Correlation between Noncompliance Behavior and Biochemical Parameters of Chronic Kidney Disease Patients Undergoing Hemodialysis

Background and Objectives Compliance with dietary, fluid, and medication instructions is a critically significant factor for the health and well-being of patients undergoing hemodialysis for an extended period. The current study assessed the correlation between noncompliance behavior and biochemical parameters of chronic kidney disease (CKD) patients undergoing hemodialysis. The study's objectives were 1) to assess patients' noncompliance behavior using a questionnaire, 2) to determine the biochemical parameters of CKD patients having noncompliance behavior, and 3) to find the correlation between biological parameters and noncompliance behavior. Methods A cross-sectional study was conducted from July 12, 2018, to February 10, 2019. A purposive sampling technique was used to recruit the participants, and 100 participants were included in the study. The End-Stage Renal Disease–Adherence Questionnaire was used to assess the non-compliance behavior. Results Most dialysis patients (70%) were compliant with the therapeutic regime, while 30% failed to comply. The study revealed a significant positive correlation between noncompliance behavior and biochemical parameters of CKD patients undergoing hemodialysis (r = 0.578, p < 0.05). Conclusion Noncompliance behavior is significantly correlated with the biochemical parameters among patients with CKD on dialysis. Optimal health is possible through fluid and dietary compliance in these patients. Hence, adherence behavior plays a significant role in the health and recovery of dialysis patients with CKD.

A cascade targeting strategy based on modified bacterial vesicles for enhancing cancer immunotherapy

Background As an efficient tumor immunotherapy, PD-1 antibody has been gradually used in clinical tumor treatment, but the low response rate and excessive immune response limit its extensive application. Results Herein, a therapeutic regime for the reinvigoration and activation of the tumor immune microenvironment is introduced to improve the anti-tumor effect of the PD-1 antibody. To comprehensively improve the effect of the immunotherapy and reduce excessive immune response, a biomimetic cascade targeting nanosystem, siRNA@PLOV, which was fused by photothermal sensitive liposomes (PTSLs) and attenuated Salmonella outer membrane vesicles (OMVs), was administered in the tumor therapy for targeting of tumor tissues and T cells within tumor respectively. The fused PLOVs which not only retained the biological character of the OMVs, but also enhanced the drug loading ability. The results demonstrated that the immunogenicity of OMVs and photothermal effects can obviously increase the infiltration of T cells and the silencing of CD38 can effectively improve the T cell cytotoxicity, especially combining with PD-1 antibody. Conclusions Interesting, this study revealed that anti-PD-1 administration on the 5th day after siRNA@PLOV treatment had the best performance in killing tumors compared with other groups. In addition, this new therapeutic regime also presents a novel strategy for inducing “vaccine effects”, conclusively highlighting its potential in preventing tumor recurrence and improving prognosis. Graphical Abstract

Ceftriaxone Mediated Synthesized Gold Nanoparticles: A Nano-Therapeutic Tool to Target Bacterial Resistance

Ceftriaxone has been a part of therapeutic regime for combating some of the most aggressive bacterial infections in the last few decades. However, increasing bacterial resistance towards ceftriaxone and other third generation cephalosporin antibiotics has raised serious clinical concerns especially due to their misuse in the COVID-19 era. Advancement in nanotechnology has converted nano-therapeutic vision into a plausible reality with better targeting and reduced drug consumption. Thus, in the present study, gold nanoparticles (GNPs) were synthesized by using ceftriaxone antibiotic that acts as a reducing as well as capping agent. Ceftriaxone-loaded GNPs (CGNPs) were initially characterized by UV-visible spectroscopy, DLS, Zeta potential, Electron microscopy and FT-IR. However, a TEM micrograph showed a uniform size of 21 ± 1 nm for the synthesized CGNPs. Further, both (CGNPs) and pure ceftriaxone were examined for their efficacy against Escherichia coli, Staphylococcus aureus, Salmonella abony and Klebsiella pneumoniae. CGNPs showed MIC50 as 1.39, 1.6, 1.1 and 0.9 µg/mL against E. coli, S. aureus, S. abony and K. pneumoniae, respectively. Interestingly, CGNPs showed two times better efficacy when compared with pure ceftriaxone against the tested bacterial strains. Restoring the potential of unresponsive or less efficient ceftriaxone via gold nanoformulations is the most alluring concept of the whole study. Moreover, applicability of the findings from bench to bedside needs further validation.

The Concerns of Pakeha Men Living on Home Haemodialysis: a Critical Interpretive Study

<p>This nursing study seeks to understand the experience of one group of people with chronic renal failure using renal replacement therapy, Pakeha men living on home haemodialysis. It is based on the assumptions that people living on dialysis have distinctive experiences that are characterized by common concerns reflecting their shared position as subjects of renal illness and therapy, but that these are not easy to discern because they are obscured by the professional viewpoint that is dominant in the renal setting. In order to understand the experience of people living on dialysis this study develops a critical interpretive approach, seeking the participant's own interpretation of their individual experiences, but then reinterpreting them from a critical standpoint, recognizing that they can only be adequately understood by contextualizing them, in order to discern the common perspective underlying them in contrast to the dominant professional viewpoint in the renal setting. Using some ideas derived from the thought of Michel Foucault this study develops a critical nursing view of the renal setting, as a specialized healthcare context that is constituted by several interrelated discourses, primarily the dominant professional discourse, but also by several other discourses, in particular a client discourse that is a response to the dominant discourse. The different discourses reflect contrasting perspectives based on the different positions of various groups within the renal context. The study presents accounts, derived from interviews, of the experience of six Pakeha men living on home haemodialysis. Reflecting on these accounts as a set, by contextualizing them in terms of the critical nursing view of the renal setting, I outline four concerns of Pakeha men living on home haemodialysis. Together these make up the renal client discourse that models the distinctive perspective from their position within the renal context, underlying each of their individual accounts of their experience of illness and therapy. These concerns include symptoms from chronic renal failure and dialysis, limitations resulting from the negotiation of the therapeutic regime into their lifestyle, their sense of ongoingness and uncertainty of living on dialysis, and the altered interrelationship between autonomy and dependence inherent in living on dialysis. The study suggests that the individual accounts can be understood as resulting from the interaction of the various dimensions of their own personal social locations, including their gender and ethnicity, with the concerns of client discourse, reflecting their common position as people living on dialysis. One important implication of this understanding is that the role of nursing in the renal setting can be articulated as a response to the experience of the person living on dialysis. The nurse can support the renal client in seeking to integrate the requirements of the therapeutic regime, reflecting the dominant discourse, into their personal situation, reflecting the interaction of their own personal location with their position as a person living on dialysis, outlined in the client discourse.</p>

The Concerns of Pakeha Men Living on Home Haemodialysis: a Critical Interpretive Study

<p>This nursing study seeks to understand the experience of one group of people with chronic renal failure using renal replacement therapy, Pakeha men living on home haemodialysis. It is based on the assumptions that people living on dialysis have distinctive experiences that are characterized by common concerns reflecting their shared position as subjects of renal illness and therapy, but that these are not easy to discern because they are obscured by the professional viewpoint that is dominant in the renal setting. In order to understand the experience of people living on dialysis this study develops a critical interpretive approach, seeking the participant's own interpretation of their individual experiences, but then reinterpreting them from a critical standpoint, recognizing that they can only be adequately understood by contextualizing them, in order to discern the common perspective underlying them in contrast to the dominant professional viewpoint in the renal setting. Using some ideas derived from the thought of Michel Foucault this study develops a critical nursing view of the renal setting, as a specialized healthcare context that is constituted by several interrelated discourses, primarily the dominant professional discourse, but also by several other discourses, in particular a client discourse that is a response to the dominant discourse. The different discourses reflect contrasting perspectives based on the different positions of various groups within the renal context. The study presents accounts, derived from interviews, of the experience of six Pakeha men living on home haemodialysis. Reflecting on these accounts as a set, by contextualizing them in terms of the critical nursing view of the renal setting, I outline four concerns of Pakeha men living on home haemodialysis. Together these make up the renal client discourse that models the distinctive perspective from their position within the renal context, underlying each of their individual accounts of their experience of illness and therapy. These concerns include symptoms from chronic renal failure and dialysis, limitations resulting from the negotiation of the therapeutic regime into their lifestyle, their sense of ongoingness and uncertainty of living on dialysis, and the altered interrelationship between autonomy and dependence inherent in living on dialysis. The study suggests that the individual accounts can be understood as resulting from the interaction of the various dimensions of their own personal social locations, including their gender and ethnicity, with the concerns of client discourse, reflecting their common position as people living on dialysis. One important implication of this understanding is that the role of nursing in the renal setting can be articulated as a response to the experience of the person living on dialysis. The nurse can support the renal client in seeking to integrate the requirements of the therapeutic regime, reflecting the dominant discourse, into their personal situation, reflecting the interaction of their own personal location with their position as a person living on dialysis, outlined in the client discourse.</p>

​Induction of Postpartum Oestrus in Lakhimi Cows through Hormonal and Nutritional Interventions

Background: Postpartum anoestrus is the most devastating cause of the dairy farming which causes more economic losses to the farmers. The present study was conducted to record the incidence of postpartum anoestrus and to evolve a suitable therapeutic regime for addressing postpartum anoestrus in Lakhimi cows. Methods: A total of 1000 Lakhimi cows maintained in different villages of Assam were selected and the incidence rate was recorded on the basis of breeding records provided by the farmers, per-rectal examination and ultrasonography screening of genital organ. To study the effect of hormonal and nutritional interventions in post partum anoestrus cows, the cows were divided randomly into seven groups comprising twelve animals in each group. The different treatment regimes were Hydroxyprogesterone caproate + eCG, Clomiphene citrate alone, Clomiphene citrate + Mineral mixture, GnRH analogue alone, GnRH analogue + Mineral mixture, Mineral mixture alone and control. The response to different treatment regimes was based on oestrus response, mean interval from the end of treatment to onset of oestrus and conception rate. Result: The incidence of postpartum anoestrus was found to be 20.60%. Clomiphene citrate + Mineral mixture administration regime brought about the highest oestrus induction response (100.00%) and conception rate (66.67%).

Comparison of ultra-performance liquid chromatography and ARKTM immunoassay for therapeutic drug monitoring of voriconazole

Background Therapeutic drug monitoring (TDM) of voriconazole is recommended for personalizing doses. The objective of this study was to compare the enzyme immunoassay developed by ARKTM Diagnostics Inc. for the quantification of voriconazole adapted to the Architect C4000 autoanalyzer (Abbott®) with ultra-performance liquid chromatography using ultraviolet detector (UPLC-UV) method. Methods Linearity, precision and accuracy of both methods were validated according to the Food and Drug Administration (FDA) and European Medicines Agency (EMA) guidelines. The limit of quantification (LOQ) of the UPLC-UV method was determined experimentally. Both methods were applied to the analysis of 62 samples from patients. Correlation was evaluated by Passing–Bablok analysis and the concordance by the Bland–Altman method. Dosage recommendations were generated; the discordances according to the technique were evaluated. Results All validation parameters determined for UPLC-UV met the criteria set out and LOQ of 0.1 μg/mL was established. However, when the enzyme immunoassay was used to determine concentrations ≤1 µg/mL, CVs were >20%. A linear correlation between both methods was found. However, an overestimation of immunoassay (systematic error of 0.39 μg/mL) was detected. In 11.3% of the samples, the differences in concentrations when they were determined by different techniques would imply a different therapeutic regime. These samples had concentrations close to 1 μg/mL. Conclusion Although both techniques can be used for TDM of voriconazole, when a value close to the lower limit of the therapeutic range is determined by the ARKTM immunoassay, it would be better to verify the result by a non-automated technique to avoid possible underdosing.

Lipid metabolism and mitochondria: Cross talk in cancer

: Metabolic reprogramming is considered a major event in cancer initiation, progression and metastasis. The metabolic signature of cancer cells includes alterations in glycolysis, mitochondrial respiration, fatty acid/lipid and amino acid metabolism. Being at a junction of various metabolic pathways, mitochondria play a key role in fueling cancer growth through regulating bioenergetics, metabolism and cell death. Increasing evidence suggests that alteration in lipid metabolism is a common feature of metastatic progression, including fatty acid synthesis as well as fatty acid oxidation. However, the interplay between lipid metabolism and mitochondria in carcinogenesis remains obscure. The present review focuses on key lipid metabolic pathways associated with mitochondrial regulation that drive cancer phenotype and metastasis. We also review potential targets of lipid metabolism and mitochondria to improve the therapeutic regime in cancer patients. This review aims to improve our current understanding of the intricate relation of lipids with mitochondria and provides insights into new therapeutic approaches.

Role of Inflammatory Mediators, Macrophages, and Neutrophils in Glioma Maintenance and Progression: Mechanistic Understanding and Potential Therapeutic Applications

Gliomas are the most common, highly malignant, and deadliest forms of brain tumors. These intra-cranial solid tumors are comprised of both cancerous and non-cancerous cells, which contribute to tumor development, progression, and resistance to the therapeutic regime. A variety of soluble inflammatory mediators (e.g., cytokines, chemokines, and chemotactic factors) are secreted by these cells, which help in creating an inflammatory microenvironment and contribute to the various stages of cancer development, maintenance, and progression. The major tumor infiltrating immune cells of the tumor microenvironment include TAMs and TANs, which are either recruited peripherally or present as brain-resident macrophages (microglia) and support stroma for cancer cell expansion and invasion. These cells are highly plastic in nature and can be polarized into different phenotypes depending upon different types of stimuli. During neuroinflammation, glioma cells interact with TAMs and TANs, facilitating tumor cell proliferation, survival, and migration. Targeting inflammatory mediators along with the reprogramming of TAMs and TANs could be of great importance in glioma treatment and may delay disease progression. In addition, an inhibition of the key signaling pathways such as NF-κB, JAK/STAT, MAPK, PI3K/Akt/mTOR, and TLRs, which are activated during neuroinflammation and have an oncogenic role in glioblastoma (GBM), can exert more pronounced anti-glioma effects.