Nevin Manimala

Dis Esophagus. 2021 Apr 24:doab021. doi: 10.1093/dote/doab021. Online ahead of print.

ABSTRACT

INTRODUCTION: The prognostic value of histomorphologic regression in primary esophageal cancer has been previously established, however the impact of lymph node (LN) response on survival still remains unclear. The aim of this review was to assess the prognostic significance of LN regression or downstaging following neoadjuvant therapy for esophageal cancer.

METHODS: An electronic search was performed to identify articles evaluating LN regression or downstaging after neoadjuvant therapy. Random effects meta-analyses were performed to assess the influence of regression in the LNs and nodal downstaging on overall survival. Histomorphologic tumor regression in LNs was defined by the absence of viable cells or degree of fibrosis on histopathologic examination. Downstaged LNs were defined as pN0 nodes by the tumor, node, and metastasis classification, which were positive prior to treatment neoadjuvant.

RESULTS: Eight articles were included, three of which assessed tumor regression (number of patients = 292) and five assessed downstaging (number of patients = 1368). Complete tumor regression (average rate of 29.1%) in the LNs was associated with improved survival, although not statistically significant (hazard ratio [HR] = 0.52, 95% confidence interval [CI] = 0.26-1.06; P = 0.17). LNs downstaging (average rate of 32.2%) was associated with improved survival compared to node positivity after neoadjuvant treatment (HR = 0.41, 95%CI = 0.22-0.77; P = 0.005).

DISCUSSION: The findings of this meta-analysis have shown a survival benefit in patients with LN downstaging and are suggestive for considering LN downstaging to ypN0 as an additional prognostic marker in staging and in the comparative evaluation of differing neoadjuvant regimens in clinical trials. No statistically significant effect of histopathologic regression in the LNs on long-term survival was seen.

PMID:33893494 | DOI:10.1093/dote/doab021

Eur J Clin Nutr. 2021 Apr 23. doi: 10.1038/s41430-021-00910-9. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to investigate the predictive potential of early pregnancy factors such as lifestyle, gestational weight gain (GWG) and mental well-being on gestational diabetes mellitus (GDM) beyond established risk factors.

METHODS: GDM risk was investigated in the cohort of the German ‘Gesund leben in der Schwangerschaft’/healthy living in pregnancy study. Women were recruited up to the 12^th week of gestation. GDM was diagnosed with a 75 g oral glucose tolerance test between the 24^th and 28^th weeks of gestation. Pre-pregnancy age and weight, mental health and lifestyle were assessed via questionnaires. Maternal weight was measured throughout pregnancy. Early excessive GWG was defined based on the guidelines of the Institute of Medicine. The association between several factors and the odds of developing GDM was assessed using multiple logistic regression analyses.

RESULTS: Of 1694 included women, 10.8% developed GDM. The odds increased with pre-pregnancy BMI and age (women with obesity: 4.91, CI 3.35-7.19, p < 0.001; women aged 36-43 years: 2.84, CI 1.45-5.56, p = 0.002). Early excessive GWG, mental health and general lifestyle ratings were no significant risk factors. A 31% reduction in the odds of GDM was observed when <30% of energy was consumed from fat (OR 0.69, CI 0.49-0.96, p = 0.026). Vigorous physical activity tended to lower the odds without evidence of statistical significance (OR 0.59 per 10 MET-h/week, p = 0.076).

CONCLUSIONS: Maternal age and BMI stand out as the most important drivers of GDM. Early pregnancy factors like dietary fat content seem to be associated with GDM risk. Further evaluation is warranted before providing reliable recommendations.

PMID:33893447 | DOI:10.1038/s41430-021-00910-9

Sci Rep. 2021 Apr 23;11(1):8871. doi: 10.1038/s41598-021-88266-9.

ABSTRACT

In this paper, we analyse the seismic noise at Ischia Island (Italy) with the objective of detecting the hydrothermal source signals taking advantage of the Covid-19 quiescence due to lockdown (strong reduction of anthropogenic noise). We compare the characteristics of the background noise in pre-, during and post-lockdown in terms of spectral content, energy release (RMS) and statistical moments. The continuous noise is decomposed into two independent signals in the 1-2 Hz and 2-4 Hz frequency bands, becoming sharpened around 1 Hz and 3 Hz respectively in lockdown. We propose a conceptual model according to which a dendritic system of fluid-permeated fractures plays as neighbour closed organ pipes, for which the fundamental mode provides the persistent whisper and the first higher mode is activated in concomitance with energy increases. By assuming reasonable values for the sound speed in low vapor-liquid mass fraction for a two-phase fluid and considering temperatures and pressures of the shallow aquifer fed by sea, meteoric and deep hydrothermal fluids, we estimate pipe lengths in the range 200-300 m. In this scheme, Ischia organ-like system can play both continuous whisper and transients, depending on the energy variations sourced by pressure fluctuations in the hydrothermal fluids.

PMID:33893368 | DOI:10.1038/s41598-021-88266-9

Sci Rep. 2021 Apr 23;11(1):8812. doi: 10.1038/s41598-021-87956-8.

ABSTRACT

The current research explores incremental effect of thermal radiation on heat transfer improvement corresponds to Darcy-Forchheimer (DF) flow of carbon nanotubes along a stretched rotating surface using RSM. Casson carbon nanotubes’ constructed model in boundary layer flow is being investigated with implications of both single-walled CNTs and multi-walled CNTs. Water and Ethylene glycol are considered a basic fluid. The heat transfer rate is scrutinized via convective condition. Outcomes are observed and evaluated for both SWCNTs and MWCNTs. The Runge-Kutta Fehlberg technique of shooting is utilized to numerically solve transformed nonlinear ordinary differential system. The output parameters of interest are presumed to depend on governing input variables. In addition, sensitivity study is incorporated. It is noted that sensitivity of SFC via SWCNT-Water becomes higher by increasing values of permeability number. Additionaly, sensitivity of SFC via SWCNT-water towards the permeability number is higher than the solid volume fraction for medium and higher permeability levels. It is also noted that sensitivity of SFC (SWCNT-Ethylene-glycol) towards volume fraction is higher for increasing permeability as well as inertia coefficient. Additionally, the sensitivity of LNN towards the Solid volume fraction is higher than the radiation and Biot number for all levels of Biot number. The findings will provide initial direction for future device manufacturing.

PMID:33893354 | DOI:10.1038/s41598-021-87956-8

Nat Commun. 2021 Apr 23;12(1):2435. doi: 10.1038/s41467-021-22757-1.

ABSTRACT

Antibiotic resistance spreads among bacteria through horizontal transfer of antibiotic resistance genes (ARGs). Here, we set out to determine predictive features of ARG transfer among bacterial clades. We use a statistical framework to identify putative horizontally transferred ARGs and the groups of bacteria that disseminate them. We identify 152 gene exchange networks containing 22,963 bacterial genomes. Analysis of ARG-surrounding sequences identify genes encoding putative mobilisation elements such as transposases and integrases that may be involved in gene transfer between genomes. Certain ARGs appear to be frequently mobilised by different mobile genetic elements. We characterise the phylogenetic reach of these mobilisation elements to predict the potential future dissemination of known ARGs. Using a separate database with 472,798 genomes from Streptococcaceae, Staphylococcaceae and Enterobacteriaceae, we confirm 34 of 94 predicted mobilisations. We explore transfer barriers beyond mobilisation and show experimentally that physiological constraints of the host can explain why specific genes are largely confined to Gram-negative bacteria although their mobile elements support dissemination to Gram-positive bacteria. Our approach may potentially enable better risk assessment of future resistance gene dissemination.

PMID:33893312 | DOI:10.1038/s41467-021-22757-1

Nat Commun. 2021 Apr 23;12(1):2463. doi: 10.1038/s41467-021-22613-2.

NO ABSTRACT

PMID:33893282 | DOI:10.1038/s41467-021-22613-2

J Contemp Dent Pract. 2020 Dec 1;21(12):1379-1383.

ABSTRACT

AIM AND OBJECTIVE: To compare the effectiveness of three irrigation systems, namely, Endovac system, Max I probe, and Navitip FX, in reduction of Enterococcus faecalis population from the root canal using agar diffusion method.

MATERIALS AND METHODS: Sixty extracted intact human permanent maxillary anterior teeth were selected for this study. In group I, root canals were irrigated using brush covered 30-gauge NaviTipFX. Ultradent in group II root canals was irrigated using brush covered 30-gauge Max-I-Probe Dentsply. In group III, root canals were irrigated using Endoactivator, Dentsply. In group IV, root canal was irrigated by using the Endovac system Sybronendo. The steps followed in the study include preparation of specimen, contamination of the samples followed by conduction of testing procedures with implementation of appropriate irrigation protocols, and sampling procedures.

RESULTS: Data were subjected to statistical analysis to interpret the significant differences among various irrigation systems. One-way analysis of variance, Post hoc Tukey tests were used for statistical analysis in the present study. Among the experimental groups, group IV showed statistically significant difference in reduction of E. faecalis. There were no statistical differences between them in reduction of E. faecalis in group I and group II compared and represented in Tables 1 and 2.

CONCLUSION: All four irrigation delivery systems have been found to be effective in the reduction of E. faecalis. Endovac showed comparable efficacy in reduction of colony-forming units to that of other delivery systems used in the study. The result has to be validated with in vivo studies and clinical trials of larger sample size.

CLINICAL SIGNIFICANCE: Selection of appropriate irrigation system capable of disinfection of canal complexities in apical third with less adverse effects is essential for good clinical success of endodontic treatment.

PMID:33893262

J Contemp Dent Pract. 2020 Dec 1;21(12):1374-1378.

ABSTRACT

AIM AND OBJECTIVE: The present study compared the fracture strength and failure pattern of endodontically treated, bi-rooted, maxillary premolars with different number of coronal walls and postendodontic restoration (one vs double post).

MATERIALS AND METHODS: 105 premolars were divided into 3 groups according to the number of residual walls: control group (intact teeth; n = 15), group 1 (3 residual walls; n = 45), group 2 (2 residual walls; n = 45). Each test group was then divided into 3 subgroups (n = 15 each) according to postendodontic restoration: no post (A), 1 post (B) or 2 posts (C). A load was applied parallel to the longitudinal axis of the teeth, thus simulating physiological occlusion. ANOVA and Tukey’s tests were used to detect fracture strength differences among groups, while Chi-square test was used to check differences in fracture pattern.

RESULTS: No significant differences were observed between control group (intact teeth) and groups A1 (p = 0.999), B1 (p = 0.997) and C1 (p = 1.000); statistically significant differences were detected between control group and groups A2 (p < 0.001), B2 (p < 0.001) and C2 (p < 0.05). Different post placement techniques were non-significantly associated with fracture pattern in both groups 1 (p = 0.666) and 2 (p = 0.143) while, irrespective of the number of posts, the presence of the post was significantly associated with the fracture pattern in teeth with two residual walls. The double-post technique did not further improve the fracture resistance of hardly damaged endodontically treated maxillary bi-rooted premolars compared to single-post technique. Therefore, the insertion of a single post in the palatal canal could be a safer and more conservative choice.

CLINICAL SIGNIFICANCE: The double-post technique did not further improve the fracture resistance of severely structurally compromised endodontically treated maxillary premolars with two roots compared to the single-post technique. Therefore, the safer and less invasive treatment is the placement of a single post in the palatal canal.

PMID:33893261

J Contemp Dent Pract. 2020 Dec 1;21(12):1368-1373.

ABSTRACT

AIM AND OBJECTIVE: To evaluate the marginal adaptation at the tooth-restoration interface at enamel and cementum margins using composite restoration reinforced with novel enamel inserts/biofillers.

MATERIALS AND METHODS: Standardized class V box-shaped cavities were prepared in 40 extracted maxillary first premolar teeth which were divided randomly into four experimental groups consisting of 10 samples each. Group I: Bulk placement. Groups II: Horizontal incremental technique. Group III: Restoration with precured composite balls (megafillers). Group IV: Restoration with biofillers. All the cavities were restored with visible light-activated direct restorative nanocomposite. The specimens were thermocycled for 24 hours. After thermocycling, the samples were immersed in a 1% methylene blue for 4 hours and subsequently evaluated for microleakage. Microleakage scores (0-4) were obtained from gingival margins of class V restorations and analyzed by statistical analysis. Evaluation of the data was performed by Kruskal-Wallis one-way analysis of variance (ANOVA), and Mann-Whitney U tests.

RESULTS: Microleakage scores have indicated restorations with biofillers showed best results followed by megafillers, incremental horizontal build-up, and bulk filling.

CONCLUSION: Biofillers provide a novel approach in improving microleakage and marginal adaptability of composite resin restorations.

CLINICAL SIGNIFICANCE: Incorporation of inserts, which are capable of adequate bonding to resin and tooth, may provide improved marginal adaptability and reduce microleakage around restorative margins.

PMID:33893260

Anat Sci Educ. 2021 Apr 23. doi: 10.1002/ase.2093. Online ahead of print.

ABSTRACT

The state of alarm due to Covid-19 pandemic in Spain stopped all educational and most university research activities. The Spanish Anatomical Society (SAE) Consensus Expert Group on Body Donations piloted a study based on a questionnaire to know the status of body donations and dissection activities during the lockdown, as well as the future implications of Covid-19 pandemic for body donation programs and Anatomy teaching. The questionnaire results show that Spanish Universities refused body donations and stopped all dissection research and teaching. The Covid-19 expected influence on Anatomy teaching was referred to the increase of teaching workforce and resources required to apply the new safety measures to future practical activities, as well as to prepare and adapt teaching material for online-only programs. The application of reinforced safety measures was expected to be perceived by the respondent’s students as a gain in teaching quality, while the transformation of the anatomy courses in online-only programs will be perceived as a quality decrease. The respondent’s concerns about future institutional implications of the pandemic were related to increased costs of the adaptation of the facilities and the reinforced preventive measures, as well as the eventual decrease in donations. The complete lockdown applied on dissection rooms is not justified by scientific evidence and represents a break of the confidence deposed in the institutions by the donors. A consensus is required for the adoption of a renewed, comprehensive protocol for present and future body donations including the evidence Covid-19 pandemic has contributed to create.

PMID:33891806 | DOI:10.1002/ase.2093