Tag: nevin manimala

Am J Obstet Gynecol MFM. 2023 Jun 3:101047. doi: 10.1016/j.ajogmf.2023.101047. Online ahead of print.

ABSTRACT

Between 53-79% of women will sustain some degree of perineal lacerations during vaginal delivery. Third and fourth degree perineal lacerations are known as obstetric anal sphincter injuries. Timely diagnosis and prompt treatment of obstetric anal sphincter injuries can help to prevent the development of severe consequences like fecal incontinence, urinary incontinence and rectovaginal fistula. Neonatal head circumference is routinely measured postpartum, but is often not mentioned as a risk factor among clinical guidelines. Thus far, no review article on risk factors for obstetric anal sphincter injuries has discussed the role of neonatal head circumference.

OBJECTIVE: This review aimed to review and analyze the relationship between head circumference and the occurrence of obstetric anal sphincter injuries among previous studies to conclude whether HC should be recognized as an important risk factor.

DATA SOURCES: Through study screening on Google Scholar, PubMed, Scopus and Science Direct for articles published between 2013 to 2023, followed by assessment of eligibility – this study ended up reviewing 25 studies, 17 of which were included in meta-analysis.

STUDY ELIGIBILITY CRITERIA: Only studies which measured both neonatal head circumference and the occurrence of obstetric anal sphincter injuries were included in this review.

STUDY APPRAISAL: Included studies were appraised using the Dartmouth Library risk of bias assessment checklist.

SYNTHESIS METHODS: Qualitative synthesis was based on the study population, findings, adjusted confounding factors and suggested causative links in each study. Quantitative synthesis was based on calculation and pooling of odds ratio and inverse variance using Review Manager 5.4.1.

RESULTS: A statistically significant association between head circumference and obstetric anal sphincter injuries was reported in 21 out of the 25 studies; four studies reported head circumference as a true independent risk factor. Meta-analysis among studies which measured neonatal HC as a dichotomous categorical variable with a cut-off point at 35±1cm yielded statistically significant pooled results (OR=1.92, 95% CI=1.80-2.04).

CONCLUSION: The risk for obstetric anal sphincter injuries increases as neonatal head circumference increases – this should be considered in decision-making during labour and postpartum management to attain the best outcome.

PMID:37277090 | DOI:10.1016/j.ajogmf.2023.101047

Environ Pollut. 2023 Jun 3:121961. doi: 10.1016/j.envpol.2023.121961. Online ahead of print.

ABSTRACT

Inadvertent human exposure to microplastics by the ingestion of microplastic-contaminated processed foods poses health risks and new preventative issues; nevertheless, investigations analyzing microplastic occurrences in commercially dried fish for direct human consumption are scarce. This study assessed the abundance and characteristics of microplastics in 25 commercially sold dried fish products (4 supermarkets, 3 street vendors, and 18 traditional agri-product farmers’ markets) from two widely consumed and commercially important Chirostoma species (C. jordani and C. patzcuaro) in Mexico. Microplastics were detected in all the samples examined, with abundances ranging from 4.00 ± 0.94 to 55.33 ± 9.43 items g^-1. C. jordani dried fish samples had higher mean microplastic abundance (15.17 ± 5.90 items g^-1) than the C. patzcuaro dried fish samples (7.82 ± 2.90 items g^-1); nevertheless, there was no statistically significant difference in microplastic concentrations between the samples. The most prevalent type of microplastic was fiber (67.55%), followed by fragment (29.18%), film (3.00%), and sphere (0.27%). Non-colored microplastics (67.35%) predominated, while microplastic sizes varied from 24 to 1670 μm, with sizes less than 500 μm (84%) being the most common. ATR-FTIR analysis revealed polyester, acrylonitrile butadiene styrene, polyvinyl alcohol, ethylene-propylene copolymer, nylon-6 (3), cellophane, and viscose in the dried fish samples. Overall, this study’s findings are the first in Latin America to demonstrate microplastic contamination in dried fish for human consumption, underscoring the need for developing countermeasures to prevent plastic pollution in fish-caught regions and reduce the risks of human exposure to these micropollutants.

PMID:37277071 | DOI:10.1016/j.envpol.2023.121961

Exp Eye Res. 2023 Jun 3:109519. doi: 10.1016/j.exer.2023.109519. Online ahead of print.

ABSTRACT

Heparanase (HPA) is believed that might mediate histone 3 lysine 9 acetylation (H3K9ac) to regulate vascular endothelial growth factor (VEGF) gene expressions in the hyperglycemia and hypoxia human retinal endothelial cells (HRECs). Cultured human retinal endothelial cells (HRECs) in hyperglycemia, hypoxia, siRNA, and normal medium, respectively. Distributions of H3K9ac and HPA in HRECs were analyzed by immunofluorescence. Western blot and real-time PCR were respectively used to evaluate the expression of HPA, H3K9ac, and VEGF. The differences in occupancies of H3K9ac and RNA polymerase II at VEGF gene promoter among three groups were studied by Chromatin immunoprecipitation (ChIP) combined with real-time PCR. Co-immunoprecipitation (Co-IP) was used to measure the status of HPA and H3K9ac. Re-ChIP was used to verify whether HPA and H3K9ac associate to the transcription of VEGF gene. HPA was consistent with that of H3K9ac in the hyperglycemia and hypoxia groups. And the fluorescent lights of H3K9ac and HPA in siRNA groups were similar to the control group, fainter than that of hyperglycemia, hypoxia, and non-silencing groups. Western blot results showed that the expressions of HPA, H3K9ac, and VEGF in hyperglycemia and hypoxia HRECs were statistically higher than that of the control. HPA, H3K9ac, and VEGF expressions in siRNA groups were statistically lower than hyperglycemia and hypoxia HRECs. The same trends also were found in real-time PCR. ChIP exhibited the occupancies of H3K9ac and RNA Pol II at VEGF gene promoter in hyperglycemia and hypoxia groups were significantly more increased than in the control group. Co-IP revealed that HPA combined with H3K9ac in hyperglycemia and hypoxia groups; while it was not discovered in the control group. Re-ChIP showed that HPA combined with H3K9ac at VEGF gene promoter in the hyperglycemia and hypoxia HRECs nuclear. In our study HPA can influence expressions of H3K9ac and VEGF in the hyperglycemia and hypoxia HRECs. HPA can probably combine with H3K9ac and regulate the transcription of the VEGF gene in the hyperglycemia and hypoxia HRECs.

PMID:37277067 | DOI:10.1016/j.exer.2023.109519

Sci Total Environ. 2023 Jun 3:164624. doi: 10.1016/j.scitotenv.2023.164624. Online ahead of print.

ABSTRACT

Overexploitation, habitat fragmentation, and flow alteration are major threats to freshwater biodiversity that can lead to fisheries collapse and species extinction. These threats are particularly alarming in poorly monitored ecosystems where resource use supports the livelihoods of numerous people. The Tonle Sap Lake in Cambodia is such an ecosystem, supporting one of the world’s largest freshwater fisheries. Tonle Sap Lake fishes are the focus of indiscriminate harvest affecting species stocks, community composition and food-web structure. Changes in the magnitude and timing of the seasonal flood pulse have also been linked to declines in fish stocks. Yet, changes in fish abundance and species-specific temporal trends remain poorly documented. Analyzing 17 years’ time series of fish catch data for 110 species, we show that fish populations have declined by 87.7 %, owing to a statistically significant decline for >74 % species, particularly the largest ones. Despite large variations in species-specific trends – going from locally extinct to >1000 % increase – declines were found across most migratory behaviors, trophic positions or IUCN threat categories, though uncertainty regarding the magnitude of effect precluded us drawing conclusions in some cases. These results, reminiscent of alarming declines in fish stocks in many marine fisheries, provide unequivocal evidence that Tonle Sap fish stocks are increasingly depleted. The consequences of this depletion on ecosystem function are unknown but will undoubtedly affect the livelihoods of millions of people, stressing the need to set-up management strategies aimed to protect both the fishery and its associated diversity. Flow alteration, habitat degradation / fragmentation – especially deforestation of seasonally inundated areas and overharvest – have been reported as major drivers in population dynamics and community structure, highlighting the need for management efforts aimed at preserving the natural flood pulse, protecting flooded forest habitats, and reducing overfishing.

PMID:37277043 | DOI:10.1016/j.scitotenv.2023.164624

Diabetes Res Clin Pract. 2023 Jun 3:110740. doi: 10.1016/j.diabres.2023.110740. Online ahead of print.

ABSTRACT

Endothelial dysfunction has been considered as a key etiological factor contributed to the development of vascular disease in diabetes mellitus. Serum level of endothelial cell adhesion molecules (AMs) were reported to be increased in GDM and pregnant women with normal glucose tolerance when compared with nonpregnant women. The literature provides limited evidence of endothelial dysfunction in GDM with heterogeneous and contradictory results respect to their possible involvement in maternal, perinatal and future complications. Our objective is to evaluate current evidence on the role of AMs in maternal and perinatal complications in women with GDM. PubMed, Embase, Web of Science, and Scopus databases were searched. We evaluated the studies’ quality using the Newcastle-Ottawa scale. Meta-analyses were conducted, and heterogeneity and publication bias were examined. Nineteen relevant studies were finally included, recruiting 765 GDM and 2368 control pregnant women. AMs levels were generally higher in GDM participants showing statistical significance maternal ICAM-1 levels (SMD=0.58, 95% CI= 0.25 to 0.91; p=0.001). Our meta-analysis did not detect significant differences in subgroups or in meta-regression analyses. Future studies are needed to establish the potential role of these biomarkers in GDM and its complications.

PMID:37276983 | DOI:10.1016/j.diabres.2023.110740

Diabetes Res Clin Pract. 2023 Jun 3:110735. doi: 10.1016/j.diabres.2023.110735. Online ahead of print.

ABSTRACT

AIM: To evaluate real-life changes of glycemic parameters among flash glucose monitoring (FLASH) users who do not meet glycemic targets.

METHODS: De-identified data were obtained between 2014 and 2021 from patients using FLASH uninterrupted for a 24-week period. Glycemic parameters during first and last sensor use were examined in four identifiable groups: type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) on basal-bolus insulin, T2DM on basal insulin, and T2DM without insulin treatment. Within each group, subgroup analyses were performed in persons with initial suboptimal glycemic regulation (time in range (TIR; 3.9-10 mmol/L) <70%, time above range (TAR; >10 mmol/L) >25%, or time below range (TBR; <3.9 mmol/L) >4%).

RESULTS: Data were obtained from 1,909 persons with T1DM and 1,813 persons with T2DM (1,499 basal-bolus insulin, 189 basal insulin, and 125 non-insulin users). In most of the performed analyses, both overall and in the various subgroups, significant improvements were observed in virtually all predefined primary (TIR) and secondary endpoints (eHbA1c, TAR, TBR and glucose variability).

CONCLUSIONS: 24-weeks FLASH use in real life by persons with T1DM and T2DM with suboptimal glycemic regulation is associated with improvement of glycemic parameters, irrespective of pre-use regulation or treatment modality.

PMID:37276981 | DOI:10.1016/j.diabres.2023.110735

J Acad Nutr Diet. 2023 Jun 3:S2212-2672(23)00288-5. doi: 10.1016/j.jand.2023.05.028. Online ahead of print.

ABSTRACT

BACKGROUND: Breastfeeding has been linked to a higher consumption of fruit and vegetables at 4 to 5 years of age. More recently, it has been suggested that it may also be associated with lower ultra-processed food (UPF) consumption in childhood.

OBJECTIVE: The aim of this study was to assess whether breastfeeding duration was associated with consumption of UPF in a sample of Mediterranean preschoolers.

DESIGN: This study involved a cross-sectional analysis of baseline information of children in the SENDO cohort. Children were enrolled at 4 to 5 years of age and information was gathered through an online questionnaire completed by parents. Dietary information was collected with a previously validated semi-quantitative food frequency questionnaire (FFQ) and foods were classified based on the degree of processing according to the NOVA classification.

PARTICIPANTS/SETTING: This study used baseline information for 806 participants enrolled in the SENDO cohort between January 2015 and June 2021 in Spain.

MAIN OUTCOMES MEASURES: Main study outcome measures were 1) Difference in g/day and in the percentage of total energy intake (TEI) from UPF consumption related to breastfeeding duration, and 2) Odds ratio (OR) that UPF represents a high percentage of TEI.

STATISTICAL ANALYSES: Crude and multivariable adjusted estimates were calculated with generalized estimating equations to account for intra-cluster correlation between siblings.

RESULTS: The prevalence of breastfeeding in the sample was 84%. After adjusting for potential confounders, children who were breastfed for some time reported significantly lower consumption of UPF than children who were not breastfed at all. The mean differences were -19.2 g. (95% CI: -44.2, 10.8) for children who were breastfed for <6 months, -42.5 g. (95% CI: -77.2, -7.80) for those who were breastfed for 6-12 months, and -43.6 g. (95% CI: -79.8, -7.48) for those who were breastfed for 12 months or more (p for trend=0.01). After adjusting for potential confounders, compared with children who were not breastfed, those who were breastfed for ≥12 months had consistently lower odds of UPF representing more than 25%, 30%, 35% and 40% of TEI.

CONCLUSION: Breastfeeding is associated with lower consumption of UPF in Spanish preschoolers.

PMID:37276962 | DOI:10.1016/j.jand.2023.05.028

Asian Nurs Res (Korean Soc Nurs Sci). 2023 Jun 3:S1976-1317(23)00031-2. doi: 10.1016/j.anr.2023.05.002. Online ahead of print.

ABSTRACT

PURPOSE: Evidence on factors influencing the variations of music effect on anxiety and pain in surgical patients is unclear. We aimed to elucidate the effects of music intervention on anxiety and pain by study characteristics.

METHODS: We conducted a search on the PubMed, CINAHL, Embase, Cochrane, and Web of Science databases from March 7 to April 21, 2022, for randomized controlled trials (RCTs) for the effect of music intervention on anxiety, pain, and physiological responses in surgical patients. We included studies published within the last 10 years. We assessed the risk of bias in study using the Cochrane risk of bias tool for randomized trials and performed meta-analyses using random-effects model for all outcomes. We used change-from-baseline scores as summary statistics and computed bias-corrected standardized mean difference (Hedges’g) for anxiety and pain outcomes and mean differences (MD) for blood pressure and heart rate.

RESULTS: Of the 454 records retrieved, 30 RCTs involving 2280 participants were found to be eligible. Music intervention was found to be superior to standard care in reducing anxiety (Hedges’g = -1.48, 95% confidence interval: -1.97 to -0.98), pain (Hedges’g = -0.67, -1.11 to -0.23), systolic blood pressure (MD = -4.62, -7.38 to -1.86), and heart rate (MD = -3.37, -6.65 to -0.10) in surgical patients. The impact of music on anxiety and pain relief varied significantly depending on the duration of the intervention. The largest effect was observed in interventions lasting between 30 to 60 minutes, with a decrease in anxiety and pain.

CONCLUSION: Music intervention is an effective way to reduce anxiety, pain, and physiological response in surgical patients. Future reviews examining the influence of different types of surgery on the effects of music would add to the body of knowledge in this field. This study has been registered on PROSPERO under the number CRD42022340203, with a registration date of July 4, 2022.

PMID:37276961 | DOI:10.1016/j.anr.2023.05.002

J Biomed Inform. 2023 Jun 3:104415. doi: 10.1016/j.jbi.2023.104415. Online ahead of print.

ABSTRACT

OBJECTIVE: Disease knowledge graphs have emerged as a powerful tool for AI, enabling the connection, organization, and access to diverse information about diseases. However, the relations between disease concepts are often distributed across multiple data formats, including plain language and incomplete disease knowledge graphs. As a result, extracting disease relations from multimodal data sources is crucial for constructing accurate and comprehensive disease knowledge graphs.

METHODS: We introduce REMAP, a multimodal approach for disease relation extraction. The REMAP machine learning approach jointly embeds a partial, incomplete knowledge graph and a medical language dataset into a compact latent vector space, aligning the multimodal embeddings for optimal disease relation extraction. Additionally, REMAP utilizes a decoupled model structure to enable inference in single-modal data, which can be applied under missing modality scenarios.

RESULTS: We apply the REMAP approach to a disease knowledge graph with 96,913 relations and a text dataset of 1.24 million sentences. On a dataset annotated by human experts, REMAP improves language-based disease relation extraction by 10.0% (accuracy) and 17.2% (F1-score) by fusing disease knowledge graphs with language information. Furthermore, REMAP leverages text information to recommend new relationships in the knowledge graph, outperforming graph-based methods by 8.4% (accuracy) and 10.4% (F1-score).

CONCLUSION: In summary, REMAP is a flexible multimodal approach for extracting disease relations by fusing structured knowledge and language information. This approach provides a powerful model to easily find, access, and evaluate relations between disease concepts.

PMID:37276949 | DOI:10.1016/j.jbi.2023.104415

Int J Radiat Oncol Biol Phys. 2023 Jun 3:S0360-3016(23)00535-7. doi: 10.1016/j.ijrobp.2023.05.045. Online ahead of print.

ABSTRACT

PURPOSE: When compared to conventional dose rate irradiation (CONV), ultra-high dose rate irradiation (UHDR) has shown superior normal tissue sparing. However, a clinically relevant widening of the therapeutic window by UHDR, termed “FLASH effect”, also depends on the tumour toxicity obtained by UHDR. Based on a combined analysis of published literature, the current study re-examines the hypothesis of tumour isoefficacy for UHDR versus CONV and aims to identify potential knowledge gaps to inspire future in vivo studies.

METHODS: A systematic literature search identified publications assessing in vivo tumour responses comparing UHDR and CONV. Qualitative and quantitative analyses were performed, including combined analyses of tumour growth and survival data.

RESULTS: We identified 66 data sets from 15 publications that compared UHDR and CONV for tumour efficacy. The median number of animals per group was 9 (range: 3-15) and the median follow-up period was 30.5 (range: 11-230) days after the first irradiation. Tumour growth assays were the predominant model used. Combined statistical analyses of tumour growth and survival data are consistent with UHDR isoefficacy compared to CONV. Only one study determined tumour-controlling dose (TCD₅₀) and reported statistically non-significant differences.

CONCLUSION: The combined quantitative analyses of tumour responses support the assumption of UHDR isoefficacy compared to CONV. However, the comparisons are primarily based on heterogeneous tumour growth assays with limited numbers of animals and short follow-up, and most studies do not assess long-term tumour control probability. Therefore, the assays may be insensitive in resolving smaller response differences, such as responses of radio-resistant tumour sub-clones. Hence, tumour cure experiments, including additional TCD₅₀ experiments, are needed to confirm the assumption of isoeffectiveness in curative settings.

PMID:37276928 | DOI:10.1016/j.ijrobp.2023.05.045