Category: Nevin Manimala

Int J Artif Organs. 2024 Feb 19:3913988231213722. doi: 10.1177/03913988231213722. Online ahead of print.

ABSTRACT

AIM: Use of microaxial mechanical circulatory support (MCS) has been reported for severe graft rejection or dysfunction after heart transplantation (HTx). We aimed to assess utilization patterns of microaxial MCS after HTx in adolescents (ages 18 and younger) and adults (ages 19 and older).

METHODS: Electronic search was performed to identify all relevant studies on post-HTx use of microaxial support in adults and adolescents. A total of 18 studies were selected and patient-level data were extracted for statistical analysis.

RESULTS: All patients (n=23), including adults (n=15) and adolescents (n=8), underwent Impella (Abiomed, Danvers, MA) microaxial MCS after HTx. Median age was 36 [IQR 18-56] years (Adults, 52 [37-59]; adolescents, 16 [15-17]). Primary right ventricular graft dysfunction was an indication exclusively seen in the adults 40% (6/15), while acute graft rejection was present in 46.7% (7/15) of adults. Median time after transplant was 9 [0-32] months (Adults, 4 [0-32]; adolescents, 11 [4.5, 45]). Duration of Impella support was comparable between adults and adolescents (5 [2.5-8] vs 6 [5-8] days, p = 0.38). Overall improvement was observed both in median LV ejection fraction (23.5% [11.3-28] to 42% [37.8-47.3], p < 0.01) and cardiac index (1.8 [1.2-2.6] to 3 [2.5-3.1], p < 0.01). Retransplantation was required in four adolescents (50%, 4/8). Survival to discharge was achieved by 60.0% (9/15) of adults and 87.5% (7/8) of adolescents respectively (p = 0.37).

CONCLUSION: Indications for microaxial MCS appear to vary between adult and adolescent patients. Overall improvement in LVEF and cardiac index was observed, however, with suboptimal survival to discharge.

PMID:38372215 | DOI:10.1177/03913988231213722

Mol Microbiol. 2024 Feb 19. doi: 10.1111/mmi.15236. Online ahead of print.

ABSTRACT

Microorganisms play a central role in biotechnology and it is key that we develop strategies to engineer and optimize their functionality. To this end, most efforts have focused on introducing genetic manipulations in microorganisms which are then grown either in monoculture or in mixed-species consortia. An alternative strategy to optimize microbial processes is to rationally engineer the environment in which microbes grow. The microbial environment is multidimensional, including factors such as temperature, pH, salinity, nutrient composition, etc. These environmental factors all influence the growth and phenotypes of microorganisms and they generally “interact” with one another, combining their effects in complex, non-additive ways. In this piece, we overview the origins and consequences of these “interactions” between environmental factors and discuss how they have been built into statistical, bottom-up predictive models of microbial function to identify optimal environmental conditions for monocultures and microbial consortia. We also overview alternative “top-down” approaches, such as genetic algorithms, to finding optimal combinations of environmental factors. By providing a brief summary of the state of this field, we hope to stimulate further work on the rational manipulation and optimization of the microbial environment.

PMID:38372207 | DOI:10.1111/mmi.15236

Knee Surg Sports Traumatol Arthrosc. 2024 Feb 19. doi: 10.1002/ksa.12078. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to validate a scale that could help surgeons evaluate patients’ psychological readiness to return to sport (RTS) after peroneal tendon pathology surgery.

METHODS: The Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) scale, which had previously been validated in ankle ligament reconstruction patients, was adapted to evaluate the psychological preparedness for RTS in athletic patients who underwent peroneal tendinopathy surgery. The Foot and Ankle Outcome Score (FAOS) and Foot Ankle Ability Measurement (FAAM) scores were employed as patient-related outcome measurement (PROM) instruments.

RESULTS: This study included 57 patients. There was a strong correlation between ALR-RSI and both FAOS and FAAM (r = -0.68 and 0.74, respectively). ALR-RSI was considerably higher in patients who returned to sports than in those who did not. The mean score was 72.9 ± 19.0 in patients who returned to the same preinjury level, 48.5 ± 24.0 in those who returned to a lower level and 53.6 ± 31.1 in patients who changed their athletic activity (p < 0.0001). Furthermore, ALR-RSI showed at least a similar discrimination ability when compared to FAOS and FAAM. The test-retest intraclass correlation coefficient was 0.95. The Cronbach’s α statistic used to measure the internal consistency was high (0.95). A Youden index of 0.65 was observed for a cut-off score of 68 points.

CONCLUSION: ALR-RSI is a valid instrument for assessing psychological readiness to RTS in an athletic population following peroneal tendon surgery. When compared to the most commonly used PROMs, it was strongly correlated and demonstrated at least similar discrimination capacity. This could assist surgeons in identifying athletes who will have poor postoperative results and advising them on their capability to RTS.

LEVEL OF EVIDENCE: Level III.

PMID:38372173 | DOI:10.1002/ksa.12078

Knee Surg Sports Traumatol Arthrosc. 2024 Feb 19. doi: 10.1002/ksa.12070. Online ahead of print.

ABSTRACT

PURPOSE: Acromioclavicular (AC) joint dislocations are common injuries, but the indication for and timing of surgery is debated. The objective of the study was to evaluate the results after acute AC joint dislocations Rockwood type III and V treated nonsurgically with the option of delayed surgical intervention.

METHODS: This is a prospective cohort study with clinical, radiological and patient-reported outcome assessment at baseline, 6 weeks, 3 months, 6 months and 1 year after acute AC joint dislocation. Patients aged 18-60 with acute AC joint dislocation and a baseline panorama (Zanca) radiograph with an increase in the coracoclavicular distance of >25% compared to the uninjured side were eligible for inclusion. All patients were treated nonsurgically with 3 months of home-based training and with the option of delayed surgical intervention. The primary outcome was the Western Ontario Shoulder Instability Index (WOSI). Secondary outcomes were surgery yes/no and the Shoulder Pain and Disability Index (SPADI).

RESULTS: Ninety-five patients were included. Fifty-seven patients were Rockwood type III and 38 patients were type V. There were no statistically significant differences in WOSI and SPADI between patients with type III and V injuries at any time point. Nine patients (9.5%) were referred for surgery; seven type III and two type V (ns).

CONCLUSION: Ninety-one percent of patients with acute AC joint dislocation Rockwood type III and V recovered without surgery and there were no differences in outcome scores between type III and V at any time point.

LEVEL OF EVIDENCE: Level IV.

PMID:38372155 | DOI:10.1002/ksa.12070

Dev Sci. 2024 Feb 19:e13487. doi: 10.1111/desc.13487. Online ahead of print.

ABSTRACT

In many domains, learners extract recurring units from continuous sequences. For example, in unknown languages, fluent speech is perceived as a continuous signal. Learners need to extract the underlying words from this continuous signal and then memorize them. One prominent candidate mechanism is statistical learning, whereby learners track how predictive syllables (or other items) are of one another. Syllables within the same word predict each other better than syllables straddling word boundaries. But does statistical learning lead to memories of the underlying words-or just to pairwise associations among syllables? Electrophysiological results provide the strongest evidence for the memory view. Electrophysiological responses can be time-locked to statistical word boundaries (e.g., N400s) and show rhythmic activity with a periodicity of word durations. Here, I reproduce such results with a simple Hebbian network. When exposed to statistically structured syllable sequences (and when the underlying words are not excessively long), the network activation is rhythmic with the periodicity of a word duration and activation maxima on word-final syllables. This is because word-final syllables receive more excitation from earlier syllables with which they are associated than less predictable syllables that occur earlier in words. The network is also sensitive to information whose electrophysiological correlates were used to support the encoding of ordinal positions within words. Hebbian learning can thus explain rhythmic neural activity in statistical learning tasks without any memory representations of words. Learners might thus need to rely on cues beyond statistical associations to learn the words of their native language. RESEARCH HIGHLIGHTS: Statistical learning may be utilized to identify recurring units in continuous sequences (e.g., words in fluent speech) but may not generate explicit memory for words. Exposure to statistically structured sequences leads to rhythmic activity with a period of the duration of the underlying units (e.g., words). I show that a memory-less Hebbian network model can reproduce this rhythmic neural activity as well as putative encodings of ordinal positions observed in earlier research. Direct tests are needed to establish whether statistical learning leads to declarative memories for words.

PMID:38372153 | DOI:10.1111/desc.13487

J Dent Res. 2024 Feb 19:220345241226871. doi: 10.1177/00220345241226871. Online ahead of print.

ABSTRACT

Quantitative analysis of irregular anatomical structures is crucial in oral medicine, but clinicians often typically measure only several representative indicators within the structure as references. Deep learning semantic segmentation offers the potential for entire quantitative analysis. However, challenges persist, including segmentation difficulties due to unclear boundaries and acquiring measurement landmarks for clinical needs in entire quantitative analysis. Taking the palatal alveolar bone as an example, we proposed an artificial intelligence measurement tool for the entire quantitative analysis of irregular dental structures. To expand the applicability, we have included lightweight networks with fewer parameters and lower computational demands. Our approach finally used the lightweight model LU-Net, addressing segmentation challenges caused by unclear boundaries through a compensation module. Additional enamel segmentation was conducted to establish a measurement coordinate system. Ultimately, we presented the entire quantitative information within the structure in a manner that meets clinical needs. The tool achieved excellent segmentation results, manifested by high Dice coefficients (0.934 and 0.949), intersection over union (0.888 and 0.907), and area under the curve (0.943 and 0.949) for palatal alveolar bone and enamel in the test set. In subsequent measurements, the tool visualizes the quantitative information within the target structure by scatter plots. When comparing the measurements against representative indicators, the tool’s measurement results show no statistically significant difference from the ground truth, with small mean absolute error, root mean squared error, and errors interval. Bland-Altman plots and intraclass correlation coefficients indicate the satisfactory agreement compared with manual measurements. We proposed a novel intelligent approach to address the entire quantitative analysis of irregular image structures in the clinical setting. This contributes to enabling clinicians to swiftly and comprehensively grasp structural features, facilitating the design of more personalized treatment plans for different patients, enhancing clinical efficiency and treatment success rates in turn.

PMID:38372132 | DOI:10.1177/00220345241226871

Hip Int. 2024 Feb 19:11207000231220031. doi: 10.1177/11207000231220031. Online ahead of print.

ABSTRACT

PURPOSE: Dislocation remains 1 of the leading causes of revision after primary total hip arthroplasty (THA) and there is clear evidence the dual-mobility (DM) is used more frequently to minimise this. But in smaller cups, whether the use of DM with smaller 22-mm heads imparts any increased stability compared to standard bearing is unknown; especially when those smaller cups now allow for large single-bearing (SB) heads.

METHODS: 3 primary cup sizes (48 mm, 50 mm, 52 mm) were chosen a priori for modelling. Head sizes trialled for the standard bearing (SB) constructs group were 28-0 mm, 32-0 mm and 36-0 mm against neutral polyethylene liners. In the modular sub-hemispheric DM constructs the inner head sizes for the DM constructs were altered where appropriate (22-0 mm vs. 28-0 mm). Cup position, stem offset, and stem size were standardised.

RESULTS: Both DM constructs outperformed all SB constructs because of a statistically significant jump distance increase (p < 0.001). However, there was no difference in range of motion (ROM) or jump distances between the 22-mm and 28-mm DM inner heads.The ROM angle before impingement between the DM (with 22-mm or 28-mm heads) and SB (with different head sizes where appropriate) showed no statistically significant difference. However, DM constructs presented significantly larger jump distances than SB constructs for both provocative dislocation tests across all 3 cup sizes.Of interest, for 50-mm and 52-mm cup sizes (for which this particular DM construct design can accommodate both 22-mm and 28-mm inner heads), there were no differences in ROM or jump distance between 22-mm versus 28-mm inner heads.

CONCLUSIONS: In this computer-modelling study, DM constructs are advantageous over SB constructs for improving jump distances in clinically provocative positions, but not range of motion angles. Inner head diameter of DM has no effect on stability.

PMID:38372123 | DOI:10.1177/11207000231220031

Cell Mol Biol (Noisy-le-grand). 2024 Jan 31;70(1):56-61. doi: 10.14715/cmb/2024.70.1.8.

ABSTRACT

The present study aimed to study the repair effect of neurotrophic factor III (NT-3) on spinal injury model rats and its mechanism. Wistar rats with spinal injury were established by accelerated compression stroke after the operation and divided into control group, model group, and NT-3 intervention group. The motor function of rats in each group was evaluated at different postoperative time points (3, 7, 14 d). HE staining was used to detect the changes in tissue structure and morphology of the injured spinal column in each group. The changes of SOD, MDA and GSH in serum of rats were detected. The concentrations of inflammatory cytokines IL-1β, IL-6, IL-17 and TNF-α in serum were detected by enzyme-linked immunosorbent assay (ELISA). Western blot was used to detect the expression changes of anti-apoptotic protein (Bcl-2) and pro-apoptotic protein (Bax) in injured spinal tissue of rats in each group. Compared with model group, motor function score of NT-3 intervention group increased gradually, and had statistical significance at 7 and 14 days (5.29±1.62 vs 9.33±2.16, 5.92±1.44 vs 14.56±2.45, T =7.386, 9.294, P =0.004, 0.000). The levels of SOD and GSH in serum of NT-3 intervention group were significantly increased (t=9.117, 12.207, P=0.000, 0.000), while the level of MDA was significantly decreased (t=5.089, P=0.011). Serum levels of inflammatory cytokines IL-1β, IL-6, IL-17 and TNF-α in NT-3 intervention group were significantly decreased (T =6.157, 7.958, 6.339, 6.288, P=0.008, 0.005, 0.005, 0.007). In the NT-3 treatment group, Bax protein was significantly decreased (0.24±0.05 vs 0.89±0.12, T =8.579, P=0.001), and the relative expression of Bcl-2 protein was significantly increased (0.75±0.06 vs 0.13±0.05, T =9.367, P=0.001). Neurotrophic factor III can promote spinal injury repair in spinal injury model rats, and play a role by enhancing antioxidant stress ability, inhibiting inflammatory factors, promoting Bcl-2 and decreasing Bax expression.

PMID:38372112 | DOI:10.14715/cmb/2024.70.1.8

Cell Mol Biol (Noisy-le-grand). 2024 Jan 31;70(1):80-86. doi: 10.14715/cmb/2024.70.1.11.

ABSTRACT

MEF2A (myocyte enhancer factor-2A) is a transcription factor of the MEF2 family. It has been recognized as the cause of coronary artery disease in the absence of any other clinical characteristic. It is involved in vascular development and is most commonly found in the coronary artery endothelium. The goal of this case-control study was to see if there was a link between polymorphisms in the MEF2A gene and coronary artery disease. A case-control study was carried out to look into the possible significance of MEF2A polymorphisms as a risk factor for coronary artery disease. This research included 225 patients and 225 healthy controls. A biochemical examination was carried out to evaluate the risk factors for developing this condition. The polymorphisms of Mef2A (1250 C > T in exon 8 and 452 G > T, 481 A > G in exon 11) were found using the PCR-RFLP technique. All identified risk variables, such as hypercholesterolemia, diabetes mellitus, and hypertriglyceridemia, were shown to be statistically significant in the current study for coronary artery disease occurrence. The most polymorphisms were found in MEF2A 1250 C > T, MEF2A 452 G > T, and MEF2A 481 A > G. The genotyping results for MEF2A 1250, MEF2A 452, and MEF2A 481 were (X2 = 2.985; P = 0.235), (X2 = 4.371; P = 0.112), and (X2 = 4.025; P = 0.134), respectively. In conclusion, we identified a much higher incidence of MEF2A in people with coronary artery disease, and MEF2A may play a crucial role in cardiovascular pathophysiology. Patients and controls had considerably different genetics and frequency of alleles.

PMID:38372109 | DOI:10.14715/cmb/2024.70.1.11

Cell Mol Biol (Noisy-le-grand). 2024 Jan 31;70(1):128-133. doi: 10.14715/cmb/2024.70.1.17.

ABSTRACT

The purpose of this study was to analyze the correlation between vaginal flora and immune function Type 1 helper T cells/Type 2 helper T cells imbalance in females having HPV infections at high risk within the female reproductive tract. We selected 150 female patients who visited our hospital for reproductive tract inflammation between March 2019 and March 2021. They were divided into high-risk HPV-positive and high-risk HPV-negative groups according to the results of the HPV tests. Vaginal flora composition, density, diversity, and Th1/Th2 immune cell cytokine expression were assessed, and their correlations were analyzed. Compared to the HPV-negative group at high risk, the HPV-positive group at high risk exhibited significantly higher rates of Lactobacillius abnormalities, Chlamydia trachomatis and Mycoplasma urealyticum positivity(P<0.05). However, no statistically significant differences in the rates of Neisseria gonorrhoeae, bacterial vaginosis, mould, and trichomonad positivity were observed in both groups (P>0.05). The high-risk HPV-positive group displayed significantly higher rates of abnormal vaginal flora density and diversity compared to the HPV-negative group at high risk (P < 0.05). Compared to the HPV-negative group at high risk, the HPV-positive group at high risk exhibited significantly lower expression levels of Th1, Th1/Th2, IFN-γ, and IL-2 and higher expression levels of Th2, IL-4, and IL-10(P<0.05). Among patients having HPV infections at high risk, those with abnormal vaginal flora had lower expression levels of Th1, Th1/Th2, IFN-γ, and IL-2 and higher expression levels of Th2, IL-4, and IL-10 compared to those with normal vaginal flora, all of which were statistically significant(P<0.05). Vaginal flora dysbiosis was correlated with Th1/Th2 imbalance (P<0.05). Women with high-risk HPV infections in the female reproductive tract exhibit abnormal vaginal flora and immune function Th1/Th2 imbalance, characterized by a shift from Th1 to Th2. Moreover, there is a close correlation between vaginal flora dysbiosis and immune function Th1/Th2 imbalance.

PMID:38372108 | DOI:10.14715/cmb/2024.70.1.17