Tag: nevin manimala

Urol J. 2022 Jun 11:7195. doi: 10.22037/uj.v19i.7195. Online ahead of print.

ABSTRACT

PURPOSE: To explore the establishment of a scoring system that can provide a reference for clinical decision making regarding the endoscopic treatment of 1-2 cm lower pole stones (LPS).

MATERIALS AND METHODS: The data of patients with renal calculi who were treated with percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) in three hospitals from January 2013 to December 2017 were analyzed retrospectively. Multivariable logistic analysis was performed to determine the statistically significant indicators and regression coefficients, which were used to construct the scoring system. The stone-free rate (SFR) and postoperative complication rates of PCNL and RIRS within the two fractional segments of the scoring system were compared to select the optimal procedures.

RESULTS: A total of 137 patients in the PCNL group and 152 patients in the RIRS group were included in this study. Five factors were found to be most predictive of endoscopic treatment choice: stone number, stone diameter, infundibulopelvic angle (IPA), infundibular length (IL), and infundibular width (IW), yielding a total score ranging from 0-5. In the 0-2 segments, the RIRS group had better outcomes than the PCNL group in terms of the postoperative complication rates (6.8% versus 18.0%, P = .026). In segments 3-5, the SFR of the PCNL group was significantly higher than that of the RIRS group (88.5% versus 70.6%, P = .017).

CONCLUSION: Our scoring system was based on the patient’s preoperative imaging examination to measure the stone number, stone diameter, IPA, IL and IW. RIRS was recommended at 0-2 segments, and PCNL was recommended at 3-5 segments. This new scoring system is expected to provide guidance for urologists to make endoscopic treatment decisions for 1-2 cm LPS.

PMID:35689463 | DOI:10.22037/uj.v19i.7195

J Bone Miner Res. 2022 Jun 11. doi: 10.1002/jbmr.4632. Online ahead of print.

ABSTRACT

New therapies may help to prevent osteoporotic fractures other than through increasing bone mineral density (BMD). Since fracture risk has an important genetic component, we aim to identify loci increasing fracture risk which do not decrease BMD, using a recently-proposed structural equation model adapted to remove genetic influences of BMD on fracture risk. We used summary statistics of the largest genome-wide association studies for BMD and for fracture in these analyses. We next estimated the genetic correlation between the non-BMD or BMD-related genetic effects and other clinical risk factors for fracture. Lastly, based on White British participants in the UK Biobank, we conducted genetic risk score analyses to assess whether the aggregated genetic effects conferred increased major osteoporotic fracture risk. We found that only three loci affecting fracture risk exhibited genetic effects not mediated by BMD: SOST, CPED1-WNT16, and RSPO3, while these three loci simultaneously conferred BMD-related effects. No strong genetic associations between non-BMD or BMD-related effects and 16 clinical risk factors were observed. However, non-BMD effects might be genetic correlated with hip bone size. In the UK Biobank, a one standard deviation increase in the non-BMD genetic risk score conferred an odds ratio of 1.17 of incident major osteoporotic fracture, compared to 1.29 for a BMD-related genetic risk score. Our study suggests that the vast majority of common genetic predisposition towards fracture risk acts upon BMD. While non-BMD genetic effects may exist, they are not strongly correlated with most traditional clinical risk factors. Risk loci harboring non-BMD genetic effects may influence other perspectives of bone quality, or confer effects that existing genome-wide association studies fail to capture, but they demonstrate weaker impact on fracture risk than BMD-related genetic effects. These findings suggest that most successful drug development programs for osteoporosis should focus on pathways identified through BMD-associated loci. This article is protected by copyright. All rights reserved.

PMID:35689460 | DOI:10.1002/jbmr.4632

Hum Reprod. 2022 Jun 11:deac136. doi: 10.1093/humrep/deac136. Online ahead of print.

ABSTRACT

STUDY QUESTION: Could the direct contribution of genetic variants to the pathophysiology of uterine fibroids and the contribution mediated by age at menarche be different?

SUMMARY ANSWER: Age at menarche plays a mediation role in the genetic influence on uterine fibroids, and four causal genetic mechanisms underlying the age at menarche-mediated effects of common genetic loci on uterine fibroid development were identified.

WHAT IS KNOWN ALREADY: Uterine fibroids are common benign tumors developing from uterine smooth muscle. Genome-wide association studies (GWASs) have identified over 30 genetic loci associated with uterine fibroids in different ethnic populations. Several genetic variations in or nearby these identified loci were also associated with early age at menarche, one of the major risk factors of uterine fibroids. Although the results of GWASs reveal how genetic variations affect uterine fibroids, the genetic mechanism of uterine fibroids mediated by age at menarche remains elusive.

STUDY DESIGN, SIZE, DURATION: In this study, we conducted a genome-wide causal mediation analysis in two cohorts covering a total of 69 552 females of Han Chinese descent from the Taiwan Biobank (TWB). TWB is an ongoing community- and hospital-based cohort aiming to enroll 200 000 individuals from the general Taiwanese population between 30 and 70 years old. It has been enrolling Taiwanese study participants since 2012 and has extensive phenotypic data collected from 148 291 individuals as of May 2021.

PARTICIPANTS/MATERIALS, SETTING, METHODS: We recruited individuals in two cohorts, with 13 899 females in TWB1 and 55 653 females in TWB2. The two sets of individuals are almost distinct, with only 730 individuals enrolled in both cohorts. Over 99% of the participants are Han Chinese. Approximately 21% of participants developed uterine fibroids. DNA samples from both cohorts were genotyped using two different customized chips (TWB1 and TWB2 arrays). After quality control and genotype imputation, 646 973 TWB1 single-nucleotide polymorphisms (SNPs) and 686 439 TWB2 SNPs were assessed in our analysis. There were 99 939 SNPs which overlapped between the TWB1 and TWB2 arrays, 547 034 TWB1 array-specific SNPs and 586 500 TWB2 array-specific SNPs. We performed GWASs for screening potential risk SNPs for age at menarche and for uterine fibroids. We subsequently identified causal mediation effects of risk SNPs on uterine fibroids mediated by age at menarche.

MAIN RESULTS AND THE ROLE OF CHANCE: In addition to known loci at LIN28B associated with age at menarche and loci at WNT4 associated with uterine fibroids, we identified 162 SNPs in 77 transcripts that were associated with menarche-mediated causal effects on uterine fibroids via four different causal genetic mechanisms: a both-harmful group with 52 SNPs, a both-protective group with 34 SNPs, a mediator-harmful group with 22 SNPs and a mediator-protective group with 54 SNPs. Among these SNPs, rs809302 in SLK significantly increased the risk of developing uterine fibroids by 3.92% through a mechanism other than age at menarche (P < 10-10), and rs371721345 in HLA-DOB was associated with a 2.70% decreased risk (P < 10-10) in the occurrence of uterine fibroids, mediated by age at menarche. These findings provide insights into the mechanism underlying the effect of genetic loci on uterine fibroids mediated by age at menarche.

LIMITATIONS, REASONS FOR CAUTION: A potential issue is that the present study relied upon self-reported age at menarche and uterine fibroid information. Due to the experimental design, the consistency between self-reports and medical records for uterine fibroids in Taiwan cannot be checked. Fortunately, the literature support that self-reporting even years later remains a practical means for collecting data on menarche and uterine fibroids. We found that the impact of under-reporting of uterine fibroids is less in our study. In addition, the rate of reporting a diagnosis of uterine fibroids was within the rates of medical diagnosis based on national health insurance data. Future work investigating the consistency between self-reports and medical records in Taiwan can remedy this issue.

WIDER IMPLICATIONS OF THE FINDINGS: This study is the first to investigate whether and to what extent age at menarche mediates the causal effects of genetic variants on uterine fibroids by using genome-wide causal mediation analysis. By treating age at menarche as a mediator, this report provides an insight into the genetic risk factors for developing uterine fibroids. Thus, this article represents a step forward in deciphering the role of intermediated risk factors in the genetic mechanism of disease.

STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the China Medical University, Taiwan (CMU110-ASIA-13 and CMU107-Z-04), the Ministry of Science and Technology, Taiwan (MOST 110-2314-B-039-058) and the International Joint Usage/Research Center, the Institute of Medical Science, the University of Tokyo, Japan (K2104). The authors have no competing interests.

TRIAL REGISTRATION NUMBER: N/A.

PMID:35689443 | DOI:10.1093/humrep/deac136

Int J Cosmet Sci. 2022 Jun 10. doi: 10.1111/ics.12794. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Premature skin ageing, and skin hyperpigmentation are influenced by exogenous factors such as ultraviolet radiation and blue light. In this study, we assess the protective effect of a sunscreen (TDF® Blu Voile Sunscreen) in protecting the skin against the harmful effects of blue light irradiation in vivo and through the in situ quantitative and qualitative evaluation of protein carbonylation in human skin explants.

METHODOLOGY: The protective effect of the test product against blue light was first evaluated ex vivo on human skin explants. The treated and non-treated explants were exposed to 14J/cm² of blue light 460 nm following which the protein carbonylation was evaluated by in situ epifluorescence imaging and separation by high resolution gel electrophoresis. To determine whether the test product could also protect against the immediate and persistent pigmenting effect of blue light, two randomized in vivo studies were conducted, which included respectively 17 subjects with a skin phototype of IV and V (Fitzpatrick classification) and 22 subjects with a skin phototype of IV, V and VI (Fitzpatrick classification). The duration of the study for each subject was 2 days (D1 and D2) for immediate observations and 5 days (D1-D5) for persistent observations. Specific zones on the subjects’ back were either left non-treated or treated with the test product and were then exposed to a unique dose of blue light 415 nm. The onset of pigmentation between the treated and exposed zones was then assessed relative to the non-exposed treated zone through colorimetric measurements of the Individual Typology Angle (ITA^o ).

RESULTS: Human skin explants treated with test product showed significantly lower levels of accumulated carbonylated proteins, with a protection of 82%, following exposure to blue light 460 nm. Findings of the in vivo studies also indicated that the test product presented significantly better protective efficacy against immediate and persistent pigmentation induced by blue light 415 nm.

CONCLUSION: Hence, it can be concluded that the test product can protect against the oxidative stress as well as the immediate and persistent pigmentation induced by blue light.

PMID:35689421 | DOI:10.1111/ics.12794

J Nurs Manag. 2022 Jun 10. doi: 10.1111/jonm.13708. Online ahead of print.

ABSTRACT

AIMS: To explore the prevalence and potential facilitators and inhibitors of compassion fatigue and compassion satisfaction among Chinese palliative care nurses.

BACKGROUND: Nurses with compassion fatigue may suffer from health-related problems, causing decreased work efficiency and quality of care. Palliative care nurses are especially at risk of compassion fatigue due to close contact with terminal patients.

METHODS: A province-wide cross-sectional survey using convenience sampling was conducted among 318 palliative care nurses at 25 hospitals and healthcare institutions in Sichuan Province, China. Data were collected using demographic questionnaire and five scales: Professional Quality of Life Scale, General Self-Efficacy Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Connor-Davison Resilience Scale. Data analyses including descriptive statistics, t-test, one-way ANOVA, simple linear regression, and multiple linear regression.

RESULTS: Mean scores (SD) for burnout, secondary traumatic stress, and compassion satisfaction were 25.42 (4.75), 26.08 (5.72), and 35.67 (5.77), respectively. Related factors predicted 40.30%, 27.10%, and 35.4% of the variance in the model of burnout, secondary traumatic stress, and compassion satisfaction, respectively (all P<0.001).

CONCLUSIONS: The levels of burnout and secondary traumatic stress among Chinese palliative care nurses were higher than those among other types of nurses. Social support, resilience, positive coping, family recognition of work, and income satisfaction are inhibitors of compassion fatigue among palliative care nurses. Implications for Nursing Management Nursing administrators and educators should consider providing effective and targeted strategies (e.g. ongoing training and psychological interventions) to decrease compassion fatigue among palliative care nurses based on the cultural and ethical settings.

PMID:35689416 | DOI:10.1111/jonm.13708

J Dent Res. 2022 Jun 10:220345221100234. doi: 10.1177/00220345221100234. Online ahead of print.

ABSTRACT

The periodontal ligament (PDL) provides support, proprioception, nutrition, and protection within the tooth-PDL-bone complex (TPBC). While understanding the mechanical behavior of the PDL is critical, current research has inferred PDL mechanics from finite element models, from experimental measures on complete TPBCs, or through direct measurement of isolated PDL sections. Here, transducers are used in an attempt to quantify ex vivo PDL strain. In-fiber Bragg grating (FBG) sensors are small flexible sensors that can be placed within an intact TPBC and yield repeatable strain measurements from within the PDL space. The objective of this study was to determine: 1) if the FBG strain measured from the PDL space of intact swine premolars ex vivo was equivalent to physical PDL strains estimated through finite element analysis and 2) if a change in FBG strain could be linearly related to a change in finite element strain under variable tooth displacement, applied to an intact swine TPBC. Experimentally, individual TPBCs were subjected to 2 displacements (n = 14). The location of the FBG was determined from representative micro-computed tomography images. From a linear elastic finite element model of a TPBC, the strain magnitudes at the sensor locations were recorded. An experimental ratio (i.e., FBG strain at the first displacement divided by the FBG strain at the second displacement) and a finite element ratio (i.e., finite element strain at the first displacement divided by the finite element strain at the second displacement) were calculated. A linear regression model indicated a statistically significant relationship between the experimental and finite element ratio (P = 0.017) with a correlation coefficient (R²) of 0.448. It was concluded that the FBG sensor could be used as a measure for a change in strain and thus could be implemented in applications where the mechanical properties of an intact PDL are monitored over time.

PMID:35689395 | DOI:10.1177/00220345221100234

Neuropathol Appl Neurobiol. 2022 Jun 10:e12828. doi: 10.1111/nan.12828. Online ahead of print.

ABSTRACT

OBJECTIVES: Acute Nipah (NiV) encephalitis is characterised by a dual pathogenetic mechanism of neuroglial infection and ischaemia-microinfarction associated with vasculitis induced thrombotic occlusion. We investigated the contributions of these two mechanisms in fatal cases.

MATERIALS AND METHODS: We analysed brain tissues (cerebrum, brainstem and cerebellum) from 15 autopsies using light microscopy, immunohistochemistry (IHC), in situ hybridization and quantitative methods RESULTS: Three types of discrete plaque-like parenchymal lesions were identified: Type 1 with neuroglial IHC positivity for viral antigens, and minimal or no necrosis; Type 2 with neuroglial immunopositivity and necrosis; and Type 3 with necrosis but no viral antigens. Most viral antigen/RNA-positive cells were neurons. Cerebral glial immunopositivity was rare suggesting that microinfarction played a more important role in white matter injury. Type 1 lesions were also detected in the brainstem and cerebellum, but the differences between cerebral cortex and these 2 regions were not statistically significant. In the cerebral cortex, Type 1 lesions overwhelmingly predominated, and only 14% Type 1 versus 69% Type 2 lesions were associated with thrombosis. This suggests that neuronal infection as a mechanism of pathogenesis was more important than microinfarction, both in general and in Type 1 lesions in particular. Between the “early” group (<8 days fever) and the “late” group (≥ 8 days fever), there was a decrease of Type 1 and Type 2 lesions with a concomitant increase of Type 3 lesions, suggesting the latter possibly represented late-stage microinfarction and/or neuronal infection.

CONCLUSION: Neuronal infection appears to play a more important role than vasculopathy-induced microinfarction in acute NiV encephalitis.

PMID:35689364 | DOI:10.1111/nan.12828

Med Sci Monit. 2022 Jun 11;28:e936614. doi: 10.12659/MSM.936614.

ABSTRACT

BACKGROUND Extracorporeal shock wave therapy (ESWT) is a modern physiotherapeutic method that is useful for treating musculoskeletal conditions. There are still limited data from well-designed studies evaluating the clinical efficiency of ESWT in low back pain (LBP). Therefore, this study aimed to assess the effectiveness of the focused ESWT (fESWT) in reducing pain and improving the functional status of patients with chronic LBP. MATERIAL AND METHODS The study involved 40 patients with L5-S1 discopathy with chronic LBP pain who were randomized into 2 groups: group A (n=20, mean age of 42.3±13.1 years) and group B (n=20, mean age of 45.4±14 years). Group A was an experimental group treated with an fESWT at the lumbar and sacral spine (0.15 mJ/mm², 1000 pulses, 4 Hz). Group B was a control group, treated with a sham fESWT. The treatment protocol in both groups included identical stabilization training (45 minutes, once a day, 5 days a week). Study outcomes included subjective pain with a visual analog scale (VAS) and Laitinen Pain Scale (LPS), and functional status using the Oswestry Disability Index (ODI). Measurements were made before and after treatments, as well as follow-up observations at 1 and 3 months following ESWT. The study was prospectively registered at the ISRCTN registry platform (no. ISRCTN13785224). RESULTS There was a significant analgesic effect (VAS and LPS) in both groups; however, it was significantly greater in the experimental group compared to the sham group (P<0.05). A more significant decrease in the perceived pain (VAS and LPS) was observed immediately after the active fESWT therapy. In follow-up observations (after 1 and 3 months), there were no significant between-group differences (P>0.05). Also, there was a significant effect in terms of functional state (ODI) for both groups (P<0.05); however, between-group comparisons revealed no statistically significant differences (P>0.05). CONCLUSIONS Focused ESWT with an exercise program can be effective in patients with chronic LBP. ESWT allows reducing pain, although it does not seem to significantly improve a patient’s functional state.

PMID:35689370 | DOI:10.12659/MSM.936614

Ann Neurol. 2022 Jun 10. doi: 10.1002/ana.26431. Online ahead of print.

ABSTRACT

OBJECTIVE: Cerebral venous thrombosis caused by vaccine-induced immune thrombotic thrombocytopenia (VITT-CVT) is a rare adverse effect of adenovirus-based SARS-CoV-2 vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality.

METHODS: We used data from an international prospective registry of patients with CVT after adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable or definite VITT-CVT cases included until 18 January 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis.

RESULTS: 99 VITT-CVT patients from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11/24 (46%), and 28/37 (76%) of patients diagnosed in March, April, and from May onwards, respectively, were treated in-line with VITT recommendations (p<0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 (32%) vs 29/55 (52%), adjusted OR 0.43 (95%CI 0.16-1.19)). However, patients who received immunomodulation had lower mortality (19/65 (29%) vs 24/34 (70%), adjusted OR 0.19 (95%CI 0.06-0.58)). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 (33%) vs 13/35 (37%), adjusted OR 0.70 (95%CI 0.24-2.04)). Mortality was also not significantly influenced by platelet transfusion (17/27 (63%) vs 26/72 (36%), adjusted OR 2.19 (95%CI 0.74-6.54)).

CONCLUSIONS: In VITT-CVT patients, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. This article is protected by copyright. All rights reserved.

PMID:35689346 | DOI:10.1002/ana.26431

Aliment Pharmacol Ther. 2022 Jul;56(1):186-187. doi: 10.1111/apt.16982.

NO ABSTRACT

PMID:35689317 | DOI:10.1111/apt.16982