Category: Nevin Manimala

Reprod Biomed Online. 2022 Jun 26:S1472-6483(22)00431-X. doi: 10.1016/j.rbmo.2022.06.018. Online ahead of print.

ABSTRACT

RESEARCH QUESTION: Is there a relationship between embryo quality, pregnancy rates and apoptotic gene expression in cumulus cells of oocytes collected from patients with poor ovarian response and polycystic ovary syndrome?

DESIGN: Fifty infertile couples who underwent assisted reproductive technology treatment were included in the study (Approval date 4 February 2020, number 03). The patients were divided into four group: control (n = 9; 90 oocytes), unexplained infertility (n = 8; 86 oocytes), polycystic ovary syndrome (PCOS) (n = 6; 137 oocytes) and poor ovarian response (POR) (n = 27; 124 oocytes). Cumulus cells were isolated individually from 437 oocytes obtained. Intracytoplasmic sperm injection was undertaken on 365 mature oocytes. The embryos were monitored. Caspase-3, Bax and Bcl-2 gene expressions of the cumulus cells were measured by real-time polymerase chain reaction.

RESULTS: A significant and negative correlation was found between Bax and Bcl-2 expressions of the cumulus cells of poor-quality embryos. The increase in Caspase-3 gene expression in the POR group statistically decreases the pregnancy rates. Fertilization and good-quality embryo development of 365 oocytes whose cumulus cells were examined, however, were not associated with apoptotic gene expression. The Bax/Bcl-2 ratio was found to be significantly lower in cumulus cells of mature oocytes.

CONCLUSIONS: Our results demonstrated no significant associations between fertilization, quality embryo development and apoptotic gene expression. Bax expression and the Bax/Bcl-2 ratio are high in immature oocyte cumulus cells has shown us that the apoptotic process may begin when the cumulus-oocyte connection exists.

PMID:36096870 | DOI:10.1016/j.rbmo.2022.06.018

Eur J Surg Oncol. 2022 May 22:S0748-7983(22)00463-2. doi: 10.1016/j.ejso.2022.05.018. Online ahead of print.

ABSTRACT

BACKGROUND: Anastomotic leakage (AL) after colorectal surgery is well-researched, yet the effect of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) after Cytoreductive Surgery (CRS) is unclear. Assessment of risk factors in these patients may assist surgeons during perioperative decision making.

METHODS: This was a single-center, retrospective study of patients who underwent CRS-HIPEC for colorectal peritoneal metastases. Main outcome measures were anastomotic leakage and associated morbidity.

RESULTS: AL was observed in 17 of the 234 (7.3%) anastomoses in 17 of the total of 165 (10.3%) of patients. No association was observed between the number and location of anastomoses and AL, although only one in 87 small bowel anastomoses showed leakage. The only factor associated with AL was administration of bevacizumab within 60 days prior to surgery with an odds ratio (OR) of 6.13 (1.32-28.39), P = 0.03. Deviating stomata were not statistically protective of increased morbidity, although more AL occurred in the patients with colocolic and colorectal anastomoses when no concomitant deviating stoma was created. Deviation stomata were reversed in 52.6%, and no AL was observed after stoma reversal.

CONCLUSION: The overall AL rate of CRS-HIPEC is comparable to colorectal surgery, and there is no cumulative risk of multiple anastomoses – especially in the case of small bowel anastomoses. Deviating stomata should be considered in patients with colocolic or colorectal anastomosis, although there is a significant chance that the stoma will not be reversed in these patients. Due to increased AL-risk surgeons should be aware of previous bevacizumab treatment, and plan the CRS-HIPEC at least 60 days after the treatment-day.

PMID:36096855 | DOI:10.1016/j.ejso.2022.05.018

Int J Urol. 2022 Sep 12. doi: 10.1111/iju.15036. Online ahead of print.

ABSTRACT

PURPOSE: To determine the efficacy and safety of trajectory infiltration with 1:150 000 Norepinephrine (NE) in reducing blood loss during percutaneous nephrolithotomy (PCNL).

MATERIALS AND METHODS: This is a prospective randomized double-blinded placebo-controlled trial. In all, 140 consecutive patients underwent PCNL for the management of large renal calculi. They were randomly assigned (1:1) to one of either study groups, the NE-PCNL group (70 patients whose PCNL-trajectory was infiltrated by NE) or the Placebo group (saline PCNL) (70 patients whose PCNL tracts were infiltrated by normal saline). Procedure-related blood loss (the primary outcome) was assessed and statistically analyzed. Also, all other procedure-related events and complications were recorded and compared.

RESULTS: The median blood loss was 378 ml (IQR: 252-504) in the NE-PCNL group versus 592 ml (IQR: 378-756) in the S-PCNL group (p < 0.0001). In addition, Hemoglobin and Hematocrit deficits were lower in NE-PCNL (p < 0.05). Patients who were randomized to the NE-PCNL group had a higher immediate stone-free rate (SFR) (80%) compared with those of the S-PCNL group (70%) (p = 0.034). However, no statistical differences were found in the final SFR. The reported overall complications between the 2 groups were similar (p > 0.05). Indeed, bleeding-related complications were 1 (1.4%) versus 10 (14.3%) for NE-PCNL and S-PCNL, respectively (p = 0.009).

CONCLUSIONS: Trajectory infiltration of PCNL tracts by NE was found to be effective and safe in mitigation of PCNL-related blood loss. This step is a timeless and cost-effective as NE is readily available in surgical theaters and of very low cost.

PMID:36094821 | DOI:10.1111/iju.15036

JMIR Med Educ. 2022 Sep 12;8(3):e37297. doi: 10.2196/37297.

ABSTRACT

BACKGROUND: Neonatal mortality accounts for approximately 46% of global under-5 child mortality. The widespread access to mobile devices in low- and middle-income countries has enabled innovations, such as mobile virtual reality (VR), to be leveraged in simulation education for health care workers.

OBJECTIVE: This study explores the feasibility and educational efficacy of using mobile VR for the precourse preparation of health care professionals in neonatal resuscitation training.

METHODS: Health care professionals in obstetrics and newborn care units at 20 secondary and tertiary health care facilities in Lagos, Nigeria, and Busia, Western Kenya, who had not received training in Helping Babies Breathe (HBB) within the past 1 year were randomized to access the electronic HBB VR simulation and digitized HBB Provider’s Guide (VR group) or the digitized HBB Provider’s Guide only (control group). A sample size of 91 participants per group was calculated based on the main study protocol that was previously published. Participants were directed to use the electronic HBB VR simulation and digitized HBB Provider’s Guide or the digitized HBB Provider’s Guide alone for a minimum of 20 minutes. HBB knowledge and skills assessments were then conducted, which were immediately followed by a standard, in-person HBB training course that was led by study staff and used standard HBB evaluation tools and the Neonatalie Live manikin (Laerdal Medical).

RESULTS: A total of 179 nurses and midwives participated (VR group: n=91; control group: n=88). The overall performance scores on the knowledge check (P=.29), bag and mask ventilation skills check (P=.34), and Objective Structured Clinical Examination A checklist (P=.43) were similar between groups, with low overall pass rates (6/178, 3.4% of participants). During the Objective Structured Clinical Examination A test, participants in the VR group performed better on the critical step of positioning the head and clearing the airway (VR group: 77/90, 86%; control group: 57/88, 65%; P=.002). The median percentage of ventilations that were performed via head tilt, as recorded by the Neonatalie Live manikin, was also numerically higher in the VR group (75%, IQR 9%-98%) than in the control group (62%, IQR 13%-97%), though not statistically significantly different (P=.35). Participants in the control group performed better on the identifying a helper and reviewing the emergency plan step (VR group: 7/90, 8%; control group: 16/88, 18%; P=.045) and the washing hands step (VR group: 20/90, 22%; control group: 32/88, 36%; P=.048).

CONCLUSIONS: The use of digital interventions, such as mobile VR simulations, may be a viable approach to precourse preparation in neonatal resuscitation training for health care professionals in low- and middle-income countries.

PMID:36094807 | DOI:10.2196/37297

Small. 2022 Sep 12:e2203234. doi: 10.1002/smll.202203234. Online ahead of print.

ABSTRACT

Air-channel devices have a special advantage due to the promise of vacuum-like ballistic transport in air, radiation insensitivity, and nanoscale size. Here, achieving high current at low voltage along with considerable mechanical stability is a primary issue. The comparative analysis of four planar and metallic electrode-pair geometries at 10 nm channel length is presented. The impact of nano-electrode-pair geometries on overall device performance is investigated. Air-channel devices are operated at the ultra-low voltage of 5 mV to demonstrate the device dynamics of air-channel devices at low power. Investigations focus on the direct tunneling (DT) mechanism which is dominant in the low-voltage regime. Comparative analysis of different electrode-pair geometries reveals two orders of magnitude increment in the current just by modulating the electrode-pair structure. Theoretical analysis suggests that the emission current is directly related to the active junction area within the metal-air-metal interface at the direct tunneling regime. The geometry-dependent mechanical stability of different electrode pairs is compared by imaging biasing triggered nanoscale structural changes and pulsed biasing stress analysis. The results and claims are confirmed and consolidated with the statistical analysis. Experimental investigations provide strong directions for high-performance and stable devices. In-depth theoretical discussions will enable the accurate modeling of emerging low-power, high-speed, radiation-hardened nanoscale vacuum electronics.

PMID:36094789 | DOI:10.1002/smll.202203234

Oral Radiol. 2022 Sep 12. doi: 10.1007/s11282-022-00655-6. Online ahead of print.

ABSTRACT

OBJECTIVES: The reasons why the maxillary posterior region is challenging for dentists are its structure and anatomical variations. For this reason, it is necessary to have complete knowledge about the anatomy of this region. In dentistry, necessary information for the desired evaluation in this region can be provided by CBCT. The fact that it provides a three-dimensional evaluation and has measurement reliability emphasizes its importance in surgical applications. The septa, haller cell, and accessory ostium are variations of the maxillary sinus. There are few studies in the literature examining the relationship between maxillary sinus diameters and its variations. The aims of this study are to determine the prevalence of maxillary sinus variations and the average of maxillary sinus diameters, to examine their relationships according to age and gender, and to evaluate the effects of maxillary sinus diameters on variations.

METHODS: In this retrospective study, CBCT images of 212 patients were examined. The examined CBCT images were analysed and recorded in more than one section. Descriptive statistics, chi-square tests, independent t test, one-way Anova tests were used to evaluate the data.

RESULTS: As a result, a statistically significant difference was observed between the variations, gender and age groups in terms of morphometric characteristics of the maxillary sinus. The most common variation was observed to be accessory ostium.

CONCLUSIONS: The rate of patients with at least one anatomical variation was 77.8%. For this reason, a detailed analysis should be performed to avoid complications before surgical procedures are performed in the area.

PMID:36094776 | DOI:10.1007/s11282-022-00655-6

Geroscience. 2022 Sep 12. doi: 10.1007/s11357-022-00659-4. Online ahead of print.

ABSTRACT

Recent monkeypox (MPX) outbreaks are major ones in non-endemic countries. The present study analyzed molecular phylogenetics, divergence, epidemiology, the geographical distribution, entropy diversity of genome, mutational landscape, and evolution of the monkeypox virus (MPXV) genome and the current MPXV is entitled “hMPXV1.” We used different in-silico and statistical methods to study our objectives. The developed phylogram from molecular phylogenetics describes the origin and evolution of hMPXV1 of A, A.1, A.1.1, A.2, and B.1 lineages. The microevolution of B.1 lineage shows its evolution from May to August 2022. B.1 lineage is further adapting and showing more mutation and sub-lineages. The scatter plot of all lineages shows the clustering pattern of lineages and the divergence. We also developed two statistical models of confirmed cases and a diagram of the age-related pattern of infected cases to illustrate the epidemiology of the MPX outbreaks. The entropy diversity and mutational landscape of the hMPXV1 genome were analyzed in nucleotide and codon contexts. Our study has shown the in-depth evolution pattern of different lineages of the hMPXV1. We found B.1 lineage is associated with the current outbreaks. The mutational landscape informs about the slow mutation of the virus. Finally, the study might assists the new therapeutic development considering all the above points and would help the researcher to set up their future research directions.

PMID:36094771 | DOI:10.1007/s11357-022-00659-4

Eur J Pain. 2022 Sep 12. doi: 10.1002/ejp.2035. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Phantom limb pain (PLP) concerns >50% of amputees and has a negative impact on their rehabilitation, mental health, and quality of life. Mirror therapy (MT) is a promising strategy, but its effectiveness remains controversial. We performed a systematic review to: (i) evaluate the effectiveness of MT versus placebo in reducing PLP, and (ii) determine MT effect on disability and quality of life.

DATABASES AND DATA TREATMENT: We selected randomized controlled trials in five databases (Medline, Cochrane Library, CINAHL, PEDro, and Embase) that included patients with unilateral lower or upper limb amputation and PLP and that compared the effects on PLP of MT versus a placebo technique. The primary outcome was PLP intensity changes and the secondary outcomes were PLP duration, frequency, patients’ disability and quality of life.

RESULTS: Among the five studies included, only one reported a significant difference between the MT group and control group, with a positive MT effect at week 4. Only one study assessed MT effect on disability, and found a significant improvement in the MT group at week 10 and month 6.

CONCLUSIONS: Our systematic review did not allow concluding that MT reduces PLP and disability in amputees. This lack of strong evidence is probably due to (i) the low methodological quality of the included studies, and (ii) the lack of statistical power. Future trials should include a higher number of patients, increase the number and frequency of MT sessions, have a long-term follow-up, and improve the methodological quality.

PMID:36094758 | DOI:10.1002/ejp.2035

Vet Res Commun. 2022 Sep 12. doi: 10.1007/s11259-022-09981-w. Online ahead of print.

ABSTRACT

The aim of this study was to determine the prevalence of the htrA, htrB and ppk1 genes -all of which are related to environmental persistence- in C. jejuni and C. coli isolates obtained from abattoir samples at the arrival of broilers (initial stage) and in meat products after processing (final stage). A total of 119 DNA extracts (55 C. jejuni and 64 C. coli) were included in the study. Identification of genes was performed by conventional PCR (one for each gene). The overall prevalence was 40.3%, 93.3% and 68.9% for the htrA, htrB and ppk1 genes, respectively. Statistically significant differences were found (p < 0.05) between prevalence of C. jejuni and C. coli for all three genes. In C. coli the prevalence was significantly higher for the htrA (p = 0.007) and htrB (p = 0.015) genes, while ppk1 gene prevalence was significantly higher in C. jejuni (p < 0.001). In addition, statistically significant increase in the frequency of htrA (p = 0.007) and htrB (p = 0.013) genes in the final product compared to broilers on arrival at the abattoir was observed in C. jejuni, but not in C. coli. These results suggest that htrA and htrB genes are involved in environmental persistence of Campylobacter jejuni.

PMID:36094751 | DOI:10.1007/s11259-022-09981-w

Environ Sci Pollut Res Int. 2022 Sep 12. doi: 10.1007/s11356-022-22875-3. Online ahead of print.

ABSTRACT

Hand, foot, and mouth disease (HFMD) is the leading Category C infectious disease affecting millions of children in China every year. In the context of global climate change, the understanding and quantification of the impact of weather factors on human health are particularly critical to the development and implementation of climate change adaptation and mitigation strategies. The aim of this study was to quantify the attributable burden of a combined bioclimatic indicator (apparent temperature) on HFMD and to identify temperature-specific sensitive populations. A total of 123,622 HFMD cases were included in the study. The non-linear relationship between apparent temperature and the incidence of HFMD was approximately M-shaped, with hot weather being more likely to be attributable than cold conditions, of which moderately hot accounting for the majority of cases (21,441, 17.34%). Taking the median apparent temperature (19.2 °C) as reference, the cold effect showed a short acute effect with the highest risk on the day of lag 0 (RR = 1.086, 95% CI: 1.024 ~ 1.152), whereas the hot effect lasted longer with the greatest risk at a lag of 7 days (RR = 1.081, 95% CI: 1.059 ~ 1.104). Subgroup analysis revealed that males, children under 3 years old, and scattered children tended to be more vulnerable to HFMD in hot weather, while females, those aged 3 ~ 5 years, and nursery children were sensitive to cold conditions. This study suggests that high temperatures have a greater impact on HFMD than low temperatures as well as lasting longer, of particular concern being moderately high temperatures rather than extreme temperatures. Early intervention takes on greater importance during cold days, while the duration of HFMD intervention must be longer during hot days.

PMID:36094702 | DOI:10.1007/s11356-022-22875-3