Exosomes from umbilical cord mesenchymal stromal cells promote collagen production of fibroblasts from pelvic organ prolapse: Study

Pelvic organ prolapse (POP) involves pelvic organ herniation into the vagina due to pelvic floor tissue laxity, and vaginal structure is an essential factor. In POP, the vaginal walls exhibit abnormal collagen distribution and decreased fibroblast levels and functions.

The intricate etiology of POP and the prohibition of transvaginal meshes in pelvic reconstruction surgery present challenges in targeted therapy development. Human umbilical cord mesenchymal stromal cells (hucMSCs) present limitations, but their exosomes (hucMSC-Exo) are promising therapeutic tools for promoting fibroblast proliferation and extracellular matrix remodeling.

The aim of research was to investigate the effects of hucMSC-Exo on the functions of primary vaginal fibroblasts and to elucidate the underlying mechanism involved.

Human vaginal wall collagen content was assessed by Masson’s trichrome and Sirius blue staining. Gene expression differences in fibroblasts from patients with and without POP were assessed via RNA sequencing (RNA-seq). The effects of hucMSC-Exo on fibroblasts were determined via functional experiments in vitro. RNA-seq data from fibroblasts exposed to hucMSC-Exo and microRNA (miRNA) sequencing data from hucMSC-Exo were jointly analyzed to identify effective molecules.

In POP, the vaginal wall exhibited abnormal collagen distribution and reduced fibroblast 1 quality and quantity. Treatment with 4 or 6 μg/mL hucMSC-Exo suppressed inflammation in POP group fibroblasts, stimulated primary fibroblast growth, and elevated collagen I (Col1) production in vitro. High-throughput RNA-seq of fibroblasts treated with hucMSC-Exo and miRNA sequencing of hucMSC-Exo revealed that abundant exosomal miRNAs downregulated matrix metalloproteinase 11 (MMP11) expression.

It was concluded that HucMSC-Exo normalized the growth and function of primary fibroblasts from patients with POP by promoting cell growth and Col1 expression in vitro. Abundant miRNAs in hucMSC-Exo targeted and downregulated MMP11 expression. HucMSC-Exo-based therapy may be ideal for safely and effectively treating POP.

Citation: Xu LM, Yu XX, Zhang N, Chen YS. Exosomes from umbilical cord mesenchymal stromal cells promote the collagen production of fibroblasts from pelvic organ prolapse. World J Stem Cells 2024; 16(6): 708-727

URL: https://www.wjgnet.com/1948-0210/full/v16/i6/708.htm

DOI: https://dx.doi.org/10.4252/wjsc.v16.i6.708

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Linking Postpartum Blood Pressure Control to Readmission: Implications for Maternal Health Strategies

USA: Postpartum care encompasses crucial aspects of maternal health, with recent studies delving into blood pressure (BP) management during this critical period. A focus on effective postpartum blood pressure control has emerged as essential in reducing the risk of maternal readmission following childbirth.

In the large, national dataset, there was a significant correlation between BP control at discharge and readmission in the postpartum period.

The findings, published in the American Journal of Obstetrics & Gynecology MFM, should inform postpartum hypertension treatment goals and the role of remote monitoring programs in improving maternal safety.

Postpartum hypertension significantly contributes to the increasing maternal mortality rates, with a significant proportion of maternal deaths occurring post-delivery. Research has indicated that the highest recorded blood pressure during labor and delivery admission can forecast the likelihood of readmission. However, the ideal blood pressure threshold to minimize readmissions and the necessity for further medical intervention during the postpartum phase remains uncertain.

Elevated BP during the postpartum period can lead to complications such as preeclampsia, eclampsia, or stroke, necessitating hospital readmission. Considering this, Kelly S. Gibson, The MetroHealth System/Case Western Reserve University, Cleveland, OH, and colleagues aimed to investigate the relationship between postpartum BP control at discharge and readmission within the first six weeks after delivery.

For this purpose, the researchers obtained data from Cosmos, an electronic health record–based, Health Insurance Portability and Accountability Act–defined limited dataset that includes more than 1.4 million birth encounters.

All postpartum individuals with recorded blood pressure measurements post-delivery were included in the study. Data on demographics, medications, and hospital readmissions were extracted from the dataset. Patients were categorized based on their blood pressure readings within the 24 hours before discharge, specifically ≥160/110, ≥150/100, ≥140/90, ≥130/80, ≥120/80, and <120/80 mm Hg. The study compared readmission rates across these defined blood pressure groups. Planned subgroup analyses involved stratification using antihypertensive medications, and a sensitivity analysis was conducted using the highest blood pressure recorded during hospital admission. Covariates considered in the analysis included maternal age, preexisting conditions such as diabetes mellitus or lupus erythematosus, and body mass index.

The following were the key findings of the study:

  • The analysis included 1,265,766 total birth encounters, 391,781 in the referent group (120/80 mm Hg), 392,592 in the group with <120/80 mm Hg, 249,414 in the group with ≥130/80 mm Hg, 16,125 in the group with ≥140/90 mm Hg, 50,659 in the group with ≥150/100 mm Hg, and 20,196 in the group with ≥160/110 mm Hg.
  • In the first six weeks after delivery, readmission rates increased with higher blood pressure readings.
  • More than 5% of postpartum patients with the highest blood pressure readings (≥160/110 mm Hg) were readmitted. These patients were almost three times more likely to be readmitted than patients whose highest blood pressure reading fell into the referent group (120/80 mm Hg) (odds ratio [OR], 2.90; 95% confidence interval, 2.69–3.12).
  • Patients with blood pressures of >150/100 mm Hg (odds ratio, 2.72), >140/90 mm Hg (odds ratio, 2.03), and >130/80 mm Hg (odds ratio, 1.43) all had higher odds of readmission, whereas patients with a blood pressure of <120/80 mm Hg had a lower odds of readmission (odds ratio, 0.78).
  • Patients who had higher blood pressures during admission but had improved control in the 24 hours before discharge had lower readmission rates than those whose blood pressures remained elevated.
  • In all BP categories, patients who received an antihypertensive prescription had higher readmission rates.

In conclusion, as healthcare continues to prioritize maternal health and safety, studies like these underscore the critical role of postpartum blood pressure management in preventing readmissions. By implementing evidence-based practices and personalized care strategies, healthcare providers can optimize outcomes and support maternal well-being post-delivery.

Reference:

Gibson, K. S., Olson, D., Lindberg, W., Keane, G., Keogh, T., Ranzini, A. C., Alban, C., & Haddock, J. (2024). Postpartum blood pressure control and the rate of readmission. American Journal of Obstetrics & Gynecology MFM, 6(7), 101384. https://doi.org/10.1016/j.ajogmf.2024.101384

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Digital face scanning reliable method for measuring changes in vertical dimension of occlusion, suggests study

Digital face scanning is a reliable method for measuring changes in the vertical dimension of occlusion, as suggested by a study published in the Journal of Dentistry.

This study evaluated the reliability of a face scanner in measuring the vertical dimension of occlusion (VDO). Fully dentate volunteers (n = 20; mean-age = 30.0 ± 10.7 years) were recruited. Clinical facial measurements were obtained using a digital caliper and a face scanner (Obiscanner, Fifthingenium, Italy). The scans were imported into a mesh-processing software, and the distances were measured digitally. Measurements were obtained for each participant with the jaws positioned in maximal intercuspation (MI) and with increased vertical distances of 2, 4, and 6 mm. Vertical and horizontal measures were obtained using facial anatomical landmarks: Glabella (GL), Pronasale (PrN), Subnasale (SbN), inferior border of the right and left Alare, Labiale superius (Ls), right and left Cheilion (Ch), Soft Pogonion (SPg), right and left Tragus of the ear (Tr), for all selected vertical positions. Data analysis included intra-class correlation coefficient (ICC), pairwise comparison tests, Bland-Altman plots, and Passing-Bablok regression. Results: 120 VDO measurements (clinical=60, digital=60) were recorded by two independent evaluators. Mean differences between digital and clinical measurements ranged from 0.054 ± 0.14 mm to 0.203 ± 0.13 mm. All parameters were strongly correlated (r > 0.93; p < 0.001). ICC estimates revealed excellent reliability, and the measuring procedure yielded the same results on repeated trials irrespective of the raters and measurement methods. Bland-Altman plots revealed a difference, between digital and clinical measurements, of 1.7 % for the vertical measurements. Regression analysis revealed no significant proportional difference between the two methods, so both can be used interchangeably. The findings of this study demonstrate that VDO can be measured accurately from face scans using 3D mesh-processing software and that even small changes in the VDO could be detected using the digital methods. Findings provide evidence about the reliability of a digital method for jaw relation registrations and may be applied towards incorporating this method into clinical workflows for computer-aided-design/ computer-assisted-manufacturing (CAD-CAM) dentures.

Reference:

Murali Srinivasan, Florentin Berisha, Innocenzo Bronzino, Porawit Kamnoedboon, Claudio Rodrigues Leles. Reliability of a face scanner in measuring the vertical dimension of occlusion, Journal of Dentistry, Volume 146, 2024, 105016, ISSN 0300-5712,

https://doi.org/10.1016/j.jdent.2024.105016.

(https://www.sciencedirect.com/science/article/pii/S0300571224001866)

Keywords:

Digital face, scanning, reliable, method, measuring, changes, vertical, dimension, occlusion, Journal of Dentistry, Vertical dimension of occlusion; Jaw relations; 3D Face scan; Digital complete dentures; Removable prosthodontics; Geriatric dentistry; CAD-CAM complete dentures

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Which adolescents are at risk of depression following early social media use?

A new study that looked for relationships between early social media use and depression across adolescence and into young adulthood found that certain factors may make social media more risky or protective regarding depression. The findings, which are published in the Journal of Adolescence, suggest that social media use does not impact all adolescents in the same way, and an individualized approach is needed to determine the benefits and harms of social media on young people’s mental health.

For the study, 488 adolescents living in the United States were surveyed once a year for 8 years (beginning in 2010 when the average age for participants was 13 years old). The investigators found 5 classes that differed in how self-reported social media use duration related to depressive symptoms. Although high amounts of reported social media use was often related to larger increases in depressive symptoms, this was not universal.

Social media use was related to increased depression for adolescents with greater parental hostility, peer bullying, anxiety, reactivity to stressors, and lower parental media monitoring. With many other characteristics and factors, social media use was related to less depression or was unrelated to depression.

“When thinking about whether social media may impact a particular teen, it’s important to take a broad perspective. If the teen is already in a vulnerable position (being bullied or having hostile parents or parents who don’t monitor their teen’s media) then social media is much more likely to be harmful. This is especially true if there is more than 3+ hours of use a day,” said corresponding author W. Justin Dyer, PhD, of Brigham Young University. “However, if their friends and parents are warm and supportive, and the parents monitor their teens’ media use, moderate amounts of social media use (less than 3 hours a day) may be a good thing. Teens appear to be greatly benefited when parents provide guidance as they navigate social media. That guidance may make all the difference.”

Reference:

W. Justin Dyer, Sarah M. Coyne, Megan Gale, J. Andan Sheppard, Who’s most at risk? A person-centered approach to understanding the long-term relationship between early social media use and later depression across adolescence, https://doi.org/10.1002/jad.12362

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MRI-Based Brain Connectivity Networks Predict Atrophy Progression in Parkinson’s Disease, Study Finds

Italy: Cutting-edge research utilizing MRI technology has uncovered promising insights into predicting patterns of atrophy progression in Parkinson’s disease (PD) through brain connectivity networks. The study, published in the journal Radiology, marks a significant advancement in understanding neurodegenerative processes associated with PD.

The researchers revealed that MRI illuminates the structural and functional organization of the brain — thus helping clinicians predict the progression of Parkinson’s disease in patients in its early stages.

They reported that Parkinson’s “disease exposure” at one and two years correlated with white matter atrophy at two years and three years after baseline imaging.

The study stated that “brain connectome, both functional and structural, showed the potential to predict progression of gray matter (GM) alteration in patients with mild Parkinson’s disease.”

Parkinson’s disease, a chronic and progressive neurological disorder, is known to manifest through symptoms such as tremors, stiffness, slowness of movement, and cognitive decline. Understanding the underlying mechanisms of brain atrophy progression is crucial for developing targeted therapies to slow disease progression and improve the quality of life for patients. Considering this, Massimo Filippi, University Hospital Maggiore della Carità, Novara, Italy, and colleagues aimed to assess the functional and structural connectivity of brain regions in healthy controls and its relationship with the spread of GM atrophy in patients with mild PD.

For this purpose, the researchers conducted a prospective study comprising participants with mild PD and controls recruited from a single center between 2012 and 2023. Participants diagnosed with PD underwent three-dimensional T1-weighted brain MRI scans to assess regional gray matter atrophy at baseline and annually for three years.

In healthy controls, structural and functional brain connectomes were generated using diffusion tensor imaging and resting-state functional MRI. Disease exposure (DE) indexes for each brain region were defined based on the connectivity patterns of all linked regions in the healthy connectome and the extent of atrophy observed in PD participants’ connected regions. Partial correlations were examined between the structural and functional DE indexes of each GM region at one- or two-year follow-up and the progression of atrophy at a two- or three-year follow-up. Prediction models for atrophy progression at two- or three-year follow-ups were developed using exhaustive feature selection methods.

The study led to the following findings:

  • The study included 86 participants with mild PD (mean age at MRI, 60 years ± 8; 48 male) and 60 healthy controls (mean age at MRI, 62 years ± 9; 31 female).
  • DE indexes at 1 and 2 years correlated with atrophy at 2 and 3 years (r range, 0.22–0.33).
  • Models including DE indexes predicted GM atrophy accumulation over three years in the right caudate nucleus and some frontal, parietal, and temporal brain regions (R2 range, 0.40–0.61).

“The functional and structural organization of the brain connectome plays a role in atrophy progression in the early stages of Parkinson’s disease,” the researchers wrote.

Reference:

https://doi.org/10.1148/radiol.232454

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Hyposalivation linked to severity of disease among psoriasis patients, States study

A recent study published in the Biotechnology and Applied Biochemistry journal illuminated the significant impact of psoriasis on salivary gland function which revealed critical insights into the effect of psoriasis on saliva secretion and associated cytokine biomarkers.

The research was conducted with a robust sample of 120 individuals and included a total of 60 patients diagnosed with active psoriasis and 60 healthy controls matched by age and gender to ensure accuracy and reliability. This research collected unstimulated whole saliva from all participants using the spitting method which is a standard and non-invasive procedure. The study evaluated the levels of several key cytokines, which were tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interleukin-2 (IL-2) and interleukin-10 (IL-10). These cytokines were measured using enzyme-linked immunosorbent assay (ELISA) techniques provided by BT Lab, Shanghai, China.

The key findings illuminated a significant reduction in saliva secretion among psoriasis patients when compared to healthy controls. This hyposalivation was closely linked to the severity and duration of the disease. The results of this study showed that patients with more severe psoriasis expressed markedly lower salivary flow rates. This reduction in saliva production was accompanied by a notable increase in pro-inflammatory cytokines (TNF-α, IFN-γ, and IL-2) and a reduction in the anti-inflammatory cytokine IL-10 in the saliva of psoriasis patients.

The elevated levels of pro-inflammatory cytokines suggest an elevated inflammatory response within the salivary glands of individuals with psoriasis. Also, the reduction in IL-10 indicates a diminished anti-inflammatory response which further contributes to the glandular inflammation and reduced saliva production observed in these patients.

This study found no significant correlation between the levels of tested cytokines and the salivary flow rates by indicating that while cytokine levels are altered, they do not directly predict the amount of saliva produced. However, the overall findings underline a significant negative correlation between salivary flow rates and the severity of psoriasis that emphasizes the impact of the disease on gland function.

These findings suggest that the inflammatory processes affecting the salivary glands, driven by increased pro-inflammatory and decreased anti-inflammatory cytokine levels, play a pivotal role in the diminished saliva secretion observed in the psoriasis patients. This research highlights the broader systemic effects of psoriasis that extend beyond the skin to influence oral health and glandular function. Overall, these outcomes suggest that monitoring cytokine levels and salivary flow rates could become an integral part of managing psoriasis. This approach may helps in understanding the progression of disease and its impact on the overall health of patients.

Reference:

Sharma, R. K., Sharma, M. R., Mahendra, A., Singh, S., Sood, S., Upadhyay, S. K., & Sharma, A. K. (2024). Hyposalivation in patients with psoriasis: Association with severity, inflammatory, and anti‐inflammatory cytokine biomarkers of the disease. In Biotechnology and Applied Biochemistry. Wiley. https://doi.org/10.1002/bab.2619

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Lancet study says nearly 50 per cent adults in India insufficiently physically active in 2022

According to a Lancet Global Health report, half of India’s adult population does not meet the standards of sufficient physical activity recommended by the World Health Organization (WHO). The report indicated that the prevalence of insufficient physical activity among Indian adults surged from 22.3% in 2000 to 49.4% in 2022, with women (57%) being more physically inactive than men (42%). India ranks 12th among 195 countries in terms of insufficient physical activity.
The report further revealed that nearly one-third of adults globally – approximately 1.8 billion people or 31% – did not meet the recommended physical activity levels in 2022. The highest rates were observed in the high-income Asia-Pacific region (48%) and South Asia (45%), while inactivity levels stood at 28% in high-income Western countries and 14% in Oceania.

Reference: Tessa Strain, PhD, Seth Flaxman, PhD, Regina Guthold, PhD, Elizaveta Semenova, PhD, Melanie Cowan, MPH, Leanne M Riley, MSc, et al; National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants; The Lancet Global Health; DOI:https://doi.org/10.1016/S2214-109X(24)00150-5

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NEET paper leaks case: CBI arrests 2 individuals from Patna

For the first time after the Bihar police transferred the NEET UG paper leak case to the Central Bureau of Investigation, the agency arrested two individuals from Patna today who have now been taken into custody.
According to the CBI officials, the accused, Manish Kumar and Ashutosh Kumar, allegedly provided safe premises to the aspirants before the NEET examination, where they were given leaked papers and answer keys, reports PTI.
For more information click on the link below:
 

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NEET UG row: Govt will investigate paper leaks, guilty will be punished, assures President Droupadi Murmu

In her address to a joint sitting of Parliament, President Droupadi Murmu spoke on the raging row over NEET 2024 across the country.
The government is fully committed to investigating the recent incidents of paper leaks and ensure that the guilty are punished, President Droupadi Murmu said, as quoted by PTI.
For more information click on the link below:

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No More penalty for leaving MBBS, BDS seats midway in Uttar Pradesh

Lucknow: Bringing good news to the MBBS and BDS students in Uttar Pradesh, the State Government has abolished the fine imposed on students who leave their medical education course midway.

Although the Government has done away with the seat-leaving monetary penalty, the provision of debarring such students from taking admission to a medical education course the next year remains in place.

Previously, any undergraduate medical or dental students pursuing their medical education in a government medical college had to pay Rs 1 lakh fine to a government college. In the case of self-financing medical colleges, the candidates had to pay the entire five-year course fee, as per the provision under the “seat-leaving bond”. Meanwhile, the amount of penalty for the candidates leaving a postgraduate medical seat in the government sector was Rs 5 lakh.

Also Read: HC Grants Interim Relief to Doctor from Rs 30 Lakh Seat Leaving Bond penalty, MGM Indore told to Return Original Documents

As per the latest media report by Hindustan Times, the State has now scrapped the provision of monetary penalty for the MBBS or BDS students for leaving their seats midway.

Commenting on the matter, the Director General of Medical Education, Kinjal Singh told HT, “Students who leave the MBBS course are themselves under too much pressure as they are leaving a bright career. They do it as a last option and have genuine reasons, including finance. In such a situation, the government thought it is not appropriate to take money from them as fine, hence the financial part of the penalty has been abolished. Uttar Pradesh is the second state after Madhya Pradesh to do so in the country.”

The Director General of Medical Education Singh sent a proposal based on the discussions with the National Medical Commission. She said, “The other part of the penalty remains the same where a candidate will be debarred from participating in NEET entrance and counselling in the next year, or the year after they leave a seat.”

“We are increasing MBBS seats and the number of the colleges in the state gradually. The focus remains to help more candidates become doctors. Hence, in the interest of students the decision has been taken to abolish the financial penalty mentioned in the seat leaving bond,” Singh added.

She further mentioned that “Though not many would leave MBBS or BDS…but the money is not important here. In such a case, we need to have sympathy with the candidate keeping in view the decision they take, putting an entire career at stake.”

There are around 9278 MBBS and 2070 BDS seats in more than 60 medical colleges in Uttar Pradesh. More than a dozen medical colleges are expected to join counselling this year as inspections are being done, which will take the number of MBBS seats to more than 10,000 MBBS seats.

Earlier this year, the Apex Medical Regulator NMC had already directed the State/UT governments to reconsider the seat leaving bond conditions for the PG medical students.

The Anti-Ragging Committee of NMC had recommended the State/UT to review the seat-leaving policy in medical colleges in an attempt to address the mental health concerns of PG medical students. Medical Dialogues had earlier reported that as an alternative, NMC had recommended that the States may consider debarring the students for admission in their States for the next one year.

Also Read: NMC considering to relax bond policies: Report

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