Notes

Social media investigation associated with publication effort of skyrocketing change in MedEd range.
Overcrowding, miscommunication, and unmet patient needs were the factors most frequently contributing to workplace violence.

Healthcare organizations should enhance workplace violence reporting systems and provide interpreters to support international nurses' communication with Saudi patients and families. Nurses need to be trained in workplace violence-related policies and procedures.
Healthcare organizations should enhance workplace violence reporting systems and provide interpreters to support international nurses' communication with Saudi patients and families. Nurses need to be trained in workplace violence-related policies and procedures.
Pancreatic elastase-1 (PE-1) has been investigated in pancreatic disorders. However, the reference interval (RI) of PE-1 in blood remains unconfirmed. We aimed to establish the blood RI of PE-1 in an adult population.

In this prospective cross-sectional study, we enrolled 400 adults who had received the whole-body physical check-up program between 1 May, 2019 and 20 November, 2019. The serum and plasma PE-1 levels were measured by latex turbidimetric immunoassay in different storage conditions (fresh, refrigerated, and frozen). The 95% and 99% RI of PE-1 were calculated according to the Clinical & Laboratory Standards Institute guidelines. The correlations between PE-1 and other parameters were analyzed using multivariable regression models. Ultimately, 38 patients with acute pancreatitis were prospectively recruited as the validation cohort.

The PE-1 levels in fresh serum were highly correlated with those in refrigerated (R
=0.998) or frozen (R
=0.942) samples; however, plasma should not be suggested in frozen conditions (plasma vs. serum R
=0.185). In the RI study population (202 males & 198 females), the median age was 52.6 (25-75% interquartile range 43.1-61.0). The 95% and 99% RIs of PE-1 were 30.0-221.0 ng/dL and 22.0-359.0 ng/dL, respectively. Triglycerides (β=0.106, P=0.033), lipase (β=0.154, P=0.007) and CA19-9 (β=0.130, P=0.008) were independent factors associated with PE-1. In the pancreatitis validation cohort, with a cut-off value of 359.0 ng/dL, the sensitivity and specificity were 100% and 99.8%, respectively.

The RI of PE-1 established in this study can be used for further applications. Serum is the suggested form for frozen sample storage.
The RI of PE-1 established in this study can be used for further applications. Serum is the suggested form for frozen sample storage.We read with interest the article entitled "Vitiligo in a COVID-19-vaccinated patient with ulcerative colitis coincidence?" by Aktas et al.1 The authors describe a 58-year-old man with ulcerative colitis who developed symmetrically distributed vitiligo facial patches around one week after receiving first dose of mRNA vaccine.1 the authors then ponder on the possible underlying immunological mechanism.Canavan disease is caused by ASPA mutations that diminish brain aspartoacylase activity, and it is characterized by excessive brain storage of the aspartoacylase substrate, N-acetyl-l-aspartate (NAA), and by astroglial and intramyelinic vacuolation. Astroglia and the arachnoid mater express sodium-dependent dicarboxylate transporter (NaDC3), encoded by SLC13A3, a sodium-coupled transporter for NAA and other dicarboxylates. Constitutive Slc13a3 deletion in aspartoacylase-deficient Canavan disease mice prevents brain NAA overaccumulation, ataxia, and brain vacuolation. ANN NEUROL 2021.Parkinson's disease (PD) is the second most common neurodegenerative disease and primarily characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta of the midbrain. Despite decades of research and the development of various disease model systems, there is no curative treatment. This could be due to current model systems, including cell culture and animal models, not adequately recapitulating human PD etiology. More complex human disease models, including human midbrain organoids, are maturing technologies that increasingly enable the strategic incorporation of the missing components needed to model PD in vitro. The resulting organoid-based biological complexity provides new opportunities and challenges in data analysis of rich multimodal data sets. Baf-A1 Emerging artificial intelligence (AI) capabilities can take advantage of large, broad data sets and even correlate results across disciplines. Current organoid technologies no longer lack the prerequisites for large-scale high-throughput screening (HTS) and can generate complex yet reproducible data suitable for AI-based data mining. We have recently developed a fully scalable and HTS-compatible workflow for the generation, maintenance, and analysis of three-dimensional (3D) microtissues mimicking key characteristics of the human midbrain (called "automated midbrain organoids," AMOs). AMOs build a reproducible, scalable foundation for creating next-generation 3D models of human neural disease that can fuel mechanism-agnostic phenotypic drug discovery in human in vitro PD models and beyond. Here, we explore the opportunities and challenges resulting from the convergence of organoid HTS and AI-driven data analytics and outline potential future avenues toward the discovery of novel mechanisms and drugs in PD research. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Transplant recipients are at high-risk of anal squamous cell cancer. We aimed to estimate the prevalence of high-risk human papillomavirus (HPV) and high-grade squamous intraepithelial lesion (HSIL) and assess characteristics associated with results METHODS We recruited kidney transplant recipients in a single-centre, 2015-2018. Participants completed a clinical questionnaire and received an anal-swab sent for HPV-DNA and cytological testing RESULTS 97 (74%) of 125 recipients approached consented to participate. Participants were median 47 (IQR 40-55) years, 60% male and median 4.5 (IQR 0.9-13) months-since-transplant. Of 86 assessable samples, at least one HPV genotype was detected in 15 (17%) participants; 1 (1%) HPV16, 8 (9%) other high-risk HPV. Of 76 assessable cytology samples, 9 (12%) showed evidence of abnormality; 1 (1%) HSIL, 1 (1%) atypical-squamous-cells, cannot exclude HSIL. Both HSIL recipients had high-risk HPV and biopsy confirmed HSIL. High-risk HPV was detected in six (9%) recipients witR 0.9-13) months-since-transplant. link2 Of 86 assessable samples, at least one HPV genotype was detected in 15 (17%) participants; 1 (1%) HPV16, 8 (9%) other high-risk HPV. Of 76 assessable cytology samples, 9 (12%) showed evidence of abnormality; 1 (1%) HSIL, 1 (1%) atypical-squamous-cells, cannot exclude HSIL. Both HSIL recipients had high-risk HPV and biopsy confirmed HSIL. High-risk HPV was detected in six (9%) recipients with normal cytology. History of sexually transmitted infection, and abnormal cervical pap smear in women, was associated with high-risk HPV and HSIL CONCLUSIONS High-risk HPV and HSIL testing may identify kidney transplant recipients at higher risk of anal cancer. Longitudinal studies are needed to describe the natural history of anal cancer in transplant recipients. link3 This article is protected by copyright. All rights reserved.The direct integration of gallium nitride (GaN) and diamond holds much promise for high-power devices. However, it is a big challenge to grow GaN on diamond due to the large lattice and thermal-expansion coefficient mismatch between GaN and diamond. In this work, the fabrication of a GaN/diamond heterointerface is successfully achieved by a surface activated bonding (SAB) method at room temperature. A small compressive stress exists in the GaN/diamond heterointerface, which is significantly smaller than that of the GaN-on-diamond structure with a transition layer formed by crystal growth. A 5.3 nm-thick intermediate layer composed of amorphous carbon and diamond is formed at the as-bonded heterointerface. Ga and N atoms are distributed in the intermediate layer by diffusion during the bonding process. Both the thickness and the sp2 -bonded carbon ratio of the intermediate layer decrease as the annealing temperature increases, which indicates that the amorphous carbon is directly converted into diamond after annealing. The diamond of the intermediate layer acts as a seed crystal. After annealing at 1000 °C, the thickness of the intermediate layer is decreased to approximately 1.5 nm, where lattice fringes of the diamond (220) plane are observed.
We aimed to (1) examine the diagnosis of opioid-induced adrenal insufficiency, and (2) investigate the diagnostic value of a morning cortisol <83 nmol/L (3 µg/dl) for the diagnosis of adrenal insufficiency, using newer more specific cortisol assays and cut-offs.

Retrospective study (5/2015-10/2020).

Cohort 1 (N = 75) adults who underwent cosyntropin stimulation testing and opioid exposure for >30 days. Cohort 2 (N = 854) adults, with or without opioid exposure, who had a morning cortisol level measured the same day as stimulation testing.

Peak cortisol during cosyntropin stimulation testing. Sensitivity and specificity of morning serum cortisol for adrenal insufficiency.

The prevalence of adrenal insufficiency in patients with chronic opioid exposure who underwent cosyntropin stimulation testing was 4.0% using a cortisol cutoff of <405 nmol/L (14.7 µg/dl) versus 19% using the traditional cutoff of <500 nmol/L (18.1 µg/dl). For hospitalized patients with and without opioid-exposure, 14 ofdiagnostic test for adrenal insufficiency in hospitalized patients, whether or not receiving opioids.
To investigate whether anti-glypican-1 antibody Miltuximab conjugated with near-infrared dye IRDye800CW can be used for invivo fluorescence imaging of urothelial carcinoma.

The conjugate, Miltuximab-IRDye800CW, was produced and characterized by size exclusion chromatography and flow cytometry with glypican-1-expressing cells. Balb/c nude mice bearing subcutaneous urothelial carcinoma xenografts were intravenously injected with Miltuximab-IRDye800CW or control IgG-IRDye800CW and imaged daily by fluorescence imaging. After 10days, tumors and major organs were collected for exvivo study of the conjugate biodistribution, including its accumulation in the tumor.

The intravenous injection of Miltuximab-IRDye800CW to tumor-bearing mice showed its specific accumulation in the tumors with the tumor-to-background ratio of 12.7±2.4, which was significantly higher than that in the control group (4.6±0.9, P<0.005). The exvivo imaging was consistent with the invivo findings, with tumors from the mice injected with Miltuximab-IRDye800CW being significantly brighter than the organs or the control tumors.

The highly specific accumulation and retention of Miltuximab-IRDye800CW in glypican-1-expressing tumors invivo shows its high potential for fluorescence imaging of urothelial carcinoma and warrants its further investigation toward clinical translation.
The highly specific accumulation and retention of Miltuximab-IRDye800CW in glypican-1-expressing tumors in vivo shows its high potential for fluorescence imaging of urothelial carcinoma and warrants its further investigation toward clinical translation.
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