Adjunctive left atrial posterior wall isolation for atrial fibrillation: An updated systematic review and meta-analysis.

OBJECTIVE: Posterior left atrial wall isolation (PWI) plus traditional pulmonary vein isolation (PVI) has been proposed as a promising intervention to decrease atrial fibrillation (AF) recurrence. We aim to investigate the efficacy and safety of adding PWI to the traditional PVI in patients with AF. METHODS: A systematic review and meta-analysis was conducted using synthesizing randomized controlled trials (RCTs) retrieved by systematically searching PubMed, Web of Science, SCOPUS, EMBASE, and Cochrane through June 14, 2023. We used Stata version 17 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI) (PROSPERO ID: CRD42023446227). RESULTS: We included 11 RCTs with a total number of 1534 patients. Combined ablation with PWI + PVI was not associated with any significant difference over PVI only regarding the recurrence of clinical AF (RR: 0.86 with 95% CI [0.70-1.06]), all atrial arrhythmia (RR: 0.93 with 95% CI [0.82-1.07]), nonatrial fibrillation arrhythmia (RR: 1.22 with 95% CI [0.97-1.53]), early AF (RR: 0.89 with 95% CI [0.62-1.27]), and antiarrhythmic drugs at discharge (RR: 0.83 with 95% CI [0.67-1.04]). However, it was associated with increased total ablation duration (minutes) (MD: 12.58 with 95% CI [6.80-18.37]) and total procedure duration (minutes) (MD: 16.77 with 95% CI [9.63-23.91]), without any significant difference regarding adverse events (RR: 1.05 with 95% CI [0.63-1.74]). CONCLUSION: While the pooled data from PWI + PVI using point-by-point radiofrequency did not suggest a benefit in the recurrence of various atrial arrhythmias compared to PVI alone, PWI+PVI using direct posterior wall ablation, especially with cryoballoon, demonstrated a significant reduction in recurrence of AF/atrial arrhythmias. Also, PWI + PVI significantly increased the ablation and total procedure durations.

Green Synthesis and Multifunctional Properties of Cu/NiO Nanocomposites Using Commelina benghalensis Leaf Extract.

This study presents the green synthesis and multifunctional properties of Cu/NiO nanocomposites (NCs) fabricated with varying ratios (90:10, 80:20, and 70:30) using Commelina benghalensis leaf extract. X-ray diffraction (XRD) analysis confirmed the polycrystalline nature of the NCs, revealing crystallite sizes of 13.62, 13.22, and 7.14 nm. Scanning electron microscopy (SEM) showed rod-shaped and agglomerated particles with sizes ranging from 17.64 to 22.97 nm. Energy-dispersive X-ray spectroscopy (EDX) verified the elemental composition of copper, nickel, oxygen, and carbon. UV-visible spectroscopy determined the energy band gaps to be in the range of 1.24-1.56 eV. Fourier-transform infrared spectroscopy (FT-IR) indicated the presence of bioactive compounds responsible for the reduction of precursor metal salts. The Cu/NiO NCs exhibited remarkable antimicrobial activity, with the 90:10 ratio showing the highest zones of inhibition at 32.76±0.23 mm, 18.66±0.33 mm, and 14.36±0.32 mm against Bacillus subtilis, Staphylococcus aureus, and Escherichia coli, respectively. Additionally, the 70:30 Cu/NiO NCs demonstrated superior antioxidant activity, with a radical scavenging efficiency of 83.22%, closely approaching that of ascorbic acid (96.98%). Photocatalytic evaluations revealed that the NCs were highly effective in degrading environmental pollutants, achieving 97.69% degradation of malachite green and 96.52% of congo red under UV light irradiation. The novelty of this work lies in the use of Commelina benghalensis leaf extract as a sustainable and eco-friendly reducing and stabilizing agent for synthesizing Cu/NiO NCs, offering a green alternative to conventional methods. The synergistic effects between Cu and NiO in the different compositions (90:10, 80:20, and 70:30) enhanced the overall antimicrobial and photocatalytic activities, highlighting their potential for environmental remediation applications.

Efficacy and safety of radiofrequency ablation versus cryoballoon ablation for persistent atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Persistent Atrial Fibrillation (PeAF) is a challenging case for rhythm control modalities. Catheter ablation is the mainstay in PeAF management; however, data regarding the comparative safety and efficacy of cryoballoon ablation (CBA) versus radiofrequency ablation (RFA) for PeAF is still limited. We aim to compare the safety and efficacy of CBA versus RFA for PeAF ablation. METHODS: We conducted a systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane through October 2023. RevMan version 5.4 software was used to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42023480314. RESULTS: Three RCTs with 400 patients were included. There was no significant difference between RFA and CBA regarding AF recurrence (RR: 0.77, 95% CI [0.50, 1.20], P = 0.25), atrial tachycardia or atrial flutter recurrence (RR: 0.54, 95% CI [0.11, 2.76], P = 0.46), and any arrhythmia recurrence (RR: 0.96, 95% CI [0.70, 1.31], P = 0.80). CBA was significantly associated with decreased total procedure duration (MD: - 45.34, 95% CI [- 62.68, - 28.00], P < 0.00001), with no significant difference in fluoroscopy duration (MD: 3.59, 95% CI [- 5.13, 12.31], P = 0.42). Safety parameters were similar in both groups, including the incidence of any complications, phrenic nerve palsy (RR: 2.91 with 95% CI [0.31, 27.54], P = 0.35), access site complications (RR: 0.33 with 95% CI [0.05, 2.03], P = 0.23), and pericardial effusion. CONCLUSIONS: In PeAF catheter ablation, CBA is comparable to RFA in terms of safety and efficacy. Also, CBA is associated with a shorter total procedure duration.

Clinical decision support systems to optimize adherence to anticoagulant guidelines in patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Clinical decision support systems (CDSS) have been utilized as a low-cost intervention to improve healthcare process measures. Thus, we aim to estimate CDSS efficacy to optimize adherence to oral anticoagulant guidelines in eligible patients with atrial fibrillation (AF). METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) with a 95% confidence interval (CI). PROSPERO ID: CRD42023471806. RESULTS: We included nine RCTs with a total of 25,573 patients. There was no significant difference, with the use of CDSS compared to routine care, in the number of patients prescribed anticoagulants (RR: 1.06, 95% CI [0.98, 1.14], P = 0.16), the number of patients prescribed antiplatelets (RR: 1.01 with 95% CI [0.97, 1.06], P = 0.59), all-cause mortality (RR: 1.19, 95% CI [0.31, 4.50], P = 0.80), major bleeding (RR: 0.84, 95% CI [0.21, 3.45], P = 0.81), and clinically relevant non-major bleeding (RR: 1.05, 95% CI [0.52, 2.16], P = 0.88). However, CDSS was significantly associated with reduced incidence of myocardial infarction (RR: 0.18, 95% CI [0.06, 0.54], P = 0.002) and cerebral or systemic embolic event (RR: 0.11, 95% CI [0.01, 0.83], P = 0.03). CONCLUSION: We report no significant difference with the use of CDSS compared to routine care in anticoagulant or antiplatelet prescription in eligible patients with AF. CDSS was associated with a reduced incidence of myocardial infarction and cerebral or systemic embolic events.

Effect of methotrexate hold on COVID-19 vaccine response in the patients with autoimmune inflammatory disorders: a systematic review and meta-analysis.

Immunosuppressants, such as methotrexate (MTX), can suppress the COVID-19 vaccine response in patients with autoimmune diseases. Thus, this study aims to evaluate the effects of MTX hold following COVID-19 vaccination on vaccine efficacy response. A systematic review and meta-analysis of relevant studies retrieved from Web of Science, SCOPUS, PubMed, and CENTRAL from inception until Oct 1, 2023, was conducted. Covidence was used to screen the eligible articles, and all relevant outcomes data were synthesized using risk ratios (RRs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) in meta-analysis models within RevMan 5.4. PROSPERO ID: CRD42024511628. Four studies with a total of 762 patients with autoimmune inflammatory disorders were included. Holding MTX following the COVID-19 vaccination for approximately 2 weeks was associated with significantly higher antibody titer (SMD: 0.70, 95% CI [0.54, 0.87], P < 0.00001). However, the flare rate was significantly higher in the MTX hold group based on CDAI > 10 or DAS28-CRP > 1.2 either after 1st dose (RR: 2.49 with 95% CI [1.39, 4.47], P = 0.002) or 2nd dose (RR: 2.16 with 95% CI [1.37, 3.41], P = 0.0009) and self-reported disease flare (RR: 1.71 with 95% CI [1.35, 2.17], P < 0.00001). Holding MTX for 2 weeks after the COVID-19 vaccination resulted in significantly higher antibody titer but also had a higher disease flare rate, necessitating cautious clinical monitoring during this period. There is still a need to investigate safer MTX hold duration, considering patients' vulnerability to COVID-19, disease status, and demographics while adopting this strategy.

Recent advancements and prospects in carbon-based nanomaterials derived from biomass for environmental remediation applications.

The conversion of waste biomass into a value-added carbonaceous nanomaterial highlights the appealing power of biomass valorization. The advantages of using sustainable and cheap biomass precursors exhibit the tremendous opportunity for boosting energy production and their application in environmental remediation processes. This review emphasis the development and production of carbon-based nanomaterials derived from biomass, which possess favourable characteristics such as biocompatibility and photoluminescence. The advantages and limitations of various nanomaterials synthesised from different precursors were also discussed with insights into their physicochemical properties. The surface morphology of the porous nanomaterials is also explored along with their characteristic properties like regenerative nature, non-toxicity, ecofriendly nature, unique surface area, etc. The incorporation of various functional groups confers superiority of these materials, resulting in unique and advanced functional properties. Further, the use of these biomass derived nanomaterials was also explored in different applications like adsorption, photocatalysis and sensing of hazardous pollutants, etc. The challenges and outcomes obtained from different carbon-based nanomaterials are briefly outlined and discussed in this review.

Paper-based sensors: affordable, versatile, and emerging analyte detection platforms.

Paper-based sensors, often referred to as paper-based analytical devices (PADs), stand as a transformative technology in the field of analytical chemistry. They offer an affordable, versatile, and accessible solution for diverse analyte detection. These sensors harness the unique properties of paper substrates to provide a cost-effective and adaptable platform for rapid analyte detection, spanning chemical species, biomolecules, and pathogens. This review highlights the key attributes that make paper-based sensors an attractive choice for analyte detection. PADs demonstrate their versatility by accommodating a wide range of analytes, from ions and gases to proteins, nucleic acids, and more, with customizable designs for specific applications. Their user-friendly operation and minimal infrastructure requirements suit point-of-care diagnostics, environmental monitoring, food safety, and more. This review also explores various fabrication methods such as inkjet printing, wax printing, screen printing, dip coating, and photolithography. Incorporating nanomaterials and biorecognition elements promises even more sophisticated and sensitive applications.

Clinical Characteristics and Prognostic Factors of Endometrial Cancer Patients With Liver Metastasis: A Surveillance, Epidemiology, and End Results Database (SEER)-Based Study of 1,034 Women.

Background There are several patterns of metastatic spread from endometrial cancer (EC). Although studies have been conducted to study the EC population with distant metastasis in the bone and lungs, there is still a lack of studies on liver metastasis. This study aims to evaluate and assess the clinical features and prognostic factors of EC patients with liver metastasis. Methodology We conducted a retrospective cohort study adhering to the guidelines for reporting observational research. We utilized the Surveillance, Epidemiology, and End Results database to gather data on female patients diagnosed with EC and reported liver metastasis. We estimated survival curves using the Kaplan-Meier method and evaluated differences in survival using the log-rank test. We also conducted univariable and multivariable Cox proportional hazards regression analyses to determine the hazard ratios with 95% confidence intervals for overall survival (OS) and identify factors that impact survival. Results We analyzed data from 1,034 EC patients with liver metastasis. Median OS after liver metastasis was six months, and cancer-specific survival was seven months. Univariate Cox regression analysis revealed several factors associated with decreased OS in EC patients. These included age (≥60 years), non-endometrioid and sarcoma histological subtypes, absence of surgery, no chemotherapy, and the presence of distant metastasis to the lung, brain, and bone. Conversely, married marital status and white race were linked to a better prognosis. Subsequent multivariate Cox regression analysis identified age (≥60 years), non-endometrioid histological subtype, absence of surgery, no chemotherapy, and the presence of distant metastasis to lung, brain, and bone remaining as independent risk factors for decreased OS. In contrast, the white race still emerged as an independent prognostic factor for better OS. Conclusions Various risk factors, such as age, race, lung, bone, or brain metastasis, as well as chemotherapy and surgery, may influence the prognosis of individuals with primary EC liver metastases.

Synthesis and characterization of nanocomposite based polymeric membrane (PES/PVP/GO-TiO2) and performance evaluation for the removal of various antibiotics (amoxicillin, azithromycin & ciprofloxacin) from aqueous solution.

The escalating global concern regarding antibiotic pollution necessitates the development of advanced water treatment strategies. This study presents an innovative approach through the fabrication and evaluation of a Polyethersulfone (PES) membrane adorned with GO-TiO2 nanocomposites. The objective is to enhance the removal efficiency of various antibiotics, addressing the challenge of emerging organic compounds (EOCs) in water systems. The nanocomposite membranes, synthesized via the phase inversion method, incorporate hydrophilic agents, specifically GO-TiO2 nanocomposites and Polyvinylpyrrolidone (PVP). The resultant membranes underwent comprehensive characterization employing AFM, EDS, tensile strength testing, water contact angle measurements, and FESEM to elucidate their properties. Analysis revealed a substantial improvement in the hydrophilicity of the modified membranes attributed to the presence of hydroxyl groups within the GO-TiO2 structure. AFM images demonstrated an augmentation in surface roughness with increasing nanocomposite content. FESEM images unveiled structural modifications, leading to enhanced porosity and augmented water flux. The pure water flux elevated from 0.980 L/m2.h-1 for unmodified membranes to approximately 6.85 L/m2.h-1 for membranes modified with 2 wt% nanocomposites. Membrane performance analysis indicated a direct correlation between nanocomposite content and antibiotic removal efficiency, ranging from 66.52% to 89.81% with 4 wt% nanocomposite content. Furthermore, the nanocomposite-modified membrane exhibited heightened resistance to fouling. The efficacy of the membrane extended to displaying potent antibacterial properties against microbial strains, including S. aureus, E. coli, and Candida. This study underscores the immense potential of GO-TiO2 decorated PES membranes as a sustainable and efficient solution for mitigating antibiotic contamination in water systems. The utilization of nanocomposite membranes emerges as a promising technique to combat the presence of EOC pollutants, particularly antibiotics, in water bodies, thus addressing a critical environmental concern.

Intensive Blood Pressure Control After Endovascular Thrombectomy for Acute Ischemic Stroke: a Systematic Review and Meta-Analysis.

BACKGROUND AND PURPOSE: Optimal clinical outcome with successful recanalization from endovascular thrombectomy (EVT) requires optimal blood pressure (BP) management. We aimed to evaluate the efficacy and safety of the intensive BP target (< 140 mm Hg) versus the standard BP target (< 180 mm Hg) after EVT for acute ischemic stroke. METHODS: We conducted a systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Embase Cochrane, Scopus, and WOS until September 7th, 2023. We used the fixed-effect model to report dichotomous outcomes using risk ratio (RR) and continuous outcomes using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: CRD42023463206. RESULTS: We included four RCTs with 1559 patients. There was no difference between intensive BP and standard BP targets regarding the National Institutes of Health Stroke Scale (NIHSS) change after 24 h [MD: 0.44 with 95% CI (0.0, 0.87), P = 0.05]. However, the intensive BP target was significantly associated with a decreased risk of excellent neurological recovery (mRS ≤ 1) [RR: 0.87 with 95% CI (0.76, 0.99), P = 0.03], functional independence (mRS ≤ 2) [RR: 0.81 with 95% CI (0.73, 0.90), P = 0.0001] and independent ambulation (mRS ≤ 3) [RR: 0.85 with 95% CI (0.79, 0.92), P < 0.0001]. CONCLUSIONS: An intensive BP target after EVT is associated with worse neurological recovery and significantly decreased rates of functional independence and independent ambulation compared to the standard BP target. Therefore, the intensive BP target should be avoided after EVT for acute ischemic stroke.

Efficacy and safety of high-power short-duration ablation for atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: High-power short-duration (HPSD) ablation has emerged as an alternative to conventional standard-power long-duration (SPLD) ablation. We aim to assess the efficacy and safety of HPSD versus SPLD for atrial fibrillation (AF) ablation. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL were performed through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42023471797. RESULTS: We included six RCTs with a total of 694 patients. HPSD was significantly associated with a decreased total procedure time (MD: -22.88 with 95% CI [-36.13, -9.63], P = 0.0007), pulmonary vein isolation (PVI) time (MD: -19.73 with 95% CI [-23.93, -15.53], P < 0.00001), radiofrequency time (MD: -10.53 with 95% CI [-12.87, -8.19], P < 0.00001). However, there was no significant difference between HPSD and SPLD ablation with respect to the fluoroscopy time (MD: -0.69 with 95% CI [-2.00, 0.62], P = 0.30), the incidence of esophageal lesions (RR: 1.15 with 95% CI [0.43, 3.07], P = 0.77), and the incidence of first pass isolation (RR: 0.98 with 95% CI [0.88, 1.08], P = 0.65). CONCLUSION: HPSD ablation was significantly associated with decreased total procedure time, PVI time, and radiofrequency time compared with SPLD ablation. On the contrary, SPLD ablation was significantly associated with low maximum temperature.

Nature-inspired polymer photocatalysts for green NADH regeneration and nitroarene transformation.

Photocatalysis has emerged as a promising approach for generating solar chemical and organic transformations under the solar light spectrum, employing polymer photocatalysts. In this study, our aim is to achieve the regeneration of NADH and fixation of nitroarene compounds, which hold significant importance in various fields such as pharmaceuticals, biology, and chemistry. The development of an in-situ nature-inspired artificial photosynthetic pathway represents a challenging task, as it involves harnessing solar energy for efficient solar chemical production and organic transformation. In this work, we have successfully synthesized a novel artificial photosynthetic polymer, named TFc photocatalyst, through the Friedel-Crafts alkylation reaction between triptycene (T) and a ferrocene motif (Fc). The TFC photocatalyst is a promising material with excellent optical properties, an appropriate band gap, and the ability to facilitate the regeneration of NADH and the fixation of nitroarene compounds through photocatalysis. These characteristics are necessary for several applications, including organic synthesis and environmental remediation. Our research provides a significant step forward in establishing a reliable pathway for the regeneration and fixation of solar chemicals and organic compounds under the solar light spectrum.

The efficacy and safety of exercise regimens to mitigate chemotherapy cardiotoxicity: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Cardiotoxicity is one of the most common adverse events of the chemotherapy. Physical exercise was shown to be cardioprotective. We aim to estimate the efficacy and safety of exercise in cancer patients receiving cardiotoxic chemotherapy. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, Web of Science, SCOPUS, Cochrane, Clinical Trials.gov, and MedRxiv through July 17th, 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: CRD42023460902. RESULTS: We included thirteen RCTs with a total of 952 patients. Exercise significantly increased VO2 peak (MD: 1.95 with 95% CI [0.59, 3.32], P = 0.005). However, there was no significant effect regarding left ventricular ejection fraction, global longitudinal strain, cardiac output, stroke volume, left ventricular end-diastolic volume, left ventricular end-systolic volume, E/A ratio, resting heart rate, peak heart rate, resting systolic blood pressure, and resting diastolic blood pressure. Also, there was no significant difference regarding any adverse events (AEs) (RR: 4.44 with 95% CI [0.47, 41.56], P = 0.19), AEs leading to withdrawal (RR: 2.87 with 95% CI [0.79, 10.43], P = 0.11), serious AEs (RR: 3.00 with 95% CI [0.14, 65.90], P = 0.49), or all-cause mortality (RR: 0.25 with 95% CI [0.03, 2.22], P = 0.21). CONCLUSION: Exercise is associated with increased VO2 peak in cancer patients receiving cardiotoxic chemotherapy. However, there was no significant difference between exercise and usual care regarding the echocardiographic and safety outcomes.

Enhancing oil-water emulsion separation via synergistic filtration using graphene oxide-silver oxide nanocomposite-embedded polyethersulfone membrane.

This study introduces an innovative approach for enhancing oil-water emulsion separation using a polyethersulfone (PES) membrane embedded with a nanocomposite of graphene oxide (GO) and silver oxide (AgO). The composite membrane, incorporating PES and polyvinyl chloride (PVC), demonstrates improved hydrophilicity, structural integrity and resistance to fouling. Physicochemical characterization confirms successful integration of GO and AgO, leading to increased tensile strength, porosity and hydrophilicity. Filtration tests reveal substantial improvements in separating various oils from contaminated wastewater, with the composite membrane exhibiting superior efficiency and reusability compared to pristine PES membranes. This research contributes to the development of environmentally friendly oil-water separation methods with broad industrial applications.

Enhanced removal of iron (Fe) and manganese (Mn) ions from contaminated water using graphene oxide-decorated polyethersulphone membranes: Synthesis and characterization.

This study addresses the urgent issue of water pollution caused by iron (Fe) and manganese (Mn) ions. It introduces an innovative approach using graphene oxide (GO) and GO-decorated polyethersulphone (PES) membranes to efficiently remove these ions from contaminated water. The process involves integrating GO into PES membranes to enhance their adsorption capacity. Characterization techniques, including scanning electron microscopy, Fourier-transform infrared, and contact angle measurements, were used to assess structural and surface properties. The modified membranes demonstrated significantly improved adsorption compared to pristine PES. Notably, they achieved over 94% removal of Mn2+ and 93.6% of Fe2+ in the first filtration cycle for water with an initial concentration of 100 ppm. Continuous filtration for up to five cycles maintained removal rates above 60%. This research advances water purification materials, offering a promising solution for heavy metal ion removal. GO-decorated PES membranes may find application in large-scale water treatment, addressing environmental and public health concerns.

Once-weekly Insulin Icodec Versus Once-daily Long-acting Insulin for Type II Diabetes: A Meta-analysis of Randomized Controlled Trials.

Background: Insulin icodec is a novel basal insulin analog with once-weekly subcutaneous administration. We aim to estimate the efficacy and safety of insulin icodec vs long-acting insulin (insulin glargine and degludec) in type II diabetic patients. Methods: We conducted a systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, Web of Science, SCOPUS, and Cochrane through May 29, 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). Our primary outcome was glycated hemoglobin (HbA1C) change. Results: We included 7 RCTs with a total of 3183 patients. Insulin icodec was associated with significantly decreased HbA1C (MD: -0.15 with 95% CI [-0.24, -0.06], P = .002) and increased percentage of time with glucose in range (TIR) (MD: 4.06 with 95% CI [2.06, 6.06], P = .0001). However, insulin icodec was associated with increased body weight (MD: 0.57 with 95% CI [0.45, 0.70], P = .00001). Also, there was no difference regarding any serious adverse events (AEs) (RR: 0.96 with 95% CI [0.76, 1.20], P = .7) or AEs leading to withdrawal (RR: 1.54 with 95% CI [0.84, 2.82], P = .16). However, insulin icodec was associated with increased any AEs incidence (RR: 1.06 with 95% CI [1.01, 1.12], P = .02). Conclusion: Insulin icodec was associated with decreased HbA1C, increased TIR, with similar hypoglycemic and serious AEs. However, it was also associated with increased body weight and the incidence of any AEs.

Reconstruction of Upper Third Defect of the Auricle by Conchal Cartilage Graft and Coverage by Postauricular Flap.

BACKGROUND: The defects of the upper third of the auricle are considered significant reconstructive challenges, as they require frequent operations with a high risk of morbidity at the donor site and result in unacceptable cosmetic abnormalities. OBJECTIVE: Is to perform the reconstruction of a full-thickness auricular defect located in the upper third of the ear using a conchal cartilage graft with postauricular flap coverage, aiming to minimize both donor and recipient morbidity. PATIENTS AND METHODS: The current study included 20 patients with unilateral upper-third auricular defects. The repair involved 2 components: a cartilage graft from the concha to provide structural support and a flap for coverage. Follow-up was conducted for 6 months after the operation. RESULTS: Successful outcomes were achieved in both subjective and doctors' assessments. Regarding subjective outcomes, 85% of the patients reported high satisfaction (P < .001). In terms of doctors' subjective assessment, 90% of the patients had excellent results (P < .001). Mild early and postoperative complications, if encountered, resolved spontaneously. CONCLUSION: The use of a combined conchal cartilage graft and postauricular flap in treating a full-thickness upper third auricular defect is safe and effective, with no major complications. The technique preserves the cosmetic and functional outcomes of the auricle, providing an excellent color match and minimal donor-site morbidity.

Hydrogen Production via Methane Decomposition over Alumina Doped with Titanium Oxide-Supported Iron Catalyst for Various Calcination Temperatures.

The decomposition of methane has been chosen as an alternative method for producing hydrogen. In this study, 20 % Fe was used as the active metal part of the catalyst. To better comprehend the impact of the supporting catalytic properties, alumina and titania-alumina composite were investigated as supports. Iron-based catalysts were prepared by impregnation method and then calcined at different temperatures (300 °C, 500 °C, and 800 °C). The catalysts were examined at 800 °C under atmospheric pressure with a 15 mL/min total flow rate and 2 : 1 CH4 to N2 feed ratio. The textural and morphological characteristics of the fresh calcined and spent catalysts were investigated. The catalytic activity and stability data demonstrated that Fe supported over TiO2-Al2O3 calcined at 500 °C performed the best of all evaluated catalysts with a more than 80 % hydrogen yield. The Raman spectra result showed that graphitic carbon was produced for all used titanium dioxide catalysts. Moreover, according to transmission electron microscopy (TEM) results, the carbon deposited on the catalysts' surface is carbon nanotubes (CNT).

Ce-doped ZnO nanostructures: A promising platform for NO2 gas sensing.

In this comprehensive study, Ce-doped ZnO nanostructures were hydrothermally synthesized with varying Ce concentrations (0.5%, 1.0%, 1.5%, and 2.0%) to explore their gas-sensing capabilities, particularly towards NO2. Structural characterization revealed that as Ce doping increased, crystal size exhibited a slight increment while band gap energies decreased. Notably, the 0.5% Ce-doped ZnO nanostructure demonstrated the highest NO2 gas response of 8.6, underscoring the significance of a delicate balance between crystal size and band gap energy for optimal sensing performance. The selectivity of the 0.5% Ce-doped ZnO nanostructures to NO2 over other gases like H2, acetone, NH3, and CO at a concentration of 100 ppm and an optimized temperature of 250 °C was exceptional, highlighting its discriminatory prowess even in the presence of potential interfering gases. Furthermore, the sensor displayed reliability and reversibility during five consecutive tests, showcasing consistent performance. Long-term stability testing over 30 days revealed that the gas response remained almost constant, indicating the sensor's remarkable durability. In addition to its robustness against humidity variations, maintaining effectiveness even at 41% humidity, the sensor exhibited impressive response and recovery times. While the response time was swift at 11.8 s, the recovery time was slightly prolonged at 56.3 s due to the strong adsorption of NO2 molecules onto the sensing material hindering the desorption process. The study revealed the intricate connection between Ce-doping levels, structure, and gas-sensing. It highlighted the 0.5% Ce-doped ZnO nanostructure as a highly selective, reliable, and durable NO2 gas sensor, with implications for future environmental monitoring and safety.

Unveiling the potential of PANI@MnO2@rGO ternary nanocomposite in energy storage and gas sensing.

The development of advanced materials for energy storage and gas sensing applications has gained significant attention in recent years. In this study, we synthesized and characterized PANI@MnO2@rGO ternary nanocomposites (NCs) to explore their potential in supercapacitors and gas sensing devices. The ternary NCs were synthesized through a multi-step process involving the hydrothermal synthesis of MnO2 nanoparticles, preparation of PANI@rGO composites and the assembly to the ternary PANI@MnO2@rGO ternary NCs. The structural, morphological, and compositional characteristics of the materials were thoroughly analyzed using techniques such as XRD, FESEM, TEM, FTIR, and Raman spectroscopy. In the realm of gas sensing, the ternary NCs exhibited excellent performance as NH3 gas sensors. The optimized operating temperature of 100 °C yielded a peak response of 15.56 towards 50 ppm NH3. The nanocomposites demonstrated fast response and recovery times of 6 s and 10 s, respectively, and displayed remarkable selectivity for NH3 gas over other tested gases. For supercapacitor applications, the electrochemical performance of the ternary NCs was evaluated using cyclic voltammetry and galvanostatic charge-discharge techniques. The composites exhibited pseudocapacitive behavior, with the capacitance reaching up to 185 F/g at 1 A/g and excellent capacitance retention of approximately 88.54% over 4000 charge-discharge cycles. The unique combination of rGO, PANI, and MnO2 nanoparticles in these ternary NCs offer synergistic advantages, showcasing their potential to address challenges in energy storage and gas sensing technologies.