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1.
BMC Med Educ ; 24(1): 506, 2024 May 07.
Article En | MEDLINE | ID: mdl-38715022

BACKGROUND: Medical students face significant psychological stress, impacting their academic performance and well-being. The Systematic Assessment for Resilience (SAR) framework is designed to enhance resilience and mitigate stress among medical students, addressing the need for interventions within the assessment system in medical education. The aim of this study was to evaluate the implementation of SAR framework on medical students' resilience, anxiety, depression, burnout, and academic stress. METHODS: This study employed a quasi-experimental design with pre- and post-testing. It involved the training of course coordinators in implementing the SAR framework and its integration into the daily learning activities. Fourth-year medical students were assessed before and after the intervention using standardized measures of resilience, anxiety, depression, burnout, and academic stress. Data were analyzed using quantitative methods and thematic analysis for qualitative feedback. RESULTS: Post-intervention, students demonstrated a significant increase in resilience scores (p < 0.001) and a notable decrease in measures of anxiety, depression, and academic stress (p < 0.001). The burnout types were also statistically different (p < 0.001) except client-related burnout (p > 0.05). Qualitative feedback of the course coordinators highlighted an improved learning environment, increased coping strategies, and a more supportive academic culture. CONCLUSION: The SAR framework significantly contributes to enhancing medical students' resilience and reducing psychological distress. Its implementation suggests a promising approach to fostering a supportive educational environment that not only addresses the psychological challenges faced by medical students but also enhances their academic performance and overall well-being. Further research is warranted to explore the long-term impacts of SAR across different medical education contexts.


Anxiety , Depression , Resilience, Psychological , Students, Medical , Humans , Students, Medical/psychology , Female , Male , Stress, Psychological , Adaptation, Psychological , Young Adult , Education, Medical, Undergraduate , Burnout, Professional/prevention & control , Burnout, Professional/psychology , Adult
2.
Int Arch Otorhinolaryngol ; 28(2): e226-e233, 2024 Apr.
Article En | MEDLINE | ID: mdl-38618592

Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation. Objective To assess the prognostic value of polypoid changes of the middle turbinate (PCMT) in relapse of paranasal sinus polyps in patients with chronic rhinosinusitis with nasal polyp (CRSwNP) after FESS and the effect of partial middle turbinectomy (PMT) on the outcome of surgery. Methods We conducted a prospective clinical study on 60 patients with CRSwNP with and without PCMT. The patients were allocated into three groups: group I included twenty patients without PCMT; group II, twenty patients with PCMT; and group III included twenty patients with PCMT submitted to PMT. The patients were evaluated endoscopically according to the Lund-Kennedy endoscopic scoring system, radiologically according to the Lund-Mackay scoring system, and symptomatically through the 22-item Sinonasal Outcome Test (SNOT-22). Results The total postoperative Lund-Kennedy score differed significantly among the 3 groups ( p < 0.001), with a group II presenting a significantly higher total score compared to groups I and III. The Preoperative SNOT-22 score differed significantly among the three groups ( p = 0.013), with group II presenting a significantly higher score compared to group I. There was a significant association involving the 3 groups and relapse at 12 months ( p = 0.029); relapse was higher in group II (50.0%) than in groups I (20%) and III (15.0%). Conclusion There was a significant association between PCMT and the relapse of nasal polyps. Also, nasal polyposis recurred at a lower rate in the group submitted to middle turbinate resection compared to the group in whom it was preserved.

3.
Biomolecules ; 14(4)2024 Mar 26.
Article En | MEDLINE | ID: mdl-38672417

Silencing of the fragile X messenger ribonucleoprotein 1 (FMR1) gene and a consequent lack of FMR protein (FMRP) synthesis are associated with fragile X syndrome, one of the most common inherited intellectual disabilities. FMRP is a multifunctional protein that is involved in many cellular functions in almost all subcellular compartments under both normal and cellular stress conditions in neuronal and non-neuronal cell types. This is achieved through its trafficking signals, nuclear localization signal (NLS), nuclear export signal (NES), and nucleolar localization signal (NoLS), as well as its RNA and protein binding domains, and it is modulated by various post-translational modifications such as phosphorylation, ubiquitination, sumoylation, and methylation. This review summarizes the recent advances in understanding the interaction networks of FMRP with a special focus on FMRP stress-related functions, including stress granule formation, mitochondrion and endoplasmic reticulum plasticity, ribosome biogenesis, cell cycle control, and DNA damage response.


Cell Nucleolus , Cytosol , Fragile X Mental Retardation Protein , Fragile X Syndrome , Humans , Fragile X Mental Retardation Protein/metabolism , Fragile X Mental Retardation Protein/genetics , Cell Nucleolus/metabolism , Cytosol/metabolism , Fragile X Syndrome/metabolism , Fragile X Syndrome/genetics , Animals , Ribonucleoproteins/metabolism , Ribonucleoproteins/genetics , Protein Processing, Post-Translational
4.
Epileptic Disord ; 2024 Mar 27.
Article En | MEDLINE | ID: mdl-38536013

Myoclonic-tonic (MT) and spasm-tonic (ST) seizures represent distinctive features in late infantile epileptic encephalopathy (LIEE). This commentary aims to delineate the electroclinical characteristics of MT and ST seizures, setting them apart from other seizure types. Our analysis encompasses 211 ST and MT seizures observed in 31 patients diagnosed with LIEE, providing a comprehensive overview of video-EEG features and polygraphic signatures. In MT seizures, EEG findings reveal a high-voltage diffuse spike/polyspike and wave discharge, often succeeded by diffuse electrodecrements. The amplitude-integrated EEG (aEEG) signature is described as a "reversed checkmark." Conversely, ST seizures exhibit EEG findings such as a vertex positive deflection after a slow-wave and relative electrodecrement, with intermixed epileptiform discharges. In comparison to MT seizures, polygraphic characteristics in ST seizures appear more distinct, featuring a brief rhomboid shape corresponding to the spasm, followed by a lengthier rectangular shape indicative of the tonic phase of the ST seizure. While the pathophysiology of ST and MT seizures remains inadequately understood, their concurrent occurrence and association with other seizure types (tonic, epileptic spasm, myoclonic) within the temporal context of LIEE and other epileptic encephalopathies prompt us to anticipate advancements in our understanding through future research. We hope that this study serves as a foundation for unraveling these complexities in the times to come.

5.
Int Arch Otorhinolaryngol ; 28(1): e165-e169, 2024 Jan.
Article En | MEDLINE | ID: mdl-38322443

Introduction Stapes surgery was traditionally performed with the use of microscopy either through postauricular, endaural or transcanal approaches. Endoscopic stapedectomy ushered a revolution as a new technique with less complications. Objective To review the outcomes of endoscopic stapes surgery with an emphasis on intraoperative and postoperative clinical and audiological results. Data Synthesis A literature review on the PubMed, Web of Science, Scopus, the Cochrane Library, and Embase databases was conducted. Endoscopic stapes surgery or stapedotomy were the main keywords used, and we searched for studies and research published from January 2015 to October 2021. Articles on endoscopic stapes surgery were included, and qualitative and descriptive analyses of the studies and outcomes data regarding audiometric changes and postoperative complications were conducted. Articles including patients with cholesteatoma were excluded. A total of 122 studies were retrieved for qualitative and descriptive analyses and to measure the outcomes of endoscopic stapedotomy; only 12 studies met the inclusion criteria, and the rest was excluded. The meta-analysis revealed a statistically significant difference in hearing improvement. The gain in air-bone gap ranged from 9 dB to 16 dB. A low rate of operative and postoperative complications was reported. Conclusions Endoscopic stapes surgery appears to be a reasonable alternative to microscopic stapes surgery, with shorter operative times, low complication rate, and significant hearing improvement. The endoscopic technique enabled a better visualization and less scutum drilling, which was confirmed by all included studies.

6.
Acta Crystallogr E Crystallogr Commun ; 80(Pt 2): 240-246, 2024 Feb 01.
Article En | MEDLINE | ID: mdl-38333130

The title compound, C16H17N3O3, is racemic as it crystallizes in a centrosymmetric space group (P ), although the trans disposition of substituents about the central C-C bond is established. The five- and six-membered rings are oriented at a dihedral angle of 75.88 (8)°. In the crystal, N-H⋯N hydrogen bonds form chains of mol-ecules extending along the c-axis direction that are connected by inversion-related pairs of O-H⋯N into ribbons. The ribbons are linked by C-H⋯π(ring) inter-actions, forming layers parallel to the ab plane. A Hirshfeld surface analysis indicates that the most important contributions for the crystal packing are from H⋯H (45.9%), H⋯N/N⋯H (23.3%), H⋯C/C⋯H (16.2%) and H⋯O/O⋯H (12.3%) inter-actions. Hydrogen bonding and van der Waals inter-actions are the dominant inter-actions in the crystal packing. The volume of the crystal voids and the percentage of free space were calculated to be 100.94 Å3 and 13.20%, showing that there is no large cavity in the crystal packing. Evaluation of the electrostatic, dispersion and total energy frameworks indicates that the stabilization is dominated by the electrostatic energy contributions in the title compound. Moreover, the DFT-optimized structure at the B3LYP/6-311 G(d,p) level is compared with the experimentally determined mol-ecular structure in the solid state. The HOMO-LUMO behaviour was elucidated to determine the energy gap.

7.
J Adv Med Educ Prof ; 12(1): 1-7, 2024 Jan.
Article En | MEDLINE | ID: mdl-38313425

Introduction: The integration of research and teaching in medical education offers numerous benefits, fostering critical thinking and analytical skills in students. Institutions worldwide have recognized the significance of this nexus and have implemented initiatives to link teaching with discipline-based research, promoting interdisciplinary collaboration. This article aims to explore the challenges and recommendations for integrating research and teaching in medical schools and provide recommendations to overcome these challenges. Methods: We conducted a comprehensive review of the literature to identify the common challenges faced by medical institutions in integrating research and teaching. PubMed, Scopus, Web of Science, ERIC, and Google Scholar databases were searched to assess the literature that met the study objectives with explicit inclusion and exclusion criteria. We also examined successful strategies employed by some institutions to promote research-teaching integration. Results: The challenges identified include limited resources, the need to balance research and curriculum requirements, and the importance of cultivating a research-oriented institutional culture. Successful strategies involve curriculum updates, faculty motivation, and cross-disciplinary collaboration. Implementing strategies involve vertically and horizontally integrating research methodology throughout the undergraduate curriculum and cross-integrating traditional medical courses with other disciplines. Collaboration between universities, enterprises, and schools can enhance comprehensive cooperation. Conclusion: To create a research-oriented learning environment, medical institutions should address these challenges and implement effective strategies. This approach will not only nurture research-oriented healthcare professionals but also advance medical knowledge for the benefit of patient care. By addressing these challenges and implementing appropriate strategies, medical institutions can create a research-oriented learning environment, nurturing research-oriented healthcare professionals and advancing medical knowledge to improve patient care.

8.
Plants (Basel) ; 13(3)2024 Jan 29.
Article En | MEDLINE | ID: mdl-38337925

Chlorophyll content reflects plants' photosynthetic capacity, growth stage, and nitrogen status and is, therefore, of significant importance in precision agriculture. This study aims to develop a spectral and color vegetation indices-based model to estimate the chlorophyll content in aquaponically grown lettuce. A completely open-source automated machine learning (AutoML) framework (EvalML) was employed to develop the prediction models. The performance of AutoML along with four other standard machine learning models (back-propagation neural network (BPNN), partial least squares regression (PLSR), random forest (RF), and support vector machine (SVM) was compared. The most sensitive spectral (SVIs) and color vegetation indices (CVIs) for chlorophyll content were extracted and evaluated as reliable estimators of chlorophyll content. Using an ASD FieldSpec 4 Hi-Res spectroradiometer and a portable red, green, and blue (RGB) camera, 3600 hyperspectral reflectance measurements and 800 RGB images were acquired from lettuce grown across a gradient of nutrient levels. Ground measurements of leaf chlorophyll were acquired using an SPAD-502 m calibrated via laboratory chemical analyses. The results revealed a strong relationship between chlorophyll content and SPAD-502 readings, with an R2 of 0.95 and a correlation coefficient (r) of 0.975. The developed AutoML models outperformed all traditional models, yielding the highest values of the coefficient of determination in prediction (Rp2) for all vegetation indices (VIs). The combination of SVIs and CVIs achieved the best prediction accuracy with the highest Rp2 values ranging from 0.89 to 0.98, respectively. This study demonstrated the feasibility of spectral and color vegetation indices as estimators of chlorophyll content. Furthermore, the developed AutoML models can be integrated into embedded devices to control nutrient cycles in aquaponics systems.

9.
Plant Cell Rep ; 43(2): 54, 2024 Feb 05.
Article En | MEDLINE | ID: mdl-38315215

KEY MESSAGE: Arbuscular mycorrhizal fungi generated systemic acquired resistance in cucumber to Zucchini yellow mosaic virus, indicating their prospective application in the soil as a sustainable, environmentally friendly approach to inhibit the spread of pathogens. The wide spread of plant pathogens affects the whole world, causing several plant diseases and threatening national food security as it disrupts the quantity and quality of economically important crops. Recently, environmentally acceptable mitigating practices have been required for sustainable agriculture, restricting the use of chemical fertilizers in agricultural areas. Herein, the biological control of Zucchini yellow mosaic virus (ZYMV) in cucumber (Cucumis sativus L.) plants using arbuscular mycorrhizal (AM) fungi was investigated. Compared to control plants, ZYMV-infected plants displayed high disease incidence (DI) and severity (DS) with various symptoms, including severe yellow mosaic, mottling and green blisters of leaves. However, AM fungal inoculation exhibited 50% inhibition for these symptoms and limited DS to 26% as compared to non-colonized ones. The detection of ZYMV by the Enzyme-Linked Immunosorbent Assay technique exhibited a significant reduction in AM-inoculated plants (5.23-fold) compared with non-colonized ones. Besides, mycorrhizal root colonization (F%) was slightly reduced by ZYMV infection. ZYMV infection decreased all growth parameters and pigment fractions and increased the malondialdehyde (MDA) content, however, these parameters were significantly enhanced and the MDA content was decreased by AM fungal colonization. Also, the protein, proline and antioxidant enzymes (POX and CAT) were increased with ZYMV infection with more enhancements due to AM root colonization. Remarkably, defence pathogenesis-related (PR) genes such as PR-a, PR-b, and PR-10 were quickly expressed in response to AM treatment. Our findings demonstrated the beneficial function of AM fungi in triggering the plant defence against ZYMV as they caused systemic acquired resistance in cucumber plants and supported their potential use in the soil as an environment-friendly method of hindering the spread of pathogenic microorganisms sustainably.


Cucumis sativus , Mosaic Viruses , Mycorrhizae , Potyvirus , Virus Diseases , Mycorrhizae/physiology , Cucumis sativus/physiology , Symbiosis , Vegetables , Soil
10.
Sci Rep ; 14(1): 4184, 2024 Feb 20.
Article En | MEDLINE | ID: mdl-38378707

In this study, polymeric graphitic carbon nitride (g-C3N4) semiconductors was synthesized via a thermal condensation method. Subsequently, Ag/AgBr nanoparticles with varying ratios were decorated onto the g-C3N4 surface using the water/oil emulsion method. The resulting nanocomposites were characterized using XRD for phase identification and structural analysis, HR-TEM and SEM&EDAX for morphological structure, particle size, and elemental composition analysis, and XPS for investigating the chemical state and electronic structure. The impact of Ag/AgBr content on the optical properties of g-C3N4 were also studied such as (optical bandgap (Eg), refractive index (n), extinction coefficient (k), optical conductivity (σopt) and dielectric function (ε*)), Electrochemical impedance spectroscopy (EIS), PL spectroscopy and Chrono-amperometric investigations were conducted to assess the charge transfer capabilities and long-term durability of the prepared nanocomposites. The results revealed a reduction in Ag/AgBr particle size with an increase in g-C3N4 content, accompanied by a decrease in the optical bandgap from 2.444 eV to 2.393 eV. Furthermore, the nanocomposites exhibited enhanced degradation efficiencies of RhB dye, with the highest tested content of Ag/AgBr achieving 100% degradation after 120 min of irradiation. However, the challenge of catalyst separation after the degradation process remained. To address this issue, we developed a novel approach by impregnating Ag/AgBr@g-C3N4 photocatalyst onto a floating porous sponge using a simple sugar-template technique, offering potential as a reusable photocatalyst material. Furthermore, the 3D PDMS - Ag/AgBr@g-C3N4 photocatalyst was evaluated and found to maintain nearly the same photocatalytic efficiency for up to 5 consecutive cycles.

11.
NPJ Digit Med ; 7(1): 42, 2024 Feb 21.
Article En | MEDLINE | ID: mdl-38383884

A major barrier to deploying healthcare AI is trustworthiness. One form of trustworthiness is a model's robustness across subgroups: while models may exhibit expert-level performance on aggregate metrics, they often rely on non-causal features, leading to errors in hidden subgroups. To take a step closer towards trustworthy seizure onset detection from EEG, we propose to leverage annotations that are produced by healthcare personnel in routine clinical workflows-which we refer to as workflow notes-that include multiple event descriptions beyond seizures. Using workflow notes, we first show that by scaling training data to 68,920 EEG hours, seizure onset detection performance significantly improves by 12.3 AUROC (Area Under the Receiver Operating Characteristic) points compared to relying on smaller training sets with gold-standard labels. Second, we reveal that our binary seizure onset detection model underperforms on clinically relevant subgroups (e.g., up to a margin of 6.5 AUROC points between pediatrics and adults), while having significantly higher FPRs (False Positive Rates) on EEG clips showing non-epileptiform abnormalities (+19 FPR points). To improve model robustness to hidden subgroups, we train a multilabel model that classifies 26 attributes other than seizures (e.g., spikes and movement artifacts) and significantly improve overall performance (+5.9 AUROC points) while greatly improving performance among subgroups (up to +8.3 AUROC points) and decreasing false positives on non-epileptiform abnormalities (by 8 FPR points). Finally, we find that our multilabel model improves clinical utility (false positives per 24 EEG hours) by a factor of 2×.

12.
RSC Adv ; 14(9): 6324-6338, 2024 Feb 14.
Article En | MEDLINE | ID: mdl-38380235

In this research study, recovered carbon black (rCB) was obtained via pyrolysis of waste tires. The obtained rCB was then converted into activated carbon species through both chemical treatment and microwave coupled with chemical treatment as a two-step activation process. The activated carbon obtained from chemical activation was denoted as C-AC, while that obtained from exposure to microwave followed by chemical activation was labeled as MC-AC. These two structures were consequently introduced as sorbents for the removal of cadmium ions from an aqueous solution. The structural characteristics of the introduced adsorbents were confirmed using various techniques, namely X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, and energy-dispersive X-ray (EDX) spectroscopy. Additionally, textual features of these adsorbents were acquired via both scanning electron microscopy (SEM) and N2 adsorption-desorption BET surface area analyses. These two structures were then introduced for Cd ion adsorption under different operating conditions. Particularly, the effect of pH, contact time, adsorbent dose, and metal ion concentration on the efficiency of adsorption was investigated. The 1maximum adsorption capacity was detected at a pH value of 5.0, a contact time of 30 min, a sorbent dose of 0.4 g L-1, and an initial metal concentration of 50 mg L-1 using MC-AC, which exhibited nearly double the sorption capacity detected for C-AC. Kinetic studies indicated that the process of Cd(ii) adsorption is perfectly described and fitted by the pseudo-second-order model. However, adsorption isotherms for the two adsorbents were found to match the Langmuir model, referring to the occurrence of uniform monolayer adsorption for the metal ions. Thermodynamic analysis demonstrated that the adsorption process was spontaneous and endothermic.

13.
Gene ; 895: 147976, 2024 Feb 15.
Article En | MEDLINE | ID: mdl-37952748

Despite remarkable discoveries in the genetic susceptibility of coronary artery disease (CAD), a large part of heritability awaits identification. Epistasis or gene-gene interaction has a profound influence on CAD and might contribute to its missed genetic variability; however, this impact was largely unexplored. Here, we appraised the associations of gene-gene interactions and haplotypes of five polymorphisms, namely methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, angiotensin converting enzyme (ACE) insertion/deletion (I/D), apolipoprotein B (APOB) R3500Q, and apolipoprotein E (APOE) ε4 with the risk of myocardial infarction (MI) and unstable angina (UA). Gene-environment interactions with traditional risk factors and clinical data were also scrutinized. This study recruited 100 MI, 50 UA patients, and 100 apparently healthy controls. Logistic regression models were employed in association analyses. We remarked that the single locus effect of individual polymorphisms was relatively weak; however, a magnified effect of their combination via gene-gene interaction may predict MI risk after adjustment for multiple comparisons. Only MTHFR C677T, ACE I/D, and APOB R5300Q were associated with the risk of UA, and the ACE I/D-R3500Q interaction posed a decreased UA risk. APOB R3500Q was in strong linkage disequilibrium with MTHFR C677T, ACE I/D, and APE ε4 polymorphisms. The TCDGε3, CADGε4, and TADGε4-C677T-A1298C-ACE I/D-R3500Q-APOE haplotypes were associated with escalating MI risk, while the CDG or CIG-C677T-ACE I/D-R3500Q haplotype was highly protective against UA risk compared to controls. Interestingly, the CADGε4 and CAIGε3 haplotypes were strongly associated with the presence of diabetes and hypertension, respectively in MI patients; both haplotypes stratified patients according to the ECHO results. In UA, the CDG haplotype was negatively associated with the presence of diabetes or dilated heart. Conclusively, our results advocate that a stronger combined effect of polymorphisms in MTHFR, ACE, APOB, and APOE genes via gene-gene and gene-environment interactions might help in risk stratification of MI and UA patients.


Coronary Artery Disease , Diabetes Mellitus , Myocardial Infarction , Humans , Gene Frequency , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Peptidyl-Dipeptidase A/genetics , Egypt , Polymorphism, Genetic , Genetic Predisposition to Disease , Myocardial Infarction/genetics , Coronary Artery Disease/genetics , Angina, Unstable , Apolipoproteins E/genetics , Apolipoproteins B/genetics , Apolipoproteins/genetics , Case-Control Studies , Genotype
14.
Med Teach ; 46(3): 304-316, 2024 03.
Article En | MEDLINE | ID: mdl-37677074

The World Health Organization (WHO) defines the Social Determinants of Health (SDOH) as the non-medical factors influencing health outcomes. SDOH is associated with conditions in which people are born, grow, work, and live. Medical schools and licensing bodies are increasingly recognizing the need for doctors and healthcare professionals to be aware of their patient's social context and how it impacts their states of health and disease. However, there is considerable variation in the approaches of different institutions and countries to incorporating SDOH into their curricula. In order to allow clinicians to adopt a holistic approach to patient health, equipping them with extensive knowledge of SDOH would give learners the confidence, skills, knowledge, and attitudes needed to effectively engage with patients and their families. This approach aids health professionals with knowledge of the influence of the social context and cultural factors that affect patients' behaviors in relation to health. Incorporating the SDOH in medical and health professional school curricula would contribute towards adequately preparing future healthcare practitioners to provide effective, comprehensive, and equitable care, especially to marginalized and underserved populations. The Guide will take an evidence-based approach grounded in the available contemporary literature and case studies. The focus will be on integrating SDOH into undergraduate and postgraduate medical curricula to promote an understanding of the social factors that influence patients' and communities' health. Ultimately, this guide seeks to contribute to the reduction of inequalities in health.


Social Determinants of Health , Social Factors , Humans , Curriculum , Social Environment , Delivery of Health Care
15.
Int Urol Nephrol ; 56(3): 813-818, 2024 Mar.
Article En | MEDLINE | ID: mdl-37870717

PURPOSE: To evaluate the effect of separation of the glanular part of the urethral plate from the underlying glans penis with creation of a glanular groove for free accommodation of the neourethra as a new modification of Thiersch-Duplay urethroplasty in proximal hypospadias repair. PATIENTS AND METHODS: Between January 2016 and January 2022, 35 patients with proximal hypospadias underwent a modified Thiersch-Duplay two-stage procedure. The glanular portion of the urethral plate was either separated from the underlying glanular tissue or discarded if found scared with mobilization of the distal portion of the neourethra to reach the tip of the glans penis. In all patients, a few millimeter of glanular tissue is excised to create a glanular groove in which the neourethra is embedded freely. RESULTS: 35 patients were involved in this study. The patient's age at the time of operation ranged from 18 months to 10 years (median 3.7 years). The mean follow-up period was 15.7 months (ranging from 12 to 18 months). Two patients developed urethrocutaneous fistula; while, none of the patients had meatal stenosis, urethral stricture, or meatal retraction. All patients have a slit-like meatus at the tip of the penis and a good cosmetic conical shape glans appearance. CONCLUSION: We believe that in Thiersch-Duplay urethroplasty, separation of the urethral plat from the underlying glanular tissue and creation of good glandular groove to accommodate the neourethra is associated with adequate glanular closure and minimization of post-operative meatal stenosis, glanular dehiscence, and meatal retraction.


Hypospadias , Plastic Surgery Procedures , Urethral Stricture , Male , Humans , Infant , Hypospadias/surgery , Constriction, Pathologic/surgery , Follow-Up Studies , Urethra/surgery , Urethral Stricture/surgery , Treatment Outcome , Urologic Surgical Procedures, Male/methods
16.
Muscle Nerve ; 69(3): 260-272, 2024 Mar.
Article En | MEDLINE | ID: mdl-38151482

The rapid advancements in artificial intelligence (AI), including machine learning (ML), and deep learning (DL) have ushered in a new era of technological breakthroughs in healthcare. These technologies are revolutionizing the way we utilize medical data, enabling improved disease classification, more precise diagnoses, better treatment selection, therapeutic monitoring, and highly accurate prognostication. Different ML and DL models have been used to distinguish between electromyography signals in normal individuals and those with amyotrophic lateral sclerosis and myopathy, with accuracy ranging from 67% to 99.5%. DL models have also been successfully applied in neuromuscular ultrasound, with the use of segmentation techniques achieving diagnostic accuracy of at least 90% for nerve entrapment disorders, and 87% for inflammatory myopathies. Other successful AI applications include prediction of treatment response, and prognostication including prediction of intensive care unit admissions for patients with myasthenia gravis. Despite these remarkable strides, significant knowledge, attitude, and practice gaps persist, including within the field of electrodiagnostic and neuromuscular medicine. In this narrative review, we highlight the fundamental principles of AI and draw parallels with the intricacies of human brain networks. Specifically, we explore the immense potential that AI holds for applications in electrodiagnostic studies, neuromuscular ultrasound, and other aspects of neuromuscular medicine. While there are exciting possibilities for the future, it is essential to acknowledge and understand the limitations of AI and take proactive steps to mitigate these challenges. This collective endeavor holds immense potential for the advancement of healthcare through the strategic and responsible integration of AI technologies.


Amyotrophic Lateral Sclerosis , Artificial Intelligence , Humans , Machine Learning , Amyotrophic Lateral Sclerosis/diagnostic imaging , Brain , Electromyography
17.
Animals (Basel) ; 13(23)2023 Dec 01.
Article En | MEDLINE | ID: mdl-38067075

Exploring alternatives to antibiotics is imperative in reducing antibiotic resistance and antibiotic residues in poultry products. The beneficial effects of antibiotic products derived from natural sources in comparison with the synthetic ones has been reported. Pediococcus pentosaceus has been applied as an animal growth bio-promoter and probiotic. To elucidate the protective mechanisms of P. pentosaceus, this study investigated the effects of different doses of P. pentosaceus supplementation on broiler growth performance, immune function, intestinal development and histomorphology. Five hundred (500) one-day-old Ross 708 broiler chicks were randomly enrolled into five experimental groups with 20 chicks per replicate. The treatments were imposed as follows: (T1) basal diet (control); (T2) basal diet with 1 g/kg antibact 3X; (T3) basal diet with P. pentosaceus GT001 at 4.0 × 108 cfu/g; (T4) basal diet with P. pentosaceus GT001 at 8.0 × 108 cfu/g; and (T5) basal diet with P. pentosaceus GT001 at 1.2 × 109 cfu/g. Dietary inclusion of P. pentosaceus GT001 at 4.0 × 108 cfu/g significantly improved body weight gain, feed intake and lipid profile of the broilers compared to the control group (p < 0.05). The addition of P. pentosaceus GT001 significantly improved the intestinal pH of the broilers. The digestive enzymes of the broilers were impacted with the supplementation of P. pentosaceus GT001 at 4.0 × 108 cfu/g. The highest serum antioxidant production was observed in the P. pentosaceus-treated group compared to the control. P. pentosaceus GT001 at 4.0 × 108 cfu/g increased the levels of serum cytokines and immunoglobin and improved the small intestinal morphology of the broilers in comparison with the control. The load of Pedococcus spp was similar among T3, T4 and T5 but significantly higher than that of the control (T1) and the antibiotics (T2)-fed birds. The load of E. coli in the gut was significantly reduced in T3, T4 and T5 compared to T1 and T2. There was no Salmonella growth among the treatments. This study highlights the importance of probiotics in broiler diets and suggests that Pediococcus pentosaceus GT001 could be used as a feasible substitute to antimicrobials in broiler production.

18.
BMC Med Educ ; 23(1): 968, 2023 Dec 18.
Article En | MEDLINE | ID: mdl-38110914

BACKGROUND: Regardless of a proliferation of interest in reducing unsafe practices in healthcare, threats to patient safety (PS) remain high. Moreover, little attention has been paid towards the role of interprofessional education (IPE) in enhancing PS. This qualitative study was conducted to unfold the insights of the senior medical, dental and health sciences students at the University of Sharjah (UoS) in the United Arab Emirates (UAE) about PS in an online IPE-based workshop. METHODS: This inductive thematic analysis study was conducted on senior medical and health students at the Colleges of Medicine, Dental Medicine, Health Sciences, and Pharmacy of UoS. During an online workshop, students discussed plausible solutions for four real practice-based clinical scenarios with elements of unsafe healthcare practices. During the breakout rooms, the students exhibited high level of articulation and proactively participated in discussions. The data from the online workshop were transcribed and then coding, categorizing, and labelling of recurrent themes were carried out. Multiple individual deliberations, consolidation, incorporation of the identified preliminary themes, and merging and reorganizing sub-themes led to a final thematic framework. RESULTS: This work delved into the perspectives of 248 students regarding teamwork, communication, problem-solving, and other aspects concerning PS in interprofessional settings in an online workshop. The iterative process of data transcription, curating and qualitative analysis surfaced 32 codes. Later, the inductive themaric analysis yielded five themes with distinct yet interconnected nested subthemes in the context of PS in IPE settings. These themes of information sharing and grounding (problem-solving, social skills), maintaining communication (clinical reasoning, shared mental model), executing interprofessional activities (collaborative practice, collaboration scripts), professional cognitive abilities (cognitive maturity, metacognition), and negotiating professional identities (systematic change, socio-economic scaffolding) emerged as fundamental pillars for enhancing PS in healthcare. CONCLUSION: Our study demonstrated the outcome of an innovative and team-based workshop which embedded PS within a scaffold of IPE environment. This research calls for incorporation of the emerging areas of clinical reasoning, problem solving, collaborative practice, and shared mental model into medical curricula for structured IPE in improving PS domains in medical education. These findings underscore the need for multifaceted dimensions of IPE imperatives for cultivating collaborative competence.


Interprofessional Relations , Patient Safety , Humans , Interprofessional Education , Qualitative Research , Curriculum
19.
J Fungi (Basel) ; 9(12)2023 Nov 24.
Article En | MEDLINE | ID: mdl-38132732

The most significant aspect of promoting greenhouse productivity is the timely monitoring of disease spores and applying proactive control measures. This paper introduces a method to classify spores of airborne disease in greenhouse crops by using fingerprint characteristics of diffraction-polarized images and machine learning. Initially, a diffraction-polarization imaging system was established, and the diffraction fingerprint images of disease spores were taken in polarization directions of 0°, 45°, 90° and 135°. Subsequently, the diffraction-polarization images were processed, wherein the fingerprint features of the spore diffraction-polarization images were extracted. Finally, a support vector machine (SVM) classification algorithm was used to classify the disease spores. The study's results indicate that the diffraction-polarization imaging system can capture images of disease spores. Different spores all have their own unique diffraction-polarization fingerprint characteristics. The identification rates of tomato gray mold spores, cucumber downy mold spores and cucumber powdery mildew spores were 96.02%, 94.94% and 96.57%, respectively. The average identification rate of spores was 95.85%. This study can provide a research basis for the identification and classification of disease spores.

20.
Acta Crystallogr E Crystallogr Commun ; 79(Pt 11): 1037-1043, 2023 Nov 01.
Article En | MEDLINE | ID: mdl-37936855

In the title mol-ecule, C8H7NO3S, the nitro-gen atom has a planar environment, and the thia-zine ring exhibits a screw-boat conformation. In the crystal, corrugated layers of mol-ecules parallel to the ab plane are formed by N-H⋯O and C-H⋯O hydrogen bonds together with C-H⋯π(ring) and S=O⋯π(ring) inter-actions. The layers are connected by additional C-H⋯O hydrogen bonds and π-stacking inter-actions. Hirshfeld surface analysis indicates that the most important contributions for the crystal packing are from H⋯O/O⋯H (49.4%), H⋯H (23.0%) and H⋯C/C⋯H (14.1%) inter-actions. The volume of the crystal voids and the percentage of free space were calculated as 75.4 Å3 and 9.3%. Density functional theory (DFT) computations revealed N-H⋯O and C-H⋯O hydrogen-bonding energies of 43.3, 34.7 and 34.4 kJ mol-1, respectively. Evaluation of the electrostatic, dispersion and total energy frameworks indicate that the stabilization is dominated via the electrostatic energy contribution. Moreover, the DFT-optimized structure at the B3LYP/ 6-311 G(d,p) level is compared with the experimentally determined mol-ecular structure in the solid state. The HOMO-LUMO behaviour was elucidated to determine the energy gap.

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