Hasil untuk "Medicine (General)"

Koneru Suvarna Vani, Puppala Praneeth, Vivek Kommareddy et al.

Human vision depends heavily on retinal tissue. The loss of eyesight may result from infections of the retinal tissues that are treated slowly or do not work at all. Additionally, the diagnosis is susceptible to inaccuracies when a large dataset is involved. Therefore, a fully automated transfer learning approach for diagnosing diabetic retinopathy (DR) is suggested to minimize human intervention while maintaining high classification accuracy. To address this issue, we proposed a transfer learning-based trilateral attention network (TaNet) for the classification. To boost the visual quality of the DR pictures, a contrast constrained adaptive histogram equalization approach is applied. The pre-processed pictures are then segmented using a bilateral segmentation network (BiSeNet). The BiSeNet segmented the optic disc and blood vessels individually. After the completion of segmentation, the features are extracted. Feature extraction is based on the wavelet scattering transformation approach. The results of many trials were evaluated against the Messidor-2, EYEPACS, and APTOS 2019 datasets. The proposed model was created using a refined pre-trained technique and transfer learning methodology. Finally, the suggested framework was tested using efficiency assessment methods, and the classification rate was recorded as having above 98% sensitivity, specificity, precision, and accuracy. The proposed approach yields greater performance and shows enhancement towards the existing approach.

Lorio MP, Tate JL, Myers TJ et al.

Morgan P Lorio,1 Jordan Lee Tate,2 Thomas J Myers,3 Jon E Block,4 Douglas P Beall5 1Advanced Orthopedics, Altamonte Springs, FL, USA; 2Southern Pain and Spine Associates, Jasper, GA, USA; 3Paradigm Health System, Slidell, LA, USA; 4Private Practice, San Francisco, CA, USA; 5Comprehensive Specialty Care, Edmond, OK, USACorrespondence: Jon E Block, Private Practice, 2210 Jackson Street, Ste. 401, San Francisco, CA, 94115, USA, Tel +1(415) 775-7947, Email jb@drjonblock.comAbstract: Specific clinical diagnostic criteria have established a consensus for defining patients with lumbar discogenic pain. However, if conservative medical management fails, these patients have few treatment options short of surgery involving discectomy often coupled with fusion or arthroplasty. There is a rapidly-emerging research effort to fill this treatment gap with intradiscal therapies that can be delivered minimally-invasively via fluoroscopically guided injection without altering the normal anatomy of the affected vertebral motion segment. Viable candidate products to date have included mesenchymal stromal cells, platelet-rich plasma, nucleus pulposus structural allograft, and other cell-based compositions. The objective of these products is to repair, supplement, and restore the damaged intervertebral disc as well as retard further degeneration. In doing so, the intervention is meant to eliminate the source of discogenic pain and avoid surgery. Methodologically rigorous studies are rare, however, and based on the best clinical evidence, the safety as well as the magnitude and duration of clinical efficacy remain difficult to estimate. Further, we summarize the US Food and Drug Administration’s (FDA) guidance regarding the interpretation of the minimal manipulation and homologous use criteria, which is central to designating these products as a tissue or as a drug/device/biologic. We also provide perspectives on the core evidence and knowledge gaps associated with intradiscal therapies, propose imperatives for evaluating effectiveness of these treatments and highlight several new technologies on the horizon.Keywords: degenerative, disc, intradiscal, autologous, allogeneic, injection, regenerative, discogenic, pain

Mengjiao Fan, Guochao Deng, Yue Ma et al.

Abstract Background Despite some therapeutic advances, improvement in survival rates of unresectable and/or metastatic pancreatic ductal adenocarcinoma (PDAC) has been minimal over recent decade. We aimed to evaluate the impact of different treatment sequences on clinical outcomes of advanced PDAC at our academic institution. Methods In this single institution retrospective analysis, we assessed characteristics and survival rates of unresectable and/or metastatic pancreatic PDAC patients who started a systemic treatment between 01/2015 and 12/2021. Survival analyses were performed by Kaplan-Meier and Cox proportional hazards model. Results The number of 285 patients received at least two lines of treatment, but only 137 patients were suitable for third-line treatment. Subgroup analysis showed that thirty-seven patients received A line (gemcitabine/nab-paclitaxel or nab-paclitaxel combined therapy to FOLFIRINOX) therapy, 37 patients received B line (nab-paclitaxel combined therapy to gemcitabine combined therapy to FOLFIRINOX) therapy, 21 patients received C line (nab-paclitaxel combined therapy to gemcitabine combined therapy to oxaliplatin or irinotecan combined therapy) therapy. Survival rates for different treatment lines were significantly different and median overall survival (OS) was 14.00, 18.00, and 14.00 months, respectively (p<0.05). Conclusion Our study provides real-world evidence for the effectiveness of different treatment sequences and underscores the treatment sequences on survival outcome when considering the entire management in advanced PDAC.

Yan Su, Gelin Liu, Haozhe Hou et al.

The residues of progestins in milk are significant risk factors for teenage acne and may cause hormone-dependent cancers in consumers, so the determination of these residues in milk is very important. However, an immunoassay or immunoassay-like method capable of determining multiple progestins in milk has not been reported so far. The present study, for the first time, synthesized a type of magnetic molecularly imprinted microsphere that was capable of simultaneously recognizing five progestins. At the same time, an enzyme labeled conjugate was synthesized by coupling progesterone 3-(o-carboxymethyl)oxime with streptavidinated horseradish peroxidase. The above two reagents were used to develop a semi-homogeneous method for the simultaneous detection of the residues of the five progestins in milk. During the experiments, biotinylated horseradish peroxidase was used to amplify the signal, so the sensitivity to the five drugs (limits of detection 0.04–0.1 pg/mL) was increased 44–75-fold. In addition, the magnetic molecularly imprinted microsphere could be regenerated four times by using simple elution. Through general comparison of its detection spectrum, sensitivity, simplicity, and reusability, the present method exhibited better performance than the previous immunoassays for the detection of progestins, and so it could be used as a routine tool for the screening of progestins residues in milk.

Cloudia Rodriguez, Ruo Ying Feng, Irene Vitoroulis

With the COVID-19 pandemic, there has been an increase in mental health problems in the population worldwide. During the pandemic, individuals from East Asian backgrounds have been blamed for COVID-19 and faced xenophobic attacks, leading to increased incidents of racial discrimination. We administered an online survey to examine (a) associations between in-person and online racial discrimination and mental health (i.e., anxiety and depression) among East Asian university students (n=169) in Canada; and (b) the extent to which coping strategies and ethnic/cultural identity stage (e.g., exploration, resolution, affirmation) moderate the associations between discrimination and mental health. Results from hierarchical regressions indicated that experiencing online racial discrimination predicted more anxiety (b= .263, SE= .070, p< .001) and depression (b= .296, SE= .073, p< .001) symptoms. Using emotion-focused disengagement coping strategies predicted more anxiety (b= .705, SE= .129, p< .001) and depression (b= .763, SE= .127, p< .001). However, identity affirmation (i.e., positive feelings towards ethnic group) predicted less depression (b= -.533, SE= .245, p= .031). Results suggest that exposure to online racial discrimination during the pandemic has a negative effect on East Asian students’ well-being. However, positive feelings towards one’s ethnic identity may protect against mental health problems related to experiences of racial discrimination.

Athanasios Michas, Vasileios Michas, Evangelos Anagnostou et al.

Colorectal carcinoma (colon and rectum) is currently considered among the most prevalent malignancies of Western societies. The pathogenesis and etiological mechanisms underlying colorectal cancer (CRC) development remain complex and heterogeneous. The homeostasis and function of normal human intestinal cells is highly regulated by microRNAs. Therefore, it is not surprising that mutations and inactivation of these molecules appear to be linked with progression of colorectal tumors. Recent studies have reported significant alterations of microRNA expression in adenomas and CRCs compared with adjacent normal tissues. This observed deviation has been proposed to correlate with the progression and survival of disease as well as with choice of optimal treatment and drug resistance. MicroRNAs can adopt either oncogenic or tumor-suppressive roles during regulation of pathways that drive carcinogenesis. Typically, oncogenic microRNAs termed oncomirs, target and silence endogenous tumor-suppressor genes. On the other hand, tumor-suppressive microRNAs are critical in downregulating genes associated with cell growth and malignant capabilities. By extensively evaluating robust studies, we have emphasized and distinguished a discrete set of microRNAs that can modulate tumor progression by silencing specific driver genes crucial in signaling pathways including Wnt/b-catenin, epidermal growth factor receptor, P53, mismatch repair DNA repair, and transforming-growth factor beta.

Dina V. Antonova, Dmitry A. Gnatenko, Elena S. Kotova et al.

Fibroblast activation protein (FAP) is an integral membrane serine protease that acts as both dipeptidyl peptidase and collagenase. In recent years, FAP has attracted considerable attention due to its specific upregulation in multiple types of tumor cell populations, including cancer cells in various cancer types, making FAP a potential target for therapy. However, relatively few papers pay attention to the mechanisms driving the cell-specific expression of the FAP gene. We found no correlation between the activities of the two FAP promoter variants (short and long) and the endogenous FAP mRNA expression level in several cell lines with different FAP expression levels. This suggested that other mechanisms may be responsible for specific transcriptional regulation of the FAP gene. We analyzed the distribution of known epigenetic and structural chromatin marks in FAP-positive and FAP-negative cell lines and identified two potential enhancer-like elements (E1 and E2) in the FAP gene locus. We confirmed the specific enrichment of H3K27ac in the putative enhancer regions in FAP-expressing cells. Both the elements exhibited enhancer activity independently of each other in the functional test by increasing the activity of the FAP promoter variants to a greater extent in FAP-expressing cell lines than in FAP-negative cell lines. The transcription factors AP-1, CEBPB, and STAT3 may be involved in FAP activation in the tumors. We hypothesized the existence of a positive feedback loop between FAP and STAT3, which may have implications for developing new approaches in cancer therapy.

M. Etxandi, I. Baenas, L. Munguía et al.

Introduction COVID19 lockdown is having a significant impact on mental health, patients with eating disorders (ED) are particularly vulnerable. Objectives 1) To explore changes in eating and other psychological features due to confinement in patients with ED from various European and Asian countries; and 2) to assess differences related to diagnostic subtypes, age and geography. Methods The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID19 Isolation Scale (CIES). Results On one hand, patients with Binge Eating Disorder experienced the highest impact on weight and ED symptoms due to confinement. Together with subjects diagnosed with Other Specified Feeding and Eating Disorders (OFSED), they also experienced a deterioration in general psychological state. On the other hand, there was less symptomatic impact on people with Bulimia Nervosa or Anorexia Nervosa and asian and younger individuals appeared to be more resilient in this situation. Conclusions The impact of COVID varied by cultural context and individual variation in age and form of illness. Services may need to target preventive measures and adapting therapeutic approaches for the most vulnerable patients. Disclosure No significant relationships.

Jairo Alberto Jimeno Orozco, Santiago Prieto Rojas, María Mercedes Lafaurie Villamil

Objetivo: Identificar aportes de la literatura científica producida en el periodo 2009-2019 en América Latina sobre atención prenatal humanizada. Fuentes de datos: Se seleccionaron artículos producidos en América Latina que abordaran la atención prenatal humanizada, publicados entre 2009 y 2019 en revistas indexadas (reportadas en MIAR) y localizados en bases de datos reconocidas. Selección de los estudios: Se tuvo en cuenta una selección basada en la fuente, calidad y pertinencia de los estudios, excluyendo la literatura gris. Luego de aplicar filtros se obtuvieron 26 artículos. Extracción de datos: Los datos fueron fichados, utilizando posteriormente una matriz analítica para su codificación. Datos: los estudios, sobre todo provenientes de Colombia y Brasil, fueron en buena parte cualitativos. Se establece que la calidad de la atención se refleja en la accesibilidad y la satisfacción de las usuarias con los servicios. El cuidado prenatal humanizado incide en la salud materno-perinatal. Es relevante el reconocimiento de las necesidades particulares de las gestantes. Los estudios recomiendan cualificar el personal de salud para fortalecer el cuidado prenatal humanizado, asumir las gestantes como protagonistas del proceso, disipando sus dudas y preocupaciones y aportar evidencia sobre la relación atención prenatal humanizada/reducción de la morbimortalidad materna.  Conclusiones: Los estudios realizados reconocen a la gestante como protagonista y sus necesidades como el punto de partida para la atención prenatal humanizada, concebida como referente esencial de la calidad de los servicios con impacto positivo sobre la satisfacción de las gestantes y los resultados maternos. Se requiere formar al personal de salud.

Masao Yoshida, Emine Cesmecioglu, Canan Firat et al.

Whole-block imaging (WBI) using micro-computed tomography (micro-CT) allows the nondestructive reconstruction of a three-dimensional view of tissues, implying that WBI may be used for accurate pathological evaluation of patients with rectal cancer. HOWEVER, the clinical impact of this approach is unclear. We aimed to clarify the efficacy of WBI in the whole-mount specimens of locally advanced rectal cancer. A total of 237 whole-mount formalin-fixed paraffin-embedded blocks from 13 patients with rectal cancer who underwent surgical treatment were enrolled and scanned with micro-CT to generate three-dimensional images. WBI was evaluated following the conventional pathological review of the corresponding whole-slide imaging (WSI). WBI identified all tumor sites detected using WSI. Furthermore, WBI revealed one additional tumor site, which was not detected using WSI. Tumor resection margin was significantly closer to the soft-tissue edge when measured using WBI (7.7 mm vs. 6.6 mm, <i>p</i> < 0.01). Seventy-six percent of tumor deposits on WSI were changed according to the evidence of tumor interaction with the surrounding tissues confirmed using WBI. Furthermore, WBI revealed 25 additional lymph nodes, six of which were metastatic. The combination of conventional hematoxylin and eosin-stained imaging and WBI may contribute to an accurate pathological assessment.

Marc Orts‐Porcar, Alejandro Ororbia, Caroline Fina et al.

Abstract Background Oesophageal pneumatosis (OP) is defined as the presence of gas within the oesophageal wall. The description of this condition in veterinary medicine is currently lacking. The pathogenesis of alimentary tract pneumatosis remains unclear. Current literature describes that access of gas into the oesophageal wall may occur by one or a combination of the following mechanisms: mucosal disruption, increased intra or extra‐luminal pressure or dissection of gas from an extra‐oesophageal source. Objectives The aim of this multi‐centric case series was to describe the computed tomography (CT) findings of OP in dogs. Methods Three adult dogs were included. One dog presented with gastrointestinal signs and general malaise while the other two presented with spontaneous facial and cervical subcutaneous emphysema. Results CT revealed different degrees of intramural gas along the oesophageal wall in all cases. The first dog was diagnosed with emphysematous gastritis based on the presence of gastric pneumatosis paired with compatible clinicopathological and endoscopic findings. This dog was successfully treated with antibiotics. The remaining two dogs were diagnosed with spontaneous pneumomediastinum and required no surgical or medical treatment. Conclusions In all cases with OP, there was concurrent gastric pneumatosis. Gas extensively and circumferentially distributed with a banded shape along the oesophageal wall was present in patients with presumed mural gas dissection because of pneumomediastinum. Conversely, a focal and mild amount of mural gas with a tubular shape was identified in the distal segment of the oesophagus in the patient with emphysematous gastritis.

Yinling Mao, Jiachen Lv, Li Jiang et al.

Abstract Background Long non-coding RNAs (lncRNAs), acting as competing endogenous RNA (ceRNA) have been reported to regulate the expression of targeted genes by sponging miRNA in colon adenocarcinoma (COAD). Methods However, their potential implications for recurrence free survival prognosis and functional roles remains largely unclear in COAD. In this study, we downloaded the TCGA dataset (training dataset) and GSE39582 (validation dataset) of COAD patients with prognostic information. Results A total of 411 differentially expressed genes (DElncRNAs: 12 downregulated and 43 upregulated), 18 DE miRNAs (9 downregulated and 9 upregulated) and 338 DEmRNAs (113 downregulated and 225 upregulated) were identified in recurrence samples compared with non-recurrence samples with the thresholds of FDR < 0.05 and |log2FC|> 0.263. Based on six signature lncRNAs (LINC00899, LINC01503, PRKAG2-AS1, RAD21-AS1, SRRM2-AS1 and USP30-AS1), the risk score (RS) system was constructed. Two prognostic clinical features, including pathologic stage and RS model status were screened for building the nomogram survival model. Moreover, a recurrent-specific ceRNA network was successfully constructed with 2 signature lncRNAs, 4 miRNAs and 113 mRNAs. Furthermore, we further manifested that SRRM2-AS1 predicted a poor prognosis in COAD patients. Furthermore, knockdown of SRRM2-AS1 significantly suppressed cell proliferation, migration, invasion and EMT markers in HT-29 and SW1116 cells. Conclusion These identified novel lncRNA signature and ceRNA network associated with recurrence prognosis might provide promising therapeutic targets for COAD patients.

Shanmei Jiang, Yin He, Mengyuan Li et al.

neriene alves, wilmar barbosa ferraz, luiz oliveira faria

In this work, the thermoluminescent (TL) response of carbon doped lanthanum aluminate crystals grown by solid state reaction method was investigated.  Three syntheses using different combinations of Al2O3, La2O3 and 0.1 wt % of carbon atoms were conducted. The 1:1 mixture of aluminum and lanthanum oxide was mixed with 0.1wt.% carbon and annealed at 1700°C for two hours in a hydrogen atmosphere. The X-ray diffraction analysis revealed the formation of the rhombohedral LaAlO3 crystallographic phase. Ultraviolet-visible spectroscopies were obtained and F and F+ centers were identified ascribed.  Fourier transform infrared spectroscopic data show higher and lower frequencies assigned to AlO6 octahedra in LaAlO3. The UV irradiations were carried out using a commercial 8W UV lamp. Thermoluminescence measurements were performed at a Harshaw 4500 TL reader. The three syntheses were very efficient to obtain carbon doped LaAlO3 crystals with high thermoluminescent output, for low exposure rates of UVR fields.

Sandeep S. V. Golla, Sofie M. Adriaanse, Maqsood Yaqub et al.

Abstract Background  Several criteria exist to identify the optimal model for quantification of tracer kinetics. The purpose of this study was to evaluate the correspondence in kinetic model preference identification for brain PET studies among five model selection criteria: Akaike Information Criterion (AIC), AIC unbiased (AICC), model selection criterion (MSC), Schwartz Criterion (SC), and F-test. Materials and Methods Six tracers were evaluated: [11C]FMZ, [11C]GMOM, [11C]PK11195, [11C]Raclopride, [18F]FDG, and [11C]PHT, including data from five subjects per tracer. Time activity curves (TACs) were analysed using six plasma input models: reversible single-tissue model (1T2k), irreversible two-tissue model (2T3k), and reversible two-tissue model (2T4k), all with and without blood volume fraction parameter (V B). For each tracer and criterion, the percentage of TACs preferring a certain model was calculated. Results For all radiotracers, strong agreement was seen across the model selection criteria. The F-test was considered as the reference, as it is a frequently used hypothesis test. The F-test confirmed the AIC preferred model in 87% of all cases. The strongest (but minimal) disagreement across regional TACs was found when comparing AIC with AICC. Despite these regional discrepancies, same preferred kinetic model was obtained using all criteria, with an exception of one FMZ subject. Conclusion In conclusion, all five model selection criteria resulted in similar conclusions with only minor differences that did not affect overall model selection.

Marisha Burden, Maria G. Frank, A. Keniston et al.

Calvin H Jan

Advanced microscopy and labeling techniques reveal that bacteria localize mRNAs within their cells in a similar way to eukaryotes.

Tuna Demirdal, Pınar Şen, Salih Atakan Nemli

M. Roth, C. Gurney, R. Garside et al.

H. Krebs