Nevin Manimala

Microsurgery. 2023 Nov 22. doi: 10.1002/micr.31126. Online ahead of print.

ABSTRACT

BACKGROUND: Radial forearm free flap (RFFF) donor site closure is traditionally performed with split thickness skin grafts (STSG), which can be associated with poor aesthetics, wrist stiffness, paresthesia, reduced strength, and tendon exposure. Full thickness skin grafts (FTSG) are potentially beneficial as they provide a more durable coverage, and the skin graft donor site can be closed primarily, which is more aesthetic. The aim of this systematic review is to compare the outcomes of STSG versus FTSG for closure of the RFFF donor site.

METHODS: A systematic review was performed, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The primary objective was to answer: do subjects undergoing RFFF harvest, utilizing FTSG to close the RFFF donor site, compared to STSG, achieve superior aesthetics at the RFFF donor site? Included papers compared FTSG and STSG with statistical data. Means were compared with t-test and proportions with Fisher’s exact test.

RESULTS: The initial search resulted in 1851 studies. After applying the inclusion/exclusion criteria, the search resulted in eight studies, with 366 total skin grafts, 197 STSG and 169 FTSG. Six studies evaluated aesthetics utilizing a Likert scale, with the scaled average aesthetic score for FTSG being 7.9/10 compared to 6.9/10 for STSG (p < .001). Tendon exposure was measured in five studies, with a rate of 13.1% for STSG versus 10.6% for FTSG (p = .555). No significant difference in function was observed, however, methods to quantify function were heterogeneous.

CONCLUSION: FTSG compared to STSG, resulted in statistically significant improved aesthetics, with comparable rates of tendon exposure and function.

PMID:37990820 | DOI:10.1002/micr.31126

Nanoscale. 2023 Nov 22. doi: 10.1039/d3nr03502f. Online ahead of print.

ABSTRACT

Thanks to their unique nanoscale properties, nanomedicines can overcome some of the shortcomings of conventional therapies. For better predictive screening, it is important to assess their performance in three-dimensional (3D) multicellular tumour spheroids (MCTS) that can recapitulate the physiological barriers found in real tumours. Today, the evaluation of drug delivery nanosystems in MCTS is mainly explored by means of microscopy techniques that are invasive and require fluorescent labels which modify the composition and fate of the carriers. In recent years, a new quantitative microscopy technique based on Brillouin light scattering (BLS) has been proposed that uses the interaction of laser light with picosecond timescale density fluctuations in the sample. Because it is label-free, all-optical and non-destructive, BLS has gained interest in the pharmaceutical and biomedical fields. In this work, we implemented a fast BLS spectrometer and used the Brillouin frequency shift at the center of the MCTS as a quantitative readout for drug efficacy. We first investigated the ability of this setup to quantify drug efficacy in MCTS grown in classical multiwell plates and concluded that the low number of samples available in the multiwells limits the statistical significance of the results. To improve the throughput, we then combined the microscope with agarose microwells designed to fabricate a large number of MCTS and test 50 MCTS in less than a minute. Using this platform, we assessed the efficacy of polymeric nanoparticles (NPs) loaded with a platinum derivative anticancer drug (dichloro(1,2-diaminocyclohexane)platinum(II)) in reducing the growth of colorectal cancer cells (HCT-116) in MCTS. We observe a time- and dose-dependent decrease in the frequency shift, revealing the progressive loss of mechanical integrity in the MCTS. These results demonstrate that BLS probing of MCTS grown in agarose microwells is a promising tool for high-throughput screening of nanocarriers in 3D models.

PMID:37990811 | DOI:10.1039/d3nr03502f

Urol J. 2023 Oct 29. doi: 10.22037/uj.v20i.7746. Online ahead of print.

ABSTRACT

PURPOSE: Few studies have evaluated the usefulness of anteroposterior dissection holmium laser enucleation of the prostate (HoLEP). Thus, this study investigated the incidence of stress urinary incontinence (SUI) after HoLEP and usefulness of anteroposterior dissection HoLEP in preventing postoperative SUI.

MATERIALS AND METHODS: In total, 288 patients who underwent HoLEP performed by a single experienced surgeon between May 2014 and September 2021 were enrolled. Furthermore, 134 patients underwent retrograde dissection using the modified Gilling method (surgery 1) and 154 patients underwent anteroposterior dissection HoLEP (surgery 2). The risk factors for SUI, as well as the rates of SUI improvement for the two surgical procedures, were evaluated.

RESULTS: Postoperative SUI was observed in 58 (20.1%) of 288 patients, of whom, 48 (82.8%) recovered continence within 6 months. Ten patients (17.2%) required more than 6 months to recover continence. SUI incidence 1 month after HoLEP was 29.9% (40/134 patients) for surgery 1 and 11.7% (18/154 patients) for surgery 2; a statistically significant difference was observed between the two groups (odds ratio [OR], 0.311; 95% confidence interval [CI], 0.168-0.575; p < 0.001). In addition, surgery 2 was significantly associated with early recovery from SUI compared with surgery 1 (stratified hazard ratio, 0.782; 95% CI, 0.615——0.995; p < 0.001). The multivariable analysis demonstrated that only surgical procedure (OR, 0.350; 95%CI, 0.168-0.732; p=0.005) was an independent predictor of SUI.- Conclusion: We reaffirmed that anteroposterior dissection HoLEP is a useful procedure for reducing the risk of postoperative SUI and early recovery of urinary continence.

PMID:37990797 | DOI:10.22037/uj.v20i.7746

Int J Nurs Knowl. 2023 Nov 21. doi: 10.1111/2047-3095.12451. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification.

METHODS: This is a case-control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included-344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee.

FINDINGS: The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25-8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77-6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29-3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03-7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69-39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85-18.37), atherosclerosis (OR:2.07; 95% CI: 1.32-3.27), critical illness (OR: 2.28; 95% CI: 1.42-3.70), and immobility (OR: 2.09; 95% CI: 1.10-4.12).

CONCLUSIONS: The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I.

IMPLICATIONS FOR NURSING PRACTICE: The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.

PMID:37990774 | DOI:10.1111/2047-3095.12451

Brain Behav. 2023 Nov 21:e3314. doi: 10.1002/brb3.3314. Online ahead of print.

ABSTRACT

BACKGROUND: The coronavirus disease of 2019 (COVID-19) pandemic is an unprecedented traumatic event that has severely impacted social, economic, and health well-being worldwide. The COvid Mental hEalth Trial was specifically designed to evaluate the impact of the COVID-19 pandemic and its containment measures on the mental health of the Italian general population in terms of COVID-19-related acute stress disorder (ASD) symptoms.

METHODS: The present cross-sectional study is based on an online survey carried out in the period March-May 2020. Italian general adult population was invited to compile an anonymous survey, which included the severity of acute stress symptoms scale/National Stressful Events Survey Short Scale to investigate the occurrence and severity of ASD symptoms.

RESULTS: The final sample consisted of 20,720 participants. During the lockdown, subjects with pre-existing mental health problems reported a statistically significant higher risk of acute post-traumatic symptoms compared to the general population (B: 2.57; 95% CI:2.04-3.09; p < .0001) and health care professionals (B: .37; 95% CI: .02-0.72; p < .05). According to multivariate regression models, the levels of acute post-traumatic symptoms (p < .0001) were higher in younger and female respondents. Social isolation and sleep disorder/insomnia represented positive predictors of acute stress (B = 3.32, 95% CI = 3.08-3.57).

CONCLUSIONS: Concerns about the risk of infection as well as social isolation caused a higher incidence of acute post-traumatic stress symptoms that may predict the subsequent development of post-traumatic stress disorder symptoms in the long term.

PMID:37990771 | DOI:10.1002/brb3.3314

Am J Hum Biol. 2023 Nov 22:e24009. doi: 10.1002/ajhb.24009. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigates the relationships between the COVID-19 pandemic, lifestyle factors, and their impact on bone mineral density in the radius forearm bone and the total bone mineral content in young adults from Slovakia.

METHODS: We assessed 773 Slovak young adults aged 18 to 30 years, divided into subgroups on their pandemic status. Bone mineral density (BMD) was analyzed by the QUS device (Sunlight MiniOmni™), and bone mineral content (BMC) and fat mass (FM) were measured by InBody 770 bioimpedance analyzer. Finally, linear regression analysis tested the associations.

RESULTS: Statistically significant lower speed of sound (SOS) along the length of the forearm radius bone and Z-score values was determined in participants during the COVID-19 pandemic than before it, and statistically significant lower BMC values were observed in the male group during COVID-19 than beforehand. Regression analysis confirmed the negative pandemic effect in the following indices: SOS (p < .001 for women and p = .035 for men), Z-score (p < .001 for women and p = .003 for men), and BMC (p = .024 for men). Vitamin D was a further significant SOS predictor in women at p = .029, but this association was not detected in men. In contrast, the significant male BMC predictors were pandemic presence (p = .028), physical activity (p = .028), and fat mass percentage (p = .001).

CONCLUSIONS: Significant COVID-19 pandemic effects on bone tissue were determined on bone mass density in the radius forearm bone and the total bone mineral content. These effects establish that the pandemic had a negative impact on both their bone quality and health.

PMID:37990761 | DOI:10.1002/ajhb.24009

Sci Rep. 2023 Nov 21;13(1):20347. doi: 10.1038/s41598-023-47043-6.

ABSTRACT

A large proportion of the world’s population has some form of immunity against SARS-CoV-2, through either infection (‘natural’), vaccination or both (‘hybrid’). This retrospective cohort study used data on SARS-CoV-2, vaccination, and hospitalization from national health system from February 2020 to June 2022 and Cox regression modelling to compare those with natural immunity to those with no (Cohort1, n = 94,982), hybrid (Cohort2, n = 47,342), and vaccine (Cohort3, n = 254,920) immunity. In Cohort 1, those with natural immunity were at lower risk for infection during the Delta (aHR 0.17, 95%CI 0.15-0.18) and higher risk (aHR 1.24, 95%CI 1.18-1.32) during the Omicron period than those with no immunity. Natural immunity conferred substantial protection against COVID-19-hospitalization. Cohort 2-in comparison to natural immunity hybrid immunity offered strong protection during the Delta (aHR 0.61, 95%CI 0.46-0.80) but not the Omicron (aHR 1.05, 95%CI 0.93-1.1) period. COVID-19-hospitalization was extremely rare among individuals with hybrid immunity. In Cohort 3, individuals with vaccine-induced immunity were at higher risk than those with natural immunity for infection (Delta aHR 4.90, 95%CI 4.48-5.36; Omicron 1.13, 95%CI 1.06-1.21) and hospitalization (Delta aHR 7.19, 95%CI 4.02-12.84). These results show that risk of infection and severe COVID-19 are driven by personal immunity history and the variant of SARS-CoV-2 causing infection.

PMID:37989858 | DOI:10.1038/s41598-023-47043-6

Sci Rep. 2023 Nov 21;13(1):20372. doi: 10.1038/s41598-023-47651-2.

ABSTRACT

Additive manufacturing of as-build metal materials with laser powder bed fusion typically leads to the formations of various chemical phases and their corresponding microstructure types. Such microstructures have very complex shape and size anisotropic distributions due to the history of the laser heat gradients and scanning patterns. With higher complexity compared to the post-heat-treated materials, the synthetic volume reconstruction of as-build materials for accurate modelling of their mechanical properties is a serious challenge. Here, we present an example of complete workflow pipeline for such nontrivial task. It takes into account the statistical distributions of microstructures: object sizes for each phase, several shape parameters for each microstructure type, and their morphological and crystallographic orientations. In principle, each step in the pipeline, including the parameters in the crystal plasticity model, can be fine-tuned to achieve suitable correspondence between experimental and synthetic microstructures as well as between experimental stress-strain curves and simulated results. To our best knowledge, this work represents an example of the most challenging synthetic volume reconstruction for as-build additive manufacturing materials to date.

PMID:37989841 | DOI:10.1038/s41598-023-47651-2

Cell Mol Life Sci. 2023 Nov 21;80(12):370. doi: 10.1007/s00018-023-05009-x.

ABSTRACT

Individuals with Down syndrome (DS) have a higher prevalence of obesity compared to the general population. Conventionally, this has been attributed to endocrine issues and lack of exercise. However, deficits in neural reward responses and dopaminergic disturbances in DS may be contributing factors. To investigate this, we focused on a mouse model (Ts65Dn) bearing some triplicated genes homologous to trisomy 21. Through detailed meal pattern analysis in male Ts65Dn mice, we observed an increased preference for energy-dense food, pointing towards a potential “hedonic” overeating behavior. Moreover, trisomic mice exhibited higher scores in compulsivity and inflexibility tests when limited access to energy-dense food and quinine hydrochloride adulteration were introduced, compared to euploid controls. Interestingly, when we activated prelimbic-to-nucleus accumbens projections in Ts65Dn male mice using a chemogenetic approach, impulsive and compulsive behaviors significantly decreased, shedding light on a promising intervention avenue. Our findings uncover a novel mechanism behind the vulnerability to overeating and offer potential new pathways for tackling obesity through innovative interventions.

PMID:37989807 | DOI:10.1007/s00018-023-05009-x

Environ Monit Assess. 2023 Nov 22;195(12):1509. doi: 10.1007/s10661-023-12046-3.

ABSTRACT

Although existing studies mainly focused on the air quality status in Bangladesh, quantifying the natural and manmade effects, the frequency of high pollution levels, and the associated health risks remained beyond detailed investigation. Air quality and meteorological data from the Department of Environment for 2012-2019 were analyzed, attempting to answer those questions. Cluster analysis of PM_2.5, PM₁₀, and gaseous pollutants implied that Dhaka and neighboring cities, Narayangonj and Gazipur, are from similar sources compared to the other major cities in the country. Apart from the transboundary sources, land use types and climate parameters unevenly affected local pollution loadings across city domains. The particulate concentrations persistently remained above the national standard for almost half the year, with the peaks during the dry months. Even though nitrogen oxides remained high in all three cities, other gaseous pollutants, such as CO and O₃, except SO₂, showed elevated concentrations solely in Dhaka city. Concentrations of gaseous pollutants in Dhaka vary spatially, but no statistical differences could be discerned between the working days and holidays. Frequency analysis results and hazard quotients revealed the likelihood of adverse health outcomes in Narayangonj ensuing from particulate exposures surpasses the other cities for different age, gender, and occupation groups. Nonetheless, school-aged children and construction workers were most at risk from chronic exposure to gaseous pollutants mostly in Dhaka. One limitation of this study was that the routine air quality monitoring happens just from five sites, making the evidence-based study concerning health outcomes quite challenging.

PMID:37989796 | DOI:10.1007/s10661-023-12046-3