Risk factors for neoplastic progression in Barrett’s esophagus

Barrett’s esophagus (BE) confers a significant increased risk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a metaplasia-dysplasia-carcinoma (MDC) sequence. Many of the genetic insults driving this MDC sequence have recently been characterized, providing targets for candidate biomarkers with potential clinical utility to stratify risk in individual patients. Many clinical risk factors have been investigated, and associations with a variety of genetic...     

Mental health impact of the Middle East respiratory syndrome,SARS, and COVID-19: A comparative systematic review and meta-analysis

BACKGROUNDOver the last few decades, 3 pathogenic pandemics have impacted the global population; severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2. The global disease burden has attributed to millions of deaths and morbidities, with the majority being attributed to SARS-CoV-2. As such, the evaluation of the mental health (MH) impact across healthcare professionals (HCPs), patients and the general public would be an important facet to evaluate to better understand short, medium and long-term exposures. AIMTo identify and report: (1) MH conditions commonly observed across all 3 pandemics; (2) Impact of MH outcomes across HCPs, patients and the general public associated with all 3 pandemics; and (3) The prevalence of the MH impact and clinical epidemiological significance.METHODSA systematic methodology was developed and published on PROSPERO (CRD42021228697). The databases PubMed, EMBASE, ScienceDirect and the Cochrane Central Register of Controlled Trials were used as part of the data extraction process, and publications from January 1, 1990 to August 1, 2021 were searched. MeSH terms and keywords used included Mood disorders, PTSD, Anxiety, Depression, Psychological stress, Psychosis, Bipolar, Mental Health, Unipolar, Self-harm, BAME, Psychiatry disorders and Psychological distress. The terms were expanded with a ‘snowballing’ method. Cox-regression and the Monte-Carlo simulation method was used in addition to I² and Egger’s tests to determine heterogeneity and publication bias. RESULTSIn comparison to MERS and SARS-CoV, it is evident SAR-CoV-2 has an ongoing MH impact, with emphasis on depression, anxiety and post-traumatic stress disorder. CONCLUSIONIt was evident MH studies during MERS and SARS-CoV was limited in comparison to SARS-CoV-2, with much emphasis on reporting symptoms of depression, anxiety, stress and sleep disturbances. The lack of comprehensive studies conducted during previous pandemics have introduced limitations to the “know-how” for clinicians and researchers to better support patients and deliver care with limited healthcare resources.     

Association of Physical Activity,Screen Time and Sleep with Depressive Symptoms in Adolescents

Little is known on the association between movement behaviors including physical activity (PA), screen time (ST) and sleep (SLP) with depression in adolescents. This study aimed to explore the associations of PA, ST and SLP with depressive symptoms in adolescents. A total of 1,331 middle school students participated in this survey and provided valid data pertaining to the study variables. Self-reported questionnaires were used to collect information on participants’ sociodemographic parameters. The Health Behavior in School-aged Children Questionnaire was used to assess the PA (days for moderate to vigorous PA), ST (daily hours of ST) and SLP (daily hours of SLP). Study participants’ depressive symptoms were assessed using the Children’s Depression Inventory. Generalized linear models were used to estimate the associations of PA, ST and SLP with depressive symptoms. Of all the 1331 study participants, boys accounted for 51.31% and percentage of 7^th, 8^th and 9^th graders were 52.44%, 23.22% and 24.34%, respectively. After controlling for sex, body mass index, grade, ethnicity, residence, siblings, perceived family affluence, father and mother educational level, only ST was positively associated with depressive symptoms (beta = 0.17, p = 0.005). This study suggests that excessive ST would be detrimental to depressive symptoms in adolescents. It may be effective to reduce ST for depression intervention or prevention. Future studies are encouraged to use an improved study design to confirm or negate this study’s research findings.     

卒中后疼痛多学科病例讨论教学法在住院医师培养中的应用

急性疼痛是卒中患者常见的临床症状,而慢性疼痛是卒中患者常见的后遗症[1],疼痛常常影响患者整体功能的康复[2-3]。为了提高住院医师对卒中后疼痛的诊疗水平,我们在我院特色的疼痛多学科会诊中心开展了典型卒中后疼痛多学科病例讨论式教学,现将其经验介绍如下。     

Dimethylacetamide can be used as an alternative to glycerol for the successful cryopreservation of koala (Phascolarctos cinereus) spermatozoa

Swelling of koala sperm chromatin following cryopreservation has largely been attributed to the absence of intermolecular disulfide cross-linkages in the marsupial sperm nucleus. Fish spermatozoa also lack disulfide bonds within their chromatin, but have been successfully cryopreserved. The present study examined the hypothesis that the cryoprotectants used for fish sperm cryopreservation would confer a similar degree of protection on koala spermatozoa. Three concentrations each of five cryoprotectants (dimethyl sulfoxide, methanol, propylene glycol, ethylene glycol and dimethylacetamide (DMA)) were evaluated. Each treatment was compared against an established koala sperm cryopreservation protocol that uses 14% glycerol. Post-thaw assessment of progressive motility, plasma membrane integrity and mitochondrial membrane potential (MMP) revealed that protocols using 15% DMA achieved 62.2 +/- 3.6% (P < 0.05) sperm survival, of which 79% (P < 0.05) had high MMP, an improvement of 32% and 40%, respectively, over sperm frozen in 14% glycerol. The percentage of spermatozoa with swollen nuclei was also lowest when frozen in 15% DMA, both immediately after thawing (18.0 +/- 3.5%; P < 0.05) and after 2 h incubation at 35 degrees C (35.8 +/- 4.4%; P < 0.05). A second study was conducted to determine the optimal concentration of DMA for use in the cryopreservation of koala spermatozoa. High DMA concentrations (17.5% and 20%) resulted in significantly lower proportions of live spermatozoa showing high MMP immediately after thawing compared with spermatozoa frozen in the lower concentrations. The percentage of koala spermatozoa with swollen chromatin following cryopreservation was not affected by DMA concentration.     

Glucagon‐Like Peptide‐1 Formulation – the Present and Future Development in Diabetes Treatment

Type 2 diabetes mellitus is a chronic metabolic disorder that has become the fourth leading cause of death in the developed countries. The disorder is characterized by pancreatic β‐cells dysfunction, which causes hyperglycaemia leading to several other complications. Treatment by far, which focuses on insulin administration and glycaemic control, has not been satisfactory. Glucagon‐like peptide‐1 (GLP1) is an endogenous peptide that stimulates post‐prandial insulin secretion. Despite being able to mimic the effect of insulin, GLP1 has not been the target drug in diabetes treatment due to the peptide's metabolic instability. After a decade‐long effort to improve the pharmacokinetics of GLP1, a number of GLP1 analogues are currently available on the market. The current Minireview does not discuss these drugs but presents strategies that were undertaken to address the weaknesses of the native GLP1, particularly drug delivery techniques used in developing GLP1 nanoparticles and modified GLP1 molecule. The article highlights how each of the selected preparations has improved the efficacy of GLP1, and more importantly, through an overview of these studies, it will provide an insight into strategies that may be adopted in the future in the development of a more effective oral GLP1 formulation.