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Introduction One of the main factors that affect the early diagnosis and intervention of hearing loss is inadequate knowledge by the health care workers. Ear, nose, and throat (ENT) specialists are the main source of information about hearing loss and its management in most developing countries, such as Jordan. Objective The purpose of the present study is to explore the level of knowledge and the practice of hearing screening and hearing loss management for children among ENT physicians in Jordan as an example of health care providers in developing countries of the Middle East. Methods This was a cross-sectional study, adapting a questionnaire of knowledge and the practice of hearing screening and hearing loss management for children. The questionnaire consisted of 2 sections with 20 questions. A total of 40 ENT physicians completed the questionnaire. Results The majority of the respondents acknowledged the importance of hearing screening for children; however, there was limited knowledge regarding hearing loss management and testing. Only 10 of the ENT physicians believed that a referral to an audiologist is warranted, and the majority of the respondents were not aware that a child with a confirmed permanent hearing loss should be referred to a speech pathologist or to a rehabilitation center. Managing unilateral and mild sensorineural hearing loss (SNHL) was another area about which ENT physicians have limited knowledge. Conclusion There is a strong need for professional intervention programs, providing the latest updates and standardizations in the field of audiology and pediatric rehabilitation for ENT physicians.

Retinopathy of prematurity (ROP) is one of the main causes of blindness in children worldwide. Brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), play critical protective roles in the development and function of neurons and vasculature. Lack of BDNF expression results in increased endothelial cell apoptosis and reduced endothelial cell-cell contact. Premature babies who develop ROP tend to have lower serum BDNF levels. BDNF expression is also significantly lower in mouse retinas following exposure to hyperoxia compared to those reared in room air. Specifically, BDNF promotes angiogenic tube formation of endothelial cells (EC), and it is considered an EC survival factor required for stabilization of intramyocardial vessels. We hypothesized that the activation of TrkB receptor protects retinal vasculature in the mice during oxygen-induced ischemic retinopathy (OIR), a model of ROP. To test this hypothesis, we treated neonatal mice with 7,8-dihydroxyflavone (DHF) (5 mg/kg body weight), a TrkB receptor agonist. We examined its potential protective effects on retinal vessel obliteration and neovascularization, two hallmarks of ROP and OIR. We found that retinas from DHF treated postnatal day 8 (P8) and P12 mice have similar levels of vessel obliteration as retinas from age-matched control mice subjected to OIR. Similarly, DHF showed no significant effect on mitigation of retinal neovascularization during OIR in P17 mice. Collectively, our studies demonstrate that the TrkB receptor agonist DHF provides no significant protective effects during OIR.

Purpose: This study assesses the impact of patient clinical history on audiologists' performance when interpreting auditory brainstem response (ABR) results. Method: Fourteen audiologists' accuracy in estimating hearing threshold for 16 infants through interpretation of ABR traces was compared on 2 occasions at least 5 months apart. On the 1st occasion, ABR traces were presented to the audiologists with no clinical information except for the age of the child. On the 2nd occasion, audiologists were given a full clinical history for the ABR cases. Results: The addition of clinical history information had no statistically significant impact on sensitivity, specificity, or accuracy of diagnosis. Although the mean numbers of true-negative and true-positive diagnoses were higher when audiologists were given clinical information, the difference was again not statistically significant. Conclusion: This study suggests that if there are circumstances in which case material is incomplete or unavailable, audiologists have no cause for concern regarding the accuracy of their interpretation of ABR traces. In a clinical manner, this may help audiologists with large caseloads or audiologists who need to provide a diagnosis of hearing loss in a short time by allowing them to focus on conducting ABR without the need for case history information.

The first objective of this study was to characterize the chemical properties of three lots of whey protein hydrolysate (WPH) obtained from a commercial manufacturer. The degree of hydrolysis (DH) of WPH was between 13.82 and 15.35%, and was not significantly (p > 0.05) different between the batches. From MALDI-TOF, 10 to 13 different peptides were observed in the range of 2.5–5 kDa and 5–8 kDa, respectively. The second objective of the study was to evaluate the effectiveness of WPH as a binder in whey protein isolate (WPI) wet agglomeration. For this purpose, a 3 × 3 × 2 factorial design was conducted with pre-wet mass (60, 100, and 140 g), WPH concentration (15, 20, and 25%), and flow rate (4.0 and 5.6 mL·min−1) as independent variables. WPI agglomeration was carried out in a top-spray fluid bed granulator (Midi-Glatt, Binzen, Germany). Agglomerated WPI samples were stored at 25 °C and analyzed for moisture content (MC), water activity, relative dissolution index (RDI), and emulsifying capacity. Pre-wet mass, flow rate, and the WPH concentration had a significant (p < 0.05) effect on the MC. Moreover, all interactions among the main effects had also a significant (p < 0.05) effect on MC. High MC and water activity were observed for the treatments with a higher pre-wet volume and higher flow rate, which also resulted in clumping of the powders. The treatment with the 60 g pre-wet mass, 20% WPH concentration, and 5.6 mL·min−1 flow rate combination had the highest RDI among all the samples. In conclusion, WPH can be used as a potential alternative to soy lecithin in WPI wet agglomeration.

Inflammation is increasingly recognized as an important modulator in the pathogenesis of neovascular age-related macular degeneration (nAMD). Although significant progress has been made in delineating the pathways that contribute to the recruitment of inflammatory cells and their contribution to nAMD, we know little about what drives the resolution of these inflammatory responses. Gaining a better understanding of how immune cells are cleared in the choroid will give a novel insight into how sustained inflammation could influence the pathogenesis of nAMD. The pro-apoptotic Bcl-2 family member Bim is a master regulator of immune cell homeostasis. In its absence, immune cell lifespan and numbers increase. Most therapeutic regimes that squelch inflammation do so by enhancing immune cell apoptosis through enhanced Bim expression and activity. To test the hypothesis that Bim expression tempers inflammation during the pathogenesis of nAMD, we used the mouse laser-induced choroidal neovascularization (CNV) model in which inflammation acts as a facilitator of CNV. Here, we showed minimal to no change in the recruitment of F4/80-, CD80-, CD11b-, and Iba1-positive myeloid-derived mononuclear phagocytes to the site of laser photocoagulation in the absence of Bim expression. However, the resolution of these cells from the choroid of Bim-deficient (Bim -/-) mice was significantly diminished following laser photocoagulation. With time, we noted increased scar formation, demonstrated by collagen I staining, in Bim -/- mice with no change in the resolution of neovascularization compared to wild-type littermates. We also noted that mice lacking Bim expression in mononuclear phagocytes (BimFlox/Flox; Lyz2-Cre (BimMP) mice) had delayed resolution of F4/80-, CD80-, CD11b-, and Iba1-positive cells, while those lacking Bim expression in endothelial cells (BimFlox/Flox; Cad5-Cre (BimEC) mice) had delayed resolution of only CD11b- and Iba1-positive cells. Both BimMP and BimEC mice demonstrated increased scar formation, albeit to differing degrees. Thus, our studies show that resolving inflammation plays an important role in moderating scar formation in nAMD, and it is impacted by Bim expression in both the endothelium and mononuclear phagocyte lineages.

Background. Artificial intelligence (AI) applications are rapidly advancing in the field of medical imaging. This study is aimed at investigating the perception and knowledge of radiographers towards artificial intelligence. Methods. An online survey employing Google Forms consisting of 20 questions regarding the radiographers' perception of AI. The questionnaire was divided into two parts. The first part consisted of demographic information as well as whether the participants think AI should be part of medical training, their previous knowledge of the technologies used in AI, and whether they prefer to receive training on AI. The second part of the questionnaire consisted of two fields. The first one consisted of 16 questions regarding radiographers' perception of AI applications in radiology. Descriptive analysis and logistic regression analysis were used to evaluate the effect of gender on the items of the questionnaire. Results. Familiarity with AI was low, with only 52 out of 100 respondents (52%) reporting good familiarity with AI. Many participants considered AI useful in the medical field (74%). The findings of the study demonstrate that nearly most of the participants (98%) believed that AI should be integrated into university education, with 87% of the respondents preferring to receive training on AI, with some already having prior knowledge of AI used in technologies. The logistic regression analysis indicated a significant association between male gender and experience within the range of 23-27 years with the degree of familiarity with AI technology, exhibiting respective odds ratios of 1.89 (COR = 1.89) and 1.87 (COR = 1.87). Conclusions. This study suggests that medical practices have a favorable attitude towards AI in the radiology field. Most participants surveyed believed that AI should be part of radiography education. AI training programs for undergraduate and postgraduate radiographers may be necessary to prepare them for AI tools in radiology development. [ABSTRACT FROM AUTHOR]

Objective: The present study aims to compare prophylactic common iliac artery (CIA) temporary clamping and preoperative balloon occlusion for managing placenta accreta spectrum (PAS) disorders. Study Design: Between January 2019 and June 2020, 46 patients with PAS disorders were included. Of them, 26 patients were offered CIA balloon occlusion (Group A), while temporary CIA clamping was done for the other 20 patients (Group B). Primary outcomes were procedure‐related complications, and secondary outcomes included intraoperative and postoperative complications, reoperation rates, total procedure time, blood loss, and amount of blood transfusion. Results: Blood loss was statistically non‐significant higher in group B than in group A (p‐value = 0.143). Only one patient in group A and three in group B needed reoperation. The bleeding continued for a mean of 1.6 days in group A and 1.7 days in group B, with non‐significant statistical differences between both groups p value = 0.71. Nine patients in group A (34.6%) and four in group B (20%) required ICU admission. The mean Apgar score was 7 and 6.6 in babies of group A and group B patients, respectively. The median number of allogeneic blood transfusions performed was two in patients in group A and 1 in group B (p‐value = 0.001). Conclusion: Both techniques offer good choices for patients with PAS to decrease mortality and morbidity rates. The selection of a better technique depends on institutional references and physicians' experience. [ABSTRACT FROM AUTHOR]

Background: Seroma is the most common complication occurring after surgery for breast cancer, leading to patient discomfort, recurrent aspirations with the risk of inflammations, long hospital stay, delayed wound healing, skin flap damage, delay in treatment with adjuvant therapies, and high surgical costs. The purpose of our study is short term follow up" within two months after operation" to compare the effectiveness of using Tetracycline and reducing the dead space in reducing seroma after Modified Radical Mastectomy (MRM). Patients and methods: Interventional study was applied on 56 females having breast cancer to evaluate different techniques for reduction of seroma formation after modified radical mastectomy at department of general surgery, Zagazig University Hospitals, during the time from October 2018 to April 2020. Patients were divided into two groups each one enrolls 28 patients Group A: we used tetracycline, suction drain and tight bandage while in Group B: we used mechanical closure of dead space, suction drain and tight bandage. All patients were subjected to history taking, complete clinical examination, Laboratory tests and breast ultrasound. Results: In this study the percentage of seroma occurred in total cases was (26.8%) this is considered good results when compared to worldwide percentage (73%). In group A (Tetracycline) seroma occurred in 32% of 28 cases and 21.4% of 28 cases in group B. Conclusion: There was no significant difference between using Tetracycline and closing the dead space in decreasing seroma formation after MRM. [ABSTRACT FROM AUTHOR]

Background: Vaccination against COVID-19 during pregnancy is suggested to avoid pregnancy complications morbidity and bad delivery outcomes. However, the safety and efficacy of COVID-19 vaccinations during pregnancy is a specific issue impacting vaccination uptake by this susceptible group due to alterations in immune, respiratory, and cardiovascular physiology that occur during pregnancy. The purpose of this study was to examine the relationship between prenatal mother COVID-19 immunization, pregnancy course, and outcomes. Patients and Methods: A retroactive cohort analysis was conducted on all women who gave birth. Women having a previous COVID-19 diagnosis, numerous pregnancies, or an uncertain vaccination status were excluded. Pregnancy, neonatal problems, and delivery were compared with women who got 1 or 2 doses of a vaccine throughout pregnancy and women who did not get any vaccinations. Using multivariable models, the background characteristics were accounted for. Results: The pregnancy complications were higher in unvaccinated group than vaccinated group with no statistical significant difference except stillbirth that was present only in unvaccinated group (3%). Women who were vaccinated gave birth at a significantly later gestational age. No differences between the groups were detected in terms of postpartum and delivery factors. Women who received vaccination delivered at slightly higher birth weight. No differences were detected in terms of neonatal features and problems between the two groups. Conclusions: We concluded that COVID-19-vaccinated pregnant women experienced similar pregnancy outcomes as unvaccinated pregnant women. In some cases, vaccination proved to be better outcome than un-vaccination. [ABSTRACT FROM AUTHOR]

Abstract Fibrosis and organ failure is a common endpoint for many chronic liver diseases. Much is known about the upstream inflammatory mechanisms provoking fibrosis and downstream potential for tissue remodeling. However, less is known about the transcriptional regulation in vivo governing fibrotic matrix deposition by liver myofibroblasts. This gap in understanding has hampered molecular predictions of disease severity and clinical progression and restricted targets for antifibrotic drug development. In this study, we show the prevalence of SOX9 in biopsies from patients with chronic liver disease correlated with fibrosis severity and accurately predicted disease progression toward cirrhosis. Inactivation of Sox9 in mice protected against both parenchymal and biliary fibrosis, and improved liver function and ameliorated chronic inflammation. SOX9 was downstream of mechanosignaling factor, YAP1. These data demonstrate a role for SOX9 in liver fibrosis and open the way for the transcription factor and its dependent pathways as new diagnostic, prognostic, and therapeutic targets in patients with liver fibrosis.