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1.
EuroIntervention ; 20(12): e770-e780, 2024 Jun 17.
Article in English | MEDLINE | ID: mdl-38887883

ABSTRACT

BACKGROUND: Coronary access (CA) is a major concern in redo-transcatheter aortic valve implantation (TAVI) for failing supra-annular self-expanding transcatheter aortic valves (TAVs). AIMS: This ex vivo study evaluated the benefit of leaflet splitting (LS) on subsequent CA after redo-TAVI in anatomies deemed at high risk of unfeasible CA. METHODS: Ex vivo, patient-specific models were printed three-dimensionally. Index TAVI was performed using ACURATE neo2 or Evolut PRO (TAV-1) at the standard implant depth and with different degrees of commissural misalignment (CMA). Redo-TAVI was performed using the balloon-expandable SAPIEN 3 Ultra (TAV-2) at different implant depths with commissural alignment. Selective CA was attempted for each configuration before and after LS in a pulsatile flow simulator. The leaflet splay area was assessed on the bench. RESULTS: In matched comparisons of 128 coronary cannulations across 64 redo-TAVI configurations, the overall feasibility of CA significantly increased after LS (60.9% vs 18.7%; p<0.001). The effect of LS varied according to the sinotubular junction height, TAV-1 design, TAV-1 CMA, and TAV-2 implant depth, given TAV-2 alignment. LS enabled CA for up to CMA 45° with the ACURATE neo2 TAV-1 and up to CMA 30° with the Evolut PRO TAV-1. The combination of LS and a low TAV-2 implant provided the highest feasibility of CA after redo-TAVI. The leaflet splay area ranged from 25.60 mm2 to 37.86 mm2 depending on the TAV-1 platform and TAV-2 implant depth. CONCLUSIONS: In high-risk anatomies, LS significantly improves CA feasibility after redo-TAVI for degenerated supra-annular self-expanding platforms. Decisions on redo-TAVI feasibility should be carefully individualised, taking into account the expected benefit of LS on CA for each scenario.


Subject(s)
Aortic Valve , Heart Valve Prosthesis , Prosthesis Design , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/methods , Transcatheter Aortic Valve Replacement/instrumentation , Aortic Valve/surgery , Aortic Valve/physiopathology , Printing, Three-Dimensional , Aortic Valve Stenosis/surgery , Coronary Vessels/surgery , Prosthesis Failure , Reoperation
2.
Brain Sci ; 14(6)2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38928574

ABSTRACT

Tobacco and alcohol have been identified as health risk behaviors associated with significant unfavorable health consequences, ranking within the list of the top ten causes of mortality and disability-adjusted life years (DALY). The combustion of tobacco leads to the formation of acrylamide (ACR), which is well known for its neurotoxic effects. Similarly, alcohol consumption has also been widely recognized for its neurotoxic effects. Both substances can affect neurons and neuroglia cells through various pathways. This study sought to examine the impacts of co-administration of ACR and intermittent-access ethanol (IAE) consumption over a period of one month. The experimental group received 20 mg/kg of ACR, administered orally, along with IAE of 20% ethanol sessions lasting 24 h, three times per week. The cognitive outcomes were assessed utilizing the elevated plus maze (EPM), which was employed as a means of assessing the capability to learn and remember, the novel object recognition (NOR) test, which was employed to assess recognition memory, and the Y-maze, which was used to explore a new environment and navigate. Additionally, ELISA assays were performed to examine underlying mechanisms, including markers associated with inflammation (NF-κB, PGE2, and TNF-α), apoptosis (Bcl2, Bax, and Caspase-3), and oxidative stress (MDA, catalase, and GSH). These markers were assessed in the brain homogenate as part of the investigation. Furthermore, a histopathological study was conducted. The findings indicated that NF-κB levels increased significantly in the combination of ACR and IAE groups (ACR + IAE) compared to either the ACR-alone or IAE-alone groups. However, parallel changes were observed in TNF-α, PGE2, Bax, Bcl-2, Caspase-3, GSH, and CAT levels when comparing the ACR + IAE group to the ACR-alone group. Comparable alterations were noted between the ACR + IAE treatment and IAE-alone groups in TNF-α, Bcl-2, MDA, GSH, and CAT levels. Moreover, the histopathological analysis revealed significant changes between the ACR + IAE and the ACR- or IAE-alone groups. Regarding memory parameters assessed using tests including EPM, NOR, and Y-maze, considerable changes were observed across all treatment groups as opposed to the control. Surprisingly, there were no notable differences in the NOR and Y-maze tasks between the alone and combination treatment. Further study is necessary to explore the long-term alteration of co-administering ACR and IAE on behavior, memory, and neurotoxicity-related mechanisms, in order to elucidate their combined effects more clearly.

4.
Neurosci Biobehav Rev ; 163: 105737, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38796122

ABSTRACT

Throughout the educational system, students experiencing active learning pedagogy perform better and fail less than those taught through direct instruction. Can this be ascribed to differences in learning from a neuroscientific perspective? This review examines mechanistic, neuroscientific evidence that might explain differences in cognitive engagement contributing to learning outcomes between these instructional approaches. In classrooms, direct instruction comprehensively describes academic content, while active learning provides structured opportunities for learners to explore, apply, and manipulate content. Synaptic plasticity and its modulation by arousal or novelty are central to all learning and both approaches. As a form of social learning, direct instruction relies upon working memory. The reinforcement learning circuit, associated agency, curiosity, and peer-to-peer social interactions combine to enhance motivation, improve retention, and build higher-order-thinking skills in active learning environments. When working memory becomes overwhelmed, additionally engaging the reinforcement learning circuit improves retention, providing an explanation for the benefits of active learning. This analysis provides a mechanistic examination of how emerging neuroscience principles might inform pedagogical choices at all educational levels.


Subject(s)
Neurosciences , Humans , Neurosciences/education , Problem-Based Learning , Memory, Short-Term/physiology , Neuronal Plasticity/physiology , Learning/physiology , Brain/physiology
5.
Nanomaterials (Basel) ; 14(9)2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38727357

ABSTRACT

This article presents, for the first time, a comparative analysis of the emission characteristics of large-area field-effect cathodes (LAFE) based on carbon nanotubes (CNTs) of various morphologies according to key parameters using a unique computerized technique. The work presents a description of a technology for creating various CNT arrays and their comprehensive structure characterization. All CNT arrays synthesized by the catalytic PECVD method on a silicon substrate showed a high degree of chemical purity under the presented technological conditions. In some cases, nanoisland films of Fe were used as a catalyst; in others, thin films of NiO were used, which were deposited on a silicon wafer by chemical vapor deposition (CVD) and atomic layer deposition (ALD), respectively. As a result of these studies, it turned out that an array with a thick CNT coating has good resistance to the action of strong electric fields, fairly good uniformity of distribution of emission centers, a fairly high selection current (2.88 mA/cm2 at 4.53 V/µm), and compliance with the normal current mode according to the "orthodox" test, which makes the morphology of such structures the most promising for further technological optimization of CNT-based cathodes for various practical applications.

6.
Curr Oncol ; 31(4): 2133-2144, 2024 04 08.
Article in English | MEDLINE | ID: mdl-38668061

ABSTRACT

Background: The incidence of colorectal cancer (CRC) is decreasing in individuals >50 years due to organised screening but has increased for younger individuals. We characterized symptoms and their timing before diagnosis in young individuals. Methods: We identified all patients diagnosed with CRC between 1990-2017 in British Columbia, Canada. Individuals <50 years (n = 2544, EoCRC) and a matched cohort >50 (n = 2570, LoCRC) underwent chart review to identify CRC related symptoms at diagnosis and determine time from symptom onset to diagnosis. Results: Across all stages of CRC, EoCRC presented with significantly more symptoms than LoCRC (Stage 1 mean ± SD: 1.3 ± 0.9 vs. 0.7 ± 0.9, p = 0.0008; Stage 4: 3.3 ± 1.5 vs. 2.3 ± 1.7, p < 0.0001). Greater symptom burden at diagnosis was associated with worse survival in both EoCRC (p < 0.0001) and LoCRC (p < 0.0001). When controlling for cancer stage, both age (HR 0.87, 95% CI 0.8-1.0, p = 0.008) and increasing symptom number were independently associated with worse survival in multivariate models. Conclusions: Patients with EoCRC present with a greater number of symptoms of longer duration than LoCRC; however, time from patient reported symptom onset was not associated with worse outcomes.


Subject(s)
Age of Onset , Colorectal Neoplasms , Humans , Colorectal Neoplasms/diagnosis , Male , Retrospective Studies , Female , Middle Aged , Adult , Aged , Time Factors , British Columbia/epidemiology , Symptom Burden
7.
EuroIntervention ; 20(6): e376-e388, 2024 03 18.
Article in English | MEDLINE | ID: mdl-38506739

ABSTRACT

BACKGROUND: There are limited data regarding treatment for failed balloon-expandable transcatheter heart valves (THVs) in redo-transcatheter aortic valve implantation (TAVI). AIMS: We aimed to assess THV performance, neoskirt height and expansion when performing redo-TAVI with the ACURATE platform inside a SAPIEN 3 (S3) compared to redo-TAVI with an S3 in an S3. METHODS: Redo-TAVI was performed on the bench using each available size of the S3, the ACURATE neo2 (ACn2) and the next-generation ACURATE Prime XL (AC XL) implanted at 2 different depths within 20 mm/23 mm/26 mm/29 mm S3s serving as the "failed" index THV. Hydrodynamic testing was performed to assess THV function. Multimodality assessment was performed using photography, X-ray, microcomputed tomography (micro-CT), and high-speed videos. RESULTS: The ACURATE in S3 combinations had favourable hydrodynamic performance compared to the S3 in S3 for all size combinations. In the 20 mm S3, redo-TAVI with the ACn2 had lower gradients compared to the S3 (mean gradient 16.3 mmHg for the ACn2 vs 24.7 mmHg for the 20 mm S3 in 20 mm S3). Pinwheeling was less marked for the ACURATE THVs than for the S3s. On micro-CT, the S3s used for redo-TAVI were underexpanded across all sizes. This was also observed for the ACURATE platform, but to a lesser extent. CONCLUSIONS: Redo-TAVI with an ACn2/AC XL within an S3 has favourable hydrodynamic performance and less pinwheeling compared to an S3 in S3. This comes at the price of a taller neoskirt.


Subject(s)
Heart Failure , Transcatheter Aortic Valve Replacement , Humans , X-Ray Microtomography , Catheters , Heart Valves
8.
Libyan J Med ; 19(1): 2321671, 2024 Dec 31.
Article in English | MEDLINE | ID: mdl-38404044

ABSTRACT

We aim to study the characteristics and outcomes of patients with a Do-Not-Attempt Resuscitation and to determine its impact on the Cost of In-Hospital Cardiac Arrest. A retrospective study of all adult patients admitted to the hospital from June 2021 to May 2022 who had a Do-Not-Resuscitate order. We abstracted patients' socio-demographics, physiologic parameters, primary diagnosis, and comorbidities from the electronic medical records. We calculated the potential economic cost using the median ICU length of stay for the admitted IHCA patients during the study period. There were 28,866 acute admissions over the study period, and 788 patients had DNR orders. The median (IQR) age was 71 (55-82) years, and 50.3% were males. The most prevalent primary diagnosis was sepsis, 426 (54.3%), and cancer was the most common comorbidity. More than one comorbidities were present in 642 (80%) of the cohort. Of the DNR patients, 492 (62.4%) died, while 296 (37.6%) survived to discharge. Cancer was the primary diagnosis in 65 (22.2%) of those who survived, compared with 154 (31.3%) of those who died (P = 0.002). Over the study period, 153 patients had IHCA and underwent CPR, with an IHCA rate of 5.3 per 1,000 hospital admissions. Without a DNR policy, an additional 492 patients with cardiac arrest would have had CPR, resulting in an IHCA rate of 22.3 per 1000 hospital admissions. Most DNR patients in our setting had sepsis complicated by multiple comorbidities. The DNR policy reduced our IHCA incidence by 76% and prevented unnecessary post-resuscitation ICU care.


Subject(s)
Heart Arrest , Neoplasms , Sepsis , Male , Adult , Humans , Aged , Aged, 80 and over , Female , Resuscitation Orders , Retrospective Studies , Developing Countries , Heart Arrest/epidemiology , Heart Arrest/therapy , Hospitals
9.
IBRO Neurosci Rep ; 16: 155-161, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38304064

ABSTRACT

The article concerns the problem of molecular mechanisms of memory formation. In this study the effects of polyclonal antibodies to serotonin-modulating anticonsolidation protein (SMAP) complex and its component dihydropyrimidinase-related protein 2 (DRP2) have been analyzed. Intra-cerebral administration of polyclonal anti-SMAP antibody significantly enhanced elaboration and strengthened memory formation in two complex behavioral conditioned models. At the same time, intra-cerebral administration of anti-SMAP antibody resulted in an increase of the content of nerve growth factor (NGF) in the water-soluble fraction of the hippocampus while intra-cerebral administration of anti-DRP2 antibody caused a decrease in the content of ß-III tubulin (a marker of differentiated neurons) in the hippocampus and in the left parietal cortex of untrained rats. The obtained results indicate that DRP2 might participate in regulation of the processes of back remodeling of mature nerve cells of adult organisms, occurring during training of rats in the behavioral paradigm used in this study under the effects of anti-SMAP and anti-DRP2 antibodies. Conclusion is made that back remodeling (dedifferentiation) of mature nerve cells, apparently, is engaged in memory formation.

10.
J Clin Med ; 13(2)2024 Jan 19.
Article in English | MEDLINE | ID: mdl-38276098

ABSTRACT

Transcatheter aortic valve implantation (TAVI) is now well established as the treatment of choice for patients with native aortic valve stenosis who are high or intermediate risk for surgical aortic valve replacement. Recent data has also supported the use of TAVI in patients at low surgical risk and also in anatomical subsets that were previously felt to be contra-indicated including bicuspid aortic valves and aortic regurgitation. With advancements and refinements in procedural techniques, the application of this technology has now been further expanded to include the management of degenerated bioprosthesis. After the demonstration of feasibility and safety in the management of degenerated aortic bioprosthetic valves, mitral and tricuspid bioprosthetic valve treatment is now also well-established and provides an attractive alternative to performing redo surgery. In this review, we appraise the latest clinical evidence and highlight procedural considerations when utilising TAVI technology in the management of degenerated aortic, mitral or tricuspid prosthesis.

11.
J Cardiovasc Dev Dis ; 11(1)2024 Jan 22.
Article in English | MEDLINE | ID: mdl-38276659

ABSTRACT

BACKGROUND: Current European guidelines support transcatheter aortic valve implantation (TAVI) in intermediate-to-low-risk patients ≥75 years-old, but its prognostic relevance is unknown. METHODS: Intermediate-to-low-risk (The Society of Thoracic Surgeons score <8%) patients enrolled in the HORSE registry were included. We compared the populations aged under 75 with those over 75. The primary endpoint was all-cause mortality. RESULTS: A total of 2685 patients were included: 280 (8.6%) < 75 and 2405 ≥ 75 years. Through a mean follow-up of 437 ± 381 days, 198 (8.2%) and 23 (8.2%) patients died in the two arms without statistically significant differences (log-rank p = 0.925). At Cox regression analysis, age did not predict the occurrence of all-cause death, neither as a continuous variable (HR 1.01, 95% CI 0.99-1.04, p = 0.294) nor dichotomizing according to the prespecified cutoff of 75 years (HR 0.97, 95% CI 0.63-1.51, p = 0.924). Time-to-event ROC curves showed low accuracy of age to predict all-cause mortality (area under the curve of 0.54 for both 1-year and 2-year outcomes). CONCLUSIONS: TAVI has comparable benefits across age strata for intermediate-to-low-risk patients. The age cutoff suggested by the current guidelines is not predictive of the risk of adverse events during hospital stays or of all-cause mortality through a mid-term follow-up.

12.
Saudi J Gastroenterol ; 29(5): 269-277, 2023.
Article in English | MEDLINE | ID: mdl-37787347

ABSTRACT

Since the emergence of artificial intelligence (AI) in medicine, endoscopy applications in gastroenterology have been at the forefront of innovations. The ever-increasing number of studies necessitates the need to organize and classify applications in a useful way. Separating AI capabilities by computer aided detection (CADe), diagnosis (CADx), and quality assessment (CADq) allows for a systematic evaluation of each application. CADe studies have shown promise in accurate detection of esophageal, gastric and colonic neoplasia as well as identifying sources of bleeding and Crohn's disease in the small bowel. While more advanced CADx applications employ optical biopsies to give further information to characterize neoplasia and grade inflammatory disease, diverse CADq applications ensure quality and increase the efficiency of procedures. Future applications show promise in advanced therapeutic modalities and integrated systems that provide multimodal capabilities. AI is set to revolutionize clinical decision making and performance of endoscopy.


Subject(s)
Colonic Neoplasms , Crohn Disease , Endoscopy, Gastrointestinal , Humans , Artificial Intelligence , Colonic Neoplasms/diagnostic imaging , Crohn Disease/diagnostic imaging , Endoscopy , Gastroenterology , Barrett Esophagus/diagnostic imaging
13.
Catheter Cardiovasc Interv ; 102(7): 1401-1405, 2023 12.
Article in English | MEDLINE | ID: mdl-37694603

ABSTRACT

Valve-in-valve TAVI to treat failing surgical aortic valves (SAVs) is increasingly performed, and commissural alignment is a key technical aspect in such procedures. Surgeons optimize valve alignment, accounting for potential coronary eccentricity and achieving a patient-specific optimized commissural orientation, representing the ideal target for TAVI alignment. Therefore, here we present a dedicated stepwise valve-in-valve implantation technique using the ACURATE neo2. In a specific SAV postoverlap view, isolating one surgical post to the right of the screen representing the target for alignment, rotational orientation of the TAVI commissures, matching the SAV orientation, is achieved and verified before implantation. This technique has been tested in a patient-specific three-dimensionally-printed aortic root anatomy, attached to a pulsatile flow simulator, allowing for native-like simulation of coronary cannulations under fluoroscopy, and enabling detailed assessment with fluoroscopic as well as direct videographic visualization. Furthermore, the technique is exemplified by providing an educational clinical case example.


Subject(s)
Aortic Valve Stenosis , Bioprosthesis , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/methods , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Treatment Outcome , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Prosthesis Design
14.
PeerJ ; 11: e15646, 2023.
Article in English | MEDLINE | ID: mdl-37456879

ABSTRACT

Sugarcane is one of the critical commercial crops and principal sources of ethanol and sugar worldwide. Unfavorable conditions and poor seed setting rates hinder variety development in sugarcane. Countries like Pakistan directly import fuzz (true seed) and other propagation material from the USA, China, Brazil, etc. In this study, we imported fuzz from China, developed 29 genotypes germinating in the glasshouse, and evaluated at field conditions along with two local checks (CPF-251 and HSF-240). Morphophysiological data were recorded, including plant height (PH), cane length (CL), internodal length (IL), tiller number (TN), brix percentage (B), cane diameter (CD), chlorophyll a (Chl. a), chlorophyll b (Chl. b), and total chlorophyll (T. Chl). Results showed highly significant (p < 0.001) differences among the sugarcane accessions for all the studied traits. High broad-sense heritability (81.89% to 99.91%) was recorded for all the studied parameters. Genetic Advance (GA) ranges from 4.6% to 65.32%. The highest GA was observed for PH (65.32%), followed by CL (63.28%). Chlorophyll leaching assay was also performed at different time points (0, 50, 100, 150, and 200 min). All the genotypes showed the same leaching trend at all times, and better performing genotypes showed less leaching compared to poor performing, indicating the high amount of cutin and wax on the leaf surface. Correlation analysis showed that PH, CL, IL, and TN had significant associations. Principal components analysis (PCA) further confirms these results. Based on PCA and correlation results, PH, CL, IL, and TN can be utilized as a selection criterion for sugarcane improvement. Genotypes such as NS-4a, NS-5, NS-6, NS-8, NS-9, and NS-15 are recommended for future breeding programs related to sugarcane variety development.


Subject(s)
Saccharum , Saccharum/genetics , Chlorophyll A , Plant Breeding/methods , Phenotype , Genotype , Edible Grain
15.
Sci Rep ; 13(1): 9958, 2023 Jun 20.
Article in English | MEDLINE | ID: mdl-37339992

ABSTRACT

Many dimensions of human life and the environment are vulnerable to anthropogenic climate change and the hazards associated with it. There are several indices and metrics to quantify climate hazards that can inform preparedness and planning at different levels e.g., global, regional, national, and local. This study uses biased corrected climate projections of temperature and precipitation to compute characteristics of potential climate hazards that are pronounced in the Gomal Zam Dam Command Area (GZDCA)- an irrigated agricultural area in Khyber Pakhtunkhwa province of Pakistan. The results answer the question of what the future holds in the GZDCA regarding climate hazards of heatwaves, heavy precipitation, and agricultural drought. The results of heatwaves and agricultural drought present an alarming future and call for immediate actions for preparedness and adaptation. The magnitude of drought indices for the future is correlated with the crop yield response based on AquaCrop model simulations with observed climate data being used as input. This correlation provides insight into the suitability of various drought indices for agricultural drought characterization. The results elaborate on how the yield of wheat crop grown in a typical setting common in the South Asian region respond to the magnitude of drought indices. The findings of this study inform the planning process for changing climate and expected climate hazards in the GZDCA. Analyzing climate hazards for the future at the local level (administrative districts or contiguous agricultural areas) might be a more efficient approach for climate resilience due to its specificity and enhanced focus on the context.

17.
Eur Heart J ; 44(35): 3311-3322, 2023 09 14.
Article in English | MEDLINE | ID: mdl-37350487

ABSTRACT

Technological advancement and the COVID-19 pandemic have brought virtual learning and working into our daily lives. Extended realities (XR), an umbrella term for all the immersive technologies that merge virtual and physical experiences, will undoubtedly be an indispensable part of future clinical practice. The intuitive and three-dimensional nature of XR has great potential to benefit healthcare providers and empower patients and physicians. In the past decade, the implementation of XR into cardiovascular medicine has flourished such that it is now integrated into medical training, patient education, pre-procedural planning, intra-procedural visualization, and post-procedural care. This review article discussed how XR could provide innovative care and complement traditional practice, as well as addressing its limitations and considering its future perspectives.


Subject(s)
COVID-19 , Virtual Reality , Humans , COVID-19/epidemiology , Pandemics/prevention & control
18.
Cureus ; 15(4): e37740, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37213951

ABSTRACT

Background Malaria transmission was stopped on most of the vast area of the Kingdom of Saudi Arabia. However, the pandemic of coronavirus disease (COVID-19) has negatively affected the efforts to control malaria. For instance, COVID-19 was reported to induce a relapse of malaria that is caused by Plasmodium vivax. Furthermore, physicians' attention toward COVID-19 can only result in neglect and delayed diagnosis of complicated malaria cases. These factors, among others, might have contributed to an increase of malaria cases in Dammam, Saudi Arabia. Thus, this study was conducted to examine the effects of COVID-19 on malarial cases. Methods The medical records of all patients who were treated at Dammam Medical Complex for malaria between July 1, 2018, and June 30, 2022, were reviewed. Malaria cases were compared between the pre-COVID-19 period (between July 1, 2018, and June 30, 2020) and the COVID-19 period (between July 1, 2020, and June 30, 2022). Results A total of 92 malaria cases occurred in the total study period. There were 60 cases of malaria in the COVID-19 period as opposed to only 32 cases in the pre-COVID-19 period. All the cases were imported from the endemic Saudi southern areas or from outside the country. Eighty-two patients (89.1%) were males. Most of them were Sundaneses (39 patients, 42.4%), Saudis (21 patients, 22.8%), and tribal peoples (14 patients, 15.2%). Fifty-four patients (58.7%) were infected with Plasmodium falciparum. Seventeen patients (18.5%) were infected with Plasmodium vivax. Another 17 patients (18.5%) had a mixed infection with both Plasmodium falciparum and Plasmodium vivax. A trend toward more infected stateless tribal patients was observed in the COVID-19 period compared to the pre-COVID-19 period (21.7% vs 3.1%). A similar trend was noticed for mixed malarial infections with both Plasmodium falciparum and Plasmodium vivax (29.8% vs 0%) with a P value of less than 0.01. Conclusion Malaria cases were almost doubled during the COVID-19 pandemic as compared to the pre-pandemic era signifying the negative effects of the pandemic on malaria epidemiology. The cases increased for a variety of causes that include alternation of health-seeking behaviors, changes in healthcare structures and regulations, and the interruption of malaria preventive services. Future research is needed to study the long-term effects of the changes imposed by the COVID-19 pandemic and to mitigate the effects of any future pandemic on malaria control. As two patients from our cohort were diagnosed with malaria based on blood smears, although they had negative rapid detection tests (RDTs), we recommend testing all the patients who are suspected to have malaria with both RDTs and peripheral blood smears.

19.
Cancer Res Commun ; 3(4): 548-557, 2023 04.
Article in English | MEDLINE | ID: mdl-37035581

ABSTRACT

Preoperative radiotherapy for early-stage rectal cancer has risks and benefits that may impact treatment choice in young patients. We reviewed radiotherapy use and outcomes for rectal cancer by age. Patients with early-stage rectal cancer in the Canadian province of British Columbia from 2002 to 2016 were identified (n = 6,232). Baseline characteristics, treatment response, overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and locoregional recurrence rate (LRR) were compared between patients <50 (early-onset; n = 532) and ≥50 years old (average-onset; n = 5,700). Early-onset patients were more likely to receive preoperative chemoradiotherapy than short-course radiotherapy [OR, 2.20; 95% confidence interval (CI), 1.67-2.89; P < 0.0001], but also had higher nodal (P = 0.00096) and overall clinical staging (P = 0.033). Cancer downstaging and pathologic complete response rates were similar in those receiving neoadjuvant chemoradiotherapy by age. Early-onset and average-onset patients had similar DSS (P = 0.91) and DFS (P = 0.27) in multivariate analysis unless non-colorectal deaths, which were higher in older patients, were censored in the DFS model (HR, 1.30; 95% CI, 1.01-1.68; P = 0.042). LRR also did not differ between age groups (P = 0.88). Outcomes did not differ based on radiotherapy type. Young patients with rectal cancer are more likely to present with higher staging and receive long-course chemoradiotherapy. DSS did not differ by age group; however, young patients had worse DFS when we censored competing risks of death in older patients. Significance: This population-based study suggests younger patients are more likely to receive chemoradiotherapy, potentially due to higher stage at diagnosis, and response is comparable by age.


Subject(s)
Neoadjuvant Therapy , Rectal Neoplasms , Humans , Aged , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Rectal Neoplasms/radiotherapy , Chemoradiotherapy , British Columbia/epidemiology
20.
Pharmaceuticals (Basel) ; 16(4)2023 Apr 12.
Article in English | MEDLINE | ID: mdl-37111339

ABSTRACT

Combination of bovine serum albumin with microemulsions as constituting ingredient biopolymer has long been regarded an innovative method to address the surface functionalization and stability issues in the targeted payload deliveries, thereupon producing effectively modified microemulsions, which are superior in loading capacity, transitional and shelf-stability, as well as site-directed/site-preferred delivery, has become a favored option. The current study aimed to develop an efficient, suitable and functional microemulsion system encapsulating sesame oil (SO) as a model payload towards developing an efficient delivery platform. UV-VIS, FT-IR, and FE-SEM were used to characterize, and analyze the developed carrier. Physicochemical properties assessments of the microemulsion by dynamic light scattering size distributions, zeta-potential, and electron micrographic analyses were performed. The mechanical properties for rheological behavior were also studied. The HFF-2 cell line and hemolysis assays were conducted to ascertain the cell viability, and in vitro biocompatibility. The in vivo toxicity was determined based on a predicted median lethal dose (LD50) model, wherein the liver enzymes' functions were also tested to assess and confirm the predicted toxicity.

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