Optical coherence tomography catheter-induced vasospasm of the left anterior descending artery: A case report.

Optical coherence tomography (OCT) helps identify coronary artery disease of different etiologies. Vasospasm from OCT catheter is a rarely reported complication that is more commonly seen in the right coronary artery. We report a case of OCT-catheter induced vasospasm of the left anterior descending artery that resolved with administration of nitroglycerine. Interventionalists need to weary of the occurrence of catheter-related coronary artery spasm to avoid stenting when not necessary.

The severity of distal sensory polyneuropathy increasing with HIV/AIDS stage.

Distal sensory polyneuropathy (DSP) is the most common neurological problem in HIV/AIDS Patients. It represents a complex symptom that occurs because of peripheral nerve damage related to advanced HIV disease and in association with the use of antiretroviral therapy. DSP is a frequent symptom in which the specific pathophysiology is not well understood. Recently, mitochondrial toxicity and antiretroviral toxic neuropathies have been more identified as a possible etiology of DSP. This study's objective was to determine factors associated with DSP severity in HIV/AIDS patients. This cross-sectional study was followed by 50 HIV/AIDS outpatients at some hospitals in Makassar, Indonesia who met the inclusion criteria. DSP is diagnosed using non-invasive screening tools subjective peripheral neuropathy screen (SPNS) which can determine the severity of DSP in advance. Some factors were analyzed by using Pearson's chi-square test and Spearman's correlation test. Forty-three participants (86%) had diagnosed DSP which is mostly moderate in severity (48%). Statistical analysis showed significant correlation between HIV/AIDS Stage and DSP severity (p=0.032) meanwhile CD4 count, antiretroviral, body mass index (BMI), and hemoglobin level have no significant correlation to DSP severity. In conclusion, HIV/AIDS stage and DSP severity correlate where the later the stage the more severe DSP.

The future of surgery: A case of Schatzker type II tibial plateau fracture operated with arthroscopic-assisted technique.

INTRODUCTION AND IMPORTANCE: One percent of adult fractures are tibial plateau fractures, but can represent significant morbidity for patients. Achieving anatomic reduction of the articular surface, adequate alignment, stable fixation consistent with early mobilization, and minimal soft tissue injury are the key goals of treatment. Compared to open reduction and internal fixation, the decreased invasiveness of arthroscopy-assisted percutaneous fixation translates into decreased morbidity rates. CASE PRESENTATION: A 35-year-old woman lost control of motorcycle and landed on her left knee. Immediate pain in her left knee and was unable to ambulate or move her knee. Initial radiographs showed a depressed lateral tibial plateau fracture and from computed tomography (CT) scan showed a depressed posterolateral tibial plateau fracture with incongruence of his joint space. Classifying the injury as a Schatzker type 2 tibial plateau fracture She underwent an arthroscopic-assisted open reduction internal fixation of her lateral tibial plateau. CLINICAL DISCUSSION: Various surgical methods are available for treating tibial plateau fractures, including open, fluoroscopic-assisted, and arthroscopic approaches. Promptly addressing depressed articular surfaces is crucial to prevent rapid arthrosis progression. Arthroscopic-assisted procedures offer benefits like direct visualization of reduction, treatment of intra-articular issues, and faster patient recovery. Recent advancements in arthroscopic techniques enable precise reduction without fluoroscopy, reducing soft tissue damage and the risk of complications such as infection and cartilage damage. CONCLUSION: Arthroscopic-assisted surgery offers precise treatment for Schatzker type II tibial plateau fractures, representing a promising future direction in surgery.

Trichoderma based formulations control the wilt disease of chickpea (Cicer arietinum L.) caused by Fusarium oxysporum f. sp. ciceris, better when inoculated as consortia: findings from pot experiments under field conditions.

Background: Commercial/chemical pesticides are available to control Fusarium wilt of chickpea, but these antifungals have numerous environmental and human health hazards. Amongst various organic alternatives, use of antagonistic fungi like Trichoderma, is the most promising option. Although, Trichoderma spp. are known to control Fusarium wilt in chickpea but there are no reports that indicate the biocontrol efficacy of indigenous Trichoderma spp. against the local pathogen, in relation to environmental conditions. Methods: In the present study, biological control activity of Trichoderma species formulations viz., Trichoderma asperellum, Trichoderma harzianum (strain 1), and Trichoderma harzianum (strain 2), either singly or in the form of consortia, was investigated against Fusarium oxysporum f. sp. ciceris, the cause of Fusarium wilt in chickpea, in multiyear pot trials under open field conditions. The antagonistic effect of Trichoderma spp. was first evaluated in in vitro dual culture experiments. Then the effects of Trichoderma as well as F. oxysporum, were investigated on the morphological parameters, disease incidence (DI), and disease severity (DS) of chickpea plants grown in pots. Results: In dual culture experiments, all the Trichoderma species effectively reduced the mycelial growth of F. oxysporum. T. asperellum, T. harzianum (strain 1), and T. harzianum(strain 2) declined the mycelial growth of F. oxysporumby 37.6%, 40%, and 42%. In open field pot trials, the infestation of F. oxysporum in chickpea plants significantly reduced the morphological growth of chickpea. However, the application of T. asperellum, T. harzianum (strain 1), and T. harzianum (strain 2), either singly or in the form of consortia, significantly overcome the deleterious effects of the pathogen, thereby resulted in lower DI (22.2% and 11.1%) and DS (86% and 92%), and ultimately improved the shoot length, shoot fresh weight and shoot dry weight by 69% and 72%, 67% and 73%, 68% and 75%, during the years 1 and 2, respectively, in comparison with infested control. The present study concludes the usefulness and efficacy of Trichoderma species in controlling wilt disease of chickpea plants under variable weather conditions.

Exploration of the Muribaculaceae Family in the Gut Microbiota: Diversity, Metabolism, and Function.

The gut microbiota are mainly composed of Bacteroidetes and Firmicutes and are crucial for metabolism and immunity. Muribaculaceae are a family of bacteria within the order Bacteroidetes. Muribaculaceae produce short-chain fatty acids via endogenous (mucin glycans) and exogenous polysaccharides (dietary fibres). The family exhibits a cross-feeding relationship with probiotics, such as Bifidobacterium and Lactobacillus. The alleviating effects of a plant-based diet on inflammatory bowel disease, obesity, and type 2 diabetes are associated with an increased abundance of Muribaculaceae, a potential probiotic bacterial family. This study reviews the current findings related to Muribaculaceae and systematically introduces their diversity, metabolism, and function. Additionally, the mechanisms of Muribaculaceae in the alleviation of chronic diseases and the limitations in this field of research are introduced.

On the Pore Geometry and Structure Rock Typing.

Rock typing is a vital step in oil and gas reservoir development to achieve predictions of hydrocarbon reserves, recovery, and underground storage capacity for CO2 or hydrogen. To address inaccurate initial hydrocarbon-in-place prediction and improper rock property distribution in a reservoir model, a recent rock typing method, pore geometry and structure (PGS), has revealed a more accurate prediction on connate water saturation and better grouping of capillary pressure. However, the current state still needs physical interpretations of the PGS rock typing. We have compiled thousands of experimentally measured hydraulic properties, such as permeability k within 12 orders of magnitude, porosity ϕ up to 0.9, specific surface area S S within 4 orders of magnitude, and pore size R ranges around 3 orders of magnitude. We conduct the first-ever holistic physical interpretations of the PGS rock typing using gathered data combined with analytical theory and the Kozeny-Carman equation. Surprisingly, our physics-inspired data-driven study reveals advanced findings on the PGS rock typing. These include (i) why PGS method prevails over the hydraulic flow unit rock typing, (ii) explanations to distinguish between causality and indirect relationships among hydraulic properties, rock type number, and electrical resistivity, (iii) a proposed novel method: permeability prediction from the resistivity and rock type number relationship, and (iv) a suggestion and criticism on how to avoid a recursive prediction on permeability.

Pectoral Nerve Block II for Cardiac Implantable Electronic Devices.

AIM: This study aimed to assess the feasibility and effectiveness of the pectoral nerves (PECS) II block in facilitating cardiac implantable electronic device (CIED) insertion in a sample of 120 patients, with a focus on the percentage of cases completed without additional intraoperative local anesthesia. METHODS: PECS II blocks were performed on the left side using ultrasound guidance in all 120 patients. Feasibility was assessed by the proportion of cases completed without the need for extra intraoperative local anesthetic. Secondary outcomes included the amount of additional local anesthetic used, intraoperative opioid requirements, postoperative pain scores, time to first postoperative analgesia, analgesic consumption, patient satisfaction, and block-related complications. RESULTS: Of the 120 patients, 78 (65%) required additional intraoperative local anesthetic, with a median volume of 8.2 mL (range 3-13 mL). Fifteen patients (12.5%) needed intraoperative opioid supplementation. Nine patients (7.5%) required postoperative tramadol for pain relief. In total, 98 patients (81.7%) reported high satisfaction levels with the procedure. CONCLUSIONS: The PECS II block, when combined with supplementary local anesthetic, provided effective postoperative analgesia for at least 24 h in 120 patients undergoing CIED insertion. While it did not completely replace surgical anesthesia in most cases, the PECS II block significantly contributed to a smoother intraoperative experience for patients.

Linkages between environmental sustainability, disaggregated emission, renewable energy, and energy efficiency: An evidence from BRI countries.

This paper examines the long-term and short-run causative relationship among environmental sustainability, energy efficiency, renewable energy and carbon emissions from all over sources (coal, oil and fossil fuels) and sector wise division (heat and power, transportation, residential, manufacturing and other sectors. The empirical evidence presented in this study is derived from a balanced panel dataset spanning the annual periods from 2000 to 2021. The dataset specifically focuses on a selection of BRI Countries. The Kao test demonstrates the presence of cointegration across variables such as carbon dioxide emissions, environmental suitability, energy efficiency and renewable energy. The Panel Pooled Mean Group-Autoregressive Distributed Lag (PMG-ARDL) model indicates a statistically significant positive association between the environmental sustainability and disaggregated CO2 emissions over a long-term period. The study found a positive relationship between disaggregated CO2 emissions and environmental sustainability and energy efficiency, with renewable energy sources reducing emissions. It suggests a need for a structural transition from an energy-intensive economy to a decarbonized one, with sectors like heat and power positively impacting sustainability. Implementing measures to reduce emissions is crucial for tackling climate change.

A comprehensive survey on exploring and analyzing COVID-19 mobile apps: Meta and exploratory analysis.

During the current COVID-19 pandemic, many digital solutions around the world have been proposed to cope with the deadly virus but the role of mobile-based applications is dominant one. In Pakistan, during the current COVID-19 pandemic, an array of mobile health applications (apps) and platforms have been launched to grapple with the impacts of the COVID-19 situation. In this survey, our major focus is to explore and analyze the starring role of mobile apps based on the features and functionalities to tackle the COVID-19 disease, particularly in Pakistan. In this study, over fifty (50) mobile apps have been scrapped from the well-known three different sources i.e. Google Play Store, iOS Play Store, and web source. We developed our own data set after searching through the different play stores. We have designed two criteria such that the first criteria are known as eligibility criteria, while the second one is known as assessment criteria. The features and functions of each mobile app are pinpointed and discussed against the parameters of the assessment criteria. The major parameters of assessment criteria are: (i) Home monitoring; (ii) COVID-19 awareness; (iii) contact tracing; (iv) telemedicine; (v) health education; (vi) COVID-19 surveillance; (vii) self-assessment; (viii) security; and (ix) accessibility. This study conducted exploratory analysis and quantitative meta-data analysis by adopting PRISMA guidelines. This survey article is not only discussing the function and features of each COVID-19-centered app in Pakistan, but it also sheds light on the limitations of every mobile app as well. The results of this survey might be helpful for the mobile developers to review the current app products and enhance the existing mobile platforms targeted towards the COVID-19 pandemic. This is the first attempt of its kind to present a state-of-the-art survey of the COVID-19-centered mobile health apps in Pakistan.

Optimised path planning using Enhanced Firefly Algorithm for a mobile robot.

Path planning is a crucial element of mobile robotics applications, attracting considerable interest from academics. This paper presents a path-planning approach that utilises the Enhanced Firefly Algorithm (EFA), a new meta-heuristic technique. The Enhanced Firefly Algorithm (FA) differs from the ordinary FA by incorporating a linear reduction in the α parameter. This modification successfully resolves the constraints of the normal FA. The research involves experiments on three separate maps, using the regular FA and the suggested Enhanced FA in 20 different runs for each map. The evaluation criteria encompass the algorithms' ability to move from the initial location to the final position without experiencing any collisions. The assessment of path quality relies on elements such as the distance of the path and the algorithms' ability to converge and discover optimum solutions. The results demonstrate significant improvements made by the Enhanced FA, with a 10.270% increase in the shortest collision-free path for Map 1, a 0.371% increase for Map 2, and a 0.163% increase for Map 3, compared to the regular FA. This work highlights the effectiveness of the Enhanced Firefly Algorithm in optimising path planning for mobile robotics applications, providing potential improvements in navigation efficiency and collision avoidance.

Predictor of left main coronary artery size: an intravascular ultrasound study in Southeast Asia population.

Left main (LM) percutaneous coronary intervention (PCI) has expanded rapidly in the past decade, with up to fourfold increase annually. Recent trials found that intravascular imaging (IVI)-guided LM PCI resulted in lower risks of cardiac death and stent failure due to suboptimal PCI compared to angiography-guided PCI. IVI usage has increased in recent years; however, its utilization remains variable across regions and is still incredibly low in developing countries. Furthermore, to date, there is no data about LM size in the Southeast Asian population. This study aims to determine the mean external elastic membrane (EEM) diameter, cross-sectional area (CSA) of LM, and its predictor. This is a cross-sectional observational study on 100 patients with coronary artery disease (CAD) who underwent IVUS-guided PCI with a pullback to LM in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from January 2020 until December 2022. Linear regression was used to determine the predictors of LM size. There were 100 segments of LM. LM's mean EEM diameter and CSA were 5.02 ± 0.43 mm and 19.93 ± 3.48 mm2. Body surface area (BSA) is an independent predictor of EEM diameter and CSA with a positive linear relationship (p 0.001 and p 0.0001). Hypertension is an independent predictor of EEM diameter with a positive linear relationship (p 0.034). The linear equation to predict EEM diameter and CSA were (2.741 + 1.272BSA(m2) + 0.165 hypertension (yes)) and (2.745 + 9.601BSA(m2)), respectively. The LM coronary artery size of the Southeast Asian population was comparable with the previous studies. BSA and hypertension are independent predictors of EEM diameter, with BSA being stronger than hypertension. Neither sex nor other cardiovascular risk factors affect the LM size. The knowledge of coronary artery size will help the clinician have a reference for intervention, especially when no intravascular imaging is available.

Coronary artery size based on intravascular ultrasound in Southeast Asia population.

BACKGROUND: One of the downsides of percutaneous coronary intervention (PCI) is stent failure which could be related to stent underexpansion. Hence, PCI based on an accurate coronary artery size obtained from intracoronary imaging is tremendously important. Until now, there is no data about all coronary artery dimensions in the Southeast Asian population performed by intravascular ultrasound (IVUS). The coronary artery size of 153 patients with chronic coronary syndrome (CCS) in acute or chronic settings who underwent percutaneous coronary intervention (PCI) with IVUS was examined. The mean artery size and its predictors were analyzed. RESULTS: There were 153 patients with 633 coronary artery segments: the mean left main (LM) external elastic membrane (EEM) diameter and cross-sectional area (CSA) were 5.02 ± 0.43 mm and 19.93 ± 3.48 mm2, proximal left anterior descending artery (LAD) 4.25 ± 0.42 mm and 14.34 ± 2.85 mm2, the mid-LAD 3.86 ± 0.39 mm and 11.70 ± 2.24 mm2, the distal LAD 3.32 (2.83-4.30) mm and 8.77(6.23-14.99) mm2, the proximal left circumflex artery (LCX) 3.91 ± 0.42 mm and 12.07 ± 2.53 mm2, the distal LCX 3.51 ± 0.47 mm and 9.90 (5.09-14.20) mm2, the proximal right coronary artery (RCA) 4.50 ± 0.48 mm and 16.14 ± 3.43 mm2, the mid-RCA 4.16 ± 0.420 mm and 13.74 ± 2.72 mm2, the distal RCA 3.81 ± 0.41 mm and 11.59 ± 2.46 mm2, respectively. Body surface area (BSA) is an independent predictor for the majority of epicardial coronary arteries with a positive linear relationship. CONCLUSIONS: The mean artery size of the Indonesian population was comparable with previous studies. The knowledge of coronary artery size will help the clinician to have a reference for intervention, especially when no intravascular imaging is available.

Optimizing decision-making with aggregation operators for generalized intuitionistic fuzzy sets and their applications in the tech industry.

Intuitionistic fuzzy sets (IFSs) represent a significant advancement in classical fuzzy set (FS) theory. This study advances IFS theory to generalized intuitionistic fuzzy sets (GIFSBs) and introduces novel operators GIFWAA, GIFWGA, GIFOWAA, and GIFOWGA, tailored for GIFSBs. The primary aim is to enhance decision-making capabilities by introducing aggregation operators within the GIFSB framework that align with preferences for optimal outcomes. The article introduces new operators for GIFSBs characterized by attributes like idempotency, boundedness, monotonicity and commutativity, resulting in aggregated values aligned with GIFNs. A comprehensive analysis of the relationships among these operations is conducted, offering a thorough understanding of their applicability. These operators are practically demonstrated in a multiple-criteria decision-making process for evaluating startup success in the Tech Industry.

Severe Multivessel Coronary Vasospasm From Hypovolemia: A Case Report.

Cases of coronary vasospasm leading to ST-elevation myocardial infarction (STEMI) have been described. However, hypovolemia as an etiology of coronary vasospasm has been rarely reported. We report the case of a 57-year-old male who presented to the hospital with syncope, with electrocardiogram (EKG) findings suggestive of ST elevation in the inferior leads. The catheterization lab was activated, and coronary angiography was performed, which showed no evidence of thrombotic occlusion with diffuse disease in the right coronary artery and left anterior descending artery that resolved with aggressive fluid resuscitation.

Connecting the Dots: Exploring the Interplay Between Preeclampsia and Peripartum Cardiomyopathy.

Preeclampsia and peripartum cardiomyopathy (PPCM) are significant obstetric problems that can arise during or after pregnancy. Both are known to be causes of maternal mortality and morbidity. Several recent studies have suggested a link between preeclampsia and the pathophysiology of PPCM. However, the common thread that connects the two has yet to be thoroughly and fully articulated. Here, we investigate the complex dynamics of preeclampsia and PPCM in this review. Our analysis focuses mainly on inflammatory and immunological responses, endothelial dysfunction as a shared pathway, and potential genetic predisposition to both diseases. To begin, we will look at how excessive inflammatory and immunological responses can lead to clinical symptoms of both illnesses, emphasizing the role of proinflammatory cytokines and immune cells in modifying vascular and tissue responses. Second, we consider endothelial dysfunction to be a crucial point at which endothelial damage and activation contribute to pathogenesis through increased vascular permeability, vascular dysfunction, and thrombus formation. Finally, we examine recent information suggesting genetic predispositions to preeclampsia and PPCM, such as genetic variants in genes involved in the management of blood pressure, the inflammatory response, and heart structural integrity. With this synergistic study, we seek to encourage more research and creative therapy solutions by emphasizing the need for an interdisciplinary approach to understanding and managing the connection between preeclampsia and PPCM.

Single hole, high-flow, spinal cord peri-medullary arteriovenous fistula (PMAVF) in a child, treated with transarterial embolization: A case report.

Peri-medullary arteriovenous fistula (PMAVF) is a rare spinal vascular malformation that manifests as progressive neurologic deficits or hemorrhage in the spinal canal. We report a case of high-flow PMAVF in a child, with a single feeder artery and a large venous pouch, which was successfully treated with transarterial endovascular intervention. A 2-year-old boy was referred with a progressive 2-year history of myelopathy. The MRI revealed a large venous pouch at the midthoracic spinal cord with segmental surrounding edema. A spinal angiogram confirmed high-flow PMAVF with a single feeder artery from the anterior radiculomedullary artery, draining into the peri-medullary vein. The patient underwent transarterial embolization at the distal feeder artery, resulting in gradual motor strength improvement. PMAVF is classified as type IV spinal vascular malformation, usually presenting as a large, high-flow fistula with multiple feeders, although there was only one in this case. PMAVFs are intradural and may cause severe neurologic deficits due to mass effect, venous congestion, or hemorrhage, hence requiring prompt treatment. Treatment options for PMAVF include microsurgery, endovascular intervention, or a combination of the 2. Endovascular intervention with coil or liquid embolic material is considered first-line treatment for IVc PMAVF, and effective in type IVb with good clinical outcome. PMAVF is a rare spinal vascular malformation commonly manifesting as severe neurologic deficits but has the potential of favorable outcomes with endovascular therapy. This case demonstrates a unique angioarchitecture of high-flow PMAVF with a single feeder artery and large venous pouch, treated successfully with endovascular therapy.

Bacteroides thetaiotaomicron With Concomitant Streptococcus milleri as a Cause of Purulent Pericarditis: A Case Report.

Purulent pericarditis secondary to bacterial infections is rarely seen in the current era of broad-spectrum antibiotics. Complications tend to be higher in comparison to viral or idiopathic etiologies in cases of bacterial pericarditis. Staphylococcal aureus, Streptococcus pneumoniae, or Haemophilus influenza are the more commonly identified pathogens in cases of bacterial pericarditis. We report a case of purulent pericarditis from Bacteroides thetaiotaomicron and Streptococcus milleri occurring in conjunction in a 56-year-old male. To our knowledge, there are no published case reports describing purulent pericarditis from B. thetaiotaomicron and S. milleri occurring simultaneously in the literature.

The Utility of Invasive Hemodynamic Assessment in Diagnosing Constrictive Pericarditis: A Case Report.

Pericarditis leading to constrictive physiology is rarely diagnosed given its vague presentation. Abnormal diastolic filling from a stiff pericardium brings about signs and symptoms consistent with right-sided heart failure. We report the case of a 57-year-old female who presented with worsening shortness of breath and signs of volume overload. Chest computed tomography showed evidence of pericardial calcifications with pericardial effusion. Further evaluation with right heart catheterization suggested findings diagnostic of constrictive pericarditis.

Generalized super-resolution 4D Flow MRI - using ensemble learning to extend across the cardiovascular system.

4D Flow Magnetic Resonance Imaging (4D Flow MRI) is a non-invasive measurement technique capable of quantifying blood flow across the cardiovascular system. While practical use is limited by spatial resolution and image noise, incorporation of trained super-resolution (SR) networks has potential to enhance image quality post-scan. However, these efforts have predominantly been restricted to narrowly defined cardiovascular domains, with limited exploration of how SR performance extends across the cardiovascular system; a task aggravated by contrasting hemodynamic conditions apparent across the cardiovasculature. The aim of our study was therefore to explore the generalizability of SR 4D Flow MRI using a combination of existing super-resolution base models, novel heterogeneous training sets, and dedicated ensemble learning techniques; the latter-most being effectively used for improved domain adaption in other domains or modalities, however, with no previous exploration in the setting of 4D Flow MRI. With synthetic training data generated across three disparate domains (cardiac, aortic, cerebrovascular), varying convolutional base and ensemble learners were evaluated as a function of domain and architecture, quantifying performance on both in-silico and acquired in-vivo data from the same three domains. Results show that both bagging and stacking ensembling enhance SR performance across domains, accurately predicting high-resolution velocities from low-resolution input data in-silico. Likewise, optimized networks successfully recover native resolution velocities from downsampled in-vivo data, as well as show qualitative potential in generating denoised SR-images from clinicallevel input data. In conclusion, our work presents a viable approach for generalized SR 4D Flow MRI, with the novel use of ensemble learning in the setting of advanced fullfield flow imaging extending utility across various clinical areas of interest.

Dengue Fever Culminating in Cardiac Arrest: A Case Report.

Infection from the dengue virus can manifest with a variety of clinical presentations. Cardiac involvement from dengue fever is a rarely reported phenomenon with significant morbidity and mortality. We illustrate the case of a 47-year-old male admitted to the hospital with fevers. The hospital course was complicated with cardiac arrest. Clinicians need to be weary of this rare occurrence particularly in areas with a known prevalence of dengue for prompt recognition and improved patient outcomes.