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Maedica Mar 2024Corneal guttata is a non-inflammatory progressive decline of endothelial cell density (ECD) which represents an early clinical feature of Fuch's dystrophy. In patients...
Corneal guttata is a non-inflammatory progressive decline of endothelial cell density (ECD) which represents an early clinical feature of Fuch's dystrophy. In patients with corneal guttata, the relative risk for corneal transplantation after phacoemulsification has been found to be 68.2 times higher than in those without it. In the present study, five patients with corneal guttata underwent 25G pars plana vitrectomy (PPV) with concurrent lensectomy and intraocular lens (IOL) implantation in the sulcus. The aim of the present study is to investigate whether this technique has a less damaging effect on endothelial cells as compared to standard phacoemulsification. This retrospective case series study was conducted at "My Retina" Athens Eye Centre, Greece. Five patients with moderate to dense cataract and clinical signs of corneal guttata were included. All patients had ECD measurement prior to and after surgery. The operation included 25-gauge pars plana vitrectomy (PPV) with subsequent lensectomy and a three-piece IOL implanted in the sulcus with intact anterior capsule. The mean value of ECD was 1157.8±237.51 cells/mm² preoperatively and 1118.2±227.42 cells/mm² postoperatively, indicating a 3.4% reduction from initial values. Retinal detachment was not observed on any of the operated patients after surgery. The IOL was well centered to the sulcus in all patients. Iatrogenic retinal tears were identified in one patient and were treated with laser retinopexy and SF6 gas tamponade. Our results show that PPV along with lensectomy through fragmatome may cause less corneal decompensation than femtosecond laser-assisted cataract surgery (FLACS) or phacoemulsification, especially in patients with corneal guttata. Therefore, reducing the risk for possible future corneal transplantation.
PubMed: 38736935
DOI: 10.26574/maedica.2024.19.11.42 -
Journal of Family Medicine and Primary... Mar 2024Mobile health applications are an established tool for healthcare management, patient education, and even capacity building for healthcare providers. However, its use...
BACKGROUND
Mobile health applications are an established tool for healthcare management, patient education, and even capacity building for healthcare providers. However, its use among traditional birth attendants (TBAs) is limited. The aim of this study is to explore the needs and bottlenecks of developing an interactive mobile application for maternal and infant care (MAI) of TBAs.
MATERIALS AND METHODS
It is a qualitative study having in-depth interviews (face-to-face approach) conducted among the seekers of MAI services. : This study is conducted in tribal and rural locations in the district Sirohi, Rajasthan. : TBAs and tribal females of reproductive age in tribal-dominated areas have participated. The development of an interactive mobile application MAI has three phases: (1) a need-based approach to identify the needs on the ground; (2) identifying intervention bottlenecks and possible solutions; (3) design and development of the mobile application.
RESULTS
Ninety-six tribal females of reproductive age participated in the needs assessment. Eighty percent of them were ≤ 30 years of age and 40% of them were uneducated. Most participants informed that lack of information (culturally/locally appropriate content), peer advocacy, affordability, lack of transportation, and the influence of TBAs are the significant factors for less uptake of maternity and child health services in the tribal and rural areas.
CONCLUSION
The MAI app has culturally/locally appropriate content and is prepared by the local TBAs and Accredited Social Health Activists, with full local character and clothing. MAI app has videos and audio in the local language (Marwari) with pictorial quizzes. Using the MAI app, TBAs may self-educate and guide tribal pregnant women about maternal hygiene and infant healthcare as needed at various stages of pregnancy and childbirth.
PubMed: 38736772
DOI: 10.4103/jfmpc.jfmpc_1315_23 -
Dental Materials : Official Publication... Jun 2024To investigate the effect of the stability of oxygen vacancies on the low-temperature degradation (LTD) resistance of two kinds of commercial zirconia-based materials...
OBJECTIVES
To investigate the effect of the stability of oxygen vacancies on the low-temperature degradation (LTD) resistance of two kinds of commercial zirconia-based materials (3Y-TZP ceramics and Ce-TZP/AlO composites) via the dielectric probing methods.
METHODS
The commercial 3Y-TZP ceramics and Ce-TZP/AlO composites were prepared via conventional solid-state methods. Density, phase content, microstructure, strain, and biaxial flexural strength (BFS) of two materials were investigated using Archimedes method, XRD, SEM, strain-electric field (S-E) loops and ball-on-ring methods, respectively. The concentration of oxygen vacancies before and after LTD of two materials were evaluated using dielectric probing and XPS methods.
RESULTS
The XRD analysis revealed that compared to the 3Y-TZP ceramics, the Ce-TZP/AlO composites showed better LTD resistance, without clear LTD. The greater LTD resistance for Ce-TZP/AlO composites was associated with their stability of oxygen vacancies, by higher activation energy based on the dielectric measurements and XPS results. For the 3Y-TZP ceramics that underwent the tetragonal to the monoclinic phase transition during the LTD treatment, the concentration of their oxygen vacancies decreased after LTD. In addition, the Ce-TZP/AlO composites exhibited higher flexural strength and potential fracture toughness based on the BFS testing and strain vs electric field measurement results, indicating a great potential for use in fixed restorative dental applications.
SIGNIFICANCE
This work suggested the stability of oxygen vacancies played a key role in the resistance to LTD. Optimizing the stability of the oxygen vacancies is key to the development of more reliable zirconia- based dental biomaterials with greater resistance to LTD.
Topics: Zirconium; Materials Testing; Ceramics; Flexural Strength; Cold Temperature; X-Ray Diffraction; Yttrium; Aluminum Oxide; Microscopy, Electron, Scanning; Surface Properties; Photoelectron Spectroscopy; Dental Materials; Cerium; Dental Stress Analysis; Oxygen
PubMed: 38719710
DOI: 10.1016/j.dental.2024.04.008 -
European Heart Journal. Case Reports May 2024Nail-Patella syndrome (NPS) is an autosomal-dominant pleiotropic condition characterized by pelvic and skeletal abnormalities and most commonly affecting a tetrad of...
BACKGROUND
Nail-Patella syndrome (NPS) is an autosomal-dominant pleiotropic condition characterized by pelvic and skeletal abnormalities and most commonly affecting a tetrad of nails, knees, elbows, and iliac horns, the iliac horns being pathognomonic for the condition. The most well-documented extra-skeletal manifestation is renal involvement with alteration in Type III collagen. No documented cases of NPS with anomalous coronary arteries or aneurysms, acute coronary occlusion, or successfully coronary interventions exist in the medical literature.
CASE SUMMARY
A 62-year-old female with a medical history significant for NPS diagnosed 50 years ago presented to the emergency department with a chief complaint of chest pain. She recently developed end-stage renal disease managed with peritoneal dialysis within the last year. Angiography revealed 100% right coronary artery occlusion with an anomalous take-off from the left circumflex artery. She demonstrated diffuse coronary aneurysms in the right coronary artery, mid-left anterior descending artery, and other epicardial vessels. Two drug-eluting stents were placed in overlapping fashion. Following careful apposition, the aneurysmal segment was successfully stented without complication. The patient was discharged without complication 2 days later.
DISCUSSION
Our case shows the first reported case of coronary vascular anomalies and successful coronary revascularization in a patient with NPS in the medical literature. Given the recently reported vascular anomalies and known collagen alterations seen in patients with the genetic disorder, clinicians should suspect further systemic vascular anomalies with their own unique therapeutic challenges when encountering patients with this rare genetic syndrome.
PubMed: 38711683
DOI: 10.1093/ehjcr/ytae188 -
Vaccine Jun 2024Measles remains a critical public health concern causing significant morbidity and mortality globally. Despite the success of measles vaccination programs, challenges...
INTRODUCTION
Measles remains a critical public health concern causing significant morbidity and mortality globally. Despite the success of measles vaccination programs, challenges persist, particularly in India. This study investigates dose-wise measles vaccination coverage and explores gaps in immunization focusing on zero-dose, one-dose, and two-dose coverage among children aged 24-35 months.
DATA SOURCES AND METHODOLOGY
The National Family Health Survey 2019-21 (NFHS-5) served as the data source and the study analyzed information from 43,864 children aged 24-35 months. Sociodemographic variables such as birth order, wealth quintile, gender, social group, religion, residence, mother education, delivery-related factors, and media exposure were considered. Statistical analysis involved weighted estimates, chi-square tests, and multivariate multinomial logistic regression.
RESULTS
The study revealed that challenges persist in achieving optimal measles vaccination coverage. Analysis by sociodemographic factors highlighted disparities in coverage, with variations in zero dose prevalence across states and districts. The percentage of zero-dose children was significantly higher, with 11.5% of children in India remaining to receive any measles vaccination. Factors influencing vaccine coverage include birth order, age, wealth quintile, social group, religion, residence, maternal education, place of delivery, media exposure, and mode of delivery. The findings from the spatial analysis show the clustering of zero-dose children is high in the northeastern states of India.
DISCUSSION
Measles zero-dose children pose a significant obstacle to achieving elimination goals. Spatial analysis identifies clusters of unvaccinated populations guiding targeted interventions. The study aligns with global initiatives such as the Immunization Agenda 2030 emphasizing equitable vaccine access and discusses how India can tailor its strategies to achieve the goal. Lessons from polio eradication efforts inform strategies for measles elimination, stressing the importance of high-quality data and surveillance. The study underscores the urgency of addressing last-mile measles vaccination gaps in India. Spatially targeted interventions informed by sociodemographic factors can enhance immunization coverage. Achieving measles elimination requires sustained efforts and leveraging lessons from successful vaccination campaigns. The study findings have the potential to contribute to informed decision-making, supporting India's roadmap for the measles and rubella elimination goal.
Topics: Humans; India; Vaccination Coverage; Measles; Measles Vaccine; Female; Male; Child, Preschool; Immunization Programs; Vaccination; Disease Eradication
PubMed: 38704248
DOI: 10.1016/j.vaccine.2024.04.075 -
BMC Musculoskeletal Disorders May 2024The current report investigates fusion rates and patient-reported outcomes following lumbar spinal surgery using cellular bone allograft (CBA) in patients with risk...
BACKGROUND
The current report investigates fusion rates and patient-reported outcomes following lumbar spinal surgery using cellular bone allograft (CBA) in patients with risk factors for non-union.
METHODS
A prospective, open label study was conducted in subjects undergoing lumbar spinal fusion with CBA (NCT02969616) to assess fusion success rates and patient-reported outcomes in subjects with risk factors for non-union. Subjects were categorized into low-risk (≤ 1 risk factors) and high-risk (> 1 risk factors) groups. Radiographic fusion status was evaluated by an independent review of dynamic radiographs and CT scans. Patient-reported outcome measures included quality of life (EQ-5D), Oswestry Disability Index (ODI) and Visual Analog Scales (VAS) for back and leg pain. Adverse event reporting was conducted throughout 24-months of follow-up.
RESULTS
A total of 274 subjects were enrolled: 140 subjects (51.1%) were categorized into the high-risk group (> 1 risk factor) and 134 subjects (48.9%) into the low-risk group (≤ 1 risk factors). The overall mean age at screening was 58.8 years (SD 12.5) with a higher distribution of females (63.1%) than males (36.9%). No statistical difference in fusion rates were observed between the low-risk (90.0%) and high-risk (93.9%) groups (p > 0.05). A statistically significant improvement in patient-reported outcomes (EQ-5D, ODI and VAS) was observed at all time points (p < 0.05) in both low and high-risk groups. The low-risk group showed enhanced improvement at multiple timepoints in EQ-5D, ODI, VAS-Back pain and VAS-Leg pain scores compared to the high-risk group (p < 0.05). The number of AEs were similar among risk groups.
CONCLUSIONS
This study demonstrates high fusion rates following lumbar spinal surgery using CBA, regardless of associated risk factors. Patient reported outcomes and fusion rates were not adversely affected by risk factor profiles.
TRIAL REGISTRATION
NCT02969616 (21/11/2016).
Topics: Humans; Spinal Fusion; Male; Middle Aged; Female; Lumbar Vertebrae; Risk Factors; Bone Transplantation; Prospective Studies; Aged; Follow-Up Studies; Patient Reported Outcome Measures; Treatment Outcome; Quality of Life; Allografts; Adult; Pain Measurement
PubMed: 38702654
DOI: 10.1186/s12891-024-07456-4 -
Current Biology : CB May 2024The hippocampal formation contains neurons responsive to an animal's current location and orientation, which together provide the organism with a neural map of space....
The hippocampal formation contains neurons responsive to an animal's current location and orientation, which together provide the organism with a neural map of space. Spatially tuned neurons rely on external landmark cues and internally generated movement information to estimate position. An important class of landmark cue are the boundaries delimiting an environment, which can define place cell field position and stabilize grid cell firing. However, the precise nature of the sensory information used to detect boundaries remains unknown. We used 2-dimensional virtual reality (VR) to show that visual cues from elevated walls surrounding the environment are both sufficient and necessary to stabilize place and grid cell responses in VR, when only visual and self-motion cues are available. By contrast, flat boundaries formed by the edges of a textured floor did not stabilize place and grid cells, indicating only specific forms of visual boundary stabilize hippocampal spatial firing. Unstable grid cells retain internally coherent, hexagonally arranged firing fields, but these fields "drift" with respect to the virtual environment over periods >5 s. Optic flow from a virtual floor does not slow drift dynamics, emphasizing the importance of boundary-related visual information. Surprisingly, place fields are more stable close to boundaries even with floor and wall cues removed, suggesting invisible boundaries are inferred using the motion of a discrete, separate cue (a beacon signaling reward location). Subsets of place cells show allocentric directional tuning toward the beacon, with strength of tuning correlating with place field stability when boundaries are removed.
Topics: Virtual Reality; Cues; Animals; Grid Cells; Male; Hippocampus; Space Perception; Rats; Place Cells; Visual Perception; Rats, Long-Evans; Orientation
PubMed: 38701787
DOI: 10.1016/j.cub.2024.04.026 -
Briefings in Bioinformatics Mar 2024Predicting protein function is crucial for understanding biological life processes, preventing diseases and developing new drug targets. In recent years, methods based...
Predicting protein function is crucial for understanding biological life processes, preventing diseases and developing new drug targets. In recent years, methods based on sequence, structure and biological networks for protein function annotation have been extensively researched. Although obtaining a protein in three-dimensional structure through experimental or computational methods enhances the accuracy of function prediction, the sheer volume of proteins sequenced by high-throughput technologies presents a significant challenge. To address this issue, we introduce a deep neural network model DeepSS2GO (Secondary Structure to Gene Ontology). It is a predictor incorporating secondary structure features along with primary sequence and homology information. The algorithm expertly combines the speed of sequence-based information with the accuracy of structure-based features while streamlining the redundant data in primary sequences and bypassing the time-consuming challenges of tertiary structure analysis. The results show that the prediction performance surpasses state-of-the-art algorithms. It has the ability to predict key functions by effectively utilizing secondary structure information, rather than broadly predicting general Gene Ontology terms. Additionally, DeepSS2GO predicts five times faster than advanced algorithms, making it highly applicable to massive sequencing data. The source code and trained models are available at https://github.com/orca233/DeepSS2GO.
Topics: Proteins; Algorithms; Neural Networks, Computer; Protein Structure, Secondary; Computational Biology; Databases, Protein; Gene Ontology; Sequence Analysis, Protein; Software
PubMed: 38701416
DOI: 10.1093/bib/bbae196 -
The Journal of Allergy and Clinical... Aug 2024Sublingual immunotherapy (SLIT) with 12 SQ house dust mile SLIT-tablet (HDM SLIT-tablet) for dust mite-induced perennial allergic rhinitis is reported as effective and...
BACKGROUND
Sublingual immunotherapy (SLIT) with 12 SQ house dust mile SLIT-tablet (HDM SLIT-tablet) for dust mite-induced perennial allergic rhinitis is reported as effective and safe. Although serious allergic reactions (SARs) and eosinophilic esophagitis (EoE) have infrequently occurred under trial conditions, the safety of HDM SLIT-tablet challenge under real-world conditions is unknown.
OBJECTIVE
Our aim was to estimate the incidence of SARs and EoE due to HDM SLIT-tablet challenge.
METHODS
Through use of administrative data from Kaiser Permanente Southern California this prospective observational study identified patients newly administered HDM SLIT-tablet with follow-up until SLIT discontinuation or end of study. Suspected cases of SARs and EoE were detected by using diagnosis and Current Procedural Terminology procedure codes and medication dispensing records. A 3-member clinical review committee of allergists adjudicated suspected reactions. The incidence rate of confirmed SARs and EoE per 1000 person years of exposure were determined.
RESULTS
A total of 521 patients (93.9% adult and 6.1% pediatric) were exposed to HDM SLIT-tablet challenge from January 2018 through May 2023, for 440.4 person years of exposure. The patients' average age (SD) was 39.3 (14.1) years, 58.7% were female, 44.3% were non-Hispanic White, 40.3% had asthma, and 15.0% had gastroesophageal reflux disease. A SAR occurred in 1 adult patient, and during initial HDM SLIT-tablet challenge, SARs occurred in 2 pediatric adolescents, for an overall incidence of 6.8 SARs per 1000 patient years (95% CI = 2.2-21.1). EoE occurred in 1 adult patient, for an overall incidence of 2.3 cases of EoE per 1000 patient years (95% CI = 0.3-16.1).
CONCLUSIONS
This real-world study demonstrated that SARs and EoE were infrequent events with HDM SLIT-tablet use, supporting the safety of HDM SLIT-tablets and need for physician supervision with initial challenge.
PubMed: 38699651
DOI: 10.1016/j.jacig.2024.100250 -
PLoS Neglected Tropical Diseases May 2024
Topics: Humans; Trypanosomiasis, African; Disease Eradication; Animals; Africa; Neglected Diseases
PubMed: 38691551
DOI: 10.1371/journal.pntd.0012091