Nevin Manimala

Spine (Phila Pa 1976). 2023 Nov 7. doi: 10.1097/BRS.0000000000004869. Online ahead of print.

ABSTRACT

STUDY DESIGN: A retrospective cohort study.

OBJECTIVE: To evaluate long-term rotational changes in the vertebrae of patients with adolescent idiopathic scoliosis (AIS) who underwent direct vertebral rotation (DVR).

SUMMARY OF BACKGROUND DATA: DVR using thoracic pedicle screws, a rotational corrective maneuver used in the surgical treatment of AIS, was introduced in 2004. Although DVR is considered to be the main axial corrective maneuver, the long-term rotational changes of vertebrae following this treatment are not well understood.

METHODS: A total of 135 vertebrae that underwent DVR using thoracic pedicle screws with a minimum 5-year follow-up were retrospectively assessed for the vertebral rotation angle. Vertebral rotation of the apical vertebra (AV), and distal end vertebra (EV) was evaluated using the Nash-Moe scale, the rotational angle to the sacrum (RAsac), and the Aaro and Dahlborn method. Student’s t-test (paired means) was used for continuous variables, and the chi-square test was used for categorical variables, as appropriate. A comparison of two and three groups used a one-way repeated measures analysis of variance, and the post hoc analysis used the Bonferroni test.

RESULTS: The mean Nash-Moe scale of distal EV showed statistically significant differences between preoperative and postoperative values (P=0.034) and no statistically significant difference between postoperative and last follow-up values (P=1.000). The last follow-up RAsac of AV did not differ significantly from the preoperative RAsac of AV (P=0.515). The last follow-up RAsac of distal EV was significantly lower than the preoperative RAsac of distal EV (P=0.001). Pearson’s correlation analysis showed that the last follow-up RAsac of distal EV was correlated with Cobb angle of the main curve (r=0.459, P=0.004), loss of correction (r=0.541, P=0.001), and LIV tilt angle (r=0.504, P=0.001).

CONCLUSIONS: The rotation regression phenomenon in AV and rotation maintenance in distal EV were observed after DVR over an average of 10-year follow-up. These findings suggest that the DVR in the surgical treatment of AIS has a positive long-term effect on the stabilization of distal EV from the point of view of axial rotation.

LEVEL OF EVIDENCE: IV.

PMID:37937448 | DOI:10.1097/BRS.0000000000004869

J Pediatr Orthop. 2023 Nov 8. doi: 10.1097/BPO.0000000000002562. Online ahead of print.

ABSTRACT

BACKGROUND: Management of postoperative knee arthrofibrosis can be challenging and the preferred time for intervention remains controversial. The purpose of this study is to evaluate the safety and efficacy of early (<3 mo postoperatively) manipulation under anesthesia (MUA) for the treatment of knee arthrofibrosis in adolescent patients. We hypothesized that early MUA could restore normal knee motion with a low complication rate and without the need for more invasive intervention.

METHODS: In a retrospective review, 57 patients who underwent MUA for postoperative knee arthrofibrosis were identified. The time between the index surgery and MUA as well as changes in range of motion (ROM) before and after MUA were analyzed. Descriptive statistics with median and interquartile range were used to analyze this non-parametric study cohort. Repeated measures ANOVA was performed to assess improvement in ROM over time. A P value <0.05 denoted statistical significance.

RESULTS: The median age of the cohort at time of MUA was 14.5 years [interquartile range (IQR) 12.9 to 17.6)]. 54.4% were male. Median time to MUA was 64 days (IQR 52 to 79) after index surgery. ROM before MUA was 90.0 degrees (IQR 75 to 100), which improved to 130 degrees (120 to 135) after MUA. At final median follow-up of 8.9 months (IQR 5.1 to 16.1), mean ROM was 133 degrees (130 to 140). There were no iatrogenic fractures or physeal separations associated with MUA. 12.3% (n=7/57) failed MUA either due to the need for subsequent repeat MUA (n=2), need for lysis of adhesions (n=3) or need for surgery after MUA (n=2). Those who failed early MUA and required subsequent procedures had ROM >120 degrees at final follow-up.

CONCLUSIONS: Postoperative knee arthrofibrosis can be safely and effectively treated with early (<3 mo postoperative) MUA. There were no iatrogenic fractures or physeal separations during MUA. Patients who had recurrence of motion deficits after early MUA and required further intervention, regained satisfactory knee motion at final follow-up. Although further research is warranted to better characterize risk factors for knee arthrofibrosis in adolescent patients, early recognition and MUA is a safe and effective treatment for arthrofibrosis to help patients regain full ROM without invasive intervention.

LEVEL OF EVIDENCE: Therapeutic Study – Level IV.

PMID:37937395 | DOI:10.1097/BPO.0000000000002562

Clin Transplant. 2023 Nov 8:e15185. doi: 10.1111/ctr.15185. Online ahead of print.

ABSTRACT

BACKGROUND: With the availability of vaccines against SARS-COV-2, recommendations for vaccination of transplant candidates are widespread. At our institution, patients may receive liver transplant (LTx) regardless of vaccine status. The purpose of this study is to compare post-LTx outcomes between vaccinated (VAX) and unvaccinated (UNVAX) LTx recipients.

METHODS: This is a retrospective, single-center study of LTx from January 1, 2021-March 30, 2022. The primary outcome is incidence of post-LTx COVID-19. Secondary outcomes include graft function, mortality, graft loss, and COVID-19 treatment.

RESULTS: One hundred and seventy-seven LTx recipients were included, 57% [101/177] VAX and 43% [76/177] UNVAX. Baseline characteristics were similar between groups. Overall, 28 (36.8%) UNVAX and 34 (33.7%) VAX tested COVID-19 positive during the study period (p = .193) at a mean of 312.6 [255.4-369.8] days for UNVAX versus 254.6 [215.2-293.9] days for VAX (p = .084). COVID-19 treatment was administered in 15 (53.6%) of the UNVAX compared to 22 (64.7%) in the VAX (p = .374), although eight (28.6%) of UNVAX required hospital admission for treatment compared with two (5.9%) of VAX (p = .016). There were no statistically significant differences in death, and no COVID-19 related death or graft loss. There were no statistically significant differences in liver function tests at 3- and 12-months post LTx.

CONCLUSION: In a series with a large percentage of UNVAX patients, LTx appears to be safe, with no difference in the rate of COVID-19 or transplant-related outcomes compared to VAX. While we encourage vaccination to prevent severe COVID, based on our results, vaccine status should not be reason to deny lifesaving transplant.

PMID:37937389 | DOI:10.1111/ctr.15185

Anal Methods. 2023 Nov 8. doi: 10.1039/d3ay01192e. Online ahead of print.

ABSTRACT

An electronic nose (e-nose) is a device designed to recognize and classify odors. The equipment is built around a series of sensors that detect the presence of odors, especially volatile organic compounds (VOCs), and generate an electric signal (voltage), known as e-nose data, which contains chemical information. In the food business, the use of e-noses for analyses and quality control of fruits and plantation crops has increased in recent years. Their use is particularly relevant due to the lack of non-invasive and inexpensive methods to detect VOCs in crops. However, the majority of reports in the literature involve commercial e-noses, with only a few studies addressing low-cost e-nose (LC-e-nose) devices or providing a data-oriented description to assist researchers in choosing their setup and appropriate statistical methods to analyze crop data. Therefore, the objective of this study is to discuss the hardware of the two most common e-nose sensors: electrochemical (EC) sensors and metal oxide sensors (MOSs), as well as a critical review of the literature reporting MOS-based low-cost e-nose devices used for investigating plantations and fruit crops, including the main features of such devices. Miniaturization of equipment from lab-scale to portable and convenient gear, allowing producers to take it into the field, as shown in many appraised systems, is one of the future advancements in this area. By utilizing the low-cost designs provided in this review, researchers can develop their own devices based on practical demands such as quality control and compare results with those reported in the literature. Overall, this review thoroughly discusses the applications of low-cost e-noses based on MOSs for fruits, tea, and coffee, as well as the key features of their equipment (i.e., advantages and disadvantages) based on their technical parameters (i.e., electronic and physical parts). As a final remark, LC-e-nose technology deserves significant attention as it has the potential to be a valuable quality control tool for emerging countries.

PMID:37937362 | DOI:10.1039/d3ay01192e

Pak J Biol Sci. 2023 Jul;26(8):419-426. doi: 10.3923/pjbs.2023.419.426.

ABSTRACT

&lt;b&gt;Background and Objective:&lt;/b&gt; Functional Voltage-Gated Sodium Channels (VGSCs) are expressed in metastatic prostate cancer (PCa) cells. A number of &lt;i&gt;in vitro&lt;/i&gt; studies have evaluated the effect of functional VGSC expression on the metastatic cell behavior of PCa cells. This study aimed to evaluate the effect of VGSC inhibition on metastatic cell behavior in PCa cells by meta-analysis. &lt;b&gt;Materials and Methods:&lt;/b&gt; Meta-analysis was performed on data taken from 13 publications that examined the effect of VGSC inhibitors on the metastatic cell behavior of metastatic PCa cells expressing functional VGSCs. The measure of effect was calculated according to the random effects model using mean differences and presented with a forest plot graph. Heterogeneity was checked using the Cochran’s Q Test (Chi-square statistic) and the I&lt;sup&gt;2&lt;/sup&gt; test statistic. In order to evaluate the objectivity, the funnels-plot graph was used. &lt;b&gt;Results:&lt;/b&gt; The g value showing the effect size was calculated as 4.49 (95% CI = 5.35-3.62) in the experiments where Tetrodotoxin (TTX) was used, which has a very high specificity for VGSCs but is not licensed for clinical use. In experiments using licensed inhibitors Lamotrigine, Oxcarbazepine, Phenytoin, Ranolazine, Riluzole and Lidocaine, the g value was 1.37 (95 % CI = 2.02-0.71). Suppression of metastatic cell behavior in both subgroups is statistically significant (p<0.00001). &lt;b&gt;Conclusion:&lt;/b&gt; Meta-analysis confirmed that VGSCs are an enhancing factor in the metastasis of PCa cells. The VGSCs appear to be an important target in the diagnosis and development of new treatment options in PCa.

PMID:37937335 | DOI:10.3923/pjbs.2023.419.426

Integr Environ Assess Manag. 2023 Nov 8. doi: 10.1002/ieam.4862. Online ahead of print.

ABSTRACT

The study is relevant as it investigates the impact of environmental factors on human health, including harmful substances, extreme temperatures, and air quality. The health status of the population in regions where many industries operate also depends on meteorological factors. The purpose of the study is to characterise and determine the influence of environmental factors (humidity, temperature, wind) and industries, including metal mining and processing regions on the health of people in the Aktobe region, Republic of Kazakhstan. The study used general theoretical methods, with the help of which the results of the meteorological service of the Aktobe region were analysed and systematised, and the experiments conducted by the branch of the National Centre of Expertise of the Committee of Sanitary and Epidemiological Control of the Ministry of Healthcare of the Republic of Kazakhstan for the Aktobe region in 2020, 2021. Statistical data on the amount of chromium, lead, and nickel in the blood, and the morbidity rate of the population were analysed. The study’s findings indicate that residents in the Aktobe region experience hypothermia during winter at temperatures between -12°C to -15°C and humidity of 81%, while summer overheating occurs at temperatures from +19.6°C to +22.5°C with humidity at 77%. These extreme temperature conditions disrupt the body’s heat exchange with the environment, impacting the respiratory and circulatory systems. Moreover, the predominantly windless conditions in the region affect the atmosphere’s self-cleaning ability, resulting in high air pollution potential throughout the year. The findings can inform strategies to improve public health and prevent diseases in industrial regions.

PMID:37937328 | DOI:10.1002/ieam.4862

Cancer Rep (Hoboken). 2023 Nov 7:e1884. doi: 10.1002/cnr2.1884. Online ahead of print.

ABSTRACT

BACKGROUND: Significant miss-expressed gene indicators contributing to cisplatin resistance in ovarian cancer have not been completely understood. It seems that several regulatory genes and signaling pathways are associated with the emergence of the chemo-resistant phenotype.

AIMS: Here, a meta-analysis approach was adopted to assess deregulated genes involved in relapse after the first line of chemotherapy (cisplatin).

METHODS AND RESULTS: To do so, six ovarian cancer libraries were gathered from GEO repository. Batch effect removal and quality assessment, and boxplots and PCA were performed using SVA and ggplot2 packages in R, respectively. Cisplatin-resistant and -sensitive ovarian cancer groups were compared with find genes with significant expression changes using linear regression models in the LIMMA R package. The significance threshold for DEGs was taken as adj p-value < .05 and – 1 > logFC > 1. A total of 261 genes were identified to have significant differential expression levels in the cisplatin-resistant versus cisplatin-sensitive group. Among the 10 top up-regulated and down-regulated genes, PITX2, SNCA, and EPHA7 (up), as well as TMEM98 (down) are indirect upstream regulators of PI3K/AKT signaling pathway, contributing greatly to the development of chemo-resistance in cancer via promoting cell proliferation, survival, and cell cycle progression as well as inhibiting apoptosis. Moreover, a comprehensive assessment of DEGs revealed the dysregulation of not only membrane ion channels KCa1.1, Kv4, and CACNB4, affecting cell excitability, proliferation, and apoptosis but also cell adhesion proteins COL4A6, EPHA3, and CD9, affecting the attachment of normal cells to ECM and apoptosis, introducing good options to reverse cisplatin resistance.

CONCLUSION: Our results predict and suggest that upstream regulators of PI3K/AKT signaling pathway, ion channels, and cell adhesion proteins play important roles in cisplatin resistance development in ovarian cancer.

PMID:37937323 | DOI:10.1002/cnr2.1884

Front Big Data. 2023 Oct 23;6:1239017. doi: 10.3389/fdata.2023.1239017. eCollection 2023.

ABSTRACT

INTRODUCTION: The main goal of this study is to develop a methodology for the organization of experimental selection of operator personnel based on the analysis of their behavior under the influence of micro-stresses.

METHODS: A human-machine interface model has been developed, which considers the change in the functional state of the human operator. The presented concept of the difficulty of detecting the object of attention contributed to developing a particular sequence of ordinary test images with stressor images included in it and presented models of the flow of presenting test images to the recipient.

RESULTS: With the help of descriptive statistics, the parameters of individual box-plot diagrams were determined, and the recipient group was clustered.

DISCUSSION: Overall, the proposed approach based on the example of the conducted grouping makes it possible to ensure the objectivity and efficiency of the professional selection of applicants for operator specialties.

PMID:37937318 | PMC:PMC10626476 | DOI:10.3389/fdata.2023.1239017

Rev Panam Salud Publica. 2023 Nov 6;47:e152. doi: 10.26633/RPSP.2023.152. eCollection 2023.

ABSTRACT

OBJECTIVE: To analyze the temporal trend of tuberculosis incidence and mortality rates in Brazil between 2011 and 2019.

METHODS: This was an ecological time series study of tuberculosis incidence and mortality rates in Brazil between 2011 and 2019. Data were extracted from the Notifiable Disease Information System and the Mortality Information System, and population estimates were from the Brazilian Institute of Geography and Statistics. Trends were analyzed by Joinpoint regression, which recognizes inflection points for temporal analysis.

RESULTS: The average incidence rate of tuberculosis in Brazil in the period was 35.8 cases per 100 000 population. From 2011 to 2015, this coefficient had an annual percentage change of -1.9% (95% CI [-3.4, -0.5]) followed by an increase of 2.4% (95% CI [0.9, 3.9]) until 2019. The average mortality rate between 2011 and 2019 was 2.2 deaths per 100 000 population, with an average annual percentage change of -0.4% (95% CI [-1.0, 0.2]). Amazonas was the only state with an increase in the annual average percentage variation for the incidence rate (3.2%; 95% CI [1.3, 5.1]) and mortality rate (2.7%; 95% CI [1.0, 4.4]) over the years, while Rio de Janeiro state had an increasing inflection for incidence from 2014 to 2019 (2.4%; 95% CI [1.4, 3.5]) and annual average of decreasing percentage variation (-3.5%; 95% CI [-5.0, -1.9]).

CONCLUSIONS: During the period analyzed, a decreasing trend in incidence was observed between 2011 and 2015, and an increasing trend for the period from 2015 to 2019. On the other hand, no change in the trend for mortality was found in Brazil.

PMID:37937313 | PMC:PMC10627430 | DOI:10.26633/RPSP.2023.152

BMJ Open Sport Exerc Med. 2023 Nov 3;9(4):e001685. doi: 10.1136/bmjsem-2023-001685. eCollection 2023.

ABSTRACT

AIM: Little is known about the relationship between personal factors and perception of hip-related function among patients with chronic hip-related groin pain (HRGP) seeking non-operative management. This analysis was performed to determine if depressive symptoms, central sensitisation, movement evoked pain (MEP), pressure hypersensitivity and activity level were associated with patients’ perception of hip-related function, represented by the International Hip Outcome Tool (iHOT-33).

METHODS: This cross-sectional study used baseline data from a pilot randomised clinical trial. Participants had anterior hip symptoms for at least 3 of the past 12 months reproduced on examination. Depressive symptoms, central sensitisation and activity level were quantified with self-report questionnaires. MEP was assessed during step down and squat. Pain pressure threshold (PPT) was used to assess pressure hypersensitivity. Statistical analysis was performed to assess bivariate association between variables and independent association of variables with iHOT-33.

RESULTS: Data from 33 participants (aged 18-40 years) with HRGP were analysed. Greater depressive symptoms (r_s=-0.48, p=0.005), higher MEP during step down (r_s=-0.36, p=0.040) and squat (r_s=-0.39, p=0.024), and greater central sensitisation (r_s=-0.33, p=0.058) were associated with lower (worse) iHOT-33 scores. Greater depressive symptoms (β=-0.47, 95% CI -0.76 to -0.17; p=0.003) and higher MEP during squat (β=-0.38, 95% CI -0.68 to -0.08; p=0.014) accounted for 37% of variability in iHOT-33. After adjusting for depressive symptoms and MEP, PPT, central sensitisation symptoms and activity level were not associated iHOT-33.

CONCLUSIONS: In patients with HRGP seeking non-operative management, greater depressive symptoms and MEP are independently associated with worse self-perceived hip function.

TRIAL REGISTRATION NUMBER: NCT03959319.

PMID:37937305 | PMC:PMC10626773 | DOI:10.1136/bmjsem-2023-001685