Nevin Manimala

J Appl Physiol (1985). 2022 Nov 10. doi: 10.1152/japplphysiol.00113.2022. Online ahead of print.

ABSTRACT

In healthy individuals, loading inspiratory muscles by brief inspiratory occlusion produces a short-latency inhibitory reflex (IR) in the electromyographic activity (EMG) of scalene and diaphragm muscles. This IR may play a protective role to prevent aspiration and airway collapse during sleep. In people with motor and sensory complete cervical spinal cord injury (cSCI), who were able to breathe independently, this IR was predominantly absent. Here, we investigated the reflex response to brief airway occlusion in 16 participants with sensory incomplete cSCI (American Spinal Injury Association Impairment Scale (AIS) score B or C). Surface EMG was recorded from scalene muscles and the lateral chest wall (overlying diaphragm). The airway occlusion evoked a small change in mouth pressure resembling a physiological occlusion. The short-latency IR was present in 10 (63%) sensory incomplete cSCI participants; significantly higher than the IR incidence observed in complete cSCI participants in our previous study (14%; p=0.003). When present, mean IR latency across all muscles was 58 ms (range 29-79 ms) and mean rectified EMG amplitude decreased to 37% pre-occlusion levels. Participants without an IR had untreated severe obstructive sleep apnoea (OSA), in contrast to those with an IR, who had either had no, mild or treated OSA (p=0.002). Insufficient power did not allow statistical comparison between IR presence, or absence and participant clinical characteristics. In conclusion, spared sensory connections or intersegmental connections may be necessary to generate the IR. Future studies to establish whether IR presence is related to respiratory morbidity in the tetraplegic population are required.

PMID:36356259 | DOI:10.1152/japplphysiol.00113.2022

Obstet Gynecol. 2022 Sep 1;140(3):519-520. doi: 10.1097/AOG.0000000000004910.

NO ABSTRACT

PMID:36356240 | DOI:10.1097/AOG.0000000000004910

Scand J Work Environ Health. 2022 Nov 10:4069. doi: 10.5271/sjweh.4069. Online ahead of print.

ABSTRACT

OBJECTIVE: Jobs characterized by low job demands and high job resources are associated with better work outcomes, yet it remains unclear whether this is the case for workers with depression. This study examined whether depression moderates the relationship between job demands, job resources, and maintaining employment.

METHODS: Data from the longitudinal population-based Lifelines cohort study were matched with register data on employment from Statistics Netherlands (N=55 950). Job demands included quantitative demands and work pace; job resources included influence at work and possibilities for development. The two-way interaction between job demands and depression and the three-way interaction between job demands, job resources and depression were examined in a zero-inflated Poisson regression model with path 1, including a binary employment outcome, and path 2, a count variable including months out of employment.

RESULTS: The interaction effect of job demands and depression on being employed was significant [b=-0.22, 95% confidence interval (CI) -0.44‒0.01]. Workers without depression were more likely to be employed whereas workers with depression were less likely to be employed if they had high job demands. The three-way interaction between job demands, job resources, and depression was significant for months out of employment (b=0.15, 95% CI 0.01‒0.29), indicating that workers with depression had more months out of employment when reporting high job demands and high job resources compared to workers without depression. Discussion Although increasing influence at work and possibilities for development to prevent negative work outcomes may be beneficial for workers without depression, this approach might be limited for workers with depression.

PMID:36356230 | DOI:10.5271/sjweh.4069

J Biomed Mater Res B Appl Biomater. 2022 Nov 10. doi: 10.1002/jbm.b.35193. Online ahead of print.

ABSTRACT

The use of inert head materials such as ceramic heads has been proposed as a method of reducing wear and corrosion products from the articulating surfaces in total hip arthroplasty, as well as from the stem-head taper connection. The aim of the present study was to compare the blood metal ion levels in patients with Oxinium and CoCrMo modular femoral heads, as well as monoblock stainless steel Charnley prostheses at 10 years postoperatively. The 150 patients with osteoarthritis of the hip joint included in a randomized clinical trial were grouped according to femoral head material. One group (n = 30) had received the Charnley monoblock stainless steel stem (DePuy, UK). The other patients (n = 120) received a Spectron EF CoCrMo stem with either a 28 mm CoCrMo or Oxinium modular head (Smith & Nephew, USA). After 10 years, 38 patients had withdrawn, 19 deceased, 7 revised due to aseptic loosening and 5 revised due to infection. The 81 patients with median age of 79 years (70-91) were available for whole blood metal ion analysis. The levels of Co, Cr, Ni and Zr in the blood were generally low with all the head materials (medians <0.3 micrograms/L) and no statistical difference between the groups were found (p = .2-.8). Based on the low blood metal ion values in our study groups, no indication of severe trunnion corrosion in patients with CoCrMo heads was observed, neither was there any beneficial reduction in metal ion exposure with the Oxinium femoral heads.

PMID:36356214 | DOI:10.1002/jbm.b.35193

Ophthalmic Plast Reconstr Surg. 2022 Oct 20. doi: 10.1097/IOP.0000000000002292. Online ahead of print.

ABSTRACT

PURPOSE: This is a multicenter prospective cohort study investigating Müller muscle conjunctival resection success rates based on marginal reflex distance-1 (MRD1) and symmetry criteria. A secondary objective was to identify predictors of success.

METHODS: One hundred fifty-two patients with unilateral or bilateral blepharoptosis (229 eyelids) undergoing Müller muscle conjunctival resection were consecutively recruited from 2015 to 2020 at the Université de Montréal and University of California San Francisco. Ptosis was defined as MRD1 ≤ 2.0 mm or MRD1 > 1 mm lower than the contralateral eyelid. Patients were selected for Müller muscle conjunctival resection surgery if they demonstrated significant eyelid elevation following phenylephrine 2.5% testing. MRD1 success (operated eyelid achieving MRD1 ≥ 2.5 mm) and symmetry success (patient achieving an intereyelid MRD1 difference ≤ 1 mm) were evaluated for the patient cohort. Predictors of MRD1 and symmetry success were analyzed using multivariate regression analysis.

RESULTS: MRD1 success was achieved in 72.1% (n = 165) of 229 operated eyelids. Symmetry success was achieved in 75.7% (n = 115) of 152 patients. MRD1 before phenylephrine testing was the only statistically significant predictor of MRD1 success (odds ratio [OR] 2.69, p = 0.001). Symmetry following phenylephrine testing was the only variable associated with increased odds of symmetry success (OR 2.71, p = 0.024), and unilateral surgery (OR 0.21, p = 0.004), the only variable associated with reduced odds of symmetry success.

CONCLUSIONS: Müller muscle conjunctival resection effectively achieves postoperative MRD1 and symmetry success. MRD1 before phenylephrine testing is the strongest determinant of MRD1 success. Neither a large rise in MRD1 with phenylephrine nor increasing tissue resection length adequately counterbalance the effect of a low MRD1 before phenylephrine. Unilateral surgery and the absence of symmetry following phenylephrine predict greater odds of symmetry failure.

PMID:36356179 | DOI:10.1097/IOP.0000000000002292

J Phys Chem B. 2022 Nov 10. doi: 10.1021/acs.jpcb.2c04986. Online ahead of print.

ABSTRACT

MA’AT analysis uses ensembles of redundant experimental NMR spin-coupling constants, parametrized J-coupling equations obtained from density functional theory (DFT) calculations, and circular statistics to produce probability distributions of molecular torsion angles in solution and information on librational motions about these angles (Meredith et al., J. Chem. Info. Model. 2022, 62, 3135-3141). Current DFT methods give nearly quantitative two- and three-bond J_HH, J_CH, and ¹J_CC values for use in MA’AT analysis of saccharides. In contrast, the accuracy of DFT-calculated one-bond ¹J_CH and ¹J_CC values is more difficult to determine, preventing their use in MA’AT modeling. This report describes experimental and computational studies that address this problem using two approaches (Strategies 1 and 2). Differences [¹J_CH^calc – ¹J_CH^exp] (Strategy 1) ranged from -1.2 to 2.5 Hz, giving an average difference of 0.8 ± 1.7 Hz. Percent differences ranged from -0.8% to 1.6%, giving an average % difference of 0.5 ± 1.1%. In comparison, [¹J_CH^MA’AT – ¹J_CH^exp] (Strategy 2) ranged from -1.8 to 0.2 Hz, giving an average difference of -1.2 ± 0.7 Hz. Percent differences ranged from -1.2% to 0.1%, giving an average % difference of -0.8 ± 0.5%. Strategy 1 gave an average difference of 2.1 Hz between calculated and experimental ¹J_CC values, with an average % difference of 5.1 ± 0.2%. Calculated ¹J_CC values were consistently larger than experimental values. Strategy 2 also gave calculated ¹J_CC values that were larger than the experimental values, with an average difference of 2.3 ± 0.6 Hz, and an average % difference of 5.6 ± 1.6%. The findings of both strategies are similar and indicate that ¹J_CH values in saccharides can be calculated nearly quantitatively, but ¹J_CC values appear to be consistently overestimated by ∼5% using current DFT methods.

PMID:36356177 | DOI:10.1021/acs.jpcb.2c04986

JBRA Assist Reprod. 2022 Nov 10. doi: 10.5935/1518-0557.20220035. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to analyze the efficacy of the dual trigger (human chorionic gonadotropin (hCG) + GnRH agonists) compared to the conventional trigger (hCG) in terms of oocyte retrieval (number and oocyte maturity), fertilization rate or number of embryos with two pronuclei, number of high-quality embryos, number of transferred embryos, number of cryopreserved embryos, implantation rate, positive β-hCG rate, ongoing pregnancy rate, abortion rate, and live birth rate.

METHODS: This search performed in this systematic review included all literature published in the PubMed database of studies on controlled ovarian stimulation with dual trigger compared with conventional trigger. The meta-analysis included clinical trials and prospective cohort studies.

RESULTS: Statistically significant differences between groups (dual trigger vs. hCG trigger) in terms of number of oocytes retrieved and live birth rate favored the dual trigger protocol. No statistically significant differences were found in the other studied variables. A tend favoring the dual trigger protocol was observed in all studied parameters.

CONCLUSIONS: Dual trigger seems to be more effective in GnRH antagonist cycles in terms of embryo and pregnancy outcome.

PMID:36356171 | DOI:10.5935/1518-0557.20220035

Swiss Med Wkly. 2022 Nov 10;152:40005. doi: 10.57187/smw.2022.40005.

ABSTRACT

BACKGROUND: In Switzerland, as in various other countries throughout the world, elderly drivers have to pass a medical screening assessment every two years to keep their driver’s licence. The scientific literature shows no clear evidence that these policies improve road safety. This study evaluated the effects of the Swiss screening policy by comparing the accident and injury rates of elderly road users in Switzerland with those in Austria and Germany, two neighbouring countries without systematic age-based screening policies. The aims of this study were to examine if the screening policy is associated with a reduced risk of elderly car drivers causing serious accidents (research question 1) or with an increased risk of elderly pedestrians or (e-)cyclists being seriously or fatally injured (research question 2).

METHODS: In all three countries, data on accidents were taken from official statistics based on police reports and mileage data from national mobility surveys. An accident was defined as serious if at least one person is seriously or fatally injured in it. Accident and injury rates were calculated using distances driven and population size as measurement of exposure. Multiple Poisson regression models were used to examine the association between the Swiss policy and the accident or injury risk of elderly persons.

RESULTS: We found no association between the screening policy for elderly drivers in Switzerland and their risk of causing a serious accident (incidence rate ratio [IRR] 1.24, 95% confidence interval [CI] 0.79-1.94). Contrary to other studies, however, the Swiss policy was not associated with an increased risk of elderly pedestrians (IRR 1.16, 95% CI 0.80-1.68) and (e-)cyclists (IRR 0.79, 95% CI 0.56-1.12) being seriously or fatally injured.

CONCLUSIONS: The intended positive effect of the Swiss screening policy on accident rates of elderly drivers could not be demonstrated in this study. These findings serve as a basis for discussion on how to proceed with the policy in the future.

PMID:36356168 | DOI:10.57187/smw.2022.40005

Science. 2022 Nov 11;378(6620):650-654. doi: 10.1126/science.add5399. Epub 2022 Nov 3.

ABSTRACT

A black hole x-ray binary (XRB) system forms when gas is stripped from a normal star and accretes onto a black hole, which heats the gas sufficiently to emit x-rays. We report a polarimetric observation of the XRB Cygnus X-1 using the Imaging X-ray Polarimetry Explorer. The electric field position angle aligns with the outflowing jet, indicating that the jet is launched from the inner x-ray-emitting region. The polarization degree is 4.01 ± 0.20% at 2 to 8 kiloelectronvolts, implying that the accretion disk is viewed closer to edge-on than the binary orbit. These observations reveal that hot x-ray-emitting plasma is spatially extended in a plane perpendicular to, not parallel to, the jet axis.

PMID:36356134 | DOI:10.1126/science.add5399

Diabetes Care. 2022 Nov 10:dc221148. doi: 10.2337/dc22-1148. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether use of glucagon-like peptide 1 (GLP-1) receptor agonists (RA) is associated with increased risk of thyroid cancer.

RESEARCH DESIGN AND METHODS: A nested case-control analysis was performed with use of the French national health care insurance system (SNDS) database. Individuals with type 2 diabetes treated with second-line antidiabetes drugs between 2006 and 2018 were included in the cohort. All thyroid cancers were identified through hospital discharge diagnoses and medical procedures between 2014 and 2018. Exposure to GLP-1 RA was measured within the 6 years preceding a 6-month lag-time period and considered as current use and cumulative duration of use based on defined daily dose (≤1, 1 to 3, >3 years). Case subjects were matched with up to 20 control subjects on age, sex, and length of diabetes with the risk-set sampling procedure. Risk of thyroid cancer related to use of GLP-1 RA was estimated with a conditional logistic regression with adjustment for goiter, hypothyroidism, hyperthyroidism, other antidiabetes drugs, and social deprivation index.

RESULTS: A total of 2,562 case subjects with thyroid cancers were included in the study and matched with 45,184 control subjects. Use of GLP-1 RA for 1-3 years was associated with increased risk of all thyroid cancer (adjusted hazard ratio [HR] 1.58, 95% CI 1.27-1.95) and medullary thyroid cancer (adjusted HR 1.78, 95% CI 1.04-3.05).

CONCLUSIONS: In the current study we found increased risk of all thyroid cancer and medullary thyroid cancer with use of GLP-1 RA, in particular after 1-3 years of treatment.

ARTICLE HIGHLIGHTS: Preclinical studies suggest that GLP-1 receptor agonists have specific effects on the thyroid gland, potentially involving the development of thyroid cancer. Studies on this subject produced conflicting results, potentially due to a lack of statistical power. The results of this nationwide population-based study suggest that use of GLP-1 receptor agonists is associated with increased risk of thyroid cancer. The increased risk was higher in the case of 1-3 years of GLP-1 receptor agonist use. Clinicians should be aware of this potential risk in initiating a GLP-1 receptor agonist and carefully monitor exposed patients.

PMID:36356111 | DOI:10.2337/dc22-1148