Development of a Novel Non-invasive Metabolomics Assay to Predict Implantation Potential of Human Embryos.

Can a set of metabolites present in embryo culture media correlate with embryo implantation? Case-control study in two phases: discovery phase (101 samples) and validation phase (169 samples), collected between 2018 and 2022, with a total of 218 participants. Culture media samples with known implantation outcomes were collected after blastocyst embryo transfer (including both PGT and non-PGT cycles) and were analyzed using chromatography followed by mass spectrometry. The spectra were processed and analyzed using statistical and machine learning techniques to identify biomarkers associated with embryo implantation, and to develop a predictive model. In the discovery phase, 148 embryo implantation biomarkers were identified using high resolution equipment, and 47 of them were characterized. Our results indicate a significant enrichment of tryptophan metabolism, arginine and proline metabolism, and lysine degradation biochemical pathways. After transferring the method to a lower resolution equipment, a model able to assign a Metabolite Pregnancy Index (MPI) to each embryo culture media was developed, taking the concentration of 36 biomarkers as input. Applying this model to 20% of the validation samples (N=34) used as the test set, an accuracy of 85.29% was achieved, with a PPV (Positive Predictive Value) of 88% and a NPV (Negative Predictive Value) of 77.78%. Additionally, informative results were obtained for all the analyzed samples. Metabolite concentration in the media after in vitro culture shows correlation with embryo implantation potential. Furthermore, the mathematical combination of biomarker concentrations using Artificial Intelligence techniques can be used to predict embryo implantation outcome with an accuracy of around 85%.

Challenges in Healthcare Management of Individuals with Special Needs in Malaysia: Perceptions of Caregivers.

Aims and Objectives: A "caregiver" is responsible for managing the basic needs of others, including individuals with special needs (IWSNs). Caregivers play an important role in the well-being of IWSNs, though caring can lead to a decline in health and quality of life. This qualitative study aimed to investigate the perceived healthcare challenges faced by caregivers of IWSNs in Malaysia. Materials and Methods: Thirty-two primary caregivers were interviewed via audio-recorded semistructured focus group discussions to investigate their perceived barriers and challenges in caring for IWSNs. The qualitative data were then analyzed via thematic analysis. Results: Thirty-two participants took part in a total of nine discussion sessions, where the majority were females (n = 29; 90.63%) and from the Malay race (n = 30; 93.75%). Most of the IWSNs under their care had autism (n = 11; 34.38%) and were between 6 and 10 years of age (n = 13; 40.63%). The main themes identified were related to healthcare services, support systems, caregivers' personal factors, and IWSN issues. Within the healthcare services domain, themes regarding the accessibility and appropriateness of healthcare facilities and the attitudes of staff were uncovered, whereas in the support system domain, themes pertaining to community and peer, family, and governmental support were discussed. In the domain of caregivers' personal factors, themes regarding stress with the burden of care and feelings of guilt were noted, and in the area of IWSN factors, the theme of behavioral difficulties exhibited by IWSNs was discussed. Conclusion: Primary caregivers in Malaysia face challenges with healthcare facilities and staff, gaining support from the community, family, and government, burning out, and feeling guilty as well as behavior issues of their IWSN. Thus, understanding these challenges is vital in providing healthcare services that cater to not only IWSNs but also their caregivers to ensure the success and well-being of all involved.

The relationship of educational environment and preparedness to practice - perceptions of Malaysian dental graduates.

Gauging dental graduates' perceptions of their university training and of how it prepares them for professional practice is useful in measuring the quality and adequacy of the curriculum to which they were exposed. OBJECTIVES: This study aimed to evaluate the perceptions of dental graduates' educational environment as well as preparedness to practice, and how these two components are correlated. METHODS: A self-administered, validated questionnaire, developed from previous studies, was distributed to dental graduates of a public Malaysian university (n = 178, response rate = 60%) via online and postal surveys. Bivariate analyses were carried out using Spearman's rank-order correlation (Spearman's Rho, significance level p < .01) to determine the correlation between (1) Global Preparedness Score and Global DREEM Score, (2) domains of DREEM Inventory and perceived preparedness, and (3) domains of perceived preparedness and DREEM Score. RESULTS: The Global Preparedness Score was 191.52, with more than 90% of respondents feeling well prepared in the "General Patient Management," "Drug and Emergency Management" and "Practice Management" domains. The Global DREEM Score was 148.99/200, interpreted as "more positive than negative." The DREEM Inventory domains with the highest and lowest scores were "Students' Academic Self-Perception" (78.03%) and "Students' Social Self-Perception" (71.86%), respectively. A moderate positive correlation was found between Global Preparedness Score and Global DREEM Score (p < .01). In addition, moderate to large positive correlations were noted between perceived preparedness and "Student Perception of Learning," "Student Perception of Atmosphere" and "Student Academic Self-Perception" (p < .01). Moderate positive correlations were also found between the DREEM Score and most domains of perceived preparedness (p < .01). CONCLUSIONS: The majority of graduates were well prepared to perform in most areas of clinical practice and perceived their overall educational environment as positive. In particular, those who viewed the educational environment in a positive light were also found to possess a good level of preparedness.

Early treatment with JNJ-46356479, a mGluR2 modulator, improves behavioral and neuropathological deficits in a postnatal ketamine mouse model of schizophrenia.

Positive allosteric modulators of the metabotropic glutamate receptor 2 (mGluR2), such as JNJ-46356479 (JNJ), may mitigate the glutamate storm during the early stages of schizophrenia (SZ), which could be especially useful in the treatment of cognitive and negative symptoms. We evaluated the efficacy of early treatment with JNJ or clozapine (CLZ) in reversing behavioral and neuropathological deficits induced in a postnatal ketamine (KET) mouse model of SZ. Mice exposed to KET (30 mg/kg) on postnatal days (PND) 7, 9, and 11 received JNJ or CLZ (10 mg/kg) daily in the adolescent period (PND 35-60). Mice exposed to KET did not show the expected preference for a novel object or for social novelty, but they recovered this preference with JNJ treatment. Similarly, KET group did not show the expected dishabituation in the fifth trial, but mice treated with JNJ or CLZ recovered an interest in the novel animal. Neuronal immunoreactivity also differed between treatment groups with mice exposed to KET showing a reduction in parvalbumin positive cells in the prefrontal cortex and decreased c-Fos expression in the hippocampus, which was normalized with the pharmacological treatment. JNJ-46356479 treatment in early stages may help improve the cognitive and negative symptoms, as well as certain neuropathological deficits, and may even obtain a better response than CLZ treatment. This may have relevant clinical translational applications since early treatment with mGluR2 modulators that inhibit glutamate release at the onset of critical phases of SZ may prevent or slow down the clinical deterioration of the disease.

Optimization of Medication Delivery Drone with IoT-Guidance Landing System Based on Direction and Intensity of Light.

This paper presents an optimization of the medication delivery drone with the Internet of Things (IoT)-Guidance Landing System based on direction and intensity of light. The IoT-GLS was incorporated into the system to assist the drone's operator or autonomous system to select the best landing angles for landing. The landing selection was based on the direction and intensity of the light. The medication delivery drone system was developed using an Arduino Uno microcontroller board, ESP32 DevKitC V4 board, multiple sensors, and IoT mobile apps to optimize face detection. This system can detect and compare real-time light intensity from all directions. The results showed that the IoT-GLS has improved the distance of detection by 192% in a dark environment and exhibited an improvement in face detection distance up to 147 cm in a room with low light intensity. Furthermore, a significant correlation was found between face recognition's detection distance, light source direction, light intensity, and light color (p < 0.05). The findings of an optimal efficiency of facial recognition for medication delivery was achieved due to the ability of the IoT-GLS to select the best angle of landing based on the light direction and intensity.

French legislation on retrospective clinical research: What to know and what to do.

The French legislation on human subject research known as the Jardé law of 5th March 2012 has been applicable since November 2016. It concerns all research involving human subjects (RIPH, in French) and is defined according to 3 categories: high-risk interventional RIPH, low-risk interventional RIPH and non-interventional RIPH. This recent development in the supervision of research on human subjects had several objectives: to redefine the various categories of research, to strengthen data protection and to effectively address the ethical guidelines of international journals. The levels of constraint differ between categories of research according to level of risk, the common objective being to ensure patient protection. Retrospective studies based on information drawn from medical records or other databases, which are widely used in the surgical field, are not covered by the Jardé law. However, they require approval by local ethics committees and compliance with European legislation on personal data protection. Simplified procedures have been set up by the research and innovation departments in our university hospitals. In this update, we shall synthesize the legal prerequisites applying to retrospective studies on data from medical files.

A longitudinal study of gene expression in first-episode schizophrenia; exploring relapse mechanisms by co-expression analysis in peripheral blood.

Little is known about the pathophysiological mechanisms of relapse in first-episode schizophrenia, which limits the study of potential biomarkers. To explore relapse mechanisms and identify potential biomarkers for relapse prediction, we analyzed gene expression in peripheral blood in a cohort of first-episode schizophrenia patients with less than 5 years of evolution who had been evaluated over a 3-year follow-up period. A total of 91 participants of the 2EPs project formed the sample for baseline gene expression analysis. Of these, 67 provided biological samples at follow-up (36 after 3 years and 31 at relapse). Gene expression was assessed using the Clariom S Human Array. Weighted gene co-expression network analysis was applied to identify modules of co-expressed genes and to analyze their preservation after 3 years of follow-up or at relapse. Among the 25 modules identified, one module was semi-conserved at relapse (DarkTurquoise) and was enriched with risk genes for schizophrenia, showing a dysregulation of the TCF4 gene network in the module. Two modules were semi-conserved both at relapse and after 3 years of follow-up (DarkRed and DarkGrey) and were found to be biologically associated with protein modification and protein location processes. Higher expression of DarkRed genes was associated with higher risk of suffering a relapse and early appearance of relapse (p = 0.045). Our findings suggest that a dysregulation of the TCF4 network could be an important step in the biological process that leads to relapse and suggest that genes related to the ubiquitin proteosome system could be potential biomarkers of relapse.

Spanish translation and linguistic validation of the North Star Ambulatory Assessment for Duchenne muscular dystrophy functional evaluation. / Traducción al español y validación lingüística de la escala North Star Ambulatory Assessment para la evaluación funcional de la distrofia muscular de Duchenne.

INTRODUCTION: There is a need for reliable and properly validated outcome measures in Duchenne muscular dystrophy, both to monitor functional impairment and to assess the impact of new therapies. OBJECTIVE: We aimed to perform a translation of the North Star Ambulatory Assessment scale into Spanish and a linguistic validation of the resulting Spanish version. MATERIALS AND METHODS: A structured multistage process based on international guidelines was used, with the following steps: translation (preparation, forward translation, reconciliation, back translation, back translation review, clinicians' review), linguistic validation though pilot testing (cognitive interviewing, medical review, review of results and final changes), and finalization (proofreading, final report). RESULTS: No major difficulties were found during translation steps. Few changes were needed to reconcile forward translations. The linguistic validation process required several meetings to solve comprehension difficulties due to subtle nuances in the meaning of some words. The pilot study was carried out in 10 practitioners from different places in Spain, including both physiotherapists and specialists and registrars in physical medicine and rehabilitation. A total of 6 comments were obtained, including 2 comments on starting positions for items 4-5 (stand on one leg) and item 10 (stand on heels) and 2 comments on scoring instructions for item 3 (stand up from chair) and item 14 (jump). CONCLUSION: Our study has resulted in a convenient and reliable instrument for the quantification of functional abilities in boys with Duchenne muscular dystrophy in Spain. Our innovations in methods and our results could be used as a suggested template for the North Star Ambulatory Assessment linguistic validation in other languages.

TITLE: Traducción al español y validación lingüística de la escala North Star Ambulatory Assessment para la evaluación funcional de la distrofia muscular de Duchenne.Introducción. En la distrofia muscular de Duchenne son necesarias medidas de evaluación fiables y validadas para el seguimiento del deterioro funcional y de los efectos de los nuevos tratamientos. Objetivo. Se realizó una traducción, seguida de validación lingüística, de la escala North Star Ambulatory Assessment al español. Materiales y métodos. Se utilizó un proceso estructurado, de múltiples etapas, basado en las guías internacionales, con los siguientes pasos: traducción (preparación, traducción directa, reconciliación, retrotraducción, revisión de la retrotraducción y revisión por médicos clínicos), validación lingüística mediante una prueba piloto (entrevista cognitiva, revisión médica, revisión de resultados y ajustes finales) y finalización (revisión de pruebas e informe final). Resultados. No surgieron dificultades importantes durante los pasos de traducción. La reconciliación de las traducciones directas requirió pocos cambios. En la validación lingüística fueron precisas varias reuniones para resolver dificultades de comprensión, en matices sutiles, en el significado de algunas palabras. El estudio piloto se realizó con 10 especialistas clínicos de diferentes lugares de España (fisioterapeutas y especialistas o residentes de medicina física y rehabilitación). Hubo seis comentarios, dos de ellos sobre las posiciones de partida en los ítems 4-5 (de pie sobre un solo pie) y 13 (de pie sobre los talones), y dos sobre las instrucciones de puntuación para los ítems 3 (levantarse de la silla) y 14 (saltar). Conclusión. Nuestro estudio ha proporcionado un instrumento cómodo y fiable para cuantificar las capacidades funcionales en niños con distrofia muscular de Duchenne en España. Las innovaciones en el método y nuestros resultados podrían usarse como modelo para la validación lingüística en otros idiomas.

Monitoring waves of the COVID-19 pandemic: Inferences from WWTPs of different sizes.

Wastewater based epidemiology was employed to track the spread of SARS-CoV-2 within the sewershed areas of 10 wastewater treatment plants (WWTPs) in Catalonia, Spain. A total of 185 WWTPs inflow samples were collected over the period consisting of both the first wave (mid-March to June) and the second wave (July to November). Concentrations of SARS-CoV-2 RNA (N1 and N2 assays) were quantified in these wastewaters as well as those of Human adenoviruses (HAdV) and JC polyomavirus (JCPyV), as indicators of human faecal contamination. SARS-CoV-2 N gene daily loads strongly correlated with the number of cases diagnosed one week after sampling i.e. wastewater levels were a good predictor of cases to be diagnosed in the immediate future. The conditions present at small WWTPs relative to larger WWTPs influence the ability to follow the pandemic. Small WWTPs (<24,000 inhabitants) had lower median loads of SARS-CoV-2 despite similar incidence of infection within the municipalities served by the different WWTP (but not lower loads of HAdV and JCPyV). The lowest incidence resulting in quantifiable SARS-CoV-2 concentration in wastewater differed between WWTP sizes, being 0.11 and 0.82 cases/1000 inhabitants for the large and small sized WWTP respectively.

Traducción al español y validación lingüística de la escala North Star Ambulatory Assessment para la evaluación funcional de la distrofia muscular de Duchenne / Spanish translation and linguistic validation of the North Star Ambulatory Assessment for Duchenne muscular dystrophy functional evaluation

Introducción: En la distrofia muscular de Duchenne son necesarias medidas de evaluación fiables y validadas para el seguimiento del deterioro funcional y de los efectos de los nuevos tratamientos. Objetivo: Se realizó una traducción, seguida de validación lingüística, de la escala North Star Ambulatory Assessment al español. Materiales y métodos: Se utilizó un proceso estructurado, de múltiples etapas, basado en las guías internacionales, con los siguientes pasos: traducción (preparación, traducción directa, reconciliación, retrotraducción, revisión de la retrotraducción y revisión por médicos clínicos), validación lingüística mediante una prueba piloto (entrevista cognitiva, revisión médica, revisión de resultados y ajustes finales) y finalización (revisión de pruebas e informe final). Resultados: No surgieron dificultades importantes durante los pasos de traducción. La reconciliación de las traducciones directas requirió pocos cambios. En la validación lingüística fueron precisas varias reuniones para resolver dificultades de comprensión, en matices sutiles, en el significado de algunas palabras. El estudio piloto se realizó con 10 especialistas clínicos de diferentes lugares de España (fisioterapeutas y especialistas o residentes de medicina física y rehabilitación). Hubo seis comentarios, dos de ellos sobre las posiciones de partida en los ítems 4-5 (de pie sobre un solo pie) y 13 (de pie sobre los talones), y dos sobre las instrucciones de puntuación para los ítems 3 (levantarse de la silla) y 14 (saltar). Conclusión: Nuestro estudio ha proporcionado un instrumento cómodo y fiable para cuantificar las capacidades funcionales en niños con distrofia muscular de Duchenne en España. Las innovaciones en el método y nuestros resultados podrían usarse como modelo para la validación lingüística en otros idiomas.(AU)

Introduction: There is a need for reliable and properly validated outcome measures in Duchenne muscular dystrophy, both to monitor functional impairment and to assess the impact of new therapies.Objective: We aimed to perform a translation of the North Star Ambulatory Assessment scale into Spanish and a linguistic validation of the resulting Spanish version. Materials and methods. A structured multistage process based on international guidelines was used, with the following steps: translation (preparation, forward translation, reconciliation, back translation, back translation review, clinicians’ review), linguistic validation though pilot testing (cognitive interviewing, medical review, review of results and final changes), and finalization (proofreading, final report). Results: No major difficulties were found during translation steps. Few changes were needed to reconcile forward translations. The linguistic validation process required several meetings to solve comprehension difficulties due to subtle nuances in the meaning of some words. The pilot study was carried out in 10 practitioners from different places in Spain, including both physiotherapists and specialists and registrars in physical medicine and rehabilitation. A total of 6 comments were obtained, including 2 comments on starting positions for items 4-5 (stand on one leg) and item 10 (stand on heels) and 2 comments on scoring instructions for item 3 (stand up from chair) and item 14 (jump). Conclusion: Our study has resulted in a convenient and reliable instrument for the quantification of functional abilities in boys with Duchenne muscular dystrophy in Spain. Our innovations in methods and our results could be used as a suggested template for the North Star Ambulatory Assessment linguistic validation in other languages.(AU)

Evaluation of two rapid ultrafiltration-based methods for SARS-CoV-2 concentration from wastewater.

Quantitative measurements of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in raw wastewater have been implemented worldwide since the beginning of the pandemic. Recent efforts are being made to evaluate different viral concentration methodologies to overcome supplier shortages during lockdowns. A set of 22-wastewater samples seeded with murine hepatitis virus (MHV), a member of the Coronaviridae family, and the bacteriophage MS2, were used to characterize and compare two ultrafiltration-based methods: a centrifugal ultrafiltration device (Centricon® Plus-70) and the automated concentrating pipette CP-Select™. Based on the recovery efficiencies, significant differences were observed for MHV, with Centricon® Plus-70 (24%) being the most efficient method. Nevertheless, concentrations of naturally occurring SARS-CoV-2, Human adenoviruses and JC polyomaviruses in these samples did not result in significant differences between methods suggesting that testing naturally occurring viruses may complement the evaluation of viral concentration methodologies. Based on the virus adsorption to solids and the necessity of a pre-centrifugation step to remove larger particles and avoid clogging when using ultrafiltration methods, we assessed the percentage of viruses not quantified after ultrafiltration. Around 23% of the detected SARS-CoV-2 would be discarded during the debris removal step. The CP-Select™ provided the highest concentration factor (up to 333×) and the lowest LoD (6.19 × 103 GC/l) for MHV and proved to be fast, automatic, highly reproducible and suitable to work under BSL-2 measures.

Perceptions of oral health education and practice among nursing students in Malaysia and Australia.

OBJECTIVE: Representing the largest proportion of healthcare workers, nurses play a significant role in oral health (OH) maintenance as part of a larger effort to promote holistic patient care. The study aims to determine nursing students' perceptions of OH education and practice in Malaysian and Australian nursing schools. MATERIALS AND METHODS: A self-administered questionnaire (content- and face-validated) survey was undertaken, classroom style, amongst final-year nursing students from selected Malaysian (n = 122, Response rate=97.6%) and Australian (n = 299, Response rate=54.7%) institutions. Quantitative data were analysed via Statistical Package for Social Science software (Chi-square and Fisher's exact tests, p ≤ 0.01). RESULTS: Significantly more Malaysian nursing students, compared to those in Australia, reported having encountered patients with OH issues (98.4% vs. 82.9%), namely halitosis (87.7% vs. 62.2%), oral ulcers (63.1% vs. 41.1%), oral/dental trauma (36.9% vs. 21.1%) and caries in children (28.7% vs. 7.7%). Less than half of Malaysian and Australian nursing students reported that they received adequate OH training (48.4% vs. 36.6%, p ≤ 0.01), especially in detecting oral cancer (18.0.0% vs. 22.6%, p ≤ 0.01) and preventing oral diseases (46.7% vs. 41.7%, p ≤ 0.01). Students in both countries demonstrated positive attitudes and believed in their role in OH care. Most students agreed that they should receive training in OH, especially in smoking cessation and providing OH care for patients with special needs. They also opined that a standardized evidence-based oral hygiene protocol is needed. CONCLUSION: Support for education and practice in this area of patient care suggested positive implications for further development of nurses' roles in OH promotion and management.

The usefulness of Olanzapine plasma concentrations in monitoring treatment efficacy and metabolic disturbances in first-episode psychosis.

INTRODUCTION: The role of Olanzapine therapeutic drug monitoring is controversial. The present study explores the associations of Olanzapine plasma concentrations with clinical response and metabolic side effects in first episode psychosis (FEP) after 2 months of treatment. METHODS: Forty-seven patients were included. Improvement in clinical symptomatology was assessed using the PANSS. Metabolic assessment included weight, blood pressure, waist circumference, blood glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. RESULTS: The Olanzapine plasma concentrations after 2 months of treatment were positively correlated with weight gain (r = 0.49, p = 0.003), and a concentration > 23.28 ng/mL was identified as a positive predictor of weight gain (≥ 7%). The Olanzapine concentration to dose (C/D) ratio was positively correlated with the percentage of improvement in the total PANSS (r = 0.46, p = 0.004), and a C/D ratio > 2.12 was identified as a positive predictor of a good response (percentage of improvement > 30%) after 2 months of treatment. We also identified several factors that could alter Olanzapine pharmacokinetics: gender (p = 0.03), diagnosis (p = 0.05), smoking habit (p = 0.05), and co-medications such as valproic acid (p = 0.05) and anxiolytics (p = 0.01). DISCUSSION: In conclusion, our results suggest that therapeutic drug monitoring of Olanzapine could be helpful to evaluate therapeutic efficacy and metabolic dysfunction in FEP patients treated with Olanzapine.

Oral health education in the undergraduate nursing curriculum of Australian and Malaysian institutions.

INTRODUCTION: A high degree of training is necessary to prepare student nurses for their roles as oral healthcare partners that can promote a holistic approach to health in the community. This study aims to determine the extent of oral health education in Australian and Malaysian nursing institutions, as well as investigate educators' perceptions of education and practice in this area of care. METHODOLOGY: An audio-recorded, semi-structured qualitative phone interview was conducted with the heads of 42 nursing schools across Australia (n = 35) and Malaysia (n = 7) during the 2015 academic year. Qualitative data were analysed via thematic analysis. Quantitative data, wherever appropriate, were measured for frequencies. RESULTS: The response rate was 34.2% (n = 12) and 71.4% (n = 5) for the Australian and Malaysian subjects, respectively. Findings revealed that although all the nursing schools measured provided didactic and clinical training in oral health, curriculum content, expected learning outcomes, amount of clinical exposure and assessment approach lacked consistency. Most nursing educators across both countries perceived an overloaded curriculum as a barrier to providing oral health education. Whilst educators demonstrated their support for training in this area of care, they expressed the need for an established national guideline that highlights the educational requirement for future nurses in oral health maintenance and their scope of practice. CONCLUSION: This study provides valuable information for further developing oral health education for nurses, to improve their competency and ultimately the health of the communities that they will serve.

Extramural Oral Health Educational Program Involving Individuals With Disabilities: Impact on Dental Students' Professionalism.

CONTEXT: Oral health inequalities experienced by patients, including people with disabilities (PWD), have been related to dentists' lack of professionalism and inadequate experience in managing patients with special needs. AIMS: This study investigated the impact of an extramural program involving PWD on dental students' professionalism and students' perception of training in managing patients with special needs. MATERIALS AND METHODS: A group of 165 undergraduate dental students (year 1 to year 5) participated in a voluntary program, involving 124 visually impaired children, at a special education school in Kuala Lumpur, Malaysia. A dedicated module in oral health was developed by specialists in special care dentistry, pedodontics, and medical sciences. Dental students then participated in a semi-structured focus group interview survey to discuss perceptions of their learning experiences. Qualitative data were analyzed via thematic analysis. RESULTS: The program had positive impact on various aspects categorized into four major domains: professional knowledge (e.g., understanding of oral-systemic-social-environmental health interaction and understanding of disability), professional skills (e.g., communication and organizational skills), professional behavior (e.g., empathy and teamwork), and value-added learning (e.g., photography and information technology skills). Students showed improved willingness to manage, and comfort in managing PWD, and expressed support for future educational programs involving this patient cohort. CONCLUSION: Improved knowledge, skills, attitudes, and personal values, as well as support for future programs, indicate the positive impact of extramural educational activities involving PWD in developing professionalism in patient care, while providing an opportunity for students to be exposed to managing patients with special needs.

Recursive independent component analysis (ICA)-decomposition of ictal EEG to select the best ictal component for EEG source imaging.

OBJECTIVE: This study aimed to present a new ictal component selection technique, named as recursive ICA-decomposition for ictal component selection (RIDICS), for potential application in epileptogenic zone localization. METHODS: The proposed technique decomposes ictal EEG recursively, eliminates a few unwanted components in every recursive cycle, and finally selects the most significant ictal component. Back-projected EEG, regenerated from that component, was used for source estimation. Fifty sets of simulated EEGs and 24 seizures in 8 patients were analyzed. Dipole sources of simulated-EEGs were compared with a known dipole location whereas epileptogenic zones of the seizures were compared with their corresponding sites of successful surgery. The RIDICS technique was compared with a conventional technique. RESULTS: The RIDICS technique estimated the dipole sources at an average distance of 12.86 mm from the original dipole location, shorter than the distances obtained using the conventional technique. Epileptogenic zones of the patients, determined by the RIDICS technique, were highly concordant with the sites of surgery with a concordance rate of 83.33%. CONCLUSIONS: Results show that the RIDICS technique can be a promising quantitative technique for ictal component selection. SIGNIFICANCE: Properly selected ictal component gives good approximation of epileptogenic zone, which eventually leads to successful epilepsy surgery.

MALDI imaging mass spectrometry and chemometric tools to discriminate highly similar colorectal cancer tissues.

Intratumour heterogeneity due to cancer cell clonal evolution and microenvironment composition and tumor differences due to genetic variations between patients suffering of the same cancer pathology play a crucial role in patient response to therapies. This study is oriented to show that matrix-assisted laser-desorption ionization-Mass spectrometry imaging (MALDI-MSI), combined with an advanced multivariate data processing pipeline can be used to discriminate subtle variations between highly similar colorectal tumors. To this aim, experimental tumors reproducing the emergence of drug-resistant clones were generated in athymic mice using subcutaneous injection of different mixes of two isogenic cell lines, the irinotecan-resistant HCT116-SN50 (R) and its sibling human colon adenocarcinoma sensitive cell line HCT116 (S). Because irinotecan-resistant and irinotecan-sensitive are derived from the same original parental HCT116 cell line, their genetic characteristics and molecular compositions are closely related. The multivariate data processing pipeline proposed relies on three steps: (a) multiset multivariate curve resolution (MCR) to separate biological contributions from background; (b) multiset K-means segmentation using MCR scores of the biological contributions to separate between tumor and necrotic parts of the tissues; and (c) partial-least squares discriminant analysis (PLS-DA) applied to tumor pixel spectra to discriminate between R and S tumor populations. High levels of correct classification rates (0.85), sensitivity (0.92) and specificity (0.77) for the PLS-DA classification model were obtained. If previously labelled tissue is available, the multistep modeling strategy proposed constitutes a good approach for the identification and characterization of highly similar phenotypic tumor subpopulations that could be potentially applicable to any kind of cancer tissue that exhibits substantial heterogeneity.

Does Lower Lean Body Mass Mediate the Relationship Between Falls and Higher Body Mass Index in Asian Older Persons?

The current evidence on the relationship between a higher body mass index (BMI) and falls in older adults is conflicting. This study, therefore, evaluated the relationship between BMI and falls and explored underlying mechanisms for this relationship. Data from 1,340 individuals from the Malaysian Elders Longitudinal Research study, obtained through home-based computer-assisted interviews and followed by hospital-based health checks, were utilized. A history of the presence of falls in the previous 12 months was obtained. The presence of at least one fall in the past 12 months was associated with a higher BMI (odds ratio = 1.03, 95% confidence interval [1.01, 1.06]). The relationship between a higher BMI and falls was, however, attenuated by a lower percentage of lean body mass, which accounted for 69% of the total effect of BMI on the risk of falls. Future studies should now investigate this aforementioned relationship prospectively.