Assessing the gas sensing capability of undoped and doped aluminum nitride nanotubes.

CONTEXT: CO2 and CO gas sensors are very important to recognize the insulation situation of electrical tools. ToCO explore the application of noble metal doped of aluminum nitride nanotubes for gas sensors, DFT computations according to the first principal theory were applied to study sensitivity, adsorption attributes, and electronic manner. In this investigation, platinum-doped aluminum nitride nanotubes were offered for the first time to analyze the adsorption towards CO2 and CO gases. Firm construction of platinum-doped aluminum nitride nanotubes (Pt-AlNNT) was investigated in four feasible places, and the binding energy of firm construction is 1.314 eV. Respectively, the adsorption energy between the CO2 and Pt-AlNNT systems was - 2.107 eV, while for instance of CO, the adsorption energy was - 3.258 eV. The mentioned analysis and computations are considerable for studying Pt-AlNNT as a new CO2 and CO gas sensor for electrical tools insulation. The current study revealed that the Pt-AlNNT possesses high selectivity and sensitivity towards CO2 and CO. METHODS: In this research, Pt-doped AlNNT (Pt-AlNNT) has been studied as sensing materials of CO and CO2 for the first time. The adsorption process of Pt-AlNNT has been computed and analyzed through the DFT approach. DFT computations by using B3LYP functional and 6-31 + G* basis sets have been applied in the GAMESS code for sensing attributes, which contribute to potential applications.

Depression and anxiety among patients with epilepsy: A cross-sectional study from Riyadh, Saudi Arabia.

Background: It is well established that epileptic disorders are associated with a wide range of psychosocial issues that overburden the affected individuals and limit their lifestyle. This study aimed to determine the commonalities between depression and anxiety symptoms among patients with epilepsy (PWE). In addition, we assessed whether depression and anxiety rates varied depending on factors related to the disease. Materials and Methods: A cross-sectional study was conducted between October 2021 and March 2022 among all PWE at Prince Mohammed bin Abdulaziz Hospital, and 147 patients who responded to the questionnaires were included for analysis (65.6% response rate). Depression was measured using the Patient Health Questionnaire depression scale (PHQ-9), while anxiety levels were measured using the Generalized Anxiety Disorder scale (GAD-7). Demographic variables such as sex, age, marital status, and factors related to epilepsy were also recorded. Results: The results showed that 39.5% and 27.9% of participants had major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively. The presence of factors that increased susceptibility to seizures was associated with a greater expression of depression (P = 0.035) and anxiety (P = 0.002) symptoms. The presence of symptoms/signs that precede seizures was associated with a higher risk of moderate and severe depression (P = 0.001) and moderate and severe anxiety (P < 0.001). Irregular use of medications was associated with a higher risk of moderate and severe depression (P = 0.037); however, lamotrigine was associated with lower rates of depression among the participants (P = 0.023). Conclusion: This study found that PWE had a higher prevalence of MDD and GAD than the general population. However, this accepted paradigm has yet to reflect a meaningful change in constructing condition-specific recommendations for PWE. Our study revealed that the presence of subjectively recognized signs of an impending ictal episode was significantly associated with a higher risk of moderate and severe depression and anxiety. Furthermore, factors that increase the susceptibility to seizures were associated with a higher risk of depression and anxiety. Irregular medication use was associated with a higher risk of moderate and severe depression. However, lamotrigine was associated with lower rates of depression among participants.

Comparing the Long-term Success Rates of Immediate Implant Placement vs. Delayed Implant Placement in Patients with Periodontally Compromised Teeth.

Background: This study aims to compare the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth. Materials and Methods: A total of 30 patients presenting with periodontally compromised teeth requiring extraction and subsequent implant placement were enrolled in this retrospective study. Patients were divided into two groups based on the timing of implant placement: Group A (immediate implant placement) and Group B (delayed implant placement). Implants were placed according to standard protocols. Patient records were reviewed for implant survival, peri-implant bone loss, and prosthetic complications. Data were statistically analyzed using appropriate tests. Results: The mean follow-up period was 5 years. In Group A, the implant survival rate was 90%, while in Group B, it was 83%. The mean peri-implant bone loss was 1.5 mm in Group A and 2.2 mm in Group B. Prosthetic complications were observed in three cases in Group A and five cases in Group B. The differences in implant survival and bone loss between the two groups were not statistically significant (P > 0.05). Conclusion: Both immediate implant placement and delayed implant placement demonstrated comparable long-term success rates in patients with periodontally compromised teeth.

The Effect of a Low-Carbohydrate Diet on Periodontal Health and Inflammation in Patients with Type 2 Diabetes.

Background: The interaction between type 2 diabetes and periodontal disease underscores the importance of exploring dietary interventions that could mitigate inflammation and improve periodontal health in diabetic patients. Materials and Methods: This randomized controlled trial included 100 patients with type 2 diabetes who were equally divided into two groups: Group A (low-carbohydrate diet) and Group B (control group). Patients in Group A followed a low-carbohydrate diet for 12 weeks, while Group B maintained their regular dietary habits. Periodontal health was assessed using clinical parameters such as probing depth (PD) and clinical attachment level (CAL), and inflammation was measured by analyzing levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Statistical analyses were performed using appropriate tests. Results: After 12 weeks, Group A exhibited significant improvements in periodontal health compared to Group B. The mean PD reduction was 0.5 mm in Group A and 0.1 mm in Group B, with a corresponding mean CAL gain of 0.3 mm in Group A and no significant change in Group B. Inflammatory markers also showed favorable outcomes in Group A, with a decrease of 1.2 mg/L in CRP levels and 20% reduction in IL-6 levels. In contrast, Group B demonstrated minimal changes in inflammatory markers. The differences in PD, CAL, CRP, and IL-6 levels between the two groups were statistically significant (P < 0.05). Conclusion: The adoption of a low-carbohydrate diet for 12 weeks demonstrated significant improvements in periodontal health and reduction of inflammation in patients with type 2 diabetes.

Prevalence of Long COVID Syndrome and its Association With Blood Group: A Cross-Sectional Study.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) virus pandemic rapidly spread across the globe since 2020. It was characterized by a number of acute signs and symptoms. There were, however, some new-onset signs and symptoms labelled as "Long COVID". This study was conducted to study its prevalence and associations with blood group. METHODS: A retrospective analysis was conducted in Islamabad for patients diagnosed with COVID-19 in 2020-2021. Information was collected through an online and physical questionnaire regarding personal demographics, symptoms during and after COVID-19, and blood group. The data was analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). RESULTS: The study identified 196 participants out of which 48.5% were male and 51% were female, with a median age of 30. Most participants (62.2%) belonged to the Punjabi ethnicity. The mean BMI was 25.56 kg/m2. The majority of the study participants reported having blood group B (n=76) followed by A (n=52). Acute symptoms were experienced by 95.4% of participants, with fatigue being the most persistent symptom at four weeks (45.9%). After four weeks, 63.3% of participants reported new symptoms like hair loss. Females were found more likely to experience long COVID symptoms. The perceived severity of acute infection was significantly associated with long COVID symptoms (p=<0.01). There was no association found between long COVID and blood group (p=0.158). CONCLUSION:  There was no association found between long COVID and ABO blood groups. Females were more likely than males to experience long COVID. Long COVID was found to be more likely to develop in those with perceived severe acute infection, highlighting the need for further research regarding aggressive care from the onset of COVID-19 infection.

Green synthesis of nanomaterials by using plant extracts as reducing and capping agents.

An alternative method to conventional synthesis is examined in this review by the use of plant extracts as reducing and capping agents. The use of plant extracts represents an economically viable and environmentally friendly alternative to conventional synthesis. In contrast to previous reviews, this review focuses on the synthesis of nano-compounds utilizing plant extracts, which lack comprehensive reports. In order to synthesize diverse nanostructures, researchers have discovered a sustainable and cost-effective method of harnessing functional groups in plant extracts. Each plant extract is discussed in detail, along with its potential applications, demonstrating the remarkable morphological diversity achieved by using these green synthesis approaches. A reduction and capping agent made from plant extracts is aligned with the principles of green chemistry and offers economic advantages as well as paving the way for industrial applications. In this review, it is discussed the significance of using plant extracts to synthesize nano-compounds, emphasizing their potential to shape the future of nanomaterials in a sustainable and ecologically friendly manner.

Survey of rectal cancer MRI technique and reporting tumour descriptors in the UK: a multi-centre British Society of Gastrointestinal and Abdominal Radiology (BSGAR) audit.

AIM: To evaluate variation in magnetic resonance imaging (MRI) technique and reporting of rectal cancer staging examinations across the UK. MATERIALS AND METHODS: A retrospective, multi-centre audit was undertaken of imaging protocols and information documented within consecutive MRI rectal cancer reports between March 2020 and August 2021, which were compared against American and European guidelines. Inclusion criteria included histologically proven rectal adenocarcinoma and baseline staging MRI rectum only. RESULTS: Fully anonymised data from 924 MRI reports by 78 radiologists at 24 centres were evaluated. Thirty-two per cent of radiologists used template reporting, but these reports offered superior documentation of 13 out of 18 key tumour features compared to free-text reports including T-stage, relation to peritoneal reflection and mesorectal fascia (MRF), nodal status, and presence of extramural venous invasion (EMVI; p<0.027 in each). There was no significant differences in the remaining five features. Across all tumour locations, the tumour relationship to the MRF, the presence of EMVI, and the presence of tumour deposits were reported in 79.5%, 85.6%, and 44% of cases, respectively, and tumour, nodal, and distant metastatic stage documented in 94.4%, 97.7%, and 78.3%. In low rectal tumours, the relationship to the anal sphincter complex was reported in only 54.6%. CONCLUSION: Considerable variation exists in rectal cancer MRI acquisition and reporting in this sample of UK centres. Inclusion of key radiological features in reports must be improved for risk stratification and treatment decisions. Template reporting is superior to free-text reporting. Routine adoption of standardised radiology practices should now be considered to improve standards to facilitate personalised precision treatment for patients to improve outcomes.

The role of diffusion-weighted MRI in the accurate diagnosis of vertebral compression fractures: A comparative study.

INTRODUCTION: Accurately distinguishing between benign and malignant vertebral compression fractures is crucial for clinical management. This study evaluated the predictive accuracy of diffusion-weighted imaging (DWI) in differentiating the cause of vertebral fractures using MRI. METHODS: A longitudinal cross-over study was conducted at Jinnah Postgraduate Medical Centre (JPMC) Karachi from July 2018 to January 2021. Patients with vertebral compression fractures underwent T1-weighted, T2-weighted, and DWI imaging with ADC mapping on a 1.5 T MRI scanner. Imaging findings were compared with histopathologic results and clinical follow-up. Sensitivity, specificity, and ROC curve analyses were performed. RESULTS: The study enrolled 303 patients with a mean age of 43.6 ± 10.9 years, of whom 118 were male. DWI demonstrated high accuracy in predicting the cause of vertebral compression fractures, with a sensitivity of 96.2 %, a specificity of 76.2 %, and an area under the ROC curve of 0.857. The optimal ADC cut-off value was 0.82 × 10˄-3 mm˄2/s, which yielded a positive predictive value of 79.7 % and a negative predictive value of 95.4 %. CONCLUSIONS: DWI is a safe and non-invasive imaging modality with excellent predictive accuracy in differentiating between benign and malignant vertebral compression fractures. Iso- or hypointensity of collapsed vertebral bodies on DWI suggests a benign lesion, while T2-weighted hyperintensity is highly indicative of malignancy. Low signal on ADC is also highly indicative of malignant vertebral fractures. Incorporating DWI improves accuracy in assessing vertebral lesions, especially when standard sequences are inconclusive. IMPLICATIONS FOR PRACTICE: DWI revolutionizes vertebral compression fracture diagnosis, distinguishing between benign and malignant cases. This precision guides treatment decisions, minimizing the necessity for invasive procedures like biopsy. As a safe and reliable imaging method, DWI elevates patient care, ensuring accurate diagnostics and improved outcomes.

CO2 reduction reaction on Sc-doped nanocages as catalysts.

CONTEXT: The catalytic ability of Sc-doped C46 and Sc-doped Al23P23 as catalysts of CO2-RR to create the CH4 and CH3OH is investigated. The mechanisms of CO2-RR are examined by theoretical methods and ΔGreaction of reaction steps of CO2-RR mechanisms are calculated. The overpotential of CH4 and CH3OH production on Sc-doped C46 and Sc-doped Al23P23 is calculated. The Sc atoms of Sc-doped C46 and Sc-doped Al23P23 can adsorb the CO2 molecule as the first step of CO2-RR. The CH4 is produced from hydrogenation of *CH3O and the *CO → *CHO reaction step is the rate limiting step for CH4 production. The CH3OH can be formed on Sc-doped C46 and Sc-doped Al23P23 by *CO → *CHO → *CH2O → *CH3O → CH3OH mechanism and HCOOH → *CHO → *CH2O → *CH3O → CH3OH mechanism. The Sc-C46 and Sc-Al23P23 can catalyze the CO2-RR to produce the CH4 and CH3OH by acceptable mechanisms. METHODS: Here, the structures are optimized by PW91PW91/6-311+G (2d, 2p) and M06-2X/cc-pVQZ methods in GAMESS software. The frequencies of nanocages and their complexes with species of CO2-RR are investigated by mentioned methods. The transition state of each reaction step of CO2-RR is searched by Berny method to find the CO2-RR intermediates. The ∆Eadsorption of intermediates of CO2-RR on surfaces of nanocages is calculated and the ∆Greaction of reaction steps of CO2-RR is calculated.

What is the educational value and clinical utility of artificial intelligence for intraoperative and postoperative video analysis? A survey of surgeons and trainees.

INTRODUCTION: Surgical complications often occur due to lapses in judgment and decision-making. Advances in artificial intelligence (AI) have made it possible to train algorithms that identify anatomy and interpret the surgical field. These algorithms can potentially be used for intraoperative decision-support and postoperative video analysis and feedback. Despite the very early success of proof-of-concept algorithms, it remains unknown whether this innovation meets the needs of end-users or how best to deploy it. This study explores users' opinion on the value, usability and design for adapting AI in operating rooms. METHODS: A device-agnostic web-accessible software was developed to provide AI inference either (1) intraoperatively on a live video stream (synchronous mode), or (2) on an uploaded video or image file (asynchronous mode) postoperatively for feedback. A validated AI model (GoNoGoNet), which identifies safe and dangerous zones of dissection during laparoscopic cholecystectomy, was used as the use case. Surgeons and trainees performing laparoscopic cholecystectomy interacted with the AI platform and completed a 5-point Likert scale survey to evaluate the educational value, usability and design of the platform. RESULTS: Twenty participants (11 surgeons and 9 trainees) evaluated the platform intraoperatively (n = 10) and postoperatively (n = 11). The majority agreed or strongly agreed that AI is an effective adjunct to surgical training (81%; neutral = 10%), effective for providing real-time feedback (70%; neutral = 20%), postoperative feedback (73%; neutral = 27%), and capable of improving surgeon confidence (67%; neutral = 29%). Only 40% (neutral = 50%) and 57% (neutral = 43%) believe that the tool is effective in improving intraoperative decisions and performance, or beneficial for patient care, respectively. Overall, 38% (neutral = 43%) reported they would use this platform consistently if available. The majority agreed or strongly agreed that the platform was easy to use (81%; neutral = 14%) and has acceptable resolution (62%; neutral = 24%), while 30% (neutral = 20%) reported that it disrupted the OR workflow, and 20% (neutral = 0%) reported significant time lag. All respondents reported that such a system should be available "on-demand" to turn on/off at their discretion. CONCLUSIONS: Most found AI to be a useful tool for providing support and feedback to surgeons, despite several implementation obstacles. The study findings will inform the future design and usability of this technology in order to optimize its clinical impact and adoption by end-users.

Appraisal of surface-groundwater anthropogenic indicators and associated human health risk in El Sharqia Governorate, Egypt.

The aim of this study was to integrate hydrogeochemistry with a multivariate statistical approach to understand the various processes that control the evolution/contamination of water resources in El Sharqia Governorate, Egypt with a particular emphasis on direct/indirect risks to human health. To achieve this, a representative collection of 21 groundwater and 35 drainage samples was taken and examined for physical, chemical, and trace element measurements. Results indicated that in shallow groundwater and drainage water samples, the relative abundance of major cations is Na+ > Mg2+ > Ca2+ > K+, and for anions it is HCO3- > Cl- > SO42- (on a molar basis). Natural processes involving the dissolution/precipitation of some minerals and other processes including leaching of solid waste, overuse of agricultural fertilizers application, and high loads of discharged sewage water are responsible for the evolution of water resources in El Sharqia Governorate. Ammonia, nitrate, biological oxygen demand (BOD), phosphate, turbidity, iron, manganese, lead, and aluminum concentrations were found to be higher than the limits set by internatio2nal drinking water regulations. The health risk index (HRI) values for children were found to be higher than those for adults when the water resources are used for drinking purposes, which poses a risk to human health.

Imaging manifestations of IgG4-related disease.

IgG4-related disease is a multisystem immune-mediated disorder associated with lesions manifesting an IgG4-rich plasma cell infiltrate and often raised serum IgG4 concentrations. The disease can mimic neoplastic, infective, and inflammatory processes due to features such as development of masses or organ enlargement. Prompt consideration of this diagnosis is essential to avoid unnecessary investigations and offer appropriate treatments, which can include steroids and other immunosuppressive agents. Although histology is typically diagnostic, imaging is critical to assess disease burden, determine biopsy targets, and evaluate response to treatment. Characteristic imaging features can also point towards the diagnosis in the absence of biopsy. This review highlights these features, as well as more atypical findings, grouped by organ or system. Differential diagnoses are emphasised. The full spectrum of imaging methods is discussed. Whole-body imaging with integrated 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT) has an evolving role in the detection of multi-organ involvement and subsequent follow-up.

The effect of photodynamic therapy on the salivary flow rate, IgA concentration and C-reactive protein levels in active smokers: a case-control study.

OBJECTIVE: This study aimed to evaluate the effect of photodynamic therapy (PDT) on the salivary flow rate, secretory immunoglobulin A, and C-reactive protein levels in active smokers. PATIENTS AND METHODS: The present study is a prospective case-control study. Twenty active smokers were allocated to two groups randomly of ten participants each: the experimental group was irradiated while the control was exposed to sham irradiation by turning off the equipment. In the experimental group, methylene blue mediated PDT was applied both intra- and extra-orally over the major and minor salivary glands using a diode laser. 780 nm wavelength and 4 J/cm2 of energy were used to irradiate the 10 points of major salivary glands (6 for parotid and 2 for submandibular glands and 2 for sublingual glands). On the other hand, 660 nm was used to apply 10 J/cm2 of energy over the minor salivary glands at numerous points. The samples of the stimulated and unstimulated saliva were collected from both groups to assess the SFR. ELISA method was used to assess the level of salivary IgA levels, statistical analysis was done using a one-way ANOVA, and a p-value of <0.05 was considered significant. RESULTS: The results showed a significant increment in salivary and secretory immunoglobulin A levels of subjects undergone photodynamic therapy. C-reactive protein levels were significantly decreased in subjects exposed to irradiation. CONCLUSIONS: The present study concludes that photodynamic therapy significantly improves the salivary flow rate, secretory Immunoglobulin A, and oral health quality of life in smokers. The inflammatory salivary marker C-reactive protein, which is usually raised in smokers, is also reduced.

The relationship between coping and distress among faculty members and students during COVID-19 pandemic lockdown: The moderating effect of gender.

Objectives: Previous research has documented significant associations between the COVID-19 pandemic lockdown, various mental health problems, and coping strategies. However, literature on the moderating role of gender on the relationship between distress and coping strategies during COVID-19 is almost nonexistent. Hence, the main objective of this study was two folds. To examine gender differences in distress and coping strategies, and to test the moderating effect of gender on the relationship between distress and coping among university faculty members and students during the COVID-19 pandemic. Method: A cross-sectional web-based study design was used to collect data from the participants. A sample of 649 participants (68.9% university students and 31.1% faculty members) was selected. The General Health Questionnaire (GHQ-12) and the Coping Inventory for Stressful Situations (CISS) were used to collect data from the participants. The survey was sent out during the COVID-19 lockdown from May 12th to June 30th, 2020. Results: The results showed significant gender differences in distress and the three coping strategies. Women consistently scored higher on distress (p < 0.01), task-focused (p < 0.05), emotion-focused (p < 0.001), and avoidance coping (p < 0.01) compared to men. Gender moderated the relationship between emotion-focused coping and distress (p < 0.001) but not the relationship between distress and task-focused or avoidance coping. Conclusion: Increased emotion-focused coping is associated with decreased distress among women while the use of emotion-focused coping by men predicted more distress. Workshops and programs focused on providing skills and techniques on how to cope with stressful situations induced by the COVID-19 pandemic are recommended.

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study.

Background/Aim: Malignant biliary obstruction (MBO) is often diagnosed at late stages with mostly unresectable lesions. Recently, EUS-guided biliary drainage (EUS-BD) has gained wide acceptance and appears to be a feasible and safe backup option after ERCP failure in such patients. Herein, we aimed to represent a 3-year multi-center Egyptian experience in the application of this challenging procedure for distal MBO as a salvage technique after failed ERCP. Patients and methods: This was a prospective multi-center study of patients underwent EUS-BD for distal MBO in the duration between December 2018 and December 2021, after ERCP failure. Results: Ninety-one patients (59 males, median age: 61 years) were included in the study. EUS-guided extrahepatic approach including choledocho-duodenostomy (CDS) was done for 48 patients (52.8%), followed by choledecho-antrostomy (CAS) in 4 patients (4.4%). The intrahepatic approach included hepaticogastrostomy (HGS) for 35 patients (38.5%) and antegrade stenting (AG) stenting in 2 patients (2.2%), while Rendezvous (RV) approach was performed in 2 patients (2.2%). Technical and Clinical success were achieved in the majority of cases; 93.4% and 94.1% respectively. Adverse events occurred in 13.2% of patients which were mostly mild (8.2%) to moderate (2.4%). Only one patient died within 48h after the procedure with progression of preceding sepsis and organ failure. Conclusion: EUS-BD is a feasible option, even in developing countries, after a failed ERCP, and it is a relatively safe option in patients with MBO once experienced team and resources were present. Majority of cases in our study have achieved technical and clinical success with relatively low incidence of adverse events.

Microwave-assisted synthesis and development of novel penicillinoate@copper metal-organic frameworks as a potent antibacterial agent.

Recently, nanoscience, especially metal-organic frameworks (MOFs), has been used to increase the effectiveness and properties of drugs. In this study, by using microwave irradiation; penicillin, which is a known antibiotic; and copper metal-organic frameworks (Cu-MOFs), a new penicillinoate@copper metal-organic framework (penicillinoate@Cu-MOF) was synthesized. The structure and characterization of the newly synthesized compound were determined using FT-IR spectrums, EDAX analysis, elemental analysis, XRD patterns, SEM images, nitrogen adsorption/desorption curves, and TGA curve. Then, its antimicrobial effects were evaluated on numerous Gram-positive and Gram-negative bacterial strains and were compared with those of penicillin and gentamicin. In continuation of the biological activities, antioxidant tests were performed on the compounds using the DPPH method. For biological activities, the synthesized penicillinoate@Cu-MOF is much more effective than penicillin and Cu-MOF. The loading of penicillin on the nanostructure and the presence of copper in the final composition can be attributed to the high antibiotic properties of the synthesized composition.

A Comprehensive Approach to the Diagnosis and Management of Klippel Feil Syndrome.

Klippel-Feil Syndrome (KFS) is a rare genetic disorder characterized by the abnormal development of the cervical spine, leading to the fusion of two or more cervical vertebrae. The syndrome presents diverse symptoms, including limited neck movement, chronic pain, and neurological manifestations such as limb numbness or weakness. The severity of KFS can vary significantly, and treatment primarily focuses on symptom management and preventing complications such as scoliosis or spinal cord compression. Surgical interventions are often necessary for patients with complex forms of the syndrome. Interestingly, Chiari 1 malformation, a cranial anomaly affecting the brainstem, can coincide anatomically with KFS. In this case report, we present the case of a 9-year-old patient who sought medical attention due to persistent, unchanging neck pain. The patient's medical history was notable for developmental delays and cervical restraint observed during physical examination. Magnetic resonance imaging (MRI) findings revealed hydrocephalus and brainstem descent, indicating the presence of Chiari 1 malformation. Comprehensive MRI and CT scans were performed, and a management plan was formulated, primarily involving cranial surgery and physiotherapy. Implementation of the treatment approach resulted in significant improvement in the patient's symptoms. This case highlights the significance of considering Chiari 1 malformation as a potential comorbidity in patients diagnosed with KFS who present with persistent neck pain. Early detection and appropriate management of both conditions are crucial for achieving favorable outcomes and enhancing the quality of life for affected individuals. Understanding the complex interplay between KFS and Chiari 1 malformation is essential for providing comprehensive care and tailored treatment strategies. Further research is warranted to elucidate the underlying mechanisms linking these two conditions and to explore optimal management approaches for patients with dual pathology. By reporting this case, we contribute to the existing literature and increase awareness among healthcare professionals regarding the potential coexistence of KFS and Chiari 1 malformation. Continued efforts in identifying associated anomalies and optimizing therapeutic interventions will aid in improving patient outcomes and ensuring optimal care for individuals affected by these conditions.

A new modality in targeted delivery of epirubicin for tumor theranosis based on PEGylated silver nanoparticles: Design, radiolabeling and bioevaluation.

This work highlights boosting the tumor targeting efficiency of epirubicin through loading on a new radionanosystem, based on the effective role of silver nanoparticles (AgNPs). Accordingly, PEGylated silver nanoparticles (PEG/AgNPs) were prepared in a size of 20.2 ± 0.1 nm. Additionally, epirubicin was loaded on PEG/AgNPs with a loading efficiency of 63 ± 3 %. Furthermore, both of PEG/AgNPs and EPI/PEG/AgNPs were radiolabeled with 131I isotope with radiolabeling yields of 85 ± 0.2 % and 90.3 ± 1 %, respectively. The in-vivo distribution of 131I-PEG/AgNPs and 131I-EPI/PEG/AgNPs were examined in healthy and tumor bearing mice models. Excitingly, 131I-EPI/PEG/AgNPs revealed a reticuloendothelial system (RES) avoidance and prolonged circulating time. In addition, 131I-EPI/PEG/AgNPs showed fast targeting of tumor site by 25.1 ± 0.1 %ID/g within 0.5 h after intravenous injection. Subsequently, the outcomes provided 131I-EPI/PEG/AgNPs as a new potential system for enhancement of tumor targeting and theranosis (therapy and/or imaging).

Factors influencing international collaboration on the prevention of COVID-19.

OBJECTIVES: COVID-19 has spread rapidly throughout the world, which has highlighted the importance of collaboration between countries to prevent further transmission of the virus. This review aims to identify the factors that influence international collaboration between policymakers for COVID-19 prevention and consider strategies to manage pandemics in the future. STUDY DESIGN: A scoping review was conducted using the Arksey and O'Malley framework for scoping reviews. METHODS: A literature search was performed across PubMed, Google Scholar, Scopus and Embase databases using relevant keywords. The initial search identified 1010 articles; after selection criteria were applied, 28 studies were included in the review. RESULTS: Most of the selected articles were literature reviews, and China had the greatest contribution of articles to this study. The following seven key categories influencing international collaboration were identified: political, structure, infrastructure, leadership and governance, knowledge and information sharing, community engagement, and process/action. CONCLUSION: Leadership and governance was the most important factor identified in international collaboration between countries. In addition, knowledge and information sharing were seen to help avoid repetition of negative situations experienced in other countries. Moreover, controlling COVID-19 on a global scale is more likely to be achieved when there are sufficient structures and resources and when appropriate communication between countries, health systems and communities is used. This collaboration can also greatly benefit low- and middle-income countries where resources and expertise are often limited.

Improving mortality prediction in Acute Pancreatitis by machine learning and data augmentation.

Acute Pancreatitis (AP) is the inflammation of the pancreas that can be fatal or lead to further complications based on the severity of the attack. Early detection of AP disease can help save lives by providing utmost care, rigorous treatment, and better resources. In this era of data and technology, instead of relying on manual scoring systems, scientists are employing advanced machine learning and data mining models for the early detection of patients with high chances of mortality. The current work on AP mortality prediction is negligible, and the few studies that exist have many shortcomings and are impractical for clinical deployment. In this research work, we tried to overcome the existing issues. One main issue is the lack of high-quality public datasets for AP, which are crucial for effectively training ML models. The available datasets are small in size, have many missing values, and suffer from high class imbalance. We augmented three public datasets, MIMIC-III, MIMIC-IV, and eICU, to obtain a larger dataset, and experiments proved that augmented data trained classifiers better than original small datasets. Moreover, we employed emerging advanced techniques to handle underlying issues in data. The results showed that iterative imputer is best for filling missing values in AP data. It beats not only the basic techniques but also the Knn-based imputation. Class imbalance is first addressed using data downsampling; apparently, it gave decent results on small test sets. However, we conducted numerous experiments on large test sets to prove that downsampling in the case of AP produced misleading and poor results. Next, we applied various techniques to upsample data in two different class splits, a 50 to 50 and a 70 to 30 majority-minority class split. Four different tabular generative adversarial networks, CTGAN, TGAN, CopulaGAN, and CTAB, and a variational autoencoder, TVAE, were deployed for synthetic data generation. SMOTE was also utilized for data upsampling. The computational results showed that the Random Forest (RF) classifier outperformed all other classifiers on a 50 to 50 class split data generated by CTGAN, with 0.702 Fß and 0.833 recall. Results produced by RF on the TVAE dataset were also comparable, with 0.698 Fß. In the case of SMOTE-based upsampling, DNN performed best with a 0.671 Fß score.