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1.
Plant J ; 116(5): 1462-1476, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37646760

ABSTRACT

Plant growth and morphogenesis are determined by the mechanical properties of its cell walls. Using atomic force microscopy, we have characterized the dynamics of cell wall elasticity in different tissues in developing roots of several plant species. The elongation growth zone of roots of all species studied was distinguished by a reduced modulus of elasticity of most cell walls compared to the meristem or late elongation zone. Within the individual developmental zones of roots, there were also significant differences in the elasticity of the cell walls of the different tissues, thus identifying the tissues that limit root growth in the different species. In cereals, this is mainly the inner cortex, whereas in dicotyledons this function is performed by the outer tissues-rhizodermis and cortex. These differences result in a different behaviour of the roots of these species during longitudinal dissection. Modelling of longitudinal root dissection using measured properties confirmed the difference shown. Thus, the morphogenesis of monocotyledonous and dicotyledonous roots relies on different tissues as growth limiting, which should be taken into account when analyzing the localization of associated molecular events. At the same time, no matrix polysaccharide was found whose immunolabelling in type I or type II cell walls would predict their mechanical properties. However, assessment of the degree of anisotropy of cortical microtubules showed a striking correlation with the elasticity of the corresponding cell walls in all species studied.


Subject(s)
Magnoliopsida , Plant Roots , Plant Roots/metabolism , Meristem , Zea mays/metabolism , Elasticity , Cell Wall/metabolism
2.
Int J Mol Sci ; 24(24)2023 Dec 08.
Article in English | MEDLINE | ID: mdl-38139081

ABSTRACT

The cellulose-enriched tertiary cell walls present in many plant fibers have specific composition, architecture, machinery of formation, and function. To better understand the mechanisms underlying their mode of action and to reveal the peculiarities of fibers from different plant species, it is necessary to more deeply characterize the major components. Next to overwhelming cellulose, rhamnogalacturonan I (RG-I) is considered to be the key polymer of the tertiary cell wall; however, it has been isolated and biochemically characterized in very few plant species. Here, we add RG-I to the list from the phloem fibers of the Phaseolus vulgaris stem that was isolated and analyzed by nuclear magnetic resonance (NMR), dynamic light scattering, and immunolabeling, both within tissue and as an isolated polymer. Additionally, fibers with tertiary cell walls from nine species of dicotyledonous plants from the orders Malphigiales, Fabales, and Rosales were labeled with RG-I-related antibodies to check the presence of the polymer and compare the in situ presentation of its backbone and side chains. The obtained results confirm that RG-I is an obligatory polymer of the tertiary cell wall. However, there are differences in the structure of this polymer from various plant sources, and these peculiarities may be taxonomically related.


Subject(s)
Galactans , Pectins , Galactans/chemistry , Pectins/chemistry , Plants , Cellulose , Cell Wall/chemistry
3.
Molecules ; 28(5)2023 Mar 04.
Article in English | MEDLINE | ID: mdl-36903620

ABSTRACT

Luminescent, heterometallic terbium(III)-lutetium(III) terephthalate metal-organic frameworks (MOFs) were synthesized via direct reaction between aqueous solutions of disodium terephthalate and nitrates of corresponding lanthanides by using two methods: synthesis from diluted and concentrated solutions. For (TbxLu1-x)2bdc3·nH2O MOFs (bdc = 1,4-benzenedicarboxylate) containing more than 30 at. % of Tb3+, only one crystalline phase was formed: Ln2bdc3·4H2O. At lower Tb3+ concentrations, MOFs crystallized as the mixture of Ln2bdc3·4H2O and Ln2bdc3·10H2O (diluted solutions) or Ln2bdc3 (concentrated solutions). All synthesized samples that contained Tb3+ ions demonstrated bright green luminescence upon excitation into the 1ππ* excited state of terephthalate ions. The photoluminescence quantum yields (PLQY) of the compounds corresponding to the Ln2bdc3 crystalline phase were significantly larger than for Ln2bdc3·4H2O and Ln2bdc3·10H2O phases due to absence of quenching from water molecules possessing high-energy O-H vibrational modes. One of the synthesized materials, namely, (Tb0.1Lu0.9)2bdc3·1.4H2O, had one of the highest PLQY among Tb-based MOFs, 95%.

4.
Planta ; 255(5): 108, 2022 Apr 21.
Article in English | MEDLINE | ID: mdl-35449484

ABSTRACT

MAIN CONCLUSION: In cells of growing rye roots, xyloglucans and homogalacturonans demonstrate developmental stage specificity, while different xylans have tissue specificity. Mannans, arabinans and galactans are also detected within the protoplast. Mannans form films on sections of fresh material. The primary cell walls of plants represent supramolecular exocellular structures that are mainly composed of polysaccharides. Cell wall properties and architecture differ between species and across tissues within a species. We revised the distribution of cell wall polysaccharides and their dynamics during elongation growth and histogenesis in rye roots using nonfixed material and the spectrum of antibodies. Rye is a member of the Poaceae family and thus has so-called type II primary cell walls, which are supposed to be low in pectins and xyloglucans and instead have arabinoxylans and mixed-linkage glucans. However, rye cell walls at the earliest stages of cell development were enriched with the epitopes of xyloglucans and homogalacturonans. Mixed-linkage glucan, which is often considered an elongation growth-specific polysaccharide in plants with type II cell walls, did not display such dynamics in rye roots. The cessation of elongation growth and even the emergence of root hairs were not accompanied by the disappearance of mixed-linkage glucans from cell walls. The diversity of xylan motifs recognized by different antibodies was minimal in the meristem zone of rye roots, but this diversity increased and showed tissue specificity during root growth. Antibodies specific for xyloglucans, galactans, arabinans and mannans bound the cell content. When rye root cells were cut, the epitopes of xyloglucans, galactans and arabinans remained within the cell content, while mannans developed net-like or film-like structures on the surface of sections.


Subject(s)
Mannans , Secale , Cell Wall/metabolism , Epitopes/metabolism , Galactans/analysis , Glucans/metabolism , Mannans/metabolism , Pectins/metabolism , Polysaccharides/metabolism , Secale/metabolism , Xylans/metabolism
5.
J Exp Bot ; 72(5): 1764-1781, 2021 02 27.
Article in English | MEDLINE | ID: mdl-33247728

ABSTRACT

To test the hypothesis that particular tissues can control root growth, we analysed the mechanical properties of cell walls belonging to different tissues of the apical part of the maize root using atomic force microscopy. The dynamics of properties during elongation growth were characterized in four consecutive zones of the root. Extensive immunochemical characterization and quantification were used to establish the polysaccharide motif(s) related to changes in cell wall mechanics. Cell transition from division to elongation was coupled to the decrease in the elastic modulus in all root tissues. Low values of moduli were retained in the elongation zone and increased in the late elongation zone. No relationship between the immunolabelling pattern and mechanical properties of the cell walls was revealed. When measured values of elastic moduli and turgor pressure were used in the computational simulation, this resulted in an elastic response of the modelled root and the distribution of stress and strain similar to those observed in vivo. In all analysed root zones, cell walls of the inner cortex displayed moduli of elasticity that were maximal or comparable with the maximal values among all tissues. Thus, we propose that the inner cortex serves as a growth-limiting tissue in maize roots.


Subject(s)
Plant Roots , Zea mays , Cell Wall , Elastic Modulus , Elasticity
6.
J Asthma ; 58(2): 231-239, 2021 02.
Article in English | MEDLINE | ID: mdl-31566040

ABSTRACT

Introduction: Transition from hospital to home is a challenging time for children with asthma and their caregivers because of the high risk for reutilization of acute hospital services. Detecting effective quality improvement initiatives to reduce utilization of urgent services in children discharged with asthma is an important clinical and public health question. This study was designed to identify the role of a multimodal, nurse-driven, inpatient initiated Community Outreach for Asthma Care and Healthy lifestyles (COACH) program on subsequent use of hospital services for pediatric patients with asthma.Methods: We utilized comparative effectiveness design to identify the difference in recurrent emergency department (ED) visits and/or admissions within 12-months after discharge between patients with asthma who engaged in the COACH program (Intervention group) and those who did not (Comparison group). We used administrative databases of hospitals included in the Meridian Health system to identify the number of and time to asthma-related readmissions and ED re-attendances.Results: We found no difference in the rate or number of recurrent hospital-based services used within 12 months, but found a reduction in ED re-visitation and/or readmission within 30 days for COACH program participants prior to and after adjustment for age, race/ethnicity, insurance status, and clinical presentation (Odd Ratio 0.44, 95% Confidence Interval 0.20, 0.93).Conclusion: Participation in the COACH program decreases the likelihood for subsequent use of hospital services within a month of discharge for children with asthma. Enhanced post-discharge interactions with families may reduce long-term reuse of hospital-based services for COACH program participants.


Subject(s)
Asthma/therapy , Continuity of Patient Care/organization & administration , Emergency Service, Hospital/statistics & numerical data , Healthy Lifestyle , Patient Education as Topic/organization & administration , Child , Child, Preschool , Community-Institutional Relations , Comparative Effectiveness Research , Family , Female , Humans , Male , Nurse's Role , Patient Admission/statistics & numerical data , Patient Discharge , Patient Readmission/statistics & numerical data , Retrospective Studies
7.
BMC Med Educ ; 21(1): 107, 2021 Feb 17.
Article in English | MEDLINE | ID: mdl-33596892

ABSTRACT

BACKGROUND: Interpersonal and communication skills (ICS) are important core competencies in medical education and certification. In this study, we identified self- and simulated patient (SP)-reported ratings of US first-year medical students' ICS and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE). METHODS: OSCE participants, including 172 first-year medical students and 15 SPs were asked to evaluate the students' ICS using the American Board of Internal Medicine-Patient-Satisfaction Questionnaire (ABIM-PSQ), electronically and via paper, respectively. Self- and SP-reported ratings of students' ICS were presented as the median on a 5-point Likert-scale and as three categories defined as "good," "very good," and "inadequate." RESULTS: SPs assessed all 172 students in the OSCE, while 43.6% of students assessed their own performance. The majority of students and SPs evaluated the students' ICS as very good. 23.3% of SPs and 5.3% of students rated the medical students' ability to encourage patient question-asking and answer questions as inadequate (P <  0.002). Neither age nor gender influenced the medical students' self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs was more likely to assign lower scores on all survey questions. CONCLUSIONS: In the present study, self- and SP-reported ratings of first-year medical students' ICS were mainly "very good" with no influence of students' age or gender. Older age and female gender among the SPs were associated with a reduction in SP-reported ratings of students' ICS.


Subject(s)
Students, Medical , Aged , Clinical Competence , Communication , Educational Measurement , Female , Humans , Patient Simulation , Physical Examination , Self-Assessment
8.
J Community Health ; 43(5): 896-900, 2018 10.
Article in English | MEDLINE | ID: mdl-29549567

ABSTRACT

Food insecurity (FI) has been recognized as a public challenge not only for developing countries but also for the U.S. POPULATION: The present study was designed to identify the prevalence of FI and the association of household FI with the health status of pediatric patients seen at a Federally Qualified Health Center in New Jersey which provides health care mainly for Latino patients. Patients were included if they were screened for FI at their well visits during a 4-month period following implementation of the 2-item screening tool recommended by American Academy of Pediatrics. We compared demographic and morbidity data of children with FI to those living in food-secure households. The results are presented as the distribution of frequency (%) and odds ratios (OR) with 95% confidence interval (95% CI). FI was detected in 15.8% (95% CI 14.2-17.5%) of 486 studied children. We recorded higher rates of anemia (10.4 vs. 3.2%, p < 0.005), hypercholesterolemia (10.4 vs. 3.4%, p < 0.01), and any morbidity (24.7 vs. 9.3%, p < 0.02) in children living in FI households. Multivariate logistic regression analysis revealed an association of household FI with at least one recorded morbidity independent of the patient's age, gender, and body mass index (OR 1.79, 95% CI 1.31-2.43). No one was diagnosed with diabetes, and only a few with asthma and hypertension. We have concluded that living in households with FI increased the risk for unfavorable health outcomes in a predominantly economically disadvantage community of children within the U.S.


Subject(s)
Child Health/statistics & numerical data , Family Characteristics , Food Supply/statistics & numerical data , Malnutrition/prevention & control , Child , Female , Health Status , Humans , Male , Malnutrition/epidemiology , New Jersey , Outcome Assessment, Health Care , Pediatrics , Poverty/statistics & numerical data , Prevalence
9.
BMC Pediatr ; 16(1): 208, 2016 12 08.
Article in English | MEDLINE | ID: mdl-27931209

ABSTRACT

BACKGROUND: Occurrence and consequence of cord blood (CB) vitamin D insufficiency/deficiency has not been adequately explored despite rising concern regarding this topic in pediatrics. This study was designed to determine the rate, maternal risk factors, and clinical outcomes in infants in association with vitamin D insufficient/deficient status at birth. METHODS: American Academy of Pediatrics (AAP) defined levels (ng/mL) were utilized to categorize the vitamin D status in CB samples as deficient (5-15), insufficient (16-20), and sufficient (21-100). We used descriptive statistics and multiple regression models to identify the rate and factors associated with vitamin D deficiency/insufficiency and related outcomes in the enrolled mother-infant pairs. RESULTS: This prospective study was conducted at a single center on postpartum women and their infants. Vitamin D deficiency and insufficiency was recorded in 38.9 and 29.8% respectively of the 265 CB samples. Deficient CB vitamin D levels in infants were associated with maternal Black, Hispanic, or Asian race/ethnicity, younger age, and increased number of pregnancies. The likelihood for infants to be born with an insufficient vitamin D level increases with younger maternal age and the number of pregnancies as well as Asian ethnicity. We did not find an association between the vitamin D status at birth and pre-discharge clinical characteristics of the neonates. CONCLUSIONS: The likelihood for an infant to be born with vitamin D deficiency/insufficiency is relatively high and is related mainly to younger maternal age, gravidity, and non-White race/ethnicity. Our findings raise a question regarding the adequacy of the AAP recommended vitamin D supplementation requirements without knowing the infant's vitamin D status at birth.


Subject(s)
Vitamin D Deficiency/epidemiology , Biomarkers/blood , Female , Fetal Blood/metabolism , Humans , Infant, Newborn , Male , New Jersey/epidemiology , Prevalence , Prognosis , Prospective Studies , Risk Factors , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/etiology
10.
J Immunol ; 191(7): 3948-54, 2013 Oct 01.
Article in English | MEDLINE | ID: mdl-24006463

ABSTRACT

Studies using genital tissue samples from HIV-infected women might provide important information about HIV susceptibility and transmission. In this study, ectocervical biopsies were obtained from 20 HIV-seropositive (HIV(+)) Kenyan female sex workers (FSW) and 20 HIV-seronegative lower risk (HIV(-) LR) women. To control for the impact of sex work, 20 HIV(-) FSW were also recruited. Immune molecules were assessed in situ by immunohistochemistry and for mRNA expression by quantitative PCR. The HIV(+) women were reportedly infected for a median of 3 y (1-21 y), with a median viral load of 11,735 copies/ml (20-648,000 copies/ml). These women had significantly lower CD4 blood cell counts than the HIV(-) LR women but comparable levels of CD4 expression in ectocervix. Whereas cellular markers were similar between the HIV(+) group and the HIV(-) LR women, the HIV-binding molecules CCR5, dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin, and mannose receptor as well as the inflammatory markers CD69, IFN-γ, IL-6, and IL-22 were significantly upregulated in the HIV(+) group. As compared with the HIV(-) FSW women, the HIV(+) women had significantly upregulated levels of CD4, CD3, CCR5, Langerin, dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin, and mannose receptor as well as inflammatory cytokines. The CD4 cell depletion previously seen in the gut mucosa of HIV-infected individuals was thus not observed in the ectocervical mucosa. Stable CD4 cell expression and local immune activation in the lower female genital tract may promote viral replication and genital shedding and increase the risk of sexual HIV transmission.


Subject(s)
CD4 Antigens/metabolism , Cervix Uteri/immunology , Cervix Uteri/metabolism , HIV Infections/immunology , HIV-1/immunology , Mucous Membrane/immunology , Mucous Membrane/metabolism , Adult , Biomarkers/metabolism , CD4 Antigens/genetics , CD4 Lymphocyte Count , Cervix Uteri/virology , Cytokines/biosynthesis , Female , Gene Expression , HIV Infections/genetics , HIV Infections/metabolism , Humans , Middle Aged , Mucous Membrane/virology , Sex Workers , Young Adult
11.
Animals (Basel) ; 14(2)2024 Jan 13.
Article in English | MEDLINE | ID: mdl-38254422

ABSTRACT

Cryopreservation is a widely used method of semen conservation in animal breeding programs. This process, however, can have a detrimental effect on sperm quality, especially in terms of its morphology. The resultant sperm disorders raise the risk of reduced sperm fertilizing ability, which poses a serious threat to the long-term efficacy of livestock reproduction and breeding. Understanding the genetic factors underlying these effects is critical for maintaining sperm quality during cryopreservation, and for animal fertility in general. In this regard, we performed a genome-wide association study to identify genomic regions associated with various cryopreservation sperm abnormalities in Holstein cattle, using single nucleotide polymorphism (SNP) markers via a high-density genotyping assay. Our analysis revealed a significant association of specific SNPs and candidate genes with absence of acrosomes, damaged cell necks and tails, as well as wrinkled acrosomes and decreased motility of cryopreserved sperm. As a result, we identified candidate genes such as POU6F2, LPCAT4, DPYD, SLC39A12 and CACNB2, as well as microRNAs (bta-mir-137 and bta-mir-2420) that may play a critical role in sperm morphology and disorders. These findings provide crucial information on the molecular mechanisms underlying acrosome integrity, motility, head abnormalities and damaged cell necks and tails of sperm after cryopreservation. Further studies with larger sample sizes, genome-wide coverage and functional validation are needed to explore causal variants in more detail, thereby elucidating the mechanisms mediating these effects. Overall, our results contribute to the understanding of genetic architecture in cryopreserved semen quality and disorders in bulls, laying the foundation for improved animal reproduction and breeding.

13.
J Matern Fetal Neonatal Med ; 36(2): 2290919, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38073078

ABSTRACT

BACKGROUND: Energy metabolism mediators, which include the adipokines (leptin, adiponectin, ghrelin) and insulin-like growth factor 1 [IGF-1], are hormone-like proteins, produced and expressed in the placenta and fetal membranes, with properties featuring metabolic adaptation and inflammatory processes. Due to the complexity of the metabolic adaptation of preterm neonates during the transition to extrauterine life, it becomes essential to recognize the factors that influence the alteration of the adipokines and IGF-1 levels in the early postpartum stage.This study assessed the significance of maternal-fetal-neonatal factors in predicting the levels of leptin, adiponectin, ghrelin, and IGF-1 in preterm infants born at 32 or fewer weeks of gestation, during the early stage of postnatal adaptation. METHODS: Energy metabolism mediator levels were measured in urine samples obtained from extremely (less than 28 weeks) and very (28-32 weeks) preterm infants, within 48 h after their birth, and before the initiation of enteral nutrition. The urine samples were analyzed using enzyme-linked immunosorbent assay (ELISA) kits. The collected data included all birth-related maternal and neonatal factors such as maternal age, race/ethnicity, hypertensive disorders of pregnancy, diabetes, gravidity, parity, type of pregnancy, mode of delivery, and antenatal use of corticosteroids, antibiotics, magnesium sulfate, Apgar scores at 1 and 5 min, gestational age, and birth weight. We investigated the correlation between the levels of the tested mediators, the significance of the differences in their average levels based on the dichotomized maternal and neonatal factors, and the effect of the selected factors, in multiple regression models. Data from the regression models constructed for leptin, adiponectin, ghrelin, and IGF-1 are presented as regression coefficient ß with Standard Error (SE) of ß, coefficient of determination (R2), and adjusted R2. Before including the factor in regression models, we tested for the multicollinearity effect. Two-sided P values <0.05 were considered statistically significant. RESULTS: Among the 70 studied infants, 47.1% were male, 40.6% were white, 28.6% were extremely preterm, and 18.6% were born with a weight <750 grams. Except for a mild interplay between the adiponectin and IGF-1 levels, there was no correlation between the levels of the other studied mediators. Up to 20% variation in the tested energy metabolism mediator levels was dependent on some of the birth-related maternal and neonatal characteristics. For instance, leptin levels were reduced in association with male gender (-0.493 [0.190], p < 0.02) and increased in infants born to primigravids (0.562 [0.215], p < 0.02). Adiponectin levels were increased in infants born to nulliparous as compared to multiparous women (0.400 [0.171], p < 0.03). Ghrelin levels were reduced in males (-0.057 [0.026], p < 0.04). IGF-1 levels were increased in the urine of extremely preterm neonates (0.357 [0.111], p < 0.01) and preterm infants born with an Apgar less than three at 1 min (0. 340 [p < 0.153], p < 0.04). CONCLUSIONS: Nearly one-fifth of the variation in the urinary levels of the adipokines (leptin, adiponectin, ghrelin) and IGF-1 during the early postnatal stage in infants born at 32 or fewer weeks of gestation was predicated on one or more of the maternal and neonatal factors such as the infant's sex, extreme preterm gestation, a low Apgar score at 1 min, or birth to nulliparous women or primigravida mothers. Further studies will be required to explain the role of energy metabolism mediators in the postnatal adaptation of preterm-born infants.


Subject(s)
Infant, Premature , Leptin , Infant , Infant, Newborn , Humans , Male , Female , Pregnancy , Ghrelin , Insulin-Like Growth Factor I , Adiponectin , Gestational Age , Energy Metabolism
14.
Pediatr Neonatol ; 64(2): 160-167, 2023 03.
Article in English | MEDLINE | ID: mdl-36224067

ABSTRACT

BACKGROUND: The role of prematurity and pulmonary inflammation in the pathogenesis of bronchopulmonary dysplasia (BPD) is very well-defined. However, there is limited knowledge about whether the level of prematurity and surfactant therapy alter the pulmonary cytokines and endothelial growth factor (VEGF). METHODS: This study analyzed the VEGF and cytokines, including interleukin (IL)-1ß, IL-6, IL-8, and IL-10, and tumor necrosis factor α (TNF-α) in the tracheal aspirate (TA) of preterm infants obtained before (within 2 h after birth) and 10-12 h after the administration of the first dose of surfactant. TA was collected from 40 infants of 35 or fewer weeks of gestation, including extremely (Group 1, n = 19), very (Group 2, n = 13), and moderate/late (Group 2, n = 8) preterm neonates. In addition to univariate analysis, controlled regression models estimated the association of perinatal factors with the tested parameters and their role in the development of BPD. RESULT: We recorded significantly lower post-partum levels of VEGF and higher IL-8, IL-1ß, and TNF-α in the TA of Group 1 infants than in Group 2 and 3. Compared to the infants in Group 2 and 3, the post-surfactant increases of pulmonary VEGF, IL-8, IL-10, and TNF-α were more significant in Group 1. All tested parameters in Group 1 and 2 infants, before and after surfactant administration, were comparable. BPD was recorded in nearly 60% of the extremely preterm survivors and was significantly predicted by increased IL-8 before, and elevated TNF-α level after surfactant administration. CONCLUSION: This study indicates the association of birth at extremely preterm gestation with reduction in pulmonary VEGF and exacerbation of pro-inflammatory cytokines followed by greater elevation post-surfactant administration levels of VEGF, IL-8, TNF-α, and IL-10 than in neonates born with gestational age of 28-35 weeks.


Subject(s)
Bronchopulmonary Dysplasia , Pneumonia , Pulmonary Surfactants , Infant , Pregnancy , Female , Infant, Newborn , Humans , Infant, Premature/metabolism , Interleukin-10 , Inflammation Mediators/metabolism , Tumor Necrosis Factor-alpha , Surface-Active Agents , Interleukin-8 , Vascular Endothelial Growth Factor A , Cytokines , Pulmonary Surfactants/therapeutic use , Bronchopulmonary Dysplasia/etiology
15.
Children (Basel) ; 10(7)2023 Jul 24.
Article in English | MEDLINE | ID: mdl-37508771

ABSTRACT

This study demonstrates the trend of computed tomography (CT) usage for children with mild traumatic brain injury (mTBI) in the context of the initiation of the Safe CT Imaging Collaborative Initiative to promote the Pediatric Emergency Care Applied Research Network (PECARN) rules at the acute care hospitals in New Jersey. We used administrative databases of 10 children's and 59 general hospitals to compare CT rates before 2014-2015, during 2016, and after the initiation of the program (2017-2019). The CT usage rates at baseline and the end of surveillance in children's hospitals (19.2% and 14.2%) were lower than in general hospitals (36.7% and 21.0%), p < 0.0001. The absolute mean difference from baseline to the end of surveillance in children's hospitals was 5.1% compared to a high of 9.7% in general hospitals, medium-high with 13.2%, and 14.0% in a medium volume of pediatric patients (p < 0.001-0.0001). The time-series model demonstrates a positive trend of CT reduction in pediatric patients with mTBI within four years of the program's implementation (p < 0.03-0.001). The primary CT reduction was recorded during the year of program implementation. Regression analysis revealed the significant role of a baseline CT usage rate in predicting the level of CT reduction independent of the volume of pediatric patients and type of hospital.

16.
Article in English | MEDLINE | ID: mdl-37462588

ABSTRACT

BACKGROUND: The risk for invasive bacterial infection (IBI) in young infants with fever increases the use of invasive and therapeutic interventions, such as lumbar puncture (LP) and antimicrobials which may be unnecessary. In the present study, we analyzed whether viral pathogen(s) detection using a respiratory pathogen panel (RPP) alters the use of LP and antibiotics in 29-90-day-old infants presenting with fever to a regional pediatric hospital. METHODS: We collected medical history, clinical presentation, diagnostic tests and results, treatment, disposition, and length of stay (LOS) for selected patients. Data were compared between RPP positive (+) and RPP negative (-) infants. Use of LP and antibiotics were controlled for using regression analysis. P values <0.05 were considered significant. RESULTS: Among 172 RPP-tested infants, 45.4% had a virus(es). LP and antibiotics were used in 14.2% and 19.5% of infants in RPP(+) and in 17.0% and 28.7% in RPP(-) groups (P=0.60, 0.16), respectively. Nearly half of the infants in both groups were admitted and had comparable LOS. Hospitalization and at least one abnormal laboratory result were associated with a 2-3 times higher chance of LP and antibiotic utilization, irrespective to age and temperature level. No studied infant had been diagnosed with IBI, and 14.5% of infants in the RPP(-) group had bacteriuria. CONCLUSIONS: Detection of viral pathogen(s) did not significantly reduce the use of LP or antimicrobials in young infants with unexplained fever.

17.
Gels ; 9(12)2023 Dec 04.
Article in English | MEDLINE | ID: mdl-38131940

ABSTRACT

OBJECTIVES: The use of non-adhesive gel-like embolic materials (NAGLEMs) in the endovascular treatment of hypervascularized formations in the head and neck is gaining in popularity because of a number of important characteristics involved. Their primary benefits are their capacity to penetrate diseased vasculature, effectively distribute, and, most importantly, remain controllable during the process. We reviewed the literature and evaluated the results of using NAGLEMs in comparison to other embolizing substances (namely, coils, glue, and particles) as alternative embolizing agents for patients receiving care at our clinic. The process comprised evaluating the safety, effectiveness, and technological elements of endovascular therapy used to treat two categories of hypervascular pathological abnormalities that were surgically corrected between 2015 and 2023. Arteriovenous malformations (AVMs) located in the head, neck, and paragangliomas with jugular/carotid body localization are combined by intense shunting blood flow and shared requirements for the embolic agent used in endovascular treatment (such as penetration, distribution, delayed polymerization, and controllability). An analysis of the literature was also conducted. Results showed 18 patients diagnosed with neck paragangliomas of the carotid body and jugular type. Five patients with arteriovenous malformation (AVM) of the face and neck were included, consisting of sixteen females and seven males with an average age of 55 ± 13 years. Endovascular procedures were performed using NAGLEMs (ONYX (Medtronic, Irvine, CA, USA), SQUID (Balt, Montmorency, France), and PHIL (Microvention, Tustin, CA, USA)) and dimethyl sulfoxide (DMSO)-compatible balloon catheters. All patients achieved complete or partial embolization of hypervascularized formations using one or more stages of endovascular treatment. Additionally, three AVMs of the face and two paragangliomas of the neck were surgically excised following embolization. In other instances, formations were not deemed necessary to be removed. The patients' condition upon discharge was assessed by the modified Rankin Scale (mRs) and rated between 0 and 2. CONCLUSION: Currently, NAGLEMs are predominantly used to treat hypervascularized formations in the neck and head due to their fundamental properties. These properties include a lack of adhesion and a delay in predictable polymerization (after 30-40 min). NAGLEMs also exhibit excellent distribution and penetration throughout the vascular bed of the formation. Adequate controllability of the process is largely achieved through the presence of embolism forms of different viscosity, as well as excellent X-ray visualization.

18.
Toxics ; 11(12)2023 Nov 23.
Article in English | MEDLINE | ID: mdl-38133358

ABSTRACT

The possibility of plants growing on serpentine soils and the ability of serpentine minerals to accumulate significant amounts of metals was the basis for developing a method for using serpentine-containing materials to restore vegetation in areas with a high level of metal pollution. Serpentine-containing products obtained from phlogopite mining overburden (Kovdor, Murmansk region, Russia) with and without thermal activation were used in a field experiment on the remediation of industrially polluted peat soil. According to the geochemical mobility of the components, one of four fractions was allocated depending on the acidic (HCl) concentration of the solution used for the material treatment: readily mobile (0.001 mol/L), mobile (0.01 mol/L), potentially mobile (0.1 mol/L), and acid-soluble (1.0 mol/L). This study showed that the addition of serpentinites to peat soil changed the fraction composition. The most significant changes were noted for serpentinite components such as Ca and Mg: their concentrations increased 2-3 times even in the smallest portion of serpentine material. On the contrary, the contents of metals in the readily mobile fraction decreased 3-18, 3-23, 5-26, and 2-42 times for Cu, Ni, Fe, and Al, respectively. The main factor causing the decrease in metal mobility was the pH rise due to the release of Ca and Mg compounds into the soil solution. This study showed that the addition of serpentine-containing material at 25 vol.% to peat soil was sufficient to create a geochemical barrier with a stable-functioning vegetation cover. All serpentine-containing materials are recommended for the remediation of large industrially polluted areas.

19.
J Community Health ; 37(2): 328-34, 2012 Apr.
Article in English | MEDLINE | ID: mdl-21811880

ABSTRACT

Although successful utilization of medical and preventive care by members of the non-US born communities is an important public health concern, our knowledge regarding health practices of different ethnic subgroups is limited. In the present study, participants of the health fairs organized during South Asian cultural and religions events were asked anonymously to complete the South Asian Total Health Initiative (SATHI) health survey questionnaire to evaluate their health-related practices, self-health perception, and satisfaction with medical care. Among 1,250 surveyed, 1,016 foreign born Asian Indians adults that represented the fastest growing subgroups of the South Asian born nationals in the US were included in the analysis. We found that the majority reported healthy behavior (exercise activities and abstinence from alcohol or tobacco), high self-health perception, satisfaction with medical care, and compliance with annual routine medical examinations that was directly associated with the annual house income. Approximately 40% of women complied with breast and cervical cancer screenings and less than 20% of men complied with prostate cancer screening guidelines. Presence of chronic conditions (mostly cardiovascular pathology and/or diabetes) that were reported by approximately half of the participants negatively impacted their self-health perception. In conclusion, positive self-reported health perception and compliance with routine health examinations of the surveyed foreign born Asian Indians was reported along with an increased rate of chronic morbidity and underutilization of specific preventive services. Observed discrepancy between self-health perception and health status highlights the need to enhance utilization of preventive services among the non-US born Asian Indian community.


Subject(s)
Asian/psychology , Diagnostic Self Evaluation , Health Behavior/ethnology , Health Services/statistics & numerical data , Patient Satisfaction/ethnology , Adolescent , Adult , Aged , Aged, 80 and over , Asian/statistics & numerical data , Female , Health Care Surveys , Humans , India/ethnology , Male , Middle Aged , United States , Young Adult
20.
Pediatr Cardiol ; 33(8): 1307-14, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22466710

ABSTRACT

The effect of patent ductus arteriosus (PDA) treatment with cyclooxygenase (COX) inhibitors (indomethacin [INDO] and ibuprofen [IBU]) on regional oxygenation requires further clarification. The authors hypothesized that both INDO and IBU reduce regional tissue oxygenation in preterm neonates with PDA but that the risk is not uniform for different tissues and other factors may contribute. Regional cerebral (rSO(2-C)), renal (rSO(2-R)), and mesenteric (rSO(2-M)) tissue oxygenation measured by near-infrared spectroscopy and peripheral arterial oxygen saturation measured by pulse oximetry were recorded simultaneously before, during, and after treatment with the first dose of INDO or IBU in very preterm-born infants with PDA. Tissue-specific fractional oxygen extraction (FOE) was calculated using the rSO(2-C), rSO(2-R), rSO(2-M), and corresponding SpO(2) measurements. The findings showed a significant reduction in rSO(2-C), rSO(2-R), and rSO(2-M) and an increase in regional FOE after treatment with COX inhibitors in approximately one third of the 38 enrolled infants, which were associated with increased baseline regional tissue oxygen saturation (p < 0.01). However, the infants with posttreatment reduction of tissue oxygenation had significantly lower baseline rSO(2-C) (66.7 ± 8.1 vs 69.7 ± 8.1 %), rSO(2-R) (55.2 ± 10.8 vs 62.7 ± 11.8 %) and especially rSO(2-M) (37.8 ± 11.4 vs 46.7 ± 16.0 %) than the neonates with unchanged or increased tissue oxygenation. The two groups did not differ in terms of the risk for posttreatment reduction in regional tissue oxygenation with respect to either INDO or IBU treatment and their respective blood levels. Treatment of PDA with either INDO or IBU is associated with a 30-40 % risk for a reduction in regional tissue oxygenation, which is more pronounced in mesenteric tissue than in cerebral or renal tissue. Despite the inconsistency, reduction of regional tissue oxygenation in preterm infants with PDA is more likely associated with the administration of INDO than with the administration of IBU.


Subject(s)
Cyclooxygenase Inhibitors/therapeutic use , Ductus Arteriosus, Patent/drug therapy , Ibuprofen/therapeutic use , Indomethacin/therapeutic use , Infant, Premature, Diseases/drug therapy , Oxygen Consumption/drug effects , Analysis of Variance , Blood Gas Analysis , Cerebrovascular Circulation/drug effects , Chi-Square Distribution , Chromatography, High Pressure Liquid , Ductus Arteriosus, Patent/diagnostic imaging , Echocardiography, Doppler , Female , Hemodynamics/drug effects , Humans , Infant, Newborn , Oximetry , Pregnancy , Prospective Studies , Renal Circulation/drug effects , Splanchnic Circulation/drug effects , Statistics, Nonparametric
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