Trends in Traumatic Brain Injury Mortality in the US.

This cohort study characterizes US trends in traumatic brain injury­related mortality by age, sex, and race and ethnicity.

Amplification-Based CRISPR/Cas12a Biosensor Targeting the COX1 Gene for Specific Detection of Porcine DNA.

We propose a CRISPR/Cas12a-mediated recombinase polymerase amplification (RPA) detection method that combines RPA with Cas12a cleavage for the detection of halal food adulteration, which is of global concern, particularly for Muslim consumers. We optimized the reagent concentrations for the Cas12a cleavage steps and designed and screened gRNA targeting a conserved area of the mitochondrial cytochrome C oxidase subunit I (COX1) gene. This procedure successfully detected the presence of porcine components as low as 5 pg/µL in the linear range of 5-1000 pg/µL. The assay's detection limit was 500 times lower than CRISPR-based approaches that exclude a preamplification step, allowing the detection of trace porcine DNA in food samples. The assay additionally showed no cross-reaction with nontarget species. Therefore, this detection platform shows tremendous potential as a method for the quick, sensitive, and specific detection of porcine-derived components.

Regulation of Rad52-dependent replication fork recovery through serine ADP-ribosylation of PolD3.

Although Poly(ADP-ribose)-polymerases (PARPs) are key regulators of genome stability, how site-specific ADP-ribosylation regulates DNA repair is unclear. Here, we describe a novel role for PARP1 and PARP2 in regulating Rad52-dependent replication fork repair to maintain cell viability when homologous recombination is dysfunctional, suppress replication-associated DNA damage, and maintain genome stability. Mechanistically, Mre11 and ATM are required for induction of PARP activity in response to replication stress that in turn promotes break-induced replication (BIR) through assembly of Rad52 at stalled/damaged replication forks. Further, by mapping ADP-ribosylation sites induced upon replication stress, we identify that PolD3 is a target for PARP1/PARP2 and that its site-specific ADP-ribosylation is required for BIR activity, replication fork recovery and genome stability. Overall, these data identify a critical role for Mre11-dependent PARP activation and site-specific ADP-ribosylation in regulating BIR to maintain genome integrity during DNA synthesis.

The Role of Social Media in Communication and Learning at the Time of COVID-19 Lockdown-An Online Survey.

This study aimed to assess orthodontic postgraduate students' use of social media during the COVID-19 lockdown. Ninety-four postgraduate students (67 master's students and 27 doctoral students) were enrolled in the study and asked to fill in an online questionnaire by answering questions regarding their use of social media during the COVID-19 lockdown. The frequency distributions and percentages were calculated using SPSS software. The results showed that 99% of the students used social media. The most frequently used type of social media was Facebook, 94%, followed by YouTube, 78%, and Instagram, 65%, while Twitter and Linkedin were used less, and no one used Blogger. About 63% of the students used elements of social media to learn more about orthodontics staging, biomechanics, and various approaches in managing orthodontic cases. About 56% of students tried uploading and downloading scientific papers, lectures, movies, presentations, and e-books from social media, while communication with professionals and searches about orthodontic products were reported in 47% of students' responses. On the other hand, 43% of the responses favored sharing orthodontic information and posts for teaching and discussion purposes. Generally, social media plays leading roles in the communication with, learning of, sharing of information with, and supervision of patients from a far during the COVID-19 lockdown.

Refractive Changes After Nd:YAG Capsulotomy in Pseudophakic Eyes.

Purpose: To analyze refractive changes after neodymium: yttrium-aluminum-garnet (Nd:YAG) posterior capsulotomy in pseudophakic eyes. Patients and Methods: Patients who underwent Nd:YAG capsulotomy after cataract surgery from January 2013 to April 2022 were included in this retrospective study. Sphere, cylinder, spherical equivalent (SE), axis, and corrected distance visual acuity (CDVA) were compared pre- and postoperatively in 683 eyes of 548 patients at one month (n = 605 eyes) and one year (n = 211 eyes). Patients with both one-month and one-year follow-ups (n = 133) were also compared. Eyes were stratified into single-piece (n = 330), three-piece (n = 30), and light adjustable lenses (LALs) (n = 16). Pre- and postoperative measurements were analyzed within each group. Results: Cylinder was significantly decreased at one-month (difference: 0.042±0.448 D, p = 0.006) and one-year (difference: 0.101±0.455 D, p = 0.003) compared to preoperative measurements. No significant change in sphere or axis was observed at follow-up visits (p > 0.05). CDVA significantly improved at both time points (p < 0.05). No significant change in any parameters between the one-month and one-year groups was observed (p > 0.05). There was significant improvement in CDVA in the single and three-piece lens groups (p < 0.0001 and p = 0.026, respectively), with no change in the LAL group (p > 0.05). Conclusion: There were no changes in sphere, axis, or spherical equivalent after Nd:YAG capsulotomy. However, cylindrical error and CDVA were significantly better after the procedure. Lens type did not impact refractive parameters postoperatively.

Improving Time to Diagnostic Resolution in the Breast Imaging Service: A Tertiary Center's Experience and Process of Improvement.

OBJECTIVE: Breast imaging services often experience a significant degree of variability in patient flow, leading to delay in time to diagnostic resolution, commonly referred to as time to resolution (TTR). This study applies Lean Six Sigma Methodology (LSSM) to reduce TTR and enhance patient outcomes. METHODS: This study was IRB-approved. A baseline audit was done using cases of mammographic recalls (BI-RADS 0) to measure baseline TTR. Multidisciplinary meetings with all members of the breast imaging service, alongside a study of patient complaint data, were utilized to identify issues that were causing prolonged TTR. Following that, possible solutions were proposed and implemented. A post-implementation audit was conducted, and the resulting TTRs were compared. Significant differences in TTR between the pre- and post-solution implementation were assessed using the Mann-Whitney U test. RESULTS: During the baseline audit of 8 months, 589 cases of mammographic recalls (BI-RADS 0) were identified, and the resulting average TTR was 86.3 days. During the post-implementation period of 3 months, 370 mammographic recalls (BI-RADS 0) occurred, with a resulting average TTR of 36.0 days. After applying LSSM, TTR was reduced by 58.3% (P < 0.01). Some changes implemented included training the coordinators, establishing a rapid diagnostic clinic using previously underutilized equipment, and having radiologists assigned full-time to the breast imaging service. CONCLUSION: Our team has successfully managed to identify various causes behind the prolonged TTR using LSSM. Team collaboration was essential to study and decide on a more achievable TTR.

Label-Free Electrochemiluminescence Nano-aptasensor for the Ultrasensitive Detection of ApoA1 in Human Serum.

A molybdenum sulfide/zirconium oxide/Nafion (MoS2/ZrO2/Naf) based electrochemiluminescence (ECL) aptasensor for the selective and ultrasensitive detection of ApoA1 is proposed, with Ru(bpy)3 2+ as the luminophore. The chitosan (CS) modification on the nanocomposite layer allowed glutaraldehyde (GLUT) cross-linking, resulting in the immobilization of ApoA1 aptamers. Scanning electron microscopy, tunneling electron microscopy, and energy dispersive X-ray spectroscopy were used to characterize the nanocomposite, while electrochemiluminescence (ECL), cyclic voltammetry, and electrochemical impedance spectroscopy were used to analyze the aptasensor assembly. The nanocomposite was used as an electrode modifier, which increased the intensity of the ECL signal. Due to the anionic environment produced on the sensor surface following the specific interaction of the ApoA1 biomarker with the sensor, more Ru(bpy)3 2+ were able to be electrostatically attached to the aptamer-ApoA1 complex, resulting in enhanced ECL signal. The ECL aptasensor demonstrated outstanding sensitivity for ApoA1 under optimal experimental conditions, with a detection limit of 53 fg/mL and a wide linear dynamic range of 0.1-1000 pg/mL. The potential practical applicability of this aptasensor was validated by analyzing ApoA1 in human serum samples, with recovery rates of 94-108% (n = 3). The proposed assay was found to be substantially better compared to the commercially available enzyme-linked immunosorbent assay method, as reflected from over 1500 times improvement in the detection limit for ApoA1.

Visual Outcomes of Photorefractive Keratectomy Enhancement After Primary LASIK.

PURPOSE: To evaluate the safety, efficacy, and predictability of photorefractive keratectomy (PRK) at least 4 years after primary laser in situ keratomileusis (LASIK) and compare it to the United States Food and Drug Administration (FDA) criteria. METHODS: This retrospective, single-site study compared patients who underwent PRK enhancement from 2014 to 2019 after primary LASIK to those who only underwent primary LASIK without re-treatment from the same time period. Patient demographics and clinical information were compared between the two groups. Visual outcomes and postoperative complications were evaluated in the enhancement group. RESULTS: A total of 374 eyes with PRK enhancement were compared to 472 without re-treatment. Age, sex, surgical eye, and preoperative sphere, and spherical equivalent (SE) were significantly different between the enhancement and control groups (P < .05). At 12 months post-enhancement, 67% had uncorrected distance visual acuity (UDVA) of 20/20 or better, 98% had UDVA of 20/40 or better, and 0.4% of eyes lost at least two lines of corrected distance visual acuity (CDVA). A total of 83% and 98% of eyes were within ±0.50 and ±1.00 diopters of the target, respectively. Post-enhancement complications (n = 66) included dryness (6.1%), epithelial ingrowth (2.7%), and haze (2.7%). CONCLUSIONS: Older age at the time of the primary LASIK, female sex, right surgical eye, and more myopic sphere and SE were risk factors for enhancement. Although PRK enhancements are considered off-label procedures, they produce favorable outcomes at 3 and 12 months postoperatively while meeting FDA benchmarks for safety, efficacy, and predictability. [J Refract Surg. 2022;38(11):733-740.].

Corneal Transplant Rejections in Patients Receiving Immune Checkpoint Inhibitors.

Immune checkpoint inhibitors (ICIs) are antibodies that target and block immune checkpoints. These biologics were initially approved by the United States Food and Drug Administration (US FDA) in 2011 for the management of melanoma. Since then, the use of ICI therapy has increased, with many new medications on the market that treat approximately 50 types of cancers. Patients receiving this therapy are at an increased risk for transplant rejection, including corneal rejection. Ophthalmologists must be aware of individuals receiving ICI therapy as it may be a relative contraindication for patients with a history of corneal transplantation. Patients on ICIs may also experience ocular side effects, including uveitis, dry eye, and inflammation, while on checkpoint inhibitor therapy. This commentary discusses the current understanding of immune checkpoint inhibitors, their mechanism of action, their ocular side effects, and their role in corneal transplant rejection.

Molecular epidemiology, genetic diversity, and vaccine availability of viral acute gastroenteritis in the middle East and North Africa (MENA) region.

Acute gastroenteritis is the cause of considerable mortality and morbidity worldwide, particularly among children under five years in underdeveloped countries. Most acute gastroenteritis (AGE) cases are attributed to viral etiologies, including rotavirus, norovirus, adenovirus, astrovirus, and sapovirus. This paper aimed to determine the prevalence rate of different viral etiologies of AGE in the Middle East and North Africa (MENA) region. Moreover, this paper explored rotavirus phylogenetic relatedness, compared VP7 and VP4 antigenic regions of rotavirus with vaccine strains, and explored the availability of vaccines in the MENA region. The literature search identified 160 studies from 18 countries from 1980 to 2019. The overall prevalence of rotavirus, norovirus, adenovirus, astrovirus, and sapovirus were 29.8 %, 13.9 %, 6.3 %, 3.5 %, and 3.2 % of tested samples, respectively. The most common rotavirus genotype combinations in the MENA region were G1P[8], G9P[9], and G2P[4], whereas GII.4 was the predominant norovirus genotype all of which were reported in almost all the studies with genotyping data. The comparison of VP7 and VP4 between circulating rotavirus in the MENA region and vaccine strains has revealed discrete divergent regions, including the neutralizing epitopes. Rotavirus vaccine was introduced to most of the countries of the MENA region; however, only a few studies have assessed the effectiveness of vaccine introduction. This paper provides a comprehensive update on the prevalence of the different viral agents of AGE in the MENA region.

Laser-Assisted In Situ Keratomileusis (LASIK) Enhancement for Residual Refractive Error after Primary LASIK.

Background: To evaluate the safety, efficacy, and predictability of laser-assisted in situ keratomileusis (LASIK) enhancement after primary LASIK and compare to Food and Drug Administration (FDA) criteria. Methods: Patients who underwent LASIK enhancement after primary LASIK between 2002 and 2019 were compared to those who underwent LASIK without retreatment. Patient demographics, preoperative characteristics, visual outcomes, and postoperative complications were compared between groups. Epithelial ingrowth (EI) development was stratified based on duration between primary and secondary procedures. Results: We compared 901 eyes with LASIK enhancement to 1127 eyes without retreatment. Age, sex, surgical eye, sphere, cylinder, and spherical equivalent (SE) were significantly different between groups (p < 0.05). At 12 months post-enhancement, 86% of the eyes had an uncorrected distance visual acuity of 20/20 or better and 93% of eyes were within ±0.50 D of the target. Development of EI (6.1%) demonstrated an odds ratio of 16.3 in the long-term compared to the short-term (95% CI: 5.9 to 45.18; p < 0.0001). Conclusions: Older age at primary LASIK, female sex, right eye, and larger sphere, cylinder and SE were risk factors for enhancement. Risk of EI significantly increased when duration between primary and enhancement procedures exceeded five years. LASIK enhancements produce favorable outcomes and meet FDA benchmarks for safety, efficacy, and predictability.

Magseed placement before neoadjuvant chemotherapy to facilitate subsequent breastconserving surgery - a single-centre audit.

BACKGROUND: A radio-opaque clip is placed in all patients planned for breast-conserving surgery (BCS) receiving neoadjuvant chemotherapy (NACT) to localise the tumour bed in case response to chemotherapy makes later localisation impossible. A tumour that was localised with a radio-opaque clip before NACT will then need a second localisation procedure, after the completion of NACT to aid BCS. The two most commonly used methods are hookwire and radioguided occult lesion localisation. Magseed®, a newly available technology consisting of a small magnetic seed, has now become available. The seed is placed instead of a radio-opaque clip before the start of or during NACT and can remain in place until the time of BCS. METHODS: A retrospective cohort study was performed, collecting data on patients who had a Magseed placed before or during NACT from December 2018 to February 2020. RESULTS: Twenty-one Magseed devices were placed into the breasts of 20 patients, 18 under ultrasound guidance, and three under stereotactic guidance. The average breast volume of individuals who had seeds placed was 1 532 g ± 869 g. The duration that the seeds were in situ was 138 days ± 45 days. All preoperatively placed seeds were retrieved at the surgery with no observed migration outside the tumour bed. CONCLUSION: Magseed placement before NACT is a safe and technically simple technique that can be done under ultrasound guidance in the majority of cases. It has the advantage of being a single procedure with an associated reduction in time off work and travel cost to the patient, as well as flexibility in terms of the time of placement.

Effect of Extrinsic Warming of Low-Osmolality CT Contrast Media (Iohexol 350) on Extravasations and Patient Reaction Rates: A Retrospective Study.

BACKGROUND. Extrinsic warming of iodinated CT contrast media to body temperature reduces viscosity and injection pressures. However, studies examining the effect of extrinsic warming on clinical adverse events are limited in number and provide conflicting results. Therefore, consensus practice recommendations have been sparse. OBJECTIVE. The purpose of this study is to compare rates of extravasation, allergic and allergiclike reactions, and physiologic reactions between iohexol 350 mg I/mL warmed to body temperature (37°C) versus this agent maintained at room temperature. METHODS. This retrospective study compared adult patients who received CT examinations using IV iohexol 350 that had either been warmed to body temperature or maintained at room temperature. At our institution, contrast media had historically been warmed to body temperature before a protocol change unrelated to this investigation. Information on the patient and CT examination was extracted from the electronic medical record. Adverse events, including extravasations, allergic and allergiclike reactions, and physiologic reactions, were compared between groups. RESULTS. A total of 3939 patients received contrast media warmed to body temperature before the protocol change; 3933 patients received contrast media at room temperature after the protocol change. The body temperature group experienced 11 (0.28%; 95% CI, 0.14-0.50%) adverse events, all extravasations; the allergic and allergic-like reaction rate was 0.00% (97.5% CI, 0.00-0.09%). The room temperature group experienced 17 (0.43%; 95% CI, 0.25-0.69%) adverse events: 13 (0.33%; 95% CI, 0.17-0.56%) extravasations and four (0.10%; 95% CI, 0.03-0.26%) allergic and allergiclike reactions. No physiologic reaction occurred in either group. The two groups were not different in terms of overall reaction rate (p = .19), extravasation rate (p = .69), allergic and allergiclike reaction rate (p = .06), or physiologic reaction rate (p > .99). Logistic regression adjusting for patient and CT characteristics (age, sex, conventional CT vs CTA, contrast media volume, injection location) showed no significant association of patient group and adverse reaction rate (odds ratio, 2.19; 95% CI, 0.68-7.00). Multivariable regression modeling showed an excess of 0.27 adverse events per 100 patients within the room temperature group, which is below a 0.6% noninferiority margin. CONCLUSION. The data suggest that maintaining iohexol 350 at room temperature is noninferior to warming the agent to body temperature before injection. CLINICAL IMPACT. The resources involved to prewarm iohexol 350 before injection may not be warranted.

Prospect of microbial food borne diseases in Pakistan: a review / Perspectiva de doenças microbianas transmitidas por alimentos no Paquistão: uma revisão

Abstract Nowadays food borne illness is most common in people due to their epidemic nature. These diseases affect the human digestive system through bacteria, viruses and parasites. The agents of illness are transmitted in our body through various types of food items, water and uncooked. Pathogens show drastic changes in immunosuppressant people. This review gives general insights to harmful microbial life. Pakistan is a developed country and because of its improper food management, a lot of gastrointestinal problems are noted in many patients. Bacteria are most common agents to spread diarrhoea, villi infection, constipation and dysenteric disease in human and induce the rejection of organ transplant. Enhancement of their lifestyle, properly cooked food should be used and to overcome the outbreak of the diseases.

Resumo Hoje em dia, as doenças transmitidas por alimentos são mais comuns em pessoas devido à sua natureza epidêmica. Essas doenças afetam o sistema digestivo humano por meio de bactérias, vírus e parasitas. Os agentes das doenças são transmitidos em nosso corpo por meio de diversos tipos de alimentos, água e crus. Os patógenos mostram mudanças drásticas em pessoas imunossupressoras. Esta revisão fornece uma visão geral da vida microbiana prejudicial. O Paquistão é um país desenvolvido e, devido ao seu manejo alimentar inadequado, muitos problemas gastrointestinais são observados em muitos pacientes. As bactérias são os agentes mais comuns para espalhar diarreia, infecção de vilosidades, obstipação e doença disentérica em humanos e induzem a rejeição de transplantes de órgãos. Melhoria de seu estilo de vida, alimentos devidamente cozidos devem ser utilizados e para superar o aparecimento de doenças.

Prospect of microbial food borne diseases in Pakistan: a review / Perspectiva de doenças microbianas transmitidas por alimentos no Paquistão: uma revisão

Abstract Nowadays food borne illness is most common in people due to their epidemic nature. These diseases affect the human digestive system through bacteria, viruses and parasites. The agents of illness are transmitted in our body through various types of food items, water and uncooked. Pathogens show drastic changes in immunosuppressant people. This review gives general insights to harmful microbial life. Pakistan is a developed country and because of its improper food management, a lot of gastrointestinal problems are noted in many patients. Bacteria are most common agents to spread diarrhoea, villi infection, constipation and dysenteric disease in human and induce the rejection of organ transplant. Enhancement of their lifestyle, properly cooked food should be used and to overcome the outbreak of the diseases.

Resumo Hoje em dia, as doenças transmitidas por alimentos são mais comuns em pessoas devido à sua natureza epidêmica. Essas doenças afetam o sistema digestivo humano por meio de bactérias, vírus e parasitas. Os agentes das doenças são transmitidos em nosso corpo por meio de diversos tipos de alimentos, água e crus. Os patógenos mostram mudanças drásticas em pessoas imunossupressoras. Esta revisão fornece uma visão geral da vida microbiana prejudicial. O Paquistão é um país desenvolvido e, devido ao seu manejo alimentar inadequado, muitos problemas gastrointestinais são observados em muitos pacientes. As bactérias são os agentes mais comuns para espalhar diarreia, infecção de vilosidades, obstipação e doença disentérica em humanos e induzem a rejeição de transplantes de órgãos. Melhoria de seu estilo de vida, alimentos devidamente cozidos devem ser utilizados e para superar o aparecimento de doenças.

Association of Body Mass Index and Blood Pressure with Age: A Cross Sectional Study in Elderly Male.

The aim of the study was to assess the status of body mass index (BMI) and blood pressure in elderly male in comparison to younger male and to study the association of BMI and blood pressure with age. This analytical type of cross-sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2019 to December 2019. A total number of 140 male subjects were included in this study. Among them seventy (70) younger males were taken as control group (Group I) and seventy (70) elderly males were taken as study group (Group II). Body mass index (BMI) was calculated as the weight in kilograms divided by the square of the height in meters (kg/m²). Systolic and diastolic blood pressure was measured by aneroid sphygmomanometer (ALPK2, Japan). Data were expressed as Mean±SD and statistical significance of difference among the group was calculated by unpaired student's 't' test. Pearson's correlation coefficient test was done to find the correlation of BMI, systolic blood pressure (SBP) & diastolic blood pressure (DBP) with age. In this study we found that mean BMI, systolic blood pressure & diastolic blood pressure were significantly higher in elderly male persons in comparison to younger male. Although the magnitude of correlation differed, we found that BMI, systolic blood pressure & diastolic blood pressure were positively correlated with age of the subjects. Based on the study carried out it can be concluded that due to aging process geriatric populations are more prone to development of hypertension and other cardiovascular complications than younger individuals.

For pulp treatment in primary teeth, rotary canal instrumentation may be modestly time efficient, but otherwise similar to manual canal instrumentation.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: A systematic review and meta-analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth. Manchanda S, Sardana D, Yiu CKY. Int Endod J. 2020;53(3):333-353. SOURCE OF FUNDING: Information not available. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.