Search

Introduction: Hepatitis B and C are viral infections causing chronic liver inflammation and, when left untreated, lead to cirrhosis and a risk for hepatocellular carcinoma, the most common type of primary liver cancer with high mortality. The hepatitis B virus-hepatitis C virus (HBV-HCV) coinfection leads to a faster progression to advanced liver diseases and higher hepatocellular carcinoma (HCC) risk than monoinfection. Unlike the relative risk for HCC due to either HBV or HCV, no recent analysis of the risk for HBV-HCV coinfection exists. Methods: Based on PRISMA recommendations and guidelines, we developed a search strategy by combining the keywords (“hepatitis B”) and (“hepatitis C”) and (“hepatocellular carcinoma” or “liver cancer”). First, we performed a title and abstract screening and, later, a full-text screening. We extracted the demographic characteristics, such as gender, age, study design, sample size, country, and biomarkers of hepatitis B surface antigen (HBsAg), HBV DNA, HBeAg, anti-HCV, and HCV RNA. The data were assessed for quality, and the Review Manager software was used for the meta-analysis. Results: We included 63 studies. The pooled analysis showed that the risk of HCC was significantly higher in the case-cohort who were positive for HBsAg (odds ratio [OR] = 9.70 [3.75, 25.12], P = 0.0001), HBV DNA or HBeAg (OR = 22.77 [10.00, 51.88], P = 0.0001), HBV and HCV coinfection (OR = 46.07 [26.33, 80.60], P = 0.0001) than the control cohort. Conclusion: Chronic HBV and HCV infections are major risk factors for HCC, and their coinfection was significantly associated with an increased risk of HCC than monoinfection.

(1) Background: Central nervous system (CNS) infections, including meningitis and encephalitis, are serious conditions which are associated with high morbidity and mortality. This study aims to identify the clinical manifestations, etiologies, and outcomes of meningitis and encephalitis in adult patients in Saudi Arabia, addressing the current gap in understanding these conditions within this population. (2) Methods: This is a single-center retrospective study which included all adult patients diagnosed with meningitis and encephalitis from March 2016 to May 2022. (3) Results: This study found that most cases of meningitis and encephalitis occurred due to unknown pathogens. Pretreatment with antibiotics prior to lumbar puncture (LP) was found in 71.2% of patients with meningitis. Altered mental status and seizures were common presenting symptoms among patients with encephalitis while altered mental status and fever were common among patients with meningitis. (4) Conclusions: Adherence to guidelines in treating meningitis and encephalitis and performing LPs in a timely manner are important. Establishing national biobanks with biological samples from patients suspected of having meningitis or encephalitis will significantly enhance our understanding of these conditions in Saudi Arabia.

The educational environment is important for the development of life skills of nursing students in late- and post-adolescence. Strengthening their mental resilience, enhancing their individual confidence, and controlling stress are necessary conditions in this direction, which will help them cope with the future challenges of their chosen profession. We aimed to study the resilience profiles of nursing students by investigating their mental resilience and its association with their individual characteristics and lifestyle factors. The Connor-Davidson Resilience Scale (CD–RISC–25) scale for resilience, the Perceived Stress Scale (PSS–14) scale for perceived stress, and the Personal Trust and Connection (PerTC) scale for trust and connections were used. The lifestyle determinants were also assessed. An e-survey that targeted 250 nursing students was conducted from November 22 to April 23. Descriptive and advanced statistical analyses were performed. 146 students participated in the study via an on-line questionnaire; the students were predominantly female (82.2%) with mean age of 22 years (SD = 6.8). Two out of ten students smoked (20.5%), 66.4% consumed at least one drink during a usual week, and 48.0% participated in sports during the last year. The mean hours spent on the Internet daily was 4.2 (SD = 1.8) and on social media was 2.7 (SD = 1.6) hours/day. The students scored highly on the 1-to-10 life-satisfaction item (Mean = 6.3, SD = 1.9), where the perceived stress was assessed as moderate/high with a mean of 33 (SD = 4.4) and trust and connections had a mean of 6.2 (SD = 1.1). In the multivariate analysis, the factors found to significantly associate with resilience (CD–RISC–25; Mean = 64.2, SD = 11.8) were age (β = 0.4; 95% CI: 0.1, 0.7), sports participation (β = 5.7; 95% CI: 2.3, 9.1), hours per day spent on social media (β = -1.3; 95% CI: -2.3, -0.3), and the number of friends (β = 0.3; 95% CI: 0.05, 0.5). Finally, resilience was positively associated with life satisfaction and the trust and connections scale (β = 1.8; 95% CI: 0.9, 2.7 and β = 1.8; 95% CI: 0.2, 3.4, respectively).

IntroductionUltra-processed foods are evident to play a role in the development of nutrition-related non-communicable diseases (NR-NCDs). There’s a scarcity of data in the Eastern Mediterranean Region (EMR) regarding ultra-processed food consumption, which highlights the need for such data in this region that is witnessing a nutrition transition. This study was conducted to assess the dietary pattern of Lebanese adults according to different degrees of food processing.MethodsA cross-sectional study involving a nationally representative sample (n = 444) of Lebanese adults (18–64 years) was conducted over the course of 5 months. A validated food frequency questionnaire and two non-consecutive 24-h recalls were used to collect the dietary intake. Sociodemographic and medical characteristics were collected using a validated questionnaire. Anthropometric measurements were taken by trained dietitians. Food items were classified according to the NOVA food classification system, and the percent contribution of every type of processing to the energy intake was calculated.ResultsUltra-processed foods contributed to the highest percent of energy intake in the sample (46.7%), followed by unprocessed and minimally processed foods (39.6%). Being male, and younger increased the odds of higher ultra-processed food intake; being employed and food secure increased the odds of a higher NOVA-UPF score. Compared with participants in Beirut, participants residing in North Lebanon and Akkar had higher odds of having a high UPF intake and lower odds of having a high NOVA-UPF score. The three most contributing food items to energy intake were ultra-processed (breads and breakfast cereals, fast foods, sweets and desserts). Compared to the unprocessed and minimally processed food diet fraction, the ultra-processed food diet fraction was significantly higher in sodium and thiamin and lower in proteins, fiber, and essential vitamins and minerals such as vitamins A, D, B12, folate, iron, calcium, and magnesium.ConclusionUPF intake was the main contributor to TEI, and the intake was considerably higher among those who reported having renal disease, younger adults, and males. In comparison to the minimally processed diet fraction, the UPF diet fraction was found to have considerably greater levels of sodium and thiamin and lower levels of proteins, fiber, and essential vitamins and minerals. The study findings call for public health policies and interventions to encourage the consumption of minimally processed foods and decrease the consumption of ultra-processed foods, especially sweets and sweetened beverages, which are especially problematic.

BackgroundResilience can protect individuals from the negative impact of adversity, facilitating a swift recovery. The exploration of protective factors contributing to resilience has been a central focus of research. Self-compassion, a positive psychological construct that involves treating oneself with kindness, holds the potential to bolster resilience. Although several studies have indicated an association between self-compassion and resilience, there is a lack of systematic reviews and meta-analyses examining this relationship and the potential moderators and mechanisms. ObjectiveThis study aimed to systematically review the literature on the relationship between self-compassion and resilience in the general population, perform a meta-analysis to quantify the effect size of their association, and explore potential moderators (eg, age, gender, culture, and health status) and mediators. MethodsWe will search the Web of Science, PsycINFO, MEDLINE, Scopus, CINAHL, and CNKI databases for peer-reviewed studies (including observational and experimental studies) that examined the relationship between self-compassion and resilience, with no language restrictions. There are no restrictions regarding participants’ age, gender, culture, or health status. Qualitative studies, conference abstracts, review articles, case reports, and editorials will be excluded. Two reviewers (XL and JH) will independently screen the literature, extract data, and assess the quality of the eligible studies. If possible, the pooled effect size between self-compassion and resilience will be meta-analyzed using a random-effect model. Meta-regression and subgroup analysis will be conducted to examine the moderating roles of age, gender, culture, health status, and other potential moderators. The characteristics and main findings of eligible studies will be summarized in tables and narrative descriptions. Results from the meta-analysis, meta-regression, and subgroup analysis will be presented quantitatively. ResultsWe registered our protocol with PROSPERO, conducted the search, and initiated the screening in April 2024. We expect to start data analysis in October 2024 and finalize the review by March 2025. ConclusionsThe systematic review and meta-analysis will provide evidence on the protective role of self-compassion in resilience under adversity. Our investigation into potential moderators will highlight the contexts and groups where the benefits of self-compassion can be maximized. The findings are expected to provide valuable insights for health care professionals and stakeholders, informing the development of interventions aimed at enhancing resilience by fostering self-compassion. Trial RegistrationPROSPERO CRD42024534390; https://tinyurl.com/3j3rmcja International Registered Report Identifier (IRRID)PRR1-10.2196/60154

Background: In genomics, highly sensitive point mutation detection is particularly relevant for cancer diagnosis and early relapse detection. Next-generation sequencing combined with unique molecular identifiers (UMIs) is known to improve the mutation detection sensitivity. Methods: We present an open-source bioinformatics framework named Interface for Point Mutation Identification (IMPI) with a graphical user interface (GUI) for processing especially small-scale NGS data to identify variants. IMPI ensures detailed UMI analysis and clustering, as well as initial raw read processing, and consensus sequence building. Furthermore, the effects of custom algorithm and parameter settings for NGS data pre-processing and UMI collapsing (e.g., UMI clustered versus unclustered (raw) reads) can be investigated. Additionally, IMPI implements optimization and quality control methods; an evolution strategy is used for parameter optimization. Results: IMPI was designed, implemented, and tested using BCR::ABL1 fusion gene kinase domain sequencing data. In summary, IMPI enables a detailed analysis of the impact of UMI clustering and parameter setting changes on the measured allele frequencies. Conclusions: Regarding the BCR::ABL1 data, IMPI’s results underlined the need for caution while designing specialized single amplicon NGS approaches due to methodical limitations (e.g., high PCR-mediated recombination rate). This cannot be corrected using UMIs.

* Context.--Low-grade fibromatosis-like metaplastic carcinoma (FLMC) is a very rare subtype of triple-negative metaplastic (spindle cell) breast carcinoma. It is characterized by the proliferation of spindle cells closely resembling fibromatosis, which represents a benign fibroblastic/myofibroblastic breast proliferation. Unlike most triple-negative and basal-like breast cancers, FLMC has a very low potential for metastases, but demonstrates frequent local recurrences. Objective.--To genetically characterize FLMC. Design.--To this end, we analyzed 7 cases by targeted next-generation sequencing for 315 cancer-related genes and performed comparative microarray copy number analysis in 5 of these cases. Results.--All cases shared TERT alterations (6 patients with recurrent c.-124C>T TERT promoter mutation and 1 patient with copy number gain encompassing the TERT locus), had oncogenic PIK3CA/PIK3R1 mutations (activation of the PI3K/AKT/mTOR pathway), and lacked mutations in TP53. TERT was overexpressed in all FLMCs. CDKN2A/B loss or mutation was observed in 4 of 7 cases (57%). Furthermore, tumors displayed chromosomal stability, with only few copy number variations and a low tumor mutational burden. Conclusions--We conclude that FLMCs typically show the recurrent TERT promoter mutation c.-124C>T, activation of the PI3K/AKT/mTOR pathway, low genomic instability, and wild-type TP53. In conjunction with previous data of metaplastic (spindle cell) carcinoma with and without fibromatosis-like morphology, FLMC is most likely distinguished by TERT promoter mutation. Thus, our data support the notion of a distinct subgroup within low-grade metaplastic breast cancer with spindle cell morphology and associated TERT mutations. (Arch Pathol Lab Med. 2023;147:1451-1457; doi: 10.5858/arpa.2022-0159-OA), Low-grade fibromatosis-like metaplastic carcinomas (FLMCs) are very rare tumors, comprising less than 0.5% of breast carcinomas. FLMCs are part of the heterogeneous group of metaplastic breast carcinomas (MBCs), characterized by [...]

Studies have shown that the production of reactive oxygen species (ROS) is triggered by bactericidal antibiotics, which contributes significantly to the killing of bacterial cells and increasing mutations in surviving cells. In this study, we hypothesized that exposure of Salmonella to sublethal concentrations of hypochlorite (NaOCl), a commonly used sanitizer in household and food industries increases mutation rates, leading to the development of antibiotic resistance. We found that a sublethal concentration (20 ppm) of NaOCl increased the mutation rates of S. typhimurium 14028s significantly (p < 0.05), which was prevented by the ROS scavenger thiourea, supporting that the increased mutation was due to NaOCl-triggered ROS production. We further found that the exposure of S. typhimurium 14028s to the same sublethal concentration of NaOCl increases resistance to kanamycin among the 3 antibiotics evaluated. The results of this study suggest that when NaOCl applied as a sanitizer fails to kill Salmonella due to diluted local concentrations or presence of organic materials, it can cause an adverse outcome of developing antibiotic resistance of the pathogen.

Fully relativistic calculations, primarily at the 4-component coupled-cluster singles and doubles with perturbative triples [CCSD(T)] level of theory with the Dirac–Coulomb (DC) Hamiltonian, have been carried out for the superheavy (E125)F molecule using large Gaussian basis sets. The electronic ground state is determined to have an [Og]8s25g16f3 configuration on E125 with an Ω = 6 ground state and an 8p electron largely donated to F. A Mulliken population analysis indicates that the ground state is mainly ionic with a partial charge of +0.79 on E125 and a single sigma bond involving the F 2p and E125 8p spinors. The occupied g spinor is not involved in the bonding. With the largest basis set used in this work, the (0 K) dissociation energy was calculated at the DC-CCSD(T) level of theory to be 7.02 eV. Analogous calculations were also carried out for the E125 atom, both the neutral and its cation. The lowest energy electron configuration of E125+, [Og] 8 s 1 / 2 2 5 g 7 / 2 1 6 f 5 / 2 3 with a J = 6 ground state, was found to be similar to that in (E125)F, while the neutral E125 atom has an [Og] 8 s 1 / 2 2 5 g 7 / 2 1 6 f 5 / 2 2 7 d 3 / 2 1 8 p 1 / 2 1 ground state electron configuration with a J = 17/2 ground state. The ionization energy (IE) of E125 is reported for the first time and is calculated to be 4.70 eV at the DC-CCSD(T) level of theory. Non-relativistic calculations were also carried out on the E125 atom and the (E125)F molecule. The non-relativistic ground state of the E125 atom was calculated to have a 5g5 ground state with an IE of just 3.4 eV. The net effect of relativity on (E125)F is to stabilize its bonding. [ABSTRACT FROM AUTHOR]

Background: Assessing food waste management in hospitals is crucial for establishing a baseline model of the impact of waste reduction strategies and monitoring progress. Limited data exists on measuring and managing food waste in hospitals, emphasizing the need for comprehensive assessment in the country. Aims: This study sought to assess the food waste management protocols in different types of food services at Lebanese hospitals. Methods: This observational, descriptive, cross-sectional study sampled 32 dietitians in Lebanese Hospitals using a convenience sampling technique, who were interviewed to complete a questionnaire. Frequencies and percentages were obtained through simple statistics. Results: Study findings showed that, in Lebanese hospitals, 81.3% of food waste was obtained from patient's tray, 66.7% from expired prepackaged food, 58.1% from hospital cafeterias, and 48.4% from expired-unconsumed cafeteria food. The aforementioned food waste obtained is mixed with general waste. None incorporates composting or anaerobic digestion due to financial issues, but 18 hospitals are open to considering these methods. About 85% of hospitals adopt different approaches for managing food waste from isolated patients. Only 18.8% had external contractors for waste management, among which 9.4% mentioned food waste management in the contract. Conclusion: Lebanese hospitals rely on garbage disposal as a food waste management technique, lacking effective strategies, such as composting or anaerobic digestion. This underscores the urgent need for comprehensive and improved food waste management measures in the country. This study is a wake-up call for policymakers to adopt a robust approach in formulating hospital food waste management policies.

Alterations in the function of K+ channels such as the voltage- and Ca2+-activated K+ channel of large conductance (BKCa) reportedly promote breast cancer (BC) development and progression. Underlying molecular mechanisms remain, however, elusive. Here, we provide electrophysiological evidence for a BKCa splice variant localized to the inner mitochondrial membrane of murine and human BC cells (mitoBKCa). Through a combination of genetic knockdown and knockout along with a cell permeable BKCa channel blocker, we show that mitoBKCa modulates overall cellular and mitochondrial energy production, and mediates the metabolic rewiring referred to as the ‘Warburg effect’, thereby promoting BC cell proliferation in the presence and absence of oxygen. Additionally, we detect mitoBKCa and BKCa transcripts in low or high abundance, respectively, in clinical BC specimens. Together, our results emphasize, that targeting mitoBKCa could represent a treatment strategy for selected BC patients in future.

Introduction The economic case for preventive care delivered in or near citizens’ homes is strong, and there is growing evidence of the role of local-level support in supporting people’s health and well-being as they age. However, effective and consistent delivery of person-centred integrated care (PIC) at the community level remains elusive. Previous systematic reviews have focused on specific processes such as case management, but none have focused on the operational delivery of community-based care networks. In this study, we aim to identify what practice-based models of PIC networks exist at the local/neighbourhood level and what evidence is available as to their effectiveness for healthy ageing in place.Methods and analysis We will undertake a scoping review following the framework proposed by Arksey and O’Malley and updated guidance by the Joanna Briggs Institute. Peer-reviewed sources will be identified through searches of seven databases, and relevant grey literature will be identified through websites of policy and voluntary sector organisations focused on integrated care and/or healthy ageing. Data from included studies will be extracted for relevance to the research questions, including aims and anticipated outcomes of network models, financial and management structures of networks, and evidence of evaluation. Summary tables and narrative comparisons of key PIC network features across settings will be presented.Ethics and dissemination As no primary data will be collected, ethical approval is not required to conduct this scoping review. In addition to publication as a peer-reviewed article, the results of this review will be summarised as shorter discussion papers for use in follow-up research.

Abstract Mycobacterium tuberculosis has evolved several mechanisms to counter host defense arsenals for its proliferation. Here we report that M. tuberculosis employs a multi-pronged approach to modify host epigenetic machinery for its survival. It secretes methyltransferase (MTase) Rv2067c into macrophages, trimethylating histone H3K79 in a non-nucleosomal context. Rv2067c downregulates host MTase DOT1L, decreasing DOT1L-mediated nucleosomally added H3K79me3 mark on pro-inflammatory response genes. Consequent inhibition of caspase-8-dependent apoptosis and enhancement of RIPK3-mediated necrosis results in increased pathogenesis. In parallel, Rv2067c enhances the expression of SESTRIN3, NLRC3, and TMTC1, enabling the pathogen to overcome host inflammatory and oxidative responses. We provide the structural basis for differential methylation of H3K79 by Rv2067c and DOT1L. The structures of Rv2067c and DOT1L explain how their action on H3K79 is spatially and temporally separated, enabling Rv2067c to effectively intercept the host epigenetic circuit and downstream signaling.

Tourette's syndrome (TS) is a condition that has been stigmatised and mocked in contemporary society, yet little is known about the subjective experience of those directly affected by it. Guided by Public and Patient Involvement (PPI) a mixed method design was used for this study to explore the experience of stigma in adults living with TS in the UK. A total of one hundred and ninety-nine adults participated in a cross-sectional online survey using an adapted version of the Discrimination and Stigma Scale (DISC-12) and the Perceived Quality of Life (PQoL) scale, twenty of whom were also interviewed using a semi-structured interview schedule. Quantitative findings indicated that participants experienced discrimination in numerous life domains; most prominently in education (75.4%), social life (71.4%), public transport (60.8%) and employment (54.3.%). The PQoL of adults with Tourette's was found to be negatively correlated with both "Enacted" and "Anticipated Discrimination" from the DISC-12 scale. Qualitative findings illustrated the pervasive nature of TS stigma, which expanded beyond micro-interactions, and which could be observed at a structural level. The peculiar impact of disparagement humour in the construction and promulgation of "othering" individuals with TS was also highlighted. Concealment and self-stigma were mechanisms commonly utilised by individuals to manage their "spoiled identity", inhibiting active and collective responses to stigmatisation. The study highlights how TS stigma acts as a barrier to social and economic participation for adults with the condition and helps identify factors that need to be considered when developing anti-stigma strategies.