Ultrasound-guided vs. Standard Coronary Access in Coronary Angiography: A Systematic Review and Meta-analysis.

Objectives: Coronary angiography is a procedure performed during cardiac catheterization to define the coronary anatomy and determine the extent of coronary artery disease (CAD). The use of a cheap, relatively available tool like an ultrasound machine to assist in vascular access might reduce the risks associated with blind access. This study aimed to explore the efficacy and associated complications of ultrasound-guided coronary artery catheterization. Methods: This systematic review of randomized controlled trials (RCTs) was conducted according to the Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA) and was registered in PROSPERO (CRD42022365518). A systematic search was performed for all published studies without language or country restrictions and all study variables were extracted into prefilled sheets by two independent reviewers. Results: This meta-analysis identified 10 RCTs. The results confirmed statistically significantly reductions of total complications (RR = 0.53, 95% CI 0.39-0.72, P < .001), and hematoma >5 cm formation (RR = 0.43, 95% CI 0.25-0.75, P = 0.003) in patients who underwent ultrasound-guided coronary artery catheterization. Conclusion: Ultrasound with catheterization, as opposed to landmark-based catheterization, significantly improved the peri-catheterization operative outcomes, providing evidence for further research to be conducted and consideration for its implementation within the medical setting.

Biomechanical Comparison of Corticopedicular Spine Fixation versus Pedicle Screw Fixation in a Lumbar Degenerative Spondylolisthesis Finite Element Analysis Model.

OBJECTIVE: To compare the stability of a corticopedicular posterior fixation (CPPF) device to traditional pedicle screws for decompression and fusion in adult degenerative lumbar spondylolisthesis. METHODS: Finite element analysis (FEA) was used in a validated model of grade 1 L4-L5 spondylolisthesis to compare segmental stability following laminectomy alone, laminectomy with pedicle screw fixation, or laminectomy with CPPF device fixation. A 500N follower load was applied to the model and different functional movements were simulated by applying a 7.5Nm force in different directions. Outcomes included degrees of motion, tensile forces experienced in the CPPF device, and stresses in surrounding cortical bone. RESULTS: At maximum loading, laminectomy alone demonstrated an 1° increase in flexion range of motion from 6.35° to 7.39°. Laminectomy with pedicle screw fixation and CPPF device fixation both reduced spinal segmental motion to ≤1° at maximum loading in all ranges of motion, including flexion (0.94° and 1.09°), extension (-0.85°and -1.08°), lateral bending (-0.56° and -0.96°), and torsion (0.63°and 0.91°), respectively. There was no significant difference in segmental stability between pedicle screw fixation and CPPF device fixation during maximum loading with a difference of ≤0.4° in any range of motion. Tensile forces in the CPPF device remained ≤51% the ultimate load to failure (487N) and stress in surrounding cortical bone remained ≤84% the ultimate stress of cortical bone (125.4 MPa) during maximum loading. CONCLUSION: CPFF fixation demonstrated similar segmental stability to traditional pedicle screw fixation while tensile forces and stress in surrounding cortical bone remained below the load to failure.

Outcomes of biological therapy in patients with severe asthma with chronic rhinosinusitis in Saudi Arabia: patients with nasal polyps versus those without nasal polyps.

BACKGROUND: This study's purposes were to evaluate the impact of biological therapies on outcomes in patients with severe asthma (SA) and chronic rhinosinusitis (CRS) and to compare these effects among those with NP (CRSwNP) versus those without NP (CRSsNP) in the "real-world" setting in Saudi Arabian patients. METHODS: From March to September 2022, a retrospective observational cohort study was undertaken at the severe asthma clinics of the Armed Forces Hospital-Southern Region (AFHSR) and King Khalid University Hospital, Abha, Saudi Arabia, to delineate the effects of dupilumab therapy. Outcomes were assessed, including clinical outcomes, FEV1, and laboratory findings before and one year after dupilumab. Post-therapy effects were compared between CRSwNP and CRSsNP. RESULTS: Fifty subjects were enrolled, with a mean age of 46.56. There were 27 (54%) females and 23(46%) males. Significant improvements in clinical parameters (frequency of asthma exacerbations and hospitalizations, the use of OCs, anosmia, SNOTT-22, and the ACT), FEV1, and laboratory ones (serum IgE and eosinophilic count) were observed 6 and 12 months after using dupilumab (p < 0.001), respectively. However, after 12 months of dupilumab therapy, there were no significant differences between those with and without NP with regards to clinical (anosmia, ACT, and OCs use), laboratory (eosinophilic count, serum IgE level) parameters, and FEV1%. CONCLUSIONS: Patients with CRS experienced significant improvements in clinical, FEV1, and laboratory outcomes after dupilumab therapy. However, these improvements were not maintained when comparing CRSwNP with CRSsNP. There were no significant differences between those with and without NP regarding ACT and OCs use or laboratory (eosinophilic count, serum IgE level) parameters. Further prospective multicenter studies are warranted.

Transgenerational hormesis in healthy aging and antiaging medicine from bench to clinics: Role of food components.

Neurodegenerative diseases have multifactorial pathogenesis, mainly involving neuroinflammatory processes. Finding drugs able to treat these diseases, expecially because for most of these diseases there are no effective drugs, and the current drugs cause undesired side effects, represent a crucial point. Most in vivo and in vitro studies have been concentrated on various aspects related to neurons (e.g. neuroprotection), however, there has not been focus on the prevention of early stages involving glial cell activation and neuroinflammation. Recently, it has been demonstrated that nutritional phytochemicals including polyphenols, the main active constituents of the Mediterranean diet, maintain redox balance and neuroprotection through the activation of hormetic vitagene pathway. Recent lipidomics data from our laboratory indicate mushrooms as strong nutritional neuronutrients with strongly activity against neuroinflammation in Meniere' diseaseas, a model of cochleovestibular neural degeneration, as well as in animal model of traumatic brain injury, or rotenone induced parkinson's disease. Moreover, Hidrox®, an aqueous extract of olive containing hydroxytyrosol, and Boswellia, acting as Nrf2 activators, promote resilience by enhancing the redox potential, and thus, regulate through hormetic mechanisms, cellular stress response mechanisms., Thus, modulation of cellular stress pathways, in particular vitagenes system, may be an innovative approach for therapeutic intervention in neurodegenerative disorders.

A Novel Technique for Improving Cyclic Behavior of Steel Connections Equipped with Smart Memory Alloys.

Residual drifts are an important measure of post-earthquake functionality in bridges and buildings, and can determine whether the structure remains fit for its intended purpose or not. This study aims at investigating numerically, through finite element (FE) analysis in ABAQUS, the cyclic response of exterior steel I beam-hollow column connection using welded shape memory alloys (SMA) bolts and seat angles. This is followed by validating the numerical model using an accredited experimental data available in the literature through different techniques, (1) SMA bolts, (2) SMA angles, (3) SMA bolts and angles. The parameters investigated included: SMA type, SMA angle thickness, SMA bolt diameter, SMA angle stiffener and SMA angle direction. The cyclic performance of the steel connection was enhanced further by varying the bolt diameter, plate thickness, angle type and direction. The results revealed that the connections equipped with a combination of SMA plates and SMA angles reduced the residual drift by up to 94%, and doubled the self-centering capability compared to conventional steel connections. Moreover, the parametric analysis showed that Fe-based SMA members could be a good alternative to NiTi based SMA members for improving the self-centering capability and reducing the residual drifts of conventional steel connections.

Correction: Association of SNPs within TMPRSS6 and BMP2 genes with iron deficiency status in Saudi Arabia.

[This corrects the article DOI: 10.1371/journal.pone.0257895.].

Design of a novel multi-epitope vaccine against Marburg virus using immunoinformatics studies.

Marburg virus (MARV) is a highly contagious and virulent agent belonging to Filoviridae family. MARV causes severe hemorrhagic fever in humans and non-human primates. Owing to its highly virulent nature, preventive approaches are promising for its control. There is currently no approved drug or vaccine against MARV, and management mainly involves supportive care to treat symptoms and prevent complications. Our aim was to design a novel multi-epitope vaccine (MEV) against MARV using immunoinformatics studies. In this study, various proteins (VP35, VP40 and glycoprotein precursor) were used and potential epitopes were selected. CTL and HTL epitopes covered 79.44% and 70.55% of the global population, respectively. The designed MEV construct was stable and expressed in Escherichia coli (E. coli) host. The physicochemical properties were also acceptable. MARV MEV candidate could predict comprehensive immune responses such as those of humoral and cellular in silico. Additionally, efficient interaction to toll-like receptor 3 (TLR3) and its agonist (ß-defensin) was predicted. There is a need for validation of these results using further in vitro and in vivo studies.

Alzheimer's disease CSF biomarkers correlate with early pathology and alterations in neuronal and glial gene expression.

INTRODUCTION: Normal pressure hydrocephalus (NPH) patients undergoing cortical shunting frequently show early AD pathology on cortical biopsy, which is predictive of progression to clinical AD. The objective of this study was to use samples from this cohort to identify CSF biomarkers for AD-related CNS pathophysiologic changes using tissue and fluids with early pathology, free of post-mortem artifact. METHODS: We analyzed Simoa, proteomic, and metabolomic CSF data from 81 patients with previously documented pathologic and transcriptomic changes. RESULTS: AD pathology on biopsy correlates with CSF ß-amyloid-40/42, neurofilament light chain (NfL), and phospho-tau-181(p-tau181)/ß-amyloid-42, while several gene expression modules correlate with NfL. Proteomic analysis highlights 7 core proteins that correlate with pathology and gene expression changes on biopsy, and metabolomic analysis of CSF identifies disease-relevant groups that correlate with biopsy data.. DISCUSSION: As additional biomarkers are added to AD diagnostic panels, our work provides insight into the CNS pathophysiology these markers are tracking.

The orthodontic research trends in Arab League Nations from 2002 to 2021: A bibliometric appraisal.

The evaluation of publication growth is a vital indicator to assess any branch of knowledge. The present study aimed to investigate the Scopus-indexed publications on orthodontics produced by the Arab League Nations in the last two decades (2002-2021). Quantitative research method based on bibliometric analysis has been used and the meta-data for the study was retrieved from Elsevier's Scopus database on November 14, 2022. The bibliographic description of all types of literature published on orthodontics from 2002 to 2021 by the authors affiliated with the Arab countries has been downloaded. The selected bibliometric indicators of the data were analyzed by using Microsoft Excel, VOSviewer and SPSS software. The Arab League Nations contributed 5.02 % to global orthodontic research. This segment has demonstrated an amazing escalation of documents from a global perspective between 2002 and 2021 from 1.24 % to 10.94 %. Slightly more than 60 % of documents were published during the last five years of study (2017-2021). The highest number of documents (41 %) was produced by Saudi Arabia, whereas documents contributed by Jordan gained the maximum citation impact. The majority of collaboration was done with the United States, but documents produced in collaboration with Turkey gained the highest citation impact. The paper highlighted that the share of Arab League Nations in orthodontic research has been growing, and Saudi Arabia emerged as the most productive country. The constructive evolution of orthodontic literature with international collaboration display an ambitious approach by Arab countries.

Efficiency of Fine-Needle Aspiration (FNA) in Relation to Tru-Cut Biopsy of Lateral Neck Swellings.

Background Lateral neck masses have always been difficult to diagnose without proposing a differential diagnosis. Fine-needle aspiration (FNA) was proposed to be a cost-effective method and less invasive than a tru-cut biopsy and may provide a provisional diagnosis in relation to cytopathology. FNA has also been shown to improve the diagnosis of neck masses such as cervical lymphadenopathy, neck cysts, and parotid masses, whether malignant or benign. This study aims to evaluate the accuracy of FNA cytopathology versus a tru-cut biopsy histopathological examination. Materials and methods This study was conducted retrospectively in King Hussein Medical Hospital, Royal Medical Services, Hashemite Kingdom of Jordan, from January 2019 to January 2024. Ethical approval was taken to conduct this study with reference number 06/2024. All patients included in this study have given verbal and written consent to perform FNA and surgical tru-cut biopsy. The inclusion of patients was based on any person above the age of 16 who underwent an FNA followed by a surgical biopsy to correlate with the primary diagnosis. Exclusion criteria involved any patient who missed one of the above criteria. Statistical analysis was performed using IBM SPSS v29 (IBM Corp., Armonk, NY, US) with significant results considered with a p-value <0.05. Results A total of 107 patients were included in this study. A correlation between FNA results and final histopathological biopsy was done with an accuracy of 90.6%, specificity of 94.3, predictive positive value of 73.6%, and negative predictive value of 94.3%. There was a statistical significance between FNA and tru-cut biopsy with a p-value of <0.001. Conclusion FNA is a great tool to consider when diagnosing lateral neck swellings. Since it was statistically significant, FNA should be considered for any lateral neck swelling before any surgical tru-cut biopsy for a definitive diagnosis.

Prenatal Stress Impacts Foetal Neurodevelopment: Temporal Windows of Gestational Vulnerability.

Prenatal maternal stressors ranging in severity from everyday occurrences/hassles to the experience of traumatic events negatively impact neurodevelopment, increasing the risk for the onset of psychopathology in the offspring. Notably, the timing of prenatal stress exposure plays a critical role in determining the nature and severity of subsequent neurodevelopmental outcomes. In this review, we evaluate the empirical evidence regarding temporal windows of heightened vulnerability to prenatal stress with respect to motor, cognitive, language, and behavioural development in both human and animal studies. We also explore potential temporal windows whereby several mechanisms may mediate prenatal stress-induced neurodevelopmental effects, namely, excessive hypothalamic-pituitary-adrenal axis activity, altered serotonin signalling and sympathetic-adrenal-medullary system, changes in placental function, immune system dysregulation, and alterations of the gut microbiota. While broadly defined developmental windows are apparent for specific psychopathological outcomes, inconsistencies arise when more complex cognitive and behavioural outcomes are considered. Novel approaches to track molecular markers reflective of the underlying aetiologies throughout gestation to identify tractable biomolecular signatures corresponding to critical vulnerability periods are urgently required.

Knowledge, Attitude, and Practice of Organ Donation Among the Population of Al-Majma'ah Region, Saudi Arabia.

BACKGROUND: Organ donation plays a pivotal role in addressing the global demand for transplantable organs and saving lives. The success of organ transplantation relies not only on medical advancements but also on the willingness of communities to participate in organ donation programs. In Saudi Arabia, specifically within the Al-Majma'ah region, understanding the dynamics of knowledge, attitudes, and practices related to organ donation is crucial for promoting a sustainable and ethical organ donation system. METHODS: A cross-sectional, retrospective study was utilized in this research, employing data from a sample of 564 participants from the general population of the Al-Majma'ah region, Saudi Arabia. The participants completed a self-administered questionnaire and ensured anonymity. RESULTS: About 545 (96.6%) respondents were familiar with the concept of organ donation, and 455 (80.7%) participants recognized the necessity for the blood groups of the donor and recipient to match before the transplant process. About 412 (73.0%) participants agreed with the practice of organ donation with 326 (57.8%) expressing support for the practice. About 417 (73.9%) participants reported that their religion permits or endorses organ donation/transplantation. A total of 151 individuals (26.8%) had a low knowledge level, with total scores below 50% (6 or lower). In contrast, 280 people (4.7%) demonstrated a moderate level of knowledge (scoring between 50% and 75%) (7 to 9). Additionally, 133 individuals (23.5%) showcased a high level of knowledge, with scores exceeding 75% (10 or higher). The study established a statistically significant association between age, marital status with p-values < 0.05 (0.001*), and the knowledge score toward organ donation. However, gender and monthly household income were not significantly associated with knowledge score toward organ transplant with p-values (p-value > 0.05). CONCLUSION: The research findings indicated a moderate level of knowledge and a positive attitude toward organ donation among the general population of the Al-Majma'ah region in Saudi Arabia. Age and marital status were found to be significantly associated with the knowledge score toward organ donation. The study noted the desire and willingness to save lives through organ donation by the residents of the Al-Majma'ah region in Saudi Arabia.

Vascular service provision during the COVID-19 pandemic worsened major amputation rates in socially deprived diabetic populations.

Introduction: The Coronavirus Disease - 2019 (COVID-19) pandemic significantly impacted healthcare service provision and put diabetic patients at increased risk of adverse health outcomes. We aimed to assess the impact of the COVID-19 pandemic on the incidence and demographic shift of major lower-limb amputation in diabetic patients. Methods: We performed a retrospective analysis of diabetic patient records undergoing major lower-limb amputation between 01/03/2019 and 01/03/2021 at the Royal Sussex County Hospital, the regional arterial hub for Sussex. Primary outcomes were amputation incidence rates and patient demographics compared between the prepandemic and pandemic cohorts. Results: The incidence rate ratio of major lower-limb amputations shows a drop in amputations during the pandemic compared to pre-pandemic (IRR 0.82; 95% CI 0.57-1.18). Data suggests a shift in the social deprivation background of patients receiving amputations to disproportionately affect those in the more deprived 50% of the population (p=0.038). Younger patients received more amputations during the pandemic compared to prepandemic levels (p=0.001). Conclusion: Results suggest that during the COVID-19 pandemic there was a paradoxical reduction in amputations compared to prepandemic levels. However, changes to the demographic makeup of patient's receiving amputations are alarming as younger, and more deprived patients have been disproportionately affected by the pandemic.

Boosting cuckoo optimization algorithm via Gaussian mixture model for optimal power flow problem in a hybrid power system with solar and wind renewable energies.

This paper presents a novel approach, the Gaussian Mixture Method-enhanced Cuckoo Optimization Algorithm (GMMCOA), designed to optimize power flow decision parameters, with a specific focus on minimizing fuel cost, emissions, network loss, and voltage deviation. GMMCOA integrates the strengths of COA and GMM while mitigating their individual limitations. While COA offers robust search capabilities, it suffers from initial parameter dependency and the risk of getting trapped in local optima. Conversely, GMM delivers high-speed performance but requires guidance to identify the best solution. By combining these methods, GMMCOA achieves an intelligent approach characterized by reduced parameter dependence and enhanced convergence speed. The effectiveness of GMMCOA is demonstrated through extensive testing on both the IEEE 30-bus and the large-scale 118-bus test systems. Notably, for the 118-bus test system, GMMCOA achieved a minimum cost of $129,534.7529 per hour and $103,382.9225 per hour in cases with and without the consideration of renewable energies, respectively, surpassing outcomes produced by alternative algorithms. Furthermore, the proposed method is benchmarked against the CEC 2017 test functions. Comparative analysis with state-of-the-art algorithms, under consistent conditions, highlights the superior performance of GMMCOA across various optimization functions. Remarkably, GMMCOA consistently outperforms its competitors, as evidenced by simulation results and Friedman examination outcomes. With its remarkable performance across diverse functions, GMMCOA emerges as the preferred choice for solving optimization problems, emphasizing its potential for real-world applications.

Integrating and Adopting AI in the Radiology Workflow: A Primer for Standards and Integrating the Healthcare Enterprise (IHE) Profiles.

The deployment of artificial intelligence (AI) solutions in radiology practice creates new demands on existing imaging workflow. Accommodating custom integrations creates a substantial operational and maintenance burden. These custom integrations also increase the likelihood of unanticipated problems. Standards-based interoperability facilitates AI integration with systems from different vendors into a single environment by enabling seamless exchange between information systems in the radiology workflow. Integrating the Healthcare Enterprise (IHE) is an initiative to improve how computer systems share information across health care domains, including radiology. IHE integrates existing standards-such as Digital Imaging and Communications in Medicine, Health Level Seven, and health care lexicons and ontologies (ie, LOINC, RadLex, SNOMED Clinical Terms)-by mapping data elements from one standard to another. IHE Radiology manages profiles (standards-based implementation guides) for departmental workflow and information sharing across care sites, including profiles for scaling AI processing traffic and integrating AI results. This review focuses on the need for standards-based interoperability to scale AI integration in radiology, including a brief review of recent IHE profiles that provide a framework for AI integration. This review also discusses challenges and additional considerations for AI integration, including technical, clinical, and policy perspectives.

Frankincense: A neuronutrient to approach Parkinson's disease treatment.

Parkinson's disease (PD), characterized by tremor, slowness of movement, stiffness, and poor balance, is due to a significant loss of dopaminergic neurons in the substantia nigra pars compacta and dopaminergic nerve terminals in the striatum with deficit of dopamine. To date the mechanisms sustaining PD pathogenesis are under investigation; however, a solid body of experimental evidence involves neuroinflammation, mitochondrial dysfunction, oxidative stress, and apoptotic cell death as the crucial factors operating in the pathogenesis of PD. Nutrition is known to modulate neuroinflammatory processes implicated in the pathogenesis and progression of this neurodegenerative disorder. Consistent with this notion, the Burseraceae family, which includes the genera Boswellia and Commiphora, are attracting emerging interest in the treatment of a wide range of pathological conditions, including neuroinflammation and cognitive decline. Bioactive components present in these species have been shown to improve cognitive function and to protect neurons from degeneration in in vitro, animal, as well as clinical research. These effects are mediated through the anti-inflammatory, antiamyloidogenic, anti-apoptotic, and antioxidative properties of bioactive components. Although many studies have exploited possible therapeutic approaches, data from human studies are lacking and their neuroprotective potential makes them a promising option for preventing and treating major neurodegenerative disorders.

Aflatoxins in Peanut (Arachis hypogaea): Prevalence, Global Health Concern, and Management from an Innovative Nanotechnology Approach: A Mechanistic Repertoire and Future Direction.

Arachis hypogaea is the most significant oilseed nutritious legume crop in agricultural trade across the world. It is recognized as a valued crop for its contributions to nourishing food, as a cooking oil, and for meeting the protein needs of people who are unable to afford animal protein. Currently, its production, marketability, and consumption are hindered because of Aspergillus species infection that consequently contaminates the kernels with aflatoxins. Regarding health concerns, humans and animals are affected by acute and chronic aflatoxin toxicity and millions of people are at high risk of chronic levels. Most methods used to store peanuts are traditional and serve effectively for short-term storage. Now the question for long-term storage has been raised, and this promptly finds potential approaches to the issue. It is imperative to reduce the aflatoxin levels in peanuts to a permissible level by introducing detoxifying innovations. Most of the detoxification reports mention physical, chemical, and biological techniques. However, many current approaches are impractical because of time consumption, loss of nutritional quality, or weak detoxifying efficiency. Therefore, it is crucial to investigate practical, economical, and green methods to control Aspergillus flavus that address current global food security problems. Herein, a green and economically revolutionary way is a nanotechnology that has demonstrated its potential to connect farmers to markets, elevate international marketability, improve human and animal health conditions, and enhance food quality and safety by the management of fungal diseases. Due to the antimicrobial potential of nanoparticles, they act as nanofungicides and have an incredible role in the control of aflatoxins. Nanoparticles have ultrasmall sizes and therefore penetrate the fungal body and invade the pathogen machinery, leading to fungal cell death by ROS production, mutation in DNA, disruption of organelles, and membrane leakage. This is the first mechanistic overview that unveils a comprehensive insight into aflatoxin contamination in peanuts, its prevalence, health effects, and management in addition to nanotechnological interventions that serve as a triple defense approach to detoxify aflatoxins. The optimum use of nanofungicides ensures food safety and the development of goals, especially "zero hunger".