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Heliyon Jun 2024Hydroxyapatite (HAp) coatings currently have limited therapeutic applications because they lack anti-infection, osteoinductivity, and poor mechanical characteristics. On...
Hydroxyapatite (HAp) coatings currently have limited therapeutic applications because they lack anti-infection, osteoinductivity, and poor mechanical characteristics. On the titanium substrate, electrochemical deposition (ECD) was used to construct the strontium (Sr)-featuring hydroxyapatite (HAp)/graphene oxides (GO)/linezolid (LZ) nanomaterial coated with antibacterial and drug delivery properties. The newly fabricated nanomaterials were confirmed by X-ray diffraction analysis (XRD), Fourier-transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS) analysis and morphological features were examined by scanning electron microscope (SEM) analysis. The results reveal multiple nucleation sites for SrHAp/GO/LZ composite coatings due to oxygen-comprising moieties on the 2D surface of GO. It was shown to be favorable for osteoblast proliferation and differentiation. The elastic modulus and hardness of LZ nanocomposite with SrHAp/GO/LZ coatings were increased by 67 % and 121 %, respectively. An initial 5 h burst of LZ release from the SrHAp/GO/LZ coating was followed by 14 h of gradual release, owing to LZ's physical and chemical adsorption. The SrHAp/GO/LZ coating effectively inhibited both and , and the inhibition lasted for three days, as demonstrated by the inhibition zone and colony count assays. When MG-63 cells are coated with SrHAp/GO/LZ composite coating, their adhesion, proliferation, and differentiation greatly improve when coated with pure titanium. A novel surface engineering nanomaterial for treating and preventing osteoporotic bone defects, SrHAp/GO/LZ, was shown to have high mechanical characteristics, superior antibacterial abilities, and osteoinductivity.
PubMed: 38947479
DOI: 10.1016/j.heliyon.2024.e31638 -
Heliyon Jun 2024The purpose of this review is to summarize the characteristics and applications of current hysteroscopic training models. (Review)
Review
OBJECTIVES
The purpose of this review is to summarize the characteristics and applications of current hysteroscopic training models.
METHODS
We conducted a systematic search of PubMed, Embase, and Cochrane Library for eligible studies published before March 2024. Manual screening of references and citation tracking were also performed.
RESULTS
Reported hysteroscopic training models included virtual reality simulators, non-biological material models, plant tissue models, animal tissue models, and human tissue models. No training model was distinctly superior in terms of realism, haptic feedback, availability of standardized scoring of operations, preparation difficulty, reusability of surgical procedure, and prices. Utilizing any type of models for hysteroscopy simulation training could assist trainees in enhancing relevant knowledge, skills, self-confidence, and comfort, but virtual reality models had an advantage in training capacity.
CONCLUSIONS
Each hysteroscopic training model has its advantages and disadvantages. An appropriate training curriculum is needed to efficiently leverage the merits of different models. The realism and training effectiveness of various training models need to be compared using rigorously designed studies and standard evaluation tools.
PubMed: 38947438
DOI: 10.1016/j.heliyon.2024.e31698 -
Global Health & Medicine Jun 2024Lacking of adequate knowledge is an obstacle to effective prevention of cervical cancer, yet factors that affect the information acquisition and seeking behavior as well...
Lacking of adequate knowledge is an obstacle to effective prevention of cervical cancer, yet factors that affect the information acquisition and seeking behavior as well as the information communication process are not well studied. We assessed information acquisition and seeking behavior, as well as perceived barriers of doctor-patient communication regarding human papilloma virus (HPV)-related information of infected women. Among 437 participants, 405 (93%) expressed demands for HPV-related information, while only a small proportion (100/437, 22.9%) actively sought information and felt obstacles comprehending. Web-based channels were most frequently utilized and medical personnel were the most trusted information source. Patients' satisfaction was significantly correlated with doctor's patience ( = 0.581, < 0.001) and emotional caring ( = 0.555, < 0.001). Compared to patients not actively seeking information, those actively seeking information were more likely to be single ( = 0.005), had higher education ( = 0.009) and monthly individual-level income ( = 0.023), and was more likely to undergo regular cervical cancer screening ( = 0.003), and were already or willing to be vaccinated ( = 0.008). The actively seeking information group also achieved higher scores in HPV knowledge test ( = 0.007). Public health interventions targeting HPV-infected women using specifically designed educational materials may influence information seeking behavior, increase HPV literacy and knowledge, which could potentially increase HPV vaccine uptake and cervical cancer screening rate.
PubMed: 38947411
DOI: 10.35772/ghm.2023.01100 -
Journal of Cancer 2024As a chemotherapy agent, cisplatin (DDP) is often associated with drug resistance and gastrointestinal toxicity, factors that severely limit therapeutic efficacy in...
As a chemotherapy agent, cisplatin (DDP) is often associated with drug resistance and gastrointestinal toxicity, factors that severely limit therapeutic efficacy in patients with ovarian cancer (OC). Naringin has been shown to increase sensitivity to cisplatin, but whether the intestinal microbiota is associated with this effect has not been reported so far. In this study, we applied a humanized mouse model for the first time to evaluate the reversal of cisplatin resistance by naringin, as well as naringin combined with the microbiota in ovarian cancer. The results showed that naringin combined with subsp. NCU-01 had an inhibitory effect on the tumor, significantly reducing tumor size (<0.05), as well as the concentrations of serum tumor markers CA125 and HE4, increased the relative abundance of and , inhibit Toll-like receptor 4 (TLR4)/nuclear factor κB (NF-κB)-induced intestinal inflammation and increase the expression of intestinal permeability-associated proteins ZO-1 (<0.001) and occludin (<0.01). In conclusion, the above data demonstrate how naringin combined with subsp. NCU-01 reverses cisplatin resistance in ovarian cancer by modulating the intestinal microbiota, inhibiting the TLR4/NF-κB signaling pathway and modulating the p38MAPK signaling pathway.
PubMed: 38947385
DOI: 10.7150/jca.96448 -
Journal of Cancer 2024Advanced-stage ovarian cancer (OC) is among the most fatal female genital tract neoplasms worldwide. Although different genetic mechanisms have been shown to be...
Advanced-stage ovarian cancer (OC) is among the most fatal female genital tract neoplasms worldwide. Although different genetic mechanisms have been shown to be involved in ovarian carcinogenesis, the role of introns methylation is still unresolved. We performed methylation analysis of introns 1, 3, and 4 of the to identify patterns in primary stage III OCs, corresponding metastases, and healthy tissues. The study involved samples of paraffin-embedded tissues obtained from 80 patients with stage III OCs, who underwent surgery at the Department of Gynecology and Gynecologic Oncology of the Military Institute of Medicine in Warsaw, Poland. Altogether, 40 serous-type G2/3 OCs and 40 endometrioid-type G2/3 OCs were included. From the same patient, metastatic and normal tissues were simultaneously analyzed. As a control group, 80 tissue samples were collected from patients after bariatric operations. Human ovarian cancer A2780 cell line was also investigated. Total genomic DNA was isolated from paraffin-embedded tissue blocks and the methylation analysis was performed by bisulfite DNA conversion, DNA amplification with specific primers, cloning, and DNA sequencing. All of the samples of intron 1 of were un-methylated in OCs, metastatic tissues, and in healthy tissues from the same patient. Also, no methylation of intron 1 was detected in cells from the human A2780 ovarian cancer cell line and in all samples from control group. In all samples, introns 3 and 4 of the were methylated in primary tumors, metastatic tissue, and in healthy tissue from the same patient, in human A2780 ovarian cell line, and in DNA samples from healthy patients. None of the clinicopatholocal features was related to the introns methylation status. Our data on introns methylation sheds new light on the mechanism of p53 activity for a better understanding of cancer biology. The study suggests the existence of an additional regulation rule of activity that involves demethylation-methylation mechanisms. Methylation at introns 3 and 4 may also overall help in protecting against damage by viral restrictases or viral DNA integration.
PubMed: 38947384
DOI: 10.7150/jca.94945 -
Health Care Science Jun 2024The sustainability of rural surgical and obstetrical facilities depends on their efficacy and quality of care, which are difficult to measure in a rural context. In an...
BACKGROUND
The sustainability of rural surgical and obstetrical facilities depends on their efficacy and quality of care, which are difficult to measure in a rural context. In an evaluation of rural practice, it is often the case that the only comparators are larger referral facilities, for which facility-level comparisons are difficult due to differences in population demographics, acuity of patients, and services offered. This publication outlines these limitations and highlights a best-practice approach to making facility-level comparisons using population-level data, risk stratification, tests of noninferiority, and Firth logistic regression analysis. This includes an investigation of minimum sample-size requirements through Monte Carlo power analysis in the context of low-acuity rural surgical care.
METHODS
Monte Carlo power analysis was used to estimate the minimum sample size required to achieve a power of 0.8 for both logistic regression and Firth logistic regression models that compare the proportion of surgical adverse events against facility type, among other confounders. We provide guidelines for the implementation of a recommended methodology that uses risk stratification, Firth penalized logistic regression, and tests of noninferiority.
RESULTS
We illustrate limitations in facility-level comparison of surgical quality among patients undergoing one of four index procedures including hernia repair, colonoscopy, appendectomy, and cesarean delivery. We identified minimum sample sizes for comparison of each index procedure that fluctuate depending on the level of risk stratification used.
CONCLUSION
The availability of administrative data can provide an adequate sample size to allow for facility-level comparisons in surgical quality, at the rural level and elsewhere. When they are made appropriately, these comparisons can be used to evaluate the efficacy of general practitioners and nurse practitioners in performing low-acuity procedures.
PubMed: 38947364
DOI: 10.1002/hcs2.94 -
Frontiers in Public Health 2024Scalable PTSD screening strategies must be brief, accurate and capable of administration by a non-specialized workforce.
BACKGROUND
Scalable PTSD screening strategies must be brief, accurate and capable of administration by a non-specialized workforce.
METHODS
We used PTSD as determined by the structured clinical interview as our gold standard and considered predictors sets of (a) Posttraumatic Stress Checklist-5 (PCL-5), (b) Primary Care PTSD Screen for the DSM-5 (PC-PTSD) and, (c) PCL-5 and PC-PTSD questions to identify the optimal items for PTSD screening for public sector settings in Kenya. A logistic regression model using LASSO was fit by minimizing the average squared error in the validation data. Area under the receiver operating characteristic curve (AUROC) measured discrimination performance.
RESULTS
Penalized regression analysis suggested a screening tool that sums the Likert scale values of two PCL-5 questions-intrusive thoughts of the stressful experience (#1) and insomnia (#21). This had an AUROC of 0.85 (using hold-out test data) for predicting PTSD as evaluated by the MINI, which outperformed the PC-PTSD. The AUROC was similar in subgroups defined by age, sex, and number of categories of trauma experienced (all AUROCs>0.83) except those with no trauma history- AUROC was 0.78.
CONCLUSION
In some East African settings, a 2-item PTSD screening tool may outperform longer screeners and is easily scaled by a non-specialist workforce.
Topics: Humans; Stress Disorders, Post-Traumatic; Female; Male; Adult; Kenya; Mass Screening; Middle Aged; Regression Analysis; Young Adult; Adolescent; Surveys and Questionnaires
PubMed: 38947359
DOI: 10.3389/fpubh.2024.1383171 -
Frontiers in Immunology 2024Despite advances in surgical and therapeutic approaches, high-grade serous ovarian carcinoma (HGSOC) prognosis remains poor. Surgery is an indispensable component of...
Despite advances in surgical and therapeutic approaches, high-grade serous ovarian carcinoma (HGSOC) prognosis remains poor. Surgery is an indispensable component of therapeutic protocols, as removal of all visible tumor lesions (cytoreduction) profoundly improves the overall survival. Enhanced predictive tools for assessing cytoreduction are essential to optimize therapeutic precision. Patients' immune status broadly reflects the tumor cell biological behavior and the patient responses to disease and treatment. Serum cytokine profiling is a sensitive measure of immune adaption and deviation, yet its integration into treatment paradigms is underexplored. This study is part of the IMPACT trial (NCT03378297) and aimed to characterize immune responses before and during primary treatment for HGSOC to identify biomarkers for treatment selection and prognosis. Longitudinal serum samples from 22 patients were collected from diagnosis until response evaluation. Patients underwent primary cytoreductive surgery or neoadjuvant chemotherapy (NACT) based on laparoscopy scoring. Twenty-seven serum cytokines analyzed by Bio-Plex 200, revealed two immune phenotypes at diagnosis: Immune High with marked higher serum cytokine levels than Immune Low. The immune phenotypes reflected the laparoscopy scoring and allocation to surgical treatment. The five Immune High patients undergoing primary cytoreductive surgery exhibited immune mobilization and extended progression-free survival, compared to the Immune Low patients undergoing the same treatment. Both laparoscopy and cytoreductive surgery induced substantial and transient changes in serum cytokines, with upregulation of the inflammatory cytokine IL-6 and downregulation of the multifunctional cytokines IP-10, Eotaxin, IL-4, and IL-7. Over the study period, cytokine levels uniformly decreased in all patients, leading to the elimination of the initial immune phenotypes regardless of treatment choice. This study reveals distinct pre-treatment immune phenotypes in HGSOC patients that might be informative for treatment stratification and prognosis. This potential novel biomarker holds promise as a foundation for improved assessment of treatment responses in patients with HGSOC. ClinicalTrials.gov Identifier: NCT03378297.
Topics: Humans; Female; Ovarian Neoplasms; Cystadenocarcinoma, Serous; Cytokines; Middle Aged; Aged; Neoadjuvant Therapy; Phenotype; Cytoreduction Surgical Procedures; Biomarkers, Tumor; Neoplasm Grading; Prognosis; Treatment Outcome; Adult
PubMed: 38947323
DOI: 10.3389/fimmu.2024.1394497 -
World Journal of Orthopedics Jun 2024The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation. While there is consensus about the posterior approach,...
BACKGROUND
The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation. While there is consensus about the posterior approach, several posterior approaches have been developed. It is debatable as to which approach is best.
AIM
To compare triceps reflecting anconeus pedicle (TRAP) and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.
METHODS
In total, 40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C, closed, and Gustilo type I intercondylar humeral fractures were included. Patients ranged in age from 18 years to 70 years. The patients were randomized into two groups: TRAP group and olecranon osteotomy group, with 20 cases in each. All were followed up at 6 wk, 3 months, 6 months, and 12 months. Functional outcomes were measured in terms of flexion-extension arc, Disabilities of Arm, Shoulder and Hand score, and Mayo Elbow Performance Score.
RESULTS
The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group. The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group (119.5 111.5 min and 9.85 5.45 d, respectively). The mean arc of flexion-extension, Disabilities of Arm, Shoulder and Hand score, and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up (107.0 106.2, 18.3 15.7, and 84.2 86.2, respectively). Ulnar paresthesia and superficial infections were comparable in both groups (2 cases 3 cases and 3 cases 2 cases, respectively). Hardware prominence was significantly higher in the olecranon osteotomy group, mostly due to tension band wiring.
CONCLUSION
Both approaches were equivalent, but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.
PubMed: 38947270
DOI: 10.5312/wjo.v15.i6.570 -
Open Medicine (Warsaw, Poland) 2024[This retracts the article DOI: 10.1515/med-2024-0913.].
[This retracts the article DOI: 10.1515/med-2024-0913.].
PubMed: 38947216
DOI: 10.1515/med-2024-1000