Is there any difference between Eastern and Western clinical practice guidelines in management of gastric cancer?

BACKGROUND AND RECENT FINDINGS: Gastric cancer (GC) has been known as one of the most common causes of cancer mortality both in Western and Eastern countries. However, there might be differences between how it is managed in different countries. Thus, we aimed to investigate these differences. MATERIALS AND METHODS: The most well-known clinical guidelines in field of GC management including Korean GC Association (KGCA), Japanese GC Association (JGCA), National Comprehensive Cancer Network (NCCN), European Society for Medical Oncology (ESMO), British Society of Gastroenterology (BSG), and National Institute for health and Care Excellence (NICE) have been reviewed. RESULTS: The contents of these guidelines were categorized under eight headings including (1) genetic predisposition, (2) prevention, (3) management of gastric polyp, atrophy, dysplasia and metaplasia, (4) diagnosis, (5) pathology and molecular biology, (6) treatment, (7) supportive and palliative care, and (8) follow up. Difference in each section was discussed. CONCLUSION: Considering KGCA and JGCA as Eastern and NCCN, ESMO, BSG, and NICE as Western guidelines, it is revealed that both sets of guidelines share common practices such as prioritizing comprehensive diagnostic evaluations, personalizing treatment plans, and palliative care. However, main differences can be seen in treatment regimens, the adoption of newer therapies like immunotherapy, and the utilization of emerging techniques such as HIPEC. These differences reflect the diverse clinical landscapes, research focuses, and healthcare systems within these regions.

Application of Deep Learning in Generating Structured Radiology Reports: A Transformer-Based Technique.

Since radiology reports needed for clinical practice and research are written and stored in free-text narrations, extraction of relative information for further analysis is difficult. In these circumstances, natural language processing (NLP) techniques can facilitate automatic information extraction and transformation of free-text formats to structured data. In recent years, deep learning (DL)-based models have been adapted for NLP experiments with promising results. Despite the significant potential of DL models based on artificial neural networks (ANN) and convolutional neural networks (CNN), the models face some limitations to implement in clinical practice. Transformers, another new DL architecture, have been increasingly applied to improve the process. Therefore, in this study, we propose a transformer-based fine-grained named entity recognition (NER) architecture for clinical information extraction. We collected 88 abdominopelvic sonography reports in free-text formats and annotated them based on our developed information schema. The text-to-text transfer transformer model (T5) and Scifive, a pre-trained domain-specific adaptation of the T5 model, were applied for fine-tuning to extract entities and relations and transform the input into a structured format. Our transformer-based model in this study outperformed previously applied approaches such as ANN and CNN models based on ROUGE-1, ROUGE-2, ROUGE-L, and BLEU scores of 0.816, 0.668, 0.528, and 0.743, respectively, while providing an interpretable structured report.

Neural correlates in functional brain mapping among breast cancer survivors receiving different chemotherapy regimens: a qEEG/HEG-based investigation.

BACKGROUND: Post-chemotherapy cognitive impairment commonly known as 'chemobrain' or 'chemofog' is a well-established clinical disorder affecting various cognitive domains including attention, visuospatial working memory, executive function, etc. Although several studies have confirmed the chemobrain in recent years, scant experiments have evaluated the potential neurotoxicity of different chemotherapy regimens and agents. In this study, we aimed to evaluate the extent of attention deficits, one of the commonly affected cognitive domains, among breast cancer patients treated with different chemotherapy regimens through neuroimaging techniques. METHODS: Breast cancer patients treated with two commonly prescribed chemotherapy regimens, Adriamycin, Cyclophosphamide and Taxol and Taxotere, Adriamycin and Cyclophosphamide, and healthy volunteers were recruited. Near-infrared hemoencephalography and quantitative electroencephalography assessments were recorded for each participant at rest and during task performance to compare the functional cortical changes associated with each chemotherapy regimen. RESULTS: Although no differences were observed in hemoencephalography results across groups, the quantitative electroencephalography analysis revealed increased power of high alpha/low beta in left fronto-centro-parietal regions involved in dorsal and ventral attention networks in the Adriamycin, Cyclophosphamide and Taxol-treated group compared with the Taxotere, Adriamycin and Cyclophosphamide and control group. The Adriamycin, Cyclophosphamide and Taxol-treated cases had the highest current source density values in dorsal attention network and ventral attention network and ventral attention network-related centers in 10 and 15 Hz associated with the lowest Z-scored Fast Fourier Transform coherence in the mentioned regions. CONCLUSIONS: The negatively affected neurocognitive profile in breast cancer patients treated with the Adriamycin, Cyclophosphamide and Taxol regimen proposes presumably neurotoxic sequelae of this chemotherapy regimen as compared with the Taxotere, Adriamycin and Cyclophosphamide regimen.

Comparative Analysis of the Chemotherapy-Related Cognitive Impairments in Patients with Breast Cancer: A Community-Based Research.

This study aimed to evaluate the effects of two common chemotherapy regimens on breast cancer (BC) survivors' cognition. The participants comprised 35 patients with BC who underwent two chemotherapy regimens, AC-T and TAC, and 24 matched healthy volunteers. The participants were assessed regarding cognitive function through Addenbrooke's Cognitive Examination and Cambridge Brain Science tests. The results represent the AC-T regimen to be more toxic than the TAC in domains of language, concentration, and visuospatial working memory (P-value = 0.036, 0.008, and 0.031, respectively) and should be prescribed with caution in patients with BC suffering from baseline cognitive impairments.

Organ-specific or personalized treatment for COVID-19: rationale, evidence, and potential candidates.

Although extrapulmonary manifestations of coronavirus disease 2019 (COVID-19) are increasingly reported, no effective therapeutic strategy for these multisystemic complications is available due to a poor understanding of the pathophysiology of COVID-19 multiorgan involvement. In this study, differentially expressed genes (DEGs) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected extrapulmonary organs including human pluripotent stem cells (hPSCs)-derived liver organoids and choroid plexus organoids besides transformed lung alveolar (A549) cells were analyzed. First, pathway enrichment analysis was done to compare the underlying biological pathways enriched upon SARS-CoV-2 infection in different organs. Then, these lists of DEGs were used in a connectivity map (CMap)-based drug repurposing experiment. Also, protein-protein interaction (PPI) network analysis was done to compare the associated hub genes. The results revealed different biological pathways and genes responsible for SARS-CoV-2 multisystemic pathogenesis based on the organ involved that highlighted the need for considering organ-specific treatments or even personalized therapy. Besides, some FDA-approved drugs were proposed as the potential therapeutic candidates for each infected cell line.

Improved Visual Function in a Case of Ultra-low Vision following Ischemic Encephalopathy Using Transcranial Electrical Stimulation; A Brief Report.

OBJECTIVES: Cerebral visual impairment is amongst the key pathological causes of pediatric visual abnormalities often resulted from hypoxic-ischemic brain injury. Such an injury results in profound visual impairments which severely impairs patients' quality of life. Given the nature of the pathology, treatments are currently limited to rehabilitation strategies such as transcranial electrical stimulation and visual rehabilitation therapy. CASE DESCRIPTION: Here, we discussed an 11-year-old girl with cerebral visual impairment who underwent concurrent visual rehabilitation therapy, transcranial electrical stimulation, and pharmacological therapy resulting in her improved visual function. CONCLUSION: Given its beneficial effects, transcranial electrical stimulation may be sought as a potential add-on modality when strategizing visual rehabilitation therapy.

A connectivity map-based drug repurposing study and integrative analysis of transcriptomic profiling of SARS-CoV-2 infection.

AIMS: The recent outbreak of COVID-19 has become a global health concern. There are currently no effective treatment strategies and vaccines for the treatment or prevention of this fatal disease. The current study aims to determine promising treatment options for the COVID-19 through a computational drug repurposing approach. MATERIALS AND METHODS: In this study, we focus on differentially expressed genes (DEGs), detected in SARS-CoV-2 infected cell lines including "the primary human lung epithelial cell line NHBE" and "the transformed lung alveolar cell line A549". Next, the identified DEGs are used in the connectivity map (CMap) analysis to identify similarly acting therapeutic candidates. Furthermore, to interpret lists of DEGs, pathway enrichment and protein network analysis are performed. Genes are categorized into easily interpretable pathways based on their biological functions, and overrepresentation of each pathway is tested in comparison to what is expected randomly. KEY FINDINGS: The results suggest the effectiveness of lansoprazole, folic acid, sulfamonomethoxine, tolnaftate, diclofenamide, halcinonide, saquinavir, metronidazole, ebselen, lidocaine and benzocaine, histone deacetylase (HDAC) inhibitors, heat shock protein 90 (HSP90) inhibitors, and many other clinically approved drugs as potent drugs against COVID-19 outbreak. SIGNIFICANCE: Making new drugs remain a lengthy process, so the drug repurposing approach provides an insight into the therapeutics that might be helpful in this pandemic. In this study, pathway enrichment and protein network analysis are also performed, and the effectiveness of some drugs obtained from the CMap analysis has been investigated according to previous researches.

The dysregulation of microarray gene expression in cervical cancer is associated with overexpression of a unique messenger RNA signature.

BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) is the fourth most common cause of cervical cancer (CC). The aim of the present study was to investigate gene expression levels of previously identified transcriptional signatures for malignant and non-malignant CC. MATERIALS AND METHODS: To validate of previously analyzed microarray gene expression data, we selected two hub genes (CDK1 and PLK1) and four differentially expressed mRNAs that were common in pre-malignant-normal and malignant-pre-malignant networks (SMS, NNT, UHMK1 and DEPDC1). To this purpose, the study included women diagnosed histologically with malignant CC (n=15), pre-malignant (n=15), and normal subjects (n=15). The expression of six host genes and viral E6/E7 genes were measured by quantitative Real-Time PCR. RESULTS: The results showed higher expression of CDK1/PLK1 hub genes and SMS, NNT and UHMK1 genes in malignant CC group than non-malignant CC group and normal group. A positive correlation was observed between gene expression of viral E6/E7 oncogenes and UHMK1 gene. CONCLUSION: Dysregulation of several mRNA signatures are a common feature of CC and can be potentially used as diagnostic and prognostic biomarkers as well as can be applied to therapeutic targets for CC treatment.

Magnetic silica coated iron carbide/alginate beads: Synthesis and application for adsorption of Cu (II) from aqueous solutions.

In the present study, a novel and high efficient magnetic alginate beads containing Fe5C2@SiO2 nanoparticles (NPs) were synthesized and applied to remove Cu (II) ions from water. The synthesized Fe5C2@SiO2 NPs were characterized by scanning electron microscopy (SEM) and Transmission electron microscopy (TEM). The elemental content of the magnetic/alginate beads before and after Cu(II) adsorption was analyzed using energy dispersive X-ray spectroscopy (EDS). The influence of important factors such as pH, contact time and initial Cu (II) concentration on the adsorption capacity of magnetic/alginate beads was investigated. The maximum adsorption percent (97.4%) was attained in the pH range of 3-4 and the adsorbent dosage of 0.41 g/L in the Cu (II) concentration of 200 mg/L. Moreover, the maximum capacity of adsorption was compared with silica coated iron carbide alginate and alginate alone. The results showed with adding a 1 mg of silica coated iron carbide NPs to sodium alginate enhanced the adsorption capacity of copper ions to ca. 2 times. The Sips isotherm model was best fitted to the experimental data with the maximum adsorption capacity of 37.73 mg/g for each layer. The adsorption kinetic followed the pseudo-second order kinetic model. These results reveal that the alginate Fe5C2@SiO2 beads could be a candidate for copper ions removal from aqueous solutions.

Carbon nanotube-encapsulated drug penetration through the cell membrane: an investigation based on steered molecular dynamics simulation.

Understanding the penetration mechanisms of carbon nanotube (CNTs)-encapsulated drugs through the phospholipid bilayer cell membrane is an important issue for the development of intracellular drug delivery systems. In the present work, steered molecular dynamics (SMD) simulation was used to explore the possibility of penetration of a polar drug, paclitaxel (PTX), encapsulated inside the CNT, through a dipalmitoylphosphatidylcholine bilayer membrane. The interactions between PTX and CNT and between PTX and the confined water molecules inside the CNT had a significant effect on the penetration process of PTX. The results reveal that the presence of a PTX molecule increases the magnitude of the pulling force. The effect of pulling velocity on the penetration mechanism was also investigated by a series of SMD simulations, and it is shown that the pulling velocity had a significant effect on pulling force and the interaction between lipid bilayer and drug molecule.