Combinatorial Efficacy and Toxicity of an Engineered Toxin Body MT-3724 with Gemcitabine and Oxaliplatin in Relapsed or Refractory Diffuse Large B Cell Lymphoma.

MT-3724 is an engineered direct-kill immunotoxin comprised of a CD20-specific scFv fused to a Shiga-like toxin subunit. In this phase IIa study, eight patients with relapsed diffuse large B-cell lymphoma were treated with MT-3724 combined with gemcitabine and oxaliplatin (GEMOX). The objective response rate was 85.7%, with a median duration of response of 2.2 months. The 12-month overall survival and progression-free survival were 71.4% and 28.6%, respectively. Two patients experienced grade 2 capillary leak syndrome (CLS). Combination therapy with MT-3724 and GEMOX demonstrated an early efficacy signal but was limited by the incidence of CLS.

Management of Vestibular Schwannoma with Normal Hearing.

INTRODUCTION: This work aimed to study the management of vestibular schwannoma (VS) patients with normal hearing (NH). METHODS: A retrospective study was undertaken in a Quaternary referral center for skull base pathologies. Among 4,000 VS patients 162 met our strict audiological criteria for NH. These patients were divided into 2 management groups, wait and scan (W&S) (45/162, 25%) and operated patients (123/162, 75%), and 6 patients were included in both groups. RESULTS: Our management strategy achieved the goals for treatment of VS. First goal, all tumors were completely removed except for 2 intentional residuals. Second goal, facial nerve (FN) function preservation (House Brackmann I, II, and III) was 95.9%. Third goal, possible hearing preservation (HP) attempts occurred in (50/122) (40.9%) with an HP rate in 44% of the patients. Additionally, there were only 2 cases of postoperative complications with no CSF leakage. The prospect of HP in NH patients did not differ with respect to tumor size. However, patients with normal preoperative ABR seemed to have better chances of HP and good FN function and vice versa. HP rate was superior for the MCFA as opposed to the RS + RLA. W&S group demonstrated hearing stability in 88.9% of the patients and FN function stability of HB I in 100% of the patients. CONCLUSIONS: Surgical resection is a reasonable and definitive management option for VS with NH. Nevertheless, choosing to manage cases with observation remains an appropriate management option for NH patients. ABR might be considered as an adjuvant tool indicating better prognosis for HP.

LncRNA NEAT2 Modulates Pyroptosis of Renal Tubular Cells Induced by High Glucose in Diabetic Nephropathy (DN) by via miR-206 Regulation.

Patients suffering from terminal-stage diabetic nephropathy (DN) are commonly diagnosed with kidney failure. The condition of DN patients gets generally improved by long-chain noncoding RNA (LncRNA) since it regulates microRNA (miR). The current study analyzes the role played by NEAT2/miR-206 upon cell death of renal tubular epithelial cells (RTECs), high glucose (HG)-induced inflammation and oxidative stress in diabetic nephropathy (DN). The researcher used high glucose (HG) to treat HK-2 cells in in vitro conditions to establish the DN cell model. qRT-PCR was used to confirm the transfection effect whereas the researcher also tested NEAT2, nucleotide-binding oligomerization domain, leucine-rich repeat and pyrin domain containing (NLRP3), caspase-1, interleukin IL-1ß, gasdermin D (GSMDD)-N, and miR-206. To analyze the proteins in caspase-1, IL-1ß, GSMDD-N, and NLRP3, Western blot technique was performed. The technique is also used to observe the pyroptosis. To identify TNF-α, IL-6, MCP-9, NEAT2, miR-206, and NLRP3, dual-luciferase reporter assay was conducted through ELISA kit to emphasize the correlation that exists among the above-mentioned factors. NEAT2 has been confirmed to have bound with miR-206 through double luciferase report experiments as well as RNA immunoprecipitation (RIP). NEAT2, present in HK-2 cells, was induced by HG. So, if NEAT2 is knocked down, it would mitigate TNF-α, IL-6, and MCP-9 as well. Among the HK-2 cells intervened with HG, the overexpressed miR-206 that was transfected into cells was in alignment with the modifications introduced in inflammatory factors and cytokines after NEAT2 is knocked down. The current study concludes that if NEAT2 is upregulated, it has the potential to retreat the inhibition of miR-206 on inflammatory response as well pyroptosis. Further, by targeting miR-206, NEAT2 has the potential to enhance HG-induced HK-2 pyroptosis. This miR-206 is predicted to be a latent target in the clinical treatment of DN.

Smart Cognitive IoT Devices Using Multi-Layer Perception Neural Network on Limited Microcontroller.

The Internet of Things (IoT) era is mainly dependent on the word "Smart", such as smart cities, smart homes, and smart cars. This aspect can be achieved through the merging of machine learning algorithms with IoT computing models. By adding the Artificial Intelligence (AI) algorithms to IoT, the result is the Cognitive IoT (CIoT). In the automotive industry, many researchers worked on self-diagnosis systems using deep learning, but most of them performed this process on the cloud due to the hardware limitations of the end-devices, and the devices obtain the decision via the cloud servers. Others worked with simple traditional algorithms of machine learning to solve these limitations of the processing capabilities of the end-devices. In this paper, a self-diagnosis smart device is introduced with fast responses and little overhead using the Multi-Layer Perceptron Neural Network (MLP-NN) as a deep learning technique. The MLP-NN learning stage is performed using a Tensorflow framework to generate an MLP model's parameters. Then, the MLP-NN model is implemented using these model's parameters on a low cost end-device such as ARM Cortex-M Series architecture. After implementing the MLP-NN model, the IoT implementation is built to publish the decision results. With the proposed implemented method for the smart device, the output decision based on sensors values can be taken by the IoT node itself without returning to the cloud. For comparison, another solution is proposed for the cloud-based architecture, where the MLP-NN model is implemented on Cloud. The results clarify a successful implemented MLP-NN model for little capabilities end-devices, where the smart device solution has a lower traffic and latency than the cloud-based solution.

The Baffle Length Effects on the Natural Convection in Nanofluid-Filled Square Enclosure with Sinusoidal Temperature.

The proper process of applying heat to many technological devices is a significant challenge. There are many nanofluids of different sizes used inside the system. The current study combines this potential to improve convection effects, considering numerical simulations of natural convection using Cu/water nanofluids in a square enclosure with bottom blocks embedded in baffles. The enclosure consists of two vertical walls with isothermal boundary conditions; the left wall is the sinusoidal heat source, whereas the right wall is cooled. The investigations dealt with the influences of nanoparticle concentration, Rayleigh number, baffle length, and thermal conductivity ratioon isotherms, stream functions, and average Nusselt number. The results present that, when the Rayleigh number rises, the fluid flow velocity increases, and the heat transfer improves. Furthermore, the baffle length case (Lb = 0.3) provides higher heat transfer characteristics than other baffle height cases.

A Brief Review on Fruit and Vegetable Extracts as Corrosion Inhibitors in Acidic Environments.

The corrosion of metals, i.e., the initiation and acceleration of the surface deterioration of metals through an electrochemical reaction with the surrounding intrusive environment, is a global concern because of the economic and environmental impacts. Corrosion inhibitors are considered the most practical choice among the available corrosion protection techniques due to their effectiveness in terms of functionality and cost. The use of traditional and toxic corrosion inhibitors has led to environmental issues, arousing the need for green counterparts that are environmentally friendly, easily accessible, biodegradable, and cost-effective. In this review, the utilization of green corrosion inhibitors purely acquired from renewable sources is explored, with an in-depth focus on the recent advancements in the use of fruit and vegetable extracts as green corrosion inhibitors. In particular, fruits and vegetables are natural sources of various phytochemicals that exhibit key potential in corrosion inhibition. To shed light on the true potential of such extracts in the protection of steel in acidic environments, the experimental techniques involved in corrosion inhibition and the mechanism of corrosion inhibition are discussed in detail. The study highlights the potential of fruit and vegetable extracts as non-toxic, economical, and effective corrosion inhibitors in the pursuit of green chemistry. In addition to discussing and outlining the current status and opportunities for employing fruit and vegetable extracts as corrosion inhibitors, the current review outlines the challenges involved in the utilization of such extracts in corrosion inhibition.

Female genital mutilation (FGM) in Egypt, knowledge and concepts of Egyptian medical students: a cross-sectional study.

There are many factors contributing to the existence of female genital mutilation (FGM). FGM has a long list of recorded complications, which include physical, obstetric, sexual, psychological and death. We assessed the knowledge, attitudes and perceptions of FGM practice among Egyptian medical students. An online questionnaire was distributed. One thousand one hundred and forty-one participants completed questionnaires. 71.2% were aware of FGM complications especially among females. Two-thirds reported illegality. 7.8% were in favour of FGM conduct with a higher male preference. Religious and traditional factors were the principle contributing factors to the practice. Three quarters of female students did not agree that FGM increased the chance of marriage. Almost one-fifth of female students reported having been subject to FGM, with a high level of dissatisfaction. It was shown that Egyptian medical students lacked knowledge about FGM with no structured training, so every effort should be done to end this inhumane practice.Impact StatementWhat is already known on this subject? The conduct of female genital mutilation (FGM) in Egypt is motivated by a variety of factors, including social notions, cultural beliefs and theological misunderstanding. FGM has a long list of recorded complications, which might include physical, obstetric, sexual, psychological and even death.What do the results of this study add? This study provides policy makers and community managers with the evidence needed to advocate for the addition of FGM education to be introduced across the board in medical school curriculums.What are the implications of these findings for clinical practice and/or further research? Possible elimination of the practice and further research on how to eradicate the roots behind it.

Metal-Ion Depletion Impacts the Stability and Performance of Battery Electrode Deionization over Multiple Cycles.

Prussian blue hexacyanoferrate (HCF) materials, such as copper hexacyanoferrate (CuHCF) and nickel hexacyanoferrate (NiHCF), can produce higher salt removal capacities than purely capacitive materials when used as electrode materials during electrochemical water deionization due to cation intercalation into the HCF structure. One factor limiting the application of HCF materials is their decay in deionization performance over multiple cycles. By examining the performance of CuHCF and NiHCF electrodes at three different pH values (2.5, 6.3, and 10.2) in multiple-cycle deionization tests, losses in capacity (up to 73% for CuHCF and 39% for NiHCF) were shown to be tied to different redox-active centers through analysis of dissolution of electrode metals. Both copper and iron functioned as active centers for Na+ removal in CuHCF, while iron was mainly the active center in NiHCF. This interaction of Na+ and active centers was demonstrated by correlating the decrease in performance to the concentration of these metal ions in the effluent solutions collected over multiple cycles at different pHs (up to 0.86 ± 0.14 mg/L for iron and 0.42 ± 0.17 mg/L for copper in CuHCF and 0.38 ± 0.05 mg/L for iron in NiHCF). Both materials were more stable (<11% decay for CuHCF and no decay for NiHCF) when the appropriate metal salt (copper or nickel) was added to the feed solutions to inhibit electrode dissolution. At a pH of 2.5, there was an increased competition between protons and Na+ ions, which decreased the Na+ removal amount and lowered the thermodynamic energy efficiency for deionization for both electrode materials. Therefore, while an acidic pH provided the most stable performance, a circumneutral pH would be useful to produce a better balance between performance and longevity.

Caffeine versus antioxidant combination (Antox) and their role in modifying cadmium-induced testicular injury in adult male albino rats.

The aim of the current work was to compare the roles of caffeine and antioxidants in prevention of cadmium-induced testicular damage when given, in addition to cadmium, in adult male albino rats. Histopathological and ultra-structural examination as well as biochemical and molecular assessments were done. Cadmium chloride (4 mg/kg body weight) was administered via oral gavage from day 21 to 28 of the experiment. Caffeine (25 mg/kg) via intra-peritoneal injection and antioxidant preparation (Antox) 10 mg/kg via oral gavage were given as a pre-treatment for 21 days and concomitantly with Cd from day 21 to 28. Real-time PCR was done for determination of 3, 17 ß hydroxy steroid dehydrogenase steroidogenic acute regulatory protein, caspase-9 and mitofusin 1,2 gene expression. Testosterone level, glutathione S-transferase enzyme activity, reactive oxygen species, malondialdehyde and superoxide dismutase were measured spectrophotometrically by ELISA. Histological and ultra-structural evaluation revealed disturbance of normal architecture, vacuolisation and necrosis. Vascular dilatation and congestion and collagen fibre deposition were present. A statistically significant difference was seen in all parameters when caffeine and antioxidants were given against cadmium-induced testicular injury. Overall, we conclude that both caffeine and antioxidants have the ability to reverse cadmium-induced testicular injury when given as pre-treatment prior to cadmium exposure.

Microtransplantation in older patients with AML: A pilot study of safety, efficacy and immunologic effects.

Older AML patients have low remission rates and poor survival outcomes with standard chemotherapy. Microtransplantation (MST) refers to infusion of allogeneic hematopoietic stem cells without substantial engraftment. MST has been shown to improve clinical outcomes compared with chemotherapy alone. This is the first trial reporting on broad correlative studies to define immunologic mechanisms of action of MST in older AML patients. Older patients with newly diagnosed AML were eligible for enrollment, receiving induction chemotherapy with cytarabine (100 mg/m2) on days 1-7 and idarubicin (12 mg/m2) on days 1-3 (7 + 3). MST was administered 24 hours later. Patients with complete response (CR) were eligible for consolidation with high dose cytarabine (HiDAC) and a second cycle of MST. Responses were evaluated according to standard criteria per NCCN. Immune correlative studies were performed. Sixteen patients were enrolled and received 7 + 3 and MST (median age 73 years). Nine (56%) had high-risk and seven (44%) had standard-risk cytogenetics. Ten episodes of CRS were observed. No cases of GVHD or treatment-related mortality were reported. Event-free survival (EFS) was 50% at 6 months and 19% at 1 year. Overall survival (OS) was 63% at 6 months and 44% at 1 year. Donor microchimerism was not detected. Longitudinal changes were noted in NGS, TCR sequencing, and cytokine assays. Addition of MST to induction and consolidation chemotherapy was well tolerated in older AML patients. Inferior survival outcomes in our study may be attributed to a higher proportion of very elderly patients with high-risk features. Potential immunologic mechanisms of activity of MST include attenuation of inflammatory cytokines and emergence of tumor-specific T cell clones.

Allogenic hematopoietic stem cell transplantation in sickle cell disease.

PURPOSE OF REVIEW: Discussing the currently available HSCT options for Hb SS patients highlighting advantages and disadvantages of each modality in the light of recently published data. RECENT FINDINGS: When MSD is available, myeloablative regimen is the preferred approach for otherwise healthy children whereas the nonmyeloablative (NMA) regimen is of choice for adults as well as children with SCD-associated morbidities. Mixed chimerism is common especially with NMA conditioning and is usually enough for cure. Alternative donor HSCT outcomes are progressively improving especially with posttransplant cyclophosphamide for GVHD prophylaxis. SUMMARY: Recent studies comparing HSCT and chronic transfusion in Hb SS patients increasingly come in favor of HSCT arm. Advances in HSCT field led to donor pool expansion and better tolerated regimens. It is easier now to tailor a personalized transplantation plan for almost every patient. A successful management plan should be sufficiently comprehensive addressing patients' and families' social and psychological concerns to ensure compliance and improve outcome.

Clinical significance of serum DRAM1 mRNA, ARSA mRNA, hsa-miR-2053 and lncRNA-RP1-86D1.3 axis expression in malignant pleural mesothelioma.

AIM AND BACKGROUND: Malignant pleural mesothelioma (MPM) is a lethal cancer mainly caused by chronic exposure of asbestos. In this pilot study, we aimed to assess the expression of serum RNA-based biomarker panel exploring their clinical utility as diagnostic and prognostic biomarkers for MPM. METHODS: We have selected an MPM-specific RNA-based biomarker panel through bioinformatics analysis based on the integration of DNA damage regulated autophagy modulator 1 (DRAM1) and arylsulfatase A ( ARSA) gene expression with their epigenetic regulators microRNA ( miR-2053) and long noncoding RNA ( lncRNA-RP1-86D1.3). Then, quantitative real-time polymerase chain reaction (qPCR) validation in sera of 60 MPM patients, 20 chronic asbestos exposure patients, and 20 healthy volunteers was done. Lastly, the prognostic power of the selected panel was assessed. RESULTS: The expression of serum DRAM1 messenger RNA (mRNA), ARSA mRNA, hsa-miR-2053 and lncRNA-RP1-86D1.3 were positive in 78.3%, 90%, 85%, and 83.3% of MPM patients, respectively. The RNA-based biomarker panel was able to discriminate between MPM patients and controls with high accuracy and their combined sensitivity reached 100% for the diagnosis of MPM. Kaplan-Meier analysis showed that hsa-miR-2053 is an independent prognostic factor of MPM. CONCLUSION: Our preliminary data revealed that the chosen RNAs play an important role in driving MPM development and progression.

Audiological Evaluation of Vestibular Schwannoma Patients with Normal Hearing.

OBJECTIVE: To evaluate the audiological aspects of vestibular schwannoma (VS) patients with normal hearing. STUDY DESIGN: Retrospective study. SETTING: Quaternary referral center for skull base pathologies. PATIENTS: The records on 4,000 patients who had been diagnosed with VS between 1986 and December 2017 were retrospectively reviewed. The patients included in the study were the ones who complied with the strict audiological normality criteria, as follows: a pure tone hearing threshold (at the 6-octave-spaced frequencies from 250 to 8,000 Hz) ≤25 dBHL; a word recognition score >90%; and interaural differences ≤10 dB at each frequency. INTERVENTIONS: Auditory brainstem response (ABR) testing and radiological imaging. MAIN OUTCOME MEASURES: The incidence of normal objective hearing among VS patients, and the diagnostic utility of the ABR and the effect of tumor size and site on the response. RESULTS: The incidence of normal hearing among VS patients was 4.2%. Tinnitus and vertigo were the most common symptoms across tumor grades; 5.6% of the tumors were large and giant tumors. The ABR yielded a sensitivity of 73.6%, with a false negative rate of 26.3% using a cutoff point of 0.2 ms for interaural latency differences. CONCLUSIONS: The diagnosis of VS should not be based on audiometric thresholds alone. Alarming signs of VS should be clear to the physician in order not to miss or delay the diagnosis of the disease. The ABR is useful in the diagnosis of VS, but normal results do not exclude the occurrence of the disease in patients with normal hearing.

Finding the right BCR-ABL1 tyrosine kinase inhibitor: a case report of successful treatment of a patient with chronic myeloid leukemia and a V299L mutation using nilotinib.

BACKGROUND: Chronic myeloid leukemia can be effectively treated with BCR-ABL1 tyrosine kinase inhibitors. However, BCR-ABL1 mutations can develop and cause secondary resistance to these inhibitors. For each of the available BCR-ABL1 inhibitors, certain mutations are known to be associated with resistance, although most mutations that confer resistance to one tyrosine kinase inhibitor remain sensitive to one or more of the other available inhibitors. For patients displaying poor response or loss of response to frontline treatment, the possibility that they have developed a new BCR-ABL1 mutation must be considered, and selection of a second-line treatment must consider the patient's mutational profile. Here we describe a case in which a patient developed a V299L mutation; although this mutation is known to be associated with resistance to dasatinib while remaining sensitive to nilotinib, limited information is currently available regarding the use of second-line nilotinib following development of a V299L mutation while receiving dasatinib. CASE PRESENTATION: A 73-year-old man presenting with fatigue and drenching night sweats lasting for 2 weeks was diagnosed with chronic myeloid leukemia based on an analysis of a bone marrow biopsy and detection of the BCR-ABL1 fusion gene in peripheral blood. The patient initiated frontline treatment with dasatinib. A good treatment response was seen initially, with a complete hematologic response by month 2 of treatment. By month 20 however, BCR-ABL1 transcript levels rose markedly, and a mutational analysis revealed a BCR-ABL1 V299L mutation. Based on the identification of this specific mutation, the patient switched treatment to nilotinib; by month 18 of nilotinib treatment, the patient achieved a deeper reduction in BCR-ABL1 transcript levels than was seen with dasatinib. To date, in month 34 of treatment with nilotinib, the patient has shown good tolerance of the drug and has no clinical evidence of disease progression. CONCLUSIONS: Our case report illustrates the benefit of having multiple drugs available to treat chronic myeloid leukemia, each with the ability to inhibit a distinct set of BCR-ABL1 mutations. This patient's case suggests that switching to nilotinib can be an effective treatment option for patients who develop a BCR-ABL1 V299L mutation while receiving dasatinib.

Accelerated Coasting Does Not Affect Oocyte Maturation.

AIMS: The study aimed to assess the efficacy of accelerating the process of coasting through adding gonadotropin releasing hormone (GnRH) antagonist (GnRH-ant) on the day of triggering of oocyte maturation without withholding the GnRH agonist (GnRHa) in women at risk for developing ovarian hyperstimulation syndrome (OHSS). METHODS: Retrospective case-control study of the outcomes of GnRHa cycles in which women were at risk to develop OHSS. Women who underwent acceleration of coasting (n = 50) were compared with a control group of women who underwent usual coasting (n = 57). RESULTS: The oocyte maturation and fertilization rates were significantly higher in the accelerated coasting group than in the usual coasting group (83.05 vs. 67.62%; p < 0.001 and 79.85 vs. 65.84%; p < 0.001, respectively). The pregnancy rates were higher in the accelerated coasting group than in the usual coasting group but without statistically significant difference. The incidences of mild, moderate, and severe OHSS were not significantly different between both groups. CONCLUSION: Acceleration of coasting in cases of OHSS through treatment with GnRH-ant after pituitary suppression with GnRHa offered a novel approach to reduce estradiol level, avoid cycle cancellation, and maintain excellent oocyte maturation rate and thus high pregnancy rate with prevention of OHSS.

Comparative QTL analysis of root lesion nematode resistance in barley.

KEY MESSAGE: This study demonstrates for the first time that resistance to different root lesion nematodes ( P. neglectus and P. penetrans ) is controlled by a common QTL. A major resistance QTL ( Rlnnp6H ) has been mapped to chromosome 6H using two independent barley populations. Root lesion nematodes (Pratylenchus spp.) are important pests in cereal production worldwide. We selected two doubled haploid populations of barley (Igri × Franka and Uschi × HHOR 3073) and infected them with Pratylenchus penetrans and Pratylenchus neglectus. Nematode multiplication rates were measured 7 or 10 weeks after infection. In both populations, continuous phenotypic variations for nematode multiplication rates were detected indicating a quantitative inheritance of resistance. In the Igri × Franka population, four P. penetrans resistance QTLs were mapped with 857 molecular markers on four linkage groups (2H, 5H, 6H and 7H). In the Uschi × HHOR 3073 population, eleven resistance QTLs (P. penetrans and P. neglectus) were mapped with 646 molecular markers on linkage groups 1H, 3H, 4H, 5H, 6H and 7H. A major resistance QTL named Rlnnp6H (LOD score 6.42-11.19) with a large phenotypic effect (27.5-36.6 %) for both pests was mapped in both populations to chromosome 6H. Another resistance QTL for both pests was mapped on linkage group 5H (Igri × Franka population). These data provide first evidence for common resistance mechanisms against different root lesion nematode species. The molecular markers are a powerful tool for the selection of resistant barley lines among segregating populations because resistance tests are time consuming and laborious.

Rapid and simple electrochemical detection of morphine on graphene-palladium-hybrid-modified glassy carbon electrode.

A hybrid of reduced graphene oxide-palladium (RGO-Pd) nano- to submicron-scale particles was simultaneously chemically prepared using microwave irradiation. The electrochemical investigation of the resulting hybrid was achieved using cyclic voltammetry and differential pulse voltammetry. RGO-Pd had a higher current response than unmodified RGO toward the oxidation of morphine. Several factors that can affect the electrochemical response were studied, including accumulation time and potential, Pd loading, scan rate, and pH of electrolyte. At the optimum conditions, the concentration of morphine was determined using differential pulse voltammetry in a linear range from 0.34 to 12 µmol L(-1) and from 14 to 100 µmol L(-1), with detection limits of 12.95 nmol L(-1) for the first range. The electrode had high sensitivity toward morphine oxidation in the presence of dopamine (DA) and of the interference compounds ascorbic acid (AA) and uric acid (UA). Electrochemical determination of morphine in a spiked urine sample was performed, and a low detection limit was obtained. Validation conditions including reproducibility, sensitivity, and recovery were evaluated successfully in the determination of morphine in diluted human urine.

The association between different anesthetic techniques and outcomes in patients undergoing transfemoral aortic valve replacement.

Background: There is an increasing number of patients undergoing transfemoral aortic valve replacement (TAVR) with sedation. There is limited data assessing the efficacy and safety of the different types of sedative drugs. The objective was to compare two sedation techniques with regard to the need for vasoactive support, respiratory support, rate of conversion to general anesthesia (GA), common perioperative morbidities, intensive care unit (ICU) stay, and in-hospital mortality. Methods: A retrospective chart review study conducted among patients who underwent TAVR at a specialized cardiac center between January 2016 and December 2019. Data collection included patient diagnosis, preoperative comorbidities, intraoperative outcomes, and postoperative outcomes. Results: A total of 289 patients received local anesthesia; 210 received propofol infusion and 79 received a mixed propofol-ketamine infusion (Ketofol). The average age was 75.5 ± 8.9 years and 58.1% of the patients were females. Comparing propofol and ketofol groups, 31.2% and 34.2% of the patients required drug support, 7.6% and 6.3% required conversion to GA, 46.7% and 59.5% required respiratory support, respectively. These intraoperative outcomes were not significantly different between groups, P = 0.540, P = 0.707, and P = 0.105, respectively. In-hospital 30-day mortality in propofol and ketofol groups were 1.9% and 3.8%, respectively, P = 0.396. In both groups, the median post-procedure coronary care unit stay was 26 hours while post-procedure hospital stay was 3 days. Conclusions: There were no significant differences in perioperative or postoperative outcomes in TAVR patients receiving either propofol or ketofol. Propofol infusion, either alone or with ketamine, is reliable and safe, with minimal side effects.

Electrochemical sensor based on PEDOT/CNTs-graphene oxide for simultaneous determination of hazardous hydroquinone, catechol, and nitrite in real water samples.

Hydroquinone (HQ), catechol (CC) and nitrite (NT) are considered aquatic environmental pollutants. They are highly toxic, harm humans' health, and damage the environment. Thus, in the present work we introduce a simple and efficient electrochemical sensor for determination of HQ, CC, and NT simultaneously in wastewater sample. The sensor is fabricated by modifying the surface of a glassy carbon electrode (GCE) by two successive thin films from poly(3,4-ethylenedioxythiophene) (PEDOT) and a mixture of carbon nanotubes-graphene oxide (CNT-GRO). Under optimized conditions the HQ, CC, and NT are successfully detected simultaneously in wastewater sample with changing their concentrations in the ranges (0.04 → 100 µM), (0.01 → 100 µM) and (0.05 → 120 µM), the detection limits are 8.5 nM, 3.8 nM and 6.1 nM, respectively. Good potential peak separations: 117 mV and 585 mV are obtained between the HQ-CC, and CC-NT. The sensor has an excellent catalytic capability toward the oxidation of HQ, CC, and NT due to good synergism between its composite components: PEDOT, GRO and CNTs. The features of the sensor are large active surface area, good electrical conductivity, perfect storage stability, good reproducibility, anti-interference capability and accepted recovery rate for HQ, CC, and NT determination in wastewater sample.