Ewingleon6297
Exhaled breath analysis is an interesting and promising approach for the diagnostics of various diseases. Being non-invasive, convenient and simple, this approach has tremendous potential utility for further translation into clinical practice. In this study, gas chromatography-mass spectrometry (GC-MS) and quartz microbalance sensor-based "electronic nose" were applied for analysis of the exhaled breath of 40 lung cancer patients and 40 healthy individuals. It was found that the electronic nose was unable to distinguish the samples of different groups. However, the application of GC-MS allowed identifying statistically significant differences in compound peak areas and their ratios for investigated groups. Diagnostic models were created using random forest classifier based on peak areas and their ratios with the sensitivity and specificity of peak areas (ratios) of 85.7-96.5% (75.0-93.1%) and 73.3-85.1% (90.0-92.5%) on training data and 63.6-75.0% (72.7-100.0%) and 50.0-69.2% (76.9-84.6%) on test data, respectively. The exhaled breath samples of lung cancer patients and healthy volunteers could be distinguished by GC-MS with the use of individual compounds, but application of their ratios could help to determine specific differences between investigated groups and the level the influence of individual metabolism features alternating from one person to another as well as daily instrument reproducibility deviations. The electronic nose has to be significantly improved to apply it to lung cancer diagnostics of exhaled breath analysis and the influence of water vapour has to be lowered to increase the sensitivity of the sensors to detect lung cancer biomarkers.Lung IL-6 is a promising biomarker for predicting respiratory failure during pulmonary infections. This biomarker is found in respiratory samples which need to be liquefied prior to analysis. Traditional liquefying methods use reducing agents such as dithiothreitol (DTT). However, DTT impairs immunodetection and does not liquefy highly viscous samples. We propose an enzymatic method that liquefies samples by means of generating O2 bubbles with endogenous catalase. Low respiratory tract specimens from 48 mechanically ventilated patients (38 with SARS-CoV-2 infection) were treated with DTT or with the enzymatic method. We used turbidimetry to compare the liquefaction degree and IL-6 was quantified with ELISA. Finally, we used AUC-ROC, time-to-event and principal component analysis to evaluate the association between respiratory compromise or local inflammation and IL-6 determined with both methods. Enzymatically treated samples were better liquefied than those reduced by DTT, which resulted in higher ELISA signals. Lung IL-6 levels obtained with the enzymatic procedure were negatively correlated with the oxygenation index (PaO2/FiO2) and the time of mechanical ventilation. The proposed enzymatic liquefaction method improves the sensitivity for lung IL-6 detection in respiratory samples, which increases its predictive power as a biomarker for evaluating respiratory compliance.Coronavirus disease-2019 (COVID-19) has adversely impacted vulnerable communities. Community health workers (CHWs) are an evidence-based solution for helping communities navigate challenges and barriers. This case study describes the work of CHWs in a large Hispanic Chicago neighborhood who experienced a disproportionate number of COVID-19 cases. Methods included semistructured interviews and conventional qualitative content analysis. Results describe the problem; the situation; CHWs' roles, motivations and actions; outcomes; lessons learned; and recommendations. The case study concludes with a discussion of effective CHW engagement-particularly for underresourced communities-and presents recommendations for CHW workforce development and policies to strengthen the health care and public health systems.
The primary cardioprotective function of high-density lipoprotein (HDL) is to remove excess cellular free cholesterol (FC) from peripheral tissues and deliver it to the liver. Here, we summarize recent research that examines apolipoprotein A-I (apoA-I) lipidation models by adenosine triphosphate binding cassette transporter A1 (ABCA1) and discuss its relevance in atherosclerotic cardiovascular disease (ASCVD).
The first step in HDL formation involves the interaction between apoA-I and ABCA1, where ABCA1 mediates the removal of FC and phospholipids from lipid-laden macrophages to form discoidal nascent HDL (nHDL). However, there are currently no clear-cut systematic models that characterize HDL formation. A number of recent studies have investigated the importance of apoA-I C- and N-terminal domains required for optimal cholesterol efflux and nHDL production. Furthermore, functional ABCA1 is required for direct or indirect binding to apoA-I where ABCA1 dimer-monomer interconversion facilitates apoA-I lipidation from plasma membrane microdomains. Microparticles are also another lipid source for apoA-I solubilization into nHDL.
ApoA-I and ABCA1 are key factors in macrophage-mediated cholesterol efflux and nHDL production. Understanding of the key steps in HDL formation may unlock the therapeutic potential of HDL and improve clinical management of ASCVD.
ApoA-I and ABCA1 are key factors in macrophage-mediated cholesterol efflux and nHDL production. Understanding of the key steps in HDL formation may unlock the therapeutic potential of HDL and improve clinical management of ASCVD.
Elevated LDL-C and triglycerides are important risk factors for the development of atherosclerotic cardiovascular disease. Although effective therapies for lipid lowering exist, many people do not reach their treatment targets. In the last two decades, ANGPTL3 has emerged as a novel therapeutic target for lowering plasma LDL-C and triglycerides. Here, an overview of the recent literature on ANGPTL3 is provided, focusing on the therapeutic benefits of inactivation of ANGPTL3 via monoclonal antibodies, antisense oligonucleotides, and other more nascent approaches. In addition, the potential mechanisms by which ANGPTL3 inactivation lowers plasma LDL-C are discussed.
ANGPTL3 is a factor secreted by the liver that inhibits lipoprotein lipase and other lipases via the formation of a complex with the related protein ANGPTL8. Large-scale genetic studies in humans have shown that carriers of loss-of-function variants in ANGPTL3 have lower plasma LDL-C and triglyceride levels, and are at reduced risk of atherosclerotic cardiovascular disease. Clinical studies in patients with different forms of dyslipidemia have demonstrated that inactivation of ANGPTL3 using monoclonal antibodies or antisense oligonucleotides markedly lowers plasma LDL-C and triglyceride levels.
Anti-ANGPTL3 therapies hold considerable promise for reducing plasma LDL-C and triglycerides in selected patient groups.
Anti-ANGPTL3 therapies hold considerable promise for reducing plasma LDL-C and triglycerides in selected patient groups.
Patients who are remote, underserved, or require specialized care services are not always able to seek appropriate care when necessary. Telehealth technology allows health care providers to connect virtually with their patients to provide safe and personalized care. To prepare future nurses and nurse practitioners for the use of technology, educators are responsible for integrating telehealth education into the curriculum. This article presents a clinical simulated approach that includes an interprofessional telehealth experience with prelicensure and nurse practitioner students within a pediatric focused simulation.
Patients who are remote, underserved, or require specialized care services are not always able to seek appropriate care when necessary. Telehealth technology allows health care providers to connect virtually with their patients to provide safe and personalized care. To prepare future nurses and nurse practitioners for the use of technology, educators are responsible for integrating telehealth education into the curriculum. This article presents a clinical simulated approach that includes an interprofessional telehealth experience with prelicensure and nurse practitioner students within a pediatric focused simulation.
Inadequate hand-off communication between nurses has been identified as a primary contributing factor leading to medical errors. The purpose of this innovative study was to assess first-semester nursing students' ability to accurately complete a shift assessment and properly communicate findings. Graduate assistants evaluated students' ability to accurately complete a shift assessment, report assessment findings, and identify at least one abnormal finding. The data related to student learning satisfaction and self-confidence were collected from participants during their shift assessment check-off.
Inadequate hand-off communication between nurses has been identified as a primary contributing factor leading to medical errors. The purpose of this innovative study was to assess first-semester nursing students' ability to accurately complete a shift assessment and properly communicate findings. Graduate assistants evaluated students' ability to accurately complete a shift assessment, report assessment findings, and identify at least one abnormal finding. The data related to student learning satisfaction and self-confidence were collected from participants during their shift assessment check-off.
Spontaneous control of HIV replication without treatment in HIV-1 controllers (HICs) was associated with the development of an efficient T cell response. In addition, increasing data suggest that the humoral response participates in viral clearance.
In depth characterization of Ab response in HICs may help to define new parameters associated with this control.
We assessed the levels of total and HIV-specific IgA and IgG subtypes induction and their functional potencies - i.e. neutralization, phagocytosis, antibody-dependent cellular cytotoxicity (ADCC), according to the individual's major histocompatibility complex class I (HLA)-B*57 status, and compared it to non-treated chronic progressors (CPs).
We found that despite an undetectable viral load, HICs displayed HIV-specific IgG levels similar to those of CPs. Interestingly, our compelling multi-functional analysis demonstrates that the functional Ab profile, by itself, allowed to discriminate HLA-B*57+ HICs from HLA-B*57- HICs and CPs.
These results show that HICs display a particular HIV-specific antibody (Ab) profile that may participate in HIV control and emphasize the relevance of multi-functional Ab response analysis in future Ab-driven vaccine studies.
These results show that HICs display a particular HIV-specific antibody (Ab) profile that may participate in HIV control and emphasize the relevance of multi-functional Ab response analysis in future Ab-driven vaccine studies.
Elite controllers (ECs) are therapy-naïve HIV-infected individuals capable of spontaneous control of plasma viraemia for at least a year. Although viraemic non-progressors are more common in vertical HIV-infection than in adults infection, elite control has been rarely characterised in the paediatric population.
We analysed the T-cell immunophenotype and the HIV-specific response by flow cytometry in four paediatric elite controllers (PECs) compared to age-matched non-progressors (PNPs), progressors (PPs) and HIV-exposed uninfected (HEUs) adolescents.
PECs T-cell populations had lower immune activation and exhaustion levels when compared to PP, reflected by a more sustained and preserved effector function. The HIV-specific T-cell responses among PECs were characterised by high-frequency Gag-specific CD4+ T-cell activity, and markedly more polyfunctional Gag-specific CD8+ activity, compared to PNPs and PPs. These findings were consistently observed even in the absence of protective HLA-I molecules such as HLA-B*27/57/81.
