Knowledge, Attitude, and Practice of Healthcare Professionals and Medical Students Regarding Probiotics and Prebiotics in Lahore, Pakistan: A Cross-Sectional Study.

Objective This study aims to explore healthcare professionals' and medical students' knowledge and attitudes toward probiotics and prebiotics in various health conditions. It seeks to identify any obstacles associated with their use and gain insight into the healthcare community's perspectives on these supplements. Methods A descriptive cross-sectional study was conducted using a preformed questionnaire. Data was collected by a convenience sampling technique during October and November 2023. A total of 417 responses were collected, and the data analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, NY, USA). Results In the study, 198 participants (47.5%) were doctors, and 219 (52.5%) were medical students. Only 81 (37%) students had good knowledge about probiotics, while 36 (16.4%) had good knowledge about prebiotics. Poor knowledge was associated with a poor knowledge, attitude, and practice (KAP) score, indicating a link between knowledge, attitude, and practice. Similarly, only 96 (48.5%) doctors had good knowledge about probiotics, while 45 (22.7%) of them had good knowledge about prebiotics. The study found that a lack of knowledge was the primary barrier to the use of prebiotics and probiotics, as reported by 226 (54.4%) participants. The chi-square test showed no significant correlation between participants' demographics and their KAP. Conclusion The majority of respondents demonstrated poor knowledge and practices regarding probiotics and prebiotics, which can be attributed to insufficient awareness of their benefits. Education tools like curriculum and training programs should include evidence-based information to raise awareness among healthcare professionals about their benefits and address concerns associated with their use in treating patients.

Cooperative Distributed Uplink Cache over B5G small cell networks.

The emergence of content-centric network has resulted in a substantial increase in data transmission in both uplink and downlink directions. To tackle the ensuing challenges of network congestion and bottlenecks in backhaul links within Beyond Fifth Generation (B5G) networks, data caching has emerged as a popular solution. However, caching for uplink transmission in a distributed B5G scenario poses several challenges, including duplicate content matching and users' obliviousness about cached contents. Furthermore, it is important to maximize available space by caching the most popular contents in a distributed manner. In this paper, we propose two schemes for uplink transmission in distributed B5G SCNs. The first scheme focuses on content matching to eliminate duplicate contents among distributed caches, while the second scheme redistributes un-duplicated cached contents among distributed caches based on their available space and content's size. These approaches aim to enhance energy and spectral efficiency by reducing unnecessary uploads and optimizing distributed content caching, in addition to improve the content delivery. The analysis shows that the proposed schemes outperform the existing schemes by improving the cache hit ratio, cache hit probability, overall distributed cache efficiency, and diversity by 29.17%, 74.89%, 24.17%, and, 80%, respectively. Furthermore, the average throughput, Spectrum Efficiency (SE), and Energy Efficiency (EE) of the access network is improved by 17.78%, 18%, and 78%, respectively. Besides that, the EE and SE of both the sidehaul and backhaul links of the SBSs are also improved.

Interface engineering and defect passivation for enhanced hole extraction, ion migration, and optimal charge dynamics in both lead-based and lead-free perovskite solar cells.

The study elucidates the potential benefits of incorporating a BiI3 interfacial layer into perovskite solar cells (PSCs). Using MAPbI3 and MAGeI3 as active layers, complemented by the robust TiO2 and Spiro-OMeTAD as the charge-transport-layers, we employed the SCAPS-1D simulation tool for our investigations. Remarkably, the introduction of the BiI3 layer at the perovskite-HTL interface significantly enhanced hole extraction and effectively passivated defects. This approach minimized charge recombination and ion migration towards opposite electrodes, thus elevating device performance relative to conventional configurations. The efficiency witnessed a rise from 19.28 to 20.30% for MAPbI3 and from 11.90 to 15.57% for MAGeI3. Additionally, MAGeI3 based PSCs saw an improved fill-factor from 50.36 to 62.85%, and a better Jsc from 13.22 to 14.2 mA/cm2, signifying reduced recombination and improved charge extraction. The FF for MAPbI3 based PSCs saw a minor decline, while the Voc slightly ascended from 1.24 to 1.25 V and Jsc from 20.01 to 21.6 mA/cm2. A thorough evaluation of layer thickness, doping, and temperature further highlighted the critical role of the BiI3 layer for both perovskite variants. Our examination of bandgap alignments in devices with the BiI3 interfacial layer also offers valuable understanding into the mechanisms fueling the observed improvements.

Prospectively accelerated dynamic speech magnetic resonance imaging at 3 T using a self-navigated spiral-based manifold regularized scheme.

This work develops and evaluates a self-navigated variable density spiral (VDS)-based manifold regularization scheme to prospectively improve dynamic speech magnetic resonance imaging (MRI) at 3 T. Short readout duration spirals (1.3-ms long) were used to minimize sensitivity to off-resonance. A custom 16-channel speech coil was used for improved parallel imaging of vocal tract structures. The manifold model leveraged similarities between frames sharing similar vocal tract postures without explicit motion binning. The self-navigating capability of VDS was leveraged to learn the Laplacian structure of the manifold. Reconstruction was posed as a sensitivity-encoding-based nonlocal soft-weighted temporal regularization scheme. Our approach was compared with view-sharing, low-rank, temporal finite difference, extra dimension-based sparsity reconstruction constraints. Undersampling experiments were conducted on five volunteers performing repetitive and arbitrary speaking tasks at different speaking rates. Quantitative evaluation in terms of mean square error over moving edges was performed in a retrospective undersampling experiment on one volunteer. For prospective undersampling, blinded image quality evaluation in the categories of alias artifacts, spatial blurring, and temporal blurring was performed by three experts in voice research. Region of interest analysis at articulator boundaries was performed in both experiments to assess articulatory motion. Improved performance with manifold reconstruction constraints was observed over existing constraints. With prospective undersampling, a spatial resolution of 2.4 × 2.4 mm2/pixel and a temporal resolution of 17.4 ms/frame for single-slice imaging, and 52.2 ms/frame for concurrent three-slice imaging, were achieved. We demonstrated implicit motion binning by analyzing the mechanics of the Laplacian matrix. Manifold regularization demonstrated superior image quality scores in reducing spatial and temporal blurring compared with all other reconstruction constraints. While it exhibited faint (nonsignificant) alias artifacts that were similar to temporal finite difference, it provided statistically significant improvements compared with the other constraints. In conclusion, the self-navigated manifold regularized scheme enabled robust high spatiotemporal resolution dynamic speech MRI at 3 T.

Emotional Stress and Immune Response in Surgery: A Psychoneuroimmunological Perspective.

Psychoneuroimmunology (PNI) offers a deep dive into the nexus between emotional stress, immunity, and surgical outcomes. In this narrative review, we first trace PNI's historical roots, providing a foundational understanding of its evolution. We then dissect its significance across the surgical journey, from the preoperative phase through to postoperative recovery. It becomes evident through our exploration that emotional stress has profound implications for surgery, notably influencing wound healing rates, susceptibility to infections, and overall postoperative well-being. Among the arsenal to combat these challenges, interventions such as cognitive-behavioral therapy, mindfulness, and complementary practices such as meditation and yoga have emerged as potent tools. They not only mitigate stress but also play a pivotal role in enhancing immune function. However, the journey to optimizing surgical outcomes is not just about identifying effective interventions. A resounding theme is the importance of holistic care, ensuring that all patients have equitable access to these tools. As PNI continues to evolve, we stand at the precipice of a healthcare revolution, one that promises a blend of personalized care, anchored in a deep understanding of the mind-body connection in surgical contexts.

Revolutionizing Inflammatory Bowel Disease Management: A Comprehensive Narrative Review of Innovative Dietary Strategies and Future Directions.

This comprehensive narrative review delves into the intricate interplay between diet and inflammatory bowel disease (IBD), shedding light on the potential impact of dietary interventions in disease management. By analyzing nutritional interventions, risks, challenges, and future perspectives, this review serves as a vital resource for clinicians, researchers, and patients alike. The amalgamation of evidence underscores the significance of customizing dietary strategies for individual patients, considering disease phenotype and cultural factors. Through an exploration of dietary components' effects on IBD, including exclusive enteral nutrition and omega-3 fatty acids, this review offers pragmatic implementation advice and outlines avenues for further research. Bridging the gap between research findings and clinical applications, the review facilitates informed decision-making and patient-centric care. In the face of escalating IBD prevalence, this review emerges as an indispensable guide for healthcare professionals, empowering them to navigate the complexities of dietary management while enabling patients to actively participate in their care trajectory. Ultimately, this narrative review advances the understanding of diet's pivotal role in IBD management, fostering a more integrated approach to patient care and paving the way for improved research and policy initiatives in the field of inflammatory bowel diseases.

Vascular Aging: Assessment and Intervention.

Vascular aging represents a collection of structural and functional changes in a blood vessel with advancing age, including increased stiffness, vascular wall remodeling, loss of angiogenic ability, and endothelium-dependent vasodilation dysfunction. These age-related alterations may occur earlier in those who are at risk for or have cardiovascular diseases, therefore, are defined as early or premature vascular aging. Vascular aging contributes independently to cardio-cerebral vascular diseases (CCVDs). Thus, early diagnosis and interventions targeting vascular aging are of paramount importance in the delay or prevention of CCVDs. Here, we review the direct assessment of vascular aging by examining parameters that reflect changes in structure, function, or their compliance with age including arterial wall thickness and lumen diameter, endothelium-dependent vasodilation, arterial stiffness as well as indirect assessment through pathological studies of biomarkers including endothelial progenitor cell, lymphocytic telomeres, advanced glycation end-products, and C-reactive protein. Further, we evaluate how different types of interventions including lifestyle mediation, such as caloric restriction and salt intake, and treatments for hypertension, diabetes, and hyperlipidemia affect age-related vascular changes. As a single parameter or intervention targets only a certain vascular physiological change, it is recommended to use multiple parameters to evaluate and design intervention approaches accordingly to prevent systemic vascular aging in clinical practices or population-based studies.

Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID.

The occurrence of post-myocardial infarction (MI) ventricular septal defect (VSD) is a rare but life-threatening complication. This case report presents a unique case of a 49-year-old female patient with an anterolateral ST-segment elevation MI who underwent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, complicated by a no-reflow phenomenon in the distal left anterior descending artery (LAD) and subsequent development of a hemodynamically significant VSD. Notably, this case occurred during the COVID-19 pandemic, which added to the complexity of the patient's management. The patient's clinical course was further complicated by cardiogenic shock, acute respiratory failure, COVID-19 pneumonia, and gastrointestinal bleeding. Despite these challenges, the patient received prompt treatment and optimal medical management, including the use of vasopressor support, insulin therapy, and bicarbonate infusions. The patient also underwent surgical repair of the VSD at a quaternary center, resulting in a favorable outcome. This case report highlights the increased incidence of mechanical complications, such as VSD, during the COVID-19 pandemic due to delayed presentation and patient concerns about exposure to the virus. It also emphasizes the occurrence of a no-reflow phenomenon during PCI, which can lead to adverse outcomes, including larger infarct size and potential ventricular septal rupture. The case further underscores the importance of multidisciplinary collaboration and early subspecialist involvement in managing complex cases of post-MI VSD.

A Perfect Storm: Ventricular Fibrillation Cardiac Arrest Due to Acute Myocardial Infarction Seen in the Postpartum Period in the Setting of COVID.

Acute myocardial infarction (AMI) in women of reproductive age is uncommon; however, the risk of AMI increases four to five-fold during pregnancy as compared to non-pregnant women of similar age. In the period following childbirth, the incidence of AMI is often attributed to a range of factors. These factors encompass coronary vessel dissection related to atherosclerosis, thrombosis, coronary spasm, and, in rare cases, takotsubo cardiomyopathy. The physiological alterations that accompany pregnancy induce a state of heightened coagulation, thereby elevating the risk of ischemic heart disease (IHD) in women. While the presence of traditional risk factors is not a strong predictor of post-partum AMI (PAMI) due to any cause, most cases of PAMI due to IHD or atherosclerosis have other mechanisms associated with AMI, significant past medical history, or the presence of other traditional risk factors. The purpose of this report is to describe an uncommon case of pregnancy associated with MI due to ischemic heart disease and discuss the pathogenesis of contributing risk factors that created the "perfect storm" leading to her presentation.

Knowledge, Attitude, and Practice on Antenatal Care Among Pregnant Women and its Association With Sociodemographic Factors: A Hospital-Based Study.

Knowledge, attitude, and practices (KAP) for an antenatal check-up during pregnancy is a key indicator of a healthcare facility in a community. Antenatal care (ANC) is a useful practice for lowering infant and maternal mortality. Therefore, the present study was planned to estimate knowledge, attitudes, and practices regarding ANC among pregnant women and determine its association with sociodemographic factors. This hospital-based cross-sectional study was conducted on 400 pregnant women through convenience sampling from March 2020 to February 2021. A semistructured questionnaire included sociodemographic and obstetrical history, and scored questionnaire on KAP was used. The analysis included parametric, nonparametric, and Pearson correlation coefficient tests. The finding of the study revealed that pregnant women had average knowledge (96%), positive attitudes (98.75%), and good practices (58.5%) toward ANC. The level of overall knowledge had a positive correlation with the practices toward ANC (r = 0.18, P < 0.001). The sociodemographic association showed that age, type of family, education, and occupation had a significant association with awareness and practices about ANC. Furthermore, the practice of ANC in our study area was low despite good knowledge and attitude toward ANC. Further, exploratory studies are required and need to be planned to improve practices in prenatal care and ultimately improve their health.

Immunotherapies against human bacterial and fungal infectious diseases: A review.

Nations' ongoing struggles with a number of novel and reemerging infectious diseases, including the ongoing global health issue, the SARS-Co-V2 (severe acute respiratory syndrome coronavirus 2) outbreak, serve as proof that infectious diseases constitute a serious threat to the global public health. Moreover, the fatality rate in humans is rising as a result of the development of severe infectious diseases brought about by multiple drug-tolerant pathogenic microorganisms. The widespread use of traditional antimicrobial drugs, immunosuppressive medications, and other related factors led to the establishment of such drug resistant pathogenic microbial species. To overcome the difficulties commonly encountered by current infectious disease management and control processes, like inadequate effectiveness, toxicities, and the evolution of drug tolerance, new treatment solutions are required. Fortunately, immunotherapies already hold great potential for reducing these restrictions while simultaneously expanding the boundaries of healthcare and medicine, as shown by the latest discoveries and the success of drugs including monoclonal antibodies (MAbs), vaccinations, etc. Immunotherapies comprise methods for treating diseases that specifically target or affect the body's immune system and such immunological procedures/therapies strengthen the host's defenses to fight those infections. The immunotherapy-based treatments control the host's innate and adaptive immune responses, which are effective in treating different pathogenic microbial infections. As a result, diverse immunotherapeutic strategies are being researched more and more as alternative treatments for infectious diseases, leading to substantial improvements in our comprehension of the associations between pathogens and host immune system. In this review we will explore different immunotherapies and their usage for the assistance of a broad spectrum of infectious ailments caused by various human bacterial and fungal pathogenic microbes. We will discuss about the recent developments in the therapeutics against the growing human pathogenic microbial diseases and focus on the present and future of using immunotherapies to overcome these diseases. Graphical AbstractThe graphical abstract shows the therapeutic potential of different types of immunotherapies like vaccines, monoclonal antibodies-based therapies, etc., against different kinds of human Bacterial and Fungal microbial infections.

Physicochemical and Anti-fungal Studies of the Pharmaceutical Co-crystal/Salt of Fluconazole.

Crystal engineering is one green alternative to organic synthesis that can be used to manipulate molecular behavior promptly and economically. We report the preparation and characterization of the pharmaceutical organic salt (FLC-C) of fluconazole (FLC) and organosulfonate (NDSA-2H), based on the sulfonate-pyridinium supramolecular synthon. Structural studies validate the crystallization of the two-component stoichiometric crystal with two molecules of water in the triclinic P1̅ space group. The anticipated proton transfer between the crystal forms leads to ionic interactions, augmenting the organic salt's thermal stability. Hirshfeld studies of FLC-C help to understand the role and significance of different types of intermolecular interactions responsible for crystal packing. The structural and theoretical studies indicate the absence of π-π interactions in FLC-C, which account for the incipience of solid-state emission in the product. The solubility studies establish augmented aqueous solubility of FLC-C over pristine FLC at physiological pH values of 2 and 7. Interestingly, in in vitro studies, FLC-C appears to serve as a potential alternative to FLC, displaying a wide spectrum of antifungal activity. FLC-C is active against several human pathogenic yeast strains, including the leading and emerging Candida strains (Candida albicans and Candida auris, respectively), at comparable and/or lower drug concentrations without showing any enhanced host cell toxicity. Interestingly, the pharmaceutical co-crystal also displays fluorescence properties inside the Candida cells.

Glucose metabolic reprogramming and modulation in glycerol biosynthesis regulates drug resistance in clinical isolates of Candida.

AIMS: The study is aimed at understanding the novel molecular mechanisms governing drug resistance in the opportunistic fungi belonging to the genus Candida. METHODS AND RESULTS: This is a multipronged study wherein different assays like drug susceptibility and whole cell proteome analysis, stress tolerance assay, measurement of total internal glycerol content, western blot analysis, reactive oxygen species (ROS) measurement, glucose uptake, lactate production, ATP generation, and NADPH measurements were made.The study reveals an incidence of different species of Candida in the northern most part of India (Kashmir valley). Resistant isolates, mostly resistant to azoles were reported across all the species. The study revealed a difference in resistance mechanisms between Candida albicans and C. glabrata clinical isolates. Further, such resistance mechanism (in the case of C. albicans) was mostly mediated by Hexokinase 2 (Hxk2) and Glucose-6-phosphate dehydrogenase (G6pd). Increased expression of Hxk2 was associated with increased glucose uptake, more lactate production, and more ATP generation in drug-resistant C. albicans. At the same time, increased G6pd expression was responsible for the increased production of NADPH, which imparts a better ROS scavenging potential. While in C. glabrata the resistance was linked with glycerol metabolism, where the drug-resistant isolate tends to accumulate more glycerol as an osmolyte in response to external stresses. This glycerol accumulation was found to be triggered by the HOG1-MAPK pathway. CONCLUSION: The study concludes that, like various human malignant tumors, there is a strong correlation between drug resistance and aberrant cellular metabolism in the opportunistic fungi belonging to the genus Candida.

Unidirectional ring vortex laser using a wedge-plate shearing interferometer.

In response to growing demand from optical vortex (OV) beam applications, numerous generation techniques have been developed competing in power scalability, purity, and wavelength flexibility. Direct vortex emission from lasers typically grants access to efficient, high power, and pure mode generation. In this work we demonstrate a compact, unidirectional Nd:YVO4 ring laser with an intracavity wedge-plate shearing interferometer (WPSI) as an output coupler, which converted the internal Gaussian mode to LG01 (Laguerre-Gaussian OV) output. It directly generated a watt-level LG01 OV with high mode purity (98%) in a single longitudinal mode. The monolithic WPSI has advantages in stability and simplicity compared to other designs. The system is compact and cheap, using off-the-shelf components, and can be readily adapted to any gain media, widening the scope for OV generation at wavelengths currently unobtainable using competing methods.

Multi-attribute decision-making based on novel Fermatean fuzzy similarity measure and entropy measure.

To deal with situations involving uncertainty, Fermatean fuzzy sets are more effective than Pythagorean fuzzy sets, intuitionistic fuzzy sets, and fuzzy sets. Applications for fuzzy similarity measures can be found in a wide range of fields, including clustering analysis, classification issues, medical diagnosis, etc. The computation of the weights of the criteria in a multi-criteria decision-making problem heavily relies on fuzzy entropy measurements. In this paper, we employ t-conorms to suggest various Fermatean fuzzy similarity measures. We have also discussed all of their interesting characteristics. Using the suggested similarity measurements, we have created some new entropy measures for Fermatean fuzzy sets. By using numerical comparison and linguistic hedging, we have established the superiority of the suggested similarity metrics and entropy measures over the existing measures in the Fermatean fuzzy environment. The usefulness of the proposed Fermatean fuzzy similarity measurements is shown by pattern analysis. Last but not least, a novel multi-attribute decision-making approach is described that tackles a significant flaw in the order preference by similarity to the ideal solution, a conventional approach to decision-making, in a Fermatean fuzzy environment.

Prevalence and global trends of polypharmacy among people living with HIV: a systematic review and meta-analysis.

Background: There has been a rising prevalence of polypharmacy among people living with HIV (PLWH). Uncertainty however remains regarding the exact estimates of polypharmacy among these cohorts of patients. Methods: We conducted a systematic search of PubMed; EMBASE, CROI, Cochrane Database of Systematic Reviews; Science Citation Index and Database of Abstracts of Reviews of Effects for studies between 1 January 2000 and 30 June 2021 that reported on the prevalence of polypharmacy (ingestion of > 5 non-ART medications) among PLWH on antiretroviral therapy regimen (ART). Prevalence of polypharmacy among HIV-positive patients on ART with Clopper-Pearson 95% confidence intervals were presented. The heterogeneity between studies was evaluated using I 2 and τ 2 statistics. Results: One hundred ninety-seven studies were initially identified, 23 met the inclusion criteria enrolling 55,988 PLWH, of which 76.7% [95% confidence interval (CI): 76.4-77.1] were male. The overall pooled prevalence of polypharmacy among PLWH was 33% (95% CI: 25-42%) (I 2 = 100%, τ2 = 0.9170, p < 0.0001). Prevalence of polypharmacy is higher in the Americas (44%, 95% CI: 27-63%) (I 2 = 100%, τ2 = 1.0886, p < 0.01) than Europe (29%, 95% CI: 20-40%) (I 2 = 100%, τ2 = 0.7944, p < 0.01). Conclusion: The pooled prevalence estimates from this synthesis established that polypharmacy is a significant and rising problem among PLWH. The exact interventions that are likely to significantly mitigate its effect remain uncertain and will need exploration by future prospective and systematic studies. Registration: PROSPERO: CRD42020170071. Plain Language Summary: Background: In people living with HIV (PLWH), what is the prevalence of polypharmacy and is this influenced by sociodemographic factors?Methods and Results: In this systematic review and meta-analysis of 23 studies comprising 55,988 participants, we have for the first time found an estimated polypharmacy pooled prevalence of 33% among PLWH. There was a relatively higher pooled prevalence of polypharmacy among the America's compared with European cohorts of PLWH.Conclusion: Polypharmacy among PLWH is a rising morbidity that needs urgent intervention both at policy and patient levels of care.

Risk factors evaluation of cerebral palsy in Hazara division Khyber Pakhtunkhwa Pakistan: A cross-sectional survey.

OBJECTIVE: To evaluate the prevalence of risk factors of cerebral palsy in the mothers of children with cerebral palsy. Methods: The cross-sectional study was conducted in 2018 at the Helping Hand Institute of Rehabilitation Sciences, Mansehra, Pakistan, and comprised mothers of cerebral palsy children aged 1-18 years from the Hazara Division. Data was collected by using a modified form of Surveillance of cerebral palsy in Europe questionnaire regarding prenatal, natal and postal natal risk factors. Data was analysed using SPSS 21. RESULTS: Of the 300 children, 190(63.3%) were males and 110(36.7%) were females. The mean age of the children was 5.43±3.63 years and that of their mothers at the time of delivery was 26.16±5.11 years. Among the prenatal risk factors, anaemia was the leading factor 179(59.6%), while delayed crying 187(63.3%) was the major postnatal factor. Consanguinity was reported by 200(66.7%) mothers. Majority of the deliveries 201(67%) had taken place at hospitals. Conclusion: Anaemia and delayed crying were the major risk factors identified in mothers and children, respectively, in the study sample.

Meta-Analysis Comparing Drug-Coated Balloons and Percutaneous Transluminal Angioplasty for Infrapopliteal Artery Disease.

Limited data is available regarding the safety and effectiveness of drug-coated balloon (DCB) versus conventional percutaneous transluminal balloon angioplasty (PTA) in the treatment of critical limb ischemia because of infrapopliteal peripheral arterial disease. We conducted an updated meta-analysis to assess the safety and efficacy of DCB in the treatment of infrapopliteal disease. A database search of PubMed/MEDLINE, EMBASE, and the Cochrane Library was performed by 2 reviewers from inception through November 15, 2021. Randomized trials that compared DCB with conventional PTA in treating infrapopliteal arterial disease were included. The risk ratios (RRs) and 95% confidence intervals (CIs) were reported. A total of 9 trials were included (1,501 participants) in the study. The mean age was 71.1 ± 10.2 years. Regarding the primary end points, treating infrapopliteal arterial disease with DCB had a lower incidence of re-stenosis (RR 0.48, 95% CI 0.33 to 0.70, p = 0.0001) with no significant difference in all-cause mortality (RR 1.11, 95% CI 0.73 to 1.69, p = 0.61), compared with conventional PTA. With regards to the secondary end points, DCB usage was associated with a significant reduction in clinically driven target lesion revascularization (RR 0.54, 95% CI 0.35 to 0.84, p = 0.006) with no significant difference with regards to major target limb amputation and major adverse cardiovascular events (p ≥0.05). In conclusion, among patients with critical limb ischemia secondary to infrapopliteal artery disease, DCB usage was associated with a significantly lower number of restenosis and clinically driven target lesion revascularization compared with conventional PTA. There was no increase in all-cause mortality or major target limb amputation with the use of DCB.

ß-Nitrostyrene derivatives as broad range potential antifungal agents targeting fungal cell wall.

The prevalence of multidrug resistance has been increasingly witnessed during the past few decades. Resistance of human pathogenic fungi against the currently available antifungal agents has increased the frequency of fungal infections and associated mortality rates. The discovery of novel lead antifungal agents is important to challenge multidrug resistance. The present study examined the antifungal potential of chemically synthesized ß-Nitrostyrene derivatives. Among the eight ß-Nitrostyrene derivatives used in this study, SS45, SS46 and SS47 showed strong antifungal potential. The results show that ß-Nitrostyrene derivatives inhibited the growth of different species of human pathogenic Candida, particularly the highly prevalent C. albicans, C. glabrata and the emerging pathogenic C. auris species. Moreover, ß-Nitrostyrene derivatives also show strong antifungal activities against drug-resistant clinical isolates and drug transporter overexpressing fungal species. The drug susceptibility assays revealed that ß-Nitrostyrene derivatives are fungicidal and show the synergy of action when combined with antifungal drugs caspofungin and fluconazole. The transcriptomic study performed on C. albicans in the presence of ß-Nitrostyrene derivatives revealed the differential expression of genes related to cell wall metabolism. Mechanistically, ß-Nitrostyrene derivatives impact cell wall morphology, enhance ROS generation and modulate drug efflux. Collectively this study reveals that ß-Nitrostyrene derivatives have strong antifungal potential with a particular mode of activity similar to known cell wall perturbing antifungal agents and thus can be exploited as promising potential antifungal agents for further studies.

Variational Manifold Learning From Incomplete Data: Application to Multislice Dynamic MRI.

Current deep learning-based manifold learning algorithms such as the variational autoencoder (VAE) require fully sampled data to learn the probability density of real-world datasets. However, fully sampled data is often unavailable in a variety of problems, including the recovery of dynamic and high-resolution magnetic resonance imaging (MRI). We introduce a novel variational approach to learn a manifold from undersampled data. The VAE uses a decoder fed by latent vectors, drawn from a conditional density estimated from the fully sampled images using an encoder. Since fully sampled images are not available in our setting, we approximate the conditional density of the latent vectors by a parametric model whose parameters are estimated from the undersampled measurements using back-propagation. We use the framework for the joint alignment and recovery of multi-slice free breathing and ungated cardiac MRI data from highly undersampled measurements. Experimental results demonstrate the utility of the proposed scheme in dynamic imaging alignment and reconstructions.