[Review on the Combination Strategy of Anti-angiogenic Agents and Other Anti-tumor Agents in Advanced Non-small Cell Lung Cancer]

Treatments for advanced non-small cell lung cancer (NSCLC) include chemotherapy, targeted therapy, and immunotherapy represented by immune checkpoint inhibitors. However, the efficacy of monotherapy is still limited. Nowdays, combination strategy has drawn great attention. Anti-angiogenic agents are widely used in treating advanced NSCLC, which can not only suppress the growth and metastasis of tumor by suppressing tumor vessels, and also have synergic effect with other anti-tumor agents because they can normalize vessels and regulate immune micro-environment. This article summarizes the underlying mechanism of combining anti-angiogenic agents and other anti-tumor agents, reviews the clinical trials on the combination strategy including monoclonal antibodies and tyrosine kinase inhibitor, so as to provide a potential strategy for treating advanced NSCLC.
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Atopy, asthma, and risk of bladder cancer: Systematic review and meta-analysis of cohort studies

The relationship between atopic diseases and cancer at various sites has been extensively studied. Previous epidemiological studies have investigated the association between atopic diseases and bladder cancer; however, the results remain inconclusive. In this study, we performed a systematic review and meta-analysis of cohort studies published thus far to evaluate the association between atopy and the risk of bladder cancer. We conducted a systematic search in PubMed, Embase, ISI Web of Science, and Scopus to identify potentially relevant studies. The pooled risk ratio (RRs) and 95% confidence intervals (95% CIs) were calculated using a random-effect model considering the heterogeneity among studies. On the basis of our selection criteria, a total of 10 cohort studies were included in our meta-analysis involving 2,341,005 participants, of whom 1720 were patients with bladder cancer. The pooled RR of bladder cancer in the group with atopic disease versus the group without atopic disease was 1.31 (95% CI: 1.10–1.56, p < 0.01), indicating a positive association between overall atopy and bladder cancer risk. In subgroup analysis, the pooled RR of bladder cancer was 1.46 (95% CI: 1.18–1.80, p < 0.001) for asthma and 1.03 (95% CI: 0.74–1.44, p = 0.86) for allergic rhinitis. The risk of bladder cancer is positively associated with overall atopy and asthma, but is not associated with allergic rhinitis.

CT Imaging Features of Patients Infected with 2019 Novel Coronavirus

Novel coronavirus pneumonia is an acute, infectious pneumonia caused by a novel coronavirus infection. Computed tomographic (CT) imaging is one of the main methods to screen and diagnose patients with this disease. Here, the importance and clinical value of chest CT examination in the diagnosis of COVID-19 is expounded, and the pulmonary CT findings of COVID-19 patients in different stages are briefly summarized, thus providing a reference document for the CT diagnosis of COVID-19 patients.

Post-mastectomy pain syndrome: A timely review of its predisposing factors and current approaches to treatment

Background:

Post-mastectomy pain syndrome (PMPS) has been reported to occur in 25–60% of patients following surgeries for breast cancer, the highest occurring cancer in women worldwide. There has been much research interest due to this high prevalence. However, there is still a lack of incorporation of PMPS prevention strategies in standard perioperative plans, and our understanding of this condition is still incomplete.

Objectives:

This narrative review discusses recent literature on modifiable risk factors, current approaches to prevention and treatment and potential directions for future treatment and research.

Methods:

A PubMed search with the relevant keywords was done for articles published in the last 10 years.

Results:

The incidence of PMPS can be reduced by early recognition and management of modifiable risk factors as well as the perioperative use of analgesics and regional nerve blocks. These also have a significant role in the management of established PMPS together with surgical interventions and physical therapy.

Conclusions:

PMPS is still poorly defined and hence underdiagnosed and undertreated at this point. Perioperative peripheral nerve blocks have a very promising role as preventive analgesia to reduce the risk of developing PMPS, but large-scale randomised controlled studies will need to be done to evaluate their comparative efficacy. There is a need to prioritise PMPS prevention as a standard inclusion into the perioperative plans of mastectomy patients.

EXPERIMENTAL STUDY OF DOUBLE CABLE-CONDUIT DRIVING DEVICE FOR MRI COMPATIBLE BIOPSY ROBOTS

Magnetic resonance imaging (MRI) is better than other imaging equipment in detecting tumors, and navigation for robotic breast intervention biopsy. However, material requirements for robots driving devices are demanding incredibly because of the environment. Given this problem, a novel double cable-conduit driving method is put forward in this paper, which can be used in MRI for breast intervention robots. Besides, lebus grooves are adopted to the driving wheels, which enable the system to realize remote-range and large-scale driving on the premise that the precision can be further enhanced. The driving characteristic of the novel cable-conduit is established. Moreover, the cable-conduit experimental data proves the results of theoretical deduction. Finally, the cable-conduit driving device is compensated, the average errors in the [Formula: see text], [Formula: see text], and [Formula: see text] directions of the needle tip entering the tissue are less than 2[Formula: see text]mm. The consequence verifies that it can meet the requirements for breast biopsy robot application under MR environment.

MicroRNA-4325 Suppresses Cell Progression in Hepatocellular Carcinoma via GATA-Binding Protein 6

MicroRNAs (miRs) are regulators of the formation and development of hepatocellular carcinoma (HCC). The biological role of miR-4325 in HCC has yet to be determined. This study is aimed at dissecting the role of miR-4325 in HCC and the underlying mechanism. Reverse transcription-quantitative PCR (RT-qPCR) was used to detect miR-4325 expression in HCC tissue specimens and cells. Cell proliferation, migration, and invasion were assessed by using the MTT assay and Transwell assay, respectively. The miR-4325 target was predicted based on bioinformatics analysis and validated using the dual-luciferase reporter assay. Rescue experiments in the cells were utilized to functionally characterize the downstream molecular targets of miR-4325. We observed that miR-4325 expression levels were significantly reduced in both HCC tissue specimens and cell lines. Meanwhile, a lower miR-4325 level was associated with a poorer prognosis. Gain and loss of function assays revealed that miR-4325 markedly downregulated HCC cell growth, migration, and invasion. Moreover, we identified GATA-binding protein 6 (GATA6) as a miR-4325 target and found that GATA6 was abnormally expressed in HCC. Rescue assays demonstrated that the regulatory function of miR-4325 in HCC was mediated by GATA6. Taken together, miR-4325 suppresses HCC cell growth, migration, and invasion by targeting GATA6, suggesting that miR-4325 may potentially serve as a novel therapeutic target for HCC.

Radiomics Analysis to Enhance Precise Identification of Epidermal Growth Factor Receptor Mutation Based on Positron Emission Tomography Images of Lung Cancer Patients

How to recognize precisely epidermal growth factor receptor (EGFR) mutation in lung cancer patients owns great clinical requirement. In this study, 1575 radiomics features were extracted from PET images of 75 lung cancer patients based on contrast agents such as 18F-MPG and 18F-FDG. The Mann-Whitney U test was used for single factor analysis, the Least Absolute Shrinkage and Selection Operator (Lasso) Regression was used for feature screening, then the radiomics classification models were established by using support vector machines and ten-fold cross-validation, and were used to identify EGFR mutation in primary lung cancers and metastasis lung cancers, accuracy based on 18F-MPG PET images are respectively 90% for primary lung cancers, and 89.66% for metastasis lung cancers, accuracy based on 18F-FDG PET images are respectively 76% for primary lung cancers and 82.75% for metastasis lung cancers. The area under the curves (AUC) based on 18F-MPG PET images are respectively 0.94877 for primary lung cancers, and 0.91775 for metastasis lung cancers, AUC based on 18F-FDG PET images are respectively 0.87374 for primary lung cancers, and 0.82251 for metastasis lung cancers. In conclusion, both 18F-MPG PET images and 18F-FDG PET images combined with established classification models can identify EGFR mutation, but 18F-MPG PET images have more precisely than 18F-FDG PET images, own clinical translational prospects.

Effect of strategic purchasing of antiviral drugs and the clinical pathway for the treatment of Chronic Hepatitis C in Colombia (hepC-STRATEGY): study protocol for a quasi-experimental study

Objective

Describe a study protocol to establish the effect of DAA's strategic purchase and the clinical pathway in the clinical outcomes, general costs, and quality of healthcare of patients with CHC in Colombia.

Methods

A quasi-experimental study will be carried out to compare clinical outcomes (treatment effectiveness), healthcare quality (access to treatment, time to treatment, patient's satisfaction and barriers/facilitators perceived) and direct costs before/after the implementation of the mentioned strategies. Patients ≥18 years old initiating DAA treatment between January 2015 and December 2019 in an outpatient pharmacist-led center in Colombia will be included. In order to reduce selection bias, the propensity score method will be used. In the bivariate analysis, χ 2 tests and t student will be used to analyse the study outcomes. A regression analysis will be used to explain the association of multiple variables with access to treatment, time to treatment and effectiveness. Descriptive statistics will be used to analyse the patient's satisfaction and barriers/facilitators perceived.

Key findings

Implementing local government policies is necessary to improve access to medicines and decrease disease burden. The strategies adopted by the Colombian Ministry of Health to manage CHC needs to be evaluated. Therefore, studies are required to establish their effects on clinical outcomes, overall costs, and quality of care.

Conclusions

This study will provide evidence on the effect of Colombian strategies to address the problem of HCC. It will provide information to policymakers in low- and middle-income countries that could reduce disease burden.

[Research Progress of Anti-angiogenic Agents Combined with Immunotherapy in Patients with Advanced Non-small Cell Lung Cancer]

Lung cancer has the highest incidence rate and mortality in China, even in the world, and non-small cell lung cancer (NSCLC) accounts for about 85%. The growth and metastasis of tumor depend on the generation of blood vessels, and anti-angiogenic therapy is playing an increasingly important role, however, no significant improvement was observed in the underwent anti-angiogenic agents used for patients alone. In recent years, the application of immune checkpoint inhibitor (ICI) has significantly improved the prognosis of some lung cancer patients, however, the objective response rate of patients receiving ICI alone is low. While anti-angiogenic agents and ICI both regulate the tumor immune microenvironment and have a potential synergistic mechanism, showing a bright prospect in the combined application of anti-tumor therapy. In this review, we focused on the research and application of anti-angiogenic agents in combination with ICI in advanced non-small cell lung cancer.

[Analysis of the Efficacy of Irinotecan in the Second-line Treatment of Refractory and Relapsed Small Cell Lung Cancer]

BACKGROUND

Among malignant tumors, lung cancer has the highest mortality rate. Small cell lung cancer (SCLC) is a kind of malignant lung cancer. Its doubling time is very fast. Patients are prone to drug resistance during treatment, and their condition often deteriorates rapidly after recurrence. Except for topotecan, there is a lack of effective second-line single-agent chemotherapy. This study aims to analysis the efficacy and safety of irinotecan (CPT-11) in the second-line treatment of refractory and relapsed SCLC.

METHODS

A total of 107 SCLC patients were collected from the Department of Oncology, Jilin Guowen Hospital, who were diagnosed from April 2012 to March 2020, relapsed within 6 months after first-line treatment, and received second-line chemotherapy with single-agent CPT-11. Follow-up until November 2020, calculate the patient's progression free survival (PFS) and overall survival (OS), and summarize the effects and adverse reactions of CPT-11 chemotherapy.

RESULTS

The patient's median PFS was 3.8 (3.4-4.4) months, median OS was 8.1 (6.5-10.9) months, objective response rate (ORR) was 16.82% (18/107), and DCR was 55.14% (59/107). The incidence of grade 3-4 adverse reactions in patients was relatively low. Among them, neutropenia was 13.08%, delayed diarrhea was 7.48%, nausea and vomiting was 17.76%, and liver function impairment was 6.54%. The influencing factors of PFS in single-agent CPT-11 second-line chemotherapy were gender (P=0.001), NSE (P=0.029), and effusion (P=0.040). While the influencing factors of OS were NSE level only (P=0.033).

CONCLUSIONS

For patients with refractory relapsed SCLC, CPT-11 single-agent second-line chemotherapy has a certain effect, is well tolerated, and is worthy of promotion.
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AMPK Is the Crucial Target for the CDK4/6 Inhibitors Mediated Therapeutic Responses in PANC-1 and MIA PaCa-2 Pancreatic Cancer Cell Lines

The survival rate of pancreatic ductal adenocarcinoma (PDAC) patients is short, and PDAC is a cancer type that ranks fourth in the statistics regarding death due to cancer. Mutation in the KRAS gene, which plays a role in pancreatic cancer development, activates the PI3K/AKT/mTOR signaling pathway. The activity of the AMPK as a cellular energy sensor is one of the fundamental mechanisms that can induce effective therapeutic responses against CDK4/6 inhibitors via adjusting the cellular and tumor microenvironment stress management. The phosphorylation of AMPKα at the different phosphorylation residues such as Thr172 and Ser 377 causes metabolic differentiation in the cells following CDK4/6 inhibitor treatment in accordance with an increased cell cycle arrest and senescence under the control of different cellular players. In this study, we examined the competencies of the CDK4/6 inhibitors LY2835219 and PD-0332991 on the mechanism of cell survival and death based on AMPK signaling. Both CDK4/6 inhibitors LY2835219 and PD-0332991 modulated different molecular players on the PI3K/AKT/mTOR and AMPK signaling axis in different ways to reduce cell survival in a cell type dependent manner. These drugs are potential inducers of apoptosis and senescence that can alter the therapeutic efficacy cells.

B7-H3 and digestive system cancers

Digestive system cancers (DSC) are the most common cancers worldwide and often associated with poor prognosis because of their characteristics of invasive and metastatic. Thus, it is particularly necessary to find novel molecular targets for early diagnosis, as well as targeted treatment of DSC. B7-H3, which was previously referred to as a modulatory ligand that regulate T-cell-mediated immune reaction, is a B7-family member of co-stimulatory biomolecules, and in recent years it was found that its concentration was remarkably up modulated in serum, as well as tissues of DSC patients. Numerous studies have documented that B7-H3 has a vital function in the DSC. Herein, we summarize the current literature on diagnosis and prognosis potential of B7-H3 in DSC including those of the esophagus, gastric, liver, pancreas, and colon.

Adenocarcinoma de colon sigmoide metastásico en paciente joven, presentación atípica: reporte de caso

El adenocarcinoma colorrectal es la tercera causa de muerte por cáncer en mujeres y la cuarta en hombres a nivel mundial. Se diagnostica en su mayoría en pacientes mayores a los 50 años, siendo la edad media al momento del diagnóstico los 72 años. A pesar eso, se estima que en los próximos años aumentará la incidencia en personas jóvenes y de mediana edad. Debido a esta proyección y considerando que la ausencia de signos y síntomas específicos no permite un diagnóstico oportuno, se hacen necesarias la sensibilización clínica y un alto índice de sospecha en las presentaciones atípicas. Se presenta el caso de una paciente joven que consulta por un cuadro de un mes de síntomas respiratorios quien, después de tratamiento antibiótico, antiviral e inmunomodulador sistémico, presenta sepsis de origen abdominal por peritonitis de cuatro cuadrantes secundaria a perforación de colon sigmoide debida a adenocarcinoma bien diferenciado, metastásico a pulmón, que la llevó a la muerte.

Autophagy in Viral Development and Progression of Cancer

Autophagy is a complex degradative process by which eukaryotic cells capture cytoplasmic components for subsequent degradation through lysosomal hydrolases. Although this catabolic process can be triggered by a great variety of stimuli, action in cells varies according to cellular context. Autophagy has been previously linked to disease development modulation, including cancer. Autophagy helps suppress cancer cell advancement in tumor transformation early stages, while promoting proliferation and metastasis in advanced settings. Oncoviruses are a particular type of virus that directly contribute to cell transformation and tumor development. Extensive molecular studies have revealed complex ways in which autophagy can suppress or improve oncovirus fitness while still regulating viral replication and determining host cell fate. This review includes recent advances in autophagic cellular function and emphasizes its antagonistic role in cancer cells.

Modeling and stability analysis of the spread of novel coronavirus disease COVID-19

Towards the end of 2019, the world witnessed the outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (COVID-19), a new strain of coronavirus that was unidentified in humans previously. In this paper, a new fractional-order Susceptible–Exposed–Infected–Hospitalized–Recovered (SEIHR) model is formulated for COVID-19, where the population is infected due to human transmission. The fractional-order discrete version of the model is obtained by the process of discretization and the basic reproductive number is calculated with the next-generation matrix approach. All equilibrium points related to the disease transmission model are then computed. Further, sufficient conditions to investigate all possible equilibria of the model are established in terms of the basic reproduction number (local stability) and are supported with time series, phase portraits and bifurcation diagrams. Finally, numerical simulations are provided to demonstrate the theoretical findings.

COVID-19 and Vulnerable Populations in Sub-Saharan Africa

The novel corona virus 2019 (COVID-19) outbreak which started in Hubei province in China has now spread to every corner of the earth. While the pandemic started later in Africa, it is now found in all African countries to varying degrees. It is thought that the prevalence and severity of disease is influenced by a number of non-communicable diseases (NCDs) which are all becoming increasingly prevalent in sub-Saharan Africa (SSA). In addition, SSA bears the major burden of human immunodeficiency virus (HIV) and tuberculosis (TB) infections. While data from Europe and the United States show that children are spared severe disease, it is uncertain if the same holds true in SSA where children suffer from sickle cell disease and malnutrition in addition to other infectious diseases. There is limited data from Africa on the effects of these conditions on COVID-19. In this review, we discuss the epidemiology of some of these conditions in Africa and the possible pathogenesis for the interactions of these with COVID-19.

The Proposition of the Pulmonary Route as an Attractive Drug Delivery Approach of Nano-Based Immune Therapies and Cancer Vaccines to Treat Lung Tumors

Lung cancer is the leading cause of cancer related deaths globally, making it a major health concern. The lung’s permissive rich microenvironment is ideal for supporting outgrowth of disseminated tumors from pre-existing extra-pulmonary malignancies usually resulting in high mortality. Tumors occurring in the lungs are difficult to treat, necessitating the need for the development of advanced treatment modalities against primary tumors and secondary lung metastasis. In this review, we explore the pulmonary route as an attractive drug delivery approach to treat lung tumors. We also discuss the potential of pulmonary delivery of cancer vaccine vectors to induce mucosal immunity capable of preventing the seeding of tumors in the lung.

δ-Tocopherol Enhances Docetaxel-Induced Growth Inhibition and Apoptosis in Ovarian Cancer SKOV3 Cells

Docetaxel is the first-line chemotherapeutic drug for ovarian cancer. However, its clinical use is limited owing to its serious side effects. Therefore, it is of great clinical significance to enhance the efficacy of docetaxel at lower doses in a less-toxic manner. In this study, we investigated whether δ-tocopherol could enhance the anti-tumor effects of docetaxel on ovarian cancer SKOV3 cells in vitro. For docetaxel and δ-tocopherol, IC50 values of 1.89 nM and 11.41 µM, respectively, were obtained, in SKOV3 cells. The combination of δ-tocopherol and docetaxel had a synergistic cell growth inhibition effect, with lower cell viability and more cell arrest at the S phase compared to either δ-tocopherol or docetaxel alone. In addition, the combination of δ-tocopherol and docetaxel had a synergistic cell apoptosis induction effect, with more apoptotic cells and reduced anti-apoptotic protein expression compared to either δ-tocopherol or docetaxel alone. Furthermore, we identified 3 hoursub genes (CAT, EP300, CREBBP), which predicted the prognosis of ovarian cancer, which correlated with δ-tocopherol and docetaxel. In conclusion, the combination of δ-tocopherol and docetaxel presented synergistic cell growth inhibition and cell apoptosis induction effects in SKOV3 cells at a low dose, which suggesting that δ-tocopherol could improve the serious side effects of docetaxel.

Demand Effects of the Internet-of-Things Sales Channel: Evidence from Automating the Purchase Process

The internet of things (IoT) is rapidly becoming one of the most popular emerging technologies in business and society. One of the major verticals that has recently begun to effectively use IoT technologies is the retail industry. Given the unprecedented opportunities IoT generates for brands and retailers, it is important to glean timely insights regarding the business value of IoT and understand whether the introduction of an IoT technology as an alternative purchase channel for consumers affects the sales of physical products. Using empirical data from a multinational online retailer who adopted an IoT technology that largely automates the consumers’ purchases and employing a quasi-experimental framework, we study the effect of the introduction of IoT as an alternative sales channel on product sales. Our analyses reveal a statistically and economically significant increase in sales and demonstrate the business value of the IoT channel for retailers and brands. In addition, we conduct other analyses of IoT to delve into the effect of heterogeneity and empirically validate the underlying mechanisms by examining the impact of IoT for products in different price ranges, levels of substitutability, and product categories. For instance, our analyses reveal that less expensive and more differentiated products, as well as experience and utilitarian goods, can accrue higher benefits leveraging more effectively novel IoT technologies. This is the first paper to study the impact of an IoT technology on product sales, drawing important implications for devices and technologies largely automating the purchase process.

Estrés cotidiano en supervivientes de cáncer

Introducción: El número de supervivientes de cáncer ha aumentado considerablemente en los últimos años. Estas personas presentan necesidades asistenciales específicas, y se sienten vulnerables ante cualquier tipo de problema de salud, por lo que, contrariamente a lo que sería esperable, la finalización del tratamiento parece dar inicio a una etapa extremadamente estresante para los supervivientes. Objetivo: Describir las características del malestar cotidiano durante situaciones consideradas estresantes para los supervivientes de cáncer. Metodología: Se ha usado una Evaluación Ecológica Momentánea para recoger información sobre las actividades cotidianas de los supervivientes de cáncer al final del día. Muestra: Sesenta supervivientes de varios tipos de cáncer, que han contestado a un cuestionario online durante 15 días consecutivos. Resultados: Los supervivientes han experimentado un evento estresante un 55,12% de los días registrados, de los cuales el 45,41% de ellos fue atribuido al hecho de ser superviviente y generó niveles de malestar más elevados. El evento estresante más frecuente, cuando se atribuye a la supervivencia, ha sido el problema físico (87,60%). Conclusiones: El problema físico es claramente un evento estresante relacionado con la fase de supervivencia y, es un problema que no parece resolverse con el tiempo. En general, los eventos estresantes atribuidos a la supervivencia generan más malestar.

Spontaneous pneumomediastinum in Covid-19 : a case of complete resolution despite invasive positive pressure ventilation

We present the case of a 65-year-old patient who was admitted to the intensive care unit (ICU) due to Covid-19 respiratory failure. During his hospital stay, he developed a spontaneous pneumomediastinum (SP). To date, there have been few reports of SP associated with Covid-19 and even less is known about the impact of positive pressure ventilation on these patients. Our patient was first treated with high-flow nasal cannula oxygen therapy (HFNC). Because of further respiratory deterioration, he was supported with non-invasive ventilation (NIV). Later, he required intubation and ventilation with invasive positive pressure ventilation. Despite this, a complete spontaneous resolution of the pneumomediastinum was observed 13 days after the initial diagnosis.

Desarrollo de una estrategia holística para la valoración de la calidad de vida en pacientes con cáncer de mama en las distintas etapas de la enfermedad

Introducción: El cáncer de mama es considerado una enfermedad crónica que impacta de modo importante en la calidad de vida (QoL) de las pacientes. En la actualidad no se dispone de un sistema de evaluación totalmente satisfactorio que refleje la complejidad del cáncer de mama. Además, la mayoría de instrumentos están más orientados a la enfermedad en estadios iniciales que a la enfermedad avanzada. Objetivo: Describir la metodología utilizada para evaluar la calidad de vida y las estrategias de afrontamiento en un grupo representativo de cáncer de mama que incluye tanto pacientes metastásicas como no metastásicas. Método: Estudio prospectivo en pacientes con cáncer de mama del Servicio de Oncología Médica del Institut Català d’Oncologia (ICO) en diferentes estadios de la enfermedad, previo consentimiento informado. Se les aplica un protocolo de aproximadamente una hora de entrevista presencial donde se recoge su información sociodemográfica, y se contestan varios cuestionarios de calidad de vida como el cuestionario QLCA-AFex Font, QLQ-C30, QLQ-BR23 HADS, DME, BRCS, MINI-MAC, LOT-R y OE, que se completan con una entrevista semiestructurada. Resultados: De junio de 2017 a marzo de 2020, 257 pacientes han sido incluidas en el estudio. La media de edad es de 57,9 años (SD 10,1), la mayoría son mujeres (98,8%), con hijos (87,9%) y casadas (65,4%). Respecto al estadiaje clínico 75,5% son no-metastásicas y 24,5% metastásicas. El cumplimiento del protocolo se consiguió en más del 90% de los cuestionarios sin diferencias entre pacientes metastásicas y no metastásicas. Conclusión: Este protocolo multidimensional permite hacer una evaluación integral de la calidad de vida, así como reflejar las necesidades no atendidas y las preocupaciones que muestran las pacientes tanto en estadio precoz como avanzado, complementando los sistemas de valoración actualmente disponibles. Después del análisis de los resultados de este estudio sería interesante poder obtener un cuestionario único con las preguntas más relevantes que pudiera ser aplicado a la práctica clínica.

Assessing the capacity for mental manipulation in patients with statically-determined mild cognitive impairment using digital technology

Aims: Prior research employing a standard backward digit span test has been successful in operationally defining neurocognitive constructs associated with the Fuster’s model of executive attention. The current research sought to test if similar behavior could be obtained using a cross-modal mental manipulation test. Methods: Memory clinic patients were studied. Using Jak-Bondi criteria, 24 patients were classified with mild cognitive impairment (MCI), and 33 memory clinic patients did not meet criteria for MCI (i.e. non-MCI). All patients were assessed with the digital version of the WRAML-2 Symbolic Working Memory Test-Part 1, a cross-modal mental manipulation task where patients hear digits, but respond by touching digits from lowest to highest on an answer key. Only 4 and 5-span trials were analyzed. Using an iPad, all test stimuli were played; and, all responses were obtained with a touch key. Only correct trials were analyzed. Average time to complete trials and latency for each digit was recorded. Results: Groups did not differ when average time to complete 4-span trials was calculated. MCI patients displayed slower latency, or required more time to re-order the 1st and 3rd digits. Regression analyses, primarily involving initial and latter response latencies, were associated with better, but different underlying neuropsychological abilities. Almost no 5-span analyses were significant. Conclusions: This cross-modal test paradigm found no difference for total average time. MCI patients generated slower 1st and 3rd response latency, suggesting differences in time allocation to achieve correct serial order recall. Moreover, different neuropsychological abilities were associated with different time-based test components. These data extend prior findings using a standard backward digit span test. Differences in time epochs are consistent with constructs underlying the model of executive attention and help explain mental manipulation deficits in MCI. These latency measures could constitute neurocognitive biomarkers that track emergent disease.

Neurological diseases caused by coronavirus infection of the respiratory airways

Infections of the central nervous system (CNS) infections are critical problems for public health. They are caused by several different organisms, including the respiratory coronaviruses (CoVs). CoVs usually infect the upper respiratory tract causing the common cold. However, in infants, and in elderly and immunocompromised persons, they can also affect the lower respiratory tract causing pneumonia and various syndromes of respiratory distress. CoVs also have neuroinvasive capabilities because they can spread from the respiratory tract to the CNS. Once infection begins in the CNS cells, it can cause various CNS problems such as status epilepticus, encephalitis, and long‐term neurological disease. This neuroinvasive properties of CoVs may damage the CNS as a result of misdirected host immune response, which could be associated with autoimmunity in susceptible individuals (virus‐induced neuro‐immunopathology) or associated with viral replication directly causing damage to the CNS cells (virus‐induced neuropathology). In December 2019, a new disease named COVID‐19 emerged which is caused by CoVs. The significant clinical symptoms of COVID‐19 are related to the respiratory system, but they can also affect the CNS, causing acute cerebrovascular and intracranial infections. We describe the possible invasion routes of coronavirus in this review article, and look for the most recent findings associated with the neurological complications in the recently published literature.

Configuração dos atendimentos oncológicos em um município de Minas Gerais, Brasil

Introdução: O câncer configura-se como um relevante problema de saúde pública mundial e impacta a carga global de doenças. Visto isso, este estudo teve como objetivo geral conhecer a configuração clínica, assistencial e epidemiológica dos atendimentos às pessoas com câncer de um município do estado de Minas Gerais, Brasil. Materiais e Métodos: Estudo transversal, descritivo, seguido por abordagem espacial em saúde, realizado com dados de prontuários que integram os registros hospitalares de câncer de um município sul mineiro no período de 2007 a 2017. Para a análise dos dados contou-se com o auxílio dos softwares EpiInfo, TerraView e QGis. Resultados: Foram 1914 pessoas atendidas, com predominância de sexo masculino, idade superior a 60 anos, cor branca, ensino fundamental completo, ocupação doméstica. Oncologia clínica, estadiamento tipo I, doença estável, câncer de pele, adenocarcinoma, cirurgia, quimioterapia e ausência de razão para não tratar despontaram como as variáveis clínico-assistenciais mais frequentes. Constatou-se um aporte expressivo dos registros a partir de 2009 e um decréscimo de casos não-analíticos. Obteve-se 94,7% de geocodificação e verificou-se uma distribuição espacial heterogênea pela área urbana, com conglomerados em diferentes bairros. Conclusão: A configuração clínica-assistencial e epidemiológica dos atendimentos oncológicos proposta foi alcançada. As distribuições temporal, espacial e de frequência dos atendimentos apontam para um incremento substancial na cobertura assistencial de pessoas com câncer tratadas no cenário estudado.

Preparation and Effect of Selenium Nanoparticles/Oligochitosan on the White Blood Cell Recovery of Mice Exposed to Gamma-Ray Radiation

Owing to their excellent bioavailability, high bioactivity, and low toxicity, selenium nanoparticles (SeNPs) are emerging nanomaterials. In this study, SeNPs with a size of ∼41.8 nm were synthesised by γ-irradiation using oligochitosan (OCS) as the stabiliser. As-synthesized SeNPs/OCS were characterised by UV-Vis spectroscopy, transmission electron microscopy, and energy-dispersive X-ray (EDX) analysis. Results revealed that the as-obtained SeNP/OCS powder exhibits high purity. The SeNP/OCS solution’s stability test results indicated that the SeNP/OCS solution stored at 4°C exhibits good stability for 60 days. The SeNP/OCS solution was unstable at ambient temperature, and SeNP/OCS exhibited agglomeration after about 15 days. SeNP/OCS products recovered the total white blood cells of γ-ray irradiated mice. The SeNP/OCS product, which was synthesised by a green approach, with high purity and efficient recuperation of white blood cells, can be used potentially as a functional supplement to assist cancer radiotherapy patients.

Identification of Hypoxia-Related Differentially Expressed Genes and Construction of the Clinical Prognostic Predictor in Hepatocellular Carcinoma by Bioinformatic Analysis

Background. Hypoxia closely relates to malignant progression and appears to be prognostic for outcome in hepatocellular carcinoma (HCC). Our research is aimed at mining the hypoxic-related genes (HRGs) and constructing a prognostic predictor (PP) model on clinical prognosis in HCC patients. Methods. RNA-sequencing data about HRGs and clinical data of patients with HCC were obtained from The Cancer Genome Atlas (TCGA) database portal. Differentially expressed HRGs between HCC and para-carcinoma tissue samples were obtained by applying the Wilcox analysis in R statistical software. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were used for gene functional enrichment analyses. Then, the patients who were asked to follow up for at least one month were enrolled in the following study. Cox proportional risk regression model was applied to obtain key HRGs which related to overall survival (OS) in HCC. PP was constructed and defined, and the accuracy of PP was validated by constructing the signature in a training set and validation set. Connectivity map (CMap) was used to find potential drugs, and gene set cancer analysis (GSCA) was also performed to explore the underlying molecular mechanisms. Results. Thirty-seven differentially expressed HRGs were obtained. It contained 28 upregulated and 9 downregulated genes. After the univariate Cox regression model analysis, we obtained 27 prognosis-related HRGs. Of these, 25 genes were risk factors for cancer, and 2 genes were protective factors. The PP was composed by 12 key genes (HDLBP, SAP30, PFKP, DPYSL4, SLC2A1, HMOX1, PGK1, ERO1A, LDHA, ENO2, SLC6A6, and TPI1). GSCA results showed the overall activity of these 12 key genes in 10 cancer-related pathways. Besides, CMap identified deferoxamine, crotamiton, talampicillin, and lycorine might have effects with HCC. Conclusions. This study firstly reported 12 prognostic HRGs and constructed the model of the PP. This comprehensive research of multiple databases helps us gain insight into the biological properties of HCC and provides deferoxamine, crotamiton, talampicillin, and lycorine as potential drugs to fight against HCC.

Induction of apoptosis and cell cycle arrest by chloroform fraction of Juniperus phoenicea and chemical constituents analysis

Different phytochemicals from various plant species exhibit promising medicinal properties against cancer. Juniperus phoenicea is a plant species that has been found to present medicinal properties. Herein, crude extract and fractions of J. phoenicea were examined to determine its anticancer properties against several cancer cells. The active fraction was chosen to assess its activity on cell cycle progression and apoptosis induction by annexin and propidium iodide (PI) biomarkers. Further, phytochemical screening for possible contents of active fraction using gas chromatography–mass spectrometry (GC-MS) analysis was conducted. It was demonstrated that cell proliferation was suppressed, and the MCF-7 cell line was the most sensitive to J. phoenicea chloroform fraction (JPCF), with the IC50 values of 24.5 μg/mL. The anti-proliferation activity of JPCF in MCF-7 cells was linked to the aggregation of cells in the G1 phase, increases in early and late apoptosis as well as necrotic cell death. Contents analysis of JPCF using GC-MS analysis identified 3-methyl-5-(2′,6′,6′-trimethylcyclohex-1′-enyl)-1-penten-3-ol (16.5%), methyl 8-oxooctanoate (15.61%), cubenol (13.48%), and 7-oxabicyclo [2.2.1] heptane (12.14%) as major constituents. Our present study provides clear evidence that J. phoenicea can inhibit cell proliferation, trigger cell cycle arrest, and induce apoptosis in tested cancer cells.

COVID-19 vaccine candidates: A review

In December 2019 the first cases of atypical pneumonia caused by a novel coronavirus SARS-CoV-2 were reported in Wuhan, China. This new infection was called coronavirus disease 2019 (COVID-19). SARS-CoV-2 is primarily transmitted human-to-human via direct contact and via the air-respiratory droplets and/or aerosols. The clinical manifestations of COVID-19 could range from asymptomatic or mild non-specific symptoms to severe pneumonia with multiple organ failure and death. The virus spread rapidly to almost all the countries in the world within a few months, and on the 11th of March 2020, the World Health Organization (WHO) announced the COVID-19 pandemic. Since then, a dynamic increase in the number of COVID-19 infections and deaths has been recorded worldwide. The COVID-19 pandemic is accelerating and causing annex tensive impact on the functioning of health care and is also leading to an economic crisis in the world. Today, it is difficult to ultimately assess the long-term effects of the pandemic, although it is known that they will be experienced for decades. Therefore, the most important goal is to stop the pandemic and develop an effective vaccine against SARS-CoV-2. Using the ClinicalTrials.gov and World Health Organization databases, we shed light on the current worldwide clinical and pre-clinical trials in search for a COVID-19 vaccine.

Characterization of collagen type I/tannic acid beads as a cell scaffold

Breast cancer is the most commonly diagnosed cancer among women worldwide. Surgical removal of tumors is often necessary and many patients suffer complications due to subsequent breast reconstruction. A safe and effective breast reconstructive material is needed for patients recovering from surgical removal of small breast cancer tumors. Our lab has developed injectable collagen/tannic acid beads seeded with patient-derived preadipocytes for regeneration of healthy breast tissue in patients post-lumpectomy. Previous research indicates that the inclusion of tannic acid in the matrix imparts an anticancer property. This research seeks to determine the variables needed to control collagen/tannic acid bead diameter and seeded cell attachment, which are essential to proper bead implantation and function. We found that as tannic acid concentration increases within the beads, cell attachment decreases. Bead diameter is controlled by bead generator voltage, solution osmolality, the degree of cell attachment, and tannic acid concentrations. Higher voltages resulted in significant decrease in bead diameter. Collagen/tannic acid beads decreased in diameter when placed in solutions of increasing osmolality. Higher degrees of cell attachment across the surface of the beads were associated with a significant decrease in diameter. In beads made with high concentrations of tannic acid, bead diameter was found to decrease. Collagen/TA beads are a promising subdermal tissue regenerative matrix with anticancer activity as an alternative to simple lipofilling in breast reconstructive procedures. This study was conducted to better understand the properties of collagen/TA beads in order to improve injection efficacy and tissue regenerative activity.

Resultados tempranos en pacientes con cáncer gástrico sometidos a gastrectomía laparoscópica con intención curativa

Introducción. El manejo de pacientes con cáncer gástrico está determinado por el estadio preoperatorio y requiere de una estrategia multidisciplinaria. La cirugía radical, especialmente en pacientes con estadios tempranos, es potencialmente curativa. El abordaje por vía laparoscópica ofrece ventajas sobre la vía abierta, sin embargo, en nuestro medio no hay información en cuanto a resultados oncológicos y posoperatorios tempranos. Métodos. Estudio retrospectivo, descriptivo, de tipo transversal, en pacientes con cáncer gástrico llevados a gastrectomía laparoscópica con intención curativa, entre el 2014 y el 2019, en tres instituciones de la ciudad de Medellín. Se analizaron los datos demográficos, los resultados posoperatorios y oncológicos a corto plazo.  Resultados. Se incluyeron 75 pacientes sometidos a gastrectomía laparoscópica. La mediana de edad fue de 64 años y el estadio más frecuente fue el III. La gastrectomía fue subtotal en 50 pacientes (66,7 %) y total en 25 pacientes (33,3 %). Se hizo disección linfática D2 en 73 pacientes (97,3 %) con una mediana en el recuento ganglionar de 27. La tasa de resección R0 fue de 97,3 %. La mediana de estancia hospitalaria fue de seis días. La tasa de complicaciones mayores fue del 20 % y la mortalidad a 90 días fue del 4 %. Discusión. La calidad oncológica de la gastrectomía laparoscópica fue adecuada y cumple con las recomendaciones de las guías internacionales. Si bien la morbilidad sigue siendo alta, tiene una tasa de sobrevida del 96 % a 90 días.

Inestabilidad microsatelital y cáncer gástrico

La inestabilidad microsatelital es causada por una alteración de los sistemas de reparación de apareamientoincorrecto, que puede afectar los microsatélites dentro de todo el genoma humano, produciendo errores en su replicación. Los estudios publicados, principalmente en la literatura inglesa, han encontrado que algunos tumores, como los gástricos, pueden expresar inestabilidad microsatelital. En la siguiente revisión de tema, se presenta una descripción de los sistemas de reparación de apareamientos incorrectos y su relación con la presencia de inestabilidad microsatelital en los tumores gástricos, así como su posible utilidad clínica, como factor asociado en la respuesta al tratamiento con inmunoterapia en los pacientes con dicha patología.

The future potential of Annona muricata L. extract and its bioactive compounds as radiation sensitizing agent: proposed mechanisms based on a systematic review

Despite technological advances in cancer treatment, especially in radiotherapy, many efforts are being made in improving cancer cell radio-sensitivity to increase therapeutic ratio and overcome cancer cell radio-resistance. In the present review, we evaluated the anticancer mechanism of Annona muricata L. (AM) leaves extract and its bioactive compounds such as annonaceous acetogenins, annomuricin, annonacin, or curcumin; and further correlated them with the potential of the mechanism to increase or to reduce cancer cells radio-sensitivity based on literature investigation. We see that AM has a promising future potential as a radio-sensitizer agent.

Development of a Health Literacy Program for Parents of Children with Cancer: A Mixed-Methods Study Protocol

Objectives: Parents’ health literacy plays an important role in the proper management of symptoms and providing appropriate care for their children living with cancer. However, studies conducted on health literacy in Iranian culture is very limited. Therefore, this study will identify the health literacy needs of parents of children with cancer and will design a program for promoting their health literacy. Methods: This exploratory mixed-methods study, using qualitative-quantitative methods including 4 consecutive phases. In the first phase, the literature review will be carried out to conceptualize and determine the domains of health literacy. In the second phase, a qualitative study will be conducted to identify and determine the needs and strategies for promoting the health literacy of parents using deep semi-structured interviews. Participants will be selected by purposive and snowball sampling methods and data will be analyzed using the directed content analysis method. In the third phase, participants’ needs will be prioritized using a panel of experts and the initial draft of the program will be designed. In the fourth phase, the modified Delphi method will be used to prioritize program strategies and select the final program. Discussion: Developing a program using a qualitative method and literature review can provide some evidence for promoting health literacy in parents of children living with cancer. Moreover, it is expected that this program promotes knowledge and empowerment of health team members, especially nurses to provide family-centered care for children with cancer. This, in turn, will increase the quality of provided treatment and care and will decrease the costs.

Supramolecular-interaction-mediated aggregation of anticarcinogens on triformyl cholic acid-functionalized Fe3O4 nanoparticles and their dual-targeting treatment for liver cancer

Herein, triformyl cholic acid-modified Fe₃O₄ nanoparticles (TCA-MNPs) were first constructed and developed as a novel drug carrier, possessing a high loading capacity, and the synergistic targeted therapy of hepatoma cells in vitro and in vivo.

Gold nanoparticles in situ generated on carbon dots grafted paper: application in enantioselective fluorescence sensing of d-alanine

The proposed PCD/AuNPs possesses good biocompatibility and was applied to detect d-Ala in serum, simulated gastric fluid, and cancer cells.