Mechanical Circulatory Support Devices in Patients with High-Risk Pulmonary Embolism.

Pulmonary embolism (PE) is a common acute cardiovascular condition. Within this review, we discuss the incidence, pathophysiology, and treatment options for patients with high-risk and massive pulmonary embolisms. In particular, we focus on the role of mechanical circulatory support devices and their possible therapeutic benefits in patients who are unresponsive to standard therapeutic options. Moreover, attention is given to device selection criteria, weaning protocols, and complication mitigation strategies. Finally, we underscore the necessity for more comprehensive studies to corroborate the benefits and safety of MCS devices in PE management.

Transcatheter Aortic Valve Replacement in Bicuspid Versus Tricuspid Aortic Valve Stenosis: Meta-Analysis and Systemic Review.

Because of its anatomic and procedural complexities, bicuspid aortic valve (BAV) has been excluded from previous trials investigating transcatheter aortic valve replacement (TAVR). We aimed to compare the clinical outcomes of TAVR in BAV and tricuspid aortic valve patients. We searched the databases systematically from inception until March 2023 for studies that reported the outcomes of TAVR in BAV and tricuspid aortic valve patients. The primary focus was all-cause mortality at 1 year. Additional outcomes included outcomes at 30-day follow-up. Secondary and subgroup analyses were performed on propensity-matched patients, patients at low surgical risk, and based on the type of transcatheter valve type. We included 30 studies with a total of 193,274 patients who underwent TAVR, of which 14,353 patients had BAV stenosis. The rate of 1-year mortality was lower in the BAV group compared with the tricuspid group with the results reaching statistical significance (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.75 to 0.98, p = 0.02). The rate of 30-day stroke, however, was higher in patients with BAV who underwent TAVR (OR 1.24, 95% CI 1.08 to 1.43, p <0.05). Other 30-day clinical outcomes were similar between the 2 groups. Similar outcomes were observed in secondary analysis of matched populations with less mortality and higher rate of stroke in patients with BAV (OR 0.84, 95% CI 0.72 to 0.96, p = 0.01, and OR 1.38, 95% CI 1.09 to 1.75, p <0.05, respectively). Comparing the outcomes for self-expandable and balloon-expandable valves resulted in similar results. Subgroup analysis of low-surgical-risk patients similarly showed lower 1-year mortality in patients with BAV (OR 0.67, 95% CI 0.50 to 0.91, p = 0.01), without difference in 30-day stroke between the 2 groups (OR 1.24, 95% CI 0.83 to 1.88, p = 0.30). In conclusion, this report indicates that TAVR is safe and feasible in patients with BAV, including patients at low surgical risk. The higher rate of 30-day stroke, however, warrants caution when pursuing TAVR in this population. More studies, specifically randomized trials, are still warranted to further assess the safety and the long-term outcomes in this group.

Improvement in clinical outcome and quality of life after arthroscopic ankle arthrodesis in paralytic foot drop.

BACKGROUND: Paralytic foot-drop is a disabling deformity that results from nerve or direct muscle injuries. Palliative surgeries such as tendon transfer and ankle arthrodesis are reserved for permanent deformity, with the arthroscopic technique had not been widely studied before. This study aims to evaluate the clinical outcome and quality of life after arthroscopic ankle fusion of paralytic foot-drop deformity. MATERIALS AND METHODS: The patients who were retrospectively enrolled in this study underwent arthroscopic ankle fusion for paralytic foot-drop deformity between March 2017 and December 2021. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Cumberland Ankle Instability Tool (CAIT) were the measures used for clinical assessment. To judge the union, serial plain radiographs of the ankle were obtained. The preoperative and postoperative means were analyzed utilizing a two-tailed paired t-test, with a p value of less than 0.05 indicating statistical significance. RESULTS: This study included 21 consecutive patients with a mean follow-up of 35.09 ± 4.5 months and a mean age of 41.5 ± 6.1 years. Highly significant improvements were observed between the preoperative and final follow-up means of the AOFAS score (from 57.6 ± 4.6 to 88.3 ± 2.7) and CAIT (from 12.1 ± 2.2 to 28.9 ± 1.01; p ˂ 0.00001 for both). All patients attained radiographic union and resumed their previous occupations without reporting serious adverse effects. CONCLUSIONS: Arthroscopic ankle fusion is an effective, minimally invasive palliative surgery for patients suffering from permanent paralytic foot-drop deformity. This technique was shown to provide good functional and radiologic outcomes without significant complications. LEVEL OF EVIDENCE: Retrospective cohort; level of evidence (IV).

Whole-Genome Sequence of Bacillus pacificus CR121, a Fish Probiotic Candidate.

We describe a promising fish probiotic, Bacillus pacificus CR121, which was isolated from the intestine of a healthy Indian major carp species, rohu (Labeo rohita) and shown to possess in vivo disease prevention efficacy in L. rohita and Oreochromis niloticus. The genome sequence information will help us make use of the probiotic potential of this strain.

"Doing good and feeling good" Relationship between authentic leadership with followers' work engagement: The mediating role of hedonic and eudaimonic wellbeing.

The positive behavioral style of authentic leadership has attracted academicians' and practitioners' attention to focus more on a healthy workplace environment and its influence on followers' valued workplace relationship outcomes, such as employees' work engagement. From the lens of social exchange perspective, we tested a unified model of authentic leadership and its influence on the followers' wellbeing (hedonic and eudaimonic wellbeing) and work engagement. We also examined the mediating role of hedonic and eudaimonic wellbeing on followers' work engagement. Using a time-lagged design, we collected data from 250 telecom sector workers employed in the capital city of Islamabad, Pakistan. The results indicate the positive influence of authentic leadership on followers' work engagement and employees' hedonic and eudaimonic wellbeing. Hedonic and eudaimonic wellbeing also positively mediated the relationship between authentic leadership and followers' work engagement. The theoretical and practical implications of the study are also discussed.

Outwelling of nutrients into the Pasur River estuary from the Sundarbans mangrove creeks.

The Pasur River estuary (PRE), the largest estuary in the Sundarbans mangrove area, provides vital fishery resources and supports millions of livelihoods in the southwestern coastal region of Bangladesh. This study focused on the tidal and run-off effects on the outwelling of nutrients from the Sundarbans mangrove creeks to the PRE. Spatial and temporal variations of nutrient and chlorophyll-a concentrations were assessed by water sampling at 11 stations in the study area from January to December 2019. Dissolved inorganic nutrients and chlorophyll-a were analyzed by standard methods using a spectrophotometer. In the tidal mangrove creeks, dissolved inorganic nitrogen, phosphate, and silica concentrations were significantly higher (p < 0.05) during the spring tide than those during the neap tide, suggesting that these nutrients were flushed from the mangrove area by the inundation and tidal mixing of the spring tide. In general, chlorophyll-a (mean ± SD) concentrations in the PRE and the tidal mangrove creeks were 5.62 ± 1.30 µg/L and 9.03 ± 0.59 µg/L in the wet season, respectively. During the dry season, the chlorophyll-a decreased to 4.37 µg/L ± 0.68 and 4.94 ± 1.52 µg/L in the PRE and the tidal mangrove creek, respectively. The amount of nutrients outwelled from the mangrove creeks to the estuary was 1.53 ± 0.67 mg/L DIP, 0.001 ± 0.0004 mg/L DIN, and 1.38 ± 0.48 mg/L dissolved silica. DIP, silica, and chlorophyll-a concentrations were significantly higher (p < 0.05) during the spring tide compared to the neap tide, but salinity was not significantly (p > 0.05) different between the two tidal levels. This study showed that the mangrove creeks formed an important link in transporting nutrients from the mangrove forest to the estuary.

Dominant phytoplankton groups as the major source of polyunsaturated fatty acids for hilsa (Tenualosa ilisha) in the Meghna estuary Bangladesh.

The tropical estuarine ecosystem is fascinating for studying the dynamics of water quality and phytoplankton diversity due to its frequently changing hydrological conditions. Most importantly, phytoplankton is the main supplier of ω3 polyunsaturated fatty acids (PUFA) in the coastal food web for fish as they could not synthesize PUFA. This study evaluated seasonal variations of water quality parameters in the Meghna River estuary (MRE), explored how phytoplankton diversity changes according to hydro-chemical parameters, and identified the major phytoplankton groups as the main source of PUFA for hilsa fish. Ten water quality indicators including temperature, dissolved oxygen, pH, salinity, dissolved inorganic nitrogen (DIN = nitrate, nitrite, ammonia) and phosphorus, dissolved silica and chlorophyll-a were evaluated. In addition, phytoplankton diversity was assessed in the water and hilsa fish gut. Principal component analysis (PCA) was used to analyze the spatio-temporal changes in the water quality conditions, and the driving factors in the MRE. Four main components were extracted and explained 75.4% variability of water quality parameters. The most relevant driving factors were dissolved oxygen, salinity, temperature, and DIN (nitrate, nitrite and ammonia). These variabilities in physicochemical parameters and dissolved inorganic nutrients caused seasonal variations in two major groups of phytoplankton. Peak abundance of Chlorophyta (green algae) occurred in water in nutrient-rich environments (nitrogen and phosphorus) during the wet (36%) season, while Bacillariophyta (diatoms) were dominant during the dry (32%) season that depleted dissolved silica. Thus, the decrease of green algae and the increase of diatoms in the dry season indicated the potential link to seasonal changes of hydro-chemical parameters. The green algae (53.7%) were the dominant phytoplankton group in the hilsa gut content followed by diatoms (22.6%) and both are contributing as the major source of PUFAs for hilsa fish according to the electivity index as they contain the highest amounts of PUFAs (60 and 28% respectively).

Driving forces of the pervasiveness of street vending: A data article.

Street vendors are prominent on public streets and in traditional markets in most developing countries. They raise significant problems for public authorities, residents, pedestrians, and formal retailers. Their informal business is problematic, leading to conflicts and sometimes violence. Moreover, unlicensed street vendors employ children and women and are accused of counterfeiting and drug trading. However, they participate in reducing poverty and unemployment. The current data article aims to formulate a public perception on the problematic issue of street vending pervasiveness by describing a survey dataset on street vending and its main driving factors. Street vending has traditionally be examined by linking it with one or more determinants; thus, the dataset covers poverty, lack of education, immigration, unemployment, urban culture, low-income consumption, resistance, and lack of microfinance as latent constructs. Five measurable variables are introduced that reflect each construct. All variables are measured via seven-point Likert scales. Using a Google Form, 425 responses were collected that reflect the attitudes of the general public in Baghdad, Iraq. This dataset is useful for research on socio-economic problems; more specifically, it introduces reliable measurement models for street vending and the eight factors driving it.

Wind-noise reduction for infrasonic measurements using adaptive line enhancement.

Measurement quality and analysis capability of infrasonic signals are both affected by background wind-noise. Physical filters, i.e., barriers and pipe arrays, are traditionally employed to reduce such noise. However, limited efficacy, site dependence, cost, requirement of space, non-portability, and frequent maintenance are some of their major drawbacks. This work proposes an adaptive filtering-based adaptive line enhancer (ALE) noise cancellation scheme as an alternative. Two infrasonic sensors (Chaparral Physics 50A), are adjacently deployed. One sensor is fitted with a conventional four-armed non-porous hose array (physical filter), while the ALE scheme is applied to the second sensor, sans physical filter. In high wind-noise conditions, the ALE scheme seems to behave as a lowpass filter (cutoff at 0.2 Hz), with a maximum attenuation of 26 dB at 8 Hz, while the physical filter provides significant attenuation only above 4 Hz with a maximum attenuation of 17 dB at 8 Hz. Generally, at other frequencies, the ALE scheme provides up to 20 dB superior noise attenuation as compared to the physical filter. The ALE also provides up to 6 dB gain in the signal-to-noise ratio as compared to the physical filter, due to non-attenuation of the infrasonic signal.

Effect of different wavelengths of LED light on the growth, chlorophyll, ß-carotene content and proximate composition of Chlorella ellipsoidea.

Chlorella ellipsoidea is a freshwater green microalga that has great prospect for the sustainable development of aquaculture industry. Microalgae require optimal lighting conditions for efficient photosynthesis. The key to cost-effective algal biomass production is to optimize algae growth conditions. This study aimed to investigate the effects of various wavelengths viz. white (380-750 nm), green (510 nm), blue (475 nm), and red (650 nm) light-emitting diodes (LEDs) on the growth, pigment content (chlorophyll-a, chlorophyll-b, and ß-carotene), and proximate composition of C. ellipsoidea with a photoperiod of 12 h:12 h light: dark cycle under indoor environmental conditions. C. ellipsoidea was cultured in Bold's Basal Medium for 18 days. The cell density (125.36×105 cells ml-1), cell dry weight (58.9 ± 4.57 mg L-1), optical density (1.66 ± 0.08 g L-1), chlorophyll-a (7.31 ± 0.04 µg ml-1), chlorophyll-b (2.73 ± 0.13 µg ml-1), and ß-carotene (0.39 ± 0.04 µg ml-1) content of C. ellipsoidea were significantly (P < 0.05) higher at 15th-day when cultured under blue LED light exposure. Significantly lower growth and nutritional values were obtained under red LED light exposure compared to the control and other LEDs spectra. In Pearson correlation analysis, the cell density and cell dry weight values showed a strong positive correlation with the values of pigment contents of C. ellipsoidea in all the treatments. The LEDs light spectra showed significant effects on proximate composition of C. ellipsoidea. Protein and lipid contents of C. ellipsoidea were significantly higher in blue LED growth conditions compared to white, green, and red LEDs. C. ellipsoidea cells were 3-7.04 µm in size and the maximum area of the cell was 38.94 µm2 in blue LED treatment. Results of this study demonstrated that blue LED light spectra was the most suitable condition to induce nutritionally rich biomass production of C. ellipsoidea, which can be used as a potential source of fish feed towards sustainable aquaculture.

Dietary chitosan promotes the growth, biochemical composition, gut microbiota, hematological parameters and internal organ morphology of juvenile Barbonymus gonionotus.

In this study, we determined the effects of dietary chitosan on the growth, biochemical composition, gut microbiota, and hematological and histological parameters of juvenile Barbonymus gonionotus. Three test diets containing three different concentrations (1, 2, and 3 g kg-1 feed) of dietary chitosan were formulated. A basal diet without dietary chitosan was considered a control, and the fish were reared for 60 days. Comparing the effects of the dietary chitosan-containing diets with those of the control diet, we found that dietary chitosan significantly improved the muscle growth, nutrient and mineral contents, hematological parameters, lactic acid bacterium abundance, and digestive enzyme activities of B. gonionotus. Moreover, dietary chitosan significantly inhibited the growth of pathogenic bacteria in fish. Interestingly, an increase in the dietary chitosan level significantly enhanced the protein contents of the muscles and inversely significantly decreased the lipid contents compared to those with the basal diet. Quantitative study revealed that dietary chitosan significantly enhanced the length of intestinal villi, and qualitative study showed that dietary chitosan considerably reduced the fat content in the liver and improved the morphology of the kidney compared to those with the basal diet. Taken together, our results suggest that the application of dietary chitosan at a dose of 1 g kg-1 feed produced the highest benefit to treated B. gonionotus, indicating its potential for safe use in aquaculture.

Policy Discourses: Shifting the Burden of Healthcare from the State to the Market in the Kingdom of Saudi Arabia.

Saudi Arabia has modified from a predominantly free, public, and comprehensive system under a welfare model to more of a mixed-economy model of healthcare. The welfare state slowly moved to a liberal model, emphasizing market forces to dominate in the provision of healthcare and the private sector was trusted to provide a better provision of healthcare. The country has to confront enormous problems in the health sector due to population growth, lifestyle changes, the shift of disease patterns, elevated expectations, escalated healthcare costs, limited infrastructure and resources, and poor management practice in the provision of healthcare. Moreover, the government has been emphasizing the need to bring in private sector investment to improve quality and efficiency, development of manpower, and standardization of services. As the current pattern of healthcare is unsustainable, the country is planning to restructure the present healthcare system toward institutionalizing it to meet future challenges. The governments must make an appropriate amount of effort to build their healthcare systems by transforming and modifying the challenges faced by society and its political-economic systems. The government should encourage equity, and fairness in the provision of healthcare.

Gut probiotic bacteria of Barbonymus gonionotus improve growth, hematological parameters and reproductive performances of the host.

This study aimed to isolate and identify probiotic bacteria from the gut of Barbonymus gonionotus and evaluate their effects on growth, hematological parameters, and breeding performances of the host. Five probiotic bacteria viz. Enterococcus xiangfangensis (GFB-1), Pseudomonas stutzeri (GFB-2), Bacillus subtilis (GFB-3), Citrobacter freundii (GFB-4), and P. aeruginosa (GFB-5) were isolated and identified using 16S rRNA gene sequencing. Application of a consortium of probiotic strains (1-3 × 1.35 × 109 CFU kg-1) or individual strain such as GFB-1 (1.62 × 109 CFU kg-1), GFB-2 (1.43 × 109 CFU kg-1), GFB-3 (1.06 × 109 CFU kg-1), GFB-4 (1.5 × 109 CFU kg-1) or GFB-5 (1.43 × 109 CFU kg-1feed) through feed significantly improved growth, histological and hematological parameters and reproductive performances of B. gonionotus compared to untreated control. Moreover, the application of these probiotics significantly increased gut lactic acid bacteria and activities of digestive enzymes but did not show any antibiotic resistance nor any cytotoxicity in vitro. The highest beneficial effects on treated fishes were recorded by the application of GFB-1, GFB-2, GFB-3, and a consortium of these bacteria (T2). This is the first report of the improvement of growth and health of B. gonionotus fishes by its gut bacteria.

The Impact of Urban Culture on Street Vending: A Path Model Analysis of the General Public's Perspective.

This study examined the relationship between urban culture and street vending. Prior research on this topic is limited and inconclusive. Therefore, we have proposed an integrated model to test the positive effect of urban culture on street vending using multiple mediations of consumption patterns, resistance, and microfinance. We tested a sample of 425 responses that reflect the public opinion in Baghdad, Iraq. These responses were collected between September and November 2018. A partial least squares-based structural equation modeling is employed to test the validity of measurement models and the significance of the entire structural model, predictive power, and mediation analysis. We found that resistance mediates the effect of urban culture on street vending; low-income consumption and resistance sequentially mediate the effect of urban culture on street vending, while resistance mediates the effect of a lack of microfinance on street vending. The direct impact of culture on street vending is not significant, and a lack of microfinance positively influences the pervasiveness of trading on streets. This study contributes to the extant literature as it proposed and tested a novel and comprehensive model to analyze the relationship between urban culture and street vending, simultaneously examining the effects of culture, consumption, resistance, and microfinance on street vending.

Social Media Efficacy in Crisis Management: Effectiveness of Non-pharmaceutical Interventions to Manage COVID-19 Challenges.

The new identified virus COVID-19 has become one of the most contagious diseases in human history. The ongoing coronavirus has created severe threats to global mental health, which have resulted in crisis management challenges and international concerns related to health issues. As of September 9, 2021, there were over 223.4 million patients with COVID-19, including 4.6 million deaths and over 200 million recovered patients reported worldwide, which has made the COVID-19 outbreak one of the deadliest pandemics in human history. The aggressive public health implementations endorsed various precautionary safety and preventive strategies to suppress and minimize COVID-19 disease transmission. The second, third, and fourth waves of COVID-19 continue to pose global challenges to crisis management, as its evolution and implications are still unfolding. This study posits that examining the strategic ripostes and pandemic experiences sheds light on combatting this global emergency. This study recommends two model strategies that help reduce the adverse effects of the pandemic on the immune systems of the general population. This present paper recommends NPI interventions (non-pharmaceutical intervention) to combine various measures, such as the suppression strategy (lockdown and restrictions) and mitigation model to decrease the burden on health systems. The current COVID-19 health crisis has influenced all vital economic sectors and developed crisis management problems. The global supply of vaccines is still not sufficient to manage this global health emergency. In this crisis, NPIs are helpful to manage the spillover impacts of the pandemic. It articulates the prominence of resilience and economic and strategic agility to resume economic activities and resolve healthcare issues. This study primarily focuses on the role of social media to tackle challenges and crises posed by COVID-19 on economies, business activities, healthcare burdens, and government support for societies to resume businesses, and implications for global economic and healthcare provision disruptions. This study suggests that intervention strategies can control the rapid spread of COVID-19 with hands-on crisis management measures, and the healthcare system will resume normal conditions quickly. Global economies will revitalize scientific contributions and collaborations, including social science and business industries, through government support.

Case Report of High-Grade Atrioventricular Block and Takotsubo Cardiomyopathy.

INTRODUCTION: Takotsubo cardiomyopathy (TTC) is a condition with a good long-term prognosis. However, when the TTC is due to a life-threatening arrhythmia, such as atrioventricular block (AVB), several considerations must be made regarding treatment. CASE PRESENTATION: A 71-year-old woman with a history of ischemic stroke presented after a syncopal episode. Before passing out, the patient was walking, nauseous, lightheaded, dizzy, and short of breath. In the emergency department, the blood pressure was 230/120 mmHg, and the heart rate was 38 beats per minute, but the patient was asymptomatic. An electrocardiogram showed a new-onset 2:1 AVB, bifascicular block, and prolonged PR and corrected QT intervals. An echocardiogram revealed a new-onset ejection fraction of 30% to 35%; hypokinesis of the apex, mid-inferoseptum, mid-anterolateral, apical to mid-inferior, and apical to mid-anterior walls; and hyperkinesis of the basal segments. The cardiac catheterization illustrated normal coronary arteries without significant stenosis. Therefore, the patient was diagnosed with TTC and 2:1 AVB. She was treated with lisinopril and metoprolol succinate and received a dual-chamber pacemaker. At the follow-up visit, the patient's ejection fraction and hypokinetic segments improved. She denied any recurrence of syncope, and her pacemaker was functioning appropriately. CONCLUSION: When AVB or other arrhythmias initiate a TTC, the patient can experience sudden cardiac death and decompensate quickly. Therefore, clinicians should understand this rare but fatal complication because these patients require pacemakers and beta blockers.

Whole-Genome Sequence of a Plant Growth-Promoting Strain, Serratia marcescens BTL07, Isolated from the Rhizoplane of Capsicum annuum L.

Serratia marcescens strain BTL07, which has the ability to promote growth and suppress plant diseases, was isolated from the rhizoplane of a chili plant. The draft genome sequence data of the strain will contribute to advancing our understanding of the molecular mechanisms underlying plant growth promotion and tolerance to different stresses.

Evaluation of seminal plasma composition and spermatozoa quality parameters of silver barb, Barbonymus gonionotus Bleeker, 1850.

Seminal composition and semen quality are the important determinants in assessing the reproductive performance of different fishes. This study was carried out to evaluate the seminal composition and sperm quality of Barbonymus gonionotus. The seminal plasma contained 17.2 ± 0.34 mmol/l, 20.9 ± 0.48 mmol/l, 0.72 ± 0.04 mmol/l, 3.8 ± 0.2 mmol/l, and 1.49 ± 0.02 g/dl of Na+, K+, Ca++, Mg++, and total protein, respectively. The physical spermatological parameters, such as sperm volume, sperm motility, motility duration, sperm density, osmolality, and pH values were 1.55 ± 0.15 ml, 89 ± 2%, 391.9 ± 8.5 s, 2.8 ± 0.2 × 1010 /ml, 400.6 ± 5.1 mmol/kg, and 8.75 ± 0.10, respectively. In correlation matrix, the K+ (R2 = 0.39, P < 0.01) and Ca++ (R2 = 0.27, P < 0.05) ions and osmolality (R2 = 0.29, P < 0.05) showed significant positive correlations with sperm motility. Similarly, fertilization rate significantly influenced by sperm motility (R2 = 0.26, P < 0.05) and K+ (R2 = 0.30, P < 0.05) and Ca++ (R2 = 0.26, P < 0.05) ions. Also, osmolality significantly and negatively correlated with Mg++ (R2 = 0.33, P < 0.05) and sperm motility duration (R2 = 0.28, P < 0.05). Therefore, based on this results, it can be concluded that seminal plasma ions, K+ and Ca++ and osmolality are the key factors for the determination of sperm quality of silver barb, and these parameters could be considered during standardization of artificial fertilization or cryopreservation technique of silver barb spermatozoa.