Expert opinion on the use of fiberoptic bronchospe to check the insertion depth of the left-sided double-lumen tube.

Left-sided double-lumen tube (LDLT) is commonly used to achieve one lung isolation in most thoracic surgical procedures. Traditionally, the LDLT is blindly placed using direct or video laryngoscopy. In this brief report, we highlight the importance of using our novel insertion depth formula to predict the appropriate LDLT insertion depth and demonstrate the current evidence supporting the efficacy of the formula. Also, we will discuss two relatively new devices of LDLTs: one with an embedded camera at the distal end of the tracheal lumen and the other with a carinal cuff between the bronchial cuff and the tracheal lumen in reducing the incidence of too deep inserted LDLT. We advocate that using our novel formula and these two new devices may reduce but not eliminate the need for FOB to check the insertion depth of LDLT.

Development and evaluation of a tool to optimise inhaler selection prior to hospital discharge following an exacerbation of COPD.

Introduction: Rates of mortality and re-admission after a hospitalised exacerbation of COPD are high and resistant to change. COPD guidelines do not give practical advice about the optimal selection of inhaled drugs and device in this situation. We hypothesised that a failure to optimise inhaled drug and drug delivery prior to discharge from hospital after an exacerbation would be associated with a modifiable increased risk of re-admission and death. We designed a study to 1) develop a practical inhaler selection tool to use at the point of hospital discharge and 2) implement this tool to understand the potential impact on modifying inhaler prescriptions, clinical outcomes, acceptability to clinicians and patients, and the feasibility of delivering a definitive trial to demonstrate potential benefit. Methods: We iteratively developed an inhaler selection tool for use prior to discharge following a hospitalised exacerbation of COPD using surveys with multiprofessional clinicians and a focus group of people living with COPD. We surveyed clinicians to understand their views on the minimum clinically important difference (MCID) for death and re-admission following a hospitalised exacerbation of COPD. We conducted a mixed-methods implementation feasibility study using the tool at discharge, and collated 30- and 90-day follow-up data including death and re-admissions. Additionally, we observed the tool being used and interviewed clinicians and patients about use of the tool in this setting. Results: We completed the design of an inhaler selection tool through two rounds of consultations with 94 multiprofessional clinicians, and a focus group of four expert patients. Regarding MCIDs, there was majority consensus for the following reductions from baseline being the MCID: 30-day readmissions 5-10%, 90-day readmissions 10-20%, 30-day mortality 5-10% and 90-day mortality 5-10%. 118 patients were assessed for eligibility and 26 had the tool applied. A change in inhaled medication was recommended in nine (35%) out of 26. Re-admission or death at 30 days was seen in 33% of the switch group and 35% of the no-switch group. Re-admission or death at 90 days was seen in 56% of the switch group and 41% of the no-switch group. Satisfaction with inhalers was generally high, and switching was associated with a small increase in the Feeling of Satisfaction with Inhaler questionnaire of 3 out of 50 points. Delivery of a definitive study would be challenging. Conclusion: We completed a mixed-methods study to design and implement a tool to aid optimisation of inhaled pharmacotherapy prior to discharge following a hospitalised exacerbation of COPD. This was not associated with fewer re-admissions, but was well received and one-third of people were eligible for a change in inhalers.

Graph Embedded Intuitionistic Fuzzy Random Vector Functional Link Neural Network for Class Imbalance Learning.

The domain of machine learning is confronted with a crucial research area known as class imbalance (CI) learning, which presents considerable hurdles in the precise classification of minority classes. This issue can result in biased models where the majority class takes precedence in the training process, leading to the underrepresentation of the minority class. The random vector functional link (RVFL) network is a widely used and effective learning model for classification due to its good generalization performance and efficiency. However, it suffers when dealing with imbalanced datasets. To overcome this limitation, we propose a novel graph-embedded intuitionistic fuzzy RVFL for CI learning (GE-IFRVFL-CIL) model incorporating a weighting mechanism to handle imbalanced datasets. The proposed GE-IFRVFL-CIL model offers a plethora of benefits: 1) leveraging graph embedding (GE) to preserve the inherent topological structure of the datasets; 2) employing intuitionistic fuzzy (IF) theory to handle uncertainty and imprecision in the data; and 3) the most important, it tackles CI learning. The amalgamation of a weighting scheme, GE, and IF sets leads to the superior performance of the proposed models on KEEL benchmark imbalanced datasets with and without Gaussian noise. Furthermore, we implemented the proposed GE-IFRVFL-CIL on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and achieved promising results, demonstrating the model's effectiveness in real-world applications. The proposed GE-IFRVFL-CIL model offers a promising solution to address the CI issue, mitigates the detrimental effect of noise and outliers, and preserves the inherent geometrical structures of the dataset.

Supporting self-management for patients with Interstitial Lung Diseases: Utility and acceptability of digital devices.

INTRODUCTION: Patients diagnosed with Interstitial Lung Diseases (ILD) use devices to self-monitor their health and well-being. Little is known about the range of devices, selection, frequency and terms of use and overall utility. We sought to quantify patients' usage and experiences with home digital devices, and further evaluate their perceived utility and barriers to adaptation. METHODS: A team of expert clinicians and patient partners interested in self-management approaches designed a 48-question cross-sectional electronic survey; specifically targeted at individuals diagnosed with ILD. The survey was critically appraised by the interdisciplinary self-management group at Royal Devon University Hospitals NHS Foundation Trust during a 6-month validation process. The survey was open for participation between September 2021 and December 2022, and responses were collected anonymously. Data were analysed descriptively for quantitative aspects and through thematic analysis for qualitative input. RESULTS: 104 patients accessed the survey and 89/104 (86%) reported a diagnosis of lung fibrosis, including 46/89 (52%) idiopathic pulmonary fibrosis (IPF) with 57/89 (64%) of participants diagnosed >3 years and 59/89 (66%) female. 52/65(80%) were in the UK; 33/65 (51%) reported severe breathlessness medical research council MRC grade 3-4 and 32/65 (49%) disclosed co-morbid arthritis or joint problems. Of these, 18/83 (22%) used a hand- held spirometer, with only 6/17 (35%) advised on how to interpret the readings. Pulse oximetry devices were the most frequently used device by 35/71 (49%) and 20/64 (31%) measured their saturations more than once daily. 29/63 (46%) of respondents reported home-monitoring brought reassurance; of these, for 25/63 (40%) a feeling of control. 10/57 (18%) felt it had a negative effect, citing fluctuating readings as causing stress and 'paranoia'. The most likely help-seeking triggers were worsening breathlessness 53/65 (82%) and low oxygen saturation 43/65 (66%). Nurse specialists were the most frequent source of help 24/63 (38%). Conclusion: Patients can learn appropriate technical skills, yet perceptions of home-monitoring are variable; targeted assessment and tailored support is likely to be beneficial.

Deciphering the chemical constituents and antimicrobial activity of Prangos pabularia Lindl. using LC-MS/MS in combination with experimental evaluation and computational studies.

This study meticulously explores the antimicrobial potential of Prangos pabularia Lindl.'s aerial parts through a comprehensive blend of in vitro and in silico analysis. Extracts with varying polarities underwent LC-MS/MS identification of active components, followed by in vitro and in silico assessments of antimicrobial efficacy against Escherichia coli, Bacillus cereus, Candida albicans, Candida glabrata, and Candida paropsilosis. The methanolic extract exhibited significant antimicrobial activity with a MIC value of 48 µg/mL against all tested strains. Molecular docking revealed the compound 9-(3-methylbut-2-enoxy)-furo-(3,2-g)-chromen-7-one's highest binding affinity against the penicillin-binding protein (PBP) bacterial drug target molecule. Other compounds also displayed substantial interactions with key antimicrobial drug target proteins. Further, Molecular dynamics simulations affirmed the stability of protein and ligand conformations. Collectively, these results underscore Prangos pabularia Lindl.'s aerial parts as a promising botanical resource in combating diverse microbial infections. This comprehensive approach not only validates it's in vitro antimicrobial properties but also provides molecular insights into interaction mechanisms, advancing our comprehension of the plant's therapeutic potential.

Incidental lymphadenopathy in renal transplantation.

INTRODUCTION: Iliac lymphadenectomy is performed to provide anastomotic access during the vascular implantation procedure in renal transplantation. Iliac lymph nodes (LNs) are often enlarged, but there are no standardised guidelines for the management of incidentally enlarged LNs during transplantation. We aimed to evaluate histological findings of LNs sent for examination at our unit. METHODS: Patients were evaluated in two distinct date cycles. In the first cycle, lymphadenectomy and histological assessment were performed at the discretion of the transplanting surgeon. In the second cycle, all incidentally enlarged LNs were sent for histological assessment, regardless of size. RESULTS: In the first cycle (n = 76), 11 patients (14.47%) had incidentally enlarged iliac LNs on lymphadenectomy and histology showed only reactive changes. In the second cycle (n = 165), eight patients (4.85%) had incidentally enlarged LNs on lymphadenectomy. One patient was found to have mature B cell chronic lymphocytic leukaemia. The patient was referred to haematology and a "watch and wait" approach was taken, with the patient still alive at last follow-up (511 days post-transplantation). DISCUSSION: There are currently no published guidelines on the management of incidentally enlarged iliac LNs during transplantation. Current literature suggests that clinically significant lymphadenopathy needs to be investigated in all patients. Based on our centre's experience of a 5.26% (1 in 19) positive pathological LN sampling, we recommend that all incidental LNs with suspicious features and/or that are greater than 10mm in diameter should be considered for histological, microbiological and molecular assessment as appropriate.

Updates on the Causes, Diagnosis, and Management of Peritoneal Abscesses: A Systematic Review.

Intra-abdominal complications such as peritoneal abscesses pose significant medical challenges. Over recent years, there has been a heightened focus on refining treatments for these conditions, such as optimal surgical techniques, drug therapies, and intervention methods. This paper aims to present a comprehensive overview of 10 research studies spanning various countries to highlight recent advancements and findings in the treatment and management of peritoneal abscesses. The paper reviewed 10 trials involving a total of 942 participants, covering diverse methodologies including randomized controlled trials, retrospective analyses, and phase 3 clinical trials. The research spanned countries such as the USA, Finland, Japan, Turkey, India, and China. Key findings included the notable benefits of laparoscopic interventions in appendiceal abscess treatments, which led to quicker recoveries and reduced readmissions compared to conservative approaches. Additionally, certain drug combinations, such as tazobactam/ceftolozane with metronidazole, showcased high clinical efficacy, particularly against resistant bacterial strains. Challenges persist in the early detection of intra-abdominal infections, emphasizing the pivotal role of antimicrobial treatments. Unique therapeutic approaches, like the use of strong acid-electrolyzed water (SAEW) in pediatric appendicitis cases, have proven effective in reducing surgical site infections. Intrabdominal complications such as peritoneal abscesses pose a real challenge. Early detection plays a critical role, which relies on using imaging techniques such as CT scans. Poorly managed mild intra-abdominal diseases can lead to the development of abscesses. Therefore, the implication of highly effective antibiotic combinations such as tazobactam/ceftolozane and metronidazole/ceftriaxone from the start can effectively combat challenging bacterial infections such as Gram-negative and anaerobic bacteria. Surgical procedures remain the most effective method to treat abscesses, and they are usually used as the last resort when drainage, laparoscopy, and other methods fail.

Evaluating a Remote Monitoring Program for Respiratory Diseases: Prospective Observational Study.

BACKGROUND: Patients with chronic respiratory diseases and those in the postdischarge period following hospitalization because of COVID-19 are particularly vulnerable, and little is known about the changes in their symptoms and physiological parameters. Continuous remote monitoring of physiological parameters and symptom changes offers the potential for timely intervention, improved patient outcomes, and reduced health care costs. OBJECTIVE: This study investigated whether a real-time multimodal program using commercially available wearable technology, home-based Bluetooth-enabled spirometers, finger pulse oximeters, and smartphone apps is feasible and acceptable for patients with chronic respiratory diseases, as well as the value of low-burden, long-term passive data collection. METHODS: In a 3-arm prospective observational cohort feasibility study, we recruited 60 patients from the Royal Free Hospital and University College Hospital. These patients had been diagnosed with interstitial lung disease, chronic obstructive pulmonary disease, or post-COVID-19 condition (n=20 per group) and were followed for 180 days. This study used a comprehensive remote monitoring system designed to provide real-time and relevant data for both patients and clinicians. Data were collected using REDCap (Research Electronic Data Capture; Vanderbilt University) periodic surveys, Remote Assessment of Disease and Relapses-base active app questionnaires, wearables, finger pulse oximeters, smartphone apps, and Bluetooth home-based spirometry. The feasibility of remote monitoring was measured through adherence to the protocol, engagement during the follow-up period, retention rate, acceptability, and data integrity. RESULTS: Lowest-burden passive data collection methods, via wearables, demonstrated superior adherence, engagement, and retention compared with active data collection methods, with an average wearable use of 18.66 (SD 4.69) hours daily (77.8% of the day), 123.91 (SD 33.73) hours weekly (72.6% of the week), and 463.82 (SD 156.70) hours monthly (64.4% of the month). Highest-burden spirometry tasks and high-burden active app tasks had the lowest adherence, engagement, and retention, followed by low-burden questionnaires. Spirometry and active questionnaires had the lowest retention at 0.5 survival probability, indicating that they were the most burdensome. Adherence to and quality of home spirometry were analyzed; of the 7200 sessions requested, 4248 (59%) were performed. Of these, 90.3% (3836/4248) were of acceptable quality according to American Thoracic Society grading. Inclusion of protocol holidays improved retention measures. The technologies used were generally well received. CONCLUSIONS: Our findings provide evidence supporting the feasibility and acceptability of remote monitoring for capturing both subjective and objective data from various sources for respiratory diseases. The high engagement level observed with passively collected data suggests the potential of wearables for long-term, user-friendly remote monitoring in respiratory disease management. The unique piloting of certain features such as protocol holidays, alert notifications for missing data, and flexible support from the study team provides a reference for future studies in this field. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/28873.

Wearable technology interventions in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death and is associated with multiple medical and psychological comorbidities. Therefore, future strategies to improve COPD management and outcomes are needed for the betterment of patient care. Wearable technology interventions offer considerable promise in improving outcomes, but prior reviews fall short of assessing their role in the COPD population. In this systematic review and meta-analysis we searched ovid-MEDLINE, ovid-EMBASE, CINAHL, CENTRAL, and IEEE databases from inception to April 2023 to identify studies investigating wearable technology interventions in an adult COPD population with prespecified outcomes of interest including physical activity promotion, increasing exercise capacity, exacerbation detection, and quality-of-life. We identified 7396 studies, of which 37 were included in our review. Meta-analysis showed wearable technology interventions significantly increased: the mean daily step count (mean difference (MD) 850 (494-1205) steps/day) and the six-minute walk distance (MD 5.81 m (1.02-10.61 m). However, the impact was short-lived. Furthermore, wearable technology coupled with another facet (such as health coaching or pulmonary rehabilitation) had a greater impact that wearable technology alone. Wearable technology had little impact on quality-of-life measures and had mixed results for exacerbation avoidance and prediction. It is clear that wearable technology interventions may have the potential to form a core part of future COPD management plans, but further work is required to translate this into meaningful clinical benefit.

Late-Onset Type 1 Diabetes Mellitus and Unexplained Subcutaneous Lesions.

Nodular fasciitis is considered a reactive lesion of connective tissue originating from the proliferation of fibroblasts and myofibroblasts. Nodular fasciitis preponderantly localizes within the higher extremities, trunk, head, and neck. We are presenting a report on the case of a 38-year-old Navy pilot who developed nodular lesions in the area of the sternum and upper back and was diagnosed concomitantly with insulin-dependent diabetes mellitus (type 1 diabetes). The patient was treated for diabetic ketoacidosis using intensive insulin therapy protocol, and the nodules were surgically excised. He was discharged from the hospital four weeks later. In our presentation, we intend to highlight the essential characteristics of this rare lesion through a review of the literature and to identify an attainable link between the development of type 1 diabetes and nodular fasciitis.

The Value of Preoperative Systemic Immune-Inflammation Index as a Predictor of Prolonged Hospital Stay in Orthopedic Surgery: A Retrospective Study.

Purpose: Many risk factors, such as the duration of surgery and higher ASA scores, are associated with longer hospitalization in patients undergoing orthopedic surgery. However, no studies have evaluated the relationship between the preoperative systemic immune-inflammation index (SII) and length of hospital stay in orthopedic surgical patients. Therefore, this study aimed to investigate whether the SII is associated with the length of hospital stay in orthopedic surgery in adults. Patients and Methods: This was a retrospective cohort study, and data were extracted from electronic health records. Patients were included if they were older than 18 years and had undergone orthopedic surgery between [2016-2021]. The patients were divided into two groups according to the median duration of hospitalization and according to SII cut-off value (high-SII group: ≥799.86, low-SII group: <799.86). Univariate and multivariate linear regression analyses were used to identify the association between SII and length of hospitalization. Results: A total of 196 patients who underwent orthopedic surgery were included, and 62 were hospitalized for >21 days. There were significant differences in terms of ASA score (P = 0.041). Patients who required a longer hospitalization of >21 days had significantly lower hemoglobin level (P < 0.001), higher duration of surgery (P = 0.015), and increased requirement of ICU admission (P < 0.001). The optimal cut-off value for preoperative SII of 799.86 stratified the patients into high-SII and low-SII groups. Patients in high-SII group had higher median LOHS (22 days) compared to low-SII group (17 days; P = 0.006). In the multivariable linear regression analysis, the SII was significantly related to the length of hospital stay (ß = 0.246, 95% confidence interval [CI] 0.000-0.005, P = 0.031). Conclusion: A high-SII value is associated with an increased risk of longer hospitalization after orthopedic surgery.

Emergence of CuInS2 derived photocatalyst for environmental remediation and energy conversion.

Hydrogen production, catalytic organic synthesis, carbon dioxide reduction, environmental purification, and other major fields have all adopted photocatalytic technologies due to their eco-friendliness, ease of use, and reliance on sunlight as the driving force. Photocatalyst is the key component of photocatalytic technology. Thus, it is of utmost importance to produce highly efficient, stable, visible-light-responsive photocatalysts. CIS stands out among other visible-light-response photocatalysts for its advantageous combination of easy synthesis, non-toxicity, high stability, and suitable band structure. In this study, we took a brief glance at the synthesis techniques for CIS after providing a quick introduction to the fundamental semiconductor features, including the crystal and band structures of CIS. Then, we discussed the ways doping, heterojunction creation, p-n heterojunction, type-II heterojunction, and Z-scheme may be used to modify CIS's performance. Subsequently, the applications of CIS towards pollutant degradation, CO2 reduction, water splitting, and other toxic pollutants remediation are reviewed in detail. Finally, several remaining problems with CIS-based photocatalysts are highlighted, along with future potential for constructing more superior photocatalysts.

Development, characterization and use of rosemary essential oil loaded water-chestnut starch based nanoemulsion coatings for enhancing post-harvest quality of apples var. Golden delicious.

The study aimed at evaluating the influence of water-chestnut starch-based coatings loaded with rosemary essential oil (REO) at concentrations of 0.10%, 0.25% and 0.50% (w/v) on postharvest cold storage stability of apple var. Golden delicious for 120 days. Average droplet diameter of nanoemulsions was in range of 315-450 nm and it increased with increase in the REO concentration. Minimum weight loss was observed in fruits treated with coating material containing 0.50% REO. Samples coated with starch+0.50% REO exhibited highest firmness value of 68.22 ± 1.02 N under controlled atmosphere storage (CAS). Anthocyanins, ascorbic acid, total phenolic content and antioxidant activity were retained in all samples coated with formulated emulsion. Antifungal assay against Pencillium expansum indicated that 0.50% REO had maximum antifungal activity. Increase in REO concentration from 0.10 to 0.50% in starch coating formulations resulted in reduced lesion diameter in coated samples under both the storage conditions. Lesion diameter (LD) was found highest in control (39.40 ± 0.20 mm) under ambient conditions. Coated fruit samples showed a significant (p≤0.05) reduction in LD under both the ambient and CAS conditions however, more pronounced effect was reported under CAS. Fruits coated with edible coatings enriched with different REO concentrations under CAS exhibited significantly (p≤0.05) lower chilling injury index (ST+0.50%REO < ST+0.25%REO<0.10%REO) compared to control.

Clinicians' Perspectives of Wearable Technology to Detect and Monitor Exacerbations of Chronic Obstructive Pulmonary Disease: Mixed-Method Survey.

Objective: To investigate clinicians' perspectives on the current use of wearable technology for detecting COPD exacerbations, and to identify potential facilitators and barriers to its adoption in clinical settings. Methods: A mixed-method survey was conducted through an online survey platform involving clinicians working with COPD patients. The questionnaires were developed by an expert panel specialising in respiratory medicine at UCL. The questionnaire evaluated clinicians' perspectives on several aspects: the current extent of wearable technology utilisation, the perceived feasibility, and utility of these devices, as well as the potential facilitators and barriers that hinder its wider implementation. Results: Data from 118 clinicians were included in the analysis. Approximately 80% of clinicians did not currently use information from wearable devices in routine clinical care. A majority of clinicians did not have confidence in the effectiveness of wearables and their consequent impact on health outcomes. However, clinicians highlighted the potential value of wearables in helping deliver personalised care and more rapid assistance. Ease of use, technical support and accessibility of data were considered facilitating factors for wearable utilisation. Costs and lack of technical knowledge were the most frequently reported barriers to wearable utilisation. Conclusion: Clinicians' perspectives of the use of wearable technology to detect and monitor COPD exacerbations are variable. While accessibility and technical support facilitate wearable implementation, cost, technical issues, and knowledge act as barriers. Our findings highlight the facilitators and barriers to using wearables in patients with COPD and emphasise the need to assess patients' perspectives on wearable acceptability.

Size-Dependent Dispersion of Rhodium Clusters into Isolated Single Atoms at Low Temperature and the Consequences for CO Oxidation Activity.

Understanding the dynamic structural evolution of supported metal clusters under reaction conditions is crucial to develop structure reactivity relations. Here, we followed the structure of different size Rh clusters supported on Al2 O3 using in situ/operando spectroscopy and ex situ aberration-corrected electron microscopy. We report a dynamic evolution of rhodium clusters into thermally stable isolated single atoms upon exposure to oxygen and during CO oxidation. Rh clusters partially disperse into single atoms at room temperature and the extent of dispersion increases as the Rh size decreases and as the reaction temperature increases. A strong correlation is found between the extent of dispersion and the CO oxidation kinetics. More importantly, dispersing Rh clusters into single atoms increases the activity at room temperature by more than two orders of magnitude due to the much lower activation energy on single atoms (40 vs. 130 kJ/mol). This work demonstrates that the structure and reactivity of small Rh clusters are very sensitive to the reaction environment.

Recent insights into Nanoemulsions: Their preparation, properties and applications.

The ever-increasing demand for healthy diet by consumers has prompted the research adopting cutting-edge methods that can maintain the quality of fruits and vegetables without the use of preservatives. Emulsion based coating approach has been regarded as a viable way to extend the shelf life of fresh produce. New opportunities are being created in a number of industries, (medicines, cosmetics and food) because of new advancements in the developing field of nanoemulsions. Nanoemulsion based methods are efficient for encapsulating the active ingredients including antioxidants, lipids, vitamins and antimicrobial agents owing to the small droplet size, stability and improved biological activity. This review provides an overview of recent developments in preserving the quality and safety of fresh-cut fruits & vegetables with nanoemulsion as a carrier of functional compounds (antimicrobial agents, antibrowning/antioxidants and texture enhancers). In addition, material and methods used for fabrication of the nanoemulsion is also described in this review. In addition, material and methods used for fabrication, of the nanoemulsion is also present.

Unrevealing tunable resonant excitons and correlated plasmons and their coupling in new amorphous carbon-like for highly efficient photovoltaic devices.

An understanding on roles of excitons and plasmons is important in excitonic solar cells and photovoltaic (PV) technologies. Here, we produce new amorphous carbon (a-C) like films on Indium Tin Oxide (ITO) generating PV cells with efficiency three order of magnitude higher than the existing biomass-derived a-C. The amorphous carbon films are prepared from the bioproduct of palmyra sap with a simple, environmentally friendly, and highly reproducible method. Using spectroscopic ellipsometry, we measure simultaneously complex dielectric function, loss function as well as reflectivity and reveal coexistence of many-body resonant excitons and correlated-plasmons occurring due to strong electronic correlations. X-ray absorption and photoemission spectroscopies show the nature of electron and hole in defining the energy of the excitons and plasmons as a function of N or B doping. Our result shows new a-C like films and the importance of the coupling of resonant excitons and correlated plasmons in determining efficiency of photovoltaic devices.

Association of Genetic and Allelic Variants of Von Willebrand Factor (VWF), Glutathione S-Transferase and Tumor Necrosis Factor Alpha with Ischemic Stroke Susceptibility and Progression in the Saudi Population.

Stroke is a key cerebrovascular disease and important cause of death and disability worldwide, including in the kingdom of Saudi Arabia (KSA). It has a large economic burden and serious socioeconomic impacts on patients, their families and the community. The incidence of ischemic stroke is probably increased by the interaction of GSTT1 and GSTM1 null genotypes with high blood pressure, diabetes and cigarette smoking. The roles of VWF, GSTs and TNF-alpha gene variations in the induction of stroke are still uncertain and require further examination. In the current study, we studied the associations of SNPs in the genes VWF, GSTs and TNF-alpha with stroke in the Saudi population. Genotyping was performed using the ARMS -PCR for TNF-alpha, AS-PCR for VWF and multiplex PCR for GSTs. The study included 210 study subjects: 100 stroke cases and 110 healthy controls. We obtained significant distributions of VWF rs61748511 T > C, TNF-alpha rs1800629 G > A and GST rs4025935 and rs71748309 genotypes between stroke cases and the healthy controls (p < 0.05). The results also indicated that the TNF-alpha A allele was associated with risk of stroke with odd ratio (OR) = 2.22 and risk ratio = RR 2.47, p < 0.05. Similarly, the VWF-TC genotype and C allele were strongly linked with stroke with OR = 8.12 and RR 4.7, p < 0.05. In addition, GSTT1 and GSTT1 null genotype was strongly associated with stroke predisposition with OR = 8.30 and RR = 2.25, p < 0.0001. We conclude that there is a possible strong association between the VWF-T > C, TNF-alpha G > A, GSTT1 gene variants and ischemic stroke susceptibility in the Saudi population. However, future well-designed and large-scale case-control studies on protein-protein interactions and protein functional studies are required to verify these findings and examine the effects of these SNPs on these proteins.