Chemical, rheological, and sensorial properties of Baladi bread supplemented with buckwheat flour produced in Egypt.

This research aimed to enhance the nutritional and sensory qualities of Balady bread by adding locally Egyptian buckwheat flours, Fagopyrum esculentum (FE) and Fagopyrum tataricum (FT), to Hard Wheat Flour (HWF) 82% extraction at three levels (10%, 20%, and 30%). The chemical composition, rheological properties, color, sensory evaluation and stalling of the balady bread were determined. The chemical composition of raw materials revealed that FE was significantly (P ≤ 0.05) higher in protein and fat contents compared to HWF and FT. While FT was higher in fiber and ash contents. The findings show that a 30% replacement with FE or FT significantly enhances the bread's nutritional profile, notably increasing protein, fiber, ash, and moisture content. Rheological analysis revealed that FE and FT alter dough handling, with a notable improvement in dough stability and mixing tolerance at 30% FT. Sensory evaluation indicated acceptable qualities even at higher substitution levels, although 30% FE showed slight declines in certain attributes. Furthermore, bread supplemented with 30% FT demonstrated slower staling and potentially extended shelf life. These results highlight the potential of FE and FT as nutritional enhancers in bread formulations, with 30% FT emerging as the optimal replacement level for balancing nutritional benefits and sensory acceptance.

Efficacy of parsley seed-supplemented bread in improving serum osteopontin level and renal health in obese women: A nutritional intervention study.

BACKGROUND: Obesity is a global epidemic and a major contributor to chronic kidney disease worldwide. This interventional study aimed to evaluate the effects of a unique parsley seed bread and a healthy balanced diet on serum osteopontin level and renal function in obese women. METHODS: A total of 85 obese women (BMI, 35.68 ± 0.47 kg/m2) participated in an 8-week nutritional intervention comprising two phases. In the first phase, participants consumed 100 g of ground parsley seed bread along with a healthy balanced low caloric regimen for four weeks. In the second phase, Baladi bread was substituted for the supplement, providing an equal caloric intake, for another four weeks. Relevant Anthropometric measurements, blood pressure, dietary recall, and biochemical parameters (osteopontin, IL-1ß, IL-10, kidney functions, and lipid parameters) were assessed before and after each intervention phase. RESULTS: Following the initial intervention phase, there were significant improvements in all recorded mean anthropometric parameters (p ≤ 0.001). Lipid parameters and risk factors also significantly decreased (p < 0.05), while osteopontin, creatinine, and IL-1ß levels decreased significantly. eGFR, creatinine clearance, IL-10 increased. However, these improved values returned to elevated levels after the omission of the supplement in the second phase. There was a significant negative correlation between osteopontin and creatinine, creatinine clearance, and IL-10. CONCLUSION: The combined effect of the novel parsley seed-based intervention and a healthy balanced low-calorie regimen demonstrated improvements in osteopontin level associated with renal disorders, and inflammation, in addition to dyslipidemia in obese women. This suggests a promising approach for improving and protecting kidney disorders.

Seroprevalence of Toxoplasma gondii, Neospora caninum and Trichinella spp. in Pigs from Cairo, Egypt.

Pork production is a niche economy in Egypt, and pigs are typically raised as backyard animals with no sanitary control, potentially exposing them to various pathogens. Commercially available ELISAs were used to detect specific antibodies to the food-borne zoonotic parasites Toxoplasma gondii and Trichinella spp., as well as to Neospora caninum, in serum samples of pigs slaughtered at Egypt's only licensed pig abattoir, the El-Bassatin abattoir in Cairo. Among the tested sera (n = 332), seroreactivity for T. gondii was 45.8% (95% confidence interval: 40.4-51.3), N. caninum was 28.0% (95% CI: 23.3-33.2), and Trichinella spp. was 1.2% (95% CI: 0.4-3.3). Mixed infection was only detected for T. gondii and N. caninum (18.7%; 95% CI: 14.7-23.4). The seroprevalence of T. gondii was significantly higher (p = 0.0003) in animals collected from southern Cairo (15 May city slum) than in eastern Cairo (Ezbet El Nakhl slum). Seroprevalence for N. caninum was higher in western (Manshiyat Naser slum; p = 0.0003) and southern Cairo (15 May city slum; p = 0.0003) than in that of eastern Cairo (Ezbet El Nakhl slum; p = 0.0003). Moreover, female pigs exhibited a higher rate of N. caninum antibodies than male ones (p < 0.0001). This study provides the first seroprevalence data for N. caninum in pigs in Egypt, and updates the prevalence of the zoonotic parasites Trichinella spp. and T. gondii.

Estimation of genetic components, heterosis and combining ability of elite Pakistani wheat varieties for yield attributing traits and stripe rust response.

Wheat (Triticum aestivum L.) is a staple food and major source of dietary calories in Pakistan. Improving wheat varieties with higher grain yield and disease resistance is a prime objective. The knowledge of genetic behaviour of germplasm is key. To achieve this objective, elite wheat varieties were crossed in 4 by 3, line × tester design, and tested in 2019 in a triplicate yield trial to estimate genetic variance, general and specific combining ability, mid-parent heterosis and stripe rust (Puccinia striiformis L.). High grain 3358 kg·ha-1 was recorded in F1 hybrid (ZRG-79 × PAK-13). Analysis of variance (ANOVA) revealed significant genotypic variance in grain yield. Broad sense heritability (H2) was recorded in the range of 28 to 100 %. General combining ability (GCA) significant for grain yield in parents except FSD-08 and PS-05 was recorded, while specific combining ability (SCA) was recorded to be highly significant for grain yield only in two crosses (ZRG-79 × NR-09 and ZRG-79 × PAK-13). Mid-parent heterosis was estimated in the range of -28 to 62.6 %. Cross combinations ZRG-79 × PAK-13 depicted highly significant mid-parent heterosis (62.6 %). Highly significant correlation was observed among spike length, spikelets per spike, plant height and 1000-grain weight. Rust resistance index was recorded in the range of 0 to 8.5. These findings suggest exploitation of GCA for higher grain yield is important due to the presence of additive gene action and selection in the filial generations will be effective with improved rust resistance, while cross combinations ZRG-79 × PAK-13 high GCA are best suited for hybrid development.

An improved deep learning procedure for statistical downscaling of climate data.

Recent climate change (CC) scenarios from the Coupled Model Intercomparison Project Phase 6 (CMIP6) have just been released in coarse resolution. Deep learning (DL) based on statistical downscaling has recently been used, but more research is needed, particularly in arid regions, because little is known about their suitability for extrapolating future CC scenarios. Here we analyzed this issue by downscaling maximum, and minimum temperature over the Egyptian domain based on one General Circulation Model (GCM) as CanESM5 and two shared socioeconomic pathways (SSPs) as SSP4.5 and SSP8.5 from CMIP6 using Convolutional Neural Network (CNN) herein after called CNNSD. The downscaled maximum and minimum temperatures based CNNSD was able to reproduce the observed climate over historical and future periods at a finer resolution (0.1°), reducing the biases exhibited by the original scenario. To the best of our knowledge, this is the first time CNN has been used to downscale CMIP6 scenarios, particularly in arid regions. The downscaled analysis showed that maximum and minimum temperatures are expected to rise by 4.8 °C and 4.0 °C, respectively, in the future (2015-2100), compared to the historical period, under the moderate scenario (SSP4.5). Meanwhile, under the Fossil-fueled Development scenario (SSP8.5), these values will rise by 6.3 °C and 4.2 °C, respectively as analyzed by the CNNSD. The developed approach could be used not only in Egypt but also in other developing countries, which are especially vulnerable to climate change and has a scarcity of related research. The established downscaled approach's supply can be used to provide climate services, as a driver for impact studies and adaptation decisions, and as information for policy development. More research is needed, however, to include multi-GCMs to quantify the uncertainties between GCMs and SSPs, improving the outputs for use in climate change impacts and adaptations for food and nutrition security.

Hyperspectral reflectance and agro-physiological traits for field identification of salt-tolerant wheat genotypes using the genotype by yield*trait biplot technique.

Introduction: Salinity is the abiotic obstacle that diminishes food production globally. Salinization causes by natural conditions, such as climate change, or human activities, e.g., irrigation and derange misuse. To cope with the salinity problem, improve the crop environment or utilize crop/wheat breeding (by phenotyping), specifically in spread field conditions. For example, about 33 % of the cropping area in Egypt is affected by salinity. Methods: Therefore, this study evaluated forty bread wheat genotypes under contrasting salinity field conditions across seasons 2019/20 and 2020/21 at Sakha research station in the north of Egypt. To identify the tolerance genotypes, performing physiological parameters, e.g., Fv/Fm, CCI, Na+, and K+, spectral reflectance indices (SRIs), such as NDVI, MCARI, and SR, and estimated salinity tolerance indices based on grain yield in non-saline soil and saline soil sites over the tested years. These traits (parameters) and grain yield are simultaneously performed for generating GYT biplots. Results: The results presented significant differences (P≤0.01) among the environments, genotypes, and their interaction for grain yield (GY) evaluated in the four environments. And the first season for traits, grain yield (GY), plant height (PH), harvest index (HI), chlorophyll content index (CCI), chlorophyll fluorescence parameter Fv/Fm, normalized difference vegetation index (NDVI) in contrasting salinity environments. Additionally, significant differences were detected among environments, genotypes, and their interaction for grain yield along with spectral reflectance indices (SRIs), e.g., Blue/Green index (BIG2), curvature index (CI), normalized difference vegetation index (NDVI), Modified simple ratio (MSR). Relying on the genotype plus genotype by environment (GGE) approach, genotypes 34 and 1 are the best for salinity sites. Genotypes 1 and 29 are the best from the genotype by stress tolerance indices (GSTI) biplot and genotype 34. Genotype 1 is the best from the genotype by yield*trait (GYT) method with spectral reflectance indices. Discussion: Therefore, we can identify genotype 1 as salinity tolerant based on the results of GSTI and GYT of SRIs and recommend involvement in the salinity breeding program in salt-affected soils. In conclusion, spectral reflectance indices were efficiently identifying genotypic variance.

Seasonal Changes in Hematological Parameters in House Sparrows of Subtropical Pakistan.

House sparrow is a globally adaptive bird. The way this creature adapted to all areas of the world, having different selection pressures, is interesting to understand. The present study is focused on seasonal changes, having different selection pressures and how it is adapted to these changes and whether hematological flexibility plays a role in this success. House sparrow's adaptations in the same area, during different seasons, have been studied in a sub-tropical area, Potohar, Pakistan. We used hematological parameter analysis for this purpose. Blood samples were collected from Sparrows in winter, spring, and summer and analyzed for some hematological parameters. White blood cells (WBCs) were higher in spring and summer which may relate to mating promiscuity. Sparrows were more stressed in summer. The Red blood cells (RBCs) and hematocrit (Hct) were greater in summer. Mean corpuscular volume (MCV) is lower in summer. This may have an adaptation to cope with high stress in summer as small-size RBCs increase gaseous exchange. Platelets were not affected by season or gender. Mean corpuscular volume and Mean corpuscular hemoglobin (MCH) are positively correlated with each other. Red blood cells, hemoglobin (Hb) and MCV were higher in males during the spring season perhaps as an adaptation to energetic activities during spring like mating calls and search for nesting sites. White blood cells remained the same in both genders in summer and winter, and effected in spring may be related to the mating system. Behavioral state is linked with physiological states that shows tradeoff and life history traits. This study is a small effort to know this incredible species. We can work further in different parts of the world to explore different aspects of it.

El gorrión común es un ave que se adapta globalmente. La forma en que esta criatura se adaptó a todas las áreas del mundo, teniendo diferentes presiones de selección, es interesante de entender. El presente estudio se centra en los cambios estacionales, teniendo diferentes presiones de selección y cómo se adapta a estos cambios y si la flexibilidad hematológica juega un papel en este éxito. Las adaptaciones de House Sparrow en la misma área, durante diferentes estaciones, se han estudiado en un área subtropical, Potohar, Pakistán. Utilizamos el análisis de parámetros hematológicos para este propósito. Se recogieron muestras de sangre de gorriones en invierno, primavera y verano y se analizaron algunos parámetros hematológicos. Los glóbulos blancos (WBC) fueron más altos en primavera y verano, lo que puede relacionarse con la promiscuidad de apareamiento. Los gorriones estaban más estresados ​​en verano. Los glóbulos rojos (GR) y el hematocrito (Het) fueron mayores en verano. El volumen corpuscular medio (MCV) es menor en verano. Esto puede tener una adaptación para hacer frente al alto estrés en verano, ya que los glóbulos rojos de pequeño tamaño aumentan el intercambio gaseoso. Las plaquetas no se vieron afectadas por la estación o el género. El MCV y la hemoglobina corpuscular media (MCH) se correlacionan positivamente entre sí. Los glóbulos rojos, la hemoglobina (Hb) y el MCV fueron más altos en los machos durante la temporada de primavera, tal vez como una adaptación a las actividades energéticas durante la primavera, como llamadas de apareamiento y búsqueda de sitios de anidación. Los glóbulos blancos se mantuvieron iguales en ambos sexos en verano e invierno, y los efectuados en primavera pueden estar relacionados con el sistema de apareamiento. El estado de comportamiento está relacionado con estados fisiológicos que muestran rasgos de compensación y de historia de vida. Este estudio es un pequeño esfuerzo por conocer esta increíble especie. Podemos trabajar más en diferentes partes del mundo para explorar diferentes aspectos del mismo.

Le Moineau domestique est un oiseau qui s"adapte à l"échelle mondiale. La façon dont cette créature s"est adaptée à toutes les régions du monde, ayant des pressions de sélection différentes, est intéressante à comprendre. La présente étude se concentre sur les changements saisonniers, ayant différentes pressions de sélection et comment il est adapté à ces changements et si la flexibilité hématologique joue un rôle dans ce succès. Les adaptations du Moineau domestique dans la même zone, à différentes saisons, ont été étudiées dans une zone subtropicale, Potohar, Pakistan. Nous avons utilisé l"analyse des paramètres hématologiques à cette fin. Des échantillons de sang ont été prélevés sur des moineaux en hiver, au printemps et en été et analysés pour certains paramètres hématologiques. Les globules blancs (WBC) étaient plus élevés au printemps et en été, ce qui peut être lié à la promiscuité sexuelle. Les moineaux étaient plus stressés en été. Les globules rouges (GR) et l"hématocrite (Het) étaient plus élevés en été. Le volume corpusculaire moyen (MCV) est plus faible en été. Cela peut avoir une adaptation pour faire face à un stress élevé en été, car les globules rouges de petite taille augmentent les échanges gazeux. Les plaquettes n"étaient pas affectées par la saison ou le sexe. Le MCV et l"hémoglobine corpusculaire moyenne (MCH) sont positivement corrélés l"un à l"autre. Les globules rouges, l"hémoglobine (Hb) et le MCV étaient plus élevés chez les mâles au printemps, peut-être en raison d"une adaptation aux activités énergétiques au printemps comme les cris d"accouplement et la recherche de sites de nidification. Les globules blancs sont restés les mêmes chez les deux sexes en été et en hiver, et effectués au printemps peuvent être liés au système d"accouplement. L"état comportemental est lié aux états physiologiques qui montrent des traits de compromis et d'histoire de vie. Cette étude est un petit effort pour connaître cette espèce incroyable. Nous pouvons continuer à travailler dans différentes parties du monde pour en explorer différents aspects.

Medication adherence and health-related quality of life among people with diabetes in Bangladesh: A cross-sectional study.

INTRODUCTION: Good adherence to anti-diabetic medications is an important protective factor for decreasing diabetes-related complications and disabilities but its association with health-related quality of life (HRQoL) is understudied. The current study aimed to assess an association between medication adherence to anti-diabetic drugs and HRQoL among people with diabetes in Dhaka city, Bangladesh. METHODS: We conducted a cross-sectional study among 480 people with diabetes aged between 50 and 70 years, who attended a tertiary-level hospital in Dhaka city. We used the EuroQol-5 Dimensions Questionnaire (EQ-5D-5L) to measure HRQoL and Morisky Medication Adherence Scale to assess the level of medication adherence to anti-diabetic drugs. Multivariable logistic regression was performed to assess the significance of relevant factors. RESULTS: The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (74%) had a lower level of medication adherence. The mean value of (EQ-5D-5L) was 2.0 (SD, 1.0). The percentage of severe disability in different domains were 6.7% for mobility, 3.5% for self-care, 11.9% for usual daily activities, 11.9% for pain/discomfort and 11.3% for anxiety. After adjusting for age, sex, years of education, household expenditure, hypertension, duration of diabetes, glycemic status and multi-morbidities; low adherence to anti-diabetic medication was inversely associated with pain (OR, 0.26; 95% CI, 0.08-0.80; p = .036), and positively associated with anxiety (OR, 7.18; 95% CI, 1.03-9.59; p = .043). CONCLUSIONS: Low medication adherence to anti-diabetic drugs was associated with anxiety and pain among the EQ-5D-5L indexes measured in people with diabetes in Dhaka, Bangladesh.

Closure of Tracheocutaneous Fistulae in Patients With Challenged Wound Healing.

OBJECTIVE: To describe and evaluate the surgical outcomes of multilayered closure of persistent tracheocutaneous fistulae (TCF) in patients with challenged wound healing. METHODS: A retrospective chart review of all patients who underwent closure of TCF by the senior author between October 2011 and December 2021 was performed. Age, body mass index (BMI), time between decannulation and TCF repair, medical comorbidities, procedure duration, length of hospitalization, and postoperative complications were recorded. The primary outcomes were closure of the fistula, postoperative subcutaneous emphysema, pneumomediastinum, pneumothorax, wound infection, or breakdown. Outcomes of patients with and without challenged wound healing were compared. RESULTS: Thirty-five patients who underwent TCF repair during the study period were identified. The mean age and BMI were 62.9 years and 28.43 respectively. Twenty-six (74%) patients met criteria for challenged wound healing at the time of the TCF repair. There was 1 (3.84%) minor complication in the challenged wound healing group and none (0%) in the control group (P = 1.00). No patients experienced wound breakdown or air leak noted on exam or chest radiography. CONCLUSION: Multilayered closure of persistent tracheocutaneous fistulae is a simple technique which is safe and effective even in patients with challenged wound healing.

Physicians' attitudes and knowledge toward artificial intelligence in medicine: Benefits and drawbacks.

The use of artificial intelligence (AI) in the medical field is increasing and is expected to shape future clinical practice and job security. Therefore, this study aimed to assess the opinions and attitudes of practicing physicians in Bahrain regarding the benefits and drawbacks of AI for their future daily practice. A cross-sectional survey of practicing physicians with a minimum of five years' experience across the main secondary and tertiary care hospitals in Bahrain was conducted. An online questionnaire was used to collect data on demographics, knowledge of AI, attitudes towards the use of AI in 10 tasks of daily clinical practice, and opinions on the benefits and drawbacks of AI. A total of 114 physicians participated in the survey. Among them, 43 (37.7%) were registered psychiatrists, 15 (13.2%) were pathologists, 17 (14.9%) were radiologists, and 39 (34.2%) were surgical specialists. The participants' attitudes were overall positive towards AI. Pathologists were particularly in favor of using AI to "Formulate personalized medication and/or treatment plans for patients" and to "Interview patients in a range of settings to obtain medical history." Most participants agreed that AI would reduce the time needed to establish a diagnosis and negatively affect employment rates. There were no correlations between the responses and the participants' age, gender, years of experience, or AI knowledge. This study demonstrates that the attitudes towards the use of AI in medicine among practicing physicians in Bahrain are similar to those of physicians in developed countries in that they are positive and welcoming of AI implementation in practice. However, the potential effects of AI on job security are a major concern.

MyI-Net: Fully Automatic Detection and Quantification of Myocardial Infarction from Cardiovascular MRI Images.

Myocardial infarction (MI) occurs when an artery supplying blood to the heart is abruptly occluded. The "gold standard" method for imaging MI is cardiovascular magnetic resonance imaging (MRI) with intravenously administered gadolinium-based contrast (with damaged areas apparent as late gadolinium enhancement [LGE]). However, no "gold standard" fully automated method for the quantification of MI exists. In this work, we propose an end-to-end fully automatic system (MyI-Net) for the detection and quantification of MI in MRI images. It has the potential to reduce uncertainty due to technical variability across labs and the inherent problems of data and labels. Our system consists of four processing stages designed to maintain the flow of information across scales. First, features from raw MRI images are generated using feature extractors built on ResNet and MoblieNet architectures. This is followed by atrous spatial pyramid pooling (ASPP) to produce spatial information at different scales to preserve more image context. High-level features from ASPP and initial low-level features are concatenated at the third stage and then passed to the fourth stage where spatial information is recovered via up-sampling to produce final image segmentation output into: (i) background, (ii) heart muscle, (iii) blood and (iv) LGE areas. Our experiments show that the model named MI-ResNet50-AC provides the best global accuracy (97.38%), mean accuracy (86.01%), weighted intersection over union (IoU) of 96.47%, and bfscore of 64.46% for the global segmentation. However, in detecting only LGE tissue, a smaller model, MI-ResNet18-AC, exhibited higher accuracy (74.41%) than MI-ResNet50-AC (64.29%). New models were compared with state-of-the-art models and manual quantification. Our models demonstrated favorable performance in global segmentation and LGE detection relative to the state-of-the-art, including a four-fold better performance in matching LGE pixels to contours produced by clinicians.

Developing an analytical framework for estimating food security indicators in the United Arab Emirates: A review.

Rapid population growth, climate change, limited natural resources, and the COVID-19 pandemic contribute to increased global hunger, necessitating intensive efforts to ensure food security and nutrition (FSN). Previous FSN approaches covered some dimensions, but not all, resulting in significant gaps in food security indicators. The Gulf Cooperation Council (GCC) and the Middle East and North Africa (MENA) regions have received less attention in food security studies, thus far necessitating considerable effort to develop an appropriate analytical framework. This study reviewed articles and international reports of FSN indicators, drivers and policies, methods, and models and extracted the challenges and gaps from the global and UAE contexts. The UAE and the world have gaps in FSN drivers, indicators, and methods, necessitating potential solutions to meet future challenges such as rapid population growth, pandemics, and limited natural resources. As a result, we created a newly developed analytical framework that addresses the shortcomings of previous approaches such as sustainable food systems developed by FAO and the Global Food Security Index (GFSI) and covers all aspects of food security. Gaps in knowledge in FSN drivers and policies, indicators, big data, methods, and models were considered in the developed framework, which has specific advantages. The novel developed framework addresses all food security dimensions (access, availability, stability, and utilization), ensuring poverty reduction, food security, and nutrition security while outperforming previous approaches (i.e., FAO and GFSI). The developed framework could be used successfully not only in the UAE and MENA, but also, globally, helping to solve food insecurity and malnutrition for future generations. The scientific community and policymakers should disseminate such solutions to address global food insecurity and ensure nutrition for future generations in the face of rapid population growth, limited natural resources, climate change, and spreading pandemics. Supplementary Information: The online version contains supplementary material available at 10.1007/s10668-023-03032-3.

Neonatal necrotizing enterocolitis due to COVID-19. A case report.

Digestive symptoms have been reported in an important proportion of children with COVID-19, and the clinical expression of critical patients with COVID-19 is thought to result from progressive increase of inflammation and an unusual trend of hypercoagulation. We report a newborn received with abdominal distension, green vomiting and imaging suggestive for enterocolitis. He had a close contact with COVID-19 and the PCR for SARS-CoV-2 came back positive. Despite the supportive measures, his condition deteriorated and a surgery was decided. The surgical exploration found an ischemic bowel. The therapeutic measures were ineffective as the child passed away a few hours after surgery despite the resuscitation treatment performed. The confirmed enterocolitis happening within the period of acute infection by SARS-CoV-2, the NEC was likely a manifestation of COVID-19.

Reversible Bevacizumab Induced Vocal Fold Necrosis.

BACKGROUND: As the use of anti-angiogenic treatments is gaining scope in the treatment of various malignancies, there are increasing reports of laryngeal side effects. We report two cases of laryngeal necrosis and dysphonia. METHODS: Two patients with gynecological malignancies presented with severe dysphonia 11-24 months after initiation of bevacizumab therapy. Videostroboscopic examination of the larynx revealed bilateral ulcerations and eschar of the superior surface with absent mucosal waves. RESULTS: Patients were treated with discontinuation of the bevacizumab, vocal rest, and proton pump inhibitors. Both had improvement in voice and resolution of the eschar and ulceration. Shallow sulci and mild breathiness persisted in one patient. CONCLUSION: With increasing use of potent systemic anti-angiogenic compounds, clinicians should be vigilant of this important complication of therapy. Time to onset of symptoms and reversibility of symptoms vary by patient and require further study. There may be long-term voice sequelae.

A Novel Low-Cost Technique to Allow for Jet Ventilation.

BACKGROUND/OBJECTIVE: Traditional jet ventilation requires the use of a catheter that is inserted either through an endotracheal tube or laryngoscope. Specially designed laryngoscopes with a built-in luer lock adapter to which the high-pressure tubing may be attached exist but are not always available. We present our experience with an adapter which allows connection of the high-pressure tubing to the suction side port of suitable laryngoscopes that is easily assembled using readily available materials in the operating room. METHOD: We designed a jet ventilator adapter using a high-pressure jet ventilation tubing assembly and a 3-way stopcock extension set which we have used for the past 13 years. A retrospective case series of all adult patients who underwent direct laryngoscopy and/or bronchoscopy using this jet ventilation adapter between January 2017 and August 2021 was performed. RESULT: A total of 100 consecutive patients underwent laryngoscopy and bronchoscopy using jet ventilation between January 2017 and August 2021 was identified. The mean age was 56.3 years, and the mean BMI was 31.2. The most common diagnoses were idiopathic subglottic/tracheal stenosis (46.4%), acquired tracheal stenosis (34.1%), and acquired subglottic stenosis (14.8%). The median duration of the surgical procedure was 53 minutes with an interquartile range of 23. The CO2 laser was used in all cases. There was no disconnection of the adapter, episodes of postoperative respiratory compromise, or extraluminal air on chest radiography for any of our cases. Oxygen saturations remained above 90% intraoperatively for all cases. CONCLUSION: Our simple jet ventilator adapter connects the jet ventilator to the suction side port of suitable laryngoscopes and eliminates the need for a jet ventilation catheter or specialized laryngoscope at a minimal cost.

Device Failure During Injection Medialization Laryngoplasty.

OBJECTIVES: Injection medialization laryngoplasty is a commonly performed procedure for the management of glottic insufficiency. Among complications of this procedure is device failure, for which the literature is scarce. Our goal was to determine the prevalence of needle failure during injection laryngoplasty among members of the American Bronchoesophagological Association (ABEA). METHODS: A questionnaire was designed and subsequently sent to members of ABEA via electronic mail. Responses were analyzed using descriptive statistics. RESULTS: Twenty-four members (6.7%) completed the survey. Eighty three percent reported experience with needle failure; 59% of these were needle clogging, 22% needle twisting, and 19% needle tip fracture. Fifty-four percent of respondents reported needle failure during a percutaneous approach, and 48% reported using calcium hydroxyapatite during device failure. Twenty percent reported having to abort the procedure due to device failure. Twenty five percent of respondents experienced needle tip fracture that led to an airway or esophageal foreign body. CONCLUSIONS: Needle failure during injection laryngoplasty was reported by most respondents. Most commonly this was due to clogging or twisting which was managed by replacing the needle but in 25% of cases was due to a broken tip that results in an aerodigestive tract foreign body and aborting of the procedure in most cases.

The pattern of physical disability and determinants of activities of daily living among people with diabetes in Bangladesh.

INTRODUCTION: Diabetes mellitus itself is a known predictor of physical disability and impairment in activities of daily living (ADL); however, there are existing controversies about the factors explaining the association between diabetes and disability. Therefore, we assessed the possible determinants associated with ADL impairment among people with diabetes in Dhaka city, Bangladesh. METHODS: We conducted a cross-sectional study among 480 people with diabetes aged between 50 and 70 years, and attended a tertiary level hospital in Dhaka city. For determining the ADL impairment, we used the Katz Index Scoring (6 = no impairment; <6 = impairment). Age, sex, educational attainment, household expenditure, body mass index, the status of diabetes (controlled or uncontrolled), hypertension and medication adherence to anti-diabetic drugs were included in the statistical models, and we defined any ADL impairment (Katz score <6) as an event. Multivariable logistic regression was performed to assess the significance of relevant factors. RESULTS: The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (76.3%) had at least some sort of physical disability. In multivariable logistic regression analysis after adjusting for all covariates simultaneously, age (odds ratio [95% confidence interval]: 1.35 [1.20 to 1.75] per 1-SD increment), BMI (1.32 [1.08 to 1.21] per 1-SD increment), higher educational attainment (0.34 [0.09-0.90]), multi-morbidity (2.79 [1.48-5.25]) and uncontrolled diabetes (1.35 [1.10-1.45]) were independently associated with ADL impairment. CONCLUSIONS: Physical disability was common, and ADL impairment was associated with age, educational attainment, BMI, multi-morbidities and uncontrolled diabetes among the people with diabetes in Bangladesh.

Saudi Expert Consensus-Based Autism Spectrum Disorder Statement: From Screening to Management.

BACKGROUND: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a national need for expert consensus on the appropriate standards for the assessment and management of children on the autism spectrum. METHODOLOGY: A guideline development group (GDC) was formed by professionals representing all related specialties and institutions involved in the management of individuals on the autism spectrum in Saudi Arabia. They met on a regular basis over 21 months. The guideline development process consisted of five steps starting from reviewing existing guidelines and ending with discussing and writing this manuscript. A formal voting process was utilized and recommendations were discussed until a consensus was reached. RESULTS: There was consensus on the following: A specialized diagnostic assessment needs to be carried out by an experienced multidisciplinary team for children referred to assess for ASD. They should be assessed for medical etiology, their behavioral history carefully reviewed, and symptoms directly observed. Longitudinal assessments are encouraged to reflect the effects of symptoms on the individual's ability to function while with their family, among peers, and in school settings. An additional formal assessment of language, cognitive, and adaptive abilities as well as sensory status is essential to complete the diagnostic process. Interventions should be individualized, developmentally appropriate, and intensive, with performance data relevant to intervention goals to evaluate and adjust interventions. Target symptoms must be identified to address and develop monitoring systems to track change. CONCLUSION: ASD is a complex condition with widely varying clinical manifestations, thus requiring evaluation and intervention by a range of professionals working in coordination. Behavioral and environmental interventions are the key to optimal outcomes, in conjunction with medications when indicated for specific symptoms. Parental involvement in interventions is vital to sustaining therapeutic gains.

Postoperative management of Zenker's diverticulum: Results of the American Bronchoesophagological Association survey.

INTRODUCTION: Although treatment of Zenker's diverticulum (ZD) is commonly performed by otolaryngologists using a variety of surgical techniques, there is little published data on the postoperative management of patients. We sought to determine practice patterns among members of the American Bronchoesophagological Association (ABEA) after surgery for ZD. METHODS: An online questionnaire was designed via JotForm™ and subsequently sent to active members of the ABEA. Responses were analyzed using descriptive statistics. RESULTS: Twenty-three members (6.6 %) completed the survey. Most (73.9 %) were fellowship trained in laryngology and reported performing >5 procedures per year. Most laryngologists reported employing multiple techniques including transcervical (TC) (73.9 %), endoscopic stapling (ES) (65.2 %), endoscopic CO2 laser (EL) (56.5 %), and endoscopic harmonic scalpel (EH) (4.3 %). Postoperatively, 52.3 % of respondents placed patients in 23-hour observation after TC, 66.7 % after ES, 69.2 % after EL, and 100 % after EH. 47.1 % of respondents used standard overnight admission after TC, as compared to 13.3 % after ES, 23.1 % after EL and 0 % after EH. Postoperative esophagography was utilized by 70.6 % of respondents after TC, 20 % after ES, 38.5 % after EL, and 100 % after EH. A peroral diet was started postoperatively on the day of surgery by 26.7 % respondents after ES but not after any of the other techniques. CONCLUSION: Most laryngology trained respondents employ multiple techniques for the treatment of ZD including at least 1 endoscopic technique. Respondents were more likely to hospitalize patients after a transcervical than endoscopic approach. Postoperative esophagography was utilized in most patients after TC, but not after ES or EL. Most respondents admit patients for 23-hour observation and start a peroral diet on postoperative day 1 regardless of technique.

Agricultural big data and methods and models for food security analysis-a mini-review.

Background: Big data and data analysis methods and models are important tools in food security (FS) studies for gap analysis and preparation of appropriate analytical frameworks. These innovations necessitate the development of novel methods for collecting, storing, processing, and extracting data. Methodology: The primary goal of this study was to conduct a critical review of agricultural big data and methods and models used for FS studies published in peer-reviewed journals since 2010. Approximately 130 articles were selected for full content review after the pre-screening process. Results: There are different sources of data collection, including but not limited to online databases, the internet, omics, Internet of Things, social media, survey rounds, remote sensing, and the Food and Agriculture Organization Corporate Statistical Database. The collected data require analysis (i.e., mining, neural networks, Bayesian networks, and other ML algorithms) before data visualization using Python, R, Circos, Gephi, Tableau, or Cytoscape. Approximately 122 models, all of which were used in FS studies worldwide, were selected from 130 articles. However, most of these models addressed only one or two dimensions of FS (i.e., availability and access) and ignored the other dimensions (i.e., stability and utilization), creating a gap in the global context. Conclusions: There are certain FS gaps both worldwide and in the United Arab Emirates that need to be addressed by scientists and policymakers. Following the identification of the drivers, policies, and indicators, the findings of this review could be used to develop an appropriate analytical framework for FS and nutrition.