Nevin Manimala

PLoS One. 2021 Oct 1;16(10):e0258049. doi: 10.1371/journal.pone.0258049. eCollection 2021.

ABSTRACT

OBJECTIVE: To assess obstetric factors associated with hysterotomy extension among women undergoing a second-stage cesarean.

STUDY DESIGN: This 5-year retrospective cohort study (2013-2017) included all women with second-stage cesarean deliveries of live-born singleton fetuses in cephalic presentation at term. It took place at a tertiary center that practices delayed pushing. We performed univariable and multivariable logistic regression to assess the maternal, obstetric, and neonatal factors associated with hysterotomy extension mentioned in the surgical report. Operative time, postpartum hemorrhage, and maternal complications were also studied.

RESULTS: Of the 3350 intrapartum cesareans, 2637 were performed at term for singleton fetuses in cephalic presentation: 747 (28.3%) during the second stage of labor, 83 (11.1%) of which were complicated by a hysterotomy extension. The median duration of the passive phase of the second stage did not differ between women with and without an extension (164 min versus 160 min, P = 0.85). No other second-stage obstetric characteristics, i.e., duration of the active phase, fetal head station, or fetal malposition, were associated with the risk of extension. Factors significantly associated with extension were the surgeon’s experience and forceps use during the cesarean. Women with an extension, compared to women without one, had a longer median operative time (49 min versus 32 min, P<0.001) and higher rates of postpartum hemorrhage and blood transfusion (respectively, 30.1% versus 15.1%, p = 0.002 and 7.2% versus 2.4%, P = 0.03).

CONCLUSION: The risk of a hysterotomy extension does not appear to be associated with second-stage obstetric characteristics, including the duration of the passive phase of this stage. In our center, which practices delayed pushing, prolonging this passive phase beyond 2 hours does not increase the risk of hysterotomy extension in second-stage cesareans.

PMID:34597319 | DOI:10.1371/journal.pone.0258049

Pediatr Endocrinol Diabetes Metab. 2021 Oct 1:44673. doi: 10.5114/pedm.2021.107717. Online ahead of print.

ABSTRACT

INTRODUCTION: Numerous studies have demonstrated the clinical benefits of using continuous glucose monitoring (CGM) systems among patients with type 1 diabetes (T1D). Aim of the study was to assess the effectiveness of CGM on metabolic control in children with T1D and well-controlled disease prior to the study.

MATERIAL AND METHODS: This prospective analysis included 99 children (46 girls) at the median age of 11.23 years and diabetes duration of at least 1 year (median: 5.16 years), generally well controlled metabolically (median HbA1c: 7.0%), and treated with continuous subcutaneous insulin infusion (CSII). The patients had used CGM for at least 150 days. We analysed the participants in subgroups based on baseline HbA1c < 7%, ≥ 7%, age, and sex.

RESULTS: Children with baseline HbA1c < 7% were characterized by significantly increased HbA1c after the median of 273 days (217; 320) of CGM usage (6.3% vs. 6.6%, respectively; p = 0.002). No significant change in HbA1c was noted in children with baseline HbA1c ≥ 7% (7.5% vs. 7.4%, respectively; p = 0.191), but 20% of the group reached the target of HbA1c < 7.0%. The analysis of CGM data revealed that no group achieved the CGM targets of good metabolic control. Total daily insulin requirements remained stable in both groups (p = 0.752; p = 0.274), but the amount of basal insulin increased statistically in both groups (p = 0.009; p ≤ 0.001).

CONCLUSIONS: The application of CGM provides detailed information concerning glycaemic control and is beneficial in some, but not all, T1D children with good diabetes control.

PMID:34596369 | DOI:10.5114/pedm.2021.107717

Pediatr Pulmonol. 2021 Oct 1. doi: 10.1002/ppul.25712. Online ahead of print.

ABSTRACT

BACKGROUND: The marked heterogeneity in CF disease complicates selection of those most likely to benefit from existing or emergent treatments.

OBJECTIVE: We aimed to predict progression of bronchiectasis in preschool children with CF.

METHODS: Using data collected up to three years of age, in the Australian Respiratory Early Surveillance Team for CF (AREST CF) cohort study, clinical information, chest computed tomography (CT) scores and biomarkers from bronchoalveolar lavage were assessed in a multivariable linear regression model as predictors for CT bronchiectasis at age 5-6.

RESULTS: Follow-up at 5-6 years was available in 171 children. Bronchiectasis prevalence at 5-6 was 134/171 (78%) and median bronchiectasis score 3 (range 0-12). The internally validated multivariate model retained eight independent predictors accounting for 37% (Adjusted R² ) of the variance in bronchiectasis score. The strongest predictors of future bronchiectasis were: pancreatic insufficiency, repeated intravenous treatment courses, recurrent lower respiratory infections in the first 3 years of life and lower airway inflammation. Dichotomizing the resulting prediction score at a bronchiectasis score of above the median resulted in a diagnostic odds ratio of 13 (95% CI 6.3-27) with positive and negative predictive values of 80% (95%CI 72%-86%) and 77% (95% CI 69%-83%) respectively.

CONCLUSION: Early assessment of bronchiectasis risk in children with CF is feasible with reasonable precision at a group level, which can assist in high-risk patient selection for interventional trials. The unexplained variability in disease progression at individual patient level remains high, limiting the use of this model as a clinical prediction tool. This article is protected by copyright. All rights reserved.

PMID:34596357 | DOI:10.1002/ppul.25712

Orthop Surg. 2021 Oct 1. doi: 10.1111/os.13107. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the functional outcomes after a novel method of H-loop knotless double-row technique in patients with rotator cuff tears.

METHOD: From June 2020 to September 2020, a total of six patients (five women, one man) with arthroscopic rotator cuff repair using the H-loop knotless double-row technique were enrolled in our study. The average age is 54 years (range: 50-61 years). The preoperative and final follow-up clinical outcome were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS), University of California Los Angeles (UCLA) score, and Constant-Murley score. The active shoulder range of motion (ROM) was also collected preoperatively and postoperatively at the final follow-up (forward flexion and abduction). Accordingly, intraoperative and postoperative complications were observed as well.

RESULT: There were six patients that underwent arthroscopic rotator cuff repair using the H-loop knotless double-row technique. The average follow-up period was 7.52 ± 0.70 months. The VAS, UCLA, ASES, and Constant-Murley scores improved from 5 ± 2.45, 15.67 ± 3.44, 47.67 ± 17.41 and 49.17 ± 8.98 preoperatively, to 0.83 ± 0.75, 36.27 ± 3.83, 91.67 ± 10.76 and 85.83 ± 4.31 at the final follow-up, with statistical significances of P = 0.009, P < 0.001, P = 0.006, and P = 0.001, respectively. Meanwhile, the active shoulder ROM (forward flexion and abduction) improved from 135.00 ± 46.80 and 125 ± 56.48 preoperatively, to 173.67 ± 4.13 and 172 ± 3.27 at final follow-up, respectively (P = 0.082, P = 0.088). During the follow-up, there were no postoperative complications such as wound-site infection, nerve or vessel damage, subcutaneous hematoma, and suture anchor problems.

CONCLUSION: With the benefit of reducing the possibility of strangulation and blood supply affection for the rotator cuff, The H-loop knotless double row technique may be an alternative method to significantly improve subjective functional outcomes and increase the healing rate of medium-sized rotator cuff tears with degeneration issues and poor tissue quality.

PMID:34596353 | DOI:10.1111/os.13107

Plant Genome. 2021 Oct 1:e20155. doi: 10.1002/tpg2.20155. Online ahead of print.

ABSTRACT

Plant phenotyping under field conditions plays an important role in agricultural research. Efficient and accurate high-throughput phenotyping strategies enable a better connection between genotype and phenotype. Unmanned aerial vehicle-based high-throughput phenotyping platforms (UAV-HTPPs) provide novel opportunities for large-scale proximal measurement of plant traits with high efficiency, high resolution, and low cost. The objective of this study was to use time series normalized difference vegetation index (NDVI) extracted from UAV-based multispectral imagery to characterize its pattern across development and conduct genetic dissection of NDVI in a large maize population. The time series NDVI data from the multispectral sensor were obtained at five time points across the growing season for 1,752 diverse maize accessions with a UAV-HTPP. Cluster analysis of the acquired measurements classified 1,752 maize accessions into two groups with distinct NDVI developmental trends. To capture the dynamics underlying these static observations, penalized-splines (P-splines) model was used to obtain genotype-specific curve parameters. Genome-wide association study (GWAS) using static NDVI values and curve parameters as phenotypic traits detected signals significantly associated with the traits. Additionally, GWAS using the projected NDVI values from the P-splines models revealed the dynamic change of genetic effects, indicating the role of gene-environment interplay in controlling NDVI across the growing season. Our results demonstrated the utility of ultra-high spatial resolution multispectral imagery, as that acquired using a UAV-based remote sensing, for genetic dissection of NDVI.

PMID:34596348 | DOI:10.1002/tpg2.20155

Int J Lab Hematol. 2021 Oct 1. doi: 10.1111/ijlh.13720. Online ahead of print.

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV2 can present from mild flu-like symptoms to acute respiratory distress syndrome. There is multi-organ involvement; particularly, hematopoietic system can be associated with morphological changes in blood cells of COVID-19 patients.

METHOD: We conducted a cross-sectional study on a cohort of 50 COVID-19 patients, confirmed on RT-PCR with documented cycle threshold (Ct) value. Peripheral blood sample of these patients was collected and examined for complete blood counts (CBC) on automated haematological analyser as well as Leishman-stained blood smears to look for morphological changes in blood cells. Morphological changes were evaluated with reference to clinical severity and Ct value. Additionally, association between Ct value and clinical severity was also performed. Statistical tests were performed, and P value <.05 was considered significant.

RESULTS: Mean age of our study group was 42.16 ± 15.55 years, with male preponderance. Most commonly observed peripheral blood changes were hypolobation (P value = .002) and toxic granules (P value = .005) in neutrophils, atypical granules with nucleolar prominence in lymphocytes, cytoplasmic granulation with clumped nuclear chromatin in monocytes, giant platelets and thrombocytopenia and normocytic normochromic anaemia.

CONCLUSION: No association was found between clinical severity and Ct value as well as peripheral blood morphological changes with Ct value. We conclude that examination of peripheral smear coupled with complete blood count (CBC) is only partially supportive of disease pathogenesis and to assess the viral load other parameters should be utilised instead of relying solely on Ct value.

PMID:34596329 | DOI:10.1111/ijlh.13720

Pest Manag Sci. 2021 Oct 1. doi: 10.1002/ps.6663. Online ahead of print.

ABSTRACT

BACKGROUND: The Colorado potato beetle (CPB) is the most harmful pest of potato in potato cultivation regions globally. Although it is an economically important agricultural pest, the population structure and colonization route of this species in Turkey are uncertain. We used microsatellite and mtDNA markers to obtain information about the population source, structure and bio-invasion route of CPB populations in Turkey.

RESULTS: The common single mtDNA haplotype in European CPB populations was obtained in all Turkish CPB populations based on mtDNA data analysis. However, microsatellites revealed a low level of genetic variation in CPB populations. The results of microsatellite analysis (FCA, BAPS, UPGMA dendrogram, F-statistics and Nei’s distances) indicated three groups for invasive CPB: Thrace-Marmara and Aegean; Black Sea, Central Anatolia and Mediterranean; Northeastern Anatolia. Region-specific alleles have been identified in regions, where commercial potato cultivation and insecticide use are intensive.

CONCLUSION: The detection of a single fixed European haplotype in all Turkish populations has proved that CPB in Turkey originated from Europe as a result of a founder event occurred in European populations. Low genetic variation was due to the short time period since the spread of CPB from America to Europe. The highest number of private alleles were found in the top commercial potato cultivation region-Central Anatolia from where the CPB populations spread to other parts of Turkey. This article is protected by copyright. All rights reserved.

PMID:34596319 | DOI:10.1002/ps.6663

J Genet Couns. 2021 Oct 1. doi: 10.1002/jgc4.1512. Online ahead of print.

ABSTRACT

Increasing demand for genetic services has led to the development of streamlined genetic counseling (GC) models. We piloted large-scale group pre-test GC with up to 50 patients per group and compared this to a traditional one-on-one approach. Patients referred to the British Columbia (BC) Cancer Hereditary Cancer Program were eligible if they had: (a) family history meeting our program’s referral criteria; (b) no relevant personal history of cancer; (c) no prior genetic testing in the family; and (d) no living testable relative in BC. Patient-reported outcome measures included: (a) Genetic Counselling Outcome Scale (GCOS) prior to pre-test GC (T1) and at 4 weeks post-test GC (T2); (b) Satisfaction Survey after pre-test GC; and (c) the Multidimensional Impact of Cancer Risk Assessment (MICRA) for patients undergoing testing (4 weeks after post-test GC). In total, 391 patients underwent GC, 184 by group and 207 by one-on-one appointments. Between May 2018 and May 2019, 6 pre-test group sessions were conducted (median number of patients per group = 28; range 15-48). 8% of patients (n = 32) declined large group GC due to personal preference for one-on-one GC. There were no statistically significant differences in MICRA and GCOS survey results when comparing the pre-test large group versus traditional pre-test one-on-one models (based on 3 MICRA subscales: p = 0.063, p = 0.612, p = 0.842; and GCOS p = 0.169). Overall, the large group pre-test counseling approach was more time-efficient with 15-48 patient group sessions conducted over a mean duration of 80 min as compared to 42 min per patient with the traditional one-on-one GC model. Large-scale group GC was feasible and acceptable to patients and represents a novel streamlined model for GC to enable timely access to cancer genetic services.

PMID:34596310 | DOI:10.1002/jgc4.1512

Aust Endod J. 2021 Oct 1. doi: 10.1111/aej.12572. Online ahead of print.

ABSTRACT

Firstly, this study investigated the direct effect of Transforming Growth Factor-beta 1 at 10, 5, 2.5 and 1.25 ng mL^-1 on human apical papilla cell proliferation and mineralisation. Cell proliferation was examined at 0, 2, 4, 6, 24, 48, 72, 96 and 120 h using Alamar Blue^TM assay. Cell mineralisation was examined at day 21 with a quantitative Alizarin Red S staining. Secondly, the study aimed to estimate the amount of Transforming Growth Factor-beta 1 (TGF-β1) released from the dentin after root canal irrigation. The solution collected from a root canal after rinsing with various protocols (normal saline solution, ethylenediaminetetraacetic acid or chlorhexidine) was analysed with an enzyme-linked immunosorbent assay. Data were statistically analysed using a one-way analysis of variance. The results, from the first part, revealed cell proliferation reduction in all experimental groups presented with TGF-β1. The higher concentration generated more deteriorating effects. Cell mineralisation was highest in a group with TGF-β1 at 1.25 ng mL^-1 (P < 0.05). For the growth factor released from dentin, the highest amount was detected only when ethylenediaminetetraacetic acid was associated with the irrigation (P < 0.05). In summary, the direct effects of TGF-β1 on cell proliferation and differentiation were diverse, depending on concentration. The release of TGF-β1 from root dentin can be achieved after rinsing with ethylenediaminetetraacetic acid.

PMID:34596309 | DOI:10.1111/aej.12572

J Magn Reson Imaging. 2021 Oct 1. doi: 10.1002/jmri.27938. Online ahead of print.

ABSTRACT

BACKGROUND: Under normal physiological conditions, the spin-lattice relaxation rate (R1) in blood is influenced by many factors, including hematocrit, field strength, and the paramagnetic effects of deoxyhemoglobin and dissolved oxygen. In addition, techniques such as oxygen-enhanced magnetic resonance imaging (MRI) require high fractions of inspired oxygen to induce hyperoxia, which complicates the R1 signal further. A quantitative model relating total blood oxygen content to R1 could help explain these effects.

PURPOSE: To propose and assess a general model to estimate the R1 of blood, accounting for hematocrit, SO₂ , PO₂ , and B0 under both normal physiological and hyperoxic conditions.

STUDY TYPE: Mathematical modeling.

POPULATION: One hundred and twenty-six published values of R1 from phantoms and animal models.

FIELD STRENGTH/SEQUENCE: 5-8.45 T.

ASSESSMENT: We propose a two-compartment nonlinear model to calculate R1 as a function of hematocrit, PO₂ , and B0. The Akaike Information Criterion (AIC) was used to select the best-performing model with the fewest parameters. A previous model of R1 as a function of hematocrit, SO₂ , and B0 has been proposed by Hales et al, and our work builds upon this work to make the model applicable under hyperoxic conditions (SO₂ > 0.99). Models were assessed using the AIC, mean squared error (MSE), coefficient of determination (R² ), and Bland-Altman analysis. The effect of volume fraction constants $W_{\mathrm{RBC}}$ and $W_{\text{plasma}}$ was assessed by the SD of resulting R1. The range of the model was determined by the maximum and minimum B0, hematocrit, SO₂ , and PO₂ of the literature data points.

STATISTICAL TESTS: Bland-Altman, AIC, MSE, coefficient of determination (R² ), SD.

RESULTS: The model estimates agreed well with the literature values of R1 of blood (R² = 0.93, MSE = 0.0013 s^-2 ), and its performance was consistent across the range of parameters: B0 = 1.5-8.45 T, SO₂ = 0.40-1, PO₂ = 30-700 mmHg.

DATA CONCLUSION: Using the results from this model, we have quantified and explained the contradictory decrease in R1 reported in oxygen-enhanced MRI and oxygen-delivery experiments.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 1.

PMID:34596290 | DOI:10.1002/jmri.27938