Category: Nevin Manimala

Ultrasound Obstet Gynecol. 2022 Apr 25. doi: 10.1002/uog.24920. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore and compare fetal cortical brain development and infant neurobehaviour in spontaneously conceived (SC) and assisted reproductive technologies (ART) offspring.

METHODS: A prospective cohort study of 210 singleton pregnancies including 70 SC pregnancies, 70 conceived by in vitro fertilization (IVF) following frozen embryo transfer (ET), and 70 IVF after fresh ET. Fetal neurosonography was performed at 32±2 weeks to assess cortical development. Sulci depths were measured off-line and normalized by biparietal diameter. Additionally, Ages & Stages Questionnaires (ASQ) were obtained postnatally, at 12±1 months of corrected age. Comparisons were adjusted by maternal age, ethnicity, nulliparity, fetal sex, weight centile and gestational age at scan for neurosonography, and by maternal age, ethnicity, nulliparity, educational level, employment status, new-born’s gestational age at birth, breastfeeding, infant’s sex and age at the ASQ evaluation.

RESULTS: In comparison to the SC, the fetuses conceived by ART showed statistically significant differences in cortical development, with reduced parieto-occipital (fresh ET mean[SD] 12.5mm[2.5] vs. frozen ET 13.4[2.6] vs. SC 13.4[2.6], p<0.001), cingulate (fresh ET 5.8[1.8] vs. frozen ET 6.0[2.1] vs. SC 6.4[1.9], p<0.001), and calcarine (fresh ET 13.3[3.9] vs. frozen ET 14.1[2.8] vs. SC 16.1[2.7], p=<0.001) sulci depth, together with lower Sylvian fissure grading score. Changes in cortical development were more pronounced in the fresh ET group as compared to the frozen ET. Additionally, ART infants showed lower ASQ scores, especially in the fresh ET group (global ASQ z-scores: fresh ET mean[SD] -0.3[0.4] vs. frozen ET -0.2[0.4] vs. SC 0[0.4], p<0.001).

CONCLUSIONS: Fetuses conceived by ART show a distinctive pattern of cortical development and suboptimal infant neurodevelopment, with more pronounced changes in fresh ET. These findings support the existence of in utero brain reorganization associated to ART and warrant follow-up studies to assess their long-term persistence. This article is protected by copyright. All rights reserved.

PMID:35468238 | DOI:10.1002/uog.24920

J Anat. 2022 Apr 25. doi: 10.1111/joa.13677. Online ahead of print.

ABSTRACT

Knowledge of the anatomical development of the calcaneal apophysis is essential in clinical assessment and management of both paediatric and sub-adult patients presenting with heel pain. Despite this, the current understanding of calcaneal apophyseal development is constrained by the limitations of the imaging modalities used to examine the apophysis, with no current literature reporting the development of the medial and lateral processes. This study aimed to overcome these limitations by investigating the ossification and fusion of the calcaneal apophysis using three-dimensional computed tomography analysis, and statistically predicting the apophyseal developmental stage in contemporary Australian children. The development and fusion status of the apophysis was scored using a novel 11-stage scoring system on 568 multi-slice computed tomography scans (295 females; 274 males) and 266 lateral radiographic scans (119 females; 147 males) from the Queensland Children’s Hospital. Multinomial logistic regression along with classification tables and predictive probabilities were then utilised to assess developmental stage likelihood from known age and sex. The apophysis commenced ossification at a mean age of 5.2 years for females and 7.2 years for males, and then elongated to form the apophyseal cap around 10 years for females and 12.4 years for males. Fusion of the apophysis commenced at a mean age of 11.18 years for females and 13.3 years for males, with the earliest age of complete fusion observed at 10 years for females and 14 years for males. The results demonstrate significant sexual dimorphism in ossification and fusion with females developing and fusing significantly earlier. Furthermore, the use of computed tomography in this study allowed for the first time evaluation of the ossification and fusion of the medial and lateral processes of the calcaneus. The medial process formed at a mean age of 9.5 years for females and 10.9 years for males while the lateral process formed at around 9.8 years for females and 11.7 years for males. The medial process demonstrated slower rates of fusion compared to the lateral process. The present study provides Queensland specific standards for assessing the calcaneal apophyseal developmental stage as well as novel predictive regression models for apophyseal stage estimation using known age and sex to aid in the diagnosis of heel pain conditions such as apophysitis or screen for developmental delays in children and subadults.

PMID:35468228 | DOI:10.1111/joa.13677

J Anat. 2022 Apr 25. doi: 10.1111/joa.13681. Online ahead of print.

ABSTRACT

Understanding how the brain is provided with glucose and oxygen is of particular interest in human evolutionary studies. In addition to the internal carotid arteries, vertebral arteries contribute significantly to the cerebral and cerebellar blood flow. The size of the transverse foramina has been suggested to represent a reliable proxy for assessing the size of the vertebral arteries in fossil specimens. To test this assumption, here, we statistically explore spatial relationships between the transverse foramina and the vertebral arteries in extant humans. Contrast computed tomography (CT) scans of the cervical regions of 16 living humans were collected. Cross-sectional areas of the right and left transverse foramina and the corresponding vertebral arteries were measured on each cervical vertebra from C1 to C6 within the same individuals. The cross-sectional areas of the foramina and corresponding arteries range between 13.40 and 71.25 mm² and between 4.53 and 29.40 mm² , respectively. The two variables are significantly correlated except in C1. Using regression analyses, we generate equations that can be subsequently used to estimate the size of the vertebral arteries in fossil specimens. By providing additional evidence of intra- and inter-individual size variation of the arteries and corresponding foramina in extant humans, our study introduces an essential database for a better understanding of the evolutionary story of soft tissues in the fossil record.

PMID:35468222 | DOI:10.1111/joa.13681

Inflamm Bowel Dis. 2022 Apr 25:izac079. doi: 10.1093/ibd/izac079. Online ahead of print.

ABSTRACT

BACKGROUND: Owing to the use of immunosuppressive agents, patients with inflammatory bowel disease (IBD) have an increased risk of vaccine preventable diseases, including infection with hepatitis B virus (HBV). Heplisav-B, an FDA-approved vaccine, is more effective (90% to 100%) than Engerix-B (70.5% to 90.2%) at inducing immunity to HBV in clinical studies. Available data on efficacy of Heplisav-B vaccine in patients with IBD are limited.

METHODS: This retrospective observational study included patients age 18 years and older with ulcerative colitis (UC) or Crohn’s disease (CD) who received 1 or 2 doses of Heplisav-B vaccine and had postvaccination serologic testing. Prior to immunization, all participants were seronegative for HBsAb antibodies (HBsAb) measured as <10 IU/mL. Postvaccination HBsAb of ≥10 IU/mL was considered successful vaccination. Patient demographics, disease characteristics, and medications were abstracted.

RESULTS: One hundred six patients were included in the analysis. Median age was 43 years, and 44 (42%) were female. Thirty-nine patients (37%) had UC, whereas 67 (63%) had CD. Eighty-three patients (78.3%) had active immunity after vaccination with Heplisav-B, with median postvaccination HBsAb levels of 114 IU/L. Patients with chronic obstructive pulmonary disease, chronic kidney disease, diabetes mellitus, immunomodulator use, or those on 2 or more of immunosuppressive medications were less likely to respond to Heplisav-B, though these findings were not statistically significant on a multivariate analysis aside from chronic kidney disease.

CONCLUSIONS: Heplisav-B, a 2-dose vaccine, is an effective vaccine for HBV in patients with IBD. In our study, its overall efficacy (78.3%) is greater than that reported for the presently available 3-dose vaccination (Engerix) in patients with IBD.

PMID:35468183 | DOI:10.1093/ibd/izac079

J Cogn Neurosci. 2022 Apr 15:1-5. doi: 10.1162/jocn_a_01857. Online ahead of print.

ABSTRACT

The field of in vivo neurophysiology currently uses statistical standards that are based on tradition rather than formal analysis. Typically, data from two (or few) animals are pooled for one statistical test, or a significant test in a first animal is replicated in one (or few) further animals. The use of more than one animal is widely believed to allow an inference on the population. Here, we explain that a useful inference on the population would require larger numbers and a different statistical approach. The field should consider to perform studies at that standard, potentially through coordinated multicenter efforts, for selected questions of exceptional importance. Yet, for many questions, this is ethically and/or economically not justifiable. We explain why in those studies with two (or few) animals, any useful inference is limited to the sample of investigated animals, irrespective of whether it is based on few animals, two animals, or a single animal.

PMID:35468209 | DOI:10.1162/jocn_a_01857

Aesthet Surg J. 2022 Apr 25:sjac108. doi: 10.1093/asj/sjac108. Online ahead of print.

ABSTRACT

BACKGROUND: Historically, common evaluations for photoaging have been subjective analysis; however, recently, investigators have turned to non-invasive devices for more objective evaluation of facial aging.

OBJECTIVES: This study aimed to establish a clinical correlation between the Glogau Photoaging Scale and VISIA-CR Complexion Analysis System. In doing so, decreasing intra- and inter-observer variability when assessing photodamage.

METHODS: One-hundred seventeen subjects between ages 18 and 89 were included. 2D facial photographs were analyzed by three independent reviewers and were assigned Glogau scores. Images were also captured and analyzed using VISIA software. Data was grouped by median Glogau score and compared between groups.

RESULTS: All groups were statistically different (p < 0.05) for Spots, Wrinkles and Remasked Wrinkles, except for Glogau 1 and 2 for Spots and Remasked Wrinkles. Wrinkles scores were plotted against age, and an exponential regression model was noted to be a better fit (R 2 = 0.5) compared to a linear model (R 2 = 0.47). The same was true for Spots with an exponential (R 2 = 0.36) compared to linear model (R 2 = 0.33). Scores were also evaluated based on sun exposure history, of which there were no significant differences.

CONCLUSIONS: The results illustrate that an imaging system can be used to reliably determine objective scores correlating to Glogau photoaging evaluations. Results also supported that aging more closely resembles an exponential process. Collectively, these findings will prove useful to those hoping to further investigate facial aging and therapeutic options available for facial skin rejuvenation and objectively assessing their outcomes.

PMID:35468182 | DOI:10.1093/asj/sjac108

PLoS One. 2022 Apr 25;17(4):e0267396. doi: 10.1371/journal.pone.0267396. eCollection 2022.

ABSTRACT

Informed antibiotic prescription offers a practical solution to antibiotic resistance problem. With the increasing affordability of different sequencing technologies, molecular-based resistance prediction would direct proper antibiotic selection and preserve available agents. Amikacin is a broad-spectrum aminoglycoside exhibiting higher clinical efficacy and less resistance rates in Ps. aeruginosa due to its structural nature and its ability to achieve higher serum concentrations at lower therapeutic doses. This study examines the predictive potential of molecular markers underlying amikacin susceptibility phenotypes in order to provide improved diagnostic panels. Using a predictive model, genes and variants underlying amikacin resistance have been statistically and functionally explored in a large comprehensive and diverse set of Ps. aeruginosa completely sequenced genomes. Different genes and variants have been examined for their predictive potential and functional correlation to amikacin susceptibility phenotypes. Three predictive sets of molecular markers have been identified and can be used in a complementary manner, offering promising molecular diagnostics. armR, nalC, nalD, mexR, mexZ, ampR, rmtD, nalDSer32Asn, fusA1Y552C, fusA1D588G, arnAA170T, and arnDG206C have been identified as the best amikacin resistance predictors in Ps. aeruginosa while faoAT385A, nuoGA890T, nuoGA574T, lptAT55A, lptAR62S, pstBR87C, gidBE126G, gidBQ28K, amgSE108Q, and rplYQ41L have been identified as the best amikacin susceptibility predictors. Combining different measures of predictive performance together with further functional analysis can help design new and more informative molecular diagnostic panels. This would greatly inform and direct point of care diagnosis and prescription, which would consequently preserve amikacin functionality and usefulness.

PMID:35468158 | DOI:10.1371/journal.pone.0267396

PLoS One. 2022 Apr 25;17(4):e0267218. doi: 10.1371/journal.pone.0267218. eCollection 2022.

ABSTRACT

PURPOSE: It is currently unclear how the shift towards virtual care during the 2019 novel coronavirus (COVID-19) pandemic may have impacted chronic disease management at a population level. The goals of our study were to provide a description of the levels of use of virtual care services relative to in-person care in patients with chronic disease across Ontario, Canada and to describe levels of healthcare utilization in low versus high virtual care users.

METHODS: We used linked health administrative data to conduct a population-based, repeated cross-sectional study of all ambulatory patient visits in Ontario, Canada (January 1, 2018 to January 16, 2021). Further stratifications were also completed to examine patients with COPD, heart failure, asthma, hypertension, diabetes, mental illness, and angina. Patients were classified as low (max 1 virtual care visit) vs. high virtual care users. A time-series analysis was done using interventional autoregressive integrated moving average (ARIMA) modelling on weekly hospitalizations, outpatient visits, and diagnostic tests.

RESULTS: The use of virtual care increased across all chronic disease patient populations. Virtual care constituted at least half of the total care in all conditions. Both low and high virtual care user groups experienced a statistically significant reduction in hospitalizations and laboratory testing at the start of the pandemic. Hospitalization volumes increased again only among the high users, while testing increased in both groups. Outpatient visits among high users remained unaffected by the pandemic but dropped in low users.

CONCLUSION: The decrease of in-person care during the pandemic was accompanied by an increase in virtual care, which ultimately allowed patients with chronic disease to return to the same visit rate as they had before the onset of the pandemic. Virtual care was adopted across various chronic conditions, but the relative adoption of virtual care varied by condition with highest rates seen in mental health.

PMID:35468168 | DOI:10.1371/journal.pone.0267218

PLoS One. 2022 Apr 25;17(4):e0267079. doi: 10.1371/journal.pone.0267079. eCollection 2022.

ABSTRACT

Floods are among the devastating types of disasters in terms of human life, social and financial losses. Authoritative data from flood gauges are scarce in arid regions because of the specific type of dry climate that dysfunctions these measuring devices. Hence, social media data could be a useful tool in this case, where a wealth of information is available online. This study investigates the reliability of flood related data quality collected from social media, particularly for an arid region where the usage of flow gauges is limited. The data (text, images and videos) of social media, related to a flood event, was analyzed using the Machine Learning approach. For this reason, digital data (758 images and 1413 video frames) was converted into numeric values through ResNet50 model using the VGG-16 architecture. Numeric data of images, videos and text was further classified using different Machine Learning algorithms. Receiver operating characteristics (ROC) curve and area under curve (AUC) methods were used to evaluate and compare the performance of the developed machine learning algorithms. This novel approach of studying the quality of social media data could be a reliable alternative in the absence of real-time flow gauges data. A flash flood that occurred in the United Arab Emirates (UAE) from March 7-11, 2016 was selected as the focus of this study. Random forest showed the highest accuracy of 80.18% among the five other classifiers for images and videos. Precipitation/rainfall data were used to validate social media data, which showed a significant relationship between rainfall and the number of posts. The validity of the machine learning models was assessed using the area under the curve, precision-recall curve, root mean square error, and kappa statistics to confirm the validity and accuracy of the model. The data quality of YouTube videos was found to have the highest accuracy followed by Facebook, Flickr, Twitter, and Instagram. These results showed that social media data could be used when gauge data is unavailable.

PMID:35468157 | DOI:10.1371/journal.pone.0267079

PLoS One. 2022 Apr 25;17(4):e0267306. doi: 10.1371/journal.pone.0267306. eCollection 2022.

ABSTRACT

The study aimed to fabricate and evaluate Meloxicam (MLX) loaded Hydroxypropyl Methylcellulose (HPMC) microparticles for colon targeting because MLX is a potent analgesic used in the treatment of pain and inflammation associated with colorectal cancer (CRC). Nevertheless, its efficiency is limited by poor solubility and gastrointestinal tracts (GIT) associated side effects. Seventeen formulations of MLX loaded HPMC microparticles were fabricated by the oil-in-oil (O/O)/ emulsion solvent evaporation (ESE) technique. A 3-factor, 3-level Box Behnken (BBD) statistical design was used to estimate the combined effects of the independent variables on the dependent variables (responses), such as the percent yield (R1), the entrapment efficiency (EE) (R2), mean particle size (R3) and in vitro percentage of cumulative drug release (R4). For physicochemical characterization FTIR, XRD, DSC, and SEM analyses were performed. Biocompatibility and non-toxicity were confirmed by in-vivo acute oral toxicity determination. The percentage yield and EE were 65.75-90.71%, and 70.62-88.37%, respectively. However, the mean particle size was 62.89-284.55 μm, and the in vitro cumulative drug release percentage was 74.25-92.64% for 24 hours. FTIR analysis showed that the composition of the particles was completely compatible, while XRD analysis confirmed the crystalline nature of the pure drug and its transition into an amorphous state after formulation. DSC analysis revealed the thermal stability of the formulations. The SEM analysis showed dense spherical particles. The toxicity study in albino rabbits showed no toxicity and was found biocompatible. The histopathological evaluation showed no signs of altered patterns. Results of this study highlighted a standard colonic drug delivery system with the ability to improve patient adherence and reduce GIT drug-associated side effects in CRC treatment.

PMID:35468155 | DOI:10.1371/journal.pone.0267306