Changes of knowledge and practical skills before and after retraining for basic life support: Focused on students of Dental School.

Background: Considering the increasing possibility of emergency situations in dental clinics over time, we conducted this study to evaluate the changes in the knowledge and practical skills of students of dental school before and after retraining for 2 years after the initial education on basic life support (BLS) of the American Heart Association (AHA). Methods: All third-year students of dental school who had received the same education on BLS provider training of the AHA 2 years earlier were included in this study. Among them, 98 students were asked to answer a questionnaire about BLS knowledge and conduct a practical skills assessment of high-quality cardiopulmonary resuscitation using Little Anne QCPR before and after retraining. Results: After retraining, the level of BLS knowledge increased in all 7 categories, and BLS performance increased in all 19 subcategories. Comparison of the QCPR numerical data items before and after retraining showed that all items after retraining met the criteria recommended by the AHA. Conclusion: Students of dental school had low levels of knowledge and practical skills of BLS before retraining after 2 years from the initial education and had high levels after retraining. Therefore, BLS training must be updated periodically, and more effective education methods are required to maintain BLS knowledge and practical skills.

Robust magnetic tweezers for membrane protein folding studies.

Single-molecule magnetic tweezers have recently been adapted for monitoring the interactions between transmembrane helices of membrane proteins within lipid bilayers. In this chapter, we describe the procedures of conducting studies on membrane protein folding using a robust magnetic tweezer method. This tweezer method is capable of observing thousands of (un)folding transitions over extended periods of several to tens of hours. Using this approach, we can dissect the folding pathways of membrane proteins, determine their folding time scales, and map the folding energy landscapes, with a higher statistical reliability. Our robust magnetic tweezers also allow for estimating the folding speed limit of helical membrane proteins, which serves as a link between the kinetics and barrier energies.

Comparison of two crystal polymorphs of NowGFP reveals a new conformational state trapped by crystal packing.

Crystal polymorphism serves as a strategy to study the conformational flexibility of proteins. However, the relationship between protein crystal packing and protein conformation often remains elusive. In this study, two distinct crystal forms of a green fluorescent protein variant, NowGFP, are compared: a previously identified monoclinic form (space group C2) and a newly discovered orthorhombic form (space group P212121). Comparative analysis reveals that both crystal forms exhibit nearly identical linear assemblies of NowGFP molecules interconnected through similar crystal contacts. However, a notable difference lies in the stacking of these assemblies: parallel in the monoclinic form and perpendicular in the orthorhombic form. This distinct mode of stacking leads to different crystal contacts and induces structural alteration in one of the two molecules within the asymmetric unit of the orthorhombic crystal form. This new conformational state captured by orthorhombic crystal packing exhibits two unique features: a conformational shift of the ß-barrel scaffold and a restriction of pH-dependent shifts of the key residue Lys61, which is crucial for the pH-dependent spectral shift of this protein. These findings demonstrate a clear connection between crystal packing and alternative conformational states of proteins, providing insights into how structural variations influence the function of fluorescent proteins.

Screening for RV Dysfunction Using Smartphone ECG Analysis App: Validation Study with Acute Pulmonary Embolism Patients.

Background: Acute pulmonary embolism (PE) is a critical condition where the timely and accurate assessment of right ventricular (RV) dysfunction is important for patient management. Given the limited availability of echocardiography in emergency departments (EDs), an artificial intelligence (AI) application that can identify RV dysfunction from electrocardiograms (ECGs) could improve the treatment of acute PE. Methods: This retrospective study analyzed adult acute PE patients in an ED from January 2021 to December 2023. We evaluated a smartphone application which analyzes printed ECGs to generate digital biomarkers for various conditions, including RV dysfunction (QCG-RVDys). The biomarker's performance was compared with that of cardiologists and emergency physicians. Results: Among 116 included patients, 35 (30.2%) were diagnosed with RV dysfunction. The QCG-RVDys score demonstrated significant effectiveness in identifying RV dysfunction, with a receiver operating characteristic-area under the curve (AUC) of 0.895 (95% CI, 0.829-0.960), surpassing traditional biomarkers such as Troponin I (AUC: 0.692, 95% CI: 0.536-0.847) and ProBNP (AUC: 0.655, 95% CI: 0.532-0.778). Binarized based on the Youden Index, QCG-RVDys achieved an AUC of 0.845 (95% CI: 0.778-0.911), with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 91.2% (95% CI: 82.4-100%), 77.8% (95% CI: 69.1-86.4%), 63.3% (95% CI: 54.4-73.9%), and 95.5% (95% CI: 90.8-100%), respectively, significantly outperforming all the expert clinicians, with their AUCs ranging from 0.628 to 0.683. Conclusions: The application demonstrates promise in rapidly assessing RV dysfunction in acute PE patients. Its high NPV could streamline patient management, potentially reducing the reliance on echocardiography in emergency settings.

Performance of ECG-Derived Digital Biomarker for Screening Coronary Occlusion in Resuscitated Out-of-Hospital Cardiac Arrest Patients: A Comparative Study between Artificial Intelligence and a Group of Experts.

Acute coronary syndrome is a significant part of cardiac etiology contributing to out-of-hospital cardiac arrest (OHCA), and immediate coronary angiography has been proposed to improve survival. This study evaluated the effectiveness of an AI algorithm in diagnosing near-total or total occlusion of coronary arteries in OHCA patients who regained spontaneous circulation. Conducted from 1 July 2019 to 30 June 2022 at a tertiary university hospital emergency department, it involved 82 OHCA patients, with 58 qualifying after exclusions. The AI used was the Quantitative ECG (QCG™) system, which provides a STEMI diagnostic score ranging from 0 to 100. The QCG score's diagnostic performance was compared to assessments by two emergency physicians and three cardiologists. Among the patients, coronary occlusion was identified in 24. The QCG score showed a significant difference between occlusion and non-occlusion groups, with the former scoring higher. The QCG biomarker had an area under the curve (AUC) of 0.770, outperforming the expert group's AUC of 0.676. It demonstrated 70.8% sensitivity and 79.4% specificity. These findings suggest that the AI-based ECG biomarker could predict coronary occlusion in resuscitated OHCA patients, and it was non-inferior to the consensus of the expert group.

Robust membrane protein tweezers reveal the folding speed limit of helical membrane proteins.

Single-molecule tweezers, such as magnetic tweezers, are powerful tools for probing nm-scale structural changes in single membrane proteins under force. However, the weak molecular tethers used for the membrane protein studies have limited the observation of long-time, repetitive molecular transitions due to force-induced bond breakage. The prolonged observation of numerous transitions is critical in reliable characterizations of structural states, kinetics, and energy barrier properties. Here, we present a robust single-molecule tweezer method that uses dibenzocyclooctyne cycloaddition and traptavidin binding, enabling the estimation of the folding 'speed limit' of helical membrane proteins. This method is >100 times more stable than a conventional linkage system regarding the lifetime, allowing for the survival for ~12 hr at 50 pN and ~1000 pulling cycle experiments. By using this method, we were able to observe numerous structural transitions of a designer single-chained transmembrane homodimer for 9 hr at 12 pN and reveal its folding pathway including the hidden dynamics of helix-coil transitions. We characterized the energy barrier heights and folding times for the transitions using a model-independent deconvolution method and the hidden Markov modeling analysis, respectively. The Kramers rate framework yields a considerably low-speed limit of 21 ms for a helical hairpin formation in lipid bilayers, compared to µs scale for soluble protein folding. This large discrepancy is likely due to the highly viscous nature of lipid membranes, retarding the helix-helix interactions. Our results offer a more valid guideline for relating the kinetics and free energies of membrane protein folding.

FlavorGraph: a large-scale food-chemical graph for generating food representations and recommending food pairings.

Food pairing has not yet been fully pioneered, despite our everyday experience with food and the large amount of food data available on the web. The complementary food pairings discovered thus far created by the intuition of talented chefs, not by scientific knowledge or statistical learning. We introduce FlavorGraph which is a large-scale food graph by relations extracted from million food recipes and information of 1,561 flavor molecules from food databases. We analyze the chemical and statistical relations of FlavorGraph and apply our graph embedding method to better represent foods in dense vectors. Our graph embedding method is a modification of metapath2vec with an additional chemical property learning layer and quantitatively outperforms other baseline methods in food clustering. Food pairing suggestions made based on the food representations of FlavorGraph help achieve better results than previous works, and the suggestions can also be used to predict relations between compounds and foods. Our research offers a new perspective on not only food pairing techniques but also food science in general.

A Literature Analysis on Medicinal Use and Research of Cannabis in the Meiji Era of Japan.

Cannabis is a historical plant which has been used as a medicine in East Asia. These days, there are active debates about using cannabis in clinical field. Collecting and comparing cannabis research articles which had been published in the Opening of Japan to spot the interactions between the traditional medicine of Japan, Rangaku which was established in Edo Period and the European medicine which is transferred after Perry Expedition is academically meaningful. This study searched publications, which were listed on Open-Access databases by Dec. 11th, 2019. We collected research articles which had been published from January 3rd, 1867 to July 30th, 1912 also known as Meiji era and uploaded on Open-Access databases. Our searching databases were J-stage, CiNii (Scholarly and Academic Information Navigator), Tokyo Metropolitan Library, The National Diet Library, IRDB (Institutional Repositories DataBase) and KAKEN (Grant-in-Aid for Scientific Research Database). Searching keywords were cannabis, hemp and all their Japanese synonyms and available combinations. We selected final 15 studies which met every selection criteria in the 346,393 collected studies. Cannabis was prescribed in Meiji era of Japan to alleviate pain and cure the digestive, respiratory, urinary, and nervous system diseases such as indigestion, asthma, tuberculosis, gonorrhea and its complications, insomnia, and nervous prostration. Cannabis was medically used in Meiji era of Japan and the reporting and sharing of its clinical effect was published on the medical journals like present days. There were already Cannabis regulations in that era, but its medicinal use was more liberated than nowadays. It may be a chance to reconsider the current legal system, which strictly controls the use of Cannabis.

Comparison of genioplasty using Medpor and osteotomy.

OBJECTIVE: This retrospective study compared genioplasty using Medpor with osteotomy by measuring the amount of anteroposterior change in hard and soft tissue. STUDY DESIGN: Thirty-three patients who underwent mentum augmentation and who were followed-up >6 months were included. Subjects were divided into 2 groups: group A, with 14 patients who underwent genioplasty using osteotomy; and group B, with 19 patients who underwent genioplasty using Medpor. Patients chose one of the treatments themselves. RESULTS: The mean relapse rate of the most prominent or anterior point on the chin in the midsagittal plane of patients who went underwent osteotomy was 18.59%, and the mean relapse rate of patients who went underwent genioplasty with Medpor was 14.56%. CONCLUSIONS: It was found that the amount of the movement at the time of surgery when checked after surgery did not change in patients who underwent genioplasty using Medpor compared with patients who underwent genioplasty using osteotomy.

A comparison of bone generation capability in rabbits using tooth ash and plaster of Paris with platelet-rich plasma or fibrin sealant.

OBJECTIVES: Increased attention has been focused on determining the most efficacious materials for generalized bone grafts. This article presents the results of a histomorphometric analysis of bone healing in the calvaria of rabbits. The study compared the use of a tooth ash and plaster of Paris mixture alone, in association with platelet-rich plasma (PRP), and in association with fibrin sealant. STUDY DESIGN: Twelve rabbits were divided into control (group 1) and experimental groups (groups 2, 3, and 4). Group 1 was maintained as an unfilled control, and tooth ash and plaster of Paris were used in group 2, tooth ash and plaster of Paris with PRP were used in group 3, and tooth ash and plaster of Paris with fibrin sealant (Tissucol Duo Quick) were used in group 4. One-half of the animals were killed after 4 weeks, and the rest were killed after 8 weeks. Bone samples were taken from the defect areas, and newly formed bone was analyzed histomorphometrically. RESULTS: The rate of new bone formation in groups 2, 3, and 4 was significantly higher than the rate in the control group. The rate of new bone formation in groups 3 and 4 was higher than the rate in group 2, but the difference was not statistically significant. CONCLUSION: The concomitant use of PRP or fibrin sealant with tooth ash and plaster of Paris graft materials may have a positive effect on bone healing.