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Atrial fibrillation, the most prevalent cardiac arrhythmia, has witnessed significant advancements in treatment modalities, transitioning from invasive procedures like the maze procedure to minimally invasive catheter ablation techniques. This review focuses on recent improvements in anesthetic approaches that enhance outcomes in catheter atrial fibrillation ablation. We highlight the efficacy of contact force sensing catheters with steerable introducer sheaths, which outperform traditional catheters by ensuring more effective contact time and lesion formation. Comparing general anesthesia with conscious sedation, we find that general anesthesia provides superior catheter stability due to reduced respiratory variability, resulting in more effective lesion formation, and reduced pulmonary vein reconnection. The use of high-frequency jet ventilation under general anesthesia, delivering low tidal volumes, effectively minimizes left atrial movement, decreasing catheter displacement and procedure time, and reducing recurrence in paroxysmal atrial fibrillation. An alternative, high-frequency low tidal volume ventilation using conventional ventilators, also shows improved catheter stability and lesion durability compared to traditional ventilation methods. However, a detailed comparative study of high-frequency jet ventilation, high-frequency low tidal volume ventilation, and conventional mechanical ventilation in catheter ablation for atrial fibrillation is lacking. This review emphasizes the need for such studies to identify optimal anesthetic techniques, potentially enhancing patient outcomes in atrial fibrillation treatment. Our findings suggest that careful selection of anesthetic methods, including ventilation strategies, plays a crucial role in the success of catheter ablation for atrial fibrillation, warranting further research for evidence-based practice.
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OBJECTIVE: To perform audit of imaging practice in different hospitals to assess their adherence to guidelines on optimizing computerized tomography of kidneys, ureter and bladder (CT KUB) technique in order to reduce unnecessary scan length. To assess improvement in adherence to guidelines after intervention, following education of the technologists. MATERIAL AND METHODS: There were 12 participant radiology departments in eight cities of Islamic Republic of Pakistan. Findings of first audit round were presented in respective departmental meetings and technologists were educated. Second round was performed after 12 weeks. Our target was to achieve 100% compliance to standards. Comparison of adherence to guidelines before and after intervention was done. Total number of axial slices of KUB CT scan, images above upper pole of highest kidney (overscan/unnecessary slices) and percentage of unnecessary images were recorded. To calculate statistical significance of difference, Fischer exact and Chi-square tests were applied. RESULTS: Percentage of patients with appropriate CT KUB technique according to RCR guidelines was far less in first round (0-64%). It significantly improved after educating the technologists (35.57- 90.90%). CONCLUSION: By following standard practice of CT KUB scan, significant radiation dose reduction is achievable without compromising diagnostic details. ADVANCES IN KNOWLEDGE: Standardization of CT KUB examination technique can valuably contribute to reduction in unessential radiation exposure.
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Background More alarming than the rise of cancer globally is its discreet changing profiles over the years. According to our knowledge, no new studies on cancer have taken place in Dir since 2004. Hence, we aimed to provide and analyze the cancer trends in district Dir, Malakand division, Khyber Pakhtunkhwa (KPK), regarding its prevalence and incidence, and compare it nationally and internationally. Methods A retrospective study was conducted by collecting data from 2647 clinically diagnosed cancer patients of all ages in district Dir, between the years 2008 and 2017, from the Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar. Statistical analysis was performed using SPSS version 20 and presented using different tables and figures. Results Out of the total patients, 52.7% were male and 47.3% were female. The most common types of cancers in both genders combined were breast (9.0%), acute lymphocytic leukemia (ALL) (6.0%), skin (5.7%), non-Hodgkin Lymphoma (NHL) (5.6%), and brain tumor (5.2%). The age-standardized incidence rate (ASIR) in males in 2017 was peaking in the age group 60-69 (2707.2) with the most prevalent cancer being NHL (7.7%). In females, ASIR was highest in the age group 30-39 (2500.8) with the majority having breast cancer (18.1%), and in children, ALL (30.9%) was most prevalent. Incidence was highest in 2014 with a staggering 15 cases/100,000 population. Cancer prevalence in females aged 50 and below was significantly higher (p<0.001) compared to males. Conclusion Our study highlights that cancer profiles in Dir in the past two decades have changed with certain results non-conforming to global and regional trends. A follow-up research should be carried out to further ascertain and analyze these diverging results in hopes of drawing a more concrete conclusion from these findings.
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In this study five different complexes of Cu(II) were synthesized for the purpose of environmentally notorious mercury sensing and preliminary biological screening. Pyridine-2,6-dicarboxylic acid (also known as dipicolinic acid, and abbreviated as H2DPA), 3-phenyl pyrazole (3-ppz), 4-iodo-1H-pyrazole (4-ipz), 4-nitropyrazole (4-npz), 4-bromopyrazole (4-bpz), and 4-chloropyrazole (4-cpz) were chosen as potential ligands. The synthesized complexes labelled as 1-5, namely [Cu(DPA)(3-ppz)], [Cu(DPA)(4-ipz)], [Cu(DPA)(4-npz)], [Cu(DPA)(4-bpz)], [Cu(DPA)(4-cpz)], were proposed based on spectroscopic data (FTIR, TGA, and UV-visible spectroscopy). These complexes feature C=O functionalities that are not involved in coordination and may be used for further applications. The isolated complexes were utilized for detecting Hg(II) ions in water samples. Various concentrations of Hg(II) ions were prepared for detection purposes, and changes in absorption concerning complexes 1-5 were determined using UV-Visible spectroscopy. It was found that complexes 3 and 4 exhibit efficient sensing abilities towards Hg(II) ions. The antibacterial activities of complexes 1-5 were assessed against S.â typhi and E.â coli. The complexes 1 and 3 displayed good antibacterial activities against S.â typhi (13.67, and 13.56â mm, respectively) while complexes 1, 2 and 4 were found to be efficient against E.â coli (11.6, 12.66, 11.31â mm, respectively). The absorption maxima of 2,2-diphenyl-1-picryhydrazyl (DPPH) at 517â nm, considerably shifted upon addition of complexes 1-5. The results reveal that the complexes possess potential free radical scavenging abilities.
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In this study, a CuInS2/Cu2O/TiO2 nanotube (TNT) heterojunction-based hybrid material is reported for the selective detection of cholesterol and ibuprofen. Anodic TNTs were co-decorated with Cu2O and CuInS2 quantum dots (QDs) using a modified chemical bath deposition (CBD) method. QDs help trigger the chemical oxidation of cholesterol by cathodically generating hydroxyl radicals (ËOH). The small size of QDs can be used to tune the energy levels of electrode materials to the effective redox potential of redox species, resulting in highly improved sensing characteristics. Under optimal conditions, CuInS2/Cu2O/TNTs show the highest sensitivity (â¼12 530 µA mM-1 cm-2, i.e. up to 11-fold increase compared to pristine TNTs) for cholesterol detection with a low detection limit (0.013 µM) and a fast response time (1.3 s). The proposed biosensor was successfully employed for the detection of cholesterol in real blood samples. In addition, fast (4 s) and reliable detection of ibuprofen (with a sensitivity of â¼1293 µA mM-1 cm-2) as a water contaminant was achieved using CuInS2/Cu2O/TNTs. The long-term stability and favourable reproducibility of CuInS2/Cu2O/TNTs illustrate a unique concept for the rational design of a stable and high-performance multi-purpose electrochemical sensor.
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Colesterol , Cobre , Ibuprofeno , Nanotubos , Oxidación-Reducción , Puntos Cuánticos , Titanio , Ibuprofeno/química , Cobre/química , Puntos Cuánticos/química , Titanio/química , Nanotubos/química , Colesterol/química , Técnicas Biosensibles , Humanos , Técnicas Electroquímicas , Indio/química , Límite de Detección , ElectrodosRESUMEN
INTRODUCTION: James Lind Alliance (JLA) Priority Setting Partnerships (PSPs) produce 'Top 10' lists of health and care research priorities through a structured, shared decision-making process with patients or service users, carers and health or care professionals who identify questions that are most important to them. To date, over 150 PSPs in different areas of health and care have published research priorities. Some PSPs share similar priorities, which could be combined, promoted and addressed through collaborative research to increase value and reduce research waste. AIM: The aim of this study was to identify overarching themes common to JLA PSP priorities across different areas of health and care. METHODS: Our analysis included 'Top 10' research priorities produced by UK-based JLA PSPs between 2016 and 2020. The priorities were coded deductively by the Health Research Classification System (HRCS) health category and research activity. We then carried out online workshops with patients, service users and carers to generate new codes not already captured by this framework. Within each code, multistakeholder inductive thematic analysis was used to identify overarching themes, defined as encompassing priorities from three or more PSPs covering two or more health categories. We used codesign methods to produce an interactive tool for end users to navigate the overarching themes. RESULTS: Five hundred and fifteen research priorities from 51 PSPs were included in our analysis. The priorities together encompassed 20 of 21 HRCS health categories, the most common being 'generic health relevance' (22%), 'mental health' (18%) and 'musculoskeletal' (14%). We identified 89 overarching themes and subthemes, which we organised into a hierarchy with seven top-level themes: quality of life, caregivers and families, causes and prevention, screening and diagnosis, treatment and management, services and systems and social influences and impacts. CONCLUSION: There are many overarching themes common to research priorities across multiple areas of health and care. To facilitate new research and research funding, we have developed an interactive tool to help researchers, funders and patients or service users to explore these priority topics. This is freely available to download online. PATIENT OR PUBLIC CONTRIBUTION: Patients or service users and carers were involved throughout the study, including deciding the aims, designing the study, analysing priorities to identify themes, interpreting and reporting the findings.
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Prioridades en Salud , Humanos , Reino Unido , Investigación sobre Servicios de Salud , Toma de Decisiones Conjunta , InvestigaciónRESUMEN
Acute coronary syndrome is commonly associated with traditional cardiovascular risk factors such as smoking, hypertension, diabetes, and hyperlipidemia. Myocardial infarction in a young person presents a significant challenge because its etiology is least likely associated with atherosclerosis. Polycythemia vera refers to one of the rare causes of myocardial infarction, which involves enhanced erythrocyte levels, leukocytosis, thrombocytosis, splenomegaly, and a greater chance of vascular occlusion due to clotting in coronary arteries. A 22-year-old male from Pakistan, Asia without typical risk factors, presented with severe chest pain. Electrocardiography indicated acute inferior wall myocardial infarction, and streptokinase was administered. Subsequent investigations confirmed polycythemia vera. Treatment with hydroxyurea and aspirin was initiated, whereas normal coronary arteries in CT coronary angiogram were observed. This case highlights polycythemia vera's rare role in young individuals' heart attacks without known risk factors, emphasizing the need for early detection and specialized treatments involving hematologists to prevent future thrombotic episodes.
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Congenital afibrinogenemia is a rare inherited blood disorder characterized by a deficiency of fibrinogen, leading to abnormal blood clotting. It is caused by mutations in fibrinogen genes and results in a propensity for bleeding. We present the case of a one-year-old male child with congenital afibrinogenemia who developed a left-sided facial haematoma following a fall from a walker. The child had a history of active bleeding during cannulation and had not undergone circumcision due to the risk of bleeding. This case highlights the need for timely diagnosis and appropriate management of rare bleeding disorders such as congenital afibrinogenemia. Collaboration between different specialties, including haematology and genetic counseling, is crucial for comprehensive care. The rarity of the condition underscores the importance of raising awareness among healthcare professionals. Genetic counseling and family studies are essential for assessing genetic implications and guiding decision-making. Further advancements in diagnostic tests and replacement therapy are needed to improve the management of patients with afibrinogenemia, particularly in regions with a high prevalence of consanguineous marriages.
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In times of crisis, stock markets experience a significant increase in return volatility, which leads to spillovers across equity sectors. The purpose of this study is to investigate the asymmetric spillovers across ten U.S. equity sectors, representing different industries. Daily prices of sector indices were collected from 02 January 2018 to 22 October 2021 for the analysis. In addition, the study applied Diebold and Yilmaz's (2012) dynamic spillover methodology, along with the static and rolling windows phenomena, to examine the daily returns spillovers across sector indices. The results indicate that 82 % of volatility forecast error variance in U.S sector indices is due to the spillover effect. Moreover, both industrials and financials exhibit the highest gross spillovers to other sectors, while they also receive the highest spillovers from other sectors. Furthermore, the oil and gas sector and utilities sector receive the highest net returns spillovers. These empirical findings provide crucial information regarding the interdependence of U.S. sector indices during the COVID-19 pandemic, which is relevant for investors and practitioners.
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The COVID-19 pandemic has resulted in significant financial losses globally, increasing the volatility of financial assets. Thus, this study models the stock market volatility of developed economies during the COVID-19 pandemic. For this purpose, we used the GJR-GARCH (Albulescu, 2020; Albulescu, 2020) [1,1] econometric model on the daily time series returns data ranging from 01st-July-2019 to 18th-November-2020. The entire dataset was equally divided into two subsets; before COVID-19, and after the COVID-19. The empirical results of this study showed the presence of volatility clustering, leverage effect, and excess kurtosis indicating leptokurtic phenomena in all stock indices returns. In addition to this, it can be noted that compared to before COVID-19, the stock markets showed negative returns, and increased volatility during the COVID-19. Hence, based on these findings, this study provides significant insights for global stock market investors and economic policymakers regarding financial portfolio construction particularly during crises times.
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BACKGROUND: Considering the rapidly spreading monkeypox outbreak, WHO has declared a global health emergency. Still in the category of being endemic, the monkeypox disease shares numerous clinical characters with smallpox. This study focuses on determining the most effective combination of autoregressive integrated moving average model to encapsulate time dependent flow behaviour of the virus with short run prediction. METHODS: This study includes the data of confirmed reported cases and cumulative cases from eight most burdened countries across the globe, over the span of May 18, 2022, to December 31, 2022. The data was assembled from the website of Our World in Data and it involves countries such as United States, Brazil, Spain, France, Colombia, Mexico, Peru, United Kingdom, Germany and Canada. The job of modelling and short-term forecasting is facilitated by the employment of autoregressive integrated moving average. The legitimacy of the estimated models is argued by offering numerous model performance indices such as, root mean square error, mean absolute error and mean absolute prediction error. RESULTS: The best fit models were deduced for each country by using the data of confirmed reported cases of monkeypox infections. Based on diverse set of performance evaluation criteria, the best fit models were then employed to provide forecasting of next twenty days. Our results indicate that the USA is expected to be the hardest-hit country, with an average of 58 cases per day with 95% confidence interval of (00-400). The second most burdened country remained Brazil with expected average cases of 23 (00-130). The outlook is not much better for Spain and France, with average forecasts of 52 (00-241) and 24 (00-121), respectively. CONCLUSION: This research provides profile of ten most severely hit countries by monkeypox transmission around the world and thus assists in epidemiological management. The prediction trends indicate that the confirmed cases in the USA may exceed than other contemporaries. Based on the findings of this study, it remains plausible to recommend that more robust health surveillance strategy is required to control the transmission flow of the virus especially in USA.
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Modelos Estadísticos , Mpox , Humanos , Factores de Tiempo , Mpox/epidemiología , Predicción , Brotes de EnfermedadesRESUMEN
Keratoconus (KC) incidence is on the increase. The advent of corneal-collagen cross-linking (CXL) has revolutionized the management of KC. This systematic review looks at the efficacy and complications of two novel treatments within CXL: Epithelial-On (Epi-On) and CXL-plus procedures. Two separate literature searches were carried out up until July 1, 2021. Articles only published in the last two years were included to ensure that only the most recent articles were reviewed. A total of 15 articles were selected for this review. There were varied results regarding the efficacy of Epi-On. No significant difference was found between Epi-On and standard Epithelial-Off (Epi-Off) CXL. However, it was found that Epi-On was inferior to standard CXL in terms of reducing KMAX. There was a higher risk of progression in patients treated with Epi-On CXL, with an increased rate of patients requiring re-treatment due to the advancement of their KC. While some studies report CXL-plus procedures demonstrate long-term efficacy and safety, a considerable number of studies advise caution, reporting a significant deterioration in corrected distance visual acuity (CDVA). Consequently, a question persists regarding the safest and most efficacious approach, given the lack of robust large randomized controlled trials (RCTs) in the current literature.
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Subsequent to the failure of the World Health Organisation (WHO) of achieving their target to eliminate trachoma by the year 2020, the most effective strategy in eliminating trachoma must be re-examined to accomplish the new target of eradication by the year 2030. Whilst antibiotic therapy is a core foundation of this elimination strategy, another important factor is the state of the environmental conditions in trachoma endemic countries. This manuscript aimed to identify the impact of environmental improvement strategies on the prevalence of trachoma and the significance of environmental improvement alongside the use of antibiotic treatment to achieve trachoma elimination. Two independent literature searches were conducted up until the 5th of July 2021. Two main databases were used to carry out these literature searches, namely, Ovid EMBASE and Ovid MEDLINE. All of the relevant references were found using MeSH and free text terms. Key terms used were 'trachoma', 'water', 'sanitation', 'hygiene' and 'environmental Improvement'. The exclusion criteria included non-African-based studies, review papers, protocols and case reports. A total of 17 studies were included for this review. Living within a close range of a water source was significantly associated with reduced risk of trachoma infection. Water obtained from piped water sources was associated with the lowest rates of active trachoma. Studies on facial cleanliness evidenced a strong association with reduced prevalence of trachoma. Whilst the provision of latrine facilities found was significantly associated with reduced prevalence of trachoma, there was no significant difference between the use of private latrine facilities over communal latrine facilities. The use of repeated scheduled antibiotic treatments over single-use antibiotic distribution had a greater impact both short term and long term on the prevalence rates of trachoma. Nonetheless, prevalence rates increased again following the commencement of treatment. Mass antibiotic treatment has been proven to have a greater impact on lowering the prevalence of trachoma initially, but this impact is not sustainable due to the rise in prevalence rates following the completion of treatment. A holistic approach, therefore, must be implemented with evidence showing that an emphasis on longer-term environmental methods should be implemented to compliment antibiotic distribution. Prioritisation of specific interventional measures should be tailored according to local epidemiology; nonetheless, these measures form the backbone of a trachoma elimination strategy to eliminate trachoma by the year 2030.
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BACKGROUND: Degenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction globally. Associated neurological symptoms and signs have historically been explained by pathobiology within the cervical spine. However, recent advances in imaging have shed light on numerous brain changes in patients with DCM, and it is hypothesised that these changes contribute to DCM pathogenesis. The aetiology, significance, and distribution of these supraspinal changes is currently unknown. The objective was therefore to synthesise all current evidence on brain changes in DCM. METHODS: A systematic review was performed. Cross-sectional and longitudinal studies with magnetic resonance imaging on a cohort of patients with DCM were eligible. PRISMA guidelines were followed. MEDLINE and Embase were searched to 28th August 2023. Duplicate title/abstract screening, data extraction and risk of bias assessments were conducted. A qualitative synthesis of the literature is presented as per the Synthesis Without Meta-Analysis (SWiM) reporting guideline. The review was registered with PROSPERO (ID: CRD42022298538). FINDINGS: Of the 2014 studies that were screened, 47 studies were identified that used MRI to investigate brain changes in DCM. In total, 1500 patients with DCM were included in the synthesis, with a mean age of 53 years. Brain alterations on MRI were associated with DCM both before and after surgery, particularly within the sensorimotor network, visual network, default mode network, thalamus and cerebellum. Associations were commonly reported between brain MRI alterations and clinical measures, particularly the Japanese orthopaedic association (JOA) score. Risk of bias of included studies was low to moderate. INTERPRETATION: The rapidly expanding literature provides mounting evidence for brain changes in DCM. We have identified key structures and pathways that are altered, although there remains uncertainty regarding the directionality and clinical significance of these changes. Future studies with greater sample sizes, more detailed phenotyping and longer follow-up are now needed. FUNDING: ODM is supported by an Academic Clinical Fellowship at the University of Cambridge. BMD is supported by an NIHR Clinical Doctoral Fellowship at the University of Cambridge (NIHR300696). VFJN is supported by an NIHR Rosetrees Trust Advanced Fellowship (NIHR302544). This project was supported by an award from the Rosetrees Foundation with the Storygate Trust (A2844).
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Enfermedades de la Médula Espinal , Humanos , Persona de Mediana Edad , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Estudios Transversales , Imagen por Resonancia Magnética , Enfermedades de la Médula Espinal/diagnóstico por imagenRESUMEN
Platelet-rich plasma (PRP) therapy, is a stand-alone therapy or is used in combination with other treatments for the treatment of androgenic alopecia. The purpose of this meta-analysis was to compare the improvement in hair density seen, when PRP was used alone and when used as an adjunct. Methods: Conforming to systematic review and meta-analysis recommendations, we performed a meta-analysis of relevant articles in multiple databases, from inception till May 2022. Randomized clinical trials were included that evaluated the use of PRP alone or used PRP as an adjuvant with previously used therapies. Hair density data at the start of treatment and follow-up after 3 and 6 months was used for analysis. Results: A review of 255 articles included nine studies, for a cumulative data set of 230 individuals. In comparison to the placebo, stand-alone PRP therapy resulted in a significant increase in hair density (MD=25.39, P<0.00001.) PRP combination therapy also showed marked improvement in hair density compared to placebo (MD=34.38, P=0.002.) When comparing stand-alone PRP to combination therapy, MD=36.16, and MD=34.63 was observed for the two groups, respectively. Conclusions: The results of this meta-analysis reaffirm previous studies that suggest the role of PRP in improving hair density in AGA; however, the results cannot justify the use of PRP-combined therapy. Stand-alone PRP therapy should be considered in the management protocols for both men and women, whereas more studies and may be, different combination therapies are required before combined therapy can be included in the management guidelines for AGA.
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Metamaterial absorbers in the terahertz region are highly desirable in sensing and detection. In this work, a novel terahertz refractive index sensor based on metamaterial absorber for sensing biomedical samples is reported. The proposed structure consists of three asymmetrical metallic resonators made of gold placed above on a gallium arsenide (GaAs) dielectric layer. Due to high-intensity field confinement in the sensing regime, four resonance modes with nearly 100% absorption are achieved with a high Q-factor of 456.5 in the absorption spectra. The design absorber is highly sensitive to the change of refractive index of the surrounding medium. Furthermore, the proposed sensor exhibits extremely high sensitivity of 1.87 THz/RIU and high FOM of 125 RIU-1 in the refractive index range from 1.35 to 1.39 with fixed analyte thickness of 45 µm. The design RI sensor can be fitted for biomedical sensing applications such sensing and detection of various cancerous cell as the RI varied in the range of 1.35-1.39. In addition, the design sensor has the ability to sense early stage infection of cancer cells with any of its four absorption bands due to its high quality factor, high sensitivity and high figure of merit.
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Neoplasias , Refractometría , Oro , VibraciónRESUMEN
BACKGROUND: Degenerative cervical myelopathy (DCM) is a recently proposed umbrella term for symptomatic cervical spinal cord compression secondary to degeneration of the spine. Currently literature searching for DCM is challenged by the inconsistent uptake of the term 'DCM' with many overlapping keywords and numerous synonyms. OBJECTIVES: Here, we adapt our previous Ovid medline search filter for the Ovid embase database, to support comprehensive literature searching. Both embase and medline are recommended as a minimum for systematic reviews. METHODS: References contained within embase identified in our prior study formed a 'development gold standard' reference database (N = 220). The search filter was adapted for embase and checked against the reference database. The filter was then validated against the 'validation gold standard'. RESULTS: A direct translation was not possible, as medline indexing for DCM and the keywords search field were not available in embase. We also used the 'focus' function to improve precision. The resulting search filter has 100% sensitivity in testing. DISCUSSION AND CONCLUSION: We have developed a validated search filter capable of retrieving DCM references in embase with high sensitivity. In the absence of consistent terminology and indexing, this will support more efficient and robust evidence synthesis in the field.
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Almacenamiento y Recuperación de la Información , Enfermedades de la Médula Espinal , Humanos , MEDLINE , Minería de DatosRESUMEN
The goal of this study was to analyze the content availability and accessibility of preventive medicine residency program websites. In COVID-related travel restrictions, the information provided on program websites has become increasingly crucial for residency applicants. A cross-sectional study was conducted by extracting the list of preventive medicine residency programs on the Fellowship and Residency Electronic and Interactive Database (FRIEDA). A 40-point criterion was used for the quality evaluation of residency programs. The study was conducted and analyzed in 2021. 82 preventive medicine residency programs were identified, and listed on FRIEDA, out of which 65 program websites were accessible. The median number of 40-point criteria met by the preventive medicine residency website was 25. The criteria fulfilled by the greatest number of program websites was research opportunity/facilities (94%). The majority of the preventive medicine residency program websites were not up to the mark regarding accessibility and quality. An updated preventive medicine residency program website is essential for the applicants. Programs with relevant and precise information on their websites have higher chances of attracting potential candidates and better chances of finding the match between applicants and programs.
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Women with colorectal cancer (CRC) have survival advantages over men, yet the underlying mechanisms are unclear. T cell infiltration within the CRC tumor microenvironment (TME) correlates strongly with survival. We hypothesized that women with CRC have increased T cell infiltration and differential gene expression in the TME compared to men. Tissue microarrays comprising primary tumor, tumor infiltrated lymph nodes, and uninvolved colon were created from CRC patients. Proportions of CD4 positive (CD4+) and CD8 positive (CD8+) T cells were identified using immunohistochemistry. TME immune- and cancer-related genetic expression from primary and metastatic CRC tumor were also evaluated via the NanoStringIO360 panel and The Cancer Genome Atlas Project database. CD4+ was higher in tumor samples from women compared to men (22.04% vs. 10.26%, p=0.002) and also in lymph node samples (39.54% vs. 8.56%, p=0.001). CD8+ was increased in uninvolved colon from women compared to men (59.40% vs. 43.61%, p=0.015), and in stage I/II tumors compared to III/IV in all patients (37.01% vs. 23.91%, p=0.009). Top CD8+ tertile patients survived longer compared to the bottom (43.9 months vs. 25.3 months, p=0.007). Differential gene expression was observed in pathways related to Treg function, T cell activity, and T cell exhaustion, amongst several others, in women compared to men. Thus, significant sexual dimorphism exists in the TME that could contribute to survival advantages observed in female patients with CRC.
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Advanced anodic SnO2 nanoporous structures decorated with Cu2O nanoparticles (NPs) were employed for creatinine detection. Anodization of electropolished Sn sheets in 0.3 M aqueous oxalic acid electrolyte under continuous stirring produced complete open top, crack-free, and smooth SnO2 nanoporous structures. Structural analyses confirm the high purity of rutile SnO2 with successful functionalization of Cu2O NPs. Morphological studies revealed the formation of self-organized and highly-ordered SnO2 nanopores, homogeneously decorated with Cu2O NPs. The average diameter of nanopores is â¼35 nm, while the average Cu2O particle size is â¼23 nm. Density functional theory results showed that SnO2@Cu2O hybrid nanostructures are energetically favorable for creatinine detection. The hybrid nanostructure electrode exhibited an ultra-high sensitivity of around 24343 µA mM-1 cm-2 with an extremely lower detection limit of â¼0.0023 µM, a fast response time (less than 2 s), and wide linear detection ranges of 2.5-45 µM and 100 µM to 15 mM toward creatinine. This is ascribed to the creation of highly active surface sites as a result of Cu2O NP functionalization, SnO2 band gap diminution, and the formation of heterojunction and Cu(1)/Cu(ll)-creatinine complexes through secondary amines which occur in the creatinine structure. The real-time analysis of creatinine in blood serum by the fabricated electrode evinces the practicability and accuracy of the biosensor with reference to the commercially existing creatinine sensor. The proposed biosensor demonstrated excellent stability, reproducibility, and selectivity, which reflects that the SnO2@Cu2O nanostructure is a promising candidate for the non-enzymatic detection of creatinine.