Search

Abstract Desalination of water is a crucial step in the process of obtaining potable water. One of the main challenges for the researchers is its efficient application and affordable preparation. It was planned to prepare the flat sheet membranes using cellulose acetate as a base polymer, and polyvinyl alcohol (PVA) as an additive with dosing of (0.1, 0.3, 0.5, and 0.7 wt%) from zirconium oxide (ZrO2) nanoparticle. SEM, TEM, and XRD analyses were used to characterize the generated ZrO2 nanoparticle in order to confirm its nano-size and crystal structure. The surface morphologies and existence of the dense layer, which is the typical property of the RO membrane capable of salt separation, were identified on the manufactured RO membranes by SEM. Membranes prepared by embedding 0.5 wt%ZrO2 with PVA/CA proved efficient as RO membranes using 2000 ppm NaCl and exhibited high salt rejection of 97% and water permeability of 12.5 LMH. Also, there is a decrease in the NaCl removal tendency was observed with the excessive dosages of ZrO2 with 0.7 wt%, which was due to the concentration polarization, which blocks the pores on the surfaces of the membranes. The antifouling behavior of the prepared membranes was tested using bovine serum albumin (BSA), the results indicate the low irreversible resistance, total fouling resistance, and high flux recovery ratio compared to the neat membrane. The prepared membranes have a stable salt rejection and water productivity even after demonstrating with chlorine (25–100 mg l−1 of NaOCl for 120 min).

Background: Bell’s palsy (BP) is a cranial nerve disorder in which unilateral or bilateral paralysis of the facial nerve occurs. The study aims to study BP’s characteristics, including its clinical manifestations, prognosis, and complications among adult patients aged 18 years and above. Methods: A retrospective study of adult patients diagnosed with BP in a primary care setting] [January 2015 to December 2022]. Results: The study included a total number of 92 patients with an incidence rate of 23 cases per 100,000 people. The mean age was 43.52 years. The most common symptoms reported were dropping of the mouth at 38.9%, loss of forehead muscle movement at 24.4%, loss of nasolabial fold at 22.2%, loss of facial expressions at 20%, and headache at 18.9%. Immunodeficiency affected 2.3% of the patients. The management of patients involved the use of steroids in 76.1% and the use of antiretroviral medications in 48.9%. Physiotherapy was used in 29.5%. The complete recovery rate during the first year was 90.8%. The rate of complete recovery within two years was 96.9%. Conclusion: The incidence of BP in the region seems to be similar to the incidence rate reported elsewhere in the world. The use of antiviral therapy seems to be high despite the controversy around the use of antivirals in the management of BP. The majority of patients with BP recover within the first year.

The utilization of human cDNA libraries in yeast genetic screens is an approach that has been used to identify novel gene functions and/or genetic and physical interaction partners through forward genetics using yeast two-hybrid (Y2H) and classical cDNA library screens. Here, we summarize several challenges that have been observed during the implementation of human cDNA library screens in Saccharomyces cerevisiae (budding yeast). Upon the utilization of DNA repair deficient-yeast strains to identify novel genes that rescue the toxic effect of DNA-damage inducing drugs, we have observed a wide range of transcripts that could rescue the strains. However, after several rounds of screening, most of these hits turned out to be false positives, most likely due to spontaneous mutations in the yeast strains that arise as a rescue mechanism due to exposure to toxic DNA damage inducing-drugs.The observed transcripts included mitochondrial hits, non-coding RNAs, truncated cDNAs, and transcription products that resulted from the internal priming of genomic regions. We have also noticed that most cDNA transcripts are not fused with the GAL4 activation domain (GAL4AD), rendering them unsuitable for Y2H screening. Consequently, we utilized Sanger sequencing to screen 282 transcripts obtained from either four different yeast screens or through direct fishing from a human kidney cDNA library. The aim was to gain insights into the different transcription products and to highlight the challenges of cDNA screening approaches in the presence of a significant number of undesired transcription products. In summary, this study describes the challenges encountering human cDNA library screening in yeast as a valuable technique that led to the identification of important molecular mechanisms. The results open research venues to further optimize the process and increase its efficiency.

Abstract The incidence of Lyme borreliosis has risen, accompanied by persistent symptoms. The innate immune system and related cytokines are crucial in the host response and symptom development. We characterized cytokine production capacity before and after antibiotic treatment in 1,060 Lyme borreliosis patients. We observed a negative correlation between antibody production and IL-10 responses, as well as increased IL-1Ra responses in patients with disseminated disease. Genome-wide mapping the cytokine production allowed us to identify 34 cytokine quantitative trait loci (cQTLs), with 31 novel ones. We pinpointed the causal variant at the TLR1-6-10 locus and validated the regulation of IL-1Ra responses at transcritpome level using an independent cohort. We found that cQTLs contribute to Lyme borreliosis susceptibility and are relevant to other immune-mediated diseases. Our findings improve the understanding of cytokine responses in Lyme borreliosis and provide a genetic map of immune function as an expanded resource.

Background: Balloon uncrossable lesions are defined as lesions that cannot be crossed with a balloon after successful guidewire crossing. Methods: We analyzed the association between balloon uncrossable lesions and procedural outcomes of 8671 chronic total occlusions (CTOs) percutaneous coronary interventions (PCIs) performed between 2012 and 2022 at 41 centers. Results: The prevalence of balloon uncrossable lesions was 9.2%. The mean patient age was 64.2 ± 10 years and 80% were men. Patients with balloon uncrossable lesions were older (67.3 ± 9 vs. 63.9 ± 10, p < 0.001) and more likely to have prior coronary artery bypass graft surgery (40% vs. 25%, p < 0.001) and diabetes mellitus (50% vs. 42%, p < 0.001) compared with patients who had balloon crossable lesions. In-stent restenosis (23% vs. 16%. p < 0.001), moderate/severe calcification (68% vs. 40%, p < 0.001), and moderate/severe proximal vessel tortuosity (36% vs. 25%, p < 0.001) were more common in balloon uncrossable lesions. Procedure time (132 (90, 197) vs. 109 (71, 160) min, p < 0.001) was longer and the air kerma radiation dose (2.55 (1.41, 4.23) vs. 1.97 (1.10, 3.40) min, p < 0.001) was higher in balloon uncrossable lesions, while these lesions displayed lower technical (91% vs. 99%, p < 0.001) and procedural (88% vs. 96%, p < 0.001) success rates and higher major adverse cardiac event (MACE) rates (3.14% vs. 1.49%, p < 0.001). Several techniques were required for balloon uncrossable lesions. Conclusion: In a contemporary, multicenter registry, 9.2% of the successfully crossed CTOs were initially balloon uncrossable. Balloon uncrossable lesions exhibited lower technical and procedural success rates and a higher risk of complications compared with balloon crossable lesions.

Background Despite optimal medical therapy, a significant proportion of patients' blood pressure remains uncontrolled. Catheter‐based renal denervation (RDN) has been proposed as a potential intervention for uncontrolled hypertension. We conducted an updated meta‐analysis to assess the efficacy and safety of RDN in patients with uncontrolled hypertension, with emphasis on the differential effect of RDN in patients on and off antihypertensive medications. Methods and Results Online databases were searched to identify randomized clinical trials comparing efficacy and safety of RDN versus control in patients with uncontrolled hypertension. Subgroup analyses were conducted for sham‐controlled trials and studies that used RDN devices that have gained or are currently seeking US Food and Drug Administration approval. Fifteen trials with 2581 patients (RDN, 1723; sham, 858) were included. In patients off antihypertensive medications undergoing RDN, a significant reduction in 24‐hour ambulatory (−3.70 [95% CI, −5.41 to −2.00] mm Hg), office (−4.76 [95% CI, −7.57 to −1.94] mm Hg), and home (−3.28 [95% CI, −5.96 to −0.61] mm Hg) systolic blood pressures was noted. In patients on antihypertensive medications, a significant reduction was observed in 24‐hour ambulatory (−2.23 [95% CI, −3.56 to −0.90] mm Hg), office (−6.39 [95% CI, −11.49 to −1.30]), home (−6.08 [95% CI, −11.54 to −0.61] mm Hg), daytime (−2.62 [95% CI, −4.14 to −1.11]), and nighttime (−2.70 [95% CI, −5.13 to −0.27]) systolic blood pressures, as well as 24‐hour ambulatory (−1.16 [95% CI, −1.96 to −0.35]), office (−3.17 [95% CI, −5.54 to −0.80]), and daytime (−1.47 [95% CI, −2.50 to −0.27]) diastolic blood pressures. Conclusions RDN significantly lowers blood pressure in patients with uncontrolled hypertension, in patients off and on antihypertensive medications, with a favorable safety profile. The efficacy of RDN was consistent in sham‐controlled trials and contemporary trials using US Food and Drug Administration–approved devices.

Coronary calcified lesions are commonly encountered and coronary atherectomy is commonly used for lesion modification during percutaneous coronary interventions (PCI). The release of adenosine during atherectomy can result in bradyarrhythmias and aminophylline is commonly used to prevent this reaction. We identified 138 patients to evaluate the safety and efficacy of intravenous (IV) aminophylline administration prior to coronary atherectomy. A total of 159 calcified lesions were treated, and the atherectomy device was orbital atherectomy, rotational atherectomy, and both in 52 %, 42 %, and 6 %; respectively. After administration of aminophylline, 4.3 % of patients required intraprocedural insertion of a transvenous pacer (TVP), and 18.1 % of patients required administration of IV atropine. Technical success was achieved in 98.6 % of patients, and no adverse reactions to aminophylline were reported. All patients survived to discharge. In conclusion, aminophylline administration prior to coronary atherectomy was safe and effective. No adverse effects of aminophylline were seen, and the rate of bailout TVP placement was low.

Literature reporting on the outcomes of the different procedures of nephrectomies (open vs laparoscopic vs robotic) in Saudi Arabia remains limited. Compare surgical and oncological outcomes between open and minimally invasive nephrectomies. A retrospective cohort study. The present study included all adult patients who underwent nephrectomies between January 1, 2015 and January 31, 2023. We collected demographic, preoperative, intraoperative, and postoperative data on 408 adult cancer patients who underwent nephrectomies at our center between January 2015 and January 2023. Statistical differences were calculated between procedure types. Overall survival was calculated using Kaplan–Meier curves with log-rank tests. P

Ancient schwannomas are a rare variation of schwannomas, with the distinction being based on histopathological examination of the excised specimen. On histopathological examination, ancient schwannomas exhibit degenerative changes such as calcification, hyalinization, and cystic necrosis, along with S100 positivity. Complete surgical excision is the mainstay treatment for ancient schwannomas and carries a favorable prognosis. Recurrence is the most common complication, often arising from incomplete surgical excision. Herein, we present a case of a 41-year-old male who presented to our center as a case of a retroperitoneal mass for further investigations and diagnostic workup. Imaging showed a retroperitoneal mass in the right iliac fossa. We proceeded with ultrasound guided needle biopsy, and examination of the specimen confirmed the diagnosis of ancient schwannoma. Subsequently, the patient underwent surgery, and complete surgical excision was achieved. On follow-up 3-months later, the patient is doing well, and no signs of recurrence were found.

Coordinating humanitarian supply chains can be challenging in terms of getting timely aid to those who need it. While operations in commercial supply chains have been well studied, research studies that address coordination in humanitarian supply chains are still lacking. Unlike commercial supply chains, humanitarian supply chains focus on delivering what customers "need" rather than "want" within difficult environments rife with uncertainty. This paper introduces the "Humanitarian Aid and Relief Distribution (HARD) Game" as an experiential learning tool that explores the potential for increased operational efficiency while balancing decision tradeoffs impacting humanitarian supply chain performance, including beneficiary demand satisfaction, operational costs, and transportation resources utilization. The HARD game is intended for graduate and undergraduate students in courses dealing with topics on supply chain management. It allows students to analyze aspects that significantly impact humanitarian supply chain operations, such as: supply chain coordination and planning, supply chain risks, demand volatility, and competing objectives. Statistical analysis of students' survey responses provide evidence that the HARD game is an effective pedagogical tool that is engaging for students and complementary to the traditional lecture format in the field of supply chain management education.

IntroductionSociodemographic disparities in genitourinary cancer-related mortality have been insufficiently studied, particularly across multiple cancer types. This study aimed to investigate gender, racial, and geographic disparities in mortality rates for the most common genitourinary cancers in the United States.MethodsMortality data for prostate, bladder, kidney, and testicular cancers were obtained from the Centers for Disease Control and Prevention (CDC) WONDER database between 1999 and 2020. Age-adjusted mortality rates (AAMRs) were analyzed by year, gender, race, urban–rural status, and geographic region using a significance level of p < 0.05.ResultsOverall, AAMRs for prostate, bladder, and kidney cancer declined significantly, while testicular cancer-related mortality remained stable. Bladder and kidney cancer AAMRs were 3–4 times higher in males than females. Prostate cancer mortality was highest in black individuals/African Americans and began increasing after 2015. Bladder cancer mortality decreased significantly in White individuals, Black individuals, African Americans, and Asians/Pacific Islanders but remained stable in American Indian/Alaska Natives. Kidney cancer-related mortality was highest in White individuals but declined significantly in other races. Testicular cancer mortality increased significantly in White individuals but remained stable in Black individuals and African Americans. Genitourinary cancer mortality decreased in metropolitan areas but either increased (bladder and testicular cancer) or remained stable (kidney cancer) in non-metropolitan areas. Prostate and kidney cancer mortality was highest in the Midwest, bladder cancer in the South, and testicular cancer in the West.DiscussionSignificant sociodemographic disparities exist in the mortality trends of genitourinary cancers in the United States. These findings highlight the need for targeted interventions and further research to address these disparities and improve outcomes for all populations affected by genitourinary cancers.

BackgroundHigher prevalence of obesity has been observed among women compared to men, which can be explained partly by the higher consumption of sweets and physical inactivity. Obesity can alter immune cell infiltration, and therefore increase the susceptibility to develop chronic inflammation and metabolic disorders. In this study, we aimed to explore the association between free sugar intake and other unhealthy lifestyle habits in relation to the proportion of circulating iNKT cells among women with healthy weight and women experiencing overweight and obesity.MethodsA cross-sectional study was conducted on 51 Saudi women > 18 years, wherein their daily free sugar intake was assessed using the validated Food Frequency Questionnaire. Data on smoking status, physical activity, and supplement use were also collected. Anthropometric data including height, weight, waist circumference were objectively measured from each participants. The proportion of circulating iNKT cells was determined using flow cytometry.ResultsSmoking, physical activity, supplement use, and weight status were not associated with proportion of circulating iNKT cells. Significant association was found between proportion of circulating iNKT cells and total free sugar intake and free sugar intake coming from solid food sources only among women experiencing overweight and obesity (Beta: -0.10: Standard Error: 0.04 [95% Confidence Interval: -0.18 to -0.01], p= 0.034) and (Beta: -0.15: Standard Error: 0.05 [95% Confidence Interval: -0.25 to -0.05], p= 0.005), respectively.ConclusionExcessive free sugar consumption may alter iNKT cells and consequently increase the risk for chronic inflammation and metabolic disorders.

Gallbladder cancer (GBC) is a rare and highly aggressive malignancy, often characterized by nonspecific clinical presentations and late diagnosis, which contribute to its poor prognosis. It is commonly detected at advanced stages, leading to low survival rates. Surgical resection is the primary treatment, with the extent of surgery depending on the T stage of the cancer. In advanced cases, surgery is only considered if it can potentially be curative. Despite various treatment approaches for advanced GBC, survival outcomes remain poor. In our case series, we introduce a novel treatment approach combining cytoreductive surgery, intraoperative radiation therapy, and hyperthermic intraperitoneal chemotherapy. Remarkably, we observed a 100% one-year survival rate, with one patient achieving eight years of disease-free survival without recurrence or metastasis. This aggressive treatment strategy did not lead to increased morbidity or mortality, suggesting its safety and feasibility. However, larger-scale studies are required to draw definitive conclusions.

Abstract Background The nucleoside transport capabilities of the human equilibrative nucleoside transporter-3 (hENT3) are disrupted by mutations in SLC29A3 (10q22.2), which are genes for the nucleoside transporter and are the cause of the unusual autosomal recessive disease known as H syndrome. As a result, histiocytic cells invade a number of organs. Case presentation A 17-year-old Syrian male was admitted to the internal medicine department with a one-month history of polyuria, polydipsia, general weakness, and pallor. He had a history of progressive bilateral sensorineural hearing loss and failure to gain weight for three years. Physical examination revealed various abnormalities, including scrotal mass, small penis and testicles, absence of pubic and axillary hair, joint abnormalities, short stature, hallux valgus, fibrous protrusion near the navel, and hyperpigmented non-itchy painful skin plaques. Clinical signs along with laboratory test results confirmed hyperglycemia, primary hypogonadism, osteopenia, and growth hormone deficiency. After a review of the relevant medical literature, this patient’s presentation of hyperglycemia with hypogonadism, hyperpigmentation, hallux valgus, hearing loss, hematological abnormalities, and short stature suggested the diagnosis of H syndrome. The patient received treatment with insulin and testosterone, leading to a significant improvement in his presenting symptoms. Conclusions H syndrome is a very rare condition, and the fact that the first case has only recently been reported in Syria serves to emphasize how rare it is. H Syndrome should be suspected if a patient has short stature with signs of hyperglycemia and other endocrine and cutaneous abnormalities. We are reporting this case to increase physicians’ awareness of this exceedingly rare and unique syndrome.

AbstractThe two main forms of healthcare data exchange among entities are business-to-business (B2B) and business-to-customer (B2C). The former uses the electronic data interchange (EDI) technology between healthcare institutions, while the latter is usually conducted by providing web-based interfaces for patients. This research argues that both forms have inherent security and privacy weaknesses. Furthermore, patients lack appropriate transparency and control over their own Personally Identifiable Information (PII). We explore the issues of medical record exchange, analyze them and suggest appropriate solutions in the form of a new model to mitigate them. The vulnerabilities, ranging from critical to minor, include the possibility of Man-in-The-Middle (MiTM) and supply chain attacks, weak cryptography, repudiable transactions, single points of failure (SPOF), and poor access controls. A novel model will be presented in this research for healthcare data sharing which applies the best security practices. The proposed unified model will counter the listed vulnerabilities. It automates the healthcare processes in decentralized architecture by utilizing the smart contracts for B2C transactions such as medicine purchase. The model is based on the Blockchain and zero-knowledge proofs. It is made with novel controls which represent the latest advancements in cybersecurity. It has the potential of setting a new cornerstone.

The Trichilia emetica plant is traditionally used for medicinal and food purposes. However, there are limited studies on the bioactivity and cytotoxicity of its seed butter and aril oil. This study aimed to assess the antidiabetic activity and cytotoxicity of seed butter and aril oil, obtained via two different extraction methods, and compare their lipid profiles. The plant samples were collected from the Faifa mountains and extracted using a Soxhlet apparatus for hot extraction and a magnetic stirrer for cold maceration. The antidiabetic activity and cytotoxicity were evaluated using the α-amylase and MTT assays, respectively. The fatty acids were quantified utilizing gas chromatography-mass spectrometry. This study proves the impact of the extraction method on the yield, cytotoxicity, antidiabetic activity and lipid profile. The highest cytotoxicity was observed with the seed butter obtained via Soxhlet extraction. The α-amylase inhibition was observed at the highest levels with the seed butter and aril oil obtained via cold maceration. The palmitic acid (PA) and oleic acid (OA) were detected at their maximal concentrations in the seed butter obtained via Soxhlet extraction and aril oil obtained via cold maceration, respectively. This study represents an essential basis for understanding the importance of T. emetica as a valuable tree for food, cosmetic and medicinal purposes. Further experiments can lead to the development of green extraction techniques and isolation of the cytotoxic and antidiabetic molecules that can be developed into new pharmaceutical products or serve as lead molecules for new drugs.

The purpose of this paper is to understand perceptions of interior design students after using game-based learning (GBL) as an approach to address workload distribution, lack of clear assessment criteria, and deficiencies of the master-apprentice model during the process of solving several small-scale design problems along the course of a semester. A literature review of the instructional issues in design studios is presented along with an overview of the activity systems theory as an underpinning theoretical perspective. This research paper explains the research design behind the case study methodology used to perform data collection, analysis measures and organize coding schemes. Findings from the study conclude that GBL fits into the iterative and experimental nature of the design process, helps students focus on the design process through trial and error without a significant risk, changes the studio's feedback structure, and allows students to track their progress while having creative freedom. This paper provides empirical evidence supporting the existence of instructional issues in traditional design studios, provides considerations for using GBL to address these issues, and suggests directions for future research studies in fields of instructional technology, design pedagogy and higher education policy.