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Background: Little is known about the effectiveness and implementation of psychosocial interventions for psychosis in low- and middle-income countries (LMICs). In South Asia, specialist psychiatric resources are scarce. Support for psychosis often falls on the family or caregiver which can increase feelings of burden, impact caregivers' wellbeing, and increase mental health stigma. Psychosocial interventions are increasingly used for psychosis in South Asia and could reduce relapse and symptoms, reduce caregiver burden, conserve cost and resources. The aim of this review was to appraise the effectiveness and implementation readiness of psychosocial interventions for people with psychosis in South Asia. Method: A systematic search was conducted on MEDLINE, PsycINFO, Global Health, and Web of Science. The review was prospectively registered on PROSPERO (CRD42022329254). Studies were rated on two scales assessing quality and implementation readiness. Results: Twenty-six papers were included, nine intervention-types including community-based interventions/assertive outreach; CaCBTp; FAP; psychoeducation; cognitive retraining/rehabilitation; social cognition/skills; family/ caregiver intervention; telehealth intervention; yoga-based intervention in six South Asian countries. Findings suggest a multicomponent community-based intervention (MCBI) was the most implementation ready due to its standardisation, good clinical outcomes for patients and caregivers, and training and cost evaluations. Conclusion: Of the included studies, MCBI and community-based outreach interventions utilising lay health workers appear to be the most implementation ready and are suggested to best address the treatment gap in South Asia. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the performance of two different cell separators used for plateletpheresis at our facility. This evaluation was done to ascertain which cell separator performed better in terms of various product parameters. Study Design: Cross Sectional study. Setting: National Hospital, Lahore. Period: July to December 2020. Material & Methods: A total of 100 plateletapheresis procedures were done, 50 on Cobe Spectra and 50 on Haemonetics MCS900. Male donors were selected after detailed medical history, screening and informed consent. For each cell separator, the total procedure time, collection rate and platelet yield of the final product (single donor platelets) was noted and compared. The predonation platelet count of each donor was also recorded. Results: Donor turnaround time was better for the Cobe 60.1 + 2.757 min vs 81.1 + 3.311 min on Heamonetics (p value < 0.0001). Cobe had a superior collection rate 0.065+0.0088 (PLTÃ--10 11/min) than Heamonetics 0.0519 + 0.007 (PLTÃ--10 11/min) (p value< 0.0001). For both cell separators, the final product was similar in terms of platelet yield (p value = 0.56). Overall, donor predonation platelet counts ranged from 220-480x109/L. Pearson correlation test showed positive correlation (r = 0811, p value; < 0.0001) between platelet yield and donor platelet count. Conclusion: Continuous flow cell separators, like the Cobe spectra, offer a high quality platelet product with greater efficiency when compared to intermittent flow cell separators like the Haemonetics. [ABSTRACT FROM AUTHOR]

Background: Disadvantaged populations (such as women from minority ethnic groups and those with social complexity) are at an increased risk of poor outcomes and experiences. Inequalities in health outcomes include preterm birth, maternal and perinatal morbidity and mortality, and poor-quality care. The impact of interventions is unclear for this population, in high-income countries (HIC). The review aimed to identify and evaluate the current evidence related to targeted health and social care service interventions in HICs which can improve health inequalities experienced by childbearing women and infants at disproportionate risk of poor outcomes and experiences. Methods: Twelve databases searched for studies across all HICs, from any methodological design. The search concluded on 8/11/22. The inclusion criteria included interventions that targeted disadvantaged populations which provided a component of clinical care that differed from standard maternity care. Results: Forty six index studies were included. Countries included Australia, Canada, Chile, Hong Kong, UK and USA. A narrative synthesis was undertaken, and results showed three intervention types: midwifery models of care, interdisciplinary care, and community-centred services. These intervention types have been delivered singularly but also in combination of each other demonstrating overlapping features. Overall, results show interventions had positive associations with primary (maternal, perinatal, and infant mortality) and secondary outcomes (experiences and satisfaction, antenatal care coverage, access to care, quality of care, mode of delivery, analgesia use in labour, preterm birth, low birth weight, breastfeeding, family planning, immunisations) however significance and impact vary. Midwifery models of care took an interpersonal and holistic approach as they focused on continuity of carer, home visiting, culturally and linguistically appropriate care and accessibility. Interdisciplinary care took a structural approach, to coordinate care for women requiring multi-agency health and social services. Community-centred services took a place-based approach with interventions that suited the need of its community and their norms. Conclusion: Targeted interventions exist in HICs, but these vary according to the context and infrastructure of standard maternity care. Multi-interventional approaches could enhance a targeted approach for at risk populations, in particular combining midwifery models of care with community-centred approaches, to enhance accessibility, earlier engagement, and increased attendance. Trial registration: PROSPERO Registration number: CRD42020218357. [ABSTRACT FROM AUTHOR]

In 2020, the authors of this article published "Abolition Medicine" as one contribution to international abolitionist conversations responding to widespread anti-Black police violence and inequity laid bare by the COVID-19 pandemic. Over the past year, there has been a surge of efforts to abolish deeply embedded patterns of race-based oppression in policing and incarceration in the United States. In this essay, the authors continue to explore how health care can join these conversations and move toward a praxis of health justice. Using the framework of Ruth Wilson Gilmore's organized abandonment, the article revisits grassroots organizations and efforts that have been engaging in abolitionist health care all along. It also looks to current and emerging abolitionist policies and practices operating at the margins of status quo health care for models of abolition in medicine. [ABSTRACT FROM AUTHOR]

Nerve growth factor (NGF) is a neurotrophin that plays a critical role in mammalian learning and memory functions. NGF also regulates neuronal cell differentiation and neurite outgrowth by activating ERK/CREB signaling. This present study examined the effects of a standardized Dioscorea extract (DA-9801), which is composed of Dioscorea japonica Thunb and Dioscorea nipponica Makino on memory function via its NGF-potentiating activities using an in vitro and in vivo paradigm. Cells were incubated with or without different concentrations of DA-9801 (10, 25, and 50 μg/ml) extract for 24 h. The cultured conditioned medium from C6 glioma cells was used for NGF production assay, and neurite length in N2a cells was measured after every 2 h. Mice were orally treated with DA-9801 (10 and 100 mg/kg/day) once daily for 7 days. They were subjected to passive avoidance test to evaluate memory functions. The question of whether DA-9801 induced NGF synthesis was assessed by measuring the levels of NGF in the mouse cortical and hippocampal tissues. Hippocampal cell differentiation and NGF-mediated ERK/CREB signaling were evaluated by performing immunohistochemical analysis using BrdU, ki67, DCX, phosphorylated ERK and CREB in the mouse hippocampus. DA-9801 treatment increased the NGF contents and neurite length, respectively. Mice with DA-9801 administration showed memory enhancement in the passive avoidance test. DA-9801 also increased newborn cell differentiation, neurite length, NGF secretion, and ERK/CREB phosphorylation in the mouse hippocampus. These results suggest that DA-9801 treatment could improve memory function by inducing hippocampal NGF synthesis and ERK/CREB signaling. [ABSTRACT FROM AUTHOR]

Background: UK maternity policy advocates a choice of birthplace in an obstetric-led unit (OU), a midwife-led unit (MLU) or at home. Although robust evidence supports the safety of birth in midwife-led settings, particularly for women with uncomplicated pregnancies, most births are in the OU. Women and babies from ethnic minority communities experience major health disparities and inequitable care, but there is limited research examining birthplace choices through an ethnicity lens. This study investigated the association between ethnicity and place of birth at an urban NHS Trust in England. Methods: A mixed-methods sequential explanatory study. Analysis of births from 2014–2023 at a London NHS Trust included multivariable logistic regression analysis of birthplace by ethnicity. Planned or pre-labour Caesareans, pre-term, and multiple births were excluded. Significant disparities between White and South Asian women were identified which informed the focus of the qualitative study. Semi-structured interviews with 10 women of South Asian heritage who had given birth in the OU, the alongside MLU or at home were conducted and analysed thematically. Results: More White women gave birth in midwife-led settings (27.5%) than all other ethnicities, particularly South Asian women (20.6%). South Asian women had fewer homebirths (0.8%) than White women (2.7%) and were much less likely to birth in a midwife-led setting after adjusting for parity, maternal age, BMI, previous Caesarean, presence of diabetes or hypertensive disorders and onset of labour (aOR 0.61, 95% CI 0.51–0.73, p < 0.001). Places of birth were similar for Black and White women, although the number of Black women in the population was too low to detect significant differences. Themes generated from interviews included the assumption that birth is hospital-based and doctor-led; choosing a midwife-led birth setting went against the cultural norm, but felt safe – physically, psychologically and culturally. Conclusions: There are ethnic disparities in place of birth. Cultural factors seem influential, but barriers to choice, such as limited evidence-sharing by midwives, may disproportionately affect women from ethnic minority communities, who may particularly benefit from midwife-led birth settings. Women need personalised information about options. Improving choice of birthplace is a step towards reducing health inequalities and promoting optimal health. [ABSTRACT FROM AUTHOR]

Consent in ante-natal and birthing contexts is often challenging, controversial and poorly understood. Increasing evidence indicates that ethnic minority women's overall experiences of ante-natal care are unsatisfactory, but little is known about their involvement in the consent process. This study aims to explore the views and experiences of ethnic minority women when making decisions requiring their consent. Qualitative interview study A national study conducted in the UK Seventeen self-selecting ethnic minority women who had given birth in a UK hospital in the previous 12 months. In-depth telephone interviews with seventeen women. A thematic analysis was conducted with a focus on women's experiences of the consent process. Three themes were identified. 1. Compromised choice: women experienced limited choice; some women were not asked for their consent at all, or consent was presumed. 2. Pressured consent and silencing: women reported feeling undermined and 'othered' based on their ethnicity. 3. Impersonal consent: discussions were impersonal and not tailored to women as individuals; some women suggested that healthcare professionals ignored cultural concerns which were important to them. There is an urgent need for healthcare professionals to be supported in actively facilitating consent consultations which enable women from ethnic minority backgrounds to freely voice their concerns and priorities without censure. This exploratory study is a first step towards understanding how consent is experienced by ethnic minority women. Many women's experiences reflected failure of healthcare professionals to support genuine choice-making which was perceived to be further undermined by negativity related to women's ethnicity and cultural identity. There is a need for further research focusing on the consent experiences of specific ethnic minority groups. • EM women express a range of serious concerns in relation to consent consultations. • EM women want to have their voices 'heard'. • HCPs need improved support to respectfully facilitate, culturally sensitive consultations which enable women to actively participate in decision making. [ABSTRACT FROM AUTHOR]

Background: Papillary thyroid carcinoma (PTC) comprises the majority of thyroid malignancy, but it is associated with excellent long-term survival. Highly prevalent, with increasing incidence, the optimal operative management for patients with 1- to 4-cm PTC remains unclear. This study determined factors that affect clinical outcomes, including survival, in this patient population.Study Design: Patients with 1- to 4-cm PTC, who underwent thyroidectomy between 2004 and 2016, were identified in the National Cancer Database (NCDB). Factors affecting survival, including margin status, extent of resection, operative volume, and institution type, were studied. Outcomes were estimated by Kaplan-Meier and log rank tests. Cox proportional hazard and binary logistic regression analyses identified factors affecting survival as well as margin positivity.Results: Of 14,471 patients with 1- to 4-cm PTC, 2,269 (15.7%) exhibited lymphovascular invasion, 6,925 (47.9%) had multifocality, 14,235 (98.3%) underwent total thyroidectomy, and 2,212 (15.3%) had microscopic margin positivity, which conferred lower survival (hazard ratio [HR] 1.464, p < 0.05), with 30-day and 90-day mortality of 0.1% and 0.2%, respectively. Operative volume (odds ratio [OR] 0.979, p < 0.01) and thyroid surgery at an academic center (OR 0.623, p < 0.001) were associated with lower odds of margin positivity.Conclusions: In patients with 1- to 4-cm PTC, margin positivity confers lower survival. Factors associated with lower rate of margin positivity are higher operative volume and referral for treatment at academic center. Because margin positivity is a modifiable risk factor, referral of patients with aggressive features of PTC to high volume academic centers may improve survival. [ABSTRACT FROM AUTHOR]

Background: Black, Asian, and minority ethnic (BAME) women have significantly higher morbidity and mortality rates in the UK as well as poorer experiences of care. To date, a systematic literature review has not been undertaken in the UK to explore ethnicity based health inequalities. Aim: To explore the maternal health inequalities encountered by BAME women in the UK in relation to their experiences and use of services. Method: A systematic literature search was conducted via five databases (PubMed, MEDLINE, CINAHL, MIDIRS and BNI). Inclusion-exclusion criterion and a keyword strategy were implemented to screen for literature published between 2013–2018. Findings: A total of eight studies with various ethnicities and geographical locations were included. Five themes emerged following thematic analysis: communication, midwife-woman relationship, healthcare services and systems, culture and social needs. Conclusion: The review identified consistency within and across the five themes. Maternity services and systems is a predominant theme that has a residual effect on the remaining four themes. [ABSTRACT FROM AUTHOR]

The present research work is focused on development and characterization of copolymerized pectin sulfonic acid hydrogels and to evaluate controlled delivery of captopril. Series of pectin–sulfonic acid-based hydrogels were synthesized by free radical copolymerization technique. Pectin has been chemically cross-linked with 2-acrylamido-2-methylpropane sulfonic acid in the presence of ammonium persulfate and sodium metabisulfite as redox initiator. Methylene bisacrylamide (MBA) was used as cross-linking agent in varying amount to investigate the degree of cross-linking as a function of increased concentration of polymer (pectin) and monomer (AMPS). Captopril was incorporated as model drug in formulated hydrogels. Fourier transform infrared spectroscopy (FTIR) was performed for structural analysis. In vitro swelling and release studies of captopril were carried out at both pH 1.2 and 7.4. Sol–gel fraction was also calculated to determine the amount of uncross-linked polymer fraction in prepared hydrogels. FTIR analysis confirmed the formation of cross-linked network between polymer (pectin) and monomer (AMPS). All formulations showed pH-dependent swelling behavior because of pectin, and drug release pattern was high at pH 1.2, and prolonged release was observed at pH 7.4 because of pH-independent behavior of sulfonic acid. The results of sol–gel analysis confirmed that gel fraction increases as amount of AMPS and MBA was increased. From current research study, it is concluded that stable formulations of pectin–sulfonic acid were formed by optimized copolymerization reaction. This newly developed polymeric network could serve as a potential system for controlled delivery of captopril for prolonged period. [ABSTRACT FROM AUTHOR]

Intraoperative parathyroid hormone monitoring (IPM) has been shown to be a useful adjunct during parathyroidectomy to ensure operative success at many specialized medical centers worldwide. Using the Miami or ">50% intraoperative PTH drop" criterion, IPM confirms the complete excision of all hyperfunctioning parathyroid tissue before the operation is finished, and helps guide the surgeon to identify additional hyperfunctioning parathyroid glands that may necessitate further extensive neck exploration when intraoperative parathyroid hormone (PTH) levels do not drop sufficiently. The intraoperative PTH assay is also used to differentiate parathyroid from non-parathyroid tissues during operations using fine needle aspiration samples and to lateralize the side of the neck harboring the hypersecreting parathyroid through differential jugular venous sampling when preoperative localization studies are negative or equivocal. The use of IPM underscores the recognition and understanding of sporadic primary hyperparathyroidism (SPHPT) as a disease of function rather than form, where the surgeon is better equipped to treat such patients with quantitative instead of qualitative information for durable long-term operative success. There has been a significant paradigm shift over the last 2 decades from conventional to focused parathyroidectomy guided by IPM. This approach has proven to be a safe and rapid operation requiring minimal dissection performed in an ambulatory setting for the treatment of SPHPT. [ABSTRACT FROM AUTHOR]

• Three new bis-thioglycosyl-1,1′-disulfides were isolated from Nasturtium officinale. • The chemical constituents of the isolates were elucidated using NMR and MS data. • Compound 5 exhibited significant inhibition activity of NO production with IC 50 value of 21.30 µM. As a part of our continuing search for bioactive constituents from Brassicaceae family, three new bis-thioglycosides (1 – 3) were isolated from the 80% MeOH extract of Nasturtium officinale , together with 13 known compounds (4 – 16). The chemical structures of three new bis-thioglycosides (1 – 3) were elucidated using NMR techniques (1H and 13C NMR, 1H–1H COSY, HSQC, and HMBC), HRESIMS, and a chemical method. All the compounds were evaluated for their inhibitory effects on nitric oxide (NO) levels in lipopolysaccharide (LPS)-stimulated murine microglia BV-2 cells. Among the isolates, compound 5 exhibited a strong inhibitory effect on NO production, and compounds 4 and 15 showed moderate inhibitory activities, suggesting the neuroprotective and anti-neuroinflammatory effects of bis-thioglycosides from N. officinale. [ABSTRACT FROM AUTHOR]

Abstract Background Parathyroidectomy guided by intraoperative parathormone (ioPTH) monitoring for primary hyperparathyroidism (pHPT) confirms removal of all hyperfunctioning parathyroid glands. This study evaluates the utility of an additional 20-min ioPTH measurement in patients who fail to meet the >50% ioPTH drop criterion. Methods A retrospective review of prospectively collected data of 706 patients with pHPT who underwent parathyroidectomy guided by ioPTH monitoring was performed. When a >50% ioPTH decrease from the highest either preincision or preexcision level was achieved after 10 min, parathyroidectomy was completed. If this criterion was not met, further exploration was performed or an additional 20-min ioPTH measurement was obtained. Results Of 706 patients, 72 (10%) patients did not meet the >50% ioPTH drop criterion at 10 min. Of these patients, 67% (48/72) underwent immediate bilateral neck exploration (BNE). For the other 33% of patients (24/72), a 20-min parathormone (PTH) measurement was drawn. Of patients with an additional 20-min PTH measurement, 46% (11/24) had a >50% ioPTH decrease at 20 min where BNE was avoided and parathyroidectomy completed, whereas 54% (13/24) did not. Compared to patients with insufficient ioPTH drop at 10 min and subsequent BNE, there was a statistically significant 46% reduction of BNE in patients with a 20-min PTH level (P < 0.01). Conclusions A 20-min ioPTH measurement is useful in preventing unnecessary BNE in some patients who undergo focused parathyroidectomy with a delayed >50% ioPTH drop. [ABSTRACT FROM AUTHOR]

Aim: This study described the steps needed to achieve full oral feeding before discharge in a group of very and extremely preterm (EPT) infants. We analysed the effects of oral feeding skills on discharge timing and on weight gain during their neonatal intensive care unit (NICU) stay.Methods: A prospective cross-sectional observational study of 100 infants who were <32 weeks of gestation (GA) was conducted at the Division of Neonatology, Graz, Austria, from March 2014 to February 2015. Patients were stratified into two groups: those who were <28 weeks at birth and those who were 28 weeks and over. Velocity of oral feeding skills attainment and weight gain were analysed.Results: All infants successfully acquired oral feeding skills during hospitalisation. The median GA at which full oral feeding skills were reached was 37 + 1 weeks in EPT and 34 + 5 weeks in very preterm infants. More immature neonates showed worse feeding performances and lower weight increments during oral feeding steps.Conclusion: Our study confirmed the role of GA in the development of oral feeding skills in the most premature babies. It also raises the question of whether expected daily weight gain should be targeted according to GA. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the utility of immature platelet fraction (IPF) as a marker in immune thrombocytopenia purpura (ITP) patients. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Haematology, Chughtai Institute of Pathology, Lahore Pakistan, from Aug to Nov 2020. Methodology: Sixty patients (Group-1) of immune thrombocytopenia purpura were selected. Sixty healthy individuals (Group-2) with normal blood count parameters were also included. A complete blood count with simultaneous evaluation of immature platelet fraction was performed for both groups on 3ml peripheral blood collected in K2EDTA. To check the reproducibility of results, each sample was run in duplicate. Results: Group-1 had a mean platelet count of 43.77±32.82 x109 /L (range 2-98x109/L), a mean immature platelet fraction of 12.93±6.11% (range 3-25%) and a mean age 36.68±7.53 years, (range 22-56 years). Group-2 had a mean platelet count of 251.7±83.55 x109 /L (range 150-450 x109 /L), a mean immature platelet fraction of 3.78±1.86 %, (range 1-7.2%) and a mean age of 36.42±6.94 years, (range 22-55 years). ROC curve analysis yielded an immature platelet fraction value of 7.0% as the cut-off between immune thrombocytopenic purpura patients and healthy individuals. Conclusion: Immature platelet fraction, though novel, is a useful marker to diagnose and monitor treatment response, diagnosis and management of immune thrombocytopenic purpura. [ABSTRACT FROM AUTHOR]

Four undescribed neolignan analogs, together with eight known compounds, were isolated from the twigs of Pinus koraiensis (Korean pine). The chemical structure of the isolated compounds was determined through extensive spectroscopic analysis and chemical method. Their relative and absolute configurations were assigned through a well-established empirical rule and electronic circular dichroism (ECD) analysis, respectively. Four compounds (3 and 9 – 11) at 20 μM concentration showed significant neurotrophic effect by inducing nerve growth factor (NGF) secretion in C6 cells with the stimulation levels a range of 140.82 ± 4.62% to 160.04 ± 11.04%. Additionally, the result indicated that the glycosylation of neolignan led to an improvement in neurotrophic activity compared to their aglycone form. A compound (7) inhibited nitric oxide production with an IC 50 value of 31.74 μM in LPS-activated BV2 cells. Twelve neolignans, including four undescribed compounds, were isolated from the twigs of Pinus koraiensis and their neurotrophic and anti-inflammatory activities were assessed. [Display omitted] • Four undescribed neolignans were isolated from the twigs of Pinus koraiensis. • The chemical structures established by spectroscopic analysis. • The stereochemistry was elucidated through an empirical rule and ECD analysis. • Some isolates showed neurotrophic activity by inducing NGF secretion in C6 cells. [ABSTRACT FROM AUTHOR]

Pericardial tuberculoma is a rare complication of tuberculous pericarditis. It may mimic a compressive mediastinal mass, often misinterpreted as a mediastinal tumour. Since, it arises from the pericardium, pericardial tuberculoma invariably compresses structures of the heart and may present with features of either-sided heart failure depending on the side of the compression. Hereby, the authors present a case of a 52-year-old woman with progressive difficulty in breathing and symptoms of right-sided heart failure as well as clinical signs of impending cardiac tamponade following a history of extra-pulmonary tuberculosis. Echocardiogram examination revealed a mass compressing the right side of the heart but was inconclusive of the mass origin. CT-Scan of the chest showed a mass arising from the pericardium. The mass was later surgically excised. Histopathology confirmed pericardial tuberculosis and a diagnosis of a pericardial tuberculoma was reached. Patient's heart failure symptoms regressed after surgery and she was discharged to continue with anti-tuberculosis regime. This report discusses the inclusion of pericardial tuberculoma in the differential diagnoses of cardiac compressing masses, particularly in tuberculosis-endemic areas and emphasize on prompt CT-scan imaging when echocardiogram is inconclusive. [ABSTRACT FROM AUTHOR]

Background: Contrast-induced nephropathy (CIN) is a major drawback in percutaneous coronary intervention (PCI). Significant uricosuria has been reported following contrast exposure. Allopurinol-a xanthine oxidase inhibitor-has been suggested to prevent the formation of oxygen-free radicals, which may contribute to CIN. The aim of the present study was to evaluate the possible efficacy of allopurinol in preventing CIN. Methods: In this double-blind placebo-controlled trial, patients with an estimated glomerular filtration rate ≥60 mL/min who were admitted for elective PCI, were randomized to receive either allopurinol 600 mg or a placebo administered 24 h before the procedure, and again immediately before the procedure. Blood samples were drawn at 24 h before and 24 h after contrast exposure to measure serum creatinine (SCr), uric acid, and serum cystatin-c. Results: The baseline characteristics were almost similar between the placebo and allopurinol groups. The overall change in SCr and the rate of CIN, which is defined as ≥25% increase in serum cystatin-c relative to baseline, failed to show a significant difference between the two groups. When adjusted on the baseline cystatin-c, SCr, sex, and positive family history, the difference in the overall increase in serum cystatin-c was statistically significantly lower in the allopurinol group. Conclusions: Allopurinol administration in patients undergoing PCI failed to show efficacy in preventing CIN. Nevertheless, this effect should be further evaluated in the patient population with chronic kidney disease. [ABSTRACT FROM AUTHOR]

Due to their beneficial effects in an array of diseases, Mesenchymal Stromal Cells (MSCs) have been the focus of intense preclinical research and clinical implementation for decades. MSCs have multilineage differentiation capacity, support hematopoiesis, secrete pro-regenerative factors and exert immunoregulatory functions promoting homeostasis and the resolution of injury/inflammation. The main effects of MSCs include modulation of immune cells (macrophages, neutrophils, and lymphocytes), secretion of antimicrobial peptides, and transfer of mitochondria (Mt) to injured cells. These actions can be enhanced by priming (i.e., licensing) MSCs prior to exposure to deleterious microenvironments. Preclinical evidence suggests that MSCs can exert therapeutic effects in a variety of pathological states, including cardiac, respiratory, hepatic, renal, and neurological diseases. One of the key emerging beneficial actions of MSCs is the improvement of mitochondrial functions in the injured tissues by enhancing mitochondrial quality control (MQC). Recent advances in the understanding of cellular MQC, including mitochondrial biogenesis, mitophagy, fission, and fusion, helped uncover how MSCs enhance these processes. Specifically, MSCs have been suggested to regulate peroxisome proliferator-activated receptor-gamma coactivator 1 alpha (PGC1α)-dependent biogenesis, Parkin-dependent mitophagy, and Mitofusins (Mfn1/2) or Dynamin Related Protein-1 (Drp1)-mediated fission/fusion. In addition, previous studies also verified mitochondrial transfer from MSCs through tunneling nanotubes and via microvesicular transport. Combined, these effects improve mitochondrial functions, thereby contributing to the resolution of injury and inflammation. Thus, uncovering how MSCs affect MQC opens new therapeutic avenues for organ injury, and the transplantation of MSC-derived mitochondria to injured tissues might represent an attractive new therapeutic approach. [ABSTRACT FROM AUTHOR]

Context: Hyperbilirubinemia due to glucose 6 phosphate dehydrogenase (G6PD) deficiency can cause permanent neurological damage and death in neonates. Screening for the enzyme enables timely diagnosis and treatment in cases of G6PD related kernicterus. Knowledge of patient G6PD status is also important in treatment of malaria, a disease endemic in Pakistan. World Health Organization recommends mandatoryuse of primaquine for radical cure and eradication of malaria. Since, Primaquine, causes hemolysis in G6PD deficient cases, widespread adoption of the drug is viewed with caution. Aims: This study assessed frequency of G6PD deficiency in Pakistani noenates and examines the need for its screening based on local disease prevalence and malaria endemicity. Settings and Design: A cross sectional study was carried at Hematology Department, Army Medical College (NUST), in collaboration with Military Hospital, Rawalpindi, Pakistan.(January - August, 2011). Methods and Material: The frequency of G6PD deficiency in newborn population was determined by quantitative (spectrophotometric) method. Cord blood (2.5 ml blood in K3EDTA bottle) samples were obtained from 240 newborns (male: female 1.2:1) after informed consent from parents. Statistical analysis used: Data obtained was analyzed using SPSS Windows version 17. Results: Frequency of G6PD deficient cases was 4.2%. Among the ten G6PD deficient patients, six had severe enzyme deficiency (<10% enzyme activity). Conclusions: The local prevalence of G6PD deficiency and its potential complications qualify it as a disease that must be screened for. Also, prior knowledge of patient G6PD status enables the physician to revert to modified treatment regimen for malaria only in enzyme deficient cases and not otherwise. [ABSTRACT FROM AUTHOR]

The newly identified tripartite motif (TRIM) family of proteins mediate innate immunity and other critical cellular functions. Here we show that TRIM21, which mediates the autoimmune diseases rheumatoid arthritis, systemic lupus erythematosus, and Sjögren's syndrome, is a previously undescribecl lgG receptor with a binding mechanism unlike known mammalian Fcγ receptors. TRIM21 simultaneously targets conserved hot-spot residues on both Ig domains of the Fc fragment using a PRYSPRY domain with a preformed multisite interface. The binding sites on both TRIM21 and Fc are highly conserved to the extent that the proteins are functionally interchangeable through murine, canine, primate, and human species. Pre-steady-state analysis exposes mechanistic conservation at the level of individual residues, which make the same energetic and kinetic contributions to binding despite varying in sequence. Together, our results reveal that TRIM21 is a previously undescribed type of IgG receptor based on a non-Ig scaffold whose interaction at the fundamental level—structural, thermodynamic, and kinetic—is evolutionarily conserved. [ABSTRACT FROM AUTHOR]

Excess amount of cadmium (Cd) in arable soils and shortage of good quality water are the major abiotic factors affecting the crop yield which needs immediate solution to feed the increasing population worldwide. Recently, nanoparticles (NPs) are widely used in various industries including agriculture which is due to the unique properties of NPs. Among NPs, iron (Fe) NPs might be used to alleviate the abiotic stresses in crops but limited informations are available in the literature about the role of Fe-NPs in crops under metal stress. The present study was designed to highlight the efficiency of Fe-NPs on Cd accumulation in Cd and drought-stressed wheat. Wheat plants were grown in Cd-contaminated soil after the supply of different levels of Fe-NPs and two water regimes were introduced in the soil in latter growth stages of the plants. Cadmium and drought stress negatively affected the wheat photosynthesis, yield and caused oxidative stress in leaves with excess accumulation of Cd in grains and other plant tissues. The NPs improved the photosynthesis, yield, Fe concentrations and diminished the Cd concentrations in tissues. The NPs alleviated the oxidative stress in leaves and the efficiency depends on the NPs concentrations applied in the soil. The results obtained indicated that Fe-NPs may be employed aiming to get wheat grains with excess Fe and decreased Cd contents. However, field investigations with various sizes, shapes and levels of NPs are needed before final recommendations to the farmers. • Combined cadmium (Cd) and drought decreased the yield of wheat. • Drought stress increased the Cd concentration in grains of wheat. • Iron oxide nanoparticles (Fe NPs) increased the wheat growth under Cd + drought stress. • Fe NPs increased photosynthesis and reduced oxidative stress in Cd and drought-stressed wheat. • Fe NPs decreased Cd and increased Fe concentrations in wheat grains. [ABSTRACT FROM AUTHOR]

Background: Parathyroidectomy is frequently performed as ambulatory surgery. This study seeks to characterize the socioeconomic factors that may impact the patient selection for outpatient parathyroidectomy. Methods: The 2016 Florida State Inpatient Database (SID) and the 2016 Florida State Ambulatory Surgery Database (SASD) were queried for all patients undergoing parathyroidectomy using the International Classification of Diseases 10 (ICD-10) procedure codes. Univariable comparison and multivariate logistic regression were performed for outpatient versus inpatient parathyroidectomy using all relevant patient and hospital characteristics from the database. Results: Seven hundred and sixteen patients underwent parathyroidectomy in Florida in 2016; 322 parathyroidectomies were performed in the ambulatory setting (45.0%). After multivariate logistic regression, patients over age 65 and parathyroidectomies performed at high-volume centers were more likely to be performed at an outpatient center. Those patients who were black, Hispanic, had a Charlson Comorbidity Index ≥3, Medicare, Medicaid, and Self-pay were associated with a decreased likelihood of having an outpatient procedure. Discussion: Access to ambulatory parathyroidectomy is more common in patients with private insurance, white ethnicity, and fewer comorbidities. [ABSTRACT FROM AUTHOR]

Polymerization/cracking and the reaction of intermediates with steam are the main routes by which the coke of very different properties might formed in steam reforming of acetic acid. This was investigated herein by conducting the steam reforming and decomposition of acetic acid on Ni/SBA-15 at 400, 550 and 700 °C, with particular focus on investigating the nature of resulting coke. Decomposition generated more coke than steam reforming at 400 °C (79.1% versus 24.6%), 550 °C (73.0% versus 45.6%) or 700 °C (39.0% versus 6.8%). More carbonaceous species like *CH x and *C C were the main intermediates, precursors of aromatic coke in decomposition, and their concentration on the catalyst surface let to serious coking at 550 °C, however, in steam reforming, oxygen-containing species like C O or C-O-C where the main intermediates precursors of coke. While larger outer diameter of carbon nanotube was formed in the reaction at 550 °C, smooth surface was formed at 700 °C. [Display omitted] • More O-containing species formed in reforming and more *CH x /*C=C in decomposition. • Higher abundance of carbonaceous intermediates was formed in decomposition. • Coking was significant at 550 °C, both in steam reforming and decomposition. • Coke from decomposition experiment was more aromatic. • Nanotube form of coke formed at 550 °C has rough surface and large diameters. [ABSTRACT FROM AUTHOR]

Objective: To compare the serum selenium levels in anemic and non-anemic Pakistani children. Study Design: Case-control Prospective study. Setting: PAEC General Hospital, Islamabad, Pakistan. Period: 1st March 2022 to 31st August 2022. Methods: A case control study was conducted wherein comparison of Selenium levels in anemic and non anaemic Pakistani children was investigated. Age, serum selenium level and haemoglobin were the quantitative variables of this study and were subjected to median and standard deviation. Severity of anemia, mean being qualitative (ordinal) variables were expressed in terms of percentages. Bar graph and tables were used to display results. Chi square test was applied to compare both the groups. Odd ratios were also calculated. A total of 60 samples from anemic and control population were selected using consecutive non-probability sampling method. Selenium levels of the serum were determined using atomic absorption spectrometry. SPSS 19 version software was used for data analysis. Results: The findings in this study indicated that 33% of cases were Selenium deficient, while 27% among controls had low Selenium levels. (p=0.57). Conclusion: This study showed no association of selenium deficiency with anaemia. [ABSTRACT FROM AUTHOR]

Background: The rising incidence of thyroid cancer has been attributed to increased detection of papillary thyroid microcarcinoma (PTMC). Although some PTMCs are thought to harbor aggressive pathologic features, the clinical significance of these features remains unclear. This study examines factors associated with survival in this patient population.Study Design: Adults with PTMC, defined as papillary thyroid carcinoma ≤ 1.0 cm, who underwent thyroidectomy between 2004 and 2016, were identified in the National Cancer Database. Demographic and clinical variables were analyzed. The primary aim was to identify factors associated with survival. The secondary aim was to assess the association of microscopic margins on survival and to identify factors associated with margin positivity. Overall survival was estimated using Kaplan-Meier methods and compared using log rank tests. Cox proportional hazards and binary logistic regression models identified factors associated with survival and margin positivity, respectively.Results: Of 77,817 patients with PTMC, 13,507 met inclusion criteria; 2,649 (20%) of these patients presented with advanced features: extrathyroidal extension (n = 916, 7%), lymphovascular invasion (n = 398, 3%), lymph node involvement (n = 2,003, 15%), and distant metastasis (n = 39, <1%). Microscopic margin positivity was present in 906 patients and associated with increased risk of death (hazard ratio 1.58, 95% CI 1.04-2.41). Academic facilities (odds ratio [OR] 0.75, 95% CI 0.59-0.95) and operative volume (OR 0.98, 95% CI 0.97-0.98) were associated with decreased margin positivity.Conclusions: Positive margin status was significantly associated with increased risk of death for PTMC. Higher operative volume and treatment at academic centers were associated with lower rates of margin positivity and may help improve survival outcomes in PTMC patients with aggressive features. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of anemia in carriers of Beta thalassemia Study Design: Retrospective Observational study. Setting: PAEC General Hospital, Islamabad, Pakistan. Period: 1st January 2022 to 30th June 2022. Methods: In this descriptive study, 131 carriers of Beta-thalassemia trait, diagnosed by hemoglobin electrophoresis on cellulose acetate membrane at alkaline pH, of any age and both genders were included. Complete blood counts were performed by hematology analyzer of Sysmex XN-1000 to determine hemoglobin level and red blood cell indices i.e. mean corpuscular volume. The studied parameters included hemoglobin and mean corpuscular volume as quantitative variables. Severity and type of anemia were the qualitative variables of this study and were expressed in terms of frequency and percentages. SPSS 19 version software was used for data analysis. Results: 131 carriers of Beta-thalassemia traits were included in study. 58 (44.27%) were males while 73 (55.73%) were females, male to female ratio being 1: 1.3. Of 131 beta thalassemia traits 67 (51.15%) were found to be anemic while 64 (48.85%) had normal hemoglobin for given age and gender. The mean corpuscular volume of anemic and non-anemics was 59.54+5.82 fl and 63.70+6.95 fl respectively. Mean hemoglobin level of anemic Beta-thalassemia traits was 9.42+1.05 g/dl while non-anemic patients was 12.12+1.39 g/dl. Conclusion: Burden of anemia among carriers of Beta-thalassemia traits is high. Understanding the prevalence of anemia in individuals with the trait is crucial for optimizing healthcare interventions and improving the quality of life for affected individuals. [ABSTRACT FROM AUTHOR]

A new diarylheptanoid glycoside, acutissioside A (4), along with five known diarylheptanoids (1–3, 5, 6) was isolated from the twigs of Quercus acutissima Carruth. The structure of the new compound was determined via spectral analysis, including NMR spectra (1H and 13C NMR, 1H–1H COSY, HSQC, HMBC) and HR-ESI-MS, acid hydrolysis, and specific optical rotation data. The neuroprotective effect of all the diarylheptanoid compounds (1–6) was evaluated. Compound 1 exhibited NGF secretion to 154.60 ± 2.87%, which was stronger than that of the positive control 6-shogaol (140.45 ± 2.18%). [ABSTRACT FROM AUTHOR]

BACKGROUND: Enteral nutrition support (ENS) is a standard of care in all NICUs. As a result of long-term ENS, tube dependency can develop. Tube dependency is an inability to make the transition from tube to oral feeds despite the absence of medical reasons for ENS and might lead to symptoms like oral aversion and food refusal. This study aims to evaluate the prevalence of prematurity in a large cohort of tube dependent children. METHODS: Prospectively collected data on tube dependent children who participated in a program based on the "Graz Model of tube weaning" from January 2009 to December 2015 was analysed quantitatively. RESULTS: The study cohort consisted of 711 tube dependent children. Using ICD-10 classification, 378 children (53.2%) were born prematurely, with 103 extremely preterm infants (EPI; including children <29 weeks of gestational age and 275 preterm infants (PI; between 29 and 36+6 weeks of gestational age). More than half (55.4%) of all included patients were female, 51.8% were tube fed via a percutaneous endoscopic gastrostomy (PEG-) tube, 45.8% had a nasogastric (NG-) tube and 2.4% were tube fed via Jejunal (J-) tube. 66% of all EPI and 63.3% of all PI were tube fed since birth. 83.5% of all EPI had no additional diagnoses beyond their extreme prematurity. No differences in tube weaning outcomes between preterm and full term infants were shown. CONCLUSION: Prematurity, especially extreme prematurity, is associated with an increased risk for development of tube dependency. Preventive measures for this specific group of children should be considered. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the prevalence of low and high-risk HPV genotypes in PAP smear samples of women in northern region of the UAE using HPV direct flow CHIP method. Methods: A cross-sectional retrospective study was conducted between September 2021 to April 2022. A total of 104 liquid-based cervical cytology samples were obtained from women aged 20–59 years attending the Gynaecology out-patient department of Thumbay University Hospital and other hospitals of Northern Emirates of UAE, processed for the routine cytological examination to identify and differentiate morphological changes of the PAP smear samples. HPV genotyping was performed using HPV direct flow CHIP method. Results: In total, 112 HPV genotypes were detected in 63 women (60.57%) included 18 abnormal cytological and 45 normal epithelial samples. 63 LR and 49 HR HPV genotypes were identified in all the 63 positive samples. Highest rate of infection with multiple LR and HR HPV genotypes were detected in women aged 40–49 years (25.9%) and 20–29 years (23.5%). Infection by HPV6 (13.46%), HPV11 (9.61%), HPV16 (9.61%), HPV62/81 (7.69%) and HPV45 (7.69%) were the most common genotypes. A moderate increase than expected incidence of HPV45 and 62/81 (7.69%) were detected. Co-infection with multiple low and high-risk genotypes is present in 20.2% cases; in that, HPV6 (15.9%) was the most common followed by HPV62/81 (12.7%) and HPV16 (11.11%). The prevalence of HPV18 was found to be 1.6%. Conclusion: The genotypes 6, 45, 16, 11, 67, 62/81 were the most common HPV infections in the women between the age group of 21 and 59-years-old. A moderate increase of HPV45, 62/81 and much less prevalence of HPV18 were detected in the study population. 43.27% of the normal epithelia were positive to different low and high-risk HPV genotypes. This finding highlights the importance of molecular genotyping of HPV to emphasize the cervical screening triage. [ABSTRACT FROM AUTHOR]

Background Both functional (hormone hypersecreting) and nonfunctional (nonhypersecreting) adrenal tumors can have benign or malignant pathology. This study compares perioperative in-hospital outcomes after adrenalectomy in patients with benign versus malignant nonfunctional primary adrenal tumors. Methods A retrospective cross-sectional analysis was performed using the Nationwide Inpatient Sample database (2006-2011) to identify patients who underwent unilateral open or laparoscopic adrenalectomy for nonfunctional primary adrenal tumors. Patients were subdivided by benign and malignant final pathology. Demographics, comorbidities, and perioperative complications were compared between groups using bivariate and multivariate logistic regression. Results Of 23,297 patients, 89.7% ( n = 20,897) had benign tumors, whereas 10.3% ( n = 2400) had malignant tumors. Those with malignant tumors had higher Charlson Comorbidity Index scores and were more likely to undergo adrenalectomy at high volume centers. For both laparoscopic and open approach, patients with malignant nonfunctional tumors had higher rates of intraoperative complications including vascular and splenic injury ( P < 0.01), as well as postoperative complications including hematoma, shock, acute kidney injury, venous thromboembolism, and pneumothorax ( P < 0.01). In addition, the malignant group had higher rates of blood transfusions, longer hospital stay, and higher in-hospital mortality ( P < 0.05) than benign counterparts. On risk-adjusted multivariate analysis, malignant nonfunctional primary adrenal tumors were independently associated with increased risk of complications following adrenalectomy. Conclusions Patients with malignant nonfunctional primary adrenal tumors have higher perioperative morbidity and mortality compared to patients with benign nonfunctional adrenal tumors. Such patients should be medically optimized before adrenalectomy, and surgeons must remain vigilant in preventing perioperative complications. [ABSTRACT FROM AUTHOR]

A new series of chiral ferrocene derivatives containing both a hydroxyalkyl group and a thyminyl group on one cyclopentadienyl ring have been synthesised to probe structure-activity relationships in cancer cell line cytotoxicities. The stereoisomers of enantiomeric pairs of these so-called ferronucleosides have been studied and characterised by a combination of chiral analytical HPLC and single-crystal X-ray diffraction. Biological activity studies revealed that changing the length of the hydroxyalkyl group had marked effects on IC50 values, with compounds having shorter arms that more closely resemble endogenous nucleosides exhibiting lower cytotoxicities. The lipophilicities and electrochemical properties of this compound series have been studied to rationalise these trends and indicate future directions of study. [ABSTRACT FROM AUTHOR]

Background Primary hyperparathyroidism (pHPT) is commonly treated with targeted parathyroidectomy (PTX) guided by preoperative imaging and intraoperative parathormone monitoring. Despite advanced imaging techniques, failure of parathyroid localization still occurs. This study determines the anatomical distribution of single abnormal parathyroid glands, which may help direct the surgeon in PTX when preoperative localization is unsuccessful. Methods A retrospective review of prospectively collected data of 810 patients with pHPT who underwent initial PTX at a tertiary medical center was performed. All patients had biochemically confirmed pHPT and single-gland disease. Abnormal parathyroid gland localization was determined at time of operation, correlated with operative and pathology reports, and confirmed by operative success defined as eucalcemia for ≥6 mo after PTX. Patients with multiple endocrine neoplasia, secondary, tertiary, or familial hyperparathyroidism, multiglandular disease, parathyroid cancer, and ectopic glands were excluded. Data were analyzed by chi-square and Z -test analyses. Results Among 810 patients who underwent PTX for pHPT, single abnormal parathyroid glands were unequally distributed among the four eutopic locations (left superior, 15.7%; left inferior, 31.3%; right superior, 15.8%; right inferior, 37.2%; P < 0.01). Abnormal inferior parathyroid glands (68.5%) were significantly more common than abnormal superior glands (31.5%), respectively ( P < 0.01). In men, the most common location for single abnormal parathyroid glands was the right inferior position (43.4%, P < 0.01). Overall, there was no significant difference in laterality. Conclusions This large series of patients suggests that single eutopic abnormal parathyroid glands are more likely to be inferior. In men, moreover, if an abnormal parathyroid gland is not localized preoperatively, the right inferior location should be explored first. Nevertheless, successful PTX remains predicated on knowledge of parathyroid anatomy, experience, and judgment of the surgeon. [ABSTRACT FROM AUTHOR]

The traditional medicinal mushroom Hericium erinaceus is known for enhancing peripheral nerve regeneration through targeting nerve growth factor (NGF) neurotrophic activity. Here, we purified and identified biologically new active compounds from H. erinaceus, based on their ability to promote neurite outgrowth in hippocampal neurons. N‐de phenylethyl isohericerin (NDPIH), an isoindoline compound from this mushroom, together with its hydrophobic derivative hericene A, were highly potent in promoting extensive axon outgrowth and neurite branching in cultured hippocampal neurons even in the absence of serum, demonstrating potent neurotrophic activity. Pharmacological inhibition of tropomyosin receptor kinase B (TrkB) by ANA‐12 only partly prevented the NDPIH‐induced neurotrophic activity, suggesting a potential link with BDNF signaling. However, we found that NDPIH activated ERK1/2 signaling in the absence of TrkB in HEK‐293T cells, an effect that was not sensitive to ANA‐12 in the presence of TrkB. Our results demonstrate that NDPIH acts via a complementary neurotrophic pathway independent of TrkB with converging downstream ERK1/2 activation. Mice fed with H. erinaceus crude extract and hericene A also exhibited increased neurotrophin expression and downstream signaling, resulting in significantly enhanced hippocampal memory. Hericene A therefore acts through a novel pan‐neurotrophic signaling pathway, leading to improved cognitive performance. [ABSTRACT FROM AUTHOR]

Plants accumulate a vast array of secondary metabolites, which constitute a natural resource for pharmaceuticals. Oldenlandia corymbosa belongs to the Rubiaceae family, and has been used in traditional medicine to treat different diseases, including cancer. However, the active metabolites of the plant, their biosynthetic pathway and mode of action in cancer are unknown. To fill these gaps, we exposed this plant to eight different stress conditions and combined different omics data capturing gene expression, metabolic profiles, and anti‐cancer activity. Our results show that O. corymbosa extracts are active against breast cancer cell lines and that ursolic acid is responsible for this activity. Moreover, we assembled a high‐quality genome and uncovered two genes involved in the biosynthesis of ursolic acid. Finally, we also revealed that ursolic acid causes mitotic catastrophe in cancer cells and identified three high‐confidence protein binding targets by Cellular Thermal Shift Assay (CETSA) and reverse docking. Altogether, these results constitute a valuable resource to further characterize the biosynthesis of active metabolites in the Oldenlandia group, while the mode of action of ursolic acid will allow us to further develop this valuable compound. [ABSTRACT FROM AUTHOR]

[Display omitted] • Remote ischemic preconditioning (RIPC) protects wild-type mice from hemorrhagic shock/resuscitation-induced (HSR) liver ischemia/reperfusion injury and inflammation. • RIPC loses its hepatoprotective capabilities in parkin knockout mice. • RIPC used prior to HSR causes a parkin -dependent increase in mitophagy. Hemorrhagic shock-resuscitation (HSR) following trauma contributes to organ dysfunction by causing ischemia–reperfusion injury (IRI). We previously showed that 'remote ischemic preconditioning' (RIPC) exerted multi-organ protection from IRI. Maintenance of mitochondrial quality by clearance of dysfunctional mitochondria via mitophagy is vital in restoring organ integrity. We hypothesized that parkin -dependent mitophagy played a role in RIPC-induced hepatoprotection following HSR. The hepatoprotective effect of RIPC in a murine model of HSR-IRI was investigated in wild type and parkin-/- animals. Mice were subjected to HSR ± RIPC and blood and organs were collected, followed by cytokine ELISAs, histology, qPCR, Western blots, and transmission electron microscopy. HSR increased hepatocellular injury, as measured by plasma ALT and liver necrosis, while antecedent RIPC prevented this injury; in parkin -/- mice, RIPC failed to exert hepatoprotection. The ability of RIPC to lessen HSR-induced rises in plasma IL-6 and TNFα, was lost in parkin -/- mice. While RIPC alone did not induce mitophagy, the application of RIPC prior to HSR caused a synergistic increase in mitophagy, this increase was not observed in parkin -/- mice. RIPC induced shifts in mitochondrial morphology favoring mitophagy in WT but not in parkin-/- animals. RIPC was hepatoprotective in WT mice following HSR but not in parkin -/- mice. Loss of protection in parkin –/– mice corresponded with the failure of RIPC plus HSR to upregulate the mitophagic process. Improving mitochondrial quality by modulating mitophagy, may prove to be an attractive therapeutic target in disease processes caused by IRI. [ABSTRACT FROM AUTHOR]

With increasing rates of obesity worldwide, a correlation between high body mass index (BMI) and postoperative morbidity after thyroid surgery remains unclear. Postoperative transient hypocalcemia is common after total thyroidectomy due to interruption of parathyroid function. This study examines the relationship between BMI and hypocalcemia after total thyroidectomy. A retrospective review of prospectively collected data for 1135 patients who underwent total thyroidectomy for cancer, multinodular goiter (MNG), or Graves' disease between June 2009 and November 2020 at a single institution was performed. BMI groups followed the World Health Organization classification. Hypocalcemia was defined as serum calcium ≤8 mg/dL. Calcium levels measured on postoperative day 0 and the following morning were compared between the BMI groups. Of 1135 total thyroidectomy patients, 85% were women. The mean age and standard deviation of patients was 49 (± 13) y, with most of Hispanic origin (64%). Overall, 41.5% of patients had cancer, 45% nontoxic MNG, 5.8% toxic MNG, and 12% Graves' disease. Stratified by BMI, 27% of patients were normal, 34% overweight, and 39% obese. Overall, overweight and obese patients experienced less transient hypocalcemia at both time points compared to normal patients postoperatively (P = 0.01 and P = 0.009). Furthermore, overweight and obese patients with Graves' disease experienced less transient hypocalcemia at both time points (P = 0.04 and P = 0.05). There was no statistical difference in other groups. A protective role of higher BMI or "obesity paradox" for postoperative hypocalcemia may exist in those obese patients after total thyroidectomy. [ABSTRACT FROM AUTHOR]

Background: Expectant parents worldwide have experienced changes in the way they give birth as a result of COVID-19, including restrictions relating to access to birthing units and the presence of birthing partners during the birth, and changes to birth plans. This paper reports the experiences of women in England.Methods: Data were obtained from both closed- and open-ended responses collected as part of the national COVID in Context of Pregnancy, Infancy and Parenting (CoCoPIP) Study online survey (n = 477 families) between 15th July 2020 - 29th March 2021. Frequency data are presented alongside the results of a sentiment analysis; the open-ended data was analysed thematically.Results: Two-thirds of expectant women reported giving birth via spontaneous vaginal delivery (SVD) (66.1%) and a third via caesarean section (CS) (32.6%) or 'other' (1.3%). Just under half (49.7%) of the CS were reported to have been elective/planned, with 47.7% being emergencies. A third (37.4%) of participants reported having no changes to their birth (as set out in their birthing plan), with a further 25% reporting COVID-related changes, and 37.4% reporting non-COVID related changes (e.g., changes as a result of birthing complications). One quarter of the sample reported COVID-related changes to their birth plan, including limited birthing options and reduced feelings of control; difficulties accessing pain-relief and assistance, and feelings of distress and anxiety. Under half of the respondents reported not knowing whether there could be someone present at the birth (44.8%), with 2.3% of respondents reporting no birthing partner being present due to COVID-related restrictions. Parental experiences of communication and advice provided by the hospital prior to delivery were mixed, with significant stress and anxiety being reported in relation to both the fluctuating guidance and lack of certainty regarding the presence of birthing partners at the birth. The sentiment analysis revealed that participant experiences of giving birth during the pandemic were predominately negative (46.9%) particularly in relation to the first national lockdown, with a smaller proportion of positive (33.2%) and neutral responses (19.9%).Conclusion: The proportion of parents reporting birthing interventions (i.e., emergency CS) was higher than previously reported, as were uncertainties related to the birth, and poor communication, leading to increased feelings of anxiety and high levels of negative emotions. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The human tripartite motif (TRIM) family comprises 70 members, including HIV restriction factor TRIM5α and disease-associated proteins TRIM20 (pyrin) and TRIM21. TRIM proteins have conserved domain architecture but diverse cellular roles. Here, we describe how the C-terminal PRYSPRY domain mediates diverse TRIM functions. The crystal structure of TRIM21 PRYSPRY in complex with its target IgG Fc reveals a canonical binding interface comprised of two discrete pockets formed by antibody-like variable loops. Alanine scanning of this interface has identified the hot-spot residues that control TRIM21 binding to Fc; the same hot-spots control HIV/murine leukemia virus restriction by TRIM5α and mediate severe familial Mediterranean fever in TRIM20/pyrin. Characterization of the IgG binding site for TRIM21 PRYSPRY reveals TRIM21 as a superantigen analogous to bacterial protein A and suggests that an antibody bipolar bridging mechanism may contribute to the pathogenic accumulation of anti-TRIM21 autoantibody immune complex in autoimmune disease. [ABSTRACT FROM AUTHOR]

Smoking a cigarette generates over 4000 chemicals that have a deleterious impact on each part of the human body. It produces three main severe effects on the liver organ: oncogenic, immunological, and indirect or direct toxic effects. It results in the production of cytotoxic substances, which raises fibrosis and necro-inflammation. Additionally, it also directs the production of pro-inflammatory cytokines tumour necrosis factor alfa (TNF-α) and interleukins (IL-1β, IL-6) that will be responsible for the chronic liver injury. Furthermore, it gives rise to secondary polycythemia and successively raises the turnover and mass of red cells, which might be a common factor responsible for the development of oxidative stress in the liver due to iron overload. It also produces chemicals that are having oncogenic properties and raises the risk of liver cancer especially in sufferers of chronic hepatitis C. Smoking modulates both humoral and cell-mediated responses by restricting the proliferation of lymphocytes and inducing their apoptosis and ultimately decreasing the surveillance of cancer cells. Moreover, it has been determined that heavy smoking impacts the response of hepatitis C patients to interferon (IFN) therapy through different mechanisms, which can be improved by phlebotomy. Efforts are being made in different nations in decreasing the prevalence of smoking to improve premature death and ill effects of their nation's individuals. [ABSTRACT FROM AUTHOR]

The Bethesda System for Reporting Thyroid Cytopathology has 6 diagnostic categories, each with an implied cancer risk of malignancy (ROM). Bethesda III, defined as atypia or follicular lesions of undetermined significance (AUS/FLUS) on fine needle aspiration (FNA), has an indeterminate ROM. This study investigates the utility of Afirma Gene Expression Classifier (GEC) and Thyroid Sequencing (ThyroSeq) molecular testing to predict malignancy in AUS/FLUS thyroid nodules. A retrospective review of prospectively collected data of 1457 patients with index thyroid nodules who underwent FNA and thyroidectomy at a single academic institution was performed. Use of GEC or ThyroSeq for AUS/FLUS thyroid nodules was examined. GEC testing was reported benign or suspicious for malignancy whereas ThyroSeq testing was reported on a spectrum of low, intermediate or high ROM. Descriptive statistics were utilized to compare the ROM among AUS/FLUS thyroid nodules. Of 1457 patients with FNA thyroid cytology, 359 (25%) corresponded to AUS/FLUS results. There were 132 (37%) patients with GEC testing and 88 (24%) had ThyroSeq testing. ROM without GEC or ThyroSeq testing was 49%, whereas ROM with suspicious GEC was 55%. ROM with positive ThyroSeq was 73%. Among ThyroSeq patients, 43 had intermediate-risk mutations with 60% malignancy, and 23 had high-risk mutations with 96% malignancy (P < 0.01). Surgical patients with AUS/FLUS thyroid nodules have a high ROM. High-risk ThyroSeq testing may have some utility in predicting malignancy, but GEC and intermediate-risk TGC results have limited value. Surgeons should carefully consider the utility of molecular tests to determine surgical resection. [ABSTRACT FROM AUTHOR]

Four compounds, hericerin (1), isohericerinol A (2), N -de-phenylethyl isohericerin (3) and corallocin A (4) were isolated from the fruiting bodies of Hericium erinaceus, a lion's mane mushroom (Hericiaceae). Among them, isohericerinol A (2) was newly reported in nature. Further investigation of the neurotrophic effect of isolated compounds demonstrated that isohericerinol A (2) strongly increased the nerve growth factor (NGF) production in C6 glioma cells followed by corallocin A (4) and hericerin (1). Increased NGF production by these compounds promoted the neurite outgrowth in N2a neuronal cells. Western blot analysis also showed the increased protein expression of NGF, brain-derived neurotrophic factor (BDNF) and synaptophysin (SYP) in C6-N2a cells. Taken together, our present study characterized the neurotrophic constituents of H. erinaceus , which may support the potential use of memory improvement. [ABSTRACT FROM AUTHOR]

Germline mutations in BRCA1 and BRCA2 (BRCA1/2) genes considerably increase breast and ovarian cancer risk. Given that tumors with these mutations have elevated genomic instability, they exhibit relative vulnerability to certain chemotherapies and targeted treatments based on poly (ADP-ribose) polymerase (PARP) inhibition. However, the molecular mechanisms that influence cancer risk and therapeutic benefit or resistance remain only partially understood. BRCA1 and BRCA2 have also been implicated in the suppression of R-loops, triple-stranded nucleic acid structures composed of a DNA:RNA hybrid and a displaced ssDNA strand. Here, we report that loss of RNF168, an E3 ubiquitin ligase and DNA double-strand break (DSB) responder, remarkably protected Brca1-mutant mice against mammary tumorigenesis. We demonstrate that RNF168 deficiency resulted in accumulation of R-loops in BRCA1/2-mutant breast and ovarian cancer cells, leading to DSBs, senescence, and subsequent cell death. Using interactome assays, we identified RNF168 interaction with DHX9, a helicase involved in the resolution and removal of R-loops. Mechanistically, RNF168 directly ubiquitylated DHX9 to facilitate its recruitment to R-loop-prone genomic loci. Consequently, loss of RNF168 impaired DHX9 recruitment to R-loops, thereby abrogating its ability to resolve R-loops. The data presented in this study highlight a dependence of BRCA1/2-defective tumors on factors that suppress R-loops and reveal a fundamental RNF168-mediated molecular mechanism that governs cancer development and vulnerability. [ABSTRACT FROM AUTHOR]

Background: Echoing international trends, the most recent United Kingdom reports of infant and maternal mortality found that pregnancies to women with social risk factors are over 50% more likely to end in stillbirth or neonatal death and carry an increased risk of premature birth and maternal death. The aim of this realist synthesis was to uncover the mechanisms that affect women's experiences of maternity care. Methods: Using realist methodology, 22 papers exploring how women with a wide range of social risk factors experience maternity care in the United Kingdom were included. The data extraction process identified contexts (C), mechanisms (M), and outcomes (0). Results: Three themes, Resources, Relationships, and Candidacy, overarched eight CMO configurations. Access to services, appropriate education, interpreters, practical support, and continuity of care were particularly relevant for women who are unfamiliar with the United Kingdom system and those living chaotic lives. For women with experience of trauma, or those who lack a sense of control, a trusting relationship with a health care professional was key to regaining trust. Many women who have social care involvement during their pregnancy perceive health care services as a system of surveillance rather than support, impacting on their engagement. This, as well as experiences of paternalistic care and discrimination, could be mitigated through the ability to develop trusting relationships. Conclusions: The findings provide underlying theory and practical guidance on how to develop safe services that aim to reduce inequalities in women's experiences and birth outcomes. [ABSTRACT FROM AUTHOR]

• The CuNiO thin film was prepared via a simple thermal evaporation method and post-anneled at different temperatures. • The XRD and SEM confirmed the formation of CuNiO thin film and secondary phases. • Post-annealing treatment greatly affects the structural, microstructure and thermoelectric properties of CuNiO thin film. • The maximum power factor PF = 2.6 μWm−1K−2 of the un-annealed sample was exhibited at room temperature. The need for the best thermoelectric power generation to extract low-grade heat energy from the human body has generated considerable interest. However, developing oxide-based thermoelectric materials with both high stability and Seebeck coefficient remains challenging. In this work, we have prepared CuNiO thin film with an economical and simple thermal evaporation method and post-annealed at different temperatures from 400 to 550 °C. XRD and SEM have determined the crystal structure and surface morphology of the CuNiO thin film. The electrical conductivity and charge carrier concentration increase with post-annealing temperature due to the formation of the secondary phases. The Seebeck coefficient has decreased from 65.1 to 37.9 µV/K with post-annealing temperature due to improved charge carrier density, the electronic band structure of the material and secondary phases. The maximum power factor has been achieved in the unannealed sample. [ABSTRACT FROM AUTHOR]