Category: Nevin Manimala

Arch Orthop Trauma Surg. 2023 Feb 23. doi: 10.1007/s00402-023-04814-0. Online ahead of print.

ABSTRACT

BACKGROUND: Proximal humeral shaft fractures are surgically challenging and plate osteosynthesis with a long straight plate is one operative treatment option in these patients although endangering the radial nerve distally. Helical plates potentially avoid the radial nerve by twisting around the humeral shaft. Aim of the study was to investigate in a human cadaveric model the biomechanical competence of helical plates versus straight lateral plates used for fixation of proximal third comminuted humeral shaft fractures.

METHODS: Eight pairs of humeral cadaveric humeri were instrumented using either a long 90°-helical plate (Group1) or a straight long PHILOS plate (Group2). An unstable proximal humeral shaft fracture was simulated by means of a 5 cm osteotomy gap. All specimens were tested under quasi-static loading in axial compression, internal and external rotation, and bending in four directions. Subsequently, progressively increasing cyclic loading in internal rotation until failure was applied and interfragmentary movements were monitored by motion tracking.

RESULTS: During static testing flexion/extension deformation in Group1 was significantly higher, however, varus/valgus deformation as well as shear and torsional displacement under torsional load remained statistically indifferent between both groups. During cyclic testing shear and torsional displacements were both significantly higher in Group1 compared to Group 2. However, cycles to catastrophic failure remained statistically indifferent between the groups.

CONCLUSIONS: From a biomechanical perspective, although 90°-helical plating is associated with higher initial stability against varus/valgus collapse and comparable endurance under dynamic loading, it demonstrates lower resistance to flexion/extension and internal rotation with bigger shear interfragmentary displacements versus straight lateral plating and, therefore, cannot be considered as its real alternative. Alternative helical plate designs should be investigated in the future.

PMID:36821049 | DOI:10.1007/s00402-023-04814-0

Reprod Sci. 2023 Feb 23. doi: 10.1007/s43032-023-01194-z. Online ahead of print.

ABSTRACT

Polycystic ovary syndrome (PCOS) is an endocrine-metabolic syndrome that involves hyperandrogenism, menstrual irregularities, and/or small cysts in one or both ovaries which might lead to infertility in women. The genetics of PCOS is heterogenous with the involvement of several genes reported in the hypothalamic-pituitary-gonadal axis. Follicular growth and steroidogenesis regulation are both critically dependent on follicle-stimulating hormone (FSH). The variants of FSHR cause abnormal folliculogenesis, steroidogenesis, and oocyte maturation at various stages of growth and may render women more susceptible to PCOS development. The present case-control study evaluated the association of FSHR rs6165 and rs6166 variants with PCOS. A total of 743 females were recruited. PCR-RFLP method was used for the genotypic analysis of FSHR polymorphisms. Obesity was examined according to the categorization of body mass index (BMI) and waist-hip ratio (WHR). Biochemical analysis, including a lipid profile, LH, FSH, and testosterone levels, was done in both PCOS women and controls. BMI and WHR revealed a statistically significant difference between PCOS cases and controls. Overall, levels of HDL were significantly lower, whereas cholesterol, triglycerides, LDL, and VLDL levels were higher in PCOS women (p < 0.05). The genotypic and allelic frequencies of rs6165 and rs6166 did not demonstrate significant differences when PCOS women were compared with the control group. However, clinical features of PCOS including gonadotropic hormone (FSH), hyperandrogenism, and dyslipidemia were significantly correlated with variants of FSHR. The present study concludes that rs6165 and rs6166 were significantly related to clinical features of PCOS, regardless of providing direct disease risk.

PMID:36821034 | DOI:10.1007/s43032-023-01194-z

Ir J Med Sci. 2023 Feb 23. doi: 10.1007/s11845-023-03311-y. Online ahead of print.

ABSTRACT

AIM: To observe the effect of the implementation of improved high-risk sign boards for older people inpatients.

METHOD: The older people inpatients of the Department of Geriatrics at our hospital were selected as the research subjects and divided into two groups. The control group used the single-strip high-risk sign, and the intervention group used the improved double-layer card slot, push-pull integrated high-risk sign board (national patent). The sign-related nurse operation time, patient/attendant satisfaction, and high-risk-related adverse events were observed and compared between the two groups.

RESULTS: After the adoption of the improved high-risk sign board, the nurse operation time was reduced from 94.3 ± 16.2 s to 53.9 ± 12.5 s, and patient/attendant satisfaction increased from 6.65 ± 0.38 points to 9.30 ± 0.52 points (P < 0.001). The incidence of high-risk-related adverse events decreased from 6.08 to 1.86%, but the difference was not statistically significant (χ² = 3.675, P = 0.055). The implementation of the improved high-risk sign board can increase nursing efficiency and enhance the awareness of risk prevention in high-risk patients among nurses, older people inpatients, and attendants.

CONCLUSION: The application of double-layer card slot and push-pull comprehensive high-risk identification card to older people inpatients can alert nurses, patients, and nursing staff more prominently, which can improve patient satisfaction, reduce installation time and reduce the incidence of adverse events to a certain extent.

PMID:36821022 | DOI:10.1007/s11845-023-03311-y

Qual Life Res. 2023 Feb 23. doi: 10.1007/s11136-023-03361-w. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: Health state utilities (HSU) are a subjective measure of an individual’s health-related quality of life (HRQoL), adjusted by societal or patient relative preference weights for living in different states of health-related quality of life (HRQoL), derived from patient-reported responses to multi-attribute utility instrument (MAUI), and can be used as inputs for cost-utility analyses and in clinical assessment. This research assessed associations of diet with subsequent HSU in a large international cohort of people living with multiple sclerosis (MS), a progressive autoimmune condition of the central nervous system.

METHODS: HSUs were generated from responses to Short-Form Six-Dimension (SF-6D) MAUI, and quality-of-the-diet by Diet Habits Questionnaire (DHQ). Cross-sectional, and short- and long-term prospective associations of DHQ with HSU evaluated by linear regression at 2.5- and 5-years. Pooled prospective associations between DHQ and HSU evaluated using linear and quantile regression. Analyses adjusted for relevant demographic and clinical covariates.

RESULTS: Among 839 participants, baseline DHQ scores showed short- and long-term associations with subsequent HSU, each 10-unit increase in total DHQ score associated with 0.008-0.012 higher HSU (out of 1.00). These associations were dose-dependent, those in the top two quartiles of baseline DHQ scores having 0.01-0.03 higher HSU at follow-up, 0.03 being the threshold for a minimally clinically important difference. Fat, fiber, and fruit/vegetable DHQ subscores were most strongly and consistently associated with better HSU outcomes. However, baseline meat and dairy consumption were associated with 0.01-0.02 lower HSU at subsequent follow-up.

CONCLUSIONS: A higher quality-of-the-diet showed robust prospective relationships with higher HSUs 2.5- and 5-years later, substantiating previous cross-sectional relationships in this cohort. Subject to replication, these results suggest interventions to improve the quality-of-the-diet may be effective to improve HRQoL in people living with MS.

PMID:36821020 | DOI:10.1007/s11136-023-03361-w

J Immunoassay Immunochem. 2023 Feb 23:1-9. doi: 10.1080/15321819.2023.2182219. Online ahead of print.

ABSTRACT

We aimed to evaluate the expression of YAP1, PTEN, VEGF in the placentas of patients with preeclampsia and placentas of healthy pregnant women for trophoblast invasion, which is similar to cancer etiopathogenesis. The placentas of 70 women who gave birth, including 30 preeclampsia and 40 healthy controls, were evaluated. YAP1, PTEN and VEGF immunohistochemical staining were performed using the microarray method on placental tissue. The mean ± standard deviation for YAP1, PTEN and VEGF intensity were; 1.57 ± 0.71,2.59 ± 0.80, 1.61 ± 0.59, respectively. PTEN intensity was statistically significantly lower in the preeclampsia group than in the control group (2.37 ± 0.99 vs 2.75 ± 0.58, p = .049). There was no difference between the groups in terms of YAP1 and VEGF staining (p > .05). The etiopathogenesis of preeclampsia is still unclear. However, since trophoblast invasion and endothelial repair have similar aspects with cancer mechanisms, both preeclampsia and cancer studies are progressing by supporting each other. Our study is a prototype study showing that large-participation studies can be carried out easily by using the microarray method as an economic model.

PMID:36815553 | DOI:10.1080/15321819.2023.2182219

J Pathol. 2023 Feb 23. doi: 10.1002/path.6072. Online ahead of print.

ABSTRACT

Hepatic angiosarcoma (HAS) is an aggressive mesenchymal malignancy that remains underexplored in its etiology and mutational landscapes. To clarify the association between HAS and end stage end-stage renal disease (ESRD), we exploited nationwide data of the National Health Insurance Research Database (NHIRD) in Taiwan, covering ~99% of the population, from 2001 to 2016. To investigate molecular signatures, we performed whole-exome sequencing (WES) in 27 surgical specimens, including 9 ESRD-associated cases. The NHIRD analysis demonstrated that HAS ranked 2^nd among all angiosarcomas in Taiwan, with the incidence rates of HAS being 0.08, 2.49, and 5.71 per 100,000 person-years in the general population, chronic kidney disease (CKD), and ESRD patients, respectively. The standardized incidence ratios of HAS in CKD and ESRD patients were 29.99 and 68.77, respectively. In comparison with nonhepatic angiosarcoma, the multivariate regression analysis of our institutional cohort validated CKD/ESRD as an independent risk factor for HAS (odds ratio: 9.521, 95% confidence interval: 2.995-30.261, P < 0.001). WES identified a high tumor mutation burden (TMB; median: 8.66 variants per megabase) and dominant A:T-to-T:A transversion in HAS with frequent TP53 (81%) and ATRX (41%) mutations, KDR amplifications/gains (56%), and CDKN2A/B deletions (48%). Notably, ESRD-associated HAS had a significantly higher TMB (17.62 variants per megabase, P = 0.01) and enriched mutational signatures of aristolochic acid exposure (COSMIC SBS22, P < 0.001). In summary, a significant proportion of HAS in Taiwan is associated with ESRD and harbors a distinctive mutational signature, which concomitantly links nephrotoxicity and mutagenesis resulting from the exposure to aristolochic acid or related compounds. High TMB may support the eligibility for immunotherapy in treating ESRD-associated HAS. This article is protected by copyright. All rights reserved.

PMID:36815532 | DOI:10.1002/path.6072

J Med Virol. 2023 Feb 23. doi: 10.1002/jmv.28601. Online ahead of print.

ABSTRACT

Supported by the GISAID data, we discuss on the more or less probable increase in the number of COVID-19 cases in the very next future. Currently, all the sequenced case in Europe, USA and Asia refer to Omicron-related variants and recombinations. Accordingly, the increasing in the attention to the Covid situation is currently not justified by looking at the available indicators and at the current variants of concern recorded worldwide This article is protected by copyright. All rights reserved.

PMID:36815498 | DOI:10.1002/jmv.28601

BJPsych Open. 2023 Feb 23;9(2):e42. doi: 10.1192/bjo.2023.20.

ABSTRACT

BACKGROUND: Music therapy can lift mood and reduce agitation for people living with dementia (PwD) in community and residential care settings, potentially reducing the prevalence of distress behaviours. However, less is known about the impact of music therapy on in-patient psychiatric wards for PwD.

AIMS: To investigate the impact of music therapy on two in-patient psychiatric wards for PwD.

METHOD: A mixed-methods design was used. Statistical analysis was conducted on incidents involving behaviours reported as ‘disruptive and aggressive’ in 2020, when music therapy delivery varied because of the COVID-19 pandemic. Semi-structured interviews conducted online with three music therapists and eight ward-based staff were analysed using reflexive thematic analysis.

RESULTS: Quantitative findings showed a significant reduction in the frequency of behaviours reported as disruptive and aggressive on days with in-person music therapy (every 14 days) than on the same weekday with no or online music therapy (every 3.3 or 3.1 days, respectively). Qualitative findings support this, with music therapy reported by music therapists and staff members to be accessible and meaningful, lifting mood and reducing agitation, with benefits potentially lasting throughout the day and affecting the ward environment.

CONCLUSIONS: We identified a significant reduction in the occurrence of distress behaviours on days with in-person music therapy when compared with no music therapy. Music therapy was reported to be a valuable intervention, supporting patient mood and reducing agitation. Interventional studies are needed to investigate the impact of music therapy and its optimum mode of delivery.

PMID:36815454 | DOI:10.1192/bjo.2023.20

Recenti Prog Med. 2023 Mar;114(3):163-169. doi: 10.1701/3981.39641.

ABSTRACT

INTRODUCTION: Bias in dissemination and reporting of clinical research findings has an impact on the pooled summary utilised to produce clinical-therapeutic guidelines and recommendations. This analysis aims to evaluate the dissemination and reporting biases of interventional and observational studies conducted in the setting of the Local health authority of Verona (Aulss). The possible correlation between both biases and profit versus no-profit sponsors was also evaluated.

METHODS: Verona’s Aulss studies completed in the period 01.01.2014-31.01.2021 were extracted from the Clinical study register of the Veneto Region and any form of results’ dissemination was identified and compared with the original protocol. Identified studies were stratified by profit or no-profit sponsor and results compared using the Chi-Square test.

RESULTS: 67 studies (29 profit; 38 non-profit) were included in this analysis. 58.2% of the studies (n=39/67) reports at least one type of findings’ dissemination, for 22.4% data-analysis or publication is in progress, while 19.4% has not been published. Regarding the evaluation on reporting bias, 36 of the 39 published studies were considered (n=19 profit; n=17 non-profit): 64% (23/36) showed inconsistencies between the results reported in the manuscript and the protocol. The number of non-compliant profit studies (n=15/19; 79%) was statistically higher than the compliant ones [n=8/17; 47%; (p=0.049; χ2=3.845)].

DISCUSSION: This study highlights that findings’ dissemination occurs for the majority of the studies evaluated and that the odds of selective reporting are higher for industry funded studies than for publicly funded studies, affecting the quality of the research.

PMID:36815420 | DOI:10.1701/3981.39641

Clin Implant Dent Relat Res. 2023 Feb 23. doi: 10.1111/cid.13195. Online ahead of print.

ABSTRACT

Optimal cell adhesion of the gingival fibroblasts to dental implants is important for maintaining good implant integration. The aim of this study was to discover, if the nanoporous TiO₂ -coating on titanium alloy substrates is able to increase the cell adhesion of the human gingival fibroblasts (HGF). The study consisted of three differently produced titanium groups: hydrothermally produced TiO₂ -coating (HT), novel TiO₂ -coating made in sol (SOL), and noncoated control group. Primary HGF cells were initiated from gingival biopsies from patients having a third molar extraction. HGF were cultivated on titanium discs for 2 and 24 h to determine the initial attachment with confocal microscope. The cell spreading and adhesion protein signals were measured. In addition, expression of adhesion proteins vinculin, paxillin, and focal adhesion kinase (FAK) were measured after 3 days of cultivation by using Western Blotting. Higher protein levels of paxillin, vinculin, and FAK were induced on both coated discs compared to noncoated discs. The difference was statistically significant (p < 0.05) concerning expression of paxillin. The cell spreading was significantly larger on SOL discs after 2 and 24 h when comparing to noncoated controls. The confocal microscope analyses revealed significantly higher adhesion protein signals on both HT- and SOL-coated titanium compared to control group. This study showed, that both methods to produce TiO₂ -coatings are able to increase HGF adhesion protein expression and cell spreading on titanium surface. Accordingly, the coatings can potentially improve the gingival attachment to titanium implant surfaces.

PMID:36815407 | DOI:10.1111/cid.13195