bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapy for Renal Artery Stenosis: A Call for Change
Authors: Dreyfus Isaac , Zilinyi Robert , Radhakrishnann Jai , Parikh Sahil A.
Published: November 2022

Atherosclerosis is the most common cause of renal artery stenosis (RAS) and exerts its effects through activation of the renin-angiotensin-aldosterone system (RAAS). Clinical manifestations of atherosclerotic renal artery stenosis (ARAS) include renovascular hypertension, cardiac destabilization syndromes, and ischemic nephropathy. Angiography is the gold standard for determining hemodynamically significant stenosis and stenosis >70% is deemed significant, while stenosis of 50%–70% requires further hemodynamic evaluation. Randomized controlled trials have failed to show benefit of renal artery stenting as a treatment modality for ARAS over optimal medical therapy; however, these trials are plagued by design and methodologic flaws and failed to enroll patients most likely to benefit from renal artery stenting. Here, we present a review of ARAS and consensus society guidelines for appropriateness of renal artery stenting, patient selection, procedural characteristics, and follow-up.

Clinical Impact

We present a brief case description of a patient who benefitted from stenting in ARAS and provide a comprehensive review of ARAS; its prevalence, pathophysiology, clinical manifestations, diagnosis and treatment. We review the evidence for and against stenting in ARAS as well as consensus guidelines for stenting. Our review is valuable as we argue that stenting in ARAS is underutilized and the randomized control data for stenting in those patients who may benefit most is lacking. Our review will provide an important perspective for clinicians faced with decisions of how to treat ARAS.
Phytochemicals Derived from Goniothalamus elegans Ast Exhibit Anticancer Activity by Inhibiting Epidermal Growth Factor Receptor
Authors: Tran Linh Thuy Thi , Pham Long-Hung Dinh , Dang Nhi Yen Thi , Nguyen Le Nguyen Thao , Nguyen Huu Bao , Nguyen Tan Khanh
Published: November 2022

Cancer is a major health burden and a leading cause of death worldwide, with numerous new molecules being studied and developed as therapeutic agents. In this study, the cytotoxicity of compounds derived from Goniothalamus elegans was evaluated for possible anticancer activity. It was observed that the crude methanol extract of G. elegans exerted the strongest cytotoxic activity against SW-480, AGS, and SK-LU-1 cell lines. In addition, two isolated alkaloids—namely, lysicamine and liriodenine—also showed strong inhibitory ability against similar cancer cell lines. To further investigate the compounds’ mechanism of action, a molecular docking approach was utilized to evaluate the potential of the two candidates to interact with the epidermal growth factor receptor. This assay estimated that lysicamine and liriodenine acquired protein binding affinities of −8.8 and −9.7 kcal/mol, respectively. Finally, the stabilities of the ligand–protein complexes were evaluated using molecular dynamics simulations of 100 ns each.
Methyl-β-D-glucopyranoside From Scabiosa comosa as a Quorum-Sensing Inhibitor
Authors: Davaapurev Bekh-Ochir , Fukumoto Atsushi , Bolortuya Byambajav , Boldbaatar Delgerbat , Maehata Yoshino , Iizaka Yohei , Kato Fumio , Batkhuu Javzan , Anzai Yojiro
Published: November 2022

Quorum sensing (QS) is an important microbial signaling system that controls the expression of many virulence genes. Combination treatment with QS inhibitors and antibiotics may be the new treatment option for infectious diseases in the future. Therefore, there is an increasing need to discover anti-QS compounds to prevent antimicrobial resistance. We isolated methyl-β-D-glucopyranoside from Scabiosa comosa and found that it exerts an anti-QS activity against Chromobacterium violaceum CV026 without exhibiting any antimicrobial activity.
Analyzing Communication Strategies Used in Long Term Care Facilities during the COVID-19 pandemic in New Brunswick, Canada
Authors: Durkee-Lloyd Janet L.
Published: November 2022

Purpose:

Effective communication is a key component to managing an event such as a global pandemic. In Canada, federal/provincial reports indicated that effective communication was a challenge in the early days of the COVID-19 pandemic. The purpose of this study was to examine the communication strategies used within long term care facilities in the Canadian province of New Brunswick.

Methods:

Online surveys were used to collect data from administrators, staff, and individuals with family members living in long-term care facilities.

Results:

The findings show an overall satisfaction with the information received by staff and families, however the frequency and format in which information was communicated were inconsistent. All participants indicated that too much information and poor quality information was a challenge. The importance of digital platforms to provide COVID-19 information was consistently identified as a successful communication strategy.

Conclusion:

The findings of this study reveal that the quantity and quality of information provided during the pandemic created challenges for administrators, staff, and families. This is in line with reports from Canadian provincial/federal reports on COVID-19 and long-term care. Recommendations have been made that would benefit the long-term care sector, not only for pandemics, but for communication in general.
Interobserver Reliability of Radiographic Angles and Measurements in Flat Foot Deformity
Authors: Weigelt Lizzy , Myatt Darren , Chapman James , Philpott Matthew , Lyle Shirley , Kelly Gerry , Kasture Sarang P. , Heyes Gavin , Mason Lyndon W. , Molloy Andrew P.
Published: November 2022

Category:

Other

Introduction/Purpose:

Radiographic angles and measurements are widely used in foot and ankle pathologies to define normal and abnormal skeletal alignment. In spite of this the inter-observer reliability of these parameters is debatable. The aim of this study was to determine the inter-observer reliability of various radiographic angles and measurements in flat foot deformity.

Methods:

Antero-posterior (AP) and lateral foot radiographs of 18 patients with flatfoot deformity were analysed by eight clinicians of various grade of experience (2 consultants, 4 fellows / registrars and 2 core training grades) with 11 different radiological parameters. A digital presentation demonstrating the method of measurement of all parameters using same software was provided to the participants. The inter-observer reliability was analysed using interclass correlation (ICC) model mixed for reliability at 95% confidence interval for individual parameters and different grade of experience.

Results:

The inter-observer reliability was excellent (>0.9) in calcaneal pitch angle (CPA), medial cuneiform height (C1H) and lateral incongruency angle (LIA). It was good (0.75 - 0.90) in talo-navicular angle (TNA), medial cuneiform articular angle (CAA), medial arch sag angle (MASA), medial cuneiform - 1st MT angle (C1MTA), talonavicular coverage angle (TNCA)andtalar - 1st MT angle on AP radiograph (T1MTA). The inter-observer reliability was moderate (0.5 - 0.75) in Meary's angle and talo-navicular uncoverage percentage (TNUP). The reliability did not differ with the grade of surgeon on sub-group analysis.

Conclusion:

This is first study to analyse the interobserver reliability of radiographic measurements in a flatfoot deformity, including grade of surgeon. The results suggest that these radiological parameters can be reliably used in clinical practice if standard measurement techniques are followed by clinicians of all grades.
Unexpected huge testicular infarct complicating obstructed adult groin hernia: a case report
Authors: Tan Shong Sheng , Mohamed Daud Mohamed Ashraf , Hashim Isa Merican Siti Rahmah , Mohammad Azmi Mohd Azem Fathi , Nik Anuar Nik Mohd Nurhafizi
Published: November 2022

Background

Testicular infarction/gangrene is usually caused by testicular torsion. Strangulated inguinal hernia complicated with testicular infarction is unusual in adults in contrast to many reported cases involving pediatric patients.

Case presentation

We report an unusual case of testicular gangrene in an elderly man presented with abandoned right obstructed inguinoscrotal hernia. He had right open hernioplasty with right orchidectomy.

Conclusion

Obstructed adult inguinoscrotal hernia potentially leading to testicular gangrene, despite being uncommon sequalae. The surgeon should always routinely examine the testis during surgery for complicated hernia to prevent missed gangrenous testis behind.
Nanopriming-mediated memory imprints reduce salt toxicity in wheat seedlings by modulating physiobiochemical attributes
Authors: Farooq Tahir , Akram Muhammad Naveed , Hameed Amjad , Ahmed Toheed , Hameed Arruje
Published: November 2022

Background

Around the globe, salinity is one of the serious environmental stresses which negatively affect rapid seed germination, uniform seedling establishment and plant developments restricting sustainable agricultural productivity. In recent years, the concepts of sustainable agriculture and cleaner production strategy have emphasized the introduction of greener agrochemicals using biocompatible and natural sources to maximize crop yield with minimum ecotoxicological effects. Over the last decade, the emergence of nanotechnology as a forefront of interdisciplinary science has introduced nanomaterials as fast-acting plant growth-promoting agents.

Results

Herein, we report the preparation of nanocomposite using chitosan and green tea (CS-GTE NC) as an ecofriendly nanopriming agent to elicit salt stress tolerance through priming imprints. The CS-GTE NC-primed (0.02, 0.04 and 0.06%), hydroprimed and non-primed (control) wheat seeds were germinated under normal and salt stress (150 mM NaCl) conditions. The seedlings developed from aforesaid seeds were used for physiological, biochemical and germination studies. The priming treatments increased protein contents (10–12%), photosynthetic pigments (Chl a (4–6%), Chl b (34–36%), Total Chl (7–14%) and upregulated the machinery of antioxidants (CAT (26–42%), POD (22–43%)) in wheat seedlings under stress conditions. It also reduced MDA contents (65–75%) and regulated ROS production resulting in improved membrane stability. The priming-mediated alterations in biochemical attributes resulted in improved final germination (20–22%), vigor (4–11%) and germination index (6–13%) under both conditions. It reduced mean germination time significantly, establishing the stress-insulating role of the nanocomposite. The improvement of germination parameters validated the stimulation of priming memory in composite-treated seeds.

Conclusion

Pre-treatment of seeds with nanocomposite enables them to counter salinity at the seedling development stage by means of priming memory warranting sustainable plant growth and high crop productivity.
Antibiotic use in gastrointestinal surgery patients at a Vietnamese national hospital
Authors: Nguyen Huyen Thi , Bui Quynh Thi Huong , Vo Tam Van , Pham Hien Thi Thu , Vo Thong Duy
Published: November 2022

Background

Invasive gastrointestinal surgery may be performed as an open or endoscopic procedure, such as laparoscopic semi-colon surgery, laparoscopic appendectomy, laparoscopic gastrectomy, and anal surgery, among other such operations. Regardless of the approach, the operative procedure interferes with the patient’s gastrointestinal tract, necessitating the rational use of prophylactic antibiotics to improve treatment outcomes and minimize postoperative infections.

Objective

To investigate the prophylactic and postoperative antibiotic usage in patients who underwent invasive gastrointestinal surgery, and to identify factors associated with postoperative infection.

Design

This descriptive, cross-sectional study included 112 patients who underwent invasive gastrointestinal surgery at the Department of Gastroenterology, Thong Nhat Hospital. We conducted a cross-sectional study in all inpatients aged 18 years and older, who underwent invasive gastrointestinal surgery between January 2020 and December 2020. We recorded patient characteristics, the administration and appropriateness of antibiotics, as well as treatment outcomes. The appropriateness of prophylactic and postoperative antibiotic usage was assessed based on 2015 Vietnamese national guideline for antibiotic use. Multivariable logistic regression analysis was used to determine the factors associated with postoperative infection.

Results

Patients’ mean age was 59.7 ± 17.2 years. Most surgeries (89.3%) were clean-contaminated procedures. The rates of appropriate types of antibiotics selected, doses, and overall rates of appropriateness of antibiotic prophylaxis were 68.0%, 76.4% and 54.7%, respectively. Of the patients investigated, 34.8% had at least one sign of postoperative infection; the overall appropriate rate of postoperative antibiotic was 38.5%. Old age was associated with postoperative infection and longer length of hospitalization.

Conclusion

Implementation of the guidelines recommended for the prophylactic and therapeutic use of antibiotics is essential to improve treatment outcomes.
Development and performance evaluation of a deep learning lung nodule detection system
Authors: Katase Shichiro , Ichinose Akimichi , Hayashi Mahiro , Watanabe Masanaka , Chin Kinka , Takeshita Yuhei , Shiga Hisae , Tateishi Hidekatsu , Onozawa Shiro , Shirakawa Yuya , Yamashita Koji , Shudo Jun , Nakamura Keigo , Nakanishi Akihito , Kuroki Kazunori , Yokoyama Kenichi
Published: November 2022

Background

Lung cancer is the leading cause of cancer-related deaths throughout the world. Chest computed tomography (CT) is now widely used in the screening and diagnosis of lung cancer due to its effectiveness. Radiologists must identify each small nodule shadow from 3D volume images, which is very burdensome and often results in missed nodules. To address these challenges, we developed a computer-aided detection (CAD) system that automatically detects lung nodules in CT images.

Methods

A total of 1997 chest CT scans were collected for algorithm development. The algorithm was designed using deep learning technology. In addition to evaluating detection performance on various public datasets, its robustness to changes in radiation dose was assessed by a phantom study. To investigate the clinical usefulness of the CAD system, a reader study was conducted with 10 doctors, including inexperienced and expert readers. This study investigated whether the use of the CAD as a second reader could prevent nodular lesions in lungs that require follow-up examinations from being overlooked. Analysis was performed using the Jackknife Free-Response Receiver-Operating Characteristic (JAFROC).

Results

The CAD system achieved sensitivity of 0.98/0.96 at 3.1/7.25 false positives per case on two public datasets. Sensitivity did not change within the range of practical doses for a study using a phantom. A second reader study showed that the use of this system significantly improved the detection ability of nodules that could be picked up clinically (p = 0.026).

Conclusions

We developed a deep learning-based CAD system that is robust to imaging conditions. Using this system as a second reader increased detection performance.
Drill-and-prechop technique: modification of the drill-and-crack technique for mature cataracts
Authors: Xu Mao , Qi Yongjun , Weng Yongde , Yang Yang , Deng Jianhua , Liu Wanjun , Mo Ting , Ye Xiangxiang
Published: November 2022

Background

There are some techniques for disassembly of hard nuclear. It is challenging in hard cataract surgery through microincision. The classic chop or prechop techniques often do not succeed,resulting in incomplete nuclear segmentation. The authors describe a new chop technique for removing hard nucleus cataracts in coaxial microincisional cataract surgery.

Methods

We create a deep hole (drill) in the central nucleus with the phaco tip and divide the nucleus (prechop) with the Nagahara chopper and the modified capsulorhexis forceps inside the hole. The chopper and the modified capsulorhexis forceps are spread apart laterally after they approach at the center of the nucleus, to create a complete fracture across the entire nucleus. Since January 2022, we have completed 27 eyes of 25 patients with hard nucleus cataract using this technique.

Results

Complete segmentation of the hard nuclear into two hemispheres was implemented with this drill and prechop technique in all cases. The effective phaco time and ultrasound energy decreased. No intraoperative complication such as iris injury, anterior capsule tears, zonulysis, or posterior capsule rupture with vitreous loss occurred during surgery.

Conclusions

This technique simplifies the previous prechop techniques especially for hard nucleus in microincisional cataract surgery. The technique is efficient, safe and simple.
Psychiatric patients’ attitudes towards being hospitalized: a national multicentre study in Norway
Authors: Hustoft Kjetil , Larsen Tor Ketil , Brønnick Kolbjørn , Joa Inge , Johannessen Jan Olav , Ruud Torleif
Published: November 2022

Background

The aim of the study was to explore patients’ attitudes towards voluntary and involuntary hospitalization in Norway, and predictors for involuntary patients who wanted admission.

Methods

A multi-centre study of consecutively admitted patients to emergency psychiatric wards over a 3 months period in 2005–06. Data included demographics, admission status (voluntary / involuntary), symptom levels, and whether the patients expressed a wish to be admitted regardless of judicial status. To analyse predictors of wanting admission (binary variable), a generalized linear mixed modelling was conducted, using random intercepts for the site, and fixed effects for all variables, with logit link-function.

Results

The sample comprised of 3.051 patients of witch 1.232 (40.4%) were being involuntary hospitalised. As expected 96.5% of the voluntary admitted patients wanted admission, while as many as 29.7% of the involuntary patients stated that they wanted the same. The involuntary patients wanting admission were less likely to be transported by police, had less aggression, hallucinations and delusions, more depressed mood, less use of drugs, less suicidality before admission, better social functioning and were less often referred by general practitioners compared with involuntary patients who did not want admission. In a multivariate analysis, predictors for involuntary hospitalization and wanting admission were, not being transported by police, less aggression and less use of drugs.

Conclusions

Almost a third of the involuntary admitted patients stated that they actually wanted to be hospitalized. It thus seems to be important to thoroughly address patients’ preferences, both before and after admission, regarding whether they wish to be hospitalized or not.
What factors influence implementation of whole-school interventions aiming to promote student commitment to school to prevent substance use and violence? Systematic review and synthesis of process evaluations
Authors: Ponsford Ruth , Falconer Jane , Melendez-Torres G. J. , Bonell Chris
Published: November 2022

Background

Whole-school interventions go beyond classroom health education to modify the school environment to promote health. A sub-set aim to promote student commitment to school to reduce substance use and violence (outcomes associated with low commitment). It is unclear what factors influence implementation of such interventions.

Methods

We conducted a systematic review including synthesis of evidence from process evaluations examining what factors affect implementation. Meta-ethnographic synthesis was informed by May’s General Theory of Implementation.

Results

Sixteen reports, covering 13 studies and 10 interventions were included in our synthesis. In terms of May’s concept of ‘sense-making’, we found that school staff were more likely to understand what was required in implementing an intervention when provided with good-quality materials and support. Staff could sometimes wilfully or unintentionally misinterpret interventions. In terms of May’s concept of ‘cognitive participation’, whereby staff commit to implementation, we found that lack of intervention adaptability could in particular undermine implementation of whole-school elements. Interventions providing local data were reported as helping build staff commitment. School leaders were more likely to commit to an intervention addressing an issue they already intended to tackle. Collaborative planning groups were reported as useful in ensuring staff ‘collective action’ (May’s term for working together) to enact interventions. Collective action was also promoted by the presence of sufficient time, leadership and relationships. Implementation of whole-school interventions took time to build. Considering May’s concept of ‘reflexive monitoring’ (formal or informal review of progress), this was important in assessing and enhancing implementation. ‘Quick wins’ could help maintain collective impetus to implement further intervention activities.

Conclusion

We identified novel factors influencing implementation of whole-school elements such as: local adaptability of interventions; providing local data to build commitment; interventions addressing an issue already on school leaders’ agenda; collaborative planning groups; and ‘reflexive monitoring’ as an explicit intervention component.
Perceived attitudes of family and peers toward same-sex marriage as a distal sexual minority stressor for gay and bisexual men in Taiwan
Authors: Chang Chih-Cheng , Lu Hsin-Yu , Chang Yu-Ping , Tsai Ching-Shu , Yen Cheng-Fang
Published: November 2022

Background

To investigate whether perceived attitudes of family and peers toward same-sex marriage (SSM) is a type of distal sexual minority stressor, as defined in minority stress theory, this cross-sectional study examined the associations of perceived attitudes of family and peers toward SSM with perceived sexual stigma from family and peers, internalized homonegativity, and mental health problems (e.g., depression, loneliness, anxiety) among gay and bisexual men in Taiwan.

Methods

We recruited 400 gay and bisexual men and assessed their perceived attitudes of family and peers toward SSM; perceived sexual stigma from family and peers; internalized homonegativity; and severity of depression, loneliness, and anxiety.

Results

Perceived attitudes of family and peers toward SSM (1) significantly correlated with various aspects of perceived sexual stigma from family and peers and (2) were significantly associated with internalized homonegativity, depression, loneliness, and anxiety.

Conclusions

Perceived attitudes of family and peers toward SSM matched the characteristics of a distal sexual minority stressor, and as a new type of distal sexual minority stressor for lesbian, gay, and bisexual individuals, these perceived attitudes and related stress warrant greater attention from mental health professionals for the development of intervention programs.
Mortality and lung function decline in patients who develop chronic pulmonary aspergillosis after lung cancer surgery
Authors: Kim Bo-Guen , Choi Yong Soo , Shin Sun Hye , Lee Kyungjong , Um Sang-Won , Kim Hojoong , Jeon Yeong Jeong , Lee Junghee , Cho Jong Ho , Kim Hong Kwan , Kim Jhingook , Shim Young Mog , Jeong Byeong-Ho
Published: November 2022

Background

Lung cancer surgery is reported as a risk factor for chronic pulmonary aspergillosis (CPA). However, limited data are available on its clinical impact. We aimed to determine the effect of developed CPA after lung cancer surgery on mortality and lung function decline.

Methods

We retrospectively identified the development of CPA after lung cancer surgery between 2010 and 2016. The effect of CPA on mortality was evaluated using multivariable Cox proportional hazard analyses. The effect of CPA on lung function decline was evaluated using multiple linear regression analyses.

Results

During a median follow-up duration of 5.01 (IQR, 3.41–6.70) years in 6777 patients, 93 developed CPA at a median of 3.01 (IQR, 1.60–4.64) years. The development of CPA did not affect mortality in multivariable analysis. However, the decline in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were greater in patients with CPA than in those without (FVC, − 71.0 [− 272.9 to − 19.4] vs. − 10.9 [− 82.6 to 57.9] mL/year,p < 0.001; FEV1, − 52.9 [− 192.2 to 3.9] vs. − 20.0 [− 72.6 to 28.6] mL/year,p = 0.010). After adjusting for confounding factors, patients with CPA had greater FVC decline (β coefficient, − 103.6; 95% CI − 179.2 to − 27.9;p = 0.007) than those without CPA. However, the FEV1decline (β coefficient, − 14.4; 95% CI − 72.1 to 43.4;p = 0.626) was not significantly different.

Conclusion

Although the development of CPA after lung cancer surgery did not increase mortality, the impact on restrictive lung function deterioration was profound.
Nurses’ knowledge and attitudes toward patient-controlled analgesia for postoperative pain control in a tertiary hospital in South Korea
Authors: Kang Mi-Ra , Kwon Youn-Ju
Published: November 2022

Background

This study investigated the knowledge and attitude of surgical ward nurses toward patient-controlled analgesia (PCA) to develop educational material for nurses on the use of PCA.

Methods

This study was a cross-sectional study comprising 120 nurses from eight surgical wards in a tertiary hospital in South Korea. A questionnaire addressing 6 domains of knowledge of and attitudes towards PCA was conducted over 1 week and analyzed using descriptive and inferential statistical methods. Knowledge was measured on a categorical scale of 0 and 1 (20 points), and attitude was measured on a Likert scale of 1 to 4 points (60 points).

Results

The total score quantifying the knowledge of and attitudes toward PCA of surgical ward nurses was 59.5 ± 5.5 out of 80.0 points. The average age of the subjects was 28.58 ± 5.68 years old, and nurses above the age of 28 had significantly greater knowledge and better attitudes (61.7 ± 5.5) than those below the age of 28 (57.9 ± 4.9) (p < .001). Nurses working on the upper abdominal surgical ward had significantly greater knowledge (16.2 ± 1.9) than nurses working on other wards (thorax: 14.0 ± 2.3, lower abdominal: 15.4 ± 1.9, and musculoskeletal: 14.5 ± 2.2) (p = .001). Nurses who received education about PCA had significantly better attitudes (45.3 ± 4.6) than those who did not (41.3 ± 3.5) (p < .001). The average correct answer rate for knowledge of opioid analgesics was lower (68.2%) than that for knowledge of the basic configuration of PCA equipment (73.3%) and areas to be identified and managed when using PCA (84.6%), and there was a significant correlation with attitudes toward side effect management (p < .05, r = .19).

Conclusions

There was a significant correlation between the knowledge and attitude of nurses regarding opioid use in PCA. Older nurses with greater clinical experience on the surgical wards who had received PCA education had a better attitude toward PCA. Therefore, newly trained nurses on surgical wards with no experience of PCA education should undergo an intensive education program on opioid analgesics used in PCA.
Using a human-centered, mixed methods approach to understand the patient waiting experience and its impact on medically underserved populations
Authors: Liao Elizabeth N. , Chehab Lara Z. , Neville Kathryn , Liao Jennifer , Patel Devika , Sammann Amanda
Published: November 2022

Purpose

To use a mixed methods approach to investigate the patient waiting experience for a medically underserved population at an outpatient surgical clinic.

Methods

We used lean methodology to perform 96 time-tracked observations of the patient journey in clinic, documenting the duration of activities from arrival to departure. We also used human-centered design (HCD) to perform and analyze 43 semi-structured interviews to understand patients’ unmet needs.

Results

Patients spent an average of 68.5% of their total clinic visit waiting to be seen. While the average visit was 95.8 minutes, over a quarter of visits (27%) were over 2 hours. Patients waited an average of 24.4 minutes in the waiting room and 41.2 minutes in the exam room; and only spent 19.7% of their visit with an attending provider and 11.8% with a medical assistant. Interviews revealed that patients arrive to their visit already frustrated due to difficulties related to scheduling and attending their appointment. This is exacerbated during the visit due to long wait times, perceived information opacity, and an uncomfortable waiting room, resulting in frustration and anxiety.

Conclusions

While time tracking demonstrated that patients spend a majority of their visit waiting to be seen, HCD revealed that patient frustrations span the waiting experience from accessing the appointment to visit completion. These combined findings are crucial for intervention design and implementation for medically underserved populations to improve the quality and experience with healthcare and also address system inefficiencies such as long wait times.
Characterization of the effect of histone deacetylation inhibitors on CD8+ T cells in the context of aging
Authors: Toma Georgiana , Karapetian Eliza , Massa Chiara , Quandt Dagmar , Seliger Barbara
Published: November 2022

Background

Posttranslational protein modifications regulate essential cellular processes, including the immune cell activation. Despite known age-related alterations of the phenotype, composition and cytokine profiles of immune cells, the role of acetylation in the aging process of the immune system was not broadly investigated. Therefore, in the current study the effect of acetylation on the protein expression profiles and function of CD8+ T cells from donors of distinct age was analyzed using histone deacetylase inhibitors (HDACi).

Methods

CD8+ T cells isolated from peripheral blood mononuclear cells of 30 young (< 30 years) and 30 old (> 60 years) healthy donors were activated with anti-CD3/anti-CD28 antibodies in the presence and absence of a cocktail of HDACi. The protein expression profiles of untreated and HDACi-treated CD8+ T cells were analyzed using two-dimensional gel electrophoresis. Proteins with a differential expression level (less than 0.66-fold decrease or more than 1.5-fold increase) between CD8+ T cells of young and old donors were identified by matrix-associated laser desorption ionization—time of flight mass spectrometry. Functional enrichment analysis of proteins identified was performed using the online tool STRING. The function of CD8+ T cells was assessed by analyses of cytokine secretion, surface expression of activation markers, proliferative capacity and apoptosis rate.

Results

The HDACi treatment of CD8+ T cells increased in an age-independent manner the intracellular acetylation of proteins, in particular cytoskeleton components and chaperones. Despite a strong similarity between the protein expression profiles of both age groups, the functional activity of CD8+ T cells significantly differed with an age-dependent increase in cytokine secretion and expression of activation markers for CD8+ T cells from old donors, which was maintained after HDACi treatment. The proliferation and apoptosis rate of CD8+ T cells after HDACi treatment was equal between both age groups.

Conclusions

Despite a comparable effect of HDACi treatment on the protein signature of CD8+ T cells from donors of different ages, an initial higher functionality of CD8+ T cells from old donors when compared to CD8+ T cells from young donors was detected, which might have clinical relevance.
Biological role of matrix stiffness in tumor growth and treatment
Authors: Deng Boer , Zhao Ziyi , Kong Weimin , Han Chao , Shen Xiaochang , Zhou Chunxiao
Published: November 2022

In recent years, the biological role of changes in physical factors in carcinogenesis and progression has attracted increasing attention. Matrix stiffness, also known as ECM stress, is a critical physical factor of tumor microenvironment and remains alternating during carcinogenesis as a result of ECM remodeling through activation of cancer-associated fibroblasts and extracellular collagen accumulation, crosslinking and fibrosis. Different content and density of extracellular collagen in ECM endows matrix with varying stiffness. Physical signals induced by matrix stiffness are transmitted to tumor cells primarily by the integrins receptor family and trigger a series of mechanotransduction that result in changes in tumor cell morphology, proliferative capacity, and invasive ability. Importantly, accumulating evidence revealed that changes in matrix stiffness in tumor tissues greatly control the sensitivity of tumor cells in response to chemotherapy, radiotherapy, and immunotherapy through integrin signaling, YAP signaling, and related signaling pathways. Here, the present review analyzes the current research advances on matrix stiffness and tumor cell behavior with a view to contributing to tumor cell growth and treatment, with the hope of improving the understanding of the biological role of matrix stiffness in tumors.
Synthesis, biological evaluation, and computational studies of some novel quinazoline derivatives as anticancer agents
Authors: Emami Leila , Khabnadideh Soghra , Faghih Zahra , Farahvasi Farnoosh , Zonobi Fatemeh , Gheshlaghi Saman Zare , Daili Shadi , Ebrahimi Ali , Faghih Zeinab
Published: November 2022

A series of quinazolinone derivatives (7a–7h) were synthesized as antiproliferative agents. All compounds, were synthesized through three steps method and structurally evaluated by FTIR, 1H-NMR, 13CNMR and Mass spectroscopy. Their cytotoxic activities were assessed using MTT protocol against three humans cancerous (MCF-7, A549 and 5637) and normal (MRC-5) cell lines. In addition, molecular docking and simulation studies of the synthesized compounds were performed to assessment their orientation, interaction mode against EGFR as plausible mechanism of quinazoline compounds as anticancer agents. The synthesized compounds mostly showed moderate activity against the three studied cell lines. They also indicated an appropriate selectivity against tumorigenic and non-tumorigenic cell line. The molecular docking results also confirmed biological activity. Most of the compounds fulfilled Lipinski rule. Collectively, these compounds with further modification can be considered as potent antiproliferative agents.
How do attitudes shape protective practices against the Asian tiger mosquito in community gardens in a nonendemic country?
Authors: Duval Pénélope , Valiente Moro Claire , Aschan-Leygonie Christina
Published: November 2022

Background

The Asian tiger mosquito Aedes albopictus is responsible for the transmission of many arboviruses worldwide and is well adapted to thrive in urban environments. In mainland France, a nonendemic area, this mosquito is responsible for several autochthonous and imported cases of chikungunya and dengue each year. Better management and prevention of mosquito-borne disease transmission in nonendemic areas is thus of global concern. In this context, the aim of this study was to provide a better understanding of mosquito–human interactions as well as human behavior and beliefs in regard to this mosquito species in urban areas.

Methods

We focused on people who participate in community gardens, which are increasingly popular initiatives in metropolitan France and are conducive to the development of tiger mosquitoes. To evaluate community gardeners’ knowledge and practices in relation to mosquito management and control, we conducted a knowledge, attitude, and practice (KAP) survey.

Results

In contrast to previous KAP studies, we showed that attitudes, more than knowledge, influence the practices of community gardeners in relation to mosquitoes. Interestingly, all gardeners who participated in the survey were concerned about the Asian tiger mosquito and were motivated to incorporate mosquito control methods in their gardens. Moreover, mosquitoes were perceived as nuisances rather than disease vector species. A change in community gardeners’ perceptions could facilitate more appropriate behavior to control this species.

Conclusions

This survey reveals the lack of knowledge and awareness of good practices for the efficient control of the Asian tiger mosquito in green urban areas.

Graphical Abstract
Pure somatic pathogenic variation profiles for patients with serrated polyposis syndrome: a case series
Authors: Hidaka Misaki , Iwaizumi Moriya , Taniguchi Terumi , Baba Satoshi , Osawa Satoshi , Sugimoto Ken , Maekawa Masato
Published: November 2022

Objective

The serrated pathway is a distinct genetic/epigenetic mechanism of the adenoma-carcinoma sequence in colorectal carcinogenesis. Although many groups have reported the genetic-phenotypic correlation of serrated lesions (SLs), previous studies regarding the serrated pathway were conducted on patients with SLs that have different germline and environmental genetic backgrounds. We aimed to compare pure somatic genetic profiles among SLs within identical patient with SPS.

Results

We analyzed SLs from one patient with SPS (Case #1) and compared DNA variant profiles using targeted DNA multigene panels via NGS among the patient’s hyperplastic polyp (HP), three sessile serrated lesions (SSLs), and one traditional serrated adenoma (TSA), and separately analyzed three SSLs and one tubular adenoma (TA) within another patient with SPS (Case #2). In two patients, known pathogenic variant of BRAF (c.1799 T > A, p.Val600Glu) was observed in one TSA and one SSL in Case #1, and in three SSLs within Case #2. The pure somatic pathogenic variant BRAF (c.1799 T > A, p.Val600Glu) among SLs with identical germline genetic background supports its importance as a strong contributor for SLs.
DNA methylation-based detection and prediction of cervical intraepithelial neoplasia grade 3 and invasive cervical cancer with the WID™-qCIN test
Authors: Herzog Chiara , Sundström Karin , Jones Allison , Evans Iona , Barrett James E. , Wang Jiangrong , Redl Elisa , Schreiberhuber Lena , Costas Laura , Paytubi Sonia , Dostalek Lukas , Zikan Michal , Cibula David , Sroczynski Gaby , Siebert Uwe , Dillner Joakim , Widschwendter Martin
Published: November 2022

Background

Cervical screening using primary human papilloma virus (HPV) testing and cytology is being implemented in several countries. Cytology as triage for colposcopy referral suffers from several shortcomings. HPV testing overcomes some of these but lacks specificity in women under 30. Here, we aimed to develop and validate an automatable triage test that is highly sensitive and specific independently of age and sample heterogeneity, and predicts progression to CIN3+ in HPV+ patients.

Results

The WID™-qCIN, assessing three regions in human genesDPP6,RALYL, andGSX1,was validated in both a diagnostic (case–control) and predictive setting (nested case–control), in a total of 761 samples. Using a predefined threshold, the sensitivity of the WID™-qCIN test was 100% and 78% to detect invasive cancer and CIN3, respectively. Sensitivity to detect CIN3+ was 65% and 83% for women < and ≥ 30 years of age. The specificity was 90%. Importantly, the WID™-qCIN test identified 52% of ≥ 30-year-old women with a cytology negative (cyt−) index sample who were diagnosed with CIN3 1–4 years after sample donation.

Conclusion

We identified suitable DNAme regions in an epigenome-wide discovery using HPV+ controls and CIN3+ cases and established the WID™-qCIN, a PCR-based DNAme test. The WID™-qCIN test has a high sensitivity and specificity that may outperform conventional cervical triage tests and can in an objective, cheap, and scalable fashion identify most women with and at risk of (pre-)invasive cervical cancer. However, evaluation was limited to case–control settings and future studies will assess performance and generalisability in a randomised controlled trial.
Visinin-like protein 1 levels in blood and CSF as emerging markers for Alzheimer’s and other neurodegenerative diseases
Authors: Halbgebauer Steffen , Steinacker Petra , Riedel Daniel , Oeckl Patrick , Anderl-Straub Sarah , Lombardi Jolina , von Arnim Christine A. F. , Nagl Magdalena , Giese Armin , Ludolph Albert C. , Otto Markus
Published: November 2022

Background

Visinin-like protein 1 (VILIP-1) belongs to the group of emerging biomarkers with the potential to support the early diagnosis of Alzheimer’s disease (AD). However, studies investigating the differential diagnostic potential in cerebrospinal fluid (CSF) are rare and are not available for blood.

Methods

We set up a novel, sensitive single molecule array (Simoa) assay for the detection of VILIP-1 in CSF and serum. In total, paired CSF and serum samples from 234 patients were investigated: 73 AD, 18 behavioral variant frontotemporal dementia (bvFTD), 26 parkinsonian syndromes, 20 amyotrophic lateral sclerosis (ALS), 22 Creutzfeldt-Jakob disease (CJD), and 75 non-neurodegenerative control (Con) patients. The differential diagnostic potential of CSF and serum VILIP-1 was assessed using the receiver operating characteristic curve analysis and findings were compared to core AD biomarkers.

Results

CSF and serum VILIP-1 levels correlated weakly (r=0.32 (CI: 0.20–0.43), p<0.0001). VILIP-1 concentrations in CSF and serum were elevated in AD compared to Con (p<0.0001 and p<0.01) and CJD (p<0.0001 for CSF and serum), and an increase in CSF was observed already in early AD stages (p<0.0001). In the discrimination of AD versus Con, we could demonstrate a strong diagnostic potential for CSF VILIP-1 alone (area under the curve (AUC): 0.87), CSF VILIP-1/CSF Abeta 1-42 (AUC: 0.98), and serum VILIP-1/CSF Abeta 1-42 ratio (AUC: 0.89).

Conclusions

We here report on the successful establishment of a novel Simoa assay for VILIP-1 and illustrate the potential of CSF and serum VILIP-1 in the differential diagnosis of AD with highest levels in CJD.
Process optimization for biosynthesis of pyruvate decarboxylase (PDC) and Neuberg’s ketol (PAC) from a novel Pichia cecembensis through response surface methodology
Authors: Mushtaq Zareena , Mukhtar Hamid
Published: November 2022

Purpose

Phenylacetylcarbinol (PAC) is an intermediate for the synthesis of several active pharmaceutical ingredients (ephedrine, pseudoephedrine, norephedrine, etc.) used for the production of antiasthematics and decongestants. An efficient biosynthesis of PAC through condensation of benzaldehyde and acetaldehyde catalyzed by a solvent tolerant pyruvate decarboxylase (PDC) is being reported. A process for the biosynthesis of PAC was designed and optimized through response surface methodology (RSM) in the present study.

Methods

The effects of incubation time (8–18 h), incubation temperature (30–38 °C), medium pH (4–10), and inoculum size (4–10%) on PAC yield, sugar consumption, and PDC activity were determined through submerged fermentation using a newly isolated potent yeast strain of Pichia cecembensis. PAC was quantified spectrophotometerically and through HPLC. PDC produced was exposed to 40 mM benzaldehyde as whole cells, crude extract, and partialy purified preparation to check its stability against the said solvent.

Results

The highest PDC activity and PAC yield during present study were found to be 56.27 U/ml and 8.44 g/l, respectively. The yield of PAC was increased by 71% (2.22 to 8.44 g/l) after process optimization through RSM with incubation time of 13 h, incubation temperature of 33 °C, and 18% total sugar as significant factors (P-values, 0.902, 0.260, and 0.247, respectively). R-squared value of 0.770 and Adeq Precision value of 4.888 show the goodness of fit of the process design. PDC is used in the form of Pichia cecembensis whole cells revealed higher stability towards benzaldehyde and elevated temperature as compared to partially purified PDC. Whole cells and partially purified PDC showed half-lives of 240 and 72 h at 4 °C, whereas 33 and 28.5 h at 25 °C. PAC was purified though HPLC with a purity level of 76.18%.

Conclusion

Incubation time, temperature, and sugar concentration were found to be significant factors for the biosynthesis of PAC. A newly isolated Pichia cecembensis produced a highly active, solvent, and temperature-tolerant pyruvate decarboxylase (PDC) which is superior to its counterpart being presently used in the industry. Hence, this novel yeast species is a promising candidate for commercial production of PAC and other related APIs owing to its highly stable PDC.
Perspectives of radiographers on the emergence of artificial intelligence in diagnostic imaging in Saudi Arabia
Authors: Aldhafeeri Faten Mane
Published: November 2022

Objectives

This study aimed to gain insight into radiographers’ views on the application of artificial intelligence (AI) in Saudi Arabia by conducting a qualitative investigation designed to provide recommendations to assist radiographic workforce improvement.

Materials and methods

We conducted an online cross-sectional online survey of Saudi radiographers regarding perspectives on AI implementation, job security, workforce development, and ethics.

Results

In total, 562 valid responses were received. Most respondents (90.6%) believed that AI was the direction of diagnostic imaging. Among the respondents, 88.5% stated that AI would improve the accuracy of diagnosis. Some challenges in implementing AI in Saudi Arabia include the high cost of equipment, inadequate knowledge, radiologists’ fear of losing employment, and concerns related to potential medical errors and cyber threats.

Conclusion

Radiographers were generally positive about introducing AI to radiology departments. To integrate AI successfully into radiology departments, radiographers need training programs, transparent policies, and motivation.
Screening of colistin-resistant bacteria in livestock animals from France
Authors: Hamame Afaf , Davoust Bernard , Hasnaoui Bouthaina , Mwenebitu David Lupande , Rolain Jean-Marc , Diene Seydina M.
Published: November 2022

Colistin is frequently used as a growth factor or treatment against infectious bacterial diseases in animals. The Veterinary Division of the European Medicines Agency (EMA) restricted colistin use as a second-line treatment to reduce colistin resistance. In 2020, 282 faecal samples were collected from chickens, cattle, sheep, goats, and pigs in the south of France. In order to track the emergence of mobilized colistin resistant (mcr) genes in pigs, 111 samples were re-collected in 2021 and included pig faeces, food, and water from the same location. All samples were cultured in a selective Lucie Bardet Jean-Marc Rolain (LBJMR) medium and colonies were identified using MALDI-TOF mass spectrometry and then antibiotic susceptibility tests were performed. PCR and Sanger sequencing were performed to screen for the presence of mcr genes. The selective culture revealed the presence of 397 bacteria corresponding to 35 different bacterial species including Gram-negative and Gram-positive. Pigs had the highest prevalence of colistin-resistant bacteria with an abundance of intrinsically colistin-resistant bacteria and from these samples one strain harbouring both mcr-1 and mcr-3 has been isolated. The second collection allowed us to identify 304 bacteria and revealed the spread of mcr-1 and mcr-3 in pigs. In the other samples, naturally, colistin-resistant bacteria were more frequent, nevertheless the mcr-1 variant was the most abundant gene found in chicken, sheep, and goat samples and one cattle sample was positive for the mcr-3 gene. Animals are potential reservoir of colistin-resistant bacteria which varies from one animal to another. Interventions and alternative options are required to reduce the emergence of colistin resistance and to avoid zoonotic transmissions.