Stem Cell Therapy for Myocardial Infarction and Heart Failure: A Comprehensive Systematic Review and Critical Analysis.

In exploring therapeutic options for ischemic heart disease (IHD) and heart failure, cell-based cardiac repair has gained prominence. This systematic review delves into the current state of knowledge surrounding cell-based therapies for cardiac repair. Employing a comprehensive search across relevant databases, the study identifies 35 included studies with diverse cell types and methodologies. Encouragingly, these findings reveal the promise of cell-based therapies in cardiac repair, demonstrating significant enhancements in left ventricular ejection fraction (LVEF) across the studies. Mechanisms of action involve growth factors that stimulate angiogenesis, differentiation, and the survival of transplanted cells. Despite these positive outcomes, challenges persist, including low engraftment rates, limitations in cell differentiation, and variations in clinical reproducibility. The optimal dosage and frequency of cell administration remain subjects of debate, with potential benefits from repeated dosing. Additionally, the choice between autologous and allogeneic stem cell transplantation poses a critical decision. This systematic review underscores the potential of cell-based therapies for cardiac repair, bearing implications for innovative treatments in heart diseases. However, further research is imperative to optimize cell type selection, delivery techniques, and long-term efficacy, fostering a more comprehensive understanding of cell-based cardiac repair.

Preventive Saline Irrigation of the Bile Duct to Reduce the Rate of Residual Common Bile Duct Stones Without Intraductal Ultrasonography: A Systematic Review and Meta-Analysis.

Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) has been proven efficacious in the removal of CBD stones. Even after endoscopic stone removal, recurring cholangitis due to a residual common bile duct (CBD) stone is prevalent in clinical practice with a residual recurrence rate of 4-24% after successful stone retrieval. This comprehensive study and meta-analysis aimed to determine if preventive saline irrigation of the bile duct (PSIB) reduces the amount of residual CBD stones. Through a comprehensive search of PubMed, EMBASE, Cochrane Library, and Web of Science until November 20, 2022, we identified 164 articles comparing the efficacy of PSIB and non-PSIB post-endoscopic CBD stone removal. After stringent selection, three studies were included for meta-analysis using ReviewManager (ReVman version 5.4.1; Cochrane, London, UK). Using a random effect (RE) model, we derived a pooled odds ratio (OR) with confidence interval (CI) (95%CI). A total of three studies have been included in the analysis. Out of which, two are randomized controlled trials (RCTs) and one is a non-randomized study. Out of 323 patients, 157 underwent PSIB after an endoscopic stone removal of CBD stones to reduce the residual of CBD stones, whereas 166 did not undergo saline irrigation (non-PSIB). In our analysis, PSIB significantly reduced the risk of residual stones (OR: 0.22, 95%CI: 0.11-0.45). However, there was no notable link between PSIB and post-irrigation cholangitis (OR: 1.08, 95%CI: 0.21-2.21). Although not statistically significant, PSIB showed a trend toward lowered risks of post-procedural pancreatitis (OR: 0.65), bleeding (OR: 0.68), and other complications (OR: 0.64). PSIB effectively reduces residual CBD stones after endoscopy, offering a cost-effective alternative to invasive procedures such as intraductal ultrasound (IDUS). However, larger RCTs are needed to validate its definitive role.

Development of myocarditis and pericarditis after COVID-19 vaccination in children and adolescents: A systematic review.

Myocarditis and pericarditis have been reported after COVID-19 vaccine administration in children and adolescents, raising the concern about their possible association with these vaccines. The objective was to explore the incidence, clinical presentation, and association of myocarditis and pericarditis with COVID-19 vaccines in children and adolescents. We conducted a systematic literature search on three databases, that is, Cochrane, MEDLINE/PubMed, and EMBASE from inception till March 2022. A total of three case reports, four case series, and six observational studies were included in the review. For case reports and case series, the mean age of the patients was 17.4 years, with 96.9% being male. Chest pain (n = 31, 93.9%), fever (n = 18, 54.5%), myalgias (n = 15, 45.4%) and headache (n = 9, 27.2%) were the most common presentations. Out of 33 patients, 32 (96.9%) of patients received Pfizer-BioNTech whereas only one (3.03%) received Moderna (mRNA 1273). Clinical investigations revealed ST elevation (n = 32, 97%), and elevated CRP (n = 9, 27.2%) and cardiac troponin (n = 29, 87.8%). The pooled incidence of myocarditis and pericarditis from observational studies was (0.00063%) and (0.000074%) %, respectively. Myocarditis and pericarditis in children and adolescents after the COVID-19 vaccines were more prevalent among males and more commonly observed after the second dose of Pfizer. Though the overall incidence was low, however, the clinicians should consider myocarditis and pericarditis as probable diagnosis when encountering young patients, with a history of vaccine administration, presenting with suggestive findings.

Design and Development of Best Class Discrete Production Model for Distributed Manufacturing under Industry 4.0.

Global competitiveness creates a challenge for manufacturing companies to maintain their market share with dynamic customer requirements. Capital investment in machinery does not allow facility expansion to accommodate large orders from customers but to reconfigure the manufacturing enterprise. Distributed manufacturing (DM) is embraced in order to increase facility utilization by decentralizing production. An enterprise in charge of a DM network allows customers to choose the best manufacturers available for their order based on their track record, which is available through historical and online performance data. Furthermore, manufacturers as members of this network may receive orders based on their past performance. Industry 4.0 with all necessary Industrial Internet of Things (IIoT) enables the online monitoring of production key parameters of manufacturers subscribed to a DM network. We develop a new network model of manufacturers teamed under specific terms and conditions to support a group of customers who have specific needs. The proposed model, known as the continuous supervised model, is created with the ARENA simulation software. We demonstrate the effectiveness of our model by contrasting it with the standard practice approach. To ensure the best possible performance, we continuously monitor the cost, quality, delivery time, and production rate indicators of the various manufacturers and update their performance ranking for current and future orders. Furthermore, using the analytic hierarchy process (AHP) approach, a single performance measure based on the four indicators is developed. Implementing the proposed model showed an improvement in the average performance by 51.3%.

A 2D Graphitic-Polytriaminopyrimidine (g-PTAP)/Poly(ether-block-amide) Mixed Matrix Membrane for CO2 Separation.

Poly(ether-block-amide)/g-PTAP mixed matrix membranes (MMMs) were developed by incorporating different wt.% (1-10%) of a novel 2D g-PTAP nanofiller and its effects on membrane structure and gas permeability were studied. The novel 2D material g-PTAP was synthesized and characterized by various analytical techniques including field-emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and Raman spectroscopy. The fabricated MMMs were investigated to study the interaction and compatibility between Pebax and g-PTAP. The MMMs showed an effective integration of g-PTAP nanofiller into the Pebax matrix without affecting its thermal stability. Gas permeation experiments with MMMs showed improved CO2 permeability and selectivity (CO2 /N2 ) upon incorporation of g-PTAP in the Pebax polymer matrix. The maximum CO2 permeability enhancement from 82.3 to 154.6 Barrer with highest CO2 /N2 selectivity from 49.5 to 83.5 were found with 2.5 wt.% of nanofiller compared to neat Pebax membranes.

Association of Lipid and Body Mass Index Profile With Chronic Hepatitis C Infection Stratified by Age and Gender.

Background In this study, we aimed to determine the association of lipid and body mass index (BMI) profiles among cases having chronic hepatitis C virus (CHCV) infection. Methodology This cross-sectional study was conducted in the outpatient department of a tertiary care hospital. A total of 320 cases of both genders, aged 18 to 60 years, with CHCV infection were enrolled in the study. After obtaining relevant history and conducting a physical examination, the venous blood sample of each patient was taken and sent to the institutional laboratory to analyze serum total cholesterol, serum triglyceride, low-density lipoprotein, and high-density lipoprotein levels. BMI of all the study participants was also noted. Results Of the total 320 cases, there were 152 (47.5%) males and 168 (52.5%) females. The overall mean age was 42.92 ± 11.38 years. Most cases [97 (30.3%)] were in the 41 to 50-year age group. Overall, the mean BMI was 27.75 ± 4.59 kg/m2. Dyslipidemia was noted in 144 (45.0%) cases. Increasing age and increasing BMI were found to have statistical significance with the presence of dyslipidemia (p < 0.05). Conclusions Increasing age and BMI have a significant association with dyslipidemia in patients with CHCV infection. Lipid profile appears to differ among different age and BMI groups.