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Abstract Background Irrational use of antibiotics in hospitals is one of the main health system problems. It leads to antibiotic resistance, adverse events, treatment failure, total treatment costs, and longer hospital stay. We aim to evaluate clindamycin use in critical care units in our hospital. It is a step to assess and then put strategies to improve the antibiotic use process. Methods This is a clindamycin use evaluation retrospective study. It was done in critical care units at Alexandria’s main university hospital. The clinical pharmacists reviewed 99 patients’ prescriptions over the last 4 months, recording patients' demographics, main diagnosis, comorbidities, type of infection, duplication of therapy, dose, the occurrence of diarrhea, serious drug interactions, clindamycin-defined daily dose per 1000 patients’ days), treatment duration and total cost of clindamycin. Results A total of 99 patients were included. Clindamycin was prescribed in appropriate indications in 57 patients (57/99 = 57.6%). Prescriptions with inappropriate indications were 42 (42/99 = 42.4%). Duplication of therapy with clindamycin was detected in 32 prescriptions (32.3%). Diarrhea was recorded in 4% of the cases. There were no severe drug interactions with clindamycin. Inappropriate indications were 320 defined Daily Dose (DDD) of total clindamycin consumption (765 DDD) and a cost of 29951.5 LE (42% of total cost). The prescribed dose of clindamycin was correct in all cases. Conclusion There is irrational clindamycin use in critical care units in some cases regarding indications and treatment duplication. Although the prescribed doses were correct. Clindamycin misuse increased total consumption and cost. Trial registration number NCT05223400 on 2 February 2022.

Abstract Background Multiple sclerosis (MS) is a long-term disease that can lead to disability. microRNAs (miRNA) can provide noninvasive markers allowing more frequent and easy testing in MS. Treatment methods based on manipulating miRNA activity can be innovative. The purpose of this work is to measure the serum expression of miRNA-191-5P and miRNA-24-3P in MS patients. The investigation was carried out on 80 patients with MS (68 patients with Relapsing–remitting multiple sclerosis (RRMS), 12 patients with Progressive MS) and 40 healthy controls. The serum expression of miRNA-191-5P and miRNA-24-3P was measured using real-time quantitative PCR. The expression of the studied miRNAs was relatively calculated using the Eq. 2−ΔΔCt. Results Serum levels of miRNA-191 and miRNA-24 showed no difference between MS patients and healthy controls, and neither between RRMS and progressive MS groups. A negative correlation was detected between miRNA-191 and disease duration. Also, a positive correlation was detected between miRNA-191 and miRNA-24 expression. RRMS patients were significantly different from progressive MS patients regarding disease duration (p value 0.001) as well as expanded disability status scale score (p value

Abstract Background Most anterior cruciate ligament (ACL) injuries which are common in violent sports require anterior cruciate ligament reconstruction (ACLR) to restore knee joint stabilization. Rectus femoris (RF) and vastus intermedius (VI) weakness are among the notable changes after ACLR. This weakness can be hazardous to the patient as it could decrease functional activity and thus increases the chances of re-injury. The objectives of the current study were to measure the (RF) thickness, (VI) thickness and the total (RF + VI) thickness on (ACL) reconstructed limb and the non-reconstructed limb of athletes using ultrasound and to compare the results pre-operatively and 6–8 months post-operative. Results The reconstructed limb showed a significant decrease in (RF), (VI) and the total thickness in the 1st, 2nd and 3rd measurements compared to that of non- reconstructed limb post-operatively. In both limbs, the decrease of (VI) thickness was significantly higher than (RF) thickness in the 1st, 2nd and 3rd measurements (p

Aiming at the increasing research demand of the resonance properties of semantic waves in quantitative analysis of English corpus, this paper constructs a three-dimensional integrated fractal model of semantic waves, and extends the transformation of semantic waves in system functional linguistics to the lexical grammar level. The in-depth analysis provides objective and explicit analysis and identification criteria for the study of semantic waves in the legalized code theory. Through the experimental method, the type resonance characteristics between different types of semantic waves in English popular science discourses are investigated. The experimental results show that the frequency of peaks and troughs varies from 2 to 153 based on different characters, and the construction of different types of semantic waves presents the legalized communication process of knowledge popularization, embodies the social education essence of popular science practice, and is the basis of popular science discourse. The legal representation of persuasive and informative discourse features in the process of knowledge construction provides a reference standard.

This article first uses the gray correlation analysis combined with the gravitational search algorithm model to model the time series linearly. In this way, the predicted value of the GEM stock price is obtained. The simulation analysis of the calculation example found that the average relative error of the prediction result of our proposed model is 0.095 and the operation efficiency is high.

It is more difficult to give Laplace transform directly in a defined form or derive it by Fourier transform in mathematics teaching. The article gives a solution for solving high exponential series sum by using Laplace transform. With the help of Laplace transform, calculus operations can be transformed into complex plane algebra operations. The application of the algorithm to the option hedging strategy verifies the applicability of the algorithm proposed in this article.

Introduction: Recently, bis(arylmethylidene)acetone drugs known as C5-curcumin, were acknowledged for their potent biological effects as a neoteric synthetic alternative to curcumin effectively used to treat many diseases. Methods: In this study, new polymeric emulsified nanoparticles (PENS) carrying biodegradable polycaprolactone (PCL) polymer moieties within their framework were developed as promising carriers for a modern synthesized bis(arylmethylidene)acetone “(1E,4E)-1,5-di(thiophen-2-yl) penta-1,4dien-3-one” (TPO) with improved bioavailability. Such systems were evaluated by studying their; encapsulation efficiency, release behavior, physicochemical evaluations, TEM and SEM measurements and cytotoxicity, besides the in-vitro and in-vivo biological studies screening. Results: The results revealed high encapsulation efficiency ranging between 99.31± 2.15 and 99.55 ± 2.03 %, and a sustained release behavior for up to 24 h with nanosized particle size. TPO emulsified nanoparticles (TPO-ENPs) showed effective antimicrobial activity against Candida albicans and Aspergillus brasiliensis as well as antioxidant efficacy with a higher scavenging activity of 177.6μg TE/ mg against free radicals of 2,2-diphenyl-1-picrylhydrazyl hydrate (DPPH) relatively to the control drug. F1’ and F2’ TPO-ENPs were safe on Vero-cells and proved a significant reduction of hepatocellular alterations and serum ALT levels in control groups. Conclusion: In conclusion, these novel synthesized TPO-ENPs showed pronounced efficacy as antimicrobial/ antioxidant/ anti-inflammatory/ analgesic/ hepatoprotective therapeutic vehicles.

The purpose of this study is to analyze the dynamics of crowdfunding campaigns in the Middle East and raise the question of “does social capital matter” in this respect? The study uses the Zoomaal.com platform as a case study for 2019 and 2020. Required data was collected from Zoomaal.com and conducted online semi- structured interviews with key people in control to further explore the crowdfunding practice in the selected Middle Eastern countries (i.e., Turkey, Egypt, Oman, Saudi Arabia, Bahrain, Kuwait, and UAE). The OLS robust standard error regression and logistic regression techniques were both utilized to test the study model. The findings reveal that social capital in the Middle East countries is very coherent and both structural dimension (DS) as measured by entrepreneurs’ interaction with the social media (such as Facebook and Instagram) and cognitive dimension (DC) as measured by the number of words that are composed by entrepreneurs in the Zoomaal.com platform has significant positive impacts on the crowdfunding campaign success. Moreover, we confirm our results to Zoomaal.com and conclude the main factors that influence the success or failure of a crowdfunding campaign in the Middle East.

BackgroundWe investigated whether epicardial adipose tissue (EAT) volume and density are related to early atherosclerosis, plaque inflammation and major adverse cardiac events (MACE, cardiac death and myocardial infarction) in asymptomatic subjects.MethodsEAT volume and density were quantified from non-contrast cardiac CT in 456 asymptomatic individuals (age 60.3 ± 8.3; 68% with CCS>0) from the prospective EISNER trial. EAT volume and density were examined in relation to coronary calcium score (CCS), inflammatory biomarkers and MACE.ResultsEAT volume was higher and EAT density lower in subjects with coronary calcium compared to subjects without [89 vs 74 cm3, p

Background: Despite the recommendation of coronary physiology to guide revascularization in angiographically intermediate stenoses without established correlation to ischemia, its uptake in clinical practice is slow. Aims: This study aimed to analyze the use of coronary physiology in clinical practice. Methods: Based on a multicenter registry (Fractional Flow Reserve Fax Registry, F(FR)2, ClinicalTrials.gov identifier NCT03055910), clinical use, consequences, and complications of coronary physiology were systematically analyzed. Results: F(FR)2 enrolled 2,000 patients with 3,378 intracoronary pressure measurements. Most measurements (96.8%) were performed in angiographically intermediate stenoses. Out of 3,238 lesions in which coronary physiology was used to guide revascularization, revascularization was deferred in 2,643 (78.2%) cases. Fractional flow reserve (FFR) was the most common pressure index used (87.6%), with hyperemia induced by an intracoronary bolus of adenosine in 2,556 lesions (86.4%) and intravenous adenosine used for 384 measurements (13.0%). The route of adenosine administration did not influence FFR results (change-in-estimate -3.1% for regression model predicting FFR from diameter stenosis). Agreement with the subsequent revascularization decision was 93.4% for intravenous and 95.0% for intracoronary adenosine (p = 0.261). Coronary artery occlusion caused by the pressure wire was reported in two cases (0.1%) and dissection in three cases (0.2%), which was fatal once (0.1%). Conclusions: In clinical practice, intracoronary pressure measurements are mostly used to guide revascularization decisions in angiographically intermediate stenoses. Intracoronary and intravenous administration of adenosine seem equally suited. While the rate of serious complications of wire-based intracoronary pressure measurements in clinical practice seems to be low, it is not negligible. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the causal association between expectations of pandemic risk and herding behavior. The study was undertaken in two stages. First, it was felt necessary to obtain a broad overview of the effect of the pandemic related risk of COVID-19 on investors’ herding in the GCC. This was achieved by analyzing secondary data (i.e. daily historic prices on five GCC country market indices). In analyzing the secondary data, the study follows Christie and Huang (1995) and employs the cross-sectional standard deviation (CSSD) of returns to detect investors’ herding behavior. Second, in an attempt to obtain a more precise understanding of the impact of pandemic related risk, a questionnaire survey was distributed and collected from 318 investors from the GCC stock markets. A confirmatory factor analysis (CFA) was also used as the primary analysis between the two variables: i.e. expectations of pandemic risk and herding behavior. The findings reveal that expectations of pandemic risk have a significant positive impact on the herding behavior in the GCC stock markets during the coronavirus crisis in the first quarter of 2020. Finally, the results of this study are robust to a range of model specifications.

Metabolic dysfunctions linked to obesity carry the risk of co-morbidities such as diabetes, hepatorenal, and cardiovascular diseases. Coumarins are believed to display several biological effects on diverse adverse health conditions. This study was conducted to uncover the impact of cichoriin on high-fat diet (HFD)-induced obese rats. Methods: Obesity was induced in twenty rats by exposure to an HFD for six weeks. The rats were randomly divided into five groups; group I comprised five healthy rats and was considered the control one. On the other hand, the HFD-induced rats were divided into the following (five per each group): group II (the HFD group), groups III (cichoriin 50 mg/kg) and IV (cichoriin 100 mg/kg) as the treatment groups, and group V received atorvastatin (10 mg/kg) (as a standard). Triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine transaminase (ALT), aspartate transaminase (AST), creatine kinase MB (CK-MB), urea, creatinine, the hepatic and renal malondialdehyde (MDA) as well as reduced glutathione (GSH) levels were assessed. Histopathological analysis of the heart, kidney, and liver tissues was investigated. mRNA and protein expressions of the peroxisome proliferator-activated receptor gamma (PPAR-γ) were estimated. Results: The administration of cichoriin alleviated HFD-induced metabolic dysfunctions and improved the histopathological characteristics of the heart, kidney, and liver. Additionally, the treatment improved the lipid profile and hepatic and renal functions, as well as the oxidative balance state. Cichoriin demonstrated an upregulation of the mRNA and protein expressions of PPAR-γ. Taken together, these findings are the first report on the beneficial role of cichoriin in alleviating adverse metabolic effects in HFD-induced obesity and adapting it into an innovative obesity management strategy.