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1.
Plant Biotechnol J ; 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38923713

RESUMO

Developing early maturing lentil has the potential to minimize yield losses, mainly during terminal drought. Whole-genome resequencing (WGRS) based QTL-seq identified the loci governing earliness in lentil. The genetic analysis for maturity duration provided a good fit to 3:1 segregation (F2), indicating earliness as a recessive trait. WGRS of Globe Mutant (late parent), late-flowering, and early-flowering bulks (from RILs) has generated 1124.57, 1052.24 million raw and clean reads, respectively. The QTL-Seq identified three QTLs (LcqDTF3.1, LcqDTF3.2, and LcqDTF3.3) on chromosome 3 having 246244 SNPs and 15577 insertions/deletions (InDels) and 13 flowering pathway genes. Of these, 11 exhibited sequence variations between bulks and validation (qPCR) revealed a significant difference in the expression of nine candidate genes (LcGA20oxG, LcFRI, LcLFY, LcSPL13a, Lcu.2RBY.3g060720, Lcu.2RBY.3g062540, Lcu.2RBY.3g062760, LcELF3a, and LcEMF1). Interestingly, the LcELF3a gene showed significantly higher expression in late-flowering genotype and exhibited substantial involvement in promoting lateness. Subsequently, an InDel marker (I-SP-383.9; LcELF3a gene) developed from LcqDTF3.2 QTL region showed 82.35% PVE (phenotypic variation explained) for earliness. The cloning, sequencing, and comparative analysis of the LcELF3a gene from both parents revealed 23 SNPs and InDels. Interestingly, a 52 bp deletion was recorded in the LcELF3a gene of L4775, predicted to cause premature termination of protein synthesis after 4 missense amino acids beyond the 351st amino acid due to the frameshift during translation. The identified InDel marker holds significant potential for breeding early maturing lentil varieties.

2.
Endoscopy ; 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38942058

RESUMO

Introduction The role of endoscopic submucosal dissection (ESD) in the treatment of Barrett's associated neoplasia (BEN) has been evolving. We examined the efficacy and safety of ESD and EMR for BEN. Methods A database search was performed for studies reporting efficacy and safety outcomes of ESD and EMR for BEN. Pooled proportional and comparative meta-analyses were performed. Results 47 studies (23 ESD, 19 EMR, and 5 comparative) were included. Mean lesion size for ESD and EMR were 22.5 mm and 15.8 mm respectively. Majority of lesions were Paris type IIa. Pooled analysis for ESD showed en-bloc resection, R0 resection, curative resection, and local recurrence rates of 98%, 78%, 65%, and 2%, respectively. Complete eradication of dysplasia (CE-D) and complete eradication of intestinal metaplasia (CE-IM) were achieved in 94% and 59% of cases. Pooled rates of perforation, intraprocedural bleeding (IPB), delayed bleeding (DB), and stricture were 1%, 1%, 2%, and 10%, respectively. Pooled analysis for EMR showed en-bloc resection, R0 resection, curative resection, and local recurrence rates of 37%, 67%, 62%, and 6%, respectively. CE-D and CE-IM were achieved in 94% and 76% of cases. Pooled rates of perforation, IPB, DB, and stricture were 0.1%, 1%, 0.4%, and 7.7%, respectively. The mean procedure time for ESD and EMR were 111.3 and 22.3 mins respectively. Comparative analysis showed higher en-bloc and R0 resection rates with ESD compared to EMR, with comparable adverse events. Conclusion ESD and EMR both can be employed to treat BEN depending on the lesion type, size, and expertise.

3.
PLoS One ; 19(5): e0302870, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38776345

RESUMO

The systematic identification of insertion/deletion (InDel) length polymorphisms from the entire lentil genome can be used to map the quantitative trait loci (QTL) and also for the marker-assisted selection (MAS) for various linked traits. The InDels were identified by comparing the whole-genome resequencing (WGRS) data of two extreme bulks (early- and late-flowering bulk) and a parental genotype (Globe Mutant) of lentil. The bulks were made by pooling 20 extreme recombinant inbred lines (RILs) each, derived by crossing Globe Mutant (late flowering parent) with L4775 (early flowering parent). Finally, 734,716 novel InDels were identified, which is nearly one InDel per 5,096 bp of lentil genome. Furthermore, 74.94% of InDels were within the intergenic region and 99.45% displayed modifier effects. Of these, 15,732 had insertions or deletions of 20 bp or more, making them amenable to the development of PCR-based markers. An InDel marker I-SP-356.6 (chr. 3; position 356,687,623; positioned 174.5 Kb from the LcFRI gene) was identified as having a phenotypic variance explained (PVE) value of 47.7% for earliness when validated in a RIL population. Thus, I-SP-356.6 marker can be deployed in MAS to facilitate the transfer of the earliness trait to other elite late-maturing cultivars. Two InDel markers viz., I-SP-356.6 and I-SP-383.9 (chr. 3; linked to LcELF3a gene) when tested in 9 lentil genotypes differing for maturity duration, clearly distinguished three early (L4775, ILL7663, Precoz) and four late genotypes (Globe Mutant, MFX, L4602, L830). However, these InDels could not be validated in two genotypes (L4717, L4727), suggesting either absence of polymorphism and/or presence of other loci causing earliness. The identified InDel markers can act as valuable tools for MAS for the development of early maturing lentil varieties.


Assuntos
Genoma de Planta , Genótipo , Mutação INDEL , Lens (Planta) , Locos de Características Quantitativas , Lens (Planta)/genética , Lens (Planta)/crescimento & desenvolvimento , Marcadores Genéticos , Reação em Cadeia da Polimerase/métodos , Mapeamento Cromossômico/métodos
5.
Indian J Community Med ; 49(2): 354-359, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38665442

RESUMO

Background: The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. Objective: To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight. Methods: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. Results: Prevalence of LBW newborns was higher in mothers with late ANC registration, <4 ANC visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns', current pregnancy birth order number more than 2, in pre term newborns' and mothers with bad obstetric history. Conclusion: Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life.

6.
Risk Anal ; 2024 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-38462733

RESUMO

Catastrophe bonds (cat bond in short) are an alternative risk-transfer instrument used to transfer peril-specific financial risk from governments, financial institutions, or (re)insurers, to the capital market. Current approaches for cat bond pricing are calibrated on seismic mainshocks, and thus do not account for potential effects induced by earthquake sequences. This simplifying assumption implies that damage arises from mainshocks only, while aftershocks yield no damage. Postearthquake field surveys reveal that this assumption is inaccurate. For example, in the 2011 Christchurch Earthquake sequence and 2016-2017 Central Italy Earthquake sequence, aftershocks were responsible for higher economic losses when compared to those caused by mainshocks. This article proposes a time-dependent aggregate loss model that takes into account seismicity clustering and damage accumulation effects in the computation of damage. The model is calibrated on the seismic events recorded during the recent 2016-2017 Central Italy Earthquake sequence. Furthermore, the effects of earthquake sequence on cat bond pricing is explored by implementing the proposed model on five Italian municipalities. The investigation showed that neglecting time-dependency may lead to higher difference (up to 45%) in the cat bond price when compared to standard approaches.

7.
Artigo em Inglês | MEDLINE | ID: mdl-38056803

RESUMO

BACKGROUND AND AIMS: Benefits of computer-aided detection (CADe) in detecting colorectal neoplasia were shown in many randomized trials in which endoscopists' behavior was strictly controlled. However, the effect of CADe on endoscopists' performance in less-controlled setting is unclear. This systematic review and meta-analyses were aimed at clarifying benefits and harms of using CADe in real-world colonoscopy. METHODS: We searched MEDLINE, EMBASE, Cochrane, and Google Scholar from inception to August 20, 2023. We included nonrandomized studies that compared the effectiveness between CADe-assisted and standard colonoscopy. Two investigators independently extracted study data and quality. Pairwise meta-analysis was performed utilizing risk ratio for dichotomous variables and mean difference (MD) for continuous variables with a 95% confidence interval (CI). RESULTS: Eight studies were included, comprising 9782 patients (4569 with CADe and 5213 without CADe). Regarding benefits, there was a difference in neither adenoma detection rate (44% vs 38%; risk ratio, 1.11; 95% CI, 0.97 to 1.28) nor mean adenomas per colonoscopy (0.93 vs 0.79; MD, 0.14; 95% CI, -0.04 to 0.32) between CADe-assisted and standard colonoscopy, respectively. Regarding harms, there was no difference in the mean non-neoplastic lesions per colonoscopy (8 studies included for analysis; 0.52 vs 0.47; MD, 0.14; 95% CI, -0.07 to 0.34) and withdrawal time (6 studies included for analysis; 14.3 vs 13.4 minutes; MD, 0.8 minutes; 95% CI, -0.18 to 1.90). There was a substantial heterogeneity, and all outcomes were graded with a very low certainty of evidence. CONCLUSION: CADe in colonoscopies neither improves the detection of colorectal neoplasia nor increases burden of colonoscopy in real-world, nonrandomized studies, questioning the generalizability of the results of randomized trials.

8.
Front Nutr ; 10: 1141040, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37396135

RESUMO

The world's most challenging environmental issue is climate change. Agricultural productivity and nutritional quality are both substantially threatened by extreme and unpredicted climate events. To develop climate resilient cultivars, stress tolerance along with the grain quality needs to be prioritized. Present study was planned to assess the effect of water limitation on seed quality in lentil, a cool season legume crop. A pot experiment was carried out with 20 diverse lentil genotypes grown under normal (80% field capacity) and limited (25% field capacity) soil moisture. Seed protein, Fe, Zn, phytate, protein and yield were recorded in both the conditions. Seed yield and weight were reduced by 38.9 and 12.1%, respectively, in response to stress. Seed protein, Fe, Zn, its availability as well as antioxidant properties also reduced considerably, while genotype dependent variation was noted with respect to seed size traits. Positive correlation was observed between seed yield and antioxidant activity, seed weight and Zn content and availability in stress. Based on principal component analysis and clustering, IG129185, IC559845, IC599829, IC282863, IC361417, IG334, IC560037, P8114 and L5126 were promising genotypes for seed size, Fe and protein content, while, FLIP-96-51, P3211 and IC398019 were promising for yield, Zn and antioxidant capacity. Identified lentil genotypes can be utilized as trait donors for quality improvement in lentil breeding.

9.
Front Plant Sci ; 13: 984912, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36204050

RESUMO

Crop yield varies considerably within agroecology depending on the genetic potential of crop cultivars and various edaphic and climatic variables. Understanding site-specific changes in crop yield and genotype × environment interaction are crucial and needs exceptional consideration in strategic breeding programs. Further, genotypic response to diverse agro-ecologies offers identification of strategic locations for evaluating traits of interest to strengthen and accelerate the national variety release program. In this study, multi-location field trial data have been used to investigate the impact of environmental conditions on crop phenological dynamics and their influence on the yield of mungbean in different agroecological regions of the Indian subcontinent. The present attempt is also intended to identify the strategic location(s) favoring higher yield and distinctiveness within mungbean genotypes. In the field trial, a total of 34 different mungbean genotypes were grown in 39 locations covering the north hill zone (n = 4), northeastern plain zone (n = 6), northwestern plain zone (n = 7), central zone (n = 11) and south zone (n = 11). The results revealed that the effect of the environment was prominent on both the phenological dynamics and productivity of the mungbean. Noticeable variations (expressed as coefficient of variation) were observed for the parameters of days to 50% flowering (13%), days to maturity (12%), reproductive period (21%), grain yield (33%), and 1000-grain weight (14%) across the environments. The genotype, environment, and genotype × environment accounted for 3.0, 54.2, and 29.7% of the total variation in mungbean yield, respectively (p < 0.001), suggesting an oversized significance of site-specific responses of the genotypes. Results demonstrated that a lower ambient temperature extended both flowering time and the crop period. Linear mixed model results revealed that the changes in phenological events (days to 50 % flowering, days to maturity, and reproductive period) with response to contrasting environments had no direct influence on crop yields (p > 0.05) for all the genotypes except PM 14-11. Results revealed that the south zone environment initiated early flowering and an extended reproductive period, thus sustaining yield with good seed size. While in low rainfall areas viz., Sriganganagar, New Delhi, Durgapura, and Sagar, the yield was comparatively low irrespective of genotypes. Correlation results and PCA indicated that rainfall during the crop season and relative humidity significantly and positively influenced grain yield. Hence, the present study suggests that the yield potential of mungbean is independent of crop phenological dynamics; rather, climatic variables like rainfall and relative humidity have considerable influence on yield. Further, HA-GGE biplot analysis identified Sagar, New Delhi, Sriganganagar, Durgapura, Warangal, Srinagar, Kanpur, and Mohanpur as the ideal testing environments, which demonstrated high efficiency in the selection of new genotypes with wider adaptability.

10.
Sci Rep ; 12(1): 9729, 2022 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-35697744

RESUMO

Catastrophe risk-based bonds are used by governments, financial institutions and (re)insurers to transfer the financial risk associated to the occurrence of catastrophic events, such as earthquakes, to the capital market. In this study, we show how municipalities prone to earthquakes can use this type of insurance-linked security to protect their building stock and communities from economic losses, and ultimately increase their earthquake resilience. We consider Benevento, a middle-sized historical town in southern Italy, as a case study, although the same approach is applicable to other urban areas in seismically active regions. One of the crucial steps in pricing catastrophe bonds is the computation of aggregate losses. We compute direct economic losses for each exposed asset based on high spatial resolution hazard and exposure models. Finally, we use the simulated loss data to price two types of catastrophe bonds (zero-coupon and coupon bonds) for different thresholds and maturity times. Although the present application focuses on earthquakes, the framework can potentially be applied to other natural disasters, such as hurricanes, floods, and other extreme weather events.


Assuntos
Tempestades Ciclônicas , Terremotos , Seguro , Cidades , Custos e Análise de Custo
11.
World J Gastroenterol ; 28(11): 1113-1122, 2022 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-35431503

RESUMO

Barrett's esophagus (BE) is a well-established risk factor for esophageal adenocarcinoma. It is recommended that patients have regular endoscopic surveillance, with the ultimate goal of detecting early-stage neoplastic lesions before they can progress to invasive carcinoma. Detection of both dysplasia or early adenocarcinoma permits curative endoscopic treatments, and with this aim, thorough endoscopic assessment is crucial and improves outcomes. The burden of missed neoplasia in BE is still far from being negligible, likely due to inappropriate endoscopic surveillance. Over the last two decades, advanced imaging techniques, moving from traditional dye-spray chromoendoscopy to more practical virtual chromoendoscopy technologies, have been introduced with the aim to enhance neoplasia detection in BE. As witnessed in other fields, artificial intelligence (AI) has revolutionized the field of diagnostic endoscopy and is set to cover a pivotal role in BE as well. The aim of this commentary is to comprehensively summarize present evidence, recent research advances, and future perspectives regarding advanced imaging technology and AI in BE; the combination of computer-aided diagnosis to a widespread adoption of advanced imaging technologies is eagerly awaited. It will also provide a useful step-by-step approach for performing high-quality endoscopy in BE, in order to increase the diagnostic yield of endoscopy in clinical practice.


Assuntos
Adenocarcinoma , Esôfago de Barrett , Neoplasias Esofágicas , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Inteligência Artificial , Esôfago de Barrett/diagnóstico por imagem , Esôfago de Barrett/epidemiologia , Endoscopia/métodos , Neoplasias Esofágicas/diagnóstico , Esofagoscopia/métodos , Humanos
12.
Wound Manag Prev ; 68(1): 16-21, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35263274

RESUMO

BACKGROUND: Necrotizing soft tissue infection (NSTI) is rare and characterized by rapid onset and spread of inflammation and necrosis. The infection starts within the fascia but can rapidly progress to include musculature, subcutaneous fat, and overlying skin. Its presentation is considered a surgical emergency. Persons who use intravenous or subcutaneous opioids are at higher risk of NSTIs. PURPOSE: The purpose of this case report is to describe the positive clinical outcome after consulting with wound specialists and using a dressing regimen to expedite more rapid wound healing, shortened time to skin graft, and improved pain tolerance in a patient with a history of intravenous and subcutaneous heroin use. CASE REPORT: The patient presented with an NSTI that required extensive debridement of the bilateral upper extremities. The acute surgical wound service was consulted. A dressing regimen consisting of hypochlorous acid-preserved wound cleansing, followed by carboxymethylcellulose fiber with 1.2% ionic silver covered by hydrocellular foam to promote a moist healing environment, was used to facilitate granulation. RESULTS: Healthy granulation tissue was noted 6 days after debridement. The improved rate of granulation and the patient's tolerance to dressing changes secondary to decreased pain from these dressings significantly expedited the time to graft and wound healing. The patient underwent split-thickness skin grafting 10 days after debridement. There was 100% uptake of the grafts on postgraft day 8. CONCLUSION: The favorable clinical outcome suggests that early consultation with wound specialists and implementation of the dressing regimen were effective in this patient regarding improved pain control and healing. However, because the patient left against medical advice on hospital day 20, the clinical course could not be followed beyond the first few postoperative weeks.


Assuntos
Transplante de Pele , Infecções dos Tecidos Moles , Bandagens , Antebraço , Heroína , Humanos , Dor
13.
Psychiatr Clin North Am ; 45(1): 211-225, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35219439

RESUMO

Across the nation, each organization and every leadership team has become battle-tested during the coronavirus disease 2019 (COVID-19) pandemic. Health care has been impacted in every community, and the mental health toll of the pandemic continues to worsen each day. Key leadership and operational lessons learned during COVID are presented for a health system with 387 care sites, across 160 programs, serving 70,000 patients. General preparedness, maintaining access to care, staffing plan strategies, supporting our employees, and moving forward beyond the pandemic are presented.


Assuntos
COVID-19 , Atenção à Saúde , Humanos , Liderança , Pandemias , SARS-CoV-2
14.
Dig Dis Sci ; 67(11): 5034-5043, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35128607

RESUMO

BACKGROUND: We aimed to understand the association of gastrointestinal (GI) symptoms at initial presentation with clinical outcomes during COVID-19 hospitalization. METHODS: This retrospective, multicenter cohort study included consecutive hospitalized COVID-19 patients from a single, large health system. The presence of GI symptoms was assessed at initial presentation and included one or more of the following: nausea, vomiting, diarrhea and abdominal pain. Patients were divided into three cohorts: Only GI symptoms, GI and non-GI symptoms and only non-GI symptoms. The primary outcome was association of GI symptoms with mortality. Secondary outcomes included prevalence of GI symptoms and survival analysis. RESULTS: A total of 1672 COVID-19 patients were hospitalized (mean age: 63 ± 15.8 years, females: 50.4%) in our system during the study period. 40.7% patients had at least one GI symptom (diarrhea in 28.3%, nausea/vomiting in 23%, and abdominal pain in 8.8% patients), and 2.6% patients had only GI symptoms at initial presentation. Patients presenting with GI symptoms (with or without non-GI symptoms) had a lower mortality rate compared to patients presenting with only non-GI symptoms (20% vs. 26%; p < 0.05). The time from hospitalization to being discharged was less for patients presenting with only GI symptoms (7.4 days vs. > 9 days, p < 0.0014). After adjusting for other factors, the presence of GI symptoms was not associated with mortality (p > 0.05). CONCLUSION: Among a hospitalized COVID-19 positive Southern US population, 41% patients presented with either diarrhea, nausea, vomiting or abdominal pain initially. The presence of GI symptoms has no association with in-hospital all-cause mortality.


Assuntos
COVID-19 , Gastroenteropatias , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , COVID-19/complicações , COVID-19/terapia , SARS-CoV-2 , Estudos Retrospectivos , Estudos de Coortes , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Náusea/epidemiologia , Náusea/etiologia , Vômito/epidemiologia , Vômito/etiologia , Diarreia/epidemiologia , Diarreia/etiologia , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia
15.
Drug Dev Res ; 83(2): 416-431, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34414591

RESUMO

Drug resistance in tuberculosis poses a serious threat to humanity because currently available antitubercular drugs are ineffective against Mycobacterium tuberculosis (M. tuberculosis). As a result, the approval of Bedaquiline and Delamanid for the treatment of drug-resistant tuberculosis was accelerated. Still, there is an urgent need to search for new antitubercular drugs with novel mechanisms of action (MoA). Due to this, we have designed a synthetic strategy by utilizing microwave-assisted organic synthesis. We have compared our method with the conventional procedure, and the data show that our procedure is more effective in the preparation of title compounds. A unique series of 1-(2-(furan-2-yl)-5-(pyridin-4-yl)-1,3,4-oxadiazol-3(2H)-yl)-3-(aryl)-prop-2-en-1-ones (5a-o) was synthesized utilizing conventional and microwave-assisted techniques. Synthetic compounds were investigated for antitubercular activity against Mycobacterium TB H37 Ra and Mycobacterium bovis (M. bovis). Compound 5b was reported to be the most effective against M. tuberculosis H37 Ra (97.69 percent inhibition at 30 µg/ml) and M. bovis (97.09 percent inhibition at 30 µg/ml). An in silico binding affinity study of mycobacterial enoyl-acyl carrier protein reductase (InhA) reveals the binding mechanism and thermodynamic interactions that determine these molecule's binding affinity. Compound 5b had a high glide score of -8.991 and low glide energy of -49.893 kcal/mol.


Assuntos
Mycobacterium tuberculosis , Tuberculose , Antituberculosos/química , Técnicas de Química Sintética , Furanos/farmacologia , Furanos/uso terapêutico , Humanos , Testes de Sensibilidade Microbiana , Micro-Ondas , Simulação de Acoplamento Molecular , Piridinas/farmacologia , Relação Estrutura-Atividade , Tuberculose/tratamento farmacológico
16.
Eur J Gastroenterol Hepatol ; 33(1S Suppl 1): e78-e83, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34907984

RESUMO

In the last decade, flexible endoscopic septotomy has been reported as a well-tolerated and effective treatment for Zenker's diverticulum. More recently, novel endoscopic submucosal tunneling techniques, namely Zenker-PerOral Endoscopic Myotomy (Z-POEM) and PerOral Endoscopic Septotomy (POES) have been proposed to obtain complete muscular septum exposure and deeper myotomy. The aim of this study is to provide a systematic review with a meta-analysis of the first experiences of third space approaches for Zenker's diverticulum. Electronic databases (Medline, Scopus, EMBASE) were searched up to October 2020. Studies including patients with symptomatic Zenker's diverticulum who underwent endoscopic treatment by submucosal tunneling technique were eligible. Procedural, clinical and safety outcomes were assessed by pooling data with a random-effect model to obtain a proportion with a 95% confidence interval. Nine retrospective studies were eligible for inclusion (196 patients). Five studies were performed in the USA, two in Europe and two in Asia. Endoscopic treatment was feasible in 96.9% (I2 = 0%) of patients. The mean procedure duration was 36.4 ± 14.3 minutes. Clinical success was achieved after 93.4% (I2 = 0%) of procedures. The overall adverse events rate was 4.9% (I2 = 0%). No differences between the two approaches (Z-POEM vs POES) have been shown in terms of both efficacy and safety. Submucosal tunneling techniques appear to be feasible for symptomatic Zenker's diverticulum, with promising results in terms of efficacy and safety outcomes.


Assuntos
Miotomia , Divertículo de Zenker , Endoscopia , Esofagoscopia/efeitos adversos , Humanos , Miotomia/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Divertículo de Zenker/etiologia , Divertículo de Zenker/cirurgia
17.
Mayo Clin Proc ; 96(12): 3030-3041, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34863394

RESUMO

OBJECTIVE: To evaluate clinical characteristics of patients admitted to the hospital with coronavirus disease 2019 (COVID-19) in Southern United States and development as well as validation of a mortality risk prediction model. PATIENTS AND METHODS: Southern Louisiana was an early hotspot during the pandemic, which provided a large collection of clinical data on inpatients with COVID-19. We designed a risk stratification model to assess the mortality risk for patients admitted to the hospital with COVID-19. Data from 1673 consecutive patients diagnosed with COVID-19 infection and hospitalized between March 1, 2020, and April 30, 2020, was used to create an 11-factor mortality risk model based on baseline comorbidity, organ injury, and laboratory results. The risk model was validated using a subsequent cohort of 2067 consecutive hospitalized patients admitted between June 1, 2020, and December 31, 2020. RESULTS: The resultant model has an area under the curve of 0.783 (95% CI, 0.76 to 0.81), with an optimal sensitivity of 0.74 and specificity of 0.69 for predicting mortality. Validation of this model in a subsequent cohort of 2067 consecutively hospitalized patients yielded comparable prognostic performance. CONCLUSION: We have developed an easy-to-use, robust model for systematically evaluating patients presenting to acute care settings with COVID-19 infection.


Assuntos
COVID-19 , Hospitalização/estatística & dados numéricos , Modelos de Riscos Proporcionais , Medição de Risco/métodos , COVID-19/mortalidade , COVID-19/prevenção & controle , COVID-19/terapia , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/estatística & dados numéricos , Comorbidade , Modelos Epidemiológicos , Feminino , Mortalidade Hospitalar , Humanos , Louisiana/epidemiologia , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Prognóstico , Reprodutibilidade dos Testes , Fatores de Risco , Índice de Gravidade de Doença
18.
Front Plant Sci ; 12: 766645, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34966400

RESUMO

Micronutrient malnutrition or hidden hunger is a serious challenge toward societal well-being. Vigna stipulacea (Lam.) Kuntz (known locally as Minni payaru), is an underutilized legume that has the potential to be a global food legume due to its rich nutrient profile. In the present study, 99 accessions of V. stipulacea were tested for iron (Fe), zinc (Zn), calcium (Ca), protein, and phytate concentrations over two locations for appraisal of stable nutrient-rich sources. Analysis of variance revealed significant effects of genotype for all the traits over both locations. Fe concentration ranged from 29.35-130.96 mg kg-1 whereas Zn concentration ranged from 19.44 to 74.20 mg kg-1 across both locations. The highest grain Ca concentration was 251.50 mg kg-1 whereas the highest grain protein concentration was recorded as 25.73%. In the case of grain phytate concentration, a genotype with the lowest value is desirable. IC622867 (G-99) was the lowest phytate containing accession at both locations. All the studied traits revealed highly significant genotypic variances and highly significant genotype × location interaction though less in magnitude than the genotypic variance. GGE Biplot analysis detected that, for grain Fe, Zn, and Ca concentration the 'ideal' genotypes were IC331457 (G-75), IC331610 (G-76), and IC553564 (G-60), respectively, whereas for grain protein concentration IC553521 (G-27) was the most "ideal type." For phytate concentration, IC351407 (G-95) and IC550523 (G-99) were considered as 'ideal' and 'desirable,' respectively. Based on the desirability index, Location 1 (Kanpur) was identified as ideal for Fe, Zn, Ca, and phytate, and for grain protein concentration, Location 2 (New Delhi) was the ideal type. A significant positive correlation was detected between grain Fe as well as grain Zn and protein concentration considering the pooled analysis over both the locations where as a significant negative association was observed between phytate and protein concentration over the locations. This study has identified useful donors and enhanced our knowledge toward the development of biofortified Vigna cultivars. Promoting domestication of this nutrient-rich semi-domesticated, underutilized species will boost sustainable agriculture and will contribute toward alleviating hidden hunger.

19.
Cancer Lett ; 521: 238-251, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34506845

RESUMO

This study aimed to evaluate the global distribution, associated factors, and epidemiologic trends of gallbladder cancer (GBC) by country, sex, and age groups. The Global Cancer Observatory was interrogated for the disease burden of GBC using age-standardized rates (ASR). The prevalence of different potential risk factors for each country was extracted from Global Health Observatory and their associations with GBC incidence and mortality were examined by linear regression analysis using beta coefficients (ß). The Cancer Incidence in Five Continents I-XI and the WHO Mortality database were searched and Average Annual Percent Change (AAPC) was generated from joinpoint regression analysis. The incidence (ASR = 2.3) and mortality (ASR = 1.7) of GBC varied globally in 2018 and were higher in more developed countries and among females. Countries with higher incidence had higher human development index (ßmale = 0.37; ßfemale = 0.27), gross domestic products (ßmale = 0.13) and higher prevalence of current smoking (ßfemale = 0.05), overweight (ßmale = 0.02), obesity (ßmale = 0.03), and hypercholesterolaemia (ßmale = 0.07). Similar patterns of associations were also observed for mortality with an additional association found for diabetes (ßfemale = 0.07). Although there was an overall decreasing trend in mortality, an increasing trend in incidence was observed among some populations, particularly in males (AAPCs, 8.97 to 1.92) and in younger individuals aged <50 years (AAPCs, 12.02 to 5.66). The incidence of GBC varied between countries and was related to differences in the prevalence of potential risk factors. There was an increasing incidence trend among males and younger individuals. More intensive lifestyle modifications and disease surveillance are recommended for these populations.

20.
Front Plant Sci ; 12: 710812, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34497624

RESUMO

Mungbeans and lentils are relatively easily grown and cheaper sources of microgreens, but their phytonutrient diversity is not yet deeply explored. In this study, 20 diverse genotypes each of mungbean and lentil were grown as microgreens under plain-altitude (Delhi) and high-altitude (Leh) conditions, which showed significant genotypic variations for ascorbic acid, tocopherol, carotenoids, flavonoid, total phenolics, DPPH (1, 1-diphenyl-2-picrylhydrazyl), FRAP (ferric-reducing antioxidant power), peroxide activity, proteins, enzymes (peroxidase and catalase), micronutrients, and macronutrients contents. The lentil and mungbean genotypes L830 and MH810, respectively, were found superior for most of the studied parameters over other studied genotypes. Interestingly, for most of the studied parameters, Leh-grown microgreens were found superior to the Delhi-grown microgreens, which could be due to unique environmental conditions of Leh, especially wide temperature amplitude, photosynthetically active radiation (PAR), and UV-B content. In mungbean microgreens, total phenolics content (TPC) was found positively correlated with FRAP and DPPH, while in lentil microgreens, total flavonoid content (TFC) was found positively correlated with DPPH. The most abundant elements recorded were in the order of K, P, and Ca in mungbean microgreens; and K, Ca, and P in the lentil microgreens. In addition, these Fabaceae microgreens may help in the nutritional security of the population residing in the high-altitude regions of Ladakh, especially during winter months when this region remains landlocked due to heavy snowfall.

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