6th Month Research Articles

Mitochondrial dynamics and metabolic remodeling in xenograft of IPSC-derived human neural precursors

It is well recognized that the regulation of mitochondrial functions affects the differentiation and maturation of neurons. The study of these processes is of both fundamental and practical importance for regenerative neurobiology. Aim of the study: to characterize the mitochondrial fission changes and their relation to the activation of oxidative phosphorylation (metabolic shift) during maturation of human IPSC-derived neural precursors grafted into rat striatum. Wistar rats (n = 15) were unilaterally injected into the caudate nucleus with neural precursors derived from human IPSCs. Changes in localization and expression of neuronal differentiation markers: nestin, NeuN, neuronal enolase, as well as mitochondrial outer membrane protein, ATP synthase and mitochondrial fission protein Drp1 were assessed by immunostaining. Measurements were performed on graft cells 2 weeks, 3 and 6 months after surgery. Maturation of grafted neurons was associated with fluctuations morphometric parameters of the mitochondrial fraction and Drp1 levels. Increased mitochondrial fission was detected 3 months after transplantation, before an increase in ATP synthase staining by 6th month and a switch of transplanted cells to oxidative phosphorylation. The conducted experiment demonstrated a link between mitochondrial dynamics and changes in the metabolic profile and maturation of transplanted neurons. The regulation of mitochondrial dynamics may have future implications for developing methods to improve the integration of transplanted neurons into recepient brain structures.

Holmium laser enucleation of the prostate: Modified urethral mucosa pre-dissected technique versus traditional three-lobe technique-A retrospective study.

The aim of this study is to investigate the effect of modified holmium laser enucleation of the prostrate (HoLEP) on the function of urine control. An analysis was conducted on a cohort of 305 elderly patients in a retrospective study spanning from February 2019 to February 2023. The cohort consisted of 150 patients who underwent modified HoLEP and 155 patients who underwent traditional HoLEP. Factors such as age, length of membranous urethra, prostate volume, BMI, IPSS, Qmax, enucleated weight, enucleation time, post-operative bladder irrigation time, catheterization and hospitalization were compared between both the groups. Multivariable logistic regression was used to identify independent predictors of urinary incontinence, and receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of urethral membrane length in the diagnosis of urinary incontinence. Postoperative Qmax,IPSS, V2 were compared between 2 groups in the 6th month. Groups were compared in terms of age, volume, BMI, IPSS, Qmax and membranous urethral length (MUL). The time of enucleation, bladder irrigation, post-operative catheterization and hospitalization was lower in the modified HoLEP group (p < 0.05). The incidence of urinary incontinence (UI) in the modified group had a statistically significant decrease at 3months (3.3% vs 9.7%, p = 0.025) and 6months (0.6% vs 5.2%, p = 0.048). The median MUL had a significant difference in the 1st month (15.07 vs 12.5mm, p < 0.001). In multivariate regression analysis, older age (OR per SD = 1.102, 95%CI: 1.077-1.136), shortened MUL (OR per SD = 0.776, 95%CI: 0.629-0.957) and increased enucleated prostate weight (OR per SD = 1.29,95%CI: 1.005-1.084) were significantly associated with UI. The ROC curve revealed the threshold value of MUL was 13.5mm, the sensitivity was 76.7%, and the specificity was 98.1%. The modified HoLEP technique is safe and effective on the function of urine control, and is superior to less residual prostate volume and higher maximum urine flow rate after surgery.

Effectiveness of a customized intraoral photobiomodulator for accelerating orthodontic tooth movement

The aim of this study was to evaluate effectiveness of a Customized Intraoral Photobiomodulator for accelerating orthodontic tooth movement using a split mouth design as only limited studies have been done to compare the effectiveness of LLLT and their iatrogenic effects between experimental and control group in the same individual (split mouth technique) with the help of a customised intraoral photobiomodulator. Consented Patients (n = 15) undergoing orthodontic therapy, diagnosed with Class 1 bimaxillary malocclusion were subjected to experiment based on randomly assigned split mouth design for both experiments in all 4 quadrants. At retraction phase, a customized introral photobiomodulator was given to all patients and the amount of anterior teeth retraction was measured at 1 month interval for 4 months (T0-T4). Apical root resorption was measured by CBCT taken at the beginning of study phase (t0) and end of 4th month (t1). PBM showed an increase in the rate of tooth movement of 4.12fold in the 1st, 2nd and 3rd month. Mandibular canine showed the maximum amount of root resorption whereas the maxillary and mandibular premolars the least. There were similar results when pulp vitality was evaluated where all the teeth in experimental and control side showed positive results to cold test. From our study, PBM is a better method compared to control group as it has shown increased rate of orthodontic teeth movement.

Case Report: Periocular Steroid Injection Combined Vemurafenib Therapy in the Long-term Management of Orbital Involvement of Erdheim-Chester Disease.

Abstract Purpose: To report a rare case of vision loss from Erdheim-Chester Disease (ECD) and long term, follow up, management and results. Case Report: A 62-year-old woman presented with bilateral exophthalmos and deterioration in visual acuity of both eyes. Magnetic resonance imaging studies revealed bilateral intraconal orbital tumors. She was diagnosed optic neuropathy in both eyes. The patient was treated with pegylated interferon and systemic pulse steroid. However, recurrences were common. Subsequently, the patient underwent regular corticosteroid injection directly into the retro-orbital region of both eyes monthly, which led to intermittent improvement of vision. At the 8th month of visual impairment, Vemurafenib was initiated. Results: The visual acuity and visual field scores were stable for 6 years during the follow-up. No major complication was observed. Conclusion: Combined vemurafenib and perioculer steroid injection is a well tolerated therapy with less systemic adverse effects which may benefit patients with orbital involvement of ECD. Key words: Erdheim–Chester disease; compressive optic neuropathy; vemurafenib; Optical coherence tomography; Optical coherence tomography angiography.

Post Operative Outcome of Desarda Technique Versus Lichtenstein Mesh Hernioplasty for Inguinal Hernia Repair

Background: Current inguinal hernia operations are generally based on anatomical considerations. Failures of such operations to some extents are due to lack of consideration of physiological aspects. Many patients with inguinal hernia are cured because of current techniques of operation, though factors that are said to prevent hernia formation are not restored. Therefore, the surgical physiology of inguinal canal needs to be reconsidered. In the year 2001, Mohan P Desarda first described a physiological repair technique of inguinal hernia, which is practiced in many centers with significantly positive outcome. To evaluate the post-operative outcome of Desarda technique versus Lichtenstein mesh hernioplasty in inguinal hernia repair, this research has performed. Materials and methods: This Quasi experimental study was carried out in Surgery Department of Chittagong Medical College Hospital, during December 2017 to January 2019. A total of 100 patients with inguinal hernia underwent surgery were included in this study. Samples were selected by convenient technique. Among them 50 patients were selected for Desarda Technique was considered as group I and the rest 50 patients were selected for Lichtenstein Mesh Hernioplasty was considered as group II. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: The proposed sample size was 50 in each group. The study group included male patient above 18 years of age undergoing Desarda Technique and Lichtenstein Mesh Hernioplasty for inguinal hernia repair. The mean age was 43.14±14.44 years in group I and 48.33±12.63 years in group II. Indirect hernia was found 37(74.0%) and 28(56.0%) in group I and group II respectively. The mean 3rd POD pain (NPRS) was 4.44±0.97 in group I and 5.52±0.71 in group II. The mean 10th POD pain Numeric Pain Rating Scale (NPRS) was 0.76±1.02 in group I and 2.62±1.21 in group II. The mean 1 month pain (NPRS) was 0.08±0.27 in group I and 0.72±0.7 in group II. The mean 3rd month pain (NPRS) was 0.02±0.14 in group I and 0.34±0.48 in group II. The mean 6th month pain (NPRS) was 0±0 in group I and 0.2±0.45 in group II. Pain (NPRS) was significantly (p&lt;0.05) higher in group II in 3rd POD and all subsequent follow-up. Seroma was found 5(10.0%) at 10th POD in group I and 5(10.0%) in group II. The difference was statistically not significant (p&gt;0.05) between two groups. Wound infection found 2(4.0%) in 3rd POD in group Iand 5(10.0%) in group II. Wound infection didn’t develop in subsequent follow-up in group I but in group II, 1(2.0%) found in 10th POD, 1(2.0%) in 1 month, 1(2.0%) in 3rd month, 1(2.0%) in 6th month. The difference was not significant (p&gt;0.05) between two groups. Recurrence was not observed in either group during this study period. Conclusion: Desarda technique of inguinal hernia repair in our set up is useful with comparable results to Lichtenstein hernioplasty. IAHS Medical Journal Vol 7(1), June 2024; 91-96

RE-DRAIN SURGERY IN PATIENTS WITH REFRACTORY GLAUCOMA

The choice of surgical treatment method for patients with refractory glaucoma of various etiologies is quite complicated. The most commonly performed surgeries are implantation of drainage devices or laser treatment methods. This article presents the results of repeated drainage surgery with Ahmed valve implantation in patients with previously implanted Ex-press shunt in patients with different types of refractory glaucoma.Objective. To present the results of surgical treatment of patients with advanced refractory glaucoma with implantation of Ahmed valve drainage after previous implantation of Ex-Press shunt.Methods. The study included 10 patients (10 eyes) with refractory glaucoma of various etiologies who had previously undergone Ex-Press implantation and subsequently received surgery with Ahmed valve implantation.Results. After surgical treatment, a statistically significant decrease in the level of intraocular pressure was detected in all cases. In the early postoperative period, in one case a choroidal detachment was detected. In the early postoperative period and also during the whole period of follow-up the drainage tube was in the correct position in anterior chamber. By the 6th month of follow-up hypotensive drops were required in 5 patients.Conclusion. At decompensation of intraocular pressure after antiglaucoma surgery with Ex-Press microshunt in patients with refractory glaucoma implantation of Ahmed valve drainage showed efficacy up to 3 years.

INCIDÊNCIA E CARACTERÍSTICAS CLÍNICO-EPIDEMIOLÓGICAS DA TUBERCULOSE EM IMPERATRIZ – MA

INTRODUCTION: Tuberculosis (TB) is an infectious disease transmitted by Mycobacterium tuberculosis, which spreads through the airways when infected individuals cough, sneeze or speak, releasing aerosols containing active bacilli. OBJECTIVE: To analyze the incidence and clinical-epidemiological characteristics of tuberculosis in Imperatriz - Ma, between 2019 and 2023. MATERIALS AND METHODS: Descriptive epidemiological study, with a quantitative approach, carried out from compulsory notifications of new cases of the disease available via DATASUS. The incidence coefficients were calculated for each year of the disease. The epidemiological variables were treated using descriptive statistics. RESULTS: During the period under investigation, 447 new cases of tuberculosis were reported in the city of Imperatriz. The detection rate of new cases was higher in 2022 and lower in 2021. Regarding the epidemiological characteristics, most cases were male, brown race/color, pulmonary clinical form, first positive sputum culture, negative TB/HIV coinfection, DOT not performed, non-smoker, non-alcoholic and with evolution to cure. In addition, the age group of 20 to 29 years, incomplete 5th to 8th grade of PE and 6th month bacilloscopy not performed stood out. FINAL CONSIDERATIONS: It is essential to invest in strategies that expand access and adherence to treatment, promote a more humanized approach in patient monitoring, and develop intersectoral actions to address socioeconomic and educational barriers.

Potential Influence of Interleukin-6 -174G/C Gene Polymorphism on Kidney Graft Function and Tacrolimus Dose Requirements: Five-Year Follow-up

1.Introduction: The study aimed to investigate the influence of interleukin (IL)-6 -174G/C gene polymorphism on graft function (defined as estimated glomerular filtration rate, eGFR), as well as on the tacrolimus (Tac) pharmacokinetics during the five years after kidney transplantation. 2.Methods: The study included 115 Caucasian kidney transplant recipients on Tac-based immunosuppression. The patients were followed between 6 and 60 post-transplantation months. Interleukin-6 and CYP3A5 genotyping were performed. 3.Results: Patients carrying the IL-6 -174GG genotype had lower eGFR values compared to the patients with the IL-6 -174GC and -174CC genotypes at the 12th, 48th and 60th post-transplantation months. The linear regression analysis indicated that eGFR at the 6th post-transplantation month and IL-6 -174G/C polymorphism are independent predictors of eGFR values in the late post-transplantation period. The IL-6 -174GG genotype carriers had lower dose-adjusted trough concentration (C0/D) of Tac compared to the IL-6 C allele carriers during the entire observation period (except at the 24th month), while this effect was independent of the CYP3A5 genotype within three years post-transplantation. 4.Conclusion: Interleukin-6 genotyping could be an additional tool to categorize patients toward the risk of graft deterioration in the long-term post-transplantation period. The IL-6 genotyping could be supportive in genotype-guided dosing of Tac.

Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study

Background Elderly patients with transfusion-dependent non-severe aplastic anemia (TD-NSAA) face limited treatment options owing to transplantation incompatibility and safety concerns. Methods Data from older patients (≥60 years) newly diagnosed with TD-NSAA and had been treated with either avatrombopag (AVA) + cyclosporine (CsA) or CsA monotherapy at our center were retrospectively collected. Results In total, 52 patients were enrolled, with 26 receiving AVA + CsA and 26 receiving CsA monotherapy. The overall response (OR) rate was higher in the AVA + CsA group than in the CsA group at the 1st, 2nd, 3rd, 6th months, and at the end of the follow-up (all p < 0.05). The complete response (CR) rate was higher in the AVA + CsA group than in the CsA group at the 6th month and at the end of follow-up (p = 0.017 and 0.039). Patients receiving AVA + CsA had a shorter time to achieve the first response (p = 0.008) and CR (p = 0.010) than those receiving CsA monotherapy. Furthermore, patients receiving AVA + CsA exhibited a higher rate of platelet transfusion independence at the 3rd (p = 0.041), 6th (p = 0.008) months, and likewise at the end of the follow-up (p = 0.097). Conclusions The addition of AVA to CsA can significantly improve the OR or CR rate and platelet levels with acceptable side effects in elderly patients, which implies that the combination is a viable alternative for elderly patients with TD-NSAA.

Investigation of homocysteine level after bariatric metabolic surgery, effect on vitamin B12 and folate levels

BackgroundObesity is a serious health problem with increasing incidence. worldwide and remains one of the most important causes of preventable deaths. We aimed to examine the relationship between Vitamin B12 and Folic acid, which have an important role for human life, and homocysteine is widely recognized for its association with the development of cardiovascular disease, although its role as an independent risk factor remains a topic of ongoing debate.Materials and methodsWe evaluated 126 patients who underwent bariatric metabolic surgery between September 2019-September 2020. In addition to demographic characteristics of the patients, weight, Vitamin B12, folate, HbA1c, cholesterol, triglyceride, ferritin, serum iron, albumin levels at preoperative, postoperative 1st month, 6th month, 12th month follow-ups were analyzed.ResultsPatients with the desired biochemical parameters at the determined follow-up points were identified and two groups were formed as RYGB(n = 43) and SG(n = 7) patients. When biochemical parameters were analyzed between the groups, homocysteine, HbA1c, HDL Cholesterol, VLDL Cholesterol, Total Cholesterol, Triglycerides, Ferritin, Serum Iron levels showed a statistical difference (p < 0.001). Folate (p = 0.064) and albumin (p = 0.257) did not show a significant difference over time. The change in vitamin B12 (p = 0.409) over time was not significant in the SG group, whereas a significant difference was observed in the RYGB group (p < 0.001). When we established a marginal model to determine the factors affecting the change in homocysteine over time, vitamin B12 and folate values.ConclusionsThe relationship between Vitamin B12, folate and homocysteine is important in order to better understand the complications that develop in bariatric metabolic surgery patients, to prevent possible complications and to better manage the process.

Is Serum Ferritin a Predictor of Blood Transfusions Outcome and Survival in Childhood Lymphomas and Solid Tumors?

Packed red blood cell (PRBC) transfusions are an important part of supportive treatment in oncology; however, when used frequently, they can be a result of transfusion-related iron overload. The aim of the study was to evaluate the role of ferritin as a non-specific marker of neoplastic growth and transfusion-related iron overload in children with lymphomas and solid tumors. We performed a longitudinal analysis of PRBC transfusions and changes in ferritin concentrations during oncological treatment of 88 children with lymphomas and solid tumors. A ferritin concentration above 500 ng/mL was diagnosed in 14.77% of patients at the moment of admission and 18.18% at the end of treatment. No differences were shown in serum ferritin in the context of tumor type-, sex-, and transfusion-related parameters. Those above the age of 10 demonstrated higher ferritin concentrations compared to subjects younger than 5 years of age. In addition, those over than 10 years old or above 30 kg in weight showed a tendency for better survival. All tested patients demonstrated highly significant correlations between ferritin at the 15th month of treatment or after therapy discontinuation and transfusion-related parameters. Interestingly, ferritin levels were found to lower back to the values before therapy shortly after its discontinuation. Transfusion parameters and ferritin levels had no influence on the survival of the studied cancer patients.

Evaluation of Internal and External Hexagon Connections in Immediately Loaded Full-Arch Rehabilitations: A Multicenter Randomized Split-Mouth Controlled Trial With a 6-Year Follow-Up.

Full-arch immediate loading rehabilitations are now a widely used rehabilitation method that guarantees predictable medium- and long-term results. Numerous factors can influence its success and stability in the medium and long term. Among these the implant-abutment connection seems to play an important role, however there is still little information on which is the most suitable in this type of treatment. The aim of the present multicenter split-mouth controlled trial is to evaluate whether external hexagonal connections (EHC) and internal hexagonal connections (IHC) can influence success, bone resorption and peri-implant parameters in immediate-load full-arch rehabilitations. Twenty patients were rehabilitated with immediately loaded fixed full-arch rehabilitations. All the implants presented the same macro- and micro-topography but different implant-abutment connection. IHC were used in one randomly selected side of the jaw and EHC was used in the other side. Outcome measures were implant survival rate, peri-implant marginal bone loss (MBL), plaque index (PI), probing depth (PD), and bleeding on probing (BoP) evaluated at 3, 6, 12, 36, and 72-month post-loading. Technical and biological complications were recorded. In 20 patients, 43 EHC and 40 IHC implants were placed. Between 32 and 72 months of follow-up two patients withdrew (died) and no implants were lost. The cumulative survival rate (CSR) was 97.44% for EHC implants and 97.22% for IHC implants. The MBL presented a resorption of 2 mm in the EHC group and 1.9 mm in the IHC group. No statistically significant differences were found between the two groups for any of the parameters at any time. No biological or technical complications were detected between the 36th and 72nd month of follow-up. After 72 months in function, both internal and external hexagon connections provided good clinical outcomes and were not associated with any significant difference in the clinical outcomes.

Fentanyl Initiation Rate Following the Requirement for Specialist Approval.

Healthcare organizations attempt to address unwarranted fentanyl use, which often leads to increased risk of addiction and overdose. To assess the impact of a requirement for a specialist's approval on fentanyl initiation for non-oncological pain. A retrospective cohort study based on observational data. All 4.4 million non-oncological members of Clalit Health Services were included, from July 20, 2021, to July 19, 2023. The rate of fentanyl initiation was assessed before and after the implementation of the requirement for specialist's approval, which was introduced on July 2022, and expanded 6months later for continued use. A sub-group analysis by age group was performed, and patient characteristics and indications were assessed. We also compared total opioid dispensation in the 6th and 12th months after the implementation with the predicted rate based on pre-implementation rates. Fentanyl initiation rate in the year before the requirement was 711 per million capita, which decreased following the requirement by - 81% (95% CI: - 77%; - 85%). The decrease attenuated with age. The prevalence of diagnosis with substance abuse disorders at the time of fentanyl initiation decreased from 6 to 3%. In the 6th and 12th months after the requirement was implemented, the morphine milligram equivalent (MME) from dispensation of total opioids was lower than predicted based on pre-implementation rates by 7% and 26%, respectively. Requiring specialist approval for fentanyl initiation for non-oncological chronic pain was associated with a decrease in fentanyl prescription initiations, especially among non-elderly patients. A decrease also occurred gradually in total opioid dispensations, further decreasing following the extension of the requirement to continuous fentanyl. The requirement for specialist approval upon fentanyl initiation and continuous fentanyl may present an effective tool for limiting the use of fentanyl and total opioids in healthcare systems.

Impact of Storage Temperature on Physical Stability and Protein-Lipid Co-oxidation in Whey Protein functional Emulsions.

The aim of this study was to investigate the effect of different storage temperatures (4°C, 25°C and 45°C, denoted as T-4, T-25 and T-45, respectively) on the physical stability and protein-lipid co-oxidation of whey protein functional emulsions during the storage period at storage times of 1, 2, 3 and 6 months. At the 6th month of storage, samples stored at 45°C were less physically stable than samples stored at 4°C, as evidenced by an increase in particle size (5.50%), a decrease in zeta potential (7.93%), and a decrease in adsorbed protein concentration (36.8%). The most severe protein-lipid co-oxidation was induced in whey protein functional emulsions under 45°C temperature conditions with increasing storage time. Protein oxidation products (carbonyls, N′-formyl-L-kynurenine, and sulfhydryl groups) and lipid oxidation products (lipid hydroperoxides, thiobarbituric acid reactive substances) were at their highest levels, and significant molecular changes were observed in the molecules of adsorbed protein or unadsorbed proteins. As the storage temperature rises it exposes the active sites such as internal sulfhydryl and hydrophobic groups in the protein, promoting cross-linking and aggregation. Cluster and correlation analyses showed that protein-lipid co-oxidation of emulsions inevitably occurs during storage, but low-temperature storage can delay this process. This study is of guiding significance for the quality maintenance of functional nutritional emulsions and the selection of storage conditions. In addition, this study may provide clearer solutions to the problems of whey protein denaturation and formation of lipid oxides caused by protein-lipid co-oxidation in the food industry, as well as to the problem of increasing the shelf life of products by choosing the appropriate storage, packaging, and transportation temperatures.

Oral Toxicity and Hypotensive Influence of Sericin-Derived Oligopeptides (SDOs) from Yellow Silk Cocoons of Bombyx mori in Rodent Studies.

Sericin-derived oligopeptides (SDOs) from yellow silk cocoons exhibit antihypertensive and hypoglycemic properties in both in vitro and in vivo studies. This study investigated the acute toxicity of SDOs as a novel food for human consumption using female ICR mice and Wistar rats, as well as the chronic toxicity test on both sexes of Wistar rats. Clinical chemistry, hematology, and histopathological studies revealed that SDOs were safe for a single dose of 2000 mg kg-1 body weight (BW) and daily oral administration of 50, 100, and 200 mg kg-1 BW for six months. The chronic toxicity study additionally measured the rats' systolic blood pressure (SBP) and blood sugar monthly as they slowly aged. In the 2nd month for male rats and the 4th month for both sexes, SDOs had a significant hypotensive effect on Wistar rats' blood pressure, lowering it from 130 mmHg to a plateau at 110-115 mmHg. In contrast, the blood pressure of the control rats exceeded 140 mmHg after five months. Nonetheless, the hypoglycemic effect was not observed. Measurements of SBP and blood glucose in aged rats during chronic toxicity tests yielded insights beyond ordinary toxicity, including the health and fitness of the lab rats, perhaps resulting in novel discoveries or areas of study that justify the sacrifice of the animals' lives.

Critical periods of maternal exposure to ambient fine particulate matter and the risks of stillbirth and spontaneous preterm birth in Western Australia

Few studies have investigated weekly or monthly exposure-lag-response association between fine particulate matter (PM2.5) and preterm birth, and there has been no known such study for stillbirth. We aimed to identify potential critical susceptible periods of the association between monthly PM2.5 exposure during pregnancy and stillbirth and spontaneous preterm birth (sPTB). A total of 414,771 singleton births, of which 0.5% and 3.9% were stillbirth and sPTB respectively, between 1st January 2000 and 31st December 2015 in Western Australia were linked to fine spatiotemporal monthly PM2.5 concentrations. Monthly distributed lag linear and non-linear Cox regressions were performed to investigate PM2.5 exposure during pregnancy and covariate-adjusted hazards of stillbirth and sPTB. The mean PM2.5 exposure during pregnancy was 8.1 μg/m3. Pregnancy PM2.5 exposure showed small dose-response associations with stillbirth and sPTB with critical susceptible periods spanning the 3rd–6th gestational months. Relative to 5 μg/m3, the strongest hazards of PM2.5 exposure were 1.04 (95% CI 0.99, 1.08) and 1.03 (95% CI 1.02, 1.05) during the 4th gestational month for stillbirth and sPTB, respectively. Monthly exposures at late pregnancy were associated with lower hazards. The average pregnancy exposure hazards were 1.08 (95% CI 0.88, 1.32) and 1.07 (95% CI 0.99, 1.15) per 5 μg/m3 increment for stillbirth and sPTB, respectively. The average entire pregnancy exposure showed potential attributable burden, synergistic interaction effects with biothermal stress, and comparatively higher hazards for female births and births to mothers who were Caucasian, < 35 years old, high SES, nulliparous, and smoked during pregnancy.

Proteome of Dried Blood Spots of Cosmonauts during a 6-Month Flight

For successful exploration of near space, construction of planetary bases and exploration of the Solar System planets, it is necessary to fill the gaps in understanding the molecular mechanisms of the human body response to space flight (SF) conditions. Subsequently, this will make it possible to get closer to the discovery of potential molecular targets for protection against adverse processes occurring in the body under the influence of SF conditions. The aim of the work was to assess the effect of a 6-month space flight on the proteome of dried blood spots of cosmonauts. As a result of proteomic analysis, processes with highly and moderately enriched proteins were identified. Among them, processes with reliable dynamics were identified on the 7th day of SF, as well as on the 3rd and 6th months of flight: these are clusters of energy processes, presentation of molecules on the membrane, initiation of immune defense, proteostasis and metabolism. Biological processes were identified in which the representation of proteins decreased most significantly, which was reflected in a weakening of activity in the presentation of molecules on the membrane, the initiation of immune defense, as well as in the mechanisms of proteostasis in the acute period of adaptation to the factors of the initial stage of flight. It has been shown that there is a close interaction with proteins of the cytoskeleton organization that disappear or reappear in the dried blood spots proteome during flight, and that relate to processes whose activity significantly decreased during SF (immune system, proteostasis, metabolism).

Functional Outcome Of Delayed Anterolateral Plating For Tibial Pilon Fractures

BACKGROUND &amp; OBJECTIVES: The Management of Tibial pilon fractures have always been perplexing. Our study was planned to evaluate functional outcome of delayed anterolateral plating for tibial pilon fractures by assessing the range of motion of ankle along with pain and affection in the activities of daily living. MATERIALS AND METHODS: A prospective observational study was done for 45 patients with tibial pilon fracture, for whom delayed anterolateral plating was done in Orthopaedics department of Government medical college, Thiruvananthapuram. The study was conducted at 6 months of follow up after surgery is done. Data collected using a structured proforma. The evaluation of results is based on scoring system given by kaikkonen ankle score RESULTS: Functional outcome was assessed at 6th month follow up using kaikkonen ankle score. The mean age of the patients was 38.53(19-72) and among them 52.78% had right side affected. 37.78% had excellent functional outcome and 51.11% had good functional outcome at the end of 6 months. Best functional outcome was obtained in Ruedi Allgower type 1 fractures. Wound related infections were noted in 6.7% cases who had significantly poor functional outcome CONCLUSION: Hence delayed anterolateral plating greatly improves the functional outcome in patients with tibial pilon fractures and allows for earlier mobilization and prevents complications like malunion.

Evaluation of β-Actin and Mitochondrial DNA Levels in Determining the Age of Suidae Remains.

African Swine Fever (ASF) is an infectious disease affecting pigs and wild boars, causing significant economic losses. Epidemiological surveillance plays an important role in minimizing its impact. The aim of this study was to evaluate the usefulness of β-actin DNA and mitochondrial DNA (mtDNA) levels in determining the age of animal remains from the Suidae family, which could be helpful in epidemiological investigations. The study included selected tissues and internal organs of Sus scrofa domesticus, exposed to natural environmental conditions or kept in stable 4 °C conditions, to assess the levels of β-actin and mtDNA over a period of 18 months. The levels of both tested parameters exhibited the expected decreasing trend over time. However, in most tissues, some discrepancies from this general pattern were observed. The results obtained for bone marrow showed a consistent downward trend and a strong correlation between mtDNA and β-actin, with long-term detectability (up to the 13th month of the study). Therefore, bone marrow could be considered a matrix of choice for age assessment. However, due to various influencing factors, further studies are required.

Nutritional management, skipping breakfast, glycemic control, and cardiovascular risk on type 2 diabetes mellitus

Abstract Background Meal timing is an emerging field that investigates the influence of eating patterns on circadian rhythm and general health. There is still disagreement in the literature as to whether eating windows could impact weight gain and biochemical markers. Purpose 1- Evaluate the impact of nutritional interventions on weight, body mass index (BMI), waist circumference (WC), fasting blood glucose (FG), glycated hemoglobin (HbA1c), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triglycerides, systolic blood pressure (SBP), and diastolic blood pressure (DBP), between 0th and 12th month in Type 2 Diabetes Mellitus (T2D); 2-Observe breakfast skipping and sleep disorders, and also analyze the influence of these data with possible changes in anthropometric and biochemical markers. Methods This experimental and observational study recruited 44 participants with T2D. The assessments were carried out in October 2022 and 2023. The nutritional assessment consisted of prescribing a personalized eating plan (Mediterranean diet and DASH). Statistical analysis: For the variables "breakfast habits", "nocturnal awakenings", and "sleep duration", the numbers of participants were converted into percentages of the total number of individuals. Parametric variables were compared using the paired t-test and non-parametric variables were compared by the Wilcoxon test. To evaluate the influence of the habit of eating breakfast and sleep disorders on quantitative variables, variations were calculated between the 0th and 12th month between participants who had or did not have the habit of eating breakfast and had or did not have sleep disorders. Parametric variables were compared using the unpaired t test and non-parametric variables using the Mann-Whitney test. Parametric data were presented as mean ± standard deviation and non-parametric data as median ± interquartile range, both accompanied by the dispersion of all repetitions. α&amp;lt;0.05 and P&amp;lt;0.05 were adopted. Results Significant reductions were found between the 0th and 12th month of FG, HbA1c, LDL-C, triglycerides, SBP, DBP, BMI, WC, and weight (p&amp;lt;0.0001). Regarding breakfast habits, in the 1st month, 77.3% of participants skipped this meal, reducing to 13.6% in the 12th month. For sleep duration, in the 1st month, 90.9% of participants slept less than 6 hours, reducing to 40.9% in the 12th month. For nocturnal awakenings, 70.5% of participants had at least 1 awakening in the 1st month, reducing to 54.5% in the 12th month. For influence analysis, no significant differences were found between changes in FG, HbA1c, LDL-C, triglycerides, SBP, DBP, BMI, WC, and weight on breakfast habit or sleep disorders, except for HDL-C and sleep disorders (p&amp;lt;0.005). Conclusion Nutritional management improved biochemical markers, reduced anthropometric data, regulated the eating window, reduced nocturnal awakenings, and optimized sleep duration in patients with T2D.