A positive correlation of serum SFRP1 levels with the risk of developing type 2 diabetes mellitus: a case-control study.

OBJECTIVE: Secreted frizzled-related protein 1 (SFRP1) is an adipokine whose production is significantly altered in metabolic disorders. Considering the relationship between dysfunction of Wnt/ß-catenin signaling and metabolic disorders as well as the inhibitory effects of SFRP1 on this signaling pathway, the present work aimed to investigate the correlation between serum SFRP1 levels and type 2 diabetes mellitus (T2DM) and its developing risk factors for the first time. METHODS: This case-control study measured serum levels of SFRP1, tumor necrosis factor (TNF)-α, interleukin (IL)-6, adiponectin, and fasting insulin using enzyme-linked immunosorbent assay kits in 80 T2DM patients and 80 healthy individuals. Biochemical parameters were determined using the AutoAnalyzer instrument. RESULTS: The T2DM group had higher levels of SFRP1 compared with the controls (146.8100 ± 43.61416 vs 81.9531 ± 32.78545 pg/mL; P < .001). There was a positive correlation between SFRP1 and insulin (r = 0.327, P = .003), TNF-α (r = 0.420, P < .001) as well as homeostatic model assessment for insulin resistance (r = 0.328, P = .003) in the T2DM group. In addition, 10-unit changes in SFRP1 levels showed the risk of T2DM in both the unadjusted (odds ratio [OR] [95% CI] = 1.564 [1.359-1.800]) and adjusted models accounting for age, gender, and body mass index (OR [95% CI] = 1.564 [1.361-1.799]; P < .001). A cut-off value of SFRP1 (105.83 pg/mL) was identified to distinguish between the T2DM patients and the healthy subjects, with sensitivity of 75.0% and specificity of 80.0%. CONCLUSION: According to our research, there was a significant and positive link between the amount of SFRP1 and the likelihood of developing T2DM as well as the related factors like insulin resistance index and TNF-α. These results indicated that SFRP1 might have a potential role in the development of T2DM.

Exploring the modulation of MLH1 and MSH2 gene expression in hesperetin-treated breast cancer cells (BT-474).

The major mortality factor for women globally is breast cancer, and current treatments have several adverse effects. Hesperetin (HSP) is a flavone that occurs naturally with anti-tumor capabilities and has been investigated as a potential treatment for cancer. This study aimed to investigate the cytotoxic and anti-malignant potential of HSP on breast cancer cells (BT-474) and normal cells (MCF-10a). The results indicated that HSP has dose-dependent cytotoxicity in BT-474 and MCF-10a cells. The elevated concentration of HSP lowered cell viability and proliferation. The half-maximal inhibitory concentration (IC50) of HSP in BT-474 cancer cells after a 48-h exposure was 279.2 µM/ml, while the IC50 in normal cells was 855.4 µM/ml. The cytotoxicity of HSP was more significant in cancer cell lines than in normal cell lines and this aspect presents a favorable factor in utilizing the drug for the treatment of breast cancer. The apoptotic effect of HSP in BT-474 cells was investigated, and it was found that the higher the concentration of HSP more the cells underwent apoptosis. Furthermore, the highest concentration of HSP led to overexpression of the MLH1 and MSH2 genes in both breast cancer and normal cell lines. Overall, our study suggests that HSP has an anticancer effect on breast cancer cell lines, and the effect is concentration dependent.

Study of hesperetin effect on modulating transcription levels of MLH1 and MSH2 genes in SKBR3 breast cancer cell line.

Hesperetin (HSP), a flavonoid, has been validated to modify gene expression and function as an epigenetic agent to stop the development of breast carcinoma cells. HSP was investigated in this research to evaluate the expression of the MLH1 and MSH2 genes in cancerous breast cell lines (SKBR3) and healthy cell lines (MCF-11A) after exposure to different dosages (200, 400, and 600 µM/mL) of HSP. After 48 h of exposure, SKBR3's half-maximal inhibitory concentration was 289.6 µM/mL and MCF-10A's was 855.4 µM/mL. The research found that increasing HSP concentrations were closely correlated with an increase in MLH1 gene levels in the SKBR3 cell line, as shown by median and percentile values. HSP therapy caused the MLH1 gene expression to substantially vary in different groups, and in the SKBR3 cell line, MSH2 gene expressions were elevated in a dose-escalating manner. Moreover, HSP also raised the number of apoptotic cells, with the fraction of apoptotic cells escalating substantially at doses of 400 and 600 µM/mL. The outcomes suggested that HSP has the potential to be utilized as a therapeutic intervention for breast cancer, as it can induce apoptosis and reduce cell viability.

Hesperetin effect on MLH1 and MSH2 expression on breast cancer cells BT-549.

Due to its genetic and phenotypic heterogeneity, breast cancer is very difficult to eliminate. The harmful consequences of conventional therapies like radiation and chemotherapy have prompted the search for organic-based alternatives. Hesperetin (HSP), a flavonoid, has been discovered to possess the ability to hinder the proliferation of cell associated with breast cancer by acting as an epigenetic agent and modifying gene expression. In this investigation, breast cancer cells (BT-549) and normal cells (MCF-10a) were subjected to the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) test and three different doses (200, 400, and 600 µM/mL) of HSP for real-time polymerase chain reaction and flow cytometry to examine its cytotoxic and anti-malignant potential. HSP was shown to be cytotoxic to both normal and breast cancer cells, but had a more pronounced effect on the cancer cell lines. After 48 h of treatment, the half-maximal inhibitory concentration (IC50) for BT-549 was 279.2 µM/mL, whereas the IC50 for MCF-10a was 855.4 µM/mL. At high HSP concentrations, upregulation of the MLH1 and MSH2 genes was observed in both cell lines. The influence of HSP on MLH1 gene expression was concentration dependent. Moreover, HSP had a concentration-dependent effect on MSH2 gene expression in the BT-549 cell line but not in the MCF-10a cell line. Cell death and early apoptosis were shown to be concentration dependent upon the application of HSP, as determined by flow cytometric analysis. HSP's capacity to cause apoptosis and its stronger impact on the malignant cell line when analyzed with the normal cell line imply that it might be useful as an effective therapeutic approach for combating breast cancer.

Textual data transformations using natural language processing for risk assessment.

Underlying information about failure, including observations made in free text, can be a good source for understanding, analyzing, and extracting meaningful information for determining causation. The unstructured nature of natural language expression demands advanced methodology to identify its underlying features. There is no available solution to utilize unstructured data for risk assessment purposes. Due to the scarcity of relevant data, textual data can be a vital learning source for developing a risk assessment methodology. This work addresses the knowledge gap in extracting relevant features from textual data to develop cause-effect scenarios with minimal manual interpretation. This study applies natural language processing and text-mining techniques to extract features from past accident reports. The extracted features are transformed into parametric form with the help of fuzzy set theory and utilized in Bayesian networks as prior probabilities for risk assessment. An application of the proposed methodology is shown in microbiologically influenced corrosion-related incident reports available from the Pipeline and Hazardous Material Safety Administration database. In addition, the trained named entity recognition (NER) model is verified on eight incidents, showing a promising preliminary result for identifying all relevant features from textual data and demonstrating the robustness and applicability of the NER method. The proposed methodology can be used in domain-specific risk assessment to analyze, predict, and prevent future mishaps, ameliorating overall process safety.

Impact of polyunsaturated fatty acid supplementation on assisted reproductive technology outcomes: a systematic review.

This review explores the impact of polyunsaturated fatty acid (PUFA) supplementation in women undergoing assisted reproductive technology (ART) on reproductive outcomes. A systematic search of English peer-reviewed journals was carried out using MEDLINE, EMBASE, and the Cochrane Library to identify articles published from January 1978 to 2021. The primary outcomes assessed included pregnancy and live birth rates. Secondary outcome measures included: (i) implantation rate; (ii) fertilisation rate; (iii) number of oocytes retrieved; (iv) number of metaphase II (MII) oocytes; (v) blastocyst conversion; and (vi) embryo quality. A total of 4 randomised control trials (RCTs) met the inclusion criteria. There is a lack of high-quality research to support widespread dietary supplementation with PUFAs in women undergoing ART. Prior to its clinical recommendation, there is a need for well-designed RCTs to facilitate an in-depth understanding of PUFA supplementation in women undergoing ART.

Assessment of Situation Awareness Conflict Risk between Human and AI in Process System Operation.

The conflict between human and artificial intelligence is a critical issue, which has recently been introduced in Process System Engineering, capturing the observation and action conflicts. Interpretation conflict is another source of potential conflict that can cause serious concern for process safety as it is often perceived as confusion, surprise, or a mistake. It is intangible and associated with situation awareness. However, interpretation conflict has not been studied with the required emphasis. The current work proposes a novel methodology to quantify interpretation conflict probability and risk. The methodology is demonstrated, tested, and validated on a two-phase separator. The results show that interpretation conflict is usually hidden, mixed, or covered by traditional faults, and noises in observation and interpretation, including sensor faults, logic errors, cyberattacks, human mistakes, and misunderstandings, may easily trigger interpretation conflict. The proposed methodology will serve as a mechanism to develop strategies to manage interpretation conflict.

Fertility Sparing Surgery and Borderline Ovarian Tumours.

To determine the oncological outcomes following fertility-sparing surgery (FSS) for the management of Borderline Ovarian Tumours (BOTs). A retrospective analysis of participants diagnosed with BOTs between January 2004 and December 2020 at the West London Gynaecological Oncology Centre was conducted. A total of 172 women were diagnosed; 52.3% (90/172) underwent FSS and 47.7% (82/172) non-FSS. The overall recurrence rate of disease was 16.9% (29/172), of which 79.3% (23/29) presented as the recurrence of serous or sero-mucinous BOTs and 20.7% (6/29) as low-grade serous carcinoma (LGSC). In the FSS group, the recurrence rate of BOTs was 25.6% (23/90) presenting a median 44.0 (interquartile range (IQR) 41.5) months, of which there were no episodes of recurrence presenting as LGSC reported. In the non-FSS group, all recurrences of disease presented as LGSC, with a rate of 7.7% (6/78), following a median of 47.5 months (IQR 47.8). A significant difference between the type of surgery performed (FSS v Non-FSS) and the association with recurrence of BOT was observed (Pearson Chi-Square: p = 0.000; x = 20.613). Twelve women underwent ultrasound-guided ovarian wedge resection (UGOWR) as a novel method of FSS. Recurrence of BOT was not significantly associated with the type of FSS performed (Pearson Chi- Square: x = 3.166, p = 0.379). Non-FSS is associated with negative oncological outcomes compared to FSS, as evidenced by the higher rate of recurrence of LGSC. This may be attributed to the indefinite long-term follow up with ultrasound surveillance all FSS women undergo, enabling earlier detection and treatment of recurrences.

Pandemic risk management using engineering safety principles.

The containment of infectious diseases is challenging due to complex transmutation in the biological system, intricate global interactions, intense mobility, and multiple transmission modes. An emergent disease has the potential to turn into a pandemic impacting millions of people with loss of life, mental health, and severe economic impairment. Multifarious approaches to risk management have been explored for combating an epidemic spread. This work presents the implementation of engineering safety principles to pandemic risk management. We have assessed the pandemic risk using Paté-Cornell's six levels of uncertainty. The susceptible, exposed, infected, quarantined, recovered, deceased (SEIQRD), an advanced mechanistic model, along with the Monte Carlo simulation, has been used to estimate the fatality risk. The risk minimization strategies have been categorized into hierarchical safety measures. We have developed an event tree model of pandemic risk management for distinct risk-reducing strategies realized due to natural evolution, government interventions, societal responses, and individual practices. The roles of distinct interventions have also been investigated for an infected individual's survivability with the existing healthcare facilities. We have studied the Corona Virus Disease of 2019 (COVID-19) for pandemic risk management using the proposed framework. The results highlight effectiveness of the proposed strategies in containing a pandemic.

The application of metabolomics in ovarian cancer management: a systematic review.

Metabolomics, the global analysis of metabolites in a biological specimen, could potentially provide a fast method of biomarker identification for ovarian cancer. This systematic review aims to examine findings from studies that apply metabolomics to the diagnosis, prognosis, treatment, and recurrence of ovarian cancer. A systematic search of English language publications was conducted on PubMed, Science Direct, and SciFinder. It was augmented by a snowball strategy, whereby further relevant studies are identified from reference lists of included studies. Studies in humans with ovarian cancer which focus on metabolomics of biofluids and tumor tissue were included. No restriction was placed on the time of publication. A separate review of targeted metabolomic studies was conducted for completion. Qualitative data were summarized in a comprehensive table. The studies were assessed for quality and risk of bias using the ROBINS-I tool. 32 global studies were included in the main systematic review. Most studies applied metabolomics to diagnosing ovarian cancer, within which the most frequently reported metabolite changes were a down-regulation of phospholipids and amino acids: histidine, citrulline, alanine, and methionine. Dysregulated phospholipid metabolism was also reported in the separately reviewed 18 targeted studies. Generally, combinations of more than one significant metabolite as a panel, in different studies, achieved a higher sensitivity and specificity for diagnosis than a single metabolite; for example, combinations of different phospholipids. Widespread metabolite differences were observed in studies examining prognosis, treatment, and recurrence, and limited conclusions could be drawn. Cellular processes of proliferation and invasion may be reflected in metabolic changes present in poor prognosis and recurrence. For example, lower levels of lysine, with increased cell invasion as an underlying mechanism, or glutamine dependency of rapidly proliferating cancer cells. In conclusion, this review highlights potential metabolites and biochemical pathways which may aid the clinical care of ovarian cancer if further validated.

Evaluating the use of telemedicine in gynaecological practice: a systematic review.

OBJECTIVES: The aim of this systematic review is to examine the use of telemedicine in the delivery and teaching of gynaecological clinical practice. To our knowledge, no other systematic review has assessed this broad topic. DESIGN: Systematic review of all studies investigating the use of telemedicine in the provision of gynaecological care and education. The search for eligible studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and focused on three online databases: PubMed, Science Direct and SciFinder. ELIGIBILITY CRITERIA: Only studies within gynaecology were considered for this review. Studies covering only obstetrics and with minimal information on gynaecology, or clinical medicine in general were excluded. All English language, peer-reviewed human studies were included. Relevant studies published up to the date of final submission of this review were considered with no restrictions to the publication year. DATA EXTRACTIONS AND SYNTHESIS: Data extracted included author details, year of publication and country of the study, study aim, sample size, methodology, sample characteristics, outcome measures and a summary of findings. Data extraction and qualitative assessment were performed by the first author and crossed checked by the second author. Quality assessment for each study was assessed using the Newcastle-Ottawa scale. RESULTS: A literature search carried out in August 2020 yielded 313 records published between 1992 and 2018. Following a rigorous selection process, only 39 studies were included for this review published between 2000 and 2018. Of these, 19 assessed gynaecological clinical practice, eight assessed gynaecological education, one both, and 11 investigated the feasibility of telemedicine within gynaecological practice. 19 studies were classified as good, 12 fair and eight poor using the Newcastle-Ottawa scale. Telecolposcopy and abortion care were two areas where telemedicine was found to be effective in potentially speeding up diagnosis as well as providing patients with a wide range of management options. Studies focusing on education demonstrated that telementoring could improve teaching in a range of scenarios such as live surgery and international teleconferencing. CONCLUSIONS: The results of this review are promising and demonstrate that telemedicine has a role to play in improving clinical effectiveness and education within gynaecology. Its applications have been shown to be safe and effective in providing remote care and training. In the future, randomised controlled studies involving larger numbers of patients and operators with measurable outcomes are required in order to be able to draw reliable conclusions.

How can process safety and a risk management approach guide pandemic risk management?

The coronavirus disease (COVID-19) brought the world to a halt in March 2020. Various prediction and risk management approaches are being explored worldwide for decision making. This work adopts an advanced mechanistic model and utilizes tools for process safety to propose a framework for risk management for the current pandemic. A parameter tweaking and an artificial neural network-based parameter learning model have been developed for effective forecasting of the dynamic risk. Monte Carlo simulation was used to capture the randomness of the model parameters. A comparative analysis of the proposed methodologies has been carried out by using the susceptible, exposed, infected, quarantined, recovered, deceased (SEIQRD) model. A SEIQRD model was developed for four distinct locations: Italy, Germany, Ontario, and British Columbia. The learning-based approach resulted in better outcomes among the models tested in the present study. The layer of protection analysis is a useful framework to analyze the effect of different safety measures. This framework is used in this work to study the effect of non-pharmaceutical interventions on pandemic risk. The risk profiles suggest that a stage-wise releasing scenario is the most suitable approach with negligible resurgence. The case study provides valuable insights to practitioners in both the health sector and the process industries to implement advanced strategies for risk assessment and management. Both sectors can benefit from each other by using the mathematical models and the management tools used in each, and, more importantly, the lessons learned from crises.

Imported bancroftian filariasis discovered in a patient infected with Plasmodium falciparum: First case of concomitant parasitism in the Al-Buraimi Governorate, Oman.

Malaria and lymphatic filariasis (LF) are endemic in tropical and subtropical regions of sub-Saharan Africa, Asia, and Central and South America. Ninety-two percent (200 million) of malaria cases in 2017 were detected in the WHO African Region. This accounts for approximately 30% of the global burden of LF disease and includes 405.9 million people at risk in 39 out of 46 member countries. Anopheles species of mosquitoes transmit Wuchereria bancrofti in most parts of Africa. Our case of a 23-year-old Nigerian woman highlights incidental laboratory findings showing the first malaria/filariasis coinfection in the governorate (province). This coinfection was ascertained during the usual medical screening before recruitment in Oman, which is routinely conducted for every expatriate.

The quality of YouTube videos on endoscopic third ventriculostomy and endoscopic third ventriculostomy with choroid plexus cauterization procedures available to families of patients with pediatric hydrocephalus.

OBJECTIVE: YouTube has become an important information source for pediatric neurosurgical patients and their families. The goal of this study was to determine whether the informative quality of videos of endoscopic third ventriculostomy (ETV) and endoscopic third ventriculostomy with choroid plexus cauterization (ETV + CPC) is associated with metrics of popularity. METHODS: This cross-sectional study used comprehensive search terms to identify videos pertaining to ETV and ETV + CPC presented on the first 3 pages of search results on YouTube. Two pediatric neurosurgeons, 1 neurosurgery resident, and 2 patient families independently reviewed the selected videos. Videos were assessed for overall informational quality by using a validated 5-point Global Quality Score (GQS) and compared to online metrics of popularity and engagement such as views, likes, likes/views ratio, comments/views ratio, and likes/dislikes ratio. Weighted kappa scores were used to measure agreement between video reviewers. RESULTS: A total of 58 videos (47 on ETV, 7 on ETV + CPC, 4 on both) of 120 videos assessed met the inclusion criteria. Video styles included "technical" (62%), "lecture" (24%), "patient testimonial" (4%), and "other" (10%). In terms of GQS, substantial agreement was seen between surgeons (kappa 0.67 [95% CI 0.55, 0.80]) and excellent agreement was found between each surgeon and the neurosurgical resident (0.77 [95% CI 0.66, 0.88] and 0.89 [95% CI 0.82, 0.97]). Only fair to moderate agreement was seen between professionals and patient families, with weighted kappa scores ranging from 0.07 to 0.56. Academic lectures were more likely to be rated good or excellent (64% vs 0%, p < 0.001) versus surgical procedure and testimonial video types. There were significant associations between a better GQS and more likes (p = 0.01), views (p = 0.02), and the likes/dislikes ratio (p = 0.016). The likes/views ratio (p = 0.31) and comments/views ratio (p = 0.35) were not associated with GQS. The number of likes (p = 0.02), views (p = 0.03), and the likes/dislikes ratio (p = 0.015) were significantly associated with video style (highest for lecture-style videos). CONCLUSIONS: Medical professionals tended to agree when assessing the overall quality of YouTube videos, but this agreement was not as strongly seen when compared to parental ratings. The online metrics of likes, views, and likes/dislikes ratio appear to predict quality. Neurosurgeons seeking to increase their online footprint via YouTube would be well advised to focus more on the academic lecture style because these were universally better rated.

Paragangliomas of the spine: a retrospective case series in a national reference French center.

INTRODUCTION: Primary paragangliomas (PG) of the spine are extremely rare entities. The present study reviews our experience over a period of 30 years. METHODS: This is a retrospective, single center, observational study. Patients surgically treated for a spinal PG with confirmed anatomopathological diagnosis were included. The McCormick classification was used as a reference for clinical evaluation. Follow-up MRI and clinical assessment took place at 6 weeks, 3 months, 6 months, and 1 year after surgery and on yearly basis after. RESULTS: Six cases have been operated in our institution. The mean age was 37.8 (median 35.5, 30-53). The mean follow-up period was 9.6 years (median 9.5, 1-23). Preoperative duration of symptoms varied between a few hours to 4 years. Low back pain was most common sign. One presented with hemorrhage and acute onset of paraplegia. All patients underwent single surgery, with the exception of one case, which had two surgeries on the same anatomical site and a third surgery on another location of the same tumor type. Preoperatively, McCormick scale was I in four cases, and II and IV in one case, respectively. Postoperatively, all patients in McCormick I retained the same class; one patient in McCormick II passed to McCormick III; the case in McCormick IV recovered to McCormick II. Five of eight surgeries achieved total resection, while two surgeries accomplished a partial microsurgical excision and one a gross total resection. Three patients had spinal leptomeningeal dissemination. Two of them benefited from extended spine radiotherapy, while the other of a "wait-and-scan" policy. Spinal leptomeningeal dissemination was stable in all patients at last follow-up. CONCLUSION: We consider surgery as primary treatment in all PG. In our experience, preoperative diagnosis is difficult and caution must be taken to perioperative course in these cases. We do not routinely perform postoperative radiation if there is a residual tumor. We regularly perform clinical and radiological follow-up, so as to be able to document recurrent cases, which have been reported even up to 30 years after primary surgical excision.

In Vitro Macrophage Nitric Oxide and Interleukin-1 Beta Suppression by Moringa peregrina Seed.

OBJECTIVES: Moringa peregrina has long been used in folk medicine to treat diseases including fever, headache, burns, constipation, gut pains, and inflammation. Nitric oxide (NO) and interleukin-1ß (IL-1ß) play an important role in the pathophysiology of inflammation. The objectives of this study were to determine the effect of M. peregrina seed ethanolic extract (MPSE) on the viability of and NO and IL-1ß production by lipopolysaccharide (LPS)-activated macrophage (J774A.1) cell line. MATERIALS AND METHODS: The 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide assay was used to determine the cytotoxic effect of MPSE treatment at concentrations ranging from 31.15 to 1000 µg/mL. The NO concentration was determined by Griess assay and IL-1ß proinflammatory cytokine concentration by enzyme-linked immunosorbent assay in the supernatant of MPSE-treated LPS-activated J774A.1 cell culture. RESULTS: The results show that the MPSE was not cytotoxic at 1000 µg/mL but significantly (p<0.001) inhibited NO and IL-1ß production by the LPS-activated macrophage J774A.1 cells. CONCLUSION: These findings suggest that M. peregrina seed extract can be used to treat and prevent inflammatory diseases through the inhibition of inflammatory mediators.

An Insurance Model for Risk Management of Process Facilities.

Most existing risk management models for process industries do not consider the effect of insurance coverage, which results in an overestimation of overall risk. A model is presented in this article to study the effect of insurance coverage of health, safety, environmental, and business risks. The effect of insurance recovery is modeled through the application of adjustment factors by considering the stochastic factors affecting insurance recovery. The insurance contract's conditions, deductibles, and policy limits are considered in developing the insurance recovery adjustment factors. Copula functions and Monte Carlo simulations are used to develop the distribution of the aggregate loss by considering the dependence among loss classes. A case study is used to demonstrate both the practical application of the proposed insurance model to improve management decisions, and the mitigating effect of insurance to minimize the residual risk.