Search

BACKGROUND: High-power short-duration (HPSD) ablation has emerged as an alternative to conventional standard-power long-duration (SPLD) ablation. We aim to assess the efficacy and safety of HPSD versus SPLD for atrial fibrillation (AF) ablation. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL were performed through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42023471797. RESULTS: We included six RCTs with a total of 694 patients. HPSD was significantly associated with a decreased total procedure time (MD: -22.88 with 95% CI [-36.13, -9.63], P = 0.0007), pulmonary vein isolation (PVI) time (MD: -19.73 with 95% CI [-23.93, -15.53], P

Introduction While surgical indications for symptomatic cholelithiasis and biliary hypokinesia are clear, hyperkinetic biliary dyskinesia (HBD) is an underrecognized condition with poorly defined symptomology and management guidelines. HBD is typically defined as a gallbladder ejection fraction (EF) ≥ 80% on a hepatobiliary iminodiacetic acid (HIDA) scan. We aimed to identify the prevalence and radiographic reporting of HBD, physician referral patterns, and clinical outcomes following cholecystectomy. Methods  A retrospective cohort study of patients with HIDA scans completed over 21 years at our tertiary care hospital was performed. Demographics, symptomatology, referral patterns, and operative data were collected. HBD was defined as HIDA EF ≥80%. Patients with HBD who underwent cholecystectomy were analyzed. ANOVA and chi-square tests were used to compare variables among patients with or without symptom improvement using Statistical Product and Service Solutions (SPSS; IBM SPSS Statistics for Windows, Armonk, NY). Results Of 1,997 patients (73% female, mean age 51.7 years) who had HIDA scans with reported EF, 730 (36.6%) had an EF≥80%. Only 13.7% of HIDA scans with EF≥80% were reported as hyperkinetic, and the rest are normal. Cholecystectomy was performed in 57 (7.8%) patients with EF≥80%, most being elective (89.5%) and all minimally invasive. Primary care physicians (PCPs) referred most elective cases to surgery (61.4%). The median time from HIDA to cholecystectomy was 146 days. Chronic cholecystitis was common in pathology (82.5%), while 38.6% had cholelithiasis. Overall, 53 patients (93.0%) reported symptom improvement at a median follow-up of 17.0 days. Patients without improvement had a higher prevalence of chronic gastrointestinal conditions (p

Evaluate the Assessment of ObesityrelatedMetabolic Comorbidities (AOMC) system tostratify diabetes response to RYGB compared todiabetes definitions by medication use and HbA1c.

Assess whether race and insurance type are associated with differences in long-term remission of obesity-related comorbidities following bariatric surgery, as measured by AOMC scores.

Clofazimine is recommended for the treatment of rifampicin-resistant tuberculosis (RR-TB), but there is currently no verified dosing guideline for its use in children. There is only limited safety and no pharmacokinetic (PK) data available for children. We aimed to characterize clofazimine PK and its relationship with QT-interval prolongation in children. An observational cohort study of South African children

Abstract Few empirical research has attempted to determine the impact of Intelligent Computer-Assisted Language Assessment (ICALA) in philosophy-based language instruction (PBLI) on critical thinking, self-evaluation, and academic resilience, despite the significant role that higher-order thinking skills play in influencing English as a Foreign Language (EFL) learners’ cognition, including their learning processes. This research addresses this knowledge vacuum by examining how ICALA in PBLI influences the development of the four primary abilities associated with critical thinking, self-evaluation, and academic resilience. A quasi-experimental strategy was used in this study among 81 EFL learners. The participants were split into two groups: one to participate in the experiment and another to serve as a control. The books for both groups were revised or supplemented according to the underlying PBLI principles. The control group (CG) students were exposed to paper format assessment. In comparison, the experimental group (EG) attended ICALA. The statistical significance of the differences between the two groups was determined using multivariate analysis of variance (MANOVA). The results demonstrated that the learners in EG outperformed their peers in CG foreign language-speaking development. Moreover, they received better critical thinking, self-evaluation, and academic resilience results.

Abstract Background Pulmonary hypertension (PH) represents a condition affecting small arteries of the pulmonary vasculature, inducing progressive blockage that results in increased pulmonary vascular resistance (PVR) as well as pulmonary arterial pressure (PAP), which are defining features of such a disorder. This work was aimed at investigating the PH prevalence among chronic kidney disease (CKD) cases and its linkage to disease severity and the relations between CKD management and PH. Methods Our prospective observational descriptive cross-sectional study was conducted on 120 CKD patients at the Chest Department, Tanta University Hospitals and Air Forces Specialized Hospitals from December 2020 to December 2022. Results The most frequent diagnosis of PH was Group 1 pulmonary arterial hypertension (36.7%) followed by Group 2 cardiac causes (30%) followed by Group 4 chronic thromboembolic PH (26.7%) and (6.7%) experienced normal pulmonary hemodynamics by RHC. Also, a statistically significant correlation was documented among CKD staging as well as risk assessment of PH (p 0.024). A significant association was documented among treatment as well as risks for developing PH (p 0.034). Patients on medical treatment (60%) showed low risk while (33.3%) of patients depending on dialysis showed high risk. Conclusions PH was diagnosed in 28 CKD patients confirmed by right (RT) side cardiac catheterization among 120 CKD patients studied for PH assessment representing 23.5%. Right-side cardiac catheterization is more accurate than echocardiography in confirming the diagnosis of PH. The severity of PH showed significant association with the CKD stage.

Purpose: It has recently been reported that the use of platelet-rich fibrin (PRF) as an extralayer over the urethroplasty has been related to a considerable reduction in fistula rates. Due to the lack of evidence supporting the usage of PRF in urethrocutaneous fistula (UCF) repair, we conducted this study to evaluate the efficacy of PRF in patients with UCF. MATERIALS AND METHODS: We conducted a randomized controlled study on patients with distal fistula after hypospadias repair. Patients were randomized into two groups, one with local dartos coverage and the other with PRF coverage layer. Results: In the present study, we included 37 patients; 20 patients underwent local dartos coverage, and 17 patients underwent PRF. The mean age was 22.45 ± 4545 ± 4515 ± ±15.35 (range 11–56) months for the study group and 20.6 ± 66 ± 614 ± ±14.5 (range 6–45) months for the control group. The incidence of recurrent UCF was 11.8% in the treatment group (two patients), whereas the incidence was 30% (six patients) in the control group (P = 0.246). Conclusion: UCF surgery may benefit from the use of PRF as a supportive tissue that promotes wound healing, angiogenesis, and tissue restoration. We believe that the use of PRF as a new approach for UCF repair should be investigated further through clinical studies.

Abstract Background Climate changes have led to health and environmental risks, so it has become essential to measure climate change literacy among the entire population, especially nursing students. The significant role of nursing students in raising public awareness and future healthcare roles emphasizes assessing the predictors of climate change literacy among nursing students. Aims This study seeks to identify the predictors of climate change literacy among nursing students in A Multi-Site Survey. Design A multi-site descriptive cross-sectional study adheres to the guidelines outlined in A Consensus-Based Checklist for Reporting Survey Studies collected for five months, from the 1st of July 2023 to November 2023. The study participants comprise 10,084 nursing students from all 27 governments in Egypt. The researcher used the Predictors of Nursing Students’ Climate Change Literacy scale in this study. Data was collected, with 25 min average time to complete. Backward multiple linear regression was used to identify these predictors. Results In the current study, nursing students demonstrated a moderate understanding of climate science (mean score 14.38), communication and advocacy skills (mean score 14.41), and knowledge of adaptation and mitigation strategies (mean score 13.33). Climate health impacts (mean score 17.72) emerged as the domain with the highest level of knowledge. No significant differences in climate literacy were observed across diverse student backgrounds (all p-values were > 0.05). Perceived faculty knowledge of climate change positively correlated with all four domains of climate literacy and emerged as a significant predictor in multiple linear regression analyses (all p-values were

Abstract Lysosomes are acidic organelles involved in crucial intracellular functions, including the degradation of organelles and protein, membrane repair, phagocytosis, endocytosis, and nutrient sensing. Given these key roles of lysosomes, maintaining their homeostasis is essential for cell viability. Thus, to preserve lysosome integrity and functionality, cells have developed a complex intracellular system, called lysosome quality control (LQC). Several stressors may affect the integrity of lysosomes, causing Lysosomal membrane permeabilization (LMP), in which membrane rupture results in the leakage of luminal hydrolase enzymes into the cytosol. After sensing the damage, LQC either activates lysosome repair, or induces the degradation of the ruptured lysosomes through autophagy. In addition, LQC stimulates the de novo biogenesis of functional lysosomes and lysosome exocytosis. Alterations in LQC give rise to deleterious consequences for cellular homeostasis. Specifically, the persistence of impaired lysosomes or the malfunctioning of lysosomal processes leads to cellular toxicity and death, thereby contributing to the pathogenesis of different disorders, including neurodegenerative diseases (NDs). Recently, several pieces of evidence have underlined the importance of the role of lysosomes in NDs. In this review, we describe the elements of the LQC system, how they cooperate to maintain lysosome homeostasis, and their implication in the pathogenesis of different NDs. Graphical Abstract

To mediate critical host-microbe interactions in the human small intestine, Paneth cells constitutively produce abundant levels of α-defensins and other antimicrobials. We report that the expression profile of these antimicrobials is dramatically askew in human small intestinal organoids (enteroids) as compared to that in paired tissue from which they are derived, with a reduction of α-defensins to nearly undetectable levels. Murine enteroids, however, recapitulate the expression profile of Paneth cell α-defensins seen in tissue. WNT/TCF signaling has been found to be instrumental in the regulation of α-defensins, yet in human enteroids exogenous stimulation of WNT signaling appears insufficient to rescue α-defensin expression. By stark contrast, forkhead box O (FOXO) inhibitor AS1842856 induced the expression of α-defensin mRNA in enteroids by >100,000-fold, restoring DEFA5 and DEFA6 to levels comparable to those found in primary human tissue. These results newly identify FOXO signaling as a pathway of biological and potentially therapeutic relevance for the regulation of human Paneth cell α-defensins in health and disease.

The design of wind turbines has been continually evolving to enhance aerodynamic efficiency, which is crucial for improving energy conversion and reducing operational costs. One promising technique is the application of the Co-Flow Jet (CFJ) method, which utilizes simultaneous blowing and suction to augment aerofoil performance. Despite its potential benefits, the relationship between aerofoil thickness and the resulting improvements in lift and drag coefficients has not been thoroughly explored, especially for the NREL aerofoils commonly used in wind turbine applications. This study utilizes Computational Fluid Dynamics (CFD) simulations in order to investigate the aerodynamic efficiency improvements of the NREL S826, NREL S825, and NREL S818 aerofoils through the application of the CFJ technique. Various configurations with different blowing (B) and suction (S) configurations were tested, including 0.08B-0.7S, 0.08B-0.8S, 0.1B-0.7S, and 0.2B-0.7S configurations. The results demonstrate that the S826-0.2B-0.7S, S825-0.2B-0.7S, and S818-0.08B-0.7S configurations yield the most significant enhancements at a common momentum coefficient (Cm) of 0.08. Specifically, there were increases in lift coefficients by about 51.1%, 66.38%, and 109%, and improvements in lift-to-drag ratios by about 11.5%, 14.38%, and 146.18% for the S826-0.2B-0.7S, S825-0.2B-0.7S and S818-0.08B-0.7S configurations, respectively.

Background: Type I diabetes mellitus (T1DM) is one of the most common chronic autoimmune diseases worldwide. miRNAs are a class of small non-coding RNA molecules that have been linked to immune system functions, β-cell metabolism, proliferation, and death, all of which contribute to pathogenesis of TIDM. Dysregulated miRNAs have been identified in Egyptian TIDM patients. Aim: Several miRNAs were profiled in Egyptian TIDM patients to determine whether they can be used as molecular biomarkers for T1DM. The relationship between the investigated miRNAs and pro-inflammatory cytokines (TNF-α and IL-6) has also been evaluated in the development of TIDM, in addition to the creation of a proposed model for TIDM prediction. Patients & methods: Case-control study included 177 Egyptian patients with confirmed type I diabetes mellitus and 177 healthy individuals. MiRNA-34 and miRNA-146 were detected in serum samples using real-time PCR, whereas TNF-α and IL-6 levels were assessed using ELIZA. Results: Patients with TIDM showed a significant decrease in the expression of miRNA-146, with a cut-off value ≤ 3.3, 48 % specificity, and 92.1 % sensitivity, whereas miRNA-34 had the highest sensitivity (95.5 %) and specificity (97.2 %) for differentiating diabetic patients from controls. Furthermore, other diagnostic proinflammatory markers showed lower sensitivity and specificity. Conclusion: Serum levels of miRNA-34a, miRNA-146, IL-6, and TNF-α provide new insights into T1DM pathogenesis and could be used for screening and diagnosis purposes. They can be also a potential therapeutic target, as well as allowing for more strategies to improve T1DM disease outcomes.