Early Loss Research Articles

Hermeneutics, Neuroscience and Psychiatry

Hermeneutics, Neuroscience and Psychiatry Michael T. H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM (bio) Hermeneutic practice in mental health has been a theme in Philosophy, Psychiatry, & Psychology (PPP) since its very beginnings. In this essay I argue that hermeneutics, the theory and practice of interpretation, promotes therapeutic interaction between mental health professionals, patients and their family. Why does this patient present in such a way at this particular point in time? The distressing symptoms are there. The changes in behavior are obvious. Impairments of functions are hurting. A mental illness clearly runs in the family. There were early losses of loved ones, physical abuse at home, bullying by peers and self-medication with drugs and alcohol. Three in four adults with a mental illness first experienced that before they turned 24. The brain goes through major reorganization during adolescence and early adulthood. If synaptic pruning went wrong, psychoses emerged. When stresses activated the hypothalamic–pituitary–adrenal axis the elevated cortisol level impacted the size and function of the hippocampus and amygdala in the genetically vulnerable; anxiety, depression, bipolar, and personality disorders developed. The patient needs a voice/language to describe all these experiences and events and the psychiatrist needs a discourse to make sense of them. Eisenberg laments the swings between "brainlessness" and "mindlessness" in psychiatry. Engel argues for a "biopsychosocial" discourse. The major challenge for psychiatry is how to organize clinical information of different nature (categories, dimensions, narratives; i.e., objective vs. subjective, personal vs. interpersonal) into a coherent and comprehensible account for us all. Mental illnesses are not only neuropsychiatric spectrum disorders but also dysfunctions of social relationship and environmental/ecological adaptation. Psychiatry as a clinical neuroscience per se lacks the semantics to address the rich interactions between the physical, psychological, social, cultural, and spiritual in the illness experience of our patients. Explanation in the diagnostic formulation (objective scientific discourse on cause and effect) and understanding in the patient narrative (subjective ordinary everyday discourse on significance and meaning) are irreducible to each other (Wong, 2018). They instead interact with one another to achieve an integrative formulation, not through merging different discourses into a single assertion/monologue but via the dialectic/dialogue of "explaining more in order to understand better," as Ricoeur puts it, and between "the whole and the parts," as Schleiermacher highlights. This "therapeutic hermeneutic circle" of "explanation vs understanding" and "the whole vs the parts" includes symptoms behavior function and life events. It correlates between bio-psychosociocultural-spiritual dimensions/perspectives and does not reduce them to any particular/single [End Page 13] stance. The whole integrates the parts and the parts enrich the whole. It explains but does not explain away. It understands through an articulation of meaning and significance. This discourse is a multilayered (bio-psycho-social-cultural-spiritual) personal narrative that formulates diagnosis and care in a correlative (linking different voices/discourses) and non-reductive (no particular voice/discourse is prejudiced against) manner that is comprehensible to us all (Wong, 2021). PPP will be an excellent forum for discussing clinical hermeneutics in the future. In this digital era of social media and virtual reality, hermeneutics has the never-ending task to tackle the unprecedented challenges to meaning illness and health posed by polarizing discourses. Michael T. H. Wong Michael T.H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM, is Hon Clinical Professor, Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, HKSAR, China. Michael is Chair, Section of Philosophy & Humanities in Psychiatry, World Psychiatric Association. He is an Organizational Partner & International Lead with The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine's College Oxford. He is Advisor to the Chinese Health Foundation of Australia. References Wong M. T. H. (2018). Ricoeur and the third discourse of the person: From philosophy and neuroscience to psychiatry and theology. London: Lexington Books. Google Scholar Wong, M. T. H. (2021). Values, meanings, hermeneutics and mental health. In Stoyanov, D., Fulford, K. M. W. F., Stanghellini, G., Van Staden, W., & Wong, M. TH. (Eds.), International perspectives in values-based mental health practice: Case studies and commentaries (pp. 341–349...

Pregastrular Development of Amphibians: Ontogenetic Diversity and Eco-Devo

Comparative and ecological aspects of the reorganizations of early development in the class Amphibia are analyzed. We used data on the developmental diversity in a number of families belonging to the orders Anura and Caudata, in which many species had lost their connection with the aquatic environment. Model representatives of the class Amphibia (Ambystoma mexicanum, Rana temporaria, and Xenopus laevis) have small eggs (no more than 2.5 mm in diameter). In these species, the slowdown in the rate of cell divisions and the loss of synchrony occur at the midblastula stage. However, phylogenetically basal amphibian species (Ascaphus truei, Cryptobranchus alleganiensis) are characterized by the large (4–6 mm in diameter) yolky eggs and a short series of synchronous blastomere divisions (the synchrony is already lost at the 8-cell stage of cleavage). They do not have a “midblastula transition”, which is characteristic of the above model species. On the other hand, many evolutionarily advanced non-model species of caudate and anuran amphibians (for example, Desmognathus fuscus, Gastrotheca riobambae, Philoria sphagnicolus), as well as the basal species, are characterized by the large, yolk-rich eggs and the early loss of cell division synchrony. Phylogenetic analysis suggests that the cleavage pattern of the most extensively studied amphibians, the Mexican axolotl (Caudata) and the African clawed frog (Anura), represents a homoplasy. The midblastula transition, which is characteristic of these two species, might have evolved convergently in these two orders of amphibians as an embryonic adaptation to development in lentic water.

Optimizing sampling frequency of surface and downhole measurements for efficient stick-slip vibration detection

Drilling vibrations significantly impact drilling operations with high costs due to early downhole equipment failure and loss of productive time. Stick-slip vibrations, a severe form of torsional vibrations, is known to be present up to 50% of total drilling time, making it a topic of immense concern and research. An ongoing discussion in the industry is regarding the reliability of surface measurements for early detection of severe downhole bit sticking. Moreover, most surface measurements are sampled at lower frequency rates closer to 1 Hz. Recently, the implementation of advanced data acquisition modules in downhole subs has greatly improved our understanding of drilling vibrations through high resolution data, sampled up to 10 kHz. However, with a wide range of sampling frequency to choose from different available tools, a critical question remains unanswered. What is an optimal and adequate sampling frequency for early detection of downhole vibrations using both surface and downhole measurements? The paper addresses the question with a focus on stick-slip vibrations through an experimental investigation. Stick slip tests are repeated for different sampling frequencies of surface and downhole measurements and the stick slip index for each case is calculated. The stick-slip index varies for different sampling frequency even though the vibration tests remain completely identical. It was inferred that sampling frequency of measurements greatly impact the detection of downhole vibrations. Even though stick-slip vibrations are characteristically low frequency vibrations (≤2Hz), a minimum of 10Hz sampling frequency is recommended for detection of stick-slip vibrations. Moreover, all characteristics of stick-slip vibrations including bit sticking, bit RPM peaks and negative bit RPMs are clearly observed at a minimum of 100Hz sampling rate.

Purine Content and Renal Acid Load Evaluation in Healthy Japanese Diets.

During the treatment of hyperuricemia, attention should be paid to purine intake as part of the diet. Additionally, many patients with obese hyperuricemic expect early weight loss through glucose restriction. However, the amounts of purine in the diet are unknown. This study aimed to compare the purine content and potential renal acid load (PRAL) of a hospital diet and a low carbohydrate (LC). We calculated the nutritional values in the menus of the normal hospital (NH), energy-control (EC) diets served at several Shizuoka general hospitals, and the menus of LC diets. The amount of purine and PRAL was determined based on the nutritional values. The average daily purine content and energy were NH 349.0 mg, 1,808 kcal, EC 340.4 mg, 1,681 kcal, and LC 697.6 mg, 1,454 kcal, respectively. LC consumed more purine than the recommended daily intake of 400 mg. The PRAL score for NH was 4.5 mEq/d, EC 3.8 mEq/d, and LC 19.0 mEq/d, with LC representing diets with a higher acid load. In terms of both purine intake and uric acid excretion, the hospital diet is preferred over the low-carbohydrate diet for patients. Dietitians should exercise caution when recommending a low-carbohydrate diet for patients with hyperuricemia.

Complete Bony Segment Flap Failure without Skin Paddle Compromise in Fibular Free Flap: A Case Report of a Rare Early Complication

The free fibula flap is sometimes associated with partial flap loss. A 62-year-old man with squamous carcinoma of the lower alveolus underwent anterior arch resection and reconstruction with a fibula osteocutaneous flap containing three bony segments. There were two perforators in the skin flap; the first perforator was proximal to the bony segments and the other perforator was at the level of the middle segment. Atherosclerosis was observed in the anastomotic vessels. During surgery, thrombosis occurred in the arterial anastomosis, but was revised before the operation was over. The patient’s early postoperative course was uneventful. In the second week, purulent discharge was observed from the drains. Flap exploration showed devascularization of bony segments and periosteum, but the skin paddle was viable. The peroneal vessel had thrombosed distal to the takeoff of the proximal perforator and the viable skin paddle perfused by proximal perforators falsely indicated the well-being of underlying bones. The de-vascularized bones and sloughed periosteum were removed at the time of exploration, after which the skin paddle was reoriented for coverage of the defect. The patient completed chemoradiation without any bony reconstruction afterwards. This is the only reported case of early total bony flap portion loss with a viable skin paddle in free fibula flap transfer.

ROCK inhibition enhanced hepatocyte liver engraftment by retaining membrane CD59 and attenuating complement activation

Hepatocyte transplantation can be an effective treatment for patients with certain liver-based metabolic disorders and liver injuries. Hepatocytes are usually infused into the portal vein, from which hepatocytes migrate into the liver and integrate into the liver parenchyma. However, early cell loss and poor liver engraftment represent major hurdles to sustaining the recovery of diseased livers after transplantation. In the present study, we found that ROCK (Rho-associated kinase) inhibitors significantly enhanced invivo hepatocyte engraftment. Mechanistic studies suggested that the isolation of hepatocytes caused substantial degradation of cell membrane proteins, including the complement inhibitor CD59, probably due to shear stress-induced endocytosis. ROCK inhibition by ripasudil, a clinically used ROCK inhibitor, can protect transplanted hepatocytes by retaining cell membrane CD59 and blocking the formation of the membrane attack complex. Knockdown of CD59 in hepatocytes eliminates ROCK inhibition-enhanced hepatocyte engraftment. Ripasudil can accelerate liver repopulation of fumarylacetoacetate hydrolase-deficient mice. Our work reveals a mechanism underlying hepatocyte loss after transplantation and provides immediate strategies to enhance hepatocyte engraftment by inhibiting ROCK.

Sagittal correction after short percutaneous fixation for thoracolumbar compression fractures: comparison of the combination of SpineJack® kyphoplasty and fractured vertebra screw fixation.

The aim of this study was to compare two percutaneous pedicle fixations for the treatment of thoracolumbar fractures: one associating a jack kyphoplasty (SpineCut) and the other using intermediate screws (Trident). All adult patients treated for single-level Magerl/AO type A thoracolumbar traumatic fractures in four orthopaedic departments, with SpineCut or Trident, with a oneyear minimum follow-up, were retrospectively included. Neurological disorders and osteoporotic fractures were not included. The following data were collected: age, sex, Magerl/AO type, type of surgery, and complications. Radiological parameters were analyzed on pre-operative CT scan, and on standing X-rays before discharge, at three months and one year post-operative: vertebral wedge angle (VWA), regional kyphosis angle (RKA), and traumatic regional angulation (TRA: difference between RKA and physiological values for each vertebra). Eighty patients were included, with 42 patients in SpineCut group and 38 in Trident group. Mean age was 41 ± 15.7 years. TRA correction did not differ between the groups: respectively 11.2 ± 8.1° in SpineCut versus 10.2 ± 9.1° in Trident group (p = 0.52). TRA loss of correction between early post-operative and three months was statistically higher in Trident group: -4 ± 5.1° versus -1.5 ± 3.8° (p = 0.03). After 3 months, TRA correction loss was comparable between the groups. Multivariate analysis demonstrated that pre-operative VWA was the only factor significantly associated with early TRA correction loss (p = 0.01). VWA correction and loss of correction did not differ significantly between the groups. No complications were observed. Percutaneous pedicle fixations of traumatic thoracolumbar fractures associating jack kyphoplasty and intermediate screws are both safe and efficient techniques.

A Retrospective Study on the Effect of Pulp Treatment on the Exfoliation of Primary Teeth

The aim of this study was to retrospectively analyze the effects of pulp treatment on exfoliation of primary teeth and its related factors. In this study, 167 teeth of 97 patients aged 6 months to 12 years who were treated with pulp treatment at Dankook Dental Hospital were selected, and information related to pulp treatment and tooth loss was collected. The included subjects were 72 primary anterior teeth (43.1%) and 95 primary posterior teeth (56.9%), of which 56 were males (57.7%) and 41 females (42.3%). The mean follow-up period was 106.1 ± 38.7 months, and the mean age at pulp treatment was 34.8 ± 15.4 months for primary anterior teeth and 69.1 ± 25.1 months for primary posterior teeth. Unilaterally pulpectomized teeth were significantly exfoliated earlier than the same tooth on the opposite side (<i>p</i> < 0.05). Also, in the case of teeth with periapical lesions, despite pulp treatment, the probability of extraction due to infection has been increased on primary anterior teeth (<i>p</i> < 0.05), but not on posterior teeth (<i>p</i> > 0.05). Pulpectomized teeth were lost earlier, an average of 7.8 months for primary anterior teeth and 8.5 months for primary posterior teeth. Early loss of the primary tooth can lead to space loss and premature eruption of the successor, so this can be considered when planning or performing treatment of the primary tooth.

Sterile Pancreas Inflammation during Preservation and after Transplantation

The pancreas is very susceptible to ischemia-reperfusion injury. Early graft losses due to pancreatitis and thrombosis represent a major issue after pancreas transplantation. Sterile inflammation during organ procurement (during brain death and ischemia-reperfusion) and after transplantation affects organ outcomes. Sterile inflammation of the pancreas linked to ischemia-reperfusion injury involves the activation of innate immune cell subsets such as macrophages and neutrophils, following tissue damage and release of damage-associated molecular patterns and pro-inflammatory cytokines. Macrophages and neutrophils favor tissue invasion by other immune cells, have deleterious effects or functions, and promote tissue fibrosis. However, some innate cell subsets may promote tissue repair. This outburst of sterile inflammation promotes adaptive immunity activation via antigen exposure and activation of antigen-presenting cells. Better controlling sterile inflammation during pancreas preservation and after transplantation is of utmost interest in order to decrease early allograft loss (in particular thrombosis) and increase long-term allograft survival. In this regard, perfusion techniques that are currently being implemented represent a promising tool to decrease global inflammation and modulate the immune response.

Implant connection and abutment selection as a predisposing and/or precipitating factor for peri-implant diseases: A review.

Peri-implant mucosal integration is becoming a critical aspect for long term implant health and can be triggered the selection of implant components. The aim of this review is therefore to investigate the evidence concerning implant connection and abutment characteristics (abutment materials, design, handling) as predisposing or precipitating factor for peri-implant mucositis and peri-implantitis. Although the evidence that these features can directly predispose/precipitate peri-implant diseases is limited, there are -few- studies showing a potential role of the implant connection, trans-mucosal configuration, and handling in the development of early bone loss and/or peri-implantitis.With bone level implants, conical internal connections (with inherent platform switching) might be preferred over internal flat-flat and external connections to decrease the risk of early bone loss and potentially the risk of peri-implant disease. Moreover, there is a trend suggesting moving the prosthetic interface coronally (to the juxta-mucosal level) as soon as possible to reduce the number of disconnections and to limit the risk of cements remnants. This can be achieved by choosing a tissue-level implant or to place a trans-mucosal abutment (one abutment-one time approach) to optimize the peri-implant soft tissue seal. In absence of evidence for the biocompatibility regarding several restorative materials, biocompatible materials such as titanium or zirconia should be preferred in the trans-mucosal portion. Finally, longer implants (≥2mm) with an emergence angle below 30° seem more favourable.It should however be noted that some of this information is solely based on indirect information (such as early bone loss) and more research is needed before making firm recommendations about abutment choice.

Administration of GnRH at day 20 of AI and embryonic losses in synchronized crossbred buffalo.

Following the application of different artificial insemination and synchronization protocols, the synchronized buffaloes had a higher incidence of early embryonic or fetal death, thus impairing reproductive performance. Therefore, there is a need to devise a synchronizing program that can improve conception, allow early pregnancy diagnosis, reduce early embryonic losses, and provide an early clue for pregnancy diagnosis and establishment. The present study aimed (1) to determine the effect of administration of different GnRH doses at day 20 of artificial insemination (AI) on the reproductive performance of buffaloes and (2) to observe the influence of synchronization protocol, parity, age, milk production, and body condition score (BCS) on early embryonic loss and progesterone (P4) levels in crossbred buffaloes. Crossbred buffaloes (n = 101) were synchronized using the GPGMH protocol. At day 20 of AI, the synchronized buffaloes were randomly divided into four groups and administrated GnRH doses (0, 100, 150, and 200 μg). The buffaloes were monitored for ovarian dynamics, P4 level, non-return rate, embryonic/fetal losses, and pregnancy rates. The previously synchronized buffaloes were also classified for synchronization protocol (with or without GnRH), parity (nulli- or multiparous), milk production (high or low), BCS (low, medium, or good) or age (>3 or < 3 years) groups for observing the embryonic loss and P4 level variations. The results indicated no difference (P > 0.05) in CL size, P4 level, pregnancy rate and embryo/fetal losses across the treatment groups at different observation periods. There was a high (P < 0.05) incidence of early embryonic mortality in aged, multiparous, low BCS and low milk-producing buffaloes treated without GnRH. The data suggest that GnRH 200 μg at day 20 of AI improves embryo survival and pregnancy maintenance in crossbred buffaloes.

Suction drainage in total knee replacement does not influence early functional outcomes or blood loss: a randomized control trial

IntroductionThe use of wound drainage following total knee arthroplasty (TKA) remains controversial. The purpose of this study was to evaluate the impact of suction drainage on early postoperative outcomes in patients who underwent TKA with concomitant administration of intravenous tranexamic acid (TXA).MethodOne hundred forty-six patients undergoing primary TKA with systematic intravenous TXA were prospectively selected and randomly divided into two groups. The first "Study group" (n = 67) received no suction drain and the second "Control" group (n = 79) had a suction drain. Perioperative hemoglobin levels, blood loss, complications, and length of hospital stay were assessed in both groups. Preoperative and postoperative range of motion and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were also compared at a 6-week follow-up.ResultsThe study group was found to have higher hemoglobin levels preoperatively and during the first two days following surgery, and no difference was found between the groups on the third day. No significant discrepancies at any time were found between groups in terms of blood loss, length of hospitalization, knee range of motion, and KOOS score. Complications requiring further treatment were observed in one patient from the study group and ten patients from the control group.ConclusionThe use of suction drains after TKA with TXA did not alter early postoperative outcomes.

Novel Hybrid Optimized Clustering Schemes with Genetic Algorithm and PSO for Segmentation and Classification of Articular Cartilage Loss from MR Images

Medical image segmentation plays an indispensable role in the identification of articular cartilage, tibial and femoral bones from magnetic resonance imaging (MRI). There are various image segmentation strategies that can be used to identify the knee structures of interest. Among the most popular are the methods based on non-hierarchical clustering, including the algorithms K-means and fuzzy C-means (FCM). Although these algorithms have been used in many studies for regional image segmentation, they have two essential drawbacks that limit their performance and accuracy of segmentation. Firstly, they rely on a precise selection of initial centroids, which is usually conducted randomly, and secondly, these algorithms are sensitive enough to image noise and artifacts, which may deteriorate the segmentation performance. Based on such limitations, we propose, in this study, two novel alternative metaheuristic hybrid schemes: non-hierarchical clustering, driven by a genetic algorithm, and Particle Swarm Optimization (PSO) with fitness function, which utilizes Kapur’s entropy and statistical variance. The goal of these optimization elements is to find the optimal distribution of centroids for the knee MR image segmentation model. As a part of this study, we provide comprehensive testing of the robustness of these novel segmentation algorithms upon the image noise generators. This includes Gaussian, Speckle, and impulsive Salt and Pepper noise with dynamic noise to objectively report the robustness of the proposed segmentation strategies in contrast with conventional K-means and FCM. This study reveals practical applications of the proposed algorithms for articular cartilage extraction and the consequent classification performance of early osteoarthritis based on segmentation models and convolutional neural networks (CNN). Here, we provide a comparative analysis of GoogLeNet and ResNet 18 with various hyperparameter settings, where we achieved 99.92% accuracy for the best classification configuration for early cartilage loss recognition.

Influence of different mucosal phenotype on early and long-term marginal bone loss around implants: a systematic review and meta-analysis.

To investigate the influence of different mucosal phenotypes on peri-implant marginal bone loss. The search was conducted in five databases including PubMed, Embase, Cochrane, Scopus, and Web of Science (until 1st Sept. 2022) to identify relevant clinical studies. Potentially relevant journals were also manually searched. Two reviewers independently screened studies, extracted data, and evaluated the quality of the studies. Prospective clinical trials and observational studies investigating peri-implant marginal bone loss in thick-mucosa and thin-mucosa groups were included. A total of 14 studies were included in this systematic review. Results of the meta-analysis revealed a weighted mean difference of 0.38mm for marginal bone loss between thick- and thin-mucosa groups (95% confidence interval = 0.02-0.74, P = 0.002). Statistical significance existed in short-term (follow-up ≤ 1year) data (WMD = 0.41mm, 95%CI = 0.11-0.70, P = 0.007), but not in long term (follow-up ≥ 3 y) data (WMD = 0.17mm, 95%CI = - 0.02-0.36, P = 0.07). Survival rate revealed no difference between thick and thin mucosa groups. In subgroup analyses, a positive association between thick mucosa and less marginal bone loss was found in the non-submerged group, cement-retained group, and bone-level group. A significantly less marginal bone loss occurred in implants with thick mucosa than with thin mucosa in the short term, whereas no significant difference was observed in the long term. Due to the substantial heterogeneity and limited long-term data, further high-quality evidence is warranted to confirm the results. Clinicians are advised to use caution in treating patients with thin mucosa and adhere closely to indications and protocols to minimize marginal bone loss.

Personality traits and preoperative lifestyle improvement are predictors of early weight loss after sleeve gastrectomy.

This study investigated the associations of personality traits and preoperative lifestyle improvements with early weight loss after sleeve gastrectomy. This was a single-center, retrospective study of 57 patients who underwent preoperative lifestyle intervention with a multidisciplinary team approach based on cognitive behavioral therapy before sleeve gastrectomy. All patients underwent preoperative psychological testing with the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) and the Tokyo University Egogram New Version II (TEG II). We investigated the associations of psychological testing results and lifestyle improvements with percent total weight loss (%TWL) one year after surgery. The median %TWL at 1year was 38.2% for patients with an improved lifestyle and 26.9% for those without improvement (P = 0.0008). Although TEG II factors were not associated with %TWL at 1year, higher NEO-FFI extraversion (E) scores were significantly associated with a better %TWL at 1year. The median %TWL at 1year was 35.2% for patients with higher E scores and 25.4% for those with lower E scores (P = 0.0247). Lifestyle improvement and the NEO-FFI E score significantly influenced %TWL at 1year based on a logistic regression analysis. The NEO-FFI E score and preoperative lifestyle improvement may be predictors of early weight loss after sleeve gastrectomy.

Quantitative Autofluorescence in Non-Neovascular Age Related Macular Degeneration.

Quantitative autofluorescence (qAF8) level is a presumed surrogate marker of lipofuscin content in the retina. We investigated the changes in the qAF8 levels in non-neovascular AMD. In this prospective cohort study, Caucasians aged ≥50 years with varying severity of non-neovascular AMD in at least one eye and Snellen visual acuity ≥6/18 were recruited. The qAF8 levels were analysed in the middle eight segments of the Delori pattern (HEYEX software, Heidelberg, Germany). The AMD categories were graded using both the Beckman classification and multimodal imaging (MMI) to include the presence of subretinal drusenoid deposits (SDD). A total of 353 eyes from 231 participants were analyzed. Compared with the age-matched controls, the qAF8 values decreased in the eyes with AMD (adjusted % difference = -19.7% [95% CI -28.8%, -10.4%]; p < 0.001) and across the AMD categories, (adjusted % differences; Early, -13.1% (-24.4%, -1%), p = 0.04; intermediate AMD (iAMD), -22.9% (-32.3%, -13.1%), p < 0.001; geographic atrophy -25.2% (-38.1%, -10.4%), p = 0.002). On MMI, the qAF8 was reduced in the AMD subgroups relative to the controls, (adjusted % differences; Early, -5.8% (-18.9%, 8.3%); p = 0.40; iAMD, -26.7% (-36.2%, -15.6%); p < 0.001; SDD, -23.7% (-33.6%, -12.2%); p < 0.001; atrophy, -26.7% (-39.3%, -11.3%), p = 0.001). The qAF8 levels declined early in AMD and were not significantly different between the severity levels of non-neovascular AMD, suggesting the early and sustained loss of function of the retinal pigment epithelium in AMD.

Importancia del citomegalovirus congénito en el programa de cribado auditivo neonatal

IntroductionIn newborns, hearing loss secondary to congenital cytomegalovirus (CMVc) infection, despite its low prevalence, can cause a serious problem in the personal development and social integration of patients. Therefore, it is important to include the determination of CMV DNA as a neonatal screening tool. Materials and methodsWe have carried out a 5-year retrospective study, by describing the CMVc in the Autonomous Community of the Basque Country (Spain) in newborns who did not pass the hearing screening in the early hearing loss detection program. The times of detection, confirmation (incidence) and intervention (treatment) are described. ResultsOf 18,782 subjects studied, 58 (3 per 1,000 live births) presented hearing loss. Of these, CMVc is guaranteed in 4patients (one woman and 3men). The mean time to hearing screening was 6.5 days (SD: ±3.69) and to detect CMV by polymerase chain reaction in urine and saliva was 4.2 days (SD: ±3.94). Time to confirm hearing loss by BAEP and audiological intervention 2.2 (SD: ±0.957) and 5 months (SD: ±3.741), respectively. Four hearing aid adaptations and one cochlear implant were performed. Discussion and conclusionNeonatal hearing screening has established itself as a good public health program. The determination of viral DNA allows an early, specific and interdisciplinary diagnosis and treatment, in which otorhinolaryngology plays a fundamental role. Our study highlights the importance of including CMV polymerase chain reaction as a universal screening tool.

Comparative Evaluation of Fixed Functional Cantilever Space Maintainer and Fixed Nonfunctional Space Maintainer: A Randomized Controlled Trial.

Effective way to prevent mesial drift after the early loss of primary first molars is by inserting a durable space maintainer. Several space maintainers are available; fixed nonfunctional (FNF) space maintainer (crown and loop) is commonly used when abutment teeth need full-coronal restoration. Disadvantages of crown and loop space maintainer are nonfunctional, nonesthetic, and fracture of solder loop. To overcome this drawback, new design of fixed functional cantilever (FFC) space maintainer (crown and pontic) using bis-acrly composite resin. The study evaluated the longevity and acceptance of an FFC and compared it with a FNF space maintainer. A total of 20 healthy children, aged 6-9 years, were selected having bilateral premature loss of lower deciduous first molars. FFC space maintainer in one quadrant and FNF space maintainer in the other was cemented. The subject's acceptance of treatment was checked using a visual analog scale after the treatment completion. Criteria for complication leading to the failure was assessed in both the designs in the 3rd, 6th, and 9th month. Cumulative success longevity was obtained at a 9 month evaluation. Patient acceptability was greater in group I (FFC) in comparison to group II (FNF). In group I, fracture of the crown and pontic was the common complication leading to failure, followed by attrition of the crown and loss of material due to abrasion. In group II, fracture of the solder joint was the common complication leading to failure, followed by slippage of the loop gingivally and cement loss. The longevity of groups I and II were 70 and 85%, respectively. FFC can be considered a viable alternative to conventional FNF space maintainers. Sathyaprasad S, Krishnareddy MG, Vinod V, et al. Comparative Evaluation of Fixed Functional Cantilever Space Maintainer and Fixed Nonfunctional Space Maintainer: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(6):750-760.

Potential of Sentinel-1 SAR to Assess Damage in Drought-Affected Temperate Deciduous Broadleaf Forests

Understanding forest decline under drought pressure is receiving research attention due to the increasing frequency of large-scale heat waves and massive tree mortality events. However, since assessing mortality on the ground is challenging and costly, this study explores the capability of satellite-borne Copernicus Sentinel-1 (S-1) C-band radar data for monitoring drought-induced tree canopy damage. As droughts cause water deficits in trees and eventually lead to early foliage loss, the S-1 radiometric signal and polarimetric indices are tested regarding their sensitivities to these effects, exemplified in a deciduous broadleaf forest. Due to the scattered nature of mortality in the study site, we employed a temporal-only time series filtering scheme that provides very high spatial resolution (10 m ×10 m) for measuring at the scale of single trees. Finally, the anomaly between heavily damaged and non-damaged tree canopy samples (n = 146 per class) was used to quantify the level of damage. With a maximum anomaly of −0.50 dB ± 1.38 for S-1 Span (VV+VH), a significant decline in hydrostructural scattering (moisture and geometry of scatterers as seen by SAR) was found in the second year after drought onset. By contrast, S-1 polarimetric indices (cross-ratio, RVI, Hα) showed limited capability in detecting drought effects. From our time series evaluation, we infer that damaged canopies exhibit both lower leaf-on and leaf-off backscatters compared to unaffected canopies. We further introduce an NDVI/Span hysteresis showing a lagged signal anomaly of Span behind NDVI (by ca. one year). This time-lagged correlation implies that SAR is able to add complementary information to optical remote sensing data for detecting drought damage due to its sensitivity to physiological and hydraulic tree canopy damage. Our study lays out the promising potential of SAR remote sensing information for drought impact assessment in deciduous broadleaf forests.

Prevention of progressive hearing loss in a mouse model of diabetes by oral intake of eicosapentaenoic acid ethyl ester

Background The prevalence of hearing impairment in patients with diabetes was significantly higher, and the development of preventive methods is desirable. Aims/objectives This study examined the effects of eicosapentaenoic acid (EPA) administration on the prevention of early hearing loss in diabetic mice. Materials and methods Tsumura, Suzuki, Obese Diabetes (TSOD) mice were used as a model of diabetes and Tsumura, Suzuki, Non Obesity (TSNO) mice were used as controls. The animals were divided into three groups: the TSNO group and the TSOD (EPA−) group (provided sunflower oil), and the TSOD (EPA+) group (provided EPA). Auditory brainstem responses (ABRs) were measured and the cochlea was evaluated histologically. Results The TSOD (EPA+) group showed a lower tendency to increase thresholds than the TSOD (EPA−) group. The TSOD (EPA+) group had a significantly lower ABR threshold than the TSOD (EPA−) group from 11 to 14 months of age at 4 kHz. Narrowing of the capillary lumens in the stria vascularis and thickening of the vessel wall in the modiolus were observed in the TSOD (EPA−) group. Conclusions and significance It was suggested that the suppression of cochlear vascular atherosclerosis by EPA administration in TSOD mice suppressed early age-related hearing loss.