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IntroductionDonation after circulatory death (DCD) liver transplantation (LT) makes up well less than 1% of all LTs with a Model for End-Stage Liver Disease (MELD)≥35 in the United States. We hypothesized DCD-LT yields acceptable ischemia-reperfusion and reasonable outcomes for recipients with MELD≥35.MethodsWe analyzed recipients with lab-MELD≥35 at transplant within the UCSF (n=41) and the UNOS (n=375) cohorts using multivariate Cox regression and propensity score matching.ResultsIn the UCSF cohort, five-year patient survival was 85% for DCD-LTs and 86% for matched-Donation after Brain Death donors-(DBD) LTs (p=0.843). Multivariate analyses showed that younger donor/recipient age and more recent transplants (2011-2021 versus 1999-2010) were associated with better survival. DCD vs. DBD graft use did not significantly impact survival (HR: 1.2, 95%CI 0.6-2.7). The transaminase peak was approximately doubled, indicating suggesting an increased ischemia-reperfusion hit. DCD-LTs had a median post-LT length of stay of 11 days, and 34% (14/41) were on dialysis at discharge versus 12 days and 22% (9/41) for DBD-LTs. 27% (11/41) DCD-LTs versus 12% (5/41) DBD-LTs developed a biliary complication (p=0.095). UNOS cohort analysis confirmed patient survival predictors, but DCD graft emerged as a risk factor (HR: 1.5, 95%CI 1.3-1.9) with five-year patient survival of 65% versus 75% for DBD-LTs (p=0.016). This difference became non-significant in a sub-analysis focusing on MELD 35-36 recipients. Analysis of MELD≥35 DCD recipients showed that donor age of

BackgroundMachine learning (ML) is a valuable tool with the potential to aid clinical decision making. Adoption of ML to this end requires data that reliably correlates with the clinical outcome of interest; the advantage of ML is that it can model these correlations from complex multiparameter data sets that can be difficult to interpret conventionally. While currently available clinical data can be used in ML for this purpose, there exists the potential to discover new “biomarkers” that will enhance the effectiveness of ML in clinical decision making. Since the interaction of the immune system and cancer is a hallmark of tumor establishment and progression, one potential area for cancer biomarker discovery is through the investigation of cancer-related immune cell signatures. Hence, we hypothesize that blood immune cell signatures can act as a biomarker for cancer progression.MethodsTo probe this, we have developed and tested a multiparameter cell-surface marker screening pipeline, using flow cytometry to obtain high-resolution systemic leukocyte population profiles that correlate with detection and characterization of several cancers in murine syngeneic tumor models.ResultsWe discovered a signature of several blood leukocyte subsets, the most notable of which were monocyte subsets, that could be used to train CATboost ML models to predict the presence and type of cancer present in the animals.ConclusionsOur findings highlight the potential utility of a screening approach to identify robust leukocyte biomarkers for cancer detection and characterization. This pipeline can easily be adapted to screen for cancer specific leukocyte markers from the blood of cancer patient.

The application of remote monitoring of surface water has focused primarily on the detection of water bodies using expensive multi-spectral IR sensors. However, critical information about surface water bodies, particularly the dynamic behavior, is better derived from water contours. We show that water body detection is inadequate in accurately capturing the contours. Furthermore, we argue that RGB-based detection should be sufficient for accurate water detection. We present a new global dataset of remote sensing images obtained from Sentinel-2 and Landsat-8 missions and contour labeled to assist in this effort. We propose a unique UNet-style contour detection system that utilizes multiscale filters to detect contours accurately. Comparisons between our proposed system, existing water detection, and other segmentation and contour detection systems show the system's effectiveness in detecting water.

The current study has portrayed the synthetic mixtures of Themeda quadrivalvis using gas chromatography–mass spectrometry (GCMS), the combination of green silver nanoparticles (AgNPs) formed with macrolide antimicrobials. The counter microbial effects were investigated with various concentrates of plant compounds, AgNPs, and macrolide-formed AgNPs against respiratory microorganisms. GCMS examination has shown the presence of various substances that intensifies the chloroform concentrate of T. quadrivalvis. A total of 51 mixtures were distinguished, and furthermore, the most severe zone of restraint was found in chloroform removal and against Klebsiella sp. (18 ± 4.7 mm). It has been demonstrated that the green mixture of AgNPs containing macrolide anti-toxins, such as azithromycin, erythromycin, and clarithromycin, demonstrates extensive antibacterial activities against a wide range of microorganisms. In contrast, the green union of AgNPs also demonstrates their efficacy against a wide range of respiratory microbes. The particles containing numerous relatively small fragments that were observed in the scanning electron microscopy analysis were found to be 20 nm in size. Previous studies have focused on phytochemicals and green amalgamations of AgNPs, but not much detail has been provided on T. quadrivalvis. It has been reported that the two concentrates (a plant concentrate in combination with consolidated green nanoparticle macrolide anti-toxins). The present study aims to treat respiratory microorganisms with a green methodology approach using nanotechnology; this analysis primarily focuses on offering creative approaches to make drugs against respiratory microbes.

الملخص: أهداف البحث: في هذه الدراسة، جرت محاولة لتطوير أقراص صغيرة جديدة متعددة الوظائف ذات إطلاق مستدام في نظام الكبسولة عن طريق غلاف فلم من فيسوتيرودين لعلاج سلس البول (زيادة تكرار التبول). طرق البحث: تم استخدام تقنية الضغط المباشر لتكوين الأقراص الصغيرة وضغط الغلاف باستخدام فثالات هيدروكسي بروبيل ميثايل السلولوز. تم إجراء دراسة ما قبل التركيبة باستخدام أدوات مثل قياس الكالوري التفرسي التفريقي، والتحليل الطيفي بالأشعة تحت الحمراء ، ومؤشرات ما بعد التركيبة مثل الصلابة ، والسمك ، وتغير الوزن ، والتوحيد ، وإطلاق الدواء. تمت دراسة حركية إطلاق الدواء للتركيبات ف1 إلى ف11. النتائج: تم العثور على جميع مؤشرات ما قبل التركيبة وما بعد التركيبة ضمن الحدود. ينتج عن تركيبة ف1 و ف2 إطلاق سريع للدواء في غضون 30 دقيقة. تظهر التركيبات ف3 و ف4 و ف5 فثالات هيدروكسي بروبيل ميثايل السلولوز المغلفة إطلاقا بنسبة 100 ٪ تقريبا خلال 3 و 4 و 5 ساعات ؛ على التوالى. تظهر التركيبات ف6 و ف7 و ف8 (2.5٪ و 5٪ و 10٪ أقراص صغيرة مغلفة بالفورمالدهيد، على التوالي) إطلاقات دوائية في الأمعاء الدقيقة وتم إطالة الإطلاق لمدة 24 ساعة حيث كانت التركيبات ف9 و ف10 و ف11 (2.5٪ ، 5٪ ، 10٪ أقراص صغيرة مغلفة بالغلوتارالدهيد، على التوالي) تطلق في الأمعاء الدقيقة ولكن يستغرق الأمر أكثر من 20 ساعة لإطلاق الدواء. الاستنتاجات: تم تطوير الأقراص الصغيرة المغلفة بالفلم إلى مستوى مرضي من حيث العديد من مؤشرات ما بعد الضغط مثل الصلابة ، والسماكة ، والتفتت ، وتغير الوزن ، وتوحيد المحتوى. كشفت دراسات الأشعة تحت الحمراء و قياس الكالوري التفرسي التفريقي أنه لا يوجد تفاعل كبير بين السواغات الدوائية. يتم إطلاق أقراص صغيرة مغلفة بفثالات هيدروكسي بروبيل ميثايل في دارئة وكان من المفترض أن يتحرر الدواء في الأمعاء مما يؤدي إلى امتصاص أفضل للدواء واتباع حركية إطلاق كورسماير-بيباس. Abstract: Objectives: In the present study, an attempt is made to develop novel multifunctional sustained-release minitablets in a capsule system by film coating Fesoterodine for the treatment of urinary incontinence (increased urinating frequency). Methodology: The direct compression technique was used to formulate the minitablets, and coating was applied using hydroxypropyl methylcellulose (HPMC) phthalate. The pre-formulation study was performed using tools like differential scanning calorimetry (DSC), infrared spectroscopy (IR) and post-formulation parameters such as hardness, thickness, weight variation, uniformity, and drug release. Drug release kinetics were studied for the formulations F1–F11. Results: All the pre- and post-formulation parameters were found to be within the limits. F1 and F2 result in burst release of the drug within 30 minutes. For the F3, F4, and F5 formulations, HPMC phthalate-coated minitablets show almost 100% drug release in 3, 4, and 5 hours, respectively. F6, F7, and F8 (2.5%, 5%, and 10% formaldehyde-coated minitablets, respectively) show drug releases in the small intestine, and the release was prolonged for 24 hours, whereas F9, F10, and F11 (2.5%, 5%, and 10% glutaraldehyde-coated minitablets, respectively) release in the small intestine, but drug release takes more than 20 hours. Conclusion: Film-coated minitablets were satisfactorily developed in terms of various post-compression parameters like hardness, thickness, friability, weight variation, and content uniformity. IR and DSC studies revealed no significant drug excipient interactions. HPMC phthalate-coated minitablets released in the buffer, and it was supposed that the drug releases in the intestine, which leads to better absorption and follows Korsmeyer-Peppas release kinetics.

In this paper, the global asymptotic stability and global Mittag–Leffler stability of a class of fractional-order fuzzy bidirectional associative memory (BAM) neural networks with distributed delays is investigated. Necessary conditions are obtained by means of the Lyapunov functional method and inequality techniques. The hybrid feedback controllers are then developed to ensure the global asymptotic synchronization of these neural networks, resulting in two additional synchronization criteria. The derived conditions are applied to check the fractional-order fuzzy BAM neural network’s Mittag–Leffler stability and synchronization. Three examples are given to demonstrate the effectiveness of the achieved results.

In mothers who are nursing their infants, increased clearance of plasma metabolites into the mammary gland may reduce ectopic lipid in the liver. No study to date has investigated the role of lactation on liver lipid synthesis in humans, and we hypothesized that lactation would modify fatty acid and glucose handling to support liver metabolism in a manner synchronized with the demands of milk production. Lactating (n = 18) and formula-feeding women (n = 10) underwent metabolic testing at 6-week postpartum to determine whether lactation modified intrahepatic triacylglycerols (IHTGs), measured by proton magnetic resonance spectroscopy. Subjects ingested oral deuterated water to measure fractional de novo lipogenesis (DNL) in VLDL-TG during fasting and during an isotope-labeled clamp at an insulin infusion rate of 10 mU/m2/min. Compared with formula-feeding women, we found that lactating women exhibited lower plasma VLDL-TG concentrations, similar IHTG content and similar contribution of DNL to total VLDL-TG production. These findings suggest that lactation lowers plasma VLDL-TG concentrations for reasons that are unrelated to IHTG and DNL. Surprisingly, we determined that the rate of appearance of nonesterified fatty acids was not related to IHTG in either group, and the expected positive association between DNL and IHTG was only significant in formula-feeding women. Further, in lactating women only, the higher the prolactin concentration, the lower the IHTG, while greater DNL strongly associated with elevations in VLDL-TG. In conclusion, we suggest that future studies should investigate the role of lactation and prolactin in liver lipid secretion and metabolism.

A large number of hitherto unexplored elastic, thermophysical, acoustic, and optoelectronic properties of a double Weyl semimetal SrSi2 have been investigated in this study. Density functional theory (DFT) based methodology has been employed. Analyses of computed elastic parameters reveal that SrSi2 is a mechanically stable, ductile, moderately machinable, and relatively soft material. The compound is predicted to be dynamically stable and possesses significant metallic bonding. Study of thermophysical properties, namely, Debye temperature, Grüneisen parameter, acoustic parameters, melting temperature, heat capacity, thermal expansion coefficient, and dominant phonon mode is also indicative of soft nature of SrSi2. The electronic band structure calculations without and with spin–orbit coupling disclose semimetallic character with clear Weyl nodes close to the Fermi level. The electronic dispersion is anisotropic as evidenced by nearly flat and linear regions within the Brillouin zone. Optical parameters at different photon energies are investigated. SrSi2 shows excellent nonselective reflection spectrum across an extended range of energy encompassing the visible range implying that the compound under study has significant potential to be used as an efficient solar energy reflector. SrSi2 absorbs ultraviolet light quite efficiently. The compound also possesses high refractive index in the low energy. All these optical features can be useful in optoelectronic device applications.

In this inspection, the structural, microstructural, electrical, and magnetic properties of Cr-doped Cu0.5Mg0.5CrxFe2−xO4 (x = 0.0, 0.04, 0.08, 0.12, and 0.16) composites were examined, which were prepared using the sol–gel technique. The x-ray diffraction patterns of the samples sintered at 700 °C for 5 h demonstrate the production of single-phase spinel ferrite. FESEM images indicate a nearly homogeneous surface morphology with non-spherical particles. The average grain size was found to decrease with the Cr concentration. The EDS spectroscopy study of the parent composition and a representative sample of doping composition (x = 0.08) revealed the existence of doped Cr, as well as Fe, Mg, Cu, and O, in the sample. The fluctuation of Cr doping has a significant impact on the magnetic characteristics. The saturation magnetization (Ms) declines as the Cr level grows up to x = 0.08 and then again increases with the increasing Cr content, which may be due to antiferromagnetic Cr not remaining at B sites. Permeability measurements show a similar trend as well. This is expected since μ′ is proportional to Ms squared and grain size. The imaginary part of the permeability decreases with increasing frequency and remains almost constant in the high frequency region. The dielectric constant decreases with frequency increment and remains almost persistent in a higher frequency range. The dielectric permittivity increases with the increasing Cr content up to x = 0.08 but then decreases for greater Cr concentrations. Lower hopping probabilities across grain boundaries may explain the decreasing tendency of the dielectric measurement and rising resistivity with Cr doping after the x = 0.08 concentration. These samples are well-suited for use in high-frequency systems due to their low dielectric loss.

Background: There has been a rise in the incidence of injection drug use and associated infective endocarditis. Methods: The clinical outcomes of 39 patients admitted with injection drug use–associated infective endocarditis were collected with a mean follow-up of 14 months. The outcomes were compared for patients treated medically with those undergoing surgical intervention. Results: The mean age was 39 ± 11 years; 54% were female. Thirty-two patients (82%) had native and 7 (18%) prosthetic infective endocarditis. The tricuspid valve was affected in 17 patients (43%), the mitral in 10 (26%), the aortic in 4 (10%), and multiple valves in 8 (20%). Sixteen (41%) patients underwent surgery, and 23 (59%) were treated with medical therapy. The indications for surgery included heart failure, systemic emboli, recurrent infection, and vegetation size ≥10 mm. Patients undergoing surgery had a higher rate of paravalvular abscess (25% vs 0%, P = 0.02), valve perforation (37% vs 11%, P = 0.04), and mitral valve involvement (44% vs 13%, P = 0.06), whereas medically treated patients had higher tricuspid valve involvement (61% vs 19%, P = 0.02). During follow-up, 26% of medical and 31% of surgical cohort patients died (P = 0.7). Mortality was highest (54%) among those who continued medical management despite an indication for surgery. Univariate predictors of mortality were age (odds ratio [OR] 1.09, 95% confidence interval [CI]: 1.01-1.17; P = 0.02), heart failure (OR 6.9; 95% CI: 1.24-37.49; P = 0.02), septicemia (OR 4.40; 95% CI:0.99-19.54; P = 0.05), and shock (OR 10.8; 95% CI: 1.68-69.92; P = 0.01). Conclusions: Despite contemporary therapy, patients with injection drug use–associated infective endocarditis remain at high risk of complications and poor clinical outcomes. These findings highlight the need for developing new care pathways and a team approach for effective management. Résumé: Introduction: Il y a eu une augmentation de l’incidence de l’endocardite infectieuse associée à l’usage de drogues par injection. Méthodes: Nous avons recueilli au cours d’un suivi moyen de 14 mois les résultats cliniques de 39 patients admis en raison d’une endocardite infectieuse associée à l’usage de drogues par injection. Les résultats ont été comparés pour les patients traités médicalement avec ceux subissant une intervention chirurgicale. Résultats: L’âge moyen était de 39 ± 11 ans; 54 % étaient des femmes. Trente-deux patients (82 %) avaient une endocardite infectieuse sur valve native et 7 (18 %), une endocardite infectieuse sur prothèse valvulaire. La valve tricuspide était touchée chez 17 patients (43 %), la valve mitrale, chez 10 patients (26 %), la valve aortique, chez 4 patients (10 %), et plusieurs valves, chez 8 patients (20 %). Seize (41 %) patients ont subi une intervention chirurgicale, et 23 (59 %) ont reçu un traitement médical. Les indications d’intervention chirurgicale étaient les suivantes : l’insuffisance cardiaque, les embolies systémiques, l’infection récurrente et la taille de la végétation ≥ 10 mm. Les patients qui avaient subi une intervention chirurgicale ont plus fréquemment eu des abcès paravalvulaires (25 % vs 0 %, P = 0,02), des perforations de valves (37 % vs 11 %, P = 0,04) et des atteintes de la valve mitrale (44 % vs 13 %, P = 0,06), tandis que les patients qui avaient reçu un traitement médical ont plus fréquemment eu des atteintes de la valve tricuspide (61 % vs 19 %, P = 0,02). Durant le suivi, 26 % des patients de la cohorte du traitement médical et 31 % des patients de la cohorte de l’intervention chirurgicale sont morts (P = 0,7). La mortalité était plus élevée (54 %) chez les patients qui poursuivaient la prise en charge médicale malgré l’indication chirurgicale. Les prédicteurs univariés de la mortalité étaient l’âge (rapport de cotes [RC] 1,09, intervalle de confiance [IC] à 95 % : 1,01-1,17; P = 0,02), l’insuffisance cardiaque (RC 6,9; IC à 95 % : 1,24-37,49; P = 0,02), la septicémie (RC 4,40; IC à 95 % : 0,99-19,54; P = 0,05) et le choc (RC 10,8; IC à 95 % : 1,68-69,92; P = 0,01). Conclusions: En dépit de l’approche thérapeutique contemporaine, les patients atteints d’une endocardite infectieuse associée à l’usage de drogues par injection restent exposés à un risque élevé de complications et de mauvais résultats cliniques. Ces résultats illustrent la nécessité d’élaborer de nouveaux cheminements cliniques et une approche du travail en équipe pour assurer une prise en charge efficace.

Abstract We investigate the Yukawa coupling unification for the third generation in a class of SO(10) unified models which are consistent with the 4.2 σ deviation from the standard model of the muon g − 2 seen by the Fermilab experiment E989. A recent analysis in supergravity grand unified models shows that such an effect can arise from supersymmetric loops correction. Using a neural network, we further analyze regions of the parameter space where Yukawa coupling unification consistent with the Fermilab result can appear. In the analysis we take into account the contributions to Yukawas from the cubic and the quartic interactions. We test the model at the high luminosity and high energy LHC and estimate the integrated luminosities needed to discover sparticles predicted by the model.

This research investigates the synchronization of distributed delayed discrete-time fractional-order complex-valued neural networks. The necessary conditions have been established for the stability of the proposed networks using the theory of discrete fractional calculus, the discrete Laplace transform, and the theory of fractional-order discrete Mittag–Leffler functions. In order to guarantee the global asymptotic stability, adequate criteria are determined using Lyapunov’s direct technique, the Lyapunov approach, and some novel analysis techniques of fractional calculation. Thus, some sufficient conditions are obtained to guarantee the global stability. The validity of the theoretical results are finally shown using numerical examples.

BACKGROUND: Thyrotoxicosis is a common medical problem. Thyroid nuclear imaging with either I123 or technetium-99m (Tc-99m) pertechnetate are used to determine the cause. Although I123 has been the standard technique, Tc-99m pertechnetate is now commonly used, acceptable and easier to perform. The commonly used normal value of Tc-99m pertechnetate is 1–4%, but lower normal values have been reported in different populations. OBJECTIVE: Determine normal reference range of Tc-99m pertechne-tate thyroid uptake for thyroid scintigraphy in Saudi Arabia. DESIGN: Retrospective, cross-sectional. SETTING: Nuclear medicine service at tertiary care center in Riyadh. PATIENTS AND METHODS: We used data from biochemically euthyroid patients who underwent a thyroid Tc-99m pertechnetate scan while having parathyroid scintigraphy for hyperparathyroidism between April 2009 to April 2019. Medical records and biochemical thyroid function tests were reviewed and Tc-99m pertechnetate thyroid uptake values were determined for each patient. MAIN OUTCOME MEASURES: Thyroid uptake of Tc-99m pertechne-tate in euthyroid patients. SAMPLE SIZE: 167 RESULTS: The mean and median uptake of Tc-99m pertechnetate in euthyroid patients were 0.86% and 1.0%, respectively, and the inter-quartile range was 0.0–1.0%. The normal reference range in the study population was 0.2-2%. Thyroid uptake inversely correlated with age in females (r=−0.37, P

Background and Aim: Paracetamol (PCM) ingestion is one of the most frequent global causes of toxicity. Salvadora persica L. is a plant that among many other effects exhibits potent antioxidant, anti-inflammatory, antimicrobial, and anticancer effects. In this study, we investigated the possible protective effect of S. persica aqueous extract in the PCM overdose-induced liver and kidney injury and hematological changes in a mice model. Materials and Methods: Mice were given PCM with and without S. persica pretreatment. Blood cell counts and liver and kidney function biomarkers were measured. Liver and kidney samples were histologically examined. Results: A single overdose of PCM caused significant elevations of alanine and aspartate transaminases, alkaline phosphate, bilirubin, urea, uric acid, and creatinine compared with the control group. In addition, PCM toxicity significantly lowered red blood cell count but insignificantly increased both white blood cell and platelet counts in comparison to the control mice. Pretreatment with S. persica significantly prevented PCM-induced changes in hepatic and renal biomarkers. S. persica also caused marked reversal of hematological changes. Histologically, the liver and kidney showed inflammation and necrosis after PCM treatment, which were significantly reduced in mice pretreated with S. persica. Conclusion: Taken together, S. persica significantly inhibited PCM-induced renal, hepatic, and hematological toxicity, pointing to its possible use in the treatment of liver and renal disorders.