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Obesity is a widespread health concern worldwide, necessitating diverse interventions for effective weight management. Despite prior unsuccessful attempts at weight loss through conventional methods, including dietary restrictions and physical exercises, this case underscores the challenges faced by individuals with morbid obesity. This case report presents the successful outcome of VASER liposuction followed by a 6-month postoperative ketogenic diet regimen in a 35-year-old man with a body mass index (BMI) of 40. The patient, initially weighing 127 kg with a BMI of 40.9 kg/m² and significant fatty deposition primarily on the chest, abdomen, and flanks, underwent tumescent VASER liposuction, removing 5 L of fat. Subsequently, adhering to a modified ketogenic diet plan led to a notable reduction in weight (from 127 kg to 97 kg) and BMI (from 40 to 31.5) over the 6-month follow-up period. Effective pain management postoperatively and improvements in skin retraction and energy levels were observed. The combined approach of VASER liposuction and a ketogenic diet yielded favorable outcomes, including significant weight loss, improved BMI, and enhanced body contouring. Importantly, minimal loose skin was observed despite substantial weight reduction, highlighting the synergistic effects of the intervention. This case highlights the potential synergistic effects of VASER liposuction and a ketogenic diet in addressing obesity, offering a promising approach for weight management in morbid obese individuals. The synergistic effects included enhanced skin tightening, safety, faster recovery, minimal pain, and substantial weight loss.
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Background: Mitral valve infective endocarditis (IE) still has a high mortality. Minimally invasive mitral valve surgery (MIMVS) is technically more challenging, especially in patients with endocarditis. Here, we compare the early postoperative outcome of patients with endocarditis and other indications for MIMVS. Methods: Two groups were formed, one consisting of patients who underwent surgery because of mitral valve endocarditis (IE group: n = 75) and the other group consisting of patients who had another indication for MIMVS (non-IE group: n = 862). Patients were observed for 30 postoperative days. Data were retrospectively reviewed and collected from January 2011 to September 2023. Results: Patients from the IE group were younger (60 vs. 68 years; p < 0.001) and had a higher preoperative history of stroke (26% vs. 6%; p < 0.001) with neurological symptoms (26% vs. 9%; p < 0.001). No difference was seen in overall surgery time (211 vs. 206 min; p = 0.71), time on cardiopulmonary bypass (137 vs. 137 min; p = 0.42) and aortic clamping time (76 vs. 78 min; p = 0.42). Concerning postoperative data, the IE group had a higher requirement of erythrocyte transfusion (2 vs. 0; p = 0.041). But no difference was seen in the need for a mitral valve redo procedure, bleeding, postoperative stroke, cerebral bleeding, new-onset dialysis, overall intubation time, sepsis, pacemaker implantation, wound healing disorders and 30-day mortality. Conclusions: Minimally invasive mitral valve surgery in patients with mitral valve endocarditis is feasible and safe. Infective endocarditis should not be considered as a contraindication for MIMVS.
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Background: Minimally invasive mitral valve surgery (MIMVS) is a treatment for severe mitral valve pathologies. In redo cases, especially after coronary artery bypass grafting (CABG) surgery with patent mammary bypass grafts, establishing aortic clamping followed by antegrade cardioplegia application might be challenging. Here, we present the outcome of hypothermic ventricular fibrillation as an alternative to conventional cardioprotection. Methods: Patients who underwent MIMVS either received hypothermic ventricular fibrillation (study group, n = 48) or antegrade cardioprotection (control group, n = 840) and were observed for 30 postoperative days. Data were retrospectively analyzed and collected from January 2011 until December 2022. Results: Patients in the study group had a higher preoperative prevalence of renal insufficiency (p = 0.001), extracardiac arteriopathy (p = 0.001), insulin-dependent diabetes mellitus (p = 0.001) and chronic lung disease (p = 0.036). Furthermore, they had a longer surgery time and a lower repair rate (p < 0.001). No difference, however, was seen in postoperative incidences of stroke (p = 0.26), myocardial infarction (p = 1) and mitral valve re-operation (p = 1) as well as 30-day mortality (p = 0.1) and postoperative mitral valve insufficiency or stenosis. Conclusions: The patients who underwent redo MIMVS with hypothermic ventricular fibrillation did not have worse outcomes or more serious adverse events compared to the patients who received routine conventional cardioprotection. Therefore, the use of hypothermic ventricular fibrillation appears to be a promising cardioprotective technique in this challenging patient population requiring redo MIMVS.
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Background As a result of the chronic nature of type 2 diabetes mellitus (T2DM), its complications, and treatment complexity, patients should have a comprehensive knowledge of various aspects of T2DM management and follow-up. The study aimed to assess T2DM patients' knowledge of disease complications and their screening strategies and the management targets for glucose, lipids, blood pressure, and body weight. Methods This was a cross-sectional and questionnaire-based study including 205 adult patients with T2DM from November 2023 to March 2024. The patients were randomly selected at one tertiary endocrine center and the outpatient clinics of three teaching hospitals in Basrah, southern Iraq. Social and disease-related data were collected. Another 18 T2DM-related questions were designed to assess the patients' knowledge about the aim of treatment; T2DM complications and their screening; the recommended targets for glycemic, lipid, and blood pressure control; and the recommended exercise and weight loss. We gave one point for each correct answer and considered a final score of 10/18 as adequate. Results Of a total of 205 patients, 109 (53.2) were women. The mean age for patients was 48.7 ± 13.1 years. Based on the patients' responses, 107 (52.2%) had adequate knowledge about T2DM. Questions about the target fasting and post-prandial capillary blood glucose, HbA1c target and frequency, and naming the current treatment were the most correctly answered questions (80.9%, 73.1%, 68.7%, and 72.6%, respectively). Questions about the lipid target, definition of hypoglycemia, and ideal lifestyle for T2DM (exercise and bodyweight loss) were least correctly answered. Patients younger than 40 years old, being a man, with a higher educational level, and T2DM duration of more than five years had significantly higher T2DM knowledge. Conclusions Only half of the patients had adequate T2DM knowledge. Better degree of knowledge was particularly observed in patients with younger age, male gender, higher educational level, and longer T2DM duration. There is a need to promote diabetes education strategies for people with T2DM.
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This study aimed to develop a delivery system for the dried aqueous extract of Rubia cordifolia leaves (RCE) that could improve the neuroprotective potential of RCE by improving the bioavailability of the chief chemical constituent rubiadin. Rubiadin, an anthraquinone chemically, is a biomarker phytoconstituent of RCE. Rubiadin is reported to have strong antioxidant and neuroprotective activity but demonstrates poor bioavailability. In order to resolve the problem related to bioavailability, RCE and phospholipids were reacted in disparate ratios of 1:1, 1:2, and 1:3 to prepare phytosome formulations PC1, PC2, and PC3, respectively. The formulation PC2 showed particle size of 289.1 ± 0.21 nm, ζ potential of -6.92 ± 0.10 mV, entrapment efficiency of 72.12%, and in vitro release of rubiadin of 89.42% at pH 7.4 for a period up to 48 h. The oral bioavailability and neuroprotective potential of PC2 and RCE were assessed to evaluate the benefit of PC2 formulation over the crude extract RCE. Formulation PC2 showed a relative bioavailability of 134.14% with a higher neuroprotective potential and significantly (p < 0.05) augmented the nociceptive threshold against neuropathic pain induced by partial sciatic nerve ligation method. Antioxidant enzyme levels and histopathological studies of the sciatic nerves in various treatment groups significantly divulged that PC2 has enough potential to reverse the damaged nerves into a normal state. Finally, it was concluded that encapsulated RCE as a phytosome is a potential carrier system for enhancing the delivery of RCE for the efficient treatment of neuropathic pain.
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Background: Coronary artery disease is a major cause of death globally. Minimally invasive direct coronary artery bypass (MIDCAB), using a small left anterior thoracotomy, aims to provide a less invasive alternative to traditional procedures, potentially improving patient outcomes with reduced recovery times. Methods: This retrospective, non-randomized study analyzed 310 patients who underwent MIDCAB between July 1999 and April 2022. Data were collected on demographics, clinical characteristics, operative and postoperative outcomes, and follow-up mortality and morbidity. Statistical analysis was conducted using IBM SPSS, with survival curves generated via the Kaplan-Meier method. Results: The cohort had a mean age of 63.3 ± 10.9 years, with 30.6% females. The majority of surgeries were elective (76.1%), with an average operating time of 129.7 ± 35.3 min. The median rate of intraoperative blood transfusions was 0.0 (CI 0.0-2.0) Units. The mean in-hospital stay was 8.7 ± 5.5 days, and the median ICU stay was just one day. Early postoperative complications were minimal, with a 0.64% in-hospital mortality rate. The 6-month and 1-year mortalities were 0.97%, with a 10-year survival rate of 94.3%. There were two cases of perioperative myocardial infarction and no instances of stroke or new onset dialysis. Conclusions: The MIDCAB approach demonstrates significant benefits in terms of patient recovery and long-term outcomes, offering a viable and effective alternative for patients suitable for less invasive procedures. Our results suggest that MIDCAB is a safe option with favorable survival rates, justifying its consideration in high-volume centers focused on minimally invasive techniques.
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Solitary wave solutions are of great interest to bio-mathematicians and other scientists because they provide a basic description of nonlinear phenomena with many practical applications. They provide a strong foundation for the development of novel biological and medical models and therapies because of their remarkable behavior and persistence. They have the potential to improve our comprehension of intricate biological systems and help us create novel therapeutic approaches, which is something that researchers are actively investigating. In this study, solitary wave solutions of the nonlinear Murray equation will be discovered using a modified extended direct algebraic method. These solutions represent a uniform variation in blood vessel shape and diameter that can be used to stimulate blood flow in patients with cardiovascular disease. These solutions are newly in the literature, and give researchers an important tool for grasping complex biological systems. To see how the solitary wave solutions behave, graphs are displayed using Matlab.
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Nonlinear Dynamics , Humans , Models, Cardiovascular , Blood Vessels/physiology , Blood Flow Velocity , AlgorithmsABSTRACT
INTRODUCTION: Platelet-rich plasma (PRP) is rich in factors that play a role in stem cell recruitment, inflammation modulation, and angiogenesis. With numerous preclinical and clinical studies exploring PRP as a potential treatment for erectile dysfunction (ED), this study focused on assessing the effectiveness of intracorporeal PRP injection for ED patients based on randomized controlled trials (RCTs). OBJECTIVES: The study sought to evaluate the efficacy and safety of intracorporeal injection of PRP in treating ED through a systematic review and meta-analysis of RCTs. METHODS: This study adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search was conducted on online databases (PubMed, Scopus, and ScienceDirect) to identify RCTs comparing PRP with a placebo for ED treatment. The primary outcomes assessed were the proportion of patients achieving the minimal clinically important difference in the International Index of Erectile Function (IIEF) domain and the change in the IIEF domain from baseline. The results were combined as a standardized mean difference between the PRP and placebo groups. RESULTS: Three RCTs comprising 230 patients were included. The overall effect favored PRP over placebo: total patients attaining minimal clinically important difference in the IIEF domain (odds ratio [OR], 5.64; 95% confidence interval [CI], 2.05 to 15.55; P = .0008), IIEF change from baseline (mean difference [MD], 2.99; 95% CI, 1.74 to 4.24; P = .00001), PSV (MD, 9.34; 95% CI, 0.84 to 17.84; P = .03), end-diastolic volume (standardized MD, 0.50; 95% CI, 0.17 to 0.83; P = .003), Sexual Encounter Profile question 3 (standardized MD, 0.78; 95% CI, 0.45 to 1.12; P = .00001), and visual analog scale score (MD, -0.30; 95% CI, -0.53 to -0.08; P = .008). CONCLUSION: PRP appears to be a safe and effective treatment for mild-to-moderate ED. However, further support from high-quality RCTs is needed to strengthen these findings.
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Identifying factors contributing to water salinity is paramount in efficiently managing limited water resources in arid environments. The primary objective of this study is to enhance understanding regarding the hydrochemistry, source, and mechanism of water salinity, as well as to assess the suitability of water for various uses in southern Iraq. The groundwater samples were collected from water wells and springs and analyzed for major cations and anions along with stable isotopes (δ18O and δ2H) to accomplish the objective. The analysis of major ion chemistry, hydrochemical techniques, principal component analysis (PCA), and isotope signatures were adopted to determine the primary factors contributing to water mineralization. The study inferred that evaporation and geological processes encompassing water-rock interactions, such as dissolution precipitation and ion exchange, were key processes. The stable isotope analysis revealed that the water originated from meteoric sources and underwent significant evaporation during or before infiltration. The utility assessment of water samples indicates that most samples are not appropriate for consumption and are significantly below the established standards for potable water. In contrast, a significant portion of the groundwater samples were found to meet the criteria for irrigation suitability by adopting Wilcox and the US Salinity Laboratory criteria. The groundwater could be considered for irrigation with proper salinity control management. Overall, this study has significantly improved the understanding of the hydrogeochemical regimes and acts as a first step toward the sustainable utilization of water resources.
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Drinking Water , Groundwater , Water Pollutants, Chemical , Environmental Monitoring/methods , Salinity , Iraq , Water Pollutants, Chemical/analysis , Groundwater/chemistry , Drinking Water/chemistry , Isotopes/analysisABSTRACT
OBJECTIVES: Comparing the survival rate and the cumulative success rates of custom-milled polyetherketone ketone posts and cores (MPP) with prefabricated fiber posts (PFP) in restoring compromised endodontically treated premolars. MATERIAL AND METHODS: This was a randomized, double-blind, parallel, two-arm controlled pilot study. A total of 24 patients (12 males, 12 females), each had a compromised lower premolar, needed a root canal treatment and to be restored with post and core. Patients were randomly allocated into two groups, MPP-group: restored with MPP, and PFP-group: restored with PFP and composite cores. After that, premolars were restored with single porcelain fused to metal (PFM) crowns. Clinical and radiographic follow-ups were conducted after 3, 6, and 12 months. The Kaplan-Meier, log-Rank, and χ2 tests were used to investigate differences between the two groups at the 0.05 significance level. RESULTS: The survival rate after 12 months in the MPP and PFP groups was 66.7% and 100%, respectively. Meanwhile, the cumulative success rates were 63.6% and 100% in the same order. The log-rank test showed a significant difference between the two groups (p = .031). The difference in cumulative success rates was also significant, as the χ2 test revealed (p = .011). CONCLUSION: The PFP group showed a higher success rate than the MPP group and according to the failure types, PEKK posts seem to be inferior to PFP in terms of the mechanical properties and bonding to resin mechanism. TRIAL REGISTRATION: ISRCTN, ISRCTN13456471. October, 14, 2019. (https://doi.org/10.1186/ISRCTN13456471ISRCTN13456471).
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Benzophenones , Polymers , Research Design , Female , Male , Humans , Follow-Up Studies , Pilot ProjectsABSTRACT
Vanillic acid (VA) - a naturally occurring phenolic compound in plants - is not only used as a flavoring agent but also a prominent metabolite post tea consumption. VA and its associated compounds are believed to play a significant role in preventing diseases, underscoring the need for a systematic investigation. Herein, we report a 4-step synthesis employing the classical organic reactions, such as Willamson's alkylation, Fischer-Spier reaction, and Steglich esterification, complemented with a protection-deprotection strategy to prepare 46 VA derivatives across the five series (1a-1i, 2a-2i, 3, 3a-3i, 4a-4i, 5a-5i) in high yields. The synthesized compounds were investigated for their antifungal, anti-inflammatory, and toxic effects. Notably, compound 1a demonstrated remarkable ROS inhibition with an IC50 value of 5.1 ± 0.7 µg/mL, which is more than twice as effective as the standard ibuprofen drug. A subset of the synthesized derivatives (2b, 2c, 2e, 3b-3d, 4a-4c, 5a, and 5e) manifested their antifungal effect against drug-resistant Candida strains. Compound 5g, in particular, revealed synergism with the established antifungal drugs amphotericin B (AMB) and fluconazole (FLZ), doubling FLZ's potency against azole resistant Candida albican ATCC 36082. Furthermore, 5g improved the potency of these antifungals against FLZ-sensitive strains, including C. glabrata ATCC 2001 and C. parapsilosis ATCC 22019, as well as various multidrug-resistant (MDR) Candida strains, namely C. albicans ATCC 14053, C. albicans CL1, and C. krusei SH2L OM341600. Additionally, pharmacodynamics of compound 5g was examined using time-kill assay, and a benign safety profile was observed with no hemolytic activity in whole blood, and no cytotoxicity towards the normal BJ human cell line. The synergistic potential of 5g was further investigated through both experimental methods and docking simulations.These findings highlight the therapeutic potential of VA derivatives, particularly in addressing inflammation and circumventing FLZ resistance in Candida albicans.
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Antifungal Agents , Mycoses , Humans , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Vanillic Acid/pharmacology , Vanillic Acid/therapeutic use , Azoles/pharmacology , Microbial Sensitivity Tests , Mycoses/drug therapy , Fluconazole/pharmacology , Candida , Candida albicans , Candida glabrata , Inflammation/drug therapyABSTRACT
BACKGROUND: Coronary slow flow (CSF) can occur due to various factors, such as inflammation, small vessel disease, endothelial dysfunction, and inadequate glucose control. However, the exact pathological mechanisms behind CSF remain incompletely understood. The objective of this study was to identify the risk factors associated with slow coronary flow in individuals with Type 2 Diabetes Mellitus (T2DM) who have non-obstructive coronary artery disease (CAD) and experience CSF. METHODS: We conducted a prospective cohort study involving 120 patients with T2DM who were referred for invasive coronary angiography due to typical chest pain or inconclusive results from non-invasive tests for myocardial ischemia. Using a 2 × 2 design, we categorized patients into groups based on their glycemic control (adequate or poor) and the presence of CSF (yes or no), defined by a TIMI frame count > 27. All patients had non-obstructive CAD, characterized by diameter stenosis of less than 40%. We identified many variables associated with CSF. RESULTS: Our investigation revealed no significant differences in age, sex, family history of coronary artery disease, ECG ischemia abnormalities, or echocardiographic (ECHO) data between the groups. In patients with adequate glycemic control, hypertension increased the risk of CSF by 5.33 times, smoking by 3.2 times, while dyslipidemia decreased the risk by 0.142. Additionally, hematocrit increased the risk by 2.3, and the platelet-to-lymphocyte ratio (PLR) increased the risk by 1.053. Among patients with poor glycemic control, hematocrit increased the risk by 2.63, and the Neutrophil-to-Lymphocyte Ratio (NLR) by 24.6. Notably, NLR was positively correlated with glycemic control parameters in T2DM patients with CSF. CONCLUSIONS: In T2DM patients with CSF, various factors strongly correlate with glycemic control parameters and can be employed to predict the likelihood of CSF. These factors encompass hypertension, smoking, increased body mass index (BMI), elevated platelet count, hematocrit, NLR, PLR, and C-reactive protein (CRP). TRIAL REGISTRATION: Registry: ZU-IRB (ZU-IRB#9419-3-4-2022), Registered on: 3 April 2022, Email: IRB_123@medicine.zu.edu.eg.
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Coronary Artery Disease , Diabetes Mellitus, Type 2 , Hypertension , Humans , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/complications , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/diagnosis , Cross-Sectional Studies , Prospective Studies , Coronary Angiography , Hypertension/complicationsABSTRACT
An orally administered bilayer tablet with Tamsulosin (TAM) as the sustained release (SR) and Finasteride (FIN) as immediate release (IR) was manufactured. A response surface methodology was employed to formulate bilayer tablets with individual release layers, i.e., sustained and immediate release (SR and IR). Independent variables selected in both cases comprise hydroxypropyl methylcellulose (HPMC) as SR polymer, and avicel PH102 in the inner layer while Triacetin and talc in the outer layer, respectively. Tablets were prepared by direct compression, a total of 11 formulations were prepared for inner layer TAM, and 9 formulations for outer layer FIN were designed; these formulations were evaluated for hardness, friability, thickness, %drug content, and %drug release. A central composite design was employed in response surface methodology to design and optimize the formulation. The percentage of drug released was evaluated by in-vitro USP dissolution method of optimized formulation for 0.5, 2, and 6 hrs, and results were 24.63, 52.96, and 97.68 %, respectively. Drug release data was plotted in various kinetic models using a D.D solver, where drug release was first order that is concentration dependent and was best explained by Korsmeyer-Peppa kinetics, as the highest linearity was observed (R2 = 0.9693). However, a very close relationship was also noted with Higuchi kinetics (R2 = 0.9358). The mechanism of drug release was determined through the Korsmeyer model, and exponent "n" was found to be 0.4, indicative of an anomalous diffusion mechanism or diffusion coupled with erosion.
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Electron magnetic circular dichroism (EMCD) is a powerful technique for estimating element-specific magnetic moments of materials on nanoscale with the potential to reach atomic resolution in transmission electron microscopes. However, the fundamentally weak EMCD signal strength complicates quantification of magnetic moments, as this requires very high precision, especially in the denominator of the sum rules. Here, we employ a statistical resampling technique known as bootstrapping to an experimental EMCD dataset to produce an empirical estimate of the noise-dependent error distribution resulting from application of EMCD sum rules to bcc iron in a 3-beam orientation. We observe clear experimental evidence that noisy EMCD signals preferentially bias the estimation of magnetic moments, further supporting this with error distributions produced by Monte-Carlo simulations. Finally, we propose guidelines for the recognition and minimization of this bias in the estimation of magnetic moments.
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BACKGROUND: Ischemic lesions on diffusion weighted imaging (DWI) are common after acute spontaneous intracerebral hemorrhage (ICH) but are poorly understood for large ICH volumes (> 30 mL). We hypothesized that large blood pressure drops and effect modification by cerebral small vessel disease markers on magnetic resonance imaging (MRI) are associated with DWI lesions. METHODS: This was an exploratory analysis of participants in the Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation phase 3 trial with protocolized brain MRI scans within 7 days from ICH. Multivariable logistic regression analysis was performed to assess biologically relevant factors associated with DWI lesions, and relationships between DWI lesions and favorable ICH outcomes (modified Rankin Scale 0-3). RESULTS: Of 499 enrolled patients, 300 had MRI at median 7.5 days (interquartile range 7-8), and 178 (59%) had DWI lesions. The incidence of DWI lesions was higher in patients with systolic blood pressure (SBP) reduction ≥ 80 mm Hg in first 24 h (76%). In adjusted models, factors associated with DWI lesions were as follows: admission intraventricular hematoma volume (p = 0.03), decrease in SBP ≥ 80 mm Hg from admission to day 1 (p = 0.03), and moderate-to-severe white matter disease (p = 0.01). Patients with DWI lesions had higher odds of severe disability at 1 month (p = 0.04), 6 months (p = 0.036), and 12 months (p < 0.01). No evidence of effect modification by cerebral small vessel disease on blood pressure was found. CONCLUSIONS: In patients with large hypertensive ICH, white matter disease, intraventricular hemorrhage volume, and large reductions in SBP over the first 24 h were independently associated with DWI lesions. Further investigation of potential hemodynamic mechanisms of ischemic injury after large ICH is warranted.
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Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage procedure that can potentially cure patients with large cholangiocarcinoma. The current study evaluates the impact of modifications on the outcomes of ALPPS in patients with cholangiocarcinoma. In this single-center study, a series of 30 consecutive patients with cholangiocarcinoma (22 extrahepatic and 8 intrahepatic) who underwent ALPPS between 2011 and 2021 was evaluated. The ALPPS procedure in our center was modified in 2016 by minimizing the first stage of the surgical procedure through biliary externalization after the first stage, antibiotic administration during the interstage phase, and performing biliary reconstructions during the second stage. The rate of postoperative major morbidity and 90-day mortality, as well as the one- and three-year disease-free and overall survival rates were calculated and compared between patients operated before and after 2016. The ALPPS risk score before the second stage of the procedure was lower in patients who were operated on after 2016 (before 2016: median 6.4; after 2016: median 4.4; p = 0.010). Major morbidity decreased from 42.9% before 2016 to 31.3% after 2016, and the 90-day mortality rate decreased from 35.7% before 2016 to 12.5% after 2016. The three-year survival rate increased from 40.8% before 2016 to 73.4% after 2016. Our modified ALPPS procedure improved perioperative and postoperative outcomes in patients with extrahepatic and intrahepatic cholangiocarcinoma. Minimizing the first step of the ALPPS procedure was key to these improvements.
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Cellulose, being a renewable and abundant biopolymer, has garnered significant attention for its unique properties and potential applications in hybrid materials. Understanding the hierarchical arrangement of cellulose nanofibers is crucial for developing cellulose-based materials with enhanced mechanical properties. In this study, the use of Scanning Electron Diffraction (SED) is presented to map the nanoscale orientation of cellulose fibers in a bio-composite material with a preserved wood cell structure. The SED data provides detailed insights into the ordering of cellulose with an extraordinary resolution of ≈15 nm. It enables a quantitative analysis of the fiber orientation over regions as large as entire cells. A highly organized arrangement of cellulose fibers within the secondary cell wall is observed, with a gradient of orientations toward the outer part of the wall. The in-plane fiber rotation is quantified, revealing a uniform orientation close to the middle lamella. Transversely sectioned material exhibits similar trends, suggesting a layered cell wall structure. Based on the SED data, a 3D model depicting the complex helical alignment of fibers throughout the cell wall is constructed. This study demonstrates the unique opportunities SED provides for characterizing the nanoscale hierarchical arrangement of cellulose nanofibers, empowering further research on a range of hybrid materials.
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Salmonella Typhi, a bacteria, is responsible for typhoid fever, a potentially dangerous infection. Typhoid fever affects a large number of people each year, estimated to be between 11 and 20 million, resulting in a high mortality rate of 128,000 to 161,000 deaths. This research investigates a robust numerical analytic strategy for typhoid fever that takes infection protection into consideration and incorporates fuzzy parameters. The use of fuzzy parameters acknowledges the variation in parameter values among individuals in the population, which leads to uncertainties. Because of their diverse histories, different age groups within this community may exhibit distinct customs, habits, and levels of resistance. Fuzzy theory appears as the most appropriate instrument for dealing with these uncertainty. With this in mind, a model of typhoid fever featuring fuzzy parameters is thoroughly examined. Two numerical techniques are developed within a fuzzy framework to address this model. We employ the non-standard finite difference (NSFD) scheme, which ensures the preservation of essential properties like dynamic consistency and positivity. Additionally, we conduct numerical simulations to illustrate the practical applicability of the developed technique. In contrast to many classical methods commonly found in the literature, the proposed approach exhibits unconditional convergence, solidifying its status as a dependable tool for investigating the dynamics of typhoid disease.
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Typhoid Fever , Humans , Typhoid Fever/microbiology , Salmonella typhiABSTRACT
PURPOSE: Myopia is known to be one of the most common causes of impaired vision. It is on the rise, especially among high-risk groups such as medical students. Our study aims to estimate the prevalence of myopia and characterize the associated risk factors among medical trainees in Lebanon. METHODS: This descriptive cross-sectional study targeted all medical students and residents enrolled at the Lebanese University in April 2020. Ocular history data, including refractive errors and daily activities, were collected using an online survey. The primary measure was the prevalence of myopia. The secondary measures were myopia risk factors. Associations of demographic and behavioral factors were explored, and risk factors were analyzed using multivariate logistic regression. RESULTS: Among 365 participants (mean age 22.8 years), 51.6% (185) were female. Myopia was found to be prevalent in 52.8% (193) of medical trainees, with a mean reported refractive error of -2.46 diopters in the study eye (right eye) and -2.41 diopters in the fellow eye (left eye). Three factors were significantly and independently associated with myopia prevalence, namely, history of myopia in siblings (P < 0.001), more hours of near activities (P = 0.026), and less outdoor activity (P = 0.007). CONCLUSION: By quantifying the high prevalence of myopia among medical trainees in Lebanon, as well as the established familial and behavioral risk factors, our findings congruently contribute to the global perspective of this long-studied refractive error.