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1.
Nucleic Acids Res ; 52(5): e23, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38281191

RESUMO

Nucleic acid interactome data, such as chromosome conformation capture data and RNA-DNA interactome data, are currently analyzed via pipelines that must be rerun for each new parameter set. A more dynamic approach is desirable since the optimal parameter set is commonly unknown ahead of time and rerunning pipelines is a time-consuming process. We have developed an approach fast enough to process interactome data on-the-fly using a sparse prefix sum index. With this index, we created Smoother, a flexible, multifeatured visualization and analysis tool that allows interactive filtering, e.g. by mapping quality, almost instant comparisons between different normalization approaches, e.g. iterative correction, and ploidy correction. Further, Smoother can overlay other sequencing data or genomic annotations, compare different samples, and perform virtual 4C analysis. Smoother permits a novel way to interact with and explore interactome data, fostering comprehensive, high-quality data analysis. Smoother is available at https://github.com/Siegel-Lab/BioSmoother under the MIT license.


Assuntos
Genômica , Software , DNA , Cromossomos , Genoma
2.
Nat Methods ; 19(2): 231-241, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35145320

RESUMO

Orexins (also called hypocretins) are hypothalamic neuropeptides that carry out essential functions in the central nervous system; however, little is known about their release and range of action in vivo owing to the limited resolution of current detection technologies. Here we developed a genetically encoded orexin sensor (OxLight1) based on the engineering of circularly permutated green fluorescent protein into the human type-2 orexin receptor. In mice OxLight1 detects optogenetically evoked release of endogenous orexins in vivo with high sensitivity. Photometry recordings of OxLight1 in mice show rapid orexin release associated with spontaneous running behavior, acute stress and sleep-to-wake transitions in different brain areas. Moreover, two-photon imaging of OxLight1 reveals orexin release in layer 2/3 of the mouse somatosensory cortex during emergence from anesthesia. Thus, OxLight1 enables sensitive and direct optical detection of orexin neuropeptides with high spatiotemporal resolution in living animals.


Assuntos
Encéfalo/metabolismo , Imagem Molecular/métodos , Receptores de Orexina/genética , Orexinas/análise , Proteínas Recombinantes/metabolismo , Animais , Comportamento Animal , Feminino , Células HEK293 , Humanos , Masculino , Camundongos Endogâmicos C57BL , Receptores de Orexina/metabolismo , Orexinas/genética , Orexinas/farmacologia , Fótons , Proteínas Recombinantes/genética , Reprodutibilidade dos Testes , Sono/fisiologia
3.
Stroke ; 55(3): 586-594, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38275115

RESUMO

BACKGROUND: Sleep-disordered breathing (SDB) and atrial fibrillation (AF) are highly prevalent in patients with stroke and are recognized as independent risk factors for stroke. Little is known about the impact of comorbid SDB and AF on long-term outcomes after stroke. METHODS: In this prospective cohort study, 353 patients with acute ischemic stroke or transient ischemic attacks were analyzed. Patients were screened for SDB by respiratory polygraphy during acute hospitalization. Screening for AF was performed using a 7-day ECG up to 3× in the first 6 months. Follow-up visits were scheduled at 1, 3, 12, 24, and 36 months poststroke. Cox regression models adjusted for various factors (age, sex, body mass index, hypertension, diabetes, dyslipidemia, and heart failure) were used to assess the impact of comorbid SDB and AF on subsequent death or cerebro-cardiovascular events. RESULTS: Among 353 patients (299 ischemic stroke and 54 transient ischemic attacks), median age, 67 (interquartile range, 57-74) years with 63% males. Moderate-to-severe SDB (apnea-hypopnea index score, ≥15/h) was present in 118 (33.4%) patients. Among the 56 (15.9%) patients with AF, 28 had comorbid moderate-to-severe SDB and AF. Over 36 months, there were 12 deaths and 67 recurrent cerebro-cardiovascular events. Patients with comorbid moderate-to-severe SDB and AF had a higher risk of subsequent death or cerebro-cardiovascular events compared with those with only moderate-to-severe SDB without AF (hazard ratio, 2.49 [95% CI, 1.18-5.24]) and to those without moderate-to-severe SDB or AF (hazard ratio, 2.25 [95% CI, 1.12-4.50]). However, no significant difference was found between the comorbid moderate-to-severe SDB and AF group and the group with only AF without moderate-to-severe SDB (hazard ratio, 1.64 [95% CI, 0.62-4.36]). CONCLUSIONS: Comorbid moderate-to-severe SDB and AF significantly increase the risk of long-term mortality or recurrent cerebro-cardiovascular events after acute ischemic stroke. Considering both conditions as cumulative and modifiable cerebro-cardiovascular risk factors is of interest for the management of acute stroke. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02559739.


Assuntos
Fibrilação Atrial , Ataque Isquêmico Transitório , AVC Isquêmico , Síndromes da Apneia do Sono , Acidente Vascular Cerebral , Masculino , Humanos , Idoso , Feminino , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/complicações , Fibrilação Atrial/complicações , AVC Isquêmico/complicações , Estudos Prospectivos , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/diagnóstico , Fatores de Risco
4.
Opt Lett ; 49(11): 3194-3197, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38824361

RESUMO

Here, we demonstrate the realization of hollow-core light cages (LCs) on commercial step-index fibers using 3D nanoprinting, resulting in fully fiber-integrated devices. Two different light cage geometries with record-high aspect ratio strands and unique sidewise access to the core have been implemented, exhibiting excellent optical and mechanical properties. These achievements are based on the use of 3D nanoprinting to fabricate light cages and stabilize them with customized support elements. Overall, this approach results in novel, to the best of our knowledge, fiber-interfaced hollow-core devices that combine several advantages in a lab-on-a-fiber platform that is particularly useful for diffusion-related applications in environmental sciences, nanosciences, and quantum technologies.

5.
Opt Lett ; 49(8): 1872-1875, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38621027

RESUMO

The coupling of light into optical fibers is limited by the numerical aperture (NA). Here, we show that large-area polymer axial-symmetric microstructures printed on silica multimode fibers improve their incoupling performance by two to three orders of magnitude beyond the numerical aperture limit. A ray-optical mathematical model describing the impact of the grating-assisted light coupling complements the experimental investigation. This study clearly demonstrates the improvement of incoupling performance by nanoprinting microstructures on fibers, opening new horizons, to the best of our knowledge, for multimode fiber applications in life sciences, quantum technologies, and "lab-on-fiber" devices.

6.
Eur J Neurol ; 31(1): e16026, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37531449

RESUMO

BACKGROUND AND PURPOSE: The diagnosis of sleep-wake disorders (SWDs) is challenging because of the existence of only few accurate biomarkers and the frequent coexistence of multiple SWDs and/or other comorbidities. The aim of this study was to assess in a large cohort of well-characterized SWD patients the potential of a data-driven approach for the identification of SWDs. METHODS: We included 6958 patients from the Bernese Sleep Registry and 300 variables/biomarkers including questionnaires, results of polysomnography/vigilance tests, and final clinical diagnoses. A pipeline, based on machine learning, was created to extract and cluster the clinical data. Our analysis was performed on three cohorts: patients with central disorders of hypersomnolence (CDHs), a full cohort of patients with SWDs, and a clean cohort without coexisting SWDs. RESULTS: A first analysis focused on the cohort of patients with CDHs and revealed four patient clusters: two clusters for narcolepsy type 1 (NT1) but not for narcolepsy type 2 or idiopathic hypersomnia. In the full cohort of SWDs, nine clusters were found: four contained patients with obstructive and central sleep apnea syndrome, one with NT1, and four with intermixed SWDs. In the cohort of patients without coexisting SWDs, an additional cluster of patients with chronic insomnia disorder was identified. CONCLUSIONS: This study confirms the existence of clear clusters of NT1 in CDHs, but mainly intermixed groups in the full spectrum of SWDs, with the exception of sleep apnea syndromes and NT1. New biomarkers are needed for better phenotyping and diagnosis of SWDs.


Assuntos
Distúrbios do Sono por Sonolência Excessiva , Narcolepsia , Transtornos do Sono-Vigília , Humanos , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Sono , Polissonografia , Transtornos do Sono-Vigília/diagnóstico , Biomarcadores
7.
Arch Gynecol Obstet ; 309(5): 1699-1705, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38180566

RESUMO

BACKGROUND: Obesity is an increasing problem, even in young women of reproductive age. Obesity has a negative impact on conception, the course of pregnancy, and neonatal outcomes. Caring for obese pregnant women has becoming an important aspect of standard prenatal care. The Guideline "Obesity and Pregnancy" of the German Society of Gynecology and Obstetrics aims to create evidence-based recommendations which can be used to improve the care of obese pregnant women. As obesity is a worldwide problem, many societies for obstetrics and gynecology have created national guidelines. METHODS: We reviewed the following guidelines for obesity and pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2021, Royal College of Obstetrics and Gynecology (RCOG) 2018; AND Society of Obstetricians and Gynecologists of Canada (SOGC) 2019. These guidelines were compared to the German guideline. RESULTS: There are some variations between the guidelines, though no major contradictions exist. Disparities were found regarding the recommendations for substitution of high folic acid and Vitamin D. Furthermore, the recommended time for screening for gestational diabetes and the methods to control fetal growth differ between the guidelines. Regarding place of birth, RCOG allows delivery in midwifery-led units in the absence of other high-risk circumstances, while others request facility of care by neonatologists and medical staff trained in care of obese women. Induction of labor at term due to increased risk of intrauterine demise is mostly limited to women with a body mass index of 40 kg/m2. Only one guideline considers induction of all obese women. For intrapartum management, the majority allows tolerating of longer labor times to delivery if fetal monitoring is sufficient and fetal stress is excluded. Special encouragement of breastfeeding and healthy lifestyle is commonly recommended; only in the Canadian guideline, postpartum depression evaluation is requested due to the overall high prevalence of depression and anxiety in obese women. CONCLUSION: All guidelines consider pregnancies in obese women as high-risk pregnancies and emphasize the need for preconception counseling. There are special needs in pregnancy care and in the intrapartum and postpartum management to be observed.


Assuntos
Trabalho de Parto , Obstetrícia , Recém-Nascido , Gravidez , Feminino , Humanos , Canadá/epidemiologia , Cuidado Pré-Natal , Obesidade/complicações , Obesidade/epidemiologia
8.
Arch Gynecol Obstet ; 309(3): 961-974, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37861742

RESUMO

Obesity is recognized by the World Health Organization (WHO) as a disease in its own right. Moreover, obesity is an increasingly concerning public health issue across the world and its prevalence is rising amongst women of reproductive age. The fertility of over-weight and obese women is reduced and they experience a higher rate of miscarriage. In pregnant women obesity not only increases the risk of antenatal complications, such as preeclampsia and gestational diabetes, but also fetal abnormalities, and consequently the overall feto-maternal mortality. Ultrasound is one of the most valuable methods to predict and evaluate pregnancy complications. However, in overweight and obese pregnant women, the ultrasound examination is met with several challenges, mainly due to an impaired acoustic window. Overall obesity in pregnancy poses special challenges and constraints to the antenatal care and increases the rate of pregnancy complications, as well as complications later in life for the mother and child.


Assuntos
Diabetes Gestacional , Complicações na Gravidez , Criança , Feminino , Gravidez , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/complicações , Diabetes Gestacional/epidemiologia , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Cuidado Pré-Natal
9.
Opt Express ; 31(2): 2833-2845, 2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36785288

RESUMO

Here, we unlock the properties of the recently introduced on-chip hollow-core microgap waveguide in the context of optofluidics which allows for intense light-water interaction over long lengths with fast response times. The nanoprinted waveguide operates by the anti-resonance effect in the visible and near-infrared domain and includes a hollow core with defined gaps every 176 µm. The spectroscopic capabilities are demonstrated by various absorption-related experiments, showing that the Beer-Lambert law can be applied without any modification. In addition to revealing key performance parameters, time-resolved experiments showed a decisive improvement in diffusion times resulting from the lateral access provided by the microgaps. Overall, the microgap waveguide represents a pathway for on-chip spectroscopy in aqueous environments.

10.
Opt Express ; 31(19): 30911-30920, 2023 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-37710623

RESUMO

In this work, we demonstrate the optical heating modulation of soliton-based supercontinuum generation through the employment of multi-walled carbon nanotubes (MW-CNTs) acting as fast and efficient heat generators. By utilizing highly dispersion-sensitive liquid-core fibers in combination with MW-CNTs coated to the outer wall of the fiber, spectral tuning of dispersive waves with response times below one second via exploiting the strong thermo-optic response of the core liquid was achieved. Local illumination of the MW-CNTs coated fiber at selected points allowed modulation of the waveguide dispersion, thus controlling the soliton fission process. Experimentally, a spectral shift of the two dispersive waves towards the region of anomalous dispersion was observed at increasing temperatures. The presented tuning concept shows great potential in the context of nonlinear photonics, as complex and dynamically reconfigurable dispersion profiles can be generated by using structured light fields. This allows investigating nonlinear frequency conversion processes under unconventional conditions, and realizing nonlinear light sources that are reconfigurable quickly.

11.
Opt Lett ; 48(20): 5411-5414, 2023 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-37831880

RESUMO

Here, we demonstrate the properties of bromotrichloromethane (CBrCl3) in the context of ultrafast supercontinuum generation in liquid-core fibers. Broadband interferometric and spectroscopic measurements of liquids and fibers indicate suitable optical properties of this halomethane for near-IR supercontinuum generation, which were confirmed in corresponding experiments using ultrashort pulses. The associated simulations showed consistent broadband power redistributions, thus confirming that this halomethane is a suitable candidate for ultrafast nonlinear frequency conversion in liquid-core fibers. It uniquely combines the advantages of an inorganic, i.e., CH-free, material with a non-vanishing hyperpolarizability, allowing to anticipate an integration of second-order nonlinearity into the fiber.

12.
J Sleep Res ; 32(2): e13640, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-35609965

RESUMO

Important brainstem regions are involved in the regulation of rapid eye movement sleep. We hypothesized that brainstem stroke is associated with dysregulated rapid eye movement sleep and related muscle activity. We compared quantitative/qualitative polysomnography features of rapid eye movement sleep and muscle activity (any, phasic, tonic) between 15 patients with brainstem stroke (N = 46 rapid eye movement periods), 16 patients with lacunar/non-brainstem stroke (N = 40 rapid eye movement periods), 15 healthy controls (N = 62 rapid eye movement periods), and patients with Parkinson's disease and polysomnography-confirmed rapid eye movement sleep behaviour disorder. Further, in the brainstem group, we performed a magnetic resonance imaging-based lesion overlap analysis. The mean ratio of muscle activity to rapid eye movement sleep epoch in the brainstem group ("any" muscle activity 0.09 ± 0.15; phasic muscle activity 0.08 ± 0.14) was significantly lower than in the lacunar group ("any" muscle activity 0.17 ± 0.2, p < 0.05; phasic muscle activity 0.16 ± 0.19, p < 0.05), and also lower than in the control group ("any" muscle activity 0.15 ± 0.17, p < 0.05). Magnetic resonance imaging-based lesion analysis indicated an area of maximum overlap in the medioventral pontine region for patients with reduced phasic muscle activity index. For all groups, mean values of muscle activity were significantly lower than in the patients with Parkinson's disease and polysomnography-confirmed REM sleep behaviour disorder group ("any" activity 0.51 ± 0.26, p < 0.0001 for all groups; phasic muscle activity 0.42 ± 0.21, p < 0.0001 for all groups). For the tonic muscle activity in the mentalis muscle, no significant differences were found between the groups. In the brainstem group, contrary to the lacunar and the control groups, "any" muscle activity index during rapid eye movement sleep was significantly reduced after the third rapid eye movement sleep phase. This study reports on the impact of brainstem stroke on rapid eye movement atonia features in a human cohort. Our findings highlight the important role of the human brainstem, in particular the medioventral pontine regions, in the regulation of phasic muscle activity during rapid eye movement sleep and the ultradian distribution of rapid eye movement-related muscle activity.


Assuntos
Doença de Parkinson , Transtorno do Comportamento do Sono REM , Acidente Vascular Cerebral , Humanos , Sono REM/fisiologia , Doença de Parkinson/complicações , Hipotonia Muscular/complicações , Transtorno do Comportamento do Sono REM/complicações , Músculos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem
13.
Eur J Neurol ; 30(6): 1696-1705, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36912423

RESUMO

BACKGROUND AND PURPOSE: Contradictory evidence on the impact of single sleep-wake-disturbances (SWD), such as sleep-disorderd breating (SDB) or insomnia, in patients with stroke, on the risk of subsequent cardio- and cerebrovascular events (CCE) and death, exists. Very recent studies in the general population suggest that the presence of multiple SWD increases cardio-cerebrovascular risk. Hence, the aim of this study was to asssess whether a novel score capturing the burden of multiple SWD, a so called "sleep burden index", is predictive for subsequent CCE including death in a prospectively followed cohort of stroke patients. METHODS: Patients with acute ischemic stroke or transient ischemic attack (TIA) were prospectively recruited. Four SWD were analyzed: (i) SDB with respirography; (ii) insomnia (defined using the insomnia severity index [ISI]); (iii) restless legs syndrome (RLS; defined using the International RLS Study Group rating scale); and (iv) self-estimated sleep duration at 1 and 3 months. A "sleep burden index", calculated using the mean of z-transformed values from assessments of these four SWD, was created. The occurrence of CCE was recorded over a mean ± standard deviation (SD) follow-up of 3.2 ± 0.3 years. RESULTS: We assessed 437 patients (87% ischemic stroke, 13% TIA, 64% males) with a mean ± SD age of 65.1 ± 13.0 years. SDB (respiratory event index ≥ 5/h) was present in 66.2% of these patients. Insomnia (ISI ≥ 10), RLS and extreme sleep duration affected 26.2%, 6.4% and 13.7% of the patients 3 months post-stroke. Seventy out of the 437 patients (16%) had at least one CCE during the follow-up. The sleep burden index was associated with a higher risk for subsequent CCE, including death (odds ratio 1.80 per index unit, 95% confidence interval 1.19-2.72; p = 0.0056). CONCLUSION: The presence of multiple SWDs constitutes a risk for subsequent CCE (including death) within the first 3 years following stroke. Larger systematic studies should assess the utility of the sleep burden index for patients' risk stratification in clinical practice.


Assuntos
Ataque Isquêmico Transitório , AVC Isquêmico , Distúrbios do Início e da Manutenção do Sono , Acidente Vascular Cerebral , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Ataque Isquêmico Transitório/complicações , AVC Isquêmico/complicações , Estudos Prospectivos , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/complicações , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia , Sono
14.
Small ; 18(38): e2202024, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35988130

RESUMO

Accurate determination of the size distribution of nanoparticle ensembles remains a challenge in nanotechnology-related applications due to the limitations of established methods. Here, a microstructured fiber-assisted nanoparticle tracking analysis (FaNTA) realization is introduced that breaks existing limitations through the recording of exceptionally long trajectories of rapidly diffusing polydisperse nanoparticles, resulting in excellent sizing precision and unprecedented separation capabilities of bimodal nanoparticle mixtures. An effective-single-mode antiresonant-element fiber allows to efficiently confine nanoparticles in a light-guiding microchannel and individually track them over more than 1000 frames, while aberration-free imaging is experimentally confirmed by cross-correlation analysis. Unique features of the approach are (i) the highly precise determination of the size distribution of monodisperse nanoparticle ensembles (only 7% coefficient of variation) and (ii) the accurate characterization of individual components in a bimodal mixture with very close mean diameters, both experimentally demonstrated for polymer nanospheres. The outstanding performance of the FaNTA realization can be quantified by introducing a new model for the bimodal separation index. Since FaNTA is applicable to all types of nano-objects down to sub-20 nm diameters, the method will improve the precision standard of mono- and polydisperse nanoparticle samples such as nano-plastics or extracellular vesicles.


Assuntos
Nanopartículas , Nanosferas , Microplásticos , Nanopartículas/análise , Nanotecnologia , Tamanho da Partícula , Polímeros
15.
Opt Express ; 30(16): 29680-29693, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36299137

RESUMO

We theoretically study the generation of photon pairs via spontaneous four-wave mixing (SFWM) in a liquid-filled microstructured suspended-core optical fiber. We show that it is possible to control the wavelength, group velocity, and bandwidths of the two-photon states. Our proposed fiber structure shows a large number of degrees of freedom to engineer the two-photon state. Here, we focus on the factorable state, which shows no spectral correlation in the two-photon components of the state, and allows the heralding of a single-photon pure state without the need for spectral post-filtering.

16.
Opt Express ; 30(2): 2768-2779, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35209410

RESUMO

Here, we introduce a quasi-analytic model that allows studying mode formation in low refractive index core waveguides through solely focusing on the cladding properties. The model isolates the reflection properties of the cladding from the modes via correlating the complex amplitude reflection coefficient of the cladding to the complex effective index of the fundamental core mode. The relevance and validity of the model are demonstrated by considering a single-ring anti-resonant fiber, revealing unexpected situations of exceptionally low loss. Our model explains mode formation by light scattering, which conceptually provides deep insights into the relevant physics.

17.
Langmuir ; 38(40): 12325-12332, 2022 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-36154138

RESUMO

Gold nanoparticles decorated with analyte recognition units can form the basis of colorimetric (bio)sensors. The presentation of those recognition units may play a critical role in determining sensor sensitivity. Herein, we use a model system to investigate the effect of the architecture of a polymeric linker that connects gold nanoparticles with the recognition units. Our results show that the number of the latter that can be adsorbed during the assembly of the colorimetric sensors depends on the linker topology. We also show that this may lead to substantial differences in colorimetric sensor performance, particularly in situations in which the interactions with the analyte are comparably weak. Finally, we discuss design principles for efficient colorimetric sensor materials based on our findings.


Assuntos
Técnicas Biossensoriais , Nanopartículas Metálicas , Técnicas Biossensoriais/métodos , Colorimetria/métodos , Ouro , Polímeros
18.
Am J Obstet Gynecol ; 227(4): 631.e1-631.e19, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35580632

RESUMO

BACKGROUND: Gestational diabetes mellitus is one of the most frequent pregnancy complications with a global prevalence of 13.4% in 2021. Pregnant women with COVID-19 and gestational diabetes mellitus are 3.3 times more likely to be admitted to an intensive care unit than women without gestational diabetes mellitus. Data on the association of gestational diabetes mellitus with maternal and neonatal pregnancy outcomes in pregnant women with SARS-CoV-2 infection are lacking. OBJECTIVE: This study aimed to investigate whether gestational diabetes mellitus is an independent risk factor for adverse maternal and fetal and neonatal outcomes in pregnant women with COVID-19. STUDY DESIGN: The COVID-19-Related Obstetric and Neonatal Outcome Study is a registry-based multicentric prospective observational study from Germany and Linz, Austria. Pregnant women with clinically confirmed COVID-19 were enrolled between April 3, 2020, and August 24, 2021, at any stage of pregnancy. Obstetricians and neonatologists of 115 hospitals actively provided data to the COVID-19-Related Obstetric and Neonatal Outcome Study. For collecting data, a cloud-based electronic data platform was developed. Women and neonates were observed until hospital discharge. Information on demographic characteristics, comorbidities, medical history, COVID-19-associated symptoms and treatments, pregnancy, and birth outcomes were entered by the local sites. Information on the periconceptional body mass index was collected. A primary combined maternal endpoint was defined as (1) admission to an intensive care unit (including maternal mortality), (2) viral pneumonia, and/or (3) oxygen supplementation. A primary combined fetal and neonatal endpoint was defined as (1) stillbirth at ≥24 0/7 weeks of gestation, (2) neonatal death ≤7 days after delivery, and/or (3) transfer to a neonatal intensive care unit. Multivariable logistic regression analysis was performed to evaluate the modulating effect of gestational diabetes mellitus on the defined endpoints. RESULTS: Of the 1490 women with COVID-19 (mean age, 31.0±5.2 years; 40.7% nulliparous), 140 (9.4%) were diagnosed with gestational diabetes mellitus; of these, 42.9% were treated with insulin. Overall, gestational diabetes mellitus was not associated with an adverse maternal outcome (odds ratio, 1.50; 95% confidence interval, 0.88-2.57). However, in women who were overweight or obese, gestational diabetes mellitus was independently associated with the primary maternal outcome (adjusted odds ratio, 2.69; 95% confidence interval, 1.43-5.07). Women who were overweight or obese with gestational diabetes mellitus requiring insulin treatment were found to have an increased risk of a severe course of COVID-19 (adjusted odds ratio, 3.05; 95% confidence interval, 1.38-6.73). Adverse maternal outcomes were more common when COVID-19 was diagnosed with or shortly after gestational diabetes mellitus diagnosis than COVID-19 diagnosis before gestational diabetes mellitus diagnosis (19.6% vs 5.6%; P<.05). Maternal gestational diabetes mellitus and maternal preconception body mass index of ≥25 kg/m2 increased the risk of adverse fetal and neonatal outcomes (adjusted odds ratio, 1.83; 95% confidence interval, 1.05-3.18). Furthermore, overweight and obesity (irrespective of gestational diabetes mellitus status) were influential factors for the maternal (adjusted odds ratio, 1.87; 95% confidence interval, 1.26-2.75) and neonatal (adjusted odds ratio, 1.81; 95% confidence interval, 1.32-2.48) primary endpoints compared with underweight or normal weight. CONCLUSION: Gestational diabetes mellitus, combined with periconceptional overweight or obesity, was independently associated with a severe maternal course of COVID-19, especially when the mother required insulin and COVID-19 was diagnosed with or after gestational diabetes mellitus diagnosis. These combined factors exhibited a moderate effect on neonatal outcomes. Women with gestational diabetes mellitus and a body mass index of ≥25 kg/m2 were a particularly vulnerable group in the case of COVID-19.


Assuntos
COVID-19 , Diabetes Gestacional , Insulinas , Adulto , COVID-19/epidemiologia , COVID-19/terapia , Teste para COVID-19 , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Recém-Nascido , Obesidade/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Sobrepeso , Gravidez , Resultado da Gravidez , SARS-CoV-2
20.
Anal Chem ; 93(2): 752-760, 2021 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-33296184

RESUMO

Emerging applications in spectroscopy-related bioanalytics demand for integrated devices with small geometric footprints and fast response times. While hollow core waveguides principally provide such conditions, currently used approaches include limitations such as long diffusion times, limited light-matter interaction, substantial implementation efforts, and difficult waveguide interfacing. Here, we introduce the concept of the optofluidic light cage that allows for fast and reliable integrated spectroscopy using a novel on-chip hollow core waveguide platform. The structure, implemented by 3D nanoprinting, consists of millimeter-long high-aspect-ratio strands surrounding a hollow core and includes the unique feature of open space between the strands, allowing analytes to sidewise enter the core region. Reliable, robust, and long-term stable light transmission via antiresonance guidance was observed while the light cages were immersed in an aqueous environment. The performance of the light cage related to absorption spectroscopy, refractive index sensitivity, and dye diffusion was experimentally determined, matching simulations and thus demonstrating the relevance of this approach with respect to chemistry and bioanalytics. The presented work features the optofluidic light cage as a novel on-chip sensing platform with unique properties, opening new avenues for highly integrated sensing devices with real-time responses. Application of this concept is not only limited to absorption spectroscopy but also includes Raman, photoluminescence, or fluorescence spectroscopy. Furthermore, more sophisticated applications are also conceivable in, e.g., nanoparticle tracking analysis or ultrafast nonlinear frequency conversion.

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