Tag: pubmed

Placenta. 2021 May 31;111:26-32. doi: 10.1016/j.placenta.2021.05.004. Online ahead of print.

ABSTRACT

INTRODUCTION: Thanks to shared circulation in monochorionic twins, single intrauterine fetal death (IUD) may lead to acute feto-fetal transfusion (aFFTR). The objective of the study was to describe our model of aFFTR simulation after IUD in monochorionic (MC) twins.

METHODS: Prospective study analyzed 99 fresh MC placentas with the physiological course. A specially designed protocol was used for the preparation and analysis of the placentas. A pair of infusion sets fixed together using a mechanical mercury sphygmomanometer cuff was connected to the cannulated umbilical arteries. The tonometer was pressurized up to 30 and 40 mmHg. A positive finding of aFFTR was determined as the amount exceeding 1 ml of dye flowed out of the umbilical cord simulating a dead fetus. The number and types of anastomoses, types, and distances between cords insertions, and the size of the placental areas for each fetus were also statistically analyzed. The placental angioarchitecture with and without proven aFFTR was statistically compared, odds ratio (OR) and multivariable logistic analysis were performed.

RESULTS: A total of 49/99 (49.5%) cases of aFFTR was proven, and the average transfusion time of 1 ml was 30 s (19-46 s). aFFTR was present in 49/78 (62.8%) of placentas with arterio-arterial (AA) anastomosis. The median diameter of AA anastomoses with the present, and absent aFFTRF was 2.0 mm and 1.0 mm, respectively. The proven interfetal transfusion was 8%, 31%, and 61% in AA anastomoses with a diameter below 0,5 mm, 0,5-1,5 mm, and above 1,5 mm, respectively (p < 0,001). AA anastomoses diameter >1.5 mm had OR of 44.2 (95% CI 5.54-352.39). In the case of coexistence of AA anastomosis and umbilical cord distance ≤5th percentile, the aFFTRF occurred in 90.9%.

DISCUSSION: The potential risk of aFFTR in monochorionic twins is mainly due to the presence and nature of AA anastomoses. The diameter and length of the vessels play a crucial role, which is clinically related to the distance of the umbilical cords insertions.

PMID:34146967 | DOI:10.1016/j.placenta.2021.05.004

Am J Emerg Med. 2021 Jun 9;49:226-232. doi: 10.1016/j.ajem.2021.05.071. Online ahead of print.

ABSTRACT

BACKGROUND: Point-of-care ultrasound (POCUS) is useful in the evaluation of early pregnancy by confirming intrauterine pregnancy and recognizing hemorrhage from ectopic pregnancy. We sought to determine whether transabdominal POCUS by itself or in conjunction with consultative radiology ultrasound (RADUS), reduces Emergency Department (ED) treatment time for patients with ectopic pregnancy requiring operative care, when compared to RADUS alone. A secondary objective was to determine whether the incorporation of POCUS reduces time to operative care for patients with ruptured ectopic pregnancy specifically, when compared to RADUS alone.

METHODS: We performed a retrospective review of patients admitted for operative management of ectopic pregnancy. We excluded patients with known ectopic pregnancy and/or imaging prior to arriving to the treatment area, found not to have an ectopic pregnancy, or did not undergo operative care. Descriptive statistics, classical and nonparametric statistical analysis, and linear regression were performed.

RESULTS: There were 220 patients admitted with ectopic pregnancy, 111 met exclusion criteria, yielding 109 for analysis. Of 109, 36 received POCUS (23/36 also had RADUS), while 73 received RADUS only. Among the POCUS group 31/36 (86%) were classified as ruptured versus 47/73 (64%) in the RADUS group. The average ED treatment time in the POCUS group for all admitted ectopic pregnancies was 157.9 min (standard deviation [SD] 101.3) versus 206.3 min (SD 76.6) in the RADUS group (p = 0.0141). The median time to operating room (OR) for ruptured ectopic pregnancies was 203.0 min (interquartile range [IQR] 159.0) in the POCUS group versus 293.0 min (IQR 139.0) in the RADUS group (p = 0.0002). Regression analysis of the primary outcome was limited by multiple interactions and sample size. When controlling for race, positive shock index and ED visit time, POCUS was found to be associated with a significantly shorter time to OR among ruptured ectopic pregnancies compared to RADUS (p = 0.0052).

CONCLUSION: Compared to RADUS alone, incorporation of POCUS was associated with significantly faster ED treatment time for all ectopic pregnancies and significantly faster time to OR for ruptured ectopic pregnancies, even when combined with RADUS. When controlling for clinical differences, time to OR was still faster for patients who underwent POCUS. The integration of POCUS should be considered to expedite care for patients with ectopic pregnancy requiring operative care.

PMID:34146921 | DOI:10.1016/j.ajem.2021.05.071

Meat Sci. 2021 Jun 12;181:108606. doi: 10.1016/j.meatsci.2021.108606. Online ahead of print.

ABSTRACT

The aim of this study was to explore the use of TD-NMR relaxometry and ¹H NMR spectroscopy-based for detecting differences in meat quality attributes. There was limited association between various TD-NMR signals and any physicochemical parameters of fresh and aged meat differing in tenderness ratings. Samples were then divided into three groups based on statistical changes in metabolite concentration. Group A samples possessed near linear increases in metabolite concentration over aging time; whereas samples assigned to Groups B and C were characterized by increases in metabolites that peaked between 7 and 14 days, and up to 14 days aging, respectively. ¹H NMR spectroscopy discriminated meat quality using changes in metabolites reflective of glycolysis, the citric acid cycle, protein degradation, amino acid generation and purine metabolisms. These data suggest segregation of meat quality is possible using both NMR technologies but additional work is necessary to understand fully their utility in a commercial industry setting.

PMID:34146920 | DOI:10.1016/j.meatsci.2021.108606

Eur J Radiol. 2021 Jun 10;141:109823. doi: 10.1016/j.ejrad.2021.109823. Online ahead of print.

ABSTRACT

PURPOSE: No comparative study on evaluating performance of radiological criteria has been investigated in metastatic colorectal cancer (mCRC) patients treated with the combination of Regorafenib and anti-programmed cell death 1(PD-1) antibody. We aimed to compare the performance of different radiological criteria in evaluating response in mCRC patients treated with the combination of Regorafenib plus anti-PD-1 antibody.

METHOD: We retrospectively recruited patients treated with Regorafenib and anti-PD-1 antibody in a single institution. Baseline and the first tumor evaluation of contrast-enhanced computed tomography (CE-CT) were assessed by three evaluation criteria: RECIST 1.1, Choi, modified Choi (mChoi). Overall survival (OS) was defined as endpoint event.

RESULTS: Twenty-three mCRC patients [age: 58.8 ± 10.6 years, 18 (78.3 %) males] were assessed. The median overall survival was 11.8 months. According to RECIST 1.1, 8 (34.8 %) patients were stable disease (SD) and 15 (65.2 %) were progressive disease (PD). According to Choi and mChoi, 5 (21.7 %) and 1(4.3 %) patient was responders, respectively. All non-PD patients showed significantly better overall survival than PD patients by all criteria. According to Choi, those identified as responders showed better overall survival than non-responders though significant statistics were not reached (P=0.262).

CONCLUSIONS: RECIST 1.1, Choi and mChoi criteria could identify survival benefit from Regorafenib plus anti-PD-1 antibody in mCRC patients. However, the value of responders detected by Choi remains to be validated in further studies.

PMID:34146911 | DOI:10.1016/j.ejrad.2021.109823

Eur J Radiol. 2021 Jun 3;141:109807. doi: 10.1016/j.ejrad.2021.109807. Online ahead of print.

ABSTRACT

PURPOSE: We evaluated respiratory triggered unidirectional single-shot echo-planar imaging (u-SSEPI) as a time-saving measure in diffusion imaging of the upper abdomen. Specifically, we compared the ADC values obtained from unidirectional DWI (u-SSEPI) and routine DWI (4t-SSEPI) and also the diagnostic accuracies of unidirectional and routine DWI sequences in the identification of focal liver lesions in the setting of chronic liver disease (CLD).

MATERIALS AND METHODS: This prospective, IRB approved study, included 48 patients of CLD who underwent-DCE-MRI on a 1.5 T scanner for hepatocellular carcinoma (HCC) workup. In addition to 4t-SSEPI, u-SSEPI was acquired with the diffusion sensitising gradient being applied in only one direction; keeping all other parameters same as 4t-SSEPI. Two blinded radiologists evaluated the DWI studies for image quality and detection of liver lesions. A composite gold standard was established using DCE-MRI, follow-up imaging and patient clinical details. The apparent diffusion coefficients (ADCs) of the liver, spleen and the lesions were compared between the two sequences. ROC analysis evaluated the diagnostic accuracy of ADC from both the sequences in identifying HCC.

RESULTS: Eighty-eight lesions were identified using the composite gold standard. u-SSEPI resulted in 3 times faster image acquisition. No statistically significant differences were demonstrated between the unidirectional and routine DWI sequences for image quality parameters and lesion detection rates. Lesion wise comparison of the ADC values from both the sequences was not statistically different (p = 0.8) with a coefficient of variation = 12-14 %. The Bland- Altman plots and the Passing-Bablock regression analysis demonstrated a systematic and proportional bias between the ADC values obtained. The AUC of the ROC curve, however, was 0.63-observer1; 0.62-oobserver2 for routine DWI and 0.65; 0.62 for unidirectional DWI when ADC was used to identify HCC (the AUCs were not statistically different (p = 0.6-0.8)).

CONCLUSION: No significant differences were demonstrated in the diagnostic accuracies of unidirectional and routine DWI in the diagnosis of HCC. Unidirectional diffusion may be further evaluated in other organs where diffusion is isotropic, especially in respiratory triggered sequences where the imaging time dividend is significant.

PMID:34146912 | DOI:10.1016/j.ejrad.2021.109807

Chemosphere. 2021 Jun 13;283:131169. doi: 10.1016/j.chemosphere.2021.131169. Online ahead of print.

ABSTRACT

BACKGROUND: More and more studies began to explore the hazardous health effects of PM_2.5, but few reported its impacts on stillbirth. The sparse results were inconsistent and remained to be integrated. Therefore, we aimed to reveal the association between maternal exposure to PM_2.5 and stillbirth.

METHODS: In this meta-analysis, we searched PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for related articles written in English and published before October 18, 2020. Study selection was conducted according to the predetermined criteria and data attraction was done with predesigned form. A new instrument was applied to conduct the risk of bias assessment. And random-effect models were used to pool the estimates.

RESULTS: A total of 3655 records were identified from the databases, but only 7 studies were ultimately included in this study. Positive association was found between the maternal exposure to PM_2.5 (per 10 μg/m³ increased) in the entire pregnancy (OR: 1.15, 95% CI: 1.07-1.25) and third trimester (OR: 1.09, 95% CI: 1.01-1.18) and stillbirth, but the association between the maternal exposure to PM_2.5 (per 10 μg/m³ increased) in the first trimester (OR: 1.01, 95% CI: 0.90-1.13) and second trimester (OR: 1.06, 95% CI: 0.98-1.14) and stillbirth was not statistically significant. Besides, there was no publication bias.

CONCLUSIONS: Maternal exposure to PM_2.5 in the entire pregnancy and third trimester was associated with elevated risk of stillbirth. However, due to the high heterogeneity, further pathophysiological researches and high quality population studies were still warranted.

PMID:34146867 | DOI:10.1016/j.chemosphere.2021.131169

J Affect Disord. 2021 Jun 8;292:464-470. doi: 10.1016/j.jad.2021.05.125. Online ahead of print.

ABSTRACT

INTRODUCTION: There is growing concern about the effect of lockdown and social distancing on mental health. Subjective feelings related to social relationships such as detachment have shown a strong effect on mental health, whereas objective factors might have a moderating role in that association.

OBJECTIVE: To investigate whether social support and living situation have a moderating effect on the association between detachment and affective disorder symptoms during the COVID-19 lockdown.

METHODS: 3,305 Spanish adults were interviewed by phone at the end of the COVID-19 lockdown (May-June 2020). Detachment during confinement was assessed with a single-item frequency question. Anxiety symptoms were measured through GAD-7, depressive symptoms through PHQ-9, and social support through the Oslo Social Support Scale (OSSS). Associations with anxiety and depressive symptoms were tested through Tobit regression models. Interactions of detachment with living situation and social support were tested as independent variables.

RESULTS: People living alone showed significantly lower levels of anxiety whereas people living with another (but not as a couple) showed higher levels of depression. Detachment was strongly associated with both affective disorders. Social support had a statistically significant moderating effect on that association. Those with a low level of social support and a high level of detachment reported means of depression and anxiety above major depression (10.5 CI 95% 9.6, 11.4 at OSSS=10) and generalized anxiety disorders (10.1 CI 95% 9.2, 11.0 at OSSS=9) cut offs CONCLUSION: Interventions centered on improving social support could alleviate feelings of detachment and prevent affective disorders during lockdowns.

PMID:34146897 | DOI:10.1016/j.jad.2021.05.125

Nurse Educ Today. 2021 Jun 2;104:104990. doi: 10.1016/j.nedt.2021.104990. Online ahead of print.

ABSTRACT

BACKGROUND: Simulation is an important learning-teaching tool for integrating theory and practice in nursing education.

OBJECTIVE: The aim of this study was to develop and to conduct the validity and reliability of a self-evaluation scale for simulation laboratory practices (SES-SLP) with undergraduate nurses.

METHODS: The study sample consisted of 220 undergraduate nursing students. Data were collected using a Descriptive Characteristic Form (DCF) and the 23-item Self-Evaluation Scale for Simulation Laboratory Practices (SES-SLP).

RESULTS: Cronbach’s alpha value of the scale was 0.94. The scale comprised of two subscales: the developing factor (19 items) and the challenging factor (4 items). All items showed a statistically significant correlation (p < 0.05).

CONCLUSIONS: The SES-SLP is a valid and reliable scale that can be used to evaluate students’ learning experience for simulation laboratory practices.

PMID:34146847 | DOI:10.1016/j.nedt.2021.104990

Mar Pollut Bull. 2021 Jun 16;170:112610. doi: 10.1016/j.marpolbul.2021.112610. Online ahead of print.

ABSTRACT

Telomeres protect the coding sequence of chromosome ends and Telomere Length (TL) has been proposed as a biomarker of cellular aging, cumulative stress exposure and life-span in humans. With the aim to propose new biomarkers, a q-PCR protocol was adapted for the measurement of TL in the European flounder Platichthys flesus. The protocol was then applied in 2-year-old flounders from the Seine Estuary. The absolute TL in the flounder is 54 ± 13 kbp per genome (mean ± standard error). Considering relative or absolute TL, no correlation was observed with DNA damage and any of the measured contaminant concentrations (trace elements, metabolites of polycyclic aromatic hydrocarbons, polychlorobiphenyls, organochlorinated pesticides, polybrominated diphenyl ethers, perfluoroalkyl substances). Because sampling was limited, further investigations are required to state a possible impact of chemical pollution on flatfish telomeres. This is motivated by correlations observed with organochlorinated compounds when decreasing statistical significance (p ≤ 0.10).

PMID:34146858 | DOI:10.1016/j.marpolbul.2021.112610

Mar Pollut Bull. 2021 Jun 16;170:112630. doi: 10.1016/j.marpolbul.2021.112630. Online ahead of print.

ABSTRACT

This study investigated the accumulation of debris at four sites, namely, Gebeng, Batu Hitam, Cherok Paloh, and Air Leleh, along the Pahang coastline, Peninsular Malaysia from March 2019 to February 2020. Plastic was the dominant debris (86.1%) and followed by cloth/fabric-based debris (6.0%), processed lumber debris (3.3%), rubber (2.7%), glass (1.5%), and metal (0.4%). The land-based debris (82.0%) was the major source of the deposition of marine waste. A statistically significant relationship was found between the seasonal variation and marine debris density in tidal and seasonal current along the Pahang coastline. In general, the Northeast Monsoon season had a higher amount of debris than the Southwest Monsoon season.

PMID:34146861 | DOI:10.1016/j.marpolbul.2021.112630