Diagnostic accuracy of cervical elastography for predicting preterm delivery: Systematic review and meta-analysis.

OBJECTIVE: Cervical elastography has been used in pregnant women to diagnose preterm births. However, there is a variability in the measured elasticity parameters and imaging mode used. We evaluated the precision of cervical elastography in identifying preterm births. METHODS: Extensive and methodical searches were made in the databases such as Scopus, Embase, Cochrane Library, PubMed Central, Medline, ScienceDirect, and Google Scholar from the inception until November 2022, for studies that report diagnostic accuracy of cervical elastography for preterm deliveries in antenatal women. RESULTS: The pooled sensitivity and specificity value of cervical elastography for preterm deliveries were 82% (95%CI: 73%-89%) and 77% (95%CI: 64%-86%), respectively with area under curve (AUC) of 0.87 (95%CI: 0.72-0.95). The diagnostic odds ratio (DOR) was 15 (95%CI: 8-28), positive likelihood ratio (LRP) was 3.5 (95%CI: 2.3-5.5) and negative likelihood ratio LRN was 0.23 (0.16-0.34). Pooled sensitivity and specificity of shear wave elastography was 88% and 71%, respectively. Pooled sensitivity and specificity of strain elastography was 80% and 79%, respectively. Heterogeneity was significant, as indicated by chi-square test and an I2 statistic of over 75. CONCLUSIONS: Cervical elastography can be used for predicting preterm deliveries with moderate to high level of accuracy.

Comprehensive evaluation of circRNAs in cirrhotic cardiomyopathy before and after liver transplantation.

Cirrhotic cardiomyopathy (CCM) is a common complication of liver cirrhosis. Many patients with cirrhotic livers do not die from liver failure but from abnormal hemodynamics secondary to liver cirrhosis. Liver transplantation is one of the most effective treatments for liver diseases. Recent studies have found that liver transplantation can reverse CCM and improve cardiac function; however, its role and remedial mechanism remain unclear. Circular RNAs (circRNAs) have become an important marker for diagnosing diseases. The differential expression of circRNAs is associated with heart diseases. In this study, we used gene sequencing to detect the circRNA expression profile of patients with CCM before and after liver transplantation and predicted the differential circRNA target genes. The results showed that a total of 1495 circRNAs were dysregulated after liver transplantation, 1319 genes were downregulated, and 176 were upregulated (P < 0.05, log2 (fold change) > 2.0). The qRT-PCR results showed that circ-ASAP1, circ-N4BP2L2, circ-EXOC6B were significantly downregulated (P < 0.05), which were consistent with the RNA sequencing data, and circ-ASAP1 had the most significant difference. Bioinformatics analysis suggested that mTOR and MAPK signaling pathways might be involved in the pathogenesis of CCM. By constructing a circRNA-miRNA-mRNA interaction network, hsa-miR-197-3p, hsa-miR-483-3p, and hsa-miR-885-3p, particularly key miRNA (hsa-miR-483-3p), were found to be the major potential genes involved in CCM regulation. In summary, this study suggested that circRNAs play a crucial regulatory role in the occurrence of CCM before and after liver transplantation, and their potential biological function might be the key to diagnosis and treatment.

miR-153-3p Targets ßII Spectrin to Regulate Formaldehyde-Induced Cardiomyocyte Apoptosis.

Background: Formaldehyde (FA) is ubiquitous in the environment and can be transferred to the fetus through placental circulation, causing miscarriage and congenital heart disease (CHD). Studies have shown that ßII spectrin is necessary for cardiomyocyte survival and differentiation, and its loss leads to heart development defects and cardiomyocyte apoptosis. Additionally, previous studies have demonstrated that miRNA is essential in heart development and remodeling. However, whether miRNA regulates FA-induced CHD and cardiomyocyte apoptosis remains unclear. Methods: Using commercially available rat embryonic cardiomyocytes and a rat model of fetal cardiomyocyte apoptosis. Real-time quantitative PCR (RT-qPCR) and Western blot were performed to examine the level of miR-153-3p, ßII spectrin, caspase 7, cleaved caspase7, Bax, Bcl-2 expression in embryonic cardiomyocytes and a rat model of fetal cardiomyocyte apoptosis. Apoptotic cell populations were evaluated by flow cytometry and Tunel. Luciferase activity assay and RNA pull-down assay were used to detect the interaction between miR-153-3p and ßII spectrin. Masson's trichrome staining detects the degree of tissue fibrosis. Fluorescence in situ hybridization (FISH) and Immunohistochemistry were used to detect the expression of miR-153-3p and ßII spectrin in tissues. Results: Using commercially available rat embryonic cardiomyocytes and a rat model of fetal cardiomyocyte apoptosis, our studies indicate that miR-153-3p plays a regulatory role by directly targeting ßII spectrin to promote cardiomyocyte apoptosis. miR-153-3p mainly regulates cardiomyocyte apoptosis by regulating the expression of caspase7, further elucidating the importance of apoptosis in heart development. Finally, the results with our animal model revealed that targeting the miR-153-3p/ßII spectrin pathway effectively regulated FA-induced damage during heart development. Recovery experiments with miR-153-3p antagomir resulted in the reversal of FA-induced cardiomyocyte apoptosis and fetal cardiac fibrosis. Conclusion: This study investigated the molecular mechanism underpinning the role of ßII spectrin in FA-induced CHD and the associated upstream miRNA pathway. The study findings suggest that miR-153-3p may provide a potential target for the clinical diagnosis and treatment of CHD.

Comparison of postoperative outcomes following multidetector computed tomography based vs transesophageal echocardiography based annulus sizing for transcatheter aortic valve replacement: A systematic review and meta-analysis.

BACKGROUND: The purpose of this paper was to evaluate the difference in postoperative outcomes following multidetector computed tomography (MDCT) and transesophageal echocardiography (TEE)-based annulus sizing for transcatheter aortic valve replacement (TAVR). METHODS: Electronic search of PubMed, Biomed Central, Scopus, and Google Scholar databases was conducted until August 15, 2019. We included all types of studies comparing MDCT-based annulus sizing with TEE-based annulus sizing and assessing paravalvular regurgitation (PVR). Data were summarized using the Mantel-Haenszel odds ratio (OR) with 95% confidence intervals (CI). RESULTS: A total of six studies were included. Pooled analysis of 431 participants in the MDCT group and 509 participants in the TEE group demonstrated that MDCT-based annulus sizing is associated with a significantly lower incidence of more than moderate PVR as compared to 2DTEE-based sizing (OR: 0.31, 95% CI: 0.18-0.54, P < .0001; I2  = 0%). There was no statistical difference in annulus rupture (OR: 0.57, 95% CI: 0.12-2.66, P = .91; I2  = 0%), procedural mortality (OR: 0.97, 95% CI: 0.19-4.86, P = .97; I2  = 0%), and 30-day mortality (OR: 0.63, 95% CI: 0.26-1.50, P = .29; I2  = 0%) with MDCT or 2DTEE-based annulus sizing. Compared with 3DTEE, the incidence of PVR in the MDCT group was lower, but there was no statistical difference in 30-day mortality. CONCLUSION: Use of MDCT in comparison with 2DTEE is associated with significantly lower incidence of more than moderate PVR after TAVR. There seems to be no difference in annulus rupture and 30-day mortality with either imaging modality.

Novel mutations in genes encoding subcortical maternal complex proteins may cause human embryonic developmental arrest.

Successful human reproduction initiates from normal gamete formation, fertilization and early embryonic development. Abnormalities in any of these steps will lead to infertility. Many infertile patients undergo several failures of IVF and intracytoplasmic sperm injection (ICSI) cycles, and embryonic developmental arrest is a common phenotype in cases of recurrent failure of IVF/ICSI attempts. However, the genetic basis for this phenotype is poorly understood. The subcortical maternal complex (SCMC) genes play important roles during embryonic development, and using whole-exome sequencing novel biallelic mutations in the SCMC genes TLE6, PADI6 and KHDC3L were identified in four patients with embryonic developmental arrest. A mutation in TLE6 was found in a patient with cleaved embryos that arrested on day 3 and failed to form blastocysts. Two patients with embryos that arrested at the cleavage stage had mutations in PADI6, and a mutation in KHDC3L was found in a patient with embryos arrested at the morula stage. No mutations were identified in these genes in an additional 80 patients. These findings provide further evidence for the important roles of TLE6, PADI6 and KHDC3L in embryonic development. This work lays the foundation for the genetic diagnosis of patients with recurrent IVF/ICSI failure.

Effect of Natural Cycle Endometrial Preparation for Frozen-Thawed Embryo Transfer in Patients with Advanced Endometriosis.

BACKGROUND The aim of this study was to investigate the effect of natural cycle (NC) endometrial preparation for frozen-thawed embryo transfer (FET) in women with advanced endometriosis. MATERIAL AND METHODS This retrospective study included 179 patients with stage III-IV endometriosis who underwent 233 FET cycles at a tertiary care academic reproductive medical center between March 2011 and August 2013 (group A). The control group included 258 patients with tubal factor infertility who underwent 300 FET cycles (group B). Both groups were prepared for FET using a NC protocol. Rates of implantation, clinical pregnancy, live birth, ongoing pregnancy, miscarriage, and pregnancy complication were recorded. RESULTS The implantation rate (A: 36.0%, B: 30.4%, P=0.06), the pregnancy rate (A: 50.2%, B: 45.3%, P=0.263), and the live birth rate (A: 39.91%, B: 39.0%, P=0.428) were similar between the stage III-IV endometriosis and tubal factor infertility groups. No differences were observed in ongoing rates of pregnancy, miscarriage, and pregnancy complications, independent of endometriosis severity. No congenital birth defects were found. When high-quality embryos are transferred, pregnancy results were not affected by active endometriosis. Although severe endometriosis did not affect birth rate, higher frequencies of premature delivery (mean gestational age A: 37 weeks, B: 38.3 weeks, P=0.044) and low birth weight were observed (<2500 g A: 26.4%, B: 16.6%, P=0.047). CONCLUSIONS There was no difference in pregnancy outcomes between patients with endometriosis and those with tubal infertility. Pregnancy outcomes in patients with endometriosis were not affected by endometriosis severity. Pregnancy outcomes were not affected by active endometrial cyst.

Analytical solution to predicting gaseous mass flow rates of microchannels in a wide range of Knudsen numbers.

To predict the gaseous mass flow rate of microchannels, conventional analytical solutions based on the Navier-Stokes equation or volume diffusion hydrodynamics (bivelocity hydrodynamics) associated with first-order or second-order slip boundary condition are not very successful, especially in high-Knudsen-number flow. An analytical solution which agrees with experimental data to a Knudsen number of 50 is presented in this paper. To achieve this goal, a concept of effective volume diffusion is defined. Then, with a general slip boundary condition, the gaseous mass flow rate of microchannel is derived by solving the momentum equation of this effective volume diffusion hydrodynamics. Compared with six other analytical solutions and one group of numerical solutions of the linearized Boltzmann equation, this solution is validated by three groups of experimental data. The results not only illustrate an improvement of this solution compared with other analytical solutions but also show the importance of the effective volume diffusion hydrodynamics for compressible microfluids.