Effects of Moleac 901 after severe spinal cord injury on chronic phase in Wistar rats.

Background: MLC901 is a phytopharmaceutical comprising significant compounds that can induce microenvironments conducive to the proliferation and specialization of neural cell progenitors. This study investigates the impact of administering MLC901, reducing the expression of NG2 and caspase-3 and increasing IL-10 levels, as well as histopathological and motor function, after severe spinal cord injury (SCI) in the chronic phase. Methods: The study employed a randomized post-test-only control group design conducted between February and April 2023 at the Integrated Biomedical Laboratory. The participants in this study were categorized into three distinct groups: normal control, negative control, and therapy. A cohort of 18 rats was utilized for the study, with each group assigned a random allocation of six rats as subjects. Results: The findings demonstrated a statistically significant disparity in the average NG2 expression (-52.00 ± 20.03; p ≤ 0.05), as well as Caspase-3 expression (-94.89 ± 8.57; p ≤ 0.05), which exhibited a lower magnitude. The levels of IL-10 (8.96 ± 3.98; p ≤ 0.05) were observed to be higher, along with an elevation in BBB score (7.67 ± 0.89; p ≤ 0.05), which was more pronounced in the treatment group compared to the negative control group. The cut-off point for cavitation diameter is determined to be 114.915 µm, exhibiting a sensitivity and specificity of 100%. The area under curve (AUC) value is 1.0. The administration of MLC901 demonstrated a strong positive correlation with the increase in IL-10 levels (B 8.968; p ≤ 0.05), as well as a substantial negative correlation with the decrease in Caspase-3 expression (B -52.000; p ≤ 0.05) and NG2 expression (B -94.892; p ≤ 0.05). The administration of MLC901 via the upregulation of NG2 and Caspase-3 significantly increased the Basso, Beattie, and Bresnahan (BBB) scores. Conclusions: MLC901 positively affects motor and histopathological outcomes in the chronic phase of severe SCI in the Wistar rat model. These benefits are believed to be achieved by suppressing gliosis, neuroapoptosis, and neuroinflammation processes.

The Impact of Machine Learning and Robot-Assisted Gait Training on Spinal Cord Injury: A Systematic Review and Meta-Analysis.

INTRODUCTION: Spinal cord injury (SCI) is a significant and transforming event, with an estimated annual incidence of 40 cases per million individuals in North America. Considering the significance of accurate diagnosis and effective therapy in managing SCI, Machine Learning (ML) and Robot-Assisted Gait Training (RAGT) technologies hold promise for enhancing optimal practices and elevating the quality of care. This study aims to determine the impact of the ML and RAGT techniques employed on the outcome results of SCI. METHODS: We reviewed four databases, including PubMed, Scopus, ScienceDirect, and the Cochrane Central Register of Controlled Trials (CENTRAL), until 20 August 2023. The keywords used in this study encompassed the following: a comprehensive search was executed on research exclusively published in the English language: machine learning, robotics, and spinal cord injury. RESULTS: A comprehensive search was conducted across four databases, identifying 2367 articles following rigorous data filtering. The results of the odd ratio (OR) and confidence interval (CI) of 95% for the ASIA Impairment Scale, or AIS grade A, were 0.093 (0.011-0.754, p = 0.026), for AIS grade B, 0.875 (0.395-1.939, p = 0.743), for AIS grade C, 3.626 (1.556-8.449, p = 0.003), and for AIS grade D, 8.496 (1.394-51.768, p = 0.020). The robotic group exhibited a notable reduction in AS (95% CI = -0.239 to -0.045, p = 0.004) and MAS (95% CI = -3.657 to -1.066, p ≤ 0.001) measures. This study also investigated spasticity and walking ability, which are significant. CONCLUSIONS: The ML approach exhibited enhanced precision in forecasting AIS result scores. Implementing RAGT has been shown to impact spasticity reduction and improve walking ability.

Analysis of PD-L1 Expression in Breast Cancer: A Systematic Review and Meta-Analysis in Asian Population.

OBJECTIVE: This study aimed to investigate the level of PD-L1 protein expression in patients with BCs who were of Asian descent. METHODS: Three databases were conducted on this article up to August 10th, 2022. The reference lists of the publications were examined for further studies, and in cases of duplicates, a study with a larger sample size was added. In survival analysis, the hazard ratio (HR) was applied to the circumstances characterized by the frequency of occurrences, and for the clinicopathological characteristic, the best-adjusted odds ratio (OR) with a 95% confidence interval (CI) was employed. The Newcastle-Ottawa Scale (NOS) was utilized to evaluate selection criteria, comparison, and exposure to establish the quality of the technique in the under-consideration studies. The Z test determined the association analysis of OS, DFS, and clinicopathological characteristics with PD-L1 expression. RESULT: All eight trials for OS and six for DFS were considered, with 4.111 and 3.071 participants, respectively. Overexpression of PD-L1 was linked to a reduced OS compared to individuals with undetectable expression (HR= 1.58, 95% CI 1.04-2.40; P=0.03). We analyzed clinicopathological features, and it elevated in individuals with histological grade III (OR=2.39, 95% CI 1.26-4.54; P=0.008) and positive node (OR=0.68, 95% CI 0.48-0.97; P<0.05). CONCLUSION: Overexpression of PD-L1 was associated with a shorter OS in BCs patients. High PDL1 was higher in persons with nodal positivity and histological grade III.

Pretreatment Leukocyte Count Ratios as Metastatic Predictive Factors in Luminal Type Breast Cancer.

OBJECTIVE: Molecular based predictive biomarkers have been developed but still unaffordable in developing countries. The leukocyte ratio is known as a promising, affordable and practical biomarker. However, the evidence to support their application is still lacking, especially from developing countries. Therefore, this study aimed to evaluate the association between leukocytes count ratios as predictive markers of metastasis in luminal type breast cancer. METHODS: A retrospective cross-sectional study was conducted using breast cancer patient data obtained at Sanglah General Hospital (2016-2020). Complete blood count (CBC) and histopathological records of the patients were collected and the basophil-to-lymphocyte ratio (BLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were calculated. Tumor stadium was classified into early (I-II) and advance (III-IV) stage while distant metastasis was classified into M0 and M1. Data were then analyzed using ROC curve and then followed by chi square and logistic regression analysis to obtain OR value. RESULTS: Two hundred eighty-three  luminal breast cancer patient data were used in this study with mean age 49.27 ± 9.451. Most of the patient had advanced disease (177 patients; 62.5%) while metastatic disease accounted for 54 patients (19.1%) of all patients. Patients with metastatic disease had higher median of BLR, MLR, NLR and PLR (0.043 ± 0.025, p=0.034; 0.289 ± 0.285, p=0.008; 3.489 ± 5.027, p=0.044; 159.538 ± 127.79, p=0.008) than patients without metastasis. The AUC (sensitivity and specificity) of BLR, MLR, NLR and PLR in predicting metastasis were 0.593 (51%; 65%), 0.616 (35%; 89%), 0.588 (46%; 75%) and 0.615 (40%; 81%), respectively. In multivariate risk analysis model, patients with metastasis were found in high BLR (Adjusted OR: 2.045; 95%CI=1.123-3.723; p=0.019), MLR (Adjusted OR: 4.862; 95%CI=2.401-9.844; p<0.001), NLR (Adjusted OR: 2.727; 95%CI=1.475-5.044; p=0.001) and PLR (Adjusted OR: 3.061; 95%CI=1.618-5.792; p=0.001). CONCLUSION: Pretreatment leukocyte ratios are potential predictive markers for metastasis. However, these findings need to be validated in larger and prospective studies with more comprehensive design.

The prevalence, predictors and outcomes of acute liver injury among patients with COVID-19: A systematic review and meta-analysis.

The data on the predictors and prognosis of acute liver injury (ALI) among patients in coronavirus disease 2019 (COVID-19) patients are limited. The aim of this study was to determine the prevalence, predictors and outcomes of ALI among patients with COVID-19. A systematic review was conducted up to 10 June 2021. The relevant papers were searched from PubMed, Embase, Cochrane and Web of Science, and the data were analysed using a Z test. A total of 1331 papers were identified and 16 papers consisting of 1254 COVID-19 with ALI and 4999 COVID-19 without ALI were analysed. The cumulative prevalence of ALI among patients with COVID-19 was 22.8%. Male and having low lymphocyte levels were more likely to be associated with ALI compared with female and having higher lymphocyte level, odds ratio (OR): 2.70; 95% confidence interval (CI): 2.03, 3.60 and mean difference (MD) -125; 95% CI: -207, -43, respectively. COVID-19 patients with ALI had higher risk of developing severe COVID-19 compared with those without ALI (OR: 3.61; 95% CI: 2.60, 5.02). Our findings may serve as the additional evaluation for the management of ALI in COVID-19 patients.