Exercise-based gaming in patients with multiple sclerosis: A systematic review and meta-analysis.

Background: Multiple sclerosis presents a significant burden, with balance disturbances impacting patients' daily living. Conventional therapies have been supplemented with technological advancements like virtual reality (VR) and exergaming, providing engaging, multisensory rehabilitation options. Objective: This study aimed to synthesize evidence on exergaming's role in multiple sclerosis treatment, particularly to evaluate the impact of exergaming on cognitive, motor, and psychological outcomes in patients with multiple sclerosis. Methods: A systematic review and subsequent meta-analysis design were employed. An extensive search was conducted up to June 2023 across five electronic databases - Web of Science, Scopus, PubMed, Cochrane, and EMBASE. The data extraction process from the selected studies was conducted independently. The risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool 1 (ROB1) and the National Institutes of Health (NIH) assessment tool. Continuous outcomes were consolidated as mean differences (MD) with 95% confidence intervals (CIs). Meta-analyses were performed using RevMan ver. 5.4. Results: Out of 1,029 studies, 27 were included for meta-analysis. There were no significant differences in cognitive outcomes between the exergaming and the no-intervention group or the Conventional Physiotherapy and Rehabilitation interventions (CPRh) subgroups. However, the Symbol Digit Modalities Test (SDMT) showed a statistically significant difference in favor of exergaming in the no-intervention subgroup (MD = 5.40, 95% CI [0.08, 10.72], p = 0.05). In motor outcomes, exergaming only demonstrated better results in the 6-minute walking test compared to the no-intervention group (MD = 25.53, 95% CI [6.87, 44.19], p = 0.007). The Berg Balance Scale score in both studied subgroups and the Timed Up and Go (TUG) test in the no-intervention group favored exergaming. In terms of psychological outcomes, the Beck Depression Inventory did not reveal any significant differences, while the Modified Fatigue Impact Scale (MFIS) score favored exergaming in the CPRh subgroup. Conclusion: Exergaming shows promise for enhancing cognitive and motor functions, motivation, adherence, and quality of life in MS patients, which is beneficial for nurses. It can be tailored to individual preferences and easily conducted at home, potentially serving as a viable alternative to traditional rehab programs, especially during relapses. However, further research is necessary to fully understand its optimal and lasting benefits.

Exploration of nonlinear optical properties of 4-methyl-4H-1,2,4-triazol-3-yl)thio)-N-phenylpropanamide based derivatives: experimental and DFT approach.

Triazoles, nitrogen-containing heterocycles, have gained attention for their applications in medicinal chemistry, drug discovery, agrochemicals, and material sciences. In the current study, we synthesized novel derivatives of N-substituted 2-((5-(3-bromophenyl)-4-methyl-4H-1,2,4-triazol-3-yl)thio)-N-phenylpropanamide and conducted a comprehensive investigation using density functional theory (DFT). These novel structural hybrids of 1,2,4-triazole were synthesized through the multi-step chemical modifications of 3-bromobenzoic acid (1). Initially, compound 1 was converted into its methyl-3-bromobenzoate (2) which was then transformed into 3-bromobenzohydrazide (3). The final step involved the cyclization of compound 3, producing its 1,2,4-triazole derivative (4). This intermediate was then coupled with different electrophiles, resulting in the formation of the final derivatives (7a-7c). Additionally, the characterization of these triazole-based compounds (7a, 7b, and 7c) were carried out using techniques such as IR, HNMR, and UV-visible spectroscopy to understand their structural and spectroscopic properties. The DFT study utilized M06/6-311G(d,p) functional to investigate geometrical parameters, HOMO-LUMO energies, natural bond orbital analyses, transition density matrix (TDM), density of states, and nonlinear optical (NLO) properties. The FMO analysis revealed that compound 7c exhibited the lowest band gap value (4.618 eV). Notably, compound 7c exhibited significant linear polarizability (4.195 > × 10-23) and first and second hyperpolarizabilities (6.317 > × 10-30, 4.314 × 10-35), signifying its potential for nonlinear optical applications. These NLO characteristics imply that each of our compounds, especially 7c, plays a crucial part in fabricating materials showing promising NLO properties for optoelectronic applications.

Exploring nanoarchitectonics and optical properties of PAA-ZnO@BCP wide-band-gap organic semiconductors.

This work reports the formation of polyacrylic acid (PAA)-zinc oxide (ZnO)-bromocresol purple (BCP), (PAA-ZnO@ (0.00-0.01) BCP wide-bandgap organic semiconductors deposited onto glass substrates via a sol-gel polymerization process. These semiconductor films were deposited on glass substrates using a spin coating and then dried at 60 °C. The PAA-ZnO film appeared to be of amorphous phase, and films loaded with BCP revealed semicrystalline behavior. The surface of the films exhibited adherence and extended grains. The hydrogen bonds formed between PAA-ZnO and the BCP dye within the PAA-ZnO@BCP films was performed using FTIR-spectroscopy. The prepared nanocomposites demonstrate an indirect band transition which is affected slightly by adding ZnO and BCP dye. Optical parameters such as the absorption coefficient, the refractive index, the dielectric constant, optical conductivity, optical depth, and optical electronegativity of the prepared nanocomposites were studied as functions of incident light energy (wavelength). The PAA carbonyl group n-π* transition and BCP aromatic ring π-π* transitions were detected at about 285 (for all samples) and 432 nm (for BCP loaded samples), respectively. The superior photoluminescence characteristics observed in the BCP/PAA-Zn films excited with a wavelength of 250 nm indicated the successful loading of the BCP dye during the self-aggregation of the PAA-Zn film.

Quantum Efficiency Measurement and Modeling of Silicon Sensors Optimized for Soft X-ray Detection.

Hybrid pixel detectors have become indispensable at synchrotron and X-ray free-electron laser facilities thanks to their large dynamic range, high frame rate, low noise, and large area. However, at energies below 3 keV, the detector performance is often limited because of the poor quantum efficiency of the sensor and the difficulty in achieving single-photon resolution due to the low signal-to-noise ratio. In this paper, we address the quantum efficiency of silicon sensors by refining the design of the entrance window, mainly by passivating the silicon surface and optimizing the dopant profile of the n+ region. We present the measurement of the quantum efficiency in the soft X-ray energy range for silicon sensors with several process variations in the fabrication of planar sensors with thin entrance windows. The quantum efficiency for 250 eV photons is increased from almost 0.5% for a standard sensor to up to 62% as a consequence of these developments, comparable to the quantum efficiency of backside-illuminated scientific CMOS sensors. Finally, we discuss the influence of the various process parameters on quantum efficiency and present a strategy for further improvement.

Optimizing magnetic, dielectric, and antimicrobial performance in chitosan-PEG-Fe2O3@NiO nanomagnetic composites.

There is a growing interest in eco-friendly and cost-effective organic-inorganic nanocomposites due to their alignment with the principles of "green" chemistry, as well as their biocompatibility and non-toxicity. This study focused on producing Chitosan-PEG-Fe2O3@NiO nanomagnetic composites to improve the stability, dielectric properties, and antimicrobial effectiveness of these nanocomposite materials. The process involved synthesizing Fe2O3@NiO via sol-gel and polymerizing chitosan-PEG. The nanocomposites were characterized by XRD, TEM, FTIR, optical, dielectric, and VSM. Incorporating Fe2O3@NiO significantly improved stability, and the interaction with Fe2O3 during the sol-gel process facilitated the formation of NiFe2O4 with an increase in the crystallinity within the chitosan-PEG matrix. The study examined optical and dielectric properties, highlighting that the 3 NiO-doped chitosan-PEG-Fe2O3 composites had high electrical conductivity (1.8 ∗ 10-3 S/cm) and a significant dielectric constant (106 at low frequencies). As the ratio of NiO NPs within the chitosan-PEG-Fe2O3 increases, the energy band gap of chitosan-PEG-Fe2O3 films decreases up to 3.7 eV. This decrease is owing to the quantum confinement effect. These composites also demonstrated improved antimicrobial activity against E. coli and S. aureus and higher activity in the presence of nanomagnetic particles. The minimum inhibitory concentrations of CS-PEG-Fe2O3/NiO NPs against (Bacillus cereus, M. luteus, S. aureus and (S. enterica, H. pylori, E. coli) were (22-35 mm) and (21-34 mm), respectively.

Advancing energy storage and supercapacitor applications through the development of Li+-doped MgTiO3 perovskite nano-ceramics.

Perovskite oxide materials, specifically MgTiO3 (MT) and Li-doped MgTiO3 (MTxLi), were synthesized via a sol-gel method and calcination at 800 °C. This study explores the impact of varying Li doping levels (x = 0, 0.01, 0.05, and 0.1) on the crystalline structure and properties of MgTiO3. X-ray diffraction analysis revealed a well-defined rhombohedral MgTiO3 phase. Optical diffuse reflectance measurements provided insights into energy gap values, refractive index, and dielectric constant. Li+ doping enhanced the electrical properties of MgTiO3, with a notable phase transition observed at 50 °C. The study investigated impedance and AC conductivity under varying temperature and frequency conditions (25-120 °C, 4 Hz to 8 MHz). Electrochemical analysis through cyclic voltammetry and electrochemical impedance spectroscopy confirmed highly electrocatalytic properties for MTxLi, particularly when modified onto screen-printed electrodes. This work not only advances the understanding of Li-doped MgTiO3 nanostructures but also highlights their significant potential for direct electrochemical applications, particularly in the realm of energy storage.

Humidity sensing using Zn(1.6 - x)Na0.4CuxTiO4 spinel nanostructures.

In this paper, we present a humidity sensing material based on nanostructured Zn(1.6 - x)Na0.4CuxTiO4 spinel to enhance optical and sensitivity performance. Nano-porous of Zn (1.6 - x) Na0.4CuxTiO4 spinel were synthesized using sol gel reactions and calcined at 700 °C. The nanostructures of Zn(1.6 - x)Na0.4CuxTiO4 spinel underwent thorough characterization through multiple techniques. X-ray diffractometry (XRD) coupled with Rietveld refinement using FullProf software, transmission electron microscopy (TEM), Raman Spectroscopy, and optical analysis were employed to assess various aspects of the nanostructures. These techniques were utilized to determine the phase composition, particle size distribution, chemical bonding, and the tunable band gap of the nanostructures. The X-ray diffraction (XRD) analysis of Zn(1.6 - x)Na0.4CuxTiO4 samples revealed well-defined and prominent peaks, indicating a highly crystalline cubic spinel structure. The lattice parameter was decreased from 8.4401 to 8.4212 Å with increasing Cu content from 0 to 1.2 mol%. UV-visible diffuse reflectance spectra were employed to investigate the optical characteristics of copper-doped Zn1.6Na0.4TiO4. The applicability of Cu@NaZT spinel nanostructures in humidity sensors was evaluated at ambient conditions. The fabricated sensor was investigated in a wide span of humidity (11-97%). The examined sensor demonstrates a low hysteresis, excellent repeatability, fast response and recovery. The response and recovery times were estimated to be 20 s and 6 s respectively. The highest sensitivity was achieved at 200 Hz. The proposed sensor can be coupled easily with electronic devices as the humidity-impedance relationship is linear.

Immunotherapy: Constructive Approach for Breast Cancer Treatment.

A novel and rapid therapeutic approach is the treatment of human breast cancer by enhancing the host's immune system. In initial findings, program death one (PD-1) and program cell death ligand one (PD-L1) showed positive results towards solid tumors, but tumor relapse and drug resistance are the major concerns. Breast cancer therapy has been transformed by the advent of immune checkpoint blockades (ICBs). Triple-negative breast cancers (TNBCs) have exhibited enduring responses to clinical usage of immune checkpoint inhibitors (ICBs) like atezolizumab and pembrolizumab. Nonetheless, a notable proportion of individuals with TNBC do not experience advantages from these treatments, and there is limited comprehension of the resistance mechanisms. Another approach to overcome resistance is cancer stem cells (CSCs), as these cells are crucial for the initiation and growth of tumors in the body. Various cancer vaccines are created using stem cells (dendritic, whole cell, bacterial) and focus primarily on targeting tumor-related antigens. The ultimate objective of cancer vaccines is to immunize the patients by active artificial immunity against cancer, though. In this review, we primarily focused on existing immunotherapeutic options, immune checkpoint blockers, the latest progress in understanding the molecular mechanisms underlying resistance to immune checkpoint inhibitors (ICBs), advanced strategies to overcome resistance to ICBs, cancer stem cell antigens and molecular markers, ongoing clinical trials for BCs and cancer vaccines for breast cancer.

The anticancer and anti-inflammatory activity screening of pyridazinone-based analogs against human epidermoid skin cancer with detailed mechanistic analyses.

3(2H)-Pyridazinone derivatives based on 4-biphenyl, naphtha-2-yl, pyridine, or piperidine moiety were synthesized and characterized using I-R and 1HNMR spectra. The activity and cytotoxicity of some synthesized compounds on the skin epidermoid cancer cell proliferation and progression were investigated. The pyridazine isomer with pyridine revealed a significant decrease in the level of nitric oxide p < 0.01 than the activity of caffeine phenecyl ester. The activity of the three active isomers recorded significant activity for their total antioxidant content that triggers their ability for the scavenging the oxygen free radicals significantly p < 0.01. Moreover, revealing the pharmaceutical activity of the isomers as anti-inflammatory agents, IL-6, IL10, and IL12 have been decreased by variable significant values. Additionally, the active isomers revealed variable actions on the skin cancer cell to induce apoptosis using annexin V-FITC/PI. Pyridine was the highest isomer to induce late apoptosis and necrosis for the skin cancer cells against the use of cisplatin. Importantly, Molecular modeling experiments including docking and dynamic simulations were done for the most active 3 analogs to explore the ligand binding and stability leading to exploring the structure-activity relationship with biological target PARP1 which showed a good binding propensity to pyridazine binding site which supports the in vitro data. In conclusion, the pyridazine moieties with piperdine, naphthayl, and pyridine have pharmacological activities against skin cancer epidermoid by triggering action in inhibition of the proliferation and progression with an up-regulated apoptotic mechanism that evades the emergence of cisplatin resistance among different cancer cells.Communicated by Ramaswamy H. Sarma.

Application of Virtual Reality-Assisted Exergaming on the Rehabilitation of Children with Cerebral Palsy: A Systematic Review and Meta-Analysis.

BACKGROUND: Rehabilitation programs for children with cerebral palsy (CP) aim to improve their motor and cognitive skills through repeated and progressively challenging exercises. However, these exercises can be tedious and demotivating, which can affect the effectiveness and feasibility of the programs. To overcome this problem, virtual reality VR-assisted exergaming has emerged as a novel modality of physiotherapy that combines fun and motivation with physical activity. VR exergaming allows children with CP to perform complex movements in a secure and immersive environment, where they can interact with virtual objects and scenarios. This enhances their active engagement and learning, as well as their self-confidence and enjoyment. We aim to provide a comprehensive overview of the current state of research on VR exergaming for CP rehabilitation. The specific objectives are: To identify and describe the existing studies that have investigated the effects of VR exergaming on motor function and participation outcomes in children with CP. In addition, we aim to identify and discuss the main gaps, challenges, and limitations in the current research on VR exergaming for CP rehabilitation. Finally, we aim to provide recommendations and suggestions for future research and practice in this field. METHODS: In June 2023, we conducted a systematic search on Scopus, Web of Science, PubMed, Cochrane, and Embase for randomized trials and cohort studies that applied VR-assisted exergaming to rehabilitating patients with CP. The inclusion criteria encompassed the following: (1) Randomized controlled trials (RCTs) and cohort studies involving the rehabilitation of children with CP; (2) the application of VR-based exergaming on the rehabilitation; (3) in comparison with conventional rehabilitation/usual care. The quality of the selected RCTs was evaluated using Cochrane's tool for risk of bias assessment bias includes. Whereas the quality of cohort studies was assessed using the National Institutes of Health (NIH) tool. RESULTS: The systematic search of databases retrieved a total of 2576 studies. After removing 863 duplicates, 1713 studies underwent title and abstract screening, and 68 studies were then selected as eligible for full-text screening. Finally, 45 studies were involved in this review (n = 1580), and 24 of those were included in the quantitative analysis. The majority of the included RCTs had a low risk of bias regarding study reporting, participants' attrition, and generating a random sequence. Nearly half of the RCTs ensured good blinding of outcomes assessors. However, almost all the RCTs were unclear regarding the blinding of the participants and the study personnel. The 2020 retrospective cohort study conducted at Samsung Changwon Hospital, investigating the effects of virtual reality-based rehabilitation on upper extremity function in children with cerebral palsy, demonstrated fair quality in its methodology and findings. VR-assisted exergaming was more effective than conventional physiotherapy in improving the Gross Motor Function Measurement (GMFM)-88 score (MD = 0.81; 95% CI [0.15, 1.47], p-value = 0.02) and the GMFM walking and standing dimensions (MD = 1.45; 95% CI [0.48, 2.24], p-value = 0.003 and MD = 3.15; 95% CI [0.87, 5.42], p-value = 0.007), respectively. The mobility and cognitive domains of the Pediatric Evaluation of Disability Inventory score (MD = 1.32; 95% CI [1.11, 1.52], p-value < 0.001) and (MD = 0.81; 95% CI [0.50, 1.13], p-value < 0.0001) were also improved. The Canadian Occupational Performance Measure performance domain (MD = 1.30; 95% CI [1.04, 1.56], p-value < 0.001), the WeeFunctional Independence Measure total score (MD = 6.67; 95% CI [6.36, 6.99], p-value < 0.0001), and the Melbourne Assessment of Unilateral Upper Limb Function-2 score (p-value < 0.001) improved as well. This new intervention is similarly beneficial as conventional therapy in improving other efficacy measures. CONCLUSIONS: Our findings suggest that VR-assisted exergaming may have some advantages over conventional rehabilitation in improving CP children's functioning and performance in daily life activities, upper and lower limb mobility, and cognition. VR-assisted exergaming seems to be as effective as conventional physiotherapy in the other studied function measures. With its potential efficacy, better feasibility, no reported side effects, and entertaining experience, VR-assisted exergaming may be a viable complementary approach to conventional physiotherapy in rehabilitating children with CP.

Application of coliphage as biocontrol agent in combination with gamma irradiation to eliminate multi-drug-resistant E. coli in minimally processed vegetables.

Biofilm formation is a rising concern in the food industry. Escherichia coli (E. coli) is one of the most important food-borne pathogens that can survive in food and food-related environments and eventually produce biofilms. This study suggested that both coliphages used were successful in preventing the creation of new biofilms as well as removing existing ones. Confocal laser scanning microscopy verified these findings. According to the findings, neither coliphage survived at 37 °C, but both remained stable at 4 °C and - 20 °C for extended periods of time. The study revealed that both coliphages demonstrated a greater degree of gamma irradiation resistance when compared to E. coli. The study's results indicate that the implementation of a dual method, which incorporates gamma irradiation (1.5 kGy) and coliphage treatment, on various kinds of vegetables that were infected with E. coli, resulted in a significant reduction in bacterial count (surpassing 99.99%) following a 24-h incubation period. Combining gamma irradiation and the coliphage approach was significantly effective at lowering polysaccharide concentrations and proteins in the biofilm matrix. The results revealed that the pairing of gamma irradiation and coliphages acted in conjunction to cause disruptions in the matrix of biofilm, thereby promoting cell removal compared with either of the individual treatments. Ca+ ions strengthen the weak virion interaction with the relevant bacterial host cell receptors during the adsorption process. In conclusion, use of coliphage in combination with gamma irradiation treatment can be applied to improve fresh produce's microbial safety and enhance its storability in supermarkets.

Development of Novel Class of Phenylpyrazolo[3,4-d]pyrimidine-Based Analogs with Potent Anticancer Activity and Multitarget Enzyme Inhibition Supported by Docking Studies.

Phenylpyrazolo[3,4-d]pyrimidine is considered a milestone scaffold known to possess various biological activities such as antiparasitic, antifungal, antimicrobial, and antiproliferative activities. In addition, the urgent need for selective and potent novel anticancer agents represents a major route in the drug discovery process. Herein, new aryl analogs were synthesized and evaluated for their anticancer effects on a panel of cancer cell lines: MCF-7, HCT116, and HePG-2. Some of these compounds showed potent cytotoxicity, with variable degrees of potency and cell line selectivity in antiproliferative assays with low resistance. As the analogs carry the pyrazolopyrimidine scaffold, which looks structurally very similar to tyrosine and receptor kinase inhibitors, the potent compounds were evaluated for their inhibitory effects on three essential cancer targets: EGFRWT, EGFRT790M, VGFR2, and Top-II. The data obtained revealed that most of these compounds were potent, with variable degrees of target selectivity and dual EGFR/VGFR2 inhibitors at the IC50 value range, i.e., 0.3-24 µM. Among these, compound 5i was the most potent non-selective dual EGFR/VGFR2 inhibitor, with inhibitory concentrations of 0.3 and 7.60 µM, respectively. When 5i was tested in an MCF-7 model, it effectively inhibited tumor growth, strongly induced cancer cell apoptosis, inhibited cell migration, and suppressed cell cycle progression leading to DNA fragmentation. Molecular docking studies were performed to explore the binding mode and mechanism of such compounds on protein targets and mapped with reference ligands. The results of our studies indicate that the newly discovered phenylpyrazolo[3,4-d]pyrimidine-based multitarget inhibitors have significant potential for anticancer treatment.

Introducing of novel class of pyrano[2,3-c]pyrazole-5-carbonitrile analogs with potent antimicrobial activity, DNA gyrase inhibition, and prominent pharmacokinetic and CNS toxicity profiles supported by molecular dynamic simulation.

Microbiological DNA gyrase is recognized as an exceptional microbial target for the innovative development of low-resistant and more effective antimicrobial drugs. Hence, we introduced a one-pot facile synthesis of a novel pyranopyrazole scaffold bearing different functionalities; substituted aryl ring, nitrile, and hydroxyl groups. All new analogs were characterized with full spectroscopic data. The antimicrobial screening for all analogs was assessed against standard strains of Gm + ve and Gm-ve through in vitro considers. The screened compounds displayed very promising MIC/MBC values against some of the bacterial strains with broad or selective antibacterial effects. Of these, 4j biphenyl analog showed 0.5-2/2-8 µg/mL MIC/MBC for suppression and killing of Gm + ve and Gm-ve strains. Moreover, the antimicrobial screening was assessed for the most potent analogs against certain highly resistant microbial strains. Consequently, DNA gyrase supercoiling assay was done for all analogs using ciprofloxacin as reference positive control. Obviously, the results showed a different activity profile with potent analog 4j with IC50 value 6.29 µg/mL better than reference drug 10.2 µg/mL. Additionally, CNS toxicity testing was done using the HiB5 cell line for attenuation of GABA/NMDA expression to both 4j and ciprofloxacin compounds that revealed better neurotransmitter modulation by novel scaffold. Importantly, docking and dynamic simulations were performed for the most active 4j analog to investigate its interaction with DNA binding sites, which supported the in vitro observations and compound stability with binding pocket. Finally, a novel scaffold pyranopyrazole was introduced as a DNA gyrase inhibitor with prominent antibacterial efficacy and low CNS side effect toxicity better than quinolones.Communicated by Ramaswamy H. Sarma.

Synthesis and characterization of chitosan-corn starch-SiO2/silver eco-nanocomposites: Exploring optoelectronic and antibacterial potential.

This work discusses the physicochemical and antimicrobial characteristics of chitosan-corn starch eco-nanocomposites integrated with silica@Ag nano-spheres. These composites were synthesized through sol-gel polymerization and subsequently exposed to simulated body fluid (SBF). The incorporation of Ag into the eco-nanocomposites led to a decrease in diffuse reflectance across the entire wavelength range. The dielectric permittivity exhibited an increase up to 52.1 at a frequency of 100 kHz, while the ac conductivity reached a value of 5.2 ∗ 10-6 (S cm-1) at the same frequency for the sample with the highest Ag content. The study utilized XRD and FTIR techniques to examine the materials before and after in vitro testing and evaluated the antibacterial properties of the eco-nanocomposites against several pathogenic microorganisms, including Staphylococcus haemolyticus, Staphylococcus aureus, Klebsiella pneumoniae, and Escherichia coli, using the agar diffusion method. The eco-nanocomposites demonstrated bioactivity by forming a hydroxy appetite layer on their surfaces and were capable of releasing silver (Ag) at concentrations of 1.3, 1.9, and 2.5 mol%. This study suggests that chitosan-corn starch-SiO2-based doped with Ag eco-nanocomposite has the potential for various applications, including biomedical and environmental fields, where their antibacterial properties can be utilized to combat harmful microorganisms.

A systematic review and meta-analysis on the efficacy and safety of the Baska mask versus other laryngeal mask airways during general anaesthesia.

BACKGROUND: The Baska mask is a supraglottic airway device used during general anaesthesia that combines features from various other devices. This systematic review aims to compare its efficacy and safety with other laryngeal mask airways. METHODS: Randomised controlled trials were identified by searching PubMed, Scopus, Web of Science and Cochrane Library. RevMan software was used for meta-analysis, with mean difference and risk ratios calculated for continuous and dichotomous data, respectively, along with a 95% confidence interval. RESULTS: The meta-analysis found that the Baska mask provides a better oropharyngeal seal pressure (mean difference = 7.03; 95% confidence interval = [6.00, 8.07], p < 0.00001) and a higher rate of maximal seal pressure (risk ratio = 18.38; 95% confidence interval = [2.53, 133.47], p = 0.004) compared to other laryngeal mask airways. However, the Baska mask had lower success rates in first-attempt insertion (risk ratio = 0.79; 95% confidence interval = [0.72, 0.86], p < 0.00001) and higher rates of insertion manipulation (risk ratio = 16.64; 95% confidence interval = [5.86, 47.24], p < 0.00001). CONCLUSION: The Baska mask offers better oropharyngeal seal pressure, but may be more difficult to insert than other laryngeal mask airways, without causing significant delays. The Baska mask appears as safe as other laryngeal mask airways, but larger trials are needed to support these findings.

Calibration method and performance of a time-of-flight detector to measure absolute beam energy in proton therapy.

BACKGROUND: The beam energy is one of the most significant parameters in particle therapy since it is directly correlated to the particles' penetration depth inside the patient. Nowadays, the range accuracy is guaranteed by offline routine quality control checks mainly performed with water phantoms, 2D detectors with PMMA wedges, or multi-layer ionization chambers. The latter feature low sensitivity, slow collection time, and response dependent on external parameters, which represent limiting factors for the quality controls of beams delivered with fast energy switching modalities, as foreseen in future treatments. In this context, a device based on solid-state detectors technology, able to perform a direct and absolute beam energy measurement, is proposed as a viable alternative for quality assurance measurements and beam commissioning, paving the way for online range monitoring and treatment verification. PURPOSE: This work follows the proof of concept of an energy monitoring system for clinical proton beams, based on Ultra Fast Silicon Detectors (featuring tenths of ps time resolution in 50 µm active thickness, and single particle detection capability) and time-of-flight techniques. An upgrade of such a system is presented here, together with the description of a dedicated self-calibration method, proving that this second prototype is able to assess the mean particles energy of a monoenergetic beam without any constraint on the beam temporal structure, neither any a priori knowledge of the beam energy for the calibration of the system. METHODS: A new detector geometry, consisting of sensors segmented in strips, has been designed and implemented in order to enhance the statistics of coincident protons, thus improving the accuracy of the measured time differences. The prototype was tested on the cyclotron proton beam of the Trento Protontherapy Center (TPC). In addition, a dedicated self-calibration method, exploiting the measurement of monoenergetic beams crossing the two telescope sensors for different flight distances, was introduced to remove the systematic uncertainties independently from any external reference. RESULTS: The novel calibration strategy was applied to the experimental data collected at TPC (Trento) and CNAO (Pavia). Deviations between measured and reference beam energies in the order of a few hundreds of keV with a maximum uncertainty of 0.5 MeV were found, in compliance with the clinically required water range accuracy of 1 mm. CONCLUSIONS: The presented version of the telescope system, minimally perturbative of the beam, relies on a few seconds of acquisition time to achieve the required clinical accuracy and therefore represents a feasible solution for beam commission, quality assurance checks, and online beam energy monitoring.

Construction and characterization of nano-oval BaTi0.7Fe0.3O3@NiFe2O4 nanocomposites as an effective platform for the determination of H2O2.

Talented di-phase ferrite/ferroelectric BaTi0.7Fe0.3O3@NiFe2O4 (BFT@NFO) in oval nano-morphology was chemically synthesized using controlled sol-gel processes and calcined at 600 °C. The effects of shielding using NiFe2O4 (NFO) nanoparticles on the microstructure, phase transition, thermal, and relative permittivity of BaTi0.7Fe0.3O3 (BTF) nano-perovskite were systematically explored. X-ray diffraction patterns and Full-Prof software exhibited the forming of the BaTi2Fe4O11 hexagonal phase. TEM and SEM images demonstrated that the coating of BaTi0.7Fe0.3O3 has been successfully controlled with exquisite nano-oval NiFe2O4 shapes. The NFO shielding can significantly promote the thermal stability and the relative permittivity of BFT@NFO pero-magnetic nanocomposites and lowers the Curie temperature. Thermogravimetric and optical analysis were used to test the thermal stability and estimate the effective optical parameters. Magnetic studies showed a decrease in saturation magnetization of NiFe2O4 NPs compared to their bulk system, which is attributed to surface spin disorder. Herein, characterization and the sensitive electrochemical sensor were constructed for the evaluation of peroxide oxidation detection using the chemically adjusted nano-ovals barium titanate-iron@nickel ferrite nanocomposites. Finally, The BFT@NFO exhibited excellent electrochemical properties which can be ascribed to this compound possessing two electrochemical active components and/or the nano-ovals structure of the particles which can further improve the electrochemistry through the possible oxidation states and the synergistic effect. The result advocates that when the BTF is shielded with NFO nanoparticles the thermal, dielectric, and electrochemical properties of nano-oval BaTi0.7Fe0.3O3@NiFe2O4 nanocomposites can be synchronously developed. Thus, the production of ultrasensitive electrochemical nano-systems for the determination of hydrogen peroxide is of extensive significance.

Safety and efficacy of daridorexant in the treatment of insomnia: a systematic review and meta-analysis of randomized controlled trials.

Daridorexant is a novel dual orexin receptor antagonist used in treating insomnia disorder. Daridorexant improves sleep quality without impairing daytime functioning. We assess the safety and efficacy of this novel drug in the treatment of insomnia. We performed a systematic search for electronic databases in SCOPUS, PubMed, Web of Science and the Cochrane library. Seven randomized controlled trials were included in this review, with 2425 participants enrolled. Daridorexant was superior to placebo in reducing wake time after sleep onset (MD = -13.26; 95% CI, -15.48 to -11.03; P < 0.00001), latency to persistent sleep (MD = -7.23; 95% CI, -9.60 to -4.85; P < 0.00001), with increasing the total sleep time (MD = 14.80; 95% CI, 11.18-18.42; P < 0.00001) and subjective total sleep time (MD = 14.80; 95% CI, 11.18-18.42], P < 0.00001). The 25 mg and 50 mg were the most officious doses. Treatment with daridorexant has resulted in a slightly higher incidence of adverse events [risk ratio (RR) = 1.19; 95% CI, 1.05-1.35;, P = 0.005], specifically somnolence (RR = 1.19; 95% CI, 1.13-3.23; P = 0.005) and fatigue (RR = 2.01; 95% CI, 1.21-3.36; P = 0.007). Daridorexant is superior to placebo in improving sleep quality. However, the drug resulted in a slightly higher incidence of adverse events, including somnolence and fatigue.

Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: an updated systematic review and meta-analysis.

BACKGROUND: Liver abscesses differ in their aetiology, location, and number. Image-guided percutaneous drainage techniques are the currently used management for liver abscesses. We conducted our study to compare the clinical safety and efficacy of percutaneous needle aspiration (PNA) to percutaneous catheter drainage (PCD). METHODS: A systematic review of major reference databases was undertaken in February 2022 for randomized controlled trials (RCTs) that compare PNA to PCD in treating liver abscess patients. The quality of the included trials was assessed using the Cochrane tool. Statistical meta-analysis was conducted using RevMan and open meta-analyst software. RESULTS: Fifteen RCTs were included in this review, with 1676 patients enrolled. The overall quality of the included trials was moderate, with most domains of unclear risk. PCD was superior to PNA in the success rate (RR = 1.23; 95% CI [1.12, 1.36], P < 0.00001), time for achieving 50% reduction of cavity size (MD = -2.32; 95% CI [-3.07, -1.57], P < 0.00001), and time for clinical improvement (MD = -1.92; 95% CI [-2.55, -1.28], P < 0.00001). The two modalities did not differ in the days of hospital stay, duration of IV antibiotics, and time needed for total or subtotal reduction of cavity size (P = 0.36, P = 0.06 and P = 0.40, respectively). High heterogeneity levels were detected. Regarding major complications, the two modalities were equally safe (P = 0.39). CONCLUSION: PCD has a higher success rate and results in a faster 50% reduction in the abscess cavity size and clinical improvement. The two modalities are equally safe.

Misconceptions and associated factors of COVID-19 infection among internally displaced persons in Sudan.

Coronavirus disease 2019 (COVID-19) is a global public health threat that has spread rapidly and caused morbidity and mortality worldwide. Reducing the myths about infectious diseases is vital for controlling transmission. This study explored the level of misconceptions and associated factors of COVID-19 among internally displaced persons in Sudan. This study is a cross-sectional, descriptive design and community-based study. We collected the data using a self-administered questionnaire via the convenience sampling technique among internally displaced persons in the camps of Zalingei town in the central Darfur region of Sudan. The total mean score of the respondents' misconception was 3.1725 (SD=0.59) with 63.2%, indicating moderate misunderstanding of COVID- 19. Multiple linear regression revealed the independent variables together had a significant impact on a misconception, F(14,116)=2.429, p<0.005. The regression model explains 22.7% of the variance in misunderstanding. Analysis of the influence of single factors on the dependent variable showed that people aged 31-40 years had significantly higher levels of misconception, 0.381 (t=2.116, p<0.037), than those aged over 60 years, and university graduates had considerably lower levels of misunderstanding, -0.061 (t=-2.091, p<0.03) than non-graduates. This study found a moderate level of misconception of COVID-19. Non-graduates had higher levels of misunderstanding than graduates. The results suggest that an education campaign should focus on people with low levels of education to correct their misconceptions regarding the prevention of COVID-19 infection.