Tag: nevin manimala

Front Neurol. 2023 Apr 28;14:1165237. doi: 10.3389/fneur.2023.1165237. eCollection 2023.

ABSTRACT

BACKGROUND: Standard-dose intravenous alteplase for acute ischemic stroke (AIS) in the unknown or extended time window beyond 4.5 h after symptom onset is both effective and safe for certain patients who were selected based on multimodal neuroimaging. However, uncertainty exists regarding the potential benefit of using low-dose alteplase among the Asian population outside the 4.5-h time window.

METHODS: Consecutive AIS patients who received intravenous alteplase between 4.5 and 9 h after symptom onset or with an unknown time of onset guided by multimodal computed tomography (CT) imaging were identified from our prospectively maintained database. The primary outcome was excellent functional recovery, defined as having a modified Rankin scale (mRS) score of 0-1 at 90 days. Secondary outcomes included functional independence (an mRS score of 0-2 at 90 days), early major neurologic improvement (ENI), early neurologic deterioration (END), any intracranial hemorrhage (ICH), symptomatic ICH (sICH), and 90-day mortality. Propensity score matching (PSM) and multivariable logistic regression models were used to adjust for confounding factors and compare the clinical outcomes between the low- and standard-dose groups.

RESULTS: From June 2019 to June 2022, a total of 206 patients were included in the final analysis, of which 143 were treated with low-dose alteplase and 63 were treated with standard-dose alteplase. After accounting for confounding factors, we observed that there were no statistically significant differences between the standard- and low-dose groups with respect to excellent functional recovery [adjusted odds ratio = 1.22 (aOR), 95% confidence interval (CI): 0.62-2.39; adjusted rate difference (aRD) = 4.6%, and 95% CI: -11.2 to 20.3%]. Patients of both groups had similar rates of functional independence, ENI, END, any ICH, sICH, and 90-day mortality. In the subgroup analysis, patients aged ≥70 years were more likely to achieve excellent functional recovery when receiving standard-dose rather than low-dose alteplase.

CONCLUSION: The effectiveness of low-dose alteplase might be comparable to that of standard-dose alteplase in AIS patients aged <70 years with favorable perfusion-imaging profiles in the unknown or extended time window but not in those aged ≥70 years. Furthermore, low-dose alteplase did not significantly reduce the risk of sICH compared to standard-dose alteplase.

PMID:37188314 | PMC:PMC10175638 | DOI:10.3389/fneur.2023.1165237

3 Biotech. 2023 Jun;13(6):177. doi: 10.1007/s13205-023-03599-8. Epub 2023 May 11.

ABSTRACT

Chickpea (Cicer arietinum L.) seeds are valued for their nutritional scores and limited information on the molecular mechanisms of chickpea fertilization and seed development is available. In the current work, comparative transcriptome analysis was performed on two different stages of chickpea ovules (pre- and post-fertilization) to identify key regulatory transcripts. Two-staged transcriptome sequencing was generated and over 208 million reads were mapped to quantify transcript abundance during fertilization events. Mapping to the reference genome showed that the majority (92.88%) of high-quality Illumina reads were aligned to the chickpea genome. Reference-guided genome and transcriptome assembly yielded a total of 28,783 genes. Of these, 3399 genes were differentially expressed after the fertilization event. These involve upregulated genes including a protease-like secreted in CO(2) response (LOC101500970), amino acid permease 4-like (LOC101506539), and downregulated genes MYB-related protein 305-like (LOC101493897), receptor like protein 29 (LOC101491695). WGCNA analysis and pairwise comparison of datasets, successfully constructed four co-expression modules. Transcription factor families including bHLH, MYB, MYB-related, C₂H₂ zinc finger, ERF, WRKY and NAC transcription factor were also found to be activated after fertilization. Activation of these genes and transcription factors results in the accumulation of carbohydrates and proteins by enhancing their trafficking and biosynthesis. Total 17 differentially expressed genes, were randomly selected for qRT-PCR for validation of transcriptome analysis and showed statistically significant correlations with the transcriptome data. Our findings provide insights into the regulatory mechanisms underlying changes in fertilized chickpea ovules. This work may come closer to a comprehensive understanding of the mechanisms that initiate developmental events in chickpea seeds after fertilization.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-023-03599-8.

PMID:37188294 | PMC:PMC10175530 | DOI:10.1007/s13205-023-03599-8

Drug Des Devel Ther. 2023 May 8;17:1395-1403. doi: 10.2147/DDDT.S407602. eCollection 2023.

ABSTRACT

OBJECTIVE: Remifentanil, in combination with etomidate and sevoflurane, is commonly used in clinics for general anesthesia induction in cesarean section (CS). This study aimed to evaluate the correlation between the induction to delivery (I-D) time and neonatal plasma drug concentration and anesthesia, as well as its effects on neonates.

METHODS: Fifty-two parturients in whom general anesthesia was induced for CS were divided into group A (I-D<8 min) and group B (I-D≥8 min). Maternal arterial (MA), umbilical venous (UV), and umbilical arterial (UA) blood samples were collected at delivery to analyze the remifentanil and etomidate concentrations using liquid chromatography-tandem mass spectrometry.

RESULTS: There were no statistically significant differences between the two groups in terms of plasma concentrations of remifentanil in the MA, UA, and UV blood (P > 0.05). The plasma concentration of etomidate in MA and UV was higher in group A than that in group B (P<0.05), whereas the UA/UV ratio of etomidate was higher in group B than that in group A (P<0.05). The Spearman rank correlation test showed no correlation between the I-D time and plasma remifentanil concentration in the MA, UA, and UV plasma (P>0.05). The concentrations of etomidate in the MA and UV were negatively correlated with the I-D time (P < 0.05).

CONCLUSION: Prolonged I-D time did not significantly influence the maternal or neonatal plasma concentration of remifentanil. It is safe to administer remifentanil target-controlled infusion in combination with etomidate and sevoflurane for general anesthesia induction during CS.

PMID:37188282 | PMC:PMC10179318 | DOI:10.2147/DDDT.S407602

Front Public Health. 2023 Apr 28;11:1091709. doi: 10.3389/fpubh.2023.1091709. eCollection 2023.

ABSTRACT

Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989-2020. However, we emphasized the current trends, 2013-2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported.

PMID:37188278 | PMC:PMC10176454 | DOI:10.3389/fpubh.2023.1091709

J Stroke Cerebrovasc Dis. 2023 May 13;32(8):107173. doi: 10.1016/j.jstrokecerebrovasdis.2023.107173. Online ahead of print.

ABSTRACT

BACKGROUND: To examine the reasonable duration of continuous electrocardiographic monitoring (CEM) to detect AF at acute ischemic stroke.

MATERIALS AND METHOD: 811 consecutive patients admitted to Tsuruga Municipal Hospital by acute ischemic stroke between April 2013 and December 2021 were enrolled in this study. Excluding 78 patients, 733 patients were analyzed by cluster analysis with SurvCART algorithm, followed by Kaplan-Meier analysis.

RESULTS: The analysis provided step graphs for 8 subgroups. The duration of CEM to achieve the sensitivity of 0.8, 0.9, and 0.95 in each could be calculated. The duration of CEM to achieve the sensitivity of 0.8 are 18 days in female patients with heart failure (HF) (subgroup 1), 24 days in male patients with HF (subgroup 2), 22 days in patients without HF with arterial occlusion and pulse rate (PR) more than 91 (subgroup 3), 24 days in patients without HF with occlusion with PR less than 91 (subgroup 4), 18 days in patients without HF without occlusion with lacuna (subgroup 5), 26 days in patients without HF, occlusion, and lacuna, with arterial stenosis (subgroup 6), 15 days in patients without HF, occlusion, lacuna, and stenosis with BMI more than 21%(subgroup 7), and 44 days in patients without HF, occlusion, lacuna, stenosis and with BMI less than 21% (subgroup 8).

CONCLUSIONS: Duration of CEM with the sensitivity of 0.8, 0.9, and 0.95 could be determined by presence of HF, female sex, arterial occlusion, PR more than 91/minute, presence of lacuna, presence of stenosis, and BMI more than 21%. (250).

PMID:37186969 | DOI:10.1016/j.jstrokecerebrovasdis.2023.107173

JCO Oncol Pract. 2023 May 15:OP2300043. doi: 10.1200/OP.23.00043. Online ahead of print.

ABSTRACT

PURPOSE: Multimodal care for cancer cachexia is needed. This study examined factors associated with practicing multimodal cachexia care among physicians and nurses engaging in cancer care.

METHODS: This was a preplanned secondary analysis of a survey investigating clinicians’ perspectives on cancer cachexia. Data of physicians and nurses were used. Data on knowledge, skills, and confidence in multimodal cachexia care were obtained. Nine items on practicing multimodal cachexia care were evaluated. Participants were divided into two groups as practicing multimodal cachexia care (above median value for the nine items) or not. Comparisons were made using the Mann-Whitney U test or chi-square test. Multiple regression analysis was performed to identify the factors of practicing the multimodal care.

RESULTS: Total of 233 physicians and 245 nurses were included. Significant differences were observed between the groups: female sex (P = .025), palliative care versus oncology specialization (P < .001), the number of clinical guidelines used (P < .001), the number of symptoms used (P = .005), training for cancer cachexia (P = .008), knowledge on cancer cachexia (P < .001), and confidence in cancer cachexia management (P < .001). Palliative care specialization (partial regression coefficient [B] = 0.85; P < .001), the number of clinical guidelines used (B = 0.44; P < .001), knowledge on cancer cachexia (B, 0.94; P < .001), and confidence in cancer cachexia management (B = 1.59; P < .001) were statistically significant in multiple regression analysis.

CONCLUSION: Specialization in palliative care, specific knowledge, and confidence were associated with the practice of multimodal care for cancer cachexia.

PMID:37186884 | DOI:10.1200/OP.23.00043

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2216765120. doi: 10.1073/pnas.2216765120. Epub 2023 May 15.

ABSTRACT

Urbanization extensively modifies surface roughness and properties, impacting regional climate and hydrological cycles. Urban effects on temperature and precipitation have drawn considerable attention. These associated physical processes are also closely linked to clouds’ formation and dynamics. Cloud is one of the critical components in regulating urban hydrometeorological cycles but remains less understood in urban-atmospheric systems. We analyzed satellite-derived cloud patterns spanning two decades over 447 US cities and quantified the urban-influenced cloud patterns diurnally and seasonally. The systematic assessment suggests that most cities experience enhanced daytime cloud cover in both summer and winter; nocturnal cloud enhancement prevails in summer by 5.8%, while there is modest cloud suppression in winter nights. Statistically linking the cloud patterns with city properties, geographic locations, and climate backgrounds, we found that larger city size and stronger surface heating are primarily responsible for summer local cloud enhancement diurnally. Moisture and energy background control the urban cloud cover anomalies seasonally. Under strong mesoscale circulations induced by terrains and land-water contrasts, urban clouds exhibit considerable nighttime enhancement during warm seasons, which is relevant to strong urban surface heating interacting with these circulations, but other local and climate impacts remain complicated and inconclusive. Our research unveils extensive urban influences on local cloud patterns, but the effects are diverse depending on time, location, and city properties. The comprehensive observational study on urban-cloud interactions calls for more in-depth research on urban cloud life cycles and their radiative and hydrologic implications under the urban warming context.

PMID:37186862 | DOI:10.1073/pnas.2216765120

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2213836120. doi: 10.1073/pnas.2213836120. Epub 2023 May 15.

ABSTRACT

In recent years, cellular biomechanical properties have been investigated as an alternative to morphological assessments for oocyte selection in reproductive science. Despite the high relevance of cell viscoelasticity characterization, the reconstruction of spatially distributed viscoelastic parameter images in such materials remains a major challenge. Here, a framework for mapping viscoelasticity at the subcellular scale is proposed and applied to live mouse oocytes. The strategy relies on the principles of optical microelastography for imaging in combination with the overlapping subzone nonlinear inversion technique for complex-valued shear modulus reconstruction. The three-dimensional nature of the viscoelasticity equations was accommodated by applying an oocyte geometry-based 3D mechanical motion model to the measured wave field. Five domains-nucleolus, nucleus, cytoplasm, perivitelline space, and zona pellucida-could be visually differentiated in both oocyte storage and loss modulus maps, and statistically significant differences were observed between most of these domains in either property reconstruction. The method proposed herein presents excellent potential for biomechanical-based monitoring of oocyte health and complex transformations across lifespan. It also shows appreciable latitude for generalization to cells of arbitrary shape using conventional microscopy equipment.

PMID:37186851 | DOI:10.1073/pnas.2213836120

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2301707120. doi: 10.1073/pnas.2301707120. Epub 2023 May 15.

ABSTRACT

[C. Koch, S. Ullman, Hum. Neurobiol.4, 219-227 (1985)] proposed a 2D topographical salience map that took feature-map outputs as its input and represented the importance “saliency” of the feature inputs at each location as a real number. The computation on the map, “winner-take-all,” was used to predict action priority. We propose that the same or a similar map is used to compute centroid judgments, the center of a cloud of diverse items. [P. Sun, V. Chu, G. Sperling, Atten. Percept. Psychophys.83, 934-955 (2021)] demonstrated that following a 250-msec exposure of a 24-dot array of 3 intermixed colors, subjects could accurately report the centroid of each dot color, thereby indicating that these subjects had at least three salience maps. Here, we use a postcue, partial-report paradigm to determine how many more salience maps subjects might have. In 11 experiments, subjects viewed 0.3-s flashes of 28 to 32 item arrays composed of M, M = 3,…,8, different features followed by a cue to mouse-click the centroid of items of just the post-cued feature. Ideal detector response analyses show that subjects utilized at least 12 to 17 stimulus items. By determining whether a subject’s performance in (M-1)-feature experiments could/could-not predict performance in M-feature experiments, we conclude that one subject has at least 7 and the other two have at least five salience maps. A computational model shows that the primary performance-limiting factors are channel capacity for representing so many concurrently presented groups of items and working-memory capacity for so many computed centroids.

PMID:37186842 | DOI:10.1073/pnas.2301707120

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2216234120. doi: 10.1073/pnas.2216234120. Epub 2023 May 15.

ABSTRACT

Neurodegenerative diseases, such as Alzheimer’s disease (AD), are associated with protein misfolding and aggregation into amyloid fibrils. Increasing evidence suggests that soluble, low-molecular-weight aggregates play a key role in disease-associated toxicity. Within this population of aggregates, closed-loop pore-like structures have been observed for a variety of amyloid systems, and their presence in brain tissues is associated with high levels of neuropathology. However, their mechanism of formation and relationship with mature fibrils have largely remained challenging to elucidate. Here, we use atomic force microscopy and statistical theory of biopolymers to characterize amyloid ring structures derived from the brains of AD patients. We analyze the bending fluctuations of protofibrils and show that the process of loop formation is governed by the mechanical properties of their chains. We conclude that ex vivo protofibril chains possess greater flexibility than that imparted by hydrogen-bonded networks characteristic of mature amyloid fibrils, such that they are able to form end-to-end connections. These results explain the diversity in the structures formed from protein aggregation and shed light on the links between early forms of flexible ring-forming aggregates and their role in disease.

PMID:37186840 | DOI:10.1073/pnas.2216234120