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Abstract Background Improvement in gene modifications of donor pigs has led to the prevention of early cardiac xenograft rejection and significantly prolonged cardiac xenograft survival in both heterotopic and orthotopic preclinical non-human primate (NHP) models. This progress formed the basis for FDA approval for compassionate use transplants in two patients. Methods Based on our earlier report of 9-month survival of seven gene-edited (7-GE) hearts transplanted (life-supporting orthotopic) in baboons, we transplanted 10 gene-edited pig hearts into baboons (n = 4) using non-ischemic continuous perfusion preservation (NICP) and immunosuppression regimen based on co-stimulation blockade by anti-CD40 monoclonal antibody. This pivotal study expands on the 7-GE backbone, with 3 additional gene edits, using 10-GE pigs as donors to baboon recipients. Results 10 GE cardiac xenografts provide life-supporting function up to 225 days (mean 128 ± 36 days) in a non-human primate model. Undetectable or latent porcine cytomegalovirus (PCMV) does not influence cardiac xenograft survival in this study but still needs more exploration with a larger cohort. Xenograft histology demonstrates adipose (Fat) deposition (n = 1), chronic vasculopathy (n = 1), micro and macro thrombosis, and acute cellular rejection (n = 1). Conclusions These data demonstrate that 10 GE cardiac xenografts have variable cardiac xenograft survival in NHP due to perhaps presence of 4th antigen and require further study. However, these 10GE organs may be suitable for clinical cardiac xenotransplantation and have already been utilized in two human cases.

Leak proof tube-to-tube sheet joints are mandatory for the optimal operation and longevity of the shell and tube heat exchanger. Tube-to-tube sheet joints play a crucial role as fluid barriers, ensuring effective separation between the tube and shell side fluids within shell and tube heat exchangers. Non-conventional friction stir welding, known for imparting less residual stresses, is not commercially used for the fabrication of tube-to-tube sheet joints due to complex joint configuration and geometrical limitations. An extensive study on friction stir welding considering the geometrical parameters of tube-to-tube sheet arrangement is highly demanded. This research examined the mutual influence of radial clearance ranging from 0 mm to 0.5 mm and tube projection lying from 1 mm to 2 mm in friction stir welding of tube to tube sheet configuration on the pull-out strength, extension and, hardness at the stirring and fusion zones. Optimum radial clearance and tube projection for achieving high mechanical weld properties was estimated using multi-objective integrated Taguchi-PCA-GRA optimization. The result proves that the friction stir welded joint is capable of achieving joint strength close to the tungsten inert gas welded joint. The optimum parameters are 2 mm for tube projection and 0 mm for radial clearance to achieve maximum strength and weld penetration, while minimizing hardness at both stir zone and fusion zone. The findings of this research proved the adaptability of friction stir welding for the fabrication of tube-to-tube sheet joints with the right choice of tube projection and radial clearance.

Abstract Legal translation is usually a challenging task for many students due to the unique features of legal discourse. Despite this, few studies have experimented training techniques aimed at helping students overcome legal translation difficulties. In this study, 37 Saudi university students received training for eight academic weeks in Arabic-English legal translation using model translated texts. Each translation activity in the training consisted of the following four stages: translating the Arabic legal text into English, comparing the translated text to its translated model, revising the translated text in light of the model, and noticing textual features of the target legal text type in more translated models. The pre- and post-tests showed that the training significantly improved the lexical, syntactic and punctuation aspects in the students’ translated texts. The qualitative data also confirmed these positive gains. The results emphasize the importance of raising students’ awareness of legal translation conventions and terminology, and the need for using relevant and graded learning materials in legal translator training.

Genetic diversity, heritability, and genetic advance are crucial considerations in the field of plant breeding. This research aimed to evaluate these factors for traits related to yield in faba bean (Vicia faba L.), specifically focusing on the F3 and F4 generations resulting from the cross between ‘Sakha 3’ and ‘Nubaria 3’. In the initial season (2021/ 2022), 200 families from each F3 population were cultivated with specific spacing, and selection criteria included seed yield per plant (SYP) and the number of pods per plant (NPP). Top-performing plants were identified for the second cycle of pedigree selection. In the following season (2022/2023), the F4 families were arranged in a randomised complete block design. Traits like the number of branches per plant (NBP), NPP, SYP, and seed index (SI) showed substantial phenotypic and genotypic coefficients of variation, indicating their noteworthy variation. Phenotypic and genotypic correlation analyses showed positive associations between SYP and the NBP and NPP. Additionally, path coefficient analysis indicated that these traits had high positive direct effects on SYP. This research provides valuable insights into the genetic variability, heritability, and selection parameters for yield-related traits in faba bean, offering a foundation for future breeding programs aimed at improving yield and productivity.

The objective of this research is to examine an open government data (OGD) intention-adoption behavioural model for the public sector organisations (PSOs), since examining the model is expected to lead to a better understanding of how to realise this technological innovation among PSOs on a large scale to excavate its innovative value. In this respect, we proposed a theoretical model to explore the factors that affect OGD adoption behaviour based on three dimensions of the TOE (technology, organisation, and environment) framework. The model was then analysed after collecting the survey data from 249 PSOs in Pakistan using a purposive sampling technique. The findings unfolded that the factors, except centralisation and civil society participation, framed in technology dimension (data resource, dataset quality, perceived benefits), organisation dimension (data-driven culture, digitisation capacity, need for transparency), and environment dimension (compliance pressure, political leadership commitment) affect the PSOs’ OGD adoption intention. Cumulatively, the intention to adopt OGD was found to have a significant positive impact on OGD adoption behaviour. Based on the TOE framework, the model, with the addition of adoption intention as a significant positive factor in adoption behaviour, bears a crucial theoretical and practical contribution in the context of OGD. Doi: 10.28991/ESJ-2024-08-05-04 Full Text: PDF

Background: Diet therapy is an effective intervention to manage a wide range of seizures and has a wide range of acceptance. This anti-epileptic effect of the ketogenic diet and fasting has been linked with increased ketone levels and may lead to hypoproteinemia or growth issues. The modified Atkin diet is safe and can be taken without fluid or caloric restriction. Furthermore, the patient can use unlimited protein and fat. OBJECTIVE: The study finds out the effects of the modified Atkins diet on fatigue and cognitive functional status in refractory epilepsy. MATERIALS AND METHODS: Twenty-seven subjects (17 males, 10 females) suffering from refractory epilepsy were recruited. The mean age range was 09–15 years. The modified Atkins diet prescribed by diet specialists was introduced. The Visual Analog Scale was used for measuring fatigue levels, and the Quality of Life in Childhood Epilepsy was used to examine the effects on life quality in epileptic patients after 16 weeks. Results: The subject’s mean age was 11.7 ± 2.02 years. They had epilepsy for about 7.8 ± 3.1 years. The seizer frequency was about 2–5 days per week. The muscle fatigue level, seizer frequency, and quality of life were improved after 16 weeks (

An important dimension in the education of health professionals is developing their English language performance to help them meet academic and professional needs. Though understanding Saudi university medical students’ English language needs is key to helping them perform well in their academic studies and future workplaces, there has been scarce research on these needs. The present study investigated Saudi university medical students’ English language difficulties, the strategies they use for overcoming these difficulties, their evaluation of the English language instruction received at their colleges and perceptions of their English language needs. The study drew upon surveying students’ language needs through using a 25-item questionnaire with four sections assessing the target dimensions. Two hundred and 55 students completed the questionnaire. The students have some difficulties when completing productive language tasks and when processing content explained or written fully in English. Their highest language needs relate to improving medical terminology and English speaking, but their lowest language need concerns listening. A few significant gender-related differences were noted. The English language instruction provided to the students studying medicine could be reformed through giving more attention to improving their productive language skills and helping them communicate fluently using target medical terminology.

The gut microbiota-brain axis has been associated with the pathogenesis of numerous disorders, but the mechanism(s) underlying these links are generally poorly understood. Accumulating evidence indicates the involvement of gut microbe-derived metabolites. Circulating levels of the gut microbe/host co-metabolite p-cresol sulfate (pCS) correlate with cerebrovascular event risk in individuals with chronic kidney disease (CKD), but whether this relationship is mechanistic is unclear. We hypothesized that pCS would impair the function of the blood–brain barrier (BBB), the primary brain vasculature interface. We report that pCS exposure impairs BBB integrity in human cells in vitro and both acutely (≤6 hours) and chronically (28 days) in mice, enhancing tracer extravasation, disrupting barrier-regulating tight junction components and ultimately exerting a suppressive effect upon whole-brain transcriptomic activity. In vitro and in vivo mechanistic studies showed that pCS activated epidermal growth factor receptor (EGFR) signaling, sequentially activating the intracellular signaling proteins annexin A1 and STAT3 to induce mobilization of matrix metalloproteinase MMP-2/9 and disruption to the integrity of the BBB. This effect was confirmed as specific to the EGFR through the use of both pharmacological and RNA interference approaches. Confirming the translational relevance of this work, exposure of the cerebromicrovascular endothelia to serum from hemodialysis patients in vitro led to a significant increase in paracellular permeability, with the magnitude of permeabilization closely correlating with serum pCS, but not most other uremic toxin, content. Notably, this damaging effect of hemodialysis patient serum was prevented by pharmacological blockade of the EGFR. Our results define a pathway linking the co-metabolite pCS with BBB damage and suggest that targeting the EGFR may mitigate against cerebrovascular damage in CKD. This work further provides mechanistic evidence indicating the role of gut microbe-derived metabolites in human disease.

ABSTRACT: Background: Traumatic thoracolumbar fracture fixation without neurological injury can be performed using the traditional open, mini-open Wiltse, and percutaneous approaches. This systematic review and meta-analysis aims to compare perioperative outcomes between these approaches. Methods: PubMed, Web of Science, Scopus, Embase, and the Cochrane Library were searched for all relevant observational comparative studies. Results: 5 randomized trials and 22 comparative cohort studies were included. Compared to the traditional open approach (n=959), the Wiltse approach (n=410) was associated with significantly lower operative time, intraoperative estimated blood loss (EBL), and length of stay (LOS). There was no significant difference between the two in terms of postoperative visual analog scale (VAS) and Cobb angle. Compared to the percutaneous approach (n=980), the Wiltse approach was associated with shorter operative and fluoroscopy time, as well as significantly improved Cobb and vertebral body angles. The percutaneous approach was associated with improved vertebral body height. There was no significant difference between the two for blood loss, postoperative VAS, or LOS. Compared to the traditional open approach, the percutaneous approach was associated with shorter operative time, lower EBL, shorter LOS and better postoperative VAS and Oswestry Disability Index. There was no difference between the two in postoperative Cobb angle, vertebral angle, or vertebral body height. Overall study heterogeneity was high. Conclusions: Utilization of minimally invasive surgical approaches holds great promise for lowering patient morbidity and optimizing care. A prospective trial is needed to assess outcomes and guide surgical decision making.

Purpose: The optimal delivery schedule for stereotactic body radiation therapy (SBRT) in treating stage I non-small cell lung cancer (NSCLC) is unknown. This study used the National Cancer Database to examine daily versus every other day (QOD) SBRT scheduling, including trends over time and association with survival. Methods and Materials: The National Cancer Database was used to retrospectively identify patients with stage I NSCLC treated with 3-, 4-, or 5-fraction of SBRT between 2004 and 2016. Survival analysis was performed using the Kaplan-Meier method and Cox regression modeling. Results: Of 15,269 patients, 3927 (25.7%) received SBRT daily, and 11,342 (74.3%) received treatment QOD. The use of QOD treatment increased from 63.2% in 2007 to 78.3% in 2016, and 5-fraction SBRT increased from 3.7% in 2004 to 51.4% in 2016 (both P < .0001). QOD 5-fraction became the most prevalent scheduling from 2012 to 2016 (28.5% in 2012 to 41.6% in 2016). Factors significantly associated with daily SBRT scheduling included number of fractions, race, lower income, lower comorbidities, and treatment at academic/research programs (all P ≤ .01).Median survival for daily SBRT was 37.9 months versus 38.4 months for QOD (P = .4). On multivariable analysis, no difference was found in overall survival between daily versus QOD scheduling (adjusted hazard ratio [aHR], 0.99; 95% confidence interval [CI], 0.94-1.04; P = .55). Five-fraction SBRT was associated with worse survival versus 3 fractions (aHR, 1.09; 95% CI, 1.03-1.15; P = .002). With 3-fraction SBRT, QOD treatment was associated with improved survival versus daily treatment (aHR, 0.91; 95% CI, 0.84-0.98; P = .02). With 5-fraction SBRT, QOD treatment was associated with worse survival versus daily treatment (aHR, 1.11; 95% CI, 1.02-1.22; P = .02). Conclusions: QOD SBRT schedules were more frequently used to treat stage I NSCLC than daily regimens by a factor of 3:1, and QOD 5-fraction SBRT became the most common dose schedule after 2012. Three-fraction QOD SBRT was associated with improved survival versus daily, whereas 5-fraction QOD SBRT was associated with worse survival versus daily.

Abstract Compared to the other English medium instruction (EMI) issues, assessment has received very scant research attention. A complex issue in EMI assessment relates to the role of English in measuring learning outcomes, and whether or not language should be assessed along with technical content. Combining questionnaire and semi-structured interviewed data, this study explored the English-related assessment practices and beliefs of native-Arabic and non-native-Arabic faculty members teaching EMI scientific majors at eight Saudi universities. Two hundred and forty-nine faculty members completed the questionnaire, whereas 20 faculty members were interviewed. The results showed that the content teachers do not give much weight to language quality when evaluating students’ written or oral performance. Compared to native-Arabic peers, the non-native-Arabic teachers, who intuitively have little or no translanguaging in their instruction, were found to pay slightly more attention to evaluating students’ English and to considering it in assessing students’ academic performance. Meanwhile, the interviews revealed that the teachers’ negative language-related assessment attitude has been shaped by the view that they are non-responsible for correcting students’ English, and by the too many language errors noted in students’ performance. Finally, the teachers’ highly-rated language assessment self-efficacy beliefs did not match their actual assessment practices.

Abstract Understanding the realities of feedback practices and activity uses in writing classrooms is key to optimizing them. This study attempted to profile Saudi university English writing teachers’ uses of feedback delivery modes, error correction strategies, and learner-centered feedback activities. The study drew upon the qualitative approach by using an open-ended questions to explore and gain an in-depth understanding of teachers’ feedback provision practices and activity uses. Open-end questionnaire responses were collected from 74 English writing teachers working at eight Saudi universities. The results revealed that handwritten and oral feedback modes are more dominant in the teachers’ practices than electronic and audio-recorded modes. Additionally, a relatively larger number of the teachers reported using direct and comprehensive error correction strategies more than indirect and selective ones. A considerable number of the teachers were found to use combinations of feedback modes, direct-indirect and comprehensive-selective error correction forms. With regard to their use of learner-centered feedback activities, a larger number of the teachers reported making use of peer feedback in their classes but neglecting student self-evaluation and automated writing evaluation activities. The paper discusses the implications pertinent to improving feedback provision practices and activity uses in the Saudi university context.

Accounting and auditing firms (AAFs) are experiencing a paradigm shift with the integration of artificial intelligence (AI), which has the potential to revolutionise important areas like fostering financial reporting accuracy, auditing efficiency, and diminishing information asymmetry. Yet, the effectiveness of AI adoption in achieving this goal is not guaranteed. Hence, this study aims to empirically explore what shapes AI adoption among AAFs, and what its potential role is in financial reporting accuracy, auditing efficiency, and information asymmetry. By applying a validated model of TOE-TAM-RDT and analysing using PLS-SEM, we found that AI adoption was shaped by competitive pressure, vendor ecosystem, top management support, relative advantage, AI readiness, and innovation climate. The adoption of AI-driven systems among AAFs exerted a positive impact on financial reporting accuracy, and auditing efficiency, while a negative impact on information asymmetry. Results further reveal a significant moderating effect of big data governance, demonstrating that proper management, quality, and ethical use of data within AAFs can amplify AI adoption benefits, boosting financial reporting accuracy, auditing efficiency, and mitigating information asymmetries between AAFs and stakeholders. These outcomes not only advance scholarly conversations on AI adoption in the financial and accounting landscape but also deliver actionable strategies for stakeholders to maximise AAFs’ benefits from this emerging revolutionary technology.

Background: Rheumatoid arthritis is an autoimmune disease characterized by autoantibodies against citrullinated antigens. The anti-cyclic citrullinated peptide test is commonly used to diagnose rheumatoid arthritis, whereas the anti-mutated citrullinated vimentin is another anti-citrullinated antibody that reacts with mutated citrullinated vimentin. Anti-mutated citrullinated vimentin antibodies have been suggested as a superior early arthritis diagnostic marker. Objectives: This study aimed to evaluate the levels of IL6 and anti-mutated citrullinated vimentin biomarkers as well as to determine their potential correlation with disease activity in rheumatoid arthritis Iraqi patients. Methods: The study included an overall sample of 120 individuals who were recruited from the Department of Rheumatology at Baghdad Teaching Hospital in Baghdad, Iraq, during the period from late August 2023 to early October 2023. They were subdivided into two primary groups. The first group consisted of 60 individuals diagnosed with RA who were further categorized based on disease activity. The second group consisted of 60 healthy individuals as controls. The age range of the participants was between 20 and 79 years. An enzyme-linked immunosorbent test was used to evaluate the blood level of anti-MCV and IL-6. Results: There was no significant correlation between anti-mutated citrullinated vimentin and disease activity(p-value:0.374) also IL-6 and disease activity(p-value:0.792) but our findings showed there is a statistical accusation between Erythrocytes Sedimentation Rate, and C-reactive protein with disease activity(p-value:0.013 and 0.025) also a high positive correlation between anti-mutated citrullinated vimentin and duration of disease and anti-mutated citrullinated vimentin with Rheumatoid factor and no significant correlation between anti-mutated citrullinated vimentin and IL6. Conclusion: anti-mutated citrullinated vimentin autoantibody shows a high correlation with the duration of disease and a positive correlation with Rheumatoid factor and has no significant correlation with disease activity.

Abstract This paper presents a novel quad-element array with multiple inputs and multiple outputs (MIMO) designed for 5th generation sub-6 GHz applications. The MIMO system achieves a wide impedance bandwidth, high gain, and high isolation among its components, representing significant advancements in sub-6 GHz antenna applications. The single element, an elliptical resonator with a circular slot, is fed by a 50 Ω microstrip feedline, achieves a broad characteristic bandwidth from 3.7 to 5.7 GHz with a resonant frequency of 4.33 GHz and a gain of 1.81 dBi. Characteristic Mode Analysis (CMA) was employed to elucidate the evolution phases of this design. The quad-element MIMO antenna array maintains a compact size and broadband characteristics by arranging mirrored elements on the same ground plane. Implemented on a cost-effective FR-4 substrate measuring 44 × 44 × 1.6 mm3, the recommended MIMO antenna array, enhanced with a partial ground plane and due to the introduction of a vertical strip, a high isolation of − 38.53 dB is achieved between MIMO components along with a realized gain of 3.01 dBi and a radiation efficiency of 71% in the 5G sub-6 GHz band. Noteworthy properties include high isolation, diversity gain (DG), and envelope correlation coefficient (ECC), verifying the appropriateness of the suggested MIMO scheme for 5G transmission and reception in sub-6 GHz applications.

Background and Purpose Posterior cerebral artery occlusion (PCAo) can cause long-term disability, yet randomized controlled trials to guide optimal reperfusion strategy are lacking. We compared the outcomes of PCAo patients treated with endovascular thrombectomy (EVT) with or without intravenous thrombolysis (IVT) to patients treated with IVT alone. Methods From the multicenter retrospective Posterior cerebraL ArTery Occlusion (PLATO) registry, we included patients with isolated PCAo treated with reperfusion therapy within 24 hours of onset between January 2015 and August 2022. The primary outcome was the distribution of the modified Rankin Scale (mRS) at 3 months. Other outcomes comprised 3-month excellent (mRS 0–1) and independent outcome (mRS 0–2), early neurological improvement (ENI), mortality, and symptomatic intracranial hemorrhage (sICH). The treatments were compared using inverse probability weighted regression adjustment. Results Among 724 patients, 400 received EVT+/-IVT and 324 IVT alone (median age 74 years, 57.7% men). The median National Institutes of Health Stroke Scale score on admission was 7, and the occluded segment was P1 (43.9%), P2 (48.3%), P3–P4 (6.1%), bilateral (1.0%), or fetal posterior cerebral artery (0.7%). Compared to IVT alone, EVT+/-IVT was not associated with improved functional outcome (adjusted common odds ratio [OR] 1.07, 95% confidence interval [CI] 0.79–1.43). EVT increased the odds for ENI (adjusted OR [aOR] 1.49, 95% CI 1.05–2.12), sICH (aOR 2.87, 95% CI 1.23–6.72), and mortality (aOR 1.77, 95% CI 1.07–2.95). Conclusion Despite higher odds for early improvement, EVT+/-IVT did not affect functional outcome compared to IVT alone after PCAo. This may be driven by the increased risk of sICH and mortality after EVT.

Background and Purpose We compared the outcomes of endovascular therapy (EVT) in an extended time window in patients with large-vessel occlusion (LVO) between patients with and without pre-stroke disability. Methods In this prespecified analysis of the multinational CT for Late Endovascular Reperfusion study (66 participating sites, 10 countries between 2014 and 2022), we analyzed data from patients with acute ischemic stroke with a pre-stroke modified Rankin Scale (mRS) score of 0–4 and LVO who underwent EVT 6–24 hours from the time last seen well. The primary outcome was the composite of functional independence (FI; mRS score 0–2) or return to the pre-stroke mRS score (return of Rankin, RoR) at 90 days. Outcomes were compared between patients with pre-stroke disability (pre-stroke mRS score 2–4) and those without (mRS score 0–1). Results A total of 2,231 patients (median age, 72 years; median National Institutes of Health Stroke Scale score, 16) were included in the present analysis. Of these, 564 (25%) had pre-stroke disability. The primary outcome (FI or RoR) was observed in 30.7% of patients with pre-stroke disability (FI, 16.5%; RoR, 30.7%) compared to 44.1% of patients without (FI, 44.1%; RoR, 13.0%) (P

Neuropsychiatric systemic lupus erythematosus (NPSLE) affects the brain, spinal cord, or other nerves and leads to neurological and psychiatric symptoms directly related to SLE. We report a series of four female patients with NPSLE as the first presentation for SLE. None of them were previously diagnosed with SLE. The first case involved a 50-yearold patient who presented with back pain and lower limb weakness for three weeks associated with numbness. A lumbar puncture was done, and CSF analysis showed high WBC and normal glucose levels with negative CSF cultures for bacteria. The patient was diagnosed with aseptic meningitis and treated with antibiotics and antiviral medication without improvement. So she was treated as a case of SLE aseptic meningitis with steroids. In the second case, a 20-yearold patient had a generalized tonic-clonic seizure with the acute manifestation of hypertensive urgency. Magnetic resonance imaging (MRI) was done and suggested posterior reversible encephalopathy syndrome (PRES). The third case was for a 38-year-old patient who complained of dizziness, general weakness, and convulsion. On review of the systems, the patients had positive symptoms of SLE. Anti-nuclear antibody (ANA) and double-stranded ds-DNA were positive. Computed tomography (CT) scans were done and showed a thymoma. The patient was diagnosed with SLE in association with focal seizures and thymoma. In the last case, a 44-year-old patient presented with tongue heaviness and right-side weakness. MRI revealed small acute lacunar infarction scattered at both cerebral hemispheres and the right side of the cerebellum, and chest CT showed pulmonary embolism (PE). The patient was diagnosed with an acute ischemic stroke and PE related to SLE. In conclusion, the neurological manifestations of SLE are a significant issue for both patients and clinicians. Here we report a unique case series and describe the prognosis and outcome of the treatment in these cases.

Atopic dermatitis (AD) or eczema is an important inflammatory chronic skin disease that brings many complications in its management and treatment. Although several chemical agents are used for treatment, the search for better anti-inflammatory and antibacterial agents of plant origin has been ongoing, since natural compounds, it is commonly believed, are less dangerous than synthetic ones. Therefore, the present study explored a medicinal plant—Eclipta prostrata (L.) L.—for its anti-inflammatory activity alone and in combination with a non-steroidal anti-inflammatory drug (NSAID), diclofenac. The plant extract was used to make a cream formulation for treating atopic dermatitis and as an antibacterial agent against Staphylococcus aures, the major infectious agent associated with AD. The phytochemical analysis of the E. prostrata extract showed the presence of various phytochemicals, including flavonoids, Tannin, saponin, terpenoids, glycosides, phenol, alkaloids, quinone, and protein. The GC-MS profiling of methanolic E. prostrata extract was performed predicted the presence of twenty important phytochemicals, including 2-[5-(2-Hydroxypropyl) oxolan-2-yl]propanoic acid, dl-Menthol, dodecane, undecane, 4,7-dimethyl-, dodecane, 2,6,10-trimethyl-, decane, 2,3,5,8-tetramethyl-, cholest-5-en-3-ol, (3.alpha.)-, TMS derivative, cyclopropane carboxylic acid, 1-hydroxy-, (2,6-di-t-butyl-4-methylphenyl) ester, alpha.-farnesene, propanoic acid, 2-methyl-, 2-ethyl-1-propyl-1,3-propanediyl ester, diethyl phthalate, corticosterone, 2-methylpropionate, hentriacontan-13-ol, O-TMS, phthalic acid, 2,4-dimethylpent-3-yl dodecyl ester, hexasiloxane, 1,1,3,3,5,5,7,7,9,9,11,11-dodecamethyl-, acetic acid, 4-t-butyl-4-hydroxy-1,5-dimethyl-hex-2-ynyl ester, octadecane, 2-methyl- octacosane, 1-iodo-, nonacosane, and eicosyl isopropyl ether. Using an egg albumin denaturation inhibition assay, the anti-inflammatory activities of E. prostrata alone and in combination with diclofenac were investigated, and they showed 93% and 99% denaturation inhibition at 5 mg concentration of E. prostrata in alone and combination with diclofenac, respectively. Heat-induced haemolysis showed 2.5% and 2.4% of haemolysis at 5 mg of E. prostrata alone and in combination with diclofenac, respectively. An MTT assay performed using L929 cells proved that the extract has no cytotoxic effect. The plant extract displayed potential antibacterial activity against Staphylococcus aureus; the growth was inhibited at 1 mg/mL of E. prostrata extract. Thus, based on this evidence, the authors suggest that E. prostrata extract should be studied further for its anti-inflammatory and antibacterial activities and topical application in the treatment of atopic dermatitis.

This study employs a robust multiphase Eulerian model to mimic heat transfer enhancement using nanofluids in a circular microchannel. Unlike the Eulerian models reported in the literature, the current model incorporates phase interactions, and its accuracy is significantly improved by integrating collision viscosity, kinetic viscosity, and frictional viscosity. Comparative analysis against other models like mixture and discrete phase models demonstrates superior performance of the current model, particularly for solid particle volume fractions exceeding 1 %. The model evaluates water-based nanofluids (Ag NPs, MgO, ZnO, Al2O3, ZrO2, SiO2) in circular microchannels. Ag NPs/water excels at low volume fractions and high Reynolds numbers, while MgO/water performs better at higher volume fractions. Moreover, the analysis of the Euler number indicates a decreasing trend with increasing Reynolds number across all nanofluids. However, no notable variation in the Euler number is observed when maintaining constant volume fraction and Reynolds number. Ultimately, the model is applied to obtain bulk fluid properties, such as viscosity and thermal conductivity, after suspending the nanoparticles. Subsequently, these properties were incorporated into the single-phase model. Utilizing these derived bulk properties was found to substantially enhance the accuracy of the single-phase model, demonstrating its reliability by yielding results within 13.52 % of experimental data.

Background With the expanding eligibility for endovascular therapy (EVT) of patients presenting in the late window (6–24 hours after last known well), we aimed to derive a score to predict favorable outcomes associated with EVT versus best medical management. Methods and Results A multinational observational cohort of patients from the CLEAR (Computed Tomography for Late Endovascular Reperfusion) study with proximal intracranial occlusion (2014–2022) was queried (n=58 sites). Logistic regression analyses were used to derive a 9‐point score for predicting good functional outcome (modified Rankin Scale score 0–2 or return to premorbid modified Rankin Scale score) at 90 days, with sensitivity analyses for prespecified subgroups conducted using bootstrapped random forest regressions. Secondary outcomes included 90‐day functional independence (modified Rankin Scale score 0–2), poor outcome (modified Rankin Scale score 5–6), and 90‐day survival. The score was externally validated with a single‐center cohort (2014–2023). Of the 3231 included patients (n=2499 EVT), a 9‐point score included age, early computed tomography ischemic changes, and stroke severity, with higher points indicating a higher probability of a good functional outcome. The areas under the curve for the primary outcome among EVT and best medical management subgroups were 0.72 (95% CI, 0.70–0.74) and 0.87 (95% CI, 0.84–0.90), respectively, with similar performance in the external validation cohort (area under the curve, 0.71 [95% CI, 0.66–0.76]). There was a significant interaction between the score and EVT for good functional outcome, functional independence, and poor outcome (all Pinteraction

الملخص: أهدف البحث: تعكس عدد حالات كورونا في إندونيسيا خطورة الأمراض وانتشارها بسرعة. تم إجراء الرصد الجينومي لفيروس كورونا المستجد والتحقيق في المجتمعات البكتيرية للجهاز التنفسي العلوي في غرب جاوة كرد فعل للتهديد المتزايد حيث يمكن أن يؤثر تفاوت التوازن في الميكروبات في الجهاز التنفسي العلوي بشكل سلبي على حالة المرضى. طرق البحث: استخدمنا منصة تسلسل النانوبور لتحليل 43 عينة من التغيرات الجينية لفيروس كورونا المستجد و11 عينة مختارة لتسلسل الجينات عبر الريبوزوم 16، تم جمعهم في الفترة من مايو إلى أغسطس 2021. النتائج: خمسة أنواع فيروسية في السكان (أ.ي.23؛ أ.ي.24؛ أ.ي.26؛ أ.ي.42؛ ب.1.1.7) كانت تهيمن على وجود النوع أ.ي.23 (82%) predominated among five virus lineages in the populations (AY.23, AY.24, AY.26, AY.42, B.1.1.7). The region in the SARS-CoV-2 genome found to have the highest number of mutations was the spike (S) protein (>20%). There was no association between SARS-CoV-2 lineages, mutation frequency, patient profile, and COVID-19 rapid spread-categorized cases. There was no association of bacterial relative abundance, alpha-beta diversity, and linear discriminant analysis effect size analysis with patient profile and rapid spread cases. MetagenomeSeq analysis showed eight differential abundance species in individual patient profiles, including Pseudomonas aeruginosa and Haemophilus parainfluenzae. Conclusions: The data demonstrated relevant AY.23 dominance (the Delta variant) in West Java during that period supporting the importance of surveillance program in monitoring disease progression. The inconsistent results of the bacterial communities suggest that a complex multifactor process may contribute to the progression of bacterial-induced disease in each patient.

ABSTRACTPolymorphism of the prion protein gene (PRNP) gene determines an animal’s susceptibility to scrapie. Three polymorphisms at codons 136, 154, and 171 have been linked to classical scrapie susceptibility, although many variants of PRNP have been reported. However, no study has investigated scrapie susceptibility in Nigerian sheep from the drier agro-climate zones. In this study, we aimed to identify PRNP polymorphism in nucleotide sequences of 126 Nigerian sheep by comparing them with public available studies on scrapie-affected sheep. Further, we deployed Polyphen-2, PROVEAN, and AMYCO analyses to determine the structure changes produced by the non-synonymous SNPs. Nineteen (19) SNPs were found in Nigerian sheep with 14 being non-synonymous. Interestingly, one novel SNP (T718C) was identified. There was a significant difference (P

Tissue culture is used to multiply Al-Taif rose (Rosa damascena f. trigintipetala (Diek) R. Keller) plants in order to meet the demands of the fragrance, cosmetic, and floriculture industries. The use of arbuscular mycorrhizal fungus (AMF) could potentially improve plant growth and acclimatization performance to ex vitro conditions. Thus, in the current study, we investigated how AMF Rhizophagus fasciculatus influences the growth, establishment, and physiological performance of micropropagated Al-Taif rose plants during the acclimatization stage. The growth and physiological parameters of the AMF-treated plants were evaluated after a 12 week growth period in the growth chambers. The plants treated with AMF exhibited greater height (25.53 cm) and biomass growth values for both shoot fresh weight (0.93 g/plant) and dry weight (0.030 g/plant), more leaves (11.3/plant), more leaf area (66.15 cm2), longer main roots (15.05 cm/plant), total root length (172.16 cm/plant), total root area (64.36 cm2/plant), and biomass from both fresh weight (383 mg/plant) and dry weight (80.00 mg/plant) of the plants. The plants treated with AMF also exhibited increased rates of net CO2 assimilation, stomatal conductance, and transpiration compared to the control plants. The proline content in the leaves and roots was significantly lower in the AMF-treated plants than untreated plants. The Fv/Fm ratio, which serves as an indicator of the intrinsic or maximal efficacy of Photosystem II (PSII) demonstrated a notable decline in the untreated Al-Taif rose plants. These results elucidate the advantageous impact of AMF colonization on micropropagated Al-Taif rose plants, thereby enhancing their resilience against adverse ex vitro conditions.

Soil salinization, especially in arid and semi-arid regions, is one of the major abiotic stresses that affect plant growth. To mediate and boost plant tolerance against this abiotic stress, arbuscular mycorrhizal fungi (AMF) symbiosis is commonly thought to be an effective tool. So, the main purpose of this study was to estimate the role of AMF (applied as a consortium of Claroideoglomus etunicatum, Funneliformis mosseae, Rhizophagus fasciculatum, and R. intraradices species) symbiosis in mitigating deleterious salt stress effects on the growth parameters (shoot length (SL), root length (RL), shoot dry weight (SDW), root dry weight (RDW), root surface area (RSA), total root length (TRL), root volume (RV), root diameter (RD), number of nodes and leaves) of Cenchrus ciliaris L. plants through improved accumulations of photosynthetic pigments (chlorophyll a, chlorophyll b, total chlorophyll), proline and phenolic compounds. The results of this experiment revealed that the roots of C. ciliaris plants were colonized by AMF under all the applied salinity levels (0, 75, 150, 225, and 300 mM NaCl). However, the rate of colonization was negatively affected by increasing salinity as depicted by the varied colonization structures (mycelium, vesicles, arbuscules and spores) which were highest under non-saline conditions. This association of AMF induced an increase in the growth parameters of the plant which were reduced by salinity stress. The improved shoot/root indices are likely due to enhanced photosynthetic activities as the AMF-treated plants showed increased accumulation of pigments (chlorophyll a, chlorophyll b and total chlorophyll), under saline as well as non-saline conditions, compared to non-AMF (N-AMF) plants. Furthermore, the AMF-treated plants also exhibited enhanced accumulation of proline and phenolic compounds. These accumulated metabolites act as protective measures under salinity stress, hence explaining the improved photosynthetic and growth parameters of the plants. These results suggest that AMF could be a good tool for the restoration of salt-affected habitats. However, more research is needed to check the true efficacy of different AMF inoculants under field conditions.

Abstract The host-microbiota co-metabolite trimethylamine N-oxide (TMAO) is linked to increased cardiovascular risk but how its circulating levels are regulated remains unclear. We applied “explainable” machine learning, univariate, multivariate and mediation analyses of fasting plasma TMAO concentration and a multitude of phenotypes in 1,741 adult Europeans of the MetaCardis study. Here we show that next to age, kidney function is the primary variable predicting circulating TMAO, with microbiota composition and diet playing minor, albeit significant, roles. Mediation analysis suggests a causal relationship between TMAO and kidney function that we corroborate in preclinical models where TMAO exposure increases kidney scarring. Consistent with our findings, patients receiving glucose-lowering drugs with reno-protective properties have significantly lower circulating TMAO when compared to propensity-score matched control individuals. Our analyses uncover a bidirectional relationship between kidney function and TMAO that can potentially be modified by reno-protective anti-diabetic drugs and suggest a clinically actionable intervention for decreasing TMAO-associated excess cardiovascular risk.

Despite the important role motivation plays in students’ writing learning and development, not much attention has been given to experimenting particular instructional techniques for developing students’ writing motivation. One of the least researched teaching techniques in writing motivation studies is genre-based instruction. In this study, we examined the impact of genre-based instruction on 21 Saudi university students’ English argumentative and classification essay writing performance and their writing motivation dimensions (writing apprehension, anxiety, self-efficacy and self-concept). Drawing upon the quasi-experimental research design and non-random sampling technique, we used genre-based instruction with a representative intact class of English-as-a-foreign-language (EFL) writing students at a Saudi university. To examine the potential impact of the treatment, we collected pre- and post-instruction data, along with data gathered through an open-ended questionnaire. The results showed that genre-based instruction has contributed significantly to improving the students’ writing performance and also their writing motivation dimensions. These positive gains varied from one writing quality aspect and motivational variable to another. The students’ answers to the open-ended questionnaire also showed the positive writing learning and motivation improvements they experienced. It is generally concluded that developing students’ language and rhetorical awareness and text composition performance seems to be a prerequisite for improving their writing motivation levels. The paper ends with discussing the implications of the results.

IntroductionAfter trivalent oral poliovirus vaccine (tOPV) cessation, Pakistan has maintained immunity to type 2 poliovirus by administering inactivated polio vaccine (IPV) in routine immunization, alongside monovalent OPV type 2 (mOPV2) and IPV in supplementary immunization activities (SIAs). This study assesses the change in poliovirus type 2 immunity after tOPV withdrawal and due to SIAs with mOPV2 and IPV among children aged 6–11 months.MethodsThree cross-sectional sequential serological surveys were conducted in 12 polio high-risk areas of Pakistan. 25 clusters from each geographical stratum were selected utilizing probability proportional to size.ResultsSeroprevalence of type 2 poliovirus was 49%, with significant variation observed among surveyed areas; 80% in Killa Abdullah, Mardan & Swabi, and Rawalpindi. SIAs with IPV improved immunity from 38 to 57% in Karachi and 60 to 88% in Khyber. SIAs with IPV following mOPV2 improved immunity from 62 to 65% in Killa Abdullah, and combined mOPV2 and IPV SIAs in Pishin improved immunity from 28 to 89%. Results also reflected that immunity rates for serotypes 1 and 3 were consistently above 90% during all three phases and across all geographical areas.ConclusionThe study findings highlight the importance of implementing effective vaccination strategies to prevent the re-emergence of poliovirus. Moreover, the results provide crucial information for policymakers working toward achieving global polio eradication.

Salicylic acid (SA) is a plant growth regulator known to take part in defense responses against different types of stresses, including salt stress. In this study, the role of foliar applied SA in improving the growth of berseem variety ‘Anmol’ under salt stress was examined. Plants were sown in plastic pots in the sand. Plants were treated with different concentrations of salinity (0, 60 mM and 120 mM NaCl) and salicylic acid (0, 100 mg L-1 and 150 mg L-1) was applied as a foliar spray. Salinity stress significantly reduced root and shoot fresh and dry weight, root and shoot length, photosynthetic pigments including Chl. a, b, a/b, total soluble proteins, total amino acids and uptake of K+ and Ca2+ ions in root and shoot tissues. Exogenous application of salicylic acid improved growth traits including shoot length, shoot fresh weight, root length, root fresh and weight, shoot dry weight, pigments contents (Chl. a, a/b and carotenoids). Total soluble protein and amino acid contents, activities of antioxidants peroxidase (POD), superoxide dismutase (SOD) and catalase (CAT) were also enhanced by the foliar spray of SA under saline and non-saline conditions. SA played a crucial role in lowering Na+ and Cl− ions content in shoot and root tissues while enhancing the uptake of K+ and Ca2+ ions. The study revealed that 100 mg L-1 SA treatment significantly influenced several plant parameters, including shoot length (8 cm), root length 6.7 cm, chlorophyll (1.2 mg/g FW), total soluble proteins (0.8 mg/g FW) and total amino acids (2.5 mg/g FW), SOD (1.22 U/mg protein), CAT (1.75 U/mg FW), potassium ions (29 mg/g DW), and calcium ions (43 mg/g DW) during salinity stress. Therefore, field use of SA (100 mg L-1) is recommended to enhance the growth of berseem and other fodder crops in saline soils.

Climate change has had significant impacts on agriculture, particularly on cotton production, where drought has emerged as a major threat worldwide. Long and intense dry periods in cotton-growing regions have become more frequent and severe. Drought stress severely affects various aspects of cotton plants, including chlorophyll pigments, carbohydrate metabolism, and enzyme activities related to fiber development, such as vacuolar invertase and sucrose synthase. Furthermore, drought stress disrupts the movement of nutrients toward the reproductive tissues in cotton, resulting in compromised pollen function, propagative failure, and fiber characteristics. To tackle these issues, scientists have made advancements in creating drought-resistant cotton varieties through transgenic methods or molecular breeding techniques, genome editing, CRISPR/Cas9, utilizing quantitative trait loci (QTL). Moreover, the application of plant growth regulators and mineral elements has displayed the potential to improve cotton’s ability to endure drought stress while also enhancing fiber yield and quality. These approaches activate stress-responsive signaling pathways, which could contribute to mitigating reproductive failure and improving fiber characteristics. While the impact of drought stress on cotton plants has been extensively studied, the variations in fiber quality resulting from drought stress are not yet completely understood. Current research has been focused on unraveling the mechanisms underlying these changes, including the physiological, biochemical, and molecular alterations during the multiplicative growth phase that contribute to poor fiber development. Understanding these mechanisms will facilitate the development of novel strategies to alleviate the adverse impact of worldwide weather changes on cotton growth and fiber quality. This research focuses on the drought stress in cotton cultivation and explores its different effects on cotton morphology, physiology, crop yield, and fiber characteristics as well as mechanisms by which cotton exhibits drought tolerance and highlights innovative strategies to mitigate drought stress.

Abstract Unlike adult mammals, zebrafish regenerate spinal cord tissue and recover locomotor ability after a paralyzing injury. Here, we find that ependymal cells in zebrafish spinal cords produce the neurogenic factor Hb-egfa upon transection injury. Animals with hb-egfa mutations display defective swim capacity, axon crossing, and tissue bridging after spinal cord transection, associated with disrupted indicators of neuron production. Local recombinant human HB-EGF delivery alters ependymal cell cycling and tissue bridging, enhancing functional regeneration. Epigenetic profiling reveals a tissue regeneration enhancer element (TREE) linked to hb-egfa that directs gene expression in spinal cord injuries. Systemically delivered recombinant AAVs containing this zebrafish TREE target gene expression to crush injuries of neonatal, but not adult, murine spinal cords. Moreover, enhancer-based HB-EGF delivery by AAV administration improves axon densities after crush injury in neonatal cords. Our results identify Hb-egf as a neurogenic factor necessary for innate spinal cord regeneration and suggest strategies to improve spinal cord repair in mammals.

Background: There is a growing need for biomarkers that can help in early diagnosis of multiple sclerosis (MS) and in recognizing patients with MS activity. Moreover, many studies are recently focusing on biomarkers that may help in diagnosis of the transition from relapsing remitting multiple sclerosis (RRMS) to secondary progressive multiple sclerosis (SPMS). Circulating microRNAs (miRNAs) are now considered promising biomarkers. Objectives: Studying the role of plasma miRNA-145 and miRNA-484 in the diagnosis of MS, disease activity and in diagnosing the transition from RRMS to SPMS. Patients and Methods: Forty-six subjects of both sexes were included, 31 patients with MS) 21 with RRMS, 8 with SPMS and Two patients with primary progressive multiple sclerosis (PPMS)) and 15 healthy controls. Expression analysis of plasma miRNAs; miR-145 and miR-484 were assessed by real-time quantitative polymerase chain reaction (PCR) after miRNA extraction. Results: MicroRNAs 145 and 484 could significantly discriminate between MS cases and controls, with best cut-off values > 0.6 and > 1.7 respectively. They could also significantly discriminate between active and inactive MS cases, with best cut-off values > 0.8 and > 2 respectively. Plasma miRNA-145 could discriminate between RRMS and SPMS cases, with best cut-off value ≤1.4. Conclusion: Plasma miRNAs 145 and 484 might be used as promising biomarkers for early diagnosis of MS and in diagnosis of disease activity. Plasma miRNA-145 could be also helpful in diagnosis of the transition from RRMS to SPMS.

Background: The second most common kind of neurodegenerative disease is Parkinson's disease (PD)., and there are still significant challenges with its pharmaceutical treatment. Due to its potential therapeutic benefits on motor functions in Parkinson's disease (PD), high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) of the motor cortex is an exciting non-invasive brain stimulation (NIBS) for treating both motor and non-motor symptoms of PD. Objectives: The purpose of this prospective sham-controlled double-blinded study was to quantify the treatable effects of high-frequency rTMS on PD-related motor and non-motor symptoms. Patients and Methods: Between August 2022 and May 2023, 35 participants of both sexes were included in this research after being diagnosed with PD. All patients were attending Minia University Hospital Neurology outpatient clinic. Patients were randomly assigned as 1:1 to either the Real-rTMS group (high-frequency, 5 HZ) or SHAM-rTMS group. Ten consecutive sessions of TMS were performed. The Unified Parkinson's Disease Rating Scale (UPDRS) was used to evaluate all patients both before the first session and again after the tenth session was completed. Results: After 10 consecutive sessions, only the real-rTMS group demonstrated statistically significant improvements in motor section of UPDRS score (UPDRS 3) and overall UPDRS scores. In contrast, the SHAM-group showed no statistically significant changes. Conclusion: These findings suggest that high-frequency rTMS might play a significant role in treating motor manifestations of PD.

Infusion-related iatrogenic retinal breaks (IRBs) are a significant complication in vitrectomies, particularly when smaller-gauge cannulas are used during fluid infusion. Using two-dimensional finite element analysis (FEA), we analyzed forces exerted on the retina from different cannulas: traditional 25-gauge, 20-gauge, 23-gauge, and 27-gauge, then investigated four alternative new cannula designs: (A) oblique orifices, (B) external obstruction, (C) side ports, and (D) perpendicular orifices. The analysis revealed that the standard 25-gauge cannula had a force of 0.546 milli-Newtons (mN). Optimized cannulas demonstrated decreased forces: 0.072 mN (A), 0.266 mN (B), 0.417 mN (C), and 0.117 mN (D). While all the designs decrease fluid jet force, each has unique challenges: Design A may complicate manufacturing, B requires unique attachment techniques, C could misdirect fluid toward the lens and peripheral retina, and D requires a sealed trocar/cannula design to prevent unwanted fluid ejection. These four innovative cannula designs, identified with detailed engineering simulations, provide promising strategies to reduce the risk of IRBs during vitrectomy, bridging the gap between engineering insights and clinical application.

Background: Nigeria has the highest maternal mortality rate among sub-Saharan African countries. Recently, universal health insurance coverage has been embraced as a means to enhance population health in low- and middle-income countries. Hitherto, the effect of health insurance coverage on the utilisation of facility-level delivery is largely unknown in the face of the earnest need to lower maternal mortality rates in developing countries. Aim: To empirically investigate the association of health insurance coverage on health services utilisation of facility-level delivery and the extent to which public- and private-sector facility delivery in Nigeria had a disproportionate associational effect with health insurance coverage, in the universal health coverage era. Setting: A cross-sectional study conducted for Nigeria. Methods: This study employed a quasi-experimental method using propensity scores along with different matching methods that were applied to the most recent wave of Nigeria’s Demographic and Health Survey (2020) data. Results: Evidence suggests that childbearing mothers from insured households had an average of 25% probability of utilising facility-level delivery relative to mothers from uninsured households in the year that preceded the survey. Moreover, private-sector facility delivery had a 31% higher associational effect with health insurance coverage than public-sector facility delivery, which had an estimated probability of 21%. Conclusion: Expansion of health insurance coverage in Nigeria will be a desirable way to stimulate the utilisation of facility-level delivery by women of childbearing age. Consequently, coverage expansion has the potential to save many maternal and newborn lives in Nigeria. Contribution: This study has contributed to the urgent attention of the federal government of Nigeria to monitor and revamp the health insurance coverage policies of the country for better facilitation of health services to the Nigerian population.

Background The optimal reperfusion technique in patients with isolated posterior cerebral artery (PCA) occlusion is uncertain. We compared clinical and technical outcomes with first‐line stent retriever (SR), contact aspiration (CA), or combined techniques in patients with isolated PCA occlusion. Methods This international case–control study was conducted at 30 sites in Europe and North America and included consecutive patients with isolated PCA occlusion presenting within 24 hours of time last seen well from January 2015 to August 2022. The primary outcome was the first‐pass effect (FPE), defined as expanded Treatment in Cerebral Infarction (TICI) 2c/3 on the first pass. Patients treated with SR, CA, or combined technique were compared with multivariable logistic regression. Results There were 326 patients who met inclusion criteria, 56.1% male, median age 75 (interquartile range 65–82) years, and median National Institutes of Health Stroke Scale score 8 (5–12). Occlusion segments were PCA‐P1 (53.1%), P2 (40.5%), and other (6.4%). Intravenous thrombolysis was administered in 39.6%. First‐line technique was SR, CA, and combined technique in 43 (13.2%), 106 (32.5%), and 177 (54.3%) patients, respectively; FPE was achieved in 62.8%, 42.5%, and 39.6%, respectively. FPE was lower in patients treated with first‐line CA or combined technique compared with SR (CA versus SR: adjusted odds ratio 0.45 [0.19–1.06]; P=0.07; combined versus SR: adjusted odds ratio 0.35 [0.016–0.80]; P=0.01). There were lower odds of functional independence (modified Rankin scale score 0–2) in the first‐line CA versus SR alone group (adjusted odds ratio 0.52 [0.28–0.95]; P=0.04). FPE was associated with higher rates of favorable outcomes (modified Rankin scale score 0–2: 58% versus 43.4%; P=0.01; modified Rankin scale score 0–1: 36.6% versus 25.8%; P=0.05). Overall, symptomatic intracranial hemorrhage was present in 5.6% (18/326) and mortality in 10.9% (35/326) without difference between first‐line technique. Conclusion In patients with isolated PCA occlusion, SR was associated with a higher rate of FPE compared with CA or combined techniques with no difference in final successful reperfusion. Functional independence at 90 days was more likely with first‐line SR compared with CA. FPE was associated with better 90‐day clinical outcomes.

Abstract Background There are many methods used for cranial nerve monitoring in cerebellopontine angle (CPA) tumor excision with or without muscle relaxant which may affect hemodynamics and consumption of drug doses. The partial neuromuscular blockade, on the other hand, appears to be compatible with monitoring in some patients, according to clinical experience. In this study, we evaluated hemodynamic changes and drug consumption differences between partial and without muscle relaxants. Forty patients ages ranging from 18 to 60 years old had CPA surgery and were given either a muscle relaxant to maintain neuromuscular blockade level train-of-four (TOF) count two (group A) or a placebo of normal saline to maintain train-of-four (TOF) count four (group B). Fentanyl was given to both groups. The dose of fentanyl was modified to 0.5–1 mcg\kg/h, while the dose of propofol was modified to have bi-spectral index between 40 and 60. The total amount of propofol and fentanyl, as well as mean blood pressure and heart rate, are all measured intraoperatively. Results There was a statistically significant difference in propofol and fentanyl doses between both research groups (p = 0.003, p = 0.002) respectively during the intraoperative period. Furthermore, there is a difference in as there were significant differences between two groups in time between stop of anesthesia and eye opening which is shorter in group with partial muscle relaxant reflecting shorter duration of anesthesia and recovery time (stop anesthesia to eye opening time) (p = 0.003, p > 0.001) respectively. Also, there was no statistically significant difference in the incidence of nausea and vomiting, shivering, bradycardia, or hypotension between the two study groups. Conclusions We demonstrated that partial muscle relaxant (train of four count 2) has benefits over no muscle relaxant (train of four count 4) for patients undergoing cerebellopontine angle tumor surgery because it can reduce anesthetic duration and generate rabid recovery. Furthermore, partial muscle relaxants exhibit the same hemodynamic stability, side effects, and surgical interruptions as group without muscle relaxants.

Abstract Background Information on common markers of metabolic resistance in malaria vectors from countries sharing similar eco-climatic characteristics can facilitate coordination of malaria control. Here, we characterized populations of the major malaria vector Anopheles coluzzii from Sahel region, spanning four sub-Saharan African countries: Nigeria, Niger, Chad and Cameroon. Results Genome-wide transcriptional analysis identified major genes previously implicated in pyrethroid and/or cross-resistance to other insecticides, overexpressed across the Sahel, including CYP450s, glutathione S-transferases, carboxylesterases and cuticular proteins. Several, well-known markers of insecticide resistance were found in high frequencies—including in the voltage-gated sodium channel (V402L, I940T, L995F, I1527T and N1570Y), the acetylcholinesterase-1 gene (G280S) and the CYP4J5-L43F (which is fixed). High frequencies of the epidemiologically important chromosomal inversion polymorphisms, 2La, 2Rb and 2Rc, were observed (~80% for 2Rb and 2Rc). The 2La alternative arrangement is fixed across the Sahel. Low frequencies of these inversions (C), between Forkhead box L1 and c-EST putative binding sites, were responsible for the high overexpression of GSTe2 in the resistant mosquitoes. Transgenic flies expressing CYP6Z2 exhibited marginal resistance towards 3-phenoxybenzylalcohol (a primary product of pyrethroid hydrolysis by carboxylesterases) and a type II pyrethroid, α-cypermethrin. However, significantly higher mortalities were observed in CYP6Z2 transgenic flies compared with controls, on exposure to the neonicotinoid, clothianidin. This suggests a possible bioactivation of clothianidin into a toxic intermediate, which may make it an ideal insecticide against populations of An. coluzzii overexpressing this P450. Conclusions These findings will facilitate regional collaborations within the Sahel region and refine implementation strategies through re-focusing interventions, improving evidence-based, cross-border policies towards local and regional malaria pre-elimination.

There is a severe lack of information about molecular mechanisms of pesticide resistance in the rust-red flour beetle, a major pest destroying grains and flour across Nigeria, hindering evidence-based control. Here, we identified to the species level three populations of the red flour beetle from Kano, Nigeria, as Tribolium castaneum (Herbst 1797) and investigated the mechanism driving their insecticide resistance. The IRAC susceptibility bioassays established cypermethrin resistance, with LC50s of 4.35–5.46 mg/mL in the three populations, NNFM, R/Zaki and Yankaba. DDT and malathion resistance were observed in NNFM, with LC50s of 15.32 mg/mL and 3.71 mg/mL, respectively. High susceptibility was observed towards dichlorvos in all three populations with LC50s of 0.17–0.35 mg/mL. The synergist bioassay with piperonylbutoxide significantly restored cypermethrin susceptibility, with mortality increasing almost threefold, from 24.8% obtained with 1.5 mg/mL of cypermethrin to 63.3% in the synergised group (p = 0.013), suggesting a preeminent role of P450s. The two major knockdown resistance (kdr) mutations, T929I and L1014F, in the IIS4 and IIS6 fragments of the voltage-gated sodium channel were not detected in both cypermethrin-alive and cypermethrin-dead beetles, suggesting a lesser role of target-site insensitivity mechanisms. These findings highlight the need to explore alternative control tools for this pest and/or utilise synergists, such as piperonyl butoxide, as additional chemistries in pesticide formulations to improve their efficacy.

Tube-to-tubesheet joints play a crucial role in providing structural integrity to the shell and tube heat exchangers. This research investigated the combined effect of roller expansion percentages and grooves on the performance of expanded and welded-expanded tube-to-tubesheet joints. The results indicated that the joint strength of welded-expanded (except for 6% tube expansion and 2 grooves) and welded joints exceeded the nominal axial strength of the tube, 404.90 MPa. The highest tube pull-out strength of 290.77 MPa in the expanded only joint (10% tube expansion and 2 grooves), lesser than the axial strength of the tube by 28.25%, suggested avoiding the expansion process alone for 23 mm thick tubesheets. High dilution and inadequate minimum leak path (

In this paper, a slotted waveguide array antenna (SWAA) is designed for S-band high-power microwave (HPM) applications. The single element of the array consists of ten Gaussian distributed slots on the broad wall of the waveguide, integrated with inside grooves. The 4-element SWAA configuration is designed to achieve a relatively high gain (24.6 dB) along with highly isolated (−24 dB) radiating elements. The gain enhancement and mutual coupling (MC) reduction is achieved by optimizing inside-grooved regions. An efficient $1\times 4$ power divider (PD) of identical phase and magnitude (−6 dB) at its output ports, is designed to feed the array elements. The radiation performance of SWAA is further improved by developing a dielectric radome. The proposed design is compact having dimensions $8.46\lambda _{0}\times 4.3\lambda _{0}\times 1.47\lambda _{0}$ , and offers return loss (RL) better than −25 dB with side lobe level (SLL) of −15 dB and −20 dB in E and H-plane, respectively. The designed array has 95.78% antenna efficiency over 3.8% measured bandwidth with 63% aperture efficiency. It has been demonstrated that the developed system, because of effective suppression of unwanted surface current, provides ±22° beam scanning without causing a significant reduction in its gain. The technique, without adding any complexity in the system, offered a 7% improvement in the gain when compared with a similar design.

Surgical techniques and technology are steadily improving, thereby expanding the pool of patients amenable for spine surgery. The growing and aging population in the United States further contributes to the increase in spine surgery cases. Traditionally, spine surgery is performed under general anesthesia. However, awake spinal surgery has recently gained traction due to evidence of decreased perioperative risks, postoperative opioid consumption, and costs, specifically in lumbar spine procedures. Despite the potential for improving outcomes, awake spine surgery has received resistance and has yet to become adopted at many healthcare systems. We aim to provide the fundamental steps in facilitating the initiation of awake spine surgery programs. We also present case reports of two patients who underwent awake spine surgery and reported improved clinical outcomes.

Objective We aimed to investigate the frequency of dysnatremia among patients admitted with COVID-19 infection and its association with inpatient mortality. Methods This retrospective longitudinal study was conducted for 12 weeks. Serum sodium levels were recorded at admission, during the hospital stay, and within 48 hours of discharge or death. Logistic regression was used to determine the predictors of mortality. Results This study included 574 patients (69.7% men, age 55.6 ± 14.4 years). On admission, mean sodium was 135.9 ± 6.4 mEq/L; 39% had hyponatremia and 4.7% had hypernatremia. During admission, hypernatremia increased to 18.8%; maximum sodium in patients who survived was 140.6 ± 5.0 mEq/L versus 151.0 ± 9.9 mEq/L in those who died. The final sodium was 145.4 ± 9.4 mEq/L in patients who died versus 137.7 ± 3.7 mEq/L in those who survived (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.13–1.32). Other predictors of mortality included ischemic heart disease (OR: 3.65, 95% CI: 1.39–9.61), acute kidney injury (OR: 6.07, 95% CI: 2.39–15.42), invasive ventilation (OR: 28.4, 95% CI: 11.14–72.40), and length of stay (OR: 0.91, 95% CI: 0.86–0.97). Conclusion Hypernatremia was frequently observed in patients who were critically ill and died and may be considered a predictor of mortality in COVID-19 infection.

This study investigates the influence of phases interactions in hybrid nanofluids using a multiphase mixture model. Neglecting phase interaction for Al2O3-Cu leads to Nusselt number difference of 0.05 (volume fraction 0.1%), increasing to 0.6 at volume fraction 2%. Among investigated nanofluids (Al2O3-Au NPs, Al2O3-CuO, Al2O3-TiO2, CuO-Au NPs, CuO-TiO2, TiO2-Au NPs), those with gold nanoparticles exhibit exceptional heat transfer enhancements: Al2O3-Au NPs (63.85%), CuO-Au NPs (64.65%), and TiO2-Au NPs (62.10%) at 3% total solid phase volume fraction. CuO-Au NPs perform best, except at ∼5% volume fraction where Al2O3-Au NPs excel. Optimization shows increasing gold particle volume fractions benefit particularly at higher Reynolds numbers. For CuO-Au NPs, highest average Nusselt numbers are obtained at gold volume fractions of 10%, 20%, 40%, and 60% of total solid phases volume fractions for Reynolds numbers 300, 500, 1000, and 2000, respectively. Moreover, the investigation showed that the performance index generally increases with volume fraction up to 5%, except for hybrid nanofluids with gold particles. Notably, in the presence of gold particles, the performance index rises distinctly up to a volume fraction of 3%, followed by a subsequent decline.

Introduction Incomplete reperfusion following Mechanical Thrombectomy (MT) ranges from 12–34% and patients with Intracranial atherosclerotic (ICAS) occlusions are disproportionally affected.(1, 2)These patients are also more likely to experience poor functional outcomes. (3) Rescue stenting (RS) in these patients has shown promising rates of recanalization and better outcomes in preliminary studies. In our systemic review and meta‐analysis, we included Sixteen dual arm and seven single arm studies in order to study recanalization rate and compare outcomes following rescue stenting in patients with incomplete reperfusion compared to those managed conservatively (no‐RS).(4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)(20, 21, 22, 23, 24, 25, 26) Methods Our study was performed according to the preferred reporting items for systematic review and meta‐analysis (PRISMA) guidelines.(27) We incorporated studies that included participants, aged 18 years or older, and met the following criteria: (1) participants with ischemic stroke with Intracranial Atherosclerotic Stenosis (ICAS) who underwent at least one attempt of MT and had incomplete perfusion after the procedure (2) participants who received rescue stenting after MT with incomplete reperfusion, with no restrictions on the type of stents or stenting procedure used; (3) both observational studies (case series, cohort studies) and experimental designs (randomized controlled trials) were considered; (4) the control group consisted of patients incomplete reperfusion following MT but did not received no rescue stenting and were conservatively managed. We reported the recanalization rate in patients undergoing MT and compared the outcomes between the RS and no‐RS groups; MRS ≤ 2 at 90 days, Mortality at 90 days, Symptomatic Intra cranial Hemorrhage (sICH), Any Intracranial Hemorrhage (ICH), vessel dissection and vessel perforation Results Patients who underwent stenting experienced recanalization rate of 84% (95% CI: 79.0 – 88.1). They also had significantly higher odds of a better functional outcome (MRS ≤ 2 at 90 days) at 3 months compared to the no‐RS group (OR 2.70 [95% CI: 1.89 ‐ 3.86]). Odds of sICH (OR 0.92 [95% CI: 0.62 ‐ 1.36]) and any ICH (OR: 0.64 [95% CI 0.40 ‐ 1.03]) were lower but insignificant in the RS group. Odds of mortality at 90 days were significantly lower in the RS group(OR 0.59 [95% CI: 0.42 ‐ 0.83]). No significant difference in Odds of Vessel dissection (OR 1.22 [95% CI: 0.19 ‐ 8.07]) or vessel perforation (OR 0.40 [ 95% CI: 0.10 ‐ 1.61]) between the two groups was noted. Conclusion Out meta‐analysis which included the most recent studies indicates that rescue setting after mechanical thrombectomy for large artery intracranial atherosclerosis with incomplete perfusion or with residual stenosis (>50 percent) is associated with better clinical outcomes and indicates lower mortality rate and associated complications. Therefore, rescue stenting can be considered as a safe and viable option in these patients.

Introduction Cerebral venous thrombosis (CVT) is an uncommon form of stroke with relatively low mortality but higher incidence in younger adults.1–3 Previous work has suggested decreased overall stroke hospitalization volumes, but preserved CVT hospitalization volumes and increased CVT mortality during the COVID‐19 pandemic.4,5 We sought to provide updated incidence and trend data for cerebral venous thrombosis (CVT) in the United States from 2016‐2020, examine the impact of the COVID‐19 pandemic on CVT, and identify predictors of in‐hospital mortality. Methods Validated ICD‐10 codes were used to identify patients with CVT in the National Inpatient Sample (NIS) between 2016 and 2020. The NIS is part of the Healthcare Cost and Utilization Project (HCUP) and is maintained the Agency for Healthcare Research and Quality. The NIS provides a stratified nationally representative 20% sample of all hospital discharges in the United States, excluding rehabilitation and long‐term acute care hospitals. Annual updates to the NIS are released approximately 20 months after the conclusion of the data year. Sample weights were applied to generate nationally representative estimates, and census data were used to compute incidence rates. The first wave of the COVID‐19 pandemic was defined as January‐May 2020. Predictor variables for mortality were selected based upon previous studies of incidence and outcomes of CVT and biological plausibility.6–8 Multivariable logistic regression was conducted using all predictor variables that achieved p

ABSTRACT The intraerythrocytic malaria parasite Plasmodium falciparum exports hundreds of proteins into the host red blood cell (RBC). Most are targeted to the endoplasmic reticulum (ER) by a stretch of hydrophobic amino acids and cleaved further downstream at a conserved motif called the Plasmodium Export Element (PEXEL) by the ER protease plasmepsin V (PM V). The mature effectors then travel through the secretory pathway to the parasitophorous vacuole (PV) that surrounds the parasite. There, PEXEL proteins are somehow recognized as export-destined proteins, as opposed to PV-resident proteins, and are selectively translocated out into the RBC. The mature N-terminus appears to be important for export. There is conflicting data on whether PM V cleavage is needed for proper export or whether any means of generating the mature N-terminus would suffice. We replaced the PEXEL-containing N-terminal sequence of an exported GFP reporter with a signal peptide sequence and showed that precise cleavage by signal peptidase, generating the proper mature N-terminus, yields export competence. Expressing a construct with only the native ER targeting signal without the PM V cleavage site dramatically decreased the amount of a mature PEXEL reporter, indicating that the hydrophobic stretch lacks an efficient cleavage signal. Therefore, the PEXEL motif functions as a specialized signal cleavage site when appropriately located after an ER targeting sequence. Our data suggest that PM V cleavage and RBC export are two independent events for PEXEL proteins. We also tested and rejected the hypothesis that an alpha-helical mature N-terminus is necessary for export. IMPORTANCE Malaria parasites export hundreds of proteins to the cytoplasm of the host red blood cells for their survival. A five amino acid sequence, called the PEXEL motif, is conserved among many exported proteins and is thought to be a signal for export. However, the motif is cleaved inside the endoplasmic reticulum of the parasite, and mature proteins starting from the fourth PEXEL residue travel to the parasite periphery for export. We showed that the PEXEL motif is dispensable for export as long as identical mature proteins can be efficiently produced via alternative means in the ER. We also showed that the exported and non-exported proteins are differentiated at the parasite periphery based on their mature N-termini; however, any discernible export signal within that region remained cryptic. Our study resolves a longstanding paradox in PEXEL protein trafficking.

Shortages of psychiatrists can lead to disparities in access to mental healthcare. We examined block-level access to psychiatric services via geospatial analysis of locations registered with National Provider Identifier numbers accounting for travel time. Among 718 counties from 12 states, 208 (29%) counties had less than half of their population within 30-min travel time, while only 51 (6%) provided their entire population convenient access to psychiatrists. A considerable amount of the population resides in areas underserved by psychiatry services with varied disparities by rurality and state. Improving access to care could improve mental health outcomes in vulnerable populations.