Category: Nevin Manimala

J Surg Oncol. 2021 Apr 9. doi: 10.1002/jso.26479. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: This study aimed to evaluate the safety and efficacy of robot-assisted laparoscopic tumor enucleation (RAE) for the treatment of renal hilar tumors and to describe our experience with renorrhaphy-related surgical techniques.

METHODS: Retrospective data were collected from 173 consecutive patients who underwent RAE for localized renal tumors (cT1-cT2N0M0) at our hospital between September 2014 and November 2019.

RESULTS: Seventy-five patients had renal hilar tumors and 98 patients had nonhilar tumors. There were no statistical differences between the hilar and nonhilar groups in operation time (190 [115-390] vs. 190 [110-390] min, p = 0.889), warm ischemia time (26 [12-60] vs. 27 [17-41] min, p = 0.257), hospital stay duration (8 [3-16] vs. 7.5 [4-18] days, p = 0.386), renal function (estimated glomerular filtration rate, 102.5 [29.4-144] vs. 101.3 [64.2-134.7] ml/min/1.73 m² , p = 0.631); creatinine level, (76 [43-169] vs. 78.5 [50-281.3] µmol/L, p = 0.673), perioperative complications rate, or surgical margin status. However, patients with hilar tumors lost significantly more blood than did those with nonhilar tumors (250 [50-1500] vs. 200 [20-1200] ml, p = 0.007). During the follow-up period (median, 30 months), three patients in each group experienced recurrence. The 5-year recurrence-free rates were 93.0% and 95.4% in the hilar and nonhilar tumor groups, respectively (p = 0.640).

CONCLUSIONS: For experienced robot laparoscopists, RAE is a safe, effective, and feasible procedure for renal hilar tumors, without increased risk of positive surgical margins or worse midterm oncologic outcomes compared with nonhilar tumors.

PMID:33836093 | DOI:10.1002/jso.26479

PLoS One. 2021 Apr 9;16(4):e0249477. doi: 10.1371/journal.pone.0249477. eCollection 2021.

ABSTRACT

BACKGROUND: The search for immune correlates of protection against Mycobacterium tuberculosis (MTB) infection in humans is limited by the focus on peripheral blood measures. Bronchoalveolar lavage (BAL) can safely be done and provides insight into cellular function in the lung where infection is first established. In this study, blood and lung samples were assayed to determine if heavily MTB exposed persons who resist development of latent MTB infection (RSTR) vs those who develop latent MTB infection (LTBI), differ in the make-up of resident BAL innate and adaptive immune cells.

METHODS: Bronchoscopy was performed on 21 healthy long-term Ugandan RSTR and 25 LTBI participants. Immune cell distributions in BAL and peripheral blood were compared by differential cell counting and flow cytometry.

RESULTS: The bronchoscopy procedure was well tolerated with few adverse reactions. Differential macrophage and lymphocyte frequencies in BAL differed between RSTR and LTBI. When corrected for age, this difference lost statistical significance. BAL CD4+ and CD8+ T cells were almost entirely composed of effector memory T cells in contrast to PBMC, and did not differ between RSTR and LTBI. BAL NKT, γδ T cells and NK cells also did not differ between RTSR and LTBI participants. There was a marginally significant increase (p = 0.034) in CD8 T effector memory cells re-expressing CD45RA (TEMRA) in PBMC of LTBI vs RSTR participants.

CONCLUSION: This observational case-control study comparing unstimulated BAL from RSTR vs LTBI, did not find evidence of large differences in the distribution of baseline BAL immune cells. PBMC TEMRA cell percentage was higher in LTBI relative to RSTR suggesting a role in the maintenance of latent MTB infection. Functional immune studies are required to determine if and how RSTR and LTBI BAL immune cells differ in response to MTB.

PMID:33836031 | DOI:10.1371/journal.pone.0249477

Arch Pathol Lab Med. 2021 Apr 9. doi: 10.5858/arpa.2020-0572-OA. Online ahead of print.

ABSTRACT

CONTEXT.—: Genomic molecular testing practices in a pediatric tertiary care institution.

OBJECTIVE.—: To evaluate exome sequencing (ES) ordering practices and the effects of applying criteria to support ES stewardship. Exome sequencing can provide molecular diagnostic information for patients with known or suspected genetic diseases, but it is relatively expensive, and the cost is often borne by patients, institutions, and payers.

DESIGN.—: We examined ordering patterns of ES approved by board-certified geneticists at our tertiary pediatric care center, as well as preauthorization outcomes for ES requests. We compared positivity rates among patients by patient phenotype, composite insurance coverage criteria, and insurance preauthorization outcome.

RESULTS.—: Patients who met composite coverage criteria were more likely to receive a positive result from ES compared to patients who did not meet composite coverage criteria, though this trend was not statistically significant. There was no significant difference in ES results between patients who were denied or not denied preauthorization by insurance payers.

CONCLUSIONS.—: Insurance payers should consider implementing and/or expanding coverage criteria for ES and institutions should implement stewardship programs to support appropriate ES practices.

PMID:33836053 | DOI:10.5858/arpa.2020-0572-OA

J Food Prot. 2021 Apr 9. doi: 10.4315/JFP-20-490. Online ahead of print.

ABSTRACT

The growth and hemolysin production of two V. alginolyticus strains (HY9901 and ATCC17749T) at 30 °C in briny tilapia, shrimp, scallop, oyster, pork, chicken, freshwater fish and egg fried rice were investigated. Bacterial counts were enumerated by plate counting. Hemolysin production was evaluated by blood agar and hemolytic titer tests. The two V. alginolyticus strains displayed similar growth and hemolysin production patterns in the foods. Based on the goodness of fit primary model statistics (R 2 , MSE, BF, AF), the modified Gompertz model was a better fit to V. alginolyticus growth in foods than the logistic model. Growth kinetic parameters of V. alginolyticus displayed a higher μ max and shorter λ in briny tilapia > shrimp > freshwater fish > egg fried rice > scallop > oyster > chicken > pork. It was notable that the V. alginolyticus counts were similar at the stationary phase, with no significant growth behavior difference between raw and cooked foods. Significantly higher (p < 0.05) thermostable direct hemolysin (TDH) activity was produced by V. alginolyticus in briny tilapia > freshwater fish > shrimp > chicken > egg fried rice > scallop > oyster > pork. But the hemolytic titer was not consistent with the TDH activity, being significantly higher (p < 0.05) in briny tilapia > egg fried rice > shrimp > freshwater fish > chicken > scallop > oyster > pork. Contrary to current belief, V. alginolyticus displayed a higher hemolysin production in some non-seafoods (freshwater fish, egg fried rice and chicken) than in scallop or oyster. This is the first report of growth and toxicity of V. alginolyticus in different food matrices and confirmation that some non-seafood contaminated with V. alginolyticus can be even more pathogenic. This study will enhance the awareness of non-seafood safety and improve the V. alginolyticus risk assessment accuracy.

PMID:33836066 | DOI:10.4315/JFP-20-490

PLoS Pathog. 2021 Apr 9;17(4):e1009501. doi: 10.1371/journal.ppat.1009501. Online ahead of print.

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein mediates infection of cells expressing angiotensin-converting enzyme 2 (ACE2). ACE2 is also the viral receptor of SARS-CoV (SARS-CoV-1), a related coronavirus that emerged in 2002-2003. Horseshoe bats (genus Rhinolophus) are presumed to be the original reservoir of both viruses, and a SARS-like coronavirus, RaTG13, closely related to SARS-CoV-2, has been identified in one horseshoe-bat species. Here we characterize the ability of the S-protein receptor-binding domains (RBDs) of SARS-CoV-1, SARS-CoV-2, pangolin coronavirus (PgCoV), RaTG13, and LyRa11, a bat virus similar to SARS-CoV-1, to bind a range of ACE2 orthologs. We observed that the PgCoV RBD bound human ACE2 at least as efficiently as the SARS-CoV-2 RBD, and that both RBDs bound pangolin ACE2 efficiently. We also observed a high level of variability in binding to closely related horseshoe-bat ACE2 orthologs consistent with the heterogeneity of their RBD-binding regions. However five consensus horseshoe-bat ACE2 residues enhanced ACE2 binding to the SARS-CoV-2 RBD and neutralization of SARS-CoV-2 pseudoviruses by an enzymatically inactive immunoadhesin form of human ACE2 (hACE2-NN-Fc). Two of these mutations impaired neutralization of SARS-CoV-1 pseudoviruses. An hACE2-NN-Fc variant bearing all five mutations neutralized both SARS-CoV-2 pseudovirus and infectious virus more efficiently than wild-type hACE2-NN-Fc. These data suggest that SARS-CoV-1 and -2 originate from distinct bat species, and identify a more potently neutralizing form of soluble ACE2.

PMID:33836016 | DOI:10.1371/journal.ppat.1009501

PLoS One. 2021 Apr 9;16(4):e0250015. doi: 10.1371/journal.pone.0250015. eCollection 2021.

ABSTRACT

Hawkes processes are a form of self-exciting process that has been used in numerous applications, including neuroscience, seismology, and terrorism. While these self-exciting processes have a simple formulation, they can model incredibly complex phenomena. Traditionally Hawkes processes are a continuous-time process, however we enable these models to be applied to a wider range of problems by considering a discrete-time variant of Hawkes processes. We illustrate this through the novel coronavirus disease (COVID-19) as a substantive case study. While alternative models, such as compartmental and growth curve models, have been widely applied to the COVID-19 epidemic, the use of discrete-time Hawkes processes allows us to gain alternative insights. This paper evaluates the capability of discrete-time Hawkes processes by modelling daily mortality counts as distinct phases in the COVID-19 outbreak. We first consider the initial stage of exponential growth and the subsequent decline as preventative measures become effective. We then explore subsequent phases with more recent data. Various countries that have been adversely affected by the epidemic are considered, namely, Brazil, China, France, Germany, India, Italy, Spain, Sweden, the United Kingdom and the United States. These countries are all unique concerning the spread of the virus and their corresponding response measures. However, we find that this simple model is useful in accurately capturing the dynamics of the process, despite hidden interactions that are not directly modelled due to their complexity, and differences both within and between countries. The utility of this model is not confined to the current COVID-19 epidemic, rather this model could explain many other complex phenomena. It is of interest to have simple models that adequately describe these complex processes with unknown dynamics. As models become more complex, a simpler representation of the process can be desirable for the sake of parsimony.

PMID:33836020 | DOI:10.1371/journal.pone.0250015

PLoS One. 2021 Apr 9;16(4):e0250037. doi: 10.1371/journal.pone.0250037. eCollection 2021.

ABSTRACT

BACKGROUND: Dietary diversity has continued to receive a global attention among pregnant women as they have been considered susceptible to malnutrition because of their increased nutrient demands. Thus, a variety of foodstuffs in their diet are necessary for ensuring the appropriateness of their nutrient consumptions. This study, therefore assessed the dietary diversity practice and its determinants among pregnant women attending antenatal clinic at Wachemo University Nigist Eleni Mohammed memorial referral hospital, Southern Ethiopia.

METHODS: A hospital-based cross-sectional study was carried out on 303 participants from May 1 to June 15, 2019 using a systematic random sampling technique. Data were entered and analyzed using SPSS (version24.0). Both bivariate and multivariable logistic regression analyses were used to decide the association of each explanatory variable with the outcome variable. Odds ratio with their 95% confidence intervals was calculated to identify the presence and strength of association, and statistical significance was declared at p < 0.05.

RESULTS: The overall prevalence of adequate dietary diversity practices was observed to be 42.6%. The determinants of dietary diversity practice included earning of a monthly income ≥2000 Ethiopian birr (AOR = 1.62; 95%CI:1.19-2.85), maternal educational level (AOR = 2.50; 95% CI: 1.05-6.12), educational status of partner (AOR = 2.45; 95% CI:1.20, 9.57), having a partner who was a government employee (AOR = 4; 95% CI:2.18-7.21), and the receiving of nutritional information (AOR = 1.35; 95% CI: 3.39-6.94).

CONCLUSIONS: The study indicated that the overall consumption of adequate dietary diversity practice was found to be low. Therefore, increasing household income, enhancing nutritional related information, advancing the academic level of both wife and her partner is essential to improve women’s dietary diversity practice.

PMID:33836030 | DOI:10.1371/journal.pone.0250037

Acta Vet Hung. 2021 Apr 8. doi: 10.1556/004.2021.00006. Online ahead of print.

ABSTRACT

Hippocampal changes in epilepsy may manifest as hippocampal atrophy/sclerosis. A recent human study suggests that the demonstration of hippocampal volume loss is more reliable using quantitative evaluation methods. The aim of the present study was to obtain volumetric data in both epileptic and healthy dogs, to compare hippocampal volumes in both groups, and to compare subjective and volumetric assessment. Volumetric measurements of the hippocampi, lateral ventricles and hemispheria were performed in 31 epileptic and 15 control dogs. There was a positive association between the body weight and the hemispheric volume, as well as between the hemispheric volume and the ipsilateral hippocampal volume. There was no significant correlation between age and the volume of any measured brain structures. There was no statistically significant difference between the hippocampal volumes of the control group and the epileptic group. A statistically significant difference between the two groups for hippocampus/hemispherium ratio or hippocampal asymmetric ratio was not identified. An extrapolated hippocampal volume based on body weight was not possible in this study population.

PMID:33835940 | DOI:10.1556/004.2021.00006

Pancreas. 2021 Mar 1;50(3):362-370. doi: 10.1097/MPA.0000000000001780.

ABSTRACT

OBJECTIVES: The postoperative quality of life (QoL) after pancreatic surgery is frequently impaired. The aim of this study was to evaluate the QoL after pancreatic surgery and its influencing risk factors. Furthermore, an age-adjusted comparison with the normal population of Germany was performed.

METHODS: A total of 94 patients were surveyed. The Short Form-36 questionnaire was sent to all patients undergoing pancreatic surgery between 2013 and 2017. All pathologies and types of pancreatic resections were included. Statistical analyses were performed, and an analysis by the Robert Koch-Institute to determine the health-related age-adjusted QoL in Germany served as control group.

RESULTS: Response rate was 29%. Median time of survey was 28 months. As compared with a normative population, QoL after pancreaticoduodenectomy was significantly impaired. Distal pancreatic resection showed no significant differences. Univariate and Lasso analyses showed that the following factors had a negative impact: coronary artery disease, chronic pancreatitis, and open access. Postoperative enzyme supplementation seemed to have a positive impact.

CONCLUSIONS: Pancreatic surgery leads to long-lasting negative effect on QoL. Distal pancreatic resections and laparoscopic access seemed to be the best tolerated. Complications seems to have less impact, whereas maintaining exocrine and endocrine function seems to have a positive effect.

PMID:33835967 | DOI:10.1097/MPA.0000000000001780

PLoS One. 2021 Apr 9;16(4):e0248356. doi: 10.1371/journal.pone.0248356. eCollection 2021.

ABSTRACT

New and more efficient methods to sustainably intensify Aquaculture production are essential to attain the seafood demand for direct human consumption in the near future. Nutrition has been identified as one strategy of early exposure that might affect animal early development and later phenotype. This strategy may have positive consequences in the modulation of fish digestive physiology, which will correlate with higher performance outputs. Thus, improving fish digestive efficiency will lead to higher productivity and lower biogenic emission from aquaculture facilities, minimising the impact on the environment while increasing the biological efficiency. An innovative in ovo nutritional modulation technique based on low-frequency ultrasounds was used to enhance the transport of amino acids across the embryo membranes. An early stimulus with either arginine or glutamine, both involved in gut maturation, was applied in zebrafish (Danio rerio) embryos at 3.5 hours post-fertilization (hpf). At 22 days post-fertilization (dpf), growth performance, digestive enzyme activities and gut microbiota composition were analysed to evaluate the larval nutrition-induced metabolic plasticity and the effects on fish digestive efficiency. Results showed that fish survival was not affected either by the sonophoresis technique or amino acid supplementation. Final dry weight at 22 dpf was statistically higher in larvae from glutamine treatment when compared to the control even with lower trypsin activity, suggesting a higher nutrient digestion capacity, due to a slightly modulation of gut microbiota. Higher arginine supplementation levels should be tested as strategy to enhance growth at later developmental stages. In conclusion, this study demonstrated the efficiency of sonophoresis technique for in ovo nutritional modulation and suggests that in ovo glutamine supplementation might promote growth at later developmental stage through a positive microbiota modulation.

PMID:33835997 | DOI:10.1371/journal.pone.0248356