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Abstract Background Cardiovascular disease (CVD) is a leading cause of global mortality. Early intervention and prevention of CVD depend on accurately predicting the risk of CVD. This study aimed to investigate the association between the TyG index and the risk of coronary heart disease (CHD), congestive heart failure (CHF), heart attack (HA), stroke, and hypertension (HTN) among patients without diabetes in the United States. Methods In this retrospective, cross-sectional study, we used data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2020. We conducted several regression analysis models and calculated the sensitivity and specificity of (TyG) index for predicting the onset of CHD, CHF, HA, stroke, and HTN. Results A total of 10,937 individuals without diabetes participated in our study. Individuals with a TyG index greater than 8.96 displayed significant increasing in various parameters, including BMI, systolic/diastolic blood pressure, total cholesterol, LDL, and Apo-B levels (p

Background: Kidney transplantation is a superior treatment for end-stage renal disease (ESRD), compared with hemodialysis, offering better quality of life and birth outcomes in women with ESRD and lower fertility rates. Objectives: To investigate the pregnancy, maternal, fetal, and graft outcomes following kidney transplantation in women with ESRD and evaluate the improvements in quality of life and associated risks. Design: A systematic review and meta-analysis performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology guidelines. Data Sources and Methods: A thorough search of multiple databases, including PubMed, Embase, Scopus, ATC abstracts, and Cochrane Central Register of Controlled Trials, was conducted to identify studies that analyzed pregnancy outcomes in kidney transplant patients. The search was conducted from the inception of each database to January 2023. Results: The study reviewed 109 studies that evaluated 7708 pregnancies in 5107 women who had undergone renal transplantation. Of these, 78.48% resulted in live births, 9.68% had induced abortion, and 68.67% had a cesarean section. Miscarriage occurred in 12.54%, preeclampsia in 20.87%, pregnancy-induced hypertension in 24.30%, gestational diabetes in 5.08%, and preterm delivery in 45.30% of cases. Of the 853 recipients, 123 had graft loss after pregnancy and 8.06% suffered acute rejection. Conclusion: Pregnancy after kidney transplantation is associated with risks for mother and fetus; however, live births are still possible. In addition, there are reduced overall risks of stillbirths, miscarriages, neonatal deaths, and gestational diabetes. Registration: PROSPERO (CRD42024541659).

Abstract Background Erectile dysfunction (ED) is commonly associated with cardiovascular diseases and age. However, it is important to note that it can also affect younger males, potentially serving as an early indicator of compromised overall health. Despite the high prevalence, ED remains underdiagnosed due to factors such as reluctance to testing, concerns about privacy, and the persistent social stigma surrounding the condition. Objective This review offers an overview of diagnostic and monitoring devices employed in the assessment of nocturnal ED and aims to assess both historical and recent developments in this field. It considers the emerging technological trends in digital innovation, particularly in the context of home‐based decentralized healthcare settings. Methods A comprehensive literature search was performed via PubMed using keywords ‘nocturnal penile tumescence’, ‘NPT’, ‘sleep‐related erection’, ‘SRE’, ‘rigidity monitoring’, ‘NPTR’, ‘tumescence monitoring’, ‘erectile dysfunction’ and ‘smart wearable’. All relevant literature was retrieved and reviewed. Web‐based Google and manual searches of references were also performed to identify relevant articles and solutions missed by online indexes. Findings An increasing number of methods and solutions are integrating digital technologies, harnessing sensors, and utilizing data analytics for continuous monitoring and AI‐assisted prediction of ED. Conclusion The future of ED monitoring is expected to leverage digital technologies to enhance evaluation, monitoring, and accurate diagnosis in decentralized healthcare environments maintaining patient privacy and driving early detection and intervention.

Abstract Background Testicular tumors have many different manifestations. The majority of these cases are presented as an incidental finding during hydrocelectomy. Malignant mesotheliomas are uncommon tumours that can arise from the coelomic epithelium of the pleura, peritoneum, pericardium, and tunica vaginalis. Case presentation We present a 51-year-old South Asian (Indian) male patient with a rare case of mesothelioma, presenting with right hydrocele, to whom a right hydrocelectomy was performed. Any history of trauma or asbestos exposure was not present. Histopathological and immunohistochemistry reports revealed a malignant mesothelioma of tunica vaginalis. There was no invasion of the tumour to the epididymis and spermatic cord. Imaging studies showed no signs of metastasis. 1 month later, a high inguinal orchidectomy was performed. The patient underwent adjuvant chemotherapy thereafter and is still on follow-up. Conclusion Although hydrocele is common, detailed evaluation is mandatory to rule out certain rare tumours-testicular and paratesticular variants.

Abstract Background The lack of appropriate prognostic biomarkers remains a significant obstacle in the early detection of Head and Neck Squamous Cell Carcinoma (HNSCC), a cancer type with a high mortality rate. Despite considerable advancements in treatment, the success in diagnosing HNSCC at an early stage still needs to be improved. Nuclear factor erythroid 2-related factor 2 (Nrf2) and Sonic Hedgehog (Shh) are overexpressed in various cancers, including HNSCC, and have recently been proposed as possible therapeutic targets for HNSCC. Circulating Tumor Cell (CTC) is a novel concept used for the early detection of cancers, and studies have suggested that a higher CTC count is associated with the aggressiveness of HNSCC and poor survival rates. Therefore, we aimed to establish molecular markers for the early diagnosis of HNSCC considering Shh/Nrf2 overexpression in the background. In addition, the relation between Shh/Nrf2 and CTCs is still unexplored in HNSCC patients. Methods In the present study, we selected a cohort of 151 HNSCC patients and categorized them as CTC positive or negative based on the presence or absence of CTCs in their peripheral blood. Data on demographic and clinicopathological features with the survival of the patients were analyzed to select the patient cohort to study Shh/Nrf2 expression. Shh and Nrf2 expression was measured by qRT-PCR. Results Considering significant demographic [smoking, betel leaf (p-value

Advanced Driver Assistance Systems (ADAS) are advanced technologies that assist drivers with vehicle operation and navigation. Recent improvements and brisk expansion in the ADAS market, as well as an increase in the frequency of incidents such as sensor spoofing, communication interruption etc., in autonomous vehicles (AVs), have raised the need to research ADAS security technology. The security issues raised by incorporating these technologies into automobiles must be addressed to protect the privacy and safety of passengers and other road users. As a result, the purpose of this research is to investigate the security issues that arise from the integration of ADAS technologies. Addressing these challenges holds the potential to establish a foundation for enhanced safety and dependability within transportation networks amidst the ongoing advancements in vehicle technology. This paper starts by describing the vulnerabilities, threats, assaults, and defense mechanisms of the ADAS. It then delves into the attacks and countermeasures in three categories, namely VANET, Hardware, and Adversarial attacks. VANET attacks encompass threats targeting Vehicular Ad Hoc Networks, aiming to disrupt communication among vehicles or between vehicles and infrastructure. Hardware attacks focus on vulnerabilities within the physical components of ADAS, including sensors, processors, or communication modules. Adversarial attacks involve deliberate manipulations or perturbations introduced into machine learning models or algorithms utilized within ADAS. These attacks aim to deceive or undermine the functionality of AI-based systems, causing misclassification, compromising system integrity, and posing risks to user safety by exploiting vulnerabilities in the AI decision-making process. Finally, this study highlights potential areas for future research, such as the utilization of artificial intelligence (AI), the necessity of industry-wide standardization, and recommends specific future work tailored to each attack described in the corresponding sections.

This research investigates the interplay between public administration, educational socialization on social media, population literacy awareness, and public satisfaction in the context of population services. The primary objective is understanding how these variables are interconnected and their collective impact on public satisfaction. The study employs a quantitative approach, collecting data through structured questionnaires from a randomly selected sample. Data analysis involves various statistical techniques using Smart PLS, including regression and mediation analysis. The findings reveal that public administration significantly influences population literacy awareness, underscoring the role of government agencies in shaping citizen understanding of demographic policies. While it was anticipated that population literacy awareness would mediate the relationship between public administration and educational socialization on social media for public satisfaction, this mediating effect needed to be supported. However, social media use was found to influence population literacy awareness, indirectly affecting public satisfaction directly. It highlights the potential of digital platforms to enhance citizen understanding and engagement. The implications are substantial. Governments should recognize the importance of effective communication and digital engagement in fostering an informed and satisfied citizenry. Additionally, tailored communication and education initiatives are crucial for promoting public understanding and engagement, ultimately contributing to higher levels of public satisfaction. The research's novelty lies in its exploration of the complex dynamics among these variables and its focus on the role of digital platforms in enhancing population literacy awareness. However, some limitations include the potential for context-specific findings and the need for further research in diverse settings.

Purpose – This paper presents the features and relevance of open distance learning in the context of the socio-economic conditions of people living in the Union Territory of Jammu and Kashmir (J&K) in India. Although the primary purpose of the present study was to ascertain the effectiveness of the learner support services (LSSs) and different facilities offered by the open distance learning (ODL) institutions in that specific region. On the basis of these findings, few suggestions are made for the improvement in the support services, in order to make the ODL system more responsive to the area-specific needs of the learners, especially those residing in inaccessible areas such as J&K. Design/methodology/approach – A survey-based descriptive methodology was applied to conduct this study. The data extracted from primary and secondary sources were analysed to reach certain conclusions. In total, 1,200 distance learners constituted the sample of the research. A semi-structured questionnaire was designed and distributed amongst learners and academics in the region to obtain their feedback and opinion on different aspects of support services and facilities offered to ODL learners. Findings – Results of the study revealed that overall, the LSSs were satisfactory on different parameters, although they slightly varied from institution to institution. However, there was still scope for improvement in certain areas, where institutions further need to make serious efforts to address the identified gaps for improving the LSS and make teaching-learning more learner-centric in view of their specific requirements and local circumstances of J&K. Research limitations/implications – The present study focusses on presenting an overview of the only major components of LSS offered by ODL institutions and covers six distance education institutions (DEIs) located in different geographical locations within the limited jurisdiction of J&K. There is still scope to make focused (institution-wise) studies in a more specific situation and context to ascertain the problems in a more realistic way. Practical implications – Although the study has been conducted in a specific territory of J&K, the findings reported in the paper may be equally useful for the other ODL institutions with similar characteristics or located in similar geographical locations, as support services are essential common components of institutions offering distance education programmes or courses. Originality/value – The study is original research work conducted in the specific context of J&K, and its findings are based on the primary and secondary data collected from learners and other stakeholders of the selected ODL institutions. This work may be significant for the DEIs of J&K to get familiar with the essential components of LSS and develop a mechanism to further improve the academic and administrative support services for distance learners.

Aim:Amblyopia is a common disease characterized by reduced visual acuity in one or both eyes during visual development in early stages of life. Satisfactory outcomes can be achieved with early diagnosis.Materials and Methods:The study included a total of 341 pediatric patients aged three to 15 years, who presented to our clinic between February 2016 and September 2022 and were diagnosed with amblyopia. Using the follow-up files of all the patients, visual examination findings and data on birth, maternal obstetric history, family history, neurological disease history, chronic systemic disease history, and ocular surgery history were reviewed.Results:A total of 341 patients, including 171 female and 170 male, were enrolled in the study. The mean age of the patients was 7.81±3.6 years. According to the type of amblyopia, refractive amblyopia was detected in 188 of the 341 patients (55.1%), strabismic+refractive amblyopia in 93 (approximately 27.3%), strabismic amblyopia in 55 (16.1%), and deprivation amblyopia in five (1.5%) patients. It was determined that amblyopia was most common in the age ranges of 3-6 (36.5%) and 7-10 (44.2%) years. Family history was found at a significantly higher rate in the amblyopia types presenting with strabismus compared to the refractive amblyopia type.Conclusion:The determination of non-ocular risk factors other than the known ocular risk factors of amblyopia will allow for the early treatment of high-risk children and prevent preventable vision loss.

This work introduces Spiromni, a single device incorporating three different pressurised metered-dose inhaler (pMDI) accessories: a pMDI spacer, an electronic monitoring device (EMD), and a spirometer. While there are devices made to individually address the issues of technique, adherence and monitoring, respectively, for asthma patients as laid out in the Global Initiative for Asthma’s (GINA) global strategy for asthma management and prevention, Spiromni was designed to address all three issues using a single, combination device. Spiromni addresses the key challenge of measuring both inhalation and exhalation profiles, which are different by an order of magnitude. Moreover, the innovative design prevents exhalation from entering the spacer chamber and prevents medication loss during inhalation using umbrella valves without a loss in flow velocity. Apart from recording the peak exhalation flow rate, data from the sensors allow us to extract other key lung volume and capacities measures similar to a medical pulmonary function test. We believe this low-cost portable multi-functional device will benefit both asthma patients and clinicians in the management of the disease.