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Tacrolimus is an immunosuppressant that is frequently used following renal transplantation. Several mild neurological side effects of tacrolimus have been reported in the literature; however, severe complications in the form of confusion, seizures, and coma are rare. Herein, we report a 16-year-old boy on tacrolimus following living-donor kidney transplant, who presented with subacute onset of hand tremors, headache, altered mental status, and progressed to akinetic mute state. He was diagnosed with tacrolimus-induced leukoencephalopathy based on findings of his magnetic resonance imaging and ruling out other possible causes. He showed clinical and radiological improvement after discontinuation of tacrolimus. Radiological features of tacrolimus-induced leukoencephalopathy are more heterogenous than commonly perceived and should be suspected in such patients. The potential neurotoxicity of tacrolimus should be recognized in patients with renal transplantation, and switching to a different immunosuppressant is warranted to prevent permanent neurological damage.

Misbahuddin Khaja,1 Darryl Adler,2 George Lominadze2 1Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, 2Division of Critical Care Medicine, New York Presbyterian‑Lawrence Hospital Center, Affiliated with Columbia University College of Physician and Surgeons, Bronx, New York, NY, USA Background: Brain abscess is an uncommon but life-threatening infection. It involves a focal, intracerebral infection that begins in a localized area of cerebritis and develops into a collection of pus, surrounded by a well-vascularized capsule. Brain abscess still poses a significant problem in developing countries but rarely in developed countries. Predisposing factors vary in different parts of the world. With the introduction of antibiotics and imaging studies, the mortality rate has decreased between 5% and 15%. If left untreated it may lead to serious neurologic sequelae. The temporal lobe abscess can be caused by conditions like sinusitis, otitis media, dental infections, and mastoiditis if left untreated or partially treated. Additionally, in neurosurgical procedures like craniotomy, the external ventricular drain can get infected, leading to abscess formation. Case presentation: We present the case study of an elderly female patient who presented with expressive aphasia caused by brain abscess, secondary to Streptococcus intermedius infection. The 72-year-old female with a medical history of hypertension came to hospital for evaluation with word-finding difficulty, an expressive aphasia that began a few days prior to presentation. Computed tomography of the head showed a left temporal lobe mass-like lesion, with surrounding vasogenic edema. The patient was empirically started on courses of antibiotics. The next day, she was subjected to magnetic resonance imaging of the brain, which showed a left temporal lobe septated rim-enhancing mass lesion, with bright restricted diffusion and diffuse surrounding vasogenic edema consistent with abscess. The patient was also seen by the neurosurgery department and underwent stereotactic, left temporal craniotomy, with drainage, and resection of abscess. Tissue culture grew S. intermedius sensitive to ampicillin sulbactam. Subsequently her expressive aphasia improved. Conclusion: Brain abscess has a high mortality, however a significant proportion of patients with appropriately treated abscess recover completely and can survive without significant neurologic damage. Advanced imaging modalities may yield more accurate methods of differentiation of mass lesions in the brain. Biopsy of brain lesion with early initiation of appropriate antibiotics will change the outcome. Keywords: expressive aphasia, Streptococcus intermedius, brain abscess

Designing a rapid, reliable and sensitive assay, for detection of hepatitis B virus and Hepatitis C virus variants by real-time PCR, is challenging at best. A recent approach for quantifying the viral load using the sensitive fluorescence principle, was used in this study. A total of 350 samples were collected from outpatient unit, Center for Liver Research and Diagnostics (CLRD). Complete Human HBV DNA and HCV sequences were obtained from the National Centre for Biotechnology Information (NCBI); primers and probes were designed and synthesized from core, surface and x region of Hepatitis B and UTR region of HCV. Real-time based detection was done, using standard kit and in-house generated standards and RT-PCR protocols. A standard curve was generated by using the Smart Cycler II software and serial dilution 102 to 108 of cloned viral regions, the calibration curve was linear in a range from 102 to108 cp/ml for both HBV and HCV, with R2 value of 0.999 and 0.995. Out of 100 predetermined HCV negative samples, 02 samples were found positive with in-house developed RT-PCR assay, the positivity of this sample was confirmed by sequencing the amplified product. Low cost of this assay procedure and précised sample volume will permit the assay to be implemented for routine screening of Hepatitis B and C virus mono-infection and co-infection using Real Time PCR , Nucleic acid Chip technology and Fluorescent End Point detection systems. This assay is reproducible showing limited inter and intra assay variability. Our results correlated well with the standard kit for HBV and HCV virus monitor.

Because of its excellent mechanical qualities and weldability, titanium alloy is used in many different biomedical applications. Wire electrical discharge machining may be used to machine materials with such greater strengths and intricate forms. Using Taguchi-Data Envelopment Analysis-based Ranking (DEAR) approach and zinc-diffused coated brass wire electrode to improve Titanium alloy machining was the goal of this research project. The quality metrics that were taken into consideration were sur-face roughness, kerf width, and material removal rate. Among the selected factors, with an error of 2.7%, the optimal configuration of input factors was determined to be 130 µs (Ton), 40 µs (Toff), 50 V (SV), 6 A (IP), and 8 Kg (WT). Due to its relevance in the process of deionization, the Ton is the high-est influential parameter for creating quality measurements.

Small ruminants and camels are important livestock species in the United Arab Emirates (UAE), although Brucella infection can limit their productivity. This study aimed to investigate the seroprevalence of Brucella infection and its associated risk factors in small ruminants and camels in the Emirate of Abu Dhabi. Additionally, seropositive animals were tested for the DNA of Brucella. Multispecies competitive enzyme-linked immunosorbent assay (c-ELISA) and multispecies indirect (i-ELISA) were used to test 3,086 animals from 2022 to 2023. Brucella cell surface 31 kDa protein (bcsp31) gene-based real-time polymerase chain reaction (q-PCR) was used to detect Brucella DNA. Multivariate logistic regression was used to assess the association between seroprevalence and potential risk factors. The overall seroprevalences of Brucella infection were 1.7% (95% confidence interval [CI], 1.2%–2.2%) and 5.8% (95% CI, 5.0%–6.7%) based on serial and parallel testing, respectively. The DNA of Brucella was detected in 13 of the 51 seropositive animals. The overall seroprevalence of Brucella infection was associated with the region, type of animal holding, species, and age of the animals. In conclusion, this study documented Brucella infection in small ruminants and camels in the Emirate of Abu Dhabi, warranting necessary intervention strategies to eliminate Brucella infections in livestock populations.

The Haber–Bosch process is a cornerstone in the field of ammonia production and represents a decisive advance in industrial chemistry. This method, developed in the early 20th century, revolutionizes agriculture and enables the mass production of fertilizers. As the world strives for sustainable energy and environmental protection, alternative methods such as the photo/photoelectrocatalytic nitrogen reduction reaction (NRR) are gaining momentum. By using sunlight, electricity, or a combination of both, these approaches promise sustainable ammonia production with renewable energy sources and innovative materials. Researchers are trying to understand the underlying principles, mechanisms, and advances of these methods to overcome the challenges and optimize their effectiveness. This research is a step toward sustainable energy and agriculture, and offers a greener and more efficient way forward. This review looks at advances in sustainable ammonia production, particularly through photo‐ and photoelectrocatalytic NRRs. It examines the hurdles in implementing these methods and provides an overview of the fundamentals of nitrogen fixation and a comparison of current mechanisms. In addition, thermodynamic, theoretical, and computational studies of these processes are summarized. Various photocatalysts and photoelectrocatalysts used for ammonia production are also presented.

Our recent studies revealed the role of mouse Aprataxin PNK-like Factor (APLF) in development. Nevertheless, the comprehensive characterization of mouse APLF remains entirely unexplored. Based on domain deletion studies, here we report that mouse APLF's Acidic Domain and Fork Head Associated (FHA) domain can chaperone histones and repair DNA like the respective human orthologs. Immunofluorescence studies in mouse embryonic stem cells showed APLF co-localized with γ-tubulin within and around the centrosomes and govern the number and integrity of centrosomes via PLK4 phosphorylation. Enzymatic analysis established mouse APLF as a kinase. Docking studies identified three putative ATP binding sites within the FHA domain. Site-directed mutagenesis showed that R37 residue within the FHA domain is indispensable for the kinase activity of APLF thereby regulating the centrosome number. These findings might assist us comprehend APLF in different pathological and developmental conditions and reveal non-canonical kinase activity of proteins harbouring FHA domains that might impact multiple cellular processes.

Background and Aim: Ostrich (Struthio camelus) farming in the United Arab Emirates (UAE) is a relatively new field of farming. Farmed ostriches are susceptible to ectoparasite infestation, which affects their production. This study was conducted to estimate the prevalence of ectoparasites on ostriches raised on a farm in Abu Dhabi Emirate. Materials and Methods: The feathers of 42 ostriches (26 females and 16 males) were collected and morphologically examined for ectoparasites. In total, 283 lice (89 males and 194 females) were collected from birds. However, there were no ticks or other ectoparasites. Lice were preserved in 1.5 mL tubes containing 70% ethanol and were later identified using taxonomic keys. The prevalence, mean intensity of infection, and mean abundance were estimated. Results: One louse species, Struthiolipeurus struthionis was identified. To the best of our knowledge, this is the first report of S. struthionis in ostriches raised in the UAE with an overall prevalence of 88%. The prevalence of lice was significantly higher in July (100%) than that in May (66.7%). Likewise, the mean intensity and abundance of lice were significantly higher in June (10.6 and 9.94, respectively) than in May (3.25 and 2.2, respectively). Conclusion: The high prevalence of lice poses a serious risk to ostrich farming by negatively affecting the health and productivity of ostriches.

Background: The United Arab Emirates (UAE) has witnessed rapid urbanization and a surge in pet ownership, sparking concerns about the possible transfer of antimicrobial resistance (AMR) from pets to humans and the environment. This study delves into the whole-genome sequencing analysis of ESBL-producing E. coli strains from healthy cats and dogs in the UAE, which exhibit multidrug resistance (MDR). Additionally, it provides a genomic exploration of the mobile colistin resistance gene mcr-1.1, marking the first instance of its detection in Middle Eastern pets. Methods: We investigate 17 ESBL-producing E. coli strains from healthy UAE pets using WGS and bioinformatics analysis to identify genes encoding virulence factors, assign diverse typing schemes to the isolates, and scrutinize the presence of AMR genes. Furthermore, we characterized plasmid contigs housing the mcr-1.1 gene and conducted phylogenomic analysis to evaluate their relatedness to previously identified UAE isolates. Results: Our study unveiled a variety of virulence factor-encoding genes within the isolates, with fimH emerging as the most prevalent. Regarding β-lactamase resistance genes, the blaCTX group 1 gene family predominated, with CTX-M-15 found in 52.9% (9/17) of the isolates, followed by CTX-M-55 in 29.4% (5/17). These isolates were categorized into multiple sequence types (STs), with the epidemic ST131 being the most frequent. The presence of the mcr-1.1 gene, linked to colistin resistance, was confirmed in two isolates. These isolates belonged to ST1011 and displayed distinct profiles of β-lactamase resistance genes. Phylogenomic analysis revealed close connections between the isolates and those from chicken meat in the UAE. Conclusion: Our study underscores the presence of MDR ESBL-producing E. coli in UAE pets. The identification of mcr-1.1-carrying isolates warrants the urgency of comprehensive AMR surveillance and highlights the role of companion animals in AMR epidemiology. These findings underscore the significance of adopting a One Health approach to mitigate AMR transmission risks effectively.

Objective: The objectives of this research are twofold. The primary goal is to introduce, investigate, and contrast consolidative multi-criteria decision-making (C-MCDM) approaches. The second objective is the investigation of five alternative additive manufacturing materials. Methods: It integrates the subjective and objective weights using the Bayes hypothesis in conjunction with a normal method. Chang's Extent Analysis Method under fuzzy logic is used to estimate subjective weights and the CRITIC approach is used for assessing objective weights. Ranking techniques, including the simple ranking process (SRP), multi-objective optimization based on ratio analysis (MOORA), measurement alternatives and ranking according to compromise solution (MARCOS), and technique for order preference by similarity to ideal solution (TOPSIS) are applied. It also encompasses sensitivity analysis based on Kendall's coefficient of concordance and rank reversal phenomenon analysis. Spearman's rank correlation coefficient, a weighted rank measure of correlation, and rank similarity coefficient are among the metrics used to evaluate agreement between different approaches. It entails gathering expert opinions regarding the importance of various criteria as well as conducting extensive experiments. Results: The findings of the study indicate that polylactic acid is the best material to use for orthoses. When compared to the other MCDM approaches being discussed, SRP is the most reliable approach. It is also demonstrated that the SRP, MARCOS, and TOPSIS methods are rank reversal-free. Furthermore, SRP exhibits a very poor association with the TOPSIS technique but a strong correlation with the MOORA and MARCOS approaches. Conclusions: To ensure results reliability, it is necessary to consider both the subjectivity and objectivity of weights as well as apply multiple MCDM methodologies in addition to sensitivity analysis.

Background & Aims: The mechanism behind the progressive pathological alteration in metabolic dysfunction-associated steatotic liver disease/steatohepatitis (MASLD/MASH)-associated hepatocellular carcinoma (HCC) is poorly understood. In the present study, we investigated the role of the polyol pathway enzyme AKR1B1 in metabolic switching associated with MASLD/MASH and in the progression of HCC. Methods: AKR1B1 expression was estimated in the tissue and plasma of patients with MASLD/MASH, HCC, and HCC with diabetes mellitus. The role of AKR1B1 in metabolic switching in vitro was assessed through media conditioning, lentiviral transfection, and pharmacological probes. A proteomic and metabolomic approach was applied for the in-depth investigation of metabolic pathways. Preclinically, mice were subjected to a high-fructose diet and diethylnitrosamine to investigate the role of AKR1B1 in the hyperglycemia-mediated metabolic switching characteristic of MASLD-HCC. Results: A significant increase in the expression of AKR1B1 was observed in tissue and plasma samples from patients with MASLD/MASH, HCC, and HCC with diabetes mellitus compared to normal samples. Mechanistically, in vitro assays revealed that AKR1B1 modulates the Warburg effect, mitochondrial dynamics, the tricarboxylic acid cycle, and lipogenesis to promote hyperglycemia-mediated MASLD and cancer progression. A pathological increase in the expression of AKR1B1 was observed in experimental MASLD-HCC, and expression was positively correlated with high blood glucose levels. High-fructose diet + diethylnitrosamine-treated animals also exhibited statistically significant elevation of metabolic markers and carcinogenesis markers. AKR1B1 inhibition with epalrestat or NARI-29 inhibited cellular metabolism in in vitro and in vivo models. Conclusions: Pathological AKR1B1 modulates hepatic metabolism to promote MASLD-associated hepatocarcinogenesis. Aldose reductase inhibition modulates the glycolytic pathway to prevent precancerous hepatocyte formation. Impact and implications: This research work highlights AKR1B1 as a druggable target in metabolic dysfunction-associated steatotic liver disease (MASLD) and hepatocellular carcinoma (HCC), which could provide the basis for the development of new chemotherapeutic agents. Moreover, our results indicate the potential of plasma AKR1B1 levels as a prognostic marker and diagnostic test for MASLD and associated HCC. Additionally, a major observation in this study was that AKR1B1 is associated with the promotion of the Warburg effect in HCC.

Foreign body in gastrointestinal tract is a common problem in small animal practice, especially in domestic cats. A case report of recurrent ingested thread as a linear foreign body with the thread held back by the tongue and stuck causing further complications is presented in this case report. Interestingly, the radiographic results did not indicate the paisley shaped gas pattern which is characteristic of a linear foreign body. The final diagnosis was made by exploratory laparotomy which confirmed the presence of several threads in the small intestine. Therefore, this complex case was diagnosed based on history, clinical signs and results of radiography and confirmed by exploratory laparotomy. This is the first ever published case report of successful clinical management of a linear foreign body in UAE according to the authors’ knowledge.

Three-dimensional printing—especially with fused deposition modeling (FDM)—is widely used in the medical field as it enables customization. FDM is versatile owing to the availability of various materials, but selecting the appropriate material for a certain application can be challenging. Understanding materials’ mechanical behaviors, particularly those of polymeric materials, is vital to determining their suitability for a given application. Physical testing with universal testing machines is the most used method for determining the mechanical behaviors of polymers. This method is resource-intensive and requires cylinders for compression testing and unique dumbbell-shaped specimens for tensile testing. Thus, a specialized fixture must be designed to conduct mechanical testing for the customized orthosis, which is costly and time-consuming. Finite element (FE) analysis using an appropriate material model must be performed to identify the mechanical behaviors of a customized shape (e.g., an orthosis). This study analyzed three material models, namely the Bergström–Boyce (BB), three-network (TN), and three-network viscoplastic (TNV) models, to determine the mechanical behaviors of polymer materials for personalized upper limb orthoses and examined three polymer materials: PLA, ABS, and PETG. The models were first calibrated for each material using experimental data. Once the models were calibrated and found to fit the data appropriately, they were employed to examine the customized orthosis’s mechanical behaviors through FE analysis. This approach is innovative in that it predicts the mechanical characteristics of a personalized orthosis by combining theoretical and experimental investigations.

Seasonal "common-cold" human coronaviruses are widely spread throughout the world and are mainly associated with mild upper respiratory tract infections. The emergence of highly pathogenic coronaviruses MERS-CoV, SARS-CoV, and most recently SARS-CoV-2 has prompted increased attention to coronavirus biology and immunopathology, but the T-cell response to seasonal coronaviruses remains largely uncharacterized. Here we report the repertoire of viral peptides that are naturally processed and presented upon infection of a model cell line with seasonal coronavirus OC43. We identified MHC-bound peptides derived from each of the viral structural proteins (spike, nucleoprotein, hemagglutinin-esterase, membrane, and envelope) as well as non-structural proteins nsp3, nsp5, nsp6, and nsp12. Eighty MHC-II bound peptides corresponding to 14 distinct OC43-derived epitopes were identified, including many at very high abundance within the overall MHC-II peptidome. Fewer and less abundant MHC-I bound OC43-derived peptides were observed, possibly due to MHC-I downregulation induced by OC43 infection. The MHC-II peptides elicited low-abundance recall T-cell responses in most donors tested. In vitro assays confirmed that the peptides were recognized by CD4+ T cells and identified the presenting HLA alleles. T-cell responses cross-reactive between OC43, SARS-CoV-2, and the other seasonal coronaviruses were confirmed in samples of peripheral blood and peptide-expanded T-cell lines. Among the validated epitopes, spike protein S903-917 presented by DPA1*01:03/DPB1*04:01 and S1085-1099 presented by DRB1*15:01 shared substantial homology to other human coronaviruses, including SARS-CoV-2, and were targeted by cross-reactive CD4 T cells. Nucleoprotein N54-68 and hemagglutinin-esterase HE128-142 presented by DRB1*15:01 and HE259-273 presented by DPA1*01:03/DPB1*04:01 are immunodominant epitopes with low coronavirus homology that are not cross-reactive with SARS-CoV-2. Overall, the set of naturally processed and presented OC43 epitopes comprise both OC43-specific and human coronavirus cross-reactive epitopes, which can be used to follow CD4 T-cell cross-reactivity after infection or vaccination, and to guide selection of epitopes for inclusion in pan-coronavirus vaccines.

Knee orthoses assist patients with impaired gait through the amendment of knee abnormalities, restoration of mobility, alleviation of pain, shielding, and immobilization. The inevitable issues with laborious traditional plaster molding procedures for orthoses can be resolved with 3D printing. However, a number of challenges have limited the adoption of 3D printing, the most significant of which is the proper material selection for orthoses. This is so because the material used to make an orthosis affects its strength, adaptability, longevity, weight, moisture response, etc. This study intends to examine the mechanical, physical, and dimensional characteristics of three-dimensional (3D) printing materials (PLA, ABS, PETG, TPU, and PP). The aim of this investigation is to gain knowledge about these materials’ potential for usage as knee orthosis materials. Tensile testing, Olympus microscope imaging, water absorption studies, and coordinate measuring machine-based dimension analysis are used to characterize the various 3D printing materials. Based on the investigation, PLA outperforms all other materials in terms of yield strength (25.98 MPa), tensile strength (30.89 MPa), and shrinkage (0.46%). PP is the least water absorbent (0.15%) and most flexible (407.99%); however, it is the most difficult to fabricate using 3D printing. When producing knee orthoses with 3D printing, PLA can be used for the orthosis frame and other structural elements, PLA or ABS for moving parts like hinges, PP for padding, and TPU or PP for the straps. This study provides useful information for scientists and medical professionals who are intrigued about various polymer materials for 3D printing and their effective utilization to fabricate knee orthoses.

Parasacral ischial plane block is a novel fascial plane approach to sacral plexus. Parasacral ischial plane block is technically less challenging and obviates the need for direct visualisation of sacral plexus. It can reliably be performed in limb-amputated patients where neuromuscular stimulation is less useful. Ten patients of the American Society of Anesthesiologists physical status II-IV, aged between 18 and 70 years, posted for elective lower limb debridement surgeries were enroled in this prospective case series. The time taken to perform the block was ≤4 minutes in all cases. Time taken for full sensory loss was 9 minutes to 15 minutes. None of the patients developed a complete motor blockade till 30 minutes after our observation. None of the patients required intraoperative supplemental analgesia. This block is technically easy, less time-consuming, and provided adequate sensory analgesia in below-knee surgeries.

The UAE's environment is characterized by low rainfall, high temperatures, poor soil and lack of natural waterways. The country has been making tremendous efforts to build a sustainable agricultural and animal wealth sector that is better able to contribute to its national agenda of food security. Commercial cattle farming in such challenging conditions would require an effective disease prediction and warning system for optimizing the production dynamics. Therefore, we are proposing the use of smart livestock system comprising of orally ingested bio-capsules for monitoring the livestock health, connected through a customized long-range network (430 MHz) in the United Arab Emirates, which monitors the real time animal body condition data (temperature and body activity) using a mobile or web-based application. The study demonstrated a 100% success rate in estrus alarms in the test animals, 61.29% for calving alerts and an accurate disease prediction warning in all the animals diagnosed unhealthy. the conception rate in these estrus diagnosed animals with artificial insemination was 61.53%, which was significantly higher than the conception rate in the absence of this detection technology at the farm. The capsule was well tolerated in all the test animals and did not show any acute adverse or allergic reactions. This is the first of its kind of study using these advanced bio-capsules and development of the customized long-range network in the United Arab Emirates for smart livestock healthcare management.

BackgroundCommercial dairy establishments are relatively young in the United Arab Emirates (UAE), and as a result, there is lack of epidemiological data on mastitis in dairy farms.MethodsA retrospective data of seven years (2015–2021) were used to estimate the cumulative average monthly incidence rate of bovine clinical mastitis and evaluate associated milk loss at the National Dairy Farm. Data were extracted from the records of lactating dairy cows (n = 1300–1450) and analyzed using repeated measure and one-way ANOVA, non-parametric Spearman correlation, paired and unpaired t tests.ResultsThe highest average cumulative monthly incidence rate was 49 cases per 1000 cows-year that was recorded in 2019 while the lowest was 19 cases per 1000 cows-year in 2021. The cumulative average monthly incidence rate of clinical mastitis significantly (p < 0.001) varied among the seven years. The cumulative average monthly incidence rate was associated with average monthly humidity (p < 0.01) and average monthly rainfall (p < 0.05); however, it was not associated with the average monthly temperature (p > 0.05). The average daily milk yield of cows with clinical mastitis (Mean ± SEM; 18.6 ± 0.54 kg) was significantly (p < 0.001) lower than the average daily milk yield of clinical mastitis free cows (40.5 ± 0.29 kg). The largest average monthly milk loss due to clinical mastitis was 5% of the average total monthly milk production in 2019 while the lowest was 2% of the average total monthly milk production in 2021.ConclusionThe result of the study indicated the direct influence of weather conditions such as increased rainfall and humidity, which caused an upsurge in the incidence rate of clinical mastitis, leading to an increased loss in milk and hence the economy of the dairy farm. Proactive preventive measures along with good dairy farm practices that help mitigate the impacts of harsh weather conditions are recommended.

Early detection, diagnosis and treatment of cattle disease is very important for any livestock farming enterprise, to remain viable. Improved cattle health and productivity through advanced and innovative smart farming technologies will pave the way for the United Arab Emirates in achieving its national agenda of food security. Advanced livestock health care bio-capsules were administered through mouth into the rumen of cattle in a private dairy farm to a group of cattle to monitor their health. The effect of using such biosensors on the animal health was not previously described by any other researchers. Hence, in the current study, we tried to understand the effects of the bio-capsules on the cattle health, if any. This was done through collecting and screening blood samples from the test animals for different hemato-biochemical parameters and our results showed that there were no harmful effects of using such bio-capsules for livestock health monitoring.

The recent development of prime editing (PE) genome engineering technologies has the potential to significantly simplify the generation of human pluripotent stem cell (hPSC)-based disease models. PE is a multicomponent editing system that uses a Cas9-nickase fused to a reverse transcriptase (nCas9-RT) and an extended PE guide RNA (pegRNA). Once reverse transcribed, the pegRNA extension functions as a repair template to introduce precise designer mutations at the target site. Here, we systematically compared the editing efficiencies of PE to conventional gene editing methods in hPSCs. This analysis revealed that PE is overall more efficient and precise than homology-directed repair of site-specific nuclease-induced double-strand breaks. Specifically, PE is more effective in generating heterozygous editing events to create autosomal dominant disease-associated mutations. By stably integrating the nCas9-RT into hPSCs we achieved editing efficiencies equal to those reported for cancer cells, suggesting that the expression of the PE components, rather than cell-intrinsic features, limit PE in hPSCs. To improve the efficiency of PE in hPSCs, we optimized the delivery modalities for the PE components. Delivery of the nCas9-RT as mRNA combined with synthetically generated, chemically-modified pegRNAs and nicking guide RNAs improved editing efficiencies up to 13-fold compared with transfecting the PE components as plasmids or ribonucleoprotein particles. Finally, we demonstrated that this mRNA-based delivery approach can be used repeatedly to yield editing efficiencies exceeding 60% and to correct or introduce familial mutations causing Parkinson’s disease in hPSCs.

Three-dimensional (3D) printing, medical imaging, and implant design have all advanced significantly in recent years, and these developments may change how modern craniomaxillofacial surgeons use patient data to create tailored treatments. Polyether-ether-ketone (PEEK) is often seen as an attractive option over metal biomaterials in medical uses, but a solid PEEK implant often leads to poor osseointegration and clinical failure. Therefore, the objective of this study is to demonstrate the quantitative assessment of a custom porous PEEK implant for cranial reconstruction and to evaluate its fitting accuracy. The research proposes an efficient process for designing, fabricating, simulating, and inspecting a customized porous PEEK implant. In this study, a CT scan is utilized in conjunction with a mirrored reconstruction technique to produce a skull implant. In order to foster cell proliferation, the implant is modified into a porous structure. The implant’s strength and stability are examined using finite element analysis. Fused filament fabrication (FFF) is utilized to fabricate the porous PEEK implants, and 3D scanning is used to test its fitting accuracy. The results of the biomechanical analysis indicate that the highest stress observed was approximately 61.92 MPa, which is comparatively low when compared with the yield strength and tensile strength of the material. The implant fitting analysis demonstrates that the implant’s variance from the normal skull is less than 0.4436 mm, which is rather low given the delicate anatomy of the area. The results of the study demonstrate the implant’s endurance while also increasing the patient’s cosmetic value.

Three-dimensional (3D) printed splints must be lightweight and adequately ventilated to maximize the patient’s convenience while maintaining requisite strength. The ensuing loss of strength has a substantial impact on the transformation of a solid splint model into a perforated or porous model. Thus, two methods for making perforations—standard approach and topological optimization—are investigated in this study. The objective of this research is to ascertain the impact of different perforation shapes and their distribution as well as topology optimization on the customized splint model. The solid splint models made of various materials have been transformed into porous designs to evaluate their strength by utilizing Finite Element (FE) simulation. This study will have a substantial effect on the designing concept for medical devices as well as other industries such as automobiles and aerospace. The novelty of the research refers to creating the perforations as well as applying topology optimization and 3D printing in practice. According to the comparison of the various materials, PLA had the least amount of deformation and the highest safety factor for all loading directions. Additionally, it was shown that all perforation shapes behave similarly, implying that the perforation shape’s effect is not notably pronounced. However, square perforations seemed to perform the best out of all the perforation shape types. It was also obvious that the topology-optimized hand splint outperformed that with square perforations. The topology-optimized hand splint weighs 26% less than the solid splint, whereas the square-perforated hand splint weighs roughly 12% less. Nevertheless, the user must choose which strategy (standard perforations or topology optimization) to employ based on the available tools and prerequisites.

Extended-spectrum β-lactamases resistant (ESBL-R) Escherichia coli (E. coli) has been reported from healthy and sick pets. However, data from Middle Eastern countries, including the United Arab Emirates (UAE), are minimal. This study provides the first evidence of ESBL-R E. coli carriage among pets in the UAE. A total of 148 rectal swabs were collected from domestic cats (n = 122) and dogs (n = 26) attending five animal clinics in the UAE. Samples were cultured directly onto selective agar, and suspected colonies were confirmed as ESBL-producing using phenotypic and molecular methods. Confirmed isolates were screened for their phenotypic resistance to twelve antimicrobial agents using the Kirby Bauer method. The owners of the pets completed a questionnaire at the time of sampling, and the data were used to identify risk factors. ESBL-R E. coli was detected in rectal swabs of 35 out of 148 animals (23.65%) (95% confidence interval [CI]: 17.06–31.32). Multivariable logistic regression analysis identified cats and dogs with access to water in ditches and puddles as 3.71 (p-value = 0.020) times more likely to be positive to ESBL-R E. coli than those without access to open water sources. Ciprofloxacin resistance was evident in 57.14% (44/77) of the ESBL-R E. coli isolates. The percentage of resistance to azithromycin and cefepime was 12.99% (10/77) and 48.05% (37/77), respectively. The blaCTX-M gene was detected in 82% of the PCR-screened isolates (n = 50). Multidrug resistance (MDR) phenotypes were evident in 91% (70/77) of the isolates. In conclusion, ESBL-R E. coli was detected at a noticeable rate among healthy pet cats and dogs in the UAE, and the majority are MDR to clinically important antimicrobials such as fluoroquinolones and 3rd and 4th generation cephalosporins. Our results call for strengthening antimicrobial stewardship among companion animal veterinarians in the UAE to reduce the potential transmission of ESBL-R E. coli between pets, humans, and urban environments.

Since printed capacitive sensors provide better sensing performance, they can be used in automotive bezel applications. It is necessary to fabricate such sensors and apply an optimization approach for choosing the optimal sensor pattern. In the present work, an effort was made to formulate interdigitated pattern-printed Silver (Ag) electrode flexible sensors and adopt the Taguchi Grey Relational (TGR)-based optimization approach to enhance the flexible sensor’s panel for enhanced automobile infotainment applications. The optimization technique was performed to derive better design considerations and analyze the influence of the sensor’s parameters on change in capacitance when touched and production cost. The fabricated flexible printed sensors can provide better sensing properties. A design pattern which integrates an overlap of 15 mm, an electrode line width of 0.8 mm, and an electrode gap 0.8 mm can produce a higher change in capacitance and achieve a lower weight. The overlap has a greater influence on sensor performance owing to its optimization of spatial interpolation.

An in-depth characterisation of protein and lipid fractions and changes in the physicochemical and meat-quality attributes of camel meat, beef and mutton over 9 days of refrigerated storage was investigated. The lipids of all the meat samples, especially those in camel meat, underwent significant oxidation in the first 3 days of storage. A decrease in pigment and redness (a* value) with an increase in the storage time was noticed in all the meat samples, suggesting the oxidation of the haem protein. The mutton samples displayed greater protein extractability, while the protein solubility values in all the meat samples were similar, and these varied as storage progressed. The drip loss percentage in camel meat and mutton were two times higher than in beef, and it increased during storage period. The textural properties of fresh camel meat were higher than mutton and beef, and these decreased during day 3 and 9, respectively, indicating the proteolysis and the degradation of the structural proteins, which were also evident from the SDS-PAGE pattern.

Numerous industries, including footwear, handicrafts, and the automobile industry, utilize leather materials. The main goal of this study was to investigate the effect of input power of the diode laser in laser cutting on vegetable chrome tanned buffalo leather to enhance the cutting process. In the present investigation, carbonization, kerf width, and material removal rate (MRR) were taken as performance measures. The diode-based laser beam machining was designed and fabricated with 2.5 W, 5.5 W, and 20 W diode laser to cut vegetable chrome tanned leather. The high-intensity 20 W diode laser produced lower carbonization, lower kerf width, and higher material removal rate compared with the 2.5 W and 5.5 W diodes. This improved performance was due to the adjustable features associated with this diode laser actuation in the form of circular shape with adjustable diameter. A high power with a lower spot size under pulsed mode can produce higher power density. Since a higher power density can establish less interaction time, it produces lower carbonization. Due to the ability of the 20 W diode laser driver to control the beam shape and size, it could produce a lower kerf width and higher MRR. The optimal parameters for cutting chrome vegetable tanned cow leather were a standoff distance of 18 mm, feed rate of 200 mm/min, and duty cycle of 70%.

Background: It is crucial to follow rational prescribing practices while prescribing antibiotics for burn patients, thus leading to better patient outcomes. The objective of this study was to assess the initiation of empirical antibiotics in the burn unit. Methods: A prospective cross-sectional study was conducted in a large tertiary care setting of the Kingdom of Saudi Arabia between August 2016 and December 2018. Results: A total of 102 hospitalized burn patients were included in this study, of whom 84 (82.4%) were males. Burns were classified as first degree, second degree, third degree, or fourth degree depending on their severity and extent of penetration into the skin. The majority (81.3%) of the patients suffered from flame burn, followed by scald (9.85), chemical (6.9%), and electrical (2%) types of burns. Broad-spectrum antibiotic such as piperacillin/tazobactam (40.57%) was the most common empirically prescribed antibiotic. In 35 patients (34.3%), there was a change in antibiotic after culture findings. Conclusion: This study demonstrated that 40% of antibiotic therapy decisions followed the recommended clinical guidelines. This study also found that Gram-negative microorganisms such as Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus were ubiquitous in our burn unit. The study results will facilitate to develop antibiogram for our study setting, thus reducing antibiotic resistance. Further studies are needed to explore the extent and consequences of irrational antibiotic prescriptions in critically ill burn patients.

Medication errors are a major healthcare problem in todays high-paced, multi-faceted healthcare environment. A well-designed change model coupled with good care givers engagement is the best way to bring positive and sustainable change to the system. The aim of this study was to assess whether implementing a combination of Kotters change model and Hersey and Blanchards situational leadership model will improve the self-reporting of medication errors (MEs) among physicians and/or nurses and to understand how physicians and nurses respond to Hersey and Blanchards behavior modification tool by analyzing ME self-reporting data trends, as determined at the end of the study. We have perused Kotters 8-stage change management model to roll out this behavioral change research study. Kotter suggested creating a sense of urgency to initiate change. To support the change, we used the recently released (March 2019) regulatory policy on ME reporting and disseminating, which created a need and urgency among team to imbibe the change and its acceptance. There were zero reports in the first month i.e. July 2019, which was a surprise and required further investigation. The second month (August 2019) noted three reports (one near miss and two self-reported MEs), which was a success in our research model. In the third month, two self-reported cases were noted and one medication error was reported. The current research study had created an opportunity to implement a unique combination of Kotters model and Hersey and Blanchards situational theory model, which was not attempted before, nor was cited in the literature. Hence, further studies are warranted on a larger scale to solidify our results and the effective use of our proposed model in a healthcare management set-up to remove medication errors reporting. [J Med Allied Sci 2020; 10(1.000): 25-32]

The reconstruction of craniomaxillofacial deformities, especially zygomatic bone repair, can be exigent due to the complex anatomical structure and the sensitivity of the crucial organs involved. The need to reconstruct the zygomatic bone in the most precise way is of crucial importance for enhancing the patient outcomes and health care-related quality of life (HRQL). Autogenous bone grafts, despite being the gold standard, do not match bone forms, have limited donor sites and bone volume, and can induce substantial surgical site morbidity, which may lead to adverse outcomes. The goal of this study is to provide an integrated approach that includes various processes, from patient scanning to implant manufacture, for the restoration of zygomatic bone abnormalities utilizing Polyetheretherketone (PEEK) material, while retaining adequate aesthetic and facial symmetry. This study takes an integrated approach, including computer-aided implant design using the mirror reconstruction technique, investigating the biomechanical behavior of the implant under loading conditions, and carrying out a fitting accuracy analysis of the PEEK implant fabricated using state-of-the-art additive manufacturing technology. The findings of the biomechanical analysis results reveal the largest stress of approximately 0.89 MPa, which is relatively low in contrast to the material’s yield strength and tensile strength. A high degree of sturdiness in the implant design is provided by the maximum value of strain and deformation, which is also relatively low at roughly 2.2 × 10−4 and 14 µm. This emphasizes the implant’s capability for load resistance and safety under heavy loading. The 3D-printed PEEK implant observed a maximum deviation of 0.4810 mm in the outside direction, suggesting that the aesthetic result or the fitting precision is adequate. The 3D-printed PEEK implant has the potential to supplant the zygoma bone in cases of severe zygomatic reconstructive deformities, while improving the fit, stability, and strength of the implant.