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Introduction Hospital performance is significantly affected by external factors (political and economic) rather than internal factors (effectiveness and efficiency). Emergency department (ED) overcrowding is a significant issue for emergency care services globally, characterized by a rising number of visits and persistent unsolved issues, resulting in increased challenges faced by ED staff and decreased patient satisfaction. This study aimed to explore the obstacles and challenges that cause variation in ED quality indicators (QIs) based on five domains: infrastructure, population, workflow, workforce, and administration. Methods A tertiary emergency center in Saudi Arabia administered a questionnaire with standardized measures to 180 nurses, using a cross-sectional descriptive design. Results Most nurses (75.5%) believed that crowded waiting rooms in the ED were the most influential factor affecting QIs. Many other challenges were identified, including bed capacity, triage area/workflow, increased volume during peak periods, demand for nonemergency visits, staff and shortages. Significant differences in nurses’ responses were found on the basis of education level (for infrastructure only, p = 0.004), specialty (for nursing administration only, p = 0.052), and ED experience (for all variables, p = 0.008–0.039). Conclusion The analysis uncovered various critical aspects of infrastructure, workflow, population, workforce, and nursing administration that have a major effect on patient flow in the ED. Comprehending these aspects will greatly affect the quality measures of ED performance and assist policymakers in formulating strategic plans to enhance ED performance. Therefore, successful implementation and optimization of ED resources depend greatly on considering the right decision variables and resource restrictions.

Background: Inflammation has long been a key tenet in the diagnosis and management of malignancies, likely contributing to cancer incidence, staging, and progression. Systemic inflammation, in particular, is often elevated prior to and during cancer development. Systemic inflammation in the context of cancer diagnosis and monitoring is measured by various inflammatory indexes such as the systemic inflammatory response index (SIRI), plasma-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and neutrophil-to-lymphocyte ratio (NLR). We set out to determine the relationship between pre- and post-treatment levels of these inflammatory indexes and the prognosis and outcomes of oropharyngeal cancer (OPC). Methods: A retrospective chart review was performed of 172 patients with OPC who underwent treatment for oropharyngeal cancer at University Medical Center in Lubbock, TX between May 2013 to May 2023. Sites of primary cancer were obtained through chart review. HPV infection status and differentiation of the tumor were noted for each patient. Treatment modalities were classified as surgery, radiation, chemotherapy, or concurrent chemotherapy and radiation. Treatment outcomes were classified based on recurrence and death secondary to disease. The relationships between treatment outcome and the described inflammatory indexes were evaluated. Appropriate parametric tests were selected based on the large number of variables. Results: Pre-treatment SIRI and Albumin levels were positively predictive in determining locoregional recurrence (p = 0.031 and p = 0.039). NLR, SII, and SIRI levels taken at three months post-treatment were also found to be positively predictive of locoregional recurrence (p = 0.005, p < 0.0005, and p = 0.007). SIRI taken at six months post-treatment was also found to be positively predictive of locoregional recurrence (p = 0.008). SII at six months post-treatment was found to be positively predictive of survival (p = 0.027). Conclusion: This study suggested that post-treatment levels of several inflammatory indexes, particularly SIRI, NLR, and SII, may be useful in determining the long-term outlook and recurrence of head and neck cancer following treatment.

Abstract Tuberculosis (TB) may cause significant long‐term cardiorespiratory complications, of which pulmonary vascular disease is most under‐recognized. TB is rarely listed as a cause of pulmonary hypertension (PH) in most PH guidelines, yet PH may develop at various stages in the time course of TB, from active infection through to the post‐TB period. Predisposing risk factors for the development of PH are likely multifactorial, involving active TB disease and post‐TB lung disease (PTLD), host‐related and environment‐related factors. Moreover, post‐TB PH should likely be classified in Group 3 PH, with the pathogenesis similarly complex and multifactorial as other Group 3 PH causes. Identifying risk factors that predispose to post‐TB PH may aid in developing risk stratification criteria for early identification and referral for confirmatory diagnostic tests. Given that universal screening for PH in TB survivors may be impractical and unfeasible, a targeted screening approach for high‐risk individuals would be sensible. In this scoping review of post‐TB PH, resulting from the proceedings of the 2nd International Post‐Tuberculosis Symposium, we aim to describe the epidemiology, risk factors, and pathophysiology of post‐TB PH. We emphasize diagnosing PH with an alternative set of diagnostic guidelines in resource‐constrained settings where right heart catheterization may not be feasible. Research to describe the burden and distribution of post‐TB PH should be prioritized as there is a current gap in knowledge regarding the prevalence and incidence of post‐TB PH among persons with TB.

Abstract This study focuses on meeting end‐users’ demand for cassava (Manihot esculenta Crantz) varieties with low cyanogenic potential (hydrogen cyanide potential [HCN]) by using near‐infrared spectrometry (NIRS). This technology provides a fast, accurate, and reliable way to determine sample constituents with minimal sample preparation. The study aims to evaluate the effectiveness of machine learning (ML) algorithms such as logistic regression (LR), support vector machine (SVM), and partial least squares discriminant analysis (PLS‐DA) in distinguishing between low and high HCN accessions. Low HCN accessions averagely scored 1–5.9, while high HCN accessions scored 6–9 on a 1–9 categorical scale. The researchers used 1164 root samples to test different NIRS prediction models and six spectral pretreatments. The wavelengths 961, 1165, 1403–1505, 1913–1981, and 2491 nm were influential in discrimination of low and high HCN accessions. Using selected wavelengths, LR achieved 100% classification accuracy and PLS‐DA achieved 99% classification accuracy. Using the full spectrum, the best model for discriminating low and high HCN accessions was the PLS‐DA combined with standard normal variate with second derivative, which produced an accuracy of 99.6%. The SVM and LR had moderate classification accuracies of 75% and 74%, respectively. This study demonstrates that NIRS coupled with ML algorithms can be used to identify low and high HCN accessions, which can help cassava breeding programs to select for low HCN accessions.

Abstract Background Sarcocystis species are obligatorily heteroxenous protozoan parasites with predator–prey life cycles. Global Knowledge about the epidemiology and the distribution pattern of different Sarcocystis species in dog feces are very scarce. Therefore, the current investigation was conducted to declare the occurrence of Sarcocystis in the fecal specimens of the most common canids in Egypt, the domestic dogs, and to identify the species present using various parasitological and molecular approaches. Methods A total of 100 dog fecal samples were collected and screened using fecal sugar flotation test for the presence of Sarcocystis oocysts/sporocysts. Additionally, thirty samples were used for genomic DNA extraction. The 18S rRNA gene fragment was the target of primers for a PCR, followed by purification and sequencing of the amplicons. Results Currently, the results obtained reviewed that 4% of fecal samples were positive for Sarcocystis spp. using LM. Additionally, Sarcocystis spp. were verified in sixteen dogs (53.3%, 16/30) using PCR and subsequent sequencing protocols. Statistically, insignificant difference in prevalence of sarcocystosis relative to age and gender was noticed. Morphologically, the detected sporocysts measured 13.2–16.0 × 9.4–11 μm. Based on the 18S rRNA gene, sequencing analysis of amplicons from sporocysts DNA revealed 99.82% nucleotide homology with published S. tenella partial nucleotide sequences from sheep in Iraq and Iran. Conclusions This is the first molecular evidence in support of the final host role of domestic dogs in the life cycle of S. tenella in Egypt, which provides a precious diagnostic tool for further epidemiological studies and for the assessment of the effectiveness of control measures for this disease.

Doxazosin is a competitive, short-acting, selective alpha 1-adrenoceptor antagonist. Selective alpha 1-blockers dilate blood vessels in the veins and arteries. The specificity for alpha-adrenoreceptors causes the smooth muscle of the blood vessels to relax. The findings of the recording and analysis demonstrate that doxazosin generates an endothelium-dependent relaxation of renal artery rings that had been pre-contracted with a high amount of KCl (60 mM) or phenylephrine (PE) (10-5 M). Additionally, doxazosin shows strong inhibitory effects on PE and weaker effects on contractions induced by KCl. Pre-incubating renal artery rings with 4-aminopyridine (4-AP), indomethacin, potassium (K+) channels blocker (TEA), barium chloride (BaCl2), prostaglandin I2 (PGI2) inhibitor (Indomethacin), and nitric oxide (NO) synthase inhibitor (L-Name), significantly affects the relaxation brought on by doxazosin. Contrarily, neither glibenclamide (GLIB) nor clotrimazole, show any effect on the relaxation caused by doxazosin. Doxazosin’s role suggests that a Ca++ channel-blocking mechanism has a relaxing impact on the smooth muscles of the renal artery. The relaxing effect of doxazosin is thus concluded from these findings to involve both potassium and calcium channels, potentially through the blockage of KV, KCa, KIr, endothelium/NO, PGI2, and voltage-dependent calcium channels.

Breeding for low-hydrogen-cyanide (HCN) varieties is a major objective of programs targeting boiled cassava food products. To enhance the breeding of low-HCN varieties, knowledge of genetic variation and trait heritability is essential. In this study, 64 cassava clones were established across four locations and evaluated for HCN using three HCN assessment methods: one with a 1 to 9 scale, on with a 0 ppm to 800 ppm scale, and a quantitative assay based on spectrophotometer readings (HCN_Spec). Data were also collected on the weather variables precipitation, relative humidity, and temperature. Highly significant differences were observed among clones (p < 0.001) and locations (p < 0.001). There was also significant clone–environment interactions, varying from p < 0.05 to p < 0.001. Locations Arua and Serere showed higher HCN scores among clones and were associated with significantly higher (p < 0.001) mean daily temperatures (K) and lower relative humidity values (%) across 12 h and 18 h intervals. Within locations, HCN broad sense heritability estimates ranged from 0.22 to 0.64, while combined location heritability estimates ranged from 0.14 to 0.32. Relationships between the methods were positive and strong (r = 0.75–0.92). The 1 to 9 scale is more accurate and more reproducible than either the 0 to 800 ppm scale or spectrophotometric methods. It is expected that the information herein will accelerate efforts towards breeding for low-HCN cassava varieties.

Diabetes mellitus (DM) and thyroid disorders are both caused by endocrine abnormalities, and both have been shown to have a reciprocal influence and frequently coexist. Hence, the current study aims to detect the thyroid functions markers among patients with Type 2 diabetes (T2DM). In this research study, 90 enrolled participants aged 40 to 60 years were taken as samples for the study. There were 66 with T2DM and 24 who were non diabetic healthy individual. All individuals were investigated in terms of age, gender, diabetes duration, glycemic control (HbA1c), fasting blood glucose (FBG), diabetic complications, Body mass index (BMI), waist circumference (WC), and family history of DM. Samples were to assess serum thyroid hormones (TSH, FT3 and FT4), HbA1c, FBG, and insulin levels. The study's findings showed higher glucose incidence, hyperinsulinemia and higher insulin resistance (IR) in diabetic patients. Additionally, it has been noted that T2DM patients have low TSH concentrations and elevated blood concentrations of FT4 and FT3 than controls. Moreover, there was a highly significant correlation between serum FT4 and FT3 with values of FBG, insulin and IR. Also, a significant association between WC with insulin and Homa – Ir was noted. In conclusion, the diabetic patients showed significant relations with thyroid functions status.

Gastrointestinal parasitic infection is a prime cause of failures in camel production. This study was conducted to ascertain the prevalence of gastrointestinal helminths of camels in Aswan district, Egypt. Besides, the prevalence of helminthiasis in camel was also evaluated considering age, gender, and rearing system. For such reason, a total of 110 dromedaries (Camelus dromedarius) in the Draw abattoir, Aswan province were screened for the presence of gastrointestinal helminths by postmortem examinations between December 2018 to November 2019. Twenty-four animals (21.82 %) were found to be infected with one or more species of gastrointestinal helminths. Moniezia expansa, and Stilesia globipunctata, emerged as the most prevalent species (29.2%), with Avitellina centripunctata also being common (20.83%). Whereas, Moniezia benedeni, was present at low infection rates (12.5 %). Furthermore, the only recorded trematode worm was Paramphistomes spp. (8.33%). Gender variations revealed significant (P≤0.05) differences among examined camels. Oppositely, age and seasonal dynamics had no significant differences with the highest peak in the winter season (33.3%). The current prevalence indicates the necessity of using an anthelmintic drug for increasing the health and productivity of camels.

Provitamin A biofortification and increased dry matter content are important breeding targets in cassava improvement programs worldwide. Biofortified varieties contribute to the alleviation of provitamin A deficiency, a leading cause of preventable blindness common among pre-school children and pregnant women in developing countries particularly Africa. Dry matter content is a major component of dry yield and thus underlies overall variety performance and acceptability by growers, processors, and consumers. Single nucleotide polymorphism (SNP) markers linked to these traits have recently been discovered through several genome-wide association studies but have not been deployed for routine marker-assisted selection (MAS). This is due to the lack of useful information on markers’ performances in diverse genetic backgrounds. To overcome this bottleneck, technical and biological validation of the loci associated with increased carotenoid content and dry matter content were carried out using populations independent of the marker discovery population. In the present study, seven previously identified markers for these traits were converted to a robust set of uniplex allele-specific polymerase chain reaction (PCR) assays and validated in two independent pre-breeding and breeding populations. These assays were efficient in discriminating marker genotypic classes and had an average call rate greater than 98%. A high correlation was observed between the predicted and observed carotenoid content as inferred by root yellowness intensity in the breeding (r = 0.92) and pre-breeding (r = 0.95) populations. On the other hand, dry matter content-markers had moderately low predictive accuracy in both populations (r< 0.40) due to the more quantitative nature of the trait. This work confirmed the markers’ effectiveness in multiple backgrounds, therefore, further strengthening their value in cassava biofortification to ensure nutritional security as well as dry matter content productivity. Our study provides a framework to guide future marker validation, thus leading to the more routine use of markers in MAS in cassava improvement programs.

Abstract Ischemic stroke is a major cause of long-term disabilities, including vision loss. Neuronal and blood vessel maturation can affect the susceptibility of and outcome after ischemic stroke. Although we recently reported that exposure of neonatal mice to hypoxia–ischemia (HI) severely compromises the integrity of the retinal neurovasculature, it is not known whether juvenile mice are similarly impacted. Here we examined the effect of HI injury in juvenile mice on retinal structure and function, in particular the susceptibility of retinal neurons and blood vessels to HI damage. Our studies demonstrated that the retina suffered from functional and structural injuries, including reduced b-wave, thinning of the inner retinal layers, macroglial remodeling, and deterioration of the vasculature. The degeneration of the retinal vasculature associated with HI resulted in a significant decrease in the numbers of pericytes and endothelial cells as well as an increase in capillary loss. Taken together, these findings suggest a need for juveniles suffering from ischemic stroke to be monitored for changes in retinal functional and structural integrity. Thus, there is an emergent need for developing therapeutic approaches to prevent and reverse retinal neurovascular dysfunction with exposure to ischemic stroke.

Abstract Purpose: Adenosine signaling modulates ocular inflammatory processes, and its antagonism mitigates neovascularization in both newborns and preclinical models of ocular neovascularization including age-related macular degeneration (AMD). The adenosine receptor expression patterns have not been well characterized in the human retina and choroid. Methods: Here we examined the expression of adenosine receptor subtypes within the retina and choroid of human donor eyes with and without AMD. Antibodies specifically targeting adenosine receptor subtypes A1, A2A, A2B, and A3 were used to assess their expression patterns. Quantitative real-time PCR analysis was used to confirm gene expression of these receptors within the normal human retina and choroid. Results: We found that all four receptor subtypes were expressed in several layers of the retina, and within the retinal pigment epithelium and choroid. The expression of A1 receptors was more prominent in the inner and outer plexiform layers, where microglia normally reside, and supported by RNA expression in the retina. A2A and A2B showed similar expression patterns with prominent expression in the vasculature and retinal pigment epithelium. No dramatic differences in expression of these receptors were observed in eyes from patients with dry or wet AMD compared to control, with the exception A3 receptors. Eyes with dry AMD lost expression of A3 in the photoreceptor outer segments compared with eyes from control or wet AMD. Conclusion: The ocular presence of adenosine receptors is consistent with their proposed role in modulation of inflammation in both the retina and choroid, and their potential targeting for AMD treatment.

Radio frequency fingerprinting (RFF) based on RF transients is one of the most effective techniques for improving wireless security. For an efficient RFF development, RF transients need to be accurately detected. However, the detection of the transient starting point remains a main challenge due to the channel noise. In the literature, several methods have been presented to detect the starting point of the transient signals. As an alternative to these methods, this study proposes a method that utilizes Energy Criterion (EC) technique for the first time. In order to test its performance, firstly, an extensive dataset consisting of Wi-Fi signals recorded under realistic Signal-to-Noise Ratio (SNR) conditions is created. Using the provided dataset, the proposed method as well as common transient detection methods are employed for transient start detection. Then, the effect of SNR on the performance of transient start detection is evaluated. Moreover, a performance comparison between the methods is provided based on their respective computational speed and complexity. The results prove the feasibility and efficiency of the proposed method to detect the transient starting point for RFF of Wi-Fi device identification. As to the knowledge of the authors, this study is the first report that comparatively assesses the transient detection methods by using extensive data under realistic noise conditions.

Prosopis farctais belonged to Mimosaceae family, commonly known as mesquite. It was chosen to investigate their effect on α-glucosidase inhibitory activity (in-vitro), serum glucose and liver functions. Roots, fruits, and leaves of P. farcta, were extracted by n-hexane, ethyl acetate, and methanol. α-glucosidase inhibition was analyzed by using ELISA technique then half maximal inhibitory concentration IC50 was found. The blood glucose levels were determined with a glucose analyzer model. The serum alkaline phosphatase (ALP), Alanine transaminase (ALT), aspartate aminotransferase (AST) and serum total bilirubin (TB) were estimated by using the Cobas diagnostic kit with a fully automated chemical analyzer. Diabetes was done by a single dose of 120 mg alloxan/kg b.w with subcutaneously injection. Ethyl acetate extracts of P. farcta showed the higher α-glucosidase inhibitory activity, and the best one was root extract. Treatments of the alloxan-induced diabetes rats were done by daily oral administration of different concentrations with P. farcta extracts of ethyl acetate for 28 days and the dose 200 mg/kg BW was the effective one. The root extract was the best one for reduction of serum glucose followed by leaves then fruits. Administration of root extract of P. farcta showed a decrease in the levels of ALP and TB in alloxan-induced diabetes rats. The fruit extract of P. farcta showed decreasing in the level of ALP in alloxan-induced diabetes rats. In conclusion, the P. farcta extracts for ethyl acetate have properties of hypoglycemic effect as well as improving some parameters related with diabetic complications of liver functions.

Cytochrome P450 (CYP) 1B1 is a heme-containing monooxygenase found mainly in extrahepatic tissues, including the retina. CYP1B1 substrates include exogenous aromatic hydrocarbons, such as dioxins, and endogenous bioactive compounds, including 17β-estradiol (E2) and arachidonic acid. The endogenous compounds and their metabolites are mediators of various cellular and physiological processes, suggesting that CYP1B1 activity is likely important in maintaining proper cellular and tissue functions. We previously demonstrated that lack of CYP1B1 expression and activity are associated with increased levels of reactive oxygen species and oxidative stress in the retinal vasculature and vascular cells, including retinal endothelial cells (ECs). However, the detailed mechanism(s) of how CYP1B1 activity modulates redox homeostasis remained unknown. We hypothesized that CYP1B1 metabolism of E2 affects bone morphogenic protein 6 (BMP6)-hepcidin-mediated iron homeostasis and lipid peroxidation impacting cellular redox state. Here, we demonstrate retinal EC prepared from Cyp1b1-deficient (Cyp1b1−/−) mice exhibits increased estrogen receptor-α (ERα) activity and expresses higher levels of BMP6. BMP6 is an inducer of the iron-regulatory hormone hepcidin in the endothelium. Increased hepcidin expression in Cyp1b1−/− retinal EC resulted in decreased levels of the iron exporter protein ferroportin and, as a result, increased intracellular iron accumulation. Removal of excess iron or antagonism of ERα in Cyp1b1−/− retinal EC was sufficient to mitigate increased lipid peroxidation and reduce oxidative stress. Suppression of lipid peroxidation and antagonism of ERα also restored ischemia-mediated retinal neovascularization in Cyp1b1−/− mice. Thus, CYP1B1 expression in retinal EC is important in the regulation of intracellular iron levels, with a significant impact on ocular redox homeostasis and oxidative stress through modulation of the ERα/BMP6/hepcidin axis.

Revealing prospective locations of hydrothermal alteration zones (HAZs) is an important technique for mineral prospecting. In this study, we used multiple criteria inferred from Landsat-8 OLI, Sentinel-2, and ASTER data using a GIS-based weighted overlay multi-criteria decision analysis approach to build a model for the delineating of hydrothermal mineral deposits in the Khnaiguiyah district, Saudi Arabia. The utilized algorithms revealed argillic, phyllic, and propylitic alteration characteristics. The HAZs map resulted in the identification of six zones based on their mineralization potential, providing a basis for potential hydrothermal mineral deposit assessment exploration, which was created by the fusion of mineral bands indicators designated very low, low, moderate, good, very good, and excellent and covers 31.36, 28.22, 20.49, 10.99, 6.35, and 2.59%. Based on their potential for hydrothermal mineral potentiality, the discovered zones match gossans related to sulfide mineral alteration zones, as demonstrated by previous studies.

Adenosine receptors (AR) are widely expressed in a variety of tissues including the retina and brain. They are involved in adenosine-mediated immune responses underlying the onset and progression of neurodegenerative diseases. The expression of AR has been previously demonstrated in some retinal cells including endothelial cells and retinal pigment epithelial cells, but their expression in the choroid and choroidal cells remains unknown. Caffeine is a widely consumed AR antagonist that can influence inflammation and vascular cell function. It has established roles in the treatment of neonatal sleep apnea, acute migraine, and post lumbar puncture headache as well as the neurodegenerative diseases such as Parkinson and Alzheimer. More recently, AR antagonism with caffeine has been shown to protect preterm infants from ischemic retinopathy and retinal neovascularization. However, whether caffeine impacts the development and progression of ocular age-related diseases including neovascular age-related macular degermation remains unknown. Here, we examined the expression of AR in retinal and choroidal tissues and cells. We showed that antagonism of AR with caffeine or istradefylline decreased sprouting of thoracic aorta and choroid/retinal pigment epithelium explants in ex vivo cultures, consistent with caffeine’s ability to inhibit endothelial cell migration in culture. In vivo studies also demonstrated the efficacy of caffeine in inhibition of choroidal neovascularization and mononuclear phagocyte recruitment to the laser lesion sites. Istradefylline, a specific AR 2A antagonist, also decreased choroidal neovascularization. Collectively, our studies demonstrate an important role for expression of AR in the choroid whose antagonism mitigate choroidal inflammatory and angiogenesis activities.

Background: Studies have shown that perceptual and cognitive asymmetries are present in the auditory system in patients with adolescent idiopathic scoliosis (AIS). The Dichotic Listening (DL) paradigm was formerly performed in non-forced (NF) conditions only, and no study has examined the conditions of attention to one ear. Objective: To investigate the perceptual and cognitive asymmetry in the auditory system in patients with AIS as well as the asymmetry changes according to the curvature characteristics of patients with AIS. Method: The DL paradigm was performed on 38 patients with AIS and 10 healthy individuals in all conditions (NF, Forced Right [FR], Forced Left [FL]). Results: In the NF and FL conditions, the mean number of correct responses for the left ear was significantly lower in patients with AIS than in healthy individuals (p 0.05). The correct responses for the right ear in the NF condition, right and left ear in the FR condition, and right ear in the FL condition did not show a significant difference between the groups (p 0.05). Also, there was no difference between patients with AIS with both functional 3-curve and 4-curve (p 0.05). Conclusion: Our study indicates perceptual and cognitive asymmetry or lateralisation in the auditory system in patients with AIS. The asymmetry might be caused by the inability to direct their attention to the left ear, which is not affected by their curvature type. Further studies are needed to investigate perceptual and cognitive asymmetry behaviour models in the auditory system in patients with AIS. Clinical implications: Determination of perceptual and cognitive asymmetry in the auditory system may offer a new perspective on conservative treatment protocols for AIS patients. Besides, the DL paradigm can be easily used in patients with AIS as a non-invasive evaluation method in clinics.

The visualization of choroidal vasculature and innate immune cells in the eyes of pigmented mice has been challenging due to the presence of a retinal pigment epithelium (RPE) layer separating the choroid and retina. Here, we established methods for visualizing the choroidal macrophages, mast cells, and vasculature in eyes of albino and pigmented mice using cell type-specific staining. We were able to visualize the choroidal arterial and venous systems. An arterial circle around the optic nerve was found in mice similar to the Zinn–Haller arterial circle that exists in humans and primates. Three different structural patterns of choriocapillaris were observed throughout the whole choroid: honeycomb-like, maze-like, and finger-like patterns. Choroidal mast cells were relatively few but dense around the optic nerve. Mast cell distribution in the middle and periphery was different among strains. Macrophages were found in all layers of the choroid. Thus, utilizing the simple and reliable methods described herein will allow the evaluation of transgenic and preclinical mouse models of ocular diseases that affect the choroid, including age-related macular degeneration (AMD), diabetic choroidopathy, and retinopathy of prematurity. These studies will advance our understanding of the pathophysiology, and molecular and cellular mechanisms that can be targeted therapeutically, in these diseases.

Background: Tuberculosis (TB) is a major cause of mortality in persons living with HIV (PLWH). Sputum-based diagnosis of TB in patients with low CD4 counts is hampered by paucibacillary disease and consequent sputum scarcity or negative sputum results. Urine lipoarabinomannan (LAM) has shown promise in the point-of-care detection of TB in this patient subset but lacks sensitivity, and its exact role in a diagnostic algorithm for TB in South Africa remains to be clarified. Objectives: The objective of this study was to better define the patient profile and the TB characteristics associated with a positive urine LAM (LAM+ve) test. Method: This multicentre retrospective record review examined the clinical, radiological, and laboratory characteristics of hospitalised PLWH receiving urine LAM testing with sputum-scarce and/or negative sputum GeneXpert ® (mycobacterium tuberculosis/resistance to rifampicin [MTB/RIF]) results. Results: More than a third of patients, 121/342 (35%), were LAM+ve. The positive yield was greater in the sputum-scarce than the sputum-negative group, 66/156 (42%) versus 55/186 (30%), P = 0.0141, respectively. Patients who were LAM+ve were more likely to be confused (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.2–3.7, P = 0.0045), have a higher median heart rate (P = 0.0135) and an elevated quick sepsis-related organ failure assessment score (≥ 2), OR = 3.5, 95% CI = 1.6–7.6, P = 0.0014. A LAM+ve test was significantly associated with disseminated TB (dTB), P 0.0001, TB-related immune reconstitution inflammatory syndrome (IRIS), P = 0.0035, and abdominal TB, P 0.0001. Laboratory predictors of a LAM+ve status included renal dysfunction, P = 0.044, severe anaemia, P = 0.0116, and an elevated C-reactive protein, P = 0.0131. Of the 12 PLWH with disseminated non-TB mycobacteria cultured from the blood and/or bone marrow, n = 9 (75%) had a LAM+ve result (OR = 5.8, 95% CI = 1.6–20.8, P = 0.0053). Conclusion: Urine LAM testing of hospitalised PLWH with suspected active TB had significant diagnostic utility in those that were sputum-scarce or sputum-negative. A LAM+ve result was associated with dTB, clinical and laboratory markers of severe illness, and TB-IRIS. Disseminated non-tuberculous mycobacterial infection of hospitalised PLWH may also yield urine LAM+ve results, and mycobacterial cultures must be checked in those non-responsive to conventional TB treatment. Selective use of the LAM test in the critically ill is likely to maximise the diagnostic yield, improve the test’s predictive value, and reduce the time to TB diagnosis and initiation of treatment.

Abstract B-cell lymphoma 2 (Bcl-2) protein is the founding member of a group of proteins known to modulate apoptosis. Its discovery set the stage for identification of family members with either pro- or anti-apoptotic properties. Expression of Bcl-2 plays an important role during angiogenesis by influencing not only vascular cell survival, but also migration and adhesion. Although apoptosis and migration are postulated to have roles during vascular remodeling and regression, the contribution of Bcl-2 continues to emerge. We previously noted that the impaired retinal vascularization and an inability to undergo pathologic neovascularization observed in mice globally lacking Bcl-2 did not occur when mice lacked the expression of Bcl-2 only in endothelial cells. To further examine the effect of Bcl-2 expression during vascularization of the retina, we assessed its contribution in pericytes or astrocytes by generating mice with a conditional Bcl-2 allele (Bcl-2Flox/Flox) and Pdgfrb-cre (Bcl-2PC mice) or Gfap-cre (Bcl-2AC mice). Bcl-2PC and Bcl-2AC mice demonstrated increased retinal vascular cell apoptosis, reduced numbers of pericytes and endothelial cells and fewer arteries and veins in the retina. Bcl-2PC mice also demonstrated delayed advancement of the superficial retinal vascular layer and aberrant vascularization of the deep vascular plexus and central retina. Although pathologic neovascularization in oxygen-induced ischemic retinopathy (OIR) was not affected by lack of expression of Bcl-2 in either pericytes or astrocytes, laser-induced choroidal neovascularization (CNV) was significantly reduced in Bcl-2PC mice compared to littermate controls. Together these studies begin to reveal how cell autonomous modulation of apoptosis in vascular cells impacts development and homeostasis.

Background: Globally, malaria is one of the six major causes of deaths from communicable diseases. In South Africa, malaria is known to be endemic in three provinces. Two large trials, AQUAMAT and SEAQUAMAT, demonstrated the superiority of intravenous (IV) artesunate compared to quinine. A systematic review (including the above trials) demonstrated a mortality benefit for adult patients treated with artesunate, but included studies that were conducted in Asia with no adult data available for Africa. Given the lack of local data, we conducted this study to investigate the use of artesunate for the treatment of severe malaria at two academic adult intensive care units (ICUs) in Johannesburg. Methods: We undertook a retrospective patient record review. All patients admitted to the two ICUs and treated for severe malaria using artesunate were included. The study period extended from April 2010 to April 2014. The primary outcome was to determine the observed mortality and relate it to the predicted mortality based on the Acute Physiology and Chronic Health Evaluation (APACHE II) severity of illness score. The ratio of the observed mortality to the expected mortality based on the APACHE II severity of illness score provides a standardised mortality ratio (SMR). Clinical and laboratory parameters data were analysed. Results: There were 56 patients included in the study, of which 40 were male (71.4%). The mean APACHE II score was 19 (standard deviation 5.4). We observed a lower than predicted mortality rate of 21.4% (SMR 0.66). Human immunodeficiency virus (HIV) was the most prevalent comorbidity (32%). There was no travel history in 26.8% of patients. Heart rate, respiratory rate and Glasgow Coma Scale (GCS) all improved significantly from admission to the time of discharge (p ≤ 0.01). Acidaemia, bilirubin, urea and bleeding risk (platelet count) also improved (p ≤ 0.01). Mechanical ventilation was associated with an increased risk of death (OR 35; CI 7.0–182). Conclusion: In this retrospective two-centre study, IV artesunate was associated with a lower than predicted mortality in adult patients with severe malaria requiring ICU admission.

Inflammation is increasingly recognized as an important modulator in the pathogenesis of neovascular age-related macular degeneration (nAMD). Although significant progress has been made in delineating the pathways that contribute to the recruitment of inflammatory cells and their contribution to nAMD, we know little about what drives the resolution of these inflammatory responses. Gaining a better understanding of how immune cells are cleared in the choroid will give a novel insight into how sustained inflammation could influence the pathogenesis of nAMD. The pro-apoptotic Bcl-2 family member Bim is a master regulator of immune cell homeostasis. In its absence, immune cell lifespan and numbers increase. Most therapeutic regimes that squelch inflammation do so by enhancing immune cell apoptosis through enhanced Bim expression and activity. To test the hypothesis that Bim expression tempers inflammation during the pathogenesis of nAMD, we used the mouse laser-induced choroidal neovascularization (CNV) model in which inflammation acts as a facilitator of CNV. Here, we showed minimal to no change in the recruitment of F4/80-, CD80-, CD11b-, and Iba1-positive myeloid-derived mononuclear phagocytes to the site of laser photocoagulation in the absence of Bim expression. However, the resolution of these cells from the choroid of Bim-deficient (Bim -/-) mice was significantly diminished following laser photocoagulation. With time, we noted increased scar formation, demonstrated by collagen I staining, in Bim -/- mice with no change in the resolution of neovascularization compared to wild-type littermates. We also noted that mice lacking Bim expression in mononuclear phagocytes (BimFlox/Flox; Lyz2-Cre (BimMP) mice) had delayed resolution of F4/80-, CD80-, CD11b-, and Iba1-positive cells, while those lacking Bim expression in endothelial cells (BimFlox/Flox; Cad5-Cre (BimEC) mice) had delayed resolution of only CD11b- and Iba1-positive cells. Both BimMP and BimEC mice demonstrated increased scar formation, albeit to differing degrees. Thus, our studies show that resolving inflammation plays an important role in moderating scar formation in nAMD, and it is impacted by Bim expression in both the endothelium and mononuclear phagocyte lineages.

The study was carried out at SUA Magadu Farm to investigate the influence of bush encroachment in a native rangeland on foraging behavior and grazing distribution of dairy cows and goats. Characterization of bush in terms of woody density was done using the PCQ method. A mixture of animals (150 cows and 60 goats) were rotationally grazed on areas with 3 different levels of bush encroachment (dense - 60%; moderate - 35%; and open grassland - ≤5%) and grazing behavior of 3 cows and 3 goats was monitored. Six trained observers recorded behavior of these animals for 2 hours in the morning and 2 hours in the afternoon for 9 days on a rotational basis. There were significant interactions between animal species in terms of grazing behavior and level of bush encroachment. Both species spent similar amounts of time grazing on open grassland (>75% of total feeding time) but on treatments with moderate and dense bush encroachment levels goats spent at least 70% of their time browsing, while grazing time of cows did not change. Goats took many more bites than cows on all treatments and as a result spent more time walking than cows. The implications of these findings for management of bush encroachment are discussed. Further studies on nutritive values and chemical composition of key forage species in the study area are recommended as well as the changes in behavior with different seasons and the impacts on animal production.

This paper presents a new copula to model dependencies between insurance entities, by considering how insurance entities are affected by both macro and micro factors. The model used to build the copula assumes that the insurance losses of two companies or lines of business are related through a random common loss factor which is then multiplied by an individual random company factor to get the total loss amounts. The new two-component copula is not Archimedean and it extends the toolkit of copulas for the insurance industry.

Unilateral absent pulmonary artery (UAPA) is a congenital abnormality rarely diagnosed in adults. UAPA has a myriad of clinical presentations and pulmonary hypertension is present in a quarter of all cases. Isolated UAPA commonly affects the right pulmonary artery and occurs as a result of abnormal development of the sixth aortic arch segment. Due to its rarity, it remains a diagnostic and therapeutic challenge. We describe a case of UAPA in an adult presenting with severe pulmonary hypertension. We describe the appropriate diagnostic approach to a patient with pulmonary hypertension and illustrate the importance of a detailed evaluation to determine the underlying aetiology, particularly in rare causes. Furthermore, we review the clinical presentation, diagnosis and management challenges of UAPA in adults.

Combinatorial therapeutic strategies to eradicate tumors can be superior to a single therapeutic modality. Docetaxel (DT) has been approved for the treatment of local or metastasized breast cancer alone or in combination with other chemotherapeutic agents. Thymoquinone (TQ) originated from the seeds of Nigella Sativa plant has been reported to possess in vitro and in vivo antitumor activity against variety of tumors. In the current study, we have investigated the synergistic anticancer efficacy of a novel combination of DT and TQ on MCF7 breast cancer cell line using MTT cell viability assay. Moreover, this study describes for the first time the co-encapsulation of DT and TQ into PEGylated liposomes. The results showed that the combination of DT and TQ resulted in significant synergistic cytotoxicity compared to DT and TQ alone. Moreover, DT and TQ have been successfully co-encapsulated into PEGylated liposomes with higher encapsulation efficiency compared to DT and TQ alone. In conclusion, DT and TQ combination poses a synergistic effect and may aid in decreasing the required doses of DT. Also, the co-encapsulation of DT and TQ into PEGylated liposomes can provide a promising DT and TQ delivery system into cancer cells.

The DNA-dependent protein kinase (DNA-PK) plays an instrumental role in the overall survival and proliferation of cells. As a member of the phosphatidylinositol 3-kinase-related kinase (PIKK) family, DNA-PK is best known as a mediator of the cellular response to DNA damage. In this context, DNA-PK has emerged as an intriguing therapeutic target in the treatment of a variety of cancers, especially when used in conjunction with genotoxic chemotherapy or ionizing radiation. Beyond the DNA damage response, DNA-PK activity is necessary for multiple cellular functions, including the regulation of transcription, progression of the cell cycle, and in the maintenance of telomeres. Here, we review what is currently known about DNA-PK regarding its structure and established roles in DNA repair. We also discuss its lesser-known functions, the pharmacotherapies inhibiting its function in DNA repair, and its potential as a therapeutic target in a broader context.

Cassava mosaic disease (CMD) is a major viral disease adversely affecting cassava production in Africa and Asia. Genomic regions conferring resistance to the disease have been mapped in African cassava germplasm through biparental quantitative trait loci (QTL) mapping and genome-wide association studies. To facilitate the utilization of these markers in breeding pipelines to support selections, proof-of-concept technical and biological validation research was carried out using independent pre-breeding and breeding populations. Kompetitive Allele-Specific Polymerase Chain Reaction (KASP) assays were designed from three single nucleotide polymorphism (SNP) markers linked to a major resistance locus on chromosome 12 (S12_7926132, S12_7926163) and a minor locus on chromosome 14 (S14_4626854). The designed assays were robust and easy to score with >99% genotype call rate. The overall predictive accuracy (proportion of true positives and true negatives) of the markers (S12_7926132 and S14_4626854) was 0.80 and 0.78 in the pre-breeding and breeding population, respectively. On average, genotypes that carried at least one copy of the resistant allele at the major CMD2 locus had a significantly higher yield advantage. Nevertheless, variation was observed in prediction accuracies for the major locus (S12_7926132) among sub-families from the two populations, suggesting the need for context-specific utilization, for example, by screening for co-segregation of favorable SNP alleles with resistance in the parents being used for crosses. Availability of these validated SNP markers on the uniplex KASP genotyping platform represents an important step in translational genetics toward marker-assisted selection to accelerate introgression of favorable resistant alleles in breeding populations.

Purpose: In a previous study, we investigated a 42-year-old male patient with primary reading epilepsy using continuous video-electroencephalography (EEG). Reading tasks induced left parasagittal spikes with a higher spike frequency when the phonological reading pathway was recruited compared to the lexical one. Here, we seek to localize the epileptogenic focus in the same patient as a function of reading pathway using multimodal neuroimaging. Methods and results: The participant read irregular words and nonwords presented in a block-design paradigm during magnetoencephalography (MEG), functional near-infrared spectroscopy (fNIRS), and functional magnetic resonance imaging (fMRI) recordings, all combined with EEG. Spike analyses from MEG, fNIRS, and fMRI–EEGs data revealed an epileptic focus in the left precentral gyrus, and spike localization did not differ in lexical and phonological reading. Conclusion: This study is the first to investigate ictogenesis in reading epilepsy during both lexical and phonological reading while using three different multimodal neuroimaging techniques. The somatosensory and motor control functions of the left precentral gyrus that are congruently involved in lexical as well as phonological reading can explain the identical spike localization in both reading pathways. The concurrence between our findings in this study and those from our previous one supports the role of the left precentral gyrus in phonological output computation as well as seizure activity in a case of reading epilepsy.

This research emphasizes eloquently on membrane technology for treatment of palm oil mill effluent (POME) as it is the Malaysia’s largest and most important agro based industry. Findings established significant quality improvement with an efficient recovery of water from palm oil mill via innovative membrane application. Conventional bio-methods, whilst adhering to the Department of Environment’s (DOE) discharge regulations, produces brownish liquid which pales in comparison to the crystal clear water obtained through membrane treatment. The pre-treatment process consists of coagulation-flocculation using green environmental coagulant bases such as Moringa oleifera (MO) seeds. The ultrafiltration polyvinylidene difluoride (PVDF) and thin film composite (TFC) reverse osmosis were vital for the membrane processes. The system gave 99% suspended solids reduction in suspended solid and 78% of water present was successfully recovered. This technology guarantees water recovery with drinking water quality; meeting the US Environmental Protection Agency (USEPA) standard or could be recycled into the plant with sludge utilization for palm oil estates, thus enabling the concept of zero discharge to be executed in the industries. In addition, green and healthy antioxidants such as oil and beta-carotene can be recovered from POME further demonstrate. Silica gel showed better performance in separation of carotenes from oil at temperature 40°C using adsorption chromatography with 1154.55 ppm. The attractiveness of this technology, enabling the utilization of reuse of agricultural waste into potentially value added products.

Cassava ( Crantz) is a clonally propagated staple food crop in the tropics. Genomic selection (GS) has been implemented at three breeding institutions in Africa to reduce cycle times. Initial studies provided promising estimates of predictive abilities. Here, we expand on previous analyses by assessing the accuracy of seven prediction models for seven traits in three prediction scenarios: cross-validation within populations, cross-population prediction and cross-generation prediction. We also evaluated the impact of increasing the training population (TP) size by phenotyping progenies selected either at random or with a genetic algorithm. Cross-validation results were mostly consistent across programs, with nonadditive models predicting of 10% better on average. Cross-population accuracy was generally low (mean = 0.18) but prediction of cassava mosaic disease increased up to 57% in one Nigerian population when data from another related population were combined. Accuracy across generations was poorer than within-generation accuracy, as expected, but accuracy for dry matter content and mosaic disease severity should be sufficient for rapid-cycling GS. Selection of a prediction model made some difference across generations, but increasing TP size was more important. With a genetic algorithm, selection of one-third of progeny could achieve an accuracy equivalent to phenotyping all progeny. We are in the early stages of GS for this crop but the results are promising for some traits. General guidelines that are emerging are that TPs need to continue to grow but phenotyping can be done on a cleverly selected subset of individuals, reducing the overall phenotyping burden.

Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy with Modularis Vario Siemens in the management of patients with renal and ureteral stones.Methods: Between 2007 and 2009, 225 outpatients were treated with Siemens Modularis Vario lithotripter at Sultan Qaboos University Hospital. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p

Despite the fact that the Sahara is considered the most arid region on Earth, it has witnessed prolonged fluvial and aeolian depositional history, and might harbor substantial fresh groundwater resources. Its ancient fluvial surfaces are, however, often concealed by aeolian deposits, inhibiting the discovery and mapping of potential groundwater recharge areas. However, recent advances in synthetic aperture radar (SAR) imaging offer a novel approach for detecting partially hidden and dynamic landscape features. Interferometry SAR coherence change detection (CCD) is a fairly recent technique that allows the mapping of very slight surface changes between multidate SAR images. Thus, this work explores the use of the CCD method to investigate the fluvial and aeolian morphodynamics along two paleochannels in Egypt. The results show that during wetter climates, runoff caused the erosion of solid rocks and the rounding of sand-sized grains, which were subsequently deposited in depressions further downstream. As an alternating dry climate prevailed, the sand deposits were reshaped into migrating linear dunes. These highly dynamic features are depicted on the CCD image with very low coherence values close to 0 (high change), while the deposits within the associated ephemeral wadis show low to moderate coherence values ranging from 0.2 to 0.4 (high to moderate change), and the country rocks show a relative absence of change with high coherence values close to 1. These linear dunes crossed their parent’s stream courses and dammed the runoff to form lakes during rainy seasons. Part of the dammed surface water would have infiltrated the ground to recharge the permeable wadi deposits. The alternation of fluvial and aeolian depositional environments produced unique hydromorphometrically trapped lakes that are very rare in arid regions, but of great interest because of their significance to groundwater recharge.

The development of Klang Valley Integrated Rapid Transit system in Klang Valley, Malaysia has been quickly gaining momentum during the recent years. There will be two new MRT lines (MRT Line 1 and MRT Line 2) and one new LRT line (LRT Line 3) extended from the current integrated rail transit system by year 2020 with more than 90 new rail stations. With the substantial addition of potential rail passengers, there are doubts whether the existing Park and Ride facilities in Klang Valley are able to accommodate the future parking space demand at rail stations. This research studies the parking occupancy at various Park and Ride facilities in Klang Valley namely Taman Jaya, Asia Jaya, Taman Paramount, Taman Bahagia and Kelana Jaya by applying the non-conventional method utilizing Google Earth imageries. Results showed that the parking occupancy rate at these LRT stations were 100% or more before the commencement of LRT extension (Kelana Jaya and Ampang Lines) in 2016 and in the range of 36% to 100% after the commencement of LRT extension due to the additionally built car parks and changes in parking pattern with dispersed passenger traffic.

β -In2S3 thin films (S/In = 1 , 2 and 4) were prepared using the pneumatic spray pyrolysis (PSP) route to analyze the effect of the S/In ratio on the physical properties. These properties were conducted using the photothermal deflection spectroscopy (PDS) method. The PDS signal amplitudes as a function of wavelength show multiple reflections which appear for all prepared In2S3 films. Such multiple reflections indicate homogeneity and high crystalline quality of the films. The deduced values of the optical band gap vary in the range 2.55–2.65 eV. The highest thermal diffusivity is obtained for S/In = 2. The product (μ ⋅ τ) is found in order of 10 − 8 cm − 1 /V. The estimated carrier diffusion lengths are 0.06, 0.11 and 0.09 μ m for films corresponding to S/In = 1 , 2 and 4, respectively. Defect absorption in β -In2S3 films is also investigated by PDS. Five absorption peaks are observed. These absorption peaks contain defect information in the band gap. Hence, this work evidences that β -In2S3 is a multi-functional material that can be used in optoelectronic, photovoltaic and visible-irradiation photocatalyst applications. [ABSTRACT FROM AUTHOR]

Abstract\nNOVELTY STATEMENTCommercial microalgae production is often interrupted by contamination, leading to short production cycles, reinoculation needs, and culture collapses, significantly increasing costs. This study focuses on investigating Recirculated Sedimentation Application (RSA) to control contamination in microalgae culture systems used for wastewater treatment. Chlorella vulgaris culture was grown in an unsterilized mixture of tertiary treatment effluent and centrate of anaerobic digestion wastewater sludge over a 90-day experimental period. 60 L raceway reactor was operated under a light intensity of 275 μM m−2.s−1 with a 16:8 h light-dark photoperiod. To evaluate the effect of RSA on biological-based problems, the experiment was conducted in three phases. The benefits of utilizing RSA were established through the following observations: effective removal of contaminants at an acceptable level without releasing the culture; extension of the biofilm formation time on the inner walls; inhibition of heterotrophic bacteria and nitrification; enhancement of the suspended solids retention capacity of the raceway tank (up to 770 mg.L−1); and improvement in ammonium removal rate to approximately 30 mg.L−1d−1. The ideal salinity level for both ammonium removal and biomass concentration in RSA should be below 0.02%. These findings demonstrate the potential of phycoremediation for sustainable wastewater treatment and contribute to environmental bioremediation strategies.This study investigates the effects of recirculated sedimentation using freshly formed and mature algae, based on settleability differences, for microalgae cultivation in open ponds with unsterilized wastewater, with the aim of maintain a stable and productive biomass community. Additionally, this study contributes to expand the current knowledge on several fronts: including removing contaminants without discharging the culture, improving biomass holding capacity of the reactor, reducing biofilm formation on reactor walls, suppressing bacterial growth in the culture media and enhancing ammonium removal rate. To the best of our knowledge, there have not been no previous studies to evaluate the effectiveness of sedimentation for these purposes. [ABSTRACT FROM AUTHOR]