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Uncontrolled regulation of oxidative stress and reactive oxygen species (ROS) in living organisms might lead to the development of various diseases. Selenium is an element in antioxidant selenoproteins and is used in different forms as a food supplement. Selenium nanoparticles (SeNPs) could show improved activity and less toxicity; their bioactivity, biocompatibility, and binding to targets might be augmented by phytochemicals decorating their surfaces during green synthesis using plant extracts. Herein, the study evaluated the antioxidant activity of Moringa peregrina-mediated SeNPs (MPM-SeNPs) and the PEGylated form (PEG-MPM-SeNPs) in vivo in lipopolysaccharide (LPS)-induced oxidative stress in a mice model. LPS injection caused a reduction in enzyme activity of both oxidative stress biomarkers superoxide dismutase (SOD) and catalase (CAT) with an elevation in protein carbonyl content level in blood sera and liver homogenates of treated mice. MPM-SeNPs and PEG-MPM-SeNPs significantly recovered SOD activity in both blood sera and liver homogenates, as well as enhanced the specific activity of CAT in LPS-injected mice. Moreover, they caused a reduction in the carbonyl content in blood sera. Thus, both SeNPs complexes were able to amend the oxidation-induced damage in the body and protect its organs against necrosis and dysfunction.

Background: One of the primary health concerns for diabetes individuals is wounds. The used drugs have several side effects, urging the need for new natural sources for therapeutics. Materials and methods: This study was designed to estimate the wound healing potential of the methanolic extract of Globularia arabica and Malva sylvestris leaves and Rhus coriaria fruits. plant extracts were orally administered to the rats to determine their effect on the wound-healing process. Results: Plant extracts significantly increased the contraction of the wound in non-diabetic and diabetic rats (P < 0.05) and increased the fibroblast's proliferation and migration resulting in a faster healing process. The plant extracts have no cytotoxic effects. The proliferation assay exhibited the lowest cell mortality after treatment with plant extract. Conclusion: These findings may indicate that the methanolic leaf extract of the above plants can be used as new therapeutics for wound healing in diabetic patients.

Tuberculosis (TB) is the top bacterial infectious disease killer and one of the top ten causes of death worldwide. The emergence of strains of multiple drug-resistant tuberculosis (MDR-TB) has pushed our available stock of anti-TB agents to the limit of effectiveness. This has increased the urgent need to develop novel treatment strategies using currently available resources. An adjunctive, host-directed therapy (HDT) designed to act on the host, instead of the bacteria, by boosting the host immune response through activation of intracellular pathways could be the answer. The integration of multidisciplinary approaches of repurposing currently FDA-approved drugs, with a targeted drug-delivery platform is a very promising option to reduce the long timeline associated with the approval of new drugs - time that cannot be afforded given the current levels of morbidity and mortality associated with TB infection. The deficiency of vitamin A has been reported to be highly associated with the increased susceptibility of TB. All trans retinoic acid (ATRA), the active metabolite of vitamin A, has proven to be very efficacious against TB both in vitro and in vivo. In this review, we discuss and summarise the importance of vitamin A metabolites in the fight against TB and what is known regarding the molecular mechanisms of ATRA as a host-directed therapy for TB including its effect on macrophages cytokine profile and cellular pathways. Furthermore, we focus on the issues behind why previous clinical trials with vitamin A supplementation have failed, and how these issues might be overcome.

Purpose: Given their negative influence on community health, vaccine hesitancy and resistance are emerging challenges that require healthcare intervention. Therefore, this study aimed to assess the impact of physician-pharmacist collaborative health coaching on rates of hesitancy and resistance for a COVID-19 vaccine. Methods: After an initial assessment of rates of hesitancy and resistance for a COVID-19 vaccine was conducted, hesitant and resistant participants were approached, recruited, and randomized into an active and control group. Pharmacists-physicians collaborative coaching intervention was delivered to active group subjects over two months through Facebook live sessions. The outcome measures were assessed in both groups before coaching, directly after coaching, and a month after coaching. Results: The proportions of hesitancy and resistance for a COVID-19 vaccine among subjects in the active group were significantly reduced from 64.3% and 35.7% before coaching to 20.1% and 7.8% directly after coaching, respectively. These proportions were further reduced to 11.1% and 3.3% a month after coaching, respectively. Furthermore, the mean scores for knowledge on, and attitude towards COVID-19 vaccine were significantly increased from 4.6 ± 1.8 and 4.1 ± 1.7 before coaching to 7.5 ± 3.1 and 8.9 ± 3.8 directly after coaching, respectively. However, the change in mean score of beliefs about COVID-19 vaccines among active group subjects was not significant. Conclusion: High rates of hesitancy and resistance for a COVID-19 vaccine were found in Jordan. These rates can be significantly reduced through online pharmacists-physicians collaborative coaching, which can also improve knowledge of and attitude towards COVID-19 vaccines.

Background: Tumor-associated macrophages (TAMs) and microvessel density (MVD) play an essential role for tumor progression in prostate cancer (PCa). In this study, we evaluated the association between TAMs, the infiltration with tumor angiogenesis and the response to androgen deprivation therapies (ADTs) in PCa to evaluate TAM infiltration as a predictive factor for PCa survival. Materials and methods: Fifty-four specimens were collected and stained with CD 68 antibody to investigated TAM infiltration in tumor. Von Willebrand factor was stained to evaluate MVD around the cancer foci. We assessed the association between patient's age, preoperative serum prostate-specific antigen, pathologic Gleason sum (GS), TAM infiltration, MVD, and the response to ADT for 5 years after PCa diagnosis. Results: The median TAM was observed in 28 (6-76)/high power field (x400). Increasing TAM correlated with increasing tumor angiogenesis (P 28) (P = 0.003). TAM infiltration was significantly higher in those with higher serum prostate-specific antigen, higher GS, and metastasis. Multivariate analysis showed that GS, ADT type, and MVD number were significant prognostic factors for response to ADT in PCa (P

Purpose: The possibility of using a passive Robot Arm (3D method) in model surgery and comparing with manual technique model surgery. Patients and methods: Seventeen patients undergoing orthognathic surgery gave consent for this study. Model surgery was performed by using a manual technique and using the Robot Arm. The model surgery that was performed by using the manual technique named group A and the one performed by the Robot Arm named group B. Patients’ maxillary casts were measured before and after model surgery, and results were compared with those for the original treatment plan in the horizontal (X-axis), vertical (Y-axis), and transverse (Z-axis) planes. Results: Statistical analysis using Mann–Whitney U test for X- and Y-axis and independent sample t test for Z-axis have shown significant differences between both groups in X-axis (P = .026) and Y-axis (P = .021) but not in Z-axis (P = .762). Conclusions: Model surgery performed with a Robot Arm is more accurate in all dimensions X, Y, and Z than the manual model surgery. Keywords: Orthognathic

Background: Familial chylomicronemia syndrome (FCS) is an ultrarare inherited disorder. Genetic testing is not always feasible or conclusive. European clinicians developed a "FCS score" to differentiate between FCS and multifactorial chylomicronemia syndrome (MCS), a more common condition with overlapping features. A diagnostic score has not been developed for use in the North American context., Objective: To develop and validate a diagnostic score for North American patients based on signs, symptoms and biochemical traits of FCS., Methods: Using the RAND/UCLA modified Delphi process, we convened ten US/Canadian physicians with experience recognizing and treating FCS and one adult patient with FCS. The panel developed and rated 296 scenarios describing patients with FCS. Linear regression analyses used median post-meeting ratings to develop score parameters. We tested the score's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in patients with classical FCS, functional FCS, and MCS from Western University's Lipid Genetics Clinic's registry., Results: Numerical scores were attributed based upon the following: age, hypertriglyceridemia onset, body mass index, history of abdominal pain/pancreatitis, presence of secondary factors, triglyceride (TG) levels, ratio of TG/total cholesterol, and apolipoprotein B level. Scores ≥60 indicate definite classical FCS; the score distinguished patients with FCS from MCS in a real-world registry (100.0 % specificity, 66.7 % sensitivity, 100.0 % PPV, 95.5 % NPV). Scores ≥45 were "very likely" to have classical FCS (96.9 % specificity, 88.9 % sensitivity)., Conclusion: Given its simplicity and high specificity for distinguishing patients with FCS from MCS, the NAFCS Score could be used in lieu of - or while awaiting - genetic testing to optimize treatment., Competing Interests: Declaration of competing interest RAH reports grants or contracts from Ionis, Arrowhead, Novartis, Amryt; consulting fees from Arrowhead, Amgen, Acasti Pharma, Aegerion Pharmaceuticals, Akcea Therapeutics/Ionis Pharmaceuticals, HLS Therapeutics, Medison, Novartis, Pfizer, Regeneron, Sanofi, and Ultragenyx; honoraria from Amgen, Sanofi, HLS Therapeutics, and Ionis; and participation on a data safety monitoring board or advisory board for Novartis. ZA reports institutional grants or contracts from the U.S. Department of Defense, the NIH, Ionis; honorarium from Ionis. AA reports grants or contracts from Aegerion, BioMarin, and NIDDK, and honorarium from Ionis. AB (Western University) reports honorarium from Ionis. ABaldassarra reports no conflicts of interest. ABrown reports consulting fees from Pfizer, Amgen, Novartis, Ionis, Esperion, and Amarin; payment or honoraria from Amgen, Regeneron, Esperion, Amarin, Zoll/Itamar. AC reports honoraria from CME Outfitters and Ionis, consulting fees LIB therapeutics. SF reports honorarium from Ionis. BK reports honorarium from Ionis. MM reports consulting fees from Amarin Corporation, 89bio, Ionis. BK reports honoraria from Ionis. MM reports consulting fees from Amarin Corporation, 89bio, and Ionis. NP reports consulting fees from Amryt Pharmaceuticals Inc. for advisory board and from Ionis; honoraria from Amryt Pharmaceuticals Inc. DES reports consulting fees from Amryt, Akcea, Ionis, Novartis, Regeneron, GenInCode; participation on a data safety monitoring board of advisory board for Amgen; contracted research with Amgen, Amryt, Ionis, Novartis, Verve, Heartflow, PCORI, NIH; leadership or fiduciary role as President, National Lipid Association and Director, Philadelphia Lipid Atherosclerosis Club. JW has no disclosures to report. MSB, EC, IY, CC, SNG are employees of PHAR, which was paid by Ionis Pharmaceuticals to conduct the research described in this article. PHAR also discloses financial relationships with the following entities outside of the submitted work: AbbVie, Akcea, Amgen, AstraZeneca, BioMarin Pharmaceuticals, Bristol-Myers Squibb, Boston Scientific Corporation, Eisai, Ethicon, Genentech, Gilead, Novartis, Otsuka, Pfizer, Recordati, Regeneron, Sanofi US Services, Sunovion, Takeda Pharmaceuticals USA., (Copyright © 2024. Published by Elsevier Inc.)

Research-based learning models, particularly interdisciplinary programs, are crucial in promoting STEM skills and fostering positive attitudes among students. This study presents a meta-analysis evaluating the impact of a chemistry-based interdisciplinary research experience program on high school students in Qatar. Over ten cohorts from 2010 to 2020, 230 students participated in multidisciplinary, hands-on research experiences. The study used pre-post questionnaires and t-test analyses, with further meta-analysis conducted using Comprehensive Meta-Analysis (CMA) software to evaluate the program's effectiveness in shaping STEM attitudes. Significant findings emerged, with a notable large effect size (Cohen's d = 0.885), underscoring the program's efficacy in bolstering positive STEM attitudes among students. The study observed that research complexity and gender do influence the outcome of the program, aligning with the tenets of Social Cognitive Theory, which posits that both individual and contextual elements are influential in attitude formation and learning processes. Conclusively, the research substantiates that interdisciplinary, experiential learning significantly heightens student interest in STEM fields. It also points to the potential benefits of further explorations into the nuances of gender disparities and the complexity of research in enhancing the scope and impact of such educational programs., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Ethyl cellulose (EC), polyvinylpyrrolidone (PVP), and phosphomolybdic acid (PMoA) were the components of a new photochromic hybrid film composed of heteropoly acids (abbreviated EC-PVP/PMoA), created by solvent evaporation. The EC-PVP/PMoA mechanism, visible light photochromic behaviors, and microstructure were closely studied by transmission electron microscopy (TEM), atomic force microscopy (AFM), ultraviolet-visible (UV-visible) spectroscopy, X-ray photo electronics (XPS), and Fourier transmission infrared spectroscopy (FTIR). FTIR spectra show that neither the core structures of EC, PVP, nor the Keggin structure of PMoA in the EC-PVP/PMoA composite hybrid film were damaged during fabrication. In the presence of oxygen, the yellowish transparent hybrid film exhibited reversible photochromism and significant photochromic reactivity, becoming blue in the presence of visible light. Upon heating the film at 90 °C for 1 h its photoresponsive properties were enhanced, making the blue color more vibrant and stable due to polyethylene glycol (PEG). The XPS spectra demonstrated a proton transfer procedure during the photochromic process, and the presence of Mo +5 species indicated a photoreduction interaction between the PMoA particles and the EC-PVP matrix. To the best of our knowledge, this is the first EC-PVP combined hybrid film with POMs with promising prospects for solar UV detection and smart glass windows applications., Competing Interests: Declaration of competing interest No financial interest was declared by the authors., (Copyright © 2024. Published by Elsevier B.V.)

Objectives: This study examines the impact of slippage in hazard ratios (tending toward the null over subsequent datacuts) for overall survival for combination treatment with a PD-(L)-1 inhibitor and a tyrosine kinase inhibitor in advanced renal cell carcinoma., Methods: Four trials' Kaplan-Meier curves were digitized over several datacuts and fitted with standard parametric curves. Accuracy and consistency of early data projections were calculated versus observed restricted mean survival time and fitted lifetime survival from the longest follow-up datacut. The change in economically justifiable price (eJP) was calculated fitting the same curve to both arms, using an assumed average utility of 0.7 and willingness-to-pay threshold of £30 000 per quality-adjusted life-year. The eJP represents the lifetime justifiable price increment for the new treatment, including differences in drug-, administration-, and disease-related costs., Results: Slippage in hazard ratios was observed in trials with longer follow-up, potentially influenced by subsequent PD-(L)-1 use after tyrosine kinase inhibitor monotherapy, early stoppage of PD-(L)-1, and development of resistance. Lognormal and log-logistic curves were more likely to overpredict the observed result; Gompertz and gamma underpredicted. Statistical measures of goodness of fit did not select the curves that resulted in the RMST closest to what was observed in the final data cut. Large differences in incremental mean life-years were observed between even the penultimate and final datacuts for most of the fitted curves, meaningfully affecting the eJP., Conclusions: This work demonstrates the challenge in predicting treatment benefits with novel therapies using immature data. Incorporating information on the impact of subsequent treatment is likely to play a key role in improving predictions., Competing Interests: Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section., (Copyright © 2024. Published by Elsevier Inc.)

Objective: Microneedles (MNs) are minimally invasive transdermal drug delivery systems capable of penetrating the stratum corneum to overcome the barrier properties. The primary objective of this research was to prepare dissolving microneedle patches (DMNP) loaded with quetiapine (QTP)., Methods: DMNP were fabricated employing the solvent casting technique, utilizing various polymer feed ratios including polyvinyl alcohol (PVA), polyvinylpyrrolidone K30 (PVP-K30), and polylactide-co-glycolide (PLGA) polymers. The loaded DMNP with QTP underwent a comprehensive characterization process encompassing assessments for compatibility, thickness, insertion potential, morphology, thermal behavior, X-ray diffraction, ex-vivo permeation, skin irritation, and histopathological changes., Results: FTIR studies confirmed the compatibility of QTP with the microneedle patch composites. The thickness of the drug-loaded DMNP ranged from 0.67 mm to 0.97 mm. These microneedles exhibited an impressive penetration depth of 480 μm, with over 80% of the needles maintaining their original shape after piercing Parafilm-M. SEM analysis of the optimized DMNP-2 revealed the formation of sharp-tipped and uniformly surfaced needles, measuring 570 μm in length. Remarkably, the microneedles did not elicit any signs of irritation upon application of the prepared DMNP. The DMNP-2 showcased an impressive cumulative ex-vivo permeation of QTP, reaching 17.82 µg/cm 2 /hr. Additionally, histopathological assessment of vital organs in rabbits attested to the safety profile of the formulated microneedle patches., Conclusions: In conclusion, the developed microneedle patch represents a promising strategy for enhancing the transdermal delivery of QTP. This innovative approach has the potential to increase patient compliance, offering a more efficient and patient-friendly method of administering QTP., Competing Interests: Declaration of Competing Interest All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript., (Copyright © 2024 American Pharmacists Association. Published by Elsevier Inc. All rights reserved.)

Despite the WHO's recommended treatment regimen, challenges such as patient non-adherence and the emergence of drug-resistant strains persist with TB claiming 1.5 million lives annually. In this study, we propose a novel approach by targeting the DNA replication-machinery of M.tb through drug-repurposing. The β2-Sliding clamp (DnaN), a key component of this complex, emerges as a potentially vulnerable target due to its distinct structure and lack of human homology. Leveraging TBVS, we screened ∼2600 FDA-approved drugs, identifying five potential DnaN inhibitors, by employing computational studies, including molecular-docking and molecular-dynamics simulations. The shortlisted compounds were subjected to in-vitro and ex-vivo studies, evaluating their anti-mycobacterial potential. Notably, Dicoumarol, Paromomycin, and Posaconazole exhibited anti-TB properties with a MIC value of 6.25, 3.12 and 50 μg/ml respectively, with Dicoumarol and Paromomycin, demonstrating efficacy in reducing live M.tb within macrophages. Biophysical analyses confirmed the strong binding-affinity of DnaN drug complexes, validating our in-silico predictions. Moreover, RNA-Seq data revealed the upregulation of proteins associated with DNA repair and replication mechanisms upon Paromomycin treatment. This study explores repurposing FDA-approved drugs to target TB via the mycobacterial DNA replication-machinery, showing promising inhibitory effects. It sets the stage for further clinical research, demonstrating the potential of drug repurposing in TB treatment., 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.)

Microcystis, a type of cyanobacteria known for producing microcystins (MCs), is experiencing a global increase in blooms. They have been recently recognized as potential contributors to the widespread of antibiotic resistance genes (ARGs). By reviewing approximately 150 pieces of recent studies, a hypothesis has been formulated suggesting that significant fluctuations in MCs concentrations and microbial community structure during Microcystis blooms could influence the dynamics of waterborne ARGs. Among all MCs, microcystin-LR (MC-LR) is the most widely distributed worldwide, notably abundant in reservoirs during summer. MCs inhibit protein phosphatases or increase reactive oxygen species (ROS), inducing oxidative stresses, enhancing membrane permeability, and causing DNA damage. This further enhances selective pressures and horizontal gene transfer (HGT) chances of ARGs. The mechanisms by which Microcystis regulates ARG dissemination have been systematically organized for the first time, focusing on the secretion of MCs and the alterations of bacterial community structure. However, several knowledge gaps remain, particularly concerning how MCs interfere with the electron transport chain and how Microcystis facilitates HGT of ARGs. Concurrently, the predominance of Microcystis forming the algal microbial aggregates is considered a hotspot for preserving and transferring ARGs. Yet, Microcystis can deplete the nutrients from other taxa within these aggregates, thereby reducing the density of ARG-carrying bacteria. Therefore, further studies are needed to explore the 'symbiotic - competitive' relationships between Microcystis and ARG-hosting bacteria under varied nutrient conditions. Addressing these knowledge gaps is crucial to understand the impacts of the algal aggregates on dynamics of waterborne antibiotic resistome, and underscores the need for effective control of Microcystis to curb the spread of antibiotic resistance. Constructed wetlands and photocatalysis represent advantageous strategies for halting the spread of ARGs from the perspective of Microcystis blooms, as they can effectively control Microcystis and MCs while maintaining the stability of aquatic ecosystem., Competing Interests: Declaration of competing interest Authors read and approved the final manuscript. There are no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The timely and accurate diagnosis of breast cancer is pivotal for effective treatment, but current automated mammography classification methods have their constraints. In this study, we introduce an innovative hybrid model that marries the power of the Extreme Learning Machine (ELM) with FuNet transfer learning, harnessing the potential of the MIAS dataset. This novel approach leverages an Enhanced Quantum-Genetic Binary Grey Wolf Optimizer (Q-GBGWO) within the ELM framework, elevating its performance. Our contributions are twofold: firstly, we employ a feature fusion strategy to optimize feature extraction, significantly enhancing breast cancer classification accuracy. The proposed methodological motivation stems from optimizing feature extraction for improved breast cancer classification accuracy. The Q-GBGWO optimizes ELM parameters, demonstrating its efficacy within the ELM classifier. This innovation marks a considerable advancement beyond traditional methods. Through comparative evaluations against various optimization techniques, the exceptional performance of our Q-GBGWO-ELM model becomes evident. The classification accuracy of the model is exceptionally high, with rates of 96.54 % for Normal, 97.24 % for Benign, and 98.01 % for Malignant classes. Additionally, the model demonstrates a high sensitivity with rates of 96.02 % for Normal, 96.54 % for Benign, and 97.75 % for Malignant classes, and it exhibits impressive specificity with rates of 96.69 % for Normal, 97.38 % for Benign, and 98.16 % for Malignant classes. These metrics are reflected in its ability to classify three different types of breast cancer accurately. Our approach highlights the innovative integration of image data, deep feature extraction, and optimized ELM classification, marking a transformative step in advancing early breast cancer detection and enhancing patient outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Precise diagnosis of complex and soft tumors is challenging, which limits appropriate treatment options to achieve desired therapeutic outcomes. However, multifunctional nano-sized contrast enhancement agents based on nanoparticles improve the diagnosis accuracy of various diseases such as cancer. Herein, a facile manganese-hafnium nanocomposites (Mn 3 O 4 -HfO 2 NCs) system was designed for bimodal magnetic resonance imaging (MRI)/computed tomography (CT) contrast enhancement with a complimentary function of photodynamic therapy. The solvothermal method was used to fabricate NCs, and the average size of Mn 3 O 4 NPs and Mn 3 O 4 -HfO 2 NCs was about 7 nm and 15 nm, respectively, as estimated by TEM. Dynamic light scattering results showed good dispersion and high negative (-33 eV) zeta potential, indicating excellent stability in an aqueous medium. Mn 3 O 4 -HfO 2 NCs revealed negligible toxic effects on the NCTC clone 929 (L929) and mouse colon cancer cell line (CT26), demonstrating promising biocompatibility. The synthesized Mn 3 O 4 -HfO 2 NCs exhibit significant enhancement in T 1 -weighted magnetic resonance imaging (MRI) and X-ray computed tomography (CT), indicating the appropriateness for dual-modal MRI/CT molecular imaging probes. Moreover, ultra-small Mn 3 O 4 -HfO 2 NCs show good relaxivities for MRI/CT. These nanoprobes Mn 3 O 4 -HfO 2 NCs further possessed outstanding reactive oxygen species (ROS) generation ability under minute ultraviolet light (6 mW·cm -2 ) to ablate the colon cancer cells in vitro. Therefore, the designed multifunctional Mn 3 O 4 -HfO 2 NCs were ideal candidates for cancer diagnosis and photodynamic therapy., 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.)

We describe a novel assay and artificial intelligence-driven histopathologic approach identifying dermatophytes in human skin tissue sections (ie, B-DNA dermatophyte assay) and demonstrate, for the first time, the presence of dermatophytes in tissue using immunohistochemistry to detect canonical right-handed double-stranded (ds) B-DNA. Immunohistochemistry was performed using anti-ds-B-DNA monoclonal antibodies with formalin-fixed paraffin-embedded tissues to determine the presence of dermatophytes. The B-DNA assay resulted in a more accurate identification of dermatophytes, nuclear morphology, dimensions, and gene expression of dermatophytes (ie, optical density values) than periodic acid-Schiff (PAS), Grocott methenamine silver (GMS), or hematoxylin and eosin (H&E) stains. The novel assay guided by artificial intelligence allowed for efficient identification of different types of dermatophytes (eg, hyphae, microconidia, macroconidia, and arthroconidia). Using the B-DNA dermatophyte assay as a clinical tool for diagnosing dermatophytes is an alternative to PAS, GMS, and H&E as a fast and inexpensive way to accurately detect dermatophytosis and reduce the number of false negatives. Our assay resulted in superior identification, sensitivity, life cycle stages, and morphology compared to H&E, PAS, and GMS stains. This method detects a specific structural marker (ie, ds-B-DNA), which can assist with diagnosis of dermatophytes. It represents a significant advantage over methods currently in use., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Cardiovascular disease, particularly coronary heart disease, is becoming more common among those living with HIV. Individuals with HIV face an increased susceptibility to myocardial infarction, also known as a heart attack, as compared to the general population in developed countries. This heightened risk can be attributed mainly to the presence of effective antiretroviral drugs and the resulting longer lifespan. Some cardiac issues linked to non-antiretroviral medications, including myocarditis, endocarditis, cardiomyopathy with dilation, pulmonary hypertension, and oedema of the heart, may affect those not undergoing highly active antiretroviral therapy (ART). Impaired immune function and systemic inflammation are significant contributors to this phenomenon after initiating highly aggressive antiretroviral treatment ART. It is becoming more challenging to determine the best course of treatment for HIV-associated cardiomyopathy due to new research suggesting that protease inhibitors might have a negative impact on the development of HF. Currently, the primary focus of research on ART medications is centered on the cardiovascular adverse effects of nucleoside reverse transcriptase inhibitors and protease inhibitors. This review paper thoroughly evaluates the advancements achieved in cardiovascular disease research and explores the potential implications for prospects. Additionally, it considers the field's future prospects while examining how ART might be altered and its clinical applications., Competing Interests: Declaration of competing interest The authors declared that they have no competing interests among them., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The trace elements present in breast milk play a vital role in the growth and development of infants. Nevertheless, numerous studies have reported the presence of toxic metal contamination in breast milk from various countries and regions, which poses potential risks to breastfed infants. This article aimed to investigate the characteristics of trace elements in breast milk and explore the relationship between breast milk and diet in Dalian, a coastal city in northeastern China. Breast milk samples and representative local food samples were collected from Dalian for research. The results revealed that 57 % of breast milk samples significantly exceeded the WHO safety limit (0.6 μg/L) for arsenic, with a measured mean value of 0.96 μg/L. Moreover, the levels of chromium (mean value: 2.63 μg/L) in 34 % of breast milk samples exceed the WHO recommended safety level (chromium: 1.5 μg/L). Aquatic foods accounted for 60 % to 90 % of the total intake of arsenic, cadmium, vanadium, mercury, and lead. The Spearman correlation analysis demonstrated strong positive correlations among breast milk metal elements, including copper-zinc (r = 0.68) and nickel‑chromium (r = 0.89). Furthermore, the food-to-milk accumulation factors (FMAF) of strontium, nickel, arsenic, vanadium, cadmium, and mercury were relatively low (median values <0.005). While the FMAF values for chromium and lead were higher, with median values of 0.038 and 0.07, respectively. The results indicated potential risks of the toxic metal arsenic in breast milk from Dalian, China for breastfed infants. Therefore, continuous monitoring of breast milk for toxic metals and foodborne contamination is necessary., 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 © 2023 Elsevier B.V. All rights reserved.)

Context: Patients with breast cancer taking adjuvant endocrine therapy (AET) experience significant symptoms impacting mood, quality of life (QOL), and AET adherence and satisfaction., Objectives: The aim of this study was to examine the extent to which coping ability and self-efficacy for symptom management moderate the relationships between patients' symptom distress and their mood, QOL, and AET adherence and satisfaction., Methods: As part of a randomized controlled trial, participants completed baseline measures including: sociodemographics, symptom distress (breast cancer prevention trial symptom checklist), coping skills (measure of current status), self-efficacy (self-efficacy for managing symptoms), anxiety and depression (hospital anxiety and depression scale), QOL (functional assessment of cancer therapy - general), AET adherence (medication adherence report scale), and AET satisfaction (cancer therapy satisfaction questionnaire). We conducted moderated regression analyses to examine whether coping and self-efficacy moderated the associations of symptom distress with baseline measures., Results: Coping skills moderated the associations of symptom distress with depression and QOL. Among those with lower coping, higher symptom distress was associated with worse depression symptoms (p=.04) and worse QOL (p < 0.001). Self-efficacy moderated the associations of symptom distress with depression symptoms and AET adherence and satisfaction. Among those with higher self-efficacy, higher symptom distress was associated with worse depression symptoms (p < 0.001), worse AET adherence (p < 0.001), and less AET satisfaction (p = 0.01)., Conclusion: Coping skills may buffer the effect of AET symptom distress. Findings indicate the relationship between symptom distress and self-efficacy is more nuanced and requires further research to better understand., (Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Naturally occurring naphthoquinones, shikonin and alkannin, are important ingredients of traditional Chinese medicine Zicao. These constituents are reported to have many therapeutic uses, such as wound healing; scar treatment; and anti-inflammation, anti-acne, anti-ulcer, anti-HIV, anticancer, and antibacterial properties. The primary objective of this investigation was to explore the effect of shikonin and alkannin on Escherichia coli ATP synthase and its cell growth. Shikonin caused complete (100 %) inhibition, and alkannin caused partial (79 %) inhibition of wild-type E. coli ATP synthase. Both caused partial (4 %-27 %) inhibition of ATP synthase with genetically modified phytochemical binding site. The growth inhibition of strains expressing normal, deficient, and mutant ATP synthase by shikonin and alkannin, corroborated the inhibition observed in isolated normal wild-type and mutant ATP synthase. Trivial inhibition of mutant enzymes indicated αR283D, αE284R, βV265Q, and γT273A are essential for formation of the phytochemical binding site where shikonin and alkannin bind. Further, shikonin was a potent inhibitor of ATP synthase than alkannin. The antimicrobial properties of shikonin and alkannin were tied to the binding at phytochemical site of microbial ATP synthase. Selective targeting of bacterial ATP synthase by shikonin and alkannin may be an advantageous alternative to address the antibiotic resistance issue., Competing Interests: Declaration of competing interest Authors declare no conflict of interest in the work presented in manuscript “Inhibition of Escherichia coli ATP synthase and cell growth by shikonin and alkannin” submitted for publication in the International Journal of Biological Macromolecules., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Across the globe, the frequent occurrence of drought spells has significantly undermined the sustainability of modern high-input farming systems, particularly those focused on staple crops like wheat. To ameliorate the deleterious impacts of drought through a biologically viable and eco-friendly approach, a study was designed to explore the effect of nicotinic acid on different metabolic, and biochemical processes, growth and yield of wheat under optimal moisture and drought stress (DS). The current study was comprised of different levels of nicotinic acid applied as foliar spray (0 g L -1 , 0.7368, 1.477, 2.2159 g L -1 ) and fertigation (0.4924, 0.9848, and 1.4773 g L -1 ) under normal conditions and imposed drought by withholding water at anthesis stage. The response variables were morphological traits such as roots and shoots characteristics, yield attributes, grain and biological yields along with biosynthesis of antioxidants. The results revealed that nicotinic acid dose of 2.2159 g L -1 out-performed rest of treatments under both normal and DS. The same treatment resulted in the maximum root growth (length, fresh and dry weights, surface area, diameter) and shoot traits (length, fresh and dry weights) growth. Additionally, foliar applied nicotinic acid (2.2159 g L -1 ) also produced as the highest spike length, grains spike -1 , spikelet's spike -1 and weight of 1000 grains. Moreover, these better yield attributes led to significantly higher grain yield and biological productivity of wheat. Likewise in terms of physiological growth of wheat under DS, the same treatment remained superior by recording the highest SPAD value, relative water content, water potential of leaves, leaf area, stomatal conductance (292 mmolm -2 S -1 ), internal carbon dioxide concentration, photosynthesis and transpiration rate. Interestingly, exogenously applied nicotinic acid remained effective in triggering the antioxidant system of wheat by recording significantly higher catalase, peroxidase, superoxide dismutase and ascorbate peroxidase., 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 © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Remote superficial femoral artery endarterectomy (RSFAE) is a hybrid procedure with low risk for perioperative complications and promising patency rates over time. The aim of this study was to summarize current literature and to determine the role of RSFAE in limb salvage with regards to technical success, limitations, patency rates and long-term outcomes., Methods: This systematic review and meta-analysis was performed according to the preferred reporting items for systematic reviews and meta-analyses guidelines., Results: Overall 19 studies were identified, comprising 1,200 patients with extensive femoropopliteal disease among whom 40% presented with chronic limb threatening ischemia. The average technical success rate was 96%, with a 7% rate for perioperative distal embolization and 13% rate for superficial femoral artery perforation. The primary patency was 64% and 56%, primary assisted patency was 82% and 77%, and secondary patency was 89% and 72% at 12 and 24 months follow-up, respectively., Conclusions: For long femoropopliteal TransAtlantic InterSociety ConsensusC/D lesions, RSFAE appears to be a minimally invasive hybrid procedure with acceptable perioperative morbidity, low mortality, and acceptable patency rates. RSFAE should be considered an alternative to open surgery or a bridge to bypass., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Given its pathophysiology and evidence on its long-term effects, coronavirus disease 2019 (COVID-19) may have altered the incidence, types, and severity of other respiratory infections (RIs). Therefore, this study aimed to evaluate the potential impact of COVID-19 on non-SARS-CoV-2 RIs in COVID-19 survivors., Methods: This cross-sectional study was conducted using a self-administered, online survey from February 2022 to April 2022 in the United Arab Emirates. Participants included adults diagnosed with COVID-19 before February 2021. Those who did not undergo nasopharyngeal swab tests for contraction of other RIs after recovering from COVID-19 were excluded., Results: Of the 384 participants, 24.5% were aged 18-24 years, and 55.5% were women. The mean body mass index (BMI) was 29.6 ± 3.7 kg/m 2 . Among the participants, 34.4% experienced at least one non-SARS-CoV-2 RI after recovering from COVID-19, of which 25.8% reported that the RI lasted longer than those previously, 27.3% sought physician advice, 31.8% reported increased coughing as a symptom of the non-SARS-CoV-2 RI, and 38.6% reported increased sputum. Based on patient responses, the degree of COVID-19 severity was significantly associated with non-SARS-CoV-2 RIs (p = 0.003), and depression was found to be a significant predictor of changes in shortness of breath symptoms (adjusted odds ratio [AOR] = 1.29; 95% confidence interval [CI], 1.17-1.46)., Conclusions: The participants of this study reported changes in the duration and severity of non-SARS-CoV-2 RIs after recovering from COVID-19. Further research is needed to confirm these findings, which suggest a need for swift action to protect the public against RIs, particularly seasonal pathogens., Competing Interests: Conflict of Interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2023 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)

Over the past few years, transition metal carbides, nitrides, and carbonitrides, commonly referred to as MXenes have been discovered and utilized quickly in a range of technical fields due to their distinctive and controlled characteristics. MXenes are a new class of two-dimensional (2D) materials that have found extensive use in a variety of fields, including energy storage, catalysis, sensing, biology, and other scientific disciplines. This is because of their exceptional mechanical and structural characteristics, metal electrical conductivity, and other outstanding physical and chemical properties. In this contribution, we review recent cellulose research advances and show that MXene hybrids are effective composites that benefit from cellulose superior water dispersibility and the electrostatic attraction between cellulose and MXene to prevent MXene accumulation and improve the composite's mechanical properties. Electrical, materials, chemical, mechanical, environmental, and biomedical engineering are all fields in which cellulose/MXene composites are used. These properties and applications-based reviews on MXene/cellulose composite, critically analyze the results and accomplishments in these fields and provide context for potential future research initiatives. It examines newly reported applications for cellulose nanocomposites assisted by MXene. To support their development and future applications, perspectives and difficulties are suggested in the conclusion., Competing Interests: Declaration of competing interest All the authors declare that there is no conflict of interest to publish our manuscript entitled “Recent advances in the development of Cellulose/MXenes based composites: A review” in International Journal of Biological Macromolecules., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Preliminary research has shown that low density lipoprotein receptor (LDLR), tumor protein (TP53) and matrix metalloproteinase 9 (MMP9) genes expression levels were significantly increased in atherosclerosis coronary artery tissue (ACAT) compared to non-atherosclerotic coronary artery tissue (NCAT) samples. Thus, further investigation was carried out to study the association of LDLR, TP53 and MMP9 gene polymorphisms and the risk of developing atherosclerosis (ATH) in a Malaysian population. Single nucleotide polymorphisms of C88S, TP53 codon 72 and MMP9C>T were analyzed in 76 ACAT samples and 149 NCAT samples, representing cases and controls, respectively. In results, heterozygous CT genotype of MMP9C>T polymorphism was significantly higher in ACAT compared to NCAT samples (57.9% vs 27.5%, χ 2  = 19.758, df= 1, P < 0.05). The CT genotype was found to be significantly associated with the risk of developing ATH (OR = 3.622, 95% CI = 2.028-6.470). However, the distribution of the CT genotype in a healthy Malaysian study population was incomparable regardless of gender and ethnicity. The DNA sequencing results validated the C88S, TP53 codon 72, and MMP9C>T polymorphisms. In conclusion, the CT genotype of the MMP9-1562C>T polymorphism was found to have a strong association with the risk of developing ATH., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Leishmaniasis is a vector-borne infection caused by protozoan parasites from the genus leishmania and is among the most neglected tropical diseases. It is highly prevalent disease, affecting about 350 million population worldwide. Only limited number of anti-leishmanial agents are approved for clinical use till now and they are associated with side effects and have limited efficacy. Subsequently, natural products based discovery of more safe and effective drugs against leishmania is under scientific consideration. Various studies reported the efficacy of natural products against intracellular and extracellular forms of leishmania species. This work is aimed to evaluate current literature focused on the anti-leihmanial efficacy of steroidal moieties from natural products and their mechanism of action. Compounds including steroidal saponins, steroidal alkaloids and phytosterols were found to exhibit considerable anti-leishmanial efficacy. For instance, steroidal saponin, (25R)-spirost-5-en-3b-ol,3-O-α-rhamnopyranosyl-(1 → 4)-α-rhamnopyranosyl-(1 → 4)-[a-rhamnopyranosyl-(1 → 2)]-glucopyranoside isolated from A. paradoxum has completely eradicated Leishmania major promastigotes at 50 µg mL -1 dose. Spirostanic saponins isolated from Solanum paniculatum L. were effective against Leishmania amazonensis promastigotes. Turgidosterones isolated from Panicum turgidum exhibited high leishmanicidal potentials against Leishmania donovani promastigotes with IC 50 of 4.95-8.03 µg mL -1 and even better activity against amastigotes exhibiting an IC 50 of 4.50-9.29 µg mL -1 . Likewise, racemoside-A from Asparagus racemosus was found effective against an antimonial sensitive (AG83) and antimonial resistant (GE1F8R) strains of the L. donovani. Moreover, steroidal alkaloids including hookerianamide-1, hookerianamide-H, hookerianamide-J, hookerianamide-K, dehydrosarsalignone, vagenine-A, sarcovagine-C, holaphylline, saracodine, holamine, 15-α hydroxyholamine, holacurtin, N-desmethyl holacurtine and elasticine has exhibited time and dose-dependent efficacy against various strains of leishmania. β-sitosterol was found active against multiple strains of leishmania. These compounds mainly exhibit their therapeutic efficacy via liberation of ROS, mitochondrial depolarization, morphological and ultra-structural changes, accumulation of lipid droplets, depletion of non-protein thiols and triggering apoptotic pathways. In conclusion, leishmaniasis is a major health problem in many countries. Plants-derived steroids moieties have reveled efficacy against leishmaniasis and is a source of lead compounds. Further detailed molecular studies are warranted for the discovery of more effective and safe anti-leishmanial drugs., 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 © 2023 Elsevier Inc. All rights reserved.)

Competing Interests: Conflicts of interest The authors have none to declare

Background: Familial hypercholesterolemia (FH) is associated with an increased prevalence of premature atherosclerotic cardiovascular disease (ASCVD), however, little is known about sex-specific differences in premature ASCVD and its risk factors., Objective: The present study seeks to assess the burden and risk factors for premature ASCVD among men and women with FH., Methods: In this study we retrospectively examined sex-specific differences in ASCVD prevalence, risk factor burdens, and lipid treatment outcomes in 782 individuals with clinically or genetically confirmed FH treated in 5 U.S. lipid and genetics clinics. A generalized linear model using Binomial distribution with random study site effect and sex-stratified analysis was used to determine the strongest predictors of premature ASCVD, and lipid treatment outcomes. Covariates included age, sex, diabetes mellitus (DM), hypertension, and current smoking., Results: Among the cohort, 98/280 men (35%) and 89/502 women (18%) had premature ASCVD (defined as <55 years in men and <65 years in women). Women with premature ASCVD had higher mean treated total cholesterol (216 vs. 179 mg/dl, p=<0.001) and LDL-C (135 vs. 109 mg/dl, p= 0.005)., Conclusion: These data confirm that high percentages of women and men with FH develop premature ASCVD, and suggest that FH may narrow the observed sex difference in premature ASCVD onset. These data support more aggressive prevention and treatment strategies in FH, including in women, to reduce non-lipid risk factors and residual hypercholesterolemia., Competing Interests: Disclosures/Conflicts of Interest Dr Aspry has contracted research paid to institution from Amgen, Akcea, Esperion, and Novartis. She received speaker honoraria in 2020–2021 from MedScape/WebMD, and the National Lipid Association. Dr Ahmad serves on the advisory board for Esperion. Dr Ballantyne receives significant grant/research support that is paid to the institution from Abbott Diagnostic, Akcea, Amgen, Esperion, Novartis, Regeneron, Roche Diagnostic, National Institutes of Health, American Heart Association, and American Diabetes Association. He is a consultant for Abbott Diagnostics, Althera, Amarin, Amgen, Arrowhead, Astra Zeneca, Corvidia, Denka Seiken, Esperion, Genentech, Gilead, Matinas BioPharma Inc, New Amsterdam, Novartis, Novo Nordisk, Pfizer, Regeneron, Roche Diagnostic, and Sanofi‐Synthelabo. Dr Goldberg receives modest honoraria from Esperion and Merck, and significant honoraria from the National Lipid Association. She receives modest research grants from Amarin, Amgen, and Pfizer and significant research grants from Novartis, Regeneron, Sanofi, and Ionis/Akcea. The remaining authors have no disclosures to report., (Copyright © 2022. Published by Elsevier Inc.)

There is an increasing body of literature suggesting a relationship between environmental factors and the development of systemic sclerosis (SSc). These include occupational exposures, chemical materials, medications, alterations in the microbiome, and dysbiosis. Environmental exposures may impact epigenetic regulation thereby triggering an aberrant immune response resulting in the clinical and serologic phenotype that we diagnose as SSc. Screening and studying putative triggers will not only improve our understanding of the pathogenesis of SSc but also inform the institution for protective measures., Competing Interests: Disclosures Dr. Johnson is supported by the Gurmej Kaur Dhanda Scleroderma Research Award, Scleroderma Association of British Columbia., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Although telemedicine services have been adopted on a large scale in the United Arab Emirates (UAE) during the coronavirus disease 2019 (COVID-19) pandemic, a little is known about the public experience., Objectives: This study aimed to investigate consumers' patterns, nature, and predictors of telemedicine utilization and consumers' attitude toward this technology., Methods: A quantitative, self-administered questionnaire was developed, validated, and delivered randomly to adults living across the United Arab Emirates (UAE) between January 2021 and January 2022. The questionnaire included questions about categories of telemedicine used, purpose of use, challenges encountered during the use of telemedicine, and reasons for not using telemedicine technology. We adopted a proportionate random sampling technique to recruit participants by 3 ways: social media, phone calls, and face to face., Results: The final dataset included 1584 participants, of which 496 (31.3%) used telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. The most common reasons for not using telemedicine during COVID-19 was having no idea that telemedicine exists (38.3%, 417 of 1088) or having no idea how to use it (33.5%, 365 of 1088). Telemedicine users reported that that telepharmacy (89.7%), teleconsultation (78.2%), and telediagnosis (23.0%) were the most frequently used telemedicine services during the COVID-19 crisis. Of the 496 telemedicine users, 469 (94.6%) reported using telemedicine for seeking a pharmacist advice about medication instructions, 422 (85.1%) for ordering nonprescription drugs, and 401 (80.8%) for seeking a physician advice. Those with high activity on social media were less likely to be associated with telemedicine users versus nonusers., Discussion: Although telepharmacy has been increasingly used by consumers, more attention is needed to fix its limitations and improve patient safety., Conclusion: This study shows a positive attitude and a general acceptance of telemedicine services among the UAE population. Some sociodemographic and clinical characteristics were significantly associated with the use of telemedicine during the pandemic., (Copyright © 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

The reaction of 4-(azobenzene)phenylstibonic acid with t-butylphosphonic acid led to the isolation of the tetranuclear oxo-hydroxo antimony cluster of formulae [(4-azobenzene-C 6 H 4 Sb) 4 (OH) 4 ( t BuPO 3 ) 6 ] (C1). The reaction of (p-t-butyl phenyl stibonic acid with phenyl phosphonic acid resulted in the isolation of complex with formulae [(p-t-BuC 6 H 4 Sb) 4 (O) 2 (PhPO 3 ) 4 (PhPO 3 H) 4 ] (C2). Based upon the initial results from docking studies, parent stibonic acids, t-butyl-phenylstibonic acid, p-isopropylphenylstibonic acid, 4-azobenzenephenylstibonic acid, and the derived tetranuclear organoantimonate-phosphonate clusters were screened against different cancer cell lines, various Gram-positive and Gram-Negative bacteria and mycobacteria for possible bioactivity profile., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Historically, people have been using pomegranate to alleviate many disease conditions. Pomegranate is known for its antiinflammatory, antioxidant, neuroprotective, anticancer, and antibacterial properties. In the current study, we examined effects of 8 dietary phenolics present in pomegranate (DPPs)-cyanidin-3-glucoside, cyanin chloride, delphinidin-3-glucoside, delphinidin-3,5-diglucoside, pelargonidin-3-glucoside, pelargonin chloride, punicalagin, and punicalin-on Escherichia coli ATP synthase and cell growth. DPPs caused complete or near complete (89%-100%) inhibition of wild-type E. coli ATP synthase and partial (5%-64%) inhibition of mutant enzymes αR283D, αE284R, βV265Q, and γT273A. Growth inhibition of wild-type, null, and mutant strains in the presence of DPPs were lower than that of isolated wild-type and mutant ATP synthase. On a molar scale, cyanin chloride was the most potent, and pelargonidin-3-glucoside was the least effective inhibitor of wild-type ATP synthase. Partial inhibition of mutant enzymes confirmed that αR283D, αE284R, βV265Q, and γT273A are essential in the formation of the phytochemical binding site. Our results establish that DPPs are potent inhibitors of wild-type E. coli ATP synthase and that the antimicrobial nature of DPPs can be associated with the binding and inhibition of microbial ATP synthase. Additionally, selective inhibition of microbial ATP synthase by DPPs is a useful method to combat antimicrobial resistance., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Familial hypercholesterolemia (FH) remains underdiagnosed and undertreated. The optimal electronic health record (EHR) screening strategy for FH is unclear., Objective: To evaluate an LDL-C threshold-based approach of identifying patients with FH from the EHR to determine the optimal LDL-C range for FH consideration., Methods: Individuals from UT Southwestern Medical Center with an LDL-C level ≥190mg/dL at any time were enrolled in an FH registry. These 5,786 patients were divided into four categories of LDL-C (190- 219, 220 - 249, 250 - 299, and ≥ 300mg/dL) with 100 individuals randomly selected for manual chart review in each category. Chart review included 1) the presence of secondary causes of dyslipidemia, 2) diagnosis of possible/definite FH by modified Simon Broome criteria, and 3) probable/definite FH by modified Dutch Lipid Clinic Network (DLCN) criteria., Results: Of the 400 individuals with an LDL-C level ≥190mg/dL (mean age 52 years ± 14), the presence of secondary causes increased across each LDL-C category (p < 0.001) with the greatest prevalence in those ≥ 300mg/dL (52%). The prevalence of possible/probable or definite FH also varied by LDL-C category, with the highest prevalence of FH by Simon Broome criteria in the 220 - 249mg/dL category (52%) and by DLCN criteria in the 250 - 299mg/dL category (46%)., Conclusions: Among those with LDL-C ≥ 190mg/dL, the prevalence of secondary causes increased markedly with higher LDL-C, while the diagnosis of FH has a parabolic relationship. Patients with intermediate LDL-C (220 - 299mg/dL) may be the optimal group to prioritize for FH screening., (Copyright © 2022. Published by Elsevier Inc.)

Few cases of hypertriglyceridemic pancreatitis have been reported in women during a vitro fertilization treatment (IVF) cycle. Here, we describe a 41-year-old woman with primary infertility and a history of acute pancreatitis (of unknown etiology) who was started on high dose ethinyl estradiol to prepare for transfer of cryopreserved embryos. She subsequently presented with nausea, vomiting, and abdominal pain to an emergency room and was found to have hypertriglyceridemic pancreatitis. Her hospitalization involved a prolonged intensive care unit stay in which she underwent three sessions of plasmapheresis. Eventually, with discontinuation of ethinyl estrogen, aggressive intravenous fluid hydration, plasmapheresis, a low-fat diet, and gemfibrozil, she had resolution of severe hypertriglyceridemia and all symptoms related to acute pancreatitis. Our case highlights the possibility that ethinyl estradiol, a commonly used form of estrogen for endometrial preparation during IVF cycles, may cause severe hypertriglyceridemia and acute pancreatitis in certain predisposed individuals. Only seven cases of hypertriglyceridemic pancreatitis during in vitro fertilization have been previously reported, and only one of these prior cases experienced pancreatitis during transfer of cryopreserved embryos like our patient. Our case, along with the few prior reported cases, demonstrate hypertriglyceridemic pancreatitis can occur during IVF. Further work is needed to understand the effects of exogenous estrogen on lipids for women undergoing IVF., (Copyright © 2022. Published by Elsevier Inc.)

In this paper, a compartmental mathematical model has been utilized to gain a better insight about the future dynamics of COVID-19. The total human population is divided into eight various compartments including susceptible, exposed, pre-asymptomatic, asymptomatic, symptomatic, quarantined, hospitalized and recovered or removed individuals. The problem was modeled in terms of highly nonlinear coupled system of classical order ordinary differential equations (ODEs) which was further generalized with the Atangana-Balaeanu (ABC) fractional derivative in Caputo sense with nonlocal kernel. Furthermore, some theoretical analyses have been done such as boundedness, positivity, existence and uniqueness of the considered. Disease-free and endemic equilibrium points were also assessed. The basic reproduction was calculated through next generation technique. Due to high risk of infection, in the present study, we have considered the reported cases from three continents namely Americas, Europe, and south-east Asia. The reported cases were considered between 1st May 2021 and 31st July 2021 and on the basis of this data, the spread of infection is predicted for the next 200 days. The graphical solution of the considered nonlinear fractional model was obtained via numerical scheme by implementing the MATLAB software. Based on the fitted values of parameters, the basic reproduction number ℜ 0 for the case of America, Asia and Europe were calculated as ℜ 0 ≈2.92819, ℜ 0 ≈2.87970 and ℜ 0 ≈2.23507 respectively. It is also observed that the spread of infection in America is comparatively high followed by Asia and Europe. Moreover, the effect of fractional parameter is shown on the dynamics of spread of infection among different classes. Additionally, the effect of quarantined and treatment of infected individuals is also shown graphically. From the present analysis it is observed that awareness of being quarantine and proper treatment can reduce the infection rate dramatically and a minimal variation in quarantine and treatment rates of infected individuals can lead us to decrease the rate of infection., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Uranium extraction from natural seawater and wastewater are quintessential requirements to supply uninterrupted carbon-free nuclear energy and to prevent potential radiochemical and toxicological effects, respectively. Owing to the complexity and low-concentration uranium of these water samples, the design and synthesis of sorbent materials for uranium extraction with meaningful efficiencies remains a grand challenge. Herein, we reported a novel three-dimensional bifunctional network of hyperbranched poly(amidoxime-ethyleneimine) (PAO-h-PEI) using PEI as the skeleton material via cyanoethylation, crosslinking and then amidoximation. As a result of the synergistic supramolecular strategy, the PAO-h-PEI membrane achieved a remarkable adsorption capacity of 985.7 mg/g for aqueous uranium solution, which was 2.5 folds that of the monofunctional h-PEI membrane (387.6 mg/g). The PAO-h-PEI membrane also exhibited good selectivity towards uranium in the presence of various metal ions, high-content salt, and natural organic matter as well as common anions. According to the XPS and FTIR results, the utilization of amines as the second ligand enhanced uranyl binding by providing additional coordination sites or by interacting with oxime to force N-OH dissociation. The good reusability (adsorption rate of 93% after six adsorption-desorption cycles) and satisfactory adsorption performance in extracting low-concentration uranium in real seawater demonstrate its practicability., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Community pharmacists have the responsibilities of identifying and resolving medication-related problems (MRPs), thereby improving patient safety., Objectives: To deliver a series of clinical case scenarios using WhatsApp and assess the impact of this method on the ability of pharmacists to identify MRPs., Methods: This study was conducted in 104 community pharmacies in the United Arab Emirates (UAE) over a period of six months. Recruited pharmacies were randomly allocated to either intervention or control groups using a 1:1 allocation ratio. Senior experts in clinical pharmacy created a series of clinical case scenarios based on their clinical practice and based on previous published studies related to MRPs. WhatsApp®, a well-known messenger application, which has been proven to be an efficient platform to improve communication between learners and educators, was used to deliver clinical scenarios-based educational interventions to pharmacists. Then, pharmacists from both groups filled a standardized data reporting form. The clinical importance of pharmacist recommendations was assessed by a multidisciplinary expert panel., Results: The total number of patients with MRPs across the intervention and control groups was 492 versus 194 (p = 0.01). While the number of MRPs identified, the mean time needed to resolve MRPs for patients with major polypharmacy, and physicians' acceptance of pharmacist recommendations across the intervention and control groups were 492 versus 194, 1589 versus 255, 6.82 (±3.86) versus 10.78 (±6.38), and 1065/1284 (82.94%) versus 125/201 (62.18%), respectively, all with p < 0.05. Efficacy-related problems (27.56%) and safety-related problems (28.44%) were the most commonly identified MRPs by pharmacists in the intervention group. Clinically significance of pharmacist recommendations was a significant predictive factor for physicians' acceptance of pharmacist recommendations., Conclusion: Clinical case scenarios delivered by WhatsApp may be useful for improving the ability of pharmacists to identify MRPs and for shortening the mean time needed to resolve MRPs., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Although community pharmacists have been actively engaged in patient care, their role in deprescribing is still restricted., Objectives: This study aimed to assess the effectiveness of a new educational approach designed to catalyze deprescribing in community pharmacies., Methods: In this 4-month, randomized, controlled trial, 108 community pharmacies in Egypt were randomly and equally distributed to either the active or the control groups. Participants from the active group pharmacies received 31 deprescribing-related clinical case scenarios, designed according to the available deprescribing guideline and clinical experiences of an expert panel members, and delivered through WhatsApp. Then participants from both groups reported the incidence of potentially inappropriate medicines (PIMs), the frequency of deprescribing opportunities, and related pharmacist interventions., Results: Pharmacists from the active group reported a considerably higher incidence of PIMs (20.87%) than that reported by pharmacists from the control group (5.03%). In addition, they made 1326 deprescribing-related interventions, of which 1022 (77.07%) were accepted and 641 (48.34%) were significant interventions. The proportions of cessation of drug therapy, reducing the dose, and persuasion of patients to accept deprescribing pharmacist interventions in the active group were 37.85%, 22.09%, and 10.63%, respectively. In contrast, 150 of 268 deprescribing-related interventions (55.97%) in the active group were accepted. The clinical value and type of deprescribing decision were statistically significant determinants for the acceptance of deprescribing decisions. The mean time needed to persuade the patient about deprescribing and the cost saved per patient across the active and the control groups were 5.09 ± 3.54 minutes versus 10.03 ± 6.19 minutes and 17.88 ± 9.60 U.S. dollars versus 4.49 ± 2.44 U.S. dollars, respectively., Conclusion: The intervention proposed improved the frequency and clinical value of deprescribing decisions., (Copyright © 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: This study describes a different approach with a 2-stage facial reanimation in patients with long-standing unilateral facial paralysis using free gracilis muscle transfer, innervated by both cross-facial nerve graft and masseteric nerve. The authors present their rationale, surgical technique, and long-term outcomes., Methods: Between August 2012 and March 2016, 11 patients (6 female and 5 male patients) underwent a 2-staged dually innervated gracilis muscle transfer. Patients were evaluated with physical examination and needle electromyography. A standardized assessment of preoperative and postoperative photographs and videos was performed using Terzis' smile functional grading system at 48 months following surgery and the Emotrics software to assess improvement in symmetry over a 36-month postoperative period., Results: Voluntary contraction of the gracilis muscle was observed in all patients at a mean of 4 months and 4 days following muscle transfer. A spontaneous smile produced without teeth clenching was developed in all patients by 18 months postoperatively. Six patients achieved excellent and 5 good results. The difference between the averaged pre- and postoperative scores was statistically significant. With Emotrics, there were significant improvements in the smile angle, upper lip elevation, commissural excursion, and commissural height, with continuous improvement over 36 months. The postoperative electromyography (EMG) confirmed dual innervation of the gracilis muscle by the facial and masseteric donor motor neural sources. We present our results at minimum 48 months postoperatively., Conclusions: Dual innervated two-stage gracilis transfer is an effective method for reanimation in long-standing unilateral facial paralysis, providing both rapid reinnervation of the transferred muscle, together with a powerful, synchronous smile., Competing Interests: Declaration of Competing Interest No author reports conflicts of interest., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)