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Planning a rapid eye movement (saccade) changes how we perceive our visual world. Even before we move the eyes visual discrimination sensitivity improves at the impending target of eye movements, a phenomenon termed "presaccadic attention." Yet, it is unknown if such presaccadic selection merely affects perceptual sensitivity, or also affects downstream decisional processes, such as choice bias. We report a surprising lack of presaccadic perceptual benefits in a common, everyday setting-detection of changes in the visual field. Despite the lack of sensitivity benefits, choice bias for reporting changes increased reliably for the saccade target. With independent follow-up experiments, we show that presaccadic change detection is rendered more challenging because percepts at the saccade target location are biased toward, and more precise for, only the most recent of two successive stimuli. With a Bayesian model, we show how such perceptual and choice biases are crucial to explain the effects of saccade plans on change detection performance. In sum, visual change detection sensitivity does not improve presaccadically, a result that is readily explained by teasing apart distinct components of presaccadic selection. The findings may have critical implications for real-world scenarios, like driving, that require rapid gaze shifts in dynamically changing environments.
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Campos Visuais , Percepção Visual , Teorema de Bayes , Atenção , Movimentos Oculares , Movimentos Sacádicos , Estimulação LuminosaRESUMO
MAIN CONCLUSION: The study demonstrated that Artemisia pallens roots can be a source of terpene-rich essential oil and root-specific ApTPS1 forms germacrene A contributing to major root volatiles. Davana (Artemisia pallens Bess) is a valuable aromatic herb within the Asteraceae family, highly prized for its essential oil (EO) produced in the aerial parts. However, the root volatile composition, and the genes responsible for root volatiles have remained unexplored until now. Here, we show that A. pallens roots possess distinct oil bodies and yields ~ 0.05% of EO, which is primarily composed of sesquiterpenes ß-elemene, neryl isovalerate, ß-selinene, and α-selinene, and trace amounts of monoterpenes ß-myrcene, D-limonene. This shows that, besides aerial parts, roots of davana can also be a source of unique EO. Moreover, we functionally characterized a terpene synthase (ApTPS1) that exhibited high in silico expression in the root transcriptome. The recombinant ApTPS1 showed the formation of ß-elemene and germacrene A with E,E-farnesyl diphosphate (FPP) as a substrate. Detailed analysis of assay products revealed that ß-elemene was the thermal rearrangement product of germacrene A. The functional expression of ApTPS1 in Saccharomyces cerevisiae confirmed the in vivo germacrene A synthase activity of ApTPS1. At the transcript level, ApTPS1 displayed predominant expression in roots, with significantly lower level of expression in other tissues. This expression pattern of ApTPS1 positively correlated with the tissue-specific accumulation level of germacrene A. Overall, these findings provide fundamental insights into the EO profile of davana roots, and the contribution of ApTPS1 in the formation of a major root volatile.
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Artemisia , Óleos Voláteis , Sesquiterpenos de Germacrano , Sesquiterpenos , Sesquiterpenos/metabolismo , Terpenos , Óleos Voláteis/química , Saccharomyces cerevisiae/metabolismo , Artemisia/genética , Artemisia/metabolismoRESUMO
Despite extensive preclinical testing, cancer therapeutics can result in unanticipated toxicity to non-tumor tissue in patients. These toxicities may pass undetected in preclinical experiments due to modeling limitations involving poor biomimicry of 2-dimensional in vitro cell cultures and due to lack of interspecies translatability in in vivo studies. Instead, primary cells can be grown into miniature 3-dimensional structures that recapitulate morphological and functional aspects of native tissue, termed "organoids." Here, human bronchioalveolar organoids grown from primary alveolar epithelial cells were employed to model lung epithelium and investigate off-target toxicities associated with antibody-drug conjugates (ADCs). ADCs with three different linker-payload combinations (mafodotin, vedotin, and deruxtecan) were tested in bronchioalveolar organoids generated from human, rat, and nonhuman primate lung cells. Organoids demonstrated antibody uptake and changes in viability in response to ADC exposure that model in vivo drug sensitivity. RNA sequencing identified inflammatory activation in bronchioalveolar cells in response to deruxtecan. Future studies will explore specific cell populations involved in interstitial lung disease and incorporate immune cells to the culture.
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Imunoconjugados , Organoides , Organoides/efeitos dos fármacos , Organoides/patologia , Animais , Imunoconjugados/toxicidade , Humanos , Ratos , Avaliação Pré-Clínica de Medicamentos/métodos , Macaca fascicularis , Células Cultivadas , Testes de Toxicidade/métodos , Alvéolos Pulmonares/efeitos dos fármacos , Alvéolos Pulmonares/patologia , Células Epiteliais Alveolares/efeitos dos fármacos , Células Epiteliais Alveolares/patologiaRESUMO
AIMS: To assess and compare 30-day perioperative adverse events following suburethral sling surgery using synthetic mesh, autologous rectus fascia, and autologous fascia lata in women. METHODS: This was a retrospective cohort study of patients who underwent fascial or synthetic sling placement for stress urinary incontinence between 2008 and 2021 using the American College of Surgeons' National Surgical Quality Improvement Program database. Current Procedural Terminology codes were used to identify patients undergoing each type of sling procedure. Multivariable regression analysis with stepwise regression was used to assess the odds of composite adverse events (e.g., urinary tract infection, surgical site infection, pulmonary embolism, and other reportable events) between cohorts. RESULTS: Of the 41 533 female patients who underwent isolated suburethral sling placement without concurrent procedures, 41 292 (99.4%) received a synthetic mesh sling, and 241 (0.6%) received an autologous facial sling. In the fascial sling cohort, 160 (66.4%) underwent rectus fascia harvest and 81 (33.6%) underwent fascia lata harvest. Sling surgeries involving autologous fascia were associated with increased odds of adverse events compared to those involving synthetic mesh, even after adjusting for confounders (adjusted odds ratio [aOR]: 3.63, 95% confidence interval [CI]: 2.56-5.15). Compared to fascial slings from rectus fascia, slings from fascia lata were associated with increased odds of composite adverse events (aOR: 2.11, 95% CI: 1.03-4.04). However, with the exclusion of urinary tract infections, the adverse event rate was similar between slings using the two fascial harvest techniques (aOR: 1.93, 95% CI: 0.81-4.63). CONCLUSIONS: In this retrospective database study, suburethral sling surgeries using autologous fascia were independently associated with a 3.6-fold increase in odds of 30-day perioperative adverse events compared to sling surgeries using synthetic mesh.
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Slings Suburetrais , Incontinência Urinária por Estresse , Humanos , Feminino , Estudos Retrospectivos , Fascia Lata , Telas Cirúrgicas , Incontinência Urinária por Estresse/cirurgia , Sistema de RegistrosRESUMO
OBJECTIVE: To determine the burden and identify correlates of female sexual dysfunction (FSD) among women with prediabetes (PreD) and type 2 diabetes (T2D) enrolled in the Diabetes Prevention Program (DPP) Outcomes Study (DPPOS). METHODS: The DPPOS visit included the Female Sexual Function Index (FSFI) to determine sexual function. Of 1464 participants, 1320 (90%) completed the (FSFI) and 426 were sexually active. A backward selection multivariable logistic regression model estimated the odds of FSD for sociodemographic, clinical, and diabetes-related covariates. RESULTS: One hundred and eighty-five (43%) had a score of ≤26.55 and met the criteria for FSD. After adjustment for DPP treatment and age, urinary incontinence (UI) (odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.15-3.17) and hysterectomy (OR = 1.89, 95% CI = 1.01-3.53) were associated with increased odds of FSD. Increased body mass index was protective for FSD (OR = 0.93 per kg/m2, 95% CI = 0.89-0.96). Michigan Neuropathy Screening Instrument-based peripheral neuropathy (mean±SD scores 1.1±1.3 vs. 0.9±1.1, p < 0.0001) and Electrocardiogram (ECG)-based autonomic dysfunction measures (mean ± SD heart rate levels 64.3 ± 6.8 vs. 65.6 ± 10.2, p = 0.008) were associated with FSD. There were no differences in diabetes rates between women who did (66.5%) and did not (66%) have (p = 0.7). CONCLUSIONS: FSD is prevalent in women with PreD and T2D. Our findings suggest that FSD is associated with neuropathic complications commonly observed in PreD and T2D.
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Diabetes Mellitus Tipo 2 , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Humanos , Feminino , Diabetes Mellitus Tipo 2/complicações , Prevalência , Inquéritos e Questionários , Disfunções Sexuais Psicogênicas/epidemiologiaRESUMO
PURPOSE: This study tested the hypothesis that ecological momentary assessment (EMA) of pelvic pain (PP) and urinary urgency (UU) would reveal unique Urologic Chronic Pelvic Pain Syndrome (UCPPS) phenotypes that would be associated with disease specific quality of life (QOL) and illness impact metrics (IIM). MATERIALS AND METHODS: A previously validated smart phone app (M-app) was provided to willing Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) participants. M-app notifications were sent 4-times daily for 14 days inquiring about PP and UU severity. A clustering algorithm that accounted for variance placed participants into PP and UU variability? clusters. Associations between clusters and QOL and IIM were then determined. RESULTS: A total of 204 participants enrolled in the M-app study (64% female). M-app compliance was high (median 63% of surveys). Cluster analysis revealed k = 3 (high, low, none) PP clusters and k = 2 (high, low) UU clusters. When adjusting for baseline pain severity, high PP variability, but not UU variability, was strongly associated with QOL and IIM; specifically worse mood, worse sleep and higher anxiety. UU and PP clusters were associated with each other (p < 0.0001), but a large percentage (33%) of patients with high PP variability had low UU variability. CONCLUSIONS: PP variability is an independent predictor of worse QOL and more severe IIM in UCPPS participants after controlling for baseline pain severity and UU. These findings suggest alternative pain indices, such as pain variability and unpredictability, may be useful adjuncts to traditional measures of worst and average pain when assessing UCPPS treatment responses.
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Dor Crônica , Qualidade de Vida , Humanos , Feminino , Masculino , Avaliação Momentânea Ecológica , Dor Crônica/diagnóstico , Dor Pélvica/diagnóstico , Medição da DorRESUMO
BACKGROUND: In India, esophageal cancer (EC) is among the major cause of cancer-related deaths in both sexes. In recent past, autophagy has emerged as one of the crucial process associated with cancer. In the development of EC, the role of autophagy and the precise molecular mechanism involved has yet to be fully understood. Recently, a small number of studies have proposed how variations in autophagy genes affect the growth and development of EC. Micro-RNA's are also known to play a critical role in the development of EC. Here, we examined the relationship between the risk of EC and two single-nucleotide polymorphisms (SNPs) in the key autophagy genes, ATG10 rs1864183 and ATG16L1 rs2241880. We also analyzed the association of miR-107 and miR-126 with EC as these miRNA's are associated with autophagy. METHODS AND RESULTS: A total of 230 EC patients and 230 healthy controls from North-west Indian population were enrolled. ATG10 rs1864183 and ATG16L1 rs2241880 polymorphism were analyzed using TaqMan genotyping assay. Expression levels of miR-107 and miR-126 were analyzed through quantitative PCR using SYBR green chemistry. We found significant association of CT + CC genotype (OR 0.64, p = 0.022) in recessive model for ATG10 rs1864183 polymorphism with decreased EC risk. For ATG16L1 rs2241880 polymorphism significant association for AG genotype (OR 1.48, p = 0.05) and G allele (OR 1.43, p = 0.025) was observed for increased EC risk. Expression levels of miR-126 were also found to be significantly up regulated (p = 0.008). CONCLUSION: Our results suggest that ATG10 rs1864183, ATG16L1 rs2241880 and miR-126 may be associated with esophageal carcinogenesis and warrant further investigation.
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Neoplasias Esofágicas , MicroRNAs , Masculino , Feminino , Humanos , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único/genética , Genótipo , Neoplasias Esofágicas/genética , MicroRNAs/genética , Proteínas Relacionadas à Autofagia/genética , Autofagia/genética , Estudos de Casos e Controles , Proteínas de Transporte Vesicular/genéticaRESUMO
INTRODUCTION AND HYPOTHESIS: The objective was to examine the outcomes of posterior tibial nerve stimulation (PTNS) on bladder, bowel, and sexual health-related quality of life among a cohort of patients with multiple sclerosis (MS) with refractory lower urinary tract symptoms (LUTS). METHODS: Patients with MS and refractory LUTS were recruited for a prospective, observational study using PTNS to treat their symptoms. Patients underwent 12 weekly 30-min PTNS sessions and bladder, bowel, and sexual symptoms were evaluated at baseline, 3, 12, and 24 months with voiding diaries, visual analog scales (VAS), and validated patient-reported questionnaires, including the American Urological Association Symptom Score (AUA-SS), Neurogenic Bladder Symptom Score (NBSS), Michigan Incontinence Symptom Index (M-ISI), Health Status Questionnaire, Sexual Satisfaction Scale, and Bowel Control Scale. RESULTS: A total of 23 patients were recruited: 18 started PTNS and 14 completed 3 months of PTNS. Of the 18 who started PTNS, the mean age was 52 years (SD 12), 61% were female, 83% were white, and most patients had relapsing remitting (39%) MS. Baseline (n=18) and 3-month voiding (n=11) outcomes showed no significant change in number of voids or incontinence episodes. The median VAS symptom improvement was 49 (IQR 26.5, 26) and 9 (53%) patients elected for monthly maintenance PTNS. On paired analysis, there was a significant improvement in median change in NBSS, AUA-SS, and M-ISI. There was no significant change in bowel or sexual dysfunction. CONCLUSIONS: This prospective, observational study of PTNS in patients with MS with refractory LUTS shows improvement in patient-reported bladder outcomes, but not in number of voids per day or bowel or bladder function.
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OBJECTIVES: Female sexual dysfunction (FSD) affects an estimated 40% of women. Unfortunately, FSD is understudied, leading to limited treatment options for FSD. Neuromodulation has shown some success in alleviating FSD symptoms. We developed a pilot study to investigate the short-term effect of electrical stimulation of the dorsal genital nerve and tibial nerve on sexual arousal in healthy women, women with FSD, and women with spinal cord injury (SCI) and FSD. MATERIALS AND METHODS: This study comprises a randomized crossover design in three groups: women with SCI, women with non-neurogenic FSD, and women without FSD or SCI. The primary outcome measure was change in vaginal pulse amplitude (VPA) from baseline. Secondary outcome measures were changes in subjective arousal, heart rate, and mean arterial pressure from baseline. Participants attended one or two study sessions where they received either transcutaneous dorsal genital nerve stimulation (DGNS) or tibial nerve stimulation (TNS). At each session, a vaginal photoplethysmography sensor was used to measure VPA. Participants also rated their level of subjective arousal and were asked to report any pelvic sensations. RESULTS: We found that subjective arousal increased significantly from before to after stimulation in DGNS study sessions across all women. TNS had no effect on subjective arousal. There were significant differences in VPA between baseline and stimulation, baseline and recovery, and stimulation and recovery periods among participants, but there were no trends across groups or stimulation type. Two participants with complete SCIs experienced genital sensations. CONCLUSIONS: To our knowledge, this is the first study to measure sexual arousal in response to short-term neuromodulation in women. This study indicates that short-term DGNS but not TNS can increase subjective arousal, but the effect of stimulation on genital arousal is inconclusive. This study provides further support for DGNS as a treatment for FSD.
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Estudos Cross-Over , Traumatismos da Medula Espinal , Humanos , Feminino , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/terapia , Adulto , Projetos Piloto , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Adulto Jovem , Excitação Sexual , Estimulação Elétrica Nervosa Transcutânea/métodos , Nervo Tibial/fisiologia , Nervo Pudendo/fisiologia , Nervo Pudendo/fisiopatologiaRESUMO
Background and Aims: Perioperative variable parameters can be significant risk factors for postoperative intensive care unit (ICU) admission after elective craniotomy for intracranial neoplasm, as assessed by various scoring systems such as Cranio Score. This observational study evaluates the relationship between these factors and early postoperative neurological complications necessitating ICU admission. Material and Methods: In total, 119 patients, aged 18 years and above, of either sex, American Society of Anesthesiologists (ASA) grades I-III, scheduled for elective craniotomy and tumor excision were included. The primary objective was to evaluate the relationship between perioperative risk factors and the incidence of early postoperative complications as a means of validation of the Cranio Score. The secondary outcomes studied were 30-day postoperative morbidity/mortality and the association with patient-related risk factors. Results: Forty-five of 119 patients (37.82%) required postoperative ICU care with the mean duration of ICU stay being 1.92 ± 4.91 days. Tumor location (frontal/infratemporal region), preoperative deglutition disorder, Glasgow Coma Scale (GCS) less than 15, motor deficit, cerebellar deficit, midline shift >3 mm, mass effect, tumor size, use of blood products, lateral position, inotropic support, elevated systolic/mean arterial pressures, and duration of anesthesia/surgery were associated with a higher incidence of ICU care. Maximum (P = 0.035, AOR = 1.130) and minimum systolic arterial pressures (P = 0.022, Adjusted Odds Ratio (AOR) = 0.861) were the only independent risk factors. Cranio Score was found to be an accurate predictor of complications at a cut-off point of >10.52%. The preoperative motor deficit was the only independent risk factor associated with 30-day morbidity (AOR = 4.66). Conclusion: Perioperative hemodynamic effects are an independent predictor of postoperative ICU requirement. Further Cranio Score is shown to be a good scoring system for postoperative complications.
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This study evaluated learning agreements (LA) as a teaching-learning tool when administered to eleven postgraduate students in Pediatrics, with each learner moving at an individual pace. After LA, the median (IQR) Gap-Kalamazoo Communication Skills Assessment Score (GKCSAC) of students increased from 14 (11, 14) to 27 (27, 33); P = 0.003. The scores on all the nine distinct components of the GKCSAC exhibited a statistically significant increase (P < 0.01). Additionally, all students perceived themselves as more competent and confident in their communication skills.
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Comunicação , Pediatria , Pediatria/educação , Humanos , Estudantes de Medicina , Educação de Pós-Graduação em Medicina/métodos , Aprendizagem , Ensino/normas , Competência ClínicaRESUMO
Mizoram (India) is part of UNESCO's biodiversity hotspots in India that is primarily populated by tribes who engage in shifting agriculture. Hence, the land use land cover (LULC) pattern of the state is frequently changing. We have used Landsat 5 and 8 satellite images to prepare LULC maps from 2000 to 2020 in every 5 years. The atmospherically corrected images were pre-processed for removal of cloud cover and then classified into six classes: waterbodies, farmland, settlement, open forest, dense forest, and bare land. We applied four machine learning (ML) algorithms for classification, namely, random forest (RF), classification and regression tree (CART), minimum distance (MD), and support vector machine (SVM) for the images from 2000 to 2020. With 80% training and 20% testing data, we found that the RF classifier works best with the most accuracy than other classifiers. The average overall accuracy (OA) and Kappa coefficient (KC) from 2000 to 2020 were 84.00% and 0.79 when the RF classifier was used. When using SVM, CART, and MD, the average OA and KC were 78.06%, 0.73; 78.60%, 0.72; and 73.32%, 0.65, respectively. We utilised three methods of topographic correction, namely, C-correction, SCS (sun canopy sensor) correction, and SCS + C correction to reduce the misclassification due to shadow effects. SCS + C correction worked best for this region; hence, we prepared LULC maps on SCS + C corrected satellite image. Hence, we have used RF classifier for LULC preparation demi-decadal from 2000 to 2020. The OA for 2000, 2005, 2010, 2015, and 2020 was found to be 84%, 81%, 81%, 85%, and 89%, respectively, using RF. The dense forest decreased from 2000 to 2020 with an increase in open forest, settlement, and agriculture; nevertheless, when Farmland was low, there was an increase in the barren land. The results were significantly improved with the topographic correction, and misclassification was quite less.
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Algoritmos , Aprendizado de Máquina , Índia , Agricultura , Florestas , Máquina de Vetores de Suporte , Conservação dos Recursos NaturaisRESUMO
The world is currently witnessing the military operations of Russia invading Ukraine, leading to missile bombing and shelling on various parts. Although the economic ill effects are more conspicuous and much talked about, the environmental impacts are grimmer and more devastating but ironically are less in the news. Hence, in this work, we focused on the environmental impact of the Russia-Ukraine war by quantifying the long-term (2001 to 2023) and short-term temperature changes using land surface temperature (LST) and air temperature (AT) as proxies and monitoring changes in air quality, mainly methane (CH4), carbon monoxide (CO) and carbon dioxide (CO2), between 2021 and 2022. We used NASA MODIS FIRMS fire points from 24th February 2022 to 08th September 2023 to prepare the heat map for identifying the regions heavily devastated by bombing. Thus, parts of Kiev, Lviv, Luhansk, Odesa, Donetsk, Kherson, etc., in Ukraine were chosen for assessing the LST, AT variations during the peak season of war along with analysis of long-term and short-term changes. We used MODIS Terra LST and Emissivity, ERA 5 AT, CH4, CO2 from AIRS and CO from Sentinel 5P. The results of the LST showed an average increase of around 2.32 °C (2022-2023), 3.44 °C (2021 and 2022) in parts of Ukraine and an increase of about 2 °C from COVID time, whilst a decrease of about 1 °C during COVID. This increase in LST will cause enhanced warming, thus changing the regional climate in a shorter time frame. A consistent upward trend in CH4, CO and CO2 is seen from 2019 to 2023. These heat waves and pollution will grip Ukraine and cause menace due to the cumulative effect of heat waves, changing climate and the aftermaths of war. This would be catastrophic as it might lead to a widespread impact on human health, agricultural yield and infrastructure, to name a few.
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Poluição do Ar , Temperatura , Ucrânia , Federação Russa , Dióxido de Carbono/análise , Monitoramento Ambiental , Monóxido de Carbono/análise , Metano/análise , Poluentes Atmosféricos/análiseRESUMO
Medicinal herbs are being widely accepted as alternative remedies for preventing various diseases especially in India and other Asian countries. However, most plant-based herbal medicines are not yet being scientifically accepted worldwide. "Tinospora cordifolia (Willd.) Miers ex Hook.F. & Thomson", one of the most promising plant species of Tinospora known as "Giloy" or Guduchi that is used in several traditional medicines in treating diseases e.g., metabolic and immune disorders, diabetes, heart diseases, cancer, and infectious diseases, has been widely investigated. Varieties of bioactive phytochemical constituents isolated from the stem, root and whole plant of T. cordifolia have been identified. In the last two decades, the diverse pharmacological activities of T. cordifolia have been continuously studied. Due to its therapeutic efficacy in immune modulation, it could be effective in viral and other diseases treatment as well. A medicinal plant could be well-suited not only for the treatment of target site but also for boosting the body's immune system. As an alternate source of medication, medicinal herbs are continuously showing better compatibility with the human body with minimal side effects than other therapies. Keeping this in mind, the present review highlights the pharmacological potential of T. cordifolia against various diseases.
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BACKGROUND: Mechanical ventilation (MV) in intensive care units (ICUs) is a stressful experience for patients. However, these experiences have not been systematically explored in low- and lower-middle-income countries (LLMICs). This systematic review (SR) aims to explore the patients' experiences of MV in ICUs in LLMICs and the factors influencing their experiences. METHODS: The PICO framework will be used to operationalize the review question into key concepts: population (mechanically ventilated adult patients in ICUs), phenomenon of interest (experiences) and context (LLMICs). PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, Scopus and Web of Science will be systematically searched since database inception. Citation, reference list and PubMed-related article searching of included studies will be done to ensure literature saturation. Empirical peer-reviewed literature exploring adult patients' (aged ≥ 18 years) experiences of MV in ICUs in LLMIC will be included. All study designs (quantitative, qualitative and mixed methods) will be included. Two independent reviewers will perform screening, data extraction and critical appraisal. The mixed-methods appraisal tool (MMAT) and Popay's narrative synthesis will be used for critical appraisal and data synthesis, respectively. DISCUSSION: This SR aims to bridge a gap in knowledge as previous evidence synthesis has described this phenomenon in developed countries. The review design, with the inclusion of quantitative, qualitative and mixed-methods studies, intends to provide a rich and in-depth exploration of the issue. The findings will be presented as themes, subthemes and their explanatory narratives. The gaps in available literature will be identified, and implications of SR findings on policy, practice and future research will be presented. The strength of this SR lies in its systematic, comprehensive, transparent, robust and explicit methodology of identifying, collating, assessing and synthesizing available evidence. By prior registration and reporting of this SR protocol, we aim to ensure transparency and accountability and minimize bias. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024507187.
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Países em Desenvolvimento , Unidades de Terapia Intensiva , Respiração Artificial , Revisões Sistemáticas como Assunto , HumanosRESUMO
PURPOSE: The purpose of this study was to determine the role of transcutaneous retrobulbar amphotericin B (TRAMB) injection in COVID-19-related rhino-orbital-cerebral mucormycosis (ROCM). MATERIALS AND METHODS: This prospective interventional case series included 7 eyes of 7 patients diagnosed with COVID-19 ROCM presenting from May to September 2021 at a tertiary care center in North India. Active or recovered cases of COVID-19 with clinical features suggestive of ROCM and early orbital involvement were included. Following functional endoscopic sinus surgery, patients were given TRAMB 3.5 mg/ml in single ocular quadrant depending upon the muscle involved on contrast-enhanced magnetic resonance imaging (MRI). Patients were followed up for a period of 12 weeks. RESULTS: All patients were diabetic and COVID-19 reverse transcription-polymerase chain reaction positive. The mean age of patients was 48.4 years ± 11 years, out of which 5 patients were male and 2 were female. The left eye was involved in 57.14% of cases whereas 42.85% of cases had right eye involvement. Presenting complaints were drooping of the upper lid (57.14%; n = 4), proptosis (28.57%; n = 2), facial pain and swelling (85.71%; n = 6), and nasal block (57.14%; n = 4). Stagewise distribution was 3a in four patients (57.14%), 3b in two patients (28.57%), and 4a in one patient. TRAMB injections (median - 3) were given, and improvement was seen in all patients in terms of ocular movements, ptosis, proptosis, and muscle enhancement on MRI scan. Three patients had an increase in intraocular pressure and inflammation which settled within a week with favorable anatomical and functional outcomes. CONCLUSION: Transcutaneous retrobulbar amphotericin B should be considered an adjunctive treatment modality for ROCM patients with limited orbital disease to preserve ocular function.
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Background and Aims: Short-term hypotension after general anaesthesia can negatively impact surgical outcomes. This study compared the predictive potential of the pleth variability index (PVI), pulse pressure variability (PPV), and perfusion index (PI) for anaesthesia-induced hypotension. This study's primary objective was to evaluate the predictive potential of PI, PVI, and PPV for hypotension. Methods: This observational study included 140 adult patients undergoing major abdominal surgery under general anaesthesia. Mean arterial pressure, heart rate, PVI, PPV, and PI were collected at 1-min intervals up to 20 min post anaesthesia induction. Hypotension was assessed at 5-min and 15-min intervals. Receiver operating characteristic (ROC) curves were plotted to determine the diagnostic performance and best cut-off for continuous variables in predicting a dichotomous outcome. Statistical significance was kept at P < 0.05. Results: Hypotension prevalence within 5 and 15 min of anaesthesia induction was 36.4% and 45%, respectively. A PI cut-off of <3.5 had an area under the ROC curve (AUROC) of 0.647 (P = 0.004) for a 5-min hypotension prediction. The PVI's AUROC was 0.717 (P = 0.001) at cut-off >11.5, while PPV's AUROC was 0.742 (P = 0.001) at cut-off >12.5. At 15 min, PVI's AUROC was 0.615 (95% confidence interval 0.521-0.708, P = 0.020), with 54.9% positive predictive value and 65.2% negative predictive value. Conclusion: PVI, PPV, and PI predicted hypotension within 5 min after general anaesthesia induction. PVI had comparatively higher accuracy, sensitivity, specificity, and positive predictive value than PI and PPV when predicting hypotension at 15 min.
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Background: Micro RNAs are new diagnostic markers and therapeutic targets in breast cancer research. miR-107 and miR-126 have been reported to be linked with the pathogenesis of breast cancer. The present study investigates the levels of expression of miR-107 and miR-126 in patients with breast cancer to find their correlation with the risk of breast cancer in Amritsar, Punjab, Northwest India. Material and Methods: In total, 200 subjects, 100 patients with breast cancer and 100 controls, were enrolled to screen the expression of miR-107 and miR-126 using quantitative reverse transcription polymerase chain reaction (RT-PCR) technique. The Livak method (2-ΔΔCt) was used to calculate the fold change of the expression of micro RNAs. Student t-test was used to calculate the significant change in the expression of miRNAs in patients as compared with controls. Spearman rank correlation coefficient and ROC were conducted. The value of p < 0.05 was considered to indicate a statistically significant difference. Results: miR-107 was downregulated in patients with breast cancer as compared with controls (fold change = 0.467; p = 0.114) but not statistically significant. The expression of miR-126 was found to be 5.37 times elevated in patients with breast cancer, specifically in stage I and stage III patients (p = 0.009), compared with controls, which may indicate its oncogenic activity. The ROC analyses revealed that miR-126 could be a potential diagnostic marker. In conclusion oncogenic behavior of miR-126 is suggestive of its role in pathogenesis in patients with breast cancer.
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Biomarcadores Tumorais , Neoplasias da Mama , Regulação Neoplásica da Expressão Gênica , MicroRNAs , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Neoplasias da Mama/genética , Feminino , Estudos de Casos e Controles , Pessoa de Meia-Idade , Adulto , Biomarcadores Tumorais/genética , Regulação Neoplásica da Expressão Gênica/genética , Índia/epidemiologia , Fatores de Risco , Idoso , Predisposição Genética para Doença/genéticaRESUMO
Attention can be deployed in multiple forms and facilitates behavior by influencing perceptual sensitivity and choice bias. Attention is also associated with a myriad of changes in sensory neural activity. Yet, the relationship between the behavioral components of attention and the accompanying changes in neural activity remains largely unresolved. We examined this relationship by quantifying sensitivity and bias in monkeys performing a task that dissociated eye movement responses from the focus of covert attention. Unexpectedly, bias, not sensitivity, increased at the focus of covert attention, whereas sensitivity increased at the location of planned eye movements. Furthermore, neuronal activity within visual area V4 varied robustly with bias, but not sensitivity, at the focus of covert attention. In contrast, correlated variability between neuronal pairs was lowest at the location of planned eye movements, and varied with sensitivity, but not bias. Thus, dissociable behavioral components of attention exhibit distinct neuronal signatures within the visual cortex.