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1.
BMC Med Educ ; 24(1): 708, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951776

RESUMO

BACKGROUND: Faculty development programs are crucial for promoting continuous learning, enhancing teaching effectiveness, and encouraging professional growth among medical educators. Problem-based learning was introduced as a teaching strategy in our Faculty of Medicine in 2007. Thereafter, several rounds of a faculty development program were conducted to help teachers recognize their role as facilitators and assess areas for improvement. METHODS: We conducted a mixed-methods study with a sample of 284 third-year medical students answering a questionnaire and 21 faculty members participating in focus groups. A validated 13-item questionnaire was used to investigate the students' evaluation of their tutors' performance in problem-based learning. Three sessions were then conducted with faculty members involved in problem-based learning to gain in-depth insights into their experiences and perspectives. RESULTS: The mean performance ranking for tutors awarded by the students was above halfway. There was a significant positive correlation between tutors' performance ranking and all five of the learning approaches examined herein: constructive/active learning, self-directed learning, contextual learning, collaborative learning, and intra-personal behavior (p < 0.05). The data from the focus groups were analyzed under five broad themes: tutors' insights into their strengths and weaknesses, challenges in conducting problem-based learning, tutors' ways of preparing for problem-based learning, feedback, and suggestions for improving problem-based learning workshops. CONCLUSIONS: This study recommends improvements and future directions for advanced program evaluation. Faculty development programs can be tailored to effectively address students and faculty members' goals and needs, which can benefit the teaching and learning process and foster a culture of continuous improvement and professional growth.


Assuntos
Docentes de Medicina , Grupos Focais , Aprendizagem Baseada em Problemas , Desenvolvimento de Pessoal , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Arábia Saudita , Inquéritos e Questionários , Avaliação de Programas e Projetos de Saúde , Educação de Graduação em Medicina , Feminino , Masculino
2.
Cureus ; 16(6): e61527, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38957260

RESUMO

Delirium is a significant public health concern, with tremendous implications for patient outcomes. Intensive care unit (ICU)-related delirium is gaining attention due to the higher prevalence of delirium in ICU-admitted patients. The most common negative outcomes of ICU delirium include cognitive impairments, functional dependence, high incidence of mortality, extended stay in the ICU, and high costs. So far, no single etiological factor has been identified as the sole cause of delirium. Several functional, neurotransmitter, or injury-causing hypotheses have been proposed for ICU delirium. Several risk factors contribute to the development of delirium in patients admitted to the ICU. These are age, gender, types of sedation, physical restraints, medical and surgical interventions, pain, and extended stay in the ICU. The most commonly used assessment modules for ICU delirium are the PREdiction of DELIRium in ICu patients (PRE-DELIRIC), Early PREdiction model for DELIRium in ICu patients (E-PRE-DELERIC), and Lanzhou Model, Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Intensive Care Delirium Screening Checklist (ICDSC), and Delirium Rating Scale (DRS). There is no proper treatment for ICU delirium; however, it can be managed through various pharmacological and non-pharmacological interventions. Healthcare providers should receive constant education and training on delirium recognition, prevention, and management to enhance patient care and outcomes in the ICU. Further research is needed on the effective prevention and management of ICU delirium.

3.
J Food Sci Technol ; 61(8): 1457-1469, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38966791

RESUMO

Nutrient-dense colostrum can be employed as a functional food ingredient. This work aimed to produce novel functional probiotic Cream cottage cheese (FPC) using probiotic (ABT) culture and bovine colostrum powder (BCP) at levels of 1, 2, and 3%. Physicochemical and functional properties (antioxidant activity, fatty acid profile, and antibacterial activity) were analyzed. The outcome revealed that hardness, cohesiveness, and gumminess were increased while springiness and chewiness were decreased for the treated cheeses. In FPC, medium-chain fatty acids were the predominant forms, followed by short- and long-chain fatty acids, polyunsaturated (PUFA), and small amounts of monounsaturated (MUFA). The antioxidant activity of all the cheese samples was significantly (P < 0.05) increased by increasing the quantity of colostrum powder and lengthening storage time. Color parameters were influenced by enrichment with BCP, whether in fresh or stored samples. With the addition of BCP, the growth of lactic acid bacteria and Bifidobacteria was enhanced, whereas that of pathogenic bacteria, mold and yeast, and coliform groups was inhibited. Cheeses fortified with 2% BCP had significantly higher score values than those in the other treatments. Therefore, it could be concluded that cottage cheese fortified with 2% BCP has high nutritional value and health benefits. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05910-0.

4.
Sci Rep ; 14(1): 15234, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956408

RESUMO

This paper presents simple numerical solutions for electromagnetic plane waves in spatially homogenous time varying medium. The solution is based on converting the resulting second order differential equation into two combined ordinary differential equations which are solved numerically by using the built-in ode113 function in Matlab. By using this method, the time domain responses of the electric and magnetic fields at fixed point in space are obtained. The proposed method is applied on two cases: linearly time varying medium and sinusoidally time varying medium. The corresponding frequency domain response is obtained by using inverse Fourier transformation of the obtained time domain response. The proposed method is compared with FDTD solution. It is found that the proposed method has the same accuracy of FDTD with much less computational time.

5.
Georgian Med News ; (349): 68-71, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38963204

RESUMO

Hyperuricemia is an objective risk factor of derangement of fasting serum glucose and type 2 diabetes (T2D), yet whether hyperuricemia has a causative influence on insulin resistance is still debatable. In this study, we tested the hypothesis that lowering uric acid in hyperuricemic nondiabetic subjects might improve insulin resistance. Patients with renal stone and hyperuricemia (n=15) were recruited from the private clinic of Ib-Sina Local Teaching Hospital in Mosul city and prospectively placed on allopurinol (300mg/day) for 6 months. Serum uric acid (SUA), fasting serum glucose (FSG), fasting insulin, and C-peptide were measured using commercial kits. Results confirmed that allopurinol has significantly (P<0.05) reduced c-peptide and insulin together with a non-significant (p>0.05) reduction of serum glucose levels. In conclusion, allopurinol has improved insulin level and glycemic control in a healthy individual, these findings could be used as a template for using allopurinol in diabetic patients to improve glycemic control or future studies could be directed toward structural modification of allopurinol which hopefully might lead to innovation of new antidiabetic drugs.


Assuntos
Alopurinol , Glicemia , Hiperuricemia , Resistência à Insulina , Insulina , Cálculos Renais , Ácido Úrico , Humanos , Alopurinol/uso terapêutico , Cálculos Renais/tratamento farmacológico , Ácido Úrico/sangue , Insulina/sangue , Masculino , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Pessoa de Meia-Idade , Hiperuricemia/tratamento farmacológico , Hiperuricemia/sangue , Hiperuricemia/complicações , Feminino , Adulto , Peptídeo C/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/sangue
6.
Sci Rep ; 14(1): 15463, 2024 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-38965254

RESUMO

Hepatitis C virus (HCV) is a major global health concern, affecting millions of individuals worldwide. While existing literature predominantly focuses on disease classification using clinical data, there exists a critical research gap concerning HCV genotyping based on genomic sequences. Accurate HCV genotyping is essential for patient management and treatment decisions. While the neural models excel at capturing complex patterns, they still face challenges, such as data scarcity, that exist a lot in computational genomics. To overcome this challenges, this paper introduces an advanced deep learning approach for HCV genotyping based on the graphical representation of nucleotide sequences that outperforms classical approaches. Notably, it is effective for both partial and complete HCV genomes and addresses challenges associated with imbalanced datasets. In this work, ten HCV genotypes: 1a, 1b, 2a, 2b, 2c, 3a, 3b, 4, 5, and 6 were used in the analysis. This study utilizes Chaos Game Representation for 2D mapping of genomic sequences, employing self-supervised learning using convolutional autoencoder for deep feature extraction, resulting in an outstanding performance for HCV genotyping compared to various machine learning and deep learning models. This baseline provides a benchmark against which the performance of the proposed approach and other models can be evaluated. The experimental results showcase a remarkable classification accuracy of over 99%, outperforming traditional deep learning models. This performance demonstrates the capability of the proposed model to accurately identify HCV genotypes in both partial and complete sequences and in dealing with data scarcity for certain genotypes. The results of the proposed model are compared to NCBI genotyping tool.


Assuntos
Genoma Viral , Genótipo , Técnicas de Genotipagem , Hepacivirus , Hepatite C , Hepacivirus/genética , Hepacivirus/classificação , Humanos , Técnicas de Genotipagem/métodos , Hepatite C/virologia , Aprendizado de Máquina Supervisionado , Aprendizado Profundo , Biologia Computacional/métodos
7.
Sci Rep ; 14(1): 15380, 2024 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-38965268

RESUMO

Concerns about challenges with water availability in the Tadla Plain region of Morocco have grown as a result of groundwater contamination brought on by human activity, climate change, and insufficient groundwater management. The objective of the study is to measure the number of resistant bacteria in the groundwater of Beni Moussa and Beni Aamir, as well as to evaluate the level of water pollution in this area. 200 samples were therefore gathered from 43 wells over the course of four seasonal campaigns in 2017 and 2018. Additionally, the samples were examined to determine whether Salmonella species were present and if they were resistant to the 16 antibiotics that were tested. Salmonella spp. have been identified in 31 isolated strains in total, accounting for 18.02% of all isolated strains. Data on antibiotic resistance show that 58.1% of Salmonella spp. strains are multidrug-resistant (MDR); 38.7% of Salmonella strains are tolerant to at least six antibiotics, 19.4% to at least nine antibiotics, 9.7% to four to seven antibiotics, 6.5% to at least eleven antibiotics, and the remaining 3.2% to up to twelve antibiotics. A considerable level of resistance to cefepime (61.29%), imipenem (54.84%), ceftazidime (45.16%), ofloxacin (70.97%), and ertapenem (74.19%) was found in the data. Consequently, it is important to monitor and regulate the growth of MDR in order to prevent the groundwater's quality from declining.


Assuntos
Antibacterianos , Água Subterrânea , Salmonella , Marrocos , Salmonella/efeitos dos fármacos , Salmonella/isolamento & purificação , Antibacterianos/farmacologia , Água Subterrânea/microbiologia , Humanos , Microbiologia da Água , Testes de Sensibilidade Microbiana , Incidência , Poços de Água , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla
8.
Surg Endosc ; 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951238

RESUMO

BACKGROUND: Adrenalectomy for pheochromocytoma (PHEO) is challenging because of the high risk of intraoperative hemodynamic instability (HDI). This study aimed to compare the incidence and risk factors of intraoperative HDI between laparoscopic left adrenalectomy (LLA) and laparoscopic right adrenalectomy (LRA). METHODS: We retrospectively analyzed two hundred and seventy-one patients aged > 18 years with unilateral benign PHEO of any size who underwent transperitoneal laparoscopic adrenalectomy at our hospitals between September 2016 and September 2023. Patients were divided into LRA (N = 122) and LLA (N = 149) groups. Univariate and multivariate logistic regression analyses were used to predict intraoperative HDI. In multivariate analysis for the prediction of HDI, right-sided PHEO, PHEO size, preoperative comorbidities, and preoperative systolic blood pressure were included. RESULTS: Intraoperative HDI was significantly higher in the LRA group than in the LLA (27% vs. 9.4%, p < 0.001). In the multivariate regression analysis, right-sided tumours showed a higher risk of intraoperative HDI (odds ratio [OR] 5.625, 95% confidence interval [CI], 1.147-27.577, p = 0.033). The tumor size (OR 11.019, 95% CI 3.996-30.38, p < 0.001), presence of preoperative comorbidities [diabetes mellitus, hypertension, and coronary heart disease] (OR 7.918, 95% CI 1.323-47.412, p = 0.023), and preoperative systolic blood pressure (OR 1.265, 95% CI 1.07-1.495, p = 0.006) were associated with a higher risk of HDI in both LRA and LLA, with no superiority of one side over the other. CONCLUSION: LRA was associated with a significantly higher intraoperative HDI than LLA. Right-sided PHEO was a risk factor for intraoperative HDI.

9.
Drug Dev Res ; 85(5): e22228, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38952003

RESUMO

Chromone-based compounds have established cytotoxic, antiproliferative, antimetastatic, and antiangiogenic effects on various cancer cell types via modulating different molecular targets. Herein, 17 novel chromone-2-carboxamide derivatives were synthesized and evaluated for their in vitro anticancer activity against 15 human cancer cell lines. Among the tested cell lines, MDA-MB-231, the triple-negative breast cancer cell line, was found to be the most sensitive, where the N-(2-furylmethylene) (15) and the α-methylated N-benzyl (17) derivatives demonstrated the highest growth inhibition with GI50 values of 14.8 and 17.1 µM, respectively. In vitro mechanistic studies confirmed the significant roles of compounds 15 and 17 in the induction of apoptosis and suppression of EGFR, FGFR3, and VEGF protein levels in MDA-MB-231 cancer cells. Moreover, compound 15 exerted cell cycle arrest at both the G0-G1 and G2-M phases. The in vivo efficacy of compound 15 as an antitumor agent was further investigated in female mice bearing Solid Ehrlich Carcinoma. Notably, administration of compound 15 resulted in a marked decrease in both tumor weight and volume, accompanied by improvements in biochemical, hematological, histological, and immunohistochemical parameters that verified the repression of both angiogenesis and inflammation as additional Anticancer mechanisms. Moreover, the binding interactions of compounds 15 and 17 within the binding sites of all three target receptors (EGFR, FGFR3, and VEGF) were clearly illustrated using molecular docking.


Assuntos
Antineoplásicos , Cromonas , Receptores ErbB , Simulação de Acoplamento Molecular , Receptor Tipo 3 de Fator de Crescimento de Fibroblastos , Neoplasias de Mama Triplo Negativas , Fator A de Crescimento do Endotélio Vascular , Humanos , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/metabolismo , Feminino , Animais , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/metabolismo , Neoplasias de Mama Triplo Negativas/patologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Linhagem Celular Tumoral , Antineoplásicos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Receptor Tipo 3 de Fator de Crescimento de Fibroblastos/antagonistas & inibidores , Receptor Tipo 3 de Fator de Crescimento de Fibroblastos/metabolismo , Camundongos , Cromonas/farmacologia , Cromonas/síntese química , Cromonas/química , Cromonas/uso terapêutico , Desenho de Fármacos , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos
10.
RSC Adv ; 14(29): 20454-20465, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38946771

RESUMO

Copper-Vit B3 MOF was successfully prepared by efficient and eco hydrothermal method. The prepared MOF was characterized as a tetragonal crystal copper-MOF nanoparticles by FTIR, SEM, TEM, EDX and XRD. The prepared nanoparticles were used as an effective, inexpensive and low-toxic catalyst in the one-pot synthesis of some new benzoxanthenone derivatives. As example 4-(9,9-dimethyl-11-oxo-8,10,11,12-tetrahydro-9H-benzo[a]xanthen-12-yl)phenyl benzoate (4h) was synthesized in high yield 92%. The MOF catalyst's role is activating the nucleophilic attack by increasing the carbonyl polarization, and this generally improves the reaction time, which ranges between 20-60 minutes and products' yields ranging between 80-92%. Prepared compounds (4a-4j) undergo molecular docking scanning as Helicobacter pylori type II dehydroquinase inhibitors, and the data obtained showed that there are three promises of the prepared compounds 4d, 4e, 4h and 4j compared with amoxicillin.

11.
Cureus ; 16(6): e61656, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38966448

RESUMO

One of the most widespread enzymopathies affecting human beings is glucose-6-phosphate dehydrogenase (G6PD) deficiency, which is brought on by inherited mutations in the X-linked gene. Red blood cells (RBCs) with a G6PD deficiency are more sensitive to oxidative assault and consequently to hemolysis. There are more than 200 known G6PD mutations, of which around half are polymorphic and thus prevalent in a variety of populations. We present a case of diabetic ketoacidosis (DKA), with severe hemolytic anemia and methemoglobinemia. The patient was admitted to the intensive care unit, treated for DKA, and received a blood transfusion. In addition, the patient presented with high methemoglobin levels and features of severe hemolytic anemia from the onset, which made the diagnostic consideration of G6PD highly likely. Accordingly, the patient was treated with several doses of ascorbic acid instead of methylene blue. In a nutshell, a patient with DKA who has hemolytic anemia has to have it properly evaluated and controlled. The link between methemoglobinemia, G6PD deficiency, and DKA should be recognized by medical professionals, particularly when oxygen saturation gaps are found.

12.
Cell Commun Signal ; 22(1): 349, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38965547

RESUMO

T lymphocytes play a primary role in the adaptive antiviral immunity. Both lymphocytosis and lymphopenia were found to be associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While lymphocytosis indicates an active anti-viral response, lymphopenia is a sign of poor prognosis. T-cells, in essence, rarely express ACE2 receptors, making the cause of cell depletion enigmatic. Moreover, emerging strains posed an immunological challenge, potentially alarming for the next pandemic. Herein, we review how possible indirect and direct key mechanisms could contribute to SARS-CoV-2-associated-lymphopenia. The fundamental mechanism is the inflammatory cytokine storm elicited by viral infection, which alters the host cell metabolism into a more acidic state. This "hyperlactic acidemia" together with the cytokine storm suppresses T-cell proliferation and triggers intrinsic/extrinsic apoptosis. SARS-CoV-2 infection also results in a shift from steady-state hematopoiesis to stress hematopoiesis. Even with low ACE2 expression, the presence of cholesterol-rich lipid rafts on activated T-cells may enhance viral entry and syncytia formation. Finally, direct viral infection of lymphocytes may indicate the participation of other receptors or auxiliary proteins on T-cells, that can work alone or in concert with other mechanisms. Therefore, we address the role of CD147-a novel route-for SARS-CoV-2 and its new variants. CD147 is not only expressed on T-cells, but it also interacts with other co-partners to orchestrate various biological processes. Given these features, CD147 is an appealing candidate for viral pathogenicity. Understanding the molecular and cellular mechanisms behind SARS-CoV-2-associated-lymphopenia will aid in the discovery of potential therapeutic targets to improve the resilience of our immune system against this rapidly evolving virus.


Assuntos
Basigina , COVID-19 , Linfopenia , SARS-CoV-2 , Humanos , Linfopenia/imunologia , Linfopenia/virologia , COVID-19/imunologia , COVID-19/virologia , COVID-19/patologia , SARS-CoV-2/metabolismo , Basigina/metabolismo , Enzima de Conversão de Angiotensina 2/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismo , Linfócitos T/virologia , Síndrome da Liberação de Citocina/imunologia , Animais
13.
Sci Rep ; 14(1): 15538, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38969729

RESUMO

Drug delivery is the process or method of delivering a pharmacological product to have therapeutic effects on humans or animals. The use of nanoparticles to deliver medications to cells is driving the present surge in interest in improving human health. Green nanodrug delivery methods are based on chemical processes that are acceptable for the environment or that use natural biomaterials such as plant extracts and microorganisms. In this study, zinc oxide-superparamagnetic iron oxide-silver nanocomposite was synthesized via green synthesis method using Fusarium oxysporum fungi mycelia then loaded with sorafenib drug. The synthesized nanocomposites were characterized by UV-visibile spectroscopy, FTIR, TEM and SEM techniques. Sorafenib is a cancer treatment and is also known by its brand name, Nexavar. Sorafenib is the only systemic medication available in the world to treat hepatocellular carcinoma. Sorafenib, like many other chemotherapeutics, has side effects that restrict its effectiveness, including toxicity, nausea, mucositis, hypertension, alopecia, and hand-foot skin reaction. In our study, 40 male albino rats were given a single dose of diethyl nitrosamine (DEN) 60 mg/kg b.wt., followed by carbon tetrachloride 2 ml/kg b.wt. twice a week for one month. The aim of our study is using the zinc oxide-superparamagnetic iron oxide-silver nanocomposite that was synthesized by Fusarium oxysporum fungi mycelia as nanocarrier for enhancement the sorafenib anticancer effect.


Assuntos
Antineoplásicos , Carcinoma Hepatocelular , Neoplasias Hepáticas , Prata , Sorafenibe , Óxido de Zinco , Animais , Sorafenibe/farmacologia , Sorafenibe/química , Sorafenibe/administração & dosagem , Óxido de Zinco/química , Óxido de Zinco/farmacologia , Prata/química , Ratos , Antineoplásicos/farmacologia , Antineoplásicos/química , Antineoplásicos/administração & dosagem , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Masculino , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Portadores de Fármacos/química , Fusarium/efeitos dos fármacos , Nanopartículas de Magnetita/química , Nanocompostos/química , Humanos , Nanopartículas Magnéticas de Óxido de Ferro/química
14.
Reprod Domest Anim ; 59(7): e14665, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38973694

RESUMO

This study aims to conduct a comparative analysis of the uterotubal junction in two distinct mammalian species, the bovine (Bos taurus) and the dromedary camel (Camelus dromedarius), focusing on histological and histomorphometric parameters. Uterotubal junction (UTJ) was dissected from 8 cows and 12 camels with dominant follicles, and processed for H&E staining for histology, and histomorphometry examination. The results showed that the camel uterotubal junction papillae (UTJP) existed only in camels and was completely absent in cattle. Histologically, the cow UTJ appears with a star-shaped lumen, and the mucosa is lined by a simple columnar epithelium with ciliated and non-ciliated cells. Superficial (SG) and deep glands (DG) were abundant in the submucosa. Camel UTJP is a conical structure, it has a pale yellowish colour, 0.5 ± 0.2 cm height, and 0.3 ± 0.1 cm width, and it has a distinct sphincter at the tip towards the uterine lumen. In the camel UTJP, the lumen is wider, and the mucosa showed large multiple folds lined with ciliated and non-ciliated cells in a pseudostratified columnar epithelium. The submucosa showed no mucosal glands. Lumen area, lumen epithelial height, luminal epithelial density, the thickness of the muscular layer, number of folds, fold height, epithelial height, fold area and epithelial perimeter were higher in camel UTJP (p < .001) than cow UTJ, while the total endosalpinx area and glandular epithelial density were lower in camel UTJP (p < .001) than in cow UTJ. In conclusion, this study elucidates potential variations in the uterotubal junction between bovines and dromedary camels, providing valuable insights into their reproductive adaptations. The epithelial lining, absence of glands and the thick layer of tunica muscularis might indicate that camel UTJP could play a mechanical role in selecting spermatozoa and assisting the hatching of blastocysts during their passage into the uterus.


Assuntos
Camelus , Útero , Animais , Camelus/anatomia & histologia , Feminino , Bovinos/anatomia & histologia , Útero/anatomia & histologia , Tubas Uterinas/anatomia & histologia
16.
Cardiovasc Diagn Ther ; 14(3): 340-351, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38975005

RESUMO

Background: Preoperative intra-aortic balloon pump (IABP) before coronary artery bypass grafting (CABG) could improve operative outcomes by augmenting the diastolic coronary blood flow. Data on preoperative IABP use in patients with left-main coronary artery (LMCA) disease are limited. This study aimed to characterize patients who received preoperative IABP before CABG for LMCA and evaluate its effect on postoperative outcomes. Methods: This multicenter retrospective cohort study that included consecutive 914 patients who underwent CABG for unprotected LMCA disease from January 2015 to December 2019 in 14 tertiary referral centers. Patients were grouped according to the preoperative IABP insertion into patients with IABP (n=101) and without IABP (n=813). Propensity score matching adjusting for preoperative variables, with 1:1 match and a caliber of 0.03 identified 80 matched pairs. The primary outcomes used in propensity score matching were cardiac mortality and major adverse cardiac and cerebrovascular events (MACCE). Results: IABP was commonly inserted in patients with previous myocardial infarction (MI), chronic kidney disease, peripheral arterial disease, and congestive heart failure. IABP patients had higher EuroSCORE [ES >8%: 95 (11.86%) vs. 40 (39.60%), P<0.001] and SYNTAX {29 [interquartile range (IQR) 25-35] vs. 33 (IQR 26-36); P=0.02} scores. Preoperative cardiogenic shock and arrhythmia were more prevalent in patients with IABP, while acute coronary syndrome was more prevalent in patients without IABP. After matching, there was no difference in vasoactive inotropic score between groups [3.5 (IQR 1-7.5) vs. 6 (IQR 1-13.5), P=0.06], and lactate levels were nonsignificantly higher in patients with IABP [2.4 (IQR 1.4-4.5) vs. 3.1 (IQR 1.05-7.75), P=0.05]. There were no differences between groups in acute kidney injury [20 (25%) vs. 26 (32.5%), P=0.34], cerebrovascular accidents [3 (3.75%) vs. 4 (5%), P>0.99], heart failure [5 (6.25%) vs. 7 (8.75%), P=0.75], MI [7 (8.75%) vs. 8 (10%), P>0.99], major adverse cardiac and cerebrovascular events [10 (12.5%) vs. 17 (21.25%), P=0.21], and cardiac mortality [6 (7.50%) vs. 14 (17.50%), P=0.09]. Patients who received IABP had longer ventilation times [8.5 (IQR 6-23) vs. 15.5 (IQR 5-50.5) h, P=0.03] and intensive care unit (ICU) stays [3 (IQR 2-5) vs. 4 (IQR 2-7.5) days, P=0.01]. Conclusions: Preoperative IABP in patients with LMCA might not be associated with reduced cardiac mortality or hospital complications. IABP could increase the duration of mechanical ventilation and ICU stay, and its use should be individualized for each patient.

17.
Artigo em Inglês | MEDLINE | ID: mdl-38977470

RESUMO

PURPOSE: Playing wind instruments is a strenuous task on the larynx, predisposing players to voice disorders. This study aims to evaluate potential vocal symptoms and vocal tract alterations in professional wind instrumentalists. METHODS: In this cross-sectional study, 26 male military subjects were interviewed, completed the voice handicap index (VHI) -10 questionnaire, and subjected to auditory-perceptual assessment, neck examination, rigid laryngostroboscopy and flexible nasofiberoscopy both before and during instrument playing. RESULTS: All participants had vocal fatigue symptoms, around one-quarter complained of voice change, one-quarter complained of shortness of breath while or after performing, and one-third complained of neck symptoms. The average score of VHI-10 was 16.2 ± 6.5, and approximately three-quarters of participants scored above the cut-off point. There were no significant correlations between age, years of instrument playing, average hours of daily practice, and VHI-10. Participants with neck symptoms had significantly higher VHI-10 scores. Those (around one-fifth) with an external neck swelling during Valsalva maneuver had a significantly higher VHI-10 score. Dysphonia, mainly mild and of strained, leaky quality, was detected in almost one-third of participants. While the instrument was being played, the vocal folds were somewhat adducted, and the vocal tract became more compressed as the task became more demanding. The most frequent observations in the vocal tract examination were hyperemia of the vocal folds or all over the laryngeal and pharyngeal mucosa, excessive secretions over the vocal folds, signs of hyperadduction, arytenoid edema, and phonatory waste. CONCLUSION: Wind instrumentalists frequently experience voice disorders, which necessitate further care and investigation.

18.
Sensors (Basel) ; 24(13)2024 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-39000842

RESUMO

Ozone generation is a water disinfection method, superior to chlorine in terms of fewer byproducts and no residual taste. However, its high production cost limits its widespread adoption. This paper designs an ozone generation sinusoidal power supply for water treatment. Ozone generation requires a high-frequency and high-voltage power supply to produce ozone from oxygen molecules. The study evaluates two power supply topologies, one with a parallel LC filter and the other with an LCL filter, assessing their feasibility, effectiveness, and reliability. Theoretically, the LCL filter achieves higher gains than the parallel LC filter. The larger inductance in the parallel LC filter reduces gain, while the larger inductance in the LCL filter increases gain. Simulation and practical results validate these findings, achieving gains of 40 for the parallel LC filter and 150 for the LCL filter.

19.
Sensors (Basel) ; 24(13)2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-39001032

RESUMO

The emergence of 6G communication technologies brings both opportunities and challenges for the Internet of Things (IoT) in smart cities. In this paper, we introduce an advanced network slicing framework designed to meet the complex demands of 6G smart cities' IoT deployments. The framework development follows a detailed methodology that encompasses requirement analysis, metric formulation, constraint specification, objective setting, mathematical modeling, configuration optimization, performance evaluation, parameter tuning, and validation of the final design. Our evaluations demonstrate the framework's high efficiency, evidenced by low round-trip time (RTT), minimal packet loss, increased availability, and enhanced throughput. Notably, the framework scales effectively, managing multiple connections simultaneously without compromising resource efficiency. Enhanced security is achieved through robust features such as 256-bit encryption and a high rate of authentication success. The discussion elaborates on these findings, underscoring the framework's impressive performance, scalability, and security capabilities.

20.
Sensors (Basel) ; 24(13)2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-39001087

RESUMO

The growing importance of edge and fog computing in the modern IT infrastructure is driven by the rise of decentralized applications. However, resource allocation within these frameworks is challenging due to varying device capabilities and dynamic network conditions. Conventional approaches often result in poor resource use and slowed advancements. This study presents a novel strategy for enhancing resource allocation in edge and fog computing by integrating machine learning with the blockchain for reliable trust management. Our proposed framework, called CyberGuard, leverages the blockchain's inherent immutability and decentralization to establish a trustworthy and transparent network for monitoring and verifying edge and fog computing transactions. CyberGuard combines the Trust2Vec model with conventional machine-learning models like SVM, KNN, and random forests, creating a robust mechanism for assessing trust and security risks. Through detailed optimization and case studies, CyberGuard demonstrates significant improvements in resource allocation efficiency and overall system performance in real-world scenarios. Our results highlight CyberGuard's effectiveness, evidenced by a remarkable accuracy, precision, recall, and F1-score of 98.18%, showcasing the transformative potential of our comprehensive approach in edge and fog computing environments.

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