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Abstract Due to the importance of both rate‐less digital fountain codes and Multi‐Input Multi‐Output (MIMO) schemes in Fifth and Sixth Generation (5G/6G) wireless networks, this paper investigates enhancing the performance of MIMO‐Orthogonal Frequency Division Multiplexing (MIMO‐OFDM) based system by employing the rate‐less fountain codes. The rate‐less codes, such as the Tornado codes and Raptor codes, have a flexible code rate that differs from the classical channel coding schemes. This paper uses Raptor code to study the MIMO system's performance with the rate‐less codes over different wireless communications channels. The proposed MIMO‐fountain code‐based system has been tested over the various wireless communication channel conditions concerning the varied Frequency Doppler (FD). In the proposed rate‐less wireless communication system, multiple interleaving techniques and equalizers are used to improve its performance. Computer‐based simulation experiments are assigned to evaluate the MIMO‐fountain code system using the different data transmission scenarios. Simulation results confirm the superiority of the presented wireless rate‐less system compared to fixed‐rate wireless systems in terms of Bit Error Rate (BER) and throughput.

Background: Stüve-Wiedemann syndrome (STWS) is an extremely uncommon disorder, which results in bent-bone dysplasia and dysfunction of the autonomic nervous system that controls involuntary processes, such as body temperature and breathing. In infants, this can result in respiratory distress, feeding and swallowing problems, and hyperthermic episodes. While STWS usually leads to infant mortality, some STWS patients might survive into early adulthood. The condition is caused by a mutation in the leukemia inhibitory factor receptor (LIFR) gene, which is inherited in an autosomal-recessive pattern. In this paper, we present a very rare case of STWS in Qatar. Case description: The case was a female baby with the features of STWS. The parents were known carriers of this syndrome with a history of a previous child with the same condition. The baby was the product of a consanguineous marriage. After delivery, the diagnosis of STWS was confirmed by clinical features and genetic testing. Consultation with the related subspecialties was requested for the management of the case. Conclusion: STWS is a rare disorder accompanied by bent-bone dysplasia and autonomic dysfunction that is generally caused by the autosomal recessive inheritance of a mutated LIFR gene. The symptoms of STWS are the result of a lack of LIFR signaling. There is currently no treatment available for STWS, but the symptoms are managed accordingly.

Background: The oral-facial-digital (OFD) syndrome is a group of hereditary disorders, manifested by anomalies of the oral cavity, face and digits that may be associated with cerebral malformations and polycystic kidney disorder. The condition is associated with either X-linked or autosomal recessive inheritance. Herein, we report a case of OFD syndrome with various manifestations. Case description: The case was a female baby with the features of the OFD syndrome. The family history was negative. The baby was the product of a non-consanguineous marriage. Diagnosis of OFD syndrome was confirmed by chromosomal microarray. The case had features of OFD type 1 in addition to central nervous system abnormalities. The chromosomal study of the parents was normal. Consultation with the related subspecialties were requested for management of the case. Conclusion: OFD syndrome is a very rare conditions, which can be easily diagnosed. Cooperation of the related subspecialities is very important for better management of these cases

Background: Testicular regression syndrome (TRS) is defined as the partial or total absence of testicular tissue in 46XY patients with normal external genitalia. The incidence of TRS has been reported to be less than 5% in patients with cryptorchidism. Herein, we report a case of a one-year old boy who underwent surgical exploration with an initial diagnosis of cryptorchidism. Case description: a one-year old male came to the outpatient clinic at Al Emadi Hospital, Doha, Qatar. Physical examination revealed normal external genitalia with palpable right testis and non-palpable left testis. The initial diagnosis was cryptorchidism. Testicular structure was not identified and a presumed testicular remnant in the left superficial inguinal ring was sent for histological examination. The histological examination revealed a fibrovascular nodule, spermatic cord structures, calcification and hemosiderin deposits supporting the diagnosis of TRS. Conclusion: When patient fulfills clinical and pathological criteria for TRS, we should consider the possibility of orchiopexy and testicular prosthesis implantation to decrease the risk of testicular torsion and negative psychological effects.

C21H16N2O2, monoclinic, P21/n (no. 14), a = 13.4768(7) Å, b = 6.9225(3) Å, c = 18.2840(8) Å, β = 107.601(2)°, V = 1625.92(13) Å3, Z = 4, Rgt(F) = 0.0593, wRref(F2) = 0.1529, T = 100 K.

Com o objetivo de estimar e interpretar geneticamente a porção de variabilidade genética existente em populações de plantas juvenis de acerola obtidas de sementes, originadas de populações submetidas a processo de seleção, foi instalado um experimento com três tipos de populações, em blocos ao acaso, com 45 progênies, três repetições e número variável de 4 a 6 plantas por parcela. Tendo em vista os resultados obtidos, conclui-se que a avaliação da variabilidade genética em populações de plantas jovens de aceroleira não se constitui em material adequado para esse tipo de estudo. Também não foi possível fazer uma interpretação genética da porção de variabilidade existente nas populações, haja vista não seguirem um padrão que possibilitasse estabelecer associações entre as populações nas condições em que o trabalho foi desenvolvido.

Climate change, driven by human activities and natural processes, has led to critical alterations in varying patterns during cropping seasons and is a vital threat to global food security. The climate change impose several abiotic stresses on crop production systems. These abiotic stresses include extreme temperatures, drought, and salinity, which expose agricultural fields to more vulnerable conditions and lead to substantial crop yield and quality losses. Plant hormones, especially salicylic acid (SA), has crucial roles for plant resiliency under unfavorable environments. This review explores the genetics and molecular mechanisms underlying SA's role in mitigating abiotic stress-induced damage in plants. It also explores the SA biosynthesis pathways, and highlights the regulation of their products under several abiotic stresses. Various roles and possible modes of action of SA in mitigating abiotic stresses are discussed, along with unraveling the genetic mechanisms and genes involved in responses under stress conditions. Additionally, this review investigates molecular pathways and mechanisms through which SA exerts its protective effects, such as redox signaling, cross-talks with other plant hormones, and mitogen-activated protein kinase pathways. Moreover, the review discusses potentials of using genetic engineering approaches, such as CRISPR technology, for deciphering the roles of SA in enhancing plant resilience to climate change related abiotic stresses. This comprehensive analysis bridges the gap between genetics of SA role in response to climate change related stressors. Overall goal is to highlight SA's significance in safeguarding plants and by offering insights of SA hormone for sustainable agriculture under challenging environmental conditions., (© 2024. The Author(s).)

Introduction: There is an increasing interest in using metformin in cardiovascular diseases and its potential new roles. Only two randomized controlled trials investigated the effect of metformin in nondiabetic heart failure (HF) patients. However, none of these studies assess the role of metformin in reducing oxidative stress. We hypothesized that metformin might improve oxidative stress and left ventricular remodeling in nondiabetic HF patients with reduced ejection fraction (HFrEF). Methods and Methods: Seventy HFrEF patients (EF 37% ± 8%; median age 66 years) were randomized to metformin ( n  = 35) or standard of care (SOC) for HF ( n  = 35) for 6 months in addition to standard therapy. Outcomes included the difference in the change (Δ) in total antioxidant capacity (TAC) and malondialdehyde (MDA), both assessed colorimetrically and left ventricular mass index (LVMI) assessed through transthoracic echocardiography. Results: Compared with the SOC, metformin treatment increased TAC [Δ = 0.12 mmol/L, confidence intervals (95% CIs): 0.03-0.21; P  = 0.007]. TAC increased significantly only in the metformin group (0.90 ± 0.08 mmol/L at baseline vs. 1.04 ± 0.99 mmol/L at 6 months, P  < 0.05). Metformin therapy preserved LVMI (Δ = -23 g/m 2 , 95% CI: -42.91 to -4.92; P  = 0.014) and reduced fasting plasma glucose (Δ = -6.16, 95% CI: -12.31 to -0.02, P  = 0.047) compared with the SOC. Results did not change after adjusting for baseline values. Changes in MDA left ventricular ejection fraction (LVEF) and blood pressure were not significantly different between groups. Conclusion: Metformin treatment in HF patients with reduced LVEF improved TAC and prevented the increase in LVMI compared with the SOC. These effects of metformin warrant further research in HF patients without diabetes to explore the potential benefits of metformin. Trial Registration Number: This protocol was registered in ClinicalTrials.gov under the number NCT05177588.

Locally advanced gastric cancer (LAGC) still poses a clinical challenge despite multimodality treatment due to multidrug resistance (MDR). Recently, research suggested that autophagy and metabolic regulation may be potential anticancer targets due to their crucial roles in MDR. Let-7a participates in glycolytic and autophagic regulations which are both essential for tumor progression and resistance to therapy. This study used IHC stains; GLUT4 and LC3B to evaluate glycolysis and autophagy respectively. Moreover, mRNA Let-7a was detected by quantitative reverse transcription PCR (q-PCR) in 53 cases of LAGC. Elevated glycolysis and autophagy in LAGC tissue specimens as indicated by high GLUT4 and LC3B expression were significantly associated with adverse prognostic factors such as high pathological grade, positive nodal metastasis, and advanced T stage. Lower Let-7a levels were significantly associated with high tumor grade and advanced T stage. A significant positive correlation between GLUT4 and LC3B expression was detected. Significant inverse correlations between let7a level and IHC expression of both GLUT4 and LC3B were found. Elevated glycolysis and autophagy were significantly associated with poor overall survival (OS). Furthermore, low levels of let-7a were significantly associated with poor OS compared to high levels. Glycolysis and autophagy in LAGC were significantly associated with poor FLOT chemotherapy response. Let7a mRNA relative expression was significantly decreased in cases showing post therapy partial response and sustained disease. Multivariate analysis showed that histologic tumor type, high GLUT4 and high LC3B expression were independent factors associated with poor OS. Poor survival and post FLOT chemotherapy resistance in LAGC cases were significantly related to elevated glycolysis, elevated autophagy, and reduced Let-7a expression. Accordingly, combined therapeutic targeting of these pathways could enhance chemosensitivity in LAGC., Competing Interests: Declaration of Competing Interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

Competing Interests: G. Esmat: investigator/speaker/advisory board member: Abbvie, Gilead Sciences, Marcyrl, Pharco, Roche. The remaining authors have no conflicts of interest to declare.

The blockchain network uses a Proof-of-Work (PoW) mechanism to validate transactions and keep the blockchain growth safe against tampering, but it is hugely energy-consuming with no benefit to the peer-to-peer network participants. In this paper, we proposed a blockchain network for distributing products to different locations based on the use of the Proof of Useful Work mechanism, in which miners use computing resources to optimize the traveling salesman problem (TSP) as an alternative to solving mathematical problems that represent the basis of the traditional PoW mechanism to get a new block. According to this proposed blockchain, it not only receives and securely stores the distribution locations but also improves the paths for salesmen when traveling between different locations during the transportation process. This strategy aims to take advantage of the miners' efforts to minimize the traveled distance by applying the clustering technique and computing the shortest path by Guided Local Search (GLS) for each cluster at the same time. According to the tested results on TSP-LIB instances, the used strategy works efficiently with an average of 0.08 compared to the rest of the meta-heuristics, and the proposed architecture reduced total distances with an average of 0.025%. In addition, the block generation time in the blockchain decreased by 11.11% compared to other works., (© 2023. Springer Nature Limited.)

Introduction: Few studies explored the association between total antioxidant capacity (TAC) and left ventricular (LV) geometry in patients with heart failure and reduced ejection fraction (HFrEF). The current study aimed to assess factors associated with LV geometry in HFrEF patients with particular emphasis on oxidative stress and glycemic status. Methods: A cross-sectional study was conducted from July 2021 to September 2022. All consecutive patients with HFrEF who were stabilized on optimal or maximally tolerated heart failure medications were recruited. Patients were classified into tertiles based on TAC and malondialdehyde for correlation with other parameters. Results: TAC was significantly associated with LV geometry ( P  = 0.01), with higher TAC levels observed in patients with normal LV geometry (0.95 ± 0.08) and concentric hypertrophy (1.01 ± 0.14) than in patients with eccentric hypertrophy (EH) (0.90 ± 0.10). There was a significant positive trend in the association between glycemic state and LV geometry ( P  = 0.002). TAC showed a statistically significant positive correlation with EF ( r  = 0.29, P  = 0.0064) and a negative correlation with LV internal diameter at end diastole ( r  = -0.26, P  = 0.014), LV mass index ( r  = -0.25, P  = 0.016), and LV mass ( r  = -0.27, P  = 0.009). After adjusting for multiple confounders, prediabetes [odds ratio (OR) = 4.19, P  = 0.032] and diabetes (OR = 7.47, P  = 0.008) were associated with higher odds of EH than normoglycemic patients. A significant inverse trend was also observed in the association between TAC tertile and the odds of LV geometry (OR = 0.51, P  = 0.046). Conclusions: TAC and prediabetes are significantly associated with LV geometry. TAC can be used as an additional marker in HFrEF patients to reflect the severity of the disease. Interventions aimed at managing oxidative stress might be useful in HFrEF patients to reduce oxidative stress and improve LV geometry and quality of life. Trial Registration Number: This study is part of an ongoing randomized clinical trial (ClinicalTrials.gov identifier NCT05177588).

Introduction: Globally, it is estimated that 290,000 patients infected with hepatitis C virus (HCV) died from hepatitis C consequences, including cirrhosis and hepatocellular carcinoma in 2019. Although daclatasvir (DCV), combined with sofosbuvir (SOF), is effective in HCV patients, the new pan-genotypic combinations are considered by many as more cost-effective and successful in eradicating HCV infection., Areas Covered: This review discusses the safety, efficacy, and cost-effectiveness of DCV as an HCV treatment option based on real-world studies and pharmacoeconomic evaluations., Expert Opinion: Real-life studies suggest that SOF/DCV has acceptable sustained virological response and can be used successfully to manage HCV. Nonetheless, the use of SOF/DCV is limited by the longer treatment duration in genotype (GT)-3 patients and the need for ribavirin (RBV) in treatment-experienced patients which increases the likelihood of adverse effects. DCV is likely to remain as a therapeutic option for the management of GT-1, GT-2, and GT-4 patients in resource limited settings, while GT-3 patients are more likely to benefit from RBV-free direct-acting antiviral combinations such as SOF/velpatasvir for 12 weeks or glecaprevir/pibrentasvir for 8 weeks. The introduction of generics for these new pan-genotypic drugs would likely eliminate the need for SOF/DCV in the near future.

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can involve any organ system. SLE typically affects the musculoskeletal system to varying degrees, and patients are frequently most prone to have pain in the hand joints., Objectives: The study aims to assess by ultrasound the presence of joint inflammation in patients with juvenile Systemic Lupus Erythematosus (JSLE) not complaining of painful joints of the hand and wrist (asymptomatic) and compare the findings with those in JSLE patients complaining of painful hand and wrist joints (symptomatic) and in healthy controls., Methods: This was a cross-sectional case control study on 37 JSLE patients. Thirty were asymptomatic for joint complaints. Ultrasound examined wrists and joints of both hands, 11 joints in each hand, to assess synovial hypertrophy, effusion and pathological vascularization (using power Doppler) (PD), and were given a score of 0-3. Patients were compared with 8 healthy controls., Results: Ultrasound abnormalities (synovial hypertrophy and increased vascularity) were detected in 22/30 of the asymptomatic patients (73.3%) and in all 7 symptomatic patients (100%). In asymptomatic children, 29 joints were affected (4.4% of all joints), compared to 13 joints in the symptomatic patients (8.4% of all joints). Synovitis score was mild or moderate (1 or 2) in both symptomatic and asymptomatic patients, with all showing increased vascularity. In the control group, 5 joints (2.8% of all joints) showed synovial hypertrophy but no increased vascularity., Conclusion: Increased vascularity (PD more than 0) is a more reliable indicator of inflammation than synovial hypertrophy, which may be detected in healthy individuals., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Left ventricular hypertrophy is a common finding in patients with ischemic heart disease and is associated with mortality in patients with cardiovascular disease (CVD). Metformin, an antidiabetic drug, has been shown to reduce oxidative stress and left ventricular mass index (LVMI) in animal hypertrophy models. We summarized evidence regarding the effect of metformin on LVMI and LVEF., Methods: Electronic databases were searched for randomized clinical trials (RCTs) that used metformin in non-diabetic patients with or without pre-existing CVD. The standardized mean change using change score standardization (SMCC) was calculated for each study. The random-effects model was used to pool the SMCC across studies. Meta-regression analysis was used to assess the association of heart failure (HF), metformin dose, and duration with the SMCC., Results: Data synthesis from nine RCTs (754 patients) showed that metformin use resulted in higher reduction in LVMI after 12 months (SMCC = -0.63, 95% CI - 1.23; - 0.04, p = 0.04) and an overall higher reduction in LVMI (SMCC = -0.5, 95% CI - 0.84; - 0.16, p < 0.01). These values equate to absolute values of 11.3 (95% CI 22.1-0.72) and 8.97 (95% CI 15.06-2.87) g/m 2 , respectively. The overall improvement in LVEF was also higher in metformin users after excluding one outlier (SMCC = 0.26, 95% CI 0.03-0.49, P = 0.03) which translates to a higher absolute improvement of 2.99% (95% CI 0.34; 5.63). Subgroup analysis revealed a favorable effect for metformin on LVEF in patients who received > 1000 mg/day (SMCC = 0.28, 95% CI 0.04; 0.52, P = 0.04), and patients with HF (SMCC = 0.23; 95% CI 0.1; 0.36; P = 0.004). These values translate to a higher increase of 2.64% and 3.21%, respectively., Conclusion: Results suggest a favorable effect for metformin on LVMI and LVEF in patients with or without pre-existing CVD. Additional trials are needed to address the long-term effect of metformin. Registration The study was registered on the PROSPERO database with the registration number CRD42021239368 ( https://www.crd.york.ac.uk/prospero )., (© 2022. The Author(s).)

Objectives: The main objective was to compare physician-obtained medication histories to the practice of medication reconciliation undertaken by a pharmacist in the intensive care unit (ICU)., Methods: A one-stem interventional study involving 500 adults 18 years and older admitted to the ICU (50 beds) of an Egyptian Joint Commission International-accredited reference hospital was conducted. The primary outcome measure was the proportion of ICU patients with missing medications in the cohorts of physician versus pharmacist-led medication reconciliation. The secondary outcome measure was the percentage of patients who had at least one clinical condition or adverse event (AE) that was left untreated during hospitalization of the 2 arms of patients after reconciliation., Results: A total of 500 patients received reconciliation. Medication discrepancies in the cohort of physician-led reconciliation were greater than that of the pharmacist (26.1% versus 2.6%, P = 0.001). The most common discrepancy was indication with no medication, which was found to be greater in the physician-led cohort of patients than that of the pharmacist cohort (25.2% versus 2.6%, P = 0.001). Untreated AEs in the former cohort were present in 9.1% of cases versus 1.5% in the pharmacist-led reconciliation cohort ( P = 0.001)., Conclusions: The present study revealed that pharmacist-led medication reconciliation in ICU has dramatically decreased medication discrepancies and AEs in adults with acute ICU admissions., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Aim: Rifaximin is an oral antibiotic with promising efficacy in the reduction of hepatic encephalopathy (HE) recurrence. Development of microbial resistance to rifaximin is not studied yet in HE. The study aim was to assess the microbial resistance, safety and efficacy of rifaximin as secondary prophylaxis of HE., Method: In this open-label parallel, prospective interventional study, 100 patients were randomly allocated either to receive 400 mg rifaximin 3 times/d plus 30-45 mL lactulose 3 times/d (intervention group) or to receive the standard of care only which is lactulose alone (control group) for 6 months. The primary outcome of the study was the difference between minimum inhibitory concentration (MIC) of rifaximin among the two studied groups at the end of treatment. The secondary outcomes included the time to first episode of HE, time to first hospitalisation, and patient's survival., Results: The MIC did not differ significantly after treatment exposure compared with baseline either between groups or within the same group. The time to new episode of HE was 18.84 ± 6.49 weeks (mean ± SD) in the intervention group and was significantly longer (P = .002) than that in the control group 14 ± 7.52 weeks. Moreover, only 23 (46%) patients developed overt HE in the intervention group compared with 35 patients (70%) in the control group (P = .005). Also, there was an observed 32% reduction in the risk of hospitalisation in intervention group compared with control group., Conclusion: Rifaximin succeeded to maintain remission from new episodes of HE in hepatitis C virus cirrhotic patients with limited potential for development of microbial resistance over the study period. ClinicalTrials.gov Identifier: NCT04736836., (© 2021 John Wiley & Sons Ltd.)