Embryologic outcomes among patients using a microfluidics chip compared to density gradient centrifugation to process sperm: a paired analysis

Journal of Assisted Reproduction and Genetics - To evaluate embryologic outcomes among paired IVF cycles in which a microfluidics chip was utilized compared to density gradient centrifugation for...     

Preterm infants who are prone to distress: differential effects of parenting on 36-month behavioral and cognitive outcomes

Background: The differential susceptibility (DS) model suggests that temperamentally prone‐to‐distress infants may exhibit adverse outcomes in negative environments but optimal outcomes in positive environments. This study explored temperament, parenting, and 36‐month cognition and behavior in preterm infants using the DS model. We hypothesized that temperamentally prone to distress preterm infants would exhibit more optimal cognition and fewer behavior problems when early parenting was positive; and less optimal cognition and more behavior problems when early parenting was less positive. Methods: Participants included 109 preterm infants (gestation <37 weeks) and their mothers. We assessed neonatal risk and basal vagal tone in the neonatal intensive care unit; infant temperament and parenting interactions at 9 months post‐term; and child behavior and cognitive skills at 36 months post‐term. Hierarchical regression analyses tested study hypotheses. Results: Temperamentally prone‐to‐distress infants exhibited more externalizing problems if they experienced more critical parenting at 9 months (β = ?.20, p < 0.05) but fewer externalizing problems with more positive parenting. Similarly, variations in maternal positive affect (β = .25, p < .01) and intrusive behaviors (β = .23, p < .05) at 9 months predicted 36‐month cognition at high but not at low levels of infant temperamental distress. Higher basal vagal tone predicted fewer externalizing problems (β = ?.19, p < .05). Conclusions: Early parenting behaviors relate to later behavior and development in preterm infants who are temperamentally prone to distress, and neonatal basal vagal tone predicts subsequent externalizing behaviors. These findings suggest that both biological reactivity and quality of caregiving are important predictors for later outcomes in preterm infants and may be considered as foci for developmental surveillance and interventions.     

Tribal Odisha Eye Disease Study # 11 - Particularly vulnerable tribal group eye health program. Program protocol and validation

Purpose:To describe and validate the eye health program protocol of Dongria tribal community, a particularly vulnerable tribal group (PVTG) in Rayagada district, Odisha, India.Methods:The program would consist of three segments. At people’s residences, trained community health workers (CHWs) will measure the vision and collect demographic data. In addition, vision technicians (VTs) will refract using a hand-held device and prescribe spectacles to people who improve to >6/12, N8. Others would be referred to the vision center (VC). At VC, the VT will perform a slit-lamp examination and re-refract. They would refer people with vision ≤6/12 to the secondary center (SC). At SC, referred people will receive a comprehensive eye examination and treatment. The ophthalmologist will assign the cause of blindness and visual impairment for people with visual acuity <6/12. The entire process was rehearsed in a pilot study.Results:The target population is approximately 10,000 people residing in 101 hutments on the hills of Rayagada district. The pilot study included 126 people. The mean age was 44 ± 18 years; 70% of the people were illiterate, and in this cohort, 97.6% (n = 123) had never worn spectacles. In the pilot study, 41% of the people had cataract, and 12% had pterygium. The agreements between optometrist versus VTs and between optometrist versus CHWs were good (k = ~0.8–1.0) in all eye conditions except for strabismus (k = ~0.56–0.65)Conclusion:The pilot study confirms the program modality, and when completed, it would help in the planning and resource allocation of Odisha PVTG eye care.     

Diseases and Disparities: The Impact of COVID-19 Disruptions on Sexual and Reproductive Health Services Among the HIV Community in India

People with HIV navigate numerous challenges to access healthcare in India. The lockdown in response to the COVID-19 pandemic presents further challenges in accessing sexual and reproductive health (SRH) services. This research explored the impact of the pandemic on SRH services, and the depth of disruptions faced by people living with HIV (PLHIV) in accessing treatment. Using purposive sampling with maximum variation technique, we recruited and conducted 150 telephonic in-depth interviews with PLHIV and HIV care providers (HCPs) from five states in India (Karnataka, Tamil Nadu, Maharashtra, Andhra Pradesh, and Telangana). The interviews were recorded, transcribed, coded, and analyzed using interpretative phenomenological analysis. Five main themes were identified: the effect of COVID-19 on (1) access to care, (2) quality of care, (3) social determinants of health, (4) system and community resilience, and (5) support required to address population-specific vulnerabilities. Despite the availability of free government treatment services during the pandemic, profound disruptions in the SRH services, particularly antiretroviral therapy and HIV care, were reported by PLHIV and HCPs. This qualitative study revealed how existing inequities in HIV treatment and care are exacerbated by the pandemic. These findings highlight that the pandemic response should be community-centered to prevent extreme disruptions in healthcare which will have a disastrous effect on the lives of PLHIV.

     

Comparing trends in mortality from cardiovascular disease and cancer in the United Kingdom, 1983–2013: joinpoint regression analysis

Background

We aimed to study the time trends underlying a change from cardiovascular disease (CVD) to cancer as the most common cause of age-standardized mortality in the UK between 1983 and 2013.

Methods

A retrospective trend analysis of the World Health Organization mortality database for mortality from all cancers, all CVDs, and their three most common types, by sex and age. Age-standardized mortality rates were adjusted to the 2013 European Standard Population and analyzed using joinpoint regression analysis for annual percent changes.

Results

The difference in mortality rate between total CVD and cancer narrowed over the study period as age-standardized mortality from CVD decreased more steeply than cancer in both sexes. We observed higher overall rates for both diseases in men compared to women, with high mortality rates from ischemic heart disease and lung cancer in men. Joinpoint regression analysis indicated that trends of decreasing rates of CVD have increased over time while decreasing trends in cancer mortality rates have slowed down since the 1990s. The lowest improvements in mortality rates were for cancer in those over 75 years of age and lung cancer in women.

Conclusions

In 2011, the age-standardized mortality rate for cancer exceeded that of CVD in both sexes in the UK. These changing trends in mortality may support evidence for changes in policy and resource allocation in the UK.

     

Enhanced oxidative stress in eales disease

A study was undertaken to evaluate oxidative stress and oxidative defense mechanisms in 14 cases of Eales disease with retinal periphlebitis and 10 controls. Alterations in activity of the enzymes sueeroxide dismutase and catalase in platelets and the lipid peroxidation product malondialdehyde were estimated biochemically. Enhanced oxidative stress (significantly increased malondialdehyde levels and decreased superoxide dismutase enzyme activity) was detected. Results suggest involvement of free radicals in the pathogenesis of Eales disease.     

Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States

Objective

To compare level 1 and 2 trauma centers with similarly sized non-trauma centers on survival after major trauma among older adults.

Data Sources and Study Setting

We used claims of 100% of 2012–2017 Medicare fee-for-service beneficiaries who received hospital care after major trauma.

Study Design

Survival differences were estimated after applying propensity-score-based overlap weights. Subgroup analyses were performed for ambulance-transported patients and by external cause. We assessed the roles of prehospital care, hospital quality, and volume.

Data Collection

Data were obtained from the Centers for Medicare and Medicaid Services.

Principal Findings

Thirty-day mortality was higher overall at level 1 versus non-trauma centers by 2.2 (95% confidence interval [CI]: 1.8, 2.6) percentage points (pp). Thirty-day mortality was higher at level 1 versus non-trauma centers by 2.3 (95% CI: 1.9, 2.8) pp for falls and 2.3 (95% CI: 0.2, 4.4) pp for motor vehicle crashes. Differences persisted at 1 year. Level 1 and 2 trauma centers had similar outcomes. Hospital quality and volume did not explain these differences. In the ambulance-transported subgroup, after adjusting for prehospital variables, no statistically significant differences remained.

Conclusions

Trauma centers may not provide longer survival than similarly sized non-trauma hospitals for severely injured older adults.