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Objective : To evaluate the relationship between the frequency of ED visits and outpatient department (OPD) follow-up in sickle cell disease (SCD) pediatric patients. Methods : A retrospective cohort study included 247 SCD pediatric patients between January 2016 and December 2018 at the Maternity and Children Hospital, Department of Pediatrics, Al Medinah Al Munawarah, Saudi Arabia. Data were extracted from electronic medical record system; patient demographics, medications, frequency of emergency department (ED) and OPD visits. Pearson correlation coefficient, linear regression and independent sample t-test were applied. Results : There was no significant correlation (95% CI [-0.013- 0.233]; p =0.07) between the frequency of ED and OPD visits. However, a significant correlation was found between ED visits and missed OPD appointments. Thus, linear regression was applied and indicated that one missed OPD appointment is associated with 1.92 ED visits, (95% CI: 0.19-0.42; p less than 0.001). Also, a higher rate of ED visits was observed when compared with other studies, with a high ED reliance of 43%. Conclusion : This study found that regular OPD visits could improve SCD management, as a directly proportional relationship between the frequency of ED visits and missed OPD appointments along with high ED reliance. Saudi Med J. 2020 Dec;41(12):1324-1329 doi: 10.15537/smj.2020.12.05585 How to cite this article: Ismail AF, Tarawah RA, Azzouni ZY, Alharbi LT, Altayyar RM. The relation between regular outpatient follow-up and frequency of emergency department visits in sickle cell pediatric patients. Saudi Med J. 2020 Dec;41(12):1324-1329. doi: 10.15537/smj.2020.12.05585. PMID: 33294890.

Background The free-breathing 3D whole-heart T2-prepared Bright-blood and black-blOOd phase SensiTive inversion recovery (BOOST) cardiovascular magnetic resonance (CMR) sequence was recently proposed for simultaneous bright-blood coronary CMR angiography and black-blood late gadolinium enhancement (LGE) imaging. This sequence enables simultaneous visualization of cardiac anatomy, coronary arteries and fibrosis. However, high-resolution (3) fully-sampled BOOST requires long acquisition times of ~ 20 min. Methods In this work, we propose to extend a highly efficient respiratory-resolved motion-corrected reconstruction framework (XD-ORCCA) to T2-prepared BOOST to enable high-resolution 3D whole-heart coronary CMR angiography and black-blood LGE in a clinically feasible scan time. Twelve healthy subjects were imaged without contrast injection (pre-contrast BOOST) and 10 patients with suspected cardiovascular disease were imaged after contrast injection (post-contrast BOOST). A quantitative analysis software was used to compare accelerated pre-contrast BOOST against the fully-sampled counterpart (vessel sharpness and length of the left and right coronary arteries). Moreover, three cardiologists performed diagnostic image quality scoring for clinical 2D LGE and both bright- and black-blood 3D BOOST imaging using a 4-point scale (1–4, non-diagnostic–fully diagnostic). A two one-sided test of equivalence (TOST) was performed to compare the pre-contrast BOOST images. Nonparametric TOST was performed to compare post-contrast BOOST image quality scores. Results The proposed method produces images from 3.8 × accelerated non-contrast-enhanced BOOST acquisitions with comparable vessel length and sharpness to those obtained from fully- sampled scans in healthy subjects. Moreover, in terms of visual grading, the 3D BOOST LGE datasets (median 4) and the clinical 2D counterpart (median 3.5) were found to be statistically equivalent (p 3.5). Conclusions The proposed framework provides high‐resolution 3D whole-heart BOOST images from a single free-breathing acquisition in ~ 7 min.

Background: Blepharoptosis is abnormal low position of the upper eyelid The effect of ptosis surgery on ocular surface is not clear and needs more clarification. Aim of this Work: To compare between levator resection and frontalis sling operations regarding tear filmand topographic changes in order to minimize postoperative morbidity and increase patient satisfaction. Patients and Methods: This study included 30 eyes of 27patients with moderate to severe ptosis and levator function within 5-6mmand with the ability to cooperate for examination and investigations. Patients were divided in a randomized manner into Two groups: Levator Resection (LR) group: 15 eyes of 15 patients underwent transcutaneous maximum levator resection. Frontalis Sling (FS) group: 15 eyes of 12 patients underwent frontalis suspension with silicon rods. The patients were subjected to complete ophthalmo-logical examination, special lid examination, tear film examination and corneal topography.Results: In frontalis sling group, Schirmer test was constant in 53.3% of cases and increased in 46.7% of cases, On the other hand, Inlevator resection group, Schirmer test decreased in 86.7% of cases and was constant in 13.3% of cases with a statistically significant difference (p-value

Novel 2-amino(substituted pyrimidin-2-yl)benzimidazole and 2-amino-3,4-dihydro[1,3,5]triazino[1,2-a]benzimidazole hybrids were synthesized and evaluated for their in vitro antitumor activity at Nat...

New series of arylazo-pyrazoles and arylazopyrazolo[1,5-a]pyrimidines are designed, synthesized, and evaluated for antimicrobial activity. The structures of new compounds were supported by IR, 1H N...

Background We aimed to describe an outbreak of cutaneous abscesses caused by Panton-Valentine leukocidin (PVL)-producing methicillin-susceptible Staphylococcus aureus (MSSA) among gold mine workers. Methods In February 2018, we retrospectively reviewed a random sample of 50 medical records from 243 cases and conducted face-to-face interviews using a structured questionnaire. Pus aspirates were sent to the National Institute for Communicable Diseases from prospectively-identified cases (November 2017–March 2018). Nasopharyngeal swabs were collected during a colonisation survey in February 2018. Staphylococcus aureus isolates were screened with a conventional PCR for lukS/F-PV. Pulsed-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness among the isolates. A sample of isolates were selected for whole genome sequencing (WGS). We conducted an assessment on biological risks associated with mining activities. Results From January 2017 to February 2018, 10% (350/3582) of mine workers sought care for cutaneous abscesses. Forty-seven medical files were available for review, 96% were male (n = 45) with a mean age of 43 years (SD = 7). About 52% (24/46) were involved in stoping and 28% (13/47) worked on a particular level. We cultured S. aureus from 79% (30/38) of cases with a submitted specimen and 14% (12/83) from colonisation swabs. All isolates were susceptible to cloxacillin. Seventy-one percent of S. aureus isolates (30/42) were PVL-PCR-positive. Six PFGE clusters were identified, 57% (21/37) were closely related. WGS analysis found nine different sequence types. PFGE and WGS analysis showed more than one cluster of S. aureus infections involving closely related isolates. Test reports for feed and product water of the mine showed that total plate counts were above the limits of 1000 cfu/ml, coliform counts > 10 cfu/100 ml and presence of faecal coliforms. Best practices were poorly implemented as some mine workers washed protective clothing with untreated water and hung them for drying at the underground surface. Conclusions PVL-producing MSSA caused an outbreak of cutaneous abscesses among underground workers at a gold mining company. To our knowledge, no other outbreaks of PVL-producing S. aureus involving skin and soft tissue infections have been reported in mining facilities in South Africa. We recommend that worker awareness of infection prevention and control practices be strengthened.

Background Ralstonia species are Gram-negative bacilli of low virulence. These organisms are capable of causing healthcare associated infections through contaminated solutions. In this study, we aimed to determine the source of Ralstonia mannitolilytica bacteraemia in affected patients in a haemodialysis unit. Methods Our laboratory noted an increase in cases of bacteraemia caused by Ralstonia mannitililytica between May and June 2016. All affected patients underwent haemodialysis at the haemodialysis unit of an academic hospital. The reverse osmosis filter of the haemodialysis water system was found to be dysfunctional. We collected water for culture at various points of the dialysis system to determine the source of the organism implicated. ERIC-PCR was used to determine relatedness of patient and environmental isolates. Results Sixteen patients were found to have Ralstonia mannitolilytica bacteraemia during the outbreak period. We cultured Ralstonia spp. from water collected in the dialysis system. This isolate and patient isolates were found to have the identical molecular banding pattern. Conclusions All patients were septic and received directed antibiotic therapy. There was 1 mortality. The source of the R. mannitolilytica infection in these patients was most likely the dialysis water as the identical organism was cultured from the dialysis water and the patients. The hospital management intervened and repaired the dialysis water system following which no further cases of R. mannitolilytca infections were detected. A multidisciplinary approach is required to control healthcare associated infections such as these. Routine maintenance of water systems in the hospital is essential to prevent clinical infections with R.mannitolilytica.

Antimicrobial chemotherapy is the clinical application of antimicrobial agents to treat infectious disease. A new series of 3,6-disubstituted- and 2,3,6-trisubstitutedquinoxalines have been synthes...

Objective: Interstitial fibrosis is a pathological expansion of the heart's inter-cellular collagen matrix. It is a potential complication of nonischemic cardiomyopathy (NICM), a class of diseases involving electrical and or mechanical dysfunction of cardiac tissue not caused by atherosclerosis. Patients with NICM and interstitial fibrosis often suffer from life threatening arrhythmias, which we aim to simulate in this study. Methods: Our methodology builds on an efficient discrete finite element (DFE) method which allows for the representation of fibrosis as infinitesimal splits in a mesh. We update the DFE method with a local connectivity analysis which creates a consistent topology in the fibrosis network. This is particularly important in nonischemic disease due to the potential presence of large and contiguous fibrotic regions and therefore potentially complex fibrosis networks. Results: In experiments with an image-based model, we demonstrate that our methodology is able to simulate reentrant electrical events associated with cardiac arrhythmias. These reentries depended crucially upon sufficient fibrosis density, which was marked by conduction slowing at high pacing rates. We also created a 2D test-case which demonstrated that fibrosis topologies can modulate transient conduction block, and thereby reentrant activations. Conclusion: Ventricular arrhythmias due to interstitial fibrosis in NICM can be efficiently simulated using our methods in medical image based geometries. Furthermore, fibrosis topology modulates transient conduction block, and should be accounted for in electrophysiological simulations with interstitial fibrosis. Significance: Our study provides methodology which has the potential to predict arrhythmias and to optimize treatments non-invasively for nonischemic cardiomyopathies.

Fungal genome have highest number of the ATP binding cassette (ABC) superfamily PDR (Pleotropic drug resistance) sub divided into MDR (multi drug resistance) and MFS (major facilitator family). The major conserved domain of the super family comprised of various alpha helix proteins in form of ATP binding cassettes as transmembrane. Another conserved (NTP) nucleotide binding domain contained of conserved amino acids is more crucial domain of super family. ABC proteins are majorly involved in transport across cytoplasm and plasma membrane for the number of substrates as proteins, amino acids, ions and drugs. According to the recent studies yeast and Neurosporacrassahave highest number of orthologs and is the best model to uncover the underlying phenomena of drug resistance for the better understanding. There is dearth of study on the existence of drug transport proteins in pathogenic fungi. Study have focused on the emergence of CDR, MDR and MRS family major drug resistant transport proteins in various fungal groups.

Background: Endomyocardial biopsy (EMB) is the gold standard method for surveillance of acute cardiac allograft rejection (ACAR) despite its invasive nature. Cardiovascular magnetic resonance (CMR)–based myocardial tissue characterization allows detection of myocarditis. The feasibility of CMR-based surveillance for ACAR-induced myocarditis in the first year after heart transplantation is currently undescribed. Methods: CMR-based multiparametric mapping was initially assessed in a prospective cross-sectional fashion to establish agreement between CMR- and EMB-based ACAR and to determine CMR cutoff values between rejection grades. A prospective randomized noninferiority pilot study was then undertaken in adult orthotopic heart transplant recipients who were randomized at 4 weeks after orthotopic heart transplantation to either CMR- or EMB-based rejection surveillance. Clinical end points were assessed at 52 weeks. Results: Four hundred one CMR studies and 354 EMB procedures were performed in 106 participants. Forty heart transplant recipients were randomized. CMR-based multiparametric assessment was highly reproducible and reliable at detecting ACAR (area under the curve, 0.92; sensitivity, 93%; specificity, 92%; negative predictive value, 99%) with greater specificity and negative predictive value than either T1 or T2 parametric CMR mapping alone. High-grade rejection occurred in similar numbers of patients in each randomized group (CMR, n=7; EMB, n=8; P =0.74). Despite similarities in immunosuppression requirements, kidney function, and mortality between groups, the rates of hospitalization (9 of 20 [45%] versus 18 of 20 [90%]; odds ratio, 0.091; P =0.006) and infection (7 of 20 [35%] versus 14 of 20 [70%]; odds ratio, 0.192; P =0,019) were lower in the CMR group. On 15 occasions (6%), patients who were randomized to the CMR arm underwent EMB for clarification or logistic reasons, representing a 94% reduction in the requirement for EMB-based surveillance. Conclusions: A noninvasive CMR-based surveillance strategy for ACAR in the first year after orthotopic heart transplantation is feasible compared with EMB-based surveillance. Registration: HREC/13/SVH/66 and HREC/17/SVH/80. Australian New Zealand Clinical Trials Registry: ACTRN12618000672257.

The antimicrobial assessments of two new series of nicotinonitriles and pyrido[2,3-d]pyrimidines were performed using amoxicillin and nystatin as reference standards. Outstanding antifungal activities were achieved by some target compounds; for instance, compounds 7 and 9 displayed a minimal inhibitory concentration (MIC) value of 1.95 µg/ml toward Candida albicans, compound 11 showed a potent anti-Rhizopus effect (MIC 1.95 µg/ml) and compound 14 elicited remarkable antifungal effects against both Aspergillis niger and C. albicans (MIC 1.95 µg/ml). However, pyrido[2,3-d]pyrimidines 12, 14, and 16 showed moderate antibacterial activities against some gram-negative bacteria. The antibiofilm results of these compounds against resistant strains of Proteus mirabilis were better than those of Pseudomonas aeruginosa. Docking studies of these hits at the DNA gyrase active site revealed affinity and docking scores comparable to that of the reference standards. Gyrase-inhibitory activities revealed that 14 (IC

Hypertensive heart disease (HHD) develops in response to the chronic exposure of the left ventricle and left atrium to elevated systemic blood pressure. Left ventricular structural changes include hypertrophy and interstitial fibrosis that in turn lead to functional changes including diastolic dysfunction and impaired left atrial and LV mechanical function. Ultimately, these changes can lead to heart failure with a preserved (HFpEF) or reduced (HFrEF) ejection fraction. This review will outline the clinical evaluation of a patient with hypertension and/or suspected HHD, with a particular emphasis on the role and recent advances of multimodality imaging in both diagnosis and differential diagnosis.

This study was conducted to explore the protective potential of three different antioxidant supplements, lycopene, citric acid, and Chlorella, against reproductive injuries induced by microplastics (MPs) in freshwater mature male catfish. A total of 150 mature male African catfish (Clarias gariepinus) were assigned to five treatment groups as follows: control group fish were fed with control diet, the second group fish were fed with 500 mg/kg MP diet, and the remaining three groups of fish were fed with 500 mg/kg MP diet plus lycopene (500 mg/kg diet), citric acid (30 g/kg diet), and Chlorella (50 g/kg diet), respectively, for 15 days. Ingestion of MPs significantly decreased serum luteinizing hormone, follicle-stimulating hormone, sex steroid (testosterone and estradiol) levels and sperm count, spermatocrit, motility, and viability. It also induced histological alterations and degenerative changes in testicular tissues. Administration of lycopene and Chlorella with MP diets maintained hormone levels comparable to those in the control group, enhanced sperm quality, and decreased testicular histological damage. Chlorella was more effective in enhancing sperm quality, and lycopene was more efficient in alleviating testicular tissue damage. Citric acid supplementation was irrelevant in mitigating MP-induced injury. This study indicated that both lycopene and Chlorella ameliorated the MP-induced reproductive dysfunction by improving reproductive hormonal levels, sperm parameters, and histological configuration, whereas the citric acid dose used in this study was not effective in ameliorating the MP-induced reproductive stress. Additional research and monitoring of MP-induced pollution in freshwater ecosystems are required to avoid the severity of reproductive toxicity in freshwater fish.

The electrophilicity of the functional groups of β-aroylpropionic acid 3 was utilized as a key starting material through the reaction with different nitrogen nucleophiles to synthesize novel various pyridazin-3(2H)-one derivatives as well as some condensed acyclic compounds. The chemical structures of the synthesized compounds were characterized by IR, 1H NMR, 13C NMR, and mass spectra beside elemental analysis. The antifungal activity of the synthesized compounds against three types of fungus namely, Fusarium solani, Alternaria solani, and Fusarium semitectum realized that β-aroylpropionic acid 3, thiosemicarbazone derivative 8, and N-cyanoacetyl dihydropyridazinone derivative 17 displayed spectacular results for antifungal study and are worth being further evaluated in vivo and in the field.

Inflammatory cardiomyopathy (I-CMP) is defined as myocarditis in association with cardiac dysfunction and/or ventricular remodelling. It is characterized by inflammatory cell infiltration into the myocardium and has heterogeneous infectious and non-infectious aetiologies. A complex interplay of genetic, autoimmune, and environmental factors contributes to the substantial risk of deteriorating cardiac function, acute heart failure, and arrhythmia as well as chronic dilated cardiomyopathy and its sequelae. Multi-parametric cardiovascular magnetic resonance (CMR) imaging is sensitive to many tissue changes that occur during myocardial inflammation, regardless of its aetiology. In this review, we summarize the various aetiologies of I-CMP and illustrate how CMR contributes to non-invasive diagnosis.

The coconut tree, Cocos nucifera L., is planted for a variety of purposes. According to the Malaysian Agricultural Research and Development Institute (MARDI), rising coconut production has resulted in an increase in agricultural waste (coconut husk) in Malaysia (536,606 million coconuts in 2018 compared to 22,167 million coconuts in 2016). More than 60% of solid waste degradation in the environment is caused by the manufacture of coconut husks each year. Recycling coconut waste, particularly coconut husk, as a source of natural compounds offers environmental and economic benefits. The objectives of this study are to extract the flavonoid compounds from coconut husk from three different types of coconut fruit (Pandan Coconut, MAWA Coconut and Yellow Coconut) by using ethanolic solvent and compare them. Secondly, the antioxidant activity of coconut husk was determined by using the free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Thirdly, the alkaline reagent test was used to determine the presence of flavonoid compounds. The flavonoid compounds are existed in the coconut husk ethanolic extract and it have the antioxidant activity. IC50 of the standard compounds, ascorbic acid was 9.2 μg/ml. The most powerful radical scavenging effect was seen in Yellow Coconut husk extract, which had an IC50 value of 8.4 μg/ml. Flavonoids found in the husk of coconuts are known to have antioxidant properties. This shows that coconut husk extract has enormous potential as a natural preservative and a good bioresource of antioxidants.

Citrus is a globally cultivated fruit crop that has been heavily industrialised to manufacture food products. It is commonly sought out for its nutritional benefits. However, parallel to rapid industrialisation, parts of the crop’s physical composition (inner and outer peel, seeds etc.) are often discarded to the environment as waste. Recent advancement in technology has led researchers to look for alternatives to recover potential therapeutic compounds from citrus fruit waste, directly extending the life of the waste and indirectly solving waste management concerns. Citrus fruit peels are especially rich in flavonoid compounds, a subclass of the many phytochemicals largely present in the body of the fruit. Flavonoid compounds have the capacity to be act as antioxidants, leaving room for the potential of the flavonoids present in fruit waste to be commercialized as a natural bioresource. This study aims to extract and recover the flavonoid compounds present in the peels of citrus fruits calamansi (Citrus microcarpa), kaffir lime (Citrus hystrix), and key lime (Citrus aurantiifolia) via ethanolic extraction and test the presence of recovered flavonoid compounds via alkaline reagent test. In addition, this study also aims to measure the antioxidant activities of all three citrus fruit peel samples via the 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay. This study hopes to shed light on the therapeutic potential of citrus fruit peel waste as a bioresource which could benefit communities in the future.

Herbicides such as atrazine and humus substances such as fulvic acid are widely used in agricultural sector. They can be traced in surface and groundwater around the agriculture field at concentrations beyond the approved limit due to their mobility and persistence. Bismuth-based photocatalysts activated by visible light are potential materials for removing various organic pollutants from water bodies. These photocatalysts can also be suitable candidates for developing a hybrid membrane with anti-fouling properties. In this study, Bi

Cardiovascular disease (CVD) is the leading single cause of morbidity and mortality, causing over 17. 9 million deaths worldwide per year with associated costs of over $800 billion. Improving prevention, diagnosis, and treatment of CVD is therefore a global priority. Cardiovascular magnetic resonance (CMR) has emerged as a clinically important technique for the assessment of cardiovascular anatomy, function, perfusion, and viability. However, diversity and complexity of imaging, reconstruction and analysis methods pose some limitations to the widespread use of CMR. Especially in view of recent developments in the field of machine learning that provide novel solutions to address existing problems, it is necessary to bridge the gap between the clinical and scientific communities. This review covers five essential aspects of CMR to provide a comprehensive overview ranging from CVDs to CMR pulse sequence design, acquisition protocols, motion handling, image reconstruction and quantitative analysis of the obtained data. (1) The basic MR physics of CMR is introduced. Basic pulse sequence building blocks that are commonly used in CMR imaging are presented. Sequences containing these building blocks are formed for parametric mapping and functional imaging techniques. Commonly perceived artifacts and potential countermeasures are discussed for these methods. (2) CMR methods for identifying CVDs are illustrated. Basic anatomy and functional processes are described to understand the cardiac pathologies and how they can be captured by CMR imaging. (3) The planning and conduct of a complete CMR exam which is targeted for the respective pathology is shown. Building blocks are illustrated to create an efficient and patient-centered workflow. Further strategies to cope with challenging patients are discussed. (4) Imaging acceleration and reconstruction techniques are presented that enable acquisition of spatial, temporal, and parametric dynamics of the cardiac cycle. The handling of respiratory and cardiac motion strategies as well as their integration into the reconstruction processes is showcased. (5) Recent advances on deep learning-based reconstructions for this purpose are summarized. Furthermore, an overview of novel deep learning image segmentation and analysis methods is provided with a focus on automatic, fast and reliable extraction of biomarkers and parameters of clinical relevance.

Facile synthesis of molecular hybrids containing a 2,4-dinitrophenyl moiety was achieved

No abstract available.

Background: The majority of data regarding tissue substrate for post myocardial infarction (MI) VT has been collected during hemodynamically tolerated VT, which may be distinct from the substrate responsible for VT with hemodynamic compromise (VT-HC). This study aimed to characterize tissue at diastolic locations of VT-HC in a porcine model.Methods: Late Gadolinium Enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging was performed in eight pigs with healed antero-septal infarcts. Seven pigs underwent electrophysiology study with venous arterial-extra corporeal membrane oxygenation (VA-ECMO) support. Tissue thickness, scar and heterogeneous tissue (HT) transmurality were calculated at the location of the diastolic electrograms of mapped VT-HC.Results: Diastolic locations had median scar transmurality of 33.1% and a median HT transmurality 7.6%. Diastolic activation was found within areas of non-transmural scar in 80.1% of cases. Tissue activated during the diastolic component of VT circuits was thinner than healthy tissue (median thickness: 5.5 mm vs. 8.2 mm healthy tissue, p < 0.0001) and closer to HT (median distance diastolic tissue: 2.8 mm vs. 11.4 mm healthy tissue, p < 0.0001). Non-scarred regions with diastolic activation were closer to steep gradients in thickness than non-scarred locations with normal EGMs (diastolic locations distance = 1.19 mm vs. 9.67 mm for non-diastolic locations, p < 0.0001). Sites activated late in diastole were closest to steep gradients in tissue thickness.Conclusions: Non-transmural scar, mildly decreased tissue thickness, and steep gradients in tissue thickness represent the structural characteristics of the diastolic component of reentrant circuits in VT-HC in this porcine model and could form the basis for imaging criteria to define ablation targets in future trials.

Nanotechnology has gained prominence as an advanced field of science, particularly its propensity to solve various environmental challenges. The use of nanomaterials is advantageous due to the unprecedented properties of nanomaterials including high surface area, high reactivity and strong mechanical properties that have been shown to be highly efficient and effective characteristics for wastewater treatment. The development of various nanomaterials provide the most exciting and encouraging advances based on their size effects to the targeted particulates. Various forms of nanomaterials, single or hybrid, have been widely used for the removal of heavy metals, microorganisms and organic pollutants from wastewater. Thus, in this chapter, we review the roles of nanomaterials in their application to wastewater treatment, underlining their advantages. Particularly, nanomaterials possess unique characteristics, depending on their classification and dimensions, which are beneficial for wastewater treatment. Nanomaterials including carbon-based nanomaterials, metal and metal oxides, metal–organic frameworks as well as hybrid nanomaterials are covered in this chapter. Lastly, future directions in the use of hybrid nanomaterials for water remediation are highlighted.

Background: There are few data on sex differences in suspected cardiac sarcoidosis. Methods: Consecutive patients with histologically proven sarcoidosis and suspected cardiac involvement were studied. We investigated sex differences in presenting features, cardiac involvement, and the long-term incidence of a primary composite end point of all-cause death or significant ventricular arrhythmia and secondary end points of all-cause death and significant ventricular arrhythmia. Results: Among 324 patients, 163 (50.3%) were female and 161 (49.7%) were male patients. Female patients had a greater prevalence of chest pain (37.4% versus 23.6%; P =0.010) and palpitations (39.3% versus 26.1%; P =0.016) than male patients but not dyspnea, presyncope, syncope, or arrhythmias at presentation. Female patients had a lower prevalence of late gadolinium enhancement on cardiovascular magnetic resonance imaging (20.2% versus 35.4%; P =0.003) and less often met criteria for a clinical diagnosis of cardiac sarcoidosis (Heart Rhythm Society consensus criteria, 22.7% versus 36.0%; P =0.012 and 2016 Japanese Circulation Society guideline criteria, 8.0% versus 19.3%; P =0.005), indicating lesser cardiac involvement. However, the long-term incidence of all-cause death or significant ventricular arrhythmia was not different between female and male patients (23.2% versus 23.2%; P =0.46). Among the secondary end points, the incidence of all-cause death was not different between female and male patients (20.7% versus 14.3%; P =0.51), while female patients had a lower incidence of significant ventricular arrhythmia compared with male patients (4.3% versus 13.0%; P =0.022). On multivariable analyses, sex was not associated with the primary end point (hazard ratio for female patients, 1.36 [95% CI, 0.77–2.43]; P =0.29). Conclusions: We observed distinct sex differences in patients with suspected cardiac sarcoidosis. A paradox was identified wherein female patients had a greater prevalence of chest pain and palpitations than male patients, but lesser cardiac involvement, and a similar long-term incidence of all-cause death or significant ventricular arrhythmia.

Cadmium (Cd) is considered to be one of the major environmental pollutants which have potential threat to human health. Reports of declining male fertility have renewed interest in the role of environmental and occupational exposures in the etiology of human infertility. Cd exposure led to obvious degenerative changes in testicular tissue. This study was performed to investigate the Cd-induced structural effects on the testes and to evaluate the possible protective effect of omega-3 oil in adult albino rats. Thirty adult male rats were used in the present work, divided randomly into five groups, six rats in each group; the first group was considered as a control group and left without treatment except the standard rat chow and tap water. The second group was given 40 mg/L of CdCl2 in drinking water while the third group was given 60 mg/L of CdCl2 in drinking water. The fourth group was given 40 mg/L of CdCl2 in drinking water plus omega-3 oil (4 g/kg diet), while the fifth group was given 60 mg/L of CdCl2 in drinking water plus omega-3 oil (4 g/kg diet), the Cd-treated rats showed dose-dependent histological and ultrastructural alterations which have been ameliorated after exposure to omega-3 oil. The present investigation concluded that omega-3 played a protective role against Cd-induced histopathological changes in rat testis.

New pyrazole and pyridine derivatives have been synthesized from sulfanilamide and phenazone via diazotization and coupling with a wide range of α-CH acids followed by heterocyclization with hydrazine derivative, hydroxylamine and cyanoacetamide. The antimicrobial tests of the products demonstrate high to moderate activity against Gram (−ve) bacteria and the tested fungi. No positive action of the products is observed against Gram (+ve) bacteria.

PURPOSE To enable free-breathing whole-heart 3D T2 mapping with high isotropic resolution in a clinically feasible and predictable scan time. This 3D motion-corrected undersampled signal matched (MUST) T2 map is achieved by combining an undersampled motion-compensated T2 -prepared Cartesian acquisition with a high-order patch-based reconstruction. METHODS The 3D MUST-T2 mapping acquisition consists of an electrocardiogram-triggered, T2 -prepared, balanced SSFP sequence with nonselective saturation pulses. Three undersampled T2 -weighted volumes are acquired using a 3D Cartesian variable-density sampling with increasing T2 preparation times. A 2D image-based navigator is used to correct for respiratory motion of the heart and allow 100% scan efficiency. Multicontrast high-dimensionality undersampled patch-based reconstruction is used in concert with dictionary matching to generate 3D T2 maps. The proposed framework was evaluated in simulations, phantom experiments, and in vivo (10 healthy subjects, 2 patients) with 1.5-mm3 isotropic resolution. Three-dimensional MUST-T2 was compared against standard multi-echo spin-echo sequence (phantom) and conventional breath-held single-shot 2D SSFP T2 mapping (in vivo). RESULTS Three-dimensional MUST-T2 showed high accuracy in phantom experiments (R2 > 0.99). The precision of T2 values was similar for 3D MUST-T2 and 2D balanced SSFP T2 mapping in vivo (5 ± 1 ms versus 4 ± 2 ms, P = .52). Slightly longer T2 values were observed with 3D MUST-T2 in comparison to 2D balanced SSFP T2 mapping (50.7 ± 2 ms versus 48.2 ± 1 ms, P < .05). Preliminary results in patients demonstrated T2 values in agreement with literature values. CONCLUSION The proposed approach enables free-breathing whole-heart 3D T2 mapping with high isotropic resolution in about 8 minutes, achieving accurate and precise T2 quantification of myocardial tissue in a clinically feasible scan time.

In this paper, we will state and prove some weighted dynamic inequalities of Opial-type involving integrals of powers of a function and of its derivative on time scales which not only extend some results in the literature but also improve some of them. The main results will be proved by using some algebraic inequalities, the Hölder inequality and a simple consequence of Keller’s chain rule on time scales. As special cases of the obtained dynamic inequalities, we will get some continuous and discrete inequalities.

Objectives: This study sought to quantify myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) in dilated cardiomyopathy (DCM) and examine the relationship between myocardial ...

Background: The diagnosis of heavily pigmented melanocytic lesions is problematic. This is often compounded by lack of visibility of nuclear detail of tumour cells due to physical masking by melanin pigment. Similarly, there can be colour merging of chromogenic final reaction products with melanin, making an evidence of antigenic localisation problematic. There are a number of melanin bleaching techniques available for immunohistochemical assessments.Material and methods: All methods to date have involved the bleaching of melanin as a manually performed primary step before loading subsequently bleached slides onto automated immunohistochemical platforms. Here we define a semi-automated bleaching procedure that allows full integration on one of the most widely employed automated IHC staining platforms (Roche Ventana BenchMark Ultra). The bleaching protocol was defined on the BenchMark Ultra and involved the assessment of 24 histological cases of heavily pigmented malignant melanoma lesions (13 cutaneous and 11 metastatic) routinely fixed processed and paraffin wax embedded.Results: Completion of the bleaching was assessed on H&E preparations performed following the semi-automated bleaching step and employing the Roche Ventana BenchMark Ultra machine for 60 min at 42°C. Complete immunohistochemical staining was achieved on the automated platform within 5-6 h including the bleaching step. Results were consistent across all tissue evaluated.Discussion: This data provides evidence that the hydrogen peroxide bleaching procedure can be adapted for integration on one of the most widely employed automated IHC staining platforms and as a result, improve the efficiency and reproducibility of the technique.

ImportanceIn patients with sarcoidosis with suspected cardiac involvement, late gadolinium enhancement (LGE) on cardiovascular magnetic resonance imaging (CMR) identifies those with an increased risk of adverse outcomes. However, these outcomes are experienced by only a minority of patients with LGE, and identifying this subgroup may improve treatment and outcomes in these patients.ObjectiveTo assess whether CMR phenotypes based on left ventricular ejection fraction (LVEF) and LGE in patients with suspected cardiac sarcoidosis (CS) are associated with adverse outcomes during follow-up.Design, Setting, and ParticipantsThis cohort study included consecutive patients with histologically proven sarcoidosis who underwent CMR for the evaluation of suspected CS from 2004 to 2020 with a median follow-up of 4.3 years at an academic medical center in Minnesota. Demographic data, medical history, comorbidities, medications, and outcome data were collected blinded to CMR data.ExposuresCMR phenotypes were identified based on LVEF and LGE presence and features. LGE was classified as pathology-frequent or pathology-rare based on the frequency of cardiac damage features on gross pathology assessment of the hearts of patients with CS who had sudden cardiac death or cardiac transplant.Main Outcomes and MeasuresComposite of ventricular arrhythmic events and composite of heart failure events.ResultsAmong 504 patients (mean [SD] age, 54.1 [12.5] years; 242 [48.0%] female and 262 [52.0%] male; 2 [0.4%] American Indian or Alaska Native, 6 [1.2%] Asian, 90 [17.9%] Black or African American, 399 [79.2%] White, 5 [1.0%] of 2 or more races (including the above-mentioned categories and Native Hawaiian or Other Pacific Islander), and 2 [0.4%] of unknown race; 4 [0.8%] Hispanic or Latino, 498 [98.8%] not Hispanic or Latino, and 2 [0.4%] of unknown ethnicity), 4 distinct CMR phenotypes were identified: normal LVEF and no LGE (n = 290; 57.5%), abnormal LVEF and no LGE (n = 53; 10.5%), pathology-frequent LGE (n = 103; 20.4%), and pathology-rare LGE (n = 58; 11.5%). The phenotype with pathology-frequent LGE was associated with a high risk of arrhythmic events (hazard ratio [HR], 12.12; 95% CI, 3.62-40.57; P P = .02) independent of age, pulmonary hypertension, LVEF, right ventricular ejection fraction, and LVLGE extent. Risk of arrhythmic events was greater with an increasing number of pathology-frequent LGE features. The absence of the pathology-frequent LGE phenotype was associated with a low risk of arrhythmic events, even in the presence of LGE or abnormal LVEF.Conclusions and RelevanceThis cohort study found that a CMR phenotype involving pathology-frequent LGE features was associated with a high risk of arrhythmic and heart failure events in patients with sarcoidosis. The findings indicate that CMR phenotypes could be used to optimize clinical decision-making for treatment options, such as implantable cardioverter-defibrillators.

Herbicides are one of the most recurring pollutants in the aquatic system due to their widespread usage in the agriculture sector for weed control. Semiconductor-based photocatalysts have gained recognition due to their ability to degrade and mineralize pollutants into harmless by-products completely. Lately, many studies have been done to design photocatalysts with efficient separation of photogenerated charge carriers and enhanced light absorption. Photocatalyst engineering through doping with metal and non-metal elements and the formation of heterojunction are proven effective for minimizing the recombination of electron-hole pairs and enlarging the absorption in the visible light region. This review focuses on discussing and evaluating the recent progress in the types of photocatalysts and their performance in the remediation of herbicides in wastewater. The development of innovative hybrid technologies is also highlighted. The limitations and challenges of photocatalysis technology in the present literature have been identified, and future studies are recommended.