Nevin Manimala

Adv Nutr. 2021 Jun 22:nmab071. doi: 10.1093/advances/nmab071. Online ahead of print.

ABSTRACT

Lutein, zeaxanthin, and meso-zeaxanthin are the only carotenoids found in the human macula and may have a role in visual function. These carotenoids are reported to protect the retina, and thus vision, as antioxidants and by acting as a blue light filter. Our objective was to determine a minimum concentration of lutein/zeaxanthin intake that is associated with a statistically significant and/or clinically important change in macular pigment optical density (MPOD) among adults with healthy eyes. We searched Ovid MEDLINE, CENTRAL, and the Commonwealth of Agriculture Bureau for English-language studies through to July 2020. Two reviewers screened results to identify studies that evaluated supplements or dietary sources of lutein/zeaxanthin on MPOD among adults with healthy eyes. One reviewer extracted data and assessed strength of evidence, which was confirmed by a second reviewer. Two independent reviewers assessed the risk of bias. Meta-analyses were stratified by total lutein/zeaxanthin dose. We included 46 studies (N = 3189 participants; mean age = 43 y; 42% male). There was no statistically significant change in MPOD among studies evaluating <5 mg/d of total lutein/zeaxanthin intake which primarily assessed dietary interventions for 3-6 mo (pooled mean difference, 0.02; 95% CI: -0.01 to 0.05). The pooled mean increase in MPOD was 0.04 units (95% CI: 0.02 to 0.07) among studies evaluating 5 to <20 mg/d of lutein/zeaxanthin and was 0.11 units (95% CI: 0.06 to 0.16) among studies evaluating ≥20 mg/d of lutein/zeaxanthin for 3-12 mo. MPOD increased with lutein/zeaxanthin intake, particularly at higher doses, among adults with healthy eyes. The effects of lutein/zeaxanthin intake at doses <5 mg/d or from dietary sources is less clear. Increased lutein/zeaxanthin intake can help with maintaining ocular health. Future research is needed to determine the minimum dose and duration of lutein/zeaxanthin intake that is associated with a clinically important change in MPOD or visual function.

PMID:34157098 | DOI:10.1093/advances/nmab071

Blood. 2021 Jun 22:blood.2021011719. doi: 10.1182/blood.2021011719. Online ahead of print.

ABSTRACT

Omidubicel is an ex vivo expanded hematopoietic progenitor cell, and non-expanded myeloid and lymphoid cell product derived from a single umbilical cord blood unit. We report results of a phase III trial to evaluate the efficacy of omidubicel compared to standard umbilical cord blood transplantation (UCBT). Between January 2017 and January 2020, 125 patients aged 13-65 with hematologic malignancies were randomized to omidubicel versus standard UCBT. Patients received myeloablative conditioning and graft versus host disease (GvHD) prophylaxis with a calcineurin inhibitor and mycophenolate mofetil. The primary endpoint was time to neutrophil engraftment. The treatment arms were well balanced and racially diverse. Median time to neutrophil engraftment was 12 days (95% CI 10-14 days) and 22 days (95% CI 19-25 days) (p<0.001) for the omidubicel and control arms, respectively. The cumulative incidence of neutrophil engraftment was 96% and 89% for patients receiving omidubicel and control transplants, respectively. The omidubicel arm had faster platelet recovery (55% vs. 35% recovery by 42 days, p=0.028), a lower incidence of first grade 2/3 bacterial or invasive fungal infections (37% vs. 57%, p=0.027), and spent more time out of hospital during the first 100 days following transplant (median 61 vs. 48 days, p=0.005) than controls. Differences in GvHD and survival between the two arms were not statistically significant. Transplantation with omidubicel results in faster hematopoietic recovery and reduced early transplant-related complications as compared to standard UCBT. The results suggest that omidubicel may be considered as a new standard of care for adult patients eligible for UCBT.

PMID:34157093 | DOI:10.1182/blood.2021011719

Br J Surg. 2021 Jun 22;108(6):702-708. doi: 10.1002/bjs.11998.

ABSTRACT

BACKGROUND: Minimally invasive oesophagectomy has been shown to reduce the risk of pulmonary complications compared with open oesophagectomy, but the effects on health-related quality of life (HRQoL) and oesophageal cancer survivorship remain unclear. The aim of this study was to assess the longitudinal effects of minimally invasive compared with open oesophagectomy for cancer on HRQoL.

METHODS: All patients who had surgery for oesophageal cancer in Sweden from January 2013 to April 2018 were identified. The exposure was total or hybrid minimally invasive oesophagectomy, compared with open surgery. The study outcome was HRQoL, evaluated by means of the European Organisation for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-OG25 at 1 and 2 years after surgery. Mean differences and 95 per cent confidence intervals were adjusted for confounders.

RESULTS: Of the 246 patients recruited, 153 underwent minimally invasive oesophagectomy, of which 75 were hybrid minimally invasive and 78 were total minimally invasive procedures. After adjustment for age, sex, Charlson Co-morbidity Index score, pathological tumour stage and neoadjuvant therapy, there were no clinically and statistically significant differences in overall or disease-specific HRQoL after oesophagectomy between hybrid minimally invasive and total minimally invasive surgical technique versus open surgery.

CONCLUSION: In this population-based nationwide Swedish study, longitudinal HRQoL after minimally invasive oesophagectomy was similar to that of the open surgical approach.

PMID:34157084 | DOI:10.1002/bjs.11998

Br J Surg. 2021 Jun 22;108(6):613-621. doi: 10.1093/bjs/znab016.

ABSTRACT

INTRODUCTION: Operating room recording, via video, audio and sensor-based recordings, is increasingly common. Yet, surgical data science is a new field without clear guidelines. The purpose of this study is to examine existing published studies of surgical recording modalities to determine which are available for use in the operating room, as a first step towards developing unified standards for this field.

METHODS: Medline, EMBASE, CENTRAL and PubMed databases were systematically searched for articles describing modalities of data collection in the operating room. Search terms included ‘video-audio media’, ‘bio-sensing techniques’, ‘sound’, ‘movement’, ‘operating rooms’ and others. Title, abstract and full-text screening were completed to identify relevant articles. Descriptive statistical analysis was performed for included studies.

RESULTS: From 3756 citations, 91 studies met inclusion criteria. These studies described 10 unique data-collection modalities for 17 different purposes in the operating room. Data modalities included video, audio, kinematic and eye-tracking among others. Data-collection purposes described included surgical trainee assessment, surgical error, surgical team communication and operating room efficiency.

CONCLUSION: Effective data collection and utilization in the operating room are imperative for the provision of superior surgical care. The future operating room landscape undoubtedly includes multiple modalities of data collection for a plethora of purposes. This review acts as a foundation for employing operating room data in a way that leads to meaningful benefit for patient care.

PMID:34157080 | DOI:10.1093/bjs/znab016

Int J Oral Maxillofac Implants. 2021 Jun 22. doi: 10.11607/jomi.8851. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to compare changes in the physicochemical and biologic characteristics of titanium surfaces through short-term re-hydrophobization for 24 hours and ultraviolet (UV) re-irradiation for 24 hours.

MATERIALS AND METHODS: Photofunctionalization was performed with four 15-W bactericidal lamps at an intensity of 5.0 mW/cm² (wavelength = 254 ± 20 nm) on sandblasted, large-grit, acid-etched (SLA)-treated titanium surfaces, which were stored in a sterilized sealed container for 8 weeks to allow enough biologic aging. The duration of the UV irradiation was as follows: irradiation group-UV irradiated for 24 hours; re-hydrophobization group-UV irradiated for 24 hours and then stored in an ambient sterilized medium; and re-irradiation group-UV irradiated for 24 hours followed by storing for 24 hours in an ambient sterilized medium and then UV re-irradiated for 24 hours. The surface characteristics were evaluated with field emission scanning electron microscopy, x-ray photoelectron spectroscopy (XPS), and water contact angle. Cell viability and morphology were measured using fluorescence staining. Alkaline phosphatase (ALP) assay and alizarin red S staining were performed to evaluate the differentiation of osteogenic cells and the mineralization capability.

RESULTS: Macroroughness and superimposed microroughness were observed on the disk surfaces in all groups as typically seen on SLA surfaces. The water contact angles were measured to be 1.85, 1.48, and 1.18 degrees for the irradiation group, re-hydrophobization group, and re-irradiation group, respectively, indicating superhydrophilicity. There was no difference in the surface elemental ratio or the spectra of XPS, cell viability, or ALP activity. Although the re-irradiation group had the highest total amount of calcium deposition, there was no statistical significance.

CONCLUSION: Within the limitations of the study, improved superhydrophilicity and bioactivity after UV irradiation were maintained during short-term re-hydrophobization and repeated re-irradiation without changing the topography of SLA titanium surfaces.

PMID:34157065 | DOI:10.11607/jomi.8851

PLoS One. 2021 Jun 22;16(6):e0253313. doi: 10.1371/journal.pone.0253313. eCollection 2021.

ABSTRACT

BACKGROUND: Over the last three decades, the accessibility and usage of mobile devices have increased among young children. This study’s objective was to develop a validated caregiver-reported digital-screen exposure questionnaire (DSEQ) for children aged 2-5 years.

METHODS: DSEQ was developed in five phases. Phase 1, a draft questionnaire was developed by reviewing the literature on existing tools (n = 2) from 2009-2017. Phase 2, face-to-face interviews with primary caregivers (n = 30) were conducted in a tertiary-care-hospital for acculturation. Nine experts assessed the face and content validity of the draft Hindi and English questionnaire. Phase 3, a pilot study conducted among randomly selected families (n = 40) to evaluate the feasibility of DSEQ in field settings. Phase 4, test-retest reliability was done among 30 primary caregivers selected randomly in another urban cluster. Phase 5, the internal consistency of DSEQ was checked by conducting a cross-sectional study among randomly selected 400 primary caregivers in Chandigarh, North India. IBM SPSS Statistics for Macintosh, version 25.0, was for data management and analysis.

RESULTS: A valid DSEQ with 86 items under five domains, including sociodemographic, screen-time exposure and home media environment, level of physical activity, media-related behaviors, and parental perceptions was developed. The pilot study showed that it was feasible to use the DSEQ in the field. DSEQ was reliable with kappa value ranging from 0.52 to 1.0, and intra-class coefficient of 0.62-0.99 (p<0.05). A strong internal consistency was observed for three domains including, screen-time exposure and home media environment (Cronbach’s alpha of 0.82), media-related behaviors (Cronbach’s alpha of 0.74) and physical activity (Cronbach’s alpha 0.73).

CONCLUSIONS: The developed DSEQ has good face and content validity and acceptable evidence of internal consistency and test-retest reliability. The DSEQ can be used for measuring digital screen exposure and its correlates among children aged 2 to 5 years.

PMID:34157053 | DOI:10.1371/journal.pone.0253313

PLoS One. 2021 Jun 22;16(6):e0253112. doi: 10.1371/journal.pone.0253112. eCollection 2021.

ABSTRACT

The chronic inflammation influences a microenvironment, where as a result of losing control over tissue homeostatic mechanisms, the carcinogenesis process may be induced. Inflammatory response cells can secrete a number of factors that support both initiation and progression of cancer and also they may consequently induct an epithelial-mesenchymal transition (EMT), the process responsible for development of distant metastasis. Macrophage migration inhibitory factor (MIF) acts as a pro-inflammatory cytokine that is considered as a link between chronic inflammation and tumor development. MIF can function as a modulator of important cancer-related genes expression, as well as an activator of signaling pathways that promotes the development of prostate cancer. The study was performed on FFPE tissues resected from patients who underwent radical prostatectomy. To investigate the relationship of studied proteins with involvement in tumor progression and initiation of epithelial-to-mesenchymal transition (EMT) process, we selected clinicopathological parameters related to tumor progression. Immunohistochemical analyses of MIF, SOX-4, β-catenin and E-cadherin were performed on TMA slides. We found a statistically significant correlation of overall β-catenin expression with the both lymph node metastasis (p<0.001) and presence of angioinvasion (p = 0.012). Membrane β-catenin expression was associated with distant metastasis (p = 0.021). In turn, nuclear MIF was correlated with lymph node metastasis (p = 0.003). The positive protein-protein correlations have been shown between the total β-catenin protein expression level with level of nuclear SOX-4 protein expression (r = 0.27; p<0.05) as well as negative correlation of β-catenin expression with level of nuclear MIF protein expression (r = -0.23; p<0.05). Our results seem promising and strongly highlight the potential role of MIF in development of nodal metastases as well as may confirm an involvement of β-catenin in disease spread in case of prostate cancer.

PMID:34157052 | DOI:10.1371/journal.pone.0253112

PLoS One. 2021 Jun 22;16(6):e0253232. doi: 10.1371/journal.pone.0253232. eCollection 2021.

ABSTRACT

A major challenge for malaria is the lack of tools for accurate and timely diagnosis in the field which are critical for case management and surveillance. Microscopy along with rapid diagnostic tests are the current mainstay for malaria diagnosis in most endemic regions. However, these methods present several limitations. This study assessed the accuracy of Gazelle, a novel rapid malaria diagnostic device, from samples collected from the Peruvian Amazon between 2019 and 2020. Diagnostic accuracy was compared against microscopy and two rapid diagnostic tests (SD Bioline and BinaxNOW) using 18ssr nested-PCR as reference test. In addition, a real-time PCR assay (PET-PCR) was used for parasite quantification. Out of 217 febrile patients enrolled and tested, 180 specimens (85 P. vivax and 95 negatives) were included in the final analysis. Using nested-PCR as the gold standard, the sensitivity and specificity of Gazelle was 88.2% and 97.9%, respectively. Using a cutoff of 200 parasites/μl, Gazelle’s sensitivity for samples with more than 200 p/uL was 98.67% (95%CI: 92.79% to 99.97%) whereas the sensitivity for samples lower than 200 p/uL (n = 10) was 12.5% (95%CI: 0.32% to 52.65%). Gazelle’s sensitivity and specificity were statistically similar to microscopy (sensitivity = 91.8, specificity = 100%, p = 0.983) and higher than both SD Bioline (sensitivity = 82.4, specificity = 100%, p = 0.016) and BinaxNOW (sensitivity = 71.8%, specificity = 97.9%, p = 0.002). The diagnostic accuracy of Gazelle for malaria detection in P. vivax infections was comparable to light microscopy and superior to both RDTs even in the presence of low parasitemia infections. The performance of Gazelle makes it a valuable tool for malaria diagnosis and active case detection that can be utilized in different malaria-endemic regions.

PMID:34157032 | DOI:10.1371/journal.pone.0253232

PLoS Negl Trop Dis. 2021 Jun 22;15(6):e0009466. doi: 10.1371/journal.pntd.0009466. eCollection 2021 Jun.

ABSTRACT

Soil-Transmitted Helminths (STH) are highly prevalent Neglected Tropical Disease in Ethiopia, an estimated 26 million are infected. Geographic Information Systems and Remote Sensing (RS) technologies assist data mapping and analysis, and the prediction of the spatial distribution of infection in relation to environmental variables. The influence of socioeconomic, environmental and soil characteristics on hookworm infection at the individual and household level is explored in order to identify spatial patterns of infection in rural villages from Zenzelema (Amhara region). Inhabitants greater than 5 years old were recruited in order to assess the presence of STH. Socioeconomic and hookworm infection variables at the household level and environmental variables and soil characteristics using RS were obtained. The dominant STH found was hookworm. Individuals which practiced open defecation and those without electricity had a significant higher number of hookworm eggs in their stool. Additionally, adults showed statistically higher hookworm egg counts than children. Nonetheless, the probability of hookworm infection was not determined by socioeconomic conditions but by environmental characteristics surrounding the households, including a combination of vigorous vegetation and bare soil, high temperatures, and compacted soils (high bulk density) with more acidic pH, given a pH of 6.0 is optimal for hatching of hookworm eggs. The identification of high-risk environmental areas provides a useful tool for planning, targeting and monitoring of control measures, including not only children but also adults when hookworm is concerned.

PMID:34157019 | DOI:10.1371/journal.pntd.0009466

PLoS Genet. 2021 Jun 22;17(6):e1009575. doi: 10.1371/journal.pgen.1009575. Online ahead of print.

ABSTRACT

Over a decade of genome-wide association studies (GWAS) have led to the finding of extreme polygenicity of complex traits. The phenomenon that “all genes affect every complex trait” complicates Mendelian Randomization (MR) studies, where natural genetic variations are used as instruments to infer the causal effect of heritable risk factors. We reexamine the assumptions of existing MR methods and show how they need to be clarified to allow for pervasive horizontal pleiotropy and heterogeneous effect sizes. We propose a comprehensive framework GRAPPLE to analyze the causal effect of target risk factors with heterogeneous genetic instruments and identify possible pleiotropic patterns from data. By using GWAS summary statistics, GRAPPLE can efficiently use both strong and weak genetic instruments, detect the existence of multiple pleiotropic pathways, determine the causal direction and perform multivariable MR to adjust for confounding risk factors. With GRAPPLE, we analyze the effect of blood lipids, body mass index, and systolic blood pressure on 25 disease outcomes, gaining new information on their causal relationships and the potential pleiotropic pathways.

PMID:34157017 | DOI:10.1371/journal.pgen.1009575