Implicit gender bias in the diagnosis and treatment of type 2 diabetes: A randomized online study.

AIMS: Implicit gender biases (IGBs) are unconscious evaluations about a person based on gender. IGBs of healthcare providers may affect medical decision making. This study investigated whether IGBs and genders of patients and general practitioners (GPs) influence diagnostics and treatment decisions in the context of diabetes type 2. METHODS: Ninety-nine GPs participated in this randomized online study. Implicit Associations Tasks were used to measure two IGBs, related to lifestyle (women have a healthier lifestyle than men) and communication (men are less communicative than women). Clinical decisions regarding type 2 diabetes were measured with vignettes that included a fictional male or female patient case. RESULTS: Female GPs exhibited a significant lifestyle IGB (p < 0.001). GPs of both genders exhibited a significant communication IGB (p < 0.001). Several associations between IGBs and clinical decisions were found. The gender of the vignette character affected several outcomes, for example GPs were less certain in the diabetes diagnosis when the character was a woman (p < 0.001). CONCLUSION: We demonstrated that GPs have IGBs and these biases as well as patient's gender affect decisions of GP's when they are solving a diabetes vignette case. Future research is needed to understand the most important consequences of IGBs in the context of type 2 diabetes.

The role of self-reported and physiological stress in nocebo hyperalgesia.

Negative expectations can increase pain sensitivity, leading to nocebo hyperalgesia. However, the physiological and psychological factors that predispose individuals to this phenomenon are still not well understood. The present study examined whether stress induced by a social stressor affects nocebo hyperalgesia, and whether this effect is mediated by self-reported and physiological stress responses. We recruited 52 healthy participants (15 men) who were randomly assigned to either the Trier Social Stress Test (TSST) or a control condition (a friendly version of the TSST). Nocebo hyperalgesia was induced using negative suggestions combined with a validated pain conditioning paradigm. We assessed self-reported (anxiety and stress) and physiological (cortisol, alpha-amylase, heart rate, and skin conductance) responses to stress. Both groups exhibited significant nocebo hyperalgesia. The stress group showed higher levels of anxiety, self-reported stress, and cortisol levels compared to the control group while no significant differences were found in other physiological markers. The stress and control groups did not differ in the magnitude of nocebo hyperalgesia, but anxiety levels partially mediated the effects of the stress test on nocebo hyperalgesia. Our findings suggest that an external social stressor does not directly affect nocebo hyperalgesia, but that increased anxiety due to the stressor enhances its magnitude. Thus, it may be worthwhile to investigate whether reducing stress-related anxiety in clinical settings would help alleviate nocebo effects.

Bioinspired superhydrophobic SERS substrates for machine learning assisted miRNA detection in complex biomatrix below femtomolar limit.

Surface-enhanced Raman spectroscopy (SERS) is an analytical method with high potential in the field of medicine. The design of SERS substrates, based on specific morphology and/or chemical modification, allow the recognition of the presence of specific analytes with precision close to a single-molecule detection limit. However, the SERS analysis of real samples is significantly complicated by the presence of a large number of "minor" molecules that can shield the signal from the target analyte and make it impossible to determine it in practice. In this work, an advanced SERS approach was used for the detection of cancer-related miRNA-21 in blood plasma, used as a molecular model background. The approach was based on the combination of the biomimetic plasmon-active SERS substrate, its tuned surface chemistry and advanced SERS data analysis, making use of artificial machine learning. In the first step, biomimetic SERS substrates were created using a butterfly wing as a starting template. The substrates were covered by thin Au layer and covalently grafted with hydrophobic chemical moieties to introduce superhydrophobic and water-adhesive properties. The self-concentration of the analyte on the substrates was achieved by minimizing the contact area between the analyte drop and the substrate, which is facilitated by surface superhydrophobicity and additionally enhanced by drop evaporation on the flipped over substrate. Due to the presence of cancer miRNA and blood plasma background, the measured SERS spectra represent a complex of interfering peaks. Thus, their interpretation was carried out using a specially trained machine learning model. As a result, reliable and repeatable quantitative detection of miRNAs below the femtomolar level (up to 10-16 M) on the background of human blood plasma becomes possible.

Label-free surface-enhanced Raman spectroscopy with artificial neural network technique for recognition photoinduced DNA damage.

Taking advantage of surface-enhanced Raman scattering (SERS) methodology with its unique ability to collect abundant intrinsic fingerprint information and noninvasive data acquisition we set up a SERS-based approach for recognition of physically induced DNA damage with further incorporation of artificial neural network (ANN). As a proof-of-concept application, we used the DNA molecules, where the one oligonucleotide (OND) was grafted to the plasmonic surface while complimentary OND was exposed to UV illumination with various exposure doses and further hybridized with the grafted counterpart. All SERS spectra of entrapped DNA were collected by several operators using the portable spectrometer, without any optimization of measurements procedure (e.g., optimization of acquisition time, laser intensity, finding of optimal place on substrate, manual baseline correction, etc.) which usually takes a significant amount of operator's time. The SERS spectra were employed as input data for ANN training, and the performance of the system was verified by predicting the class labels for SERS validation data, using a spectra dataset, which has not been involved in the training process. During that phase, accuracy higher than 98% was achieved with a level of confidence exceeding 95%. It should be noted that utilization of the proposed functional-SERS/ANN approach allows identifying even the minor DNA damage, almost invisible by control measurements, performed with common analytical procedures. Moreover, we introduce the advanced ANN design, which allows not only classifying the samples but also providing the ANN analysis feedback, which associates the spectral changes and chemical transformations of DNA structure.

[Operon for riboflavin synthesis in Bacillus subtilis. XI. Determination of the type of regulation using a test for dominance of operator-constitutive and regulator-constitutive mutations]. / Issledovanie operona biosinteza riboflavina u Bacillus subtilis. Soobshchenie XI. Opredelenie tipa reguliatsii s pomoshch'iu testa na dominantnost' operator-konstitutivnykh i reguliator-konstitutivnykh mutatsii

The strain GSY 468 of Bacillus subtilis, giving persistent unstable merozogotes was used as recipient in transformation. Diploid cells bearing a regulator constitutive or operator constitutive mutation were obtained, and their phenotype was studied. The operator constitutive mutation behaves as a dominant one, but the regulator constitutive is recessive. Hence the regulation type in riboflavin operon is negative. The product of the regulator gene is obviously a repressor protein.

[Operon of riboflavin biosynthesis in Bacillus subtilis. VIII. Localization of group ribC markers in relation to the structural gene cluster group]. / Issledovanie operona biosinteza riboflavina u Bacillus subtilis. Soobshchenie iii. lokalizatsiia markerov gruppy ribC otnositel'no gruppy stsepleniia strukturnykh genov

Regulatory markers of ribC group were located on the chromosome of Bacillus subtilis by means of genetic transformation using DNA isolated by the phenol-benzoate method of Kelly. Markers of this group controlling the regulation of riboflavin biosynthesis were mapped in the terminal region of the chromosome between phe and lys markers. A maximal value of contransfer index between ribC 1 and lys42 markers was found to be 3.5%.

[Treatment of intestinal insufficiency syndrome in patients with peritonitis]. / Lechenie sindroma kishechnoi nedostatochnosti u bol'nykh s peritonitom.

Results of the treatment of 90 patients with generalized peritonitis and syndrome of intestinal insufficiency were analyzed. In the study group (45 patients) enteral administration of 1% pectin solution and glutamin solution (15-30 g/day) were included in combined therapy. Clinical and laboratory control, radiation monitoring and bacteriological studies carried out for evaluation of efficacy of therapy established. A decrease of endogenous intoxication and time of repair of functional activity of the gastrointestinal tract, immunomodulation, normalization of microbiocenosis of the small intestine. This therapy diminishes the number of complications and lethality.

[Choice of surgery scope in occlusive obstruction of the colon]. / Vybor ob''ema operativnogo vmeshatel'stva pri obturatsionnoi neprokhodimosti obodochnoi kishki.

From 1980 five hundred and seventy-three patients underwent surgery for occlusive obstruction of the colon (OOC). Radical surgeries (left-sided hemicolonectomy, Hartman's surgery, subtotal colonectomy) were performed in 440 (77%) patients, 133 (23%) patients underwent palliative surgeries. One hundred and sixty-one patients of radically operated underwent one-stage surgeries (93 right-sided hemicolonectomies and 68 subtotal colonectomies). Postoperative lethality after radical surgeries was 16.5%. Postoperative lethality, time of hospital stay, rate of postoperative complications after Haptman's surgery and subtotal colintcyomy don't differ, but patients after subtotal colonectomy don't require reconstruction surgery.

[Toxicity of mushrooms Paxillus involutus and Paxillus atrotomentosus]. / K voprosu o toksichnosti gribov vida svinushka tonkaia i tolstaia.

Thirty-eight patients with mushroom (Paxillus involutus and Paxillus atrotomentosus) poisoning were treated. Slight poisoning (acute gastroenteritis) was diagnosed in 17 patients, medium-severe in 13, severe in 6, and extremely severe in 2 patients. Changes in the LPO-AOD system correlated with the severity of hepatorenal involvement. The treatment included hepatotropic therapy; patients with acute renal failure were treated by hemodialysis. Paxillus mushrooms induced functional evacuatory disorders in the small intestine. Eleven patients with adhesions in the abdominal cavity developed ileus. Two patients died: a man aged 26 years after eating fried (not boiled) mushrooms and a woman aged 76 years with ileus with symptoms of multiple organ dysfunction. The rest patients were discharged from hospital in satisfactory condition. Clinical course of poisoning with Paxillus mushrooms is discussed.

[Gastric and intestinal scintigraphy in the complex diagnosis of small bowel obstruction].

An algorithm has been developed for radiation diagnosis of small bowel obstruction, which involves abdominal X-ray and ultrasound studies at the first stage and radionuclide evaluation of gastrointestinal transit, by using 100-150 ml of aqueous 99mTc-technefite or 99mTc-bromeside solution in a dose of 50-100 MBq (radiation load 0.7-1.4 MeV) per os. The sensitivity, specificity, and diagnostic efficiency of the whole radiation diagnostic complex and each procedure separately were determined by the results of examination in 180 patients with suspected small bowel obstruction, of whom 104 patients were operated on, but obstruction ceased during medical treatment. Inclusion of the radionuclide technique into the diagnostic complex involving plain radiography and ultrasonography was shown to enhance diagnostic efficiency up to 97-98%.