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OBJECTIVES RBC distribution width is reported to be an independent predictor of outcome in adults with a variety of conditions. We sought to determine if RBC distribution width is associated with morbidity or mortality in critically ill children. DESIGN Retrospective observational study. SETTING Tertiary PICU. PATIENTS All admissions to St. Louis Children's Hospital PICU between January 1, 2005, and December 31, 2012. INTERVENTIONS We collected demographics, laboratory values, hospitalization characteristics, and outcomes. We calculated the relative change in RBC distribution width from admission RBC distribution width to the highest RBC distribution width during the first 7 days of hospitalization. Our primary outcome was ICU mortality or use of extracorporeal membrane oxygenation as a composite. Secondary outcomes were ICU- and ventilator-free days. MEASUREMENTS AND MAIN RESULTS We identified 3,913 eligible subjects with an estimated mortality (by Pediatric Index of Mortality 2) of 2.94% ± 9.25% and an actual ICU mortality of 2.91%. For the study cohort, admission RBC distribution width was 14.12% ± 1.89% and relative change in RBC distribution width was 2.63% ± 6.23%. On univariate analysis, both admission RBC distribution width and relative change in RBC distribution width correlated with mortality or the use of extracorporeal membrane oxygenation (odds ratio, 1.19 [95% CI, 1.12-1.27] and odds ratio, 1.06 [95% CI, 1.04-1.08], respectively; p < 0.001). After adjusting for confounding variables, including severity of illness, both admission RBC distribution width (odds ratio, 1.13; 95% CI, 1.03-1.24) and relative change in RBC distribution width (odds ratio, 1.04; 95% CI, 1.01-1.07) remained independently associated with ICU mortality or the use of extracorporeal membrane oxygenation. Admission RBC distribution width and relative change in RBC distribution width both weakly correlated with fewer ICU- (r = 0.038) and ventilator-free days (r = 0.05) (p < 0.001). CONCLUSIONS Independent of illness severity in critically ill children, admission RBC distribution width is associated with ICU mortality and morbidity. These data suggest that RBC distribution width may be a biomarker for RBC injury that is of sufficient magnitude to influence critical illness outcome, possibly via oxygen delivery impairment.

Aims: Two simple and sensitive stability- indicating methods were developed and validated for the quantitative determination of oseltamivir phosphate in presence of its degradation product. Place and Duration of Study: Analytical Chemistry Department, Faculty of Pharmacy (Girls), Al-Azhar University, between January 2016 and Augest 2016. Methodology: The first method depends on densitomeric determination of thin layer chromatograms of the drug using a mobile phase of methanol – toluene – ammonia (8: 10: 2, v/v/v). The second method was UPLC method, in which efficient separation was carried out on phenomenex kinetex 2.6 μm C18100 A column using a mobile phase consisting of 85% potassium hydrogen phosphate - methanol (80:20, v/v), adjusted to pH 3.5 with orthophosphoric acid at a flow rate of 1 mL min-1 and UV detection at 207 nm. Results: Beer’ law was obeyed in the range of 1-15 mg/spot and 6-14 μg mL–1 of the drug using the two procedures, respectively. Conclusion: The proposed methods were successfully applied for the determination of oseltamivir phosphate in bulk powder, laboratory prepared mixtures and pharmaceutical dosage form with good accuracy and precision. The methods were validated according to ICH guidelines. The results obtained were compared with those of the reported method and were found to be in good agreement.

A facile aliphatic nucleophilic fluorination with cesium fluoride in the presence of molybdenum oxide as a catalyst has been demonstrated. Reactivity of molybdenum oxide in nanocrystal form was found to be chemoselective in the presence of water. Furthermore, the reaction is highly specific with alkyl sulfonate substrates.

In this study, we report the in vitro anti-HIV1 activity of acetone and methanol extracts of fruit of Terminalia paniculata. Cytotoxicity tests were conducted on TZM-bl cells and peripheral blood mononuclear cells (PBMC), the CC50 values of both the extracts were ≥260 μg/mL. Using TZM-bl cells, the extracts were tested for their ability to inhibit replication of two primary isolates HIV-1 (X4, Subtype D) and HIV-1 (R5, Subtype C). The activity against HIV-1 primary isolate (R5, Subtype C) was confirmed using activated PBMC and by quantification of HIV-1 p24 antigen. Both the extracts showed anti-HIV1 activity in a dose-dependent manner. The EC50 values of the acetone and methanol extracts of T. paniculata were ≤10.3 μg/mL. The enzymatic assays were performed to determine the mechanism of action which indicated that the anti-HIV1 activity might be due to inhibition of reverse transcriptase (≥77.7% inhibition) and protease (≥69.9% inhibition) enzymes.

Pancreaticopleural fistula (PPF) is a rare complication of pancreatitis that requires a high index of clinical suspicion as patients typically present with pulmonary symptoms related to the pleural effusion rather than pancreatitis. Diagnosis is made by detection of amylase in the pleural fluid. Magnetic resonance cholangiopancreatography can aid in visualizing the fistula. We present a case of massive left pleural effusion secondary to a PPF due to acute on chronic pancreatitis.

Acute pancreatitis is a sudden inflammatory condition of the pancreas, caused mainly by gallstones and alcohol abuse. A significant proportion of acute pancreatitis cases remain idiopathic. Recent reports have highlighted cannabis use as an etiology of acute pancreatitis. A few case reports are available that report the association of cannabis with acute pancreatitis. Considering the global use of cannabis medically and illicitly, it becomes imperative to explore this adverse effect of cannabis use especially in idiopathic cases of acute pancreatitis. Here, in this report, we present a case of acute pancreatitis with no obvious cause. The patient was a 48-year-old female with no history of alcohol use. She had a history of cholecystectomy with normal serum triglycerides and calcium levels. The patient was consuming marijuana (cannabis) daily for the last three years. The diagnosis of cannabis-induced acute pancreatitis was made in the patient after other causes were excluded. It is difficult to distinguish cannabis-induced pancreatitis as there are no clear and specific associated clinical features. The diagnosis of cannabis-induced pancreatitis becomes even more challenging due to the use of multiple drugs. It becomes difficult to point out the causative agent among the multitude of drugs. Hence, a detailed history of drug intake in cases of acute pancreatitis may help to identify the candidature of the drugs in the pathogenesis of the disease. In view of the increasing illicit and medical use of cannabis, it becomes quintessential for clinicians to consider pancreatitis as a possible adverse effect of cannabis.

Radiotherapy is a common treatment modality for cancer patients; however, its use is limited by decreasing the probability of fertility in male cancer survivors. Therefore, this study aimed to define the capability of coenzyme Q10 (CoQ10), a potent stimulator of mitochondrial function, in attenuating ionizing radiation (IR)-induced spermatogenesis impairments. Male Sprague Dawley rats were exposed to a single dose of ϒ-rays (10 Gy) and/or treated with CoQ10 (10 mg/kg, orally, for 2 consecutive weeks). IR mediated irregular seminiferous tubules, which were emerged with typical morphological characteristics of apoptosis, and nuclear condensation, while CoQ10 significantly preserved the testicular structure and maintained spermatogenesis, which was displayed by higher levels of serum estradiol and testosterone. CoQ10 remarkably augmented sperm count, motility, and viability while diminished the rate of sperm-defects relatively to their counterparts after IR exposure. CoQ10 modulations in reproductive parameters were underpinned by attenuating IR-induced oxidative stress as evidenced by decreasing lipid peroxidation and increasing the antioxidant enzymes glutathione peroxidase and glutathione-s-transferase activities, and glutathione level. Supporting the involvement of CoQ10 in the anti-apoptotic response, the reduced mRNA expression levels of p53, Puma, and Bax accompanied by the increased Bcl-2 mRNA expression were observed. Subsequently, CoQ10 ameliorated the mitochondria dependent apoptotic pathway through diminishing Bax/Bcl-2 ratio, caspase-3 protein expression, and DNA fragmentation in testes of irradiated rats. Taken together, our findings showed that CoQ10 conserved against IR-induced steroidogenesis disruption through subsiding mitochondria-mediated oxidative stress injury in germinal cells.

Urinothorax is the presence of urine in the pleural space. It can occur at any age and is more common in males. It typically results from obstructive uropathy but can also be caused by malignancy or trauma. Urinothorax is a rare cause of transudative pleural effusion and the only cause of low pH (pH

to assess salivary glucose correlation with blood glucose and its accuracy in diagnosis of diabetes and prediabetes.A comparative study including 204 adults in 3 groups (104 type 2 diabetics, 50 prediabetics, 50 non-diabetic controls) aging 18-65 years. The participants were interviewed about their socio-demographic, comorbidities,drug treatment using a predesigned questionnaire. Salivaryblood samples were collected and analyzed.Mean salivary glucose was observed to be 23.40 ± 12.755 mg/dl in control group, 42.68 ± 20.830 mg/dl in prediabetic group and 59.32 ± 19.147 mg/dl in diabetic group with significant difference between the 3 groups (P value 0.001). Salivary glucose was significantly correlated to FBS with strong positive association (r = 0.67, P value 0.001 in control group, r = 0.56, P value 0.001in diabetic group and r = 0.36, P value 0.01 in pre-diabetic group). Salivary glucose could differentiate non-diabetics from diabetics (AUC: 0.928, P value 0.001) with sensitivity (94.2%) and specificity (62%)differentiate non-diabetics from prediabetics (AUC: 0.928, P value 0.001) with sensitivity (94.2%) and specificity (62%).Salivary glucose estimation can serve as valid and non-invasive test for screening and diagnosis of diabetesprediabetes.

Terpene synthase catalyses acyclic diphosphate farnesyl diphosphate into desired sesquiterpenes. In this study, a fusion enzyme was constructed by linking Santalum album farnesyl pyrophosphate synthase (SaFPPS) individually with terpene synthase and Artemisia annua Epi‐cedrol synthase (AaECS). The stop codon at the N‐terminus of SaFPPS was removed and replaced by a short peptide (GSGGS) to introduce a linker between the two open reading frames. This fusion clone was expressed in Escherichia coli Rosseta DE3 cells. The fusion enzyme FPPS‐ECS produced sesquiterpene 8‐epi‐cedrol from substrates isopentenyl pyrophosphate and dimethylallyl pyrophosphate through sequential reactions. The K (m) values for FPPS‐ECS for isopentyl diphosphate was 4.71 µM. The fusion enzyme carried out the efficient conversion of IPP to epi‐cedrol, in comparison to single enzymes SaFPPS and AaECS when combined together in enzyme assay over time. Further, the recombinant E. coli BL21 strain harbouring fusion plasmid successfully produced epi‐cedrol in fermentation medium. The strain having fusion plasmid (pET32a‐FPPS‐ECS) produced 1.084 ± 0.09 mg/L epi‐cedrol, while the strain harbouring mixed plasmid (pRSETB‐FPPS and pET28a‐ECS) showed 1.002 ± 0.07 mg/L titre in fermentation medium by overexpression and MEP pathway utilization. Structural analysis was done by I‐TASSER server and docking was done by AutoDock Vina software, which suggested that secondary structure of the N‐ C terminal domain and their relative positions to functional domains of the fusion enzyme was greatly significant to the catalytic properties of the fusion enzymatic complex than individual enzymes.

This paper presents the establishment of look-up table (LUT) for speed versus field current. LUT is necessary as an input reference for the close loop control of field current. The LUT was developed with the assistance of a genetic algorithm (GA). GA was used for optimization of the field current to maintain the motor torque for DC series motor running in parallel mode. Other than that, the LUT was employed when the FQDC was run in parallel mode for the purpose of climbing up a steep hill or slope. The simulation results using MATLAB/Simulink showed that the DC series motor with the assistance of LUT could overcome the drawbacks of DC series motor as speed decreases drastically when climbing a steep hill. In conclusion, the GA had successfully determined the best optimum field current to produce the highest torque to overcome load effect when tested using the proposed Four-Quadrant DC Chopper.

Catalytic wet air oxidation (CWAO) of an aqueous solution of bisphenol A (BPA) was investigated at 160 ℃ and 2.0 MPa of air in a batch reactor. Activity of supported platinum catalysts (2.5 wt%), prepared by wet impregnation, was compared with pure cerium and cerium–titanium oxide catalysts. Supported platinum catalysts showed higher activities in the removal of BPA than pure CeO2, Ce0.8Ti0.2O2 and Ce0.2Ti0.8O2. The oxidation reaction was followed the pseudo-first order rate law and the highest BPA removal, 97% and 95%, was achieved with Pt/CeO2 and Pt/Ce0.8Ti0.2O2 catalysts respectively. The CWAO of BPA aqueous solution was not a surface area specific reaction but the more important factor affecting the activity of studied catalysts was the amount of chemisorbed oxygen of these samples.

Assaying different biological markers (biomarkers) is commonly used to monitor health status and aid in the diagnosis of diseases. With the recent advances in highly sensitive protein assays, whole saliva (WS) and gingival crevicular fluid (GCF) appear to be fluids that may contain important biomarkers with various applications in dentistry and medicine. Herein, we describe the process of GCF and WS sample collection and preparation for assaying clinically relevant biomarkers in clinical screening trials. Analysis of biomarkers in WS and GCF represents an easy and practical approach for the diagnosis and screening of different pathological conditions particularly in epidemiological surveys.

Dental caries is an infectious oral disease caused primarily by complex interactions of cariogenic oral flora (biofilm) with dietary carbohydrates on the tooth surface over time. Streptococcus mutans and Streptococcus sobrinus (S. mutans and S. sobrinus) are the most prevalent cariogenic species within the oral biofilm and considered the main etiological agents of caries. Pulp exposure and infection can be caused by trauma, carious lesion, and mechanical reasons. Pulp response to these exposures depends on the state of the pulp as well as the potential bacterial contamination of pulp tissue. Herein, we describe the process of using two in vivo rodent models to study the progression of dental caries and pulp disease: a nutritional microbial model and a pulp disease induction model. The progression of the carious lesion and pulpal infections in both models was assessed by micro-CT imaging and histomorphometric analysis. Moreover, the pulp disease induction models can be used to compare and assess the antibacterial and reparative properties of the different pulp capping materials.

Due to the high failure rates of traditional dental restorations, there is an ongoing effort to develop modified and new restorative biomaterials in dentistry. Being the most commonly used restorative material, most of these efforts primarily aim to improve dental composite. Generally, the main objective of such modifications is to enhance the restorative physical and antimicrobial properties in order to limit micro-leakage and inhibit bacterial biofilm cultivation. Herein, we describe the process of designing a simple in vitro model to assess the physical and antimicrobial properties of novel restorative materials in addition to evaluating their effect on the fragile balance between enamel de- and remineralization.

Delivery of angiogenic growth factors lessens ischemia in preclinical models but has demonstrated little benefit in patients with peripheral vascular disease. Augmenting the wrapping of nascent microvessels by mural cells constitutes an alternative strategy to regenerating a functional microvasculature, particularly if integrated with a sustained delivery platform. Herein, electrospun poly(ester amide) (PEA) nanofiber mats are fabricated for delivering a mural cell-targeting factor, fibroblast growth factor 9 (FGF9). Proof-of-principle is established by placing FGF9/FGF2-loaded PEA fiber mats on the chick chorioallantoic membrane and identifying enhanced angiogenesis by 3D power Doppler micro-ultrasound imaging. To assess the delivery system in ischemic muscle, FGF9-loaded PEA fiber mats are implanted onto the surface of the tibialis anterior muscle of mice with hindlimb ischemia. The system supplies FGF9 into the tibialis anterior muscle and yields a neo-microvascular network with enhanced mural cell coverage up to 28 days after injury. The regenerating muscle that receives FGF9 display near-normal sized myofibers and reduced interstitial fibrosis. Moreover, the mice demonstrate improved locomotion. These findings of locally released FGF9 from PEA nanofibers raise prospects for a microvascular remodeling approach to improve muscle health in peripheral vascular disease.

Oryzias marmoratusis one of the ornamental aquarium fish species that live endemic to Towuti Lake, South of Sulawesi, Indonesia. However, the fish has been categorized as near threatened by IUCN. A current report showed the fish could be cultivated. This research aims to improve the reproduction quality in cultivation by using artificial feed containingSpirulina(A=0, B=3, and C=6) % dry weight. The study was conducted with two replications using an aquarium (80 x 40 x 40 cm) for 40 days (October-December 2020) at Research Center for Limnology-LIPI. Each aquarium contains 21 broodstock (female: male = 2:1). Observation parameters are the total number of spawning/ToS (time), ovulated eggs number/OEN, fertilization ability/FA (%), hatching ability/HA (%), number of larvae/NoL, the egg of incubation time/EIT (day), survival of larvae seven days old after hatching/SR7 (%). Based on descriptive analysis, the use of feed C (containing 6%Spirulina) produced the highest values of ToS, OEN, %HA, NoL, and SR7 (%) were ten times; 89 eggs; 89 larvae, 100%; and 98.89±3.51% respectively.Spirulinacould increase the reproduction viability and is presumed to enhance feed efficiency ofOryzias marmoratus, but the optimum levels have not been obtained.

Background: Evaluating gender-specific effects of COVID-19 is important to develop effective therapeutic strategies. The aim of this study was to explore gender difference in perceived symptoms and laboratory investigations in suspected and confirmed cases. Methods: This is a retrospective study that included data from suspected COVID-19 patients during the first wave of the pandemic. Participants using the phone triaging system at Kasralainy outpatient clinics were included. The analyzed data included patient history and results of nasopharyngeal swab and laboratory data. Results: Out of 440 COVID-19 suspected cases, 56.36% were females. The perceived COVID-19 symptoms showed no significant gender difference in suspected cases while in confirmed cases females were 4 times more likely to complain of cough [OR (95% CI) 3.92 (1.316–11.68), P-value .014] and 5 times more likely to experience loss of smell or taste [OR (95% CI) 4.84 (1.62–14.43), P-value .005]. Laboratory markers revealed high levels of aspartate aminotransferase, alanine aminotransferase, blood urea, serum creatinine, creatine kinase, and serum ferritin in males and this was statistically significant ( P-value Conclusion: Gender differences were found in laboratory markers in COVID-19 suspected and confirmed cases and in perceived symptoms in confirmed cases.

The Saudi Pediatric Pulmonology Association (SPPA) is a subsidiary of the Saudi Thoracic Society (STS), which consists of a group of Saudi experts with well-respected academic and clinical backgrounds in the fields of asthma and other respiratory diseases. The SPPA Expert Panel realized the need to draw up a clear, simple to understand, and easy to use guidance regarding the application of different aerosol therapies in respiratory diseases in children, due to the high prevalence and high economic burden of these diseases in Saudi Arabia. This statement was developed based on the available literature, new evidence, and experts' practice to come up with such consensuses about the usage of different aerosol therapies for the management of respiratory diseases in children (asthma and nonasthma) in different patient settings, including outpatient, emergency room, intensive care unit, and inpatient settings. For this purpose, SPPA has initiated and formed a national committee which consists of experts from concerned specialties (pediatric pulmonology, pediatric emergency, clinical pharmacology, pediatric respiratory therapy, as well as pediatric and neonatal intensive care). These committee members are from different healthcare sectors in Saudi Arabia (Ministry of Health, Ministry of Defence, Ministry of Education, and private healthcare sector). In addition to that, this committee is representing different regions in Saudi Arabia (Eastern, Central, and Western region). The subject was divided into several topics which were then assigned to at least two experts. The authors searched the literature according to their own strategies without central literature review. To achieve consensus, draft reports and recommendations were reviewed and voted on by the whole panel.

Imidazolium based IL's has gained vast interest in developing biological applications. Oligomerization and fibrillization of amyloid β (1-42) peptide are mainly responsible for the extra-neuronal deposition of amyloid fibrils in neurodegenerative disorders like Alzheimer's disease (AD). Here, we report an effect of tert-BuOH-functional imidazolium ILs on oligomerization and fibrillization of amyloid β (1-42) Peptide in vitro. In this study, a series of these [alkyl-tOHim][OMs] ILs with methyl sulphonate counter anion by varying alkyl chains were used. Among the seven protic ILs, four showed strong binding and inhibition activity for the formation of amyloid β (1-42) aggregation by using Thioflavin T fluorescence binding assay. The secondary structural analysis of the peptide, pre-incubated with active ILs shows the loss of ordered β-sheet amyloid structure. The longer alkyl chain ILs showed that an increased in amyloid binding and hence an inhibition effect on amyloid aggregation was enhanced. Thus, we propose that ILs could be presented as potential candidates for therapeutic intervention against Alzheimer's disease (AD).

Chemobrain refers to a cluster of cognitive deficits which affects almost 4-75% of chemotherapy-treated cancer patients. Sunitinib, an FDA-approved multityrosine kinase inhibitor, is currently used in treating different types of tumors. Despite being regarded as targeted therapy which blunts sustained angiogenesis in cancer milieu through inhibiting vascular endothelial growth factor receptor 2 (VEGFR2) signaling, the latter has a cardinal role in cognition. Recent clinical reports warned that sunitinib adversely affected memory processing in cancer patients. Nevertheless, the underlying mechanisms have not been investigated yet. Hence, we explored the impact of a clinically relevant dose of sunitinib on memory processing in vivo and questioned the implication of VEGFR2 signaling, autophagy and apoptosis. Strikingly, sunitinib preferentially impaired spatial cognition as evidenced in Morris water maze, T-maze and passive avoidance task. Consistently, sunitinib degenerated cortical and hippocampal neurons as assessed by histopathological examination and toluidine blue staining. Ultrastructural examination also depicted chromatin condensation, mitochondrial damage and accumulated autophagosomes. Digging deeper, central VEGF/VEGFR2/mTOR signaling was robustly suppressed. Besides, sunitinib boosted cortical and hippocampal p53 and executioner caspase-3 and decreased nuclear factor kappa B and Bcl-2 levels promoting apoptotic cell death. It also profoundly impeded neuronal autophagic flux as shown by decreased beclin-1 and Atg5 and increased p62/SQTSM1 levels. To our knowledge, this is the first study to provide molecular insights into sunitinib-induced chemofog where impeded VEGFR2 signaling and autophagic and hyperactivated apoptotic machineries act in neurodegenerative concert. Importantly, our findings shed light on potential therapeutic strategies to be exploited in the management of sunitinib-induced chemobrain.

Epicedrol synthase catalyzes the cyclization of achiral diphosphate substrate, ( E , E )-farnesyldiphosphate (FPP) into epicedrol. GC–MS analysis of assay extracts obtained by incubating FPP with epicedrol synthase in 21.6 at % H 2 18 O buffer showed the molecular ion of 224 for epicedrol. The labeled oxygen study presented here unambiguously demonstrates that the hydroxyl group of the epicedrol synthase enzymatic product, epicedrol, is derived from a water molecule, not from the phosphate moiety of the FPP.

This paper applies Taguchi optimisation method to determine the best machining parameters for pocket milling process of polypropylene using a CNC milling machine where the surface roughness is considered and high speed steel inserts are used as cutting tool. Three machining parameters; speed, feed rate and depth of cut are investigated at three levels; low, medium and high for each parameter (Taguchi orthogonal arrays). The setting of machining parameters was determined using Taguchi Method and the signal-to-noise ratio is assessed to define the optimal levels and to predict the effect of surface roughness with assigned parameters based on nine different experiments. The final experimental outcomes presented to validate the optimal parameters recommended by manufacturer are accurate.

Introduction effective communication in a clinical environment plays a vital role in patient assessment and treatment. The aim of this study was to understand the experiences of Malaysian medical students concerning communication barriers during clinical practice. The goal was to provide answers for three important research questions, i.e., 1) Are communication barriers an impediment to Malaysian students during clinical teaching? 2) What is the nature of the language barriers that the students encounter? and 3) What are the best ways of reducing these barriers during clinical teaching? Methods The qualitative method was used to conduct the research, and open-ended questionnaires were used to collect the data. The study was conducted on 95 fourth-, fifth-, and sixth-year students, 80% of whom completed the study. Results Medical students from Malaysia who have limited knowledge of the Arabic language experience some difficulties in communicating with staff members, patients, and nurses during their clinical practices. Conclusion Successful orientation of students to the language used in the clinical environment will help the students overcome the communication barriers they encounter during their clinical practices.

Comparative study of cardio protective effect of aliskiren, telmisartan, and torsemide was carried out on l-nitro arginine methyl ester (l-NAME) induced hypertension in rats. The three drugs were given daily for 8weeks simultaneously with l-NAME, with a control group for each drug and l-NAME. The degree of protection was assessed by measurement of systolic blood pressure and heart rate of animals every two weeks. At the end of the experimental period blood sampling was carried out for estimation of the level of NO2−/NO3−. After which animals were sacrificed for heart dissection to detect collagen types I and III gene expression. Histopathological study was done to evaluate the extension of collagen deposits. The study revealed that the three drugs decreased blood pressure significantly compared to l-NAME. There was no significant difference between aliskiren and telmisartan in all measurements, but there was significant decrease in measurements of both aliskiren and telmisartan treated groups compared to torsemide starting from 4th week. There were insignificant changes in pulse rate values between the three l-NAME treated groups through the experiment. The three drugs significantly increased NO compared to l-NAME. Collagen I and III gene expression was significantly decreased by the three drugs but the highest percentage of inhibition was with telmisartan compared to l-NAME. Comparing the percentage inhibition of cardiac fibrosis, there was insignificant difference between telmisartan and torsemide treated groups while both were superior to aliskiren. In conclusion, further experimental studies are required to elucidate the potential cardioprotective mechanisms of aliskiren, telmisartan and torsemide, and assess their efficacy in treatment of heart failure.

Maninjau lake has currently been under eutrophic condition and needs urgent efforts to recover it. Integrated multitrophic aquaculture (IMTA) has proposed as one among those pointed measures, by using lake water to perform inland aquaculture activity, in which an aquatic plant was employed to carry out double functions, as water phytoremediator and source of natural feed for fish. This research was focused on the ability of the duckweeds to support growth of Tilapia (Oreochromis niloticus), carried out in IMTA ponds located at Nagari Batang, Maninjau Lake, West Sumatra for 40 days (September-October 2018). IMTA systems have been implemented as an effort to utilize lake water for growth media. It consisted of 3 tilapia ponds of 4×6 m2and 12 duckweed ponds (8 ponds of 4×4 m2and 4 ponds of 4×8 m2). The lake water was lifted up into the fish ponds (265 fishes/pond) and then channeled down into the duckweeds ponds, so as the duckweeds grew while absorbing nutrients content of waste fertile water from the fish ponds. The obtained duckweed biomass was then fed up to the fish. The result showed that the fish average SGR was 0.54 (0.31-0.73)%, the survival rate was 95.26 (92.88-98.12)% and the average FCR was 21.03 (14.02-28.29). Proximatee analysis of the fish showed the protein content was 45.767 (42.17-50.99)% and lipid was 7.923 (4.42-11.79)%. The daily production of duckweed was 48.19 (35.00-72.92) g/m2/day; with SGR 17.57 (3.15-31.43) %, while the protein content of Lemna was 32.896 (29.58-36.22)% and lipid 9.732 (8.47-10.99)%. The duckweed was able to convert eutrophic water into useful biomass for fish feed and can be promoted to support development of inland aquaculture activity nearby the Maninjau Lake.

Aluminophosphate compounds (AlPO4-5) with the AFI structure framework are important members of microporous zeolites group and molecular sieves materials because having an enormous variety of structures leading to high potential catalytic applications. AlPO4-5 molecular sieves have been prepared via the hydrothermal reaction by using triethylamine as a template. Molybdenum and zinc bimetal supported AlPO4-5 zeolite catalysts (MoZn/AlPO4-5) were prepared using a co-impregnation method with different molar ratios. The obtained samples were described by the physicochemical characterizations techniques. The bimetal ratios effect towards the dehydration of ethanol was investigated. MoZn(4)/AlPO4-5 exhibit the most active catalyst towards ethylene formation and the parent AlPO4-5 was the least active but with high selectivity towards diethyl ether production. This conversion convinced by ZnMoO4 phase formation during Mo and Zn oxides interactions leading to improving the acid sites which are a favorite environment and augment to ethylene formation.

Medical monitoring requires instant visibility across data sources and access to dynamic analyses. However medical monitoring among patients, perform in-stream medical advice, remains a challenging problem. Blood banks suffer frequent shortage of blood due to lack of blood donations, hence blood donation requests are frequently seen on social media for patients who urgently require blood transfusion with specific blood group. Recently, worldwide efforts have been undertaken to utilize social media and smart phone applications to make the blood donation process more convenient and provide a concrete information system that allows donors and blood donation centers to communicate efficiently and coordinate with each other to minimize time and effort required for blood donation process. This paper aims at developing a Cloud medical monitoring and Web-Based Blood Donation System which will allow blood donors and patients to offer/request blood donation from blood banks. Additionally, a new method is proposed for continuous observation and communication among doctors and patients. Using IOT cloud platform, simple medical devices equipped with medical sensors can monitor health status of patients and update the electronic medical records of patients’ information. Medical experts can remotely monitor patients dynamic status and give prompt medical advice. The developed Web-Based application utilizes a cloud based hosting platform to enhance system performance and ensure high availability. A mobile application has been developed where users will be able to use as an application installed on their smart phones to help them complete blood donation process with minimum effort and time. This application helps people receive remotely medical advices and helps establish a blood donation community through social networks. This paper also presents various tools that were used to measure system performance.

In this study, a novel thermo stable biosurfactants, 1-Pentanonacontene (C95H190) a fatty alkene and 3-Hydroxy-16-methylheptadecanoic acid (C18H36O3) were isolated from a marine isolate SGD-AC-13. Biosurfactants were produced using 1% yeast extract in tap water as production medium at 24 h in flask and 12 h in bioreactor. Using 16S rRNA gene sequence (1515 bp) and BCL card (bioMerieux VITEK®), strain was identified as Bacillus sp. Crude biosurfactant reduced the surface tension of distilled water to 31.32 ± 0.93 mN/m with CMC value of 0.3 mg/ml. Cell free supernatant showed excellent emulsification and oil displacement activity with stability up to 160 °C, pH 6–12 and 50 g/L NaCl conc. Biosurfactants were characterized using FTIR, TLC, HPLC LC–MS and NMR spectroscopy. Cell free supernatant reduced the contact angle of distilled water droplet from 117° to 52.28° and of 2% pesticide from 78.77° to 73.42° while 750 μg/ml of crude biosurfactant reduced from 66.06° to 56.33° for 2% pesticide and recovered 35% ULO and 12% HWCO from the contaminated sand. To our best of knowledge, this is the first report of thermo stable fatty alkene as a biosurfactant and is structurally different from previously reported, with having potential application in agriculture, oil recovery and bioremediation.

Acinetobacter baumannii is an opportunistic pathogen that has been held responsible for a lot of infections worldwide. Infections caused by this pathogen are difficult to control because of the widespread of antimicrobial resistance mechanisms. The aim of the present study is to assess the prevalence of extended spectrum β-lactamases (ESBLs) and AmpC β-lactamases among isolates of A. baumannii collected from different clinical sources in Mansoura University Hospitals, Egypt. Antimicrobial susceptibility testing has demonstrated elevated resistance level to β-lactams, quinolones and aminoglycosides. All isolates were sensitive to colistin and polymyxin B. ESBL activity was detected in 86% of the isolates. Among the tested ESBL encoding genes, blaTEM gene was the most prevalent gene as it was detected in 52% of the isolates. While blaPER, blaSHV and blaVEB were detected in 12%, 4%, and 2%, respectively. AmpC activity and blaADC gene were detected in 90% of the tested isolates. Insertion sequence ISAba1 was located 9 bp upstream of blaADC gene in 88.9% of the ADC-expressing isolates providing a potent promoter activity for its expression. To our knowledge this is the first report of loss of intrinsic ADC activity, in 10% of the tested isolates, as a result of insertional inactivation by an element belonging to IS5 family transposase. Co-expression of both ESBLs and AmpC β-lactamases was detected in 78% of the isolates. The study demonstrates high prevalence of resistance to β-lactam antibiotics through ESBLs and AmpC β-lactamases production among A. baumannii clinical isolates. Prevalence of β-lactamases should be detected routinely and reported in hospitals to avoid inappropriate use of antibiotics and therapeutic failure.

Pulmonary hypertension with transposition of the great arteries is associated with significant morbidity and mortality. At the worst end of the spectrum are patients who undergo extracorporeal support perioperatively. We describe our experience with three patients who received preoperative extracorporeal support and separated from cardiopulmonary bypass successfully on conventional postoperative care, with no significant deficits on follow-up.

Dependence on coastal areas for the City of Baubau is very dominant, as evidenced by the activities of many people who depend their lives on the use of resources in the coastal areas. In order not to be damaged, it requires commitment from all components in the City of Baubau including all academicians at Buton University of Muhammadiyah to protect and manage the coastal environment through conservation efforts, of course with the same vision and understanding starting from campus. This study aims to (1) test and analyze the effect of motivation on participation in the preservation of the coastal environment. (2) Test and analyze the influence of organizational culture on participation in the preservation of the coastal environment. (3) Test and analyze the influence of leadership on participation in the preservation of the coastal environment. (4) Test and analyze the influence of conflict management on participation in the preservation of the coastal environment. This study uses explanatory patterns. The number of samples used was 147 respondents. Significant values for motivation, transformational leadership, and conflict management are smaller than the probability value with the t-value positive sign, which means motivation, transformational leadership and conflict management have a positive and significant effect on coastal environment participation at Muhammadiyah Buton University, while organizational culture has no effect on coastal environment participation at Buton Muhammadiyah University, because the significant value for organizational culture variables is greater than the probability value. Organizational culture needs to be encouraged starting from the smallest unit of study program to be more concerned with environmental issues, especially coastal areas so that sustainability is guaranteed.

The selection of local anaesthetic in dental practice is essential to the patient's comfort and the success of the treatment. Many patients prefer anaesthesia even for short treatments. Articaine is a local anaesthetic commonly used for dental practice. The duration of the effect of articaine on the nerve fibres is not yet precisely reported. This study was aimed to evaluate the clinical efficacy of 4% articaine with and without epinephrine in treatment of occlusal caries. Thirty healthy patients were included in this randomised double-blind study. Each subject received 4% articaine with and without epinephrine (1:100 000). Maxillary infiltration was used for occlusal caries of the maxillary premolars on right and left sides. Quantitative sensory testing (QST) was performed in the innervation area of the infraorbital nerve, and pulp vitality test was performed on restoration-free canines. Duration of anaesthesia was longer when articaine with epinephrine was used. Articaine without epinephrine showed faster recovery of sensory blockade compared to articaine with epinephrine. The epinephrine-containing agent, when compared to the plain articaine solution, showed significantly stronger and longer anaesthetic efficacy on the soft tissue by all parameters of QST. Articaine with epinephrine caused a more reliable pulpal analgesia. A pain-free treatment of the soft tissue up to 15 minutes can be performed under the vasoconstrictor-free anaesthetic without causing long-lasting numbness. Epinephrine-containing articaine delivers a longer, more effective anaesthesia and is preferable for caries treatments and longer invasive treatments of the soft tissue.

BACKGROUND: Globally, >300 million patients have surgery annually, and ≤20% experience adverse postoperative events. We studied the impact of both cardiac and noncardiac adverse events on 1-year disability-free survival after noncardiac surgery. METHODS: We used the study cohort from the Evaluation of Nitrous oxide in Gas Mixture of Anesthesia (ENIGMA-II) trial, an international randomized trial of 6992 noncardiac surgical patients. All were ≥45 years of age and had moderate to high cardiac risk. The primary outcome was mortality within 1 postoperative year. We defined 4 separate types of postoperative adverse events. Major adverse cardiac events (MACEs) included myocardial infarction (MI), cardiac arrest, and myocardial revascularization with or without troponin elevation. MI was defined using the third Universal Definition and was blindly adjudicated. A second cohort consisted of patients with isolated troponin increases who did not meet the definition for MI. We also considered a cohort of patients who experienced major adverse postoperative events (MAPEs), including unplanned admission to intensive care, prolonged mechanical ventilation, wound infection, pulmonary embolism, and stroke. From this cohort, we identified a group without troponin elevation and another with troponin elevation that was not judged to be an MI. Multivariable Cox proportional hazard models for death at 1 year and assessments of proportionality of hazard functions were performed and expressed as an adjusted hazard ratio (aHR) and 95% confidence intervals (CIs). RESULTS: MACEs were observed in 469 patients, and another 754 patients had isolated troponin increases. MAPEs were observed in 631 patients. Compared with control patients, patients with a MACE were at increased risk of mortality (aHR, 3.36 [95% CI, 2.55-4.46]), similar to patients who suffered a MAPE without troponin elevation (n = 501) (aHR, 2.98 [95% CI, 2.26-3.92]). Patients who suffered a MAPE with troponin elevation but without MI had the highest risk of death (n = 116) (aHR, 4.29 [95% CI, 2.89-6.36]). These 4 types of adverse events similarly affected 1-year disability-free survival. CONCLUSIONS: MACEs and MAPEs occur at similar frequencies and affect survival to a similar degree. All 3 types of postoperative troponin elevation in this analysis were associated, to varying degrees, with increased risk of death and disability.

Prenatal and postnatal myogenesis share many cellular and molecular aspects. Myogenic regulatory factors are basic Helix-Loop-Helix transcription factors that indispensably regulate both processes. These factors (Myf5, MyoD, Myogenin, and MRF4) function as an orchestrating cascade, with some overlapped actions. Prenatally, myogenic regulatory factors are restrictedly expressed in somite-derived myogenic progenitor cells and their derived myoblasts. Postnatally, myogenic regulatory factors are important in regulating the myogenesis process via satellite cells. Many positive and negative regulatory mechanisms exist either between myogenic regulatory factors themselves or between myogenic regulatory factors and other proteins. Upstream factors and signals are also involved in the control of myogenic regulatory factors expression within different prenatal and postnatal myogenic cells. Here, the authors have conducted a thorough and an up-to-date review of the myogenic regulatory factors since their discovery 30 years ago. This review discusses the myogenic regulatory factors structure, mechanism of action, and roles and regulations during prenatal and postnatal myogenesis.Impact statementMyogenic regulatory factors (MRFs) are key players in the process of myogenesis. Despite a considerable amount of literature regarding these factors, their exact mechanisms of actions are still incompletely understood with several overlapped functions. Herein, we revised what has hitherto been reported in the literature regarding MRF structures, molecular pathways that regulate their activities, and their roles during pre- and post-natal myogenesis. The work submitted in this review article is considered of great importance for researchers in the field of skeletal muscle formation and regeneration, as it provides a comprehensive summary of all the biological aspects of MRFs and advances a better understanding of the cellular and molecular mechanisms regulating myogenesis. Indeed, attaining a better understanding of MRFs could be utilized in developing novel therapeutic protocols for multiple myopathies.

Cardiovascular disease is one of the leading causes of death in the developed world. Ischemic heart disease and acute myocardial infarction can cause progressive left ventricular remodeling and myocardial dysfunction resulting in subsequent heart failure. Cardiac regenerative therapy has advanced from delivering simple cell suspensions, proteins, or small drug molecules to utilizing nanocomposite biomaterials as depots for localized and controlled delivery of cell sheets, growth factors, and RNA therapeutics to the ischemic myocardium. Spatiotemporal release of therapeutics from either an implantable nanofibrous scaffold, an injectable hydrogel, or a nanoparticulate carrier can mimic the biological regenerative process to achieve enhanced cardiac repair. These advanced strategies have demonstrated great potential in preclinical studies with limited clinical translation to date. In this chapter, biomaterial nanocomposite systems for the delivery of cells and/or therapeutics for myocardial repair and regeneration are reviewed with focus on advanced and multimodal delivery approaches. Temporal delivery of therapeutic agents, including dual, simultaneous, sequential, and triggered release was reviewed. Major hurdles for clinical translation were discussed with recommendations for achieving positive impact on patient outcomes in the future.

A new method is used in this work to classify ECG beats. The new method is about using an optimization algorithm for selecting the features of each beat then classify them. For each beat, twenty-four higher order statistical features and three timing interval features are obtained. Five types of beat classes are used for classification in this work, atrial premature contractions (APC), normal (NOR), premature ventricular contractions (PVC), left bundle branch (LBBB) and right bundle branch (RBBB). Cuttlefish algorithm is used for feature selection which is a new bio-inspired optimization algorithm. Four classifiers are used within CFA, Scaled Conjugate Gradient Artificial Neural Network (SCG-ANN), K-Nearest Neighborhood (KNN), Interactive Dichotomizer 3 (ID3) and Support Vector Machine (SVM). The final results show an accuracy of 97.96% for ANN, 95.71% for KNN, 94.69% for ID3 and 93.06% for SVM, these results were tested on fourteen signal records from MIT-HIH database, where 1400 beats were extracted from these records.

Here, we review current data elucidating the role of red blood cell derived microparticles (RMPs) in normal vascular physiology and disease progression. Microparticles (MPs) are submicron-size, membrane-encapsulated vesicles derived from various parent cell types. MPs are produced in response to numerous stimuli that promote a sequence of cytoskeletal and membrane phospholipid changes and resulting MP genesis. MPs were originally considered as potential biomarkers for multiple disease processes and more recently are recognized to have pleiotropic biological effects, most notably in: promotion of coagulation, production and handling of reactive oxygen species, immune modulation, angiogenesis, and in initiating apoptosis. RMPs, specifically, form normally during RBC maturation in response to injury during circulation, and are copiously produced during processing and storage for transfusion. Notably, several factors during RBC storage are known to trigger RMP production, including: increased intracellular calcium, increased potassium leakage, and energy failure with ATP depletion. Of note, RMP composition differs markedly from that of intact RBCs and the nature/composition of RMP components are affected by the specific circumstances of RMP genesis. Described RMP bioactivities include: promotion of coagulation, immune modulation, and promotion of endothelial adhesion as well as influence upon vasoregulation via influence upon nitric oxide (NO) bioavailability. Of particular relevance, RMPs scavenge NO more avidly than do intact RBCs; this physiology has been proposed to contribute to the impaired oxygen delivery homeostasis that may be observed following transfusion. In summary, RMPs are submicron particles released from RBCs, with demonstrated vasoactive properties that appear to disturb oxygen delivery homeostasis. The clinical impact of RMPs in normal and patho-physiology and in transfusion recipients is an area of continued investigation.