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Background: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) presents significant treatment challenges due to its chronic nature, varied clinical presentations, and rarity. Subcutaneous immunoglobulin (SCIG) has emerged as a maintenance therapy, offering potential advantages in administration and patient experience over the previously recognized intravenous immunoglobulin (IVIG). Methods: We included all clinical studies involving CIDP patients treated with SCIG from eleven databases up to March 2024. Results: 50 clinical studies were included in the systematic review, with 22 involved in the meta-analysis. These studies offer clinical data on around 1400 CIDP patients. Almost all studies considered SCIG a maintenance therapy, with the majority of results suggesting it as a viable substitute that may offer comparable or enhanced advantages. Studies covered aspects such as efficacy, safety, quality of life, practicality, economic evaluation, and patient preference. Meta-analysis showed SCIG significantly improved muscle strength and sensory function, had fewer and milder side effects, reduced relapse rates, and received a strong preference. Conclusions: Findings suggest that SCIG for CIDP maintenance not only provides a more feasible alternative, with economic evaluations showing considerable cost reductions over time, and patient preference for SCIG being pronounced, but may also deliver comparable or superior health outcomes. Ongoing research lines on formulations, techniques, and direct comparative studies are critical to further illuminate, enhance, and expand SCIG's role in treatment. [ABSTRACT FROM AUTHOR]

To investigate the association between anti-prothrombin IgM and IgG antibodies and recurrent pregnancy loss (RPL) in a cohort of Lebanese women, and their impact on pregnancy outcomes. This was a retrospective case–control study involving 207 women with RPL and 179 age-matched multiparous controls. Quantitative sandwich ELISA assayed anti-prothrombin IgM and IgG antibodies. Univariate and multivariate logistic regression were employed to assess the risk imparted by anti-prothrombin antibodies, while ROC analysis was used to determine their sensitivity and specificity. Our study revealed that women with RPL had significantly higher serum levels of anti-prothrombin IgM and IgG than controls. Univariate regression analysis demonstrated that elevated anti-prothrombin IgM (OR = 1.13; 95% CI = 1.07, 1.19; P < 0.001) and IgG (OR = 1.05; 95% CI = 1.03, 1.08; P < 0.001) were associated with increased RPL risk. Multivariate analysis confirmed these findings, indicating that anti-prothrombin IgM (aOR = 1.13; 95% CI = 1.05, 1.20; P < 0.001) and IgG (aOR = 1.08; 95% CI = 1.05, 1.11; P < 0.001) are independent risk factors. ROC analysis yielded an AUC of 0.720 for IgM and 0.649 for IgG, underscoring their predictive value and offering hope for improved risk assessment and management of RPL. Elevated levels of anti-prothrombin IgM and IgG are significantly associated with RPL, suggesting an autoimmune component to pregnancy loss. These findings highlight the importance of screening for these antibodies in women with unexplained RPL to guide management and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review aims to synthesize the latest evidence focused on therapies related to comorbid obesity and heart failure, with particular attention to lifestyle, pharmacological, and surgical modalities. Recent Findings: Obesity is a common risk factor for heart failure, which can also exacerbate symptom burden of heart failure. Emerging treatments, such as the use of GLP-1 analogs like semaglutide, have shown promising results in improving symptoms and physical limitations in the setting of comorbid heart failure with preserved ejection fraction and obesity. Conversely, the efficacy of such treatments in heart failure with reduced ejection fraction remains uncertain, with some studies suggesting potential adverse outcomes. Lifestyle interventions, including dietary changes and structured exercise programs, may be associated with benefits in terms of functional capacity and symptom burden, and retrospective cohort studies of surgical weight loss have raised the possibility of improvements in medium term survival for patients with baseline HF, challenging the previous notions of the "obesity survival paradox". Summary: The management of comorbid obesity and heart failure is a rapidly evolving field. The interplay of pharmacological, lifestyle, and surgical interventions highlights the need for personalized treatment plans to mitigate the risks and enhance the quality of life for patients with heart failure. It is hoped that future guidelines will integrate these findings to address the nuances of optimally treating both heart failure and obesity in patients with both conditions. [ABSTRACT FROM AUTHOR]

Introduction: In Japan, patients with chronic obstructive pulmonary disease (COPD) can be escalated to treatment with inhaled triple therapy. Two single-inhaler triple therapies combining an inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β2-agonist (ICS/LAMA/LABA) are approved maintenance therapies for patients with COPD, and multiple-inhaler triple therapies (MITTs) are also available. There is limited evidence regarding real-life treatment patterns and characteristics of patients with COPD initiating triple therapies. Methods: This observational, retrospective cohort study identified patients with COPD in Japan from an administrative claims database (May 2018–December 2021). Demographics, clinical characteristics, and healthcare resource utilization (HCRU) were assessed in four cohorts initiating a triple therapy: budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) early adopters (initiated ≤ 12 months after market approval [September 1, 2019]), contemporary BGF users (initiated > 12 months after market approval), fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) users, and any MITT users. Results: A total of 636 patients were BGF early adopters, 2558 were contemporary BGF users, 11,187 used FF/UMEC/VI, and 5931 used MITT. The percentage of patients with concomitant asthma in each cohort was 73.0%, BGF early adopter; 74.2%, contemporary BGF; 75.7%, FF/UMEC/VI; and 84.5%, MITT. During the 12-month baseline period, the frequency of patients with ≥ 1 moderate/severe exacerbation was 18.2%, BGF early adopter; 14.3%, contemporary BGF; 13.1%, FF/UMEC/VI; and 14.0%, MITT. ICS/LABA treatment during baseline was the most frequent pathway to triple therapy, ranging from 38.2% to 51.7% across cohorts. HCRU was relatively high across cohorts (range of hospital outpatient visits/patient during the 12-month baseline period, 11.0–14.1). Multimorbidity was observed in > 80% of patients in all cohorts; cardiovascular diseases were among the most common. Conclusion: Many patients initiating triple therapy for COPD had concomitant asthma and had previously received ICS/LABA maintenance therapy. Patients prescribed BGF in the initial post-launch period were more likely to have a previous exacerbation history versus other cohorts, indicating more severe disease. Plain Language Summary: In Japan, single inhalers containing three medicines, known as single-inhaler triple therapies, are approved for people with chronic obstructive pulmonary disease (COPD). These inhalers include one medicine that reduces inflammation (a corticosteroid) and two medicines that expand the airways in the lung (bronchodilators). There are two approved single-inhaler triple therapies for long-term COPD treatment in Japan, consisting of active substances referred to as budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) or fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI). Although guidance is available to doctors on when to prescribe single-inhaler triple therapy, two important questions related to use in routine clinical practice remain: when are these medicines prescribed, and what types of patients receive them. To answer these questions, we assessed anonymized medical claims of people with COPD obtained from a large database in Japan. People with COPD who had used triple therapy were split into four groups: early BGF users (started treatment within 1-year of approval in Japan), contemporary BGF users (started treatment over 1-year after approval in Japan), FF/UMEC/VI users, and users of any multiple-inhaler triple therapy. Our findings showed that the majority of patients starting any triple therapy had diagnoses of both asthma and COPD, and multiple other medical conditions, including heart-related conditions. Healthcare use, including outpatient hospital clinic visits, was high across all groups before starting triple therapy. As early BGF users were more likely to have previous flare-ups (acute worsening of COPD symptoms) than the other groups, upon approval in Japan, doctors may have initially prescribed BGF to people with more severe COPD. [ABSTRACT FROM AUTHOR]

The development of composite materials with fewer interface problems always helps to obtaining good properties. Two types of insulating biopolymers (7% w/w) were incorporated into a conductive matrix (polyaniline) during polymerization. The synthesis method, inspired by the synthesis of polyaniline and the coating of chitosan for the development of flexible electrodes, produces thermosets that are more thermally stable than the matrix until 350 °C. While one (gum) reduces the electrical conductivity, the other (lignin) increases the basic value of the raw material (~ 0.72 S Cm–1) by a factor of 10. The physicochemical and morphological analyses show the formation of the polymer on the surface of the biopolymer with the appearance of new chemical bonds by interactions between hydroxyls of the biopolymer and the nitrogen of amine function from the polyaniline. [ABSTRACT FROM AUTHOR]

Citrobacter koseri causes infection in people who are immunocompromised. Without effective antibiotics, these infections can become severe and life-threatening, so effective drugs are essential to treat these infections. Utilizing subtractive genomics, 2699 ORFs were predicted and translated into amino acid sequences. Metabolic pathway analysis and subcellular localization helped define the roles of key bacterial proteins. Two druggable proteins, WP_012000829.1 and WP_275157394.1, were discovered as promising targets. Alpha Fold provided 3D structures, and a library of 1600 echinoderm metabolites was docked against these proteins, with Ampicillin, Levofloxacin, and Doxycycline as controls. Notably, CMNPD13085 and CMNPD15632 exhibited the highest binding affinities for WP_012000829.1 and WP_275157394.1, respectively. Molecular dynamics simulations and MM-GBSA binding free energy complemented docking results. However, acknowledging the reliance on computational validations, the study emphasizes the need for essential in-vitro research to transform these potential inhibitors into therapeutic drugs. [ABSTRACT FROM AUTHOR]

Purpose: To investigate functional, oncological and complication outcomes in women undergoing robot-assisted cystectomy (RARC) with intracorporeal orthotopic neobladder. Methods: From a multi-institutional database, we identified females with bladder cancer treated with RARC and intracorporeal orthotopic neobladder. We evaluated the continence rate, short-term oncological outcomes, and complication rates. Analyses were repeated and stratified by the status of preserving gynecological organs. Results: The study involved 146 patients with the median age 60 years (IQR, 51–66 years). Pelvic organ-preserving procedure (POP) was performed in 77 patients (53%). Overall daytime and nighttime continence rates were 54% and 53%, respectively. For POP, the continence rate was 58% for both daytime and nighttime continence. In the non-POP cohort, the continence rate was 50% for daytime and 49% for nighttime continence. Both groups had balanced positive surgical margin rates (5,3% for POP and 4,7% for non-POP). In the whole cohort, high-grade (Clavien-Dindo ≥3) early and late complication rate was 7,5% and 7,5%, respectively. Conclusions: Robot-assisted radical cystectomy with intracorporeal orthotopic neobladder in females demonstrate excellent functional and complication outcomes. Pelvic organ-preserving cystectomy enhances urinary continence rates without adversely affecting surgical margins. Orthotopic neobladder in selected women with bladder cancer, along with pelvic organ-preserving cystectomy may be used for improved functional outcomes without compromising oncological results. [ABSTRACT FROM AUTHOR]

This research aims to develop a perovskite ceramic with optimized electrical and dielectric properties for applications in energy storage, medical technologies, and electronic devices. A bismuth ferric titanate compound, Bi0.9Ba0.1Fe0.8Ti0.2O₃, doped with barium at the A-site, was successfully synthesized using the sol–gel method. X-ray diffraction at room temperature confirmed a rhombohedral structure within the R3́C space group. Scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX) revealed an average grain size of 273 nm with uniform grain distribution and chemical composition. The study identified a clear correlation between temperature, frequency, and the material’s electrical characteristics. Impedance spectroscopy and electrical modulus analysis, conducted over a frequency range of 1 kHz to 1 MHz and temperatures between 260 and 340 K, indicated non-Debye relaxation behavior. Additionally, the material’s frequency-dependent electrical conductivity, analyzed through Jonscher’s law at various temperatures, showed that barium doping significantly enhanced conductivity and dielectric properties compared to undoped BiFeTiO₃. Consistent conduction and relaxation mechanisms were observed across the entire temperature range, highlighting the material's potential for use in capacitors and electric fields over a wide range of conditions. [ABSTRACT FROM AUTHOR]

Corosolic acid (CA) is a well-known natural pentacyclic triterpene found in numerous therapeutic plants that can exhibit many bioactivities including anti-inflammatory and anti-tumor actions. The current investigation explores the chemoprotective roles of CA against azoxymethane (AOM)-induced colonic aberrant crypt foci (ACF) in rats. Thirty Sprague Dawley rats were grouped in 5 cages; Group A, normal control rats inoculated subcutaneously (sc) with two doses of normal saline and fed orally on 10% tween 20; Groups B-E received two doses (sc) of azoxymethane in two weeks and treated with either 10% tween 20 (group B) or two intraperitoneal injections of 35 mg/kg 5-fluorouracil each week for one month (group C), while group D and E treated with 30 and 60 mg/kg, respectively, for 2 months. The toxicity results showed lack of any behavioral abnormalities or mortality in rats ingested with up-to 500 mg/kg of CA. The present AOM induction caused a significant initiation of ACF characterized by an increased number, larger in size, and well-matured tissue clusters in cancer controls. AOM inoculation created a bizarrely elongated nucleus, and strained cells, and significantly lowered the submucosal glands in colon tissues of cancer controls compared to 5-FU or CA-treated rats. CA treatment led to significant suppression of ACF incidence, which could be mediated by its modulatory effects on the immunohistochemical proteins (pro-apoptotic (Bax) and reduced PCNA protein expressions in colon tissues). Moreover, CA-treated rats had improved oxidative stress-mediated cytotoxicity indicated by increased endogenous antioxidants (SOD and CAT) and reduced lipid peroxidation indicators (MDA). In addition, CA ingestion (30 and 60 mg/kg) suppressed the inflammatory cascades, indicated by decreased serum TNF-α and IL-6 cytokines and increased anti-inflammatory (IL-10) cytokines consequently preventing further tumor development. CA treatment maintained liver and kidney functions in rats exposed to AOM cytotoxicity. CA could be a viable alternative for the treatment of oxidative-related human disorders including ACF. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) has emerged as a promising tool for detecting and characterizing colorectal polyps during colonoscopy, offering potential enhancements in traditional colonoscopy procedures to improve outcomes in patients with inadequate bowel preparation. Aims: This study aimed to assess the impact of an AI tool on computer-aided detection (CADe) assistance during colonoscopy in this population. Methods: This case–control study utilized propensity score matching (PSM) for age, sex, race, and colonoscopy indication to analyze a database of patients who underwent colonoscopy at a single tertiary referral center between 2017 and 2023. Patients were excluded if the procedure was incomplete or aborted owing to poor preparation. The patients were categorized based on the use of AI during colonoscopy. Data on patient demographics and colonoscopy performance metrics were collected. Univariate and multivariate logistic regression models were used to compare the groups. Results: After PSM patients with adequately prepped colonoscopies (n = 1466), the likelihood of detecting hyperplastic polyps (OR = 2.0, 95%CI 1.7–2.5, p < 0.001), adenomas (OR = 1.47, 95%CI 1.19–1.81, p < 0.001), and sessile serrated polyps (OR = 1.90, 95%CI 1.20–3.03, p = 0.007) significantly increased with the inclusion of CADe. In inadequately prepped patients (n = 160), CADe exhibited a more pronounced impact on the polyp detection rate (OR = 4.34, 95%CI 1.6–6.16, p = 0.049) and adenomas (OR = 2.9, 95%CI 2.20–8.57, p < 0.001), with a marginal increase in withdrawal and procedure times. Conclusion: This study highlights the significant improvement in detecting diminutive polyps (< 5 mm) and sessile polyps using CADe, although notably, this benefit was only seen in patients with adequate bowel preparation. In conclusion, the integration of AI in colonoscopy, driven by artificial intelligence, promises to significantly enhance lesion detection and diagnosis, revolutionize the procedure's effectiveness, and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Esophageal food impaction (EFI) is a common complaint of patients presenting to the emergency department. EFI requires urgent evaluation by the gastroenterology service and often necessitates esophagogastroduodenoscopy (EGD) for management. Timing of EGD in patients with EFI that does not improve with medical management remains a point of contention. We aim to evaluate outcomes of EFI in the context of time to intervention. Methods: A retrospective cohort study was performed among patients who presented to a multicenter health system with EFI between 2018 and 2022. Patients with EFI that did not resolve after medical management and required EGD were included. Outcome analysis evaluated rates of complications and hospitalizations. Results: Two hundred eighty sis unique patient presentations were included. 175 (61.2%) of patients underwent EGD within six hours of presentation, 59 (20.6%) underwent EGD six to twelve hours after presentation, and 52 (18.2%) underwent EGD beyond twelve hours after presentation. Complication rates did not differ between patients depending on timing of EGD (p = 1.000). Admission rates were higher among patients in whom EGD was performed longer after presentation (p = 0.003). Complication rates were higher among patients with advanced age (p = 0.037), prior impaction (p = 0.004), and those who have not received glucagon (p = 0.007). Conclusion: Timing of EGD after presentation in patients with EFI was not associated with a difference in complication rates. Delayed intervention was associated with a higher rate of hospitalization which should be taken into consideration when assessing the cost of EFI to the healthcare system. [ABSTRACT FROM AUTHOR]

Background: Bone denudation after conventional relaxing incisions could be a critical factor in inhibiting maxillofacial growth. To address this, alternative relaxing incisions were designed. Thus, this study aimed to compare the effectiveness of palatal relaxing incisions versus nasopharyngeal relaxing incisions in enhancing postoperative outcomes. Materials and methods: A retrospective cohort study was conducted, involving a total of 120 patients divided into three groups: 40 patients have received modified Furlow palatoplasty with nasopharyngeal relaxing incisions (M.F + N.P.I palatoplasty), and 40 patients who received modified Furlow palatoplasty with palatal relaxing incisions (M.F + P.R.I palatoplasty). The other 40 patients received original Furlow palatoplasty without relaxing incisions (F palatoplasty). Data collected included gender, cleft type, cleft width, age at repair, velopharyngeal function, presence of palatal fistula, and follow-up. The chi-square test compared frequencies of sex, cleft type, postoperative fistula, and velopharyngeal outcomes across groups. The Mann–Whitney and independent t-tests compared mean values, with statistical significance set at p < 0.05. Results: The mean age at repair was similar across groups, with follow-up periods ranging from 5 to 11 years. No significant differences were found among the M.F + N.P.I and M.F + P.L.I groups regarding gender, cleft type, cleft width, and age at repair. However, the F group had a significantly narrowest cleft width compared to the other groups. Postoperative outcomes showed no significant differences in velopharyngeal function among the three groups, but the F group had a significantly higher rate of palatal fistula (32.5%) compared to the M.F + P.L.I (10%) and M.F + N.P.I (7.5%) groups. A comparison of the two modified Furlow techniques revealed no significant differences in velopharyngeal closure rates or the incidence of velopharyngeal insufficiency and persistent palatal fistula across different Veau classifications. Conclusions: While both incisions showed similar impacts on palatoplasty outcomes, palatal relaxing incisions may expose more bone and pose a higher risk of secondary healing issues. Therefore, nasopharyngeal relaxing incisions are recommended as an effective and potentially preferable technique in palatoplasty whenever feasible. Clinical relevance: The current study suggests that, whenever feasible, nasopharyngeal relaxing incisions are advised as an effective and potentially superior technique in palatoplasty. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the antibacterial activity of essential oils from Cupressus sempervirens (CSEO) and Eucalyptus globulus (EGEO) against clinical isolates of colistin-resistant E. coli and methicillin-resistant M. sciuri recovered from diseased food-producing animals in Tunisia. The chemical compositions of both essential oils were analyzed using Gas chromatography-mass spectrometry (GC–MS). Antibacterial activity was determined through disk diffusion and microdilution assays, while the fractional inhibitory concentration index (FICI) was used to measure the synergistic effect of CSEO and colistin. The major constituents of CSEO were α-pinene (59.03%), δ-3 Carene (21.48%), D-limonene (5.62%) and α-thujene (3.08%), while EGEO contained eucalyptol (52.1%), α-pinene (26.51%), γ-terpinene (4.81%) and D-limonene (3.54%). The inhibition zone diameters (IZDs) against E. coli and M. sciuri ranged from 6 to 29 mm for CSEO and 9.3 to 28.6 mm for EGEO. Minimum inhibitory concentrations (MICs) showed a range of 4 to 512 µg/mL for CSEO against M. sciuri and 2 to 426.66 µg/mL for EGEO. For E. coli, MICs ranged from 170.66 to 512 µg/mL for CSEO and 53.33 to 512 µg/mL for EGEO. The checkerboard test demonstrated a synergistic effect between CSEO and colistin against two colistin-resistant E. coli isolates, with FICI 3- to 32-fold lower than the MICs of the individual compounds. This study highlights the potency of essential oils from CSEO and EGEO against antibiotic-resistant M. sciuri and E. coli strains from animals in Tunisia and provides evidence of the synergistic effect between CSEO and colistin against clinically relevant colistin-resistant E. coli isolates. [ABSTRACT FROM AUTHOR]

We studied the strategies exploiting the post-earnings announcement drift, the momentum, and the long-term return reversal in the Saudi stock market and their explanations. Using individual data for all the listed firms over the period 2010–2019, we found that these strategies are significantly profitable regardless of the formation and holding period length, and their profitability generally persists for the subperiods. Two controversial explanations for this profitability were examined using a time series approach: the risk-based rational explanation and the under- and overreaction-based behavioral explanation. We found that the profitability of the three strategies persists after controlling for risk using the Capital Asset Pricing Model, the Fama–French three-factor model, and the Fama–French five-factor model, which rejects the risk hypothesis. To examine the behavioral explanation, we extended the Fama–French five-factor model to include a factor reflecting the underreaction or the overreaction to quarterly earnings announcement based on unexpected earnings. Our findings indicate that the momentum can be explained by the market underreaction to firms' earnings announcement, while the long-term return reversal cannot be explained by the overreaction to a series of similar information conveyed by earnings announcement events. [ABSTRACT FROM AUTHOR]

The priority in oilseed rape (Brassica napus L.) research and breeding programs worldwide is to combine different features to develop cultivars tailored to specific applications of this crop. In this study, forms with a modified fatty acid composition of seed oil were successfully combined with a source of resistance to Plasmodiophora brassicae Wor., a harmful protist-causing clubroot. Three HO-type recombinants in F6–F12 generations with oleic acid content of 80.2–82.1% and one HOLL-type F6 inbred mutant recombinant (HOmut × LLmut), with a high oleic acid content (80.9%) and reduced linolenic acid content (2.3%), were crossed with the cultivar Tosca, resistant to several pathotypes of P. brassicae. The work involved genotyping with the use of DNA markers specific for allelic variants of desaturase genes responsible for the synthesis of oleic and linolenic fatty acids, CAPS (FAD2 desaturase, C18:1), and SNaPshot (FAD3 desaturase, C18:3), respectively. Of 350 progenies in the F3 generation, 192 (55%) were selected for further studies. Among them, 80 HO (≥ 72%) lines were identified, 10 of which showed resistance to at least one up to four P. brassicae pathotypes. Thirty lines in the selected progeny contained high oleic acid and less than 5% linolenic acid; eight of them belonged to the HOLL type conferring resistance to at least one pathotype. Two HO lines and two HOLL lines were resistant to four pathotypes. The resulting HO-CR and HOLL-CR inbred lines with altered seed oil fatty acid composition and resistance to P. brassicae represent unique oilseed rape material with the desired combination of valuable traits. [ABSTRACT FROM AUTHOR]

Purpose of Review: Evaluation of social influences on cardiovascular care requires a comprehensive analysis encompassing economic, societal, and environmental factors. The increased utilization of electronic health registries provides a foundation for social phenotyping, yet standardization in methodology remains lacking. This review aimed to elucidate the primary approaches to social phenotyping for cardiovascular risk stratification through electronic health registries. Recent Findings: Social phenotyping in the context of cardiovascular risk stratification within electronic health registries can be separated into four principal approaches: place-based metrics, questionnaires, ICD Z-coding, and natural language processing. These methodologies vary in their complexity, advantages and limitations, and intended outcomes. Place-based metrics often rely on geospatial data to infer socioeconomic influences, while questionnaires may directly gather individual-level behavioral and social factors. Z-coding, a relatively new approach, can capture data directly related to social determinant of health domains in the clinical context. Natural language processing has been increasingly utilized to extract social influences from unstructured clinical narratives—offering nuanced insights for risk prediction models. Each method plays an important role in our understanding and approach to using social determinants data for improving population cardiovascular health. Summary: These four principal approaches to social phenotyping contribute to a more structured approach to social determinant of health research via electronic health registries, with a focus on cardiovascular risk stratification. Social phenotyping related research should prioritize refining predictive models for cardiovascular diseases and advancing health equity by integrating applied implementation science into public health strategies. [ABSTRACT FROM AUTHOR]

The use of natural fibers has seen a significant rise in the composites sector, resulting in the creation of polymer composites with exceptional strength. These environmentally-friendly alternatives offer a compelling substitute for synthetic composites. This study explores the use of date palm waste as reinforcement for the fabrication of polyvinyl chloride (PVC) composites. A surface modification method was essential for improving the binding interaction between palm fibers and PVC composites. The two-hour benzoyl chloride treatment at 140 °C played a crucial role. The study examined the effects of hydrothermal aging on mechanical properties of composites, using various techniques such as surface morphology analysis, Fourier Transform Infrared spectroscopy, and Thermogravimetric Analysis, on composites made of untreated fibers and those treated with benzoyl chloride. Although the treatment of palm fiber-reinforced composites with benzoyl chloride improved their mechanical properties, it is crucial to note that hydrothermal aging reduced their tensile strength by 10%. Despite this, these composites prove to be well-suited for applications requiring moderate strength and stiffness in mild environmental conditions. These composites, while utilizing benzoyl chloride for surface treatment, still represent a more sustainable alternative to traditional synthetic composites by incorporating renewable date palm waste and enhancing mechanical properties, which potentially reduces overall environmental impact. [ABSTRACT FROM AUTHOR]

Polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs), and per- and poly-fluoroalkyl substances (PFAS) are persistent organic pollutants (POPs) that remain detrimental to critical subpopulations, namely pregnant women. Required tests for biomonitoring are quite expensive. Moreover, statistical models aiming to discover the relationships between pollutants levels and human characteristics have their limitations. Therefore, the objective of this study is to use machine learning predictive models to further examine the pollutants' predictors, while comparing them. Levels of 33 congeners were measured in the serum of 269 pregnant women, from whom data was collected regarding sociodemographic, dietary, environmental, and anthropometric characteristics. Several machine learning algorithms were compared using "Python" for each pollutant: support vector machine (SVM), random forest, XGBoost, and neural networks. The aforementioned characteristics were included in the model as features. Prediction, accuracy, precision, recall, F1-score, area under the ROC curve (AUC), sensitivity, and specificity were retrieved to compare the models between them and among pollutants. The highest performing model for all pollutants was Random Forest. Results showed a moderate to acceptable performance and discriminative power among all POPs, with OCPs' model performing slightly better than all other models. Top related features for each model were also presented using SHAP analysis, detailing the predictors' negative or positive impact on the model. In conclusion, developing such a tool is of major importance in a context of limited financial and research resources. Nevertheless, machine learning models should always be interpreted with caution by exploring all evaluation metrics. [ABSTRACT FROM AUTHOR]

We study the asymptotic behavior of trajectories of the continuous dynamical system(CDS) associated with the discrete viscosity approximation method for fixed point problem of nonexpansive mapping (DDS) which was introduced by Moudafi (J Math Anal Appl 241:46–55, 2000). We establish that the trajectories x(t) of the continuous dynamical system (CDS) has an asymptotic behavior similar to the behavior of the sequences (x n) generated by the discrete viscosity approximation (DDS) [ABSTRACT FROM AUTHOR]

MicroRNAs (miRs) play a crucial role in the leukemogenesis and the prognosis of acute myeloid leukemia (AML). This study investigated the therapeutic effects of resveratrol, gallic acid, and piperine as natural anticancer agents on the HL-60 cell line and their roles in apoptosis. In this experimental study, quantitative analysis of miRs, including miR-17, miR-92b, miR-181a, and miR-222, were performed in 150 newly diagnosed patients with AML by real-time PCR assay. HL-60 cell viability as well as the expression of miRs, BAX, BCL-2, MCL-1, WT1, c-Kit, and CEBPA, were also assessed after transfection with the LNA-miRs and treatment with resveratrol, gallic acid, and piperine. The expression of miR-17 and miR-181a decreased significantly in LNA-anti-miRs. Although HL-60 cell viability decreased in LNA-anti-miR-222, miR-17, and miR-92b, blockade of miR-181a increased the cell viability. Besides, the cell viability increased merely in the piperine-treated group. Compared to untreated cells, miR-17 and miR-92b expression significantly increased in gallic acid- and resveratrol-treated cells. In HL-60 cells treated with resveratrol, gallic acid, and piperine, the expression of miR-181a was also increased significantly. The expression of BAX was also increased in resveratrol and piperine-treated groups. Compared to untreated cells, the expression of c-Kit increased significantly in the piperine-treated group; however, it decreased in the resveratrol-treated group. LNA-anti-miRs may be a promising agent for the treatment of AML. All three compounds used in this study showed anticancer effects, which can exert the desired outcome in patients with AML. [ABSTRACT FROM AUTHOR]

Clinopodium menthifolium (wood calamint) is a folkloric medicinal plant ingested as a treatment for many human disorders including gastric disorders. Our study evaluates the anti-ulcer potentials of Clinopodium menthifolium ethanol extracts (CMEE) in induced gastric ulcers in rats. Thirty Dawley male rats were divided into 5 groups: normal and ulcer controls, treated orally with Tween 20%; reference rats treated with Omeprazole 20 mg/kg, and the remaining two groups received 250 and 500 mg/kg CMEE for 2 weeks. After that, food was taken away for 24 h, and then, rats received ethanol-induced gastric ulceration (except normal control), 80% (1 ml/rat). After anesthetization and sacrificing, the ulcer index, mucus content, and other ulcer measurements were obtained from dissected rat stomachs. Stomach tissues were also analyzed by different histology procedures and homogenized stomach tissues were assessed for their antioxidant contents. The toxicity trial showed the absence of any toxic signs in rats supplemented with 2 and 5 g/kg of CMEE. The gastroprotective results showed a significantly lower ulcer index and higher gastric mucin content in CMEE-ingested rats compared to ulcer controls. Furthermore, CMEE treatments significantly increased the intensity of periodic acid Schiff stained (PAS), HSP 70 protein, and down-regulation of Bax protein expression in the stomach epithelium. Rats supplemented with 500 mg/kg revealed noticeable changes in their serum inflammatory cytokines along with positive regulations of antioxidant enzymes. The outcomes provide a scientific backup behind the gastroprotective potential effect of CMEE that could serve as a natural resource against peptic ulcers. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is a risk factor for intracerebral hemorrhage (ICH), both with and without use of anticoagulation. Limited data exists on mortality trends and disparities related to this phenomenon. We aimed to assess ICH mortality trends and disparities based on demographic factors in individuals with atrial fibrillation in the United States (US). Methods: Our cross-sectional analysis utilized mortality data from the CDC database through death certificate queries from the years 1999 to 2020 in the US. We queried for all deaths with ICH as the underlying cause of death and atrial fibrillation as the multiple causes of death. Mortality data was obtained for overall population and demographic subpopulations based on sex, race and ethnicity, and geographic region. Trend analysis and average annual-mortality percentage change (AAPC) were completed using log-linear regression models. Results: ICH age-adjusted mortality rate (AAMR) in patients with AF increased from 0.27 (95% CI 0.25–0.29) in 1999 to 0.30 (95% CI 0.29–0.32) in 2020. A higher mortality rate was observed in males (AAMR 0.33) than in females (AAMR 0.26). The highest mortality was found in Asian/Pacific Islander (AAMR: 0.32) populations, followed by White (AAMR: 0.30), Black (AAMR: 0.15), and American Indian/Alaska Native (AAMR: 0.11) populations. Southern (AAPC: 1.3%) and non-metropolitan US regions (AAPC: + 1.9%) had the highest increase in annual mortality change. Conclusion: Our findings highlight the disparities in ICH mortality in patients with AF. Further investigation is warranted to confirm these findings and evaluate for contributors to the observed disparities. [ABSTRACT FROM AUTHOR]

Although continuous glucose monitoring (CGM) devices are now considered the standard of care for people with type 1 diabetes mellitus, the uptake among people with type 2 diabetes mellitus (T2DM) has been slower and is focused on those receiving intensive insulin therapy. However, increasing evidence now supports the inclusion of CGM in the routine care of people with T2DM who are on basal insulin-only regimens or are managed with other medications. Expanding CGM to these groups could minimize hypoglycaemia while allowing efficient adaptation and escalation of therapies. Increasing evidence from randomized controlled trials and observational studies indicates that CGM is of clinical value in people with T2DM on non-intensive treatment regimens. If further studies confirm this finding, CGM could soon become a part of routine care for T2DM. In this Perspective we explore the potential benefits of widening the application of CGM in T2DM, along with the challenges that must be overcome for the evidence-based benefits of this technology to be delivered for all people with T2DM. Continuous glucose monitoring (CGM) is an effective tool in the management of diabetes mellitus. This Perspective discusses the potential benefits of widespread adoption of CGM in people with type 2 diabetes mellitus at different stages of disease progression and treatment intensification. [ABSTRACT FROM AUTHOR]

Alloying metals to form intermetallics has been proven effective in tuning the chemical properties of metal-based catalysts. However, intermetallic alloys can undergo structural and chemical transformations under reactive conditions, leading to changes in their catalytic function. Elucidating and understanding these transformations are crucial for establishing relevant structure-performance relationships and for the rational design of alloy-based catalysts. In this work, we used CuZn alloy nanoparticles (NPs) as a model material system and employed in situ transmission electron microscopy (TEM) to investigate the structural and chemical changes of CuZn NPs under H2, O2 and their mixture. Our results show how CuZn NPs undergo sequential transformations in the gas mixture at elevated temperatures, starting with gradual leaching and segregation of Zn, followed by oxidation at the NP surface. The remaining copper at the core of particles can then engage in dynamic behavior, eventually freeing itself from the zinc oxide shell. The structural dynamics arises from an oscillatory phase transition between Cu and Cu2O and is correlated with the catalytic water formation, as confirmed by in situ mass spectrometry (MS). Under pure H2 or O2 atmosphere, we observe different structural evolution pathways and final chemical states of CuZn NPs compared to those in the gas mixture. These results clearly demonstrate that the chemical state of alloy NPs can vary considerably under reactive redox atmospheres, particularly for those containing elements with distinct redox properties, necessitating the use of in situ or detailed ex situ characterizations to gain relevant insights into the states of intermetallic alloy-based catalysts and structure-activity relationships. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review evaluates how Artificial Intelligence (AI) enhances atherosclerotic cardiovascular disease (ASCVD) risk assessment, allows for opportunistic screening, and improves adherence to guidelines through the analysis of unstructured clinical data and patient-generated data. Additionally, it discusses strategies for integrating AI into clinical practice in preventive cardiology. Recent Findings: AI models have shown superior performance in personalized ASCVD risk evaluations compared to traditional risk scores. These models now support automated detection of ASCVD risk markers, including coronary artery calcium (CAC), across various imaging modalities such as dedicated ECG-gated CT scans, chest X-rays, mammograms, coronary angiography, and non-gated chest CT scans. Moreover, large language model (LLM) pipelines are effective in identifying and addressing gaps and disparities in ASCVD preventive care, and can also enhance patient education. Summary: AI applications are proving invaluable in preventing and managing ASCVD and are primed for clinical use, provided they are implemented within well-regulated, iterative clinical pathways. [ABSTRACT FROM AUTHOR]

National consensus recommendations have recently been developed to standardize colorectal tumour localization and documentation during colonoscopy. In this qualitative semi-structured interview study, we identified and contrast the perceived barriers and facilitators to using these new recommendations according to gastroenterologists and surgeons in a large central Canadian city. Interviews were analyzed according to the Consolidated Framework for Implementation Research (CFIR) through directed content analysis. Solutions were categorized using the Expert Recommendations for Implementing Change (ERIC) framework. Eleven gastroenterologists and ten surgeons participated. Both specialty groups felt that the new recommendations were clearly written, adequately addressed current care practice tensions, and offered a relative advantage versus existing practices. The new recommendations appeared appropriately complex, applicable to most participants, and could be trialed and adapted prior to full implementation. Major barriers included a lack of relevant external or internal organizational incentives, non-existing formal feedback processes, and a lack of individual familiarity with the evidence behind some recommendations. With application of the ERIC framework, common barriers could be addressed through accessing new funding, altering incentive structures, changing record systems, educational interventions, identifying champions, promoting adaptability, and employing audit/feedback processes. Future research is needed to test strategies for feasibility and effectiveness. [ABSTRACT FROM AUTHOR]

The Mediterranean region is projected to experience severe drying trends and more extreme hydroclimate events as a consequence of anthropogenic climate change over the next century. In some places this signal may have already emerged from natural variability, but uncertainty in long-term paleoclimate reconstructions can be a significant challenge to the detection of the influence of rising CO 2 on droughts. Here we provide expanded context for recent and future hydroclimate changes with a new high-resolution (0.5 o ) spatial reconstruction of the Palmer Drought Severity Index (PDSI) using a tree-ring network that spans much of the last millennium. This network provides new perspective on the existing Old World Drought Atlas (OWDA) and allows us to characterize differences between OWDA and our reconstruction. In light of the uncertainties we identify, we also reexamine previous conclusions about the severity of recent droughts in the context of earlier centuries. We find that, in both the western Mediterranean and the Levant, recent dry periods remain the worst in at least the last 500 years, but our assessment of the significance and confidence in this finding is affected by differences in the tree-ring networks used for the reconstructions. Long millennium-length hydroclimate reconstructions in the Mediterranean do provide the opportunity to understand variability and trends in the hydroclimate of the region, but extant uncertainties arising from the existing tree-ring chronology network and methodological choices call attention to locations that require further proxy collection, chronology updates, and statistical scrutiny. [ABSTRACT FROM AUTHOR]

This study investigates the dynamic return connectedness among Decentralized Finance (DeFi) assets [Chainlink (LINK), Maker (MAKER), Basic Attention Token (BAT), and Synthetix (SNX)] and Centralized Financial assets (CeFi), specifically MSCI World, MSCI US, MSCI Europe, MSCI East Europe, MSCI Asia, and MSCI Far East. The Time-Varying Parameter Vector Autoregressions (TVP-VAR) framework is adopted. Our research findings demonstrate that economic events create variations in the dynamic connectedness of a system. There were peaks throughout the COVID-19 pandemic. Furthermore, the results indicate that DeFi assets like BAT and LINK are the most common shock transmitters, while MAKER and SNX are the most common shock receivers. Nonetheless, the pairwise connectedness for LINK and MSCI Far EAST (FarEAST) shows that may not only influence other markets but are also equally receptive to innovations that occur in the majority of these markets due to their high pairwise links. The retrieved evidence has major implications for investors in terms of the creation of strategies for the optimization of portfolios and asset allocation, the minimizing of downside risk, and hedging techniques. [ABSTRACT FROM AUTHOR]

Olive oil, particularly monovarietal virgin olive oil (MVOO), has garnered significant attention due to its potential health benefits attributed to a rich composition of bioactive compounds. This study aimed to assess the composition of bioactive compounds and the antioxidant activity of monovarietal virgin olive oil (MVOO). Specifically, the objective was to investigate the protective effects of MVOO in alleviating the adverse effects induced by titanium dioxide nanoparticles (NPTiO2). Bioactive compounds in MVOO were analyzed using UV–visible spectrophotometry, along with High-Performance Liquid Chromatography with a Photodiode Array (HPLC–PDA) for a comprehensive assessment. Antioxidant activity in vitro was evaluated through 2,2-diphenyl-1-picrylhydrazyl (DDPH) assays and on rats in vivo. A total of twenty-four male Wistar albino rats were randomly divided into four groups: one served as the control (Control), and the three remaining groups were injected with NPTiO2. Among the NPTiO2-injected groups, one received no treatment (NPTiO2), while the other two (NPTiO2 + MVOO1 and NPTiO2 + MVOO2) were treated with different doses of MVOO (2 g/kg bw and 6 g/kg bw). Commencing 24 h after NPTiO2 injection, the treatment with MVOO began, and body weight was consistently recorded. After 6 weeks of dietary manipulation, the fasting animals were sacrificed, and evaluations of hematological parameters, biochemical parameters, and oxidative stress markers in the liver and kidney were conducted. Histological examinations were performed to confirm protective effects. The analysis revealed significant levels of bioactive compounds in MVOO, with a remarkable DDPH antioxidant activity of 87.70%. Additionally, HPLC–PDA revealed the presence of quercetin and cinnamic acid. NPTiO2 induced oxidative stress, evidenced by increased biochemical parameters and elevated malondialdehyde levels in the liver and kidney (by + 91.30% and + 89.47%, respectively). Furthermore, there was a notable decrease in both hepatic and renal glutathione concentrations (-42% and -60%, respectively) and a reduction in antioxidant enzyme activities (GPx: -54.64% and -85.31%, GST: -77.70% and -74.33%, CAT: -87.21% and -73.11% for hepatic and renal, respectively), compared to the control group. Hematological profiles showed a decline in red blood cells and hemoglobin (-32.02%). Treatment with MVOO exhibited a protective effect by effectively mitigating biochemical parameters and enhancing antioxidant enzyme activities in the NPTiO2 + MVOO1 and NPTiO2 + MVOO2 groups, compared to the NPTiO2 group. Histological findings confirmed the protective effects of MVOO on liver and kidney damage caused by NPTiO2. MVOO demonstrated a potent protective effect against NPTiO2-induced oxidative stress, attributed to its richness in bioactive compounds. [ABSTRACT FROM AUTHOR]

Purpose of the Review: Our review explores the epidemiology, physiology, and clinical data surrounding the connection between hyperuricemia and metabolic syndrome, chronic kidney disease, and hypertension. Recent Findings: Compelling physiologic mechanisms have been proposed to explain a causal relationship between hyperuricemia and metabolic syndrome, chronic kidney disease, and hypertension but clinical studies have given mixed results in terms of whether intervening with hyperuricemia using urate-lowering therapy has any beneficial effects for patients with these conditions. Summary: Despite the large amount of research already put into this topic, more randomized placebo-controlled trials are needed to more firmly establish whether a cause-effect relationship exists and whether lowering uric acid levels in patients with these conditions is beneficial. [ABSTRACT FROM AUTHOR]

Laparoscopic sleeve gastrectomy with omentopexy (O-LSG) has been compared to laparoscopic sleeve gastrectomy with no-omentopexy (NO-LSG) in terms of postoperative outcomes and one-year anthropometric results. This systematic review with meta-analysis aimed to compare the utility of omentopexy in sleeve gastrectomy. We performed a systematic review with meta-analysis according to PRISMA 2020 and AMSTAR 2 guidelines. We included studies that systematically searched electronic databases and compared the O-LSG with the NO-LSG conducted through 1st March 2023. The bibliographic research yielded 13 eligible studies. These studies included 5514 patients. The O-LSG is associated with lower leakage (OR = 0.22; 95% CI [0.08, 0.55], p = 0.001), bleeding (OR = 0.33; 95% CI [0.19, 0.57], p < 0.0001), vomiting (OR = 0.50; 95% CI [0.28, 0.89], p = 0.02), twist (OR = 0.09; 95% CI [0.02, 0.39], p = 0.001), and shorter hospital stay (MD = − 0.33; 95% CI [− 0.61, − 0.05], p = 0.02) compared with NO-LSG. The O-LSG is associated with longer operative time (MD = 8.15; 95% CI [3.65, 12.64], p = 0.0004) than the NO-LSG. There were no differences between the two groups in terms of postoperative GERD (OR = 0.53; 95% CI [0.27, 1.02], p = 0.06), readmission (OR = 0.60; 95% CI [0.27, 1.37], p = 0.23), and one-year total weight loss (MD = 2.06; 95% CI [− 1.53, 5.65], p = 0.26). In the subgroup analysis including only RCTs, postoperative GERD was lower in the O-LSG (OR = 0.26; 95% CI [0.11, 0.63], p = 0.003). Our systematic review and meta-analysis concluded that omentopexy in sleeve gastrectomy is feasible and safe It reduced leakage, bleeding, and twist. It probably increased the operative time. It may reduce vomiting, GERD, and hospital stay. We don't know if it led to an additional readmission rate or one-year total weight loss. Registration The protocol was registered in PROSPERO with the ID CRD42022336790. [ABSTRACT FROM AUTHOR]

The autonomous ground vehicle's successful navigation with a high level of performance is dependent on accurate state estimation, which may help in providing excellent decision-making, planning, and control tasks. Outside factors like air bias and multipath effects have an impact on the GPS data, obtaining accurate pose estimation remains challenging. To obtain a highly precise pose estimation, the authors propose using an end-to-end simultaneous localization and mapping architecture based on scan matching and an extended Kalman filter to perform a successful prediction using lidar, GNSS and IMU data sensor fusion. In terms of pose estimation efficiency, the obtained results from EKF are compared to the UKF filter in different sequences on the Kitti dataset to more thoroughly evaluate our designed approach. The EKF filter has a good improvement, with approximately 0.29, 0.31, 0.24, 0.34, and 0.27 of the mean RMSE error of the trajectories 09_30_drive_0018, 09_30_drive_0020, 09_30_drive_0027, 10_03_drive_0033, and 10_03_drive_0034, respectively. The proposed approach was evaluated not only on KITTI dataset but also using our data recording platform called KONA Platform. [ABSTRACT FROM AUTHOR]

The fouling phenomenon grabbed global attention and caused huge economic losses specifically in marine-related industries. Sessile behavior exposed the sponge to the risk of fouling. However, their bodies remained free from foulers, which were attributed to the chemical defense system. The objectives of this study were to determine the antibiofilm activity of the marine sponge, Stylissa carteri, and to characterize the isolated compound involved. The antibiofilm activity of S. carteri methanolic crude extract (MCE) and fractions was tested against biofilm-producing bacteria, Pseudomonas aeruginosa, using two different modes of crystal violet biofilm assays: preventive and detachment. Besides that, the disc-diffusion test was conducted to screen the antibacterial activity against gram-positive and gram-negative bacteria while a cytotoxicity assay was conducted on the HepG2 cell line. Bioassay-guided fractionation was carried out using vacuum liquid chromatography (VLC) and solid phase extraction using a C18 Sep-Pak Cartridge. The crystal compound was isolated and characterized through thin-layer chromatography (TLC), Fourier transform infrared (FTIR) spectroscopy, liquid chromatography-mass spectrometry (LCMS), and nuclear magnetic resonance (NMR) spectroscopy. The S. carteri MCE showed a promising result with a half-maximal inhibitory concentration (IC50) of 20.22 μg/mL in the preventive assay, while no IC50 was determined in the detachment assay since all inhibitions < 50%. The S. carteri MCE exhibited broad-spectrum antibacterial activity and displayed a non-cytotoxic effect. Fraction 4 from MCE of S. carteri (IC50 = 2.40 μg/mL) reduced the biofilm in the preventive assay at all concentrations and exhibited no antibacterial activity indicating the independence of antibiofilm from antibacterial properties. Based on the data obtained, an alkaloid named debromohymenialdisine (DBH) was identified from Fraction 4 of S. carteri MCE. In conclusion, S. carteri was able to reduce the establishment of the biofilm formed by P. aeruginosa and could serve as a prominent source of natural antifouling agents. [ABSTRACT FROM AUTHOR]

This study determined the prevalence and the associated factors with meeting the recommended amount of physical activity among type 2 diabetes mellitus (T2DM) patients receiving care in resource-limited settings of the West Bank of Palestine. Physical activity was assessed using the World Health Organization's Global Physical Activity Questionnaire. Associations were examined using multivariate logistic regression. Of the 302 patients included, 117 (38.7%) met the recommended amount of physical activity. Being younger than 58 years [aOR = 2.1 (95% CI 1.0–4.3], were employed [aOR = 2.3 (95% CI 1.1–4.9)], had high income [aOR = 3.9 (95% CI 1.3–11.9)], had thought that physical activity was crucial for T2DM patients [aOR = 32.7 (95% CI 3.9–275.5)], did not have comorbidities [aOR = 2.2 (95% CI 1.1–4.4)], had normal weight [aOR = 2.8 (95% CI 1.3–6.0)], and those who were overweight [aOR = 2.6 (95% CI 1.1–6.0)] were more likely to meet the recommended amount of physical activity compared to the patients who were 58 years or older, had low income, did not think that physical activity was crucial for T2DM patients, had comorbidities, and were obese, respectively. There is a need to increase physical activity among T2DM patients in resource limited settings. [ABSTRACT FROM AUTHOR]

Purpose: Impaired insulin sensitivity is central in the etiology of type 2 diabetes in people with obesity. The effectiveness of resistance training (RE) alone in improving insulin sensitivity in people with obesity is undetermined. This study aimed to determine the influence of obesity on insulin sensitivity responses to RE. Methods: Nineteen sedentary men were allocated to Lean (BMI 22.7 ± 2.5 kg m−2; n = 10) or Obese group (BMI 33.2 ± 3.2 kg m−2; n = 9). Participants were evaluated before and after a 10-week supervised progressive RE (3 sets of 10 repetition maximum (RM), 3 d/wk) for insulin sensitivity indexes using an oral glucose tolerance test, body composition using anthropometrics, and strength using 1RM. Results: Groups were matched at baseline for all variables except for body composition and absolute strength. Body fat was not changed in both groups. Matsuda insulin sensitivity index, hepatic insulin resistance, and insulin area under the curve improved by 64.3 ± 61.9 unit, − 58.2 ± 102.9 unit, 2.3 ± 4.1 unit, and − 721.6 ± 858.2 µU/ml, respectively, only in the Lean group. The increased 1RM% for leg press was greater in the Lean (49.5 ± 18.7%) than in the Obese (31.5 ± 13.9), but not different for bench press (18.0 ± 9.1% vs. 16.4 ± 6.0%, respectively). Conclusion: Sustained obesity precludes insulin sensitivity improvements and attenuates strength gains in response to progressive RE. Additional strategies such as caloric restriction might be necessary for RE to improve insulin sensitivity, particularly at high levels of obesity. [ABSTRACT FROM AUTHOR]

Background: Following marketing authorization in Japan, for almost all new drugs or new indications, postmarketing studies (PMS) are a regulatory requirement. These PMS focus on accrual of a defined number of cases with data being collected for a predetermined period after approval to confirm efficacy/effectiveness, safety, and quality in the Japanese population. In contrast to other regions where PMS are only required to address a specific scientific uncertainty, in Japan, PMS are often required regardless of any specific scientific uncertainty, and therefore, their scientific value is unclear. Objectives: To determine the contribution to the understanding of benefit/risk of PMS conducted by Pfizer in Japan over 2000–2020 for Pharmaceuticals and Medical Devices Agency (PMDA) reexamination. Methods: A retrospective analysis of all Pfizer Japan postmarketing studies (PMS) during 2000–2020 was performed. Available Pfizer clinical study reports (CSRs) and PMDA reexamination reports (RERs) were reviewed for key safety findings. The primary analysis was conducted on the subset of PMS that had both an English CSR and a discussion of that PMS in the relevant RER issued by the PMDA, which was subsequently translated into English by a professional translation vendor. Reexamination outcome is included in each RER and served to demonstrate the impact of the study of the benefit/risk profile of the drug. Results: A total of 79 PMS for 43 different drug products across therapy areas enrolled a total of 98,035 patients. The 79 PMS comprised 34 general drug use investigation (GDUI) studies and 45 special investigation (SI) studies. The primary analysis involved 37 PMS with a CSR and RER available in English (40,470 patients); all of which were observational in design. For 31 of 37 PMS, the RER concluded the overall adverse drug reaction (ADR) rate in the PMS was nominally lower than in the phase 3 program. Unlabeled ADRs were reported in 28 of 37 PMS; however, no new safety concerns requiring regulatory action arose from any PMS. The PMDA did not require additional risk minimization measures for any of the 43 drug products studied in any of the 79 PMS assessed. Japan PMS data were consistent with prior global data with no evidence of clinically meaningful differences in safety in Japanese patients. In all cases, the reexamination outcome was category 1 ("usefulness is confirmed"). Conclusions: The reexamination process did not result in regulatory changes for any of the examined drugs. The Japan new-drug application (J-NDA) review and approval process, including implementation of the initial Japan product label, assures acceptable benefit/risk at the time of approval such that mandatory GDUI or SI studies for all products should be reconsidered. In the case of genuine scientific uncertainty to the extent that the benefit/risk of the product is not clear, a PMS is warranted. [ABSTRACT FROM AUTHOR]

Inertial underdamped collisions preserve the memory of physical parameters that existed before the collision, leading to phenomena usually unseen in overdamped systems. Here we probe the less studied inertial chiral matter with spinners on an air table. We show here the emergence of high levels of spin for a minority of (+) handed spinners in the presence of a majority of (−) handed spinners (vice versa). This deep violation of equipartition occurs due to the inertial (memory preserving) nature of elastic collisions between underdamped translating and rotating objects. Underdamped spinners of the same spin sign annihilate their spins when they elastically collide, transferring their spin angular momentum into orbital angular momentum, while oppositely handed spinners tend to preserve their individual spin levels, leading to the pumping of minority spinners to high spin levels. Entropy production and the flow of entropy in this underdamped system are also counter-intuitive, showing dramatic oscillations in time. By studying inertial spinners on an air table with different ratios between counterclockwise and clockwise species, the authors found that underdamped chiral spinners display phenomena usually unseen in overdamped chiral spinners. These include higher energy pumped into the minority species and oscillatory entropy when one species dominates the other. [ABSTRACT FROM AUTHOR]

The increasing demand for renewable energy has increased in the last decade due to climate change resulting from conventional energy and solar cells become popular. The perfect absorption in solar cells can be achieved with artificially engineered materials at low cost for solar absorbers with high efficiency. A perfect ultra-broadband solar absorber can be achieved by using metamaterial (MM) based on surface plasmon resonance phenomena. We design a near-ideal ultra-broadband plasmonic MM absorber for solar energy harvesting over an ultra-broadband wavelength range (0.4–4 μ m ). The structure is made up of periodic taper arrays consisting of a thin, multilayered titanium nitride–titanium dioxide MM. The proposed structure has an absorption greater than 96% between the visible to infrared (IR) regime. It is independent of both polarization and incident angle. The large operational bandwidth, high absorption percentage, and compact thin structure combined with the strong thermal stability of metal TiN make an advantageous choice for solar thermophotovoltaics. [ABSTRACT FROM AUTHOR]

The proliferation of carbon dioxide (CO2) emissions has resulted in significant environmental challenges worldwide, particularly within industrialized nations. The present paper tries to investigate the role of food, beverages, and tobacco in mitigating CO2 emissions in the top industrial countries. Economic growth and renewable and non-renewable energy consumption are integrated as control variable in the empirical model. The study applied the pooled mean group-autoregressive distributed lag (PMG-ARDL) model proposed by (J Appl Econ, 16:289-326, 2001) and Granger causality test for causalities directions. The empirical outcomes suggest the presence of cross-sectional dependence, and variables are integrated of order one and cointegrated. Long-run estimates revealed the presence of inversed U curve proving the validity of the environmental Kuznets curve. Also, the results show that renewable energy (RE) consumption contribute in reducing emissions, while non-renewable energy (NRE) and food, beverages, and tobacco (FBT) led to increase emissions level in the long run. Granger shows bidirectional long-run relationship between CO2 emissions, non-renewable energy, and economic growth. Moreover, Granger recorded no causality between food, beverages, and tobacco and any other variable. We recommend that firms engaged in the production of food, beverages, and tobacco products are increasingly urged to make investments in clean technologies powered by renewable energy sources for their manufacturing processes. This is considered a necessary step to achieve a significant reduction in CO2 emissions over an extended period. [ABSTRACT FROM AUTHOR]

Coronary artery calcium (CAC) is a powerful tool to refine atherosclerotic cardiovascular disease (ASCVD) risk assessment. Despite its growing interest, contemporary public attitudes around CAC are not well-described in literature and have important implications for shared decision-making around cardiovascular prevention. We used an artificial intelligence (AI) pipeline consisting of a semi-supervised natural language processing model and unsupervised machine learning techniques to analyze 5,606 CAC-related discussions on Reddit. A total of 91 discussion topics were identified and were classified into 14 overarching thematic groups. These included the strong impact of CAC on therapeutic decision-making, ongoing non-evidence-based use of CAC testing, and the patient perceived downsides of CAC testing (e.g., radiation risk). Sentiment analysis also revealed that most discussions had a neutral (49.5%) or negative (48.4%) sentiment. The results of this study demonstrate the potential of an AI-based approach to analyze large, publicly available social media data to generate insights into public perceptions about CAC, which may help guide strategies to improve shared decision-making around ASCVD management and public health interventions. [ABSTRACT FROM AUTHOR]

Purpose: Elevated costs of cancer treatment can result in economic and psychological "financial toxicity" distress. This pilot study assessed the feasibility of a point-of-care intervention to connect adult patients with cancer-induced financial toxicity to telehealth-delivered financial counseling. Methods: We conducted a three-armed parallel randomized pilot study, allocating newly referred patients with cancer and financial toxicity to individual, group accredited telehealth financial counseling, or usual care with educational material (1:1:1). We assessed the feasibility of recruitment, randomization, retention, baseline and post-intervention COmprehensive Score for Financial Toxicity (COST), and Telehealth Usability Questionnaire (TUQ) scores. Results: Of 382 patients screened, 121 were eligible and enrolled. 58 (48%) completed the intervention (9 individual, 9 group counseling, 40 educational booklet). 29 completed follow-up surveys: 45% female, 17% African American, 79% white, 7% Hispanic, 55% 45–64 years old, 31% over 64, 34% lived in rural areas, 24% had cancer stage I, 21% II, 7% III, 31% IV. Baseline characteristics were balanced across arms, retention status, surveys completion. Mean (SD) COST was 12.4 (6.1) at baseline and 16.0 (8.4) post-intervention. Mean (SD) COST score differences were 6.3 (11.6) after individual counseling, 5.8 (8.5) after group counseling, and 2.5 (6.4) after usual care. Mean TUQ score among nine counseling participants was 5.5 (0.9) over 7.0. Non-parametric comparisons were not statistically meaningful. Conclusion: Recruitment and randomization were feasible, while study retention presented challenges. Nine participants reported good usability and satisfaction with telehealth counseling. Larger-scale trials focused on improving participation, retention, and impact of financial counseling among patients with cancer are justified. [ABSTRACT FROM AUTHOR]

Zinc plays an important role in the biosynthesis and storage of insulin. Consequently, its deficiency may have a deleterious impact on the progression of diabetes and its associated consequences. Thus, this study was conducted to investigate the effect of hawthorn Crataegus azarolus on blood biochemical parameters, tissue zinc status, and oxidative stress biomarkers in streptozotocin-induced diabetic rats fed a zinc-insufficient diet. Thirty-two male albino Wistar rats were divided into four groups: two groups were fed a zinc-sufficient diet (one non-diabetic and the other diabetic), while the other two groups of diabetic rats were fed a zinc-insufficient diet. One group was not treated, and the other was treated with an extract of Crataegus azarolus (150 mg/kg body weight). Body weight and food intake were regularly recorded. After 4 weeks of dietary manipulation, the fasting animals were sacrificed. Zinc-deficient feed decreased body weight, insulin, and tissue zinc levels (in the femur, liver, kidney, and pancreas), as well as glutathione concentrations, lactic dehydrogenase, catalase, superoxide dismutase, glutathione peroxidase, and glutathione reductase activities. It was also noted that inadequate dietary zinc intake increased concentrations of glucose, cholesterol, triglycerides, urea, uric acid, creatinine, lipid peroxidation levels, and transaminase activities. However, oral administration of hawthorn extract was observed to improve all of the previously mentioned parameters, bringing them approximately back to their normal levels. The present study showed that Crataegus azarolus supplementation, presumably acting as an antioxidant, can be a natural source for reducing the development of diabetes caused by zinc deficiency. [ABSTRACT FROM AUTHOR]

Background: To potentially improve impaired vasomotion of patients with multiple organ dysfunction syndrome (MODS), we tested whether an electromagnetic field of low flux density coupled with a biorhythmically defined impulse configuration (Physical Vascular Therapy BEMER®, PVT), in addition to standard care, is safe and feasible and might improve disturbed microcirculatory blood flow and thereby improve global haemodynamics. Methods: In a prospective, monocentric, one-arm pilot study, 10 MODS patients (APACHE II score 20–35) were included. Patients were treated, in addition to standard care, for 4 days with PVT (3 treatment periods of 8 min each day; day 1: field intensity 10.5 μT; day 2:14 μT, day 3:17.5 μT; day 4:21.0 μT). Primary endpoint was the effect of PVT on sublingual microcirculatory perfusion, documented by microvascular flow index (MFI). Patient safety, adverse events, and outcomes were documented. Results: An increase in MFI by approximately 25% paralleled 4-day PVT, with the increase starting immediately after the first PVT and lasting over the total 4-day treatment period. Concerning global haemodynamics (secondary endpoints), halving vasopressor use within 24 h, and haemodynamic stabilisation paralleled 4-day PVT with an increase in cardiac index, stroke volume index, and cardiac power index by 30%–50%. No adverse events (AEs) or serious adverse events (SAEs) were classified as causally related to the medical product (PVT) or study. Three patients died within 28 days and one patient between 28 and 180 days. Conclusion: PVT treatment was feasible and safe and could be performed without obstruction of standard patient care. An increase in microcirculatory blood flow, a rapid reduction in vasopressor use, and an improvement in global haemodynamics paralleled PVT treatment. Findings of this pilot study allowed forming a concept for a randomized trial for further proof. [ABSTRACT FROM AUTHOR]

Clustering divides a set of objects into several classes, where each class is composed of similar objects. Traditional centralized clustering algorithms target those objects located on the same site since they cannot perform on distributed objects. Distributed clustering algorithms, however, can fulfil this gap. They extract a classification model from the distributed objects even when they are in different sites and locations. With the trend of storing data in different locations and sites, and with the vast amount of data propagating throughout the web, it seems it will be one of the prevailing fields. Even though much research and work have been done on this topic, it is still considered in its infantry because of the challenges that are still popping up, such as bandwidth limitation, transferring data to a single site, and many others. In this work, we present DG-means, a greedy algorithm that performs on distributed data sets. Three datasets—the wholesale dataset, banknotes dataset, and Iris dataset, are used to compare multiple distributed clustering algorithms on different metrics: runtime execution, stability, and accuracy. DG-means exhibited superior performance when compared to the other algorithms. [ABSTRACT FROM AUTHOR]

Background: Despite modern imaging modalities, lymph-node staging before radical prostatectomy (RP) remains challenging in patients with prostate cancer (PCa). The visibility of lymph-node metastases (LNMs) is critically influenced by their size. Objective: This study aims to describe the distribution of maximal tumor diameters (i.e., size) in LNMs of pN1-PCa at RP and its consequences on visibility in preoperative imaging and oncological outcomes. Design, setting, and participants: A total of 2705 consecutive patients with pN1-PCa at RP, harboring a cumulative 7510 LNMs, were analyzed. Descriptive and multivariable analyses addressed the risk of micrometastases (MM)-only disease and the visibility of LNMs. Kaplan–Meier curves and Cox analyses were used for biochemical recurrence-free survival (BCRFS) stratified for MM-only disease. Results: The median LNM size was 4.5mm (interquartile range (IQR): 2.0–9.0 mm). Of 7510 LNMs, 1966 (26%) were MM (≤ 2mm). On preoperative imaging, 526 patients (19%) showed suspicious findings (PSMA-PET/CT: 169/344, 49%). In multivariable analysis, prostate-specific antigen (PSA) (OR 0.98), age (OR 1.01), a Gleason score greater than 7 at biopsy (OR 0.73), percentage of positive cores at biopsy (OR 0.36), and neoadjuvant treatment (OR 0.51) emerged as independent predictors for less MM-only disease (p < 0.05). Patients with MM-only disease compared to those harboring larger LNMs had a longer BCRFS (median 60 versus 29 months, p < 0.0001). Conclusion: Overall, 26% of LNMs were MM (≤ 2mm). Adverse clinical parameters were inversely associated with MM at RP. Consequently, PSMA-PET/CT did not detect a substantial proportion of LNMs. LNM size and count are relevant for prognosis. [ABSTRACT FROM AUTHOR]

This study assessed aluminum concentrations in breast milk samples obtained from breastfeeding women in resource-limited countries, estimated daily intake of aluminum by breastfed infants, and identified predictors of higher breast milk aluminum concentrations. A descriptive analytical approach was used in this multicenter study. Breastfeeding women were recruited from different maternity health clinics in Palestine. Aluminum concentrations in 246 breast milk samples were determined using an inductively coupled plasma-mass spectrometric method. The mean breast milk aluminum concentration was 2.1 ± 1.5 mg/L. The mean estimated daily intake of aluminum by infants was 0.37 ± 0.26 mg/kg body weight/day. Multiple linear regression showed that breast milk aluminum concentrations were predicted by living in urban areas, closer to industrial areas, waste disposals, frequent use of deodorants, and less frequent use of vitamins. Breast milk aluminum levels among Palestinian breastfeeding women were comparable to those previously determined in occupationally unexposed women. [ABSTRACT FROM AUTHOR]

In this research, structural, electronic and optical properties of ANBN quantum dots (QD) with N = 2,3,4 in the absence and presence of Cu impurity atom have been investigated based on density functional theory and using Siesta computational code. Local density approximation (LDA) is used for exchange–correlation functional. The band structure shows that ANBN QD structures have a semiconductor behavior. By adding Cu atom, a cross band with the Fermi level can be seen in the band structure, therefore, ANBN QD structures show semi-metallic behavior in the presence of Cu atom. The study of the optical properties of ANBN quantum dots and the calculation of their dielectric function, absorption coefficients and refractive index have been realized. Examining the optical results confirms that the transition threshold energy of quantum dots corresponds to their band gap value. [ABSTRACT FROM AUTHOR]