Diagnostic performance of loop-mediated isothermal amplification (LAMP) and Ultra-sensitive PCR in diagnosis of malaria in western Saudi Arabia

Malaria diagnosis continues to be one of the most important steps in the cycle of control specially in endemic countries with low parasitic load infections. Loop-mediated isothermal amplification (LAMP) and ultrasensitive PCR (Us-PCR) are two promising candidates for malaria diagnosis. A cross sectional study performed at King Faisal Hospital, Taif KSA involved patients suffering from signs and symptoms suggesting of malaria, 35 blood samples diagnosed by Nested Multiplex PCR as a reference method (13 P. falciparum, 17 P. vivax, 3 mixed P. falciparum and P. vivax) plus two negative controls were selected to be included in this study to analyse the performance of two LAMP methods (LAMP OptiGene® and LAMP WarmStart®) and two ultrasensitive PCRs (Us-PCR TARE-2 and Us-PCR Var-ATS). LAMP OptiGene® and LAMP WarmStart® performances were identical and better than the performance of Us PCR TARE 2 and Us-PCR var-ATS for P. falciparum, achieving 93.75% sensitivity, 100% specificity and 97.17% accuracy versus 87.5% sensitivity, 100% specificity and 94.29% accuracy for the Us PCR TARE 2 and 81.25% sensitivity, 94.74% specificity and 88.57% accuracy for the Us PCR var-ATS respectively. In P. vivax diagnosis LAMP OptiGene® performed excellently with 100% sensitivity, specificity, and accuracy while LAMP WarmStart® and Us-PCR Cox1 achieved 100% sensitivity, specificity 93.33% and 97.14% accuracy. The study results highlighted the benefits of using LAMP techniques for field diagnosis of malaria in different settings where the need for a more sensitive and reliable molecular tool is mandatory but at the same time removing the high cost, long turnaround time and the need of highly specialized trained technicians to perform more sophisticated molecular techniques.The authors would like to acknowledge The Deanship of Scientific Research, Taif University, Taif, Saudi Arabia for funding of the resent research.S

Anticancer effects of punicalagin and 5-fluorouracil on laryngeal squamous cell carcinoma: an <i>in vitro</i> study

The purpose of this study was to assess the apoptotic effects of punicalagin alone and in combination with 5-fluorouracil (5-FU) on laryngeal squamous cell carcinoma (Hep-2) cell line. Hep-2 cells were cultured and divided into four groups: Group 1 received no therapy and served as control, Group 2 received 5-FU only, Group 3 received punicalagin only, and Group 4 received a combination of 5-FU and punicalagin. After 48 hours of incubation, cellular changes were examined under an inverted microscope. The methyl thiazolyl tetrazolium assay, caspase-3 gene level, and vascular endothelial growth factor (VEGF) level were assessed. The control group showed the highest mean value of cancer cell proliferation rate (1.595±0.58), followed by the punicalagin group (1.263±0.447), then the 5-FU group (0.827±0.256), while the combination group showed the lowest proliferation rate (0.253±0.111). The combination group showed the highest mean value of caspase-3 concentration (3.177±0.736), followed by the 5-FU group (1.830±0.646), and punicalagin group (0.741±0.302), while the control group showed the lowest mean value (0.359±0.117). Regarding VEGF levels, the control group had a statistically significant higher mean value, followed by the punicalagin and 5-FU groups, and finally, the combination group which showed the lowest value. Punicalagin exerts an anticancer effect through anti-proliferative action and induction of apoptosis on Hep-2 cell line. Combining punicalagin with 5-FU potentiates its anti-proliferative, apoptotic, and anti-angiogenic actions. It, further, helps in mitigating the putative side effects of 5-FU by reducing the dose required for its therapeutic effects

Persistence of TEL-AML1 fusion gene as minimal residual disease has no additive prognostic value in CD 10 positive B-acute lymphoblastic leukemia: a FISH study

<p>Abstract</p> <p>Objectives </p> <p>We have analyzed t(12;21)(p13:q22) in an attempt to evaluate the frequency and prognostic significance of <it>TEL-AML1 </it>fusion gene in patients with childhood CD 10 positive B-ALL by fluorescence in situ hybridization (FISH). Also, we have monitored the prognostic value of this gene as a minimal residual disease (MRD).</p> <p>Methods</p> <p>All bone marrow samples of eighty patients diagnosed as CD 10 positive B-ALL in South Egypt Cancer Institute were evaluated by fluorescence in situ hybridization (FISH) for t(12;21) in newly diagnosed cases and after morphological complete remission as a minimal residual disease (MRD). We determined the prognostic significance of <it>TEL-AML1 </it>fusion represented by disease course and survival.</p> <p>Results</p> <p><it>TEL-AML1 </it>fusion gene was positive in (37.5%) in newly diagnosed patients. There was a significant correlation between <it>TEL-AML1 </it>fusion gene both at diagnosis (r = 0.5, P = 0.003) and as a MRD (r = 0.4, P = 0.01) with favorable course. Kaplan-Meier curve for the presence of <it>TEL-AML1 </it>fusion at the diagnosis was associated with a better probability of overall survival (OS); mean survival time was 47 ± 1 month, in contrast to 28 ± 5 month in its absence (P = 0.006). Also, the persistence at <it>TEL-AML1 </it>fusion as a MRD was not significantly associated with a better probability of OS; the mean survival time was 42 ± 2 months in the presence of MRD and it was 40 ± 1 months in its absence. So, persistence of <it>TEL-AML1 </it>fusion as a MRD had no additive prognostic value over its measurement at diagnosis in terms of predicting the probability of OS.</p> <p>Conclusion</p> <p>For most patients, the presence of <it>TEL-AML1 </it>fusion gene at diagnosis suggests a favorable prognosis. The present study suggests that persistence of <it>TEL-AML1 </it>fusion as MRD has no additive prognostic value.</p

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

فخار ما قبل التاريخ خلال العصر الحجري الحديث (الألفية الخامسة ق.م. في وادي النيل في مصر): رؤية فنية من المواد المضافة التي تظهر في نسيج الأواني الفخارية بعد الحرق Pottery of the Neolithic (The Fifth Millennium BCE in the Nile Valley of Egypt): An Artistic View of the Additives that Appear in the Fabric of Pottery Vessels after Firing

{AR} تركز دراسات الفخار على قيمته الجمالية إلا أن أي تغييرٍ في سمة من سمات الإناء الفخاري ينتج عنه تغير في السمات الأخرى؛ ولقد تأخرت كثيرا تلك الدراسات التي تتناول تغير تقنية صناعة الفخار من فترة لأخرى، لذا فإن الدراسات الحديثة تحث على دراسة نسيج الفخار، والذي يحتوي على المواد المضافة التي لم تدرس بعد بشكل منتظم؛ نظراً لأن فترة العصر الحجري الحديث في مصر تُوصف بأنها غير مفهومة تناولت هذه الدراسة المواد المضافة التي تظهر في نسيج الفخار بعد الحرق والمستخدمة في صناعة الأواني الفخارية في حضارات وادي النيل في مصر خلال العصر الحجري الحديث مثل الفيوم ومرمدة بني سلامة وحلوان/العُمري والبداري؛ ونظراً لقيام الدراسات السابقة بتحديد المواد المضافة في نسيج الفخار لكن دون الاهتمام بوظيفة واستخدامات تلك الأواني الفخارية قامت هذه الورقة البحثية بتحديد العلاقة بين هذه المواد واستخدامات الأواني بوصفها سلوكاً بشرياًّ فردياًّ توجد بينه وبين السلوك الاجتماعي علاقة مباشرة وكذلك العلاقة بين المواد المضافة للإناء الفخاري والزخارف المنفذة عليه. استخدمت الدراسة المنهج التاريخي والوصفي التحليلي الخاص بتحليل هيكل التصميم – أي التصور المسبق - ووجدت أن فخار الفيوم كان فخاراً خشناً مضافاً له مواد نباتية ومعدنية، وهو يختلف بذلك عن فخار مرمدة بني سلامة التي افتقرت أوانيها للإضافات مع صقلها أفقياً ثم زادت الخشونة والأشكال وقلَّت الزخارف. واحتوت أواني حلوان/العُمري على المغرة الحمراء أحياناً، ثم ظهرت تركيبات متنوعة الخشونة في فخار البداري مما يعني وجود استخدامات محددة للأواني, وهو ما يعكس تطور المجتمع وتطور صناعة الفخار؛ لذا تستنتج هذه الدراسة أن المواد المضافة التي تظهر في نسيج الأواني الفخارية بعد الحرق لها علاقة بزخارف وفنون ما قبل التاريخ {EN} Pottery attributes have an intricate nature; any change in one attribute leads to changes in the others. Studies of technological change over time arrived late in the discipline. Hence, pottery studies call for shedding more light on composition, which includes temper that was only sporadically studied. The Neolithic of Egypt was described as not being well understood. Therefore, this paper dealt with temper in pottery vessels during the Neolithic of the Nile Valley in the cultures of Fayum, Merimde, el-Omari and Badari. Previous studies identified the additives in the fabric of the pottery, but without paying attention to the function and uses of those pottery vessels, this research paper determined the relationship between these materials and the uses of the pots as individual human behavior with which there is a direct relationship with social behavior, as well as the relationship between the materials added to the pottery vessel and the decorations implemented on it. This study traced the development of temper using descriptive and analytical theoretical frameworks, namely design structure analysis. Results confirmed that temper changed and developed overtime. Fayoum pottery was tempered with plant and mineral material. Even within the same culture, like in the case of Merimde, temper changed from un-tempered clay with polished surfaces, then later adding temper. The latter practice resulted in rougher pots with fewer decorations and more forms. The red color was sometimes added as a temper to pottery from el-Omari. Badari pots showed the use of particular Nile fabrics: A, B, and C, reflecting the specific use of vessels, which coincided with an increase in social complexity and the development of pottery production within the society. This study confirmed that pottery temper could be studied from an artistic perspective

sEMG-based automatic characterization of swallowed materials

Abstract Monitoring of ingestive activities is critically important for managing the health and wellness of individuals with various health conditions, including the elderly, diabetics, and individuals seeking better weight control. Monitoring swallowing events can be an ideal surrogate for developing streamlined methods for effective monitoring and quantification of eating or drinking events. Swallowing is an essential process for maintaining life. This seemingly simple process is the result of coordinated actions of several muscles and nerves in a complex fashion. In this study, we introduce automated methods for the detection and quantification of various eating and drinking activities. Wireless surface electromyography (sEMG) was used to detect chewing and swallowing from sEMG signals obtained from the sternocleidomastoid muscle, in addition to signals obtained from a wrist-mounted IMU sensor. A total of 4675 swallows were collected from 55 participants in the study. Multiple methods were employed to estimate bolus volumes in the case of fluid intake, including regression and classification models. Among the tested models, neural networks-based regression achieved an R 2 of 0.88 and a root mean squared error of 0.2 (minimum bolus volume was 10 ml). Convolutional neural networks-based classification (when considering each bolus volume as a separate class) achieved an accuracy of over 99% using random cross-validation and around 66% using cross-subject validation. Multiple classification methods were also used for solid bolus type detection, including SVM and decision trees (DT), which achieved an accuracy above 99% with random validation and above 94% in cross-subject validation. Finally, regression models with both random and cross-subject validation were used for estimating the solid bolus volume with an R 2 value that approached 1 and root mean squared error values as low as 0.00037 (minimum solid bolus weight was 3 gm). These reported results lay the foundation for a cost-effective and non-invasive method for monitoring swallowing activities which can be extremely beneficial in managing various chronic health conditions, such as diabetes and obesity

miRNA-148a and miRNA-30c expressions as potential biomarkers in breast cancer patients

Background: Breast cancer is an extensively identified malignant tumor and is a prime cause of cancer mortalities in females. It has been shown that alteration of miRNAs expression (up or down regulation) can affect the initiation and progression of many malignancies. We aimed to evaluate the role of circulating miRNA-148a and miRNA-30c in female patients with breast cancer and estimate their usage as potential biomarkers in the diagnosis, prognosis and survival of breast cancer. Methods: This study included 75 breast cancer female patients.They were compared with 55 apparently healthy female subjects. miRNAs expression analysis was assessed via real-time PCR. Results: To discriminate breast cancer patients from controls, miR-30c showed the best performance at a cut off value of ≤20.6 (AUC = 0.998, 97.33% sensitivity, 96.36% specificity, p 21.3), and finally CEA (AUC = 0.751, 70.67% sensitivity, 63.64% specificity, p 2.5). Conclusion: miRNA-148a and miRNA-30c expressions were down regulated in female patients with breast cancer and might be considered as potential blood biomarkers. Both also might have rule in disease treatment and selection of therapeutic targets. Future studies are needed to improve their role in predicting response to treatment and prognosis