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Journal of Orthopaedic Case Reports Mar 2024Congenital upper limb amelia is one of the extremely rare conditions. It is defined as a complete absence of upper limbs. It may present as isolated or with other...
INTRODUCTION
Congenital upper limb amelia is one of the extremely rare conditions. It is defined as a complete absence of upper limbs. It may present as isolated or with other associated anomalies.
CASE REPORT
We present a case of a 2-year-old male child with congenital complete absence of bilateral upper limb. This male child was born after four female children. With the advancement in modern-era prenatal diagnostic facilities and a better understanding of fetal-maternal drug pharmacology, such cases are rare entity.
CONCLUSION
Amelia is a very rare and challenging situation for clinicians. Regular prenatal checkup and knowledge of maternal and fetal drug interactions during pregnancy are key factors for prevention.
PubMed: 38560324
DOI: 10.13107/jocr.2024.v14.i03.4268 -
Carbohydrate Polymers Jun 2024Sugammadex, marketed as Bridion™, is an approved cyclodextrin (CD) based drug for the reversal of neuromuscular blockade in adults undergoing surgery. Sugammadex forms...
Sugammadex, marketed as Bridion™, is an approved cyclodextrin (CD) based drug for the reversal of neuromuscular blockade in adults undergoing surgery. Sugammadex forms an inclusion complex with the neuromuscular blocking agent (NMBA) rocuronium, allowing rapid reversal of muscle paralysis. In silico methods have been developed for studying CD inclusion complexes, aimed at accurately predicting their structural, energetic, dynamic, and kinetic properties, as well as binding constants. Here, a computational study aimed at characterizing the sugammadex-rocuronium system from the perspective of docking calculations, free molecular dynamics (MD) simulations, and biased metadynamics simulations with potential of mean force (PMF) calculations is presented. The aim is to provide detailed information about this system, as well as to use it as a model system for validation of the methods. This method predicts results in line with experimental evidence for both the optimal structure and the quantitative value for the binding constant. Interestingly, there is a less profound preference for the orientation than might be assumed based on electrostatic interactions, suggesting that both orientations may exist in solution. These results show that this technology can efficiently analyze CD inclusion complexes and could be used to facilitate the development and optimization of novel applications for CDs.
Topics: Humans; Adult; Sugammadex; Rocuronium; gamma-Cyclodextrins; Cyclodextrins; Molecular Dynamics Simulation; Neuromuscular Nondepolarizing Agents; Androstanols
PubMed: 38553217
DOI: 10.1016/j.carbpol.2024.122018 -
Transactions on Machine Learning... Sep 2023The ubiquity of missing values in real-world datasets poses a challenge for statistical inference and can prevent similar datasets from being analyzed in the same study,...
The ubiquity of missing values in real-world datasets poses a challenge for statistical inference and can prevent similar datasets from being analyzed in the same study, precluding many existing datasets from being used for new analyses. While an extensive collection of packages and algorithms have been developed for data imputation, the overwhelming majority perform poorly if there are many missing values and low sample sizes, which are unfortunately common characteristics in empirical data. Such low-accuracy estimations adversely affect the performance of downstream statistical models. We develop a statistical inference framework for . Our framework, RIFLE (Robust InFerence via Low-order moment Estimations), estimates low-order moments of the underlying data distribution with corresponding confidence intervals to learn a distributionally robust model. We specialize our framework to linear regression and normal discriminant analysis, and we provide convergence and performance guarantees. This framework can also be adapted to impute missing data. In numerical experiments, we compare RIFLE to several state-of-the-art approaches (including MICE, Amelia, MissForest, KNN-imputer, MIDA, and Mean Imputer) for imputation and inference in the presence of missing values. Our experiments demonstrate that RIFLE outperforms other benchmark algorithms when the percentage of missing values is high and/or when the number of data points is relatively small. RIFLE is publicly available at https://github.com/optimization-for-data-driven-science/RIFLE.
PubMed: 38550611
DOI: No ID Found -
Implementation Science Communications Mar 2024Participatory design approaches can improve successful selection and tailoring of implementation strategies by centering the voices of key constituents. To reduce...
Co-designing strategies to implement long-acting injectable PrEP for sexual minority men in Chicago: a study protocol for an innovation tournament and implementation mapping.
BACKGROUND
Participatory design approaches can improve successful selection and tailoring of implementation strategies by centering the voices of key constituents. To reduce incidence of the human immunodeficiency virus (HIV) in the USA, co-design of implementation strategies is needed for long-acting injectable cabotegravir (CAB-LA), a new form of HIV pre-exposure prophylaxis, among the disproportionately impacted population of sexual minority men (SMM). This manuscript describes the protocol for participatory design approaches (i.e., innovation tournament and implementation mapping) to inform implementation of CAB-LA among SMM (≥ 12 years), particularly Black and Latino populations, in Chicago.
METHODS
This research incorporates innovative methods to accomplish two objectives: (1) to crowdsource ideas for the design of implementation strategies for CAB-LA through a virtual innovation tournament and (2) to leverage the ideas from the innovation tournament to operationalize implementation strategies for CAB-LA thorough the systematic process of implementation mapping. A committee of constituents with diverse expertise and perspectives (e.g., SMM, implementation scientists, HIV clinicians, public health leadership, and community partners) will provide input throughout the design process.
DISCUSSION
This research will produce a menu of co-designed implementation strategies, which can guide plans for CAB-LA integration in Chicago and provide insights for other EHE regions. Further, as the first innovation tournament focused on HIV prevention, this research can provide a framework for participatory approaches across the care continuum. Given that the co-design of implementation strategies often does not involve the participation of individuals with lived experiences, this work will center the voices of those who will benefit most.
PubMed: 38528628
DOI: 10.1186/s43058-024-00574-z -
Vaccine Apr 2024Prior experience of an adverse event following immunisation is a known barrier to vaccination. Limited Australian data evaluating adverse event recurrence among children...
OBJECTIVE
Prior experience of an adverse event following immunisation is a known barrier to vaccination. Limited Australian data evaluating adverse event recurrence among children exists to inform clinical decisions. We aimed to assess adverse event following immunisation recurrence among children with prior adverse events and to evaluate if family history increased adverse event risk.
METHODS
A prospective cohort study was conducted from March 3rd until August 18th, 2023. Children ≤ 16 years with prior adverse events following immunisation in themselves or family were recruited from specialist immunisation clinics at two quaternary paediatric hospitals. Adverse event outcomes were collected via surveys administered at presentation, three, and eight days post vaccination, and analysed by key characteristics and potential risk factors.
RESULTS
Forty three of forty nine (43/49, 87.8 %) children enrolled received further vaccines. Of those who completed the follow up surveys, 50.0 % (16/32) reported an adverse event. Recurrence of prior adverse events occurred for 23.3 % (10/43, 95 % CI: 11.8 % - 38.6 %) of the cohort. Two of twelve (2/12, 16.7 %) participants with prior serious adverse events who received further vaccines reported a serious adverse event recurrence. No post review serious adverse events were observed in children with prior non serious adverse events. Neurological conditions were a risk factor for prior (neurological condition 3/3 versus no neurological condition 2/40, p < 0.001) and post review (neurological condition 2/3 versus no neurological condition 0/28, p = 0.006) post vaccination seizures. Family history had no relationship to post review adverse events (family history 5/8 versus no family history 11/23, p = 0.685).
CONCLUSION
Revaccination is safe for the majority of children with a personal or family history of adverse event following immunisation.
Topics: Child; Humans; Australia; Immunization, Secondary; Prospective Studies; Vaccination; Vaccines; Adolescent
PubMed: 38490823
DOI: 10.1016/j.vaccine.2024.03.025 -
Nutrients Feb 2024Gut dysbiosis refers to an imbalance in gut microbiota composition and function. extract has been shown to modulate gut microbiota by improving SCFA production in vivo... (Randomized Controlled Trial)
Randomized Controlled Trial
Gut dysbiosis refers to an imbalance in gut microbiota composition and function. extract has been shown to modulate gut microbiota by improving SCFA production in vivo and gastrointestinal discomfort (GD) in humans. The aim of this study was to demonstrate the efficacy of Odilia on gastrointestinal health by changing the microbial diversity of species involved in inflammation, immunity, oxidation, and the brain-gut-muscle axis. A randomized, double-blind clinical trial was conducted in 80 adults with gut dysbiosis. The intervention consisted of a 300 mg daily intake of Odilia (n = 40) or maltodextrin as a placebo (n = 40), administered for 8 weeks. Intervention effect was evaluated using 16S metagenomics and GIQLI/GSAS scores at baseline, at 4 and 8 weeks. Eight weeks of Odilia supplementation positively modulates gut microbiota composition with a significant reduction in the to ratio ( = 0.0012). Relative abundances of beneficial bacteria ( and ) were significantly increased ( < 0.001), in contrast to a significant reduction in pro-inflammatory bacteria ( < 0.001). Accordingly, GIQLI and GSAS scores revealed successful improvement in GD. Odilia may represent an effective and well-tolerated treatment in subjects with gut dysbiosis.
Topics: Adult; Humans; Prebiotics; Opuntia; Dysbiosis; Feces; Bacteria; Double-Blind Method
PubMed: 38474715
DOI: 10.3390/nu16050586 -
Cureus Feb 2024The study aims to investigate the normal reference values for optic nerve head (ONH) and retinal nerve fiber layer (RNFL) parameters in emmetropic Malay children,...
BACKGROUND AND OBJECTIVES
The study aims to investigate the normal reference values for optic nerve head (ONH) and retinal nerve fiber layer (RNFL) parameters in emmetropic Malay children, utilizing measurements obtained through Cirrus SD-OCT (Carl Zeiss Meditec, Dublin, CA).
METHODOLOGY
A cross-sectional study was conducted on 95 Malay children, aged between seven and 17 years, with no ocular abnormalities. It was held at Hospital Universiti Sains Malaysia, Malaysia, from January 2014 to December 2015. All children underwent a full ocular examination, including refraction and calculation of axial length. ONH and retinal nerve fiber layer thickness (RNFLT) parameters were measured using the Cirrus SD-OCT machine. One eye of each subject was selected randomly for study. The associations between the parameters and the effect of age, gender, axial length, and spherical equivalent (SE) on the measurements were statistically validated.
RESULTS
Ninety-five children were involved in the study, with 65 females (68.4%) and 30 males (31.6%). The mean age was 10.6 (2.82) years, the mean intraocular pressure (IOP) was 14.8 (2.81) mmHg, the mean SE-refraction was 0.12 (0.28) diopters, and the mean axial length was 23.03 (0.76) mm. The mean disc area, rim area, and cup volume were 2.32 (0.40) mm, 1.53 (0.33) mm, and 0.204 (0.16) mm, respectively. The average cup-to-disc ratio (SD) (CDR) and the vertical CDR were 0.55 (0.13) and 0.50 (0.14). Mean (SD) RNFLT was 102.08 (11.08) μm for all patients. There was a strong positive correlation between the average, superior, and inferior RNFLT with the optical disc area. The rim area and the average, superior, inferior, and nasal RNFLT also showed a significant correlation. The inferior RNFLT was negatively correlated with the average CDR. There was also a major influence of gender on the disc area. There were no major age, axial length, and SE influences on the measurements.
CONCLUSIONS
This study provided normative information for ONH and RNFLT parameters in emmetropic Malay children. It was observed that emmetropic Malay males exhibited a significantly larger optical disc area. The increase in RNFLT is correlated with a significant increase in disc and rim areas.
PubMed: 38465057
DOI: 10.7759/cureus.53890 -
Narra J Dec 2023Congenital heart disease (CHD) is a congenital disorder primarily affecting newborns and children. Children with CHD have a greater risk of experiencing growth delays or...
Congenital heart disease (CHD) is a congenital disorder primarily affecting newborns and children. Children with CHD have a greater risk of experiencing growth delays or disorders compared to healthy children. CHD also affects various aspects of a child's development. The aim of this study was to determine the association of CHD types (cyanotic and acyanotic) with the growth and development status of children. A cross-sectional study was conducted among CHD patients at a national reference hospital in Sumatra, H. Adam Malik General Hospital in Medan, Indonesia. The children's growth status was assessed using the WHO growth chart, and the developmental condition was evaluated through the Denver Developmental Screening Test-II. Chi-squared test and Fisher's exact test were used to assess the association between the type of CHD with growth and development status in children. Using a consecutive sampling method, a total of 53 individuals were included in this study. Almost half of CHD patients (48.1%) were within the age group of 0-2 years and more than half (61.1%) were girls. Acyanotic CHD (74.1%) was more prevalent than cyanotic CHD (25.9%), with ventricular septum defect (VSD) as the most common diagnosis. A total of 37% of children with CHD suffered from malnutrition, whereas the remaining 62.9% had good nutrition. The Denver Developmental Screening Test-II indicated that 81.4% of the children were normal, whereas 18.5% had developmental disorders. Our data suggested a significant association between cyanotic CHD and poor growth status in children based on weight-for-age, weight-for-length, and body mass index (BMI)-for-age. However, there was no association between the type of CHD and developmental status in children. This study highlights that the type of CHD is significantly associated with the growth status of children, but not with their developmental status.
PubMed: 38450335
DOI: 10.52225/narra.v3i3.414 -
Scientific Reports Mar 2024Although medial temporal atrophy (MTA) and parietal atrophy (Koedam score) have been used to diagnose Alzheimer's disease (AD), early detection of other dementia types...
Although medial temporal atrophy (MTA) and parietal atrophy (Koedam score) have been used to diagnose Alzheimer's disease (AD), early detection of other dementia types remains elusive. The study aims to investigate the association between these brain imaging markers and cognitive function in dementia. This cross-sectional study collected data from the Memory Clinic of Dr. Sardjito General Hospital Yogyakarta, Indonesia from January 2020 until December 2022. The cut-off value of MTA and Koedam score was set with Receiver Operating Curve. Multivariate analysis was performed to investigate the association between MTA and Koedam score with cognitive function. Of 61 patients, 22.95% had probable AD, 59.01% vascular dementia, and 18.03% mixed dementia. Correlation test showed that MTA and Koedam score were negatively associated with Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) score. MTA score ≥ 3 (AUC 0.69) and Koedam score ≥ 2 (AUC 0.67) were independently associated with higher risk of poor cognitive function (OR 13.54, 95% CI 1.77-103.43, p = 0.01 and OR 5.52, 95% CI 1.08-28.19, p = 0.04). Higher MTA and Koedam score indicate worse cognitive function in dementia. Future study is needed to delineate these findings as prognostic markers of dementia severity.
Topics: Humans; Cross-Sectional Studies; Cognition; Brain; Alzheimer Disease; Atrophy
PubMed: 38438548
DOI: 10.1038/s41598-024-56023-3 -
F1000Research 2023is well known to cause a multitude of clinical manifestations, from mild to severe bloodstream infections that could lead to death. Infections are common, either in... (Observational Study)
Observational Study
Prevalence of Panton-Valentine leucocidin ( ) and exfoliative toxin A ( ) gene within methicillin resistant and susceptible in an urban tertiary hospital: A molecular epidemiology pilot study.
BACKGROUND
is well known to cause a multitude of clinical manifestations, from mild to severe bloodstream infections that could lead to death. Infections are common, either in community-acquired or hospital-acquired settings, and treatment remains a challenge due to methicillin-resistant (MRSA). The pathogenesis of is mediated by several cell-surface and secreted virulence factors. The virulence factors discussed in this study are Panton-Valentine leucocidin ( ) and exfoliative toxin A ( ). Identifying both and gene may help in studying bacterial pathogenesis and biology thus creating possible therapeutic pathway or intervention.Our pilot study aimed to observe and as virulence gene prevalence in a North Sumatera tertiary referral health center.
METHODS
Our study was a descriptive-analytical observational study with a cross-sectional design in which we collected isolates over a single time period. The frequency of genes is reported as a percentage comparison between MRSA and methicillin-susceptible (MSSA). Qualitative gene prevalence analysis was carried out using the polymerase chain reaction (PCR).
RESULTS
Our results showed that from 38 MRSA sample isolates, 32 samples were found to be -positive, or 84,3% of the total samples. From 40 MSSA sample isolates, one sample was found to be -positive MSSA, or 97,5%. Regarding , from 38 MRSA sample isolates, 81,6% of the total sample did not have , while from 40 MSSA sample isolates, all samples were found to be positive for . We found that both and were significantly more likely to be expressed in the MSSA strain.
CONCLUSIONS
Our study shows that and are more likely expressed in MSSA strains than in MRSA strains in Indonesia.
Topics: Humans; Staphylococcus aureus; Methicillin-Resistant Staphylococcus aureus; Methicillin Resistance; Pilot Projects; Exfoliatins; Molecular Epidemiology; Tertiary Care Centers; Leukocidins; Prevalence; Cross-Sectional Studies; Staphylococcal Infections; Methicillin; Virulence Factors; Disease Susceptibility
PubMed: 38434669
DOI: 10.12688/f1000research.134641.2