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The desire to increase resource management efficacy in the construction sector is expanding because of measures to reduce costs, boost productivity, and minimize environmental impact. The Internet of Things (IoT) has the potential to alter resource management in the construction sector by delivering real-time data and insights that may assist decision-makers in optimizing resource allocation and usage. Incorporating Internet of Things (IoT) technology into the construction sector will be investigated in this study to discover how resource management is affected. The aim of the study is to identify the essential aspects that promote optimal IoT integration and to investigate how IoT may influence resource management. The relations between variables and their fundamental elements are investigated using structural equation modelling (SEM). In the context of building projects, the study analyses how IoT integration influences resource allocation and utilization, real-time monitoring, and proactive maintenance. The building sector in Malaysia provides concepts on IoT in resource management. Based on this research's outcomes, there is a distinct association between the utilization of IoT technology and effective resource management in the construction sector. IoT adoption is affected by a multiplicity of issues, including data analytics, data security and privacy, integration and interoperability, scalability, and flexibility. This study contributes to addressing considerable gaps in the corpus of information on IoT technology integration in the construction sector. It analyses how IoT may effect resource management, emphasizing how IoT technology may enhance the efficacy of human, mechanical, and material resources.
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Patients with peripheral neuropathy could have damaged peripheral nerves, which leads to sensory and motor dysfunction. Diabetes, infections, and trauma are the major causes of peripheral neuropathy. Vibratory perception threshold (VPT) tools are commonly used to detect peripheral neuropathy. This study aims to determine the assessment of peripheral neuropathy through the different diagnostic tools in the community in Malaysia. A total number of 1283 participants were recruited from the seven retail pharmacies located in Selangor, Malaysia. The peripheral neuropathy test was conducted based on VPT tools on both feet using the digital biothesiometer. Following that, Neurological Symptom Score (NSS) and Neurological Disability Score (NDS) were taken from the participants to assess the neurological symptoms. Participants had an average age of 40.6 ± 12.9 years and were mostly of Chinese ethnicity (54.1%). The findings show that increasing age was associated with more severe peripheral neuropathy across the various assessment tools, but gender differences were found with the biothesiometer test and ethnicity has severity in the biothesiometer and disability scores. The sensitivity and specificity of the biothesiometer test were 0.63 and 0.84, respectively. The combined tool NSS and NDS had high specificity and a high positive predictive value, suggesting that it could be a reliable indicator of peripheral neuropathy when both scores are elevated. The findings show that the biothesiometer test, NSS, and NDS are considered screening VPT tools for diagnosing peripheral neuropathy. However, further evaluation and diagnostic testing are necessary in cases of a positive test result.
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Humans suffer from various diseases that require more specific drugs to target them. Among the different potent agents, ß-lactamases serve as good antibacterial agents; however, ß-lactamases are resistant to such antibiotics. The present study was designed to prepare efficient ß-lactamase inhibitor amides (12-15) from inexpensive, easily accessible, and bioactive precursors; Morita Baylis Hillman (MBH) adducts (5-8). The adducts (5-8) were primarily prepared by treating their respective aldehydes with the corresponding acrylate in the presence of an organic Lewis base at ambient temperature. The compounds were characterized using mass spectrometry, FTIR and NMR spectroscopy. Furthermore, in silico studies (using AutoDock Tools and AutoDock Vina programs) on the adduct and corresponding amide product revealed that all MBH adducts (5-8) and their product amides (12-15) are significant inhibitors of ß-lactamase. Additionally, among the MBH adducts, adduct 7 showed the highest binding affinity with ß-lactamase, whereas amide 15 was identified as a highly potent antibacterial based on its docking score (-8.6). In addition, the absorption, distribution, metabolism, and excretion (ADME) test of the synthesized compounds demonstrated that all compounds showed drug-likeness properties.
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Gold is generally considered a noble metal since it is inherently inert in its bulk state. However, gold demonstrates reactivity when it is in its ionic state. The inherent inertness of bulk gold has resulted in its widespread recognition as a vital raw material in various biomedical processes. The applications of these technologies include drug delivery microchips, dental prostheses, reconstructive surgery, culinary additives, and cardiovascular stents. Gold can also exist in molecules or ions, particularly gold ions, which facilitates the production of gold nanomaterials. In this paper, we have computed differential and integral operators by using the M -Polynomial of gold crystals and by utilizing this polynomial, we have also computed eleven topological indices like 1 s t Zagreb, 2 n d Zagreb, Hyper, Sigma, Second Modified, General Randic, General Reciprocal Randic, 3 r d Redefined Zagreb, Symmetric Division Degree, Harmonic, Inverse Sum indices for the structure of Gold crystal.
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Shigellosis, a significant public health concern, has increasingly been recognized as a sexually transmitted infection (STI) among men who have sex with men (MSM), particularly in those with HIV. This case report describes a 25-year-old MSM with advanced HIV who presented with recurrent multidrug-resistant (MDR) Shigella flexneri infection despite multiple hospitalizations and antibiotic courses. The patient's high-risk sexual behaviors and suboptimal HIV management likely contributed to recurrent exposure to Shigella and the selection of resistant strains. This case highlights the complex interplay of individual behaviors, immune suppression, antimicrobial resistance, and the healthcare system in the context of this emerging STI. It underscores the importance of optimized HIV care, comprehensive patient education, robust healthcare coordination, and strengthened surveillance to effectively combat MDR shigellosis in vulnerable populations.
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Colorectal cancer (CRC) is the second leading cause of cancer death in the world, originating from the glandular epithelial cells of the large intestine and the rectum. This article aims to review the epidemiology of CRC in Saudi Arabia, focusing on prevalence, incidence, risk factors, preventive measures, and outcomes. This narrative review utilized the PubMed database for data extraction, including freely accessible studies published in the last 15 years. Sixteen articles from different study designs were included, while awareness and non-English language studies were excluded. In 2020, the incidence and mortality rate of CRC in Saudi Arabia were 14.6% and 1.48% among all cancers, respectively. From 2006 to 2016, the number of colon cancer and rectal cancer cases increased by 8% and 7%, respectively. Risk factors for CRC in Saudi Arabia include low education level, unemployment, physical inactivity, excess weight, poor knowledge of foods rich in fiber, cigarette smoking, reduced serum vitamin D and calcium levels, and certain gene mutations. National guidelines in Saudi Arabia recommend CRC screening for all individuals above 45 years using colonoscopy, flexible sigmoidoscopy, or fecal occult blood test. The 10-year survival rate for CRC in Saudi Arabia is 44.6%. The overall 5-year survival rate for the Ministry of National Guard-Health Affairs is 52.0%. To lower the incidence and mortality of CRC, primary, secondary, and tertiary prevention are all very important. The most crucial aspect is to concentrate on primary prevention, which may involve raising public awareness of CRC risk factors and strategies for reducing or eliminating them.
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This study introduces innovative operational laws, Einstein operations, and novel aggregation algorithms tailored for handling q-spherical fuzzy rough data. The research article presents three newly designed arithmetic averaging operators: q-spherical fuzzy rough Einstein weighted averaging, q-spherical fuzzy rough Einstein ordered weighted averaging, and q-spherical fuzzy rough Einstein hybrid weighted averaging. These operators are meticulously crafted to enhance precision and accuracy in arithmetic averaging. By thoroughly examining their characteristics and interrelations with existing aggregate operators, the article uncovers their distinct advantages and innovative contributions to the field. Furthermore, the study illustrates the actual implementation of these newly constructed operators in a variety of attribute decision-making scenarios employing q-SFR data, yielding useful insights. Our suite of decision-making tools, including these operators, is specifically designed to address complex and uncertain data. To validate our approach, this study offers a numerical example showcasing the real-world applicability of the proposed operators. The results not only corroborate the efficacy of the proposed method but also underscore its potential significance in practical decision-making processes dealing with intricate and ambiguous data. Additionally, comparative and sensitivity analyses are presented to assess the effectiveness and robustness of our proposed work relative to other approaches. The acquired knowledge enriches the current understanding and opens new avenues for future research.
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Automonitorização da Glicemia , Glicemia , Diabetes Mellitus Tipo 1 , Satisfação do Paciente , Humanos , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Criança , Adolescente , Glicemia/análise , Glicemia/metabolismo , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Insulina/administração & dosagem , Sistemas de Infusão de InsulinaRESUMO
The pervasive presence of microplastics in various settings, such as freshwater and marine ecosystems, has sparked serious concerns. Microplastics can operate as possible transporters for hazardous trace elements or microbes, even though they are not naturally able to actively absorb these compounds. The binding sites on the plastic's surface or the complexes that are formed with the organic material on the plastic are how this adsorption process takes place. Microplastics' surfaces also seem to be attractive to microorganisms, such as bacteria and algae. Microorganisms can adhere to the rough surface of microplastics, which facilitates their colonization and formation of biofilms. Numerous bacteria, including ones that have the ability to absorb hazardous trace elements, can be found in these biofilms. Microplastics and microbes can interact in ways that are advantageous and detrimental. Microplastics have the ability to act as a substrate for microbial growth, which could lead to an increase in the quantity of microorganisms in the surrounding environment. On the other hand, microplastics may make it easier for microbes to spread to new areas, which could help dangerous or deadly species proliferate. Research is still ongoing to determine the degree to which microplastics serve as carriers of microbes and hazardous trace elements. Comprehending the implications of microplastics, pollutants, and microorganisms in a variety of environmental conditions is difficult due to their complex interplay. This review provides a detailed description of the complexity of the problem and used the examples related to microplastics, its environmental effects, and impacts on human health.
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Microplásticos , Oligoelementos , Biofilmes , Bactérias/metabolismo , Poluentes Químicos da ÁguaRESUMO
BACKGROUND & AIMS: Investigating the tissue-associated microbiota after surgically induced remission may help to understand the mechanisms initiating intestinal inflammation in Crohn's disease. METHODS: Patients with Crohn's disease undergoing ileocolic resection were prospectively recruited in 6 academic centers. Biopsy samples from the neoterminal ileum, colon, and rectosigmoid were obtained from colonoscopies performed after surgery. Microbial DNA was extracted for 16S rRNA gene sequencing. Microbial diversity and taxonomic differential relative abundance were analyzed. A random forest model was applied to analyze the performance of clinical and microbial features to predict recurrence. A Rutgeerts score ≥i2 was deemed as endoscopic recurrence. RESULTS: A total of 349 postoperative colonoscopies and 944 biopsy samples from 262 patients with Crohn's disease were analyzed. Ileal inflammation accounted for most of the explained variance of the ileal and colonic mucosa-associated microbiota. Samples obtained from 97 patients who were in surgically induced remission at first postoperative colonoscopy who went on to develop endoscopic recurrence at second colonoscopy showed lower diversity and microbial deviations when compared with patients who remained in endoscopic remission. Depletion of genus Anaerostipes and increase of several genera from class Gammaproteobacteria at the 3 biopsy sites increase the risk of further recurrence. Gut microbiome was able to predict future recurrence better than clinical features. CONCLUSIONS: Ileal and colonic mucosa-associated microbiome deviations precede development of new-onset ileal inflammation after surgically induced remission and show good predictive performance for future recurrence. These findings suggest that targeted microbial modulation is a plausible modality to prevent postoperative Crohn's disease recurrence.
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Green synthesis methods offer a cost-effective and environmentally friendly approach to producing nanoparticles (NPs), particularly metal-based oxides. This study explores the green synthesis of copper oxide nanoparticles using Aloe vera (Aloe barbadensis Miller) leaf extract. The characterization revealed a unique sago-shaped morphology revealed by field-emission scanning electron microscopy and X-ray diffraction analysis. Distinctive metal-oxygen bonds at 521 and 601 cm-1 were confirmed by Fourier-transform infrared (FT-IR) spectroscopy. Furthermore, UV-visible spectroscopy revealed absorbance at 248 nm, suggesting electron transitions across energy bands and varying surface conduction electrons. The band gap value indicated the presence of quantum confinement effects, which were probably caused by the distinctive morphology and surface structure of the biogenic NPs. Additionally, molecular docking studies were carried out against key proteins of Salmonella typhi and Listeria monocytogenes, namely, listeriolysin O (PDB ID: 4CDB), internalin (InlA) (PDB ID: 1O6T), Salmonella effector protein (SopB) (PDB ID: 4DID), and YfdX (PDB ID: 6A07) using AutoDock 4.2. The results revealed binding energies against S. typhi and L. monocytogenes proteins, indicating potential interactions establishing the foundation for further in-depth understanding of the molecular basis underlying the observed antibacterial effects in vitro against S. typhi, Klebsiella pneumoniae, Pseudomonas aeruginosa, and L. monocytogenes. Antibacterial activity evaluation yielded impressive results, with CuO NPs displaying significant activity against S. typhi and L. monocytogenes, exhibiting zones of inhibition values of 13 ± 0.02 and 15 ± 0.04 mm, respectively. Moreover, the CuO NPs demonstrated remarkable photocatalytic efficacy, resulting in the degradation of 77% of the methylene blue dye when exposed to UV irradiation. This study highlighted the potential of green-synthesized CuO NPs derived from A. vera with their unique morphology, interesting spectroscopic properties, and promising antibacterial and photocatalytic activities.
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Background and objective The incidence of hypertension is growing at an alarming rate globally. In the United States, nearly half of the adult population suffers from hypertension, a disease potentially associated with long-term dire consequences and comorbidities. While Internet access has proliferated, and free Internet-based education resources for healthy lifestyles have exponentially increased over the past two decades, little is known about whether Internet-based information can be or is used as a self-learning tool for hypertension management in a community setting. With almost no published data, if and to what degree Internet-based, self-directed learning tools are used for hypertension management needs to be assessed. In light of this, we aimed to evaluate the prevalence of Internet use as a source of information in patients with known diagnoses of hypertension who presented to our Internal Medicine clinic at Texas Tech University Health Sciences Center, El Paso. Materials and methods We conducted a single-center, cohort-based observational study at our teaching hospital's internal medicine clinic. A survey questionnaire was distributed to all adults aged more than 18 years with a known diagnosis of hypertension. Consent for participation was obtained from all participants. Of the total studied population, 93.6% (190/203) were of Hispanic descent. Moreover, 67.5% (137/203) identified as female. Of note, 22.7% (46/203) reported using the Internet to learn about hypertension. Internet users were younger, with a mean age of 61.4 years compared to 68.7 (p=0.02) years for non-Internet users, attended institutions of a higher grade of education, and mostly received information regarding hypertension from their families (91.3% vs 2.5%, p<0.001). While most patients used the Internet for making treatment decisions and were satisfied with their choices, more than a quarter felt confused and anxious after using Internet-based resources. Results Most patients in the study were found to not use the Internet as a resource tool for hypertension management (157/203; 77.3%). Among the 22.7% of patients who used the Internet for hypertension management, the most commonly utilized resource was Google.com, as an initial step to hypertension research (26/46, 58.6%, p<0.001), followed by multiple resources within a predetermined list on the provided survey (14/46, 30.4%). The survey also assessed the reasons for using Internet-based resources, with the primary reason being evaluating treatment options (19/46, 41.5%), followed by developing coping skills (13/46, 28.2%), and lastly aiding in decision-making (10/46, 21.5%). Conclusions Internet-based educational tools are mushrooming as the Internet is becoming more pervasive. This study shows that within this predominant Hispanic population, nearly one-quarter of patients with hypertension are using Internet-based, self-learning tools. This highlights a slow shift in medical education which providers have to be prepared for as patients will be using these tools as secondary information sources for medical decision-making more frequently going forward. Further studies need to be conducted to evaluate the current and longitudinal impact of these new information sources.
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The nanozymes (NZs) are the artificial catalyst deployed for bio sensing with their uniqueness (high robustness, surface tenability, inexpensive and stability) for obtaining a better response/miniaturization of the varied sensors compared to their traditional ancestors. Now a days, nanomaterials with their broadened scale such as metal-organic frameworks (MOFs), metals/metal oxides are widely engaged in the generation of NZs based biosensors (BS). Diverse strategies like fluorescent, colorimetric, surface-enhanced Raman scattering (SERS), and electrochemical sensing principles were implemented for signal transduction of NZs. Despite of broad advantages, numerous encounters (like specificity, feasibility, stability and issues in scale-up) are affecting the potentialities of NZs based BS, and thus need a prior attention for a promising exploration for a revolutionary outcome in advanced theranostics. This review is included with different types of NZs, the progress of numerous NZs tailored bio-sensing techniques in detection of abundant bio analytes for the theranostic purpose. Further, discussion was highlighted with some recent challenges along with their progressive way of possible overcoming followed by commercial outbreaks.
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OBJECTIVE: Alcoholic hepatitis (AH) represents a severe manifestation of alcoholic liver disease (ALD) associated with a wide severity spectrum. ALD is linked to nutritional deficiencies, with the gravity of malnutrition escalating as alcohol abuse and ALD progress. This study aims to delve into the impact of malnutrition on the clinical trajectory of AH. METHODS: We identified adult patients admitted with AH using the National Readmission Database (NRD) 2016-2020. We further classified AH patients based on the severity of malnutrition. We compared the outcomes of AH hospitalizations using a multivariate regression model. RESULTS: We included 82,367 AH patients, of whom 15,693 (19.00%) had malnutrition. 4,243 (5.15%) patients exhibited mild to moderate malnutrition, 5,862 (7.07%) patients had severe malnutrition, and 5,588 (6.78%) patients had unspecified severity of malnutrition. We found that adjusted in-hospital mortality due to AH was higher in patients with malnutrition, corresponding to the severity of malnutrition (adjusted odds ratio [aOR] 1.62 and 3.14 in mild-moderate malnutrition and severe malnutrition, respectively; p < .01). Additionally, patients with malnutrition had progressively elevated odds of septic shock, vasopressor requirement, mechanical ventilation, and intensive care unit (ICU) admission with escalating intensity of malnutrition. Liver-related complications, such as spontaneous bacterial peritonitis, coagulopathy, hepatorenal syndrome, and hepatic encephalopathy, were also found to have an increased likelihood in the presence of malnutrition. Furthermore, resource utilization showed a progressive increase with increasing severity of malnutrition. CONCLUSION: Our findings indicate that malnutrition is a common comorbidity in AH patients, with varying degrees of severity, which correlates with higher mortality rates, emphasizing the critical role of nutritional status in the prognosis of AH. These findings underscore the importance of addressing and managing malnutrition in patients with AH, not only for its potential contribution to mortality but also because of its association with a spectrum of complications and increased healthcare resource utilization.
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Pancreatic ductal adenocarcinoma (PDAC) is an increasingly diagnosed cancer that kills 90% of afflicted patients, with most patients receiving palliative chemotherapy. We identified neuronal pentraxin 1 (NPTX1) as a cancer secreted protein that becomes over-expressed in human and murine PDAC cells during metastatic progression and identified adhesion molecule with Ig like domain 2 (AMIGO2) as its receptor. Molecular, genetic, biochemical and pharmacologic experiments revealed that secreted NPTX1 acts cell-autonomously on the AMIGO2 receptor to drive PDAC metastatic colonization of the liver-the primary site of PDAC metastasis. NPTX1-AMIGO2 signaling enhanced hypoxic growth and was critically required for hypoxia induced factor-1a (HIF1a) nuclear retention and function. NPTX1 is over-expressed in human PDAC tumors and upregulated in liver metastases. Therapeutic targeting of NPTX1 with a high-affinity monoclonal antibody substantially reduced PDAC liver metastatic colonization. We thus identify NPTX1-AMIGO2 as druggable critical upstream regulators of the HIF1a hypoxic response in PDAC.
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BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune encephalitis due to immune production of anti-NMDAR antibodies against the NR1 subunit of the NMDA receptor which is present throughout the central nervous system. This condition had been reported to be prevalent in patients with certain medical conditions; however so far, there have been limited systematic reviews and meta-analyses on the prevalence and factors associated. OBJECTIVE: This study was to determine the prevalence and factors associated with anti-NMDAR encephalitis among affected patients. MATERIAL AND METHODS: The protocol of this study has been registered (2019: CRD42019142002) with the International Prospective Register of Systematic Reviews (PROSPERO). The primary outcome was the incidence or prevalence of anti-NMDAR encephalitis and secondary outcomes were factors associated with anti-NMDAR encephalitis. RESULTS: There were 11 studies and a total of 873 million patients taken from high-risk populations across 11 countries that were included in the primary analysis. The overall pooled prevalence of anti-NMDAR encephalitis among patients with medical conditions was 7.0% (95% CI = 4.4, 9.6). Those with first episode of psychosis or schizophrenia were at a higher risk of developing anti-NMDAR encephalitis with an odds ratio of 5.976 (95% CI = 1.122, 31.825). CONCLUSION: We found that almost one-tenth of patients with medical conditions had anti-NMDAR encephalitis; particularly those with first episode of psychosis or schizophrenia were among the high-risk medical conditions.