Nevin Manimala

Biosens Bioelectron. 2021 Nov 17:113810. doi: 10.1016/j.bios.2021.113810. Online ahead of print.

ABSTRACT

Exploring reliable and highly-sensitive SARS-CoV-2 antibody diagnosis by point-of-care (POC) manner, holds great public health significance for extensive COVID-19 screening and controlling. Unfortunately, the currently applied gold based lateral flow immunoassay (GLFIA) may expose both false-negative and false-positive interpretations owing to the sensitivity and specificity limitations, which may cause significant risk and waste of public resources for large population screening. To simultaneously overcome the drawbacks of GLFIA, a novel fluorescent LFIA based on signal amplification and dual-antigen sandwich structure was established with largely improved sensitivity and specificity. The compact three-dimensional incorporation of hydrophobic quantum dots within dendritic affinity templates and multilayer surface derivation guaranteed a high and robust fluorescence of single label, which lowered the false negative rate of GLFIA prominently. A dual-antigen sandwich structure using labeled/immobilized SARS-CoV-2 spike receptor binding domain antigen for capturing total human SARS-CoV-2 antibody was developed, instead of general indirect antibody capturing approach, to reduce the false positive rate of GLFIA. Over 300 cases of COVID-19 negative and 97 cases of COVID-19 positive samples, the current assay revealed a 100% sensitivity and 100% specificity confirmed by both polymerase chain reaction (PCR) and chemiluminescence immunoassay (CLIA), compared with the considerable misinterpretation cases by currently applied GLFIA. The quantitative results verified by receiver operating characteristic curve and other statistical analysis indicated a well-distinguished positive/negative sample groups. The proposed strategy is highly sensitive towards low concentrated SARS-CoV-2 antibody serums and highly specific towards serums from COVID-19 negative persons and patients infected by other viruses.

PMID:34840014 | DOI:10.1016/j.bios.2021.113810

Nutr Metab Cardiovasc Dis. 2021 Sep 16:S0939-4753(21)00446-4. doi: 10.1016/j.numecd.2021.09.006. Online ahead of print.

ABSTRACT

AIMS: The impact of behavioural risk factors on the metabolic syndrome has not been well understood by the researchers. This information is important to the policymakers for developing effective strategies and implement relevant policies or programs. Hence, we undertook this meta-analysis to estimate the effect of behavioural risk factors on the burden of metabolic syndrome.

DATA SYNTHESIS: We conducted a search in the databases, such as PubMed Central, EMBASE, MEDLINE, and Cochrane library, and search engines, such as ScienceDirect and Google Scholar, from inception until March 2021. We used the Newcastle-Ottawa Scale (NOS) to assess the quality of published studies. We carried out a meta-analysis with random-effects model and reported pooled odds ratio (OR) with 95% confidence interval (CI). In total, we analysed 30 studies with 41,090 participants. The majority of the studies had good to satisfactory quality as per NOS. Physical activity had a statistically significant association with the prevalence of metabolic syndrome (pooled OR = 1.57; 95%CI: 1.28 to 1.93, I² = 91%). However, smoking (pooled OR = 0.96; 95%CI: 0.75 to 1.23, I² = 90.5%) and alcohol (pooled OR = 1.00; 95%CI: 0.75 to 1.33, I² = 90.8%) did not reveal a statistically significant association with the burden of metabolic syndrome.

CONCLUSION: Physical inactivity was found to be a significant risk factor for metabolic syndrome. Given the evidence, it is important that the clinicians and policymakers are alike to recommend regular physical activity among the patients and general population.

PMID:34840004 | DOI:10.1016/j.numecd.2021.09.006

J Fr Ophtalmol. 2021 Nov 25:S0181-5512(21)00568-4. doi: 10.1016/j.jfo.2021.08.009. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to evaluate the relationship between application of the MGDRx thermal eyebag and dry eye signs and symptoms in young and older subjects and to compare the results between the two groups.

METHODS: Thirty young, healthily volunteers between 18 and 31 years of age (23.95±3.94 years) and thirty older subjects between 61 and 90 years of age (77.97±8.11 years) participated in this study. Ocular surface parameters were assessed using the Oculus Keratograph 5M, following the guidelines of the Tear Film and Ocular Surface Dry Eye Workshop II Diagnostic Methodology report. Only subjects with a positive score on at least one questionnaire and an initial Non-Invasive Keratograph Break-Up Time (NIKBUT) under 10seconds were included in the study. After thermal bag self-application in both eyes every day for 2 weeks, the protocol was carried out again. Lid massage was performed after lid warming. Compliance and degree of improvement were also assessed.

MAIN RESULTS: The young volunteer group showed an improvement in NIKBUT, lipid layer score, upper eyelid gland drop-out percentage and dry eye symptoms over the two week treatment period. Improvements in meibum quality, gland obstruction, telangiectasia scores, and dry eye symptoms were found in the older subjects. Mixed ANOVA revealed better NIKBUT and lipid layer values in the young subjects. Despite the treatment compliance being statistically higher in the older group than in the younger subjects (P=0.002), there were no significant differences in subjective improvement between groups (P=0.097).

CONCLUSION: Dry eye-related symptoms were improved after thermal bag application, while NIKBUT and lipid layer thickness were improved only in the younger subjects.

PMID:34840000 | DOI:10.1016/j.jfo.2021.08.009

Curr Probl Diagn Radiol. 2021 Nov 2:S0363-0188(21)00167-5. doi: 10.1067/j.cpradiol.2021.10.001. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the use of virtual monoenergetic images (VMI) in pre-operative CT angiography of potential donors for living donor adult liver transplantation (LDALT), and to determine the optimal energy level to maximize vascular signal-to-noise and contrast-to-noise ratios (SNR and CNR, respectively).

MATERIALS AND METHODS: We retrospectively evaluated 29 CT angiography studies performed preoperatively in potential liver donors on a spectral detector CT scanner. All studies included arterial, early venous, and delayed venous phase imaging. Conventional polyenergetic images were generated for each patient, as well as virtual monoenergetic images in 10 keV increments from 40 -100 keV. Arteries (aorta and celiac, superior mesenteric, common hepatic, right and left hepatic arteries) were assessed on arterial phase images; portal venous system branches (splenic, superior mesenteric, main, right, and left portal veins) on early venous phase images; and hepatic veins on late venous phase images. Vascular attenuation, background parenchymal attenuation, and noise were measured on each set of virtual monoenergetic and conventional images.

RESULTS: Background hepatic and vascular noise decreased with increasing keV, with the lowest noise at 100 keV. Vascular SNR and CNR increased with decreasing keV and were highest at 40 keV, with statistical significance compared with conventional ( P < 0.05).

CONCLUSIONS: In preoperative CT angiography for potential liver donors, the optimal keV for assessing the vasculature to improve SNR and CNR is 40 keV. Use of low keV VMI in LDALT CT protocols may facilitate detection of vascular anatomical variants that can impact surgical planning.

PMID:34839975 | DOI:10.1067/j.cpradiol.2021.10.001

Food Chem. 2021 Nov 11:131586. doi: 10.1016/j.foodchem.2021.131586. Online ahead of print.

ABSTRACT

Various structural types of polysaccharides are recognized by toll-like receptor 4 (TLR4). However, the mechanism of interaction between the polysaccharides with different structures and TLR4 is unclarified. This review summarized the primary structure of polysaccharides related to TLR4, mainly including molecular weight, monosaccharide composition, glycosidic bonds, functional groups, and branched-chain structure. The optimal primary structure for interacting with TLR4 was obtained by the statistical analysis. Besides, the dual-directional regulation of TLR4 signaling cascade by polysaccharides was also elucidated from an immune balance perspective. Finally, the 3D interaction model of polysaccharides to TLR4-myeloid differentiation factor 2 (MD2) complex was hypothesized according to the LPS-TLR4-MD2 dimerization model and the polysaccharides solution conformation. The essence of polysaccharides binding to TLR4-MD2 complex is a multivalent non-covalent bond interaction. All the arguments summarized in this review are intended to provide some new insights into the interaction between polysaccharides and TLR4.

PMID:34839969 | DOI:10.1016/j.foodchem.2021.131586

Mar Pollut Bull. 2021 Nov 25:113174. doi: 10.1016/j.marpolbul.2021.113174. Online ahead of print.

ABSTRACT

Sea urchins are highly abundant in the marine ecosystem where they graze limiting algal biomass and also serving as food for other predators. In this work, the presence of microplastics in the digestive tracts and gonads of 33 Diadema africanum sea urchins collected at two sampling points in Tenerife (Canary Islands, Spain) was studied. After separation and digestion of the digestive tracts and the gonads, the visualization of the filtrates under the stereomicroscope revealed the presence of 320 items which were microfibers (97.5%), fragments (1.9%) and films (0.6%), mainly blue (43.3 and 47.0% in the two sampling points, Tajao and El Porís, respectively) and translucent white (32.5 and 39.5%, respectively). Statistical analysis revealed that there were no significative differences in the contents of gonads and digestive tracts between both sampling locations. Regarding microfibers lengths, significative differences were only observed between the two sampling points, not between tissues. μRaman analysis showed that they were mainly cellulosic (46.0%), polypropylene (24.3%) and polyethylene terephthalate (24.3%). This study confirms for the first time the presence of microplastics in sea urchins from the Macaronesian region and also from Spain.

PMID:34839951 | DOI:10.1016/j.marpolbul.2021.113174

J Mol Diagn. 2021 Dec;23(12):1732-1740. doi: 10.1016/j.jmoldx.2021.08.013.

ABSTRACT

Complex insertion-deletion (indel) events in the globin genes manifest in widely variable clinical phenotypes. Many are incompletely characterized because of a historic lack of efficient methods. A more complete assessment enables improved prediction of clinical impact, which guides emerging therapeutic choices. Current methods have limited capacity for breakpoint assignment and accurate assessment of mutation extent, especially in cases containing duplications or multiple deletions and insertions. Technology, such as long-read sequencing, holds promise for significant impact in the characterization of indel events because of read lengths that span large regions, resulting in improved resolution. Four known complex β-globin gene cluster indel types were assessed using single-molecule, real-time sequencing technology and showed high correlation with previous reports, including the Caribbean locus control deletion (g.5,305,478_5,310,336del), a large β-gene duplication containing the Hb S mutation (g.4,640,335_5,290,171dup with g.5,248,232T>A, c.20A>T; variant allele fraction, 64%), and two nested variants (double deletions with intervening inversion): the Indian ^Gγ(^Aγδβ)⁰-thalassemia (g.5,246,804-5,254,275del, g.5,254,276_5,269,600inv, and g.5,269,601_5,270,442del) and the Turkish/Macedonian (δβ)⁰ thalassemia (g.5,235,064_5,236,652del, g.5,236,653_5,244,280inv, and g.5,244,281_5,255,766del). Our data confirm long-read sequencing as an efficient and accurate method to identify these clinically significant complex events. Limitations include high-complexity sample preparation requirements, which hinder routine use in clinical laboratories. Continued improvements in sample and data workflow processes are needed to accommodate volumes in a tertiary clinical laboratory.

PMID:34839893 | DOI:10.1016/j.jmoldx.2021.08.013

Med Intensiva (Engl Ed). 2021 Dec;45(9):516-531. doi: 10.1016/j.medine.2021.03.001.

ABSTRACT

OBJECTIVE: The “Open Lung Approach” (OLA), that includes high levels of positive end-expiratory pressure coupled with limited tidal volumes, is considered optimal for adult patients with ARDS. However, many previous meta-analyses have shown only marginal benefits of OLA on mortality but with statistical heterogeneity. It is crucial to identify the most likely moderators of this effect. To determine the effect of OLA strategy on mortality of ventilated ARDS patients. We hypothesized that the degree of recruitment achieved in the control group (PaO₂/FiO₂ ratio on day 3 of ventilation), and the difference in Mechanical Power (MP) or Driving Pressure (DP) between experimental and control groups will be the most likely sources of heterogeneity.

DESIGN: A Systematic Review and Meta-analysis was performed according to PRISMA statement and registered in PROSPERO database. We searched only for randomized controlled trials (RCTs). GRADE guidelines were used for rating the quality of evidence. Publication bias was assessed. For the Meta-analysis, we used a Random Effects Model. Sources of heterogeneity were explored with Meta-Regression, using a priori proposed set of possible moderators. For model comparison, Akaike’s Information Criterion with the finite sample correction (AICc) was used.

SETTING: Not applicable.

PATIENTS: Fourteen RCTs were included in the study.

INTERVENTIONS: Not applicable.

MAIN VARIABLES OF INTEREST: Not applicable.

RESULTS: Evidence of publication bias was detected, and quality of evidence was downgraded. Pooled analysis did not show a significant difference in the 28-day mortality between OLA strategy and control groups. Overall risk of bias was low. The analysis detected statistical heterogeneity. The two “best” explicative meta-regression models were those that used control PaO₂/FiO₂ on day 3 and difference in MP between experimental and control groups. The DP and MP models were highly correlated.

CONCLUSIONS: There is no clear benefit of OLA strategy on mortality of ARDS patients, with significant heterogeneity among RCTs. Mortality effect of OLA is mediated by lung recruitment and mechanical power.

PMID:34839883 | DOI:10.1016/j.medine.2021.03.001

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021 Sep;33(9):1110-1115. doi: 10.3760/cma.j.cn121430-20210402-00497.

ABSTRACT

OBJECTIVE: To investigate the possible mechanism of ultrasound therapy in the rat model of sepsis.

METHODS: Seventy-eight male Sprague-Dawley (SD) rats were randomly divided into Sham group (n = 12), septic model group (n = 22), ultrasound treatment group (n = 22), methyllycaconitine citrate (MLA) combined with ultrasound treatment group (n = 22). In the Sham group, only the abdomen was opened, the cecum was found to be free, without cecal ligation and puncture (CLP). In the septic model group, CLP was used to replicate the septic rat model. After operation, each group of rats were subcutaneously injected with preheated 37 centigrade normal saline. The rats in the ultrasound treatment group were treated with ultrasound [Philips IU22 L9-3 ultrasound instrument and 9 MHz probe were used to break the sequence in the spleen area once every 6 seconds, with 1 second for each time, the mechanical index (MI) was 0.72, and the treatment time was 10 minutes]. In the MLA combined with ultrasound treatment group, α7 nicotinic acetylcholine receptor (α7nAChR) specific blocker MLA 4 mg/kg was injected intraperitoneally 30 minutes before operation, and ultrasound treatment was performed 2 hours after operation. The levels of tumor necrosis factor-α (TNF-α) and interleukin (IL-1β, IL-6) in serum of each group were measured by enzyme-linked immunosorbent assay (ELISA) at 24 hours after operation. The 10-day survival rate of each group was recorded, and the symptoms of each group were evaluated by clinical disease score (CDS). The histopathological changes of lung and colon were observed under light microscope.

RESULTS: Compared with the Sham group, the 10-day survival rate of rats in the septic model group was decreased significantly [40% (4/10) vs. 100% (6/6)], the CDS was (10.73±2.19 vs. 6.17±0.58) and the levels of TNF-α, IL-6, and IL-1β were increased significantly at 24 hours after operation [TNF-α (ng/L): 42.00±8.92 vs. 13.16±3.19, IL-6 (ng/L): 129.37±25.04 vs. 63.99±12.92, IL-1β (ng/L): 254.98±67.27 vs. 76.83±25.39, all P < 0.01]. Compared with the septic model group, the survival rate in the ultrasound treatment group was improved [70% (7/10) vs. 40% (4/10)], but there was no significant difference (P > 0.05). The CDS (7.64±2.68 vs. 10.73±2.19) and the expressions of TNF-α, IL-6, and IL-1β were significantly reduced at 24 hours after operation [TNF-α (ng/L): 16.93±6.02 vs. 42.00±8.92, IL-6 (ng/L): 73.65±24.38 vs. 129.37±25.04, IL-1β (ng/L): 111.86±14.08 vs. 254.98±67.27, all P < 0.01]. Compared with the ultrasound treatment group, the survival rate in the MLA combined with ultrasound treatment group was reduced [60% (6/10) vs. 70% (7/10)], but the difference was not statistically significant (P > 0.05). CDS was significantly increased (9.55±2.72 vs. 7.64±2.68), and the levels of TNF-α, IL-6 and IL-1β were significantly increased at 24 hours after operation [TNF-α (ng/L): 34.61±7.89 vs. 16.93±6.02, IL-6 (ng/L): 112.92±10.42 vs. 73.65±24.38, IL-1β (ng/L): 212.57±32.16 vs. 111.86±14.08, all P < 0.01]. Microscopically, in the septic model group, the alveolar septum was thickened, a large number of inflammatory cells infiltrated, normal pulmonary reticular structure disappeared, and pulmonary interstitium showed obvious hemorrhage and edema, meanwhile, the structure of colonic villi was obviously abnormal, with cells were edema and inflammatory cell infiltration, and the arrangement was disordered, so that the subepithelial space and the top of it fell off. After ultrasound treatment, the thickness of the alveolar interval in rats was similar to that in Sham group, without obvious inflammatory cell infiltration, and the pulmonary reticular structure was relatively intact. At the same time, the morphology of colonic villi was basically normal and orderly, the edema of cell was not obvious, and subcutaneous space and tip fall off were not obvious. After being antagonized by MLA, the rat lung tissue showed thickened alveolar septum, inflammatory cell infiltration, incomplete pulmonary network structure, hemorrhage and edema in the interstitium. The villi structure of the colon was faintly visible, with obvious cell edema and inflammatory cell infiltration, and the arrangement was abnormal.

CONCLUSIONS: Ultrasound treatment improves the prognosis of septic rats, MLA can reverse the anti-inflammatory effect of ultrasound therapy by antagonizing α7nAChR, suggesting that the protective mechanism of ultrasound in sepsis may be related to activating the cholinergic anti-inflammatory pathway mediated by α7nAChR.

PMID:34839871 | DOI:10.3760/cma.j.cn121430-20210402-00497

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021 Sep;33(9):1084-1087. doi: 10.3760/cma.j.cn121430-20210425-00608.

ABSTRACT

OBJECTIVE: To observe the clinical effect of the cannula under laparoscopy, percutaneous puncture cannula, and conventional surgery cannula for peritoneal dialysis.

METHODS: From May 3, 2015 to February 14, 2020, 87 patients with end-stage renal disease needing peritoneal dialysis in Ningbo Zhenhai People’s Hospital were enrolled. These patients were divided into three groups including cannula under laparoscopy (23 cases), percutaneous puncture cannula (29 cases), and conventional surgery cannula (35 cases). The baseline characteristics, perioperative conditions (surgical time, post-surgical hospitalization time), the incidence of recent complications (abdominal hemorrhage, direct abdominal hemorrhage, incision pain, leakage, catheter shift, peritonitis), and long-term complications (catheter shift, peritonitis, hernia, thoracic and abdominal fistula, abdominal tube obstruction) among the three groups were compared.

RESULTS: Compared with the group of conventional surgery cannula, the operation time in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly shorter (minutes: 32.5±12.3, 28.9±11.8 vs. 61.3±15.4, both P < 0.05), the in-hospital stay in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were reduced (days: 9.8±3.4, 9.2±2.6 vs. 10.7±3.2), but there was no statistical significance among the three groups (P > 0.05). The incidence of abdominal bleeding, rectus abdominis bleeding, and incision pain in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly lower than those in the group of conventional surgery cannula [incidence of abdominal bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of rectus abdominis bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of incision pain: 8.7% (2/23), 10.3% (3/29) vs. 42.9% (15/35), all P < 0.01]. The difference between the group of cannula under laparoscopy and the group of percutaneous puncture cannula had no statistical significance. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 27.6% (8/29), 31.4% (11/35), both P < 0.05]. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in long-term complications in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 24.1% (7/29), 31.4% (11/35), both P < 0.05], however, the difference of that between the group of conventional surgery cannula and the group of percutaneous puncture cannula was not statistically significant. The incidence of hernia in the group of cannula under laparoscopy was significantly higher than that in the group of percutaneous puncture cannula or in the group of conventional surgery cannula [21.7% (5/23) vs. 3.4% (1/29), 2.8% (1/35), both P < 0.05], and all of that were umbilical hernia, however, the difference of that between the group of percutaneous puncture cannula and the group of conventional surgery cannula was not statistically significant.

CONCLUSIONS: Compared with the traditional conventional surgical cannula placement methods, percutaneous puncture has the advantages of simple operation, short operation time, small trauma, but still cannot reduce the incidence of drift tube; laparoscopic peritoneal dialysis tube has the advantages of short operation time, small trauma and low catheter displacement rate, but increases the risk of umbilical hernia.

PMID:34839866 | DOI:10.3760/cma.j.cn121430-20210425-00608