Parenteral nutrition emulsion inhibits CYP3A4 in an iPSC derived liver organoids testing platform

OBJECTIVES

Parenteral nutrition (PN) is used for patients of varying ages with intestinal failure to supplement calories. Premature newborns with low birth weight are at a high risk for developing PN associated liver disease (PNALD) including steatosis, cholestasis, and gallbladder sludge/stones. To optimize nutrition regimens, models are required to predict PNALD.

METHODS

We have exploited induced pluripotent stem cell derived liver organoids to provide a testing platform for PNALD. Liver organoids mimic the developing liver and contain the different hepatic cell types. The organoids have an early postnatal maturity making them a suitable model for premature newborns. To mimic PN treatment we used medium supplemented with either clinoleic (80% olive oil/20% soybean oil) or intralipid (100% soybean oil) for 7 days.

RESULTS

Homogenous HNF4a staining was found in all organoids and PN treatments caused accumulation of lipids in hepatocytes. Organoids exhibited a dose dependent decrease in CYP3A4 activity and expression of hepatocyte functional genes. The lipid emulsions did not affect overall organoid viability and glucose levels had no contributory effect to the observed results.

CONCLUSIONS

Liver organoids could be utilized as a potential screening platform for the development of new, less hepatotoxic PN solutions. Both lipid treatments caused hepatic lipid accumulation, a significant decrease in CYP3A4 activity and a decrease in the RNA levels of both CYP3A4 and CYP1A2 in a dose dependent manner. The presence of high glucose had no additive effect, while Clinoleic at high dose, caused significant upregulation of interleukin 6 and TLR4 expression.

Bacillus tequilensis influences metabolite production in tomato and restores soil microbial diversity during Fusarium oxysporum infection

This study evaluates cellular damage, metabolite profiling, and defence-related gene expression in tomato plants and soil microflora during Fusarium wilt disease after treatment with B. tequilensis PBE-1. Histochemical analysis showed that PBE-1 was the primary line of defence through lignin deposition and reduced cell damage. GC-MS revealed that PBE-1 treatment ameliorated stress caused by F. oxysporum infection. PBE-1 also improved transpiration, photosynthesis, and stomatal conductance in tomato. qRT-PCR suggested that the defence-related genes FLS2, SERK, NOS, WRKYT, NHO, SAUR, and MYC2, which spread infection, were highly upregulated during F. oxysporum infection, but either downregulated or expressed normally in PBE-1 + P treated plants. This indicates that the plant not only perceives the bio-control agent as a non-pathogen entity but its presence in normal metabolism and gene expression within the host plant is maintained. The study further corroborated findings that application of PBE-1 does not cause ecological disturbances in the rhizosphere. Activity of soil microflora across four treatments, measured by Average Well Colour Development (AWCD), showed continuous increases from weeks 1 to 4 post-pathogen infection, with distinct substrate usage patterns like tannic and fumaric acids impacting microbial energy source utilization and diversity. Principal Component Analysis (PCA) and diversity indices like McIntosh, Shannon, and Simpson further illustrated significant microbial community shifts over the study period. In conclusion, our findings demonstrate that B. tequilensis PBE-1 is an ideal bio-agent for field application during Fusarium wilt disease management in tomato.

Exploring combinations of dimensionality reduction, transfer learning, and regularization methods for predicting binary phenotypes with transcriptomic data

BACKGROUND

Numerous transcriptomic-based models have been developed to predict or understand the fundamental mechanisms driving biological phenotypes. However, few models have successfully transitioned into clinical practice due to challenges associated with generalizability and interpretability. To address these issues, researchers have turned to dimensionality reduction methods and have begun implementing transfer learning approaches.

METHODS

In this study, we aimed to determine the optimal combination of dimensionality reduction and regularization methods for predictive modeling. We applied seven dimensionality reduction methods to various datasets, including two supervised methods (linear optimal low-rank projection and low-rank canonical correlation analysis), two unsupervised methods [principal component analysis and consensus independent component analysis (c-ICA)], and three methods [autoencoder (AE), adversarial variational autoencoder, and c-ICA] within a transfer learning framework, trained on > 140,000 transcriptomic profiles. To assess the performance of the different combinations, we used a cross-validation setup encapsulated within a permutation testing framework, analyzing 30 different transcriptomic datasets with binary phenotypes. Furthermore, we included datasets with small sample sizes and phenotypes of varying degrees of predictability, and we employed independent datasets for validation.

RESULTS

Our findings revealed that regularized models without dimensionality reduction achieved the highest predictive performance, challenging the necessity of dimensionality reduction when the primary goal is to achieve optimal predictive performance. However, models using AE and c-ICA with transfer learning for dimensionality reduction showed comparable performance, with enhanced interpretability and robustness of predictors, compared to models using non-dimensionality-reduced data.

CONCLUSION

These findings offer valuable insights into the optimal combination of strategies for enhancing the predictive performance, interpretability, and generalizability of transcriptomic-based models.

Modulating selective ionic enrichment and depletion zones in straight nanochannels via the interplay of surface charge modulation and electric field mediated fluid-thickening

We report the possibilities of achieving highly controlled segregation of ion-enriched and ion-depleted regions in straight nanochannels. This is achieved via harnessing the interplay of an axial gradient of the induced transverse electric field on account of electrical double layer phenomenon and the localized thickening of the fluid because of intensified electric fields due to the large spatial gradients of the electrical potential in extreme confinements. By considering alternate surface patches of different charge densities over pre-designed axial spans, we illustrate how these effects can be exploited to realize selectively ion-enriched and ion-depleted zones. Physically, this is attributed to setting up of an axial concentration gradient that delves on the ionic advection due to the combined effect of an externally applied electric field and induced back-pressure gradient along the channel axis and electro-migration due to the combinatorial influences of the applied and the induced electrostatic fields. With an explicit handle on the pertinent parameters, our results offer insights on the possible means of imposing delicate controls on the solute-enrichment and depletion phenomena, a paradigm that remained unexplored thus far.

Synthesis of Amino Acid-Based Cationic Lipids and Study of the Role of the Cationic Head Group for Enhanced Drug and Nucleic Acid Delivery

Leveraging liposomes for drug and nucleic acid delivery, though promising due to reduced toxicity and ease of preparation, faces challenges in stability and efficiency. To address this, we synthesized cationic amphiphiles from amino acids (arginine, lysine, and histidine). Histidine emerged as the superior candidate, leading to the development of three histidine-rich cationic amphiphiles for liposomes. Using the hydration method, we have prepared the liposomes and determined the optimal N/P ratios for lipoplex formation via gel electrophoresis. In vitro transfection assays compared the efficacy of our lipids to Fugene, while MTT assays gauged biocompatibility across cancer cell lines (MDA-MB 231 and MCF-7). The histidine-based lipid demonstrated marked potential in enhancing drug and nucleic acid delivery. This improvement stemmed from increased zeta potential, enhancing electrostatic interactions with nucleic acids and cellular uptake. Our findings underscore histidine's crucial role over lysine and arginine for effective delivery, revealing a significant correlation between histidine abundance and optimal performance. This study paves the way for histidine-enriched lipids as promising candidates for efficient drug and nucleic acid delivery, addressing key challenges in the field.

Estimating hidden relationships in dynamical systems: Discovering drivers of infection rates of COVID-19

Discovering causal influences among internal variables is a fundamental goal of complex systems research. This paper presents a framework for uncovering hidden relationships from limited time-series data by combining methods from nonlinear estimation and information theory. The approach is based on two sequential steps: first, we reconstruct a more complete state of the underlying dynamical system, and second, we calculate mutual information between pairs of internal state variables to detail causal dependencies. Equipped with time-series data related to the spread of COVID-19 from the past three years, we apply this approach to identify the drivers of falling and rising infections during the three main waves of infection in the Chicago metropolitan region. The unscented Kalman filter nonlinear estimation algorithm is implemented on an established epidemiological model of COVID-19, which we refine to include isolation, masking, loss of immunity, and stochastic transition rates. Through the systematic study of mutual information between infection rate and various stochastic parameters, we find that increased mobility, decreased mask use, and loss of immunity post sickness played a key role in rising infections, while falling infections were controlled by masking and isolation.

Help-Seeking Patterns Among Students Experiencing Sexual Harassment: A Latent Class Analysis

Sexual harassment continues to be a pervasive problem in institutes of higher education. Despite this, there are significant gaps in research and our understanding related to students' help-seeking associated with sexual harassment. Understanding students' help-seeking patterns is critical in improving and streamlining campus-wide resources. The following study uses a latent class analysis to examine whether unique patterns of help-seeking exist among students experiencing sexual harassment and whether there are meaningful differences between help-seeking groups with respect to incident characteristics, campus climate, and demographic profiles. Data used in this analysis are from an anonymous, web-based campus climate survey across a university system that included 7,318 undergraduate and 3,484 graduate students. Of these, 704 undergraduates and 229 graduate students reported experiencing sexual harassment. Our results indicated four help-seeking groups: Comprehensive help-seeking group (engaged in multiple types of formal and informal help-seeking), Informal help-seeking group (relied exclusively on friends as sources of support), Low help-seeking group (individuals in this group told virtually no one about their experience, including friends or family), and Unsure group (reached out to friends in large numbers but universally characterized themselves as not knowing what to do). Across classes, findings highlight significant differences related to incident characteristics (offender identity and incident location), student status, and racial identity. Our results point to the heterogeneity of patterns and responses in help-seeking for students experiencing sexual harassment. Variations in help-seeking across different classes highlight that students' perceptions and preferences for formal and informal support depend on their specific type. Our study is a reminder that survivors access support through diverse ways; understanding these distinct patterns in help-seeking behaviors based on specific subgroups will help universities tailor programs that better align with students' contextual needs and realities.

"These Places are easy to get into but Impossible to get out of": Women's Pathways to Psychiatric Institutions and Barriers to Community Reentry in India

In India, where institutional-based mental health care is common, gender and other intersecting marginalized identities along with absent familial support contribute to women's admission and prolonged confinement to psychiatric institutions. However, an intersectional analysis of factors that prevent women with limited familial support from returning to their communities is lacking. This article is based on narratives of eleven women residing at a halfway home in an urban city in India, awaiting return to their communities. We include descriptions and an intersectional analysis of women's pathways to psychiatric institutions, their experiences receiving institutional-based mental health care, and the challenges they face as they contemplate returning to their communities. This study adds to the minimal research examining women's gendered pathways to psychiatric institutions in India. Women's narratives highlight that gender and illness-related disadvantages coupled with economic adversity that led to the initial admission also serve as deterrents to reentering the community.

Student psychological well-being in higher education: The role of internal team environment, institutional, friends and family support and academic engagement

Psychological well-being of students is an area of concern in higher education institutes across the world. Although several studies have explored the factors associated with students' psychological well-being, limited research has focused on the relation between the overall support for students and psychological well-being. Students of higher education may get formal support, in the form of team environment and institutional support; and informal support, in the form of family and friends' support. The purpose of this study is to examine the relation of these four kinds of support with psychological well-being of management students. We also examine the intervening role of academic engagement in this relationship. Analysis using structural equation modeling and hierarchical regression on data collected from 309 management students from Indian universities, shows that positive internal team environment, and institutional and family support positively relate to students' psychological well-being. Academic engagement partially mediates the relation between positive internal team environment and psychological well-being, and family support and psychological well-being. Also, academic engagement fully mediates the relation between institutional support and psychological well-being. The study highlights the significance of internal team environment and institutional support for students' academic engagement and psychological well-being, and the role of academic engagement in determining well-being. Based on these findings, we suggest interventions that can be undertaken by educational institutions to enhance psychological well-being of students. Theoretical implications and research avenues are discussed.

Employment of trauma informed principles in the Palabras Fuertes project: Implications for narrative research with older Latinx communities

In the US, there is a growing number of older Latinx communities. Qualitative approaches such as narrative inquiry may be fruitful endeavors to elucidate their lived experiences. However, older Latinx communities, including sexual minorities, are disproportionately exposed to social, health, and historical challenges that may result in exposure to potentially traumatic events (e.g. discrimination, illness, grief, etc.). The recognition of high rates of exposure to potentially traumatic events among participants has led to the recommended adoption of Trauma Informed (TI) principles for use in non-trauma specific research. At present, there are limited examples and discussions about the implementation of TI principles in qualitative research and our literature review yielded no discussion of the use of TI principles in narrative inquiry or with older Latinx communities. In this manuscript, we advocate for the adoption of TI principles when engaging in narrative inquiry with older Latinx adults. Second, we discuss examples of TI guided practices we employed while conducting the Palabras Fuertes study of life history narratives with older Latino immigrant gay men living in New York City. Finally, based on these experiences, we provide recommendations for incorporating TI into future narrative research with older Latinx communities.

Identification of a methylation panel as an alternative triage to detect CIN3+ in hrHPV-positive self-samples from the population-based cervical cancer screening programme

BACKGROUND

The Dutch population-based cervical cancer screening programme (PBS) consists of primary high-risk human papilloma virus (hrHPV) testing with cytology as triage test. In addition to cervical scraping by a general practitioner (GP), women are offered self-sampling to increase participation. Because cytological examination on self-sampled material is not feasible, collection of cervical samples from hrHPV-positive women by a GP is required. This study aims to design a methylation marker panel to detect CIN3 or worse (CIN3+) in hrHPV-positive self-samples from the Dutch PBS as an alternative triage test for cytology.

METHODS

Fifteen individual host DNA methylation markers with high sensitivity and specificity for CIN3+ were selected from literature and analysed using quantitative methylation-specific PCR (QMSP) on DNA from hrHPV-positive self-samples from 208 women with CIN2 or less (< CIN2) and 96 women with CIN3+. Diagnostic performance was determined by area under the curve (AUC) of receiver operating characteristic (ROC) analysis. Self-samples were divided into a train and test set. Hierarchical clustering analysis to identify input methylation markers, followed by model-based recursive partitioning and robustness analysis to construct a predictive model, was applied to design the best marker panel.

RESULTS

QMSP analysis of the 15 individual methylation markers showed discriminative DNA methylation levels between < CIN2 and CIN3+ for all markers (p < 0.05). The diagnostic performance analysis for CIN3+ showed an AUC of ≥ 0.7 (p < 0.001) for nine markers. Hierarchical clustering analysis resulted in seven clusters with methylation markers with similar methylation patterns (Spearman correlation> 0.5). Decision tree modeling revealed the best and most robust panel to contain ANKRD18CP, LHX8 and EPB41L3 with an AUC of 0.83 in the training set and 0.84 in the test set. Sensitivity to detect CIN3+ was 82% in the training set and 84% in the test set, with a specificity of 74% and 71%, respectively. Furthermore, all cancer cases (n = 5) were identified.

CONCLUSION

The combination of ANKRD18CP, LHX8 and EPB41L3 revealed good diagnostic performance in real-life self-sampled material. This panel shows clinical applicability to replace cytology in women using self-sampling in the Dutch PBS programme and avoids the extra GP visit after a hrHPV-positive self-sampling test.

Discovery of novel metabolic signatures for early identification of women at risk of developing gestational hypertension

INTRODUCTION

Gestational hypertension (GH) is defined as the presence of systolic blood pressure (BP) ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg, measured at least 4 h apart after 20 weeks of gestation. Early identification of women at high-risk of developing GH could contribute significantly towards improved maternal and fetal outcomes.

OBJECTIVES

To determine early metabolic biomarkers in women with GH as compared with normotensive women.

METHODS

Serum samples were collected from subjects during three stages of their pregnancy: 8-12 weeks, 18-20 weeks and after 28 weeks (< 36 weeks) of gestation and studied using nuclear magnetic resonance (NMR) metabolomics approach. Multivariate and univariate analyses were performed to determine the significantly altered metabolites in GH women.

RESULTS

A total of 10 metabolites, including isoleucine, glutamine, lysine, proline, histidine, phenylalanine, alanine, carnitine, N-acetyl glycoprotein and lactic acid were observed to be significantly downregulated during all pregnancy stages in women with GH as compared with controls. Furthermore, expression of 5 metabolites in the first trimester i.e., phenylalanine [area under the curve (AUC) = 0.745], histidine [AUC = 0.729], proline [AUC = 0.722], lactic acid [AUC = 0.722], and carnitine [AUC = 0.714] exhibited highest potential in discriminating GH from normotensive women.

CONCLUSION

The present study is the first of its kind to identify significantly altered metabolites that have the potential to discriminate between women at risk of developing GH and normotensive women across three trimesters of pregnancy. This opens up the possibility of exploring these metabolites as potential early predictive markers of GH.

Updated assessment of occupational safety and health hazards of climate change

Workers, particularly outdoor workers, are among the populations most disproportionately affected by climate-related hazards. However, scientific research and control actions to comprehensively address these hazards are notably absent. To assess this absence, a seven-category framework was developed in 2009 to characterize the scientific literature published from 1988-2008. Using this framework, a second assessment examined the literature published through 2014, and the current one examines literature from 2014-2021. The objectives were to present literature that updates the framework and related topics and increases awareness of the role of climate change in occupational safety and health. In general, there is substantial literature on worker hazards related to ambient temperatures, biological hazards, and extreme weather but less on air pollution, ultraviolet radiation, industrial transitions, and the built environment. There is growing literature on mental health and health equity issues related to climate change, but much more research is needed. The socioeconomic impacts of climate change also require more research. This study illustrates that workers are experiencing increased morbidity and mortality related to climate change. In all areas of climate-related worker risk, including geoengineering, research is needed on the causality and prevalence of hazards, along with surveillance to identify, and interventions for hazard prevention and control.

Sexual assault and harassment victimization and post-assault help-seeking among undergraduate students: Comparing residential and nonresidential campuses

In the United States, campus sexual violence research has mostly focused on 4-year residential campuses. The experiences of students on nonresidential campuses are less well understood. Using data from a Web-based campus climate survey, this study explores sexual assault and sexual harassment victimization rates, victimization characteristics, and post-assault help-seeking across nonresidential and residential students in a campus system that contains both residential and nonresidential campuses. Our analyses highlight that sexual victimization rates, characteristics, and post-assault help-seeking patterns vary by campus type. Interestingly, while nonresidential students on nonresidential campuses reported lower rates of victimization, they accessed formal support resources at higher rates than students on a residential campus. Findings underscore the importance of accounting for campus type in campus sexual violence research and programming and to center nonresidential campuses to learn more about the strategies they adopt to address their students' unique victimization needs and experiences.

Exploring the relationship between social accountability and competency-based medical education: A narrative review

BACKGROUND

Social accountability (SA), a quintessential goal of medical education, has been discussed as a precipitant for the transition toward competency-based medical education (CBME). However, the relationship between SA and CBME remains unclear. A narrative review was conducted to systematically explore the relationship between SA and CBME as described in the literature.

METHODS

Electronic databases, select journals, and medical education organizations were systematically searched. 363 titles and abstracts were screened and 147 full texts were reviewed. The salient text was extracted from 36 records, which were then inductively coded before narrative synthesis and interpretation.

RESULTS

The relationship between SA and CBME was described in three manners: (1) CBME as a natural driver of SA where CBME was perceived to be inherently socially accountable, (2) CBME as an opportunistic mechanism for actively changing medical training to better meet standards of SA, and (3) CBME as a tool to measure SA relating to measurable outcomes data provided by CBME.

CONCLUSION

CBME has theoretical potential to assist programs in becoming more socially accountable if the communities they serve are considered key stakeholders in the design, implementation, and evaluation. A paucity of evidence remains which provides empirical evidence of SA within programs that have implemented CBME.

Comparison of suspected and confirmed internal EVD-related infections: a prospective multi-centre U.K. observational study

Background

Diagnosis of internal external ventricular drain (EVD)-related infections (iERI) is an area of diagnostic difficulty. Empiric treatment is often initiated on clinical suspicion. There is limited guidance around antimicrobial management of confirmed versus suspected iERI.

Methods

Data on patients requiring EVD insertion were collected from 21 neurosurgical units in the United Kingdom from 2014 to 2015. Confirmed iERI was defined as clinical suspicion of infection with positive cerebrospinal fluid (CSF) culture and/or Gram stain. Cerebrospinal fluid, blood, and clinical parameters and antimicrobial management were compared between the 2 groups. Mortality and Modified Rankin Scores were compared at 30 days post-EVD insertion.

Results

Internal EVD-related infection was suspected after 46 of 495 EVD insertions (9.3%), more common after an emergency insertion. Twenty-six of 46 were confirmed iERIs, mostly due to Staphylococci (16 of 26). When confirmed and suspected infections were compared, there were no differences in CSF white cell counts or glucose concentrations, nor peripheral blood white cell counts or C-reactive protein concentrations. The incidence of fever, meningism, and seizures was also similar, although altered consciousness was more common in people with confirmed iERI. Broad-spectrum antimicrobial usage was prevalent in both groups with no difference in median duration of therapy (10 days [interquartile range {IQR}, 7–24.5] for confirmed cases and 9.5 days [IQR, 5.75–14] for suspected, P = 0.3). Despite comparable baseline characteristics, suspected iERI was associated with lower mortality and better neurological outcomes.

Conclusions

Suspected iERI could represent sterile inflammation or lower bacterial load leading to false-negative cultures. There is a need for improved microbiology diagnostics and biomarkers of bacterial infection to permit accurate discrimination and improve antimicrobial stewardship.

Yellow-Emitting Carbon Dots for Selective Fluorescence Imaging of Lipid Droplets in Living Cells

This study shows a one-pot preparation of carbon dots by a solvothermal method in ethylene glycol. The carbon dots show yellow-colored fluorescence emission in water. The carbon dots showed distinct preference to be present in the hydrophobic environment which was evident from their efficient transfer from aqueous phase to organic phase. They were also found to locate themselves in the vesicle bilayer and micelle core. This inherent lipophilic character of these carbon dots has been successfully utilized for the selective imaging of lipid droplets inside the living cells. The selective imaging of lipid droplets was confirmed by similar staining patterns with other staining dyes and the starvation study.

Risk factors associated with mortality in hypersensitivity pneumonitis: a meta-analysis

BACKGROUND

Hypersensitivity pneumonitis (HP) related deaths have increased substantially in recent years. It is important to identify the risk factors of HP significantly associated with mortality to ensure close patient monitoring and assess disease progression.

RESEARCH DESIGN AND METHODS

Extensive literature search was conducted in accordance with the PRISMA checklist. Literature search of PUBMED, EMBASE and Cochrane Library database between January 2009 and April 2021 using the terms "hypersensitivity pneumonitis", "hazard ratio", and "mortality" identified 325 articles. A total of 22 independent original studies focusing on mortality of HP patients were assessed.

RESULTS

This systematic review and meta-analysis suggests that increased age, male sex, honeycombing and traction bronchiectasis patterns on high-resolution computed tomography (HRCT) images are the major mortality-related risk factors of patients with HP. In case of chronic HP, antigen exposure appeared to be an additional risk factor.

CONCLUSIONS

The clinico-radiological risk factors of mortality identified for HP will enable effective and close monitoring of patients, prognostication and guide towards appropriate management decisions. However, association between the type of antigen and mortality remains to be explored.

Pericytes as mediators of infiltration of macrophages in multiple sclerosis

Background

Multiple sclerosis (MS) is a neurodegenerative condition of the central nervous system (CNS). It is associated with blood–brain barrier (BBB) breakdown and intravasation of leukocytes, particularly monocyte-derived macrophages, into the CNS. Pericytes are mural cells that are encased within the basement membrane of vasculature, and they contribute functionally to the neurovascular unit. These cells play an important role in maintaining BBB integrity and CNS homeostasis. However, the critical role of pericytes in mediating inflammation in MS or its models is unclear. Whether pericytes infiltrate into the CNS parenchyma in MS also needs clarification.

Methods

CNS samples from the experimental autoimmune encephalomyelitis (EAE) mouse model of MS were collected at different time points for immunohistochemical analysis of pericytes along the inflamed vasculature. These findings were validated using MS brain specimens, and further analysis of pericyte involvement in inflammation was carried out by culturing primary pericytes and macrophages. Multiplex ELISA, transmigration assay and real-time PCR were used to study the inflammatory potential of pericytes in cultures.

Results

We found that pericytes exhibit a heterogenous morphology, with notable elongation in the inflamed perivascular cuffs of EAE. This was manifested by a decrease in pericyte density but an increase in the coverage by pericytes along the vasculature. Chondroitin sulfate proteoglycans (CSPGs), a family of extracellular matrix proteins enriched within inflamed perivascular cuffs, elevated levels of pro-inflammatory chemokines/cytokines in pericytes in culture. Importantly, pericytes stimulated with CSPGs enhanced macrophage migration. We did not detect pericytes in the CNS parenchyma during EAE, and this was corroborated in MS brain samples.

Conclusions

Our data suggest that pericytes seek to restore the BBB through increased coverage, but that their exposure to CSPGs prompt their facilitation of macrophages to enter the CNS to elevate neuroinflammation in EAE and MS.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12974-021-02358-x.

Therapeutic potential of curcumin in endometrial disorders: Current status and future perspectives

Endometrial disorders collectively encompass a broad spectrum of pathologies, including but not limited to endometriosis, endometrial cancer and endometritis. The current therapeutic management of these diseases is associated with several limitations. This has prompted interest in the use of plant-based bioactive compounds as alternative strategies to achieve high therapeutic efficacy and avoid adverse effects. In this context, curcumin, a polyphenol abundantly present in turmeric, is gaining increasing attention for its therapeutic potential to restore homeostasis in endometrial dysfunctionality. We comprehensively review the multifaceted role of curcumin, discussing mechanistic insights in various endometrial pathologies. We also provide an in-depth analysis of the concerns and challenges associated with the role of curcumin in endometrial research and outline a road map for future investigations.

Risk Factors Associated With Mortality in Hypersensitivity Pneumonitis: A Meta-analysis.. [DOI: 10.21203/rs.3.rs-951727/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Purpose: Hypersensitivity pneumonitis (HP), an immune-mediated form of diffuse parenchymal lung disease (DPLD), is triggered by inhalation of a wide variety of allergens in susceptible individuals. Several studies suggest that the death rate associated with this disease has increased significantly in recent years. This meta-analysis investigates the significant clinico-radiological characteristics which may be appraised as potential risk factors associated with disease mortality.Methods: Extensive literature search was conducted for original articles published between January 2009 and April 2021 through PubMed, Google Scholar, EMBASE, and Cochrane Library using the keywords: “hypersensitivity pneumonitis”, “hazard ratio” and “mortality”. Results: A total of 21 independent studies related to mortality of HP subjects could be identified. The combined results of univariate and multivariate analysis suggest that older age [univariate odds ratio (OR) 1.038 (1.028-1.048); multivariate OR 1.036, (1.025-1.046)], male subjects [univariate OR 1.508, (1.240- 1.834); multivariate OR 1.396, (1.004-1.943)], honeycombing [univariate OR 1.086 (1.065- 1.108); multivariate OR 1.121 (1.070- 1.175)] and traction bronchiectasis [univariate OR 1.141 (1.092- 1.192); multivariate OR 1.107 (1.048-1.169)] are significantly associated with mortality risk of HP subjects. Further, forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLco), ground glass opacity (GGO) and mosaic attenuation were associated with lower risk of all-cause mortality. Although smoking status correlated with mortality risk in these patients, the findings appeared to be insignificant. Conclusion: Individual male subjects with older age and presence of extensive fibrosis, i.e., honeycombing and traction bronchiectasis experience an increased mortality risk.

Identification of novel metabolic signatures potentially involved in the pathogenesis of COPD associated pulmonary hypertension

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) associated pulmonary hypertension (COPD-PH), one of the most prevalent forms of PH, is a major burden on the healthcare system. Although PH in COPD is usually of mild-to-moderate severity, its presence is associated with shorter survival, more frequent exacerbations and worse clinical outcomes. The pathophysiologic mechanisms responsible for PH development in COPD patients remain unclear. It is envisioned that a better understanding of the underlying mechanism will help in diagnosis and future treatment strategies.

OBJECTIVES

The present study aims to determine metabolomic alterations in COPD-PH patients as compared to healthy controls. Additionally, to ensure that the dysregulated metabolites arise due to the presence of PH per se, an independent COPD cohort is included for comparison purposes.

METHODS

Paired serum and exhaled breath condensate (EBC) samples were collected from male patients with COPD-PH (n = 60) in accordance with the 2015 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines. Age, sex and BMI matched healthy controls (n = 57) and COPD patients (n = 59) were recruited for comparison purposes. All samples were characterized using ¹H nuclear magnetic resonance (NMR) spectroscopy.

RESULTS

Fifteen serum and 9 EBC metabolites were found to be significantly altered in COPD-PH patients as compared to healthy controls. Lactate and pyruvate were dysregulated in both the biofluids and were further correlated with echocardiographic systolic pulmonary artery pressure (sPAP). Multivariate analysis showed distinct class separation between COPD-PH and COPD.

CONCLUSIONS

The findings of this study indicate an increased energy demand in patients with COPD-PH. Furthermore, both lactate and pyruvate correlate with sPAP, indicating their importance in the clinical course of the disease.

Robust metabolic transcriptional components in 34,494 patient-derived cancer-related samples and cell lines

Background

Patient-derived bulk expression profiles of cancers can provide insight into the transcriptional changes that underlie reprogrammed metabolism in cancer. These profiles represent the average expression pattern of all heterogeneous tumor and non-tumor cells present in biopsies of tumor lesions. Hence, subtle transcriptional footprints of metabolic processes can be concealed by other biological processes and experimental artifacts. However, consensus independent component analyses (c-ICA) can capture statistically independent transcriptional footprints of both subtle and more pronounced metabolic processes.

Methods

We performed c-ICA with 34,494 bulk expression profiles of patient-derived tumor biopsies, non-cancer tissues, and cell lines. Gene set enrichment analysis with 608 gene sets that describe metabolic processes was performed to identify the transcriptional components enriched for metabolic processes (mTCs). The activity of these mTCs was determined in all samples to create a metabolic transcriptional landscape.

Results

A set of 555 mTCs was identified of which many were robust across different datasets, platforms, and patient-derived tissues and cell lines. We demonstrate how the metabolic transcriptional landscape defined by the activity of these mTCs in samples can be used to explore the associations between the metabolic transcriptome and drug sensitivities, patient outcomes, and the composition of the immune tumor microenvironment.

Conclusions

To facilitate the use of our transcriptional metabolic landscape, we have provided access to all data via a web portal (www.themetaboliclandscapeofcancer.com). We believe this resource will contribute to the formulation of new hypotheses on how to metabolically engage the tumor or its (immune) microenvironment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40170-021-00272-7.

Delineating the complex mechanistic interplay between NF-κβ driven mTOR depedent autophagy and monocyte to macrophage differentiation: A functional perspective

Autophagy is an extremely essential cellular process aimed to clear redundant and damaged materials, namely organelles, protein aggregates, invading pathogens, etc. through the formation of autophagosomes which are ultimately targeted to lysosomal degradation. In this study, we demonstrated that mTOR dependent classical autophagy is ubiquitously triggered in differentiating monocytes. Moreover, autophagy plays a decisive role in sustaining the process of monocyte to macrophage differentiation. We have delved deeper into understanding the underlying mechanistic complexities that trigger autophagy during differentiation. Intrigued by the significant difference between the protein profiles of monocytes and macrophages, we investigated to learn that autophagy directs monocyte differentiation via protein degradation. Further, we delineated the complex cross-talk between autophagy and cell-cycle arrest in differentiating monocytes. This study also inspects the contribution of adhesion on various steps of autophagy and its ultimate impact on monocyte differentiation. Our study reveals new mechanistic insights into the process of autophagy associated with monocyte differentiation and would undoubtedly help to understand the intricacies of the process better for the effective design of therapeutics as autophagy and autophagy-related processes have enormous importance in human patho-physiology.

Proprotein convertase subtilisin/kexin type 9 (PCSK9): A potential multifaceted player in cancer

Proprotein convertase subtilisin/kexin type 9 (PCSK9) has emerged as a novel pharmacological target for hypercholesterolemia and associated cardiovascular diseases owing to its function to mediate the degradation of low-density lipoprotein receptor (LDLR). Findings over the past two decades have identified novel binding partners and cellular functions of PCSK9. Notably, PCSK9 is aberrantly expressed in a broad spectrum of cancers and apparently contributes to disease prognosis, indicating that PCSK9 could be a valuable cancer biomarker. Experimental studies demonstrate the contribution of PCSK9 in various aspects of cancer, including cell proliferation, apoptosis, invasion, metastasis, anti-tumor immunity and radioresistance, strengthening the idea that PCSK9 could be a promising therapeutic target. Here, we comprehensively review the involvement of PCSK9 in cancer, summarizing its aberrant expression, association with disease prognosis, biological functions and underlying mechanisms in various malignancies. Besides, we highlight the potential of PCSK9 as a future therapeutic target in personalized cancer medicine.

"The Day I Die Is The Day I Will Find My Peace": Narratives of Family, Marriage, and Violence Among Women Living With Serious Mental Illness in India

In India, there is limited research on the nature of familial relationships and domestic violence that women living with serious mental illness (SMI) experience. Using the self-in-relation theory and through 34 in-depth interviews, I explored narratives related to family, marriage, and violence in familial relationships among women living with SMI at a psychiatric institution in an urban city in India. These narratives are critical because they highlight how the presence of mental illness exacerbates the violence women experience. Informed by participants' narratives, I offer specific recommendations on creating gender-sensitive mental health care that is mindful of women's social realities.

A longitudinal study of perceived stress and cortisol responses in an undergraduate student population from India

Young adults entering college experience immense shifts in personal and professional environments. Such a potentially stressful event may trigger multiple psychological and physiological effects. In a repeated-measures longitudinal survey (N = 6 time-points) of first year cohort of residential undergraduate students in India, this study evaluates multiple psychological parameters: PSS14 (Perceived Stress Scale), K10 (distress scale) and positive mood measures, along with salivary cortisol levels. We find that compared to women, men showed significantly lower levels of salivary cortisol and also a decrease in perceived stress (PSS14) and distress (K10) with time. By contrast, women reported similar perceived stress and distress levels over time but had higher cortisol levels at the end of the academic year. Academic stress was reported by the students to be the most important stressor. This study highlights notable gender-/sex-differences in psychological and physiological stress responses and adds a valuable longitudinal dataset from the Indian undergraduate student cohort which is lacking in literature.

A Non-Fourier Bioheat Transfer Model for Cryosurgery of Tumor Tissue with Minimum Collateral Damage

BACKGROUND AND OBJECTIVES

Incorporation of non-Fourier heat conduction while studying heat transfer phenomena in biological materials has emerged has an important approach as it predicts better and more realistic results than Fourier based models. In this article we have proposed a non-Fourier computational model and applied the same to simulate cryosurgery of lung tumor and attempted minimization of freezing damage of healthy lung tissue using pulsed laser irradiation.

METHODS

A non-Fourier bioheat transfer model for phase change in biological tissues is solved via a Fourier heat conduction based solution approach. A unified model is proposed combining all variants of bioheat models: Fourier's heat conduction based Pennes' bioheat model, hyperbolic heat conduction model and dual phase lag model. The proposed model takes into account the different thermophysical properties of frozen and unfrozen regions. In order to mimic the actual biotransport process, the blood perfusion and metabolic heat generation are switched off in the frozen region. Implicit source based enthalpy method is used to model phase change process. A new iterative enthalpy update equation is developed for capturing evolution of freezing front implicitly. Finite Volume based numerical discretization technique is used to discretize the governing PDE. The resulting discrete algebraic equation set is solved implicitly by Tri-diagonal Matrix Algorithm. The proposed model is verified with existing results from the literature.

RESULTS

For Fourier heat conduction, freezing time of 99.99% of tumor is 1247s, which increases to 1267s for τ_q= 5s (τ_T= 0s) and again reduces to 1255s for τ_q= 5s and τ_T= 3s. τ_q and τ_T are phase lag parameters for non-Fourier heat conduction. For τ_q= 5s and τ_T= 0.05s, the freezing damage of healthy tissue decreases by 23.76% when pulsed laser irradiation (I_o = 10⁶ W/m²) is used to warm the neighboring healthy tissue.

CONCLUSIONS

So non-Fourier bioheat transport models are better and more accurate in predicting temperature history, freezing time and freezing front propagation as compared to Fourier based models. Pulsed laser irradiation can prove to be a very efficient technique in minimizing collateral damage during cryosurgery.

The Histopathology of Oral Cancer Pain in a Mouse Model and a Human Cohort

Oral cancer patients often have severe, chronic, and mechanically induced pain at the site of the primary cancer. Oral cancer pain is initiated and maintained in the cancer microenvironment and attributed to release of mediators that sensitize primary sensory nerves. This study was designed to investigate the histopathology associated with painful oral cancers in a preclinical model. The relationship of pain scores with pathologic variables was also investigated in a cohort of 72 oral cancer patients. Wild-type mice were exposed to the carcinogen, 4-nitroquinoline 1-oxide (4NQO). Nociceptive (pain) behavior was measured with the dolognawmeter, an operant device and assay for measuring functional and mechanical allodynia. Lesions developed on the tongues and esophagi of the 4NQO-treated animals and included hyperkeratoses, papillomas, dysplasias, and cancers. Papillomas included lesions with benign and dysplastic pathological features. Two histologic subtypes of squamous cell carcinomas (SCCs) were identified-SCCs with exophytic and invasive components associated with papillary lesions (pSCCs) and invasive SCCs without exophytic histology (iSCCs). Only the pSCC subtype of tongue cancer was associated with nociceptive behavior. Increased tumor size was associated with greater nociceptive behavior in the mouse model and more pain experienced by oral cancer patients. In addition, depth of invasion was associated with patient-reported pain. The pSCC histology identifies 4NQO-induced tongue cancers that are expected to be enriched for expression and release of nociceptive mediators.

Beyond barrier functions: Roles of pericytes in homeostasis and regulation of neuroinflammation

Pericytes are contractile cells that extend along the vasculature to mediate key homeostatic functions of endothelial barriers within the body. In the central nervous system (CNS), pericytes are important contributors to the structure and function of the neurovascular unit, which includes endothelial cells, astrocytes and neurons. The understanding of pericytes has been marred by an inability to accurately distinguish pericytes from other stromal cells with similar expression of identifying markers. Evidence is now growing in favor of pericytes being actively involved in both CNS homeostasis and pathology of neurological diseases, including multiple sclerosis, spinal cord injury, and Alzheimer's disease among others. In this review, we discuss the current understanding on the characterization of pericytes, their roles in maintaining the integrity of the blood-brain barrier, and their contributions to neuroinflammation and neurorepair. Owing to its plethora of surface receptors, pericytes respond to inflammatory mediators such as CCL2 (monocyte chemoattractant protein-1) and tumor necrosis factor-α, in turn secreting CCL2, nitric oxide, and several cytokines. Pericytes can therefore act as promoters of both the innate and adaptive arms of the immune system. Much like professional phagocytes, pericytes also have the ability to clear up cellular debris and macromolecular plaques. Moreover, pericytes promote the activities of CNS glia, including in maturation of oligodendrocyte lineage cells for myelination. Conversely, pericytes can impair regenerative processes by contributing to scar formation. A better characterization of CNS pericytes and their functions would bode well for therapeutics aimed at alleviating their undesirable properties and enhancing their benefits.

MAP Kinase driven actomyosin rearrangement is a crucial regulator of monocyte to macrophage differentiation

Rearrangement of actin cytoskeleton correlates significantly with the immune responses as the perturbation of cytoskeletal dynamics leads to many immune deficiencies. Mechanistic insights into this correlation remain unknown. Cellular spreading, the most characteristic phenotype associated with monocyte to macrophage differentiation, led us to investigate the contribution of actomyosin dynamics in monocyte differentiation. Our observation revealed that actomyosin reorganization intrinsically governs the process of monocyte to macrophage differentiation. Further, we established that the MAPK-driven signaling pathways regulate the cellular actomyosin dynamics that direct monocyte to macrophage differentiation. We also identified P42/44 Mitogen-Activated Protein Kinase (P42/44 MAPK), P38 Mitogen-Activated Protein Kinase (P38 MAPK), MAP Kinase Activated Protein Kinase 2 (MK-2), Heat Shock Protein 27 (Hsp-27), Lim Kinase (Lim K), non-muscle cofilin (n-cofilin), Myosin Light Chain Kinase (MLCK) and Myosin Light Chain (MLC) as critical components of the signaling network. Moreover, we have shown the involvement of the same signaling cascade in 3D gel-like microenvironment induced spontaneous monocyte to macrophage differentiation and in human blood-derived PBMC differentiation. Our study reveals new mechanistic insights into the process of monocyte to macrophage differentiation.

THU0531 A PROSPECTIVE STUDY EVALUATING THE ROLE OF 68GA-RGD2 PET/CT ANGIOGENESIS IMAGING IN ASSESSING DISEASE ACTIVITY AND TREATMENT RESPONSE IN RHEUMATOID ARTHRITIS AND ITS COMPARISON WITH DAS28

Background:

PET/CT imaging of synovial angiogenesis using68Ga-RGD (cyclic tripeptide agent targeting αvβ3integrin) to study disease activity in rheumatoid arthritis (RA) has been demonstrated earlier in a few patients. However, post treatment changes in disease activity on68Ga-RGD2PET/CT imaging have not been adequately assessed.

Objectives:

To compare the performance of68Ga-RGD2PET/CT with disease activity score (DAS) 28 in assessing disease activity and treatment response in RA.

Methods:

Thirty patients (24F, 6M) aged 43±12 years with clinically diagnosed RA were prospectively studied. After calculation of DAS28 by a rheumatologist, all 30 patients underwent68Ga-RGD2PET/CT scan. Of these, 27 patients underwent a second68Ga-RGD2PET/CT scan and clinical assessment after at least 3 months of treatment. Total body and regional images of the upper limbs were acquired and interpreted by two nuclear medicine physicians blinded to the clinical findings. Joints showing focally increased tracer uptake compared to the background were considered positive and joints showing uptake equal to or less than background were considered negative. Data of 30 patients were used for inter-observer and inter-modality agreement calculations. Changes in PET parameters and DAS28 were compared in 27 patients to assess treatment response.

Results:

Out of 1560 joints examined in the initial scan, 394 were positive on PET/CT compared to 348 on clinical evaluation. Inter-observer agreement between nuclear medicine physicians was excellent (Cohen’s kappa 0.92, p<0.05) and inter-modality agreement between PET and clinical examination was moderate (Cohen’s kappa 0.55, p<0.05). The DAS28 and SUVmax values (highest and average) of 27 patients showed significant reduction on follow-up compared to the initial evaluation. There was significant correlation between percentage change in DAS28 and percentage change in scan parameters like PET positive joint counts (0.689, p<0.001), average SUVmax (0.712, p<0.001) and highest SUVmax values (0.558, p=0.003) of scan-positive joints in 27 patients. Additional advantages of68Ga-RGD2PET/CT included objective assessment, whole body evaluation of all small and large joints, and greater reproducibility.

Conclusion:

68Ga-RGD2PET/CT is a promising tool for objective assessment of disease activity and treatment response in patients with RA.

Table 1.

Clinical and PET parameters of the patients

ParameterInitial data (n=27)Mean (SD)/Median (IQR)Follow-up data (n=27)Mean (SD)/Median (IQR)TJC(28)10 (5-13)3 (2-4)SJC(28)6 (3-7)1 (0-2)ESR25 (20-41)24 (18-35)PtGA6.0 (5.0-6.0)3.0 (2.0-4.0)DAS28(3)5.14 (0.85)3.74 (0.88)DAS28(4)5.60 (0.90)3.80 (0.96)PET positive Joints12 (7-8)4 (2-9)aSUVmax2.08 (1.68-2.52)1.79 (1.00-2.06)hSUVmax3.45 (2.71-4.70)3.34 (1.95-4.25)

TJC/SJC: tender/swollen joint counts; ESR: erythrocyte sedimentation rate; PtGA: patients global assessment scale; DAS: disease activity score; aSUVmax/hSUVmax: average/highest SUVmax (maximum standardized uptake value); SD: standard deviation; IQR: interquartile range

Figure 1.

68Ga-RGD2PET scan of a 26-year female RA patient on treatment.A.Initial scan shows increased tracer uptake in multiple joints of upper and lower limbs and tendon sheaths of hands and ankle region (arrows); DAS28 was 4.56 (moderate disease activity) and ESR 12 mm/1sthour.B. Follow-up scan after 4 months shows resolution of tracer activity in the previously involved joints with only a mild focus persisting in the left knee joint; DAS28 was 1.73 (clinical remission according to ARA) and ESR 08 mm/1sthour.

Acknowledgments:

This study was supported by Indian Council of Medical Research, New Delhi [grant no.3/2/June-2017/PG-Thesis-HRD (23)]

Disclosure of Interests:

None declared

Synergistic antibacterial, antifungal and antioxidant efficacy of cinnamon and clove essential oils in combination

The present investigation aimed to evaluate antibacterial, antifungal and antioxidant efficacy of essential oils of three commonly used spices (black pepper, cinnamon and clove) in combination along with chemical characterization and toxicity evaluation. Among the possible combinations tested, cinnamon/clove oil combination showed synergistic antibacterial activity against foodborne bacteria Staphylococcus aureus, Listeria monocytogenes, Salmonella typhimurium and Pseudomonas aeruginosa and synergistic antifungal activity against Aspergillus niger as well as synergistic antioxidant potential in DPPH radical scavenging model system. GC-HRMS analysis revealed that out of thirteen identified components from clove oil, eugenol was found to be the main constituent of the oil; whereas out of twenty one identified constituents from cinnamon oil, the main component was cinnamaldehyde. Cinnamon/clove oil combination did not show any cytotoxic potential at recommended dosage level (IC₅₀ > 2000 µg/ml). The results provide evidence that cinnamon/clove oil combination might indeed be used as a potential source of safe and effective novel natural antibacterial, antifungal and antioxidant blend in the food and pharmaceutical industries. To the best of our knowledge, this is the first time a combination of essential oils has been tested as natural preservatives to prevent both microbial proliferation and oxidative deterioration at sufficiently low concentrations.

Reactive oxygen species-mediated cytoplasmic stiffening impairs the phagocytic ability of the macrophage

The phagocytic ability of macrophages empowers them to enforce innate immunity. RAW264.7, THP-1 and peripheral blood mononuclear cell-derived macrophages display considerable variability with regards to their phagocytic ability. We identify the underlying causes that attenuate the phagocytic abilities of a macrophage. Deformability of the cytoplasm and cortex influences the macrophage's phagocytic ability, and macrophages use the large cell-to-cell variability of their cytoplasmic stiffness to modulate their phagocytic ability. We find that the more-deformable macrophages have a higher phagocytic ability than those that are less deformable. Further, the subcellular spatial variability of cortex stiffness gives rise to more-deformable subdomains on the membrane for pathogen ingestion. We report a previously unknown negative-feedback loop that is triggered by the phagocytic oxidative burst. Macrophages utilize the excess reactive oxygen species to stiffen the cytoplasm, reducing their phagocytic propensity. In organisms, ageing or pathological conditions impair the phagocytic ability of macrophages. Our findings identify the targets that could potentially be utilized for restoring the phagocytic ability of the defunct macrophages.

Symphytum officinale augments osteogenesis in human bone marrow-derived mesenchymal stem cells in vitro as they differentiate into osteoblasts

ETHNOPHARMACOLOGICAL RELEVANCE

Mesenchymal stem cells (MSCs) are multipotent stem cells possessing regenerative potential. Symphytum officinale (SO) is a medicinal plant and in homoeopathic literature, believed to accelerate bone healing.

AIM OF THE STUDY

This study aimed to determine if homoeopathic doses of SO could augment osteogenesis in MSCs as they differentiate into osteoblasts in vitro.

MATERIALS AND METHODS

Bone marrow samples were obtained from patients who underwent bone grafting procedures (n = 15). MSCs were isolated, expanded and characterized by flow cytometry (CD90, CD105). Cytotoxicity of SO was evaluated by MTT assay. Osteogenic differentiation was induced in MSCs with β-glycerophosphate, ascorbic acid and dexamethasone over 2 weeks. Different homoeopathic doses of SO (MT, 3C, 6C, 12C and 30C) were added to the basic differentiation medium (BDM) and efficiency of MSCs differentiating into osteoblasts were measured by evaluating expression of Osteocalcin using flow cytometry, and alkaline phosphatase activity using ELISA. Gene expression analyses for osteoblast markers (Runx-2, Osteopontin and Osteocalcin) were evaluated in differentiated osteoblasts using qPCR.

RESULTS

Flow cytometry (CD90, CD105) detected MSCs isolated from bone marrow (93-98%). MTT assay showed that the selected doses of SO did not induce any cytotoxicity in MSCs (24 hours). The efficiency of osteogenic differentiation (2 weeks) for different doses of Symphytum officinale was determined by flow cytometry (n = 10) for osteoblast marker, Osteocalcin, and most doses of Symphytum officinale enhanced osteogenesis. Interestingly, gene expression analysis for Runx-2 (n = 10), Osteopontin (n = 10), Osteocalcin (n = 10) and alkaline phosphatase activity (n = 8) also showed increased osteogenesis with the addition of Symphytum officinale to BDM, specially mother tincture.

CONCLUSIONS

Our findings suggest that homoeopathic dose (specially mother tincture) of Symphytum officinale has the potential to enhance osteogenesis.

Effects of Heat Exposure from Live-Burn Fire Training on Postural Stability of Firefighters

Firefighters perform physically intensive jobs in suboptimal environments, making it even more important for them to maintain good functional postural balance or stability. As part of their training, firefighters are required to perform physically demanding tasks under high stress and high heat environments. These demanding tasks lead to increased physical fatigue which can then result in poor performance and/or postural instability. The objectives of this study were to 1) investigate the effect of live-firefighting training-induced heat stress on static postural balance, and 2) investigate the association between commonly monitored physiological responses (core body temperature, heart rate, oxygen saturation and blood pressure) and measures of static postural balance. Twenty-six firefighters (mean ± SD: age 36.0 years ±5.2, weight 216 lbs. ± 34, BMI 29.7 ± 4.2) participated in live firefighting training while performing following tasks: search and rescue, hose advancement, and backup. Prior to heat exposure (PRE) and following each scenario (POST1, POST2, POST3), firefighters' postural balance was assessed with a wearable 3-D inertial sensor system quantifying time dependent changes in linear acceleration (LIN ACC) and angular velocity (AV) about three orthogonal axes [Anterior-Posterior (AP), Medial-Lateral (ML), and vertical (V)] during one foot balance tests for 30 seconds under eyes open and eyes closed conditions. The outcome variables from 3-D wearable sensors were used to create 3-D Phase-Plane based postural stability metrics. Physiological measurement of core body temperature (CBT) (measured with a radio pill) as well as perception of heat increased significantly during the live fire-training exercise. In addition, firefighters also perceived an increase in physical fatigue and respiratory distress. Angular combined stability parameters (ACSP), RMS angular velocity around ML axis were significantly correlated with CBT. In the multivariate analysis adjusted for the scenarios, height and weight of the firefighters, these measures of static postural balance were significantly associated with CBT. As per the model results, static postural balance, as indicated by ACSP, worsened with an increase in CBT. Future studies should place sensors at body extremities along with close to center of mass to capture the kinematic movements more comprehensively influencing postural balance.

Positron emission tomography/computed tomography guided percutaneous biopsies of Ga-68 avid lesions using an automated robotic arm

PURPOSE

The purpose of this prospective study was to evaluate the feasibility of positron emission tomography/computed tomography (PET/CT)-guided biopsy of Ga-68 avid lesions using an automated robotic arm and determine the diagnostic yield of this technique.

MATERIAL AND METHODS

Patients who underwent Ga-68 labelled tracers imaging followed by PET/CT-guided biopsies of tracer-avid lesions were prospectively included. Biopsies were performed using a dedicated automated-robotic-arm assisted PET/CT-guided biopsy device on the same-day of diagnostic PET/CT-imaging. The tissue samples were retrieved after confirming the position of needle-tip in the target lesion. Procedure-related complications and radiation exposure of the interventionist were recorded. Histopathological reports were reviewed for diagnostic yield.

RESULTS

A total of 25 patients (19 men, six women) with a mean age of 50.8±17.3 (SD) years (range: 17-83 years) were included. The biopsies were performed after PET/CT using Ga-68 DOTANOC (n=16) or Ga-68 PSMA (n=8) and Ga-68 chemokine-analogue (n=1). The biopsy samples were obtained from the liver (n=9), bone (n=8), lymph-nodes (n=3), lung (n=1), pancreas (n=1), anterior mediastinal lesion (n=1), peritoneal-deposit (n=1) and thigh-lesion (n=1). No immediate or delayed procedure-related complications were documented in any patient. PET/CT-guided molecular sampling was technically successful in all the patients. Histopathology revealed malignancies in all the biopsied specimens without the need for repeat sampling or further invasive-diagnostic workup, with a diagnostic yield of 100%. The estimated absorbed-radiation dose was 566.7μSv/year for the interventionist.

CONCLUSION

PET/CT-guided molecular biopsy using Ga-68 labelled radiotracers is feasible and can be performed safely and accurately with a high-diagnostic yield. It is helpful in accurately staging the disease when tracer-avid isolated distant lesion evident on imaging and highly practical in patients with previous inconclusive sampling.