Nevin Manimala

BMC Pregnancy Childbirth. 2022 Jul 21;22(1):581. doi: 10.1186/s12884-022-04884-9.

ABSTRACT

BACKGROUND AND OBJECTIVE: More than five million individuals died because of problems connected to COVID-19. SARS-Cov-2 poses a particular challenge to expectant mothers, who comprise one of the most vulnerable segments of the population. Our aim is to demonstrate the maternal and neonatal safety of the COVID-19 vaccine during pregnancy.

METHODS: We searched PubMed, Cochrane Library, Scopus, Web of Science (WOS), Embase, Ovid, MedRxiv, and BioRxiv databases from inception till December 2021 and then updated it in April 2022. Additionally, we searched ClinicalTrials.gov, Research Square and grey literature. Cohort, case-control studies, and randomized controlled trials detecting the safety of the Covid-19 vaccine during pregnancy were included. We used the Cochrane tool and Newcastle-Ottawa Scale to assess the risk of bias of the included studies and the GRADE scale to assess the quality of evidence. A meta-analysis was conducted using review manager 5.4.

RESULTS: We included 13 studies with a total number of 56,428 patients. Our analysis showed no statistically significant difference in the following outcomes: miscarriage (1.56% vs 0.3%. RR 1.23; 95%CI 0.54 to 2.78); length of maternal hospitalization (MD 0.00; 95%CI -0.08 to 0.08); puerperal fever (1.71% vs 1.1%. RR 1.04; 95%CI 0.67 to 1.61); postpartum hemorrhage (4.27% vs 3.52%. RR 0.84; 95%CI 0.65 to 1.09); instrumental or vacuum-assisted delivery (4.16% vs 4.54%. RR 0.94; 95%CI 0.57 to 1.56); incidence of Apgar score ≤ 7 at 5 min (1.47% vs 1.48%. RR 0.86; 95%CI 0.54 to 1.37); and birthweight (MD -7.14; 95%CI -34.26 to 19.99).

CONCLUSION: In pregnancy, the current meta-analysis shows no effect of SAR-CoV-2 vaccination on the risk of miscarriage, length of stay in the hospital, puerperal fever, postpartum hemorrhage, birth weight, or the incidence of an Apgar score of ≤ 7 at 5 min.

PMID:35864455 | DOI:10.1186/s12884-022-04884-9

BMC Med Res Methodol. 2022 Jul 21;22(1):199. doi: 10.1186/s12874-022-01670-1.

ABSTRACT

INTRODUCTION: Studying the relationship between unemployment and health raises many methodological challenges. In the current study, the aim was to evaluate the sensitivity of estimates based on different ways of measuring unemployment and the choice of statistical model.

METHODS: The Northern Swedish cohort was used, and two follow-up surveys thereof from 1995 and 2007, as well as register data about unemployment. Self-reported current unemployment, self-reported accumulated unemployment and register-based accumulated unemployment were used to measure unemployment and its effect on self-reported health was evaluated. Analyses were conducted with G-computation, logistic regression and three estimators for the inverse probability weighting propensity scores, and 11 potentially confounding variables were part of the analyses. Results were presented with absolute differences in the proportion with poor self-reported health between unemployed and employed individuals, except when logistic regression was used alone.

RESULTS: Of the initial 1083 pupils in the cohort, our analyses vary between 488-693 individuals defined as employed and 61-214 individuals defined as unemployed. In the analyses, the deviation was large between the unemployment measures, with a difference of at least 2.5% in effect size when unemployed was compared with employed for the self-reported and register-based unemployment modes. The choice of statistical method only had a small influence on effect estimates and the deviation was in most cases lower than 1%. When models were compared based on the choice of potential confounders in the analytical model, the deviations were rarely above 0.6% when comparing models with 4 and 11 potential confounders. Our variable for health selection was the only one that strongly affected estimates when it was not part of the statistical model.

CONCLUSIONS: How unemployment is measured is highly important when the relationship between unemployment and health is estimated. However, misspecifications of the statistical model or choice of analytical method might not matter much for estimates except for the inclusion of a variable measuring health status before becoming unemployed. Our results can guide researchers when analysing similar research questions. Model diagnostics is commonly lacking in publications, but they remain very important for validation of analyses.

PMID:35864450 | DOI:10.1186/s12874-022-01670-1

BMC Bioinformatics. 2022 Jul 21;23(1):288. doi: 10.1186/s12859-022-04826-4.

ABSTRACT

BACKGROUND: Methods for the multiview clustering and integration of multi-omics data have been developed recently to solve problems caused by data noise or limited sample size and to integrate multi-omics data with consistent (common) and differential cluster patterns. However, the integration of such data still suffers from limited performance and low accuracy.

RESULTS: In this study, a computational framework for the multiview clustering method based on the penalty model is presented to overcome the challenges of low accuracy and limited performance in the case of integrating multi-omics data with consistent (common) and differential cluster patterns. The performance of the proposed method was evaluated on synthetic data and four real multi-omics data and then compared with approaches presented in the literature under different scenarios. Result implies that our method exhibits competitive performance compared with recently developed techniques when the underlying clusters are consistent with synthetic data. In the case of the differential clusters, the proposed method also presents an enhanced performance. In addition, with regards to real omics data, the developed method exhibits better performance, demonstrating its ability to provide more detailed information within each data type and working better to integrate multi-omics data with consistent (common) and differential cluster patterns. This study shows that the proposed method offers more significant differences in survival times across all types of cancer.

CONCLUSIONS: A new multiview clustering method is proposed in this study based on synthetic and real data. This method performs better than other techniques previously presented in the literature in terms of integrating multi-omics data with consistent and differential cluster patterns and determining the significance of difference in survival times.

PMID:35864439 | DOI:10.1186/s12859-022-04826-4

Eur Arch Paediatr Dent. 2022 Jul 21. doi: 10.1007/s40368-022-00734-6. Online ahead of print.

ABSTRACT

OBJECTIVE: Physical and mechanical properties of three different (Ketac Molar Easymix, Dyract XP, Cention N (CN)) restoratives with different ingredients were evaluated.

MATERIALS AND METHODS: Four groups were obtained; Group 1: CN LightCure, Group 2: CN SelfCure, Group 3: Ketac Molar Easymix and Group 4: Dyract XP. Disk-shaped samples (n = 10) were prepared and evaluated for the surface roughness test using a profilometer. For the flexure strength test, 2 × 2 × 25 mm bar-shaped samples (n = 10) were prepared, and a three-point bending test was applied to the samples. After preparing cavities for microleakage tests, teeth were restored with restoratives, immersed in dye, and microleakage was assessed. For the microtensile bond strength (µTBS) test, ten sticks were obtained for each group and were stressed under tension.

RESULTS: According to surface roughness tests, CN SelfCure showed the lowest value (0.13 μm), while Ketac Molar Easymix showed the highest value (0.28 μm), and significant differences were found between the groups. In flexural strength tests, the highest values were seen in CN SelfCure (82.94 MPa), with statistically significant differences between the groups. When CN SelfCure was applied with an adhesive, the teeth showed statistically decreased leakage than other groups on the gingival side. Higher leakage values were seen on the gingival side than the occlusal side in most groups, and the SelfCure groups showed decreased leakage than the LightCure groups. According to µTBS tests, the highest value was obtained in CN SelfCure-Adhesive group, while the lowest was in CN LightCure-Non-adhesive group. When µTBS was evaluated regardless of adhesive use, the SelfCure groups showed higher µTBS values than the LightCure groups. As a result of the µTBS and microleakage test, the difference between the use of CN with and without adhesive, regardless of the polymerization type, was found to be significant (p < 0.05).

CONCLUSION: Cention N showed better properties in SelfCure mode, compared to the rest materials tested, but further in vitro and in vivo studies are needed to investigate the effect of different polymerization modes and the oral environmental conditions.

PMID:35864436 | DOI:10.1007/s40368-022-00734-6

Acta Neurol Belg. 2022 Jul 21. doi: 10.1007/s13760-022-02030-y. Online ahead of print.

ABSTRACT

OBJECTIVES: In this study, we aimed to evaluate the clinical significance of osmophobia and its effect on quality of life in people with migraine.

METHODS: A total of 145 people with migraine were included in this cross-sectional study. Patients were evaluated with the migraine data form, the Migraine 24-Hour Quality of Life Questionnaire (24-HrMQoLQ), the Migraine Disability Assessment Scale (MIDAS), the Patient Health Questionnaire-9 (PHQ-9), the Insomnia Severity Index (ISI), the Generalized Anxiety Disorder-7 (GAD-7), the Allodynia Symptom Checklist (ASC), and the Fatigue Severity Scale (FSS). To evaluate the presence of osmophobia retrospectively, a semi-structured interview was conducted with the patients by the neurologist.

RESULTS: The mean 24-Hr-MQoLQ of patients with osmophobia was significantly lower than those without osmophobia. The decrease in the 24-Hr-MQoLQ was statistically significant in the areas of feeling and concerns and social functionality. The mean of the MIDAS scale was higher significantly in patients with osmophobia than those without osmophobia. In addition, the mean ISI, PHQ-9, FSS and ASC scores of patients with osmophobia were statistically significantly higher than those without osmophobia.

CONCLUSIONS: Both 24-h and 3-month quality of life of people with migraine with osmophobia were more affected than those without osmophobia. At the same manner, insomnia, depression, fatigue and allodynia were observed at higher rates in people with migraine with osmophobia than in migraine without osmophobia. Osmophobia, which is one of the specific symptoms that distinguishes migraine from other headache disorders, deserves further and multifaceted investigation.

PMID:35864435 | DOI:10.1007/s13760-022-02030-y

Interact Cardiovasc Thorac Surg. 2022 Jul 21:ivac200. doi: 10.1093/icvts/ivac200. Online ahead of print.

ABSTRACT

OBJECTIVES: The standard approach for minimaly invasive cardiac surgery for repair of the atrioventricular valves is a right lateral minithoracotomy. In this study we report our experience with a periareolar endoscopic approach which aims at an optimal cosmetic outcome while preserving optimal clinical outcomes.

METHODS:  All patients underwent periareolar endoscopic minimaly invasive cardiac surgery using high-definition three-dimensional endoscopic visualization without additional rib-spreading. Patients presented with degenerative and/or functional mitral regurgitation. Patients undergoing concomitant tricuspid valve surgery, cryo-ablation, patent foramen ovale closure, left atrial appendage occlusion and/or left atrial myxoma extirpation were included. This descriptive paper analyzed the aesthetic and functional outcome of the periareolar scar using five most common and clinimetrically sound scar assessment scales. For statistical analysis of the scar assessment grading scales, box and whisker plots were calculated depicting median, interquartile range and high and low range data points.

RESULTS: Median scar assessment scale scores for n = 100 male patients (response-rate 100/109; 91.7%) were 2 [1, 4], 7.5 [6, 9], 11 [8, 14], 3 [2, 3], 10 [9, 11] for the Vancouver Scar Scale, Manchester Scar Scale, Patient Scar Assessment Scale, Stony Brook Scar Evaluation Scale, and Dermatology Quality of Life Index scales, respectively. 97 patients received mitral valve repair, 7 mitral valve replacement, whereas 5 had left atrial myxoma extirpation. Concomitant tricuspid annuloplasty, cryo-ablation, left atrial appendage occlusion and patent foramen ovale closure surgery were performed in 12, 29, 5 and 8 patients, respectively. Median procedure-, cardiopulmonary bypass-, and cross-clamp times were 169.5 [154.3, 189.3], 111.5 [97, 127], and 68.5 [58.8, 81] min, respectively.

CONCLUSIONS: Periareolar endoscopic minimaly invasive cardiac surgery is safe and cosmetically appealing. It is feasible and allows for complex mitral valve repair, mitral valve replacement and concomitant surgery. Data from five scar assessment scales suggest that this technique delivers patient-satisfying results regarding functional and cosmetic outcome.

PMID:35863058 | DOI:10.1093/icvts/ivac200

Jpn J Clin Oncol. 2022 Jul 22:hyac119. doi: 10.1093/jjco/hyac119. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the invasive capability and other clinicopathological features of conventional papillary thyroid carcinoma (CVPTC) with intraglandular lymphatic dissemination.

METHODS: Seventy-three conventional papillary thyroid carcinoma patients receiving total thyroidectomy were analyzed in this study. The expression of BRAF-V600E, D2-40 and CD31 in all thyroid samples was detected by immunohistochemical staining. The results were evaluated by two pathologists and were statistically analyzed. The rate of positive BRAF-V600E expression and the clinical invasiveness of CVPTC with intraglandular dissemination, multifocal non-intraglandular dissemination-CVPTC and single focus-CVPTC were evaluated. The correlation between BRAF-V600E expression, lymphatic vessel density, microvessel density and the clinicopathological characteristics of conventional papillary thyroid carcinoma were assessed.

RESULTS: Twenty-five intraglandular dissemination-CVPTC, 17 multifocal non-intraglandular dissemination-CVPTC and 31 single focus-CVPTC cases were included in this study. The results showed that BRAF-V600E expression was independently correlated with intraglandular dissemination, age and pN staging (P < 0.05). The lymphatic vessel density in the intraglandular dissemination-CVPTC group was higher than that in the non-intraglandular dissemination-CVPTC group (P < 0.05). Compared with cases without intraglandular dissemination, intraglandular dissemination-CVPTC was associated with a younger age, higher lymph node metastasis rate, pN staging, the expression of BRAF-V600E and increased Capsule invasion and lymphovascular tumor thrombus (P < 0.05). During the follow-up of 30 months (median 15 months), two patients in the intraglandular dissemination-CVPTC group had cervical lymph node metastasis after the first operation.

CONCLUSIONS: Intraglandular dissemination-CVPTC shows more aggressive features, and intraglandular lymphatic dissemination may be a potential biological indicator of poor prognosis.

PMID:35863013 | DOI:10.1093/jjco/hyac119

Microbiol Spectr. 2022 Jul 7:e0117622. doi: 10.1128/spectrum.01176-22. Online ahead of print.

ABSTRACT

Chlorhexidine (CHX) is widely used to control the spread of pathogens (e.g., human/animal clinical settings, ambulatory care, food industry). Enterococcus faecalis, a major nosocomial pathogen, is broadly distributed in diverse hosts and environments facilitating its exposure to CHX over the years. Nevertheless, CHX activity against E. faecalis is understudied. Our goal was to assess CHX activity and the variability of ChlR-EfrEF proteins (associated with CHX tolerance) among 673 field isolates and 1,784 E. faecalis genomes from the PATRIC database from different sources, time spans, clonal lineages, and antibiotic-resistance profiles. The CHX MIC (MIC_CHX) and minimum bactericidal concentration (MBC_CHX) against E. faecalis presented normal distributions (0.5 to 64 mg/L). However, more CHX-tolerant isolates were detected in the food chain and recent human infections, suggesting an adaptability of E. faecalis populations in settings where CHX is heavily used. Heterogeneity in ChlR-EfrEF sequences was identified, with isolates harboring incomplete ChlR-EfrEF proteins, particularly the EfrE identified in the ST40 clonal lineage, showing low MIC_CHX (≤1mg/L). Distinct ST40-E. faecalis subpopulations carrying truncated and nontruncated EfrE were detected, with the former being predominant in human isolates. This study provides a new insight about CHX susceptibility and ChlR-EfrEF variability within diverse E. faecalis populations. The MIC_CHX/MBC_CHX of more tolerant E. faecalis (MIC_CHX = 8 mg/L; MBC_CHX = 64 mg/L) remain lower than in-use concentrations of CHX (≥500 mg/L). However, increased CHX use, combined with concentration gradients occurring in diverse environments, potentially selecting multidrug-resistant strains with different CHX susceptibilities, signals the importance of monitoring the trends of E. faecalis CHX tolerance within a One Health approach. IMPORTANCE Chlorhexidine (CHX) is a disinfectant and antiseptic used since the 1950s and included in the World Health Organization’s list of essential medicines. It has been widely applied in hospitals, the community, the food industry, animal husbandry and pets. CHX tolerance in Enterococcus faecalis, a ubiquitous bacterium and one of the leading causes of human hospital-acquired infections, remains underexplored. Our study provides novel and comprehensive insights about CHX susceptibility within the E. faecalis population structure context, revealing more CHX-tolerant subpopulations from the food chain and recent human infections. We further show a detailed analysis of the genetic diversity of the efrEF operon (previously associated with E. faecalis CHX tolerance) and its correlation with CHX phenotypes. The recent strains with a higher tolerance to CHX and the multiple sources where bacteria are exposed to this biocide alert us to the need for the continuous monitoring of E. faecalis adaptation toward CHX tolerance within a One Health approach.

PMID:35862993 | DOI:10.1128/spectrum.01176-22

Microbiol Spectr. 2022 Jul 7:e0121822. doi: 10.1128/spectrum.01218-22. Online ahead of print.

ABSTRACT

A total of 232 goat fecal samples (124 diarrheic and 108 nondiarrheic) collected from 12 farms in Southwest China were tested for astrovirus using RT-PCR. A total of 16.9% (21/124) of diarrheic and 20.4% (22/108) of nondiarrheic samples were astrovirus-positive, and no statistical difference was found in the detection rate between healthy and sick goats. Furthermore, 28 obtained complete ORF2 sequences could be classified into six genotypes according to the species classification criteria of the International Committee on Taxonomy of Viruses (ICTV). It is worth noting that, in addition to four known caprine astrovirus genotypes (MAstV-33, MAstV-34, Caprine Astrovirus G5.1, and Caprine Astrovirus G3.1), MAstV-13 and MAstV-24 genotypes were identified in goats. Interestingly, five of 19 ORF2 sequences in the Caprine Astrovirus G3.1 genotype showed possible intragenotypic recombination events. Furthermore, nearly complete caprine astrovirus genomes of MAstV-13 and MAstV-24 genotypes were obtained. The genome of the SWUN/ECJK3/2021 strain shared the highest similarity (62.0% to 73.9%) with astrovirus in MAstV-13, and clustered in the so-called human-mink-ovine (HMO) clade, which contained the majority of the neurotropic astrovirus strains. Moreover, the SWUN/LJK2-2/2020 strain showed the highest similarity (69.7% to 78.6%) and the closest genetic relationship to the known porcine and bovine astroviruses in MAstV-24. In conclusion, this study confirmed six genotypes of astrovirus circulating among goats in Southwest China, including MAstV-13 and MAstV-24 genotypes. These findings enhance our knowledge of the prevalence and diversity of astroviruses. IMPORTANCE Caprine astrovirus is a newly emerging virus, and information regarding its prevalence and molecular characteristics remains limited. In this study, six genotypes of astrovirus, including MAstV-13 and MAstV-24, were identified in goats, adding two novel caprine astrovirus genotypes to the four previously known genotypes, thereby enriching the diversity of the caprine astrovirus. Moreover, genomes of MAstV-13 SWUN/ECJK3/2021 and MAstV-24 SWUN/LJK2-2/2020 strains were obtained from goats, which aids in the understanding of the infection spectrum and host range of the two genotypes. This study is the first to demonstrate the presence of neurotropic-like astrovirus (MAstV-13) in goats, which has significant implications for the diagnosis of neurological diseases in goats.

PMID:35862967 | DOI:10.1128/spectrum.01218-22

J Spec Oper Med. 2022 Jul 21:A10N-KTMD. doi: 10.55460/A10N-KTMD. Online ahead of print.

ABSTRACT

BACKGROUND: Transfusion of whole blood (WB) is a lifesaving treatment that prolongs life until definitive surgical intervention can be performed; however, collecting WB is a time-consuming and resource-intensive process. Furthermore, it may be difficult to collect sufficient WB at the point of injury to treat critically wounded patients or multiple hemorrhaging casualties. This study is a follow-up to the proof-of-concept study on the effect of airdrop on WB. In addition, this study confirms the statistical significance for the plausibility of using airdrop to deliver WB to combat medics treating casualties in the pre-hospital setting when Federal Drug Administration (FDA)-approved cold-stored blood products are not available.

METHODS: Forty-eight units of WB were collected and loaded into a blood cooler that was dropped from a fixed-wing aircraft under a Standard Airdrop Training Bundle (SATB) parachute or 68-in pilot chute. Twenty-four of these units were dropped from a C-145 aircraft, and 24 were dropped from a C-130 aircraft. A control group of 15 units of WB was stored in a blood cooler that was not dropped. Baseline and post-intervention laboratory tests were measured in both airdropped and control units, including complete blood count; prothrombin time/partial thromboplastin time (PT/PTT); pH, lactate, potassium, bilirubin, glucose, fibrinogen, and lactate dehydrogenase (LDH) levels; and peripheral blood smears.

RESULTS: The blood cooler, cooling packs, and all 48 WB units did not sustain any major damage from the airdrop. There was no evidence of hemolysis. Except for the one slightly damaged bag that was not sampled, all airdropped blood met parameters for transfusion per the Joint Trauma System Whole Blood Transfusion Clinical Practice Guideline and the Association for the Advancement of Blood and Biotherapies (AABB) Circular of Information for the Use of Human Blood and Blood Components.

CONCLUSIONS: Airdrop of fresh or stored WB in a blood cooler with a chute is a viable way of delivering blood products to combat medics treating hemorrhaging patients in the pre-hospital setting. This study also demonstrated the portability of this technique for multiple aircraft. The techniques evaluated in this study have the potential for utilization in other austere settings such as wilderness medicine or humanitarian disasters where an acute need for WB delivery by airdrop is the only option.

PMID:35862850 | DOI:10.55460/A10N-KTMD