Boosting photocatalytic water splitting of TiO2 using metal (Ru, Co, or Ni) co-catalysts for hydrogen generation.

The photocatalytic activity of titanium dioxide (TiO2) nanoparticles toward hydrogen generation can be significantly improved via the loading of various metals e.g., Ru, Co, Ni as co-catalysts. The metal co-catalysts are loaded into TiO2 nanoparticles via different deposition methods; incipient wet impregnation (Imp), hydrothermal (HT), or photocatalytic deposition (PCD). Among all of the tested materials, 0.1 wt% Ru-TiO2 (Imp) provided the highest initial hydrogen catalytic rate of 23.9 mmol h-1 g-1, compared to 10.82 and 16.55 mmol h-1 g-1 for 0.3 wt% Ni-TiO2 (Imp) and 0.3 wt% Co-TiO2 (Imp), respectively. The loading procedures, co-catalyst metals type, and their loading play a significant role in elevating the photocatalytic activity of pristine TiO2 semiconductors toward hydrogen generation. Redox transition metals e.g., Co and Ni exhibit comparable photocatalytic performance to expensive elements such as Ru.

MAFLD identifies patients with significant hepatic fibrosis better than MASLD.

BACKGROUND AND AIMS: Diagnostic criteria for metabolic dysfunction-associated steatotic liver disease (MASLD) have been proposed but not yet validated. This study aimed to compare the diagnostic accuracy of the MASLD definition with the existing criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) in identifying patients with significant fibrosis. METHODS: The analysis included a total of 8317 individuals who had complete biochemical and liver ultrasonography data from the National Health and Nutrition Examination Survey (2017-2020). In this study, significant fibrosis (≥ F2) was determined by a median liver stiffness of ≥ 8.0 kPa. To identify independent factors associated with significant fibrosis, multivariable logistic regression analyses were applied. RESULTS: MAFLD (OR 3.44; 95% CI 2.88-4.12; P < 0.0001) has a trend for stronger and independent association with significant fibrosis compared to MASLD (OR 2.63; 95% CI 2.22-3.11; P < 0.0001). Non-MASLD MAFLD is independently associated with a 14.28-fold higher odds of significant fibrosis compared to non-MAFLD MASLD. The sensitivity for detecting significant fibrosis for MAFLD and MASLD was 76.23% vs 69.94%, respectively. The performance of MAFLD remains consistent in a sub-analysis of patients with no or mild alcohol intake. CONCLUSIONS: The definition of MAFLD provides a more precise identification of individuals who have both fatty liver and significant fibrosis, assessed by non-invasive tests.

A Machine Learning-Based Mortality Prediction Model for Patients with Chronic Hepatitis C Infection: An Exploratory Study.

Background: Chronic hepatitis C (HCV) infection presents global health challenges with significant morbidity and mortality implications. Successfully treating patients with cirrhosis may lead to mortality rates comparable to the general population. This study aims to utilize machine learning techniques to create predictive mortality models for individuals with chronic HCV infections. Methods: Data from chronic HCV patients at Sultan Qaboos University Hospital (2009-2017) underwent analysis. Data pre-processing handled missing values and scaled features using Python via Anaconda. Model training involved SelectKBest feature selection and algorithms such as logistic regression, random forest, gradient boosting, and SVM. The evaluation included diverse metrics, with 5-fold cross-validation, ensuring consistent performance assessment. Results: A cohort of 702 patients meeting the eligibility criteria, predominantly male, with a median age of 47, was analyzed across a follow-up period of 97.4 months. Survival probabilities at 12, 36, and 120 months were 90.0%, 84.0%, and 73.0%, respectively. Ten key features selected for mortality prediction included hemoglobin levels, alanine aminotransferase, comorbidities, HCV genotype, coinfections, follow-up duration, and treatment response. Machine learning models, including the logistic regression, random forest, gradient boosting, and support vector machine models, showed high discriminatory power, with logistic regression consistently achieving an AUC value of 0.929. Factors associated with increased mortality risk included cardiovascular diseases, coinfections, and failure to achieve a SVR, while lower ALT levels and specific HCV genotypes were linked to better survival outcomes. Conclusions: This study presents the use of machine learning models to predict mortality in chronic HCV patients, providing crucial insights for risk assessment and tailored treatments. Further validation and refinement of these models are essential to enhance their clinical utility, optimize patient care, and improve outcomes for individuals with chronic HCV infections.

Global Perspectives on the Hepatitis B Vaccination: Challenges, Achievements, and the Road to Elimination by 2030.

Annually, more than 1.5 million preventable new hepatitis B (HBV) infections continue to occur, with an estimated global burden of 296 million individuals living with chronic hepatitis B infection. This substantial health challenge results in over 820,000 annual deaths being attributed to complications such as liver cirrhosis and hepatocellular carcinoma (HCC). The HBV vaccination remains the cornerstone of public health policy to prevent chronic hepatitis B and its related complications. It serves as a crucial element in the global effort to eliminate HBV, as established by the World Health Organization (WHO), with an ambitious 90% vaccination target by 2030. However, reports on global birth dose coverage reveal substantial variability, with an overall coverage rate of only 46%. This comprehensive review thoroughly examines global trends in HBV vaccination coverage, investigating the profound impact of vaccination on HBV prevalence and its consequences across diverse populations, including both high-risk and general demographics. Additionally, the review addresses the essential formidable challenges and facilitating factors for achieving WHO's HBV vaccination coverage objectives and elimination strategies in the coming decade and beyond.

Elective Joint Replacement Among Medicaid Beneficiaries: Utilization and Postoperative Adverse Events by Racial and Ethnic Groups.

Hip and knee replacement have been marked by racial and ethnic disparities in both utilization and postoperative adverse events among Medicare beneficiaries, but limited knowledge exists regarding racial and ethnic differences in joint replacement care among Medicaid beneficiaries. To close this gap, this study used Medicaid claims in 2018 and described racial and ethnic differences in the utilization and postoperative adverse events of elective joint replacements among Medicaid beneficiaries. Among the 2,260,272 Medicaid beneficiaries, 5987 had an elective joint replacement in 2018. Asian (0.05%, 95% confidence interval [CI]: 0.03%-0.07%) and Hispanic beneficiaries (0.12%, 95% CI: 0.07%-0.18%) received joint replacements less frequently than American Indian and Alaska Native (0.41%, 95% CI: 0.27%-0.55%), Black (0.33%, 95% CI: 0.19%-0.48%), and White (0.37%, 95% CI: 0.25%-0.50%) beneficiaries. Black patients demonstrated the highest probability of 90-day emergency department visits (34.8%, 95% CI: 32.7%-37.0%) among all racial and ethnic groups and a higher probability of 90-day readmission (8.0%, 95% CI: 6.9%-9.0%) than Asian (3.4%, 95% CI: 0.7%-6.0%) and Hispanic patients (4.4%, 95% CI: 3.4%-5.3%). These findings indicate evident disparities in postoperative adverse events across racial and ethnic groups, with Black patients demonstrating the highest probability of 90-day emergency department visits. This study represents an initial exploration of the racial and ethnic differences in joint replacement care among Medicaid beneficiaries and lay the groundwork for further investigation into contributing factors of the observed disparities.

Quantification of Skeletal Muscle Perfusion in Peripheral Artery Disease Using 18F-Sodium Fluoride Positron Emission Tomography Imaging.

BACKGROUND: Perfusion deficits contribute to symptom severity, morbidity, and death in peripheral artery disease (PAD); however, no standard method for quantifying absolute measures of skeletal muscle perfusion exists. This study sought to preclinically test and clinically translate a positron emission tomography (PET) imaging approach using an atherosclerosis-targeted radionuclide, fluorine-18-sodium fluoride (18F-NaF), to quantify absolute perfusion in PAD. METHODS AND RESULTS: Eight Yorkshire pigs underwent unilateral femoral artery ligation and dynamic 18F-NaF PET/computed tomography imaging on the day of and 2 weeks after occlusion. Following 2-week imaging, calf muscles were harvested to quantify microvascular density. PET methodology was validated with microspheres in 4 additional pig studies and translated to patients with PAD (n=39) to quantify differences in calf perfusion across clinical symptoms/stages and perfusion responses in a case of revascularization. Associations between PET perfusion, ankle-brachial index, toe-brachial index, and toe pressure were assessed in relation to symptoms. 18F-NaF PET/computed tomography quantified significant deficits in calf perfusion in pigs following arterial occlusion and perfusion recovery 2 weeks after occlusion that coincided with increased muscle microvascular density. Additional studies confirmed that PET-derived perfusion measures agreed with microsphere-derived perfusion measures. Translation of imaging methods demonstrated significant decreases in calf perfusion with increasing severity of PAD and quantified perfusion responses to revascularization. Perfusion measures were also significantly associated with symptom severity, whereas traditional hemodynamic measures were not. CONCLUSIONS: 18F-NaF PET imaging quantifies perfusion deficits that correspond to clinical stages of PAD and represents a novel perfusion imaging strategy that could be partnered with atherosclerosis-targeted 18F-NaF PET imaging using a single radioisotope injection. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03622359.

Innovative Water-Wire Cannulation Technique for Managing Near-Complete Obstruction Due to Post-orthotopic Liver Transplant Anastomotic Strictures: A Report of Two Cases.

This report presents an innovative water-wire cannulation technique for managing challenging anastomotic strictures in post-orthotopic liver transplant patients, highlighting its successful application in two distinct cases. Anastomotic strictures pose a significant hurdle in hepatobiliary medicine, often complicating the course post-liver transplantation. Standard endoscopic retrograde cholangiopancreatography (ERCP) methods frequently encounter limitations in severe stricture cases, necessitating alternative approaches. The water-wire cannulation technique, introduced in this report, innovatively utilizes water injection to gently dilate the stricture, enabling successful guidewire insertion and subsequent standard endoscopic interventions. This method was effectively applied in two patients with severe anastomotic strictures, where conventional ERCP techniques were unsuccessful. The technique's effectiveness, demonstrated in these cases, offers a less invasive and potentially safer alternative to traditional options like cholangioscopy, percutaneous transhepatic cholangiography (PTC), or surgical revision, which carry higher risks and complexities. The water-wire cannulation technique's success emphasizes the need for innovative and adaptable strategies in hepatobiliary medicine, especially for managing post-transplant complications. Its potential applicability in a broader spectrum of biliary strictures warrants further exploration. Overall, this technique represents a significant advancement in the endoscopic management of complex biliary strictures, promising to enhance patient care and outcomes in hepatobiliary medicine.

Vascular Bundle for Exceptional Water Confinement, Transport, and Evaporation.

Nature, through billions of years of evolution, has constructed extremely efficient biosystems for transporting, confining, and vaporizing water. Mankind's ability to master water, however, is far from impeccable, and a sustainable supply of clean fresh water remains a global challenge. Here, we learn from Nature and prepare papyrus carbon (PC) from Egyptian papyrus paper as a sustainable solar desalination material. By taking advantage of the capillary pores from vascular bundles that are inherently built for transporting water in plants, PC achieves an evaporation rate of 4.1 kg m-2 h-1 in a passive single-stage device. Raman spectroscopy and thermal calorimetry show that the capillary pores pose a confinement effect to generate loosely hydrogen-bonded intermediate water, which substantially reduces the enthalpy of vaporization, allowing for exceptionally high energy efficiencies. The understanding is applicable to all nature-designed vascular plants and man-made separation and purification systems.

A bioluminescent and homogeneous assay for monitoring GPCR-mediated cAMP modulation and PDE activity.

3',5'-Cyclic adenosine monophosphate (cAMP), the first identified second messenger, is implicated in diverse cellular processes involving cellular metabolism, cell proliferation and differentiation, apoptosis, and gene expression. cAMP is synthesized by adenylyl cyclase (AC), which converts ATP to cAMP upon activation of Gαs-protein coupled receptors (GPCRs) in most cases and hydrolyzed by cyclic nucleotide phosphodiesterases (PDEs) to 5'-AMP. Dysregulation of cAMP signaling is implicated in a wide range of pathophysiological conditions such as cardiovascular diseases, neurodegenerative and behavioral disorders, cancers, diabetes, obesity, cataracts, and others. Therefore, cAMP targeted therapies have been and are still undergoing intense investigation for the treatment of these and other diseases. This highlights the need for developing assays to detect and monitor cAMP levels. In this study, we show cAMP Lumit assay as a highly specific homogeneous bioluminescent assay suitable for high throughput screenings with a large assay window and a wide dynamic range for cAMP detection. We believe that this assay will aid and simplify drug discovery screening efforts for cAMP signaling targeted therapies.

Advanced chemometric methods for simultaneous quantitation of caffeine, codeine, paracetamol, and p-aminophenol in their quaternary mixture.

Two different multivariate techniques have been applied for the quantitative analysis of caffeine, codeine, paracetamol and p-aminophenol (PAP) in quaternary mixture, namely, Partial Least Squares (PLS-1) and Artificial Neural Networks (ANN). For suitable analysis, a calibration set of 25 mixtures with various ratios of the drugs and PAP impurity were established using a 4-factor 5-level experimental design. The most meaningful wavelengths for the chemometric models were chosen using Genetic Algorithm (GA) as a variable selection technique. By using an independent validation set, the validity of the proposed methods was evaluated. A comparative study was established between the three multivariate models (PLS-1, GA-PLS and GA-ANN). The comparison between the various models revealed that the GA-ANN model was superior at resolving the highly overlapped spectra of this quaternary combination. The drugs were successfully quantified in their pharmaceutical dosage form utilizing the GA-ANN models.

Patient's satisfaction towards healthcare services and its associated factors at the highest patient loads government primary care clinic in Pahang.

INTRODUCTION: Patient satisfaction is widely used to monitor the quality of health care services. A significant patient load may influence health care services and patient satisfaction. Klinik Kesihatan Bandar Kuantan, Pahang (KKBK) has the highest patient loads in Pahang state, followed by Klinik Kesihatan Beserah and Klinik Kesihatan Kurnia. There are up to 700 attendees at KKBK per day, representing a population of 209679. KKBK had receives several complaints and patient unhappiness with its health care services, despite the administration's efforts to improve the clinics healthcare delivery. Thus, this study aimed to measure patients' satisfaction towards health care services at Pahang's highest patient loads primary care clinic. MATERIALS AND METHODS: A cross-sectional study was conducted at Klinik Kesihatan Bandar Kuantan, Kuantan, Pahang. Patients were selected using stratified random sampling, and 201 participants were selected. The selected participants were asked to fill up the self-administered validated questionnaires consisting of background characteristics and Patient Satisfaction Questionnaire 18 (PSQ-18). Data collection period was from March 2022 to August 2022. Descriptive analysis was used to describe the background characteristics of respondents and the score of patient satisfaction. Multiple linear regression was used to determine the factors associated with patient satisfaction while adjusting for cofounders. RESULTS: A total of 201 eligible data points were analysed in the study. The respondent mean age was 47.1 ± 16.9. Most respondents were Malay (68.7%), having secondary education (54.2%) and predominantly from the B40 income class (88.1%). The overall mean patient satisfaction score was 3.83 ± 0.31. There were significant associations between overall satisfaction with patient education level (B = -0.144; 95% CI -0.246, -0.042; p = 0.006), waiting time (B = -0.371; 95% CI -0.534, -0.209; p = 0.001) and consultation duration (B = -0.154; 95% CI -0.253, -0.055; p = 0.0020). It was found that patients with secondary education were less satisfied compared to patients with primary education level on health care services they received. Meanwhile, those who were not happy with the waiting time and consultation duration showed less satisfaction with overall healthcare services. CONCLUSION: Despite serving the most significant number of patients in Pahang state, most of the patient were satisfied by the health care services at Klinik Kesihatan Bandar Kuantan. However, it is recommended to improve the waiting time and the consultation time in this clinic.

Optimal controller design for reactor core power stabilization in a pressurized water reactor: Applications of gold rush algorithm.

Nuclear energy (NE) is seen as a reliable choice for ensuring the security of the world's energy supply, and it has only lately begun to be advocated as a strategy for reducing climate change in order to meet low-carbon energy transition goals. To achieve flexible operation across a wide operating range when it participates in peak regulation in the power systems, the pressurised water reactor (PWR) NE systems must overcome the nonlinearity problem induced by the substantial variation. In light of this viewpoint, the objective of this work is to evaluate the reactor core (main component) of the NE system via different recent optimization techniques. The PWR, which is the most common form, is the reactor under investigation. For controlling the movement of control rods that correspond with reactivity for power regulation the PWR, PID controller is employed. This study presents a dynamic model of the PWR, which includes the reactor core, the upper and lower plenums, and the piping that connects the reactor core to the steam alternator is analyzed and investigated. The PWR dynamic model is controlled by a PID controller optimized by the gold rush optimizer (GRO) built on the integration of the time-weighted square error performance indicator. Additionally, to exhibit the efficacy of the presented GRO, the dragonfly approach, Arithmetic algorithm, and planet optimization algorithm are used to adjust the PID controller parameters. Furthermore, a comparison among the optimized PID gains with the applied algorithms shows great accuracy, efficacy, and effectiveness of the proposed GRO. MATLAB\ Simulink program is used to model and simulate the system components and the applied algorithms. The simulation findings demonstrate that the suggested optimized PID control strategy has superior efficiency and resilience in terms of less overshoot and settling time.

Predictors of survival among patients with chronic hepatitis C at a tertiary care center in Oman.

BACKGROUND: Chronic hepatitis C (CHC) is a leading cause of cirrhosis and hepatocellular carcinoma (HCC) worldwide. This study aimed to determine rates and predictors of survival among Omani patients with CHC at a tertiary hospital in Muscat, Oman. METHODS: This ambidirectional cohort study included all CHC patients who presented to the Sultan Qaboos University Hospital between January 2009 and December 2017. Baseline demographic, clinical, laboratory, and radiological data were analyzed. Patients were followed-up until death or the endpoint of the study (April 2022) to determine survival and associations with other parameters. RESULTS: A total of 702 CHC patients were included, of which 398 (56.7%) were under 50 years of age and 477 (67.9%) were male. Overall, 180 patients (25.6%) died by the study endpoint. The mean duration of follow-up was 93.3 ± 48.0 months. The 5-year survival rate was estimated to be 80.5%, while the 10-year survival was 73%. Sustained virological response and the absence of diabetes mellitus, chronic kidney disease, HCC, or other malignancies were associated with significantly better overall survival. The 3- and 5-year survival rate of patients with hepatitis C virus (HCV)-related HCC was 46.5% and 27.6%, respectively, with a median survival of 29.5 months. Co-infection with hepatitis B was associated with poor survival among this subgroup; conversely, early HCV screening and the presence of a single HCC lesion were associated with better overall survival. CONCLUSIONS: National policies for early CHC screening and rapid treatment are needed to improve survival rates in this population.

Monitoring phosphorylation and acetylation of CRISPR-mediated HiBiT-tagged endogenous proteins.

Intracellular pathways transduce signals through changes in post-translational modifications (PTMs) of effector proteins. Among the approaches used to monitor PTM changes are immunoassays and overexpression of recombinant reporter genes. Genome editing by CRISPR/Cas9 provides a new means to monitor PTM changes by inserting reporters onto target endogenous genes while preserving native biology. Ideally, the reporter should be small in order not to interfere with the processes mediated by the target while sensitive enough to detect tightly expressed proteins. HiBiT is a 1.3 kDa reporter peptide capable of generating bioluminescence through complementation with LgBiT, an 18 kDa subunit derived from NanoLuc. Using HiBiT CRISPR/Cas9-modified cell lines in combination with fluorescent antibodies, we developed a HiBiT-BRET immunoassay (a.k.a. Immuno-BRET). This is a homogeneous immunoassay capable of monitoring post-translational modifications on diverse protein targets. Its usefulness was demonstrated for the detection of phosphorylation of multiple signaling pathway targets (EGFR, STAT3, MAPK8 and c-MET), as well as chromatin containing histone H3 acetylation on lysine 9 and 27. These results demonstrate the ability to efficiently monitor endogenous biological processes modulated by post-translational modifications using a small bioluminescent peptide tag and fluorescent antibodies, providing sensitive quantitation of the response dynamics to multiple stimuli.

A Homogeneous Bioluminescent System to Monitor Cyclic Guanosine Monophosphate.

Cyclic guanosine monophosphate (cGMP) is a critical second messenger involved in various physiological processes, such as vasodilation and phototransduction. Its synthesis is stimulated by nitric oxide and natriuretic hormones, while its breakdown is mediated through highly regulated phosphodiesterase activities. cGMP metabolism has been targeted for the treatment of several diseases, including erectile dysfunction, hypertension, and heart failure. As more drugs are being sought, it will be critical to develop assays that accurately determine cGMP levels. Here, we present cGMP Lumit, a sensitive and specific bioluminescent assay to detect cGMP. We demonstrate the utility of the detection system in enzyme assays, cell-based assays, and high-throughput screening formats. It is anticipated that this assay will be of significant value to aid in further understanding the role of cGMP in physiology and support further drug discovery efforts toward the treatment of human disease.

Softening of a flat phonon mode in the kagome ScV6Sn6.

Geometrically frustrated kagome lattices are raising as novel platforms to engineer correlated topological electron flat bands that are prominent to electronic instabilities. Here, we demonstrate a phonon softening at the kz = π plane in ScV6Sn6. The low energy longitudinal phonon collapses at ~98 K and q = [Formula: see text] due to the electron-phonon interaction, without the emergence of long-range charge order which sets in at a different propagation vector qCDW = [Formula: see text]. Theoretical calculations corroborate the experimental finding to indicate that the leading instability is located at [Formula: see text] of a rather flat mode. We relate the phonon renormalization to the orbital-resolved susceptibility of the trigonal Sn atoms and explain the approximately flat phonon dispersion. Our data report the first example of the collapse of a kagome bosonic mode and promote the 166 compounds of kagomes as primary candidates to explore correlated flat phonon-topological flat electron physics.

Gender as a moderating variable in online misinformation acceptance during COVID-19.

Misinformation remained a critical consideration during the COVID-19 that further cultivated fears leading to strong unrest among the public globally. This study clarifies certain misconceptions related to the pandemic by investigating whether factors such as altruism, entertainment, information-sharing, information-seeking, comprehensibility have impact on COVID-19 misinformation acceptance and sharing it in the UAE culture, with gender as a moderating factor. An online survey (google.com) was used, with a sample of 200 university students, and analyzed using PLS-SEM software to determine the effects of constructed factors. The findings indicated that entertainment, information-sharing, and information-seeking factors have impact on sharing COVID-19 misinformation, while comprehensibility has impact on acceptance of misinformation. Interestingly, gender was found to have no impact on all the constructed factors, suggesting that other moderating factors (e.g., age) need to be considered in future research. Generally, online users need to learn how to verify online information that they receive/share on other social media, especially regarding health concern.

Continuous wavelet transform for solving the problem of minor components in quantitation of pharmaceuticals: a case study on the mixture of ibuprofen and phenylephrine with its degradation products.

The presence of minor components represents a challenging problem in spectrophotometric analysis of pharmaceuticals. If one component has a low absorptivity or present in a low concentration compared to the other components, this will hinder its quantitation by spectrophotometric methods. Continuous Wavelet Transform (CWT) as a signal processing technique was utilized to figure out a solution to such a problem. A comparative study was established between traditional derivative spectrophotometry (Numerical Differentiation, ND) and CWT to indicate the advantages and limitations of each technique and possibility of solving the problem of minor components. A mixture of ibuprofen (IBU) and phenylephrine (PHE) with its degradation products forming a ternary mixture was used for comparing the two techniques. The two techniques were applied on raw spectral data and on ratio spectra data resulting in four methods, namely ND, CWT, Derivative Ratio-Zero Crossing (DRZC) and Continuous Wavelet Transform Ratio-Zero Crossing (CWTR-ZC) methods. By comparing the results in laboratory prepared mixtures, CWT technique showed advantages in analysis of mixtures with minor components than ND. The proposed methods were validated according to the ICH guideline Q2(R1), where their linearity was established with correlation coefficient ranging from 0.9995 to 0.9999. The linearity was in the range 3-40 µg/mL for PHE in all methods, while for IBU it was 20-180 and 30-180 µg/mL in CWT and ND methods, respectively. The CWT methods were applied for quantitative determination of the drugs in their dosage form showing the ability of the methods to quantitate minor components in pharmaceutical formulations.