Search results for: advanced gastric cancer
3140 Anti-Angiogenic and Anti-Metastatic Effect of Aqueous Fraction from Euchelus Asper Methanolic Extract
Authors: Sweta Agrawal, Sachin Chaugule, Gargi Rane, Shashank More, Madhavi Indap
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Angiogenesis and metastasis are two of the most important hallmarks of cancer. Hence, most of the cancer therapies nowadays are multi-targeted so as to reduce resistance and have better efficacy. As synthetic molecules arise with a burden of their toxicities and side-effects, more and more research is being focussed on exploiting the vast natural resources of drugs, in the form of plants and animals. Although, the idea of using marine organisms as a source of pharmaceuticals is not new, the pace at which marine drugs are being discovered, has definitely up surged! In the present study, we have assessed the anti-angiogenic and in vitro anti-metastatic activity of aqueous fraction from the extract of marine gastropod Euchelus asper. The soft body of Euchelus Asper was extracted with methanol and named EAME. Partition chromatography of EAME gave three fractions EAME I, II and III. Biochemical analysis revealed the presence of proteins in EAME III. Preliminary analysis had revealed the anti-angiogenic activity was exhibited by EAME III out of the three fractions. Hereafter, EAME III (concentration 25µg/ml-400µg/ml) was tested on chick chorioallantoic membrane (CAM) model for the detailed analysis of its potential anti-angiogenic effect. In vitro testing of the fraction (concentration 0.25µg/ml - 1µg/ml), involved cytotoxicity by SRB assay, cell cycle analysis by flow cytometry and anti-proliferative effect by scratch wound healing assay on A549 lung carcinoma cells. Apart from this, a portion of treated CAM as well as conditioned medium from treated A549 were subjected to gelatin zymography for assessment of matrix metalloproteinases MMP-2 and MMP-9 levels. Our results revealed that EAME III exhibited significant anti-angiogenic activity on CAM which was also supported by histological observations. During histological studies of CAM, it was found that EAME III caused reduction in angiogenesis by altering the extracellular matrix of the CAM membrane. In vitro analysis disclosed that EAME III exhibited moderate cytotoxic effect on A549 cells and its effect was not dose-dependent. The results of flow cytometry confirmed that EAME III caused cell cycle arrest in A549 cell line as almost all of the treated cells were found in G1 phase. Further, the migration and proliferation of A549 was significantly reduced by EAME III as observed from the scratch wound assay. Moreover, Gelatin zymography analysis revealed that EAME III caused suppression of MMP-2 in CAM membrane and reduced MMP-9 and MMP-2 expression in A549 cells. This verified that the anti-angiogenic and anti-metastatic effects of EAME III were correlated with the suppression of MMP-2 and -9. To conclude, EAME III shows dual anti-tumour action by reducing angiogenesis and exerting anti-metastatic effect on lung cancer cells, thus it has the potential to be used as an anti-cancer agent against lung carcinoma.Keywords: angiogenesis, anti-cancer, marine drugs, matrix metalloproteinases
Procedia PDF Downloads 2313139 Toxicological Effects of Atmospheric Fine Particulate Matter on Human Bronchial Epithelial Cells: Metabolic Activation, Genotoxicity and Epigenetic Modifications
Authors: M. Borgie, Z. Dagher, F. Ledoux, A. Verdin, F. Cazier, H. Greige, P. Shirali, D. Courcot
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In October 2013, the International Agency for Research on Cancer (IARC) classified outdoor air pollution and fine particulate matter (PM2.5) as carcinogenic to humans. Despite the clearly relationship established by epidemiological studies between PM exposure and the onset of respiratory and cardiovascular diseases, uncertainties remain about the physiopathological mechanisms responsible for these diseases. The aim of this work was to evaluate the toxicological effects of two samples of atmospheric PM2.5 collected at urban and rural sites on human bronchial epithelial cells, BEAS-2B, especially to investigate the metabolic activation of organic compounds, the alteration of epigenetic mechanisms (i.e. microRNAs genes expression), the phosphorylation of H2AX and the telomerase activity. Our results showed a significant increase in CYP1A1, CYP1B1, and AhRR genes expression, miR-21 gene expression, H2AX phosphorylation and telomerase activity in BEAS-2B cells after their exposure to PM2.5, both in a dose and site-dependent manner. These results showed that PM2.5, especially urban PM, are able to induce the expression of metabolizing enzymes which can provide metabolic biotransformation of organic compounds into more toxic and carcinogenic metabolites, and to induce the expression of the oncomiR miR-21 which promotes cell growth and enhances tumor invasion and metastasis in lung cancer. In addition, our results have highlighted the role of PM2.5 in the activation of telomerase, which can maintain the telomeres length and subsequently preventing cell death, and have also demonstrated the ability of PM2.5 to induce DNA breaks and thus to increase the risk of mutations or chromosomal translocations that lead to genomic instability. All these factors may contribute to cell abnormalities, and thus the development of cancer.Keywords: BEAS-2B cells, carcinogenesis, epigenetic alterations and genotoxicity, PM2.5
Procedia PDF Downloads 3823138 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning
Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu
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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.
Procedia PDF Downloads 893137 An Ensemble Deep Learning Architecture for Imbalanced Classification of Thoracic Surgery Patients
Authors: Saba Ebrahimi, Saeed Ahmadian, Hedie Ashrafi
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Selecting appropriate patients for surgery is one of the main issues in thoracic surgery (TS). Both short-term and long-term risks and benefits of surgery must be considered in the patient selection criteria. There are some limitations in the existing datasets of TS patients because of missing values of attributes and imbalanced distribution of survival classes. In this study, a novel ensemble architecture of deep learning networks is proposed based on stacking different linear and non-linear layers to deal with imbalance datasets. The categorical and numerical features are split using different layers with ability to shrink the unnecessary features. Then, after extracting the insight from the raw features, a novel biased-kernel layer is applied to reinforce the gradient of the minority class and cause the network to be trained better comparing the current methods. Finally, the performance and advantages of our proposed model over the existing models are examined for predicting patient survival after thoracic surgery using a real-life clinical data for lung cancer patients.Keywords: deep learning, ensemble models, imbalanced classification, lung cancer, TS patient selection
Procedia PDF Downloads 1453136 Anticancer and Anti-Apoptotic Potential of Tridham and 1,2,3,4,6-Penta-O-Galloyl-β-D-Glucose in MCF-7 Breast Cancer Cell Line
Authors: R. Stalin, D. Karthick, H. Haseena Banu, T. P. Sachidanandam, P. Shanthi
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Background: Breast cancer is emerging as one of the leading cause of cancer related deaths and hence there arises the need to look out for drugs which are more targets specific with minimal side effects. In recent times, there is a shift towards alternative medicine due to low cost and less side effects. Siddha system of medicine is one the oldest system of medicine practiced against various ailments. Tridham (TD) is a herbal formulation prepared in our laboratory consisting of Terminalia chebula, Elaeocarpus ganitrus and Prosopis cineraria in a definite ratio (TD) and its anticancer potential is evaluated in terms of induction of apoptosis. Objective: The present study was designed to investigate the anti proliferative effect of TD and 1,2,3,4,6-penta-O-galloyl-b-D-glucose (PGG), a pure compound isolated from TD on human mammary carcinoma cell line (MCF-7). Materials and Methods: Cell viability was studied using MTT analysis and trypan blue staining. Mitochondrial membrane potential was studied using DAPI staining. The protein and mRNA expressions of pro-apoptotic and anti- apoptotic markers namely Bax, Bad, Bcl-2 and caspases were also assessed by Western Blotting and RT PCR. Results: Viability studies of TD and PGG treated MCF-7 cells showed an inhibition in cell growth in time and dose dependent manner. The alteration in mitochondrial membrane potential was restored through treatment with TD and PGG which was confirmed by DAPI staining. The protein and mRNA expression of pro-apoptotic markers was found to be significantly increased in TD and PGG treated cells with a concomitant decrease in anti-apoptotic markers. Conclusion: The results of the study suggest that TD and PGG exhibit their anticancer effect through its membrane stabilizing property and activation of apoptotic cascade in MCF-7 cells.Keywords: apoptosis, mammary carcinoma, MCF-7, penta galloyl glucose, Tridham
Procedia PDF Downloads 3123135 Early Identification and Early Intervention: Pre and Post Diagnostic Tests in Mathematics Courses
Authors: Kailash Ghimire, Manoj Thapa
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This study focuses on early identification of deficiencies in pre-required areas of students who are enrolled in College Algebra and Calculus I classes. The students were given pre-diagnostic tests on the first day of the class before they are provided with the syllabus. The tests consist of prerequisite, uniform and advanced content outlined by the University System of Georgia (USG). The results show that 48% of students in College Algebra are lacking prerequisite skills while 52% of Calculus I students are lacking prerequisite skills but, interestingly these students are prior exposed to uniform content and advanced content. The study is still in progress and this paper contains the outcome from Fall 2017 and Spring 2018. In this paper, early intervention used in these classes: two days vs three days meeting a week and students’ self-assessment using exam wrappers and their effectiveness on students’ learning will also be discussed. A result of this study shows that there is an improvement on Drop, Fail and Withdraw (DFW) rates by 7%-10% compared to those in previous semesters.Keywords: student at risk, diagnostic tests, identification, intervention, normalization gain, validity of tests
Procedia PDF Downloads 2083134 MSIpred: A Python 2 Package for the Classification of Tumor Microsatellite Instability from Tumor Mutation Annotation Data Using a Support Vector Machine
Authors: Chen Wang, Chun Liang
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Microsatellite instability (MSI) is characterized by high degree of polymorphism in microsatellite (MS) length due to a deficiency in mismatch repair (MMR) system. MSI is associated with several tumor types and its status can be considered as an important indicator for tumor prognostic. Conventional clinical diagnosis of MSI examines PCR products of a panel of MS markers using electrophoresis (MSI-PCR) which is laborious, time consuming, and less reliable. MSIpred, a python 2 package for automatic classification of MSI was released by this study. It computes important somatic mutation features from files in mutation annotation format (MAF) generated from paired tumor-normal exome sequencing data, subsequently using these to predict tumor MSI status with a support vector machine (SVM) classifier trained by MAF files of 1074 tumors belonging to four types. Evaluation of MSIpred on an independent 358-tumor test set achieved overall accuracy of over 98% and area under receiver operating characteristic (ROC) curve of 0.967. These results indicated that MSIpred is a robust pan-cancer MSI classification tool and can serve as a complementary diagnostic to MSI-PCR in MSI diagnosis.Keywords: microsatellite instability, pan-cancer classification, somatic mutation, support vector machine
Procedia PDF Downloads 1733133 A Review of Recent Studies on Advanced Technologies for Water Treatment
Authors: Deniz Sahin
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Growing concern for the presence and contamination of heavy metals in our water supplies has steadily increased over the last few years. A number of specialized technologies including precipitation, coagulation/flocculation, ion exchange, cementation, electrochemical operations, have been developed for the removal of heavy metals from wastewater. However, these technologies have many limitations in the application, such as high cost, low separation efficiency, Recently, numerous approaches have been investigated to overcome these difficulties and membrane filtration, advanced oxidation technologies (AOPs), and UV irradiation etc. are sufficiently developed to be considered as alternative treatments. Many factors come into play when selecting wastewater treatment technology, such as type of wastewater, operating conditions, economics etc. This study describes these various treatment technologies employed for heavy metal removal. Advantages and disadvantages of these technologies are also compared to highlight their current limitations and future research needs. For example, we investigated the applicability of the ultrafiltration technology for treating of heavy metal ions (e.g., Cu(II), Pb(II), Cd(II), Zn(II)) from synthetic wastewater solutions. Results shown that complete removal of metal ions, could be achieved.Keywords: heavy metal, treatment methodologies, water, water treatment
Procedia PDF Downloads 1703132 Micro-Scale Digital Image Correlation-Driven Finite Element Simulations of Deformation and Damage Initiation in Advanced High Strength Steels
Authors: Asim Alsharif, Christophe Pinna, Hassan Ghadbeigi
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The development of next-generation advanced high strength steels (AHSS) used in the automotive industry requires a better understanding of local deformation and damage development at the scale of their microstructures. This work is focused on dual-phase DP1000 steels and involves micro-mechanical tensile testing inside a scanning electron microscope (SEM) combined with digital image correlation (DIC) to quantify the heterogeneity of deformation in both ferrite and martensite and its evolution up to fracture. Natural features of the microstructure are used for the correlation carried out using Davis LaVision software. Strain localization is observed in both phases with tensile strain values up to 130% and 110% recorded in ferrite and martensite respectively just before final fracture. Damage initiation sites have been observed during deformation in martensite but could not be correlated to local strain values. A finite element (FE) model of the microstructure has then been developed using Abaqus to map stress distributions over representative areas of the microstructure by forcing the model to deform as in the experiment using DIC-measured displacement maps as boundary conditions. A MATLAB code has been developed to automatically mesh the microstructure from SEM images and to map displacement vectors from DIC onto the FE mesh. Results show a correlation of damage initiation at the interface between ferrite and martensite with local principal stress values of about 1700MPa in the martensite phase. Damage in ferrite is now being investigated, and results are expected to bring new insight into damage development in DP steels.Keywords: advanced high strength steels, digital image correlation, finite element modelling, micro-mechanical testing
Procedia PDF Downloads 1453131 Physicochemical Properties, Antioxidant and Cytotoxic Activities of Extracts and Fractions from Phyllanthus amarus
Authors: Van Tang Nguyen, Jennette A. Sakoff, Christopher J. Scarlett
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Phyllanthus amarus (P. amarus) has been used as a traditional herbal plant for the treatment of chronic ailments such as hepatitis, diabetes and cancer. The objectives of this study were to determine the physicochemical properties, antioxidant and cytotoxic activities of crude P. amarus extracts and fractions using MTT and CCK-8 assays for cytotoxic evaluation. The outcomes indicated that P. amarus methanol (PAM) extract had lower residual moisture (7.40%) and water activity (0.24) and higher contents of saponins, phenolics, flavonoids and proanthocyanidins (1657.86 mg escin equivalents, 250.45 mg gallic acid equivalents, 274.73 mg rutin equivalents and 61.22 mg catechin equivalents/g dried extract, respectively) than those of P. amarus water (PAW) extract, resulting antioxidant activity of PAM extract was significantly higher (P < 0.05) than that of PAW extract, PAM fractions and phyllanthin (a major compound in P. amarus). Cytotoxic activity of PAM extract for cancer cell lines of MiaPaCa-2 (pancreas), HT29 (colon), A2780 (ovarian), H460 (lung), A431 (skin), Du145 (prostate), BE2-C (neuroblastoma), MCF-7 (breast), MCF-10A (normal breast), and U87, SJ-G2, SMA (glioblastoma) was higher than those of PAW extract and PAM fractions. Therefore, we can conclude that the PA extracts are a potential source for the development of natural antioxidant products and/or novel anticancer drugs.Keywords: antioxidant, cytotoxicity, Phyllanthus amarus, physicochemical
Procedia PDF Downloads 3243130 Erectile Dysfunction in A Middle Aged Man 6 Years After Bariatric Surgery: A Case Report
Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya
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Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido
Procedia PDF Downloads 2833129 Exploring Tweet Geolocation: Leveraging Large Language Models for Post-Hoc Explanations
Authors: Sarra Hasni, Sami Faiz
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In recent years, location prediction on social networks has gained significant attention, with short and unstructured texts like tweets posing additional challenges. Advanced geolocation models have been proposed, increasing the need to explain their predictions. In this paper, we provide explanations for a geolocation black-box model using LIME and SHAP, two state-of-the-art XAI (eXplainable Artificial Intelligence) methods. We extend our evaluations to Large Language Models (LLMs) as post hoc explainers for tweet geolocation. Our preliminary results show that LLMs outperform LIME and SHAP by generating more accurate explanations. Additionally, we demonstrate that prompts with examples and meta-prompts containing phonetic spelling rules improve the interpretability of these models, even with informal input data. This approach highlights the potential of advanced prompt engineering techniques to enhance the effectiveness of black-box models in geolocation tasks on social networks.Keywords: large language model, post hoc explainer, prompt engineering, local explanation, tweet geolocation
Procedia PDF Downloads 263128 Grade and Maximum Tumor Dimension as Determinants of Lymphadenectomy in Patients with Endometrioid Endometrial Cancer (EEC)
Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris
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Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size
Procedia PDF Downloads 1823127 Molecular Motors in Smart Drug Delivery Systems
Authors: Ainoa Guinart, Maria Korpidou, Daniel Doellerer, Cornelia Palivan, Ben L. Feringa
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Stimuli responsive systems arise from the need to meet unsolved needs of current molecular drugs. Our study presents the design of a delivery system with high spatiotemporal control and tuneable release profiles. We study the incorporation of a hydrophobic synthetic molecular motor into PDMS-b-PMOXA block copolymer vesicles to create a self-assembled system. We prove their successful incorporation and selective activation by low powered visible light (λ 430 nm, 6.9 mW). We trigger the release of a fluorescent dye with high release efficiencies over sequential cycles (up to 75%) with the ability to turn on and off the release behaviour on demand by light irradiation. Low concentrations of photo-responsive units are proven to trigger release down to 1 mol% of molecular motor. Finally, we test our system in relevant physiological conditions using a lung cancer cell line and the encapsulation of an approved drug. Similar levels of cell viability are observed compared to the free-given drugshowing the potential of our platform to deliver functional drugs on demand with the same efficiency and lower toxicity.Keywords: molecular motor, polymer, drug delivery, light-responsive, cancer, selfassembly
Procedia PDF Downloads 1353126 Exploring the Biocompatibility and Performance of Metals and Ceramics as Biomaterials, A Comprehensive Study for Advanced Medical Applications
Authors: Ala Abobakr Abdulhafidh Al-Dubai
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Biomaterials, specifically metals and ceramics, are indispensable components in the realm of medical science, shaping the landscape of implantology and prosthetics. This study delves into the intricate interplay between these materials and biological systems, aiming to scrutinize their suitability, performance, and biocompatibility. Employing a multi-faceted approach, a range of methodologies were meticulously employed to comprehensively characterize these biomaterials. Advanced material characterization techniques were paramount in this research, with scanning electron microscopy providing intricate insights into surface morphology, and X-ray diffraction unraveling the crystalline structures. These analyses were complemented by in vitro assessments, which gauged the biological response of cells to metals and ceramics, shedding light on their potential applications within the human body. A key facet of our investigation involved a comparative study, evaluating the corrosion resistance and osseointegration potential of both metals and ceramics. Through a series of experiments, we sought to understand how these biomaterials interacted with physiological environments, paving the way for informed decisions in medical applicationsKeywords: metals, ceramics, biomaterials, biocompatibility, osseointegration
Procedia PDF Downloads 693125 Comparison of Support Vector Machines and Artificial Neural Network Classifiers in Characterizing Threatened Tree Species Using Eight Bands of WorldView-2 Imagery in Dukuduku Landscape, South Africa
Authors: Galal Omer, Onisimo Mutanga, Elfatih M. Abdel-Rahman, Elhadi Adam
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Threatened tree species (TTS) play a significant role in ecosystem functioning and services, land use dynamics, and other socio-economic aspects. Such aspects include ecological, economic, livelihood, security-based, and well-being benefits. The development of techniques for mapping and monitoring TTS is thus critical for understanding the functioning of ecosystems. The advent of advanced imaging systems and supervised learning algorithms has provided an opportunity to classify TTS over fragmenting landscape. Recently, vegetation maps have been produced using advanced imaging systems such as WorldView-2 (WV-2) and robust classification algorithms such as support vectors machines (SVM) and artificial neural network (ANN). However, delineation of TTS in a fragmenting landscape using high resolution imagery has widely remained elusive due to the complexity of the species structure and their distribution. Therefore, the objective of the current study was to examine the utility of the advanced WV-2 data for mapping TTS in the fragmenting Dukuduku indigenous forest of South Africa using SVM and ANN classification algorithms. The results showed the robustness of the two machine learning algorithms with an overall accuracy (OA) of 77.00% (total disagreement = 23.00%) for SVM and 75.00% (total disagreement = 25.00%) for ANN using all eight bands of WV-2 (8B). This study concludes that SVM and ANN classification algorithms with WV-2 8B have the potential to classify TTS in the Dukuduku indigenous forest. This study offers relatively accurate information that is important for forest managers to make informed decisions regarding management and conservation protocols of TTS.Keywords: artificial neural network, threatened tree species, indigenous forest, support vector machines
Procedia PDF Downloads 5153124 Experience in Caring for a Patient with Terminal Aortic Dissection of Lung Cancer and Paralysis of the Lower Limbs after Surgery
Authors: Pei-Shan Liang
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Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. The patient, diagnosed with aortic dissection during chemotherapy for lung cancer, faced post-surgical lower limb paralysis, leading to feelings of helplessness and hopelessness as they approached death with reduced mobility. Methods: The nursing period was from July 19 to July 27, during which the author, alongside the intensive care team and palliative care specialists, conducted a comprehensive assessment through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used for a holistic evaluation, identifying four nursing health issues: "pain related to terminal lung cancer and invasive procedures," "decreased cardiac tissue perfusion due to hemodynamic instability," "impaired physical mobility related to lower limb paralysis," and "hopelessness due to the unpredictable prognosis of terminal lung cancer." Results: The medical team initially focused on symptom relief, administering Morphine 5mg in 0.9% N/S 50ml IVD q6h for pain management and continuing chemotherapy as prescribed. Open communication was employed to address the patient's physical, psychological, and spiritual concerns. Non-pharmacological interventions, including listening, caring, companionship, opioid medication, and distraction techniques like comfortable positioning and warm foot baths, were used to alleviate pain, reducing the pain score to 3 on the numeric rating scale and easing respiratory discomfort. The palliative care team was also involved, guiding the patient and family through the "Four Paths of Life," helping the patient achieve a good end-of-life experience and the family to experience a peaceful life. This process also served to promote the concept of palliative care, enabling more patients and families to receive high-quality and dignified care. The patient was encouraged to express inner anxiety through drawing or writing, which helped reduce the hopelessness caused by psychological distress and uncertainty about the disease's prognosis, as assessed by the Hospital Anxiety and Depression Scale, reaching a level of mild anxiety but acceptable without affecting sleep. Conclusion: What left a deep impression during the care process was the need for intensive care providers to consider the patient's psychological state, not just their physical condition, when the patient's situation changes. Family support and involvement often provide the greatest solace for the patient, emphasizing the importance of comfort and dignity. This includes oral care to maintain cleanliness and comfort, frequent repositioning to alleviate pressure and discomfort, and timely removal of invasive devices and unnecessary medications to avoid unnecessary suffering. The nursing process should also address the patient's psychological needs, offering comfort and support to ensure that they can face the end of life with peace and dignity.Keywords: intensive care, lung cancer, aortic dissection, lower limb paralysis
Procedia PDF Downloads 253123 In situ Ortho-Quinone Methide Reactions for Construction of Flavonoids with Fused Ring Systems
Authors: Vidia A. Nuraini, Eugene M. H. Yee, Mohan Bhadbhade, David StC. Black, Naresh Kumar
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Flavonoids are naturally occurring compounds that have been shown to exhibit a wide range of biological properties including anticancer and anti-inflammatory activities. However, flavonoids suffer from low bioavailability, which limits their overall utility for therapeutic applications. One of the methods to overcome this limitation is through structural modification of natural flavonoids. In this study, flavanone, isoflavanone, and isoflavene, were structurally modified through the introduction of additional fused-ring systems via ortho-quinone methide intermediates (o-QMs). These intermediates can readily undergo a [4+2] cycloaddition through an inverse-electron-demand Diels–Alder reaction with electron-rich dienophiles. A regioselective Mannich reaction using bis-(N,N-dimethylamino)methane was employed to generate the o-QM precursors of flavanone, isoflavanone, and isoflavene. The o-QM intermediates were subsequently generated in situ through thermal elimination of the dimethylamine functionality and reacted with a variety of dienophiles to produce novel flavonoids with fused-ring systems. A total of 21 novel flavonoid analogs were successfully synthesized. The X-ray crystal structure of cycloaddition adducts, particularly those derived from 3,4-dihydro-2H-pyran and p-methoxystyrene revealed a special case of enantiomeric disorder, where two enantiomers in equal amounts superpose with one another, with the exception for atoms that have opposite configuration. The anticancer properties of fused-ring systems derived from isoflavene were evaluated against the neuroblastoma SKN-BE(2)C, the triple negative breast cancer MDA-MB-231, and the glioblastoma U87 cancer cell lines. One of these cycloaddition adducts had displayed improved anti-proliferative activity against MDA-MB-231 and U87 cancer cell lines as compared to the parent compound. Further anticancer and anti-inflammatory activities of the flavanone and isoflavanone analogs are currently being investigated.Keywords: Diels-Alder reaction, flavonoids, Mannich reaction, ortho-quinone methide.
Procedia PDF Downloads 2513122 Reconstruction Post-mastectomy: A Literature Review on Its Indications and Techniques
Authors: Layaly Ayoub, Mariana Ribeiro
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Introduction: Breast cancer is currently considered the leading cause of cancer-related deaths among women in Brazil. Mastectomy, essential in this treatment, often necessitates subsequent breast reconstruction to restore physical appearance and aid in the emotional and psychological recovery of patients. The choice between immediate or delayed reconstruction is influenced by factors such as the type and stage of cancer, as well as the patient's overall health. The decision between autologous breast reconstruction or implant-based reconstruction requires a detailed analysis of individual conditions and needs. Objectives: This study analyzes the techniques and indications used in post-mastectomy breast reconstruction. Methodology: Literature review conducted in the PubMed and SciELO databases, focusing on articles that met the inclusion and exclusion criteria and descriptors. Results: After mastectomy, breast reconstruction is commonly performed. It is necessary to determine the type of technique to be used in each case depending on the specific characteristics of each patient. The tissue expander technique is indicated for patients with sufficient skin and tissue post-mastectomy, who do not require additional radiotherapy, and who opt for a less complex surgery with a shorter recovery time. This procedure promotes the gradual expansion of soft tissues where the definitive implant will be placed. Both temporary and permanent expanders offer flexibility, allowing for adjustment in the expander size until the desired volume is reached, enabling the skin and tissues to adapt to the breast implant area. Conversely, autologous reconstruction is indicated for patients who will undergo radiotherapy, have insufficient tissue, and prefer a more natural solution. This technique uses the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi muscle flap, the gluteal flap, and local muscle flaps to shape a new breast, potentially combined with a breast implant. Conclusion: In this context, it is essential to conduct a thorough evaluation regarding the technique to be applied, as both have their benefits and challenges.Keywords: indications, post-mastectomy, breast reconstruction, techniques
Procedia PDF Downloads 293121 Computational Model for Predicting Effective siRNA Sequences Using Whole Stacking Energy (ΔG) for Gene Silencing
Authors: Reena Murali, David Peter S.
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The small interfering RNA (siRNA) alters the regulatory role of mRNA during gene expression by translational inhibition. Recent studies shows that up regulation of mRNA cause serious diseases like Cancer. So designing effective siRNA with good knockdown effects play an important role in gene silencing. Various siRNA design tools had been developed earlier. In this work, we are trying to analyze the existing good scoring second generation siRNA predicting tools and to optimize the efficiency of siRNA prediction by designing a computational model using Artificial Neural Network and whole stacking energy (ΔG), which may help in gene silencing and drug design in cancer therapy. Our model is trained and tested against a large data set of siRNA sequences. Validation of our results is done by finding correlation coefficient of experimental versus observed inhibition efficacy of siRNA. We achieved a correlation coefficient of 0.727 in our previous computational model and we could improve the correlation coefficient up to 0.753 when the threshold of whole tacking energy is greater than or equal to -32.5 kcal/mol.Keywords: artificial neural network, double stranded RNA, RNA interference, short interfering RNA
Procedia PDF Downloads 5263120 Gene Expression Signature-Based Chemical Genomic to Identify Potential Therapeutic Compounds for Colorectal Cancer
Authors: Yen-Hao Su, Wan-Chun Tang, Ya-Wen Cheng, Peik Sia, Chi-Chen Huang, Yi-Chao Lee, Hsin-Yi Jiang, Ming-Heng Wu, I-Lu Lai, Jun-Wei Lee, Kuen-Haur Lee
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There is a wide range of drugs and combinations under investigation and/or approved over the last decade to treat colorectal cancer (CRC), but the 5-year survival rate remains poor at stages II–IV. Therefore, new, more efficient drugs still need to be developed that will hopefully be included in first-line therapy or overcome resistance when it appears, as part of second- or third-line treatments in the near future. In this study, we revealed that heat shock protein 90 (Hsp90) inhibitors have high therapeutic potential in CRC according to combinative analysis of NCBI's Gene Expression Omnibus (GEO) repository and chemical genomic database of Connectivity Map (CMap). We found that second generation Hsp90 inhibitor, NVP-AUY922, significantly down regulated the activities of a broad spectrum of kinases involved in regulating cell growth arrest and death of NVPAUY922-sensitive CRC cells. To overcome NVP-AUY922-induced upregulation of survivin expression which causes drug insensitivity, we found that combining berberine (BBR), a herbal medicine with potency in inhibiting survivin expression, with NVP-AUY922 resulted in synergistic antiproliferative effects for NVP-AUY922-sensitive and -insensitive CRC cells. Furthermore, we demonstrated that treatment of NVP-AUY922-insensitive CRC cells with the combination of NVP-AUY922 and BBR caused cell growth arrest through inhibiting CDK4 expression and induction of microRNA-296-5p (miR-296-5p)-mediated suppression of Pin1–β-catenin–cyclin D1 signaling pathway. Finally, we found that the expression level of Hsp90 in tumor tissues of CRC was positively correlated with CDK4 and Pin1 expression levels. Taken together, these results indicate that combination of NVP-AUY922 and BBR therapy can inhibit multiple oncogenic signaling pathways of CRC.Keywords: berberine, colorectal cancer, connectivity map, heat shock protein 90 inhibitor
Procedia PDF Downloads 3063119 Effectiveness of Simulation Resuscitation Training to Improve Self-Efficacy of Physicians and Nurses at Aga Khan University Hospital in Advanced Cardiac Life Support Courses Quasi-Experimental Study Design
Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani
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Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation
Procedia PDF Downloads 803118 Saving Energy through Scalable Architecture
Authors: John Lamb, Robert Epstein, Vasundhara L. Bhupathi, Sanjeev Kumar Marimekala
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In this paper, we focus on the importance of scalable architecture for data centers and buildings in general to help an enterprise achieve environmental sustainability. The scalable architecture helps in many ways, such as adaptability to the business and user requirements, promotes high availability and disaster recovery solutions that are cost effective and low maintenance. The scalable architecture also plays a vital role in three core areas of sustainability: economy, environment, and social, which are also known as the 3 pillars of a sustainability model. If the architecture is scalable, it has many advantages. A few examples are that scalable architecture helps businesses and industries to adapt to changing technology, drive innovation, promote platform independence, and build resilience against natural disasters. Most importantly, having a scalable architecture helps industries bring in cost-effective measures for energy consumption, reduce wastage, increase productivity, and enable a robust environment. It also helps in the reduction of carbon emissions with advanced monitoring and metering capabilities. Scalable architectures help in reducing waste by optimizing the designs to utilize materials efficiently, minimize resources, decrease carbon footprints by using low-impact materials that are environmentally friendly. In this paper we also emphasize the importance of cultural shift towards the reuse and recycling of natural resources for a balanced ecosystem and maintain a circular economy. Also, since all of us are involved in the use of computers, much of the scalable architecture we have studied is related to data centers.Keywords: scalable architectures, sustainability, application design, disruptive technology, machine learning and natural language processing, AI, social media platform, cloud computing, advanced networking and storage devices, advanced monitoring and metering infrastructure, climate change
Procedia PDF Downloads 1063117 Macroalgae as a Gaseous Fuel Option: Potential and Advanced Conversion Technologies
Authors: Muhammad Rizwan Tabassum, Ao Xia, Jerry D. Murphy
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The aim of this work is to provide an overview of macroalgae as an alternative feedstock for gaseous fuel production and key innovative technologies. Climate change and continuously depleting resources are the key driving forces to think for alternative sources of energy. Macroalgae can be favored over land based energy crops because they are not in direct competition with food crops. However, some drawbacks, such as high moisture content, seasonal variation in chemical composition and process inhibition limit the economic practicability. Macroalgae, like brown seaweed can be converted into gaseous and liquid fuel by different conversion technologies. Biomethane via anaerobic digestion is the appealing technology due to its dual advantage of a commercially applicable and environment friendly technology. Other technologies like biodiesel and bioethanol conversion technologies from seaweed are still under progress. Screening of high yielding macroalgae species, peak harvesting season and process optimization make the technology economically feasible for alternative source of feedstock for biofuel production in future.Keywords: anaerobic digestion, biofuels, bio-methane, advanced conversion technologies, macroalgae
Procedia PDF Downloads 3073116 Studying Together Affects Perceived Social Distance but Not Stereotypes: Nursing Students' Perception of Their Intergroup Relationship
Authors: Michal Alon-Tirosh, Dorit Hadar-Shoval
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Social Psychology theories, such as the intergroup contact theory, content that bringing members of different social groups into contact is a promising approach for improving intergroup relations. The heterogeneous nature of the nursing profession generates encounters between members of different social groups .The social relations that nursing students develop with their peers during their years of study, and the meanings they ascribe to these contacts, may affect the success of their nursing careers. Jewish-Arab relations in Israel are the product of an ongoing conflict and are characterized by stereotyped negative perceptions and mutual suspicions. Nursing education is often the first situation in which Jewish and Arab nursing students have direct and long-term contact with people from the other group. These encounters present a significant challenge. The current study explores whether this contact between Jewish and Arab nursing students during their academic studies improves their perception of their intergroup relationship. The study explores the students' perceptions of the social relations between the two groups. We examine attribution of stereotypes (positive and negative) and willingness to engage in social interactions with individuals from the other group. The study hypothesis is that academic seniority (beginning students, advanced students) will be related to perceptions of the relations between the two groups, as manifested in attributions of positive and negative stereotypes and willingness to reduce the social distance between the two groups. Method: One hundred and eighty Jewish and Arab nursing students (111 Jewish and 69 Arab) completed questionnaires examining their perceptions of the social relations between the two groups. The questionnaires were administered at two different points in their studies (beginning students and those at more advanced stages Results: No differences were found between beginning students and advanced students with respect to stereotypes. However, advanced students expressed greater willingness to reduce social distance than did beginning students. Conclusions: The findings indicate that bringing members of different social groups into contact may improve some aspects of intergroup relations. The findings suggest that different aspects of perceptions of social relations are influenced by different contexts: the students' specific context (joint studies and joint work in the future) and the broader general context of relations between the groups. Accordingly, it is recommended that programs aimed at improving relations in a between social groups will focus on willingness to cooperate and reduce social distance rather than on attempts to eliminate stereotypes.Keywords: nursing education, perceived social relations, social distance, stereotypes
Procedia PDF Downloads 1043115 Autophagy Acceleration and Self-Healing by the Revolution against Frequent Eating, High Glycemic and Unabsorbable Substances as One Meal a Day Plan
Authors: Reihane Mehrparvar
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Human age could exceed further by altering gene expression through food intaking, although as a consequence of recent century eating patterns, human life-span getting shorter by emerging irregulating in autophagy mechanism, insulin, leptin, gut microbiota which are important etiological factors of type-2 diabetes, obesity, infertility, cancer, metabolic and autoimmune diseases. However, restricted calorie intake and vigorous exercise might be beneficial for losing weight and metabolic regulation in a short period but could not be implementable in the long term as a way of life. Therefore, the lack of a dietary program that is compatible with the genes of the body is essential. Sweet and high-glycemic-index (HGI) foods were associated with type-2 diabetes and cancer morbidity. The neuropsychological perspective characterizes the inclination of sweet and HGI-food consumption as addictive behavior; hence this process engages preference of gut microbiota, neural node, and dopaminergic functions. Moreover, meal composition is not the only factor that affects body hemostasis. In this narrative review, it is believed to attempt to investigate how the body responded to different food intakes and represent an accurate model based on current evidence. Eating frequently and ingesting unassimilable protein and carbohydrates may not be compatible with human genes and could cause impairments in the self-renovation mechanism. This trajectory indicates our body is more adapted to starvation and eating animal meat and marrow. Here has been recommended a model that takes into account three important factors: frequent eating, meal composition, and circadian rhythm, which may offer a promising intervention for obesity, inflammation, cardiovascular, autoimmune disorder, type-2 diabetes, insulin resistance, infertility, and cancer through intensifying autophagy-mechanism and eliminate medical costs.Keywords: metabolic disease, anti-aging, type-2 diabetes, autophagy
Procedia PDF Downloads 813114 The Antibacterial and Anticancer Activity of Marine Actinomycete Strain HP411 Isolated in the Northern Coast of Vietnam
Authors: Huyen T. Pham, Nhue P. Nguyen, Tien Q. Phi, Phuong T. Dang, Hy G. Le
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Since the marine environmental conditions are extremely different from the other ones, so that marine actinomycetes might produce novel bioactive compounds. Therefore, actinomycete strains were screened from marine water and sediment samples collected from the coastal areas of Northern Vietnam. Ninety-nine actinomycete strains were obtained on starch-casein agar media by dilution technique, only seven strains, named HP112, HP12, HP411, HPN11, HP 11, HPT13 and HPX12, showed significant antibacterial activity against both gram-positive and gram-negative bacteria (Bacillus subtilis ATCC 6633, Staphylococcus epidemidis ATCC 12228, Escherichia coli ATCC 11105). Further studies were carried out with the most active HP411strain against Candida albicans ATCC 10231. This strain could grow rapidly on starch casein agar and other media with high salt containing 7-10% NaCl at 28-30oC. Spore-chain of HP411 showed an elongated and circular shape with 10 to 30 spores/chain. Identification of the strain was carried out by employing the taxonomical studies including the 16S rRNA sequence. Based on phylogenetic and phenotypic evidence it is proposed that HP411 to be belongs to species Streptomyces variabilis. The potent of the crude extract of fermentation broth of HP411that are effective against wide range of pathogens: both gram-positive, gram-negative and fungi. Further studies revealed that the crude extract HP411 could obtain the anticancer activity for cancer cell lines: Hep-G2 (liver cancer cell line); RD (cardiac and skeletal muscle letters cell line); FL (membrane of the uterus cancer cell line). However, the actinomycetes from marine ecosystem will be useful for the discovery of new drugs in the furture.Keywords: marine actinomycetes, antibacterial, anticancer, Streptomyces variabilis
Procedia PDF Downloads 4193113 Shared Decision Making in Oropharyngeal Cancer: The Development of a Decision Aid for Resectable Oropharyngeal Carcinoma, a Mixed Methods Study
Authors: Anne N. Heirman, Lisette van der Molen, Richard Dirven, Gyorgi B. Halmos, Michiel W.M. van den Brekel
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Background: Due to the rising incidence of oropharyngeal squamous cell cancer (OPSCC), many patients are challenged with choosing between transoral(robotic) surgery and radiotherapy, with equal survival and oncological outcomes. Also, functional outcomes are of little difference over the years. With this study, the wants and needs of patients and caregivers are identified to develop a comprehensible patient decision aid (PDA). Methods: The development of this PDA is based on the International Patient Decision Aid Standards criteria. In phase 1, relevant literature was reviewed and compared to current counseling papers. We interviewed ten post-treatment patients and ten doctors from four head and neck centers in the Netherlands, which were transcribed verbatim and analyzed. With these results, the first draft of the PDA was developed. Phase 2 beholds testing the first draft for comprehensibility and usability. Phase 3 beholds testing for feasibility. After this phase, the final version of the PDA was developed. Results: All doctors and patients agreed a PDA was needed. Phase 1 showed that 50% of patients felt well-informed after standard care and 35% missed information about treatment possibilities. Side effects and functional outcomes were rated as the most important for decision-making. With this information, the first version was developed. Doctors and patients stated (phase 2) that they were satisfied with the comprehensibility and usability, but there was too much text. The PDA underwent text reduction revisions and got more graphics. After revisions, all doctors found the PDA feasible and would contribute to regular counseling. Patients were satisfied with the results and wished they would have seen it before their treatment. Conclusion: Decision-making for OPSCC should focus on differences in side-effects and functional outcomes. Patients and doctors found the PDA to be of great value. Future research will explore the benefits of the PDA in clinical practice.Keywords: head-and-neck oncology, oropharyngeal cancer, patient decision aid, development, shared decision making
Procedia PDF Downloads 1443112 Change of Endocrine and Exocrine Insufficiency on Non-Diabetes Patients after Distal Pancreatectomy: A Nationwide Database Study
Authors: Jin-Ming Wu, Te-Wei Ho, Yu-Wen Tien
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Background: The aim of this population-based study was to determine the occurrence of diabetes and exocrine pancreatic insufficiencies (EPI) on non-diabetes subjects receiving distal pancreatectomy (DP). Method: A nationwide cohort study between 2000 and 2010 was collected from the Taiwan National Health Insurance Research Database. Among 3264 DP patients, we identified 1410 non-diabetes and 966 non-diabetes non-EPI. Results. Of 1410 non-diabetes DP subjects, 312 patients (22.1%) developed newly-diagnosed diabetes after PD. On a multiple logistic regression model, co-morbid hyperlipidemia (odds ratio, 1.640; 95% CI, 1.362–2.763; P < 0.001) and pancreatitis (odds ratio, 2.428; 95% CI, 1.889–3.121; P < 0.001) significantly contributed to higher incidences of diabetes after DP. Moreover, 380 subjects (39.3%) developed EPI, and pancreatic cancer is the statistically significant risk factor (odds ratio, 4.663; 95% CI, 2.108–6.085; P < 0.001). Conclusion: The patients with co-morbid hyperlipidemia and chronic pancreatitis had higher rates of newly-diagnosed diabetes after DP, moreover, pancreatic cancer subjects had higher rates of pancreatic exocrine insufficiency after DP. The clinicians should be alert to follow up glucose metabolism and clinical symptoms of fat intolerance for DP patients.Keywords: distal pancreatectomy, National database, diabetes, exocrine insufficiency
Procedia PDF Downloads 1963111 Camptothecin Promotes ROS-Mediated G2/M Phase Cell Cycle Arrest, Resulting from Autophagy-Mediated Cytoprotection
Authors: Rajapaksha Gedara Prasad Tharanga Jayasooriya, Matharage Gayani Dilshara, Yung Hyun Choi, Gi-Young Kim
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Camptothecin (CPT) is a quinolone alkaloid which inhibits DNA topoisomerase I that induces cytotoxicity in a variety of cancer cell lines. We previously showed that CPT effectively inhibited invasion of prostate cancer cells and also combined treatment with subtoxic doses of CPT and TNF-related apoptosis-inducing ligand (TRAIL) potentially enhanced apoptosis in a caspase-dependent manner in hepatoma cancer cells. Here, we found that treatment with CPT caused an irreversible cell cycle arrest in the G2/M phase. CPT-induced cell cycle arrest was associated with a decrease in protein levels of cell division cycle 25C (Cdc25C) and increased the level of cyclin B and p21. The CPT-induced decrease in Cdc25C was blocked in the presence of proteasome inhibitor MG132, thus reversed the cell cycle arrest. In addition to that treatment of CPT-increased phosphorylation of Cdc25C was the resulted of activation of checkpoint kinase 2 (Chk2), which was associated with phosphorylation of ataxia telangiectasia-mutated. Interestingly CPT induced G2/M phase of the cell cycle arrest is reactive oxygen species (ROS) dependent where ROS inhibitors NAC and GSH reversed the CPT-induced cell cycle arrest. These results further confirm by using transient knockdown of nuclear factor-erythroid 2-related factor 2 (Nrf2) since it regulates the production of ROS. Our data reveal that treatment of siNrf2 increased the ROS level as well as further increased the CPT induce G2/M phase cell cycle arrest. Our data also indicate CPT-enhanced cell cycle arrest through the extracellular signal-regulated kinase (ERK) and the c-Jun N-terminal kinase (JNK) pathway. Inhibitors of ERK and JNK more decreased the Cdc25C expression and protein expression of p21 and cyclin B. These findings indicate that Chk2-mediated phosphorylation of Cdc25C plays a major role in G2/M arrest by CPT.Keywords: camptothecin, cell cycle, checkpoint kinase 2, nuclear factor-erythroid 2-related factor 2, reactive oxygen species
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