Nevin Manimala

Obstet Gynecol. 2022 Oct 6. doi: 10.1097/AOG.0000000000004953. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare trend of primary cesarean delivery rate and composite neonatal and maternal adverse outcomes in low-risk pregnancies among racial and ethnic groups: non-Hispanic White, non-Hispanic Black, and Hispanic.

METHODS: This population-based cohort study used U.S. vital statistics data (2015-2019) to evaluate low-risk, nulliparous patients with nonanomalous singletons who labored and delivered at 37-41 weeks of gestation. The primary outcome was the primary cesarean delivery rate. Secondary outcomes included composite neonatal adverse outcome (Apgar score less than 5 at 5 minutes, assisted ventilation for more than 6 hours, seizure, or death), and composite maternal adverse outcome (intensive care unit admission, blood transfusion, uterine rupture, or unplanned hysterectomy), as well as infant death. Multivariable Poisson regression models were used to estimate adjusted relative risks (aRR) and 95% CIs.

RESULTS: Among 4.3 million births, 60.6% identified as non-Hispanic White, 14.6% identified as non-Hispanic Black, and 24.8% identified as Hispanic. The rate of primary cesarean delivery was 18.5% (n=804,155). An increased risk for cesarean delivery was found in non-Hispanic Black (21.7%, aRR 1.24, 95% CI 1.23-1.25) and Hispanic (17.3%, aRR 1.09, 95% CI 1.09-1.10) individuals, compared with non-Hispanic White individuals (18.1%) after multivariable adjustment. There was an upward trend in the rate of primary cesarean delivery in all racial and ethnic groups (P for linear trend<0.001 for all groups). However, the racial and ethnic disparity in the rate of primary cesarean delivery remained stable during the study period. The composite neonatal adverse outcome was lower in Hispanic individuals in all newborns (10.7 vs 8.3 per 1,000 live births, aRR 0.74, 95% CI 0.72-0.75), and in newborns delivered by primary cesarean delivery (18.5 vs 15.0 per 1,000 live births, aRR 0.73, 95% CI 0.70-0.76), compared with non-Hispanic White individuals.

CONCLUSION: Using a nationally representative sample in the United States, we found racial and ethnic disparities in the primary cesarean delivery rate in low-risk nulliparous patients, which persisted throughout the study period.

PMID:36201767 | DOI:10.1097/AOG.0000000000004953

Retina. 2022 Oct 3. doi: 10.1097/IAE.0000000000003639. Online ahead of print.

ABSTRACT

PURPOSE: To describe characteristics of indocyanine green (ICG) angiographic plaques in the nonexudative fellow eye of Caucasian patients with unilateral treatment-naïve exudative neovascular age-related macular degeneration (nAMD) through optical coherence tomography (OCT) and OCT angiography (OCTA).

METHODS: In this retrospective cross-sectional study, nonexudative eyes with ICG angiographic plaques were analyzed by OCT B-scans for the sensitivity of a double-layer sign (DLS), a pigment epithelium detachment (PED), outer retinal atrophy (ORA), hyperreflective dots (HRD) and subretinal hyperreflective material (SRHM). The ICG angiographic plaque was matched with a macular neovascularization (MNV) in OCTA en-face scans and color-coded B-scans.

RESULTS: In total, 35 ICG angiographic plaques in 33 of 291 (11%) nonexudative eyes were diagnosed. OCT revealed: 27 DLS (78%), 8 PED (23%), 8 ORA (23%), 8 HRD (23%), 1 SRHM (3%). OCTA confirmed a MNV in 28 plaques (80%): 7 (20%) in en-face scans, 3 (9%) in color-coded B-scans and 18 (51%) in both. The area size in OCTA was significantly smaller as compared to ICG angiography (p=0,002).

CONCLUSION: The diagnosis of an ICG angiographic plaque in nonexudative fellow eyes of Caucasians with unilateral treatment-naïve exudative nAMD was highly suggestive of a typical MNV type 1 as characterized by OCT and OCTA.

PMID:36201752 | DOI:10.1097/IAE.0000000000003639

N Z Med J. 2022 Oct 7;135(1563):62-69.

ABSTRACT

AIMS: The aims of this study were to quantify the burden, and the cost of health loss, following hospitalisation for major trauma in New Zealand.

METHOD: Hospitalised major trauma patients injured between July 2017 and June 2020 were extracted from the New Zealand Trauma Registry. Case-mix of major trauma in each year was summarised using descriptive statistics. Disability-adjusted life years (DALYs) were calculated for the cohort. A cost per DALY was applied to estimate the cost of health loss.

RESULTS: A total of 6,629 major trauma cases were recorded, rising from 2,072 in 2017-2018 to 2,191 in 2019-2020. The patient case-mix remained relatively consistent over the timeframe while the in-hospital mortality rate declined from 9.2% to 7.3%. Hospitalised major trauma patients accrued 22,718 DALYs (average 7,573 DALYs per year) at an estimated health loss cost of $1.02 billion ($341 million per year). The cost of health loss per case declined from $162,747 in 2017-2018 to $143,577 in 2019-2020.

CONCLUSION: The burden of major trauma is high. As injury is a preventable condition, the findings highlight the need for dedicated investment in both primary prevention and trauma care in New Zealand to reduce these avoidable costs.

PMID:36201731

N Z Med J. 2022 Oct 7;135(1563):52-61.

ABSTRACT

AIM: The safety of dabigatran is poorly studied in patients with liver cirrhosis and has rarely been compared to warfarin in terms of bleeding risks.

METHOD: We undertook a retrospective cohort study across three tertiary centres in Auckland, New Zealand, between 2008 to 2020. Adults 18 years and over and those with a clinically confirmed diagnosis of cirrhosis were included. Data collected included demographic data and clinical characteristics, baseline medication and comorbidities. The primary outcome measure was the incidence of any bleeding event that resulted in hospital admission.

RESULTS: Overall, 100 patients were included in this study. A total of 52 patients took warfarin, and 48 took dabigatran. Baseline characteristics for both groups were generally similar. The incidence rate of bleeds for patients taking warfarin was 14.4 per 100 person-years (95% CI, 8.8-23.5) compared to 9.1 per 100 person-years (95% CI, 4.5-18.1) for patients taking dabigatran. The incidence rate ratio comparing dabigatran to warfarin was 0.63 (95% CI, 0.23-1.60), p=0.25.

CONCLUSION: Our study found that patients on dabigatran may have a lower bleeding risk than patients taking warfarin, but this was not statistically significant.

PMID:36201730

PLoS One. 2022 Oct 6;17(10):e0275195. doi: 10.1371/journal.pone.0275195. eCollection 2022.

ABSTRACT

Plasmodium falciparum is a parasitic protozoan that can cause malaria, which is a deadly disease. Therefore, the accurate identification of malaria parasite mitochondrial proteins is essential for understanding their functions and identifying novel drug targets. For classifying protein sequences, several adaptive statistical techniques have been devised. Despite significant gains, prediction performance is still constrained by the lack of appropriate feature descriptors and learning strategies in current systems. Moreover, good ground truth data is important for Artificial Intelligence (AI)-based models but there is a lack of that data in the literature. Therefore, in this work, we propose a novel hybrid network that combines 1D Convolutional Neural Network (CNN) and Bidirectional Gated Recurrent Unit (BGRU) to classify the malaria parasite mitochondrial proteins. Furthermore, we curate a sequential data that are collected from National Center for Biotechnology Information (NCBI) and UniProtKB/Swiss-Prot proteins databanks to prepare a dataset that can be used by the research community for AI-based algorithms evaluation. We obtain 4204 cases after preprocessing of the collected data and denote this set of proteins as PF4204. Finally, we conduct an ablation study on several conventional and deep models using PF4204 and the benchmark PF2095 datasets. The proposed model ‘CNN-BGRU’ obtains the accuracy values of 0.9096 and 0.9857 on PF4204 and PF2095 datasets, respectively. In addition, the CNN-BGRU is compared with state-of-the-arts, where the results illustrate that it can extract robust features and identify proteins accurately.

PMID:36201724 | DOI:10.1371/journal.pone.0275195

J Craniofac Surg. 2022 Oct 1;33(7):2272-2275. doi: 10.1097/SCS.0000000000008747. Epub 2022 Aug 1.

ABSTRACT

This study aimed to investigate the effects of systemic irisin hormone application on new bone formation in peri-implant bone defects. After surgically creating peri-implant bone defects in the metaphyseal part of the tibiae of rats, the rats were randomly divided into 2 equal groups: a control group and an irisin group. In the control group, the rats received no further treatment during the 4-week experimental period after the surgery. The rats in the irisin group, 100 ng/kg irisin was administered intraperitoneally 3 days a week during the 8 weeks experimental period after the surgery. At the end of the experimental period, the rats were euthanized. Implants and surrounding bone tissues were collected for histological new bone formation analysis. The Student t test was used for statistical analysis. There were no significant differences between the groups in the histological analysis, new bone formation and fibrosis (P>0.05). Also, in the irisin group, there was numerically but not statistically more new bone formation detected compared with the controls. Within the limitations of this study, irisin did not affect new bone formation in peri-implant defects, although the numerical values favored the irisin group.

PMID:36201689 | DOI:10.1097/SCS.0000000000008747

Int J Environ Health Res. 2022 Oct 6:1-17. doi: 10.1080/09603123.2022.2130881. Online ahead of print.

ABSTRACT

This study aims to evaluate the extent to which virtual reality (VR) natural and built settings affect emotional states. Web of Science, SCOPUS, and PubMed were searched for relevant articles prior to February 2022. Of 15 articles identified for systematic review, 6 met the inclusion criteria for meta-analysis (studies with only pre- and post-condition measures of the Positive and Negative Affect Schedule (PANAS) were included). Both positive affect (g = 0.20, p = 0.001) and negative affect (g = – 0.30, p = 0.001) change scores for the VR natural environment were statistically significant. On the other hand, change scores for VR built environment were not significant in both positive affect (g = – 0.08, p = 0.355) and negative affect (g = – 0.08, p = 0.058). The findings revealed that, in addition to a VR natural environment, a VR built environment is capable of providing restorative experiences against negative mood in some circumstances.

PMID:36201684 | DOI:10.1080/09603123.2022.2130881

Environ Sci Technol. 2022 Oct 6. doi: 10.1021/acs.est.2c06211. Online ahead of print.

ABSTRACT

Methane mitigation from the oil and gas (O&G) sector represents a key near-term global climate action opportunity. Recent legislation in the United States requires updating current methane reporting programs for oil and gas facilities with empirical data. While technological advances have led to improvements in methane emissions measurements and monitoring, the overall effectiveness of mitigation strategies rests on quantifying spatially and temporally varying methane emissions more accurately than the current approaches. In this work, we demonstrate a quantification, monitoring, reporting, and verification framework that pairs snapshot measurements with continuous emissions monitoring systems (CEMS) to reconcile measurements with inventory estimates and account for intermittent emission events. We find that site-level emissions exhibit significant intraday and daily emission variations. Snapshot measurements of methane can span over 3 orders of magnitude and may have limited application in developing annualized inventory estimates at the site level. Consequently, while official inventories underestimate methane emissions on average, emissions at individual facilities can be higher or lower than inventory estimates. Using CEMS, we characterize distributions of frequency and duration of intermittent emission events. Technologies that allow high sampling frequency such as CEMS, paired with a mechanistic understanding of facility-level events, are key to an accurate accounting of short-duration, episodic, and high-volume events that are often missed in snapshot surveys and to scale snapshot measurements to annualized emissions estimates.

PMID:36201663 | DOI:10.1021/acs.est.2c06211

Clin Transl Gastroenterol. 2022 Oct 6. doi: 10.14309/ctg.0000000000000540. Online ahead of print.

ABSTRACT

BACKGROUND: We compared esophageal mucosal gene transcript expression in proton pump inhibitor (PPI) responsive (PPI-R) eosinophilic esophagitis (EoE), PPI non-responsive (PPI-NR) EoE, and healthy controls.

METHODS: Transcript expression in mid-esophagus biopsies was determined using Nanostring and a custom panel of EoE-specific genes. The top up/downregulated genes with ≥2-fold difference in expression and statistically significant (P<0.05) were identified.

RESULTS: Nearly all of the top upregulated (17 out of 20) and downregulated (5 out of 5) genes in EoE, compared to healthy controls, were shared between the PPI-R and PPI-NR groups.

CONCLUSION: Esophageal mucosal transcript expressions are remarkably similar in PPI-R and PPI-NR EoE compared to healthy controls.

PMID:36201660 | DOI:10.14309/ctg.0000000000000540

Eye Contact Lens. 2022 Oct 6. doi: 10.1097/ICL.0000000000000939. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effects of the systemic diseases and drugs of the donor on Descemet membrane (DM) graft preparation.

METHODS: Seventy-eight corneas of 58 donors, of whom the DM grafts were used in Descemet membrane endothelial keratoplasty (DMEK) surgery, between January 2018 and January 2020, were enrolled in this retrospective study. The hospital records of the donors were analyzed. Age, sex, blood type, systemic diseases, and drugs; complete blood count; biochemistry panel for liver and kidney functions in the past 48 hours; and the drugs used in the hospital, if any, in the past 24 hours were recorded. The grafts with tears that occurred while preparation were included in group 1, and the successful grafts with no tears were included in group 2.

RESULTS: There were no statistically significant differences in the characteristics of the donors between groups. However, breast cancer and the use of sevelamer were found to be significantly higher in group 1 (P=0.010, P=0.033, respectively). No statistically significant difference in the use of other drugs was found between groups.

CONCLUSION: Although diabetic donors have been reported to be inappropriate candidates for the preparation of DM grafts for DMEK, most of the donors with several systemic diseases including diabetes can be used in DMEK surgery, with the right technique in DM graft preparation.

PMID:36201646 | DOI:10.1097/ICL.0000000000000939