Using hardystonite as a biomaterial in biomedical and bone tissue engineering applications.

Widespread adoption for substitutes of artificial bone grafts based on proper bioceramics has been generated in recent years. Among them, calcium-silicate-based bioceramics, which possess osteoconductive properties and can directly attach to biological organs, have attracted substantial attention for broad ranges of applications in bone tissue engineering. Approaches exist for a novel strategy to promote the drawbacks of bioceramics such as the incorporation of Zn2+, Mg2+, and Zr4+ ions into calcium-silicate networks, and the improvement of their physical, mechanical, and biological properties. Recently, hardystonite (Ca2ZnSi2O7) bioceramics, as one of the most proper calcium-silicate-based bioceramics, has presented excellent biocompatibility, bioactivity, and interaction. Due to its physical, mechanical, and biological behaviors and ability to be shaped utilizing a variety of fabrication techniques, hardystonite possesses the potential to be applied in biomedical and tissue engineering, mainly bone tissue engineering. A notable potential exists for the newly developed bioceramics to help therapies supply clinical outputs. The promising review paper has been presented by considering major aims to summarize and discuss the most applicable studies carried out for its physical, mechanical, and biological behaviors.

Outcomes of transcatheter aortic valve implantation for native aortic valve regurgitation.

BACKGROUND: Large datasets of transcatheter aortic valve implantation (TAVI) for pure aortic valve regurgitation (PAVR) are scarce. AIMS: We aimed to report procedural safety and long-term clinical events (CE) in a contemporary cohort of PAVR patients treated with new-generation devices (NGD). METHODS: Patients with grade III/IV PAVR enrolled in the FRANCE-TAVI Registry were selected. The primary safety endpoint was technical success (TS) according to Valve Academic Research Consortium 3 criteria. The co-primary endpoint was defined as a composite of mortality, heart failure hospitalisation and valve reintervention at last follow-up. RESULTS: From 2015 to 2021, 227 individuals (64.3% males, median age 81.0 [interquartile range {IQR} 73.5-85.0] years, with EuroSCORE II 6.0% [IQR 4.0-10.9]) from 41 centres underwent TAVI with NGD, using either self-expanding (55.1%) or balloon-expandable valves (44.9%; p=0.50). TS was 85.5%, with a non-significant trend towards increased TS in high-volume activity centres. A second valve implantation (SVI) was needed in 8.8% of patients, independent of valve type (p=0.82). Device size was ≥29 mm in 73.0% of patients, post-procedure grade ≥III residual aortic regurgitation was rare (1.2%), and the permanent pacemaker implantation (PPI) rate was 36.0%. At 30 days, the incidences of mortality and reintervention were 8.4% and 3.5%, respectively. The co-primary endpoint reached 41.6% (IQR 34.4-49.6) at 1 year, increased up to 61.8% (IQR 52.4-71.2) at 4 years, and was independently predicted by TS, with a hazard ratio of 0.45 (95% confidence interval: 0.27-0.76); p=0.003. CONCLUSIONS: TAVI with NGD in PAVR patients is efficient and reasonably safe. Preventing the need for an SVI embodies the major technical challenge. Larger implanted valves may have limited this complication, outweighing the increased risk of PPI. Despite successful TAVI, PAVR patients experience frequent CE at long-term follow-up.

A hybrid Transformer-LSTM model apply to glucose prediction.

The global prevalence of diabetes is escalating, with estimates indicating that over 536.6 million individuals were afflicted by 2021, accounting for approximately 10.5% of the world's population. Effective management of diabetes, particularly monitoring and prediction of blood glucose levels, remains a significant challenge due to the severe health risks associated with inaccuracies, such as hypoglycemia and hyperglycemia. This study addresses this critical issue by employing a hybrid Transformer-LSTM (Long Short-Term Memory) model designed to enhance the accuracy of future glucose level predictions based on data from Continuous Glucose Monitoring (CGM) systems. This innovative approach aims to reduce the risk of diabetic complications and improve patient outcomes. We utilized a dataset which contain more than 32000 data points comprising CGM data from eight patients collected by Suzhou Municipal Hospital in Jiangsu Province, China. This dataset includes historical glucose readings and equipment calibration values, making it highly suitable for developing predictive models due to its richness and real-time applicability. Our findings demonstrate that the hybrid Transformer-LSTM model significantly outperforms the standard LSTM model, achieving Mean Square Error (MSE) values of 1.18, 1.70, and 2.00 at forecasting intervals of 15, 30, and 45 minutes, respectively. This research underscores the potential of advanced machine learning techniques in the proactive management of diabetes, a critical step toward mitigating its impact.

Radical Prostatectomy Versus Stereotactic Radiotherapy for Clinically Localised Prostate Cancer: Results of the PACE-A Randomised Trial.

BACKGROUND AND OBJECTIVE: Randomised data on patient-reported outcomes (PROs) for stereotactic body radiotherapy (SBRT) and prostatectomy in localised prostate cancer are lacking. PACE-A compared patient-reported health-related quality of life after SBRT with that after prostatectomy. METHODS: PACE is a phase 3 open-label, randomised controlled trial. PACE-A randomised men with low- to intermediate-risk localised prostate cancer to SBRT or prostatectomy (1:1). Androgen deprivation therapy (ADT) was not permitted. The coprimary outcomes were the Expanded Prostate Index Composite (EPIC-26) number of absorbent urinary pads required daily and bowel domain score at 2 yr. The secondary endpoints were clinician-reported toxicity, sexual functioning, and other PROs. KEY FINDINGS AND LIMITATIONS: In total, 123 men were randomised (60 undergoing prostatectomy and 63 SBRT) from August 2012 to February 2022. The median follow-up time was 60.7 mo. The median age was 65.5 yr and the median prostate-specific antigen (PSA) value 7.9 ng/ml; 92% had National Comprehensive Cancer Network (NCCN) intermediate-risk disease. Fifty participants received prostatectomy and 60 received SBRT. At 2 yr, 16/32 (50%) prostatectomy and three of 46 (6.5%) SBRT participants used one or more urinary pads daily (p < 0.001; 15 and two, respectively, used one pad daily); the estimated difference was 43% (95% confidence interval [CI]: 25%, 62%). At 2 yr, bowel scores were better for prostatectomy (median [interquartile range] 100 [100-100]) than for SBRT (87.5 [79.2-100]; p < 0.001), with an estimated mean difference of 8.9 between these (95% CI: 4.2, 13.7); sexual scores were worse for prostatectomy (18 [13.8-40.3]) than for SBRT (62.5 [32.0-87.5]). The limitations were slow recruitment and incomplete 2-yr PRO response rates. CONCLUSIONS AND CLINICAL IMPLICATIONS: SBRT was associated with less patient-reported urinary incontinence and sexual dysfunction, and slightly more bowel bother than prostatectomy. These randomised data should inform treatment decision-making for patients with localised, intermediate-risk prostate cancer.

Cellulose nanofibers of oil palm fronds as a filler in nanocomposite coating for corrosion protection of copper.

Cellulose nanofibers (CNF) create a physical barrier preventing contact with corrosive substances and improving corrosion prevention. Oil palm fronds (OPF), the primary source of underused biomass waste from plantations, were processed into CNF. The OPF-CNF, mixed with hydroxyethyl cellulose as the matrix, forms a nanocomposite. Corrosion analysis using electrochemical methods demonstrated that copper coated with cellulose-rich nanocomposite containing 5 % CNF had a significantly decreased corrosion rate with an efficiency of 97.92 %. This CNF-based coating, combining barrier and passivation mechanisms, enhances performance, providing a competitive, eco-friendly alternative to conventional coatings.

An ultra-sensitive ammonia sensor based on a quartz crystal microbalance using nanofibers overlaid with carboxylic group-functionalized MWCNTs.

Detecting ammonia at low concentrations is crucial in various fields, including environmental monitoring, industrial processes, and healthcare. This study explores the development and performance of an ultra-sensitive ammonia sensor using carboxylic group-functionalized multi-walled carbon nanotubes (f-MWCNTs) overlaid on polyvinyl acetate nanofibers coated on a quartz crystal microbalance (QCM). The sensor demonstrates high responsiveness, with a frequency shift response of over 120 Hz when exposed to 1.5 ppm ammonia, a sensitivity of 23.3 Hz ppm-1 over a concentration range of 1.5-7.5 ppm, and a detection limit of 50 ppb. Additionally, the sensor exhibits a rapid response time of only 14 s, excellent selectivity against other gases, such as acetic acid, formaldehyde, methanol, ethanol, propanol, benzene, toluene, and xylene, and good stability in daily use. These characteristics make the sensor a promising tool for real-time ammonia detection in diverse applications.

Diretor-Geral da OMS declara surto de mpox como uma emergência de saúde pública de importância internacional

O diretor-geral da Organização Mundial da Saúde (OMS), Tedros Adhanom Ghebreyesus, determinou que o aumento de casos de mpox na República Democrática do Congo (RDC) e em um número crescente de países na África, constitui uma emergência de saúde pública de importância internacional (ESPII) no marco do Regulamento Sanitário Internacional (2005) (RSI).

Países das Américas devem fortalecer a vigilância de mpox em face da possível disseminação de uma nova variante detectada na região da África, afirma OPAS

Em alerta epidemiológico divulgado em 8 de agosto, a Organização Pan-Americana da Saúde (OPAS) chamou a atenção dos países das Américas para fortalecerem a vigilância, incluindo a detecção laboratorial e o sequenciamento genômico dos casos confirmados, após a identificação de uma nova variante do vírus da mpox, Clado I (Clado Ib), na região da África Subsaariana. Embora a nova variante não tenha sido notificada nas Américas, os países devem permanecer alertas para possíveis casos importados.

Dia Mundial de combate à Hepatite: OPAS incentiva a ampliação do acesso a diagnóstico e tratamento

Antecipando o Dia Mundial de Combate à Hepatite (28 de julho), a Organização Pan-Americana da Saúde (OPAS) está incentivando os países a expandirem o acesso ao teste e tratamento para hepatite viral, que afeta mais de dez milhões de pessoas nas Américas, das quais apenas 23% são diagnosticadas.

Oropouche: casos de transmissão de gestante para bebê em investigação no Brasil

A Organização Pan-Americana da Saúde (OPAS) emitiu um alerta epidemiológico informando seus Estados membros sobre a identificação de possíveis casos, atualmente em investigação no Brasil, de transmissão do vírus Oropouche (OROV) da mãe para o bebê durante a gestação. O alerta recomenda reforçar a vigilância ante a possível ocorrência de casos similares em outros países com a circulação do OROV e outros arbovírus.

Diretrizes para a Detecção e Vigilância de Oropouche em possíveis casos de infecção vertical, malformação congênita ou morte fetal/Directrices para la Detección y Vigilancia de Oropouche en posibles casos de infección vertical, malformación congénita o muerte fetal

Orientaciones sobre el diagnóstico y vigilancia por laboratorio de arbovirus emergentes, incluyendo OROV, se detallan en las “Directrices para la Detección y Vigilancia de Arbovirus Emergentes en el Contexto de la Circulación de Otros Arbovirus”

Perguntas e respostas sobre o vírus Oropouche/Preguntas y respuestas sobre el virus Oropouche/ Q&A – Oropouche fever

Washington D.C., 24 de julho de 2024 (OPAS) [Atualizado em 26 de julho de 2024] – Em julho deste ano, a Organização Pan-Americana da Saúde (OPAS) emitiu alerta epidemiológico sobre um aumento nos casos notificados do vírus Oropouche (OROV) em cinco países (Brasil, Bolívia, Peru, Cuba e Colômbia) na Região das Américas. Washington D.C., 24 de julio de 2024 (OPS) [Actualizado el 26 de julio de 2024] – En julio de este año, la Organización Panamericana de la Salud (OPS) emitió una alerta epidemiológica sobre un aumento de casos reportados del virus Oropouche (OROV) en cinco países (Brasil, Bolivia, Perú, Cuba y Colombia) de la Región de las Américas. Washington D.C., 24 July 2024 (PAHO) [Updated 26 July 2024] – In July this year, the Pan American Health Organization (PAHO) issued an epidemiological alert on an increase in reported cases of Oropouche virus (OROV) in five countries (Brazil, Bolivia, Peru, Cuba and Colombia) in the Region of the Americas.

The predictive role of modified stress hyperglycemia rate in predicting early pneumonia after isolated coronary bypass surgery in patients with diabetes mellitus.

Postoperative pneumonia (PP) is one of the most serious complications following coronary artery bypass graft (CABG) surgery. The recently developed admission blood glucose (ABG)/estimated average glucose (eAG) ratio has been identified as a prognostic marker in cardiovascular diseases. This study aimed to investigate the predictive role of the modified ABG/eAG (mABG/eAG) ratio in the development of pneumonia during the early postoperative period in diabetic patients undergoing CABG surgery. In this single-center study, diabetic patients who underwent isolated coronary bypass surgery at the Training and Research Hospital between 1 January 2018 and 1 January 2023 were included. Patients who did not develop PP were assigned to the control group, while those who developed PP were assigned to the PP group. A total of 549 patients were included in the study, 478 patients in the control group (median age = 58 years [range 35-81]) and 71 patients in the PP group (median age = 63 years [37-86]). In the multivariate analysis, the use of packed blood products (odds ratio [OR] = 1.685, 95% confidence interval [CI]: 1.453 - 1.892; P = 0.027), mABG/eAG ratio (OR = 1.659, 95% CI: 1.190 - 2.397; P = 0.019), and re-intubation (OR = 1.829, 95% CI: 1.656 - 1.945; P = 0.034) were identified as independent predictors for the development of PP. Our findings demonstrate that the mABG/eAG ratio is an independent predictor of PP in diabetic patients undergoing CABG surgery. Based on our results, high-risk patients can be identified by calculating the mABG/eAG ratio.

Periprosthetic hip infection: Current concepts and the Wrightington experience.

Total hip arthroplasty (THA) is a highly successful operation performed worldwide in increasing numbers for a wide range of indications. There has been a corresponding rise in the incidence of periprosthetic joint infection of the hip (PJIH), which is a devastating complication. There is a significant variation in the definition, diagnosis and management of PJIH largely due to a lack of high-level evidence. The current standard of practice is largely based on cohort studies from high-volume centres, consensus publications amongst subject experts, and national guidance. This review describes our philosophy and practical approach of managing PJIH at a regional tertiary high-volume joint replacement centre.

Kyasanur Forest Disease: A Comprehensive Review.

Vector-borne microbial diseases are ubiquitous, and their management remains elusive. Such diseases with zoonotic potential result in public health challenges requiring additional control and preventive measures. Despite their cosmopolitan presence, vector-borne infections are neglected due to their endemicity in specified geographical regions. The Kyasanur forest disease (KFD) caused by the Kyasanur forest disease virus (KFDV) is among such diseases transmitted through ticks and localized to India. Despite its prevalence, high transmissibility, and potential to cause fatalities, KFDV has not been given the deserved attention by the governments. Further, KFDV circulates in the rural and wild geographical areas threatening infections to people living in these areas with limited access to medical and healthcare. Therefore, physicians, healthcare workers, and the general population need to understand the KFDV and its ecology, epidemiology, transmission, pathogenesis, laboratory diagnosis, and control and prevention as described comprehensively in this review.

Strengthening surgical healthcare research capacity in sub-Saharan Africa: impact of a research training programme in Nigeria.

Background: Limited research capacity has contributed to the lack of high-quality research from low-and middle-income countries. This is compounded by limited research training opportunities. Research capacity scale-up training was deployed as part of the implementation of the National Surgical, Obstetrics, Anaesthesia, and Nursing Plan for Nigeria. We report the impact of this locally contextualized efforts to scale up research capacity in sub-Saharan Africa. Methods: This is an evaluation of the training of 65 participants in research, grant writing and manuscript writing and publication. Pre- and post-training surveys using a 5-point Likert scale and open-ended questions were administered to evaluate the impact of the programme. Results: There were 39 (60%) males and 26 (40%) females aged 26-62 years (median 42 years). Thirty-nine (60%) participants had previous training in research, but only 12 (18.5%) had previously received grant writing training, and 17 (26.2%) had previously received manuscript writing and publishing training. Following training, 45 (70.3%) participants agreed that the training was relevant. The research, grant writing and manuscript writing, and publication components of the training were rated high by the participants (45-59, 70.3-92.2%). However, 41.2% felt that there was not enough time, and 32.4% felt that the training was too comprehensive. Nearly all the participants agreed that the training had improved their skills in research, grant writing and manuscript writing and publication, and more than two-thirds subsequently engaged in informal mentoring of others. Overall, participants achieved success in designing their own research projects and publishing manuscripts and grants. Three (4.6%) of the participants had gone on to become faculty for the research training programme. The three top barriers encountered following training were time constraints (67.3%), lack of funding (36.5%) and not being able to find research collaborators (25%). Conclusion: Outcome of this training programme is encouraging and highlights the feasibility and potential impact of deploying such programmes in low and middle income countries (LMICs). Despite the positive outcomes, barriers including time constraints, funding limitations, and difficulties in finding research collaborators remain to be addressed. Such training programmes need to be supported to strengthen the research capacity in this and similar settings.

Resolving Differences between MLSS and CP by Considering Rates of Change of Blood Lactate during Endurance Exercise.

PURPOSE: To develop a new method that more closely represents the heavy-to-severe exercise domain boundary by evaluating the rates of blood lactate accumulation during the constant power output exercise bouts that are employed in the assessment of the maximal lactate steady state (MLSS). METHODS: Eight well-trained male cyclists completed five exercise tests of up to 30 min for determination of the traditional MLSS (MLSSTRAD) and a further four maximal tests for determination of critical power (CP). The rates of change of blood [lactate] between 10 min and the end of exercise in the MLSS tests were plotted against the corresponding power outputs and a two-segment linear regression model was used to identify individualised breakpoints in lactate accumulation vs. power output (MLSSMOD). RESULTS: MLSSMOD was significantly higher than MLSSTRAD (297 ± 41 vs. 278 ± 41 W; P < 0.001) but was not significantly different from CP (297 ± 41 W; P > 0.05); MLSSMOD and CP were closely aligned (r: 0.97; Bias: -0.52 W; SEE: 10 W; Limits of Agreement: -20 to 19 W). The rates of change of both blood [lactate] and V̇O2 were significantly greater, and exercise intolerance occurred before 30 min, at a power output slightly above MLSSMOD. CONCLUSIONS: A novel method for evaluating blood lactate kinetics during a traditional MLSS protocol produces a modified MLSS that is not different from CP and better represents the heavy-to-severe exercise domain boundary.

Genetic and Epigenetic Biomarkers Associated with Early Relapse in Pediatric Acute Lymphoblastic Leukemia: A Focused Bioinformatics Study on DNA-Repair Genes.

Genomic instability is one of the main drivers of tumorigenesis and the development of hematological malignancies. Cancer cells can remedy chemotherapeutic-induced DNA damage by upregulating DNA-repair genes and ultimately inducing therapy resistance. Nevertheless, the association between the DNA-repair genes, drug resistance, and disease relapse has not been well characterized in acute lymphoblastic leukemia (ALL). This study aimed to explore the role of the DNA-repair machinery and the molecular mechanisms by which it is regulated in early- and late-relapsing pediatric ALL patients. We performed secondary data analysis on the Therapeutically Applicable Research to Generate Effective Treatments (TARGET)-ALL expansion phase II trial of 198 relapsed pediatric precursor B-cell ALL. Comprehensive genetic and epigenetic investigations of 147 DNA-repair genes were conducted in the study. Gene expression was assessed using Microarray and RNA-sequencing platforms. Genomic alternations, methylation status, and miRNA transcriptome were investigated for the candidate DNA-repair genes. We identified three DNA-repair genes, ALKBH3, NHEJ1, and PARP1, that were upregulated in early relapsers compared to late relapsers (p < 0.05). Such upregulation at diagnosis was significantly associated with disease-free survival and overall survival in precursor-B-ALL (p < 0.05). Moreover, PARP1 upregulation accompanied a significant downregulation of its targeting miRNA, miR-1301-3p (p = 0.0152), which was strongly linked with poorer disease-free and overall survivals. Upregulation of DNA-repair genes, PARP1 in particular, increases the likelihood of early relapse of precursor-B-ALL in children. The observation that PARP1 was upregulated in early relapsers relative to late relapsers might serve as a valid rationale for proposing alternative treatment approaches, such as using PARP inhibitors with chemotherapy.

Optimizing Gaussian process regression (GPR) hyperparameters with three metaheuristic algorithms for viscosity prediction of suspensions containing microencapsulated PCMs.

Suspensions containing microencapsulated phase change materials (MPCMs) play a crucial role in thermal energy storage (TES) systems and have applications in building materials, textiles, and cooling systems. This study focuses on accurately predicting the dynamic viscosity, a critical thermophysical property, of suspensions containing MPCMs and MXene particles using Gaussian process regression (GPR). Twelve hyperparameters (HPs) of GPR are analyzed separately and classified into three groups based on their importance. Three metaheuristic algorithms, namely genetic algorithm (GA), particle swarm optimization (PSO), and marine predators algorithm (MPA), are employed to optimize HPs. Optimizing the four most significant hyperparameters (covariance function, basis function, standardization, and sigma) within the first group using any of the three metaheuristic algorithms resulted in excellent outcomes. All algorithms achieved a reasonable R-value (0.9983), demonstrating their effectiveness in this context. The second group explored the impact of including additional, moderate-significant HPs, such as the fit method, predict method and optimizer. While the resulting models showed some improvement over the first group, the PSO-based model within this group exhibited the most noteworthy enhancement, achieving a higher R-value (0.99834). Finally, the third group was analyzed to examine the potential interactions between all twelve HPs. This comprehensive approach, employing the GA, yielded an optimized GPR model with the highest level of target compliance, reflected by an impressive R-value of 0.999224. The developed models are a cost-effective and efficient solution to reduce laboratory costs for various systems, from TES to thermal management.