinical) and organizational predictors (eg, ownership, quality, staffing) of receiving multiparticipant therapy using mixed-effects logistic regression. Among individuals who received any multiparticipant therapy, those patient or facility factors associated with high rates of multiparticipant therapy provision were also determined. RESULTS Less than 3% of individuals received multiparticipant therapy in 2018. Patient functional and cognitive impairment and indicators of market regulation were associated with lower odds of multiparticipant therapy. Effect sizes for organizational factors associated with multiparticipant therapy provision were generally larger compared with patient factors. High multiparticipant therapy provision was concentrated in <2% of SNFs and was positively associated with for-profit ownership, contract staffing, and low 5-star quality ratings. CONCLUSION SNF organizational characteristics tended to have stronger associations with multiparticipant therapy provision than patient factors, suggesting that changes in patient case-mix, as expected during the COVID-19 pandemic, may have less of an impact on multiparticipant therapy provision than organizational factors. Results suggest that for-profit SNFs in states with higher market regulation, SNFs providing high volumes of therapy, and SNFs utilizing high proportions of assistants and contract staff may be more responsive to Medicare policy by increasing multiparticipant therapy provision. IMPACT This study may help identify SNFs that are more likely to increase multiparticipant therapy provision under new Medicare payment policy.
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Affiliation(s)
- Rachel A Prusynski
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Sujata Pradhan
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Tracy M Mroz
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
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Pradhan S, Kim Y, Park J, Jeong SY, Koh S, Mandakhalikar K, Kim J, Jaison L. 3P Targeting pancreatic adenocarcinoma upregulated factor (PAUF) to treat pancreatic cancer (PC): In vivo efficacy and safety of PBP1510, a first in class monoclonal antibody (mAb). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Basu S, Pradhan S, Barnett S, Mikkelsen M, Kapse K, Murnick J, Quistorff J, Lopez C, du Plessis A, Limperopoulos C. Regional Differences in Gamma-Aminobutyric Acid and Glutamate Concentrations in the Healthy Newborn Brain. AJNR Am J Neuroradiol 2022; 43:125-131. [PMID: 34764083 PMCID: PMC8757541 DOI: 10.3174/ajnr.a7336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/10/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Gamma-aminobutyric acid and glutamate system disruptions may underlie neonatal brain injury. However, in vivo investigations are challenged by the need for special 1H-MR spectroscopy sequences for the reliable measurement of the neurotransmitters in this population. We used J-edited 1H-MR spectroscopy (Mescher-Garwood point-resolved spectroscopy) to quantify regional in vivo gamma-aminobutyric acid and glutamate concentrations during the early postnatal period in healthy neonates. MATERIALS AND METHODS We prospectively enrolled healthy neonates and acquired Mescher-Garwood point-resolved spectroscopy spectra on a 3T MR imaging scanner from voxels located in the cerebellum, the right basal ganglia, and the right frontal lobe. CSF-corrected metabolite concentrations were compared for regional variations and cross-sectional temporal trends with advancing age. RESULTS Fifty-eight neonates with acceptable spectra acquired at postmenstrual age of 39.1 (SD, 1.3) weeks were included for analysis. Gamma-aminobutyric acid (+ macromolecule) (2.56 [SD, 0.1]) i.u., glutamate (3.80 [SD, 0.2]), Cho, and mIns concentrations were highest in the cerebellum, whereas NAA (6.72 [SD, 0.2]), NAA/Cho, Cr/Cho, and Glx/Cho were highest in the basal ganglia. Frontal gamma-aminobutyric acid (1.63 [SD, 0.1]), Glx (4.33 [SD, 0.3]), Cr (3.64 [SD, 0.2]), and Cho concentrations were the lowest among the ROIs. Glx, NAA, and Cr demonstrated a significant adjusted increase with postmenstrual age (β = 0.2-0.35), whereas gamma-aminobutyric acid and Cho did not. CONCLUSIONS We report normative regional variations and temporal trends of in vivo gamma-aminobutyric acid and glutamate concentrations reflecting the functional and maturational status of 3 distinct brain regions of the neonate. These measures will serve as important normative values to allow early detection of subtle neurometabolic alterations in high-risk neonates.
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Affiliation(s)
- S.K. Basu
- From the Department of Neonatology (S.K.B.),Developing Brain Institute (S.K.B., S.P., S.D.B., K.J.K., J.L.Q., C.A.L., C.L.),George Washington University School of Medicine (S.K.B. S.P., S.D.B., J.M., A.J.d.P., C.L.), Washington, DC
| | - S. Pradhan
- Developing Brain Institute (S.K.B., S.P., S.D.B., K.J.K., J.L.Q., C.A.L., C.L.),George Washington University School of Medicine (S.K.B. S.P., S.D.B., J.M., A.J.d.P., C.L.), Washington, DC
| | - S.D. Barnett
- Developing Brain Institute (S.K.B., S.P., S.D.B., K.J.K., J.L.Q., C.A.L., C.L.),George Washington University School of Medicine (S.K.B. S.P., S.D.B., J.M., A.J.d.P., C.L.), Washington, DC
| | - M. Mikkelsen
- Department of Radiology (M.M., J.M.), Weill Cornell Medicine, New York, New York
| | - K.J. Kapse
- Developing Brain Institute (S.K.B., S.P., S.D.B., K.J.K., J.L.Q., C.A.L., C.L.)
| | - J. Murnick
- George Washington University School of Medicine (S.K.B. S.P., S.D.B., J.M., A.J.d.P., C.L.), Washington, DC,Department of Radiology (M.M., J.M.), Weill Cornell Medicine, New York, New York
| | - J.L. Quistorff
- Developing Brain Institute (S.K.B., S.P., S.D.B., K.J.K., J.L.Q., C.A.L., C.L.)
| | - C.A. Lopez
- Developing Brain Institute (S.K.B., S.P., S.D.B., K.J.K., J.L.Q., C.A.L., C.L.)
| | - A.J. du Plessis
- Fetal Medicine Institute (A.J.d.P.), Children’s National Hospital, Washington, DC,George Washington University School of Medicine (S.K.B. S.P., S.D.B., J.M., A.J.d.P., C.L.), Washington, DC
| | - C. Limperopoulos
- Developing Brain Institute (S.K.B., S.P., S.D.B., K.J.K., J.L.Q., C.A.L., C.L.),Division of Diagnostic Imaging and Radiology (C.L.),George Washington University School of Medicine (S.K.B. S.P., S.D.B., J.M., A.J.d.P., C.L.), Washington, DC
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15
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Osborne JA, Botkin R, Colon-Semenza C, DeAngelis TR, Gallardo OG, Kosakowski H, Martello J, Pradhan S, Rafferty M, Readinger JL, Whitt AL, Ellis TD. Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association. Phys Ther 2021; 102:6485202. [PMID: 34963139 PMCID: PMC9046970 DOI: 10.1093/ptj/pzab302] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
A clinical practice guideline on Parkinson disease was developed by an American Physical Therapy Association volunteer guideline development group that consisted of physical therapists and a neurologist. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches for management of Parkinson disease. The Spanish version of this clinical practice guideline is available as a supplement (Suppl. Appendix 1).
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Affiliation(s)
- Jacqueline A Osborne
- Brooks Rehabilitation Hospital, Brooks Institute of Higher Learning, Jacksonville, Florida, USA
| | - Rachel Botkin
- Botkin Rehab Services, Physical Therapy, Columbus, Ohio, USA
| | - Cristina Colon-Semenza
- Department of Kinesiology, Doctor of Physical Therapy Program, University of Connecticut, Storrs, Connecticut, USA
| | - Tamara R DeAngelis
- Boston University Sargent College of Health and Rehabilitation Services, Physical Therapy and Athletic Training, Boston, Massachusetts, USA
| | - Oscar G Gallardo
- Rancho Los Amigos National Rehabilitation Center, Physical Therapy, Downey, California, USA
| | - Heidi Kosakowski
- Address all correspondence to Dr Kosakowski care of the Department of Practice of the American Physical Therapy Association at:
| | | | - Sujata Pradhan
- University of Washington, Rehabilitation Medicine, Seattle, Washington, USA
| | - Miriam Rafferty
- Northwestern University, Center for Education in Health Sciences, Chicago, Illinois, USA
| | | | | | - Terry D Ellis
- Boston University Sargent College of Health and Rehabilitation Services, Physical Therapy and Athletic Training, Boston, Massachusetts, USA
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16
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McGovern E, Alsaied T, Szugye N, Pradhan S, Batlivala SP, Lubert A, Hirsch R. The Fontan Pathway: Change in Dimension and Catheter-Based Intervention over Time. Pediatr Cardiol 2021; 42:1740-1748. [PMID: 34136951 DOI: 10.1007/s00246-021-02658-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
An unobstructed Fontan pathway is essential for optimal hemodynamics. We hypothesize that more extracardiac conduit (ECC) Fontan pathways develop obstruction compared to lateral tunnel (LT) Fontans and that the dilation typically observed in LTs results in similar mid-term clinical outcomes. A single-center, retrospective study was done including all Fontan cardiac catheterizations from 2006 to 2019. Angiography and medical records were reviewed to define Fontan pathway dimensions, interventions, and clinical outcomes. 232 patients underwent cardiac catheterization, where 60% were ECCs and 30% LTs. The minimum cross-sectional area (CSA) of ECCs was significantly smaller than LTs and LTs dilated over time. 13% of patients had Fontan pathway stenting at a median age of 16.2 years. The minimum CSA for patients who underwent intervention was significantly smaller than patients who did not. Lower weight at Fontan surgery was associated with intervention on the Fontan pathway, with a threshold weight of 15 kg for patients with an ECC. The median follow-up was 3.3 years. Patients who had Fontan pathway intervention were not more likely to experience the composite adverse clinical outcome. LTs were more likely than ECCs to have worse clinical outcome, when liver fibrosis was included. This is the first study to describe angiographic dimensions of the Fontan pathway in a large number of patients over time. ECCs tend to become stenotic. Lower weight at Fontan surgery is a potential risk for Fontan pathway intervention. LTs may experience worse clinical outcomes in follow-up. This information can help inform the optimal timing and method of post-Fontan surveillance.
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Affiliation(s)
- E McGovern
- Division of Pediatric Cardiology, Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
| | - T Alsaied
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - N Szugye
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S Pradhan
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S P Batlivala
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A Lubert
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Hirsch
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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17
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Ratan A, Pradhan S, Panigrahi PK, Sahu M, Peepal P, Das S. Role of Laparoscopy in Diagnosis and Treatment of Endometriosis Associated with Infertility: A Prospective Analysis. Siriraj Med J 2021. [DOI: 10.33192/smj.2021.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: Endometriosis is often considered as an enigma due to its varied clinical presentation and challenges in diagnosis. The objective of this study is to evaluate the role of laparoscopy in diagnosis and treatment of endometriosis associated with infertility.Materials and Methods: Infertile females diagnosed to have endometriosis during or before undergoing laparoscopic surgery from August 2018 to February 2020 were followed up for spontaneous conception for 6 months following laparoscopy. Revised American Fertility Society (r-AFS) scoring system was used to score endometriosis and stage the disease (stage I-IV). Surgical interventions were done on individual cases basis following ESHRE guidelines.Results: Fifty infertile females diagnosed with endometriosis during or before laparoscopy were recruited for the study. Mean age of patients was 28.58 (±4.21) years. Thirty-four (68%) patients had primary infertility and 16 (32%) has secondary infertility. Mean duration infertility was 3.33 (±1.43). Only 37 patients (74%) had evidence of endometriosis in pre-operative ultrasonography. During the follow up period of first 6 months after surgery 34 (68%) patients conceived spontaneously. Lower mean endometriosis score (p=0.00) and early stage of endometriosis (p=0.00) were associated with higher chances of conception. But, female age, duration and type infertility, USG findings, and type of surgical interventions did not affect pregnancy rate.Conclusion: Laparoscopy helps in diagnosis of endometriosis. Laparoscopic therapeutic interventions for endometriosis increase the probability of spontaneous conception in infertile females. Lower surgical score and early stages of endometriosis are associated with higher chance of conception.
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18
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Pradhan S, Schwartz RA, Patil A, Grabbe S, Goldust M. Treatment options for leishmaniasis. Clin Exp Dermatol 2021; 47:516-521. [PMID: 34480806 DOI: 10.1111/ced.14919] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022]
Abstract
Leishmaniasis is broadly classified into three types: cutaneous, mucocutaneous and visceral. The visceral form is most dangerous and can result in death. Although leishmaniasis is an ancient disease, its treatment is still challenging. Several drugs, differing in their cost, toxicity, treatment duration and emergence of drug resistance, are used for different types of leishmaniasis. To overcome these limitations, the search for newer drugs and other treatments continues. In this article, we discuss conventional drugs, other treatments, including newer options such as immunotherapy and immunochemotherapy, and future prospects for leishmaniasis treatment.
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Affiliation(s)
| | - R A Schwartz
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - A Patil
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - S Grabbe
- Department of Pharmacology, DY Patil Deemed, To Be University, Navi Mumbai, Maharashtra, India.,Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - M Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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19
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Nandy N, Pradhan S. Stationary joint distribution of a discrete-time group-arrival and batch-size-dependent service queue with single and multiple vacation. COMMUN STAT-THEOR M 2021. [DOI: 10.1080/03610926.2021.1966469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N. Nandy
- Department of Mathematics, Visvesvaraya National Institute of Technology, Nagpur, India
| | - S. Pradhan
- Department of Mathematics, Visvesvaraya National Institute of Technology, Nagpur, India
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20
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Swamidas J, Assenholt M, Serban M, Jain J, Chopra S, Hande V, Pradhan S, Tanderup K. PO-1855 Protocol compliance of two Knowledge Based models in two Geo-Ethnic populations for cervical cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08306-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Agarwal P, Pattanaik S, Epili D, Mukherji A, Pradhan S. PO-1874 Impact of Arc length on unilateral dose volume parameters and plan delivery: A Dosimetry study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08325-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Brewer, Pradhan S, Carvell G, Delitto A. Application of Modified Regression Techniques to a Quantitative Assessment for the Motor Signs of Parkinson's Disease. IEEE Trans Neural Syst Rehabil Eng 2021; PP. [PMID: 34077364 DOI: 10.1109/tnsre.2009.2034080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Effective clinical trials for neuroprotective interventions for Parkinson's disease (PD) require a way to quantify an individual's motor symptoms and analyze the change in these symptoms over time. Clinical scales provide a global picture of function but cannot precisely measure specific aspects of motor control. We have used commercially available sensors to create a protocol called ASAP (Advanced Sensing for Assessment of Parkinson's disease) to obtain a quantitative and reliable measure of motor impairment in early to moderate PD. The ASAP protocol measures grip force as an individual tracks a sinusoidal or pseudorandom target force under three conditions of increasing cognitive load. Thirty individuals with PD have completed the ASAP protocol. The ASAP data for 26 of these individuals were summarized in terms of 36 variables, and modified regression techniques were used to predict an individual's score on the Unified Parkinson Disease Rating Scale based on ASAP data. We observed a mean prediction error of approximately 3.5 UPDRS points, and the predicted score accounted for approximately 76% of the variability of the UPDRS. These results demonstrate that the ASAP protocol can measure differences for individuals who are clinically different. This indicates that the ASAP protocol may be able to measure changes with time in the motor signs of an individual with PD.
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23
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Chakradhar A, Humagain M, Acharya N, Pradhan S, Poudel P. Self-confidence Level among Intern Dentists in Performing Endodontic Treatment Procedures in Nepal. Kathmandu Univ Med J (KUMJ) 2021; 19:168-172. [PMID: 34819430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Endodontics is considered as one of the most difficult and stressful disciplines in dentistry. This might be due to the complex anatomical variations, recent advances in equipment, technology, materials and lack of self-confidence. Objective To determine the self-confidence level among the intern dentists in performing endodontic procedures from six different colleges of Kathmandu University, Nepal. Method A descriptive cross-sectional study was conducted among 145 intern dentists. The online questionnaire regarding confidence level (5 point Likert scale) in different endodontic procedures and difficulty level (easy, ok and difficult) with respect to teeth was distributed. For descriptive purpose, frequency and percentage for each response were calculated. Result Dental interns were confident in performing majority of the normal endodontic procedures, however, they showed less confidence in performing difficult steps like rubber dam application for anterior (74, 51%) and posterior tooth (91, 62.7%), use of electronic apex locator (89, 61.4%), using rotary files (114, 78.6%), management of flare-ups (86, 59.4%), assessment of quality of post-endodontic treatment (85, 58.5%), recall periods (75, 51.6%) and performing post and core (82, 56.6%). Likewise, upper first molars (84, 57.9%) and second molars (104, 71.7%) were found to be the most difficult teeth to treat. Conclusion It can be concluded that majority of the dental interns were confident in performing basic endodontic procedures, however, they were found to have low confidence in performing difficult steps. Further training and exposure should be incorporated to increase their confidence level.
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Affiliation(s)
- A Chakradhar
- Department of Conservative Dentistry and Endodontics, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - M Humagain
- Department of Periodontics and Oral Implantology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - N Acharya
- Department of Conservative Dentistry and Endodontics, Institute of Medicine, Maharajgunj Medical Campus, Dental Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - S Pradhan
- Department of Conservative Dentistry and Endodontics, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - P Poudel
- Department of Oral and Maxillofacial Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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24
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Pabby A, Swain B, Sonar N, Mittal V, Valsala T, Ramsubramanian S, Sathe D, Bhatt R, Pradhan S. Radioactive waste processing using membranes: State of the art technology, challenges and perspectives. Separation & Purification Reviews 2021. [DOI: 10.1080/15422119.2021.1878221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- A.K. Pabby
- INRP(O), Nuclear Recycle Board, BARC, Palghar, Tarapur, India
- Faculty of Chemical Sciences , Homi Bhabha National Institute, Mumbai, Anushaktinagar, India
| | - B. Swain
- Faculty of Chemical Sciences , Homi Bhabha National Institute, Mumbai, Anushaktinagar, India
- INRPC, Nuclear Recycle Board (T), BARC, Maharashtra, Tarapur, India
| | - N.L. Sonar
- INRP(O), Nuclear Recycle Board, BARC, Palghar, Tarapur, India
| | - V.K. Mittal
- INRP(O), Nuclear Recycle Board, BARC, Palghar, Tarapur, India
| | - T.P. Valsala
- INRP(O), Nuclear Recycle Board, BARC, Palghar, Tarapur, India
| | | | - D.B. Sathe
- INRP(O), Nuclear Recycle Board, BARC, Palghar, Tarapur, India
| | - R.B. Bhatt
- INRP(O), Nuclear Recycle Board, BARC, Palghar, Tarapur, India
| | - S. Pradhan
- INRP(O), Nuclear Recycle Board, BARC, Palghar, Tarapur, India
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25
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Thakur P, Pradhan S. Comparative Analysis of Effectiveness of Clomiphene Citrate and Letrozole Combined with Low Dose Human Menopausal Gonadotropin for Controlled Ovarian Stimulation in Intrauterine Insemination Cycles. Siriraj Med J 2021. [DOI: 10.33192/smj.2021.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To compare the efficacy of clomiphene citrate and letrozole in combination with low dose human menopausal gonadotropin for controlled ovarian stimulation in intrauterine insemination (IUI) cycles.Methods: During January-2018 to December-2019 for intending 496 IUI cycles, controlled ovarian stimulation was performed with either clomiphene or letrozole combined with human menopausal gonadotropin (hMG), in two arms: subjects in one arm (Group A) were with clomiphene and hMG in 222 cycles; those in the second arm (Group B) were with letrozole and hMG in 274 cycles. Pregnancy rate and clinical pregnancy rate of both groups were considered as the primary outcomes.Results: Patient characteristics like female age, indications for IUI, type of IUI, endometrial thickness and total motile fraction (TMF) of spermatozoa of male partners were seen similar in both groups. The letrozole-hMG group (Group B) had significantly higher numbers of cycles with single dominant follicle (P=0.01) and human chorionic gonadotropin (hCG) was more frequently used as the ovulation trigger (P=0.03). Pregnancy rate (18.5% vs. 15.3%, P=0.35) and clinical pregnancy rate (18.5% vs. 15.3%, P=0.35) were similar in groups A and B, respectively.Conclusion: Clomiphene citrate and letrozole combined with low dose human menopausal gonadotropin were equally effective for controlled ovarian stimulation in IUI cycles.
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26
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Pradhan S, Thakur P. The Effects of Ovulation Documentation before Insemination on Intrauterine Insemination Cycle Outcomes: A Retrospective Analysis. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/46802.14629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Ovulation is the key event in Intrauterine Insemination (IUI) cycles. Monitoring ovulation prior to insemination will help to alter insemination time to improve pregnancy rate. Aim: To compare pregnancy rates and live birth rates in presence and absence of ultrasonographic features of ovulation before insemination in IUI cycles. Materials and Methods: This was a retrospective cohort study conducted in a Institute of Medical Sciences and SUM Hospital, Bhubaneswar. Three hundred eighty eight IUI cycles performed in the period of January 2017 to December 2018 were analysed. On the day of IUI prior to insemination, transvaginal ultrasonography was done 36-38 hours after ovulation trigger to document ovulation. Presumptive signs of ovulation were documented in 201 cycles (Group A) and there was no feature suggestive of ovulation in 187 cycles (Group B). In all the cycles, single insemination was performed at 38-40 hours after ovulation trigger. Baseline characteristics were compared. Mann-Whitney U test was used to compare continuous variables. Chi-square test and Fisher’s-exact test were applied to find out the differences in the categorical variables as well as the pregnancy outcomes among the groups. Pregnancy rate and live birth rate were considered as the primary outcomes. Results: Pregnancy rate (17.9% vs 18.2%, p-value=0.945) and live birth rate (17.9% vs 16.0%, p-value=0.625) were similar irrespective of ovulation status documented in ultrasonography performed before insemination. Conclusion: IUI cycle outcomes are independent of the ovulation status documented before insemination.
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Yamagami M, Imsdahl S, Lindgren K, Bellatin O, Nhan N, Burden SA, Pradhan S, Kelly VE. Effects of virtual reality environments on overground walking in people with Parkinson disease and freezing of gait. Disabil Rehabil Assist Technol 2020; 18:266-273. [PMID: 33155870 DOI: 10.1080/17483107.2020.1842920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Freezing of gait (FoG) is a common target of rehabilitative interventions for people with Parkinson disease (PD). Virtual reality (VR) holds potential for advancing research and clinical management of FoG through flexible creation of FoG-provoking environments that are not easily or safely replicated in the clinic. OBJECTIVE The aim of this study was to investigate whether VR environments that replicate FoG-provoking situations would exacerbate gait impairments associated with FoG compared to unobstructed VR and physical laboratory environments. METHODS Gait characteristics (pace, rhythm, variability, asymmetry, and postural control domains) and festination were measured using motion capture while people with PD walked in VR environments based on FoG-provoking situations (doorway, hallway, and crowd environments) compared to unobstructed VR and physical laboratory environments. The effect of VR environments was assessed using one-way repeated measures ANOVAs with planned contrasts. RESULTS Ten participants (mean age 74.1 years, 3 females, Hoehn and Yahr stage 2-3) with PD who self-reported FoG participated. Gait speed and step length were reduced in all VR environments compared to the physical laboratory. Step width was wider, step length was more variable, and festination was more common for some of the VR environments compared to the physical laboratory environment. Compared to the unobstructed virtual laboratory environment, step length was more variable in VR crowd and doorway environments. CONCLUSIONS The exacerbation of gait impairments that are characteristic precursors of FoG in FoG-provoking VR environments supports the potential utility of VR technology in the assessment and treatment of gait impairments in PD.Implications for rehabilitationFreezing increases fall risk and reduces quality of life in Parkinson disease (PD).Virtual reality (VR) can simulate visuospatial environments that provoke freezing.Immersive VR doorway, hallway, and crowd environments were developed.Gait speed slowed when people with PD walked overground in all VR environments.Step variability and festination increased in freeze-provoking environments.
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Affiliation(s)
- Momona Yamagami
- Department of Electrical & Computer Engineering, University of Washington, Seattle, WA, USA
| | - Sheri Imsdahl
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Kyle Lindgren
- Department of Electrical & Computer Engineering, University of Washington, Seattle, WA, USA
| | - Olivia Bellatin
- Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA
| | - Nawat Nhan
- Department of Mechanical Engineering, Gonzaga University, Spokane, WA, USA
| | - Samuel A Burden
- Department of Electrical & Computer Engineering, University of Washington, Seattle, WA, USA
| | - Sujata Pradhan
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Valerie E Kelly
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Pal S, Pradhan S, Narayan G, Ghosh A, Singh T, Prasad C, Ranjan R. Change in Expression of Biomarkers Bcl-2 and Survivin in Patients of Cancer Cervix Undergoing Chemo-radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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Yin B, Ran X, Zhang C, Xie Z, Ran Y, Fu L, Pradhan S. Tinea incognito infection with Trichophyton erinacei from a pet hedgehog. Br J Dermatol 2020; 183:e92. [PMID: 32538462 DOI: 10.1111/bjd.19206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- B Yin
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - X Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - C Zhang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Z Xie
- Department of Dermatovenereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Y Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - L Fu
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - S Pradhan
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
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30
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Pradhan S, Gupta UC. Stationary queue and server content distribution of a batch-size-dependent service queue with batch Markovian arrival process: BMAP/Gn(a,b)/1. COMMUN STAT-THEOR M 2020. [DOI: 10.1080/03610926.2020.1813304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- S. Pradhan
- Department of Mathematics, Visvesvaraya National Institute of Technology, Nagpur, India
| | - U. C. Gupta
- Department of Mathematics, Indian Institute of Technology, Kharagpur, India
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31
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Kayastha R, Acharya R, Pradhan S, Tuladhar AS, Shrestha A. Adrenal Ganglioneuroma. Kathmandu Univ Med J (KUMJ) 2020; 18:316-319. [PMID: 34158444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Adrenal ganglioneuromas are rare sympathetic differentiated tumors which originate from neural crest cells. These lesions are usually discovered incidentally on imaging and tend to be hormonally silent. Preoperative diagnosis of adrenal ganglioneuroma remains extremely challenging and the gold standard treatment is adrenalectomy. There is good prognosis after surgery without recurrence. We herein report a case of adrenal ganglioneuroma in a 15 year old female who presented with complaint of abdominal discomfort. Contrast Enhanced Computed Tomography abdomen showed a large septated hypodense right suprarenal mass which was echogenic on Ultrasonography. It showed T1 hypointense and T2 hyperintense signal on Magnetic Resonance Imaging of abdomen and pelvis. Excisional biopsy and histological examination of the mass was suggestive of adrenal ganglioneuroma. This report presents the clinical and radiological data for the rare tumor which would share some experience to facililate the diagnosis of adrenal ganglioneuroma.
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Affiliation(s)
- R Kayastha
- Department of Radiology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal
| | - R Acharya
- Department of Radiology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal
| | - S Pradhan
- Department of Radiology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal
| | - A S Tuladhar
- Department of Radiology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal
| | - A Shrestha
- Department of Radiology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal
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Pradhan S, Brooks A, Yadavalli V. Nature-derived materials for the fabrication of functional biodevices. Mater Today Bio 2020; 7:100065. [PMID: 32613186 PMCID: PMC7317235 DOI: 10.1016/j.mtbio.2020.100065] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 11/18/2022] Open
Abstract
Nature provides an incredible source of inspiration, structural concepts, and materials toward applications to improve the lives of people around the world, while preserving ecosystems, and addressing environmental sustainability. In particular, materials derived from animal and plant sources can provide low-cost, renewable building blocks for such applications. Nature-derived materials are of interest for their properties of biodegradability, bioconformability, biorecognition, self-repair, and stimuli response. While long used in tissue engineering and regenerative medicine, their use in functional devices such as (bio)electronics, sensors, and optical systems for healthcare and biomonitoring is finding increasing attention. The objective of this review is to cover the varied nature derived and sourced materials currently used in active biodevices and components that possess electrical or electronic behavior. We discuss materials ranging from proteins and polypeptides such as silk and collagen, polysaccharides including chitin and cellulose, to seaweed derived biomaterials, and DNA. These materials may be used as passive substrates or support architectures and often, as the functional elements either by themselves or as biocomposites. We further discuss natural pigments such as melanin and indigo that serve as active elements in devices. Increasingly, combinations of different biomaterials are being used to address the challenges of fabrication and performance in human monitoring or medicine. Finally, this review gives perspectives on the sourcing, processing, degradation, and biocompatibility of these materials. This rapidly growing multidisciplinary area of research will be advanced by a systematic understanding of nature-inspired materials and design concepts in (bio)electronic devices.
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Affiliation(s)
- S. Pradhan
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - A.K. Brooks
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - V.K. Yadavalli
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, 23284, USA
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Costedoat G, Feria CS, Pradhan S, Stone LS, Flynn-Evans EE. 0254 The Effects of Chronic Sleep Restriction on Multiple Object Tracking. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The ability to simultaneously track numerous moving objects in the presence of irrelevant stimuli is essential for successfully carrying out a variety of tasks. Sleep loss impairs neurocognitive functioning and, as a result, attentional processing capacity is reduced. The objective of the current study was to determine if performance on the multiple object tracking (MOT) task was adversely impacted by a week of chronic sleep restriction (CSR).
Methods
Twelve healthy participants (6 males, 6 females) kept a fixed sleep-wake schedule, with a constant waketime, at home for four weeks (actigraphy confirmed compliance). During weeks one and three, participants maintained 9 hours in bed. During weeks two and four, participants were randomly assigned to 5 and 9 hours of sleep. Following weeks two and four, participants completed a 13-hour laboratory visit under dim light (< 15 lux), where they maintained a constant posture and were provided with hourly isocaloric snacks. MOT was presented at approximately 6 and 8 hours after waking. Participants were required to track four, five, or six moving targets in the presence of identical distractors (always 12 total objects).
Results
Participants slept significantly less when assigned to 5 (M = 4.43 hours, SD = 0.33 hours), compared to 9 hours of sleep (M = 7.42 hours, SD = 0.42 hours; F (1, 22) = 206.89, p = 0.00). The proportion of correct MOT responses was significantly lower following 5 (M = 0.70, SD = 0.15) compared to 9 hours of sleep (M = 0.77, SD = 0.12; F (1, 22) = 10.29, p < .05).
Conclusion
A week of CSR adversely impacted MOT performance compared to a week of sleep satiation. These findings have implications for individuals, such as air traffic controllers and truck drivers, who must visually track multiple moving objects, often while chronically sleep deprived.
Support
Supported by the Force Health Protection Program of the Office of Naval Research (SAA2402925-1, Contract Award no. N0001418IP00050).
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Affiliation(s)
- G Costedoat
- San Jose State University Research Foundation, Moffett Field, CA
| | - C S Feria
- San Jose State University, San Jose, CA
| | - S Pradhan
- Department of Management, Menlo College, Atherton, CA
- San Jose State University Research Foundation, Moffett Field, CA
| | - L S Stone
- NASA Ames Research Center, Moffett Field, CA
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Abstract
Abstract
Introduction
Prior research on travel in the National Basketball Association’s (NBA) regular season has shown that teams journeying west relative to their home base face circadian disadvantages for evening games, while those traveling east have advantages. The current study extends previous research by examining these effects within the NBA playoffs. We hypothesized that teams would have a greater circadian advantage during eastward compared to westward travel.
Methods
In 2013, the NBA implemented a 7-game series playoff structure, in which teams play an alternating home/away 2-2-1-1-1 format. Data for all 499 postseason games played during the 2013–14 to 2018–2019 seasons were collected from Basketball-Reference and FiveThirtyEight. We investigated the impact of direction of travel based on home base city (same time zone, westward, eastward) and time zones traveled on game outcomes, Elo rating differences (i.e., a team quality metric based on wins and losses), win probability, and team scoring.
Results
Teams had lower win probabilities following 3-hour westward than same time zone and all eastward travel, while 3-hour eastward travel related to higher probabilities of winning compared to same time and all westward travel (p < .001, d > .95). Teams travelling westward with 2-hour time changes lost significantly more games than those experiencing 1-hour westward (p = .04, OR = 2.45), 1-hour eastward (p = .05, OR = 2.34), and 3-hour eastward changes (p = .02, OR = 4.68). Scoring was significantly higher following eastward travel compared to both westward (p = .001, d = 0.60) and same time zone travel (p = .003, d = 0.44). There were no differences in team quality based on direction of travel or number of time zones traveled, and game outcomes based on overall direction of travel (p > .05).
Conclusion
Direction and magnitude of travel were related to win probability, team scoring, and game outcomes, whereby teams travelling eastward and within the same time zone gained an advantage over those travelling westward. Adjustment to travel and time changes appear to influence in-game performances and outcomes in the NBA playoffs.
Support
None
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Affiliation(s)
| | - K Gregory
- NASA Ames Research Center, Moffett Field, CA
| | | | - R Chachad
- University of California, San Francisco, San Francisco, CA
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MacArthur C, Hernandez M, Landon M, Switalski S, Pradhan S, Guzman J, Lakshmipathy U. Efficient generation of CD4 & CD8 T cell derived iPSC for potential use in allogeneic cellular therapies. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Koirala R, Panthee N, Pradhan S, Rajbhandari N, Shrestha DK, Chhetri S, Shrestha Y, Dahal A, Dhakal S, Thapa S. Multi-drug Resistant and Extended Spectrum β-lactamase Producing Salmonella Species Isolated from Fresh Chicken Liver Samples. Kathmandu Univ Med J (KUMJ) 2020; 18:133-138. [PMID: 33594018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background Ductus arteriosus is a vascular structure which connects the roof of main pulmonary artery near the origin of the left branch pulmonary artery to the proximal descending aorta. Patent ductus arteriosus (PDA) closure is indicated for any patient who is symptomatic from left to right shunting. Objective To investigate the hospital outcomes of surgical closure of patent ductus arteriosus over last 19 years starting from the very first case of our center. Method This is a retrospective analysis of all patent ductus arteriosus treated surgically from August 2001 to July 2019. Patients who underwent isolated surgical closure of patent ductus arteriosus were included. Data have been presented in three different eras (Era 1: 2001-2007, Era 2: 2008-2013, and Era 3: 2014-2019) to see the trend of evolution of this surgery. Result A total of 901 patients aged 8.67±8.76 years under went patent ductus arteriosus surgical closure over last 19 years. Patients in the initial era 2001-2007 were significantly older compared with other 2 eras (p=0.000). Males accounted for 35.5% of all cases. Twenty percent had severe pulmonary artery hypertension.Duration of mechanical ventilation was 3.57±9.64 hours with ICU stay of 1.55±1.53 days, and hospital stay of 3.9±2.3 days. Overall in hospital mortality was 0.8%; for isolated patent ductus arteriosus diagnosis, mortality was 0.2%. Chylothorax was noted in 0.4%. Conclusion This is the first report to analyze surgical outcomes of patent ductus arteriosus ligation in our center. We have discussed the evolution of patent ductus arteriosus surgery in our center, and have shown favorable outcomes in terms of morbidity and mortality.
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Affiliation(s)
- R Koirala
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - N Panthee
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Pradhan
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - N Rajbhandari
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - D K Shrestha
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Chhetri
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - Y Shrestha
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - A Dahal
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Dhakal
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Thapa
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
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Sinha R, Mukherjee A, Banerjee S, Pradhan S. SAT-469 EFFECT OF RITUXIMAB ON GROWTH AND BODY MASS INDEX IN CHILDHOOD STEROID DEPENDENT NEPHROTIC SYNDROME: A RETROSPECTIVE MULTI-CENTER REVIEW. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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BASNET N, Pradhan S, Gautam K, Dhakal A, Kafle R. SAT-098 LEVELS OF HIGH-SENSITIVITY C-REACTIVE PROTEIN IN NON-DIABETIC CHRONIC HEMODIALYSIS PATIENTS IN A SINGLE OUT-PATIENT HEMODIALYSIS UNIT. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Pradhan S, Panda S, Chopra S, Kannan S, Swamidas J. OC-081: Knowledge based treatment planning and validation of VMAT for Cervical Cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(20)30450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Affiliation(s)
- S Pradhan
- Department of Dermatovenereology, West China Hospital, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - X Ran
- Department of Dermatovenereology, West China Hospital, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - C Zhang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - X Li
- Department of Dermatovenereology, West China Hospital, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Y Ran
- Department of Dermatovenereology, West China Hospital, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
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Singh N, Yang H, Pradhan S, Ran X, Ran Y. Image Gallery: Wandering
Demodex
mite
in vivo
under ultraviolet dermoscopy of rosacea. Br J Dermatol 2019; 182:e2. [PMID: 31432494 DOI: 10.1111/bjd.18370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- N. Singh
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
| | - H. Yang
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
| | - S. Pradhan
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
| | - X. Ran
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
| | - Y. Ran
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
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Pradhan S, Kelly VE. Quantifying physical activity in early Parkinson disease using a commercial activity monitor. Parkinsonism Relat Disord 2019; 66:171-175. [PMID: 31420310 DOI: 10.1016/j.parkreldis.2019.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/08/2019] [Accepted: 08/02/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Physical inactivity in Parkinson disease (PD) has an impact on motor and non-motor symptoms of the disease. It is unclear whether this decline in physical activity occurs early in the disease, in addition to any decline due to aging, and whether commercial activity monitors can be used to self-monitor physical activity levels in this population. OBJECTIVE To compare the quantity and intensity of physical activity (PA), as measured by commercial activity monitors, in people with mild PD and healthy older adults (HOA). A secondary objective was to assess adherence and user experience with wearing the activity monitoring device. METHODS An observational descriptive study design examined PA levels over a 14-day period using commercially-available activity monitors (Fitbit Charge HR). RESULTS Individuals with PD (n = 30) and HOA (n = 30) both demonstrated high adherence with wear time (PD = 13.8 [0.5] days, HOA = 13.9 [0.4] days, p = 0.55). People with PD took fewer steps per day than HOA (PD = 6416.9 (2795.5), HOA = 11441.3 (3932.1), p < 0.001). Compared to HOA, individuals with PD spent fewer minutes per day engaged in moderate to vigorous intensity activity (PD = 33.0 (22.5), HOA = 72.0(37.3), p < 0.001) and more minutes per day sedentary (PD = 803.74 (154.9), HOA = 578.26 (103.7), p < 0.001). Both groups reported that ease of use and satisfaction with the activity monitor were high. CONCLUSIONS People with mild PD demonstrated reduced quantity and intensity of PA compared to HOA. Both the PD and the HOA groups had good adherence wearing a commercial activity monitor that provided feedback regarding activity levels.
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Affiliation(s)
- Sujata Pradhan
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, United states.
| | - Valerie E Kelly
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, United states
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Pradhan S, van Teijlingen E, Simkhada PP, Dhungel A, Silwal RC, Fanning P, Wasti SP. Factors Affecting the Uptake of Institutional Delivery, Antenatal and Postnatal Care in Nawalparasi District, Nepal. Kathmandu Univ Med J (KUMJ) 2019; 17:206-211. [PMID: 33305749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background Maternal deaths and complications are highly preventable with good antenatal, postnatal and skilled care during childbirth. Inadequate information on the factors affecting these services could be barrier to a reduction of maternal deaths in lowincome countries. Objective To assess the uptake of antenatal, postnatal and skilled care during childbirth. Method A cross-sectional study was conducted in eight villages of Nawalparasi district in southern Nepal. A total of 447 women who had given birth within the preceding 24 months were recruited using multistage random sampling. Data were collected using a pre-tested semi-structured questionnaire. Chi-square tests were used to assess association between variables. Result Over 70% of women had gone for at least four antenatal care check-ups while only 14.3% had at least three postnatal check-ups in their last pregnancies. The proportion of institution delivery was 54%. Women's literacy was associated with the uptake of antenatal services (p=< 0.001), postnatal care (p=0.04) and institutional delivery (p=< 0.001). Knowledge of antenatal (p=< 0.001) and postnatal care was also associated with uptake of respective services (p=< 0.001). Conclusion The uptake and knowledge of antenatal care was much better than of postnatal care. Home delivery rates were still very high. A scaling-up of education and awarenessraising interventions in this community could help improve the uptake of maternal health services.
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Affiliation(s)
- S Pradhan
- Green Tara Nepal, Kathmandu, Nepal. CMMPH, Bournemouth University, Bournemouth, UK
| | - E van Teijlingen
- CMMPH, Bournemouth University, Bournemouth, UK. Manmohan Memorial Institute of Health Sciences, (MMIHS), Kathmandu, Nepal. Nobel College, Kathmandu, Nepal
| | - P P Simkhada
- CMMPH, Bournemouth University, Bournemouth, UK. Manmohan Memorial Institute of Health Sciences (MMIHS), Kathmandu, Nepal. Nobel College, Kathmandu, Nepal. School of Human and Health Sciences, University of Huddersfield, Huddersfild, UK
| | | | | | | | - S P Wasti
- Independent Research Consultant, Kathmandu, Nepal
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BASNET N, Gautam K, Pradhan S, Kafle Kumar R. MON-288 DECREASED GLUCOSE-6-PHOSPHATE DEHYDROGENASE LEVEL IN BLOOD IS RELATED TO INCREASED RISK OF DIABETES AND RENAL IMPAIRMENT. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Pradhan MM, Anvikar AR, Daumerie PG, Pradhan S, Dutta A, Shah NK, Joshi PL, Banerji J, Duparc S, Mendis K, Murugasampillay S, Valecha N. Comprehensive case management of malaria: Operational research informing policy. J Vector Borne Dis 2019; 56:56-59. [PMID: 31070167 DOI: 10.4103/0972-9062.257776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In 2013, the Odisha state Vector Borne Disease Control Programme led a five year operational research project, under programmatic conditions, in close collaboration with several partners. This Comprehensive Case Management Project covered a population of 900,000 across paired control and intervention blocks in four districts, each with different transmission intensities. Key gaps in access to malaria services were identified through household surveys and a detailed situation analysis. The interventions included ensuring adequate stocks of rapid diagnostic tests and antimalarial drugs at the village level, the capacity building of health workers and ASHAs, setting up microscopy centres at the primary health care level, and conducting mass screening and treatment in poorly accessible areas. The programme strengthened the routine health system, and improved malaria surveillance as well as the access to and quality of care. Initially, the programme led to increased case reporting due to improved detection, followed by a decline in malaria incidence. Lessons from the project were then scaled up statewide in the form of a new initiative-Durgama Anchalare Malaria Nirakaran (DAMaN).
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Affiliation(s)
- M M Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, Odisha, India
| | | | | | - S Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, Odisha, India
| | - A Dutta
- Indian Institute of Public Health, Bhubaneswar, Odisha, India
| | - N K Shah
- Independent Malariologist, Ganiyari, India
| | - P L Joshi
- Independent Malariologist, New Delhi, India
| | - J Banerji
- Medicines for Malaria Venture, Geneva, Switzerland
| | - S Duparc
- Medicines for Malaria Venture, Geneva, Switzerland
| | - K Mendis
- Independent Malariologist, Colombo, Sri Lanka
| | | | - N Valecha
- ICMR-National Institute of Malaria Research, New Delhi, India
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Lakshmipathy U, Pradhan S, Dargitz C, Guzman J. Identification and quantification of immune cell types using PCR-based PureQuant methylation assay. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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MacArthur C, Pradhan S, Switalski S, Landon M, Lakshmipathy U. Establishing iPSC cell banks derived using reagents and workflows optimized for cell therapy manufacturing. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yang Q, Tang JQ, Pradhan S, Ran X, Ran YP. Image Gallery: A case of malignant syphilis in an HIV-infected patient mimicking fungal infection. Br J Dermatol 2019; 178:e64. [PMID: 29357605 DOI: 10.1111/bjd.16069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Q Yang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - J Q Tang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - S Pradhan
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - X Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Y P Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
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Kajaria A, Sharma N, Sharma S, Pradhan S, Mandal A, Aggarwal L. Monte Carlo Study of Unflattened Photon Beams Shaped by Multileaf Collimator. J Biomed Phys Eng 2019; 9:137-150. [PMID: 31214519 PMCID: PMC6538911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 06/15/2016] [Indexed: 11/02/2022]
Abstract
INTRODUCTION This study investigates basic dosimetric properties of unflattened 6 MV photon beam shaped by multileaf collimator and compares them with those of flattened beams. MATERIALS AND METHODS Monte Carlo simulation model using BEAM code was developed for a 6MV photon beam based on Varian Clinic 600 unique performance linac operated with and without a flattening filter in beam line. Dosimetric features including lateral profiles, central axis depth dose, photon and electron spectra were calculated for flattened and unflattened cases, separately. RESULTS An increase in absolute depth dose with a factor of more than 2.4 was observed for unflattened beam which was dependent on depth. PDDs values were found to be lower for unflattened beam for all field sizes. Significant decrease in calculated mlc leakage was observed when the flattening filter was removed from the beam line. The total scatter factor, SCP was found to show less variation with field sizes for unflattened beam indicating a decrease in head scatter. The beam profiles for unflattened case are found to have lower relative dose value in comparison with flattened beam near the field edge, and it falls off faster with distance. CONCLUSION Our study showed that increase in the dose rate and lower peripheral dose could be considered as realistic advantages for unflattened 6MV photon beams.
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Affiliation(s)
- A. Kajaria
- School of Biomedical Engineering, Indian Institute of Technology (BHU), Varanasi, UP, India
| | - N. Sharma
- School of Biomedical Engineering, Indian Institute of Technology (BHU), Varanasi, UP, India
| | - Sh. Sharma
- School of Biomedical Engineering, Indian Institute of Technology (BHU), Varanasi, UP, India
| | - S. Pradhan
- Department of Radiotherapy and Radiation Medicine, Institute of Medical Science (BHU), Varanasi, UP, India
| | - A. Mandal
- Department of Radiotherapy and Radiation Medicine, Institute of Medical Science (BHU), Varanasi, UP, India
| | - L.M. Aggarwal
- Department of Radiotherapy and Radiation Medicine, Institute of Medical Science (BHU), Varanasi, UP, India
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Pradhan S, Ran X, Xu X, Yang Y, Lei S, Ran Y. Image Gallery: Dermoscopy of perianal molluscum contagiosum in a child caused by molluscum contagiosum virus subtype I. Br J Dermatol 2019; 180:e68. [PMID: 30821395 DOI: 10.1111/bjd.17401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- S Pradhan
- Department of Dermatovenereology, Sichuan University, Chengdu, 610041, China
| | - X Ran
- Department of Dermatovenereology, Sichuan University, Chengdu, 610041, China
| | - X Xu
- Department of Dermatovenereology, Sichuan University, Chengdu, 610041, China
| | - Y Yang
- Department of Dermatovenereology, Sichuan University, Chengdu, 610041, China
| | - S Lei
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Y Ran
- Department of Dermatovenereology, Sichuan University, Chengdu, 610041, China
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