Search

Ashwaq Alolyan,1 Kanan Alshammari,1 Mohammad Arabi,1 Ahmed Alshehri,2 Hamad Alsuhaibani,3 Fahad Ibnshamsah,4 Abdullah Alsharm,5 Mervat Mahrous,6,7 Adnan Al Zanbagi,8 Mazen Hassanain,9 Shouki Bazarbashi10 1Department of Medical Oncology, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; 2Department of Oncology, King Khalid National Guard Hospital Abdulaziz Medical City, Jeddah, Saudi Arabia; 3Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 4Department of Medical Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 5Department of Medical Oncology, King Fahad Medical City, Riyadh, Saudi Arabia; 6Department of Oncology, Prince Sultan Military Medical City Hospital, Riyadh, Saudi Arabia; 7Department of Medicine, Minia University of Egypt, Faculty of Medicine, Minia, Egypt; 8Department of Gastroenterology and Hepatology, King Abdullah Medical City, Makkah, Saudi Arabia; 9Department of Surgery, King Saudi University, Riyadh, Saudi Arabia; 10Department of Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaCorrespondence: Shouki Bazarbashi, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia, Email bazarbashi@gmail.comAbstract: Hepatocellular carcinoma (HCC) is the sixth most common type of cancer in the world associated with high morbidity and mortality. Despite being a significant healthcare burden there is limited information on the unmet needs and current treatment practices for intermediate and advanced-stage HCC in Saudi Arabia. This article analyzes the gaps and provides expert consensus on the management strategies for unresectable HCC in Saudi Arabia. A pre-meeting online questionnaire, comprising 20 objective questions about the treatment landscape and diagnosis of HCC in Saudi Arabia, was distributed to experts in the field of HCC management. An advisory board meeting including a panel of 13 experts was held in September 2022 where the responses to the survey questionnaire were reviewed and discussed. The survey results and experts’ discussion highlighted the growing incidence of liver cancer in Saudi Arabia. HCC comprised the majority of all liver cancer cases due to rising rates of chronic viral infections and lifestyle-related risk factors. Most physicians in Saudi Arabia follow the Barcelona Clinic Liver Cancer guidelines as a prognostic tool for the detection and staging of patients with HCC. Most of the patients with HCC in Saudi Arabia are diagnosed in the intermediate or advanced stages with poor prognoses and limited therapeutic options. Establishing evidence-based surveillance techniques, a multidisciplinary approach to diagnosis, and better accessibility of treatment options is vital for the management of HCC in Saudi Arabia.Keywords: hepatocellular carcinoma, treatment patterns, multidisciplinary

This article, titled "Pregnancy after Hybrid Embolization for Uterine Arteriovenous Malformation: An Uncommon but Successful Outcome," discusses a case study of a 30-year-old woman who experienced amenorrhea after a D&C procedure and was later diagnosed with a uterine arteriovenous malformation (AVM). The woman underwent five sessions of hybrid embolization, which successfully devascularized the AVM. Following the treatment, the woman became pregnant and delivered a healthy baby. The article concludes that hybrid embolization can be an effective treatment option for uterine AVMs, allowing patients to have successful pregnancies. [Extracted from the article]

The UV radiation level at the Earth's surface is generally affected by several factors such as time, geographic location, and climate. The first observations of solar UV radiation ever made in NW Iran, obtained in June 2019 are reported in this work. The analysis of hourly values of UV irradiances measured in the study area reveals significant diurnal variation during daylight hours, with lower values in the morning and afternoon and higher around noon. Mean hourly UV (A+B) ranged from 2755 to 10434 µW/cm2 with an average value being about 7960 µW/cm2. Mean hourly UV (C) ranged from 40 to 91 µW/cm2 with an average value being about 76 µW/cm2. The results of a short but intense measurement campaign in Ardabil-Sarein indicate the trends for geographical latitude, longitude, and altitude from surface UV measurements. The UV intensity is associated with geographical longitude (r2= 0.15 for UV (A+B); r2= 0.13 for UV (C)). Furthermore, UV intensity varies with the local latitude in the study area. There is a strong linear relationship between average UV and altitude and a trend of rising UV with increasing altitude is obtained. A decrease in UV radiation with increasing solar zenith (°) was observed. However, the correlation between UV radiation and solar azimuth (°) was not significant. Understanding the factors influencing near-surface UV radiation through systematic ground-based UV will help determine whether long-term changes occur as a result of changes in cloud cover or climate change, and how specific it means to identifying the causes. [ABSTRACT FROM AUTHOR]

Transfer Factors (Fv) of 238U, 226Ra, 234Th, 210Po and 210Pb from five different agricultural soils in semi-arid region (Syria) to four different barley genotypes were studied in an agricultural potted experiment. The geometric mean of the Fv values were (0.08) for 210Pb, and (0.02) for 210Po, while it ranged from 0.18 to 0.42 ,from 0.08 to 0.15 and from 0.22 to 0.4 for 238U, 234Th and 226Ra, respectevily. The Fv values of 238U and 226Ra were within the recommended global medians, while the Fv values of 234Th, 210Pb and 210Po were higher. There is no clear relationship between the soil properties and Fv of all studied radionuclides to barley genotypes. Moreover, the expression of glutathione (GSH) gene, which is belived to be involoved in heavy metal removal was generally low in all studied varieties grown in all soil types. [ABSTRACT FROM AUTHOR]

Spot blotch (SB) caused by the fungus Cochliobolus sativus is a destructive disease of barley worldwide. Functional cooperation between Jasmonic acid (JA) and pathogenesis-related 3 (PR3) gene signaling pathways in barley with SB have been poorly documented. Keeping in view this objective, SB-resistant 'Banteng' and susceptible 'WI2291' genotypes were evaluated using qRT-PCR across four-time points after pathogen challenge. Data showed significant variance in the expression patterns of JA and PR3 between inoculated and noninoculated plants in both genotypes, and their expressions were higher and faster in the resistant cultivar 'Banteng' as compared with the susceptible one 'WI2291' at each infection time point. However, qRT-PCR showed that 24 h constitute a significant starting time-point for PR3 and JA in demonstrating the differential response of both genotypes towards C. sativus. The maximum expressions were recorded for PR3 (5.43 and 2.81-fold) at 48 hours post inoculation (hpi) and for JA (152 and 142 ng/g) in the resistant and susceptible genotypes respectively, at 72 hpi. Taken together, our results confirm the importance of PR3 and JA - dependent signaling during barley-C. sativus interactions. [ABSTRACT FROM AUTHOR]

Spot blotch (SB), caused by Cochliobolus sativus is a common foliar disease of barley worldwide. The phytohormones jasmonic acid (JA) and salicylic acid (SA) play important functions in plant defense systems. However, the changes in JA and SA pathways in response to SB disease have been poorly documented. In the current work and to better understand the mechanisms of barley resistance to this disease, JA and SA pathways were evaluated in resistant 'Banteng' and susceptible 'WI2291' cultivars across four time points post pathogen challenge. The data showed that JA and SA contents were elevated in fungus-inoculated and non-inoculated leaves in both resistant and susceptible interactions 24h post inoculation. However, although JA signaling was activated in parallel with SA signaling up to 72h in both cultivars, JA had no significant differences across four time points as compared with noninoculated controls. Furthermore, the resistant cultivar 'Banteng' constitutively contained higher levels of SA (956.2 ng/g) comparing with the susceptible one 'WI2291' (192.5 ng/g) 96h post inoculation, whereas, JA pathway was weakly activated over time. We thus hypothesized that SA signaling has an important function in resistance mechanisms against SB disease, whereas JA signaling has a contrasting role in this defense system, which might prove crucial information concerning barley signaling events induced by C. sativus invasion. [ABSTRACT FROM AUTHOR]

Hydrogen sulfide (H 2 S) in natural water plays an important role in carbon and sulfur cycles in biosphere. Current detection protocol is complicated, which need to "bring back water" to lab followed by gas chromatograph analysis. In situ, field detection is still challenging. Herein, a portable, sensitive surface enhanced Raman scattering (SERS) chip was proposed for in situ H 2 S sampling and SERS signal stabilizing, enabling a "bring back chip" manner for lab analysis. The SERS chip was composed of single core-shell gold nanorod-ZIF-8 framework (Au NR@ZIF-8) nanoparticle. Relying on headspace adsorption, evaporated H 2 S was enriched in the ZIF-8 shell and then reacted with Au NR, resulting in the weakening of the Au-Br bond Raman peak (175 cm -1 ) and the appearance of the Au-S bond Raman peak (273 cm -1 ). The SERS signal reached equilibrium in 10 min. The detection range of H 2 S was 0.1-2000 μg/L and limit of detection was 0.098 μg/L. SERS signal was not interfered by normal volatile gases. Moreover, SERS signal of a reacted chip was stable at an ambient condition, allowing for in situ sampling and bring-back detection. The applicability of the chip was verified by dynamic H 2 S monitoring during artificial black-odor water evolution, and in-field quantitative analysis of H 2 S content in river water and sediment. Finally, the chip was sealed in a waterproof breathable membrane device, which realized the detection of vertical profiles of H 2 S in the river. This work provided a promising tool for field analysis of H 2 S in natural environments., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: The aim of this study was to describe our experience and outcome of ablation therapy for arrhythmias in pediatrics at a tertiary care center., Methods: Data was collected retrospectively from the hospital medical records. All pediatrics presenting to AUBMC between 2000 and 2020 who underwent cardiac ablation were included. The data collected included type of arrhythmia, ablation technique, age and weight at ablation, procedure complications, medications used, and outcome assessment., Results: We had 67 patients who underwent cardiac ablation. Of those, 60% were males with a mean age of 15 years. Structural heart disease was present in 6% of patients. Wolff-Parkinson-White syndrome (WPW) was most prevalent at 31%, followed by atrioventricular nodal reentrant tachycardia (AVNRT) at 24%, atrioventricular reentrant tachycardia (AVRT) at 16%, ventricular tachycardia (VT) at 10%, atrial fibrillation (AF) at 3%, and atrial tachycardia (AT) at 1%. The remaining 15% of patients presented with less common types of arrhythmias, including other supraventricular tachycardias (SVTs), retrograde dual atrioventricular nodal reentry, and premature ventricular contractions (PVC). Antiarrhythmic medications were started before the procedure in 59% of our population. Medication regimens postablation included beta-blockers (68%), type 1c antiarrhythmics (25%), calcium channel blockers (3%), ivabradine (2%), and amiodarone (2%). The completed procedures showed a success rate of 93%., Conclusion: Ablation of arrhythmias in pediatrics is an effective procedure in the treatment of childhood arrhythmias. More studies are needed on cardiac ablation in this age group and those with structural heart disease in the Middle East region., (© 2024 Wiley Periodicals LLC.)

Biofuel has gained significant attention as a potential source to meet fuel demands instead of fossil fuel. The price of biofuel and alternative fuel have a considerable impact on biofuel demand. Thus, it is important to design a biofuel supply chain network that incorporates the biofuel price into an elastic demand. More precisely, a variable demand, including customer importance level (to the environment), biofuel price, and substituted fuel price, is considered in this research. Furthermore, this research presents a bi-objective mixed-integer quadratic formulation that aims to maximize the total profit of the supply chain and carbon absorption in harvesting areas. The problem is solved by the ε-constraint and lagrangian relaxation methods due to its complexity. Moreover, substituted fuel price uncertainty is addressed by two-stage stochastic programming. Finally, a real case study utilizing the data envelopment analysis approach is applied to assess the efficiency and currency of the addressed model. Several consequences are illustrated in the case study, such as rich areas for exporting algae, suggesting hub locations for biofuel production, etc., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: The prevalence of neural tube defects (NTDs) is higher in Ethiopia than most other countries, and ~84% of Ethiopian women of reproductive age (WRA) have folate insufficiency, a major risk factor for NTDs. Salt fortification with folic acid is a potential strategy to improve women's folate status, but data are needed on the acceptability, nutritional impact and safety of folic acid fortification of iodised salt., Methods and Analysis: The study is designed as a community-based, household-randomised, dose-response trial. A total of 360 non-pregnant WRA 18-49 years of age will be randomly assigned to one of three intervention arms: (1) iodised salt fortified with 30 ppm folic acid to provide ~200 µg folic acid/day; (2) iodised salt fortified with 90 ppm folic acid to provide ~600 µg folic acid/day; or (3) iodised salt (comparator). The preweighed salts will be delivered to participants' homes biweekly for 26 weeks; unused salt will be collected and weighed. Fasting, venous blood samples will be collected at baseline, end line and a randomly assigned intermediate time point for assessment of folate, iodine, vitamin B 12 and other micronutrient status biomarkers. Women's dietary intakes, including discretionary salt consumption, will be measured using weighed food records; 24-hour urine specimens will be analysed for sodium and iodine excretion. Primary outcomes are women's consumption of study salts, change in biomarkers of folate and iodine status and prevalence of adverse events. Results will be analysed using analysis of covariance models to estimate group mean differences for continuous outcomes, controlling for baseline measurements, and log-binomial or modified Poisson regressions for categorical outcomes. Prespecified effect modifications will be explored., Ethics and Dissemination: The study has been approved by the Ethiopian Public Health Institute's Institutional Review Board, and the protocol has been registered with ClinicalTrials.gov (registration number NCT06223854). Study results will be published in open access scientific journals and disseminated nationally in Ethiopia., Trial Registration Number: NCT06223854., Competing Interests: Competing interests: KHB is a part-time consultant for the Bill & Melinda Gates Foundation. MA and HM are employees of Nutrition International., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Background: Unroofed coronary sinus (UCS) is a rare subtype of atrial septal defect. It is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac malformation., Case Summary: This report describes a rare case of an adolescent patient with UCS featuring atrial situs solitus, absence of the right superior vena cava and a persistent left superior vena cava draining into the left atrium consistent with total unroofing of the coronary sinus. This was associated with concurrent severe mitral insufficiency secondary to redundant and prolapsing leaflets, and a substantial left-to-right shunt across the coronary sinus orifice. A comprehensive examination of the existing literature is included, shedding light on the diagnostic challenges of UCS and describing the available surgical options within the context of mitral valve surgery., Conclusion: UCS is a complex condition requiring careful consideration of associated anomalies and a tailored surgical approach., Competing Interests: Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Stormwater capture and use (SCU) projects have the potential to provide a significant portion of municipal water demand. However, uncertainty about the degree of microbial contamination in stormwater and the required treatment is a barrier for implementation of SCU projects. Stormwater runoff could become contaminated with human fecal matter in areas with deteriorating infrastructure where raw wastewater exfiltrates from sewer networks to stormwater collection networks, homeless encampments exist, or sanitary sewer overflows (SSOs) occur. Estimation of human fecal contamination can inform selection of stormwater treatment targets. This study investigates stormwater microbial contamination originating from human fecal matter using observed detections and concentrations of human microbial source tracking (MST) markers and potentially human-infectious pathogens (PHIPs). First, a systematic review complied measurements of human MST markers in wet and dry weather stormwater flows and influent wastewater. In addition, measurements of viral pathogens (e.g., adenoviruses, norovirus GI+GII, and enteroviruses) and protozoan pathogens (e.g., Giardia lamblia and Cryptosporidium parvum) in wet weather flows and influent wastewater were assessed. Human MST marker and PHIP data were statistically analyzed and applied to estimate a human fecal contamination analog (HFCA) which is an estimate of the amount of human fecal matter based on relative concentrations of microbial contaminants in stormwater compared to municipal wastewater. Human MST-based HFCAs in wet and dry weather flows ranged from <10 -7.0 to 10 -1.5 (median = 10 -4.5 ) and 10 -12 to 10 -2.6 (median = 10 -7.0 ), respectively. PHIP-based HFCAs in wet weather flows ranged from ∼10 -8 to 10 -0.14 . Estimates of human MST-based HFCAs are more reliable than PHIP-based HFCAs because the current PHIP datasets are generally limited by the number of data points, percent detection, variability observed within the statistical distributions, and the geographical span of sampling locations. The use of human MST-based HFCAs is recommended to guide the selection of stormwater treatment process trains that are protective of public health based on the intended end use. Application of HFCA 10 -1 (i.e., sewage dilution 10 -1 ) remains a reasonable conservative estimate of human fecal contamination in stormwater to inform selection of pathogen log reduction targets based on the data presently available., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: The two classic manifestations of primary aldosteronism are hypertension and hypokalemia. However, acute respiratory failure due to hypokalemia in primary hyperaldosteronism is rare., Case Presentation: The patient was a 27-year-old female who presented with drowsiness and weakness in all extremities. She had been diagnosed with hypertension three years prior, with irregular follow-up, and had a history of preeclampsia one year later. She exhibited high blood pressure and severe hypokalemia (2 mEq/L), leading to respiratory depression and impending respiratory arrest. Consequently, the patient was intubated and transferred to the intensive care unit (ICU). She also developed rhabdomyolysis. Blood pressure tests, including hormonal tests (aldosterone: 13.2 ng/dL, plasma renin activity: 0.32 ng/mL/h), were conducted. Due to the high aldosterone-renin ratio, an abdominopelvic computed tomography (CT) scan was performed. The CT scan revealed a 14 × 12 mm round mass with a washout value above 60%, consistent with an adrenal adenoma, leading to a diagnosis of primary aldosteronism. The patient was discharged after stabilization, and one and a half months after ICU admission, a laparoscopic left adrenalectomy was successfully performed without post-operative complications. Histopathology showed encapsulated hypertrophy of the adrenal cortex with a predominance of large clear cells, confirming the diagnosis of adrenal adenoma. At the most recent follow-up, the patient had normal potassium levels, was normotensive without any medications, and exhibited no alarming signs or symptoms., Conclusion: Respiratory depression to the extent of impending respiratory failure and rhabdomyolysis as a result of hypokalemia in primary aldosteronism are extremely rare. In this patient, who developed respiratory depression due to resistant hypokalemia, timely investigation of secondary causes and diagnosis of adrenal adenoma were crucial. The surgery provided definitive treatment for the patient's blood pressure and prevented the recurrence of life-threatening complications., (© 2024. The Author(s).)

Background: Tetralogy of Fallot with an absent pulmonary valve is a very rare variant of tetralogy. It is characterized by absent valve tissue, severe pulmonary regurgitation, and secondary aneurysmal dilatation of the pulmonary arteries., Aim: In this study, we aim to investigate the clinical presentations, management strategies, and outcomes of patients with tetralogy of Fallot and absent pulmonary valve., Methodology: We retrospectively reviewed the charts of all patients who presented to the American University of Beirut Medical Center between January 2010 and December 2020 and who were diagnosed with this anomaly., Results: A total of 300 cases of tetralogy of Fallot were identified, of which 18 patients had absent pulmonary valves. They were followed up for an average of 8.2 years. Prenatal diagnoses were made in four patients, while 13 patients were identified in the neonatal period, with an average age of 4.5 days. Genetic testing confirmed DiGeorge syndrome in one patient. Five patients underwent surgical intervention in the neonatal period, while the remaining patients were operated on during their early childhood. While overall there were no surgical mortalities nor any need for reinterventions, a variety of morbidities were encountered., Conclusion: This study provides an overview of this rare anomaly and its management in a developing country., (© 2024 Wiley Periodicals LLC.)

Concentrations of toxic metals (Hg, Pb, and Cd) were determined in the muscles of Lepomis macrochirus , Barbus callensis , and Barbus nasus caught from the Moulouya River of Morocco by graphite furnace (for Pb and Cd) and cold vapour (for Hg) atomic absorption spectrometry, after acid digestion. Although the concentration of metals in some species was relatively high, no health risk has been identified in comparison to the maximum limits as set by the European Commission. The order of increasing concentrations was Cd < Hg < Pb. Calculated Target Hazard Quotients and Hazard Indices were below 1, indicating that the intake of metals via consumption of the muscles of both fish species does not represent a hazard to human health.

Introduction: Development of multi-, extensively-, and pandrug-resistant (MDR, XDR, and PDR) strains of Pseudomonas aeruginosa remains a major problem in medical care. The present study evaluated the effect of antimicrobial photodynamic therapy (aPDT) as a monotherapy and in combination with colistin against P. aeruginosa isolates., Methods: Two P. aeruginosa isolates recovered from patients with respiratory tract infections were examined in this study. Minimum inhibitory concentration (MIC) of colistin was determined by the colistin broth disk elution (CBDE) and the reference broth microdilution (rBMD) methods. aPDT was performed using the photosensitizer (Ps) riboflavin at several concentrations and a light-emitting diode (LED) emitting blue light for different irradiation times with or without colistin at 1/2 × MIC concentration., Results: Both PA1 and PA2 isolates were identified as colistin-resistant P. aeruginosa with a MIC ≥4 μg/mL by the CBDE and MICs of 512 μg/mL and 256 μg/mL, respectively, by the rBMD. In aPDT, neither riboflavin nor LED light alone had antibacterial effects. The values of colony forming units per milliliter (CFU/mL) in both isolates were significantly reduced by LED + Ps treatments in a time-dependent manner (LED irradiation time) and dose-dependent manner (Ps concentration). In comparison with control, treatment with Ps (50 μM) + LED (120 s) and Ps (100 μM) + LED (120 s) resulted in 0.27 log 10  CFU/mL and 0.43 log 10  CFU/mL reductions in PA1, and 0.28 log 10  CFU/mL and 0.34 log 10  CFU/mL reductions in PA2, respectively, (P < 0.01). The best results were obtained after the combination of aPDT followed by colistin, which increased bacterial reduction, resulting in a 0.41-0.7 log 10  CFU/mL reduction for PA1 and 0.35-0.83 log 10  CFU/mL reduction for PA2 (P = 0.001)., Conclusions: This study suggests the potential implications of aPDT in combination with antibiotics, such as colistin for treatment of difficult-to-treat P. aeruginosa infections., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Objectives: COVID-19, caused by the SARS-CoV-2 virus, has generated a global pandemic with a wide range of clinical manifestations. Cardiovascular complications are frequently observed in individuals with COVID-19, particularly those with preexisting cardiovascular risk factors or diseases. Cardiac biomarkers, including troponin, natriuretic peptides, and inflammatory markers, play a vital role in risk stratification, diagnosis, monitoring, and prognosis in COVID-19 patients. These biomarkers provide valuable insights into cardiac injury, myocardial stress, inflammation, and the prediction of adverse cardiovascular outcomes. This review aims to provide better understanding of how Cardiac biomarkers correlate to clinical manifestation of COVID-19., Methods: We retrieved studies from PubMed, Medline, and Google Scholars that included results on cardiac biomarkers in COVID-19. Total of 14 studies were reviewed., Results: 8 studies showed evidence of poor progression of the disease when there is increased troponin. 6 studies out of the 14 mentioned in this review showed positive correlation between mortality and elevation in cardiac biomarkers. This shows the significance of cardiac biomarkers in predicting the mortality in patients with COVID-19., Conclusion: It was shown that elevated cardiac biomarkers were associated significantly to poor outcome of covid-19 infection. The outcomes that were linked to increased cardiac biomarkers included increased length of hospitalization, need of life sustaining treatment, myocarditis, invasive and non-invasive respiratory support, and even death were linked to elevated cardiac biomarkers levels.

In this research, we utilized an efficient approach to synthesize superparamagnetic graphene oxide (SPGO) rapidly in a one-pot method using microwave irradiation of graphene oxide (GO), urea, and Fe(III) ion. Tannic acid (TA) was introduced to the surface of SPGO through a straightforward and eco-friendly process. Methods were devised to furnish GO nanosheets and modify their surfaces with TA in an environmentally friendly manner. Two series of nanosheets, namely, SPGO/TA-COOH and SPGO/TA-IM, were engineered on the surface and used for immobilizing lipase enzyme. Through various analytical tools, the unique biocatalysts SPGO/TA-COOH/L and SPGO/TA-IM/L were confirmed. These biocatalysts exhibited enhanced stability at high temperatures and pH levels compared with free lipase. They also demonstrated prolonged storage stability and reusability over four months and seven cycles, respectively. Furthermore, the catalytic activity of immobilized lipase showed minimal impairment based on kinetic behavior analysis. The kinetic constants of SPGO/TA-IM/L were determined as V max = 0.24 mM min -1 , K m = 0.224 mM, and k cat = 0.8 s -1 . Additionally, the efficiency of biocatalysts for biodiesel production from palmitic acid was studied, focusing on various reaction parameters, such as temperature, alcohol to palmitic acid molar ratio, water content, and lipase quantity. The esterification reaction of palmitic acid with methanol, ethanol, and isopropanol was tested in the presence of SPGO/TA-COOH/L and SPGO/TA-IM/L, and the corresponding esters were obtained with a yield of 30.6-91.6%.

Backgrounds: Manifestation of cystic hygroma in adulthood is very rare. The rarity of cystic hygroma in adults has caused problems in its diagnosis and management and few studies have reported cystic hygroma in adults., Case Presentation: In this study, we reported a rare case with cervical cystic hygroma in adults. We report a 20-year-old Iranian male (Iranian ethnicity) with a diagnosis of right-side neck cystic hygroma and discuss the presentation, diagnosis, and clinical, radiological, and operative aspects of it., Conclusion: Cystic hygromas are a rare occurrence in adults. They are typically asymptomatic, rarely complicated, and can be mistaken for a cystic neck mass. This study showed that in our case, surgical resection may be a safe and effective treatment for cystic hygroma, with minimal risk of complications during the procedure., (© 2024. The Author(s).)

Objectives: To compare the primary patency and restenosis rates in treatment naieve dialysis arteriovenous fistulas (AVFs) after drug-coated balloons (DCB) versus plain balloon angioplasty (PTA)., Methods: This retrospective study included 157 patients who underwent AVF angioplasty for treatment-native AVF stenosis between January 2012 to 2022. The fistulas were Brachiocephalic (75%), Brachiobasilic (17%), and radiocephalic (8%). The index intervention was with either DCB or percutaneous transluminal angioplasty (PTA) with subsequent follow up. Patients with central venous stenosis, thrombosed fistula, fistula stents, AV graft or surgical intervention after the index procedure were excluded., Results: Arteriovenous fistula angioplasty was done in 28 patients using DCB and in 129 patients using PTA. A total of 108 patients presented with a single stenosis, 42 with 2 stenoses, and 7 with 3 stenoses. The location of these stenoses was in the venous outflow (57%), the juxta anastomotic segment (31%), and cephalic arch (12%). The median time to re-intervention for the PTA was 216 days compared to 304 days for the DCB ( p =0.079). Primary patency at 6 months was 60.4% for PTA and 75% for DCB ( p =0.141) CONCLUSION: Although DCB angioplasty of treatmentnaïve dysfunctional AVF tends to improve the time to intervention and 6-month primary patency compared to PTA, this difference did not reach statistical significance., (Copyright: © Saudi Medical Journal.)

MEMS/NEMS resonant sensors hold promise for minute mass and force sensing. However, one major challenge is that conventional externally driven sensors inevitably encounter undesired intrinsic noise, which imposes a fundamental limitation upon their signal-to-noise ratio (SNR) and, consequently, the resolution. Particularly, this restriction becomes increasingly pronounced as sensors shrink to the nanoscale. In this work, we propose a counterintuitive paradigm shift that turns intrinsic thermal noise from an impediment to a constituent of the sensor by harvesting it as the driving force, obviating the need for external actuation and realizing 'noise-driven' sensors. Those sensors employ the dynamically amplified response to thermal noise at resonances for stimulus detection. We demonstrate that lightly damped and highly compliant nano-structures with high aspect ratios are promising candidates for this class of sensors. To overcome the phase incoherence of the drive force, three noise-enabled quantitative sensing mechanisms are developed. We validated our sensor paradigm by experimental demonstrating noise-driven pressure and temperature sensors. Noise-driven sensors offer a new opportunity for delivering practical NEMS sensors that can function at room temperature and under ambient pressure, and a development that suggests a path to cheaper, simpler, and low-power-consumption sensors., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2024.)

Aim: To evaluate the effect of auraptene (AUR) treatment in forms of free and encapsulated in niosome nanoparticles by investigating the mRNA expression level of vascular endothelium growth factor (VEGF)-A and platelet-derived growth factors (PDGFs) in human retinal pigment epithelium (RPE) cell line., Methods: Niosome nanocarriers were produced using two surfactants Span 60 and Tween 80. RPE cell line was treated with both free AUR and niosome-encapsulated. Optimum dosage of treatments was calculated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Expression of VEGF-A and PDGF-A , PDGF-B , PDGF-C , PDGF-D genes was measured after total RNA extraction and cDNA synthesis, using real-time polymerase chain reaction (RT-PCR)., Results: The highest entrapment efficiency (EE) was achieved by Span 60:cholesterol (1:1) with 64.3%. The half maximal inhibitory concentration (IC 50 ) of free and niosome-encapsulated AUR were 38.5 and 27.78 µg/mL, respectively. Release study revealed that niosomal AUR had more gradual delivery to the cells. RT-PCR results showed reduced expression levels of VEGF-A , PDGF-A , PDGF-B , PDGF-C , and PDGF-D after treatment with both free and niosomal AUR., Conclusion: Niosomal formulation of Span 60: cholesterol (1:1) is an effective drug delivery approach to transfer AUR to RPE cells. VEGF-A, PDGF-A, PDGF-B, PDGF-C, and PDGF-D are four angiogenic factors, inhibiting which by niosomal AUR may be effective in age-related macular degeneration., Competing Interests: Conflicts of Interest: Vahidi A, None; Khosravi T, None; Dastaviz F, None; Sheikh Arabi M, None; Khosravi A, None; Oladnabi M, None., (International Journal of Ophthalmology Press.)

Due to the deleterious global impact of the COVID-19 pandemic, tremendous effort has been invested in the development of vaccines against the virus. Vaccine candidates are first tested in adult populations, a number of which have been approved for EUL by the WHO, and are in use across the USA and MENA region. The question remains whether these (or other) vaccines should be recommended to a neonatal, pediatric, and/or adolescent cohort. Incidence and severity of COVID-19 infection are low in pediatric, neonatal, and adolescent patients. Since both overall incidence and severity are lower in children than in adults, safety is an important consideration in vaccine approval for these age groups, in addition to efficacy and a decreased risk of transmission. The following review discusses vaccine immunology in children aged 0-18 years, with emphasis on the negative impact of the COVID-19 pandemic on the lives of children, considerations for pediatric vaccine approval, and available vaccines for pediatric cohorts along with a breakdown of the efficacy, advantages, and disadvantages for each. This review also contains current and future perspectives, as well as a section on the cardiovascular implications and related dynamics of pediatric COVID-19 vaccination., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Ghena Lababidi et al.)

NT-proBNP is a peptide related to brain natriuretic peptide, a cardiac biomarker and a member of the natriuretic family of peptides. NT-proBNP has demonstrated its clinical utility in the assessment of a wide spectrum of cardiac manifestations. It is also considered a more precise diagnostic and prognostic cardiac biomarker than brain natriuretic peptide. With the appearance of the Severe Acute Respiratory Syndrome Coronavirus 2 virus and the subsequent COVID-19 pandemic, diagnosis of heart implications began to pose an increasing struggle for the physician. Echocardiography is considered a central means of evaluating cardiac disorders like heart failure, and it is considered a reliable method. However, other diagnostic methods are currently being explored, one of which involves the assessment of NT-proBNP levels. In the literature that involves the adult population, significant positive correlations were drawn between the levels of NT-proBNP and COVID-19 outcomes such as high severity and fatality. In the paediatric population, however, the literature is scarce, and most of the investigations assess NT-proBNP in the context of Multiple Inflammatory Syndrome in Children, where studies have shown that cohorts with this syndrome had elevated levels of NT-proBNP when compared to non-syndromic cohorts. Thus, more large-scale studies on existing COVID-19 data should be carried out in the paediatric population to further understand the prognostic and diagnostic roles of NT-proBNP.

Aim: Pulmonary artery banding serves as an important palliative procedure used for the management of several congenital heart lesions. This study aims to describe a 20-year experience of pulmonary artery banding at a tertiary care center in a developing country., Methods: This is a retrospective chart review of patients who underwent pulmonary artery banding over a 20-year period between January 2000 and July 2020 in a tertiary care center in a developing country. Data regarding demographics, indications, diagnosis, echocardiographic findings, postoperative complications, hospital stay, and outcomes were recorded., Results: A total of 143 patients underwent pulmonary artery banding between 2000 and 2020, with a decrease from approximately 15 surgeries per year in 2012 to 1-2 surgeries a year in 2020. At the time of banding, the median age of patients was approximately 90 days [interquartile range, IQR, 30-150 days]. Four patients (2.8%) died during the band placement. No significant association was observed between baseline characteristics or type of heart defect at presentation and postoperative morbidity and mortality., Conclusion: Pulmonary artery banding remains useful in a subset of congenital heart lesions and as a surgical palliation, with relatively low mortality, allowing postponement of total correction to a higher weight. This technique continues to be valuable in developing countries or for heart surgical programs with limited resources., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Ghoussaini, Zareef, Makarem, Younis, Al Hassan, El Rassi, Obeid, Bitar and Arabi.)

Molecular imprinting-based surface-enhanced Raman scattering (MI-SERS) sensors have shown remarkable potential from an academic standpoint. However, their practical applications, especially in the detection of large-size protein (≥10 nm), face challenges due to the lack of versatile sensing strategies and nonspecific fouling of matrix species. Herein, we propose a Raman reporter inspector mechanism (RRIM) implemented on a protein-imprinted polydopamine (PDA) layer coated on the SERS active substrate. In the RRIM, after large-size protein recognition, the permeability of the PDA imprinted cavities undergoes changes that are scrutinized by Raman reporter molecules. Target proteins can specifically bind and fully occupy the imprinted cavities, whereas matrix species cannot. Then, Raman reporter molecules with suitable size are introduced to serve as both inspectors of the recognition status and inducers of the SERS signal, which can only penetrate through the vacant and nonspecifically filled cavities. Consequently, changes in the SERS signal exclusively originate from the specific binding of target proteins, while the nonspecific recognition of matrix species is curbed. The RRIM enables reproducible quantitation of the large-size cyanobacteria-specific protein model (≥10 nm), phycocyanin, at the level down to 2.6 × 10 -3 μg L -1 . Finally, the practical applicability of the RRIM is confirmed by accurately analyzing crude urban waterway samples over 21 min without any pretreatment.

Background: Hypoplastic left heart syndrome (HLHS) accounts for 2.6% of congenital heart disease and is an invariably fatal cardiac anomaly if left untreated. Approximately 33,750 babies are born annually with HLHS in developing countries. Unfortunately, the majority will not survive due to the scarcity of resources and the limited availability of surgical management., Aim: To describe and analyze our experience with the hybrid approach in the management of HLHS in a developing country., Methods: We performed a retrospective single-center study involving all neonates born with HLHS over five years at the Children's Heart Center at the American University of Beirut. The medical records of patients who underwent the hybrid stage 1 palliation were reviewed, and data related to baseline characteristics, procedure details and outcomes were collected to describe the experience at a tertiary care center in a developing country., Results: A total of 18 patients were diagnosed with HLHS over a five-year period at our institution, with male to female ratio of 1:1. Of those, eight patients underwent the hybrid stage I procedure. The mean weight at the time of the procedure was 3.3 ± 0.3 kg with an average age of 6.4 ± 4 days. The mean hospital length of stay was 27.25 days, with an interquartile range of 33 days. The cohort's follow-up duration averaged 5.9 ± 3.5 years. The surgical mortality was zero. Only one mortality was recorded during the interstage period between stage I and II and was attributed to sepsis. Notably, all surviving patients maintained preserved and satisfactory cardiac function with good clinical status., Conclusion: Our limited experience underscores the potential of developing countries with proper foundations to adopt the hybrid procedure for HLHS, yielding outcomes on par with those observed in developed countries. This demonstrates the viability of establishing a more balanced global landscape for children with congenital heart disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Bitar, El-Rassi, Zareef, Jassar, Abboud, Bulbul, Bitar and Arabi.)

Purpose: Starting in 2019, coronavirus disease 2019 (COVID-19) caused an epidemic that was growing rapidly and has harmed millions of people globally. It has been demonstrated that survivin regulates lymphocyte survival, a main route involved in COVID-19 pathogenesis. Survivin belongs to the inhibitor of apoptosis protein (IAP) family, and its primary functions comprise regulating mitosis and inhibiting apoptosis. Since lower survivin expression has been shown to increase the sensitivity of lymphocytes to apoptotic induction, we looked into the function of survivin and its corresponding pathways in COVID-19 pathogenesis., Materials and Methods: The expression of survivin, X-linked inhibitor of apoptosis protein (XIAP), caspases 3, 7, 9, and poly (ADP-ribose) polymerase (PARP) was evaluated at both mRNA and protein levels in peripheral blood mononuclear cells (PBMCs) derived from healthy donors and patients with severe and moderate COVID-19 by qRT-PCR and Western blotting, respectively. Then, we enforced apoptosis to COVID-19 patient-derived lymphocytes, and the percent was assessed by flow cytometry., Results: Survivin and XIAP were less expressed in PBMCs derived from COVID-19 patients as apoptosis inhibitors than PARP, cleaved-PARP, caspase 9, and cleaved caspases 3 and 7, according to the results of real-time PCR and Western blot analysis. Additionally, according to the flow cytometry results, the down-regulation of survivin served as a potential factor in the lymphocyte depletion observed in patients with COVID-19., Conclusion: The role of survivin and its related pathway was first discovered in the development of COVID-19 and may serve as a potential prognostic and therapeutic target., Competing Interests: Declaration of competing interest The authors declare no conflict of interests., (Copyright © 2024 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.)

Lung cancer has a high morbidity rate worldwide due to its resistance to therapy. So new treatment options are needed to improve the outcomes of lung cancer treatment. This study aimed to evaluate the effectiveness of oncolytic viruses (OVs) as a new type of cancer treatment. In this study, 158 articles from PubMed and Scopus from 1994 to 2022 were reviewed on the effectiveness of OVs in the treatment of lung cancer. The oncolytic properties of eight categories of OVs and their interactions with treatment options were investigated. OVs can be applied as a promising immunotherapy option, as they are reproduced selectively in different types of cancer cells, cause tumor cell lysis and trigger efficient immune responses.

Aim: To investigate the impact of niosome nanoparticles carrying umbelliprenin (UMB), an anti-angiogenic and anti-inflammatory plant compound, on the expression of vascular endothelial growth factor ( VEGF-A ) and connective tissue growth factor ( CTGF ) genes in a human retinal pigment epithelium (RPE)-like retina-derived cell line., Methods: UMB-containing niosomes were created, optimized, and characterized. RPE-like cells were treated with free UMB and UMB-containing niosomes. The IC 50 values of the treatments were determined using an MTT assay. Gene expression of VEGF - A and CTGF was evaluated using real-time polymerase chain reaction after RNA extraction and cDNA synthesis. Niosomes' characteristics, including drug entrapment efficiency, size, dispersion index, and zeta potential were assessed. Free UMB had an IC 50 of 96.2 µg/mL, while UMB-containing niosomes had an IC 50 of 25 µg/mL., Results: Treatment with UMB-containing niosomes and free UMB resulted in a significant reduction in VEGF-A expression compared to control cells ( P =0.001). Additionally, UMB-containing niosomes demonstrated a significant reduction in CTGF expression compared to control cells ( P =0.05). However, there was no significant reduction in the expression of both genes in cells treated with free UMB., Conclusion: Both free UMB and niosome-encapsulated UMB inhibits VEGF-A and CTGF genes expression. However, the latter demonstrates significantly greater efficacy, potentially due to the lower UMB dosage and gradual delivery. These findings have implications for anti-angiogenesis therapeutic approaches targeting age-related macular degeneration., (International Journal of Ophthalmology Press.)

Background: Congenital heart disease (CHD) remains the number one birth defect worldwide. Pulse oximetry screening (POS) is a widely used CHD screening modality effective in detecting critical lesions. This study is aimed at assessing the accuracy and cost-effectiveness of POS in a cohort of term well-babies admitted to a regular nursery in a tertiary care center., Methods: We reviewed the charts of term babies admitted to our regular nursery over a period of one year. The results of POS and the findings of echocardiography were collected. Similarly, we explored the records of our fetal echocardiography program to identify the fetuses screened for CHD during the same period., Results: 900 term babies were born and admitted to newborn nursery at our center, and 69 fetuses were evaluated by our fetal cardiology team during the study period. None of our term babies had a positive POS at birth or 24 hours of age. However, 56 babies had a cardiac echo before hospital discharge due to suspicious findings on physical examination or a family history of CHD. A simple noncritical CHD was noted in 10 of them. Additionally, 53 babies underwent echocardiography within the first five years of life; a simple CHD was noted in 6 of them. In parallel, 21 of our fetuses were found to have CHD: 16 simple CHD and 5 critical CHD (CCHD)., Conclusion: Despite its cost-effectiveness and efficacy in screening for CCHD, POS is suboptimal for detecting simple CHD. In the absence of a proper prenatal screening and fetal echocardiography program, POS remains a cost-effective modality for detecting CCHD., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Ziad R. Bulbul et al.)

Background: While research on congenital heart disease has been extensively conducted worldwide, comprehensive studies from developing countries and the Arab world remain scarce., Aim: This study aims to perform a bibliometric review of research on congenital heart disease in the Arab world from 1997 to 2022., Methods: We analyzed data from the Web of Science, encompassing various aspects such as topics, countries, research output, citations, authors, collaborations, and affiliations. This comprehensive science mapping analysis was done using the R statistical software's Bibliometrix Package., Results: The research output from Arab countries over the 25 years showed an average annual growth rate of 11.5%. However, Arab countries exhibited lower research productivity than the United States and Europe, with a 24-fold difference. There was substantial variation in research output among 22 Arab countries, with five countries contributing to 78% of the total publications. Most of the published research was clinical, with limited innovative contributions and a preference for regional journals. High-income Arab countries displayed higher research productivity and citation rates than their low-income developing counterparts. Despite being categorized as upper-middle-income, post-conflict countries exhibited low research productivity. About one-quarter of the published articles (26%) resulted from collaborative efforts among multiple countries, with the United States being the most frequent collaborator. Enhanced research productivity and impact output were strongly associated with increased international cooperation., Conclusion: Research productivity in the Arab region closely correlates with a country's GDP. Success hinges on governmental support, funding, international collaboration, and a clear research vision. These findings offer valuable insights for policymakers, educational institutions, and governments to strengthen research programs and nurture a research culture., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Bitar, Arabi, Bulbul, Nemer, Jassar, Bitar and Abdul Sater.)

Background & Objective: Patients in the intensive care unit have a high prevalence of vitamin D deficiency (VDD). In the present study, clinical outcomes in the ICU were analyzed with vitamin D status., Materials and Methods: In this prospective, multicenter study, sampling was conducted on seven ICUs in three hospitals. Within the first 24 h of ICU admission, patient's serum vitamin D levels were measured, and their disease severity was monitored using the scores of acute physiologic assessment and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), and the modified Nutrition Risk in Critically ill (mNUTRIC) score., Results: A total of 236 patients were enrolled in this study, of which 163 (69.1%) had lower vitamin D levels than 20 ng/ml upon ICU admission. The patients with VDD had higher APACHE II scores)P = 0.02), SOFA scores (P < 0.001), and mNUTRIC scores (P = 0.01). Patients with sufficient levels of vitamin D (> 30 ng/ml) had a shorter stay at ICU (P < 0.001). VDD was independently associated with 28-day mortality (OR: 4.83; 95% CI: 1.63-14.27; P = 0.004)., Conclusion: The data showed that VDD was common among the critically ill and was related to a more severe course of illness and a higher mortality rate., (© 2024. The Author(s).)

Selenium (Se), an essential trace element, plays an important role in the antioxidative defense mechanism, and it has been proven to improve fertility and reproductive efficiency in dairy cattle. The present study evaluated the potential protective action of Se supplement of in vitro maturation (IVM) media on the maturation and subsequent development of bovine cumulus-oocyte complexes (COCs) exposed to heat stress (HS). The treatment with Se improved the viability of cumulus cells (CCs) and oocytes (P < 0.05). The proportion of oocytes reached metaphase II (MII) and those arrested at metaphase I (MI) was greater and lower in treatment than control respectively (P < 0.05). Supplementation with Se increased the percentage of cleaved embryos, total blastocysts, and blastocyst/cleavage ratio (P < 0.05). Moreover, the upregulation of CCND1, SEPP1, GPX-4, SOD, CAT, and downregulation of GRP78, CHOP, and BAX in both Se-treated CCs and oocytes were recorded. The upregulation of NRF2 was detected in Se-treated CCs other than in oocytes, which showed upregulation of IGF2R and SOX-2 as the markers of quality as well. Se supplement in IVM media improved the viability, maturation, and the level of transcripts related to antioxidant defense and quality of heat-treated oocytes, which coincided with greater subsequent development outcomes. Se ameliorated the viability of CCs along with upregulation of antioxidative candidate gene expression and downregulation of apoptosis-related ones to support their protective role on restoring the quality of oocytes against compromising effects of HS., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

With multiple food fortification frameworks, countries can find it challenging to determine optimal methods for planning and implementing food fortification programmes to combat vitamin and mineral deficiencies, especially without additional technical support. To address this challenge, this study aimed to review existing frameworks to determine consistencies, differences, strengths, and weaknesses across the frameworks, and based on the review findings, formulate an enhanced and streamlined fortification framework. Nineteen frameworks were ultimately examined following a comprehensive literature review and key informant interviews. Generally, the reviewed frameworks amply describe motives and methods for the determination of fortification need and feasibility, industry engagement/quality assurance and quality control, and impact evaluations/surveillance. However, there was limited inclusion or discussion throughout the reviewed frameworks around harmonization of fortification with existing micronutrient interventions; fortification policy and/or strategy; enforcement, incentives, and penalties to ensure producer compliance with industry standards; and periodic fortification programme review and reassessment. The findings were used to develop a comprehensive Fortification Blueprint that aims to provide structured guidance and a library of tools and resources to fortification programme managers and key stakeholders to ensure optimal and sustainable programme design., (© 2023 Nutrition International. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)