Hypoxic Culture Conditions as a Solution for Mesenchymal Stem Cell Based Regenerative Therapy

Cell-based regenerative therapies, based on in vitro propagation of stem cells, offer tremendous hope to many individuals suffering from degenerative diseases that were previously deemed untreatable. Due to the self-renewal capacity, multilineage potential, and immunosuppressive property, mesenchymal stem cells (MSCs) are considered as an attractive source of stem cells for regenerative therapies. However, poor growth kinetics, early senescence, and genetic instability during in vitro expansion and poor engraftment after transplantation are considered to be among the major disadvantages of MSC-based regenerative therapies. A number of complex inter-and intracellular interactive signaling systems control growth, multiplication, and differentiation of MSCs in their niche. Common laboratory conditions for stem cell culture involve ambient O-2 concentration (20%) in contrast to their niche where they usually reside in 2-9% O-2. Notably, O-2 plays an important role in maintaining stem cell fate in terms of proliferation and differentiation, by regulating hypoxia-inducible factor-1 (HIF-1) mediated expression of different genes. This paper aims to describe and compare the role of normoxia (20% O-2) and hypoxia (2-9% O-2) on the biology of MSCs. Finally it is concluded that a hypoxic environment can greatly improve growth kinetics, genetic stability, and expression of chemokine receptors during in vitro expansion and eventually can increase efficiency of MSC-based regenerative therapies.Article Link: http://www.hindawi.com/journals/tswj/2013/632972

Prevalence of Chlamydia trachomatis infection in the general population of women in Qatar

Objectives The Arabian Gulf region has limited epidemiological data related to sexually transmitted infections. The objective of this study was to estimate the prevalence of Chlamydia trachomatis infection among general population women in Doha, Qatar. Methods Endocervical swabs were collected from healthy women attending primary healthcare centres in Doha, June–December 2008. The specimens were tested for C trachomatis by a commercially available PCR-based assay. Data on basic socio-demographic characteristics, medical history and sexual behaviour were obtained using self-administered questionnaires. The prevalence of C trachomatis and of background variables were stratified by nationality, Qatari nationals versus non-Qatari residents. Results A total of 377 women were enrolled in the study, out of whom 351 (37.9% Qataris, 62.1% non- Qataris) were tested for the presence of C trachomatis in their specimens. The mean age of participants was 41.2 years, and the vast majority (93%, 95% CI 90.3 to 95.7) were married. The mean age at sexual debut was significantly lower among Qatari women compared with non-Qatari women (19.2 vs 22.2 years, respectively p<0.001), but the mean number of reported lifetime sexual partners (1.1 partner) was nearly the same in both groups (p=0.110). The prevalence of C trachomatis infection was 5.3% among Qatari women and 5.5% among non-Qatari women, with no statistically significant difference between both groups ( p=0.923). Conclusions The prevalence of C trachomatis among women was higher than expected, with no significant difference between Qatari nationals and expatriate residents. The higher prevalence may reflect, in part, the limited access to and use of chlamydia screening and management.Research Committee of the College of Arts and Sciences, Qatar University (QUUG-CAS-DHS-10/11-6); Qatar National Research Fund (NPRP 4-924-3-251); The Biostatistics, Epidemiology, and Biomathematics Research Core at the Weill Cornell Medical Colleg

Management of Chest Injuries: A prospective study

Objective: Chest injuries constitute a continuing challenge, relating to the trauma team or general surgeon, who practicing in a developing country. This study reviews the pattern and management of these injuries mainly by general surgeons. Methods: A prospective review of 112 patients admitted into the surgical wards of the the AL-Gumhouri-Teaching Hospital Sana'a between March 2006 and August 2009. Results: 112 patients with various forms of chest injuries were managed in the AL-Gumhouri Teaching Hospital Sana'a between March 2006 and August 2009. There were 100 (89.3%) males and 12 (10.7%) females.. The age ranged between 16-45 years, with a mean of 26.4 years. Most of the injuries, 68 (60.7%) were penetrating, 42 (37.5%) were due to gun shots and 26 (23.2%) from stab wounds. Blunt injuries constituted the remaining 44 (39.3%), 36 (32.1%) were due to road traffic accident and 8 (7.2%) fall from height. All patients had chest radiographs.The commonest abnormal findings were rib fractures 38 (33.9%), pneumothorax 36 (32.14%), haemothorax 30 (26.8%), haemopneumothorax 24 (21.43%). Most patients 80 (71.4%) required tube thoracostomy as definitive treatment. Ten patients (8.9%) required thoracotomy. The commonest extra-thoracic associated injuries were abdominal injuries in 12 (10.7%), head injuries 6 (5.4%), limb fractures 4 (3.6%), one (0.9%) vertebral bodies fracture. and eight (8.04%) had multiple injuries involving thorax with more than two body systems .The most encountered complications were posttraumatic infection. The overall mortality rate was (8.9%). Conclusion: Penetrating injury of chest is the most common causes of chest injuries in adults in this study although blunt trauma is still common.The majority of the chest trauma are successfully managed by tube thoracostomy and supportive measures

Strategic Approaches to Design Teams for Construction Quality Management and Green Building Performance

Buildings exert a profound influence on the environment, with the design phase recognized as the pivotal determinant of a building’s overall performance. Green building design, in particular, introduces heightened complexity, where the attributes of the design team play a pivotal role in shaping performance outcomes. Consequently, the characteristics of the design team emerge as crucial factors in the enhancement of both green building design performance and client attributes. This study aims to empirically examine a model formulated to gauge the extent to which Effective Design Team Attributes contribute to the enhancement of performance in designing green buildings and influencing client attributes. To achieve this objective, a comprehensive questionnaire survey was administered to professionals within the architecture and engineering domains actively engaged in the design and consulting sectors of the building industry. The collected data underwent meticulous scrutiny for authenticity and dependability using the WINSTEPS 5.2.5 software before undergoing subsequent analysis. Statistical analyses were conducted using SPSS version 19, with Principal Components Analysis (PCA) and the Structural Equation Modeling (SEM) approach implemented through Amos version 18 to derive the most robust model. The findings underscore the pivotal role of an adeptly managed design team in significantly improving both the performance of green building designs and the qualities of clients. Rasch’s analysis confirmed the validity of our 5-point Likert scale for Design Green Building Performance (DGBP), Effective Design Team Attributes (EDTA), and Client Qualities (CQ). All items demonstrated excellent reliability, separation, and discrimination, ensuring robust data quality. Dimensionality tests revealed the appropriateness of response categories, indicating satisfactory scale performance. The Effective Design Team Model, validated through Principal Components Analysis (PCA), exhibited a satisfactory fit, supported by significant chi-square statistics, high goodness-of-fit indices, and acceptable root mean square residual values. Client attributes displayed a strong association with effective design team management, validating key model elements. The intricacies inherent in the design process can be mitigated by adopting the green design charrette approach. Consequently, the establishment of an effective design team, coupled with green design leadership, active participation, and clarity in roles and responsibilities, emerges as a potent strategy for elevating the performance level of green building designs

Opportunities and Challenges in Designing Participant-Centric Smoking Cessation System

Smoking is one of the most challenging behavioral health problems. In the past, failed quit attempts have been attributed to factors including stress, presence of smoking cues, and negative affect-most of which were self-reported and prone to recall-bias. The first step in designing effective smoking cessation systems is to objectively identify factors that contribute to lapse. In our research, we collected physiological data utilizing wearable sensors from a four day pre-quit, post-quit study (N=55). We also collected self-report measures (n=3120), which offer rich contextual information about users\u27 social, emotional, geographical, and physiological conditions. Analysis of collected data informed the design of MyQuitPal, a participant-centric cessation support system, which aims to assist individuals to better understand their smoking behavior. The design of MyQuitPal is also grounded on theories of long term health-behavior change. We believe our research advances understanding of complexities and opportunities surrounding the design of smoking cessation systems

Correlation between Post-COVID-19, Chemosensitive Function, Blood Group, and Oral Health-Related Quality of Life

Background/Purpose. Several studies reported chemosensitive dysfunction in the olfactory and gustatory domains following coronavirus disease 2019 (COVID-19). However, the long-term convalescence period of these sensory functions and associated factors remains unknown. Hence, this study explored the correlation between post-COVID-19 conditions, chemosensitive function, blood group, and oral health-related quality of life. Materials and Methods. A cross-sectional information on demographics, symptomatic disease status, ABO blood group, and oral health-related quality of life (OHRQoL) was collected among 100 patients who were earlier tested positive for COVID-19 reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and were now reporting to the College of Dentistry for routine treatment after recovery. Objective evaluation of olfactory and gustatory disturbances was elicited using the Connecticut Chemosensory Clinical Research Center (CCCRC) test and gustatory function testing. Furthermore, OHRQoL was assessed using Oral Health Impact Profile (OHIP-14). Results. More than half of the patients (62%) had some form of olfactory dysfunction/alteration, and 42% had poor CCCRC scores. About 14% reported ageusia, while 68% reported some form of taste alterations, and 55% reported poor OHRQoL. A statistically significant difference was reported between different ABO blood groups and subjective loss of smell (p0.05), but the taste intensity score was dependent on OHIP 14 (p<0.05). Moreover, a majority (70.8% and 70.0%) with poor OHIP-14 scores had taste intensity scores of 3 and 4, respectively, while those with moderate (68.4% and 48.6%) OHIP-14 had scored 1 and 2, respectively. Conclusion. Olfactory and gustatory disturbances were found to be a long-term feature in post-COVID-19 patients. The blood group is a predisposing factor for persistent smell alterations in post-COVID-19 patients

Correlation between Post-COVID-19, Chemosensitive Function, Blood Group, and Oral Health-Related Quality of Life

Background/Purpose. Several studies reported chemosensitive dysfunction in the olfactory and gustatory domains following coronavirus disease 2019 (COVID-19). However, the long-term convalescence period of these sensory functions and associated factors remains unknown. Hence, this study explored the correlation between post-COVID-19 conditions, chemosensitive function, blood group, and oral health-related quality of life. Materials and Methods. A cross-sectional information on demographics, symptomatic disease status, ABO blood group, and oral health-related quality of life (OHRQoL) was collected among 100 patients who were earlier tested positive for COVID-19 reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and were now reporting to the College of Dentistry for routine treatment after recovery. Objective evaluation of olfactory and gustatory disturbances was elicited using the Connecticut Chemosensory Clinical Research Center (CCCRC) test and gustatory function testing. Furthermore, OHRQoL was assessed using Oral Health Impact Profile (OHIP-14). Results. More than half of the patients (62%) had some form of olfactory dysfunction/alteration, and 42% had poor CCCRC scores. About 14% reported ageusia, while 68% reported some form of taste alterations, and 55% reported poor OHRQoL. A statistically significant difference was reported between different ABO blood groups and subjective loss of smell ( p &lt; 0.05 ). The subjective loss of taste, CCCRC score, and dysgeusia were found to be independent of OHIP-14 ( p &gt; 0.05 ), but the taste intensity score was dependent on OHIP 14 ( p &lt; 0.05 ). Moreover, a majority (70.8% and 70.0%) with poor OHIP-14 scores had taste intensity scores of 3 and 4, respectively, while those with moderate (68.4% and 48.6%) OHIP-14 had scored 1 and 2, respectively. Conclusion. Olfactory and gustatory disturbances were found to be a long-term feature in post-COVID-19 patients. The blood group is a predisposing factor for persistent smell alterations in post-COVID-19 patients.</jats:p

A Dual-Cup Reverse Shoulder Replacement Improves Impingement-Free Motion

Background Advances in reverse shoulder arthroplasty (RSA) design have improved functional outcomes, which approach those of the anatomic total shoulder arthroplasty (aTSA) in certain patients. However, restoration of motion, especially functional internal rotation, remains a concern following RSA. A novel dual-cup RSA design1 was developed to improve impingement-free range of motion. The passive motion of the dual-cup RSA is compared to that of a commercially-available RSA design in a cadaveric model. Methods , Five fresh-frozen cadaveric upper extremity specimens were included in the study. The scapula was rigidly fixed, allowing for isolation of glenohumeral joint motion. The novel dual-cup RSA design was tested with and without a flanged component. The dual-cup has an outer diameter of 36 mm, articulates with a 32+4 mm glenosphere, and provides 6 mm of glenoid lateralization. A 32+4 mm lateralized glenosphere and a 36+6 mm lateralized glenosphere served as controls. Measurements of motion were performed using an electromagnetic tracking device and modes of impingement were recorded. An Analysis of Variance (ANOVA) test was performed with a post-hoc Tukey test to compare the relative changes in range of motion among groups. Results The dual-cup (without flange) design improved external rotation (ER) at 0° abduction by 20.9° and improved IR by 11.5° compared to the 32+4 mm control (p Discussion The dual-cup design improves all rotational motions relative to control models except internal rotation with an abduction angle reaching or exceeding 45°. The dual-cup design improves impingement free motion, including functional internal rotation, without additional lateralization in this study. The dual-dup with flange design eliminates impingement of the humeral cup on the glenoid neck without significantly affecting most motions relative to control models.https://doi.org/10.1053/j.sart.2024.12.00

Classification of the Disposition of Patients Hospitalized with COVID-19: Reading Discharge Summaries Using Natural Language Processing (Preprint)

BACKGROUND Medical notes are a rich source of patient data; however, the nature of unstructured text has largely precluded the use of these data for large retrospective analyses. Transforming clinical text into structured data can enable large-scale research studies with electronic health records (EHR) data. Natural language processing (NLP) can be used for text information retrieval, reducing the need for labor-intensive chart review. Here we present an application of NLP to large-scale analysis of medical records at 2 large hospitals for patients hospitalized with COVID-19. OBJECTIVE Our study goal was to develop an NLP pipeline to classify the discharge disposition (home, inpatient rehabilitation, skilled nursing inpatient facility [SNIF], and death) of patients hospitalized with COVID-19 based on hospital discharge summary notes. METHODS Text mining and feature engineering were applied to unstructured text from hospital discharge summaries. The study included patients with COVID-19 discharged from 2 hospitals in the Boston, Massachusetts area (Massachusetts General Hospital and Brigham and Women’s Hospital) between March 10, 2020, and June 30, 2020. The data were divided into a training set (70%) and hold-out test set (30%). Discharge summaries were represented as bags-of-words consisting of single words (unigrams), bigrams, and trigrams. The number of features was reduced during training by excluding n-grams that occurred in fewer than 10% of discharge summaries, and further reduced using least absolute shrinkage and selection operator (LASSO) regularization while training a multiclass logistic regression model. Model performance was evaluated using the hold-out test set. RESULTS The study cohort included 1737 adult patients (median age 61 [SD 18] years; 55% men; 45% White and 16% Black; 14% nonsurvivors and 61% discharged home). The model selected 179 from a vocabulary of 1056 engineered features, consisting of combinations of unigrams, bigrams, and trigrams. The top features contributing most to the classification by the model (for each outcome) were the following: “appointments specialty,” “home health,” and “home care” (home); “intubate” and “ARDS” (inpatient rehabilitation); “service” (SNIF); “brief assessment” and “covid” (death). The model achieved a micro-average area under the receiver operating characteristic curve value of 0.98 (95% CI 0.97-0.98) and average precision of 0.81 (95% CI 0.75-0.84) in the testing set for prediction of discharge disposition. CONCLUSIONS A supervised learning–based NLP approach is able to classify the discharge disposition of patients hospitalized with COVID-19. This approach has the potential to accelerate and increase the scale of research on patients’ discharge disposition that is possible with EHR data. </sec