Low volume polyethylene glycol combined with senna versus high volume polyethylene glycol, which regimen is better for bowel preparation for colonoscopy? A randomized, controlled, and single‐blinded trial

Background and Aims

Bowel preparation affects the quality of colonoscopy. Reaching the optimal preparation has been a challenge for years. Polyethylene glycol (PEG) is the sole FDA‐approved substance for this purpose. However, patients find it unpleasant and often complain about its adverse effects. In this study, we aimed to reduce these complaints by lowering the amount of PEG and adding senna which is an herbal stimulant laxative.

Methods

Four hundred and eighty‐six patients were admitted for colonoscopy. Finally, 382 patients were enrolled in the study and we divided them into two groups; 186 patients were placed in which conventional high volume PEG‐alone regimen was consumed and 196 patients in which low volume PEG plus senna regimen was offered. The quality of colon preparation was compared between the two groups by independent two samples t‐test (or its corresponding nonparametric test), Fisher's exact, or χ² test in SPSS software version 22.

Results

The colon preparation quality was equally efficient in the two groups as 69.36% in the high volume PEG group and 71.94% in PEG plus senna group had adequate bowel preparation (p = 0.58). Adverse effects, like nausea, bloating, headache, and sleeplessness were significantly less in the low volume PEG plus senna group.

Conclusion

Besides the fact that bowel preparation by low volume PEG plus senna combination was noninferior to the conventional high volume PEG‐alone regimen, the side effects were much less common with the low volume PEG plus senna regimen.

The Relationship between Health Anxiety and Perceived Stress with Moral Distress in Emergency Nurses: The Mediating Role of Distress Tolerance

Background: Nurses in emergency departments are exposed to stress and ethical issues due to the specific nature of their job. Therefore, the aim of the present study was to present a relationship between health anxiety and perceived stress with Moral distress and mediation of turmoil tolerance in emergency department nurses. Methods: This descriptive correlational study was performed on 230 emergency nurses in Tehran in 1399 using available sampling method. In this study, the Cohen, Kamark and Marmelstein (1983) Perceived Stress Questionnaire, Salkowski and Warwick (2002), Simmons and Gahr (2005) Perturbation Tolerance, and Jamton's Moral Perturbation Questionnaire were used. Data analysis was performed by path analysis using SPSS-24 and Amos-24 software. Results: The findings of the study showed that perceived stress (t = 5.58) and health anxiety (t = 7.1) had a positive and direct effect on Moral distress and distress Tolerance(t = 8.33) on Moral distress. The effect is negative and direct (P <0.01). The results also showed that disturbance tolerance has a mediating role in the relationship between perceived fear and health anxiety with moral distress (P <0.01). Conclusion: distress Tolerance mediates the relationship between perceived stress and health anxiety with Moral distress. The findings of this study can be used to improve the degree of distress Tolerance and improve the level of work ethic and reduce the Moral distress of emergency department nurses.

Comparison of portal hypertensive gastropathy and gastric antral vascular ectasia: an update

Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) are two distinct entities that are frequently mistaken with each other, because they present with similar manifestations. This issue may cause catastrophic outcomes, as each one of them has a unique pathophysiology, thereby making their management approaches completely different. There are clinical clues that help physicians distinguish these two. Direct vision via upper endoscopy is often mandatory to establish the diagnosis, and sometimes biopsy is required. In this review, we sought to discuss different aspects of both conditions and highlight clinical evidence that may help in identifying and managing the disease appropriately.

Modeling the Relationship Between Occupational Accidents, Work-Family Conflict, and Quality of Work-Life in Emergency Room Nurses

Background: This study aimed to model the relationship between occupational accidents, work-family conflict, and quality of work-life in emergency room nurses. Materials and Methods: This correlational research uses path analysis. The study population consisted of all nurses working in the emergency rooms of hospitals in Tehran City, Iran, in 2020. Of them, 200 samples were selected by the available sampling method. To obtain the data, we used the occupational accidents questionnaire, the quality of work-life questionnaire, and the work-family conflict scale. SPSS v. 24 and Amos v. 24 software were used for data analysis. Results: The analysis of the findings showed that occupational accidents and work-family conflict have a negative and direct effect on the quality of work-life (P<0.01). Occupational accidents also have a positive and direct effect on work-family conflict (P<0.01). On the other hand, the mediating role of work-family conflict between occupational accidents and quality of work-life was confirmed (P<0.01). Conclusion: The relationship model of occupational accidents with quality of work-life mediated by work-family conflict has a good fit, and there is a relationship between family, job, and environmental stressors with the quality of work-life.

Analytical design of multi-threshold and high fan-in DNA-based logical sensors to profile the pattern of MS microRNAs

Early detection of diseases is very important to increase the life quality and reduce the treatment cost for the patient. MicroRNAs have been introduced in recent years as an efficient class of biomarkers for detecting the risky situation of many diseases such as cancers, Multiple sclerosis (MS), and heart attacks, and other diseases. Now, real-time PCR has been used to profile the microRNA expression, which is expensive, time-consuming, and has low accuracy. Most recently, DNA logic gates are used to detect the MicroRNA expression level that is more accurate and faster than previous methods. In this paper, we improved the design of multi-threshold and multi-input DNA-based logic gates in response to specific microRNA (miRNA) inputs. The proposed design style can simultaneously recognize multiple miRNAs with different rising and falling thresholds. The proposed structure in this paper is used to diagnose Multiple Sclerosis (MS) as a case study. We simulated this system to understand its performance and compare it with other existing methods. The simulation results show the efficiency of the proposed method in terms of accuracy, efficiency, and speed. In this analysis, unwanted reactions, fault positive, and the probability of generating the final output using the formal method are investigated in depth. Finally, the proposed solutions are improved based on the results of these analyses. The analytic approach of this paper helps to design the DNA-based logic gates for real diseases.

RNA secondary structured logic gates for profiling the microRNA cancer biomarkers

Deregulation of microRNAs expression is symptomatic of cancer disease and occurs before the awareness of cancer signs. Early detection of cancer disease can improve or drop the disease entirely. DNA computing is an emerging field of detecting microRNAs based on toehold-mediated strand displacement reactions, which is a more efficient method than the commonly used method like real-time PCR. Accuracy and cost of diagnostic applications are essential criteria that are achieved by using the DNA logic gates based on the DNA computing method. In this study, the authors proposed the multi-input liver cancer biosensor with the RNA secondary structure motifs as the computational module and two approaches are suggested.

Grafted human chorionic stem cells restore motor function and preclude cerebellar neurodegeneration in rat model of cerebellar ataxia

Cerebellar ataxia (CA) is a form of ataxia that adversely affects the cerebellum. Cell replacement therapy (CRT) has been considered as a potential treatment for neurological disorders. In this report, we investigated the neuro-restorative effects of human chorionic stem cells (HCSCs) transplantation on rat model of CA induced by 3-acetylpyridine (3-AP). In this regard, HCSCs were isolated and phenotypically determined. Next, a single injection of 3-AP was administered for ataxia induction, and bilateral HCSCs implantation was conducted 3 days after 3-AP injection, followed by expression analysis of a number of apoptotic, autophagic and inflammatory genes as well as vascular endothelial growth factor (VEGF) level, along with assessment of cerebellar neurodegeneration, motor coordination and muscle activity. The findings revealed that grafting of HCSCs in 3-AP model of ataxia decreased the expression levels of several inflammatory, autophagic and apoptotic genes and provoked the up-regulation of VEGF in the cerebellar region, prevented the degeneration of Purkinje cells caused by 3-AP toxicity and ameliorated motor coordination and muscle function. In conclusion, these data indicate in vivo efficacy of HCSCs in the reestablishment of motor skills and reversal of CA.

Multi-threshold and multi-input DNA logic design style for profiling the microRNA biomarkers of real cancers

Early detection of cancer is very critical because it can reduce the treatment risk and cost. MicroRNAs (miRNAs) have been introduced in recent years as an efficient class of biomarkers for cancer early detection. Now, real-time polymerase chain reaction has been used to profile the miRNA expression, which is costly, time consuming and low accuracy. Most recently, DNA logic gates are used to detect the miRNA expression level that is more accurate and faster than previous methods. The DNA-based logic gates face with serious challenges such as the large complexity and low scalability. In this study, the authors proposed a methodology to design multi-threshold and multi-input DNA-based logic gates in response to specific miRNA inputs in live mammalian cells. The proposed design style can simultaneously recognise multiple miRNAs with different rising and falling thresholds. The design style has been evaluated on the lung cancer biomarkers and the experimental results show the efficiency of the proposed method in terms of accuracy, efficiency and speed.

PEGylated trimethylchitosan emulsomes conjugated to octreotide for targeted delivery of sorafenib to hepatocellular carcinoma cells of HepG2

The current study aimed to develop PEGylated trimethyl chitosan (TMC) coated emulsomes (EMs) conjugated with octreotide for targeted delivery of sorafenib to hepatocellular carcinoma cells (HCC) of HepG2. Sorafenib loaded TMC coated EMs were prepared by the emulsion evaporation method and characterized concerning particle size, zeta potential, drug encapsulation efficiency, and in vitro drug release. Synthesized EMs were then conjugated to octreotide. The cytotoxicity of the targeted and non-targeted EMs was determined by cellular uptake and MTT assay on HepG2 cell. Cell cycle assay was also studied using flow cytometry. The results showed the optimized EMs had the particle size of 127 nm, zeta potential of -5.41 mV, loading efficiency of 95%, and drug release efficiency of 62% within 52 h. Octreotide was attached efficiently to the surface of EMs as much as 71%. MTT assay and cellular uptake studies showed that targeted EMs had more cytotoxicity than free sorafenib and non-targeted EMs. Cell cycle analyses revealed that there was a significant more accumulation of targeted EMs treated HepG2 cells in the G1 phase than free sorafenib and non-targeted EMs. The results indicate that designed EMs may be promising for the treatment of hepatocellular carcinoma.

Optimization of Poly(methyl vinyl ether-co-maleic acid) Electrospun Nanofibers as a Fast-Dissolving Drug Delivery System

Background:

Poly(methyl vinyl ether-maleic acid) (PMVEMA) is a water-soluble, biodegradable polymer used for drug delivery. The aim of the present study was to prepare nanofibers of this polymer as a fast-dissolving carrier for montelukast.

Materials and Methods:

Polymeric nanofibers were spun by electrospinning method using different ratios of biodegradable polymer of PMVEMA. The processing variables including voltage, distance of the needle to rotating screen, and flow rate of the solution were optimized based on the diameter of the nanofibers, drug content, and release efficiency by a Taguchi design. The morphology, diameter, and diameter distribution of the nanofibers were studied by scanning electron microscopy (SEM). Drug loading and its release rate from the nanofibers were analyzed spectrophotometrically. The possible molecular between the polymer and the drug was characterized with Fourier-transform-infrared spectroscopy.

Results:

The results showed the best situation for electrospinning of the polymer obtained at the polymer concentration of 37%, the distance of the needle to rotating screen of 19 cm, the voltage of 120 kV, and the rate of injection of 0.2 ml/h. In these situations, the fiber diameter and drug loading efficiency percentage were 273 nm and 83%, respectively. These nanofibers released the total loaded drug within 1–3 s with no residue in the dissolution medium. SEM results showed that the optimized nanofibers were quite smooth and without beads.

Conclusions:

The results indicated that the nanofibers of PMVEMA could dissolve the drug very rapidly and can be adopted for fast-dissolving dosage forms.

Web pages: What can you see in a single fixation?

Research in human vision suggests that in a single fixation, humans can extract a significant amount of information from a natural scene, e.g. the semantic category, spatial layout, and object identities. This ability is useful, for example, for quickly determining location, navigating around obstacles, detecting threats, and guiding eye movements to gather more information. In this paper, we ask a new question: What can we see at a glance at a web page – an artificial yet complex “real world” stimulus? Is it possible to notice the type of website, or where the relevant elements are, with only a glimpse? We find that observers, fixating at the center of a web page shown for only 120 milliseconds, are well above chance at classifying the page into one of ten categories. Furthermore, this ability is supported in part by text that they can read at a glance. Users can also understand the spatial layout well enough to reliably localize the menu bar and to detect ads, even though the latter are often camouflaged among other graphical elements. We discuss the parallels between web page gist and scene gist, and the implications of our findings for both vision science and human-computer interaction.

Improved experimental time of ultra-large bioassays using a parallelised microfluidic biochip architecture/scheduling

Digital microfluidic is an emerging technology to reduce the cost and time of experiments and improve the flexibility, automate-ability and correctness of biochemical assays. In many of applications such as drug discovery and DNA profiling, a large number of bio-operations (e.g. the chemical operations used in biology applications) must be done. In these applications, parallelising the operations will be critical in accuracy and cost of the process and digital microfluidic biochips can be considered as a reasonable platform. In this study, a new microfluidic architecture and the corresponding CAD flow is introduced to parallelise the assays on this platform. The authors implemented the proposed architecture and evaluated it using the large real bioassays. The authors' simulations show that the degree-of-parallelism and speed of bioassays are increased more than 4× and the improvements will be better for larger assays. This contribution can open new horizons in drug testing, biology experiments and medical diagnosis operations that contain iterative, time-consuming and labour experiments.