Parametric Optimization of FDM Process for PA12-CF Parts Using Integrated Response Surface Methodology, Grey Relational Analysis, and Grey Wolf Optimization.

Efficiently managing multiple process parameters is critical for achieving optimal performance in additive manufacturing. This study investigates the relationship between eight key parameters in fused deposition modeling (FDM) and their impact on responses like average surface roughness (Ra), tensile strength (TS), and flexural strength (FS) of carbon fiber-reinforced polyamide 12 (PA 12-CF) material. The study integrates response surface methodology (RSM), grey relational analysis (GRA), and grey wolf optimization (GWO) to achieve this goal. A total of 51 experiments were planned using a definitive screening design (DSD) based on response RSM. The printing process parameters, including layer thickness, infill density, and build orientation, significantly affect Ra, TS, and FS. GRA combines responses into a single measure, grey relational grade (GRG), and a regression model is developed. GWO is then employed to optimize GRG across parameters. Comparison with GRA-optimized parameters demonstrates GWO's ability to discover refined solutions, reducing average surface roughness to 4.63 µm and increasing tensile strength and flexural strength to 88.5 MPa and 103.12 MPa, respectively. Practical implications highlight the significance of GWO in industrial settings, where optimized parameters lead to reduced costs and improved product quality. This integrated approach offers a systematic methodology for optimizing FDM processes, ensuring robustness and efficiency in additive manufacturing applications.

The Safety of Cold Versus Hot Snare Polypectomy in Polyps 10-20 mm: A Systematic Review and Meta-Analysis.

Colonoscopy remains the primary method for preventing colorectal cancer. Traditionally, hot snare polypectomy (HSP) was the method of choice for removing polyps larger than 5 mm. Yet, for polyps smaller than 10 mm, cold snare polypectomy (CSP) has become the favored approach. Lately, the use of CSP has expanded to include the removal of sessile polyps that are between 10 and 20 mm in size. Our systematic review and meta-analysis aimed to evaluate the safety of cold snare polypectomy (CSP) compared to hot snare polypectomy (HSP) for resecting polyps measuring 10-20 mm. We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, and Cochrane databases up to April 2020 to find studies that directly compared CSP to HSP for polyps larger than 10 mm. Our main focus was on assessing the risk of delayed bleeding after polypectomy; a secondary focus was the incidence of any adverse events that required medical intervention post procedure. Our search yielded three comparative studies, two observational studies, and one randomized controlled trial (RCT), together encompassing 1,193 polypectomy procedures. Of these, 485 were performed using CSP and 708 with HSP. The pooled odds ratio (OR) for post-polypectomy bleeding (PPB) was 0.36 (95% confidence interval {CI}: 0.02, 7.13), with a Cochran Q test P-value of 0.11 and an I2 of 53%. For the risk of any adverse events necessitating medical care, the pooled OR was 0.15 (95% CI: 0.01, 2.29), with a Cochran Q test P-value of 0.21 and an I2 of 35%. The quality of the two observational studies was deemed moderate, and the RCT was only available in abstract form, preventing quality assessment. Our analysis suggests that there is no significant difference in the incidence of delayed post-polypectomy bleeding or other adverse events requiring medical attention between CSP and HSP for polyps measuring 10-20 mm.

Application of traceable calibration for gaseous oxidized mercury in air.

BACKGROUND: The current speciation methods for mercury (Hg) measurements are fraught with considerable uncertainty, from sample collection to calibration. High reactivity of gaseous oxidized Hg (GOM) species and their ultra-trace level presence makes them difficult to sample and calibrate. Given that improper calibration may lead to measurement biases, reliable and metrologically traceable calibration methods are required for accurately quantifying GOM in air. In the present study, we applied the recently developed calibration method based on non-thermal plasma oxidation of elemental Hg, to a commercially available Hg air speciation system for actual environmental measurements of GOM for the first time. RESULTS: Hg species such as HgO, HgCl2, and HgBr2 were produced with trace amounts of reactant gases (oxygen and electrolytically produced chlorine and bromine) and the production was driven by plasma-assisted oxidation. The plasma oxidation efficiency of elemental Hg with oxygen was 98.5 ± 7.5 % (k = 2), while that for chlorine and bromine was 96.8 ± 6.9 % (k = 2) and 97.4 ± 9.6 % (k = 2), respectively. The calibration method was tested against the internal permeation (Hg0) source of the Tekran 2537B Hg analyzer on-field by loading HgO to different KCl-coated denuders using the plasma. GOM concentrations were measured using the Tekran speciation system. With internal calibration, concentrations were up to 9.1 % lower than those in plasma calibration, thereby emphasizing the importance of the calibration strategy. Measurement uncertainty (k = 2) further emphasizes this distinction. Internal calibration measurement uncertainty was 36.8 %, while plasma calibration boasted lower uncertainty at 13.8 %. SIGNIFICANCE: The non-thermal plasma calibration strategy, as a unique and discrete calibration method traceable to the NIST SRM 3133 for ambient air GOM measurements, provide a higher level of confidence in the accuracy of GOM measurements with several advantages over other methods. Calibrations at extreme low concentrations (<100 pg) are possible with this method relevant to ambient air GOM concentrations.

Analysis of thermal decomposition kinetics of chicken feather fiber reinforced Poly-lactic acid composites filament.

Derivative Thermogravimetric analysis under air was used to observe the thermal decomposition process of Chicken feather fiber (CFF) reinforced Poly-lactic acid (PLA) composite filament of 2.2 mm diameter. The thermal degradation of the sample was initiated at 140 Ö¯C. Approximately 75 % of the thermal degradation occurred between the temperature of 357 Ö¯C and 399 Ö¯C. The composite's activation energy was established using the Coats-Redfern method. The results showed that the activation energy of 112.06 kJ/mol is utilized for the sample throughout the temperature range of 23 Ö¯C to 398 Ö¯C. A low activation energy is indicative of rapid chemical reactions between the CFF and PLA molecules. The results from TGA and DTGA indicate that the addition of CFF in the PLA matrix enhanced the thermal stability.

Modulation of antioxidant defense and PSII components by exogenously applied acetate mitigates salinity stress in Avena sativa.

Salinity stress has detrimental effects on various aspects of plant development. However, our understanding of strategies to mitigate these effects in crop plants remains limited. Recent research has shed light on the potential of sodium acetate as a mitigating component against salinity stress in several plant species. Here, we show the role of acetate sodium in counteracting the adverse effects on oat (Avena sativa) plants subjected to NaCl-induced salinity stress, including its impact on plant morphology, photosynthetic parameters, and gene expression related to photosynthesis and antioxidant capacity, ultimately leading to osmoprotection. The five-week experiment involved subjecting oat plants to four different conditions: water, salt (NaCl), sodium acetate, and a combination of salt and sodium acetate. The presence of NaCl significantly inhibited plant growth and root elongation, disrupted chlorophylls and carotenoids content, impaired chlorophyll fluorescence, and down-regulated genes associated with the plant antioxidant defense system. Furthermore, our findings reveal that when stressed plants were treated with sodium acetate, it partially reversed these adverse effects across all analyzed parameters. This reversal was particularly evident in the increased content of proline, thereby ensuring osmoprotection for oat plants, even under stressful conditions. These results provide compelling evidence regarding the positive impact of sodium acetate on various plant development parameters, with a particular focus on the enhancement of photosynthetic activity.

Optimization of a pre-concentration method for the analysis of mercury isotopes in low-concentration foliar samples.

Hg isotope analysis in samples from background regions is constrained by the presence of low Hg concentration and therefore requires a pre-concentration method. Existing Hg pre-concentration methods are constrained by long sample processing time and limited sample loading capacity. Using foliar samples as a test case, an optimized Hg pre-concentration method is presented that involves the microwave-assisted digestion of samples for Hg isotope analysis with the addition of a pre-digestion step. Microwave-digested foliar samples and CRMs were transferred to an impinger, reduced with SnCl2, and collected in a 2.25 mL concentrated inverse aqua regia (3:1 HNO3:HCl, v/v). This resulted in an optimal acid concentration in the solution ideal for analysis on MC-ICP-MS. The time for purging with Hg-free N2 was optimized to 30 min and the efficiency of the pre-concentration method was tested using a combination of approaches. Tests performed on pure reagents and matrix of foliar samples spiked with 197Hg radiotracer showed recoveries averaging 99 ± 1.7% and 100 ± 3.0%, respectively. Mercury at concentrations as low as 1.83 ng g-1 was pre-concentrated by digesting aliquots of foliage samples in individual digestion vessels. Recoveries following their pre-concentration averaged 99 ± 6.0%, whereas recoveries of 95 ± 4.7% and 95 ± 2.5% were achieved for NIST SRM 1575a (pine needle) and reagents spiked with NIST SRM 3133, respectively. Analysis using multicollector-ICP-MS showed low fractionation of δ202Hg during sample pre-concentration with no significant mass-independent fractionation. The proposed method is a relatively simple and robust way to prepare Hg samples for Hg isotopic analysis and is suitable even for complex biological matrices.

Efficacy of platelet-rich plasma (PRP) in benign vocal fold lesions: a systematic review and meta-analysis.

OBJECTIVES: To evaluate the efficacy of platelet-rich plasma (PRP) in benign vocal fold lesions. METHODS: MEDLINE, Cochrane Central, Web of Science, and Scopus databases were searched in April 2023 for relevant clinical trials. Inclusion criteria were clinical trials evaluating the efficacy of PRP in benign vocal fold lesions. We conducted a comparative double-arm analysis using the pooled mean difference (MD) and 95% confidence interval (CI). Outcomes of interest included the vocal handicap index (VHI), the Jitter and Shimmer percentages, and the noise-to-harmonic ratio (NHR). RESULTS: Six studies matched the inclusion criteria. The pooled analysis shows that PRP was associated with significantly lower VHI scores compared with the control (MD = - 5.06, p < 0.01). Regarding the Jitter percentage, the PRP group was not superior to the control group at 2 and 4 weeks. However, the results revealed that PRP significantly reduced the Jitter percentage at 3 months (MD = - 0.61, p = 0.0008). The overall analysis favored the PRP arm significantly (p < 0.001). As for the Shimmer percentage, the combined effect estimate favored the PRP group (MD = - 1.22, p = 0.002). Subgroup analysis according to the time did not reveal any significant differences between studies at 2 weeks, 4 weeks, and 3 months. The analysis of the NHR outcome revealed a significant difference between both groups (MD = -1.09, p = 0.01). However, at 4 weeks, the treatment group had a significantly lower NHR % compared to the control group (MD = - 0.61, p = 0.02). There was no significant difference at 3 months (MD = - 2.14, p = 0.14). CONCLUSIONS: Platelet-rich plasma is effective in reducing VHI scores, Jitter and Shimmer percentages, and NHR values. This effect is more evident after follow-up, especially 3 months.

Recognition of Arabic Air-Written Letters: Machine Learning, Convolutional Neural Networks, and Optical Character Recognition (OCR) Techniques.

Air writing is one of the essential fields that the world is turning to, which can benefit from the world of the metaverse, as well as the ease of communication between humans and machines. The research literature on air writing and its applications shows significant work in English and Chinese, while little research is conducted in other languages, such as Arabic. To fill this gap, we propose a hybrid model that combines feature extraction with deep learning models and then uses machine learning (ML) and optical character recognition (OCR) methods and applies grid and random search optimization algorithms to obtain the best model parameters and outcomes. Several machine learning methods (e.g., neural networks (NNs), random forest (RF), K-nearest neighbours (KNN), and support vector machine (SVM)) are applied to deep features extracted from deep convolutional neural networks (CNNs), such as VGG16, VGG19, and SqueezeNet. Our study uses the AHAWP dataset, which consists of diverse writing styles and hand sign variations, to train and evaluate the models. Prepossessing schemes are applied to improve data quality by reducing bias. Furthermore, OCR character (OCR) methods are integrated into our model to isolate individual letters from continuous air-written gestures and improve recognition results. The results of this study showed that the proposed model achieved the best accuracy of 88.8% using NN with VGG16.

Systematic Review on the Efficacy, Effectiveness, Safety, and Immunogenicity of Monkeypox Vaccine.

BACKGROUND: The variation in the reported vaccine safety and effectiveness could contribute to the high rates of vaccine hesitancy among the general population and healthcare workers in areas where monkeypox (mpox) is circulating. In this review, our objective was to evaluate the safety, immunogenicity, effectiveness, and efficacy of the mpox vaccines. METHODS: An extensive search for articles across multiple databases was performed, including searching six databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Cochrane, ProQuest), two pre-print databases (European PMC Preprint and MedRxiv), and Google Scholar. RESULTS: A total of 4290 citations were retrieved from the included databases. Following the removal of duplicates and the initial screening of records, a total of 36 studies were included into the analysis. Additionally, we identified five more studies through manual searches, resulting in a total of 41 eligible articles for qualitative synthesis. The study findings revealed that mpox vaccines demonstrate the ability to generate adequate antibodies; however, their effectiveness may decrease over time, exhibiting varying safety profiles. Most of the included studies consistently reported substantial levels of effectiveness and efficacy against mpox. Interestingly, the number of vaccine doses administered was found to influence the degree of immunogenicity, subsequently impacting the overall effectiveness and efficacy of the vaccines. Furthermore, we found that smallpox vaccines exhibited a form of cross-protection against mpox. CONCLUSIONS: Vaccines can be used to prevent mpox and effectively control its spread.

Teachers' experiences of remote teaching in the COVID-19 pandemic for students with intellectual disabilities in the kingdom of Saudi Arabia.

The objective of this study is to investigate the experiences of teachers of students with Intellectual Disabilities (ID) with remote teaching during the COVID-19 pandemic, and to suggest solutions to address challenges. The study used an electronic questionnaire to collect field data from 150 teachers of students with IDs located in various cities of the Kingdom of Saudi Arabia (KSA). The study found that the most significant challenge encountered by teachers was that their students with ID found it challenging to complete online assessments in a specified amount of time and also to communicate with their peers and teachers. The findings of this study highlight the need for teachers to receive support from parents and the Ministry of Education of the KSA to improve the effectiveness of remote teaching for students with intellectual disabilities.

Antecedents for online food delivery platform leading to continuance usage intention via e-word-of-mouth review adoption.

The focus of hospitality initially was on ambience and novelty to attract customers. With the rise of the digital revolution, the hospitality industry has also undergone significant change. Long-distance travel at the workplace, odd working hours, and a variety of food options have driven people staying in Indian metropolises towards online food delivery (OFD) services. The popularity of OFD services has risen because of their practicality, simplicity, and a rise in consumer confidence in digital payments. Specifically, for the food industry, digitalization has opened new horizons to capture customers. The competition is not among the big brands, but big brands are competing with homemakers who run tiffin services, and street food hawkers who claim to provide traditional Dhaba-style food and fast food. The customers are loaded with unlimited options to choose the food in terms of price, cuisine, quality, etc. The present research examines the associations between service quality of OFD services, perceived ease of use, and word-of-mouth review adoption, leading to expectation confirmation modeling. The path analysis was carried out using data from 500 Indian respondents residing in Tier-I cities who have been using OFD services regularly. The research outcome shows that servqual has a positive influence on perceived ease of use and confirmation. Additionally, it encourages continued usage intentions because of its favorable impact on the adoption of e-word-of-mouth reviews.

Translation and Validation of the Arabic Version of the Reflux Symptom Score, Short Version 12 (RSS-12).

BACKGROUND: The Reflux Symptom Score (RSS) is a patient-related outcomes measure (PROM) that was developed to diagnose Laryngopharyngeal reflux (LPR), by assessing the severity and frequency of specific symptoms and their respective impact on quality of life (QoL). OBJECTIVE: To develop the Arabic version of RSS-12 (Ar-RSS-12), and to assess its validity and reliability. METHOD: The RSS-12 was translated from French into Arabic using the forward-backward translation method, and the translated version underwent transcultural validation. A case-control study was conducted at the otolaryngology clinics of a referral hospital, during the period November to December 2022. It included 61 patients with LPR-related symptoms and a Reflux Symptom Index (RSI) score >13, and 61 control without LPR-related symptoms and negative RSI scores ≤13. The internal consistency, internal and external validity, and Test-Retest reliability of Ar-RSS-12 were analyzed. RESULT: Patients had significantly higher scores than controls in all 12 items and total Ar-RSS and QoL impact scores, with high Z score values. Item scores showed variable correlation levels with total Ar-RSS score, with ear-nose-throat items showing the strongest correlation (Spearman's rho 0.592-0.866). The QoL scores were more strongly correlated to the symptoms' severity than frequency. The internal consistency was high, with Cronbach's alpha = 0.878. Regarding external validity, correlations with RSI score showed high Spearman's rho values for total Ar-RSS (0.905) and QoL total score (0.903). No statistically significant difference was observed between Test and Retest results in any of the 12 items' score or the total score and QoL, indicating the reproducibility of the test. CONCLUSION: The Ar-RSS is a valid and reproducible tool for the screening, assessment, and monitoring of LPR in Arabic speaking patients. The inclusion of symptoms severity and frequency, as well as their individual effects on patient's QoL, support the superior clinical applications of RSS compared to other existing PROMs.

Safety and Efficacy of Endoscopic Submucosal Dissection in the Management of Gastric Tube Cancers After Esophagectomy: A Systematic Review.

Esophagectomy is the proposed standard of care for resectable primary esophageal cancers and recurrent lesions in the reconstructed gastric tube (GT); however, it carries significant morbidity and mortality. Endoscopic submucosal dissection (ESD) has established its role in the management of primary esophageal cancers with growing evidence of its safety in resecting recurrent primary lesions in GT. Our study aims to evaluate the safety and efficacy of ESD in the management of recurrent, localized primary esophageal cancers in GT. We searched PubMed, CENTRAL, EMBASE, Scopus, and clinical trial registries from inception to March 2023 for articles evaluating the safety and efficacy of ESD in the management of recurrent cancerous lesions in GT. Our primary outcome was the en bloc resection rate. Secondary outcomes were curative resection rate, complete resection rate, intra-procedural complication rate, post-procedure complication rate, and five-year survival rate. Seven studies with a total of 165 patients undergoing 192 ESDs were included in the review. The pooled en bloc resection rate was 92.5% (95% CI: 87.7-95.6), which was reported in all seven studies. Pooled complete resection rate was 78.9% (95% CI: 64.5-88.5) per three studies, pooled curative resection rate was 73.9% (95% CI: 63.5-82.2) per four studies, and pooled intra-procedural complication rate was 10.2% (95% CI: 1.5-46.3), which was reported in four studies. Only three studies reported a five-year survival rate that was 65.5% (95% CI: 56.0-73.9). ESD is safe and efficacious in the management of GT cancer after esophagectomy.

Etiology and clinical characteristics of a non-cystic fibrosis bronchiectasis cohort in a middle eastern population.

BACKGROUND: Bronchiectasis is a widely prevalent airway disease characterized by airway dilatation and recurrent infections, that can lead to respiratory failure in severe cases. The etiology of bronchiectasis varies geographically, but there is a lack of published data examining its etiology specifically within the Middle Eastern population. METHODS: We conducted a retrospective analysis of our bronchiectasis patient registry, extracting clinical and demographic characteristics from electronic medical records. Quantitative variables were presented as the median and interquartile range (IQR), while categorical variables were expressed as numbers and percentages. Statistical comparisons for continuous characteristics were performed using the t-test, and significance was determined by a p-value less than 0.05. RESULTS: In total we analysed 260 records (63% female, 37% male), with median age of 58 years (interquartile range (IQR) 38-71), Body Mass Index (BMI) 25.8(IQR 22-30), forced expiratory volume in the first second (FEV1) %predicted 65 (IQR 43-79) and FEV1/forced vital capacity (FVC) 0.76 (0.67-0.86). Sixty-five cases (25%) were post-infectious in aetiology (excluding post-TB - n:27 10.4%). Forty-eight (18.5%) patients were labelled idiopathic, while Primary Ciliary Dyskinesia (PCD) accounted for 23 (8.8%) cases. Pseudomonas aeruginosa was the most common colonizing organism (32.7%), followed by Haemophilus influenzae (9.2%) and Methicillin-Sensitive Staphylococcus aureus(6.9%). At the time of review, 11 patients had died (median age, FEV %predicted, and bronchiectasis severity index (BSI) 59 years, 38% and 15.5 respectively), all due to respiratory failure, and as expected, all were classed severe on BSI. The BSI score was available for 109 patients, of which 31(28%) were classed mild, 29(27%) were moderate, and 49 (45%) were classed severe. The median BSI score was 8 (IQR 4-11). On dividing the patients according to obstructive vs. restrictive spirometry, we found that patients with FEV1/FVC < 0.70 had significantly higher BSI (10.1 vs. 6.9, p-value < 0.001) and that 8 out of the 11 deceased patients had FEV1/FVC < 70%. CONCLUSIONS: In our study, post-infectious, idiopathic, and PCD were identified as the most common etiologies of bronchiectasis. Additionally, patients with obstructive spirometry appeared to have a worse prognosis compared to those with restrictive spirometry.

Automated Monkeypox Skin Lesion Detection Using Deep Learning and Transfer Learning Techniques.

The current outbreak of monkeypox (mpox) has become a major public health concern because of the quick spread of this disease across multiple countries. Early detection and diagnosis of mpox is crucial for effective treatment and management. Considering this, the purpose of this research was to detect and validate the best performing model for detecting mpox using deep learning approaches and classification models. To achieve this goal, we evaluated the performance of five common pretrained deep learning models (VGG19, VGG16, ResNet50, MobileNetV2, and EfficientNetB3) and compared their accuracy levels when detecting mpox. The performance of the models was assessed with metrics (i.e., the accuracy, recall, precision, and F1-score). Our experimental results demonstrate that the MobileNetV2 model had the best classification performance with an accuracy level of 98.16%, a recall of 0.96, a precision of 0.99, and an F1-score of 0.98. Additionally, validation of the model with different datasets showed that the highest accuracy of 0.94% was achieved using the MobileNetV2 model. Our findings indicate that the MobileNetV2 method outperforms previous models described in the literature in mpox image classification. These results are promising, as they show that machine learning techniques could be used for the early detection of mpox. Our algorithm was able to achieve a high level of accuracy in classifying mpox in both the training and test sets, making it a potentially valuable tool for quick and accurate diagnosis in clinical settings.

How does Linkage to the National Death Index Affect Population-Based Net Survival Estimates for Women with Cervical Cancer in Saudi Arabia?

BACKGROUND: Population-based cancer survival is a key metric for the assessment of cancer control strategies. Accurate estimation of cancer survival requires complete follow-up data for all patients. AIM: To explore the impact of linking national cancer registry data to the national death index on net survival estimates for women diagnosed with cervical cancer in Saudi Arabia during 2005-2016. METHODS: We acquired data on 1,250 Saudi women diagnosed with invasive cervical cancer during the 12- year period 2005-2016 from the Saudi Cancer Registry. These included the woman's last known vital status and the date of last known vital status, but this was restricted to information from clinical records and death certificates that mention cancer as a cause of death ("registry follow-up"). We submitted available national ID numbers to the National Information Center (NIC) of the Ministry of Interior, to ascertain the date of death, from any cause of death, for women who had died up until 31 December 2018 ("NIC follow-up"). We estimated age-standardised 5-year net survival using the Pohar-Perme estimator under five different scenarios using the two sources of follow-up, and censoring at the date of last contact with the registry versus extending survival until the closing date if no information on death was obtained. RESULTS: 1,219 women were eligible for survival analysis. Five-year net survival was lowest when using NIC followup only (56.8%; 95%CI 53.5 - 60.1%), and highest when registry follow-up only was used and survival time was extended until closure date for those with no information on death (81.8%; 95%CI 79.6 - 84%). CONCLUSION: Reliance solely on information from deaths certified as due to cancer and clinical records leads to a high proportion of missing deaths in the national cancer registry. This is probably due to low quality of certification of the cause of death in Saudi Arabia. Linkage of the national cancer registry to the national death index at the NIC identifies virtually all deaths, providing more reliable survival estimates, and it eliminates the ambiguity in determining the underlying cause of death. Therefore, this should become the standard approach to estimating cancer survival in Saudi Arabia.

Classic Cystic Fibrosis Presentation in Two Middle Eastern Siblings with a rare CFTR mutation (c.80G>T).

Cystic fibrosis (CF) is a common autosomal recessive disorder which is mainly found in Caucasians but has also been reported in Asian populations. CF is primarily caused by mutations in the CFTR gene which regulates the transport of chloride ions across the cell membrane. We describe the cases of two siblings with CF diagnosed with the rare missense mutation c.80G>T, which has only been referenced once in the literature and shows a possible association with classical form of CF. LEARNING POINTS: c.80G>T is a very rare CFTR missense mutation which has not been known to be a disease-causing alteration.The mutation causes an amino acid switch from glycine to valine at position 27 in exon 2, resulting in the production of defective CFTR protein.In the homozygous state, c.80G>T seems to be associated with the classic CF phenotype.

Serial Sessions of a Novel Low-Level Light Therapy Device for Home Treatment of Dry Eye Disease.

INTRODUCTION: This study aimed to evaluate the changes that a recently developed at-home device using low-level light therapy (LLLT) produced in signs and symptoms of patients with dry eye disease (DED) owing to meibomian gland dysfunction (MGD). METHODS: In this prospective study, patients with DED owing to MGD not successfully responding to first-line therapy (tear substitutes and eye lid hygiene) were treated with four serial sessions (every other day) of mask based on LLLT technology and dedicated for home use (my-mask®, Espansione Marketing S.p.A., Bologna, Italy). Non-invasive ocular surface examination was carried out by means of Keratograph 5M (Oculus, Wetzlar, Germany) before and after four mask sessions for the evaluation of (i) tear meniscus height (TMH); (ii) first and average non-invasive Keratograph breakup time (NIKBUT); (iii) meibomian gland loss (MGL). Ocular Surface Disease Index (OSDI) questionnaire was used to assess ocular discomfort symptoms. RESULTS: Overall, 17 patients (3 male, 14 female; mean age 61.47 ± 11.93 years) were enrolled and all of them regularly completed the entire cycle of four sessions without reporting any adverse event. The mean values of NIKBUT first and NIKBUT average increased significantly after treatment (from 5.29 ± 2.60 at T0 to 9.04 ± 3.49 s at T1 [P = 0.001] and from 9.40 ± 3.81 to 11.28 ± 2.81 s [P = 0.017]); in parallel, the mean value of TMH increased significantly from 0.27 ± 0.06 to 0.32 ± 0.09 mm (P = 0.029). Conversely, there were not statistically significant differences for MGL (P = 0.346). In addition, the mean value of OSDI score decreased after treatment (from 32.00 ± 7.96 at T0 to 20.71 ± 8.03 at T1; P < 0.001). CONCLUSIONS: One week of serial sessions of a newly developed LLLT device for home use significantly improved tear film production and stability along with ocular discomfort symptoms in patients with DED owing to MGD. These findings open up a new scenario for patients with MGD who can enjoy the unique benefits of LLLT at home.

Epidemiology of irritable bowel syndrome in hospitalized patients with inflammatory bowel disease: Nationwide Inpatient Sample analysis from 2007-2016.

Background: Despite effective treatments for inflammatory bowel disease (IBD), patients in remission may still suffer from gastrointestinal symptoms attributable to overlying irritable bowel syndrome (IBS). In this population-based cohort study, we investigated the epidemiology of IBS in hospitalized IBD patients and explored the differences between hospitalized IBD-IBS vs. IBD patients to distinguish this patient population. Methods: Using the Nationwide Inpatient Sample database from 2007-2016, we identified patients with a primary or secondary discharge diagnosis of IBD, with or without IBS, using ICD-9 and ICD-10 codes. We extracted information on demographics, psychological comorbidities, IBD complications, cost and duration of stay of each group, from either discharge records or diagnosis codes. These were analyzed using SAS version 4.0. Results: There was a rise in the prevalence of IBS among inpatients with ulcerative colitis (P=0.025) and Crohn's disease (P=0.0014) over the study period. This study revealed that IBD patients with IBS tend to be female, younger, are less likely to be morbidly obese and have higher rates of psychological disorders (P<0.001) compared to IBD patients with no IBS co-diagnosis. They also have fewer IBD-specific complications, such as strictures, obstruction, fistula and abdominal abscess (P<0.001). Shorter hospital stays (P<0.001) and lower hospital charges (P<0.001) were also noted in these patients. Conclusions: IBD patients with IBS are significantly different from other IBD patients, and are associated with less severe disease, a shorter hospital stay and lower hospital expenses. Early and accurate classification of this patient population may prevent unnecessary treatment and hospitalization in the future.