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Pivotal role of exosomes in diagnosis and treatment of esophageal cancer in a new era of precision medicine 精准医疗新时代,外泌体在食管癌诊断和治疗中的关键作用
Pub Date : 2024-03-20 DOI: 10.5662/wjm.v14.i1.90624
G. Christodoulidis, Konstantinos-Eleftherios Koumarelas, Marina-Nektaria Kouliou
In this editorial we comment on the article published by Ning et al , “Role of exosomes in metastasis and therapeutic resistance in esophageal cancer”. Esophageal cancer (EC) represents a significant global health concern, being the seventh most common and sixth in terms of mortality worldwide. Despite the advances in therapeutic modalities, the management of patients with EC remains challenging, with a 5-year survival rate of only 25% and a limited eligibility for curative surgery due to its late diagnosis. Conventional screening methods are impractical for the early detection of EC, given their either invasive or insensitive nature. The advent of liquid biopsy, with a focus on circulating tumor cells, circulating tumor DNA, and exosomes, heralds a non-invasive avenue for cancer detection. Exosomes, small vesicles involved in intercellular communication, are highlighted as potential biomarkers for EC diagnosis and prognosis. Along with a diverse cargo encompassing various types of RNA, DNA molecules, proteins, and metabolites, exosomes emerge as key players in tumorigenesis, tumor development, and metastasis. Their significance extends to carrying distinctive biomarkers, including microRNAs (miRNAs), long non-coding RNAs, and circular RNAs, underscoring their potential diagnostic and prognostic value. Furthermore, exosomes may be utilized for therapeutic purposes in the context of EC treatment, serving as efficient delivery vehicles for therapeutic agents such as chemotherapeutic medicines and miRNAs. In this editorial we delve into the applications of exosomes for the early detection and treatment of EC, as well as the future perspectives.
在这篇社论中,我们对宁等人发表的文章《外泌体在食管癌转移和耐药性中的作用》(Role of exosomes in metastasis and therapeutic resistance in esophageal cancer)进行了评论。食管癌(EC)是全球关注的重大健康问题,其发病率居全球第七位,死亡率居全球第六位。尽管治疗方法不断进步,但食管癌患者的治疗仍然充满挑战,5 年生存率仅为 25%,而且由于诊断较晚,接受根治性手术的资格有限。传统的筛查方法具有侵入性或不敏感性,因此不适合用于早期检测癌变率。以循环肿瘤细胞、循环肿瘤DNA和外泌体为重点的液体活检的出现,预示着一种非侵入性的癌症检测途径的到来。外泌体是一种参与细胞间通讯的小囊泡,是诊断和预后心血管疾病的潜在生物标记物。外泌体的载体多种多样,包括各种类型的 RNA、DNA 分子、蛋白质和代谢物,是肿瘤发生、肿瘤发展和转移的关键因素。外泌体的重要作用还包括携带独特的生物标志物,包括微RNA(miRNA)、长非编码RNA和环状RNA,这凸显了外泌体在诊断和预后方面的潜在价值。此外,外泌体还可用于心血管疾病的治疗,成为化疗药物和 miRNA 等治疗药物的高效递送载体。在这篇社论中,我们将深入探讨外泌体在心肌梗死早期检测和治疗中的应用以及未来前景。
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引用次数: 0
Therapeutic role of yoga in hypertension 瑜伽对高血压的治疗作用
Pub Date : 2024-03-20 DOI: 10.5662/wjm.v14.i1.90127
Anjali Mangesh Joshi, Arkiath Veettil Raveendran, Muruganathan Arumugam
Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.
全身性高血压是冠心病和脑血管意外的既定风险因素,控制血压可降低发生重大心血管事件的风险。治疗高血压有非药物治疗和药物治疗两种方法。瑜伽作为一种治疗各种生活方式疾病的方法,最近受到越来越多的关注,尽管瑜伽在印度自古以来就有。在这篇综述中,我们将分析瑜伽在治疗全身性高血压中的作用。
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引用次数: 0
Time-dependent impact of a high-fat diet on the intestinal barrier of male mice 高脂饮食对雄性小鼠肠道屏障的时间依赖性影响
Pub Date : 2024-03-20 DOI: 10.5662/wjm.v14.i1.89723
C. S. Miranda, Daiana Araujo Santana-Oliveira, Isabela Macedo Lopes Vasques-Monteiro, Nathan Soares Dantas-Miranda, Jade Sancha de Oliveira Glauser, F. Silva-Veiga, Vanessa Souza-Mello
BACKGROUND Excessive saturated fat intake compromises the integrity of the intestinal mucosa, leading to low-grade inflammation, impaired mucosal integrity, and increased intestinal permeability, resulting in the migration of lipopolysaccharide (LPS) to other tissues. AIM To evaluate the chronic effects (at 10 and 16 wk) of a high-fat diet (HFD) (with 50% energy as fat) on the phylogenetic gut microbiota distribution and intestinal barrier structure and protection in C57BL/6 mice. METHODS Forty adult male mice were divided into four nutritional groups, where the letters refer to the type of diet (control and HFD or HF) and the numbers refer to the period (in weeks) of diet administration: Control diet for 10 wk, HFD for 10 wk, control diet for 16 wk, and HFD for 16 wk. After sacrifice, biochemical, molecular, and stereological analyses were performed. RESULTS The HF groups were overweight, had gut dysbiosis, had a progressive decrease in occludin immunostaining, and had increased LPS concentrations. Dietary progression reduced the number of goblet cells per large intestine area and Mucin2 expression in the HF16 group, consistent with a completely disarranged intestinal ultrastructure after 16 wk of HFD intake. CONCLUSION Chronic HFD intake causes overweight, gut dysbiosis, and morphological and functional alterations of the intestinal barrier after 10 or 16 wk. Time-dependent reductions in goblet cell numerical density and mucus production have emerged as targets for countering obesity-driven intestinal damage.
背景 摄入过多饱和脂肪会损害肠道黏膜的完整性,导致低度炎症、黏膜完整性受损和肠道通透性增加,从而导致脂多糖(LPS)迁移到其他组织。目的 评估高脂饮食(HFD)(50% 的能量为脂肪)对 C57BL/6 小鼠肠道微生物群系分布、肠道屏障结构和保护的慢性影响(10 周和 16 周)。方法 将 40 只成年雄性小鼠分为四个营养组,其中字母指的是饮食类型(对照组和高脂饮食组或高脂饮食组),数字指的是饮食给药时间(以周为单位):对照组 10 周,HFD 组 10 周,对照组 16 周,HFD 组 16 周。牺牲后,进行生化、分子和立体学分析。结果 高频组体重超重、肠道菌群失调、闭塞素免疫染色逐渐降低、LPS浓度升高。HF16组每大肠面积的鹅口疮细胞数量和Mucin2表达量在摄入HFD 16周后逐渐减少,肠道超微结构完全紊乱。结论 长期摄入高氟日粮会导致超重、肠道菌群失调以及肠道屏障在 10 或 16 周后发生形态和功能改变。随着时间的推移,鹅口疮细胞数量密度和粘液分泌的减少已成为应对肥胖导致的肠道损伤的目标。
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引用次数: 0
Study on good clinical practices among researchers in a tertiary healthcare institute in India. 关于印度一家三级医疗保健机构研究人员良好临床实践的研究。
Pub Date : 2023-12-20 DOI: 10.5662/wjm.v13.i5.466
Harshita Harshita, Prasan Kumar Panda

Background: Good clinical practice (GCP) is put in place to protect human participants in clinical trials as well as to ensure the quality of research. Non-adherence to these guidelines can produce research that may not meet the standards set by the scientific community. Therefore, it must be ensured that researchers are well-versed in the GCP. But not much is known about the knowledge and practices of the GCP in the medical colleges of North India.

Aim: To assess the knowledge and practices of researchers about GCP and analyze these with respect to the demographics of participants.

Methods: This is a cross-sectional study. A self-structured questionnaire about GCP, after expert validations, was circulated among researchers, at a tertiary healthcare institute, All India Institute of Medical Sciences (AIIMS), Rishikesh. A total of 59 individuals, who were selected by universal sampling, participated in the study. All healthcare workers who have been investigators of Institutional Ethics Committee-approved research projects, except residents and faculty, and are still a part of the institute have been included in the study. The study was approved by the Institutional Ethics Committee of AIIMS, Rishikesh. We used descriptive analysis and the Chi-squared test to analyze data. P value < 0.05 was considered significant.

Results: Out of 59 participants, only 11 (18.6%) were certified for GCP. Most of the participants (64.4%) had "Average" knowledge, 33.9% had "Good" knowledge and 1.7% had "Poor" knowledge. Only 49% of participants had satisfactory practices related to GCP. There was a significant difference in the knowledge based on the current academic position for the items assessing knowledge of institutional review board (P = 0.010), confidentiality & privacy (P = 0.011), and participant safety & adverse events (P < 0.001). There was also a significant difference in knowledge of research misconduct (P = 0.024) and participant safety & adverse events (P = 0.011) based on certification of GCP. There was a notable difference in the practices related to recruitment & retention on the basis of current academic position (P < 0.001) and certification of GCP (P = 0.023). We also observed a considerable difference between the knowledge and practices of GCP among the participants (P = 0.013).

Conclusion: Participants have basic knowledge of GCP but show a lack thereof in certain domains of GCP. This can be addressed by holding training sessions focusing on these particular domains.

背景:制定良好临床实践(GCP)的目的是保护临床试验中的人类参与者,并确保研究质量。不遵守这些准则可能导致研究结果不符合科学界设定的标准。因此,必须确保研究人员精通 GCP。目的:评估研究人员对 GCP 的了解和实践,并根据参与者的人口统计学特征进行分析:这是一项横断面研究。经过专家论证后,在里什凯什的一家三级医疗保健机构--全印度医学科学院 (AIIMS) 的研究人员中分发了一份关于 GCP 的自我结构化问卷。通过普遍抽样,共有 59 人参与了研究。除住院医师和教职员工外,所有曾参与机构伦理委员会批准的研究项目,且目前仍在该学院工作的医护人员均被纳入研究范围。本研究获得了瑞诗凯诗 AIIMS 机构伦理委员会的批准。我们采用了描述性分析和卡方检验来分析数据。P值小于0.05为有意义:在 59 名参与者中,只有 11 人(18.6%)获得了 GCP 认证。大多数参与者(64.4%)的知识水平为 "一般",33.9%为 "良好",1.7%为 "较差"。只有 49% 的参与者在 GCP 方面的实践令人满意。在评估机构审查委员会(P = 0.010)、保密和隐私(P = 0.011)以及受试者安全和不良事件(P < 0.001)知识的项目中,基于当前学术职位的知识存在明显差异。根据 GCP 认证情况,对研究不端行为(P = 0.024)和参与者安全及不良事件(P = 0.011)的了解程度也存在明显差异。根据目前的学术职位(P < 0.001)和 GCP 认证(P = 0.023),在招聘和留用相关实践方面存在明显差异。我们还观察到,参与者对 GCP 的了解和实践之间存在相当大的差异(P = 0.013):结论:参与者具备 GCP 的基本知识,但在 GCP 的某些领域存在不足。可以通过举办针对这些特定领域的培训课程来解决这一问题。
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引用次数: 0
Machine learning and deep neural network-based learning in osteoarthritis knee 膝关节骨性关节炎中基于机器学习和深度神经网络的学习
Pub Date : 2023-12-20 DOI: 10.5662/wjm.v13.i5.419
H. Ratna, Madhan Jeyaraman, Naveen Jeyaraman, A. Nallakumarasamy, Shilpa Sharma, Manish Khanna, Ashim Gupta
Osteoarthritis (OA) of the knee joint is considered the commonest musculoskeletal condition leading to marked disability for patients residing in various regions around the globe. Application of machine learning (ML) in doing research regarding OA has brought about various clinical advances viz, OA being diagnosed at preliminary stages, prediction of chances of development of OA among the population, discovering various phenotypes of OA, calculating the severity in OA structure and also discovering people with slow and fast progression of disease pathology, etc. Various publications are available regarding machine learning methods for the early detection of osteoarthritis. The key features are detected by morphology, molecular architecture, and electrical and mechanical functions. In addition, this particular technique was utilized to assess non-interfering, non-ionizing, and in-vivo techniques using magnetic resonance imaging. ML is being utilized in OA, chiefly with the formulation of large cohorts viz, the OA Initiative, a cohort observational study, the Multi-centre Osteoarthritis Study, an observational, prospective longitudinal study and the Cohort Hip & Cohort Knee, an observational cohort prospective study of both hip and knee OA. Though ML has various contributions and enhancing applications, it remains an imminent field with high potential, also with its limitations. Many more studies are to be carried out to find more about the link between machine learning and knee osteoarthritis, which would help in the improvement of making decisions clinically, and expedite the necessary interventions.
膝关节骨性关节炎(OA)被认为是最常见的肌肉骨骼疾病,会导致全球不同地区的患者明显残疾。应用机器学习(ML)进行有关 OA 的研究带来了各种临床进展,如在初期阶段诊断 OA、预测人群中 OA 的发病几率、发现 OA 的各种表型、计算 OA 结构的严重程度以及发现疾病病理进展缓慢和快速的人群等。关于早期检测骨关节炎的机器学习方法,目前已有各种出版物。主要特征通过形态学、分子结构、电气和机械功能进行检测。此外,这项特殊技术还被用于评估非干扰、非电离和使用磁共振成像的体内技术。目前,ML 正在被用于 OA 领域,主要是通过制定大型队列,即 OA 倡议(一项队列观察研究)、多中心骨关节炎研究(一项观察性、前瞻性纵向研究)和队列髋关节和队列膝关节研究(一项髋关节和膝关节 OA 的观察性队列前瞻性研究)。尽管 ML 有着各种贡献和更多的应用,但它仍然是一个迫在眉睫的具有巨大潜力的领域,同时也有其局限性。我们还需要开展更多的研究,进一步了解机器学习与膝关节骨性关节炎之间的联系,这将有助于改进临床决策,加快必要的干预措施。
{"title":"Machine learning and deep neural network-based learning in osteoarthritis knee","authors":"H. Ratna, Madhan Jeyaraman, Naveen Jeyaraman, A. Nallakumarasamy, Shilpa Sharma, Manish Khanna, Ashim Gupta","doi":"10.5662/wjm.v13.i5.419","DOIUrl":"https://doi.org/10.5662/wjm.v13.i5.419","url":null,"abstract":"Osteoarthritis (OA) of the knee joint is considered the commonest musculoskeletal condition leading to marked disability for patients residing in various regions around the globe. Application of machine learning (ML) in doing research regarding OA has brought about various clinical advances viz, OA being diagnosed at preliminary stages, prediction of chances of development of OA among the population, discovering various phenotypes of OA, calculating the severity in OA structure and also discovering people with slow and fast progression of disease pathology, etc. Various publications are available regarding machine learning methods for the early detection of osteoarthritis. The key features are detected by morphology, molecular architecture, and electrical and mechanical functions. In addition, this particular technique was utilized to assess non-interfering, non-ionizing, and in-vivo techniques using magnetic resonance imaging. ML is being utilized in OA, chiefly with the formulation of large cohorts viz, the OA Initiative, a cohort observational study, the Multi-centre Osteoarthritis Study, an observational, prospective longitudinal study and the Cohort Hip & Cohort Knee, an observational cohort prospective study of both hip and knee OA. Though ML has various contributions and enhancing applications, it remains an imminent field with high potential, also with its limitations. Many more studies are to be carried out to find more about the link between machine learning and knee osteoarthritis, which would help in the improvement of making decisions clinically, and expedite the necessary interventions.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"17 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New evidence-based practice: Artificial intelligence as a barrier breaker 新的循证实践:人工智能作为突破口
Pub Date : 2023-12-20 DOI: 10.5662/wjm.v13.i5.384
Ricardo Maia Ferreira
The concept of evidence-based practice has persisted over several years and remains a cornerstone in clinical practice, representing the gold standard for optimal patient care. However, despite widespread recognition of its significance, practical application faces various challenges and barriers, including a lack of skills in interpreting studies, limited resources, time constraints, linguistic competencies, and more. Recently, we have witnessed the emergence of a groundbreaking technological revolution known as artificial intelligence. Although artificial intelligence has become increasingly integrated into our daily lives, some reluctance persists among certain segments of the public. This article explores the potential of artificial intelligence as a solution to some of the main barriers encountered in the application of evidence-based practice. It highlights how artificial intelligence can assist in staying updated with the latest evidence, enhancing clinical decision-making, addressing patient misinformation, and mitigating time constraints in clinical practice. The integration of artificial intelligence into evidence-based practice has the potential to revolutionize healthcare, leading to more precise diagnoses, personalized treatment plans, and improved doctor-patient interactions. This proposed synergy between evidence-based practice and artificial intelligence may necessitate adjustments to its core concept, heralding a new era in healthcare.
循证实践的概念已持续数年之久,至今仍是临床实践的基石,代表着最佳患者护理的黄金标准。然而,尽管人们普遍认识到循证实践的重要性,但在实际应用中却面临着各种挑战和障碍,包括缺乏解读研究的技能、资源有限、时间紧迫、语言能力不足等等。最近,我们目睹了一场划时代的技术革命--人工智能的出现。虽然人工智能已经越来越多地融入我们的日常生活,但在某些公众群体中仍存在一些不情愿的情绪。本文探讨了人工智能在解决循证实践应用过程中遇到的一些主要障碍方面的潜力。文章重点介绍了人工智能如何帮助人们掌握最新证据、加强临床决策、解决病人的错误信息以及缓解临床实践中的时间限制。人工智能与循证实践的结合有可能彻底改变医疗保健,带来更精确的诊断、个性化的治疗方案和更好的医患互动。循证实践与人工智能之间的协同作用可能需要对其核心理念进行调整,从而预示着医疗保健的新时代即将到来。
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引用次数: 0
Using national census data to facilitate healthcare research 利用全国人口普查数据促进医疗保健研究
Pub Date : 2023-12-20 DOI: 10.5662/wjm.v13.i5.414
Michael J Colwill, Andrew Poullis
National censuses are conducted at varying intervals across both the developed and developing world and collect detailed data on a wide range of societal, economic and health questions. This immense volume of data has many potential uses in the field of healthcare research and can be utilised either in isolation or in conjunction with other information sources such as hospital records. At a governmental level census data can be used for healthcare service planning by providing accurate population density information but also, through the use of more detailed data collection, by helping to identify high-risk populations that may require increased resource allocation. It can also be a key tool in addressing and improving healthcare inequality and deprivation by both identifying those populations with poorer healthcare outcomes and through helping researchers to better understand the causes of this inequality. Similarly, it has utility when studying the complex causes of disease and assessing the success of strategies designed to tackle these aetiologies. However, the maximum benefit from these various uses can only be realised if the data collection and analysis processes utilised are robust and this requires that census bureaus regularly review and modify their methods in a transparent and thorough way.
发达国家和发展中国家每隔不同时间都会进行一次全国人口普查,收集有关各种社会、经济和健康问题的详细数据。这些海量数据在医疗保健研究领域有许多潜在用途,既可单独使用,也可与医院记录等其他信息来源结合使用。在政府层面,人口普查数据可通过提供准确的人口密度信息用于医疗保健服务规划,也可通过使用更详细的数据收集,帮助确定可能需要增加资源分配的高风险人群。通过识别医疗保健结果较差的人群,并帮助研究人员更好地了解造成这种不平等的原因,人口普查也可以成为解决和改善医疗保健不平等和贫困问题的重要工具。同样,它在研究疾病的复杂成因和评估旨在解决这些病因的战略的成功与否时也很有用。然而,只有在数据收集和分析过程稳健的情况下,才能从这些不同的用途中获得最大的收益,这就要求普查局以透明和彻底的方式定期审查和修改其方法。
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引用次数: 0
Inflammatory bowel disease among first generation immigrants in Israel: A nationwide epi-Israeli Inflammatory Bowel Disease Research Nucleus study 以色列第一代移民中的炎症性肠病:全国范围内的以色列炎症性肠病研究核心(epi-Israeli Inflammatory Bowel Disease Research Nucleus)研究
Pub Date : 2023-12-20 DOI: 10.5662/wjm.v13.i5.475
Mira Y Stulman, G. Focht, Y. Loewenberg Weisband, S. Greenfeld, Amir Ben Tov, N. Ledderman, E. Matz, Ora Paltiel, S. Odes, Iris Dotan, Eric Ian Benchimol, Dan Turner
BACKGROUND Israel has a high rate of Jewish immigration and a high prevalence of inflammatory bowel disease (IBD). AIM To compare IBD prevalence in first-generation immigrants vs Israel-born Jews. METHODS Patients with a diagnosis of IBD as of June 2020 were included from the validated epi-IIRN (Israeli IBD Research Nucleus) cohort that includes 98% of the Israeli population. We stratified the immigration cohort by IBD risk according to country of origin, time period of immigration, and age group as of June 2020. RESULTS A total of 33544 patients were ascertained, of whom 18524 (55%) had Crohn’s disease (CD) and 15020 (45%) had ulcerative colitis (UC); 28394 (85%) were Israel-born and 5150 (15%) were immigrants. UC was more prevalent in immigrants (2717; 53%) than in non-immigrants (12303, 43%, P < 0.001), especially in the < 1990 immigration period. After adjusting for age, longer duration in Israel was associated with a higher point prevalence rate in June 2020 (high-risk origin: Immigration < 1990: 645.9/100000, ≥ 1990: 613.2/100000, P = 0.043; intermediate/low-risk origin: < 1990: 540.5/100000, ≥ 1990: 192.0/100000, P < 0.001). The prevalence was higher in patients immigrating from countries with high risk for IBD (561.4/100000) than those originating from intermediate-/low-risk countries (514.3/100000; P < 0.001); non-immigrant prevalence was 528.9/100000. CONCLUSION Lending support to the environmental effect on IBD etiology, we found that among immigrants to Israel, the prevalence of IBD increased with longer time since immigration, and was related to the risk of IBD in the country of origin. The UC rate was higher than that of CD only in those immigrating in earlier time periods.
背景 以色列的犹太人移民率很高,炎症性肠病(IBD)的发病率也很高。目的 比较第一代移民与以色列出生的犹太人的 IBD 患病率。方法 从经过验证的 epi-IIRN(以色列 IBD 研究核心)队列中纳入截至 2020 年 6 月诊断为 IBD 的患者,该队列包括 98% 的以色列人口。我们根据原籍国、移民时间和截至 2020 年 6 月的年龄组对移民队列进行了 IBD 风险分层。结果 共确定了 33544 名患者,其中 18524 人(55%)患有克罗恩病(CD),15020 人(45%)患有溃疡性结肠炎(UC);28394 人(85%)在以色列出生,5150 人(15%)为移民。溃疡性结肠炎在移民(2717 人,53%)中的发病率高于非移民(12303 人,43%,P < 0.001),尤其是在 < 1990 年的移民时期。在对年龄进行调整后,2020 年 6 月,在以色列居住时间越长,点患病率越高(高风险原籍:移民 < 1990 年:645.9/100000,≥ 1990 年:613.2/100000,P = 0.043;中/低风险原籍:移民 < 1990 年:540.5/100000,≥ 1990 年:613.2/100000,P = 0.043):< 1990: 540.5/100000, ≥ 1990: 192.0/100000, P < 0.001).来自IBD高风险国家的移民患者的患病率(561.4/100000)高于来自中/低风险国家的移民患者(514.3/100000;P < 0.001);非移民患者的患病率为528.9/100000。结论 我们发现,在以色列移民中,IBD 患病率随着移民时间的延长而增加,并与原籍国的 IBD 风险有关,这支持了环境对 IBD 病因学的影响。只有在较早移民的人群中,UC 的发病率才高于 CD。
{"title":"Inflammatory bowel disease among first generation immigrants in Israel: A nationwide epi-Israeli Inflammatory Bowel Disease Research Nucleus study","authors":"Mira Y Stulman, G. Focht, Y. Loewenberg Weisband, S. Greenfeld, Amir Ben Tov, N. Ledderman, E. Matz, Ora Paltiel, S. Odes, Iris Dotan, Eric Ian Benchimol, Dan Turner","doi":"10.5662/wjm.v13.i5.475","DOIUrl":"https://doi.org/10.5662/wjm.v13.i5.475","url":null,"abstract":"BACKGROUND\u0000 Israel has a high rate of Jewish immigration and a high prevalence of inflammatory bowel disease (IBD).\u0000 AIM\u0000 To compare IBD prevalence in first-generation immigrants vs Israel-born Jews.\u0000 METHODS\u0000 Patients with a diagnosis of IBD as of June 2020 were included from the validated epi-IIRN (Israeli IBD Research Nucleus) cohort that includes 98% of the Israeli population. We stratified the immigration cohort by IBD risk according to country of origin, time period of immigration, and age group as of June 2020.\u0000 RESULTS\u0000 A total of 33544 patients were ascertained, of whom 18524 (55%) had Crohn’s disease (CD) and 15020 (45%) had ulcerative colitis (UC); 28394 (85%) were Israel-born and 5150 (15%) were immigrants. UC was more prevalent in immigrants (2717; 53%) than in non-immigrants (12303, 43%, P < 0.001), especially in the < 1990 immigration period. After adjusting for age, longer duration in Israel was associated with a higher point prevalence rate in June 2020 (high-risk origin: Immigration < 1990: 645.9/100000, ≥ 1990: 613.2/100000, P = 0.043; intermediate/low-risk origin: < 1990: 540.5/100000, ≥ 1990: 192.0/100000, P < 0.001). The prevalence was higher in patients immigrating from countries with high risk for IBD (561.4/100000) than those originating from intermediate-/low-risk countries (514.3/100000; P < 0.001); non-immigrant prevalence was 528.9/100000.\u0000 CONCLUSION\u0000 Lending support to the environmental effect on IBD etiology, we found that among immigrants to Israel, the prevalence of IBD increased with longer time since immigration, and was related to the risk of IBD in the country of origin. The UC rate was higher than that of CD only in those immigrating in earlier time periods.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"93 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Urine exosome mRNA-based test for monitoring kidney allograft rejection: Effects of sample transportation and storage, and interference substances 基于尿液外泌体 mRNA 的肾移植排斥反应监测试验:样本运输和储存以及干扰物质的影响
Pub Date : 2023-12-20 DOI: 10.5662/wjm.v13.i5.492
M. McFaul, Chris Ventura, Sean Evans, Halil Dundar, M.J. Rumpler, C. McCloskey, Dave Lowe, A. Vlassov
BACKGROUND Exosomes are 30-150 nm nanovesicles with sophisticated nucleic acids cargo, actively secreted by all cells within human body, and found in abundance in all body fluids, including urine. These extracellular vesicles have tremendous potential for next generation diagnostics, theoretically enabling noninvasive assessment of organ and tissue function via liquid biopsy analysis. AIM Recently, feasibility of an exosomal molecular test was demonstrated for post-organ transplant monitoring: Analysis of urine-derived exosomal mRNA cargo allowed early detection of kidney allograft rejection. Here, we further studied urine-derived exosomes and their mRNA content as a highly promising diagnostic modality. This included stability studies of urine samples and exosomal mRNA upon transportation from the point of collection to a centralized testing facility, short-term storage of urine at different conditions upon receipt till the point molecular assay is performed, and effects of various potentially interfering substances on the downstream quantitative polymerase chain reaction (qPCR) assay. METHODS The urine specimens were stored at various conditions and pre-processed in different ways. Next, samples were passed through the columns to capture all extracellular vesicles, the vesicles were lysed to release their content and the exosomal RNA was purified on the mini-columns, reverse transcription was performed, next pre-amplification, followed by a qPCR analysis for a panel of mRNA markers. RESULTS To ensure exosomal RNA integrity, the harvested urine specimens should be shipped refrigerated, by overnight delivery. Urine can next be stored at the test site for up to 1 wk at 4 °C, and long term should be frozen at -80 °C. Urine specimens must be centrifuge at low G-force to deplete cells and debris, to ensure consistent top results in downstream molecular assays. All commonly used medications (tacrolimus, cyclosporin A, mycophenolic acid, everolimus, sirolimus, ascomycin, teriflunomide) were tested and confirmed that they do not cause assay interference. CONCLUSION mRNA from urine-derived exosomes was shown to be stable across a broad range of conditions and produced accurate results when analyzed via qPCR assay for detection of kidney allograft rejection. We identified the most optimal conditions for every step of the process, ensuring pre-analytical sample integrity and robust qPCR results.
背景 外泌体是一种 30-150 纳米的纳米囊泡,内含复杂的核酸,由人体内所有细胞主动分泌,大量存在于包括尿液在内的所有体液中。这些细胞外囊泡在下一代诊断中具有巨大潜力,理论上可通过液体活检分析对器官和组织功能进行无创评估。目的 最近,用于器官移植后监测的外泌体分子检验的可行性得到了证实:通过分析尿液外泌体 mRNA 货物,可以早期检测肾移植排斥反应。在此,我们进一步研究了尿液外泌体及其 mRNA 含量,将其作为一种极具前景的诊断方式。研究内容包括尿液样本和外泌体 mRNA 从采集点运输到集中检测机构过程中的稳定性研究、尿液从接收到进行分子检测前在不同条件下的短期储存,以及各种潜在干扰物质对下游定量聚合酶链反应(qPCR)检测的影响。方法 将尿液样本储存在不同条件下,并以不同方式进行预处理。然后,将样本通过小柱以捕获所有细胞外囊泡,裂解囊泡以释放其内容物,在迷你柱上纯化外泌体 RNA,进行反转录,接着进行预扩增,然后对一组 mRNA 标记进行 qPCR 分析。结果 为确保外泌体 RNA 的完整性,采集的尿液标本应冷藏后隔夜运送。接下来,尿液可在检测地点 4 ℃ 下保存 1 周,长期应冷冻至 -80 ℃。尿液标本必须在低离心力下离心,以清除细胞和碎片,确保下游分子检测结果一致。对所有常用药物(他克莫司、环孢素 A、霉酚酸、依维莫司、西罗莫司、阿霉素、特立氟胺)进行了检测,确认它们不会对检测产生干扰。结论 尿液外泌体的 mRNA 在各种条件下都很稳定,通过 qPCR 分析检测肾脏异体移植排斥反应时结果准确。我们确定了整个过程中每一步的最佳条件,确保了分析前样本的完整性和可靠的 qPCR 结果。
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引用次数: 0
Effect of vaccination status on CORADS and computed tomography severity score in hospitalized COVID-19 patients: A retrospective study 疫苗接种情况对 COVID-19 住院患者 CORADS 和计算机断层扫描严重程度评分的影响:回顾性研究
Pub Date : 2023-12-20 DOI: 10.5662/wjm.v13.i5.456
U. Binay, E. Karavaş, F. Karakeçili, Orçun Barkay, Sonay Aydın, Duzgun Can Senbil
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is continuing. The disease most commonly affects the lungs. Since the beginning of the pandemic thorax computed tomography (CT) has been an indispensable imaging method for diagnosis and follow-up. The disease is tried to be controlled with vaccines. Vaccination reduces the possibility of a severe course of the disease. AIM The aim of this study is to investigate whether the vaccination status of patients hospitalized due to COVID-19 has an effect on the CT severity score (CT-SS) and CORADS score obtained during hospitalization. METHODS The files of patients hospitalized between April 1, 2021 and April 1, 2022 due to COVID-19 were retrospectively reviewed. A total of 224 patients who were older than 18 years of age, whose vaccination status was accessible, whose severe acute respiratory syndrome coronavirus 2 polymerase chain reaction result was positive, and who had a Thorax CT scan during hospitalization were included in the study. RESULTS Among the patients included in the study, 52.2% were female and the mean age was 61.85 years. The patients applied to the hospital on the average 7th day of their complaints. While 63 patients were unvaccinated (Group 1), 20 were vaccinated with a single dose of CoronaVac (Group 2), 24 with a single dose of BioNTech (Group 3), 38 with 2 doses of CoronaVac (Group 4), 40 with 2 doses of BioNTech (Group 5), and 39 with 3 doses of vaccine (2 doses of CoronaVac followed by a single dose of BioNTech, Group 6). CT-SS ranged from 5 to 23, with a mean of 12.17. CT-SS mean of the groups were determined as 14.17, 13.35, 11.58, 10.87, 11.28, 10.85, respectively. Accordingly, as a result of the comparisons between the groups, the CT-SS levels of the unvaccinated patients found to be significantly higher than the other groups. As the vaccination rates increased, the rate of typical COVID-19 findings on CT was found to be significantly lower. CONCLUSION Increased vaccination rates in COVID-19 patients reduce the probability of typical COVID-19 symptoms in the lungs. It also reduces the risk of severe disease and decreases CT Severity Scores. This may lead to a loss of importance of Thorax CT in the diagnosis of COVID-19 pneumonia as the end of the pandemic approaches.
背景 2019 年冠状病毒病(COVID-19)大流行仍在继续。该疾病最常影响肺部。自大流行开始以来,胸部计算机断层扫描(CT)一直是诊断和随访不可或缺的成像方法。该疾病试图通过疫苗来控制。疫苗接种可减少疾病严重恶化的可能性。目的 本研究旨在探讨因 COVID-19 而住院的患者的疫苗接种情况是否会对住院期间获得的 CT 严重程度评分(CT-SS)和 CORADS 评分产生影响。方法 回顾性审查了 2021 年 4 月 1 日至 2022 年 4 月 1 日期间因 COVID-19 住院患者的档案。研究共纳入了 224 名年龄大于 18 岁、疫苗接种情况可查、严重急性呼吸系统综合征冠状病毒 2 聚合酶链反应结果呈阳性、住院期间进行过胸部 CT 扫描的患者。结果 在纳入研究的患者中,52.2% 为女性,平均年龄为 61.85 岁。患者平均在主诉的第 7 天向医院提出申请。63 名患者未接种疫苗(第 1 组),20 名患者接种了单剂 CoronaVac 疫苗(第 2 组),24 名患者接种了单剂 BioNTech 疫苗(第 3 组),38 名患者接种了 2 剂 CoronaVac 疫苗(第 4 组),40 名患者接种了 2 剂 BioNTech 疫苗(第 5 组),39 名患者接种了 3 剂疫苗(第 6 组,先接种 2 剂 CoronaVac 疫苗,再接种 1 剂 BioNTech 疫苗)。CT-SS从5到23不等,平均为12.17。各组的 CT-SS 平均值分别为 14.17、13.35、11.58、10.87、11.28 和 10.85。因此,通过组间比较发现,未接种疫苗患者的 CT-SS 水平明显高于其他组别。随着疫苗接种率的增加,CT 上发现典型 COVID-19 的比率明显降低。结论 提高 COVID-19 患者的疫苗接种率可降低肺部出现典型 COVID-19 症状的概率。这也降低了严重疾病的风险,并降低了 CT 严重性评分。这可能会导致随着大流行结束的临近,胸部 CT 在 COVID-19 肺炎诊断中失去重要性。
{"title":"Effect of vaccination status on CORADS and computed tomography severity score in hospitalized COVID-19 patients: A retrospective study","authors":"U. Binay, E. Karavaş, F. Karakeçili, Orçun Barkay, Sonay Aydın, Duzgun Can Senbil","doi":"10.5662/wjm.v13.i5.456","DOIUrl":"https://doi.org/10.5662/wjm.v13.i5.456","url":null,"abstract":"BACKGROUND\u0000 The coronavirus disease 2019 (COVID-19) pandemic is continuing. The disease most commonly affects the lungs. Since the beginning of the pandemic thorax computed tomography (CT) has been an indispensable imaging method for diagnosis and follow-up. The disease is tried to be controlled with vaccines. Vaccination reduces the possibility of a severe course of the disease.\u0000 AIM\u0000 The aim of this study is to investigate whether the vaccination status of patients hospitalized due to COVID-19 has an effect on the CT severity score (CT-SS) and CORADS score obtained during hospitalization.\u0000 METHODS\u0000 The files of patients hospitalized between April 1, 2021 and April 1, 2022 due to COVID-19 were retrospectively reviewed. A total of 224 patients who were older than 18 years of age, whose vaccination status was accessible, whose severe acute respiratory syndrome coronavirus 2 polymerase chain reaction result was positive, and who had a Thorax CT scan during hospitalization were included in the study.\u0000 RESULTS\u0000 Among the patients included in the study, 52.2% were female and the mean age was 61.85 years. The patients applied to the hospital on the average 7th day of their complaints. While 63 patients were unvaccinated (Group 1), 20 were vaccinated with a single dose of CoronaVac (Group 2), 24 with a single dose of BioNTech (Group 3), 38 with 2 doses of CoronaVac (Group 4), 40 with 2 doses of BioNTech (Group 5), and 39 with 3 doses of vaccine (2 doses of CoronaVac followed by a single dose of BioNTech, Group 6). CT-SS ranged from 5 to 23, with a mean of 12.17.\u0000 CT-SS mean of the groups were determined as 14.17, 13.35, 11.58, 10.87, 11.28, 10.85, respectively. Accordingly, as a result of the comparisons between the groups, the CT-SS levels of the unvaccinated patients found to be significantly higher than the other groups. As the vaccination rates increased, the rate of typical COVID-19 findings on CT was found to be significantly lower.\u0000 CONCLUSION\u0000 Increased vaccination rates in COVID-19 patients reduce the probability of typical COVID-19 symptoms in the lungs. It also reduces the risk of severe disease and decreases CT Severity Scores. This may lead to a loss of importance of Thorax CT in the diagnosis of COVID-19 pneumonia as the end of the pandemic approaches.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"39 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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World journal of methodology
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