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Background: Globally, diet low in milk is the third greatest risk factor for colorectal cancer (CRC). However, there has been a lack of detailed worldwide analysis of the burden and trends of CRC attributable to diet low in milk. Objective: We aim to assess the spatiotemporal trends of CRC-related mortality and disability-adjusted life-years (DALYs) attributable to diet low in milk at the global, regional, and national levels from 1990 to 2019. Methods: Data of mortality, DALYs, age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of CRC attributable to diet low in milk were extracted from the Global Burden of Disease (GBD) 2019 study. The burden of CRC attributable to diet low in milk was estimated using the ASMR and ASDR, while accounting for sex, age, country, and socio-demographic index (SDI). From 1990 to 2019, the estimated annual percentage change (EAPC) was calculated to clarify the temporal trends in the ASMR and ASDR attributable to diet low in milk. Results: In 2019, there were 166,456 (95% UI = 107,221-226,027) deaths and 3,799,297 (95% UI = 2,457,768-5,124,453) DALYs attributable to diet low in milk, accounting for 15.3 and 15.6% of CRC-related deaths and DALYs in 2019. CRC-related deaths and DALYs attributed to diet low in milk increased by 130.5 and 115.4%, from 1990 to 2019. The burden of CRC attributable to diet low in milk varied notably among regions and nations. High-middle SDI regions had the highest ASDR and ASMR of CRC linked to diet low in milk, while there was a slight downward trend high SDI regions. Among geographical regions, East Asia had the highest number of CRC-related deaths and DALYs attributable to diet low in milk. Notably, the burden of CRC was highest in males and the elderly. With coefficients of -0.36 and -0.36, the EAPC in ASMR and ASDR was significantly inversely correlated with the Human Development Index in 2019. Conclusion: Globally, the number of CRC deaths attributable to diet low in milk has continued to increase over the last 30 years. Therefore, government and authorities should conduct education campaigns to encourage individuals to increase daily milk intake.
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BACKGROUD: A systematic analysis was conducted to investigate the molecular etiology of fetal cleft lip and/or palate (CL/P) and the association between various types of CL/P and copy number variations (CNVs), as well as their impact on birth outcomes. METHODS: In this retrospective study conducted between January 2016 and July 2022, a cohort of pregnancies diagnosed with fetal CL/P was enrolled and comprehensive clinical data for all cases were extracted from our medical record database, including demographic data about the pregnancies, ultrasound findings, results of Chromosomal microarray (CMA), as well as relevant pregnant and perinatal outcomes. RESULTS: Among the 358 cases, 32 clinically significant variants in 29 (8.1%) fetuses with CL/P were detected by CMA. In 338 singleton pregnancies, the diagnostic yield of CMA in the context of CL/P fetuses was determined to be 7.7% (26/338). CP cases exhibited a relatively higher prevalence of pathogenic/likely pathogenic CNVs at a rate of 25% (3/12), followed by CLP cases at 8.0% (23/288). Notably, the CL group did not demonstrate any pathogenic/likely pathogenic CNV findings among the examined cases (0/38). The diagnostic rate of clinically significant variants was notably higher in the non-isolated CL/P group than in the isolated CL/P group (11/33, 33.3% vs. 15/305, 4.9%, p < 0.001). Within the remaining 20 twin pregnancies, three clinically significant variants (15%) were observed. CONCLUSIONS: This study provides powerful evidence supporting the efficacy of CMA as a valuable tool for facilitating the prenatal genetic diagnosis of fetal CL/P. The presence of CP and CLP in fetal cases demonstrated a relatively higher incidence of pathogenic/likely pathogenic CNVs. Moreover, when these cases were accompanied by additional ultrasound abnormalities, the likelihood of identifying diagnostic CNVs significantly increased. Conversely, cases of CL alone might not be associated with positive CNVs. The present data may significantly enhance prenatal diagnosis accuracy and facilitate informed genetic counseling for cases of fetal CL/P.
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Labio Leporino , Fisura del Paladar , Variaciones en el Número de Copia de ADN , Ultrasonografía Prenatal , Humanos , Labio Leporino/genética , Labio Leporino/diagnóstico por imagen , Femenino , Estudios Retrospectivos , Fisura del Paladar/genética , Fisura del Paladar/diagnóstico por imagen , Embarazo , China/epidemiología , Adulto , Centros de Atención Terciaria , Pueblos del Este de AsiaRESUMEN
Aflatoxin B1 (AFB1) is a mycotoxin which is responsible for severe damage to the immune system of humans and livestock. Licochalcone A (Lico A), a polyphenol derived from turmeric, has attracted great attention due to its wonderful antioxidant properties. Ferroptosis, an iron-dependent cell death related to oxidative stress, which plays a crucial role in the resistance of phytochemical to immune-associated injury. Nevertheless, effects of Lico A on the bursa of broilers exposed to AFB1 remain unclear. In this work, broilers were fed diets supplemented with 2 mg/kg of AFB1 and 50 mg/kg of Lico A. Meanwhile, various concentrations of Lico A and AFB1 (15 µM) were used to stimulate macrophages. These results revealed that AFB1 resulted in more severe bursa atrophy and relative weight reduction; the expression of pro-ferroptosis protein ACSL4 and the content of malondialdehyde (MDA) were significantly elevated, while the expression of anti-ferroptosis proteins GPX4, xCT, FSP1 and the content of Glutathione (GSH) was obviously reduced. However, Lico A treatment effectively reversed these effects in the bursa of broilers. Meanwhile, in bursa and macrophages, Lico A mitigated the expression of AFB1-induced apoptosis-associated protein (Caspase-3, Bax, Bcl-2) as well as antioxidant protein (Nrf2, GCLM, HO-1). Importantly, ferroptosis was also observed in macrophages induced by AFB1. Lico A efficaciously alleviated AFB1-induced mitochondrial membrane potential decrease and reactive oxygen species (ROS) production in macrophages; in contrast, Lico A evidently inhibited AFB1-triggered ROS generation and cytotoxicity, which was disabled by the addition of Erastin. Moreover, Liproxstatin-1 significantly inhibited ROS generation induced by AFB1. In summary, the present study elucidates that the main mechanism by which Lico A attenuates AFB1-induced immunotoxicity is through the suppression of ferroptosis, apoptosis, mitochondrial damage and oxidative stress, which is promising for the improvement of immunotoxic effects of AFB1.
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Background: IgA nephropathy (IgAN) is a significant contributor to chronic kidney disease (CKD). Renal arteriolar damage is associated with IgAN prognosis. However, simple tools for predicting arteriolar damage of IgAN remain limited. We aim to develop and validate a nomogram model for predicting renal arteriolar damage in IgAN patients. Methods: We retrospectively analyzed 547 cases of biopsy-proven IgAN patients. Least absolute shrinkage and selection operator (LASSO) regression and logistic regression were applied to screen for factors associated with renal arteriolar damage in patients with IgAN. A nomogram was developed to evaluate the renal arteriolar damage in patients with IgAN. The performance of the proposed nomogram was evaluated based on a calibration plot, ROC curve (AUC) and Harrell's concordance index (C-index). Results: In this study, patients in the arteriolar damage group had higher levels of age, mean arterial pressure (MAP), serum creatinine, serum urea nitrogen, serum uric acid, triglycerides, proteinuria, tubular atrophy/interstitial fibrosis (T1-2) and decreased eGFR than those without arteriolar damage. Predictors contained in the prediction nomogram included age, MAP, eGFR and serum uric acid. Then, a nomogram model for predicting renal arteriolar damage was established combining the above indicators. Our model achieved well-fitted calibration curves and the C-indices of this model were 0.722 (95%CI 0.670-0.774) and 0.784 (95%CI 0.716-0.852) in the development and validation groups, respectively. Conclusion: With excellent predictive abilities, the nomogram may be a simple and reliable tool to predict the risk of renal arteriolar damage in patients with IgAN.
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Glomerulonefritis por IGA , Nomogramas , Humanos , Glomerulonefritis por IGA/patología , Glomerulonefritis por IGA/diagnóstico , Masculino , Femenino , Adulto , Arteriolas/patología , Estudios Retrospectivos , Persona de Mediana Edad , Riñón/patología , Pronóstico , Tasa de Filtración Glomerular , Modelos EstadísticosRESUMEN
OBJECTIVE: To present the prenatal sonographic features and genomic spectrum of pregnancies with fetal Bardet-Biedl syndrome (BBS). METHODS: This was a retrospective study of 11 cases with BBS diagnosed by prenatal ultrasound and confirmed by genetic testing. Clinical and laboratory data were collected and reviewed for these cases, including maternal demographics, prenatal sonographic findings, molecular testing sequencing results, and pregnancy outcomes. RESULTS: All cases had unremarkable first-trimester ultrasound scans without reporting limb malformations. All had second-trimester abnormal ultrasounds: postaxial polydactyly in nine cases (9/11), renal abnormalities in seven (7/11), reduced amniotic fluid volume in two (2/11), central nervous system anomalies in two (2/11), and ascites in three (3/11). Ten fetuses presented with at least two-system anomalies, and one (Case 11) presented with only postaxial polydactyly. Variants were detected in five genes, including BBS2, ARL6/BBS3, BBS7, CEP290/BBS14 and IFT74/BBS22. Ten pregnancies were terminated in the second trimester, while one continued to term. CONCLUSION: Enlarged hyperechogenic kidneys and postaxial polydactyly are the two most common sonographic features of fetal BBS. Prenatal diagnosis of BBS can be done with ultrasound and genetic testing although the diagnosis may be made in the second trimester.
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Síndrome de Bardet-Biedl , Fenotipo , Ultrasonografía Prenatal , Humanos , Síndrome de Bardet-Biedl/genética , Síndrome de Bardet-Biedl/diagnóstico , Femenino , Embarazo , Estudios Retrospectivos , Adulto , Polidactilia/genética , Polidactilia/diagnóstico por imagen , Polidactilia/diagnóstico , Genotipo , Segundo Trimestre del Embarazo , Pruebas Genéticas/métodosRESUMEN
A two-dimensional unsteady seepage model for coal using a finite element program is developed, and the temporal variations of key factors such as water pressure and hydraulic gradient are analyzed in this paper. Additionally, the triaxial rock mechanical experiment and utilized pneumatic fracturing equipment on raw coal samples to investigate both hydraulic and pneumatic fracturing processes are conducted. Through these experiments, the relationship between pressure and crack formation and expansion are examined. The analysis reveals that the pore pressure gradient at the coal inlet reaches its peak during rapid surges in water pressure but diminishes over time. Conversely, the pore pressure gradient at the outlet side exhibits a gradual increase. Hydraulic fracturing is most likely to occur at the water inlet during sudden increases in water pressure. Besides, as the permeability of coal decreases, the duration for seepage stabilization prolongs due to the intensified pore pressure gradient resulting from sudden increases in water pressure. Moreover, an extended period of high hydraulic gradient further increases the risk of hydraulic fracturing. The experimental findings indicate that coal samples initially experience tensile failure influenced by water and air pressure. Subsequently, mode I cracks form under pressure, propagating along the fracture surface and becoming visible. The main types of failure observed in hydraulic and pneumatic fracturing are diametrical tensile failure, and the development of fractures can be categorized into three distinct stages, which contains the initial stage characterized by slight volume changes while water pressure increases, the expansion stage when pressure reaches the failure strength, and the crack closure stage marked by little or even decreasing volume changes during pressure unloading. The acoustic emission signal accurately corresponds to these three stages.
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BACKGROUND: The molecular mechanism of fetal cystic hygroma (CH) is still unclear, and no study has previously reported the transcriptome changes of single cells in CH. In this study, single-cell transcriptome sequencing (scRNA-seq) was used to investigate the characteristics of cell subsets in the lesion tissues of CH patients. METHODS: Lymphoid tissue collected from CH patients and control donors for scRNA-seq analysis. Differentially expressed gene enrichment in major cell subpopulations as well as cell-cell communication were analyzed. At the same time, the expression and interactions of important VEGF signaling pathway molecules were analyzed, and potential transcription factors that could bind to KDR (VEGFR2) were predicted. RESULTS: The results of scRNA-seq showed that fibroblasts accounted for the largest proportion in the lymphatic lesions of CH patients. There was a significant increase in the proportion of lymphatic endothelial cell subsets between the cases and controls. The VEGF signaling pathway is enriched in lymphatic endothelial cells and participates in the regulation of cell-cell communication between lymphatic endothelial cells and other cells. The key regulatory gene KDR in the VEGF signaling pathway is highly expressed in CH patients and interacts with other differentially expressed EDN1, TAGLN, and CLDN5 Finally, we found that STAT1 could bind to the KDR promoter region, which may play an important role in promoting KDR up-regulation. CONCLUSION: Our comprehensive delineation of the cellular composition in tumor tissues of CH patients using single-cell RNA-sequencing identified the enrichment of lymphatic endothelial cells in CH and highlighted the activation of the VEGF signaling pathway in lymphoid endothelial cells as a potential modulator. The molecular and cellular pathogenesis of fetal cystic hygroma (CH) remains largely unknown. This study examined the distribution and gene expression signature of each cell subpopulation and the possible role of VEGF signaling in lymphatic endothelial cells in regulating the progression of CH by single-cell transcriptome sequencing. The enrichment of lymphatic endothelial cells in CH and the activation of the VEGF signaling pathway in lymphatic endothelial cells provide some clues to the pathogenesis of CH from the perspective of cell subpopulations.
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Linfangioma Quístico , Análisis de la Célula Individual , Receptor 2 de Factores de Crecimiento Endotelial Vascular , Humanos , Linfangioma Quístico/genética , Linfangioma Quístico/metabolismo , Linfangioma Quístico/patología , Femenino , Receptor 2 de Factores de Crecimiento Endotelial Vascular/metabolismo , Receptor 2 de Factores de Crecimiento Endotelial Vascular/genética , Análisis de Secuencia de ARN , Transducción de Señal , Factor A de Crecimiento Endotelial Vascular/metabolismo , Factor A de Crecimiento Endotelial Vascular/genética , Factor de Transcripción STAT1/metabolismo , Factor de Transcripción STAT1/genética , TranscriptomaRESUMEN
For the effectiveness of a computer-aided diagnosis system, the quality of whole-slide image (WSI) is the foundation, and a useful autofocus method is an important part of ensuring the quality of WSI. The existing autofocus methods need to balance focusing speed and focusing accuracy, and need to be optimized separately for different samples or scenes. In this paper, a robust autofocus method based on fiber bundle illumination and image normalization analysis is proposed. For various application scenes, it meets the requirements of autofocusing through active illumination, such as bright field imaging and fluorescence imaging. For different structures on samples, it ensures the autofocusing accuracy through image analysis. The experimental results imply that the autofocusing method in this paper can effectively track the change of the distance from the sample to the focal plane and significantly improve the WSI quality.
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The foundation ring (FR) is a steel component embedded within the concrete of a wind turbine foundation, playing a pivotal role in connecting the wind turbine tower to the foundation structure. In this paper, the FR-foundation connection is equivalent to the exposed foundation and the shallow foundation by analyzing the anchorage characteristics of the foundation ring. Based on the ABAQUS concrete damaged plasticity model, full-scale modeling of the wind turbine foundation is carried out. The influence of embedment depth, ring radius and base flange width of the foundation ring on moment capacity is simulated. Based on the observed stress distributions under ultimate loads, analytical expressions were proposed to estimate the variation law of anchorage load-bearing capacity in the ultimate load state. Compared with the numerical simulation, the average errors under different influencing factors are 8.2%, 9.6% and 10.8%, respectively. The results indicate that the base flange provided the majority of the moment capacity, though the contribution of the sidewall increased to 25-50% that of the base flange in later stages.
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A pregnant woman had a normal second-trimester anatomic survey at 22 weeks gestation. She was revealed to have a fetal oral mass with polyhydramnios and invisible stomach bubble by ultrasound at 28 weeks. A 50 mm × 36 mm × 42 mm, solid mass was found in the fetal mouth, filling the entire oral cavity. Fetal magnetic resonance imaging showed a homogeneous solid mass in the oral cavity compressing the hypopharynx. At 33 weeks, preterm labor occurred because of the continuation of increased amniotic fluid volume, and a female infant was vaginally delivered. The infant died shortly after tracheal intubation attempt failed. Autopsy confirmed the prenatal sonographic finding. The final pathologic diagnosis was oral immature teratoma. Our study indicates that although oral teratomas are rare, they are readily apparent at prenatal sonographic examinations. Respiratory compromise is the frequent complication of oral teratomas, which is associated with high perinatal mortality.
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INTRODUCTION: CHARGE syndrome is an autosomal dominant genetic disorder with known pattern of features. The aim of the study was to present the fetal features of CHARGE syndrome to gain awareness that the antenatal characteristics can be very nonspecific. CASE PRESENTATION: This was a retrospective study of 13 cases with CHARGE syndrome diagnosed by prenatal or postnatal genetic testing and physical examination. Two (15.4%; 2/13) had normal ultrasound scans during pregnancy. One (7.7%; 1/13) with first-trimester cystic hygroma presented intrauterine fetal demise at 16 weeks gestation. The remaining 10 (76.9%; 10/13) cases had abnormal ultrasound features in utero; among these, 1 had an increased nuchal translucency in the first trimester, 5 had second-trimester abnormal ultrasounds including micrognathia, cardiac defects, and facial defects, and 4 third-trimester abnormal ultrasounds including micrognathia, isolated fetal growth restriction, and polyhydramnios. Among the 11 cases with abnormal prenatal ultrasound scans, no fetus could reach the diagnostic criteria of CHARGE syndrome if only based on the results of ultrasound. However, the diagnosis was made in all cases when CHD7 defects were detected. DISCUSSION/CONCLUSION: The CHARGE syndrome presents non-specific abnormal ultrasound markers in utero. Exome sequencing in the genetic workup will aid in prenatal diagnosis of this syndrome.
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Síndrome CHARGE , Fenotipo , Ultrasonografía Prenatal , Humanos , Síndrome CHARGE/genética , Síndrome CHARGE/diagnóstico , Femenino , Embarazo , Estudios Retrospectivos , Adulto , ADN Helicasas/genética , Proteínas de Unión al ADN/genética , Medida de Translucencia Nucal , Pruebas GenéticasRESUMEN
Detecting road cracks is essential for inspecting and assessing the integrity of concrete pavement structures. Traditional image-based methods often require complex preprocessing to extract crack features, making them challenging when dealing with noisy concrete surfaces in diverse real-world scenarios, such as autonomous vehicle road detection. This study introduces an image-based crack detection approach that combines a Random Forest machine learning classifier with a deep convolutional neural network (CNN) to address these challenges. Three state-of-the-art models, namely MobileNet, InceptionV3, and Xception, were employed and trained using a dataset of 30,000 images to build an effective CNN. A systematic comparison of validation accuracy across various base learning rates identified a base learning rate of 0.001 as optimal, achieving a maximum validation accuracy of 99.97%. This optimal learning rate was then applied in the subsequent testing phase. The robustness and flexibility of the trained models were evaluated using 6,000 test photos, each with a resolution of 224 × 224 pixels, which were not part of the training or validation sets. The outstanding results, boasting a remarkable 99.95% accuracy, 99.95% precision, 99.94% recall, and a matching 99.94% F1 Score, unequivocally affirm the efficacy of the proposed technique in precisely identifying road fractures in photographs taken on real concrete surfaces.
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High efficient dispersant that meanwhile possesses additional functions is highly desirable for the fabrication of graphene-based composite. In this paper, a new reactive dispersant, multi-silanols grafted naphthalenediamine (MSiND), is synthesized, which shows superiority compared with conventional dispersants. It can not only stabilize graphene in water at a high concentration of up to 16 mg mL-1, but also simultaneously be applicable for ethanol medium, in which the graphene concentration can be as high as 12 mg mL-1 at the weight ratio of 1:1 (MSiND:graphene). The dispersion is compatible with multi-matrixes and affinity to various substrates. In addition, MSiND exhibits excellent reactivity due to the existence of high-density silanol groups. Tough graphene coatings are constructed on glass slides and non-woven fabric simply by direct painting and dip-coating. Moreover, with the assistance of MSiND, graphene-doped phase-change coatings on hydrophobic non-woven fabric (e.g., functional mask) are prepared via the spray method. The composite coatings show enhanced mechanical strength and excellent energy storage performance, exhibiting great potential in heat preservation and thermotherapy.
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The present investigation aims to design and development of hybrid zinc oxide (ZnO) and manganese dioxide (MnO2) nanoparticles (NPs) doped-biopolymer matrix-based cost-effective technique for the synthesis of biocompatible Kaolinite/Chitosan (Ka/CS) nanocomposites (NCs) could be used as agents for wound healing due to their efficiency and low toxicity. The crystallite size, phase purity and surface morphology of the synthesised NCs were investigated systemic analytical methods. The results revealed that the metal oxide nanocomposites presented that in rod-crystalline in shape and additionally exhibits that 20-30 nm in size. In vitro antibacterial analyses demonstrates that NCs have significantly improved bactericidal inhibition efficiency when compared to the bare hybrid NPs and polymeric components. The in vitro biocompatibility observation demonstrates that prepared hybrid-NPs encapsulated NCs have enhanced cell survival rate (>90 %), which was established by MTT assay and Live/Dead fluorescence assay methods at different incubation time. The DPPH assay was used to investigate the synergistic effects of prepared dressing materials increased antioxidant activity. Preliminary research indicates that these nanocomposites, ZnO/MnO2 incorporated and decorated with Ka/CS NCs, could be a significant promoter and potential candidate for use as a robust wound healing agent in post-operative nursing care.
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AIMS: To develop a nomogram to provide a screening tool for recognising patients at risk of post-operative pain undergoing abdominal operations. BACKGROUND: Risk prediction models for acute post-operative pain can allow initiating prevention strategies, which are valuable for post-operative pain management and recovery. Despite the increasing number of studies on risk factors, there were inconsistent findings across different studies. In addition, few studies have comprehensively explored predictors of post-operative acute pain and built prediction models. DESIGN: A prospective observational study. METHODS: A total of 352 patients undergoing abdominal operations from June 2022 to December 2022 participated in this investigation. A nomogram was developed for predicting the probability of acute pain after abdominal surgery according to the results of binary logistic regression. The nomogram's predictive performance was assessed by discrimination and calibration. Internal validation was performed via Bootstrap with 1000 re-samplings. RESULTS: A total of 139 patients experienced acute post-operative pain following abdominal surgery, with an incidence of 39.49%. Age <60, marital status (unmarried, divorced, or widowed), consumption of intraoperative remifentanil >2 mg, indwelling of drainage tubes, poor quality sleep, high pain catastrophizing, low pain self-efficacy, and PCIA not used were predictors of inadequate pain control in patients after abdominal surgery. Using these variables, we developed a nomogram model. All tested indicators showed that the model has reliable discrimination and calibration. CONCLUSIONS: This study established an online dynamic predictive model that can offer an individualised risk assessment of acute pain after abdominal surgery. Our model had good differentiation and calibration and was verified internally as a useful tool for risk assessment. RELEVANCE TO CLINICAL PRACTICE: The constructed nomogram model could be a practical tool for predicting the risk of experiencing acute post-operative pain in patients undergoing abdominal operations, which would be helpful to realise personalised management and prevention strategies for post-operative pain. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study. PATIENT OR PUBLIC CONTRIBUTION: Before the surgery, research group members visited the patients who met the inclusion criteria and explained the purpose and scope of the study to them. After informed consent, they completed the questionnaire. The patients' pain scores (VAS) were regularly assessed and documented by the bedside nurse for the first 3 days following surgery. Other information was obtained from medical records.
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Dolor Agudo , Nomogramas , Dolor Postoperatorio , Humanos , Estudios Prospectivos , Femenino , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/diagnóstico , Abdomen/cirugía , Factores de Riesgo , Adulto , Anciano , Dimensión del Dolor/métodos , Medición de Riesgo/métodosRESUMEN
BACKGROUND: Inadequately managed postoperative pain remains a common issue. Examining factors like pain sensitivity, pain catastrophizing, and pain self-efficacy can help improve postoperative pain management. While these factors have been identified as potential predictors of acute postoperative pain, their effects have been inconsistent. Few studies have explored the interactions between these factors. AIM: To investigate the influence of preoperative pain sensitivity, pain catastrophizing, and pain self-efficacy on acute postoperative pain in abdominal surgery patients and to determine the mediating roles of pain catastrophizing and pain self-efficacy in the relationship between pain sensitivity and acute postoperative pain, as per the gate control theory. METHODS: A total of 246 patients were enrolled in this study. General information was collected before surgery, and the Pain Sensitivity Questionnaire (PSQ), Pain Catastrophizing Scale (PCS), and Pain Self-Efficacy Questionnaire (PSEQ) were administered. After surgery, patients' average pain scores over the 24 hours were reported using the Numerical Rating Scale (NRS). Correlation analyses and a structural equation model were used to examine the relationships among these variables. RESULTS: NRS scores over 3 during the 24 hours post-surgery were reported by 21.54% of patients. Postoperative acute pain was found to be associated with pain sensitivity (rs = 0.463, p < .001), pain catastrophizing (rs = 0.328, p < .001), and pain self-efficacy (rs = -0.558, p < .001). A direct effect on postoperative acute pain was exerted by pain sensitivity (effect = 0.250, p = .001), along with indirect effects through: (A) pain catastrophizing (effect = 0.028, p = .001); (B) pain self-efficacy (effect = 0.132, p = .001); and (C) the chain mediation of pain self-efficacy and pain catastrophizing (effect = 0.021, p = .008). CONCLUSIONS: The severity of postoperative acute pain can be predicted by pain self-efficacy and pain catastrophizing, and the connection between moderate pain sensitivity and postoperative acute pain severity is mediated by them. Therefore, intervention programs aimed at boosting pain self-efficacy and reducing pain catastrophizing can enhance postoperative pain outcomes for abdominal surgery patients.
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Dolor Agudo , Humanos , Autoeficacia , Catastrofización , Dolor Postoperatorio , Dimensión del DolorRESUMEN
OBJECTIVE: To present the prenatal features and postnatal outcomes of pregnancies with fetal nemaline myopathy (NM). STUDY DESIGN: This was a retrospective study of nine cases with NM diagnosed by prenatal or postnatal clinical features and confirmed by genetic testing. Clinical and laboratory data were collected and reviewed for these cases, including maternal demographics, prenatal sonographic findings, exome sequencing (ES) results, and pregnancy outcomes. RESULTS: All of the nine cases were detected to have NM-causing variants, involving NEB gene in 2 cases, ACTA1 in 3 cases, KLHL40 in 3 cases, and TPM2 in 1 case. Almost all (8/9) had normal first-trimester ultrasound scans except one who had an increased nuchal translucency. Seven (7/9) cases had second-trimester abnormal ultrasounds with fetal akinesia and/or extremity anomalies. Two (2/9) had only third-trimester abnormal ultrasounds with fetal akinesia and polyhydramnios, with one combined with fetal growth restriction. Four pregnancies with a positive prenatal ES were terminated, while five having not receiving prenatal ES continued to term. Only one infant survived 1 year old, and four passed away within 12 months. CONCLUSION: Prenatal ultrasound can detect clues that lead to the diagnosis of NM, such as reduced or absent fetal movements, polyhydramnios and extremity anomalies.
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Miopatías Nemalínicas , Polihidramnios , Embarazo , Femenino , Humanos , Lactante , Miopatías Nemalínicas/diagnóstico por imagen , Miopatías Nemalínicas/genética , Estudios Retrospectivos , Ultrasonografía Prenatal/métodos , Resultado del Embarazo , Proteínas MuscularesRESUMEN
OBJECTIVE: To analyze the risk for genetic aberrations and pregnancy outcomes in pregnancies with isolated polyhydramnios. STUDY DESIGN: This was a retrospective study of singleton pregnancies complicated by isolated polyhydramnios that underwent genetic amniocentesis between 2016 and 2021. Clinical and laboratory data were collected and reviewed for these cases, including maternal demographics, prenatal sonographic findings, chromosomal microarray results, and pregnancy outcomes. RESULTS: A total of 94 singleton pregnancies were included. Three (3.2%) cases with chromosomal abnormalities were detected, including 2 case of trisomy 21 and 1 of 22q21.1 microdeletion. One case was diagnosed as Prader-Willi syndrome caused by maternal uniparental disomy of chromosome 15. Perinatal death occurred in 1 case with severe polyhydramnios, and was retrospectively diagnosed as Bartter syndrome. Of the 90 infants survived, two were identified to have single gene disorders after birth by whole exome sequencing. CONCLUSION: We first attempted to determine the value of exome sequencing in pregnancies with isolated polyhydramnios. Our results warrant more studies to evaluate advanced genetic testing technologies used in such pregnancies.