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Thrombosis Research Jun 2024Primary liver cancer is the third leading cause of cancer related deaths worldwide, and the disease is associated with high incidence rate of thrombosis. Studies...
BACKGROUND
Primary liver cancer is the third leading cause of cancer related deaths worldwide, and the disease is associated with high incidence rate of thrombosis. Studies indicate that Tissue Factor Pathway Inhibitor (TFPI) plays a role in cancer development. We aimed to study its expression, clinical role and regulation by micro RNAs (miRNAs) in hepatocellular carcinoma (HCC).
METHODS
Publically available datasets were used for clinical analysis of TFPI and miRNAs expression by web analysis tools. miRNA mimics targeting TFPIα 3'untranslated region (UTR) were selected from target prediction programs and verified by luciferase reporter assay. In vitro effects of miRNAs overexpression in HCC cell lines on TFPI expression and cell proliferation and apoptosis were analysed.
RESULTS
TFPI expression was significantly increased in HCC tumours compared to normal tissue. Low TFPI tumour expression was associated with better survival probability. Four candidate miRNAs were selected from the target prediction programs. miR-7-5p and miR-1236-3p were validated in HepG2 and Huh7 cells to reduce TFPI mRNA and protein levels following overexpression. Furthermore, miR-7-5p and miR-1236-3p reduced TFPIα-3'UTR-controlled luciferase activity. The two validated miRNAs inhibited proliferation of HepG2 cells, and had clinical significance in HCC.
CONCLUSIONS
TFPI was increased in HCC tumours compared to normal tissue and high TFPI expression was associated with an unfavorable outcome in HCC patients. miR-7-5p and miR-1236-3p were identified as novel regulators of TFPI in vitro.
PubMed: 38945092
DOI: 10.1016/j.thromres.2024.109073 -
Thrombosis Research Jun 2024Incidence of central venous catheter (CVC)-related thrombosis in critically ill patients remains ambiguous and its association with potential hazardous sequelae unknown....
BACKGROUND
Incidence of central venous catheter (CVC)-related thrombosis in critically ill patients remains ambiguous and its association with potential hazardous sequelae unknown. The primary aim of the study was to evaluate the epidemiology of CVC-related thrombosis; secondary aims were to assess the association of catheter-related thrombosis with catheter-related infection, pulmonary embolism and mortality.
METHODS
This was a single-center, prospective observational study conducted at a tertiary intensive care unit (ICU) in the Netherlands. The study population consisted of CVC placements in adult ICU patients with a minimal indwelling time of 48 h. CVC-related thrombosis was diagnosed with ultrasonography. Primary outcomes were prevalence and incidence, incidence was reported as the number of cases per 1000 indwelling days.
RESULTS
173 CVCs in 147 patients were included. Median age of patients was 64.0 [IQR: 52.0, 72.0] and 71.1 % were male. Prevalence of thrombosis was 0.56 (95 % CI: 0.49, 0.63) and incidence per 1000 indwelling days was 65.7 (95 % CI: 59.0, 72.3). No association with catheter-related infection was found (p = 0.566). There was a significant association with pulmonary embolism (p = 0.022). All 173 CVCs were included in the survival analysis. Catheter-related thrombosis was associated with a lower 28-day mortality risk (hazard ratio: 0.39, 95 % CI: 0.17, 0.87).
CONCLUSION
In critically ill patients, prevalence and incidence of catheter-related thrombosis were high. Catheter-related thrombosis was not associated with catheter-related infections, but was associated with pulmonary embolism and a decreased mortality risk.
PubMed: 38945091
DOI: 10.1016/j.thromres.2024.109068 -
Environment International Jun 2024Facing the great threats to ecosystems and human health posed by the continuous release of chemicals into aquatic environments, effect-directed analysis (EDA) has... (Review)
Review
Facing the great threats to ecosystems and human health posed by the continuous release of chemicals into aquatic environments, effect-directed analysis (EDA) has emerged as a powerful tool for identifying causative toxicants. However, traditional EDA shows problems of low-coverage, labor-intensive and low-efficiency. Currently, a number of high-efficiency techniques have been integrated into EDA to improve toxicant identification. In this review, the latest progress and current limitations of high-efficiency EDA, comprising high-coverage effect evaluation, high-resolution fractionation, high-coverage chemical analysis, high-automation causative peak extraction and high-efficiency structure elucidation, are summarized. Specifically, high-resolution fractionation, high-automation data processing algorithms and in silico structure elucidation techniques have been well developed to enhance EDA. While high-coverage effect evaluation and chemical analysis should be further emphasized, especially omics tools and data-independent mass acquisition. For the application status in aquatic environments, high-efficiency EDA is widely applied in surface water and wastewater. Estrogenic, androgenic and aryl hydrocarbon receptor-mediated activities are the most concerning, with causative toxicants showing the typical structural features of steroids and benzenoids. A better understanding of the latest progress and application status of EDA would be beneficial to further advance in the field and greatly support aquatic environment monitoring.
PubMed: 38945088
DOI: 10.1016/j.envint.2024.108855 -
Biomedicine & Pharmacotherapy =... Jun 2024The main objective of this study was to find if thiamine disulfide (TD) lowers blood glucose level and improves insulin resistance (IR) in liver and muscle in rats with...
OBJECTIVE
The main objective of this study was to find if thiamine disulfide (TD) lowers blood glucose level and improves insulin resistance (IR) in liver and muscle in rats with chronic type 1 diabetes (T1DM) using euglycemic-hyperinsulinemic clamp technique.
METHODS
A total of fifty male Wistar rats were assigned to five groups consisted of: non-diabetic control (NDC), diabetic control (DC), diabetic treated with thiamine disulfide (D-TD), diabetic treated with insulin (D-insulin), and diabetic treated with both TD and insulin (D-insulin+TD). Diabetes was induced by a 60 mg/kg dose of streptozotocin. Blood glucose levels, pyruvate tolerance test (PTT), intraperitoneal glucose tolerance test (IPGTT), levels of glycosylated hemoglobin (HbA1c), glucose infusion rate (GIR), liver and serum lipid profiles, liver glycogen stores, liver enzymes ([ALT], [AST]), and serum calcium and magnesium levels. were evaluated. Additionally, gene expression levels of phosphoenolpyruvate carboxykinase (Pepck), forkhead box O1 (Foxo1), and glucose transporter type 4 (Glut4) were assessed in liver and skeletal muscle tissues.
RESULTS
Blood glucose level was reduced by TD treatment. In addition, TyG index, HOMA-IR, serum and liver lipid profiles, HbA1c levels, and expressions of Foxo1 and Pepck genes were decreased significantly (P<0.05) in all the treated groups. However, TD did not influence Glut4 gene expression, but GIR as a critical index of IR were 5.0±0.26, 0.29±0.002, 1.5±0.07, 0.9±0.1 and 1.3±0.1 mg.minKg in NDC, DC, D-TD, D-insulin and D-insulin+TD respectively.
CONCLUSIONS
TD improved IR in the liver primarily by suppressing gluconeogenic pathways, implying the potential use of TD as a therapeutic agent in diabetes.
PubMed: 38945083
DOI: 10.1016/j.biopha.2024.117053 -
Injury Jun 2024Racial and ethnic disparities in orthopaedic surgery are well documented. However, the extent to which these persist in fracture care is unknown. This study sought to...
INTRODUCTION
Racial and ethnic disparities in orthopaedic surgery are well documented. However, the extent to which these persist in fracture care is unknown. This study sought to assess racial disparities in the postoperative surgical and medical management of patients after diaphyseal tibia fracture fixation.
METHODS
Patients with surgically treated tibial shaft fractures from October 1, 2015, to December 31, 2020, were identified in the MarketScan® Medicaid Database. Exclusion criteria included concurrent fractures or amputation. Outcomes included 2-year postoperative complications, reoperation rates, and filled prescriptions. Surgically-treated Black and White cohorts were propensity-score matched using nearest-neighbor matching on patient demographics, comorbidities, fracture pattern and severity, and fixation type. Chi-square tests and survival analyses (Kaplan-Meier and Cox proportional hazard models) were conducted.
RESULTS
5,472 patients were included, 2,209 Black and 3,263 White patients. After matching, 2,209 were retained in each cohort. No significant differences in complication rates were observed in the matched Black vs White cohorts. Rates of reoperation, however, were significantly lower in Black as compared to White patients (28.5 % vs. 35.5 % rate, risk difference = 7.0 % (95 % confidence interval (CI): 4.2 % to 9.7 %)). Implant removal was also significantly lower in Black (17.9 %) vs. White (25.1 %) patients (Risk difference = 7.2 %, (95 %CI: 4.8 % to 9.6 %)). The adjusted hazard ratio comparing the reoperation rate in Black versus White patients was 0.77 (95 %CI: 0.69-0.82, p < 0.0001). Significantly lower proportions of Black vs White patients filled at least one prescription for benzodiazepine, antidepressants, strong opiates, or antibiotics at every time point post-index.
DISCUSSION
Fewer resources were used in post-operative management after surgical treatment of tibial shaft fractures for Black versus White Medicaid-insured patients. These results may be reflective of the undertreatment of complications after tibia fracture surgery for Black patients and highlight the need for further interventions to address racial disparities in trauma care.
PubMed: 38945078
DOI: 10.1016/j.injury.2024.111696 -
Journal of Anxiety Disorders Jun 2024This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental... (Review)
Review
This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.
PubMed: 38945067
DOI: 10.1016/j.janxdis.2024.102891 -
Australian and New Zealand Journal of... Jun 2024This article presents a longitudinal analysis of COVID-19 infection and vaccination coverage in Melbourne metropolitan local government areas (LGAs) during the 2021...
OBJECTIVE
This article presents a longitudinal analysis of COVID-19 infection and vaccination coverage in Melbourne metropolitan local government areas (LGAs) during the 2021 Delta wave.
METHODS
COVID-19 vaccination and infection data from 12 July to 27 November 2021 were sourced from government websites. Summary statistics and associated 95% confidence intervals (95% CI) were compared by LGA ranked according to socioeconomic status: total "burden" (total infections per thousand), "peak" (highest weekly infection rate), "lag" (interval between peak and 70% double vaccination).
RESULTS
LGAs in the bottom five deciles for social advantage experienced higher infection rates (39.0 per thousand [95% CI: 38.5, 39.5] vs. 14.8 [14.7, 14.9]), and had lower two-dose vaccination coverage (23.8% [23.6, 23.9] vs. 32.7% [32.6, 32.7]) compared with LGAs in the top five deciles. LGAs that achieved 70% coverage two weeks or more after the infection peak experienced nearly twice the total infection burden (27.7 per 1000 [27.3, 28.0] compared with 14.9 [14.7, 15.0]) than LGAs with a shorter lag.
CONCLUSIONS
Exposure and transmission risk factors cluster within disadvantaged LGAs. The potential for large local outbreaks is heightened if vaccination uptake trails in these communities.
IMPLICATIONS FOR PUBLIC HEALTH
In a pandemic, decision-makers must prioritise disease control and harm reduction interventions for at-risk LGAs.
PubMed: 38945056
DOI: 10.1016/j.anzjph.2024.100164 -
Australian and New Zealand Journal of... Jun 2024We sought to explore the lived experience of people with Debilitating Symptom Complexes Attributed to Ticks (DSCATT) to inform the development of a potential treatment...
OBJECTIVE
We sought to explore the lived experience of people with Debilitating Symptom Complexes Attributed to Ticks (DSCATT) to inform the development of a potential treatment intervention.
METHODS
We conducted one-to-one in-depth, semi-structured interviews with 13 people living in Australia affected by DSCATT. Interviews were transcribed and analysed using thematic analysis.
RESULTS
Although participants attributed the origin of their illness to tick bites, not all were adamant they had Lyme disease. Negative experiences in conventional healthcare were marked and were reported to exacerbate the impact of the illness and affect mental health. Further, these negative experiences propelled participants to seek unapproved treatments (by Australian standards). The desire for the illness to be acknowledged and causative agents identified was pronounced among the participant group.
CONCLUSIONS
Individuals with DSCATT experience significant challenges amid a contentious healthcare landscape surrounding chronic symptoms attributed to ticks in Australia. Our findings suggest the need for empathetic, supportive and patient-centred treatments for this cohort.
IMPLICATIONS FOR PUBLIC HEALTH
DSCATT results in a considerable burden across multiple domains for those affected. Negative experiences with healthcare exacerbate the suffering of people with DSCATT in Australia. New approaches that acknowledge the illness experience of people with DSCATT, alongside evidence-based treatments that encompass biopsychosocial models of care, are needed to tackle this debilitating condition.
PubMed: 38945055
DOI: 10.1016/j.anzjph.2024.100163 -
Australian and New Zealand Journal of... Jun 2024Understanding New Zealand-Samoan young people's experiences and definitions of anger.
OBJECTIVE
Understanding New Zealand-Samoan young people's experiences and definitions of anger.
METHODS
Focus group talanoa (discussions) with 12 New Zealand-born Samoan young people guided by 'Teu le Va' methodology. We used a culturally informed thematic analysis approach.
RESULTS
Participants defined anger as a 'bottled up' emotion and emphasised understanding cultural contexts that normalised covert and passive ways of expressing anger. Other key themes around anger we identified included experiencing multiple layers of racism and disconnection in westernised social spaces and pressures to juggle traditional Samoan and western identities. Participants also explored gendered expressions of anger. Communicating anger was important, but not in ways that harm communal values.
CONCLUSIONS
Culturally appropriate qualitative research helps understand complex cultural determinants of mental health and wellbeing and suicidal behaviour.
IMPLICATIONS FOR PUBLIC HEALTH
We must recognise the positive, polycultural capital of a generation that navigates many cultural spaces, including their emotional expressions. Anger should be understood in relation to cultural and societal pressures. Improved understanding of the cultural context of anger can inform systemic responses during crises in mental health and prevention of suicidality.
PubMed: 38945053
DOI: 10.1016/j.anzjph.2024.100162 -
Ultrasonics Sonochemistry Jun 2024The study aimed to extract and encapsulate betalain pigment from prickly pear (Opuntia ficus-indica) using ultrasound-assisted extraction and eco-friendly glycerol....
The study aimed to extract and encapsulate betalain pigment from prickly pear (Opuntia ficus-indica) using ultrasound-assisted extraction and eco-friendly glycerol. Subsequent analysis encompassed assessing its thermal stability, shelf-life, bio-accessibility, and biological properties. The process optimization employed Response Surface Methodology (RSM), focusing on glycerol concentration (20-50 %), sample to solvent ratio (1:10-1:20), temperature (30-60 °C), and time (10-30 min). Optimal conditions were determined as 23.15 % glycerol, 1:10 sample to solvent ratio, 10.43 min treatment time, and 31.15 °C temperature. Under these conditions, betalain content reached 858.28 mg/L with a 93.76 % encapsulation efficiency. Thermal stability tests (80-180 °C; 30 & 60 min) showed degradation of betalain with higher temperatures and longer durations, affecting the visual aspect (ΔE) of the pigment. Encapsulated betalain exhibited favorable shelf stability, with optimal storage life of 404.27 days at 4 °C in amber conditions, compared to 271.99 days at 4 °C without amber, 141.92 days at 25 °C without amber, and 134.22 days at 25 °C with amber. Bio-accessibility of encapsulated betalain was significantly higher (2.05 ± 0.03 %) than conventionally extracted pigment (1.03 ± 0.09 %). The encapsulated pigment displayed strong anti-inflammatory properties in dosages of 2-20 µL, with no cytotoxic effects. Additionally, incorporation into gummies was successful and visually approved by sensory panellists. Glycerol proved to be a green encapsulating agent for betalain, offering high shelf life and bio-accessibility, making it suitable for food industry applications. The encapsulated pigment demonstrated robust thermal stability and shelf life, making it suitable for food industry applications. This study highlights glycerol's potential as a sustainable alternative for natural pigment extraction.
PubMed: 38945052
DOI: 10.1016/j.ultsonch.2024.106975