Tag: nevin manimala

ACS Macro Lett. 2022 Oct 4:1217-1223. doi: 10.1021/acsmacrolett.2c00517. Online ahead of print.

ABSTRACT

Poly(methyl methacrylate/n-butyl acrylate) [P(MMA/BA)] copolymer with an alternating structure was synthesized via an activator regenerated by electron transfer (ARGET) atom transfer radical (co)polymerization (ATRP) of 2-ethylfenchyl methacrylate (EFMA) and n-butyl acrylate (BA) with subsequent postpolymerization modifications (PPM). Due to the steric hindrance of the bulky pendant group of EFMA, as well as the low reactivity ratio of BA in copolymerization with methacrylates, copolymerization of EFMA and BA generated a copolymer with a high content of alternating dyads. A subsequent PPM procedure of the alternating EFMA/BA copolymer was comprised of the hydrolysis of a tertiary ester by trifluoroacetic acid and methylation by (trimethylsilyl)diazomethane. After the modifications, the architecture of the obtained alternating MMA/BA copolymers was compared with gradient and statistical copolymers with overall similar compositions, molecular weights, and dispersities. ¹³C NMR indicated the absence of either MMA/MMA/MMA or BA/BA/BA sequences, in contrast to an abundance of homotriads in either the statistical or especially in the gradient copolymer. All three copolymers had similar glass transition temperatures, as measured by differential scanning calorimetry (DSC), but the alternating copolymer had the narrowest range of glass transition.

PMID:36194204 | DOI:10.1021/acsmacrolett.2c00517

J Chin Med Assoc. 2022 Oct 4. doi: 10.1097/JCMA.0000000000000819. Online ahead of print.

ABSTRACT

BACKGROUND: Neoadjuvant concurrent chemoradiotherapy (nCCRT) followed by total mesorectal excision has become the standard of care for advanced rectal cancer, but the most effective regimen of chemotherapeutic agents has not yet been determined. The purpose of this study is to determine the effect of Mitomycin-C (MMC) in nCCRT for rectal cancer.

METHODS: From 2000 to 2017, patients with rectal adenocarcinoma who received nCCRT followed by radical surgery were enrolled in our study. The patients were retrospectively separated into two groups according to nCCRT regimens (with or without MMC). Other factors related to cancer downstaging after nCCRT, disease-free survival (DFS) and overall survival (OS)were analyzed.

RESULTS: One hundred ninety-five patients received radiotherapy (RT) + MMC + oral tegafur-uracil (UFUR), and 191 patients received RT + UFUR without MMC as neoadjuvant CCRT. Adding MMC might increase the downstaging rate (odds ratio (OR) = 1.520, p = 0.058), and downstaging had significant effect to improve overall survival (OR = 1.726, p = 0.002) and disease-free survival (OR = 2.185, p < 0.001). The overall survival and disease-free survival were improved in patients who received MMC, although this result did not reach a statistically significant difference. There was a higher incidence of low-grade toxicities in the MMC group, especially neutropenia, genitourinary side effects, and dermatological side effects (p < 0.001).

CONCLUSION: Adding MMC to the regimen of nCCRT for rectal adenocarcinoma is shown to increase tumor downstaging rate and improve disease-free and overall survival, although these benefits come at the cost of increased low-grade toxicities. Prospective randomized studies are needed to explore the role of MMC in nCCRT for rectal cancer.

PMID:36194168 | DOI:10.1097/JCMA.0000000000000819

J Chin Med Assoc. 2022 Oct 4. doi: 10.1097/JCMA.0000000000000818. Online ahead of print.

ABSTRACT

BACKGROUND: Iron is a vital trace element for energy production and oxygen transportation; importantly, it is essential to athletic performance. Maintaining iron balance is tightly controlled at systemic and cellular levels. This study aimed to determine serum iron tests, hepcidin levels, and cellular iron import and export activities in peripheral blood mononuclear cells (PBMCs) in ultramarathon runners to elucidate the association of systemic inflammation response and iron metabolism.

METHODS: Sixteen amateur runners were enrolled. Blood samples were taken one week before, immediate, and 24 h after the run. Plasma hepcidin levels were measured by enzyme-linked immunosorbent assay. The expression levels of divalent metal iron transporter 1 (DMT1), ZRT/IRT-like protein 14 (ZIP14), transferrin receptor 1 (TfR1), and ferroportin (FPN) in PBMCs were measured using real-time quantitative reverse-transcription polymerase chain reaction.

RESULTS: Serum iron concentrations and transferrin saturation significantly decreased immediately after the race and dramatically recovered 24 h post-race. Serum ferritin levels had a statistically significant rise immediately after the race and remained high 24 h after the completion of the race. Ultramarathons were associated with increased plasma interleukin (IL)-6 concentrations corresponding to the state of severe systemic inflammation and therefore boosted plasma hepcidin levels. The expression levels of DMT1 and FPN mRNA were markedly decreased immediately and 24 h after the race. The ZIP14 and TfR1 mRNA expression in PBMCs significantly decreased immediately after the race and returned to the baseline level at 24 h post-race. Positive significant correlations were observed between plasma hepcidin and ferritin levels.

CONCLUSION: Iron homeostasis and systemic inflammatory response are closely interconnected. Cellular iron import and export mRNA activities in PBMCs were acutely inhibited during an ultramarathon.

PMID:36194166 | DOI:10.1097/JCMA.0000000000000818

Radiology. 2022 Oct 4:213256. doi: 10.1148/radiol.213256. Online ahead of print.

ABSTRACT

Background MRI is a standard of care tool to measure liver iron concentration (LIC). Compared with regulatory-approved R2 MRI, R2* MRI has superior speed and is available in most MRI scanners; however, the cross-vendor reproducibility of R2*-based LIC estimation remains unknown. Purpose To evaluate the reproducibility of LIC via single-breath-hold R2* MRI at both 1.5 T and 3.0 T with use of a multicenter, multivendor study. Materials and Methods Four academic medical centers using MRI scanners from three different vendors (three 1.5-T scanners, one 2.89-T scanner, and two 3.0-T scanners) participated in this prospective cross-sectional study. Participants with known or suspected liver iron overload were recruited to undergo multiecho gradient-echo MRI for R2* mapping at 1.5 T and 3.0 T (2.89 T or 3.0 T) on the same day. R2* maps were reconstructed from the multiecho images and analyzed at a single center. Reference LIC measurements were obtained with a commercial R2 MRI method performed using standardized 1.5-T spin-echo imaging. R2*-versus-LIC calibrations were generated across centers and field strengths using linear regression and compared using F tests. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic performance of R2* MRI in the detection of clinically relevant LIC thresholds. Results A total of 207 participants (mean age, 38 years ± 20 [SD]; 117 male participants) were evaluated between March 2015 and September 2019. A linear relationship was confirmed between R2* and LIC. All calibrations within the same field strength were highly reproducible, showing no evidence of statistically significant center-specific differences (P > .43 across all comparisons). Calibrations for 1.5 T and 3.0 T were generated, as follows: for 1.5 T, LIC (in milligrams per gram [dry weight]) = -0.16 + 2.603 × 10^-2 R2* (in seconds^-1); for 2.89 T, LIC (in milligrams per gram) = -0.03 + 1.400 × 10^-2 R2* (in seconds^-1); for 3.0 T, LIC (in milligrams per gram) = -0.03 + 1.349 × 10^-2 R2* (in seconds^-1). Liver R2* had high diagnostic performance in the detection of clinically relevant LIC thresholds (area under the ROC curve, >0.98). Conclusion R2* MRI enabled accurate and reproducible quantification of liver iron overload over clinically relevant ranges of liver iron concentration (LIC). The data generated in this study provide the necessary calibrations for broad clinical dissemination of R2*-based LIC quantification. ClinicalTrials.gov registration no.: NCT02025543 © RSNA, 2022 Online supplemental material is available for this article.

PMID:36194113 | DOI:10.1148/radiol.213256

J Burn Care Res. 2022 Oct 4:irac144. doi: 10.1093/jbcr/irac144. Online ahead of print.

ABSTRACT

It is crucial to provide an adequate level of sedation and analgesia during burn dressing changes in the pediatric population due to the amount of pain and anxiety patients experience during the procedure. To evaluate the safety and efficacy of an intensivist-based deep sedation regimen using a combination of propofol and ketamine to provide procedural sedation to pediatric burn patients. This is a retrospective chart review of pediatric patients who underwent inpatient burn wound dressing changes from 2011 through 2021. Demographic and clinical data, including age, length of the procedure, recovery time, medications doses, and adverse events, were collected. A total of 104 patients aged between 45 and 135 months with a median total burn body surface area (TBSA) of 11.5 % (IQR 4.0, 25.0) underwent 378 procedural sedation encounters with propofol and ketamine-based sedation. The median total dose of propofol was 7 mg/kg (IRQ 5.3, 9.2). Of these sedations, 64 (17%) had minor adverse events, of which 50 (13%) were transient hypoxemia, 12 (3%) were upper airway obstruction, and 2 (0.5%) were hypotension. There were no serious adverse events. Hypoxemia was not related to age, weight, gender, burn TBSA, or total dose of propofol. There were 35 (33.6%) patients who had repetitive sedation encounters with no statistically significant changes in propofol dose or adverse events with the repeated encounters. Children can be effectively sedated for repetitive inpatient burn dressing changes. Given the high-risk patient populations, this procedure should be performed under the vigilance of highly trained providers.

PMID:36194090 | DOI:10.1093/jbcr/irac144

Eur J Transl Myol. 2022 Oct 4. doi: 10.4081/ejtm.2022.10736. Online ahead of print.

ABSTRACT

The endeavor to evaluate the linearity of myofibrillar structures and their potential deviation from a straight line is a fascinating problem in muscle tissue image analysis. In this Letter, we suggest two different strategies for solving the same challenge. The first strategy is based on an alignment index, which could be derived by comparing the sum of the lengths of the individual sarcomeres with the distance between the “head” of the first and the “tail” of the last sarcomere. The second strategy relies on circular statistics, which takes a cue from an already suggested method. Our proposed methods are alternatives: the former has the advantage of simplicity; the latter is certainly more elegant and gives greater substance to statistical analysis, but in contrast, it also has greater computational complexity.

PMID:36193819 | DOI:10.4081/ejtm.2022.10736

Contact Dermatitis. 2022 Oct 4. doi: 10.1111/cod.14230. Online ahead of print.

ABSTRACT

BACKGROUND: This study investigated cases diagnosed as allergic contact dermatitis (ACD) in emergency departments (EDs) and management.

METHODS: A multi-site retrospective study of patients attending EDs in metropolitan Melbourne between July 2017 and June 2018 was performed. Using International Statistical Classification of Disease-10 (ICD-10) codes, the Victorian Agency for Health Information generated a list of cases of contact dermatitis (CD). Demographic and clinical data were analysed.

RESULTS: 228 patients from 14 different sites were diagnosed with ACD. Hair dyes caused the most cases, and one such case was admitted to hospital. It was apparent from the specified causes that cases of irritant CD were misdiagnosed as ACD. There were significant differences in management with dermatology input, with dermatologists more often advising oral corticosteroids (33.3% vs 14.5%, p= 0.004) topical corticosteroids (92.9% vs 38.7% p <0.01), emollients (38.1% vs 20.4%, p = 0.01) and less often advising antihistamines (16.7% vs 44.6%, p <0.001). With dermatology input, potent or very potent steroids were more likely to be prescribed (69.3% vs 11.1%, p < 0.001); without, a mild potency steroid was more likely to be prescribed (63.9% vs 4%, p=0.01).

CONCLUSION: Improved understanding, diagnosis and management of CD is needed in EDs. This article is protected by copyright. All rights reserved.

PMID:36193797 | DOI:10.1111/cod.14230

Pediatr Pulmonol. 2022 Oct 4. doi: 10.1002/ppul.26178. Online ahead of print.

ABSTRACT

OBJECTIVES: Analyze the relationship between family styles and quality of life in adolescents with bronchial asthma and study the influence of self-esteem as a protective factor and threat perception as a risk factor.

METHODS: Family styles, quality of life (QoL), perceived threat of the disease, and self-esteem were assessed in a total of 150 adolescents diagnosed with bronchial asthma with ages ranging from 12 to 16 years (M=13.28; SD=1.29), 60.7% being male. Descriptive statistics and mean comparisons were conducted according to the level of self-esteem. Relationships between variables were also studied using Pearson correlations, and finally, the mediating role of self-esteem and the perceived threat of the disease was assessed using PROCESS.

RESULTS: Adolescents shown healthy family characteristics (high scores on affect and parental mood and low scores on psychological control) and high scores on quality of life. 35% of adolescents showed low self-esteem and a tendency to underestimate the disease. There are existing relationships between family styles and quality of life; thus, healthy family characteristics (affection, parental mood, autonomy promotion) were positively associated with quality of life, while psychological control was negatively associated with QoL. Disease threat and self-esteem mediated the relationship between family styles and adolescent QoL. Disease threat was negatively, and self-esteem was positively associated with QoL.

CONCLUSIONS: Self-esteem and family support are protective factors for the well-being of adolescents with bronchial asthma; however, the high perceived threat of the disease can have negative consequences for the adolescent’s health and negatively impact their quality of life. This article is protected by copyright. All rights reserved.

PMID:36193795 | DOI:10.1002/ppul.26178

Schweiz Arch Tierheilkd. 2022 Oct;164(10):687-693. doi: 10.17236/sat00368.

ABSTRACT

The study aimed to describe clinical indications for eye enucleation and exenteration, the occurrence of complications and long-term outcome in cattle, and examine owners’ attitude towards enucleation and exenteration and their satisfaction with the surgical outcome. Medical records from the two veterinary teaching hospitals in Switzerland were reviewed to identify cattle that underwent unilateral enucleation or exenteration between January 2013 and December 2020. Data extracted included medical history, ocular examination, clinical diagnosis, surgical procedure including anesthesia, suture material and pattern used, complications, and treatment thereof. Long-term follow-up was evaluated via national animal database inquiries to determine survival time and via owners’ interviews with the use of a standardized questionnaire that included questions regarding the occurrence of complications and reason for culling, production performances and perceived quality of life after surgery, concerns, factors affecting the decision to proceed with surgery, and general satisfaction with the outcome. Descriptive statistics, Fisher’s exact tests and unpaired t-test were used to summarize the data and assess association between variables. Association was considered significant if p < 0,05. Thirty-eight cases were identified, with a median age of 5 years. More than half of the cases (55,3 %) were diagnosed with non-neoplastic ocular lesions represented by severe trauma with loss of globe content, globe rupture with history of infectious keratoconjunctivitis or hypopyon, or congenital malformations. The remaining cases were diagnosed with neoplastic lesions, including ocular squamous cell carcinoma (OSCC), melanoma, or sarcoma. Complications following surgery were reported in 29 % of cases and included postoperative infection and recurrence of OSCC. There was no significant association between ocular diagnosis and the occurrence of postoperative complications or survival time. Surgery did not seem to influence the animals’ postoperative production performance or the perceived quality of life. Most owners (92 %) were satisfied with the surgical outcome. The occurrence of postoperative complications leading to increased overall costs and culling was the main reason for lower owner satisfaction.

PMID:36193779 | DOI:10.17236/sat00368

Microsurgery. 2022 Oct 4. doi: 10.1002/micr.30967. Online ahead of print.

ABSTRACT

BACKGROUND: The behavior of blood flow changes within free flaps following microvascular anastomosis is not well described in the literature. The aim of this study was to determine the immediate blood flow behavior of different free flaps as reference values for various clinical applications.

METHODS: Intraoperative transit-time flow measurements were performed on patients receiving free flap transfer in the head and neck area comprising radial forearm flaps (RFF), peroneal artery perforator flaps (PAP), anterolateral thigh flaps (ALT), vastus lateralis flaps (VLF), parascapular flaps (PSF), latissimus dorsi flaps (LDF), fibula free flaps (FFF), deep circumflex iliac artery flaps (DCIA), and scapular flaps (SF). In accordance with a structured protocol, measurements took place at the pedicle directly before flap harvesting and at the recipient vessels 1 h after flap transfer. Heart rate, transplant weight, and other patient characteristics were recorded and analyzed.

RESULTS: A total of 129 were enrolled, comprising 66 RFF, 8 ALT, 6 PAP, 11 VLF, 3 PSF, 2 LDF, 24 FFF, 7 DCIA, and 2 SF. In most of the transplant groups, arterial perfusion increased after anastomosis at the recipient site. The arterial pulsatility index developed indirectly proportionally to arterial blood flow, whereas venous blood drainage did not show any statistically significant changes. Muscle flaps had the highest arterial perfusion before flap transfer. Composite transplants with hard and soft tissue presented the greatest increase in arterial perfusion. The lowest arterial blood flow after anastomosis was measured in PAP and RFF. In contrast, RFF and PAP presented the highest arterial perfusion per 100 g transplant weight.

CONCLUSIONS: Arterial perfusion changed, whereas venous blood flow did not show any statistically significant variations in any transplant group. Perfusion of free flaps does not only depend on the recipient vessel and the recipient bed, but also on flap-specific anatomy and physiology.

PMID:36193758 | DOI:10.1002/micr.30967