Nanohexagonal iron barium titanate nanoparticles surface-modified NiFe2O4 composite screen-printed electrode for enzymatic glucose monitoring.

A nanocomposite of iron barium titanate/NiFe2O4 (FBT/NF) was synthesized using sol-gel techniques to form organized hexagonal structures. The effects of NiFe2O4 nanostructures on FBT's phase purity, morphology, and dielectric properties were systematically explored and intensively discussed. TEM imaging confirmed the hexagonal structure, and electrical measurements revealed that para-electric NF influenced the conductivity and impedance of ferroelectric FBT, with a shift in Curie temperature to lower values. The FBT/NF nanocomposite was optimized for use in glucose amperometric biosensors, offering fast and direct electron transfer from glucose oxidase that was chemically immobilized on disposable sensor chips. Thus, the biosensor exhibited high sensitivity (757.14 µA mM-1 cm-2), a fast response time of 50 seconds, and a wide linear range of 0.0027-1.9 mM with a low detection limit of 0.5 µM. Accordingly, the biosensor was exploited for blood glucose detection, showing high precision compared to reference methods. These findings highlighted the potential of the FBT/NF nanocomposite for use in developing biosensor portable devices.

Effect of channel roughness on the particle diffusion and permeability of carbon nanotubes in reverse electrodialysis process applying molecular dynamics simulation.

Innovative technology and methods are crucial for making pure and refreshing water. Two main methods are present to delete soluble salts from water: membrane processes and thermal processes. A beneficial membrane technique is reverse electrodialysis. This research used molecular dynamics (MD) simulation to investigate how channel roughness affected particle diffusion and permeability in carbon nanotubes (CNTs) via the reverse electrodialysis process. The results indicate that adding roughness in the CNT duct increased the force between the primary fluid and the duct. Using an armchair-edged CNT structure maximized the electric current in the sample. Furthermore, the roughness increased the intensity of force in the channel, which was due to gravity, leading to a decrease in the mobility of fluid particles. Additionally, several broken hydrogen bonds inside the simulation box increased from 116 to 128 in the duct sample with roughness.

Bringing PERT to Pediatrics: Initial Experience and Outcomes of a Pediatric Multidisciplinary Pulmonary Embolism Response Team (PERT).

BACKGROUND: Multidisciplinary pulmonary embolism response teams (PERTs) streamline care of adults with life-threatening pulmonary embolism (PE). Given rarity of pediatric PE, developing a clinical, educational, and research PERT paradigm is a novel and underused concept in pediatrics. RESEARCH QUESTION: Is a PERT feasible in pediatrics, and does it improve PE care? STUDY DESIGN AND METHODS: A strategy-to-execution proposal to launch a pediatric PERT was developed for institutional buy-in. Key stakeholders collectively implemented the PERT. Data were collected for the 2-year pre-PERT and post-PERT eras, and outcomes were compared. RESULTS: PERT implementation took 12 months. Our PERT, led by hematology, is composed of pediatric experts in emergency medicine, critical care, interventional cardiology, anesthesiology, and interventional radiology. Data on 30 patients pre-PERT and 31 patients post-PERT were analyzed. Pre-PERT, 10% (3 of 30), 13% (4 of 30), 20% (6 of 30), and 57% (17 of 30), and post-PERT, 3% (1 of 31), 10% (3 of 31), 16% (5 of 31), and 71% (22 of 31) were categorized as high-risk, intermediate-low-risk, intermediate-high-risk, and low-risk PE, respectively. Post-PERT, there were 13 unique PERT activations. PERT was activated on all eligible patients with PE and, additionally, on 4 low-risk PEs. Time to echocardiogram was shorter post-PERT (4.7 vs 2 hours, P = .0147). Anticoagulation was ordered (90 vs 54 minutes, P = .003) and given sooner (154 vs 113 minutes, P = .049) post-PERT. There were no differences in time to reperfusion therapies (12 hours pre-PERT vs 8.7 hours post-PERT, P = .10). Five of 6 (83.3%) eligible (intermediate-high and high-risk) patients received reperfusion therapies in the post-PERT era compared to 3 of 8 (37.5%) eligible patients in the pre-PERT era (P = .0001). There were no differences in major bleeding, mortality, or length of stay in either era. INTERPRETATION: The pediatric PERT paradigm was successfully created and adopted locally. Our PERT enhanced access to experts, facilitated timely advanced therapies, and held value for low-risk PE. The University of Texas Southwestern Medical Center and Children's Health System of Texas pediatric PERT may serve as a best practice model for streamlining care for pediatric PE.

Correlation Between Diverse Smoking Habits and the Risk of Developing Type 2 Diabetes: A Comparative Analysis.

BACKGROUND: Diabetes mellitus (DM) is a prevalent metabolic illness that arises as a result of a complex interplay between genetic predisposition, environmental influences, and lifestyle choices. The precise mechanisms elucidating the association between smoking and the onset of DM remain incompletely understood, despite the proposal of several ideas. The objective of this study was to conduct a comparative analysis of blood glucose levels, hemoglobin A1c (HbA1c) levels, insulin hormone levels, and homeostasis model assessment of insulin resistance (HOMA-IR) levels in diabetic patients who smoked and those who did not. METHODS: The study included a total of 320 volunteers divided into four groups, with each group consisting of 80 volunteers. The first group served as the control group and consisted of healthy individuals. The remaining three groups consisted of type 2 diabetes mellitus (T2DM) patients, categorized based on their smoking habits. The second group comprised T2DM patients who did not smoke, the third group consisted of T2 DM patients who smoked cigarettes, and the fourth group included T2DM patients who smoked e-cigarettes.  At recruitment, data on age, fat %, waist circumference (cm), and body mass index (kg/m2) was collected. Biochemical markers measured were fasting blood glucose (FBG), HbA1c, insulin, and HOMA-IR levels. RESULTS: The findings demonstrated a statistically significant increase (P<0.001) in the levels of each parameter, particularly among patients with T2DM who engaged in e-cigarette smoking, compared to the control group. It was found that engaging in dual smoking, which involves the use of both traditional cigarettes and e-cigarettes, was associated with a higher likelihood of elevated HbA1c levels and other negative health effects. CONCLUSION: When it comes to the management of diabetic patients, abstaining from smoking and participating in smoking cessation programs, for patients who smoke, should be the essential approaches. It was found that dual smoking led to a higher likelihood of elevated HbA1c levels and this association was most pronounced among male individuals, those who were physically inactive, and those classified as obese. Further studies should be conducted on the detrimental health consequences associated with e-cigarettes, with a particular focus on enhancing the awareness of healthcare professionals and their patients of the potential risks. This is particularly significant due to the prevailing perception that e-cigarettes are inherently "safe".

GDF15 antagonism limits severe heart failure and prevents cardiac cachexia.

AIMS: Heart failure and associated cachexia is an unresolved and important problem. This study aimed to determine the factors that contribute to cardiac cachexia in a new model of heart failure in mice that lack the integrated stress response (ISR) induced eIF2α phosphatase, PPP1R15A. METHODS AND RESULTS: Mice were irradiated and reconstituted with bone marrow cells. Mice lacking functional PPP1R15A, exhibited dilated cardiomyopathy and severe weight loss following irradiation, whilst wild-type mice were unaffected. This was associated with increased expression of Gdf15 in the heart and increased levels of GDF15 in circulation. We provide evidence that the blockade of GDF15 activity prevents cachexia and slows the progression of heart failure. We also show the relevance of GDF15 to lean mass and protein intake in patients with heart failure. CONCLUSION: Our data suggest that cardiac stress mediates a GDF15-dependent pathway that drives weight loss and worsens cardiac function. Blockade of GDF15 could constitute a novel therapeutic option to limit cardiac cachexia and improve clinical outcomes in patients with severe systolic heart failure.

Analysing the public's beliefs, emotions and sentiments towards Metaverse workplace: A big-data qualitative inquiry.

The Metaverse is gaining attention as a potential future workplace, and advancements in VR/AR technologies are set to revolutionise how we work and collaborate. Extensive research using big data is still needed to fully comprehend the public's perception of this emerging field. Grounded in the Technology Acceptance Model (TAM), the Diffusion of Innovations Theory (DIT), and Social Presence Theory (SPT), this study seeks to fill this knowledge gap. Using a methodology that involved machine learning and qualitative analysis of big data, the research gathered comments from social media users on widely viewed YouTube videos discussing the Metaverse workplace. The initial dataset, which contained 6982 comments, underwent thorough cleaning processes, resulting in the analysis of 2804 comments through thematic, emotion, and sentiment analyses. The process of the thematic analysis revealed that out of the total comments, 472 were unclassified, while the remaining 2332 helped structure the public's beliefs about the Metaverse workplace into four overarching themes: 1- benefits of flexibility and accessibility (37 %), highlighting VR's potential to transform workspaces, especially for creative fields and efficient space use; 2- Health concerns (26 %), including eye strain and physical discomfort from prolonged headset use; 3- data privacy and corporate control fears (20 %), reflecting worries over pervasive data collection and potential misuse of power; 4- scepticism over readiness and practicality (17 %), noting visual clarity challenges and ergonomic issues. The overall vibes about working in the Metaverse are mixed. While more than half the sentiments were positive, expressing contentment, curiosity and enthusiasm, there were also concerns about health effects, data privacy, and integration issues. The public recognises Metaverse's potential for remote work, desiring improvements in areas like visual clarity, ergonomics and productivity support before widespread adoption. This study is a pioneering effort in the field, providing a first-of-its-kind structure of the public's beliefs about the Metaverse workplace, drawing upon naturally occurring data. The findings not only contribute to the academic understanding of the Metaverse workplace but also have significant implications for society and practitioners for optimising the positive aspects to enhance overall acceptance in this relatively understudied field.

Measurements of Chemical Potentials in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV.

This Letter presents the most precise measurement to date of the matter-antimatter imbalance at midrapidity in Pb-Pb collisions at a center-of-mass energy per nucleon pair sqrt[s_{NN}]=5.02 TeV. Using the Statistical Hadronization framework, it is possible to obtain the value of the electric charge and baryon chemical potentials, µ_{Q}=-0.18±0.90 MeV and µ_{B}=0.71±0.45 MeV, with unprecedented precision. A centrality-differential study of the antiparticle-to-particle yield ratios of charged pions, protons, Ω baryons, and light (hyper)nuclei is performed. These results indicate that the system created in Pb-Pb collisions at the LHC is on average baryon-free and electrically neutral at midrapidity.

Relationships of mitochondrial DNA mutations and select clinical diagnoses in perinatally HIV- and ART-exposed uninfected children.

The prevalence of pathogenic mutations within mitochondrial (mt) DNA of youth who were perinatally exposed to HIV and ART but remained uninfected (YHEU) were assessed relative to phenotypic clinical indicators of mitochondrial dysfunction (MtD). This was a cross-sectional, nested case-control study. A total of 144 cases met at least one clinical MtD definition and were matched with up to two controls each (n = 287). At least one risk mutation was present in nearly all YHEU (97 %). No differences in mutation frequencies were observed between metabolic or neurodevelopmental cases and respective controls; however, higher frequencies were found in controls versus respective neurologic or growth cases.

Survival of hospitalised COVID-19 patients in Hawassa, Ethiopia: a cohort study.

The COVID-19 pandemic, caused by SARS-CoV-2, led to 622,119,701 reported cases and 6,546,118 deaths. Most studies on COVID-19 patients in hospitals are from high-income countries, lacking data for developing countries such as Ethiopia.This study assesses clinical features, demographics, and risk factors for in-hospital mortality in Hawassa, Ethiopia. The research cohort comprises 804 cases exhibiting clinical diagnoses and/or radiological findings and indicative of symptoms consistent with COVID-19 at Hawassa University Comprehensive Specialized Hospital from September 24, 2020, to November 26, 2021. In-hospital mortality rate was predicted using Cox regression. The median age was 45 years, with males making up 64.1% of the population. 173 (21.5%) fatalities occurred, with 125 (72.3%) among males. Male patients had higher mortality rates than females. Severe and critical cases were 24% and 21%. 49.1% had at least one comorbidity, with 12.6% having multiple. Common comorbidities were diabetes (15.9%) and hypertension (15.2%). The Cox regression in Ethiopian COVID-19 patients found that factors like gender, advanced age group, disease severity, symptoms upon admission, shortness of breath, sore throat, body weakness, hypertension, diabetes, multiple comorbidities, and prior health facility visits increased the risk of COVID-19 death, similar to high-income nations. However, in Ethiopia, COVID-19 patients were young and economically active. Patients with at least one symptom had reduced death risk. As a conclusion, COVID-19 in Ethiopia mainly affected the younger demographic, particularly economically active individuals. Early detection can reduce the risk of mortality. Prompt medical attention is essential, especially for individuals with comorbidities. Further research needed on diabetes and hypertension management to reduce mortality risk. Risk factors identified at admission play a crucial role in guiding clinical decisions for intensive monitoring and treatment. Broader risk indicators help prioritize patients for allocation of hospital resources, especially in regions with limited medical facilities. Government's focus on timely testing and strict adherence to regulations crucial for reducing economic impact.

Soft Tissue Facial Changes Following Massive Weight Loss Secondary to Medical and Surgical Bariatric Interventions: A Systematic Review.

Bariatric interventions, both surgical and medical, are increasingly employed by patients to achieve weight reduction and enhance overall health. However, there is growing concern about the associated changes in soft tissue facial aesthetics resulting from these interventions. In this systematic review, the authors aimed to analyze the existing literature regarding soft tissue facial changes after bariatric interventions, with a focus on the influence of massive weight loss on facial aging, attractiveness, and considerations for facial rejuvenation. A systematic review was conducted until February 10, 2024, using electronic databases such as PubMed, Scopus, Web of Science, Embase, and Google Scholar. This review was registered in the open science framework. The Covidence software (Melbourne, VIC, Australia) facilitates title, abstract, and full-text screening, as well as data extraction. In total, 309 papers were identified, 94 duplicates were removed, and 194 studies were excluded on the basis of inclusion criteria. Of the remaining 21 studies, 13 met the inclusion criteria with an additional single study from the conference abstract. Descriptive analysis was conducted. We observed a correlation between massive weight loss and facial aging. The most significant fat regional devolumization was observed along the mid-cheek region and with central neck skin laxity. The apparent age of patients was higher among those with massive weight loss. In our study, we demonstrated that massive weight loss causes accelerated facial aging, manifested through fat devolumization, and increased skin laxity. Further quantitative volumetric facial analyses postbariatric surgery would yield valuable results.

Evaluation of Buccolingual Inclinations of First Molars Among Different Vertical Facial Patterns in Class II Division I Subjects.

Background Knowing the characteristics of vertical patterns is crucial to provide the best orthodontic treatment. Cone beam computed tomography (CBCT) offers a valuable tool for evaluating true buccolingual inclinations. The current study investigates the buccolingual inclination of first molars in adult subjects with different vertical facial patterns. Methods CBCT scans of 66 adult patients (31 males, 35 females) with a mean age of 31.6 years (SD: 6.4 years) exhibiting skeletal class II division I maxillomandibular relationships were employed. Participants were categorized into three groups based on linear and angular measurements: normodivergent group (n=22), hypodivergent group (n=22), and hyperdivergent group (n=22). The independent samples t-test and Mann-Whitney U-test were conducted to investigate statistical differences in terms of buccolingual inclination between the three vertical patterns. Results Statistically significant differences were observed in the buccolingual inclinations of both maxillary and mandibular first molars in the hypodivergent group compared to the other groups (p<0.05). Conclusions In patients with class II division I sagittal relationships, the buccolingual inclinations of the first molars exhibit similarities between normodivergent and hyperdivergent groups. However, these inclinations differ significantly in hypodivergent adult subjects.

Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference.

OBJECTIVES: To present recommendations and consensus statements with supporting literature for the clinical management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE) consensus conference. DATA SOURCES: Systematic review was performed using PubMed, Embase, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021, followed by serial meetings of international, interprofessional experts in the management ECMO for critically ill children. STUDY SELECTION: The management of ECMO anticoagulation for critically ill children. DATA EXTRACTION: Within each of eight subgroup, two authors reviewed all citations independently, with a third independent reviewer resolving any conflicts. DATA SYNTHESIS: A systematic review was conducted using MEDLINE, Embase, and Cochrane Library databases, from January 1988 to May 2021. Each panel developed evidence-based and, when evidence was insufficient, expert-based statements for the clinical management of anticoagulation for children supported with ECMO. These statements were reviewed and ratified by 48 PEACE experts. Consensus was obtained using the Research and Development/UCLA Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. We developed 23 recommendations, 52 expert consensus statements, and 16 good practice statements covering the management of ECMO anticoagulation in three broad categories: general care and monitoring; perioperative care; and nonprocedural bleeding or thrombosis. Gaps in knowledge and research priorities were identified, along with three research focused good practice statements. CONCLUSIONS: The 91 statements focused on clinical care will form the basis for standardization and future clinical trials.

Management of Bleeding and Thrombotic Complications During Pediatric Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.

OBJECTIVES: To derive systematic-review informed, modified Delphi consensus regarding the management of bleeding and thrombotic complications during pediatric extracorporeal membrane oxygenation (ECMO) for the Pediatric ECMO Anticoagulation CollaborativE Consensus Conference. DATA SOURCES: A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021. STUDY SELECTION: The management of bleeding and thrombotic complications of ECMO. DATA EXTRACTION: Two authors reviewed all citations independently, with a third independent reviewer resolving conflicts. Twelve references were used for data extraction and informed recommendations. Evidence tables were constructed using a standardized data extraction form. DATA SYNTHESIS: Risk of bias was assessed using the Quality in Prognosis Studies tool. The evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Forty-eight experts met over 2 years to develop evidence-based recommendations and, when evidence was lacking, expert-based consensus statements for the management of bleeding and thrombotic complications in pediatric ECMO patients. A web-based modified Delphi process was used to build consensus via the Research And Development/University of California Appropriateness Method. Consensus was defined as greater than 80% agreement. Two good practice statements, 5 weak recommendations, and 18 consensus statements are presented. CONCLUSIONS: Although bleeding and thrombotic complications during pediatric ECMO remain common, limited definitive data exist to support an evidence-based approach to treating these complications. Research is needed to improve hemostatic management of children supported with ECMO.

Assessment of Pregnant Women's Knowledge and Perceptions of Antenatal Ultrasound in Saudi Arabia.

Background: This study aims to evaluate pregnant women's knowledge of antenatal ultrasound in Saudi Arabia and its correlation with demographic factors like age and education to enhance prenatal care. Methods: A cross-sectional study was conducted in six Saudi Arabian hospitals, involving 22 questions split between sociodemographic information and knowledge of antenatal ultrasound. Descriptive statistics were used to characterize the participants' demographics and responses. Additionally, inferential statistics were employed to analyze the relationships and differences among the study variables. Results: Among the 531 pregnant women in the study, most demonstrated a good understanding of antenatal ultrasound, identifying its various uses. Specifically, they recognized its roles in evaluating fetal growth (82.5%), placental location (81.7%), amniotic fluid volume (67%), and fetal morphology (65%), predicting the delivery date (79%), and determining the baby's sex (89%). A majority viewed ultrasound as important (89.3%), safe (82.3%), and tolerable (76.3%) for prenatal care. Additionally, 66.7% felt adequately informed, mainly through clinical staff and doctors. Younger age, lower education, lack of prior ultrasound experience, and first pregnancy were linked to lower knowledge. Approximately 65% were uncertain about the nonionizing radiation properties of ultrasound. Conclusions: The study found that while most pregnant women in Saudi Arabia understand the objectives of antenatal ultrasonography, there are gaps in their knowledge about its nonionizing properties. Younger age, lower education, lack of prior ultrasound experience, and first pregnancy contribute to lower knowledge.

Observation of Medium-Induced Yield Enhancement and Acoplanarity Broadening of Low-p_{T} Jets from Measurements in pp and Central Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV.

The ALICE Collaboration reports the measurement of semi-inclusive distributions of charged-particle jets recoiling from a high transverse momentum (high p_{T}) hadron trigger in proton-proton and central Pb-Pb collisions at sqrt[s_{NN}]=5.02 TeV. A data-driven statistical method is used to mitigate the large uncorrelated background in central Pb-Pb collisions. Recoil jet distributions are reported for jet resolution parameter R=0.2, 0.4, and 0.5 in the range 7

Why Evidence Generation Should Matter to Payers and How They Can Help.

Importance: The US leads the world in bringing new medical products to market, but the ability to generate evidence to inform clinical practice in postmarket settings needs improvement. Although a diverse group of stakeholders is working to improve postmarket evidence generation, the role of private payers has been underappreciated. Observations: Payers are crucial allies in improving evidence generation because better data would better inform coverage decisions, their policies and practices influence the conduct of care and research, and their claims data are a source of real-world evidence used in medical product evaluation. In addition, payers have a stake in improving evidence generation because the kinds of evidence needed to inform health care and coverage decisions are often not available when a product enters the market and may not be generated without their involvement. Here, we describe several key steps payers could take to improve evidence generation, including participating in efforts to reduce administrative and financial barriers to the conduct of clinical trials, directly incentivizing evidence generation on high-priority questions by funding potential cost-saving trials, increasing engagement with the medical products industry on evidentiary needs for coverage decisions, and improving usability of claims data by reducing data lags and routinely recording unique device identifiers. Broad payer engagement with US Food and Drug Administration recommendations regarding evidence generation will ensure that the opportunities to participate in clinical research are extended to all communities and that evidence needed to inform care is generated in trials and surveillance systems that reflect the clinical reality across the US. Conclusions and Relevance: Increasing payer involvement in evidence generation can benefit all participants in the medical innovation ecosystem. The importance of payers in these efforts will continue to grow in response to imperatives to increase integration of care and research, engage a diverse set of communities in clinical research, and move toward alternative payment models.

Why Should the FDA Focus on Pragmatic Clinical Research?

This Viewpoint from the FDA discusses how pragmatic clinical research­assessment that uses real-world data, often in combination with research data, after initial marketing approval­can help in evaluation of new technologies, benefit research sites in underresourced settings, and better inform regulatory decisions and clinical practice.

Don't Ask Us to Stop Cycling: A Surgical Perspective.

MINI ABSTRACT: In this surgical perspective, we argue that counseling avoidance of bicycle commuting is not the right approach to cycling injury prevention or to overall urban health. Instead, we propose surgeons should take a more holistic approach that includes mitigating individual risk factors as well as creating an equitable environment of safety.

Photoproduction of K

K^{+}K^{-} pairs may be produced in photonuclear collisions, either from the decays of photoproduced ϕ(1020) mesons or directly as nonresonant K^{+}K^{-} pairs. Measurements of K^{+}K^{-} photoproduction probe the couplings between the ϕ(1020) and charged kaons with photons and nuclear targets. The kaon-proton scattering occurs at energies far above those available elsewhere. We present the first measurement of coherent photoproduction of K^{+}K^{-} pairs on lead ions in ultraperipheral collisions using the ALICE detector, including the first investigation of direct K^{+}K^{-} production. There is significant K^{+}K^{-} production at low transverse momentum, consistent with coherent photoproduction on lead targets. In the mass range 1.1

First Measurement of the |t| Dependence of Incoherent J/ψ Photonuclear Production.

The first measurement of the cross section for incoherent photonuclear production of J/ψ vector mesons as a function of the Mandelstam |t| variable is presented. The measurement was carried out with the ALICE detector at midrapidity, |y|<0.8, using ultraperipheral collisions of Pb nuclei at a center-of-mass energy per nucleon pair of sqrt[s_{NN}]=5.02 TeV. This rapidity interval corresponds to a Bjorken-x range (0.3-1.4)×10^{-3}. Cross sections are given in five |t| intervals in the range 0.04<|t|<1 GeV^{2} and compared to the predictions by different models. Models that ignore quantum fluctuations of the gluon density in the colliding hadron predict a |t| dependence of the cross section much steeper than in data. The inclusion of such fluctuations in the same models provides a better description of the data.