Socioeconomic and geographical inequalities in delivery by cesarean section among women in Bangladesh, 2004-2017.

BACKGROUND: There is a dearth of evidence on the trends and inequalities in utilizing cesarean section (CS) among women in Bangladesh. Hence, this study aimed to estimate the socioeconomic and geographical inequalities in delivery by CS among Bangladeshi women from 2004 to 2017. METHODS: Data from Bangladesh Demographic and Health Survey 2004, 2007, 2011, 2014, and 2017 were analyzed using the WHO's Health Equity Assessment Toolkit (HEAT) software. Inequalities were measured using four summary measures: Difference (D), Population Attributable Risk (PAR), Population Attributable Fraction (PAF), and Ratio (R). Socioeconomic inequalities were assessed using two equity dimensions: household wealth status, and level of education, while geographical disparities were measured using two equity dimensions: place of residence, and sub-national regions. For each measure, point estimates and their 95% confidence intervals were reported. RESULTS: An increasing trend in the prevalence (weighted) of CS in Bangladesh use was found from 4.50% in 2004 to 32.73% in 2017 We found significant socioeconomic inequalities in CS in every survey point, with a higher concentration of CS among the rich (in 2017, PAR = 28.57; 95% CI: 26.69-30.46) indicating a pro-rich inequality, and higher educated (in 2017, PAF = 23.97; 95% CI: 12.26-35.68) sub-groups. We also identified significant geographical disparities in CS with a higher concentration of CS among people from urban areas (in 2017, PAR = 10.99; 95% CI: 10.19-11.79), and a coastal region (Khulna division) (in 2017, PAF: 30.48 (95% CI: 18.66-42.30). CONCLUSION: We observed both socioeconomic and geographical inequalities in CS exist in Bangladesh, though the trends of these inequalities were curved over time. Thus, it is important to comprehend these pro-rich and geographical inequalities better and implement appropriate interventions and policies to alleviate them.

An Objective Evaluation of Cleft Lip Repair Deformities Based on Standardized Photographic Views.

BACKGROUND: Several assessment systems of the cleft-related facial deformity have been reported in the medical literature. Assessments have been made from direct clinical evaluations, photographs, on-screen digital images, and 3-dimensional imaging. An evaluation method based on standardized photographic views is developed to evaluate the most common postoperative deformities and to detect the responsible factors for occurrence of these deformities and how to avoid them. MATERIALS AND METHODS: One hundred forty-five cleft lip cases (105 unilateral and 40 bilateral) were evaluated by using standard sheet and scoring system designed by Operation Smile Inc (Virginia Beach). The scoring system is based on photographic analysis of items including Cupid's bow, nasal symmetry, vermilion contour, white roll continuity, and scar quality. RESULTS: In the unilateral cleft cases, we found 0.4% excellent, 48.57% good, 38% fair, and 2.85% poor cases. For bilateral clef lip cases, we found 27.5% excellent, 47.5% good, 17.5% fair, and 7.5% poor outcomes. The most common postoperative deformities were nasal asymmetry, scar hypertrophy, deformed Cupid's bow, and vermilion contour asymmetry. CONCLUSIONS: This objective evaluation system can determine the common cleft lip nasal deformities with detection of the responsible factors. Principles that guide optimum surgical repair have been advocated to avoid the common postoperative deformities. Scar formation is an independent factor that must be managed early and separately to maintain surgical outcomes.

Socioeconomic and geographical inequalities in using skilled birth attendants during delivery in Bangladesh over two decades.

BACKGROUND: Maternal and neonatal mortality is a major public health concern globally. Evidence supports that skilled birth attendants (SBA) can significantly reduce maternal and neonatal mortality. Despite the improvement in SBA use, Bangladesh lacks evidence of equality in SBA use across socioeconomic and geographic regions. Therefore, we aim to estimate the trends and magnitude of inequality in SBA use in Bangladesh over the last two decades. METHODS: Data from the last 5 rounds of Bangladesh Demographic and Health Surveys (BDHS; 2017-18, 2014, 2011, 2007, and 2004) were used to measure the inequalities in the SBA use utilizing the WHO's Health Equity Assessment Toolkit (HEAT) software. Inequality was assessed by four summary measures, namely, Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) based on the four equity dimensions: wealth status, education level, place of residence, and subnational regions (divisions). Point estimates and a 95% confidence interval (CI) were reported for each measure. RESULTS: An increasing trend in the overall prevalence of SBA use was observed (From 15.6% in 2004 to 52.9% in 2017). We found significant inequalities in SBA use in every wave of BDHS (from 2004 to 2017), with the result concentrating on the rich (in 2017, PAF: 57.1; 95% CI: 52.5-61.7), educated (in 2017, PAR: 9.9; 95% CI: 5.2-14.5),  and people from urban areas (in 2017, PAF: 28.0; 95% CI: 26.4-29.5). We also identified geographic disparities in SBA use favoring Khulna and Dhaka divisions (in 2017, PAR: 10.2; 95% CI: 5.7-14.7). Our study also observed inequality in using SBA among Bangladeshi women decreased over time. CONCLUSION: To increase SBA use and to decrease inequality in all four equity dimensions, disadvantaged sub-groups should be prioritized in policies and planning for program implementation.

Sleep Apnea Detection Using Wavelet Scattering Transformation and Random Forest Classifier.

Obstructive Sleep Apnea (OSA) is a common sleep-breathing disorder that highly reduces the quality of human life. The most powerful method for the detection and classification of sleep apnea is the Polysomnogram. However, this method is time-consuming and cost-inefficient. Therefore, several methods focus on using electrocardiogram (ECG) signals to detect sleep apnea. This paper proposed a novel automated approach to detect and classify apneic events from single-lead ECG signals. Wavelet Scattering Transformation (WST) was applied to the ECG signals to decompose the signal into smaller segments. Then, a set of features, including higher-order statistics and entropy-based features, was extracted from the WST coefficients to formulate a search space. The obtained features were fed to a random forest classifier to classify the ECG segments. The experiment was validated using the 10-fold and hold-out cross-validation methods, which resulted in an accuracy of 91.65% and 90.35%, respectively. The findings were compared with different classifiers to show the significance of the proposed approach. The proposed approach achieved better performance measures than most of the existing methodologies.

A rare heterozygous TREM2 coding variant identified in familial clustering of dementia affects an intrinsically disordered protein region and function of TREM2.

Rare coding variants in the triggering receptor expressed on myeloid cells-2 (TREM2) gene have been associated with Alzheimer disease (AD) and homozygous TREM2 loss-of-function variants have been reported in families with monogenic frontotemporal-like dementia with/without bone abnormalities. In a whole-exome sequencing study of a family with probable AD-type dementia without pathogenic variants in known autosomal dominant dementia disease genes and negative for the apolipoprotein E (APOE) ε4 allele, we identified an extremely rare TREM2 coding variant, that is, a glycine-to-tryptophan substitution at amino acid position 145 (NM_018965.3:c.433G>T/p.[Gly145Trp]). This alteration is found in only 1 of 251,150 control alleles in gnomAD. It was present in both severely affected as well as in another putatively affected and one 61 years old as yet unaffected family member suggesting incomplete penetrance and/or a variable age of onset. Gly145 maps to an intrinsically disordered region (IDR) of TREM2 between the immunoglobulin-like and transmembrane domain. Subsequent cellular studies showed that the variant led to IDR shortening and structural changes of the mutant protein resulting in an impairment of cellular responses upon receptor activation. Our results, suggest that a p.(Gly145Trp)-induced structural disturbance and functional impairment of TREM2 may contribute to the pathogenesis of an AD-like form of dementia.

Characteristics, Management, and Outcomes of Surgically Treated Arteriovenous Fistula Aneurysm in Patients on Regular Hemodialysis.

BACKGROUND: To investigate the clinical characteristics, surgical interventions, and outcomes of arteriovenous fistula (AVF) aneurysms, we retrospectively analyzed patients on regular hemodialysis (HD). METHODS: We conducted a cohort study of all patients with HD access who presented with AVF aneurysms and underwent operative procedures over a 11-year period. Patients' demographics, comorbidities, vascular access characteristics, management of aneurysms, complications, and outcomes were analyzed. RESULTS: Of the 700 end-stage renal failure patients, 530 patients were maintained on HD (130 through PermCath and 400 through AV access in terms of AVF and arteriovenous graft). We identified 129 patients who developed AV aneurysms, and 40 of them required surgical interventions (24 men and 16 women) with a mean age of 58 ± 14.6 years. The 40 patients who developed AVF aneurysms underwent 43 surgical interventions. The majority of aneurysms were presented with thinning and ulceration (82.5%) of the overlying skin. Thirty-four patients had true aneurysms and 6 had pseudoaneurysms. The aneurysmal AVF comprised 26 brachiocephalic fistulas, 9 radiocephalic fistulas, 3 brachial artery grafts, 1 ulnar-basilic fistula, and 1 Fem-Fem graft at presentation. Patients were treated mainly with ligation (13; 32.5%), excision and repair with graft interposition (15; 37.5%) or vein interposition (11; 27.5%), and end-to-end AVF (1; 2.5%). The median follow-up postsurgery duration was 53 months (range 1-192) and the median duration from fistula creation to the surgical intervention was 52 months (range 4-182). On follow-up, 34 patients continued on HD, while 5 underwent renal transplantation and 1 shifted to peritoneal dialysis. The overall all-cause mortality rate was 37.5% and the leading causes of mortality were sepsis/pneumonia (60%), myocardial infarction, and heart failure (40%). CONCLUSIONS: In HD patients, the rate of AVF aneurysmal formation is high with a significant rate of morbidity and mortality. Therefore, timely and appropriate evaluation and surgical intervention are crucial.

Localization of reelin signaling pathway components in murine midbrain and striatum.

We investigated the distribution patterns of the extracellular matrix protein Reelin and of crucial Reelin signaling components in murine midbrain and striatum. The cellular distribution of the Reelin receptors VLDLr and ApoER2, the intracellular downstream mediator Dab1, and the alternative Reelin receptor APP were analyzed at embryonic day 16, at postnatal stage 15 (P15), and in 3-month-old mice. Reelin was expressed intracellularly and extracellularly in midbrain mesencephalic dopaminergic (mDA) neurons of newborns. In the striatum, Calbindin D-28k(+) neurons exhibited Reelin intracellularly at E16 and extracellularly at P15 and 3 months. ApoER2 and VLDLr were expressed in mDA neurons at E16 and P15 and in oligodendrocytes at 3 months, whereas Dab1 and APP immunoreactivity was observed in mDA at all stages analyzed. In the striatum, Calbindin D-28k(+)/GAD67(+) inhibitory neurons expressed VLDLr, ApoER2, and Dab1 at P15, but only Dab1 at E16 and 3 months. APP was always expressed in mouse striatum in which it colocalized with Calbindin D-28k. Our data underline the importance of Reelin signalling during embryonic development and early postnatal maturation of the mesostriatal and mesocorticolimbic system, and suggest that the striatum and not the midbrain is the primary source of Reelin for midbrain neurons. The loss of ApoER2 and VLDLr expression in the mature midbrain and striatum implies that Reelin functions are restricted to migratory events and early postnatal maturation and are dispensable for the maintenance of dopaminergic neurons.

PYCR1, BANF1, and STARD8 Expression in Gastric Carcinoma: A Clinicopathologic, Prognostic, and Immunohistochemical Study.

BACKGROUND: It will be important to understand the molecular pathways of gastric cancer (GC) occurrence and progression, thus detecting predictive and prognostic biomarkers of GC. Pyrroline-5-carboxylate reductase 1 (PYCR1) was upregulated in many cancers, suggesting its possible roles in carcinogenesis and tumor metastases. Barrier-of-autointegration factor 1 (BANF1) is a protein family that plays essential roles in maintaining the integrity of an intact cellular genome. Rho-GTPs are molecular switches that control many signal transduction pathways in normal cells, including 3 subgroups from 1 to 3 (DLC1-3). DLC-3, known as StAR-related lipid transfer domain protein 8 (STARD8), and its role in cancers were not sufficiently studied. The study aimed to investigate the significance of PYCR1, BANF1, and STARD8 protein expression in GC tissues and normal gastric mucosa retrieved from patients with GC to detect prognostic roles of expression. PATIENTS AND METHODS: Specimens were collected from 100 patients with gastric carcinoma. After the application of the inclusion criteria of the study, we prepared 100 paraffin blocks from samples of the 100 included patients; each block included samples from gastric carcinoma and adjacent non-neoplastic gastric mucosa. We assessed the expression of PYCR1, BANF1, and STARD8 using immunohistochemistry in all studied samples. We followed patients for the detection of disease progression and survival rates. We correlate PYCR1, BANF1, and STARD8 expression with clinical, pathologic, and prognostic parameters. RESULTS: Overexpression of PYCR1 and BANF1 and decreased expression of STARD8 was found in gastric carcinoma tissues than adjacent non-neoplastic gastric mucosa ( P <0.001), and was positively associated with high grade ( P =0.006), depth of tumor invasion, presence of lymph nodes metastases and advanced stage ( P =0.001), high incidence of GC progression, recurrence, unfavorable disease-free survival ( P =0.003) and unfavorable overall survival rates ( P <0.001). Thus, it was revealed that; in univariate and multivariate analyses, levels of PYCR1, BANF1, and STARD8 are associated with the overall survival rate of GC patients. CONCLUSIONS: We showed that overexpression of PYCR1 and BANF1 and decreased expression of STARD8 in GC tissues was associated with poor prognosis and GC progression.

Distribution of microglia in the postnatal murine nigrostriatal system.

Parkinson's disease (PD) is characterized by the degeneration of dopaminergic neurons in the substantia nigra (SN) and the subsequent loss of striatal target innervation. Neuroinflammatory responses have been described for virtually all PD cases analysed. Microglia are the resident immune cells of the central nervous system and, thus, are the mediators of neuroinflammation. Approximately 12% of all central nervous system cells are microglia but the distribution and density of microglia differ within distinct brain regions. Interestingly, the SN has been shown to contain more microglia than adjacent structures. We have analysed changes in microglia numbers and in microglial morphology in the postnatal murine nigrostriatal system at various stages ranging from postnatal day 0 (P0) up to 24 months of age. We clearly show that the microglia numbers in the SN and in the striatum dramatically increase from P0 to P15 and significantly decrease in both areas in 18-month-old and 24-month-old animals. Moreover, microglia in the nigrostriatal system of aged mice show signs of dystrophy and degeneration, such as cytoplasmic inclusions, deramification of their processes and membrane blebbing. Our results support the hypothesis of microglial dystrophy during aging in the murine nigrostriatal system, accompanied by subsequent impairment of normal microglial functions. Microglial dysfunction during aging might be a potential risk factor for the development and/or progression of PD.

An Unusual Case of Escherichia Coli Meningitis in an Immunocompetent Adult.

Spontaneous meningitis caused by Gram-negative bacilli is rare in adults. It typically occurs after a neurosurgical procedure or head injury but may also be related to the presence of a neurosurgical device, cerebrospinal fluid (CSF) leak syndrome, or seen in immunosuppressed patients. Escherichia coli (E. coli) is the leading cause of Gram-negative bacilli meningitis. We describe the case of a 47-year-old man who was hospitalized for spontaneous, community-acquired E. coli meningitis, which is unusual to see in an immunocompetent adult. CSF analysis was consistent with bacterial meningitis; his blood culture was positive for E. coli. Within 24 hours of initiation of antibiotics, his status improved.

Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality.

BACKGROUND: Evidence suggested that inequalities based on education, wealth status, place of residence, and geographical regions significantly influence the key breastfeeding indicators including early initiation of breastfeeding. This study aimed to estimate the trends and magnitude of inequalities in early initiation of breastfeeding practice in Bangladesh from 2004 to 2017 applying both absolute and relative measures of inequality. METHODS: We used data from the last five Bangladesh Demographic Health Survey (BDHS) from 2004 to 2017 to measure the inequalities in early initiation of breastfeeding practice using the WHO's Health Equity Assessment Toolkit (HEAT) software. Following summary measures were estimated to measure the inequalities: Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) where the equity dimensions were wealth status, education level, sex of child, place of residence, and subnational regions (divisions). For each measure, point estimates along with a 95% confidence interval (CI) were reported. RESULTS: An uprising pattern in the prevalence of early initiation of breastfeeding was found, where early initiation of breastfeeding increased from 24.9% to 2004 to 59.0% in 2017. We found significant wealth-driven inequalities in early initiation of breastfeeding practice in every wave of survey favoring the poorest wealth quintile (in 2017, D -10.5; 95% CI -16.6 to -4.3). We also identified geographical disparities in early initiation of breastfeeding practice (in 2017, PAF 11.1; 95% CI 2.2 to 19.9) favoring the Rangpur (65.5%), and Sylhet (65.3%) divisions. Education-related disparities were observed in 2004 only, but not in later survey years, which was due to a much lower level of adherence among those with secondary or higher education. There were no significant disparities in early initiation of breastfeeding based on the urban vs. rural residence and sex of the child. CONCLUSIONS: The highest attention should be placed in Bangladesh to attain the WHO's 100% recommendation of timely initiation of breastfeeding. This study emphasizes on addressing the existing socioeconomic and geographic inequalities. Awareness-raising outreach programs focusing the mothers from wealthier sub-groups and divisions with lower prevalence should be planned and implemented by the joint effort of the government and non-government organizations.

Predictors of 1- and 12-month mortality in bifurcation coronary intervention: a contemporary perspective.

Aim: Bifurcation-PCI is performed frequently, although without extensive evidence to back up a definitive solution for its complexity. We set out to identify factors associated with 1- and 12-month mortality after bifurcation-PCI between 2017 and 2021 in our tertiary center in Wales, UK. Results: Of 732 bifurcation PCI cases (mean age 69; 25% female), 67% were in ACS, 42% were left main PCI and 25.3% involved two-stent strategy. 30-day and 12-month mortality were 1.9 and 8.2%, respectively. Age, diabetes, smoking and renal failure are associated with mortality after bifurcation-PCI, while the choice between provisional and 2-stent strategies did not impact mortality/TLR. Conclusion: Awareness of 'real-world' outcomes of bifurcation-PCI should be used for appropriate patient selection, technique planning and procedural consent.

Effects of Fogging System and Nitric Oxide on Growth and Yield of 'Naomi' Mango Trees Exposed to Frost Stress.

In years with unfavorable weather, winter frost during the blossoming season can play a significant role in reducing fruit yield and impacting the profitability of cultivation. The mango Naomi cultivar Mangifera indica L. has a low canopy that is severely affected by the effects of frost stress. As a result of the canopy being exposed to physiological problems, vegetative development is significantly inhibited. The current investigation aimed to study the influence of spraying nitric oxide and fogging spray systems on Naomi mango trees grafted on 'Succary' rootstock under frost stress conditions. The treatments were as follows: nitric oxide (NO) 50 and 100 µM, fogging spray system, and control. In comparison to the control, the use of nitric oxide and a fogging system significantly improved the leaf area, photosynthesis pigments of the leaf, the membrane stability index, yield, and physical and chemical characteristics of the Naomi mango cultivar. For instance, the application of 50 µM NO, 100 µM NO, and the fogging spray system resulted in an increase in yield by 41.32, 106.12, and 121.43% during the 2020 season, and by 39.37, 101.30, and 124.68% during the 2021 season compared to the control, respectively. The fogging spray system and highest level of NO decreased electrolyte leakage, proline content, total phenolic content, catalase (CAT), peroxidases (POX), and polyphenol oxidase (PPO) enzyme activities in leaves. Furthermore, the number of damaged leaves per shoot was significantly reduced after the application of fogging spray systems and nitric oxide in comparison to the control. Regarding vegetative growth, our results indicated that the fogging spray system and spraying nitric oxide at 100 µM enhanced the leaf surface area compared to the control and other treatments. A similar trend was noticed regarding yield and fruit quality, whereas the best values were obtained when the fogging spray system using nitric oxide was sprayed at a concentration of 100 µM. The application of fogging spray systems and nitric oxide can improve the production and fruit quality of Naomi mango trees by reducing the effects of adverse frost stress conditions.

Magnitude and trends in inequalities in healthcare-seeking behavior for pneumonia and mortality rate among under-five children in Bangladesh: Evidence from nationwide cross-sectional survey 2007 to 2017.

Background and Aims: Bangladesh did not have enough evidence on the current estimates and trend in inequities in the under-five mortality rate (U5MR). There is also a shortage of evidence on trends and inequalities in healthcare-seeking for pneumonia among under-five children (U5C) in Bangladesh. Hence, this study investigated the inequalities in U5MR and health care seeking for pneumonia in U5C through socioeconomic and geographic disparities in Bangladesh between 2007 and 2017. Methods: Data from 2007, 2011, 2014, and 2017 Bangladesh Demographic and Health surveys were analyzed using the Health Equity Assessment Toolkit (HEAT) software by World Health Organization (WHO). The data on U5MR and healthcare-seeking for pneumonia were first disaggregated into five equity dimensions: wealth status, education, child sex, place of residence, and administrative divisions. Second, using summary metrics such as difference (D), population attributable risk (PAR), ratio (R), and population attributable fraction (PAF), inequalities were assessed. Results: The U5MR declined from 73.9 deaths per 1000 live births in 2007 to 48.6 deaths in 2017, while the prevalence of healthcare-seeking for pneumonia in U5C fluctuated over time (34.6% in 2007, 35.4% in 2011, 42.0% in 2014, and 39.8% in 2017). Profound socioeconomic and geographic disparities in U5MR and the prevalence of healthcare-seeking for pneumonia in U5C favored the wealthy, educated, and urban residents. At the same time, the Sylhet division showed the worst situation for U5MR. There were also sex-related disparities in U5MR (PAR = -4.5, 95% confidence interval: -5.3 to -3.7) with higher risk among male children than females. Conclusion: These results indicate that improving disadvantaged women, such as the poor, uneducated, and rural inhabitants, who exhibit disproportionate disparities in U5MR and healthcare-seeking behavior is important. To reduce childhood mortality, it is essential to improve healthcare-seeking for pneumonia among U5C. Facilitating women for better education and economic encompasses would help reducing disparity.

Hepatitis C virus infection could be a risk factor for adult-onset vitiligo in Egyptian patients: A cross-sectional study.

BACKGROUND: Vitiligo is a common skin disorder resulting from the destruction of melanocytes. Hepatitis C virus (HCV) infection has been linked to a variety of extrahepatic manifestations, including skin diseases. AIM: To measure the prevalence of HCV-seroreactivity among vitiligo patients. METHODS: This cross-sectional study included 108 vitiligo patients. Serum anti-HCV antibodies were detected by chemiluminescence immunoassay. RESULTS: Eighteen patients (16.7%) out of 108 were HCV-reactive; all of them had adult-onset vitiligo. They represented approximately 34.6% of the total patients with adult-onset vitiligo (52 patients). On the contrary, all patients with childhood-onset vitiligo were HCV-non-reactive. Moreover, adult-onset vitiligo was significantly associated with HCV-seroreactivity (p < .001). Also, there was a significant difference between HCV-reactive and HCV-non-reactive vitiligo patients regarding the age of patients and their ages at the onset of vitiligo (p < .001). CONCLUSIONS: HCV may be the triggering factor for adult-onset vitiligo, particularly in regions with a high prevalence of HCV. Therefore, patients with adult-onset vitiligo, rather than childhood-onset disease, should be screened for associated HCV infection in HCV-endemic regions.

Prediction of high-risk esophageal varices in patients with compensated cirrhosis using albumin-bilirubin-platelet score.

BACKGROUND: Despite the fact that endoscopy is the gold standard for screening of high-risk varices (HRVs) in patients with compensated cirrhosis, it is invasive, costly and not necessary for all patients. So, noninvasive tests can replace endoscopy. We aimed at evaluating the albumin-bilirubin-platelet (ALBL-PLT) score as a noninvasive test in predicting HRVs in compensated cirrhotic patients versus Baveno VI and extended Baveno VI criteria. METHODS: patients with compensated cirrhosis (n = 204) were included. Laboratory parameters, esophagogastroduodenoscopy (EGD) and liver stiffness measurement by transient elastography were done. Classification of patients according to the status of HRVs was done. We compared both groups on the basis of ALBL-PLT score, Baveno VI and extended Baveno VI criteria. RESULTS: Among the total patients, 96/204 (47%) patients had HRVs. They have higher liver stiffness measurement than those without HRVs (33 ± 13.1 versus 19.3 ± 8.25, CI, -19.94, -7.31, P value <0.001). Also, all HRVs patients have an ALBL-PLT score of more than 3. The area under the receiver operating characteristic curve for the ALBL-PLT score is higher than that for Baveno VI and extended Baveno VI criteria (0.894 versus 0.722 and 0.792, respectively). CONCLUSION: ALBL-PLT score of more than three has a good predictive value in predicting HRVs among compensated cirrhotic patients.

Two-Photon Polymerization of 2.5D and 3D Microstructures Fostering a Ramified Resting Phenotype in Primary Microglia.

Microglia are the resident macrophages of the central nervous system and contribute to maintaining brain's homeostasis. Current 2D "petri-dish" in vitro cell culturing platforms employed for microglia, are unrepresentative of the softness or topography of native brain tissue. This often contributes to changes in microglial morphology, exhibiting an amoeboid phenotype that considerably differs from the homeostatic ramified phenotype in healthy brain tissue. To overcome this problem, multi-scale engineered polymeric microenvironments are developed and tested for the first time with primary microglia derived from adult rhesus macaques. In particular, biomimetic 2.5D micro- and nano-pillar arrays (diameters = 0.29-1.06 µm), featuring low effective shear moduli (0.25-14.63 MPa), and 3D micro-cages (volume = 24 × 24 × 24 to 49 × 49 × 49 µm3) with and without micro- and nano-pillar decorations (pillar diameters = 0.24-1 µm) were fabricated using two-photon polymerization (2PP). Compared to microglia cultured on flat substrates, cells growing on the pillar arrays exhibit an increased expression of the ramified phenotype and a higher number of primary branches per ramified cell. The interaction between the cells and the micro-pillar-decorated cages enables a more homogenous 3D cell colonization compared to the undecorated ones. The results pave the way for the development of improved primary microglia in vitro models to study these cells in both healthy and diseased conditions.

Magnetic Iron-Improved Growth, Leaf Chemical Content, Yield, and Fruit Quality of Chinese Mandarin Trees Grown under Soil Salinity Stress.

Chinese mandarin fruits are an inexpensive and rich source of vitamin C. They have potential benefits in treating acute respiratory infections and mitigating inflammation in critical patients with COVID-19. In Egypt, citrus is the most important fruit tree but is sensitive to salinity stress, resulting in poor vegetative tree growth and reductions in productivity and fruit quality. Magnetic iron has emerged as a promising approach in the citrus tree industry, since it improves vegetative growth, yield, and fruit quality and alleviates salinity stress in Chinese mandarin trees grown in soils suffering from high salt stress. This research is aimed at studying the influence of adding magnetic iron (as soil treatment) on tree canopy growth, yield, and fruit quality of 'Chinese' mandarin trees. Therefore, the treatments were as follows: 0, 250, 500, and or 750 g of magnetic iron.tree-1. Our results indicated that all applications of magnetic iron significantly improved tree canopy volume, leaf total chlorophyll, relative water content, yield (kg.tree-1), and the fruit physical and chemical characteristics of Chinese mandarin. In contrast, leaf Na and Cl content, (%), proline, and total phenolic content were decreased by magnetic iron soil treatments. In respect to vegetative growth, our results indicated that adding magnetic iron at the concentration 750 g.tree-1 caused the best values of tree canopy volume. A similar trend was noticed regarding yield. The increase in yield attained was nearly 19%; the best values were obtained when magnetic iron were used at 750 g.tree-1. In conclusion, the application of magnetic iron can lead to improved fruit production and fruit quality of Chinese mandarin trees grown in salinity stress conditions.

Hydrogel Improved Growth and Productive Performance of Mango Trees under Semi-Arid Condition.

Nowadays, the production of new mango cultivars is increased in many countries worldwide. The soil application of hydrogel represents a novel approach in the fruit trees industry. This investigation aims to study the effect of adding hydrogel (as soil conditioner) on the growth and yield of Shelly cv. mango trees. The experimental groups were assigned to a control group and three other treated groups, including 250, 500, or 750 g hydrogel∙tree-1. The results demonstrated that all applications of hydrogel composite had higher vegetative growth parameters, yield, and fruit quality characteristics of Shelly cv. mango trees compared to the control. The treatment of 750 g hydrogel∙tree-1 had higher values of vegetative growth parameters such as the leaf area, shoot length and tree canopy volume, compared to the control group and the other treatments. Similarly, higher values for yield and fruit quality were observed in the treatment of 750 g hydrogel∙tree-1. In conclusion, different amounts of hydrogel agent can improve the production and fruit quality of Shelly cv. mango trees in arid and semi-arid conditions in a dose-dependent manner.

Mechanisms and kinetics of greywater treatment using biologically active granular activated carbon.

The high adsorption capacity of granular activated carbon (GAC) makes it an effective biofilter media for greywater (wastewater generated in households and office buildings from streams without fecal contamination). This study investigates the mechanisms and kinetics of greywater treatment using biologically active GAC (BAC). This was achieved by assessing the role of each of the sorption and biodegradation mechanisms to the overall treatment process, characterizing and modelling the adsorption capacity of the media, and analysing and modelling the kinetics of adsorption. The biodegradation mechanism was found to contribute less than 26% to the overall treatment process with biomass density of 178.71 ± 14.12 mg g-1 BAC, whereas sorption mechanisms were responsible for the remaining greywater treatment. The Freundlich isotherm was found to best-represent the equilibrium adsorption data with Freundlich constant and intensity parameter of 1.48 × 10-5 L g-1 and 0.39, respectively. Pseudo-second order and intraparticle diffusion models were created to fit the kinetics adsorption with rate constant values of 0.12 g mg-1 h-1 and 1.91 mg g-1 h-0.5 during the first 2 h of the experiment and 0.08 g mg-1 h-1 and 0.50 mg g-1 h-0.5 onwards, respectively. Intraparticle pore diffusion was determined to be the rate limiting step of the greywater treatment; some mass transfer resistance was observed due to external film diffusion at lower substrate gradients during greywater treatment. This study improves our understanding of the behaviour of GAC biofilters through understanding their treatment mechanisms and kinetics, leading to more efficient greywater treatment.