Neurocognitive outcome of monochorionic twins with different birth weights

M.D.Background: Although the long term effect of intrauterine growth restriction has been assessed in a number of singleton studies, they all suffer from multiple confounding effects. A model that utilises monozygotic twins may markedly reduce the effect of confounders as monochorionic twins share the same gestational age length, family background, gender and genetic influences on growth and cognition. Comparison of monochorionic twins with birth weight discordance of 20% or more could be used as a model of in utero growth constraint. This model will still involve certain limitations and assumptions nevertheless; we used this to determine the level of cognitive function of in-utero growth discordant monochorionic twins in later childhood along with any differences in auxology and behavioural problems. Methods: This was a retrospective cohort study. Eligible twins were identified from the Northern Survey of Twins and Multiple Pregnancies register. Cognitive function was assessed by a single observer using the British Ability Scales 2 to measure the general conceptual ability. Strength and Difficulties Questionnaire was used to identify behavioral problems. Height, weight, mid arm circumference, waist measurement and head circumference were also collected. Generalised estimating equations were used to determine the effect of birth weight on general conceptual ability scores. Statistical analyses were performed using SPSS v19. Results: Between 2000 and 2004, a total of 51 twin pairs were assessed (n=23 female) with mean birth weight discordance 664gm and mean gestational age 34.7 weeks. The mean difference in the general conceptual ability score between the heavier and lighter twins was 3 points. Significant association between within pair differences in birth weight and general conceptual ability scores was found. Increasing birth weight discordance was not associated with a decrease of general conceptual ability scores. The differences in the size seen at birth between the twins were still detectable at the age of 5-8 years. There was a trend to increased prevalence of behavioural problems in the lighter twin compared to the heavier twin as reported by both teachers and parents but this result was not statistically significant. Conclusions: The smaller twin of a monochorionic growth discrepant pair was statistically significantly more likely to have a lower cognitive score compared to their co-twin at 5-8 years of age. This suggests that growth restriction in-utero is associated with lower cognitive scores in later childhood

INFLUENCE OF STABILIZATION EXERCISES ON ARTICULAR CARTILAGE CHANGES IN DEGENERATIVE TIBIO- FEMORAL JOINT DISEASE- A PILOT STUDY

Objectives: To determine the effectiveness of knee joint stabilization exercises in minimizing articular cartilage degeneration and to examine theeffectiveness of knee joint stabilization exercises on decreasing pain, improving range of motion (ROM) and muscle strength.Methods: About 20 volunteer subjects (age 35-65 years) with primary osteoarthritis fulfilled the inclusion criteria given the knee stabilizationexercises for 8 weeks. Pain, muscle strength, functional outcome score, and serum cartilage oligomeric matrix protein (COMP) values were measuredpre- and post-intervention using visual analog scale, dynamometer, and ELISA test. Data were analyzed using a paired t-test with Statistical Packagefor the Social Sciences version 20 to find out the difference between the pre- and post-test.Results: The results of the study have shown that significant difference between pre- and post-test values of pain, ROM, muscle strength and functionaloutcome score with p<0.05, and there is statistical in significance in serum COMP value (p<0.05).Conclusion: Stabilization exercises of knee joint were shown to be beneficial for decreasing pain, improving ROM and muscle strength, and there wasno effect on articular cartilage changes in degenerative tibiofemoral joint disease.Keywords: Serum cartilage oligomeric matrix protein, Knee stabilization exercises, Proprioception exercises, Muscle strength. Â

Differential Scanning calorimetric studies on the interaction of N-acylethanolamines with cholesterol

Earlier studies have suggested the formation of a 1 : 1 (mol/mol) complex between N-myristoylethanolamine (NMEA) and cholesterol in aqueous dispersion. In this study, this interaction has been investigated further by differential scanning calorimetry (DSC) on dry mixtures of NMEA, N-palmitoylethanolamine (NPEA) and N-stearoylethanolamine (NSEA) with cholesterol. The results obtained indicate that addition of cholesterol to NMEA leads to a new phase transition at 86.5°C, besides the solid-liquid phase transition of NMEA at 95°C. The intensity of the peak corresponding to the new transition increases with cholesterol content up to 50 mol%, but decreases thereafter, whereas the intensity of the peak corresponding to the melting of NMEA decreases with increasing cholesterol content, with concomitant and gradual shift to lower temperatures and vanishes at 50 mol% cholesterol. These results are consistent with the formation of a 1:1 molar complex between NMEA and cholesterol proposed earlier and indicate that these two amphiphiles are associated in the solid state as well. DSC studies on hydrated mixtures of NPEA and NSEA with cholesterol yielded results that parallel those obtained with the NMEA/cholesterol system, indicating that these two long-chain NAEs also form 1:1 (mol/mol) complexes with cholesterol

Marginal and internal fit evaluation of conventional metal-ceramic versus zirconia CAD/CAM crowns

The purpose of this in vivo study was to compare the marginal and internal gap widths of monolithic zirconia crowns fabricated by CAD/CAM technique and metal-ceramic crowns fabricated by conventional technique. 10 participants needing a single restoration were selected. Zirconia crowns using CAD/CAM technology (Group A) (n=10) and metal-ceramic crowns (Group B) (n=10) using lost wax casting technique were fabricated for each selected tooth. The marginal and internal gaps of crowns were recorded using a replica technique with light body silicone material stabilized with a regular set putty. Each replica was sectioned buccolingually and mesiodistally and then evaluated at five pre-determined sites. The points measured were PM for marginal gap, PA for axial gap, PAO for axio-occlusal transition gap and PO and PCO for occlusal gaps using a stereomicroscope at 30× magni?cation. The Paired Sample (t) test was used to detect significant differences between the two groups in terms of marginal and internal fit (?= 0.05). The mean for the marginal gap was 77.42?m (±39.5?m) for Group A compared with 95.86?m (±55.12?m) for Group B. Mean values for internal gap was 87.24 (±21.7 µm) for Group A and 132.91 µm (± 50.63 µm) for Group B. Significant differences were observed between both the groups for marginal (p=.010) and internal (p=.000) fit. The CAD/CAM fabricated zirconia crowns demonstrated a better accuracy of fit when compared to metal-ceramic crowns fabricated by conventional technology

LP-Based Approximation Algorithms for Facility Location in Buy-at-Bulk Network Design

Abstract We study problems that integrate buy-at-bulk network design into the classical (connected) facility location problem. In such problems, we need to open facilities, build a routing network, and route every client demand to an open facility. Furthermore, capacities of the edges can be purchased in discrete units from K different cable types with costs that satisfy economies of scale. We extend the linear programming frame-work of Talwar [IPCO 2002] for the single-source buy-at-bulk problem to these variants and prove integrality gap upper bounds for both facility location and connected facility location buy-at-bulk problems. For the unconnected variant we prove an integrality gap bound of O(K), and for the connected version, we get an improved bound of O(1).

Prediction of preterm delivery in symptomatic women using PAMG‐1, fetal fibronectin and phIGFBP‐1 tests: systematic review and meta‐analysis

Objective To assess the accuracy of placental alpha microglobulin‐1 (PAMG‐1), fetal fibronectin (fFN) and phosphorylated insulin‐like growth factor‐binding protein‐1 (phIGFBP‐1) tests in predicting spontaneous preterm birth (sPTB) within 7 days of testing in women with symptoms of preterm labor, through a systematic review and meta‐analysis of the literature. The test performance of each biomarker was also assessed according to pretest probability of sPTB ≤ 7 days. Methods The Cochrane, MEDLINE, PubMed and ResearchGate bibliographic databases were searched from inception until October 2017. Cohort studies that reported on the predictive accuracy of PAMG‐1, fFN and phIGFBP‐1 for the prediction of sPTB within 7 days of testing in women with symptoms of preterm labor were included. Summary receiver–operating characteristics (ROC) curves and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and positive (LR+) and negative (LR–) likelihood ratios were generated using indirect methods for the calculation of pooled effect sizes with a bivariate linear mixed model for the logit of sensitivity and specificity, with each diagnostic test as a covariate, as described by the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Results Bivariate mixed model pooled sensitivity of PAMG‐1, fFN and phIGFBP‐1 for the prediction of sPTB ≤ 7 days was 76% (95% CI, 57–89%), 58% (95% CI, 47–68%) and 93% (95% CI, 88–96%), respectively; pooled specificity was 97% (95% CI, 95–98%), 84% (95% CI, 81–87%) and 76% (95% CI, 70–80%) respectively; pooled PPV was 76.3% (95% CI, 69–84%) (P < 0.05), 34.1% (95% CI, 29–39%) and 35.2% (95% CI, 31–40%), respectively; pooled NPV was 96.6% (95% CI, 94–99%), 93.3% (95% CI, 92–95%) and 98.7% (95% CI, 98–99%), respectively; pooled LR+ was 22.51 (95% CI, 15.09–33.60) (P < 0.05), 3.63 (95% CI, 2.93–4.50) and 3.80 (95% CI, 3.11–4.66), respectively; and pooled LR– was 0.24 (95% CI, 0.12–0.48) (P < 0.05), 0.50 (95% CI, 0.39–0.64) and 0.09 (95% CI, 0.05–0.16), respectively. The areas under the ROC curves for PAMG‐1, fFN and phIGFBP‐1 for sPTB ≤ 7 days were 0.961, 0.874 and 0.801, respectively. Conclusions In the prediction of sPTB within 7 days of testing in women with signs and symptoms of PTL, the PPV of PAMG‐1 was significantly higher than that of phIGFBP‐1 or fFN. Other diagnostic accuracy measures did not differ between the three biomarker tests. As prevalence affects the predictive performance of a diagnostic test, use of a highly specific assay for a lower‐prevalence syndrome such as sPTB may optimize management

Analysis and prediction of cancerlectins using evolutionary and domain information

<p>Abstract</p> <p>Background</p> <p>Predicting the function of a protein is one of the major challenges in the post-genomic era where a large number of protein sequences of unknown function are accumulating rapidly. Lectins are the proteins that specifically recognize and bind to carbohydrate moieties present on either proteins or lipids. Cancerlectins are those lectins that play various important roles in tumor cell differentiation and metastasis. Although the two types of proteins are linked, still there is no computational method available that can distinguish cancerlectins from the large pool of non-cancerlectins. Hence, it is imperative to develop a method that can distinguish between cancer and non-cancerlectins.</p> <p>Results</p> <p>All the models developed in this study are based on a non-redundant dataset containing 178 cancerlectins and 226 non-cancerlectins in which no two sequences have more than 50% sequence similarity. We have applied the similarity search based technique, i.e. BLAST, and achieved a maximum accuracy of 43.25%. The amino acids compositional analysis have shown that certain residues (e.g. Leucine, Proline) were preferred in cancerlectins whereas some other (e.g. Asparatic acid, Asparagine) were preferred in non-cancerlectins. It has been found that the PROSITE domain "Crystalline beta gamma" was abundant in cancerlectins whereas domains like "SUEL-type lectin domain" were found mainly in non-cancerlectins. An SVM-based model has been developed to differentiate between the cancer and non-cancerlectins which achieved a maximum Matthew's correlation coefficient (MCC) value of 0.32 with an accuracy of 64.84%, using amino acid compositions. We have developed a model based on dipeptide compositions which achieved an MCC value of 0.30 with an accuracy of 64.84%. Thereafter, we have developed models based on split compositions (2 and 4 parts) and achieved an MCC value of 0.31, 0.32 with accuracies of 65.10% and 66.09%, respectively. An SVM model based on Position Specific Scoring Matrix (PSSM), generated by PSI-BLAST, was developed and achieved an MCC value of 0.36 with an accuracy of 68.34%. Finally, we have integrated the PROSITE domain information with PSSM and developed an SVM model that has achieved an MCC value of 0.38 with 69.09% accuracy.</p> <p>Conclusion</p> <p>BLAST has been found inefficient to distinguish between cancer and non-cancerlectins. We analyzed the protein sequences of cancer and non-cancerlectins and identified interesting patterns. We have been able to identify PROSITE domains that are preferred in cancer and non-cancerlectins and thus provided interesting insights into the two types of proteins. The method developed in this study will be useful for researchers studying cancerlectins, lectins and cancer biology. The web-server based on the above study, is available at <url>http://www.imtech.res.in/raghava/cancer_pred/</url></p

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries