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Objective(s): Using histopathological and immunohistochemical methods, we aimed to examine the dose-dependent effects of chronic caffeine consumption on the recovery of burn wounds in an in vivo rat model.Materials and Methods: Forty-five rats were randomly assigned to a high-dose group (20 mg/kg per day for eight weeks; n=15), a low-dose group (10 mg/kg per day for eight weeks; n=15), or a control group (n=15). The burn model was created in rats. The groups were separated into three subgroups (n=5) based on the day after injury (7th, 14th, or 21st day). The wound area, wound closure percentage, and histopathological and immunohistochemical reactivity were evaluated.Results: Successful wound healing was noted in rats treated with low doses of caffeine, similar to the control group. Pathology revealed low re-epithelization, low inflammation, and high granulation in the high-dose group. In addition, there was a significant difference between the control and high-dose groups regarding the immunohistochemical reactivity of αVβ3 integrin, VEGF, and MMP-9 (P

Abstract Methods to quantify cortical hyperexcitability are of enormous interest for mapping epileptic networks in patients with focal epilepsy. We hypothesize that, in the resting state, cortical hyperexcitability increases firing-rate correlations between neuronal populations within seizure onset zones (SOZs). This hypothesis predicts that in the gamma frequency band (40–200 Hz), amplitude envelope correlations (AECs), a relatively straightforward measure of functional connectivity, should be elevated within SOZs compared to other areas. To test this prediction, we analyzed archived samples of interictal electrocorticographic (ECoG) signals recorded from patients who became seizure-free after surgery targeting SOZs identified by multiday intracranial recordings. We show that in the gamma band, AECs between nodes within SOZs are markedly elevated relative to those elsewhere. AEC-based node strength, eigencentrality, and clustering coefficient are also robustly increased within the SOZ with maxima in the low-gamma band (permutation test Z-scores > 8) and yield moderate discriminability of the SOZ using ROC analysis (maximal mean AUC ~ 0.73). By contrast to AECs, phase locking values (PLVs), a measure of narrow-band phase coupling across sites, and PLV-based graph metrics discriminate the seizure onset nodes weakly. Our results suggest that gamma band AECs may provide a clinically useful marker of cortical hyperexcitability in focal epilepsy.

It has been aimed to compare the level of cell-free nucleic acids (DNA, RNA, and miRNA) concentrations in laryngeal cancer patients with the control group composed of healthy individuals. It has been utilized 46 patients with laryngeal carcinoma who were previously diagnosed and treated were included and 46 healthy individuals were included as a control group. Peripheral blood samples were obtained from all participants. DNA, RNA, and miRNA were fluorometrically measured. We applied Mann Whitney U test to compare both groups and the adjusted general lineal model to identify associations between nucleic acid concentrations and tumor stages. Circulating cell-free microRNA and RNA concentrations in the laryngeal cancer patients were significantly different (p

Abstract To date, degraded mangrove ecosystem restoration accomplished worldwide primarily aligns towards rehabilitation with monotypic plantations, while ecological restoration principles are rarely followed in these interventions. However, researchers admit that most of these initiatives' success rate is not appreciable often. An integrative framework of ecological restoration for degraded mangroves where site-specific observations could be scientifically rationalized, with co-located reference pristine mangroves as the target ecosystem to achieve is currently distinctively lacking. Through this experimental scale study, we studied the suitability of site-specific strategies to ecologically restore degraded mangrove patches vis-à-vis the conventional mono-species plantations in a highly vulnerable mangrove ecosystem in Indian Sundarbans. This comprehensive restoration framework was trialed in small discrete degraded mangrove patches spanning ~ 65 ha. Site-specific key restoration components applied are statistically validated through RDA analyses and Bayesian t-tests. 25 quantifiable metrics evaluate the restoration success of a ~ 3 ha degraded mangrove patch with Ridgeline distribution, Kolmogorov–Smirnov (K-S) tests, and Mahalanobis Distance (D2) measure to prove the site’s near-equivalence to pristine reference in multiple ecosystem attributes. This restoration intervention irrevocably establishes the greater potential of this framework in the recovery of ecosystem functions and self-sustenance compared to that of predominant monoculture practices for vulnerable mangroves.

BACKGROUND: Medical treatment, expectant approaches, and surgical treatment options are available in the treatment of ectopic pregnancy. Regardless of the treatment, in addition to its effectiveness, the main concern is to limit the risk of relapse and preserve fertility. OBJECTIVES: Determine the impact of medical or surgical treatment for ectopic pregnancy on future fertility. DESIGN: Retrospective SETTING: Department of obstrtrics and gynecolgy at Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey PATIENTS AND METHODS: Patients who were treated for ectopic pregnancy between June 2016 and November 2019 were allocated into two groups. Expectant approach or medical treatment by methotrexate constituted the conservative treatment group while salpingectomy by laparoscopy indicated the surgical treatment group. MAIN OUTCOME MEASURES: Fertility rates within two years following treatment were evaluated according to treatment options. SAMPLE SIZE: 202 patients RESULTS: Of the 202 patients, 128 had medical treatment and 74 patients had surgical treatment for ectopic pregnancy. Of 272 diagnosed with ectopic pregnancy, 70 were excluded for various reasons. Parity and unemployment rate was significantly higher in the surgical treatment (P=.006 and P=.12, respectively). Moreover, ectopic mass size and serum β-hCG levels were significantly higher in the surgical treatment group (P

Abstract Epilepsy is a chronic neurological disease, characterized by spontaneous, unprovoked, recurrent seizures that may lead to long-term disability and premature death. Despite significant efforts made to improve epilepsy detection clinically and pre-clinically, the pervasive presence of noise in EEG signals continues to pose substantial challenges to their effective application. In addition, discriminant features for epilepsy detection have not been investigated yet. The objective of this study is to develop a hybrid model for epilepsy detection from noisy and fragmented EEG signals. We hypothesized that a hybrid model could surpass existing single models in epilepsy detection. Our approach involves manual noise rejection and a novel statistical channel selection technique to detect epilepsy even from noisy EEG signals. Our proposed Base-2-Meta stacking classifier achieved notable accuracy (0.98 ± 0.05), precision (0.98 ± 0.07), recall (0.98 ± 0.05), and F1 score (0.98 ± 0.04) even with noisy 5-s segmented EEG signals. Application of our approach to the specific problem like detection of epilepsy from noisy and fragmented EEG data reveals a performance that is not only superior to others, but also is translationally relevant, highlighting its potential application in a clinic setting, where EEG signals are often noisy or scanty. Our proposed metric DF-A (Discriminant feature-accuracy), for the first time, identified the most discriminant feature with models that give A accuracy or above (A = 95 used in this study). This groundbreaking approach allows for detecting discriminant features and can be used as potential electrographic biomarkers in epilepsy detection research. Moreover, our study introduces innovative insights into the understanding of these features, epilepsy detection, and cross-validation, markedly improving epilepsy detection in ways previously unavailable.

Background: Dermatoglyphics is the study of epidermal ridge patterns on the fingers, palms, and soles. Correlation of dermatoglyphic patterns with many chromosomal abnormalities and genetic predisposing diseases such as diabetes mellitus, hypertension, schizophrenia, and bronchial asthma is evidenced by many researchers. Literature on sexual dimorphism of dermatoglyphic patterns revealed it as an important characteristic feature. Aims and Objectives: The aim of the study is to study the variance of ridge patterns among male and female patients of Type 2 diabetes mellitus patients of West Bengal and determine the sex-specific digital and palmar ridge patterns in Type 2 Diabetes mellitus. Materials and Methods: A cross-sectional study has been done on 100 male and 100 female Type 2 diabetes mellitus patients. Digital and palmar prints were taken by the traditional ink method. Digital ridge pattern, pattern intensity index, total finger ridge count (TFRC), absolute finger ridge count (AFRC), and a-b ridge count were studied. The data on these patterns was recorded and statistically analyzed by Chi-square test and Student’s t-test. Results: The frequency of ulnar loop is higher in female diabetics in comparison to male diabetics. Statistically significant increase in mean TFRC and mean AFRC is seen in male diabetics. Conclusion: Our study exhibits that dermatoglyphic pattern significantly differs in male and female diabetics. The knowledge and reference range of dermatoglyphic parameters among male and female diabetics are essential in the use of this study as a screening tool or diagnostic tool in Type 2 diabetes mellitus.

Objective: Breast cancer clinical stage and nodal status are the most clinically significant drivers of patient management, in combination with other pathological biomarkers, such as estrogen receptor (ER), progesterone receptor or human epidermal growth factor receptor 2 (HER2) receptor status and tumor grade. Accurate prediction of such parameters can help avoid unnecessary intervention, including unnecessary surgery. The objective was to investigate the role of magnetic resonance imaging (MRI) radiomics for yielding virtual prognostic biomarkers (ER, HER2 expression, tumor grade, molecular subtype, and T-stage). Materials and Methods: Patients with primary invasive breast cancer who underwent dynamic contrast-enhanced (DCE) breast MRI between July 2013 and July 2016 in a single center were retrospectively reviewed. Age, N-stage, grade, ER and HER2 status, and Ki-67 (%) were recorded. DCE images were segmented and Haralick texture features were extracted. The Bootstrap Lasso feature selection method was used to select a small subset of optimal texture features. Classification of the performance of the final model was assessed with the area under the receiver operating characteristic curve (AUC). Results: Median age of patients (n = 209) was 49 (21–79) years. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the model for differentiating N0 vs N1-N3 was: 71%, 79%, 76%, 74%, 75% [AUC = 0.78 (95% confidence interval (CI) 0.72–0.85)], N0-N1 vs N2–N3 was 81%, 59%, 24%, 95%, 62% [AUC = 0.74 (95% CI 0.63–0.85)], distinguishing HER2(+) from HER2(-) was 79%, 48%, 34%, 87%, 56% [AUC = 0.64 (95% CI 0.54–0.73)], high nuclear grade (grade 2–3) vs low grade (grades 1) was 56%, 88%, 96%, 29%, 61% [AUC = 0.71 (95% CI 0.63–0.80)]; and for ER (+) vs ER(-) status the [AUC=0.67 (95% CI 0.59–0.76)]. Radiomics performance in distinguishing triple-negative vs other molecular subtypes was [0.60 (95% CI 0.49–0.71)], and Luminal A [0.66 (95% CI 0.56–0.76)]. Conclusion: Quantitative radiomics using MRI contrast texture shows promise in identifying aggressive high grade, node positive triple negative breast cancer, and correlated well with higher nuclear grades, higher T-stages, and N-positive stages.

BackgroundOpioid overdose is a global health crisis, affecting over 27 million individuals worldwide, with more than 100,000 drug overdose deaths in the United States in 2022-2023. This protocol outlines the development of the PneumoWave chest biosensor, a wearable device being designed to detect respiratory depression in real time through chest motion measurement, intending to enhance early intervention and thereby reduce fatalities. ObjectiveThe study aims to (1) differentiate opioid-induced respiratory depression (OIRD) from nonfatal opioid use patterns to develop and refine an overdose detection algorithm and (2) examine participants’ acceptability of the chest biosensor. MethodsThe study adopts an observational design over a 6-month period. The biosensor, a small device, will be worn by consenting participants during injecting events to capture chest motion data. Safe injecting facilities (SIF) in Melbourne, Victoria (site 1), and Sydney, New South Wales (site 2), which are legally sanctioned spaces where individuals can use preobtained illicit drugs under medical supervision. Each site is anticipated to recruit up to 100 participants who inject opioids and attend the SIF. Participants will wear the biosensor during supervised injecting events at both sites. The biosensor will attempt to capture data on an anticipated 40 adverse drug events. The biosensor’s ability to detect OIRD will be compared to the staff-identified events that use standard protocols for managing overdoses. Measurements will include (1) chest wall movement measured by the biosensor, securely streamed to a cloud, and analyzed to refine an overdose detection algorithm and (2) acute events or potential overdose identified by site staff. Acceptability will be measured by a feedback questionnaire as many times as the participant is willing to throughout the study. ResultsAs of April 2024, a total of 47 participants have been enrolled and data from 1145 injecting events have already been collected, including 10 overdose events. This consists of 17 females and 30 males with an average age of 45 years. Data analysis is ongoing. ConclusionsThis protocol establishes a foundation for advancing wearable technology in opioid overdose prevention within SIFs. The study will provide chest wall movement data and associated overdose data that will be used to train an algorithm that allows the biosensor to detect an overdose. The study will contribute crucial insights into OIRD, emphasizing the biosensor’s potential step forward in real-time intervention strategies. International Registered Report Identifier (IRRID)DERR1-10.2196/57367

Hepatic factors secreted by the liver promote homeostasis and are pivotal for maintaining the liver-gut axis. Bile acid metabolism is one such example wherein, bile acid synthesis occurs in the liver and its biotransformation happens in the intestine. Dysfunctional interactions between the liver and the intestine stimulate varied pathological outcomes through its bidirectional portal communication. Indeed, aberrant bile acid metabolism has been reported in inflammatory bowel disease (IBD). However, the molecular mechanisms underlying these crosstalks that perpetuate intestinal permeability and inflammation remain obscure. Here, we identify a novel hepatic gene program regulated by Rela and Stat3 that accentuates the inflammation in an acute experimental colitis model. Hepatocyte-specific ablation of Rela and Stat3 reduces the levels of primary bile acids in both the liver and the gut and shows a restricted colitogenic phenotype. On supplementation of chenodeoxycholic acid (CDCA), knock-out mice exhibit enhanced colitis-induced alterations. This study provides persuasive evidence for the development of multi-organ strategies for treating IBD and identifies a hepatocyte-specific Rela-Stat3 network as a promising therapeutic target.

Abstract Surface modification by suitable technique aids in improving the characteristics of material to resist severe wear in demanding environments and challenging applications. The present study aims to analyse the tribological performance of Stainless Steel (SS304) reinforced with CoCrCuFeTi High Entropy Alloy (HEA) through friction stir processing and compares the results with annealed specimens. The CoCrCuFeTi HEA was ball milled and revealed irregular fragment particles with Body Centred Cubic (BCC) phase. The processed samples exhibited excellent refinement in grains with uniform HEA reinforcement distribution. The grains were observed to be in nano level post-annealing promoting exceptional microhardness. The pin-on-disc wear test was conducted by varying load (10-40N), sliding velocity (0.5–3.5 m/s) and sliding distance (500–2000 m) and the respective worn surface was analysed. The processed sample with HEA after annealing offered 29.8%, 57.4% and 58.49% improved wear resistance at the minimum level of load, sliding velocity and sliding distance than the processed base samples. The worn morphology revealed delamination, abrasion, adhesion and oxide layer formation to be the predominant wear mechanisms.

Urinary biomarkers are a promising diagnostic modality whose role was explored in nephrotic syndrome (NS). We estimated urinary apolipoprotein A1 (Apo A1) and neutrophil gelatinase-associated lipocalin (NGAL) in children with first-episode NS (FENS) and controls with a longitudinal follow-up to see the serial changes during remission. The study groups comprised 35 children with FENS and an equal number of age- and sex-matched controls. Patients were followed up at regular intervals, and 32 patients were classified as having steroid-sensitive NS (SSNS) and 3 as having steroid-resistant NS (SRNS). The mean follow-up period was 8.7 ± 4.2 months. Three patients in the SSNS group were labeled as having frequent relapses or steroid-dependent disease during follow-up. Of the three children with SRNS, two had minimal changes in the disease and one had idiopathic membranous nephropathy. The levels of Apo A1:creatinine, NGAL:creatinine, and spot urinary protein:urinary creatinine ratios were significantly higher in children with FENS compared with controls. The levels of the urine biomarkers decreased significantly at subsequent follow-up with remission. The Apo A1 and NGAL levels in SSNS patients were significantly high compared with both the controls and FENS patients. Urinary Apo A1 levels in SRNS patients were lower at initial presentation. This longitudinal study revealed changes in the urinary Apo A1 and NGAL in NS over the course of the disease.

Introduction: The Pulmonary Artery (PA) catheter continues to be used for monitoring haemodynamic parameters in the majority of patients undergoing Coronary Artery Bypass Grafting (CABG) surgeries, despite concerns raised regarding costeffectiveness and safety issues. Sometimes, placement takes longer or is difficult just by looking at the pressure waves. There are several factors that may influence the duration of Pulmonary Artery Catheter (PAC) insertion. Aim: To determine the factors affecting PAC in anaesthetised patients undergoing elective CABG. Materials and Methods: A single-centred, cross-sectional study was conducted in the Cardiothoracic and Vascular Surgery operation theartre at IPGME&R and SSKM Hospital, Kolkata, India including 138 patients aged 35-65 years of either sex undergoing elective CABG surgery in a tertiary care hospital in Eastern India. The attempt to perform successful first-time catheterisation or failure of the PAC done by a resident cardioanaesthesiologist was noted, as well as whether catheterisation was successfully done within a specified time or not. This time was obtained as the 75th percentile of the time taken for catheter placement for the first 30 cases catheterised in the first attempt. For ease of analysis, all first attempt successful cases were considered as Group A (n=125), and all first attempt failure cases as Group B (n=13). The study data on various parameters were recorded on a proforma and summarised as the mean and standard deviation for normally distributed numerical variables, median and interquartile range for skewed numerical variables, and counts and percentages for categorical variables. A p-value

Abstract Having powerful antibacterial and antioxidant effects, zinc oxide and manganese oxide nanomaterials are of great interest. Here we have synthesized manganese oxide decorated zinc oxide (MZO) nanocomposites by co-precipitation method, calcined at different temperatures (300–750 °C) and studied various properties. Here the crystalline structure of the nanocomposite and phase change of the manganese oxide are observed with calcination temperature. The average crystalline size increases and the dislocation density and microstrain decrease with the increase in calcined temperature for the same structural features. The formation of composites was confirmed by XRD pattern and SEM images. EDAX spectra proved the high purity of the composites. Here, different biological properties change with the calcination temperature for different shapes, sizes and structures of the nanocomposite. Nanomaterial calcined at 750 °C provides the best anti-microbial activity against Escherichia coli, Salmonella typhimurium, Shigella flexneri (gram-negative), Bacillus subtilis and Bacillus megaterium (gram-positive) bacterial strain at 300 µg/mL concentration. The nanomaterial with calcination temperatures of 300 °C and 450 °C provided better antioxidant properties.

Abstract Thermal Power Plant generates FGD gypsum as by-product during coal combustion. This study evaluates the characterization (spectroscopic and elemental), potentially toxic elements (PTEs) distribution, and environmental risk assessment of FGD gypsum for safe and sustainable use in agriculture. The XRD and SEM analysis confirmed the dominance of crystalline CaSO4·2H2O in FGD gypsum. The order of concentrations of PTEs in FGD gypsum was Fe > Al > Mn > Zn > Ni > Co. The residual fraction was the dominant pool, sharing 80–90% of the total PTEs. The heavy metals (HMs) were below the toxic range in the leachates. The Co, Ni, Al, Fe Mn, Zn had low (

This is the first UK trial of pressurised intraperitoneal aerosolised chemotherapy (PIPAC) for colorectal cancer peritoneal metastases. This trial aimed to assess the impact of PIPAC in combination with standard of care systemic treatment on: progression free survival (PFS); quality of life (QoL); and short-term complications. In addition, this trial set out to demonstrate that PIPAC can be performed safely in operating theatres within a National Health Service (NHS) setting.

Stroke is one of the most common causes of long-term disability in adults. Prevalence of hemiplegic shoulder pain; it is approximately 22-23% in the general population who have had a stroke. It has been evaluated as approximately 54-55% in rehabilitated stroke patients. One of the aims of rehabilitation in the management of stroke patients is to determine the etiology of shoulder pain, to increase functionality and pain control with correct diagnosis and effective intervention. In the literature on the management of hemiplegic shoulder pain, publications on injections and complementary medicine methods have been increasing rapidly. In current meta-analyses, suprascapular nerve injections are recommended for the management of acute hemilegic shoulder pain and increasing the range of motion of the joint. It has been reported that pain and joint range of motion improve with botulinum toxin injections and this effect persists in the long term. Studies on acupuncture, dry needling, and neuromuscular taping, which are complementary medicine methods, have been conducted in patients with hemiplegic shoulder pain. This review covers the epidemiology and diagnostic methods of shoulder pain in stroke patients and the approach to hemiplegic shoulder pain in the light of current literature.

Abstract Collective migration of cells is a fundamental behavior in biology. For the quantitative understanding of collective cell migration, live-cell imaging techniques have been used using e.g., phase contrast or fluorescence images. Particle tracking velocimetry (PTV) is a common recipe to quantify cell motility with those image data. However, the precise tracking of cells is not always feasible. Particle image velocimetry (PIV) is an alternative to PTV, corresponding to Eulerian picture of fluid dynamics, which derives the average velocity vector of an aggregate of cells. However, the accuracy of PIV in capturing the underlying cell motility and what values of the parameters should be chosen is not necessarily well characterized, especially for cells that do not adhere to a viscous flow. Here, we investigate the accuracy of PIV by generating images of simulated cells by the Vicsek model using trajectory data of agents at different noise levels. It was found, using an alignment score, that the direction of the PIV vectors coincides with the direction of nearby agents with appropriate choices of PIV parameters. PIV is found to accurately measure the underlying motion of individual agents for a wide range of noise level, and its condition is addressed.

Abstract Exploration of cytokine levels in systemic sclerosis-associated interstitial lung disease (SSc-ILD) and idiopathic pulmonary fibrosis (IPF) is needed to find common and diverse biomolecular pathways. Circulating levels of 87 cytokines were compared amongst 19 healthy controls and consecutive patients with SSc-ILD (n = 39), SSc without ILD (n = 29), and IPF (n = 17) recruited from a Canadian centre using a log-linear model adjusted for age, sex, baseline forced vital capacity (FVC), and immunosuppressive or anti-fibrotic treatment at time of sampling. Also examined was annualized change in FVC. Four cytokines had Holm’s corrected p-values less than 0.05. Eotaxin-1 levels were increased approximately two-fold in all patient categories compared to healthy controls. Interleukin-6 levels were eight-fold higher in all ILD categories compared to healthy controls. MIG/CXCL9 levels increased two-fold more in all but one patient category compared to healthy controls. Levels of a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13, (ADAMTS13) were lower for all categories of patients compared to controls. No substantial association was found for any of the cytokines with FVC change. Observed cytokine differences suggest both common and diverse pathways leading to pulmonary fibrosis. Further studies evaluating longitudinal change of these molecules would be informative.

Twenty-seven scientists met for the annual Auxological conference held at Aschau, Germany, to particularly discuss the interaction between social factors and human growth, and to highlight several topics of general interest to the regulation of human growth. Humans are social mammals. Humans show and share personal interests and needs, and are able to strategically adjust size according to social position, with love and hope being prime factors in the regulation of growth. In contrast to Western societies, where body size has been shown to be an important predictor of socioeconomic status, egalitarian societies without formalized hierarchy and material wealth-dependent social status do not appear to similarly integrate body size and social network. Social network structures can be modeled by Monte Carlo simulation. Modeling dominance hierarchies suggests that winner-loser effects play a pivotal role in robust self-organization that transcends the specifics of the individual. Further improvements of the St. Nicolas House analysis using re-sampling/bootstrap techniques yielded encouraging results for exploring dense networks of interacting variables. Customized pediatric growth references, and approaches towards a Digital Rare Disease Growth Chart Library were presented. First attempts with a mobile phone application were presented to investigate the associations between maternal pre-pregnancy overweight, gestational weight gain, and the child’s future motor development. Clinical contributions included growth patterns of individuals with Silver-Russell syndrome, and treatment burden in children with growth hormone deficiency. Contributions on sports highlighted the fallacy inherent in disregarding the biological maturation status when interpreting physical performance outcomes. The meeting explored the complex influence of nutrition and lifestyle on menarcheal age of Lithuanian girls and emphasized regional trends in height of Austrian recruits. Examples of the psychosocial stress caused by the forced migration of modern Kyrgyz children and Polish children after World War II were presented, as well as the effects of nutritional stress during and after World War I. The session concluded with a discussion of recent trends in gun violence affecting children and adolescents in the United States, and aspects of life history theory using the example of "Borderline Personality Disorder." The features of this disorder are consistent with the notion that it reflects a "fast" life history strategy, with higher levels of allostatic load, higher levels of aggression, and greater exposure to both childhood adversity and chronic stress. The results were discussed in light of evolutionary guided research. In all contributions presented here, written informed consent was obtained from all participants in accordance with institutional Human investigation committee guidelines in accordance with the Declaration of Helsinki amended October 2013, after information about the procedures used.

Myocardial fibrosis is the excessive deposition of extracellular matrix (ECM) proteins in the cardiac interstitium leading to pathological conditions of the heart. The objective is to understand the pathophysiology of cardiac fibrosis and the quest for serum biomarkers that will assist in early diagnosis before the occurrence of major cardiac events. There are many serum biomarkers that get elevated highlighting ECM remodeling during cardiac fibrosis. Lysyl oxidase like -2 is one such ECM protein, plays a crucial role in the up-regulation of TGF - β, the transformation of cardiac fibroblast to myoblast, the migration of collagen, and cross-linking of collagen and elastin. However, assessment of lysyl oxidase like-2 (LOXL-2) in different pathologically driven cardiac fibrosis is limited. Also, none of the serum biomarkers has proved to be the most accurate diagnostic tool for assessing fibrosis independently; hence, meticulous, less invasive, and cost-effective serum biomarkers need to be scrutinized. Hence lysyl oxidase Like-2 (LOXL-2) in combination with other serum biomarkers like PICP/PINP/TIMP-1/ST-2, or Galectin-3 can be combined to assess the presence of fibrosis in the heart. This review includes the journal, articles, and research paper on cardiac fibrosis which was published in the last 10–15 years to highlight the huge gap in the treatment of cardiac fibrosis and the need for a new combination of biomarkers with better prognostic and diagnostic value.

Abstract The interrelations between human activity and animal populations are of increasing interest due to the emergence of the novel COVID-19 and the consequent pandemic across the world. Anthropogenic impacts of the pandemic on animals in urban-suburban environments are largely unknown. In this study, the temporal and spatial patterns of urban animal response to the COVID-19 lockdown were assessed using animal-vehicle collisions (AVC) data. We collected AVC data over two 6-month periods in 2019 and 2020 (January to June) from the largest metropolis in southern Poland, which included lockdown months. Furthermore, we used traffic data to understand the impact of lockdown on AVC in the urban area. Our analysis of 1063 AVC incidents revealed that COVID-19 related lockdown decreased AVC rates in suburban areas. However, in the urban area, even though traffic volume had significantly reduced, AVC did not decrease significantly, suggesting that lockdown did not influence the collision rates in the urban area. Our results suggest that there is a need to focus on understanding the effects of changes in traffic volume on both human behaviour and wildlife space use on the resulting impacts on AVC in the urban area.

Robotic surgical techniques aimed to improve patient outcomes and satisfy patient outcomes while reducing surgical morbidity and mortality. One of the most performed surgeries, robotic assisted laparoscopic radical prostatectomy (RALRP), is characterized by many factors such as steep Trendelenburg position, and challenging access to the patient. We planned to evaluate anesthesia management and postoperative patient outcomes in RALRP. Patients planned for RALRP between January 2017 and June 2021 were included. Demographic data, additional diseases and Charlson Comorbidity Index (CCI) of the patients were recorded. The methods used in anesthesia maintenance, muscle relaxant and sugammadex dose, postoperative pain treatment protocol, duration of anesthesia and surgery, length of stay (LOS) in ICU or hospital, early postoperative complications and Clavien Dindo Classification (CDC) were evaluated by examining the follow-up forms in the intraoperative and postoperative period. Two hundred and sixteen patients underwent robotic assisted laparoscopic surgery between January 2017 and June 2021 and, 141 of them (65.3%) had RALRP. The mean age of the patients was 62.38±6.94, the body mass index was 27.60±3.94, and the mean CCI was 4.08±0.93. Total intravenous anesthesia (TIVA) (n=108, 76.6%) was mostly used for anesthesia maintenance. The median time spent during anesthesia was 278.5±63.6 minutes. The median time for surgery was 239.5±65.9 minutes. According to the CDC, grade-I was 5.7%, grade-II was 2.1%, grade-IVa 7.8%. The most common complication was acute kidney injury (11, 7.8%), followed by atelectasis (4, 2.8%). 98.6% of all patients were sent to the ward from PACU, except two. The mean LOS in hospital was 4.57±2.34 days. Robotic assisted laparoscopic radical prostatectomy is most performed surgery among all robotic surgeries. We think that, patient optimization and communication between surgeon and anesthesiologist is crucial to avoid the negative effects of steep Trendelenburg position and pneumoperitoneum in terms of improving outcome. [Med-Science 2022; 11(4.000): 1482-6]

Background: Hepatic iron overload resulting from multiple red cell transfusions over a long period of time is a complication of thalassemia major. Hepatocellular iron deposits with a decreasing gradient from periportal to centrilobular areas in the liver have been referred to as the HH pattern and those deposits primarily in reticuloendothelial cells and macrophages with occasional heterogeneous deposits in periportal hepatocytes are referred to as the non-HH pattern. Aims and Objectives: The purpose of this study was to evaluate patterns of liver siderosis in these patients and correlate with number of units of blood transfused. Materials and Methods: Thirty beta-thalassemia patients were selected, having splenomegaly and during splenectomy, liver biopsy was taken and sent for histopathology examination and pattern of siderosis was noted as HH (Hepatocytes), non-HH (Reticuloendothelial cells/Kupffer cells/macrophages) or HH; non-HH (Mixed). Results: Mean number of units transfused was 48.429±9.53 (SD) for patients having HH pattern of liver siderosis whereas it was 58.667±13.27 (SD) for patients having HH; non-HH pattern of liver siderosis. Independent-samples non-parametric Mann–Whitney U test was performed and P-value was found to be 0.028 which emphasized that total number of units of blood transfused vary significantly with two groups showing different patterns of siderosis. Conclusion: Hence, pattern of liver siderosis can be a good indicator for transfusional iron overload in beta-thalassemia major patients.

Background and objectives: A progressive accumulation of body iron easily occurs as a result of long-term transfusions in patients with anaemia of genetic disorders such as thalassaemia. Iron deposit in liver biopsy sections was studied in beta-thalassaemia major patients to assess the grade of liver siderosis and to correlate the grade with amount of blood transfused. Materials and methods: Beta-thalassaemia major patients having splenomegaly and selected for splenectomy were enrolled. Liver biopsy was taken from every patient during the splenectomy. Liver tissue was sectioned and stained with Perls’ prussian blue method for the presence of iron deposition. The degree of iron deposition was expressed as grades of siderosis from 0 to 4. Results: A total of 30 beta-thalassemia patients were enrolled in the study. Out of 30 patients, 7 were males (23.3%) and 23 females (76.7%). The mean age of patients was 15.2 ± 1.4 years. The mean serum iron and ferritin levels of the study cases were above the normal range. Blood received by all patients was 51.5 ± 11.6 units (range 31 to 88 units). Out of 30 patients, grade 1, 2, 3 and 4 liver siderosis was present in 1, 3, 9 and 17 patients respectively. Serum ferritin level of patients with grade 4 siderosis was significantly higher (p = 0.03) compared to grade 3 cases. Pearson’s correlation coefficient test revealed significant positive correlation between grades of liver siderosis and amount of blood transfusion received (0.626, p < 0.01). Conclusion: Grade of liver siderosis is associated with increased units of blood transfusion and is a good indicator for transfusional iron overload in beta-thalassaemia major patients. IMC J Med Sci. 2023. 17(1): 004. DOI: https://doi.org/10.55010/imcjms.17.004 *Correspondence: Dr. Souvik Basak, Department of General Surgery, Medical College, Kolkata, West Bengal, India. Email: sb009cmc@gmail.com

Abstract Large topologically associated domains (TADs) contain irregularly spaced nucleosome clutches, and interactions between such clutches are thought to aid the compaction of these domains. Here, we reconstituted TAD-sized chromatin fibers containing hundreds of nucleosomes on native source human and lambda-phage DNA and compared their mechanical properties at the single-molecule level with shorter ‘601’ arrays with various nucleosome repeat lengths. Fluorescent imaging showed increased compaction upon saturation of the DNA with histones and increasing magnesium concentration. Nucleosome clusters and their structural fluctuations were visualized in confined nanochannels. Force spectroscopy revealed not only similar mechanical properties of the TAD-sized fibers as shorter fibers but also large rupture events, consistent with breaking the interactions between distant clutches of nucleosomes. Though the arrays of native human DNA, lambda-phage and ‘601’ DNA featured minor differences in reconstitution yield and nucleosome stability, the fibers’ global structural and mechanical properties were similar, including the interactions between nucleosome clutches. These single-molecule experiments quantify the mechanical forces that stabilize large TAD-sized chromatin domains consisting of disordered, dynamically interacting nucleosome clutches and their effect on the condensation of large chromatin domains.

Abstract Leptin exerts its effects on energy balance by inhibiting food intake and increasing energy expenditure via leptin receptors in the hypothalamus. While LepR neurons in the arcuate nucleus of the hypothalamus, the primary target of leptin, have been extensively studied, LepR neurons in other hypothalamic nuclei remain understudied. LepR neurons in the lateral hypothalamus contribute to leptin's effects on food intake and reward, but due to the low abundance of this population it has been difficult to study their molecular profile and responses to energy deficit. We here explore the transcriptome of LepR neurons in the LH and their response to energy deficit. Male LepR-Cre mice were injected in the LH with an AAV carrying Cre-dependent L10:GFP. Few weeks later the hypothalami from fed and food-restricted (24-h) mice were dissected and the TRAP protocol was performed, for the isolation of translating mRNAs from LepR cells in the LH, followed by RNA sequencing. After mapping and normalization, differential expression analysis was performed with DESeq2. We confirm that the isolated mRNA is enriched in LepR transcripts and other known neuropeptide markers of LepRLH neurons, of which we investigate the localization patterns in the LH. We identified novel markers of LepRLH neurons with association to energy balance and metabolic disease, such as Acvr1c, Npy1r, Itgb1, and genes that are differentially regulated by food deprivation, such as Fam46a and Rrad. Our dataset provides a reliable and extensive resource of the molecular makeup of LH LepR neurons and their response to food deprivation.

For at least two centuries, scientists have been enthralled by the “zombie” behaviors induced by mind-controlling parasites. Despite this interest, the mechanistic bases of these uncanny processes have remained mostly a mystery. Here, we leverage the Entomophthora muscae-Drosophila melanogaster “zombie fly” system to reveal the mechanistic underpinnings of summit disease, a manipulated behavior evoked by many fungal parasites. Using a high-throughput approach to measure summiting, we discovered that summiting behavior is characterized by a burst of locomotion and requires the host circadian and neurosecretory systems, specifically DN1p circadian neurons, pars intercerebralis to corpora allata projecting (PI-CA) neurons and corpora allata (CA), the latter being solely responsible for juvenile hormone (JH) synthesis and release. Using a machine learning classifier to identify summiting animals in real time, we observed that PI-CA neurons and CA appeared intact in summiting animals, despite invasion of adjacent regions of the “zombie fly” brain by E. muscae cells and extensive host tissue damage in the body cavity. The blood-brain barrier of flies late in their infection was significantly permeabilized, suggesting that factors in the hemolymph may have greater access to the central nervous system during summiting. Metabolomic analysis of hemolymph from summiting flies revealed differential abundance of several compounds compared to non-summiting flies. Transfusing the hemolymph of summiting flies into non-summiting recipients induced a burst of locomotion, demonstrating that factor(s) in the hemolymph likely cause summiting behavior. Altogether, our work reveals a neuro-mechanistic model for summiting wherein fungal cells perturb the fly’s hemolymph, activating a neurohormonal pathway linking clock neurons to juvenile hormone production in the CA, ultimately inducing locomotor activity in their host.

Aim:Patients with chronic diseases were forced into lockdown due to the coronavirus disease-2019 pandemic. Extended quarantine could lead to physical inactivity and psychiatric problems. We investigated the effects of quarantine and social isolation during the pandemic on the motor and non-motor symptoms (NMS) of Parkinson’s disease (PD) patients with and without deep brain stimulation (DBS).Methods:This study included 168 patients with PD who were in quarantine for 2 months (between April 1, 2020 and May 31, 2020). Eighty-three patients had undergone bilateral subthalamic DBS surgery. A questionnaire with three parts was administered via phone: 1) motor symptoms, 2) NMS, and 3) the reasons for impairment.Results:Of the patients, 54.7% reported impairment in at least one motor symptom and 58.9% reported impairment in at least one NMS. Increased tremors, difficulty with turning in bed, and insomnia were significantly more pronounced in patients without DBS. Patients with DBS complained less of being bored due to staying at home and had less deterioration due to lack of exercise and slower disease progression.Conclusion:Half of the symptoms of patients with PD worsened during quarantine, but patients with DBS tolerated the lockdown better. Telemedicine and online physiotherapy programs should be recommended to prevent rapid disease progression.

Aim:Activation-induced cytidine deaminase (AID) has been associated with tumor initiation and development because of its ability to generate DNA damage and somatic mutations that cause genomic instability. This study aimed to investigate the relationship between AID expression levels and the risk of developing BCR/ABL1-negative myeloproliferative neoplasms (MPNs) by comparing the AID expression levels of the patients and controls.Methods:This case-control study was conducted on 117 cases (64 essential thrombocythemia, 23 primary myelofibrosis, and 30 polycythemia vera) with MPNs and 69 healthy controls. The JAK2 V617F somatic mutation analysis was performed using a real-time polymerase chain reaction (RT-PCR). The relative expression levels of AID in the patient and the control groups were analyzed using quantitative RT-PCR and the 2-ΔΔCT method.Results:AID expression levels were significantly higher in the patient group compared to the control group (p

Background While clinical decision rules have been developed to evaluate exacerbations and decisions on hospitalisation and discharge in emergency departments (EDs) in patients with chronic obstructive pulmonary disease (COPD), these rules are not widely used in EDs. In this study, we compare the predictive efficacy of the Ottawa Chronic Obstructive Pulmonary Disease Risk Scale (OCRS) and the Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF) score in estimating the short-term poor outcome of patients in our ED with exacerbations of COPD. Methods This single-centre prospective observational study was conducted over 6 months. Patients with acute exacerbations of COPD admitted to the ED during the study period were included in the study. A poor outcome was defined as any of the following: readmission and requiring hospitalisation within 14 days of discharge, requiring mechanical ventilation on the first admission, hospitalisation for longer than 14 days on the first admission, or death within 30 days. The sensitivity and specificity of the OCRS and the DECAF score for a poor outcome and for mortality were calculated. Results Of the 385 patients who participated in the study, 85 were excluded based on the exclusion criteria. 66% of the patients were male, and the mean age was 70.15±10.36 years. A total of 20.7% of all patients (n=62) experienced poor outcomes. The sensitivity of an OCRS score

Parkinson's disease (PD) is the fastest-growing neurodegenerative disorder, currently affecting ~7 million people worldwide. PD is clinically and genetically heterogeneous, with at least 10% of all cases explained by a monogenic cause or strong genetic risk factor. However, the vast majority of our present data on monogenic PD is based on the investigation of patients of European White ancestry, leaving a large knowledge gap on monogenic PD in underrepresented populations. Gene-targeted therapies are being developed at a fast pace and have started entering clinical trials. In light of these developments, building a global network of centers working on monogenic PD, fostering collaborative research, and establishing a clinical trial-ready cohort is imperative. Based on a systematic review of the English literature on monogenic PD and a successful team science approach, we have built up a network of 59 sites worldwide and have collected information on the availability of data, biomaterials, and facilities. To enable access to this resource and to foster collaboration across centers, as well as between academia and industry, we have developed an interactive map and online tool allowing for a quick overview of available resources, along with an option to filter for specific items of interest. This initiative is currently being merged with the Global Parkinson's Genetics Program (GP2), which will attract additional centers with a focus on underrepresented sites. This growing resource and tool will facilitate collaborative research and impact the development and testing of new therapies for monogenic and potentially for idiopathic PD patients.

This current study is a meta-analysis conducted on 63 studies on video-game based cognitive interventions (118 investigations, N = 2,079), which demonstrated a moderate and significant training effect on overall gains in cognition, g = 0.25, p < .001. Significant evidence of transfer was found to overall cognition, as well as to attention/perception and higher-order cognition constructs. Examination of specific gameplay features however showed selective and differential transfer to these outcome measures, whereas the genre labels of "action", "strategy", "casual", and "non-casual" were not similarly predictive of outcomes. We therefore recommend that future video-game interventions targeting cognitive enhancements should consider gameplay feature classification approach over existing genre classification, which may provide more fruitful training-related benefits to cognition.

The efficiency with which conventional boilers perform, in terms of sustainability, is affected by a variety of factors. Unsustainable boiler operating practices are still surprisingly frequent in developing countries, resulting in environmental liabilities and catastrophic accidents. It is a serious problem in developing countries like Bangladesh, where boilers are utilized extensively in the apparel manufacturing sector. However, no research has yet examined the challenges or barriers associated with sustainable boiler operation in the apparel manufacturing sector. This study, thereby, utilizes an integrated MCDM approach, combining the fuzzy theory and the decision-making trial and evaluation laboratory (DEMATEL) method, to identify, prioritize, and explore the relations among the barriers to sustainable boiler operation in the apparel manufacturing industry, from an emerging economy perspective. The barriers were initially identified from the literature and a visual survey of 127 factories. After expert validation, thirteen barriers were finally selected to be analyzed utilizing the fuzzy DEMATEL method. The study findings revealed that 'Absence of water treatment facilities', 'Fossil fuel burning and GHG emissions', and 'Excessive consumption of groundwater' are the three most prominent barriers to sustainable boiler operation. The cause-effect relations among the barriers suggest that 'Inadequate compliance with safety and hazard regulations' is the most influential and 'Fossil fuel burning and GHG emissions' is the most influenced barrier. This study is expected to guide the managers and policymakers of the apparel manufacturing sector in successfully overcoming the barriers to sustainable boiler operation, thus mitigating the operational hazards and achieving the sustainable development goals (SDGs).

In this work, we examine the changes in demand for bike-sharing platforms with the onset of the Covid-19 pandemic. Using the fixed-effects regression formulation of difference-in-differences, we evaluate how the demand for bike-sharing platforms changed after the first cases of Covid were discovered and after the first executive orders were implemented. Accounting for weather conditions, socio-economic characteristics, time trends, and fixed effects across cities, our findings indicate that there is an increase in daily bike-sharing trips by 22% on average after the first Covid-19 case diagnosis, and a decrease of 30% after the first executive order implementation in each municipality, using the data up to August 2020. Moreover, we observe a 22% increase in weekday-specific trip frequency after the first Covid-19 case diagnosis and a 28% decrease in weekend-specific trip frequency after the first executive order implementation. Finally, we find that there is an increase in the frequency of trips on bike-sharing platforms in more bike-friendly, transit-friendly, and pedestrian-friendly cities upon both the first Covid-19 case diagnosis and the first executive order implementation.

Abstract Human Action Recognition (HAR) is a popular area of research in computer vision due to its wide range of applications such as surveillance, health care, and gaming, etc. Action recognition based on 3D skeleton data allows simplistic, cost-efficient models to be formed making it a widely used method. In this work, we propose DSwarm-Net, a framework that employs deep learning and swarm intelligence-based metaheuristic for HAR that uses 3D skeleton data for action classification. We extract four different types of features from the skeletal data namely: Distance, Distance Velocity, Angle, and Angle Velocity, which capture complementary information from the skeleton joints for encoding them into images. Encoding the skeleton data features into images is an alternative to the traditional video-processing approach and it helps in making the classification task less complex. The Distance and Distance Velocity encoded images have been stacked depth-wise and fed into a Convolutional Neural Network model which is a modified version of Inception-ResNet. Similarly, the Angle and Angle Velocity encoded images have been stacked depth-wise and fed into the same network. After training these models, deep features have been extracted from the pre-final layer of the networks, and the obtained feature representation is optimized by a nature-inspired metaheuristic, called Ant Lion Optimizer, to eliminate the non-informative or misleading features and to reduce the dimensionality of the feature set. DSwarm-Net has been evaluated on three publicly available HAR datasets, namely UTD-MHAD, HDM05, and NTU RGB+D 60 achieving competitive results, thus confirming the superiority of the proposed model compared to state-of-the-art models.

Abstract There is a closely relationship between the development and progression of nonalcoholic fatty liver disease (NAFLD) or metabolic associated fatty liver disease (MAFLD) and obesity and diabetes. NAFLD fibrosis scores should be routinely used to rule out patients with advanced fibrosis. High scores may help identify patients at higher risk of all causes andliverrelated morbidity and mortality. The aim of this study was to investigate the association between exenatide and fibrosis scores. The effect of exenatide treatment on fibrosis scores was evaluated in type 2 diabetes mellitus (DM) patients with MAFLD. Evaluation was made of 50 patients with type 2 DM and MAFLD. The NFS, FIB4 and APRI scores were calculated before and after 6 months of treatment. After 6 months of exenatide treatment, the NFS and APRI scores were determined to have decreased significantly. Exenatide was observed to control blood glucose, reduce body weight and improve fibrosis scores in MAFLD patients with type 2 diabetes.

Abstract There is a strong genetic contribution to Amyotrophic lateral sclerosis (ALS) risk, with heritability estimates of up to 60%. Both Mendelian and small effect variants have been identified, but in common with other conditions, such variants only explain a little of the heritability. Genomic structural variation might account for some of this otherwise unexplained heritability. We therefore investigated association between structural variation in a set of 25 ALS genes, and ALS risk and phenotype. As expected, the repeat expansion in the C9orf72 gene was identified as associated with ALS. Two other ALS-associated structural variants were identified: inversion in the VCP gene and insertion in the ERBB4 gene. All three variants were associated both with increased risk of ALS and specific phenotypic patterns of disease expression. More than 70% of people with respiratory onset ALS harboured ERBB4 insertion compared with 25% of the general population, suggesting respiratory onset ALS may be a distinct genetic subtype.

Abstract Oral mucositis (OM) is one of the most frequent adverse events of high-dose conditioning chemotherapy with melphalan prior to autologous hematopoietic stem cell transplantation (AHSCT). It significantly reduces the patients’ quality of life. One of the preventive strategies for OM is cryotherapy. We retrospectively analyzed whether commercially available ice-cream could prevent OM during the melphalan infusion. We retrospectively analyzed 74 patients after AHSCT to see whether there is any correlation between OM and cryotherapy (ice-cream), melphalan dose (140 mg/m2 or 200 mg/m2). The incidence of OM in our study inversely correlated with cryotherapy in the form of ice-cream. Out of 74 patients receiving conditioning chemotherapy with high-dose melphalan, 52 received cryotherapy. Fifteen patients in the cryotherapy group (28.84%) developed OM, whereas 13 patients (59.09%) developed it in the group without cryotherapy. In a multiple linear regression test cryotherapy remained a significant protective factor against OM (p = 0.02) We have also seen the relationship between melphalan dose with OM (p

ABSTRACT BACKGROUND: Many scoring systems for predicting mortality, rebleeding and transfusion needs among patients with upper gastrointestinal bleeding (UGIB) have been developed. However, no scoring system can predict all these outcomes. OBJECTIVE: To show whether the perfusion index (PI), compared with the Rockall score (RS), helps predict transfusion needs and prognoses among patients presenting with UGIB in emergency departments. In this way, critical patients with transfusion needs can be identified at an early stage. DESIGN AND SETTING: Prospective cohort study in an emergency department in Turkey, conducted between June 2018 and June 2019. METHODS: Patients’ demographic parameters, PI, RS, transfusion needs and prognosis were recorded. RESULTS: A total of 219 patients were included. Blood transfusion was performed in 174 patients (79.4%). The PI cutoff value for prediction of the need for blood transfusion was 1.17, and the RS cutoff value was 5. The area under the curve (AUC) value for PI (AUC: 0.772; 95% confidence interval, CI: 0.705-0.838; P < 0.001) was higher than for RS (AUC: 0.648; 95% CI: 0.554-0.741; P = 0.002). 185 patients (84.5%) were discharged, and 34 patients (15.5%) died. The PI cutoff value for predicting mortality was 1.1, and the RS cutoff value was 7. The AUC value for PI (AUC: 0.743; 95% CI: 0.649-0.837; P < 0.001) was higher than for RS (AUC: 0.725; 95% CI: 0.639-0.811; P < 0.001). CONCLUSION: PI values for patients admitted to emergency departments with UGIB on admission can help predict their need for transfusion and mortality risk.

Introduction Vestibular pathologies cause physical and psychological symptoms, as well as cognitive problems. Objective To evaluate the deterioration in sleep quality associated with vestibular pathologies. Methods The Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), the Pittsburgh Sleep Quality Index (PSQI), and the Limits of Stability test (LOS) were applied to the participants. Results We included 25 patients with Meniere's disease (MD), 22 patients with benign paroxysmal positional vertigo (BPPV), 21 patients with unilateral peripheral vestibular loss (UPVL), 23 patients with vestibular migraine (VM), and 43 controls. The total PSQI scores of the controls were better than those of the MD (p = 0.014), VM (p < 0.001), BPPV (p = 0.003), and UPVL (p = 0.001) groups. The proportion of poor sleepers in the MD (p = 0.005), BPPV (p = 0.018), and UPVL (p < 0.001) groups was significantly higher than that of the controls. The highest total DHI score (45.68 ± 25.76) was found among the MD group, and it was significantly higher than the scores of the BPPV (p = 0.007) and control (p < 0.001) groups. The highest BDI score was obtained in the VM group, and it was significantly higher than the scores of the BPPV (p = 0.046) and control (p < 0.001) groups. Moreover, the BDI scores of the MD (p = 0.001) and UPVL groups were also significantly worse than the score of the controls (p = 0.001). Conclusion The present study showed thatpatients with vestibular symptoms have physical and functional complaints, as well as increased psychosocial stress and decreased sleep quality. Evaluating multiple parameters of quality of life may contribute to a better understanding of vestibular physiology and symptoms, and may help establish a more effective therapeutic approach.

Introduction The bone-anchored hearing implant system (BAHS) is an effective amplification system that transmits the sounds received by an external operating system to the inner ear by bypassing the middle ear placed in the temporal bone. Objective This study compares the results of patients who underwent bone-anchored hearing implant system (BAHS) surgery using two different surgical methods in terms of preoperative and postoperative complications, surgical time, audiological findings, and patient satisfaction. Methods The results of 22 patients who underwent BAHS were evaluated retrospectively from video records and audiological results, The Turkish Version of the Glasgow Benefit Inventory (GBI) questionnaire were evaluated. Two different surgical approaches were used for implantation: the linear incision technique (n = 9) and the punch technique (n = 13). Results Mean surgical durations were 9.67 ± 2.85 and 47.65 ± 6.13 minutes for Groups A and B, respectively, and these were significantly different (p

Aim:In children presenting to the emergency room with traumatic tooth avulsion (TTA), the immediate replantation of the avulsed permanent tooth is required. We study aimed to investigate the knowledge and attitude of emergency physicians (ER) regarding emergency management of avulsed teeth.Methods:This multi-center cross-sectional survey study was conducted from October to December 2020. A self-administered questionnaire that had been designed in the Internet environment was sent to directors of ER facilities in hospitals regarding physicians at the emergency room in the hospitals. A total of 381 physicians participated by filling out the questionnaire.Results:Data revealed that 92.1 % of the participants did not find prior knowledge sufficient about avulsion and only 8.9% would replant the tooth by themselves. 56.2% of the physicians did not know the importance of tetanus prophylaxis. Only 48% of the participants selected the best transport media for an avulsed tooth. Experienced physicians and the emergency specialist had significantly better knowledge about the management of avulsed teeth (p=0.005 and p

Abstract Clostridium difficile is a spore-forming gram-positive bacterium, recognized as the primary cause of antibiotic-associated nosocomial diarrhoea. Clostridium difficile infection (CDI) has emerged as a major health-associated infection with increased incidence and hospitalization over the years with high mortality rates. Contamination and infection occur after ingestion of vegetative spores, which germinate in the gastro-intestinal tract. The surface layer protein and flagellar proteins are responsible for the bacterial colonization while the spore coat protein, is associated with spore colonization. Both these factors are the main concern of the recurrence of CDI in hospitalized patients. In this study, the CotE, SlpA and FliC proteins are chosen to form a multivalent, multi-epitopic, chimeric vaccine candidate using the immunoinformatics approach. The overall reliability of the candidate vaccine was validated in silico and the molecular dynamics simulation verified the stability of the vaccine designed. Docking studies showed stable vaccine interactions with Toll‐Like Receptors of innate immune cells and MHC receptors. In silico codon optimization of the vaccine and its insertion in the cloning vector indicates a competent expression of the modelled vaccine in E. coli expression system. An in silico immune simulation system evaluated the effectiveness of the candidate vaccine to trigger a protective immune response.

Abstract COVID-19 has crippled the world’s healthcare systems, setting back the economy and taking the lives of several people. Although potential vaccines are being tested and supplied around the world, it will take a long time to reach every human being, more so with new variants of the virus emerging, enforcing a lockdown-like situation on parts of the world. Thus, there is a dire need for early and accurate detection of COVID-19 to prevent the spread of the disease, even more. The current gold-standard RT-PCR test is only 71% sensitive and is a laborious test to perform, leading to the incapability of conducting the population-wide screening. To this end, in this paper, we propose an automated COVID-19 detection system that uses CT-scan images of the lungs for classifying the same into COVID and Non-COVID cases. The proposed method applies an ensemble strategy that generates fuzzy ranks of the base classification models using the Gompertz function and fuses the decision scores of the base models adaptively to make the final predictions on the test cases. Three transfer learning-based convolutional neural network models are used, namely VGG-11, Wide ResNet-50-2, and Inception v3, to generate the decision scores to be fused by the proposed ensemble model. The framework has been evaluated on two publicly available chest CT scan datasets achieving state-of-the-art performance, justifying the reliability of the model. The relevant source codes related to the present work is available in: GitHub.

Objective: To assess the changes in children’s oral health-related quality of life following the treatment of severely affected molar-incisor hypomineralisation with Glass Hybrid Restorative System (GH) after selective caries removal. Method: The observational cross-sectional study was conducted at the Marmara University, School of Dentistry, Department of Pediatric Dentistry. Children aged 11–14 years (n = 55) who were diagnosed with MIH and had finished their dental treatment from November 2018 to December 2019, were included. The children’s MIH-affected teeth were treated with GH after SCR. Participants answered the Child Perceptions Questionnaire (CPQ) prior to their dental treatment and 6 months after the treatment. Results: Of the fifty-five patients, 40 patients (24 girls-16 boys) completed baseline and follow-up data. The mean age of the children was 11.85 (±1.02) years. The overall CPQ score ranged from 3–83 (average 33.27 ± 16.46) at baseline and 0–61 (average 11.67 ± 11.21) at follow up. The emotional well-being among children was the highest score at baseline. A significant decrease (p < 0.001) in the mean values was observed for both the overall CPQ scores and for the scores of the oral symptoms, functional limitations, and social-emotional well-being limitation. All subdomains showed large effect sizes and oral symptom limitation domain presented the greatest effect. Wilcoxon Rank test was used to determine the statistical significance of the changes and the magnitude of change was determined by calculating and classifying the effect size. Conclusion: Restorative treatment with GH following selective caries removal positively influenced the oral health-related quality of life of children with severe molar-incisor hypomineralisation. Key Words: Health-related quality of life, Dental enamel hypoplasia, Questionnaires, Child, Oral health.

The scaffold protein PSD-95 links postsynaptic receptors to sites of presynaptic neurotransmitter release. Flexible linkers between folded domains in PSD-95 enable a dynamic supertertiary structure. Interdomain interactions within the PSG supramodule, formed by PDZ3, SH3, and Guanylate Kinase domains, regulate PSD-95 activity. Here we combined discrete molecular dynamics and single molecule Förster resonance energy transfer (FRET) to characterize the PSG supramodule, with time resolution spanning picoseconds to seconds. We used a FRET network to measure distances in full-length PSD-95 and model the conformational ensemble. We found that PDZ3 samples two conformational basins, which we confirmed with disulfide mapping. To understand effects on activity, we measured binding of the synaptic adhesion protein neuroligin. We found that PSD-95 bound neuroligin well at physiological pH while truncated PDZ3 bound poorly. Our hybrid structural models reveal how the supertertiary context of PDZ3 enables recognition of this critical synaptic ligand.