Notes

Antiphospholipid syndrome-induced ischemic cerebrovascular event following pembrolizumab: Situation record and thorough assessment.
ients.
syndrome is a rare tumor predisposition syndrome caused by germline
mutation, which is related to a variety of benign and malignant diseases. Our report is the first described case of these three disease phenotypes of
syndrome. The female patient with a novel germline
nonsense mutation (c.1088_1089delCTinsAA p.F363X) in exon 8 that was inherited from her mother. In addition to germline
mutation, two different hotspot somatic
mutations were detected in her ovarian tissue and goiter tissue. Our report will expand the report of
mutations in
syndrome-related diseases and provide case references for further research in the future.

When the related disease phenotype appears in childhood, it should be considered whether it is
syndrome. Genetic testing can help diagnose
syndrome and develop related surveillance strategies. Awareness of the
syndrome may result in early recognition of these rare pediatric tumors and appropriate therapeutic management.
When the related disease phenotype appears in childhood, it should be considered whether it is DICER1 syndrome. Genetic testing can help diagnose DICER1 syndrome and develop related surveillance strategies. Awareness of the DICER1 syndrome may result in early recognition of these rare pediatric tumors and appropriate therapeutic management.
Ferroptosis, as a novel regulated cell death form, has a close interaction with metabolism, which is largely unknown in cancer. In the present study, we conducted a comprehensive analysis of ferroptosis-related metabolic genes to delineate the metabolic signatures induced by ferroptosis and evaluate its prognostic significance in hepatocellular carcinoma (HCC).

The ferroptosis-related metabolic genes (Fer-MRGs) were identified by correlation analyses with transcriptome data from The Cancer Genome Atlas and Gene Expression Omnibus. Then, univariate and the least absolute shrinkage and selection operator Cox regression analysis was used to establish a novel risk score model. Univariate and multivariate COX analyses were used to identify independent prognostic factors for overall survival (OS) of HCC, and a nomogram was developed. The Fer-MRGs' expression was further evaluated by quantitative real-time polymerase chain reaction in HCC.

A total of 77 metabolic genes were identified as Fer-MRGs, and 26 were ese results indicated the intense interaction between ferroptosis and metabolism, the significant role of ferroptosis-related MRGs, and the great potential of the novel risk score model for prognosis prediction in HCC.
Musculoskeletal disorders contributed from chronic kidney disease are increasing worldwide. Musculoskeletal disorders had a significant health burden and are leading causes of co-morbidities, disability and low productivity, which potentially affect individual's functional status and quality of life.

The aim of this study was to assess the prevalence of musculoskeletal disorders and its associated factors among patients with chronic kidney attending in Saint Paul Hospital, Addis Ababa, Ethiopia.

An institution-based cross-sectional study was conducted on 302 enrolled study participants through systematic random sampling techniques. Face-to-face interview, physical examination and chart reviews were used to collect data using semi-structured questionnaire adapted from a standard Nordic Musculoskeletal Questionnaire and other literatures. Data were entered into Epi Info version 7 and exported to SPSS version 23 for analysis. Bivariate logistic regression analysis was employed with a p-value less than 0.25their association with musculoskeletal disorders.
MSDs were shown to be moderately common in CKD patients. Female gender, age between 40 and 49 yrs, stage III and stage IV CKD, hypertension, higher PTH level, lower calcium level and lower vitamin D level were statistically significant in their association with musculoskeletal disorders.The role of traumatic brain injury in the development of glioma is highly controversial since first presented. This is not unexpected because traumatic brain injuries are overwhelmingly more common than glioma. However, the causes of post-traumatic glioma have been long discussed and still warrant further research. In this review, we have presented an overview of previous cohort studies and case-control studies. We have summarized the roles of microglial cells, macrophages, astrocytes, and stem cells in post-traumatic glioma formation and development, and reviewed various carcinogenic factors involved during traumatic brain injury, especially those reported in experimental studies indicating a relationship with glioma progression. Besides, traumatic brain injury and glioma share several common pathways, including inflammation and oxidative stress; however, the exact mechanism underlying this co-occurrence is yet to be discovered. In this review, we have summarized current epidemiological studies, clinical reports, pathophysiological research, as well as investigations evaluating the probable causes of co-occurrence and treatment possibilities. More efforts should be directed toward elucidating the relationship between traumatic brain injury and glioma, which could likely lead to promising pharmacological interventions towards designing therapeutic strategies.
Inflammation has a significant impact on CYP3A activity. We hypothesized that this effect might be age dependent. Our objective was to conduct a population pharmacokinetic study of midazolam in mice at different developmental stages with varying degrees of inflammation to verify our hypothesis.

Different doses (2 and 5 mg/kg) of lipopolysaccharide (LPS) were used to induce different degrees of systemic inflammation in Swiss mice (postnatal age 9-42 days, n = 220). The CYP3A substrate midazolam was selected as the pharmacological probe to study CYP3A activity. Postnatal age, current body weight, serum amyloid A protein 1 (SAA1) levels and LPS doses were collected as covariates to perform a population pharmacokinetic analysis using NONMEM 7.2.

A population pharmacokinetic model of midazolam in juvenile and adult mice was established. Postnatal age and current body weight were the most significant and positive covariates for clearance and volume of distribution. LPS dosage was the most significant and negative covariate for clearance. LPS dosage can significantly reduce the clearance of midazolam by 21.8% and 38.7% with 2 mg/kg and 5 mg/kg, respectively. Moreover, the magnitude of the reduction was higher in mice with advancing postnatal age.

Both inflammation and ontogeny have an essential role in CYP3A activity in mice. The effect of LPS-induced systemic inflammation on midazolam clearance in mice is dependent on postnatal age.
Both inflammation and ontogeny have an essential role in CYP3A activity in mice. The effect of LPS-induced systemic inflammation on midazolam clearance in mice is dependent on postnatal age.Endoscopic submucosal dissection (ESD) is a method of en-bloc resection of neoplastic colorectal lesions which is less invasive compared to surgical resection. Lesion stratification, architecture recognition and estimation of depth of invasion are crucial for patient selection. Expert endoscopists have integrated a variety of classification systems including Paris, lateral spreading tumor (LST), narrow band imaging (NBI), international colorectal endoscopic (NICE) and Japanese NBI expert team (JNET) in their day-to-day practice to enhance lesion detection accuracy. Major societies recommend ESD for LST-non granular (NG), Kudo-VI type, large depressed and protruded colonic lesions with shallow submucosal invasion. Chance of submucosal invasion enhances with increased depth as well as tumor location and size. In comparison to endoscopic mucosal resection (EMR), ESD has a lowerl recurrence rate and higher curative resection rate, making it superior for larger colonic lesions management. Major complications such as bleeding and perforation could be seen in up to 11% and 16% of patients, respectively. In major Western countries, performing ESD is challenging due to limited number of expert providers, lack of insurance coverage, and unique patient characteristics such as higher BMI and higher percentage of previously manipulated lesions.
Vitiligo can cause disfiguration, impair the social function of the patients and induce physiological burdens. However, limited research about the health-related quality of life has been conducted in vitiligo patients' sleeping conditions.

To evaluate the prevalence, severity, and risk factors of insomnia in vitiligo patients.

This case-control study was performed in March 2021. An online survey questionnaire including baseline information and the sleep-related instrument was sent to 762 vitiligo patients. The vitiligo-related evaluation was conducted by online video interview. According to whether having insomnia or not, patients were grouped and compared their clinical and demographic characteristics. The logistic regression model was conducted to analyze the risk factors for insomnia.

A total of 409 patients were included. About 49.9% of patients (204/409) experienced insomnia. About 55.9% (114/204) of the insomnia in vitiligo patients was adjustment sleep disorder caused by vitiligo. Development, is prevalent in vitiligo patients. Dermatologists should identify this condition carefully, especially humanistic factors in social life, and perform individualized "non-drug" treatment.Pruritus is the most burdensome and prevalent symptom in patients suffering from atopic dermatitis. Treating atopic itch has historically been a challenge due to multiple underlying mechanisms within its pathogenesis and an incomplete understanding of them. In recent years, our understanding of these mechanisms have increased tremendously and subsequently, new treatments have reached the market that target the pathophysiology of atopic itch from different angles. In addition, there are several promising new treatments currently in development and trials. In the current article, we discuss these currently available treatment options, their available evidence and efficacy, and highlight some of the more recent advancements in the field.
In the present study, we performed bioinformatics studies and in vitro functional assays to explore the underlying role of serpin family H member 1 (SERPINH1) in the diabetic retinopathy.

Common differentially expressed genes (DEGs) between diabetic retinal tissues and normal retinal tissues were analyzed using Gene Expression Omnibus (GEO) database. The proliferation and migration of human retinal endothelial cells (HRECs) was evaluated by MTS, EdU and wound healing assays, respectively; the miRNA and mRNAs expression levels of hub genes in HRECs were determined using quantitative real-time PCR (qRT-PCR). Protein levels were determined using a Western blot assay.

A total of 189 common DEGs were screened between two GEO datasets (GSE60436 and GSE94019), and ten potential hub genes that may link to the progression of diabetic retinopathy were detected. The qRT-PCR results showed that collagen, type I, alpha 1 (COL1A1), Collagen, type I, alpha 2 (COL1A2) and serpin family H member 1 (SERPINH1) mRNA expresssociated with diabetic retinopathy pathophysiology. Further mechanistic studies indicated that miR-29b/SERPINH1 signaling participated in high glucose-induced enhancement in the proliferation and migration of HRECs.
Guangdong, located in South China, is one of the areas heavily affected by HIV-1 in China. The transmission of HIV-1 among men who have sex with men (MSM) has gradually been increasing in Guangdong.

To investigate the characteristics of the HIV-1 drug resistance, and genetic transmission networks in MSM with antiretroviral therapy (ART) failure from 2014 to 2019 in Guangdong.

HIV-1
gene sequences were amplified. An online subtyping tool was used to determine the genotype, and a maximum likelihood phylogenetic tree was reconstructed to confirm the genotype results. The Stanford University HIV Drug Resistance Database was used to analyse the sequences of drug resistance mutations (DRMs) and drug resistance profiles. A pairwise Tamura-Nei 93 genetic distance-based method was used to analyse the genetic transmission networks.

Of 393 sequences isolated from HIV-infected MSM with ART failure, CRF01_AE (47.3%), CRF07_BC (21.4%) and CRF55_01B (21.4%) were the top three strains. 55.2% individuals harboured on network analysis revealed a complex transmission pattern, and more attention should be given to younger HIV-1-infected MSM with multiple links.
Accumulating evidence demonstrates that genetic susceptibility genes can be used as biomarkers to assess sepsis susceptibility, and genetic variation is associated with susceptibility and clinical outcomes in patients with sepsis and inflammatory disease. Although studies have shown that the lncRNA
is involved in inflammatory diseases, it remains unclear whether
gene polymorphisms are associated with susceptibility to inflammatory diseases, such as sepsis, in children.

We genotyped the rs6983267
polymorphism in 474 cases (pediatric sepsis) and 678 controls using TaqMan methods, and odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of associations.

Our results indicate that the rs6983267 T > G polymorphism is significantly associated with an increased risk of sepsis in children (TG and TT adjusted OR = 1.311, 95% CI = 1.016-1.743, GG and TT adjusted OR = 1.444, 95% CI = 1.025-2.034 dominant model GG/TG vs TT adjusted OR = 1.362, 95% CI = 1.055-1.756). Furthermore, the risk effect was more pronounced in children younger than 60 months who were male and who had sepsis.

We found that the
gene polymorphism rs6983267 T > G may be associated with an increased risk of pediatric sepsis in southern China. A larger multicenter study should be performed to confirm these results.
G may be associated with an increased risk of pediatric sepsis in southern China. A larger multicenter study should be performed to confirm these results.
Prostate cancer is the second leading cause of cancer death in men worldwide. Olaparib is clinically approved for the treatment prostate cancer, but cytotoxicity and off-target effects including DNA damage limit its clinical applications. In the current study, new strategies to improve the therapeutic efficacy of olaparib for the treatment of prostate cancer were investigated.

Two prostate cancer cell lines were exposed to the c-MET inhibitor PHA665752 and/or the PARP inhibitor olaparib. Cell counting kit-8, colony formation assays, and transwell assays were conducted to evaluate the cytotoxicity of olaparib alone or in combination with PHA665752 in prostate cancer cell lines. Western blotting, immunofluorescence staining, and the comet assay were used to assess the effects of PHA665752 on olaparib-induced DNA damage.

Combined inhibition of c-MET and PARP resulted in effective and synergistic blocking of the growth of prostate cancer cell lines. Invasion and migration were significantly suppressed when the agents were combined. Mechanistically, dual blocking of PARP and c-MET in prostate cancer cell lines was associated with an impaired DNA damage response. Interestingly, immunofluorescence staining analysis of RAD51 protein indicated that the c-MET inhibitor PHA665752 significantly impaired homologous repair via downregulated translocation of RAD51 into the nucleus in prostate cancer cells.

The combination of the c-MET inhibitor PHA665752 and the PARP inhibitor olaparib may be a promising therapeutic strategy in patients with prostate cancer.
The combination of the c-MET inhibitor PHA665752 and the PARP inhibitor olaparib may be a promising therapeutic strategy in patients with prostate cancer.
Glioblastoma multiforme (GBM) is the primary aggressive malignancy of the brain with poor outcome. Curcumin analogues are polyphenolic compounds as the bioactive substances extracted from turmeric. This study aims to investigate the anti-cancer effects of four curcumin analogues. Furthermore, the molecular mechanisms of dimethoxycurcumin in human gliomas were analyzed by Western blot.

Human LN229 and GBM8401 glioma cells were treated by four curcumin analogues with different number of methoxy groups. The cell viability, cell cycle, apoptosis, proliferation and ROS production of human gliomas were analyzed by flow cytometry. Moreover, the effects of four curcumin analogues on tumorigenesis of gliomas wereconducted by wound healing assay and colony formation assay. Furthermore, the molecular mechanisms of dimethoxycurcumin in human gliomas were analyzed by Western blot.

Our data showed that four different curcumin analogues including curcumin, bisdemethoxycurcumin, demethoxycurcumin, and dimethoxycurcumin promote sub-G1 phase, G2/M arrest, apoptosis, and ROS production in human glioma cells. Moreover, dimethoxycurcumin suppressed cell viability, migration, and colony formation, induction of sub-G1, G2/M arrest, apoptosis, and ROS production in glioma cells. Moreover, the mechanism of dimethoxycurcumin is ROS production to increase LC3B-II expression to induce autophagy. Furthermore, dimethoxycurcumin suppressed apoptotic marker, BCL-2 to promote apoptosis in LN229 and GBM8401 glioma cells.

Our study found that dimethoxycurcumin induced apoptosis, autophagy, ROS production and suppressed cell viability in human gliomas. Dimethoxycurcumin might be a potential therapeutic candidate in human glioma cells.
Our study found that dimethoxycurcumin induced apoptosis, autophagy, ROS production and suppressed cell viability in human gliomas. Dimethoxycurcumin might be a potential therapeutic candidate in human glioma cells.
Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related death worldwide with poor prognosis. Accumulating evidence indicates that miR-765 is an important regulator in the progression and prognosis of various cancers. In this study, the function in the progression and prognosis of NSCLC was investigated.

The expression of miR-765 in NSCLC was analyzed by qRT-PCR. The effect of miR-765 on cell proliferation, migration, and invasion of NSCLC was evaluated by CCK8 and Transwell assay. Kaplan-Meier analysis and Cox regression analysis were employed to assess the prognostic value of miR-765.

The results demonstrated the significant upregulation of miR-765 in NSCLC tissues and cell lines relative to normal tissues and cells. High miR-765 expression was significantly correlated with the TNM stage of patients. Patients with high miR-765 expression showed a poorer prognosis than that of patients with low miR-765 expression. Cox analysis indicated that miR-765 could be considered as an independent prognostic factor for NSCLC. Additionally, the upregulation of miR-765 was revealed to promote NSCLC cell proliferation, migration, and invasion by targeting BMP6.

The overexpression of miR-765 in NSCLC was associated with TNM stage and poor prognosis of patients. miR-765 served as a tumor promoter of NSCLC by regulating BMP6. These findings provide a potential biomarker and therapeutic target for the prognosis and treatment of NSCLC.
The overexpression of miR-765 in NSCLC was associated with TNM stage and poor prognosis of patients. miR-765 served as a tumor promoter of NSCLC by regulating BMP6. These findings provide a potential biomarker and therapeutic target for the prognosis and treatment of NSCLC.Anaplastic lymphoma kinase (ALK) rearrangement is extremely rare in lung squamous cell carcinoma (LSCC), and it remains controversial as to whether LSCC patients with ALK rearrangement can benefit from ALK tyrosine kinase inhibitors (TKIs). Here, we report an LSCC patient with ALK rearrangement who was treated with sequential ALK TKI therapies and experienced a clinical benefit of 35 months. Although the use of ALK TKIs showed clinical benefits, targeted next-generation sequencing (NGS) for dynamic monitoring of circulating tumor DNA (ctDNA) from patient plasma revealed the accumulation of ALK resistance mutations, which could provide valuable information in designing the treatment strategy. Our study highlights the importance of dynamic monitoring of ctDNA using NGS to discover tumor evolution to guide treatment decision-making and provides meaningful insights into the potential treatment options for ALK-positive LSCC patients.[This corrects the article DOI 10.2147/OTT.S286627.].
Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat's effect on blood glucose especially in our setting, Harar estern Ethiopia.

Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects.

A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement.

(Median ± IQR [interquartile range]) fasso that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.
Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.As the world continues to respond to the coronavirus pandemic (COVID-19), there is a larger hidden threat of antimicrobial resistance (AMR) lurking behind. AMR remains worrisome in that the pathogens causing resistant infections to thrive in hospitals and medical facilities, putting all patients at risk, irrespective of the severity of their medical conditions, further compounding the management of COVID-19. This study aims to provide overview of early findings on COVID-19 and AMR as well as to provide recommendations and lesson learned toward improving antimicrobial stewardship. We conducted a rapid narrative review of published articles by searching PubMed and Google Scholar on COVID-19 and Antimicrobial Resistance with predetermined keywords. Secondary bacterial infections play crucial roles in mortality and morbidity associated with COVID-19. Research has shown that a minority of COVID-19 patients need antibiotics to treat secondary bacterial infections. Current evidence reiterates the need not to give antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless it is indicated. The pandemic has also brought to the fore the deficiencies in health systems around the world. This comes with a lot of lessons, one of which is that despite the advances in medicine; we remain incredibly vulnerable to infections with limited or no standard therapies. This is worth thinking in the context of AMR, as the resistant pathogens are evolving and leading us to the era of untreatable infections. There is a necessity for continuous research into understanding and controlling infectious agents, as well as the development of newer functional antimicrobials and the need to strengthen the antimicrobial stewardship programs.Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of staff perception on existing hospital patient safety culture (PSC) is the first step to promote PSC. This paper is aimed to assess the patient safety culture in 1 big public autonomous general hospital in Hanoi, Vietnam. This cross-sectional study surveyed 638 healthcare professional utilizing the validated (Hospital Survey on Patient Safety Culture [HSOPSC]) in an online format. This study adhered to STROBE guidelines. The positive response rate was high, with a percentage of 74.2. The strongest areas are teamwork within units (91.3%) and organizational learning/continuous improvement (88.4%). The areas for improvement are staffing (49.4%) and non-punitive response to error (53.1%). Hospital administrators should strengthen the culture of patient safety by formulating strategies and implementing interventions with emphasis on adequate staffing and promoting blame-free working environment.
Anemia is a global public health problem affecting both developing and developed countries. It is associated with increased morbidity and mortality in pregnant women and children. Nevertheless, information regarding the prevalence of anemia and associated factors among pregnant in the study area is limited. Therefore, this study was aimed to assess the prevalence of anemia and associated factors among pregnant women attending antenatal care clinic in Adare General Hospital, Southern Ethiopia.

A facility-based cross-sectional study was conducted from October 1, 2020, to December 15, 2020, among 340 pregnant women aged 15 to 49 years who came for focused antenatal care follow-up. Trained data collectors administered questionnaires, and collected capillary blood and stool samples. Data were coded and entered into EPI Info 7 and the analysis was done using SPSS version 20.0. Factors associated with anemia were assessed using binary logistic regression. Those variables that had a
-value less than .25 on bi-vpansion of prenatal iron-folate supplementation.
Anemia had moderate public health significance in the study. Low monthly family income, educational status, iron tablet consumption during pregnancy and Plasmodium vivax infection were found to be independent predictors for anemia in pregnancy. The burden of anemia should be alleviated through enhancing maternal socio-economic status, prevention of illnesses targeting pregnant women, and strengthening the expansion of prenatal iron-folate supplementation.
Strategies to improve sexual health outcomes have evolved over the years due to technology's evolution to ensure that they are relevant. Challenges have been noticed in different systems that run parallel, particularly in Low-Income Countries where the majority utilise Indigenous Health Systems. Optimisation of resources and minimisation of conflicts could be realised through integrated health systems in the management of adolescents' sexual health issues. This study sought to develop strategies to facilitate Indigenous Health System and Modern Health System integration to improve the management of Adolescent Sexual Health issues, leveraging results from 3 papers.

A multi-stage approach was utilised, with Phase 1 focussing on a preliminary assessment through merging findings from the 4 papers. The Strengths, Weaknesses, Opportunities, and Threats analyses were then used, followed by the Basic Logic Model to identify critical aspects that needed to be considered in building the strategies. The second phaseween the 2 systems and ensuring collaborative efforts towards shared goals that would transform to better Sexual Health Outcomes for adolescents.Our objective is to analyze the economic burden of chronic kidney disease (CKD) in Vietnam, particularly in District 2 Hospital at Ho Chi Minh City in 2019. This is a descriptive cross-sectional study. The data source is the medical records of the patients. Encoding the data, analyzing treatment cost, regression modeling, and verification were performed using Stata 15 software. Patients with stage 3 CKD account for the highest proportion of the CKD patient population. CKD comorbidities include hypertension, diabetes, cardiovascular disease, and anemia, which increase the treatment fees of patients. Approximately half of the patients with CKD have diabetes or cardiovascular disease. Treatment costs increase as the condition of the patient worsens (except for stage 1 and 2 CKD). The total expenses of all CKD patients in District 2 Hospital were USD 916 423 988.60. Five main factors that affect the treatment fee of a patient CKD stage, age, gender, and the presence of diabetes, cardiovascular disease, and anemia. The regression model correctly predicts 96% of cases and can explain 64.15% of the fluctuations in costs. The cost of CKD treatment was higher than Vietnam's per capita GDP in 2019, and the primary factors affecting costs are comorbidities and dialysis.The occurrence of several disinfectant byproducts has been investigated in swimming pools. Until now, there are only a few studies on nitrosamine, particularly N-nitrosodimethylamine in swimming pool water. This could be due to the lack of a suitable method that is sensitive enough for the measurement of N-nitrosodimethylamine in pool waters. Other disinfectant byproducts formed in pool water widely documented are trihalomethanes, haloacetic acids, halonitromethanes, and chloramines but inadequate information on N-nitrosodimethylamine. This paper provides a review of the nitrogenous disinfectant byproduct in swimming pools and its health implications. Anthropogenic substances introduced by swimmers such as sweat, lotions, and urine contribute to the formation of N-nitrosodimethylamine. The reaction of secondary amines such as dimethylamine with mono/dichloroamines produced dimethyl hydrazine and further undergo oxidation to form N-nitrosodimethylamine. The reaction of chlorine and other disinfectants with these anthropogenic sources in swimming pools cause cancer and asthma in human tissues. Thus, the assessment of N-nitrosodimethylamine in the swimming pool is less well documented. Therefore, the health consequences, mutagenic, and genotoxic potentials of N-nitrosodimethylamine should be the focus of more research studies.
Coronavirus-2019 (COVID-19) is affecting many people. Chronic patients are highly vulnerable to contracting an infection. Most people recover within a week, but chronic patients can face severe illness or death. The increasing of cases, complications, and mortality demands compulsory preventive measures. Therefore, this study was designed to identify major preventive practices and associated factors.

A facility-based cross-sectional study was employed from November to December 2020 among diabetics and HIV/AIDS follow-up clients in Dessie referral hospital. Data were entered into EpiData manager 4.6.0 version and exported to Statistical Package for Social Science (SPSS) version 25.0 for data cleaning and analysis. Logistic regression analysis was done and an adjusted odds ratio (AOR) with its 95% confidence interval (CI) was used for determining the strength of association.

Data were collected from 426 participants with a mean age of 46.54 years. The overall poor prevention practice rate of COVID-19 amonlow-up clients was poor. Illiteracy, having a family size greater than four, not having health professionals in the household, not having health insurance and urban residency were associated with poor prevention practices. Therefore, continuous health educations about good preventive behavioral practice should be enhanced by the health professionals.
Student-led clinics have gained increasing attention as a mechanism for students across various health professions to gain authentic interprofessional clinical placement experience during their educational programme.

This scoping review is designed to identify and describe experiences relating to student-led clinics in Aotearoa New Zealand.

The review involved five key steps 1) identifying the research question; 2) identifying relevant studies; 3) study selection; 4) charting the data; and 5) collating, summarising and reporting the results.

Student-led health clinics present invaluable educational opportunities for authentic collaborative practice and capacity to improve population health and well-being, especially in marginalised and disadvantaged communities. Clinic establishment and operation require consideration of a complex set of factors.

Community consultation (including with Indigenous populations) should precede establishment of clinics. There is scope for more reporting and objective evaluation to ensure best practice is being determined, developed, and achieved.
Community consultation (including with Indigenous populations) should precede establishment of clinics. There is scope for more reporting and objective evaluation to ensure best practice is being determined, developed, and achieved.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a valuable tool for diagnosing pulmonary disease due to its efficiency and safety. We retrospectively analyzed patients with mediastinal masses who underwent diagnostic EBUS-TBNA at Shanghai Chest Hospital, and evaluated the clinical accuracy of EBUS-TBNA in the diagnosis mediastinal masses.

From 2009 and 2014, patients who received EBUS-TBNA to diagnose a isolated mediastinal mass were enrolled. Clinical follow-up was performed to ascertain the patient's final diagnosis.

Forty-six patients were enrolled in this study. Thirty-seven were diagnosed with an oncologic disease, 3 were diagnosed with a mediastinal infection, and 2 were found to have a mediastinal goiter. The overall sensitivity, specificity, positive predictive value, negative predictive value, diagnostic yield was 63.6%, 100%, 100%, 42.9%, and 71.4%, respectively.

EBUS-TBNA is a safe and effective means of diagnosing mediastinal masses.
EBUS-TBNA is a safe and effective means of diagnosing mediastinal masses.The COVID-19 has spread to almost all countries since its emergence from Wuhan, China. Afghanistan has entered the third wave of the COVID-19 pandemic in May 2021. The county is bracing the third wave at a time when challenges like continuous conflict, illiteracy, poverty, inadequate healthcare personnel and service coverage, inadequate testing capacity, shortage of laboratory kits and reagents, lower public awareness and lower public trust on the government have brought it to its knees. All stakeholders including government, healthcare workers, civil societies, the public and the international community should combine their efforts to combat such a devastating situation. Although the inception of vaccination program against COVID-19 seems relieving, but it may take several months until a significant proportion of the people get vaccinated to reach the herd immunity. Thus, non-pharmaceutical intervention should be followed strictly. Moreover, awareness campaigns should also be continued to educate people and keep them supportive of the government plans and policies. Otherwise, the current wave may cause deadly consequences in such a complex situation.
Pressure on Australia's healthcare system is increasing annually due to corresponding increases in chronic diseases such as obesity and rapidly ageing population growth across Australia, resulting in requirements for increased funding. This study investigates the financial impact to hospitals due to inaccurate obese patient recording and coding.

Australian healthcare organisations receive Activity-Based Funding (ABF) which provides reimbursement of costs relating to the type of patient care delivered and the resources required for the patient treatment. Accurate healthcare data are essential to ensure accuracy of ABF and appropriate reimbursement of costs incurred by hospitals that manage obese patients. Managing obese patients results in operational funding requirements such as increased staffing and purchasing of equipment such as hoists, bariatric wheelchairs and bariatric beds, and hospitals must ensure that these clinical requirements are documented accurately in order to be reimbursed of these costsunities and reduced cost burdens that hospitals currently experience when required to fund obesity-related clinical and safety requirements within operational budgets.
Improvements are required in the clinical recording and coding of patient obesity, such as mandatory recording of patient weight and height data and automated BMI calculations within electronic patient records. Enhanced obesity recording and coding accuracy will result in increased funding opportunities and reduced cost burdens that hospitals currently experience when required to fund obesity-related clinical and safety requirements within operational budgets.The taro plant, Colocasia esculenta, contains bioactive proteins with potential as cancer therapeutics. Several groups have reported anti-cancer activity in vitro and in vivo of taro-derived extracts (TEs). We reported that TE inhibits metastasis in a syngeneic murine model of Triple-Negative Breast Cancer (TNBC).
We sought to confirm our earlier studies in additional models and to identify novel mechanisms by which efficacy is achieved.

We employed a panel of murine and human breast and ovarian cancer cell lines to determine the effect of TE on tumor cell viability, migration, and the ability to support cancer stem cells. Two syngeneic models of TNBC were employed to confirm our earlier report that TE potently inhibits metastasis. Cancer stem cell assays were employed to determine the ability of TE to inhibit tumorsphere-forming ability and to inhibit aldehyde dehydrogenase activity. To determine if host immunity contributes to the mechanism of metastasis inhibition, efficacy was assessed in immune-comprosing an isolation protocol described earlier (TE). In preparation for a near future clinical trial, we have now developed a strategy to isolate an enriched taro fraction, TE-method 2, (TE-M2) as well as a more purified subfraction (TE-M2F1) which can be scaled up under Good Manufacturing Practice (GMP) conditions for evaluation in human subjects. We demonstrate that TE-M2 and TE-M2F1 retain the anti-metastatic properties of TE.

These studies provide further support for the continued examination of biologically active components of
as potential new therapeutic entities and identify a method to isolate sufficient quantities under GMP conditions to conduct early phase clinical studies.
These studies provide further support for the continued examination of biologically active components of Colocasia esculenta as potential new therapeutic entities and identify a method to isolate sufficient quantities under GMP conditions to conduct early phase clinical studies.
While getting anti-epileptic drugs (AEDs) treatment around two-thirds of the patients with epilepsy enter a seizure-free state, but some of them continue to experience seizures which increase the risk of accident, disability, death, and treatment side effects. Therefore, this study aimed to identifychanges in the frequency of seizure attacks overtime and associated factors among adult patients with epilepsy.

A retrospective two year follow-up study was conducted among adult patients with epilepsy who initiated AEDs between July 2017 and June 2019. A simple random sampling technique was applied to select 394 patient charts. The data were entered into Epi-data and then exported to R software for further analysis. A generalized linear mixed model under a negative binomial family was applied to identify determinants of the frequency of seizure attacks.

The median number of seizure attacks at baseline were 3 with the IQR of 2 and on average the frequency of seizure attacks decrease in a linear pattern over tion that might reflect treatment effects of AEDs. Smokers, khat chewers, suffering a head injury, depression, experienced sleep deprivation, and clumsiness increases the number of seizure attacks. Conversely, the age group 25-34 years saw a decrease in the number of seizure attacks. This underscores that special attention should be given to substance users and those with related mental health disorders.[This corrects the article DOI 10.2147/NDT.S321675.].
Patients with early-onset schizophrenia usually exhibit more severe symptoms, revealing a potentially distinctive disease phenotype. Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme in folate conversion and methylation modification associated with the disease. We aimed to investigate the potential effects of
polymorphisms and related methylation patterns in patients with early-onset schizophrenia, which implies special phenotypes of schizophrenia.

In 177 patients with schizophrenia,
polymorphism at three sites (C677T, A1298C, and G1793A) and the Positive and Negative Syndrome Scale (PANSS) were tested. Differential methylation positions (DMPs) and enrichment of genes and related pathways were analyzed by testing the genomic methylation level. Catechol-O-methyltransferase (
), solute carrier family 6 member 4 (
), neuregulin1 (
), and brain-derived neurotrophic factor (
) were selected to evaluate the methylation levels of specific CpG regions by pyrosequencing.

Higher levels of symptom severity and
polymorphisms and lower levels of global DNA methylation in patients with early-onset schizophrenia were observed in this study.
was hypermethylated, and
was hypomethylated in specific regions of patients with early-onset schizophrenia.

Aggravating symptoms, increased
polymorphisms, and reduced genomic methylation levels may be characteristics and underlying mechanisms of early-onset schizophrenia, which implies a special disease phenotype. Beyond that, specific genes and biological pathways may imply the potential phenotype of schizophrenia.
Aggravating symptoms, increased MTHFR polymorphisms, and reduced genomic methylation levels may be characteristics and underlying mechanisms of early-onset schizophrenia, which implies a special disease phenotype. Beyond that, specific genes and biological pathways may imply the potential phenotype of schizophrenia.
A novel RGD-modified PEGylated lipid-core micelle delivery system was designed to improve the anti-cancer effect of docetaxel on triple negative breast cancer (TNBC).

The tumor-targeted lipid-core micelles loaded with docetaxel were prepared and characterized. Their morphology, particle size, zeta potential, entrapment efficiency, release profiles, and targeting effects were studied. The antitumor effects of the docetaxel-loaded nano-micelles were investigated in a MDA-MB-231 cell model in vitro and a MDA-MB-231 xenograft model in vivo.

The prepared RGD-modified docetaxel-loaded lipid-core micelles were spherical with a particle size of 16.44±1.35 nm, zeta potential of -19.24±1.24 mV, and an encapsulation efficiency of 96.52±0.43%. The drug delivery system showed sustained release properties and could significantly enhance docetaxel uptake by MDA-MB-231 tumor cells in vitro, which was proved to be a caveolae pathway mediated process requiring ATP, Golgi apparatus, and acid lysosomes. The results of the pharmacokinetic study displayed that the area under the curve of the targeted micelles was 3.2-times higher than that of docetaxel commercial injections. Furthermore, in a MDA-MB-231 tumor-bearing mice model, a higher antitumor efficacy than docetaxel commercial injections was displayed, and the safety experiments showed that the micellar material did not cause major organ damage after intravenous administration in mice.

The novel RGD-modified PEGylated lipid-core micelle delivery system significantly improved the antitumor effects and reduced the side-effects of docetaxel, providing a promising therapeutics for the treatment of TNBC.
The novel RGD-modified PEGylated lipid-core micelle delivery system significantly improved the antitumor effects and reduced the side-effects of docetaxel, providing a promising therapeutics for the treatment of TNBC.
To compare the ability of both terpesomes (TPs) and leciplex (LPs) loaded moxifloxacin hydrochloride (MOX) for enhancing ocular drug conveyance.

Two separate 2
.3
full-factorial trials were established to determine the influence of multiple variables upon nanovesicles properties and select the optimized formulae using Design Expert
software. The thin-film hydration method was used to formulate TPs, while the single-step procedure was used for LPs. All formulae were characterized for their entrapment efficiency percent (EE%), particle size distribution (PS), polydispersity index (PDI), and zeta potential (ZP). Then, the optimized formulae were selected, evaluated, and compared for additional assessments.

The optimized formulae TP4 and LP1 showed EE% of 84.14±0.21 and 78.47±0.17%, PS of 578.65±5.65 and 102.41±3.39 nm, PDI of 0.56±0.04 and 0.28±0.01, ZP of -12.50±0.30 and 32.50±0.50 mV, respectively. Further, LP1 showed enhanced corneal permeation across cow cornea compared to MOX solution and TP4. Besides, confocal laser scanning microscopy assessment viewed valuable infiltration from the fluoro-labeled LP through corneal layers compared to TP. LP1 showed spherical morphology and, its ability to adhere to mucus membranes was justified. Further, LP1 showed superiority over MOX solution in biofilm inhibition and eradication in addition to the treatment of infected mice with methicillin-resistant
without any inflammatory response. Finally, the histopathological study verified the harmlessness and biocompatibility of the assembled LPs.

The gained outcomes confirmed the capability of utilizing LPs as a successful nanovesicle for the ocular conveyance of MOX over TPs and MOX solution.
The gained outcomes confirmed the capability of utilizing LPs as a successful nanovesicle for the ocular conveyance of MOX over TPs and MOX solution.
Caregivers of COPD patients experience various caregiving burden, which is related to their quality of life. We aimed to explicitly explore whether social support and negative coping styles play the chain mediating roles in the relationship between the caregiving burden of caregivers of COPD patients and their health-related quality of life.

We conducted a multicenter cross-sectional survey in four hospitals using a convenience sample. Participants who met the inclusion criteria completed five relevant scales, including a sociodemographic scale. One-way ANOVA and Pearson's method were used to analyze the data accordingly, and chain mediated effect values were estimated by bootstrap method to determine whether the model holds.

Among the 201 caregivers who participated in this study, the mean age was 55.94 years, most of them were female (61.2%), the mean caregiving burden score was 52.39 ± 14.65, and the quality of life score was 37.97 ± 3.55. Among them, age, gender, education, relationship with the patf life. The combination of adequate perceived social support and lower negative coping can be effective in alleviating caregiving burden and improving their quality of life. Therefore, healthcare professionals should provide targeted guidance to caregivers with the help of social support and interventions that regulate negative coping styles.[This corrects the article DOI 10.2147/COPD.S297980.].High-throughput experiments enable researchers to explore complex multifactorial diseases through large-scale analysis of omics data. Challenges for such high-dimensional data sets include storage, analyses, and sharing. Recent innovations in computational technologies and approaches, especially in cloud computing, offer a promising, low-cost, and highly flexible solution in the bioinformatics domain. Cloud computing is rapidly proving increasingly useful in molecular modeling, omics data analytics (eg, RNA sequencing, metabolomics, or proteomics data sets), and for the integration, analysis, and interpretation of phenotypic data. We review the adoption of advanced cloud-based and big data technologies for processing and analyzing omics data and provide insights into state-of-the-art cloud bioinformatics applications.
Schizophrenia is characterized by a high disease burden. Olanzapine is a common drug used in antipsychotic medication. Little is known about the population pharmacokinetics of olanzapine in elderly patients. Missed doses are a common and unavoidable issue during the treatment of psychiatric diseases, especially in elderly patients. This study aimed to identify what an elderly person should do if doses are inadvertently missed.

Data were collected from 140 elderly psychiatric patients (aged ≥65 years) who received olanzapine therapy. Olanzapine concentrations were determined by high pressure liquid chromatographic tandem mass spectrometry (HPLC-MS/MS) and a population-based approach was used to quantify the characteristics of elderly patients. A non-linear mixed-effects model was used for data analysis. Simulations based on the final model were applied to predict situations involving a single missed dose or three consecutive missed doses under several remedial regimens.

A total of 474 samples from 140 elderly patients were included in the therapeutic drug monitoring (TDM) data analysis. A one-compartment model, with no significant covariates, was developed to describe the population pharmacokinetics of olanzapine in elderly patients. The population predicted systematic clearance (CL/F) and volumes of distribution (V/F) were 18 L/h and 785 L, respectively. The simulation demonstrated that in a missed dose situation, elderly patients should take the regular dose immediately; the refill dose used at the second remedial time point depends on the length of the time delay.

Here, we used a simulation to provide a remedial regimen for missed doses of olanzapine in the elderly population. Our simulation can provide valuable suggestions for individualized therapy in elderly patients.
Here, we used a simulation to provide a remedial regimen for missed doses of olanzapine in the elderly population. Our simulation can provide valuable suggestions for individualized therapy in elderly patients.Levosimendan is a distinctive inodilator combing calcium sensitization, phosphodiesterase inhibition and vasodilating properties through the opening of adenosine triphosphate-dependent potassium channels. It was first approved in Sweden in 2000 for the short-term treatment of acutely decompensated severe chronic heart failure when conventional therapy is not sufficient, and in cases where inotropic support is considered appropriate. After more than 20 years, clinical applications have considerably expanded across critical care and emergency medicine, and levosimendan is now under investigation in different cardiac settings (eg, septic shock, pulmonary hypertension) and for non-cardiac applications (eg, amyotrophic lateral sclerosis). This narrative review outlines key milestones in levosimendan history, by addressing regulatory issues, pharmacological peculiarities and clinical aspects (efficacy and safety) of a drug that did not receive great attention in the heart failure guidelines. A brief outlook to the ongoing clinical trials is also offered.
Read More: