Maternal and neonatal outcome in primigravida with mobile head at ≥39 weeks of gestation

Background: Primigravida with mobile head at ≥39 weeks of gestation are prone to the probability of caesarean section. With this study we aimed to identify the maternal and neonatal outcome of primigravida with mobile head at ≥39 weeks of gestation under the watchful expectancy and good conduct of labour.Methods: A cross sectional study was conducted among primigravida with mobile head at ≥39 weeks admitted for delivery in the department of obstetrics and gynaecology, govt. medical college, Kottayam, Kerala, from February 2021 to September 2021. A sample size of 247 was identified considering 28% proportion of presentation with deflexed head, 95% confidence interval and 2% margin of error. A detailed history, physical examination and ultrasonography was performed.Results: Of the 250 participants, the mean age of the study subjects was 24.97±3.93 and mean body mass index (BMI) was 23.72±4.78 kg/m2. The most common cause for mobile head was a deflexed head (35.2%). A lower segment caesarean section (LSCS) was conducted in 28.8% participants while vacuum assistance ad forceps assistance was required for 9.6% and 4.4% participants respectively. The most common indication for LSCSC being moderate to thick meconium-stained amniotic fluid (MSAF) 23% followed by 1st degree CPD failed trial in 17% cases. A significant association with maternal morbidity was observed in undiagnosed placenta previa (p=0.039) and vacuum-assisted deliveries (p=0.001). We observed that 3.6% of babies have meconium aspiration syndrome, and 8% of new born were admitted in intensive care for foetal distress.Conclusions: Primigravida with mobile head at term during labour requires intense monitoring. Although the duration of labour appeared to be prolonged in a small proportion of patients with watchful expectancy and good conduct of labour and timely intervention, vaginal delivery is possible with minimal maternal and neonatal morbidity.

Outlook for tuberculosis elimination in California: An individual-based stochastic model.

RationaleAs part of the End TB Strategy, the World Health Organization calls for low-tuberculosis (TB) incidence settings to achieve pre-elimination (<10 cases per million) and elimination (<1 case per million) by 2035 and 2050, respectively. These targets require testing and treatment for latent tuberculosis infection (LTBI).ObjectivesTo estimate the ability and costs of testing and treatment for LTBI to reach pre-elimination and elimination targets in California.MethodsWe created an individual-based epidemic model of TB, calibrated to historical cases. We evaluated the effects of increased testing (QuantiFERON-TB Gold) and treatment (three months of isoniazid and rifapentine). We analyzed four test and treat targeting strategies: (1) individuals with medical risk factors (MRF), (2) non-USB, (3) both non-USB and MRF, and (4) all Californians. For each strategy, we estimated the effects of increasing test and treat by a factor of 2, 4, or 10 from the base case. We estimated the number of TB cases occurring and prevented, and net and incremental costs from 2017 to 2065 in 2015 U.S. dollars. Efficacy, costs, adverse events, and treatment dropout were estimated from published data. We estimated the cost per case averted and per quality-adjusted life year (QALY) gained.Measurements and main resultsIn the base case, 106,000 TB cases are predicted to 2065. Pre-elimination was achieved by 2065 in three scenarios: a 10-fold increase in the non-USB and persons with MRF (by 2052), and 4- or 10-fold increase in all Californians (by 2058 and 2035, respectively). TB elimination was not achieved by any intervention scenario. The most aggressive strategy, 10-fold in all Californians, achieved a case rate of 8 (95% UI 4-16) per million by 2050. Of scenarios that reached pre-elimination, the incremental net cost was $20 billion (non-USB and MRF) to$48 billion. These had an incremental cost per QALY of $657,000 to$3.1 million. A more efficient but somewhat less effective single-lifetime test strategy reached as low as $80,000 per QALY.ConclusionsSubstantial gains can be made in TB control in coming years by scaling-up current testing and treatment in non-USB and those with medical risks

Composed solutions of synchronized patterns in multiplex networks of Kuramoto oscillators

Networks with different levels of interactions, including multilayer and multiplex networks, can display a rich diversity of dynamical behaviors and can be used to model and study a wide range of systems. Despite numerous efforts to investigate these networks, obtaining mathematical descriptions for the dynamics of multilayer and multiplex systems is still an open problem. Here, we combine ideas and concepts from linear algebra and graph theory with nonlinear dynamics to offer a novel approach to study multiplex networks of Kuramoto oscillators. Our approach allows us to study the dynamics of a large, multiplex network by decomposing it into two smaller systems: one representing the connection scheme within layers (intra-layer), and the other representing the connections between layers (inter-layer). Particularly, we use this approach to compose solutions for multiplex networks of Kuramoto oscillators. These solutions are given by a combination of solutions for the smaller systems given by the intra and inter-layer system and, in addition, our approach allows us to study the linear stability of these solutions

Anti-inflammatory and analgesic effects of coral reef associated gastropod, Trochus tentorium from Tuticorin coastal waters, Southeastern India

The aim of this work was to investigate extensively, the biomedical potential of the mollusc Trochus tentorium which are abundantly associated with coral reef of the Tuticorin coastal water. The 100% acetone fraction of the gastropod tested for its analgesic effect on Swiss mice model and anti-inflammatory activity on albino rat showed promising results. T. tentorium at the concentration of 25 and 50 mg/kg (p.o) showed significant decrease in the paw thickness (41.15 and 73.6%, respectively) at the 5th hour of the experiment. The 100% column-purified fraction of the T. tentorium (200 mg/kg p.o) exhibited significant (p < 0.001) inhibition of 79.22% against acetic acid induced abdominal constrictions. The dose of 25 mg/kg showed the inhibitions in the writhings of 67.86% (p<0.001) of animals when compared to the standard (diclofenac sodium), and 56.83% (50 mg/kg) inhibition was observed. These facts suggest that T. tentorium is a potential source for anti-inflammatory and analgesic compounds.Key words: Analgesic activity, anti-inflammatory activity, mollusc, southeastern India

RNAI MEDIATED GENE SILENCING OF EIF3A: A POSSIBLE SOLUTION TO CONTROL BREAST CANCER

Objective: The eukaryotic translational initiation factor 3A (eIF3A) is reported to be over expressed in most breast cancer cells. In the present study, our aim is to suppress the over expression of eIF3A in human breast cancer MCF-7 cell line using gene silencing technique (RNA interference (RNAi)).Methods: The artificial microRNA (amiRNA) targeting eIF3A gene was constructed by incorporating short interference RNA (siRNA) sequences against eIF3A gene into endogenous microRNA30 (miR-30) and cloned into pcDNA3.1 vector. The amiRNA containing plasmid was then transfected into MCF-7 cell line and the expression of eIF3A was examined by RT-PCR. The cytotoxicity of plasmid with amiRNA targeting eIF3A on MCF–7 cells was evaluated by MTT assay.Results: The amiRNA construct significantly inhibited eIF3A gene expression and reduce the cell viability of MCF-7 cell line.Conclusion: The usage of modified endogenous amiRNA in vector based expression system with significant gene silencing efficiency suggests that RNAi based gene silencing method can be considered as one of the effective means to control cancer.Â

Estimating heritability using family and unrelated individuals data

For the family data from Genetic Analysis Workshop 17, we obtained heritability estimates of quantitative traits Q1 and Q4 using the ASSOC program in the S.A.G.E. software package. ASSOC is a family-based method that estimates heritability through the estimation of variance components. The covariate-adjusted mean heritability was 0.650 for Q1 and 0.745 for Q4. For the unrelated individuals data, we estimated the heritability of Q1 as the proportion of total variance that can be accounted for by all single-nucleotide polymorphisms under an additive model. We examined a novel ordinary least-squares method, a naïve restricted maximum-likelihood method, and a calibrated restricted maximum-likelihood method. We applied the different methods to all 200 replicates for Q1. We observed that the ordinary least-squares method yielded many estimates outside the interval [0, 1]. The restricted maximum-likelihood estimates were more stable than the ordinary least-squares estimates. The naïve restricted maximum-likelihood method yielded an average estimate of 0.462 ± 0.1, and the calibrated restricted maximum-likelihood method yielded an average of 0.535 ± 0.121. Our results demonstrate discrepancies in heritability estimates using the family data and the unrelated individuals data

Methylation of HIN-1, RASSF1A, RIL and CDH13 in breast cancer is associated with clinical characteristics, but only RASSF1A methylation is associated with outcome

BACKGROUND: Aberrant promoter CpG island hypermethylation is associated with transcriptional silencing. Tumor suppressor genes are the key targets of hypermethylation in breast cancer and therefore may lead to malignancy by deregulation of cell growth and division. Our previous pilot study with pairs of malignant and normal breast tissues identified correlated methylation of two pairs of genes - HIN-1/RASSFIA and RIL/CDH13 - with expression of estrogen receptors (ER), progesterone receptors (PR), and HER2 (HER2). To determine the impact of methylation on clinical outcome, we have conducted a larger study with breast cancers for which time to first recurrence and overall survival are known. METHODS: Tumors from 193 patients with early stage breast cancer who received no adjuvant systemic therapy were used to analyze methylation levels of RIL, HIN-1, RASSF1A and CDH13 genes for associations with known predictive and prognostic factors and for impact on time to first recurrence and overall survival. RESULTS: In this study, we found that ER was associated with RASSF1A methylation (p < 0.001) and HIN-1 methylation (p = 0.002). PR was associated with RIL methylation (p = 0.012), HIN-1 (p = 0.002), and RASSF1A methylation (p = 0.019). Tumor size was associated with RIL and CDH13 methylation (both p = 0.002), and S-phase was associated with RIL methylation (p = 0.036). Only RASSF1A was associated with worse time to first recurrence (p = 0.045) and worse overall survival (p = 0.016) after adjusting for age, tumor size, S-phase, estrogen receptor and progesterone receptor. CONCLUSIONS: Methylation of HIN-1, RASSF1A, RIL and CDH13 in breast cancers was associated with clinical characteristics, but only RASSF1A methylation was associated with time to first recurrence and overall survival. Our data suggest that RASSF1A methylation could be a potential prognostic biomarker

Identification of shared and disease-specific host gene–microbiome associations across human diseases using multi-omic integration

While gut microbiome and host gene regulation independently contribute to gastrointestinal disorders, it is unclear how the two may interact to influence host pathophysiology. Here we developed a machine learning-based framework to jointly analyse paired host transcriptomic (n = 208) and gut microbiome (n = 208) profiles from colonic mucosal samples of patients with colorectal cancer, inflammatory bowel disease and irritable bowel syndrome. We identified associations between gut microbes and host genes that depict shared as well as disease-specific patterns. We found that a common set of host genes and pathways implicated in gastrointestinal inflammation, gut barrier protection and energy metabolism are associated with disease-specific gut microbes. Additionally, we also found that mucosal gut microbes that have been implicated in all three diseases, such as Streptococcus, are associated with different host pathways in each disease, suggesting that similar microbes can affect host pathophysiology in a disease-specific manner through regulation of different host genes. Our framework can be applied to other diseases for the identification of host gene–microbiome associations that may influence disease outcomes