Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: a systematic review of the literature

Background: The majority of lower limb amputations are undertaken in people with peripheral arterial occlusive disease,\ud and approximately 50% have diabetes. Quality of life is an important outcome in lower limb amputations; little is known\ud about what influences it, and therefore how to improve it.\ud Objectives: The aim of this systematic review was to identify the factors that influence quality of life after lower limb\ud amputation for peripheral arterial occlusive disease.\ud Methods: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science and Cochrane databases were searched to identify\ud articles that quantitatively measured quality of life in those with a lower limb amputation for peripheral arterial occlusive\ud disease. Articles were quality assessed by two assessors, evidence tables summarised each article and a narrative\ud synthesis was performed.\ud Study design: Systematic review.\ud Results: Twelve articles were included. Study designs and outcome measures used varied. Quality assessment scores\ud ranged from 36% to 92%. The ability to walk successfully with a prosthesis had the greatest positive impact on quality\ud of life. A trans-femoral amputation was negatively associated with quality of life due to increased difficulty in walking\ud with a prosthesis. Other factors such as older age, being male, longer time since amputation, level of social support and\ud presence of diabetes also negatively affected quality of life.\ud Conclusion: Being able to walk with a prosthesis is of primary importance to improve quality of life for people with lower\ud limb amputation due to peripheral arterial occlusive disease. To further understand and improve the quality of life of this\ud population, there is a need for more prospective longitudinal studies, with a standardised outcome measure

Deep Learning Image Analysis to Isolate and Characterize Different Stages of S-phase in Human Cells

Abstract. This research used deep learning for image analysis by isolating and characterizing distinct DNA replication patterns in human cells. By leveraging high-resolution microscopy images of multiple cells stained with 5-Ethynyl-2′-deoxyuridine (EdU), a replication marker, this analysis utilized Convolutional Neural Networks (CNNs) to perform image segmentation and to provide robust and reliable classification results. First multiple cells in a field of focus were identified using a pretrained CNN called Cellpose. After identifying the location of each cell in the image a python script was created to crop out each cell into individual .tif files. After careful annotation, a CNN was created from scratch using the TensorFlow Keras package and trained on those images to categorize them into five distinct replication patterns. Using a holdout test set our model was able to achieve an accuracy of 86.5%. This analysis method for segmentation and classification enhances the efficiency and reproducibility of DNA replication analysis, allowing for high-throughput processing and analysis of replication foci. This research can enhance image analysis in cell biology by providing a time-efficient and accurate tool to investigate replication dynamics, advance cancer research, and contribute to scientific discovery in various domains

Binding of hydrophobic guests in a coordination cage cavity is driven by liberation of 'high-energy' water

The cavity of an M8L12 cubic coordination cage can accommodate a cluster of ten water molecules in which the average number of hydrogen bonds per water molecule is 0.5 H-bonds less than it would be in the bulk solution. The presence of these 'hydrogen-bond frustrated' or 'high-energy' water molecules in the cavity results in the hydrophobic effect associated with guest binding being predominantly enthalpy-based, as these water molecules can improve their hydrogen-bonding environment on release. This contrasts with the classical form of the hydrophobic effect in which the favourable entropy change associated with release of ordered molecules from hydrophobic surfaces dominates. For several guests Van't Hoff plots showed that the free energy of binding in water is primarily enthalpy-driven. For five homologous pairs of guests related by the presence or absence of a CH2 group, the incremental changes to ∆H and T∆S for guest binding ¬- i.e. ∆∆H and T∆∆S, the difference in contributions arising from the CH2 group - are consistently 5±1 kJ mol-1 for ∆∆H and 0±1 kJ mol-1 for T∆∆S. This systematic dominance of ∆H in the binding of hydrophobic guests is consistent with the view that guest binding is dominated by release of 'high energy' water molecules into a more favourable solvation environment, as has been demonstrated recently for some members of the cucurbituril family

Overview of data-synthesis in systematic reviews of studies on outcome prediction models

Background: Many prognostic models have been developed. Different types of models, i.e. prognostic factor and outcome prediction studies, serve different purposes, which should be reflected in how the results are summarized in reviews. Therefore we set out to investigate how authors of reviews synthesize and report the results of primary outcome prediction studies. Methods: Outcome prediction reviews published in MEDLINE between October 2005 and March 2011 were eligible and 127 Systematic reviews with the aim to summarize outcome prediction studies written in English were identified for inclusion. Characteristics of the reviews and the primary studies that were included were independently assessed by 2 review authors, using standardized forms. Results: After consensus meetings a total of 50 systematic reviews that met the inclusion criteria were included. The type of primary studies included (prognostic factor or outcome prediction) was unclear in two-thirds of the reviews. A minority of the reviews reported univariable or multivariable point estimates and measures of dispersion from the primary studies. Moreover, the variables considered for outcome prediction model development were often not reported, or were unclear. In most reviews there was no information about model performance. Quantitative analysis was performed in 10 reviews, and 49 reviews assessed the primary studies qualitatively. In both analyses types a range of different methods was used to present the results of the outcome prediction studies. Conclusions: Different methods are applied to synthesize primary study results but quantitative analysis is rarely performed. The description of its objectives and of the primary studies is suboptimal and performance parameters of the outcome prediction models are rarely mentioned. The poor reporting and the wide variety of data synthesis strategies are prone to influence the conclusions of outcome prediction reviews. Therefore, there is much room for improvement in reviews of outcome prediction studies. (aut.ref.

Assessment of hand hygiene compliance after hand hygiene education among health care workers in Cambodia

2016-05Health care-associated infection (HCAI) is the most frequent adverse event for hospitalized patients. Hand hygiene is a simple and effective solution to protect patients from HCAI. This study aimed to introduce hand hygiene to health care workers based on the World Health Organization guideline for reducing HCAI in Cambodia and to assess their behavioral patterns on hand hygiene. All health care workers at Kampong Cham provincial hospital had lectures and practice on hand hygiene in January 2012. The surveys for hand hygiene compliance (HHC) were performed after 6 months, 1 year and 2 years, respectively. The number of surgical site infections (SSI) was counted in 2011 and 2014. Our analysis used the data of 58 workers, who were observed at all three points, although 139 workers were observed during the study period. The average of HHC at 6 months, 1 year and 2 years were 62.37%, 85.76% and 80.36%, respectively. The improved group (HHC 2 years/1 year≧1) had 32 workers, whereas the worsened group (HHC 2 years/1 year<1) had 26. There was a significant difference in departments of the two groups (P=0.011) but not in sex, age or occupations. The improved group had more workers of General (31.2% vs. 19.2%), Surgical (25.0% vs. 11.5%) and Infection (21.9% vs. 11.5%) categories compared to the worsened group. The incidence of SSI was improved from 32.26% in 2011 to 0.97% in 2014. Our results suggest that the education and the survey on hand hygiene are effective for reducing HCAI in Cambodia.departmental bulletin pape

MDC1 collaborates with TopBP1 in DNA replication checkpoint control

The DNA damage checkpoint protein MDC1 also interacts with TopBP1 to promote DNA replication checkpoint control

Transcriptional Regulation of an Evolutionary Conserved Intergenic Region of CDT2-INTS7

In the mammalian genome, a substantial number of gene pairs (approximately 10%) are arranged head-to-head on opposite strands within 1,000 base pairs, and separated by a bidirectional promoter(s) that generally drives the co-expression of both genes and results in functional coupling. The significance of unique genomic configuration remains elusive.Here we report on the identification of an intergenic region of non-homologous genes, CDT2, a regulator of DNA replication, and an integrator complex subunit 7 (INTS7), an interactor of the largest subunit of RNA polymerase II. The CDT2-INTS7 intergenic region is 246 and 245 base pairs long in human and mouse respectively and is evolutionary well-conserved among several mammalian species. By measuring the luciferase activity in A549 cells, the intergenic human sequence was shown to be able to drive the reporter gene expression in either direction and notably, among transcription factors E2F, E2F1 approximately E2F4, but not E2F5 and E2F6, this sequence clearly up-regulated the reporter gene expression exclusively in the direction of the CDT2 gene. In contrast, B-Myb, c-Myb, and p53 down-regulated the reporter gene expression in the transcriptional direction of the INTS7 gene. Overexpression of E2F1 by adenoviral-mediated gene transfer resulted in an increased CDT2, but not INTS7, mRNA level. Real-time polymerase transcription (RT-PCR) analyses of the expression pattern for CDT2 and INTS7 mRNA in human adult and fetal tissues and cell lines revealed that transcription of these two genes are asymmetrically regulated. Moreover, the abundance of mRNA between mouse and rat tissues was similar, but these patterns were quite different from the results obtained from human tissues.These findings add a unique example and help to understand the mechanistic insights into the regulation of gene expression through an evolutionary conserved intergenic region of the mammalian genome

Predicting successful prosthetic rehabilitation in major lower-limb amputation patients: a 15-year retrospective cohort study

Objective: To determine and compare specific factors that could be associated and predictive with successful prosthetic rehabilitation in major lower-limb amputations. Methods: A 15-year long (2000-2014) retrospective observational cohort study was conducted. Two different criteria were used to define successful prosthetic rehabilitation: (1) the ability to walk at least 45 m, regardless of assistive devices; and (2) walking >45 m without other ambulatory aids than one cane (if required). Age, gender, comorbidities, cause and level of amputation, stump characteristics, ulcers in the preserved limb, and time between surgery and physical therapy were examined as predictors of successful prosthetic rehabilitation. Results: A total of 169 patients (61.60±15.9 years) were included. Regarding walking ability with or without walking aids, the presence of ulcers in the preserved limb was individually associated with failed prosthetic rehabilitation (p < 0.001), while being male (OR = 0.21; 95%CI = 0.06-0.80) and transtibial level of amputation (OR = 6.73; 95%CI = 1.92-23.64) were identified as independent predictors of failure and success, respectively. Regarding the criterion of successful rehabilitation, a shorter time until rehabilitation was individually associated with improved walking ability (p < 0.013), while failure could be predicted by comorbidities (OR = 0.48; 95%CI = 0.29---0.78) and age groups of 65---75 years old (OR = 0.19; 95%CI = 0.05-0.78) and over 75 years old (OR = 0.19; 95%CI = 0.04-0.91). Conclusions: Regarding walking ability with or without walking aids, male gender and transtibiallevel of amputation are independently associated with failure and success respectively, whereasolder age and comorbidities can predict failed prosthetic rehabilitation when assistive walking devices are considered. Future prospective cohort studies are needed to confirm these findings

Pin1 and WWP2 regulate GluR2 Q/R site RNA editing by ADAR2 with opposing effects

While the essential role of the adenosine deaminase ADAR2 in RNA editing is well established, how it is regulated remains largely unknown. Here, the prolyl isomerase Pin1 and the E3 ubiquitin ligase WWP2 are shown to play a role in regulating ADAR2 localisation and stability