The impact of different fixatives on immunostaining of lung adenocarcinomas in pleural effusion cell blocks.

BACKGROUND: Cell blocks (CBs) are widely used for biomarker analyses such as immunostaining. Although immunohistochemistry on formalin-fixed paraffin-embedded tissues is standardized, there are multiple preparation methods and fixatives for cytology. Our objective was to investigate the effect of different common fixatives on the immunoreactivity of pleural effusion CBs with metastatic lung adenocarcinomas. METHODS: This prospective study included 24 malignant pleural effusions from different patients with lung adenocarcinoma. From each case, four identical CBs were fixed in 10% neutral buffered formalin, PreservCyt, CytoLyt, and CytoRich Red (only 17 of the cases), respectively. Samples containing <100 malignant cells were excluded. All CBs were stained with thyroid transcription factor 1 (TTF-1; clones 8G7G3/1 and SPT24), napsin A, claudin 4, CEA, CK7, and epithelial cell adhesion molecule (EpCAM; clones BS14, Ber-Ep4, and MOC-31). The fraction and intensity of stained cells were evaluated. RESULTS: Of the investigated markers, a significant difference in staining proportion was seen for TTF-1 clone 8G7G3/1 and EpCAM clone MOC-31, especially with cases being negative in CytoLyt (33.3% and 83.3% positive, respectively) and PreservCyt (62.5% and 83.3%) whereas being positive in CytoRich Red (76.5% and 94.1%) and formalin (both 95.8%). A significantly weaker intensity of staining was seen for all alcohol-based fixatives compared to formalin for TTF-1 clone 8G7G3/1, napsin A, and EpCAM clone MOC-31, whereas EpCAM clone Ber-Ep4 was significantly weaker only in PreservCyt compared with formalin. CONCLUSIONS: Immunocytochemical expression and concordance with formalin-fixed CBs differ depending on the used fixative as well as the antibody and clone, warranting investigation of the reliability of each biomarker for non-formalin-fixed cytology.

Corrigendum to:"Deep learning based suture training system" [Surgery Open Science 15 (2023) 1-11/1].

[This corrects the article DOI: 10.1016/j.sopen.2023.07.023.].

Corrigendum: Anemia detection through non-invasive analysis of lip mucosa images.

[This corrects the article DOI: 10.3389/fdata.2023.1241899.].

Anemia detection through non-invasive analysis of lip mucosa images.

This paper aims to detect anemia using images of the lip mucosa, where the skin tissue is thin, and to confirm the feasibility of detecting anemia noninvasively and in the home environment using machine learning (ML). Data were collected from 138 patients, including 100 women and 38 men. Six ML algorithms: artificial neural network (ANN), decision tree (DT), k-nearest neighbors (KNN), logistic regression (LR), naive bayes (NB), and support vector machine (SVM) which are widely used in medical applications, were used to classify the collected data. Two different data types were obtained from participants' images (RGB red color values and HSV saturation values) as features, with age, sex, and hemoglobin levels utilized to perform classification. The ML algorithm was used to analyze and classify images of the lip mucosa quickly and accurately, potentially increasing the efficiency of anemia screening programs. The accuracy, precision, recall, and F-measure were evaluated to assess how well ML models performed in predicting anemia. The results showed that NB reported the highest accuracy (96%) among the other ML models used. DT, KNN and ANN reported an accuracies of (93%), while LR and SVM had an accuracy of (79%) and (75%) receptively. This research suggests that employing ML approaches to identify anemia will help classify the diagnosis, which will then help to create efficient preventive measures. Compared to blood tests, this noninvasive procedure is more practical and accessible to patients. Furthermore, ML algorithms may be created and trained to assess lip mucosa photos at a minimal cost, making it an affordable screening method in regions with a shortage of healthcare resources.

Profile of orthopaedic day-case procedures at a district general hospital (retrospective study).

BACKGROUND: The outcomes of orthopaedic day-case procedures have been reported widely, but there is a lack of reports from secondary health facilities such as district hospitals. AIM: We aimed to perform a retrospective analysis of patient records to capture the profile of day-case procedures performed. MATERIALS AND METHODS: We conducted a retrospective analysis of day-case procedures at the dedicated Day Surgery Unit of a moderate-sized district hospital in Saudi Arabia between January 2021 and December 2022. The medical records of all the patients who had day-case procedures by the hospital's orthopaedic unit were analyzed. RESULTS: Within the study period, 71 out of 914 elective orthopaedic procedures were carried out as day-cases, giving a day-case surgery rate of 7.8%. The mean age was 25.3 ± 12.2 (range, 4-55 years), and the male-to-female ratio was 6:1. The spectrum of the procedures was dominated by implant removal in 59 cases (83.1%). Whilst the anaesthetic technique varied, all the patients were ASA class I or II. There were minor complications in 10 patients (14.0%), with 7 of them (9.8%) needing inpatient admission. There was no cancellation of cases in our study. CONCLUSION: We found day-case procedures to be safe and effective but with low utilisation of the Day Surgery Unit, which can be improved through the development of a detailed protocol for day surgery in the hospital.

Non-invasive detection of anemia using lip mucosa images transfer learning convolutional neural networks.

Anemia is defined as a drop in the number of erythrocytes or hemoglobin concentration below normal levels in healthy people. The increase in paleness of the skin might vary based on the color of the skin, although there is currently no quantifiable measurement. The pallor of the skin is best visible in locations where the cuticle is thin, such as the interior of the mouth, lips, or conjunctiva. This work focuses on anemia-related pallors and their relationship to blood count values and artificial intelligence. In this study, a deep learning approach using transfer learning and Convolutional Neural Networks (CNN) was implemented in which VGG16, Xception, MobileNet, and ResNet50 architectures, were pre-trained to predict anemia using lip mucous images. A total of 138 volunteers (100 women and 38 men) participated in the work to develop the dataset that contains two image classes: healthy and anemic. Image processing was first performed on a single frame with only the mouth area visible, data argumentation was preformed, and then CNN models were applied to classify the dataset lip images. Statistical metrics were employed to discriminate the performance of the models in terms of Accuracy, Precision, Recal, and F1 Score. Among the CNN algorithms used, Xception was found to categorize the lip images with 99.28% accuracy, providing the best results. The other CNN architectures had accuracies of 96.38% for MobileNet, 95.65% for ResNet %, and 92.39% for VGG16. Our findings show that anemia may be diagnosed using deep learning approaches from a single lip image. This data set will be enhanced in the future to allow for real-time classification.

Arabic translation, cross cultural adaptation, and validation of Foot Health Status Questionnaire among Saudi individuals with plantar fasciitis.

BACKGROUND: Measuring quality of life (QoL) plays an essential role in enabling meaningful cross-cultural comparisons. The Foot Health Status Questionnaire (FHSQ) is a valid tool for assessing both foot-specific and general health-related quality of life (HrQoL), making it suitable for evaluating Plantar Fasciitis (PF) patients. METHODOLOGY: The aim of this study is to translate the FHSQ into Arabic following methodological assessments of the translation procedure. The translation was done using forward and back translation. A pre-test questionnaire was distributed among 50 patients, resulting in the final FHSQ-Ar version, which then underwent various psychometric evaluations among 87 persons with PF, including internal consistency, dimensionality, reliability, interpretability, and construct validity against the 100-mm Visual Analogue Scale (VAS). RESULTS: Internal consistency was adequate, ranging from 0.70 to 0.92. Reliability values ranged from 0.69 to 0.80, with a poor standard error of measurement (individual) but an acceptable standard error of measurement (group). Two domains exhibited floor effects, while one domain showed a ceiling effect. Regarding validity, three out of four hypothesized correlations with VAS scores were confirmed. Factor analysis revealed four dimensions, and confirmatory factor analysis demonstrated good fit (comparative fit index = 0.98, standardized root mean square = 0.06). CONCLUSION: The psychometric properties of the FHSQ-Ar were satisfactory. Further validation for other diseases may be warranted.

Deep learning based suture training system.

Background and objectives: Surgical suturing is a fundamental skill that all medical and dental students learn during their education. Currently, the grading of students' suture skills in the medical faculty during general surgery training is relative, and students do not have the opportunity to learn specific techniques. Recent technological advances, however, have made it possible to classify and measure suture skills using artificial intelligence methods, such as Deep Learning (DL). This work aims to evaluate the success of surgical suture using DL techniques. Methods: Six Convolutional Neural Network (CNN) models: VGG16, VGG19, Xception, Inception, MobileNet, and DensNet. We used a dataset of suture images containing two classes: successful and unsuccessful, and applied statistical metrics to compare the precision, recall, and F1 scores of the models. Results: The results showed that Xception had the highest accuracy at 95 %, followed by MobileNet at 91 %, DensNet at 90 %, Inception at 84 %, VGG16 at 73 %, and VGG19 at 61 %. We also developed a graphical user interface that allows users to evaluate suture images by uploading them or using the camera. The images are then interpreted by the DL models, and the results are displayed on the screen. Conclusions: The initial findings suggest that the use of DL techniques can minimize errors due to inexperience and allow physicians to use their time more efficiently by digitizing the process.

Estimation of lower limb joint moments based on the inverse dynamics approach: a comparison of machine learning algorithms for rapid estimation.

The aim of this study is to estimate the joint moments of the ankle, knee, and hip joints during walking. A sit-to-stand (STS) movement analysis was first performed on 20 participants with different anthropometric characteristics. Then, analysis of the dynamics of the STS motion was used to develop a biomechanical model. Decision tree (DT), linear regression (LR), support vector machine (SVM), random forest (RF), and three deep learning (DL) algorithms and deep neural network (DNN), long-short-term memory (LSTM), and convolutional neural network (CNN) are examined in this work to estimate three joint moments: ankle, knee, and hip. The results of the seven algorithms were evaluated using four statistical benchmarks: MSR, RMSE, correlation coefficient (R), and MAE to find the most accurate one. The results show that the most successful algorithms were LSTM in estimating knee, hip, and ankle joint moments using 19 and 7 inputs. The R value was 0.9990 using 19 inputs and 0.9972 using 7 inputs. The other algorithms have a correlation coefficient (R) success of 0.9902, 0.9770, 0.9884, 0.9577, 0.9786, and 0.9022 for RF, CNN, DT, DNN, SVM, and LR, respectively. The prediction of joint moments plays a crucial role in the design of the biomechanical system with the desired mechanical properties. Especially, the need has arisen to predict joint moments in a shorter time to utilize in real-time active prosthesis/orthosis controllers.

Validating the anti-lymphoma pharmacodynamic actions of the endocannabinoids on canine non-Hodgkin lymphoma.

AIMS: This study established the in vitro anti-lymphoma pharmacodynamic actions of the endocannabinoids (anandamide-AEA and 2-arachidonoylglycerol-2AG) on canine non-Hodgkin lymphoma (NHL) and human NHL cells. MAIN METHODS: The expression of cannabinoid (CB1 and CB2) receptors in various canine NHL cells {1771, CLBL-1, CLL-1, peripheral blood mononuclear cells (PBMCs)} was studied using Quantitative real-time PCR (RT-qPCR). Anti-lymphoma cell viability assay was performed to assess the effect of endocannabinoids on various canine and human NHL cells (1771, CLBL-1, CLL-1, Ramos cells). The spectrophotometric and fluorometric procedures evaluated oxidative stress, inflammation, apoptosis, and mitochondrial function markers. SAS® and Prism-V La Jolla, CA, USA, were used for statistical analysis. KEY FINDINGS: The current study validated the presence of CB1 and CB2 receptors in the canine NHL cells. There was a significantly higher expression of CB1 and CB2 receptors in B-cell lymphoma (BCL) cells (1771, CLBL-1, Ramos) compared to canine T-cell lymphoma (TCL) cells (CL-1). AEA and 2AG dose and time-dependently exhibited significant but differential anti-lymphoma effects on canine and human NHL cells. Anti-lymphoma pharmacodynamic actions of the endocannabinoids in the canine 1771 NHL cells revealed a significant alteration in the markers of oxidative stress, inflammation, and a decrease in mitochondrial function without altering the apoptotic markers. SIGNIFICANCE: Establishing the anti-lymphoma pharmacodynamic actions of endocannabinoids may provide new therapeutic interventions and expedite cannabinoid research.

Comparison of immunohistochemical mesothelial biomarkers in paired biopsies and effusion cytology cell blocks from pleural mesothelioma.

OBJECTIVE: Traditionally, the diagnosis of pleural mesothelioma is based on histological material. Minimally invasive effusion cytology specimens are an alternative that, like biopsies, require ancillary analyses. Validation of immunohistochemical (IHC) analyses on cytology, including the surrogate markers for molecular alterations BAP1 and MTAP, is of interest. METHODS: IHC for eight different markers was performed on 59 paired formalin-fixed, paraffin-embedded pleural biopsies and pleural effusion cell blocks with mesothelioma. Immunoreactivity in ≥10% of tumour cells was considered positive/preserved. The concordance between histological and cytological materials was assessed. RESULTS: The overall percentage of agreement between the histological epithelioid component in 58 biopsies and paired cell blocks was 93% for calretinin, 98% for CK5, 97% for podoplanin, 90% for WT1, 86% for EMA, 100% for desmin, 91% for BAP1, and 72% for MTAP. For 11 cases with biphasic or sarcomatoid histology, the concordance between cytology and the histological sarcomatoid component was low for calretinin, CK5, and WT1 (all ≤45%). For the whole cohort, loss of both BAP1 and MTAP was seen in 40% while both markers were preserved in 11% of the biopsies for epithelioid histology. The corresponding numbers were 54% and 8%, respectively, for the paired cell blocks. CONCLUSIONS: Generally, a high concordance for IHC staining was seen between paired biopsies and pleural effusion cell blocks from mesotheliomas, but the somewhat lower agreement for WT1, EMA, and especially MTAP calls for further investigation and local quality assurance. The lower concordance for the sarcomatoid subtype for some markers may indicate biological differences.

Assessment of functional feeding groups (FFG) structure of aquatic insects in North- western Rif - Morocco.

The involvement of trait-based approaches is crucial for understanding spatial patterns, energy flow and matter transfer in running water systems, which requires consistent knowledge of the functional structures of aquatic communities, with the advantage of combining physical properties and behavioral mechanisms of food acquisition rather than the taxonomic group. The present study indicated how functional feeding groups may be used as a proxy for classical taxonomic evaluation, as well as the potential interest in incorporating them as indicators of anthropogenic stressors. The composition and abundance of the functional feeding groups of aquatic insects were examined from September 2021 to August 2022 along the Western Rif Region. Benthic samples were collected from nine sampling points in the studied area using a Surber sampler with a mesh size of 500 µm and a diameter of 20*20 cm. The stations included in this work were chosen for their accessibility as well as their position on the hydrographic systems. The abundance of sampled aquatic organisms in the whole study area revealed 5,342 individuals belonging to 60 families and seven orders of aquatic insects, classified into five feeding functional groups. In terms of abundance, Collector-gatherers (Ephemeroptera and Diptera) were the most abundant trophic group at most of the sites, with a proportion of 38.47%. Predators (Coleoptera, Hemiptera and Odonata) were the second group at all sites, followed by Collector-filters, accounting for 39.53%, 28.14% and 22.37% respectively, while Scarpers and Shredders had the lowest representation across all sites with 4.16%. The high number of registered Collectors could be related to their ability to feed on a diverse range of food items compared to the remaining trophic guilds. According to the Canonical Correspondence Analysis results, physicochemical (i.e. T, pH, BOD5, Cl- and NO3-) and hydromorphological (i.e. current velocity and depth) variables were amongst the key predictors of shaping the functional structure of aquatic biota during this investigation. It is highly recommended to carry out suitable measures to largely attenuate anthropogenic pressures in order to preserve the integrity of freshwater bodies and their biota.

A Brief Review of Demographic and Clinical Correlates of Cholesteatoma Surgery in the Qassim Region.

Background Cholesteatoma is described as the accumulation of squamous epithelium and keratinocytes within and around the middle ear cleft. There is a paucity of information regarding demographic and treatment outcomes for cholesteatoma in Saudi Arabia. An evaluation of the prevalence of comorbidities, complications and associations, of surgical treatment and demographics in the Qassim region was conducted. Methods This was a six-year retrospective review of patients treated for cholesteatoma at a private health facility, from August 2016 to July 2022. Data for age, gender, nationality, presence of comorbidities, type of surgery, type of anesthesia, and associated complications were collected from the electronic medical records and analyzed with Statistical Package for Social Sciences software. Results A total of 60 participants records were retrieved. The average age of the study population was ([43.2 ±SD] 21.8) years. There was a slightly higher male preponderance (males 51.7% and females 48.3%). Hypertension was the most commonly reported comorbidity (31.7%), followed by diabetes mellitus (25%). Age and gender were not statistically significantly associated with type of surgery or complications. Conclusion Demographic variables were not significantly associated with clinical correlates, however, further studies with larger sample sizes, robust clinical information, and long-term follow-up are required.

Spatial regulation of the glycocalyx component podocalyxin is a switch for prometastatic function.

The glycocalyx component and sialomucin podocalyxin (PODXL) is required for normal tissue development by promoting apical membranes to form between cells, triggering lumen formation. Elevated PODXL expression is also associated with metastasis and poor clinical outcome in multiple tumor types. How PODXL presents this duality in effect remains unknown. We identify an unexpected function of PODXL as a decoy receptor for galectin-3 (GAL3), whereby the PODXL-GAL3 interaction releases GAL3 repression of integrin-based invasion. Differential cortical targeting of PODXL, regulated by ubiquitination, is the molecular mechanism controlling alternate fates. Both PODXL high and low surface levels occur in parallel subpopulations within cancer cells. Orthotopic intraprostatic xenograft of PODXL-manipulated cells or those with different surface levels of PODXL define that this axis controls metastasis in vivo. Clinically, interplay between PODXL-GAL3 stratifies prostate cancer patients with poor outcome. Our studies define the molecular mechanisms and context in which PODXL promotes invasion and metastasis.

Exploring digital technologies used in the design and manufacture of craniofacial implant surgical guides: A scoping review.

STATEMENT OF PROBLEM: Unlike intraoral implants, digitally planned surgical templates used for guiding the ideal position of the craniofacial implants are not well established, and clear methods and guidelines for their design and construction are lacking. PURPOSE: The purpose of this scoping review was to identify the publications that used a full or partial computer-aided design and computer-aided manufacture (CAD-CAM) protocol to create a surgical guide that achieves the correct positioning of craniofacial implants to retain a silicone facial prosthesis. MATERIAL AND METHODS: A systematic search was conducted in MEDLINE/PubMed, Web of Science, Embase, and Scopus for articles published before November 2021 in the English language. Articles needed to satisfy the eligibility criterion of in vivo articles that created a surgical guide with digital technology for inserting titanium craniofacial implants to hold a silicone facial prosthesis. Articles that inserted implants in the oral cavity or upper alveolus only and articles that did not describe the structure and retention of the surgical guide were excluded. RESULTS: Ten articles were included in the review; all were clinical reports. Two of the articles used a CAD-only approach alongside a conventionally constructed surgical guide. Eight articles described applying a complete CAD-CAM protocol for the implant guides. The digital workflow varied considerably depending on the software program, design, and retention of guides. Only 1 report described a follow-up scanning protocol to verify the accuracy of the final implant positions compared with the planned positions. CONCLUSIONS: Digitally designed surgical guides can be an excellent adjunct to accurately place titanium implants in the craniofacial skeleton for support of silicone prostheses. A sound protocol for the design and retention of the surgical guides will enhance the use and accuracy of craniofacial implants in prosthetic facial rehabilitation.

Corrigendum: Non-invasive detection of anemia using lip mucosa images transfer learning convolutional neural networks.

[This corrects the article DOI: 10.3389/fdata.2023.1291329.].

Healthcare Professionals' Perception Regarding Patient Rights and Safety in Najran, Saudi Arabia.

BACKGROUND: Patient safety and rights are the most crucial aspects of healthcare quality. In Saudi Arabia, there is a paucity of evidence concerning the perspectives of healthcare providers on the rights and safety of patients. Hence, this study aimed to assess the perceptions of healthcare providers toward patients' rights and safety in Najran, Saudi Arabia. METHODOLOGY: A cross-sectional study was undertaken in Najran, Saudi Arabia, from December 2022 to October 2023, utilizing an online survey. This study included 307 healthcare providers who responded to the questionnaire via Google web link (Google LLC, Mountain View, California, United States). RESULTS: The present research comprised 307 healthcare personnel, of whom 65.8% were male and possessed a variety of academic backgrounds. The participants exhibited a high level of support for patients' rights, as evidenced by their agreement with 88.4-90% of questions on a variety of dimensions; this demonstrated their dedication to providing patient-centered care. Concerning medical errors, a significant proportion of respondents (74.9-86.1%) exhibited comprehensive comprehension and a readiness to disclose such incidents. Diverse viewpoints surfaced regarding the attribution of errors, the necessity of reporting, and the accountability for disclosure. The interdependence of patient rights and attitudes towards patient safety was highlighted by substantial positive correlations. CONCLUSION: The viewpoints of healthcare professionals regarding medical errors and patients' liberties were discussed in this study. Advocacy for patients' rights is indicative of a commitment to patient-centered care that prioritizes autonomy and transparency. Although most participants demonstrated a willingness to report medical errors and possess a solid comprehension of their causes, divergent views emerged regarding attribution and disclosure. The interrelation between patient rights and attitudes toward patient safety was supported by positive correlations. The significance of continuous education in healthcare to promote a safety culture and enhance patient-centric practices is underscored by these results. Future research is needed to investigate the effects of culturally tailored interventions on the attitudes and practices of healthcare providers in Najran with regard to patient rights and safety.

An Infant Presenting with Interstitial Lung Disease Diagnosed Later as Hunter Syndrome: A Case Report.

BACKGROUND Hunter syndrome is a multisystem metabolic inherited disease belonging to the large group of mucopolysaccharidoses (MPSs). Hunter syndrome is also known as MPS type II. Its association with respiratory symptoms has been well documented in the literature; however, it is uncommon that these patients initially present with diffuse lung disease and respiratory failure. Diffuse lung disease has a wide range of differential diagnoses that can overlap in some clinical and radiological aspects, making physicians struggle to quickly reach a final diagnosis. CASE REPORT We report a case of a full-term male infant who presented postnatally with progressive respiratory distress, hypoxemia, and radiologically-demonstrated ground-glass opacity and pneumothorax requiring mechanical ventilation and an extensive workup including CT scan of the chest, a flexible and rigid bronchoscopic examination of the airway with bronchoalveolar lavage, and whole-exome sequencing, which eventually resulted in a diagnosis of Hunter syndrome. After enzyme therapy was initiated, the patient showed marked improvement in clinical status and biological and imaging data and was weaned off oxygen a few months later. CONCLUSIONS The diagnostic approach for patients with diffuse lung disease is challenging and requires centers with expertise to reach a final diagnosis, especially in the presence of an unusual clinical presentation. The choice of the diagnostic approach can be influenced by factors such as the patient's critical condition, clinical presentation, imaging data, genetic analysis, and family decision.

Assessment of Public Perception and Attitude Toward Skin Donation in Saudi Arabia.

Background The skin is the largest organ of the body. Burns are important health issues that significantly affect a variety of population groups. Skin grafting is still regarded as the gold standard in surgical burn treatment. The availability of skin for grafting is one of the main challenges in burn surgical therapies. Thus, this study aimed to assess the public perception and attitude regarding skin donation in Saudi Arabia. Method The study was a cross-sectional study that included the general population in Saudi Arabia (≥ 18 years old). A self-administered survey was distributed online. Statistical analysis was carried out using RStudio (R version 4.1.1). Categorical data were presented as frequencies and percentages, while continuous data were expressed as the median and interquartile range (IQR). Results A total of 8515 were included in the study. Most participants (71.5%) were females. Among the respondents, 64.9% were between the ages of 18 and 30. Females had a higher knowledge level of skin graft donation compared to males. Participants aged >30 years had lower knowledge levels compared to younger participants. Lower knowledge scores were also observed among married, widows, as well as uneducated participants. Five thousand two hundred and seven (61.1%) participants support skin donation. The most reported barrier to skin donation was religious reasons (52.4%), while the main motives for supporting skin donation were humane-related factors (73.2%). The influence of close relatives on participants' decisions to donate was evident in 52.6% of the instances. Conclusion It was found that most participants support skin donation in Saudi Arabia. Religious reasons were the most common hindering factors against skin donation. Females and young-aged groups were found to have a higher knowledge level. Further studies are recommended to shed light on this subject allowing for appropriate solutions implantation.