Ovarian balls (Floating ovaries) of Rhadinorhynchus niloticus Mohamadain, 1989 from the Nile perch Lates niloticus Linnaeus, 1758; an electron microscope study.

In Acanthocephala, the ovarian balls (floating ovaries) are distinctive structures found suspended in the fluid-filled metasoma of females and are responsible for egg production and maturation. Those structures have not been studied in Rhadinorhynchus niloticus. We aimed to investigate their ultra-structure by means of scanning and transmission electron microscopy. A total of 30 Lates niloticus fish individuals were collected by fishermen from the River Nile, Egypt, and the isolated adult female specimens were processed for electron microscopy studies. The ovarian balls are elongated and lobulated structures freely scattered in the metasoma. They exhibited three distinct primary structural zones, a central oogonial syncytium, a peripheral cellular zone and a surrounding somatic supporting syncytium. The oogonia, within the central syncytium, give rise to developing oocytes that transform into mature oocytes. The latter enclose some inclusions such as large yolk granules and smaller egg-shell granules. We also describe the process of fertilization within the ovarian ball. The structure of the ovarian ball and the steps of fertilization in R. niloticus are described, for the first time, in the present study.

Enhancement of biomass productivity and biochemical composition of alkaliphilic microalgae by mixotrophic cultivation using cheese whey for biofuel production.

The growth of microalgae under alkaline conditions ensures an ample supply of CO2 from the atmosphere, with a low risk of crashing due to contamination and predators. The present study investigated the mixotrophic cultivation of two alkaliphilic microalgae (Tetradesmus obliquus and Cyanothece sp.) using cheese whey as an organic carbon source. The variation in cheese whey concentration (0.5-4.5% (v/v)), culture pH (7-11), and NaNO3 concentrations (0-2 gL-1) was evaluated using central composite design in response to biomass productivity and the contents of lipids, total proteins, and soluble carbohydrates. Both investigated microalgae effectively utilized cheese whey as an organic carbon source. The optimum conditions for simultaneously maximizing biomass and lipid productivity in T. obliquus were 3.5% (v/v) whey, pH 10.0, and 0.5 g L-1 NaNO3. Under these conditions, the biomass, lipid, soluble carbohydrate, and protein productivities were 48.69, 20.64, 7.02, and 10.97 mg L-1 day-1, respectively. Meanwhile, Cyanothece produced 52.78, 11.42, 4.31, and 7.89 mg L-1 day-1 of biomass, lipid, carbohydrate, and protein, respectively, at 4.5% (v/v) whey, pH 9.0, and 1.0 g L-1 NaNO3. The lipids produced under these conditions were rich in saturated fatty acids (FAs) and monounsaturated FAs, with no polyunsaturated FAs in both microalgae. Moreover, several biodiesel characteristics were estimated, and results fell within the ranges specified by international standards. These findings indicate that the mixotrophic cultivation of alkaliphilic microalgae could open new avenues for promoting microalgae productivity through low-cost biofuel production.

Prevalence and Determinants of Obesity and Overweight Among Children and Adolescents in the Middle East and North African Countries: An Updated Systematic Review.

In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother's occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.

Artificially Intelligent Billing in Spine Surgery: An Analysis of a Large Language Model.

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: This study assessed the effectiveness of a popular large language model, ChatGPT-4, in predicting Current Procedural Terminology (CPT) codes from surgical operative notes. By employing a combination of prompt engineering, natural language processing (NLP), and machine learning techniques on standard operative notes, the study sought to enhance billing efficiency, optimize revenue collection, and reduce coding errors. METHODS: The model was given 3 different types of prompts for 50 surgical operative notes from 2 spine surgeons. The first trial was simply asking the model to generate CPT codes for a given OP note. The second trial included 3 OP notes and associated CPT codes to, and the third trial included a list of every possible CPT code in the dataset to prime the model. CPT codes generated by the model were compared to those generated by the billing department. Model evaluation was performed in the form of calculating the area under the ROC (AUROC), and area under precision-recall curves (AUPRC). RESULTS: The trial that involved priming ChatGPT with a list of every possible CPT code performed the best, with an AUROC of .87 and an AUPRC of .67, and an AUROC of .81 and AUPRC of .76 when examining only the most common CPT codes. CONCLUSIONS: ChatGPT-4 can aid in automating CPT billing from orthopedic surgery operative notes, driving down healthcare expenditures and enhancing billing code precision as the model evolves and fine-tuning becomes available.

KaryoCreate: A CRISPR-based technology to study chromosome-specific aneuploidy by targeting human centromeres.

Aneuploidy, the presence of chromosome gains or losses, is a hallmark of cancer. Here, we describe KaryoCreate (karyotype CRISPR-engineered aneuploidy technology), a system that enables the generation of chromosome-specific aneuploidies by co-expression of an sgRNA targeting chromosome-specific CENPA-binding ɑ-satellite repeats together with dCas9 fused to mutant KNL1. We design unique and highly specific sgRNAs for 19 of the 24 chromosomes. Expression of these constructs leads to missegregation and induction of gains or losses of the targeted chromosome in cellular progeny, with an average efficiency of 8% for gains and 12% for losses (up to 20%) validated across 10 chromosomes. Using KaryoCreate in colon epithelial cells, we show that chromosome 18q loss, frequent in gastrointestinal cancers, promotes resistance to TGF-ß, likely due to synergistic hemizygous deletion of multiple genes. Altogether, we describe an innovative technology to create and study chromosome missegregation and aneuploidy in the context of cancer and beyond.

Effects of Therapeutic Calf Massage on Cardiac Autonomic Function in Healthy Volunteers-a Pilot Study.

Background: Calf massage is a therapeutic intervention that improves circulation and relieves us from pain & tightness. The calf massage also improves autonomic performance by modulating the vagal tone of the cardiovascular system. Therefore, the current study was intended to determine therapeutic calf massage on cardio autonomic activity in healthy subjects. Objective: To assess the immediate effect of a single 20-min session of calf massage on cardiac autonomic modulation through heart rate variability (HRV) measurement. Materials & Methods: In this study, 26 apparent healthy female participants aged between 18 and 25 years participated. Massage over the calf muscles on both legs for 20 min was performed, and resting cardiovascular parameters and HRV parameters were measured at baseline, immediately after the massage, and during the recovery periods (10 and 30 min after the massage). Data were analyzed using one-way ANOVA followed with post hoc analysis. Results: Immediately after the massage intervention, heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure were decreased (p < .01), and the reduction was persisted at 10 min and 30 min of the recovery period (p < .01). In HRV parameters, the root mean square of successive differences (RMSSD) and high-frequency normalized unit (HF n.u.) increased, and low frequency (LF n.u.) decreased after the massage, and at the 10 and 30 min of the recovery period. Conclusion: The present study reports suggest a significant reduction in heart rate and blood pressure after the massage therapy. A drop in sympathetic tone and raise in parasympathetic tone can also attribute to the therapeutic effect.

Study of some immunological signatures and their association with COVID-19 in a sample of recovered Iraqi patients.

Since its emergence about two years ago, the novel coronavirus has continued to be a challenge and threat to public health, struck most parts of the world, leaving more than half a billion cases of infection and more than five million deaths. Immune response abnormalities post-infection with SARS-CoV-2 have been reported, and the mechanisms that lead to them are still ambiguous. This study was conducted to evaluate some immunological markers in the serum samples of COVID-19 convalescent patients and investigate the association of these immunological signatures with their age and sex. The serum levels of immunoglobulin G, interleukin-1 beta, and interferon lambda-1 of 75 patients and 50 healthy control group members were measured, with 55 % males and 45 % females participating and ages ranging from 20 to 80 years. The measurement of the immunological signatures was performed using the enzyme-linked immunosorbent assay (ELISA). The result revealed highly significant elevated levels of the serum immunological signatures of the convalescent group in comparison to the control group, with P-values of 0.00001 for each signature. Moreover, age was observed to have an association with an elevated level of the immunological signatures as it increased in the elderly, whereas no association with sex was detected. The findings strongly suggest that COVID-19 infection results in a persistent inflammatory response, which leads to prolonged post-recovery symptoms. Post-COVID-19 syndrome necessitates additional research to clarify its pathophysiology, pathogenesis, and long-term implications.

Comparing the Effects of Radial and Jacketed Laser Tip Fibers on Outcome of Endovenous Laser Ablation of Lower Limb Truncal Venous Reflux.

BACKGROUND: Saphenous vein reflux is one of the leading causes of cosmetic and functional disabilities. The recent European Society of Vascular Surgery guidelines recommend endovenous thermal ablation over surgery or sclerotherapy for the treatment of great saphenous vein (GSV) reflux in patients with chronic venous disease. The aim of this study is to compare different laser fiber tip configurations to outcome regarding technical success and incidence of complications. DESIGN: A retrospective analysis conducted on patients with documented GSV reflux from 2020 to 2022, comparing baseline parameters and outcome between 2 groups of laser tip fibers used; radial tip and jacketed tip. Primary end point was technical success. Secondary endpoints included incidence of complications in each group, and VCSS score difference in both groups. METHODS: Inclusion criteria entailed patients with primary varicose veins over the age of 18 years, free from malignancy, hematological disorders, and having documented GSV reflux of more than 0.5 sec. All patients had endovenous laser ablation (EVLA) of the GSV, with complementary foam sclerotherapy or ambulatory phlebectomies as required. RESULTS: A total of 74 patients underwent EVLA (85 limbs). Fifty-four were done using the radial laser fibers, and 32 using jacketed fibers. Technical success was achieved in 78 limbs (92.9%), 6 limbs (7.1%) had recanalization of the proximal 3 cm of the GSV at 1 month, 2 patients experienced hematomas, and 5 patients had superficial vein thrombosis. There was no significant association between postoperative pain, bruising, recanalization, hematoma formation, and superficial vein thrombosis with different laser fiber tip configurations (P-value 0.95, 0.6, 0.18, 1, and 1, respectively), nor was there any significant difference in VCSS between them (P-value 0.14).Technical success was 90% in the jacketed fibers and 94.1% in the radial fibers group (P-value 0.18). CONCLUSIONS: Neither does laser fiber tip configuration nor its make have a significance on outcome of EVLA of GSV reflux. Both radial and jacketed laser fiber tips exhibit similar safety and efficacy in EVLA.

The buried gems of disease tolerance in animals: Evolutionary and interspecies comparative approaches: Interspecies comparative approaches are valuable tools for exploring potential new mechanisms of disease tolerance in animals: Interspecies comparative approaches are valuable tools for exploring potential new mechanisms of disease tolerance in animals.

Host defense mechanisms are categorized into different strategies, namely, avoidance, resistance and tolerance. Resistance encompasses mechanisms that directly kill the pathogen while tolerance is mainly concerned with alleviating the harsh consequences of the infection regardless of the pathogen burden. Resistance is well-known strategy in immunology while tolerance is relatively new. Studies addressed tolerance mainly using mouse models revealing a wide range of interesting tolerance mechanisms. Herein, we aim to emphasize on the interspecies comparative approaches to explore potential new mechanisms of disease tolerance. We will discuss mechanisms of tolerance with focus on those that were revealed using comparative study designs of mammals followed by summarizing the reasons for adopting comparative approaches on disease tolerance studies. Disease tolerance is a relatively new concept in immunology, we believe combining comparative studies with model organism study designs will enhance our understanding to tolerance and unveil new mechanisms of tolerance.

Case Report and Review of Literature: Familial Malignant Pleural Mesothelioma in a 39 Years Old Patient With an Inconclusive 18F-FDG PET/CT Result.

Malignant pleural mesothelioma (MPM) is a rare yet aggressive neoplasm that was linked only to asbestos exposure for decades, although familial clusters were diagnosed with MPM without a known history of asbestos exposure most likely due to genetic susceptibility. Here, we describe a case of familial malignant mesothelioma in a 39 years old patient with a confirmed BAP1 mutation in addition to a known family history with the same mutation. The patient presented with progressive shortness of breath and recurrent pleural effusions and diagnosis was made through biopsies taken during uniportal Video-Assisted Thoracoscopic Surgery. After the inconclusive result of 18F-FDG PET/CT scan, subxiphoid uniportal Video-Assisted Thoracoscopic Surgery left pleural and laparoscopic peritoneal biopsies were obtained for staging and evaluating contralateral lung and peritoneal cavity. Finally, two important educational values should be acquired from this case: genetic predisposition and BAP1 tumor suppressor gene mutation might affect the age of presentation and overall prognosis of the disease. Also, 18F-FDG PET/CT scan may not be the best modality for staging and confirming the diagnosis of malignant pleural mesothelioma.

Effect of melatonin in children with neurodevelopmental disabilities and sleep disorders.

Objectives: The aim of this study is to assess the efficacy and side effects of melatonin use in a population of children with neurodevelopmental disabilities who had sleep disorders. Methods: This is a cross-sectional study conducted in the pediatric neurology clinic at King Abdulaziz Medical City. A designed questionnaire was given to the parents to inquire about the sleep characteristics of their children before and after using melatonin. The patients' demographic data were collected and different parameters before and after starting melatonin were compared. Categorical variables were summarized and reported in terms of frequency and percent (n%). Continuous variables were reported in terms of mean and standard deviation. Results: A total of 23 patients were enrolled in our study, of which 15 (65.22%) were male. The mean age was 5.83 ± 3.07 years. For melatonin dose, 9 (39.13%) received 1 mg, 8 (34.78%) received 2 mg, and 6 (26.09%) received over 3 mg. Regarding melatonin duration of use, 7 (30.43%) received melatonin for 0 to 6 months, 7 (30.43%) received it for 7 to 12 months, and 9 (39.13%) received it for over a year. Significant differences were observed in time taken to fall asleep (P =0.046), the number of times the child woke up at night (P =0.071), total sleep time within 24 hours (P =.011), and time taken to wake up (P =.007), while no significant difference was observed in the number of naps taken during the daytime (P =.801). There were no major side effects reported. Conclusion: Melatonin had a significant impact on total sleep time and quality during the pre and post assessment of children with neurodevelopmental disabilities and sleep disorders.

The Impact of Treatment for Smoking on Breast Cancer Patients' Survival.

BACKGROUND: Smoking negatively affects overall survival after successful breast cancer (BC) treatment. We hypothesized that smoking cessation would improve survival outcomes of BC patients who were smokers at the time of diagnosis. METHODS: This was a retrospective analysis of self-identified smokers with BC treated at The University of Texas MD Anderson Cancer Center. Patient demographics, date of diagnosis, tumor stage, tobacco treatment program (TP) participation, and time to death were extracted from our departmental databases and institutional electronic health records. We examined associations between tobacco abstinence status and survival using survival models, with and without interactions, adjusted for personal characteristics and biomarkers of disease. RESULTS: Among all 31,069 BC patients treated at MD Anderson between 2006 and 2017, we identified 2126 smokers (6.8%). From those 2126 self-identified smokers, 665 participated in the TP, reporting a conservative estimate of 31% abstinence (intent-to-treat) 9 months into the program. Patients without reported follow-up abstinence status (including TP and non-TP participants) were handled in the analyses as smokers. Survival analysis controlled for multiple factors, including disease characteristics and participation in the TP, indicated that abstainers were more likely to be alive with no evidence of disease compared to non-abstainers (HR, 0.593; 95% CI, 0.386-0.911; p = 0.017). CONCLUSION: Our results suggest that quitting smoking is associated with improved survival among BC patients who were smokers at time of diagnosis across all tumor stages. Comprehensive approaches for smoking cessation in patients diagnosed with BC may prolong survival when started as early as the time of diagnosis.

Surface Ultrastructure of the Adult and Juvenile Stages of the Trematode Astiotrema Impletum (Looss, 1899) Looss 1900 (incertae Sedis) from the Nile puffer, Tetraodon Lineatus Linnaeus, 1758.

A scanning electron microscope study was performed on the surface of the trematode Astiotrema impletum (Looss, 1899) Looss 1900 from the Nile puffer, Tetraodon lineatus Linnaeus, 1758 (Syn. Tetraodon fahaka) for the first time. Adult A. impletum have a markedly large, sub-terminal oral sucker and a small ventral sucker. As with most trematodes, tegumental spines are concentrated anteriorly and are absent just anterior the ventral sucker. Spines have serrated tips on a short, tongue-shaped body. At the level of the ventral sucker the base of each spine exhibits a three bulbous-like structure that can be partially or completely withdrawn into the tegument. Sensory papillae are concentrated around the oral and ventral suckers and genital pores. Papillae are conical or knob-like, either ciliated or non-ciliated; some are protruded and others are embedded inside the tegument. In the juvenile stage, spines are smaller, less well-developed and tightly packed. The cytoplasmic processes of the posterior quarter of body show brain-like velvety appearance on the adult and small cobblestone-like on the juvenile.

Novel determination of spa gene diversity and its molecular typing among Staphylococcus aureus Iraqi isolates obtained from different clinical samples.

Staphylococcus aureus is the most frequent agent causing nosocomial infections in Baghdad hospitals. This study aimed to determine S. aureus methicillin resistance, spa gene typing and phylogenic analysis in Iraqi S. aureus isolates. Two hundred samples including clinical (n = 100) and environmental (n = 100) specimens were collected. S. aureus isolates were identified using multiplex PCR amplification of femA and mecA (for methicillin-resistant S. aureus (MRSA) strains) genes. The spa gene was also amplified. Sequence alignment and identification of spa types was then obtained. Of 74 studied S. aureus isolates, 61 (82.43%) harboured the mecA gene (p < 0.001). A spa gene variation was detected in 41 (67.2%) of 61 (p 0.0011) MRSA and 6 (46.15%) of 13 methicillin-susceptible S. aureus isolates. Amino acid sequence analysis revealed a great change in amino acid pattern among local isolates compared to National Center for Biotechnology Information control. Some of the MRSA isolates had high-level similarity with t10214. No genetic relationship with the infection sources was observed. None of the environmental isolates had spa gene variations. Most S. aureus isolates were MRSA. The spa gene variations was significantly higher among clinical isolates. spa sequencing showed different tandem repeats in local MRSA isolates compared to global spa types. We conclude that there was no outbreak in hospital settings in the city of Baghdad. However, our data suggest that isolates from the hospital environment are highly clonal.

Central Pain Mimicking Trigeminal Neuralgia as a Result of Lateral Medullary Ischemic Stroke.

BACKGROUND: Central pain mimicking trigeminal neuralgia (TN) as a result of lateral medullary infarction or Wallenberg syndrome has been rarely reported. CASE REPORT: We discuss a patient who presented with a lateral medullary infarct and shortly after developed facial pain mimicking TN. We also elaborate on the anatomical pathway of the trigeminal nerve explaining facial pain as a result of a lateral medullary lesion. DISCUSSION: Clinicians should be aware of this typical complication of lateral medullary infarct in order to attain proper management and work-up.

Spray-On Liquid-Metal Electrodes for Graphene Field-Effect Transistors.

Advancements in flexible circuit interconnects are critical for widespread adoption of flexible electronics. Non-toxic liquid-metals offer a viable solution for flexible electrodes due to deformability and low bulk resistivity. However, fabrication processes utilizing liquid-metals suffer from high complexity, low throughput, and significant production cost. Our team utilized an inexpensive spray-on stencil technique to deposit liquid-metal Galinstan electrodes in top-gated graphene field-effect transistors (GFETs). The electrode stencils were patterned using an automated vinyl cutter and positioned directly onto chemical vapor deposition (CVD) graphene transferred to polyethylene terephthalate (PET) substrates. Our spray-on method exhibited a throughput of 28 transistors in under five minutes on the same graphene sample, with a 96% yield for all devices down to a channel length of 50 µm. The fabricated transistors possess hole and electron mobilities of 663.5 cm²/(V·s) and 689.9 cm²/(V·s), respectively, and support a simple and effective method of developing high-yield flexible electronics.

Prevalence of Homelessness in the Emergency Department Setting.

INTRODUCTION: According to the National Alliance to End Homelessness, the national rate of homelessness has been cited as 17.7 homeless people/10,000 people in the general population, and 24.8 homeless veterans/10,000 veterans in the general population. However, it is unknown what the prevalence of homelessness is in the emergency department (ED) setting. We set out to determine the prevalence of homelessness or at risk for homelessness in the ED setting. METHODS: Using a five-question screening tool derived from the U.S. Department of Housing and Urban Development, Health and Human Services and the Veterans Administration definition for homelessness, we surveyed all patients meeting inclusion/exclusion criteria on scheduled shifts in one of three EDs in Northeastern Pennsylvania. To participate, subjects had to be a registered patient in the ED, be 18 years or older, speak English, have the capacity to answer survey questions, not be critically ill, be willing to participate, and not have taken the survey before. We selected two survey periods to represent seasonal variations. RESULTS: We included 4,395 subjects in the analysis. The mean age of those who screened positive for homelessness or at risk for homelessness was 43.1 (SD 16.6). Overall, 136 (3.1%) participants screened positive for at risk for homelessness and 309 (7.0%) screened positive for homelessness. A total of 103 subjects (9.8%) screened positive for homelessness or at risk for homelessness on weekends and 312 (10.3%) on weekdays (p=0.64). The proportion of those screening positive for homelessness or at risk for homelessness varied by site: 145 (7.5%) at the trauma center, 151(9.1%) at the suburban site, and 149 (18.7%) at the center city site, p<0.001.There was no statistical significance to the difference between the trauma center and the suburban site (p=.088), but there was statistical significance between both the suburban and the trauma center when compared to the center city site (both p<0.0001). The proportion of those screening positive for homelessness in the summer months (156, 7.5%) was similar to those in the winter months (153, 6.6%), p=0.23. CONCLUSION: In our study, the overall prevalence of homelessness or at risk for homelessness was 10.1 percent. This prevalence did not seem to vary between weekdays and weekends. Additionally, summer months had a prevalence that was as concerning as winter months. The prevalence does, however, seem to vary by institutional characteristics even in the same geographic region. Understanding the patterns of prevalence of homelessness is a step toward considering possible interventions to assist this vulnerable population.

The association of oxidant-antioxidant status in patients with chronic renal failure.

Oxidative stress has been linked to disease progression, including chronic renal failure (CRF). The aim of the present study was to determine malondialdehyde (MDA) as a sign of lipid peroxidation, and to investigate the association between antioxidant activities and three trace elements, in 49 patients with CRF. The erythrocyte and plasma trace elements [selenium (Se), zinc (Zn), and copper (Cu)] and antioxidant defense levels were determined: glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT), vitamins E and C. The obtained values were compared with 42 age- and sex-matched healthy controls. There were significantly lower mean values of plasma Se, GPx, vitamins E and C, erythrocyte Se, SOD and CAT levels in the patient group compared to the control group (p < 0.001). Plasma MDA showed a significant increase in all CRF patients in comparison with controls. No significant difference was found in plasma Cu, Zn, and erythrocyte GPx, Cu and Zn levels between patient and control groups. These findings indicate oxidative stress is present in patients of CRF, and may serve to establish a simple protocol for evaluation of renal function.