Effect of different impression coping and scan body designs on the accuracy of conventional versus digital implant impressions: An in vitro study.

OBJECTIVES: This in vitro study compared the accuracy of conventional versus digital impression techniques for angulated and straight implants using two different impression coping and scan body designs. METHODS: Two implant systems were used: Straumann and Dentegris. Two implants were placed for each system, straight and angulated at 15 degrees mesiodistally. Conventional impressions were made using the splinted open-tray technique using narrow impression coping (NIC) and wide impression coping (WIC). The stone casts produced from the conventional impression were digitized with a lab scanner (3Shape D2000). Digital impressions were made using four intraoral scanners (IOS): 3Shape Trios 3, Medit i700, Cerec Omnicam, and Emerald Planmeca using short scanbodies (SSB) and long scanbodies (LSB). The scanning was repeated ten times to generate the Standard Tessellation Language (STL) files. The distance and angle deviations between impression copings and scanbodies were measured in reference to the master model. RESULTS: The trueness and precision of SSB and WIC were significantly better than LSB and NIC (p<0.001). The range trueness of the platform deviation was better with SSB (37.1 to 51.9) than LSB (89.6 to 127.9 µm) and for WIC than NIC in conventional impressions (58.2 and 75.1 µm, respectively). The trueness of the angle deviation of digital scans with SSB (0.11 to 0.25 degrees) was significantly better than scans with LSB (0.31 to 0.57 degrees) and for WIC than NIC (0.21 and 0.52 degrees, respectively). The precision of the platform deviation of digital scans with SSB (12.4 to 34.5 µm) was higher than other scans and conventional impressions (42.9 to 71.4 µm). The precision of the angle deviation of Medit i700 and Trios 3 with SSB (0.17 and 0.20 degrees, respectively) was higher than other scans with SSB and conventional impressions (0.54 to 1.63 degrees). CONCLUSIONS: Digital scans with SSB were more accurate than conventional splinted open-tray impressions. The type of impression coping and scanbody significantly affected the impression accuracy. CLINICAL SIGNIFICANCE: The use of a short scanbody can increase the accuracy of digital impressions, and wide impression coping can increase the accuracy of conventional impressions, resulting in improved clinical outcomes.

Polyurethane reinforced with micro/nano waste slag as a shielding panel for photons (experimental and theoretical study).

This study not only provides an innovative technique for producing rigid polyurethane foam (RPUF) composites, but it also offers a way to reuse metallurgical solid waste. Rigid polyurethane (RPUF) composite samples have been prepared with different proportions of iron slag as additives, with a range of 0-25% mass by weight. The process of grinding iron slag microparticles into iron slag nanoparticles powder was accomplished with the use of a high-energy ball mill. The synthesized samples have been characterized using Fourier Transform Infrared Spectroscopy, and Scanning Electron Microscope. Then, their radiation shielding properties were measured by using A hyper-pure germanium detector using point sources 241Am, 133 BA, 152 EU, 137Cs, and 60Co, with an energy range of 0.059-1.408 MeV. Then using Fluka simulation code to validate the results in the energy range of photon energies of 0.0001-100 MeV. The linear attenuation coefficient, mass attenuation coefficient, mean free path, half-value layer and tenth-value layer, were calculated to determine the radiation shielding characteristics of the composite samples. The calculated values are in good agreement with the calculated values. The results of this study showed that the gamma-ray and neutron attenuation parameters of the studied polyurethane composite samples have improved. Moreover, the effect of iron slag not only increases the gamma-ray attenuation shielding properties but also enhances compressive strength and the thermal stability. Which encourages us to use polyurethane iron-slag composite foam in sandwich panel manufacturing as walls to provide protection from radiation and also heat insulation.

The protective effects of some herbs on mitigating HFD-induced obesity via enhancing biochemical indicators and fertility in female rats.

The potential of plant-based diets and drugs to prevent and control obesity has been attributed to the presence of several biologically active phytochemicals. The study aimed to assess herb consumption's impact on alleviating the risks and hazards associated with obesity induced by a high-fat diet (HFD) and the promotion of fertility. Eighty rats were allocated into four distinct groups. Group 1 (G1) was provided with a basal diet and acted as the control group. Group 2 (G2) was provided with an HFD. Group 3 (G3) was provided with HFD supplemented with chia seeds and Hibiscus sabdariffa L. The fourth group of subjects was provided with HFD supplemented with Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander). The feeding session was sustained for 10 weeks, and the biochemical parameters were evaluated. The administration of Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander) (G4) resulted in a more significant reduction in all biochemical parameters compared to G3, which received a diet consisting of chia seeds and Hibiscus sabdariffa L. Additionally, the average number of embryonic lobes and the average number of offspring after birth were found to be considerably more significant in the normal control group (G1) and group (G4) compared to the HFD group (G2) and group (G3) (P < 0.01). Group 4 (G4) was administered a diet enriched with Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander), which demonstrated superior outcomes in many biochemical indicators and the promotion of fertility in obese female rats.

Harmonics management and hosting capacity enhancement: Optimal double-resistor damped double-tuned power filter with artificial hummingbird optimization.

This paper introduces a novel and improved double-resistor damped double-tuned passive power filter (DR-DDTF), designed using multi-objective optimization algorithms to mitigate harmonics and increase the hosting capacity of distribution systems with distributed energy resources. Although four different topologies of single-resistor damped double-tuned filters (DDTFs) have been studied before in the literature, the effectiveness of two different DR-DDTF configurations has not been examined. This work redresses this gap by demonstrating that via comprehensive simulations on two power systems, DR-DDTF provides better harmonic suppression and resonance mitigation than single-resistor alternatives. When it comes to optimizing the DR-DDTF for maximum hosting capacity and minimum system active power losses, the multi-objective artificial hummingbird outperformed six other algorithms in the benchmark. To allow for higher penetration of distributed generation without requiring grid upgrades, this newly developed harmonic mitigation filter provides a good alternative.

Influence of different printing orientations and post-polymerization time on the translucency of three-dimensional (3D) printed denture base resins.

PURPOSE: To evaluate the effect of different printing orientations and post-polymerization time with thermal cycling on the translucency of 3D-printed denture base resins. METHODS: Heat-polymerized (HP) acrylic resin specimens were fabricated and 3D-printed denture base materials (NextDent, ASIGA, FormLabs) were printed with different printing orientations (0, 45, 90 degrees) and subjected to different post-polymerization times (15-, 30-, 60-, and 90-min). All specimens were polished and immersed in distilled water for 1 day at 37°C. CIEDE2000 was used to measure the translucency parameters (TP00) before and after thermal cycling (5000 cycles) recording the color parameters (L*, a*, b*) against a black and white background using a spectrophotometer. k-factors ANOVA followed by post hoc Tukey's test (α = .05) was performed for statistical analysis. RESULTS: The k-factors ANOVA test showed a significant effect of resin material, post-polymerization time, and printing orientation on translucency (p < 0.001). In comparison to HP, all 3D-printed resins showed lower translucency with all post-polymerization times and printing orientation (p < 0.001) except FormLabs resin (p > 0.05). For all 3D-printed resins, the translucency increased, with increasing the post-polymerization time (p < 0.001) and 60- and 90-min showed the highest translucency. For printing orientation, 90 and 45 degrees significantly showed high translucency in comparison to 0 degrees (p < 0.001). FormLabs showed significantly higher translucency when compared with NextDent and ASIGA per respective printing orientation and post-polymerization time. The translucency significantly decreased after thermal cycling for all tested resins (p < 0.001). CONCLUSION: The findings of this study demonstrated that the translucency of 3D-printed resins is influenced by the printing orientation, post-polymerization time, and resin type. As a result, choosing a resin type, and printing orientation, with a longer post-polymerization time should be considered since it may improve the esthetic appearance of the 3D-printed resins.

Diagnostic Accuracy of Integrating Ultrasound and Shear Wave Elastography in Assessing Carpal Tunnel Syndrome Severity: a Prospective Observational Study.

Purpose: Carpal tunnel syndrome (CTS) is a common condition characterized by compression of the median nerve (MN) within the carpal tunnel. Accurate diagnosis and assessment of CTS severity are crucial for appropriate management decisions. This study aimed to investigate the combined diagnostic utility of B-mode ultrasound (US) and shear wave elastography (SWE) for assessing the severity of CTS in comparison to electrodiagnostic tests (EDT). Materials and Methods: This prospective observational study was conducted over 9-month periods at a tertiary care hospital. A total of 48 patients (36 females, 12 males; mean age 44 ± 10.9 years; age range 28-57 years) with clinically suspected CTS were enrolled. All patients underwent EDT, US, and SWE. Based on the EDT results, CTS cases were categorized into four groups: mild, moderate, severe, and negative. The cross-sectional area (CSA) and elasticity (E) of the MN were measured at the tunnel inlet (CSAu and Eu) and pronator quadratus region (CSAo and Eo). The differences (CSAu-CSAo and Eu-Eo) were calculated. The primary outcomes were the diagnostic performance of CSAu, CSAu-CSAo, Eu, and Eu-Eo in differentiating moderate/severe from mild/negative CTS compared to EDT findings. Secondary outcomes included a correlation of US/SWE parameters with EDT grades and between each other. ANOVA, correlation, regression, and receiver operating characteristic (ROC) curve analyses were performed. Results: CSAu and CSAu-CSAo increased progressively with worsening CTS severity. E measurements were significantly higher in moderate-to-severe CTS compared to mild or negative cases. The combined metric of CSAu-CSAo at a 5 mm threshold exhibited enhanced performance, with a higher sensitivity (83.3%), specificity (100%), and area under the curve (AUC) (0.98), surpassing the results of CSAu when used independently. Similarly, the SWE measurements indicated that Eu-Eo at a 56.1kPa cutoff achieved an AUC of 0.95, with a sensitivity of 93.3% and specificity of 94.4%, outperforming the metrics for Eu when used alone, which had an AUC of 0.93, with identical sensitivity and specificity values (93.3% and 94.4%, respectively). Conclusion: The integration of ultrasound, shear wave elastography, and electrodiagnostic tests provides a comprehensive approach to evaluate anatomical and neurological changes and guide management decisions for CTS.

Evaluation of Sechium edule fruit attenuation impact on the cardiomyopathy of the STZ-induced diabetic rats.

Sechium edule, commonly known as chayote is known for its low glycemic index, high fiber content, and rich nutritional profile, which suggests it may be beneficial for individuals with diabetes. While research specifically examining the impact of chayote on diabetes is limited, this study screened its biological impacts by using different biomarkers on streptozotocin-induced diabetic (STZ-ID) rats. The ethanolic extract of the Sechium edule fruits was assessed for different phytochemical, biochemical, and anti-diabetic properties. In the results, chayote extract had high phenolic and flavonoid contents respectively (39.25 ± 0.65 mg/mL and 12.16 ± 0.50 mg/mL). These high phenolic and flavonoid contents showed high implications on STZ-ID rats. Altogether 200 and 400 mg/kg of the extract considerably reduced the blood sugar level and enhanced the lipid profile of the STZ-ID rats. Additionally, they have decreased blood urea and serum creatinine levels. Besides, the levels of SGOT, SGPT, LDH, sodium, and potassium ions were significantly lowered after the administration period. More importantly, the electrocardiogram (ECG) parameters such as QT, RR, and QTc which were prolonged in the diabetic rats were downregulated after 35 days of administration of S. edule extract (400 mg/kg). And, the histological examination of the pancreas and kidney showed marked improvement in structural features of 200 and 400 mg/kg groups when compared to the diabetic control group. Where the increase in the glucose levels was positively correlated with QT, RR, and QTc (r2 = 0.76, r2 = 0.76, and r2 = 0.43) which means that ECG could significantly reflect the diabetes glucose levels. In conclusion, our findings showed that the fruit extract exerts a high potential to reduce artifacts secondary to diabetes which can be strongly suggested for diabetic candidates. However, there is a need to study the molecular mechanisms of the extract in combating artifacts secondary to diabetes in experimental animals.

Spatial analysis of leachate penetration at Lemna dumpsite, Calabar: Implications for sustainable waste management in Cross River State.

This study rigorously investigated the spatial analysis of leachate penetration at Lemna dumpsite, located in Calabar, Cross River State, Nigeria. Purposeful soil sampling, performed at specific intervals (5 m, 25 m, and 50 m) along the Electrical Resistivity profile line within the dumpsite, was augmented by water sample collection from five boreholes near Lemna dumpsite. Utilizing Electrical Resistivity Tomography (ERT) and Vertical Electric Sounding (VES) survey techniques, resistivity data were systematically gathered to comprehensively analyze the Leachate Penetration in the Lemna dumpsite. Laboratory analysis of soil and borehole water quality focused on Benzene, Toluene, Ethylbenzene, and Xylene (BTEX), with paired sample t-tests applied for statistical scrutiny. Analyzing the ERT and VES data employed sophisticated techniques embedded in Resistivity Two Dimension Invasion software and Advanced Geosciences Incorporation Earth Imager software. Substantial disparities (p < 0.05) emerged in the paired sample t-tests for BTEX in soil compared to National Environmental Standard Regulation and Enforcement Agency (NESREA) limits. Similarly, BTEX in borehole water displayed significant differences (p < 0.05) when compared to World Health Organization (WHO) standards, raising alarming concerns about the safety and portability of groundwater in the area. The examination of dumpsite leachate penetration revealed a resistivity anomaly of 8.01 Ωm and an inverse depth of 12.4 m, underscoring profound environmental implications and necessitating immediate remediation efforts. Additionally, Vulnerability and Aquifer Protective Capacity Index (VES) results, with a rating of <0.1, indicated severely compromised aquifer protective capacity, emphasizing the vulnerability of groundwater resources to further contamination. Our study advocates for strategic management, remediation, and monitoring measures to prevent contamination and safeguard water quality in the region.

Analysis of wind characteristics and wind energy resource assessment for Tonga using eleven methods of estimating Weibull parameters.

of wind characteristics and assessment of wind energy resource is carried out at a location in Tonga with the help of twelve months of measurements carried out at 34 m and 20 m heights above ground level. The daily, monthly and annual averages are computed. The wind shear analysis and its diurnal variation were studied and compared with the temperature variation. The turbulence levels at the two heights were estimated for the entire measurement period as well as for some typical days. For estimating the Weibull parameters, eleven methods were employed along with goodness of fit and error estimates to find the best method. The overall averaged wind speed for the entire period of study is estimated to be 4.41 m/s at 34 m above ground level. The predominant wind direction was south-east for Tonga. 'Moments' is seen to be the best method to determine accurate Weibull parameters. The average net annual energy production from one Vergnet 275 kW wind turbine is 198.57 MWh. A payback period of 8.95 years by installing five turbines near the measurement location was estimated, which is very encouraging in terms of investment. Installing wind turbines will lower the heavy reliance on the imported fossil fuels in the country and also help in achieving Sustainable Development Goal 7.

Advancements in SARS-CoV-2 detection: Navigating the molecular landscape and diagnostic technologies.

According to information from the World Health Organization, the world has experienced about 430 million cases of COVID-19, a world-wide health crisis caused by the SARS-CoV-2 virus. This outbreak, originating from China in 2019, has led to nearly 6 million deaths worldwide. As the number of confirmed infections continues to rise, the need for cutting-edge techniques that can detect SARS-CoV-2 infections early and accurately has become more critical. To address this, the Federal Drug Administration (FDA) has issued emergency use authorizations (EUAs) for a wide range of diagnostic tools. These include tests based on detecting nucleic acids and antigen-antibody reactions. The quantitative real-time reverse transcription PCR (qRT-PCR) assay stands out as the gold standard for early virus detection. However, despite its accuracy, qRT-PCR has limitations, such as complex testing protocols and a risk of false negatives, which drive the continuous improvement in nucleic acid and serological testing approaches. The emergence of highly contagious variants of the coronavirus, such as Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529), has increased the need for tests that can specifically identify these mutations. This article explores both nucleic acid-based and antigen-antibody serological assays, assessing the performance of recently approved FDA tests and those documented in scientific research, especially in identifying new coronavirus strains.

Streptococcus pneumoniae among the children of Aden, Yemen: a cross-sectional report of post-pneumococcal conjugate vaccine.

INTRODUCTION: Streptococcus pneumoniae cause a significant global health challenge. We aimed to determine nasopharyngeal carriage, serotypes distribution, and antimicrobial profile of pneumococci among the children of Aden. METHODOLOGY: A total of 385 children, aged 2-17 years, were included. Asymptomatic samples were randomly collected from children in selected schools and vaccination centers. Symptomatic samples were obtained from selected pediatric clinics. The nasopharyngeal swabs were tested for pneumococci using culture and real time polymerase chain reaction (RT-PCR). Serotyping was done with a pneumotest-latex kit and antimicrobial susceptibility was tested by disc diffusion and Epsilometer test. RESULTS: The total pneumococcal carriage was 44.4% and 57.1% by culture and RT-PCR, respectively. There was a statistically significant association between carriage rate and living in single room (OR = 7.9; p = 0.00001), sharing a sleeping space (OR = 15.1; p = 0.00001), and low monthly income (OR = 2.02; p = 0.007). The common serotypes were 19, 1, 4, 5, 2, and 23. The proportion of non-pneumococcal conjugate vaccine (non-PCV13) serotypes was 24%. Pneumococci were resistant to penicillin (96.5%), cefepime (15.8%), ceftriaxone (16.4%), and amoxicillin-clavulanate (0%). Erythromycin, azithromycin, and doxycycline had resistance rates of 48%, 31%, and 53.3%, respectively. CONCLUSIONS: A high pneumococcal carriage rate was observed in Yemeni children, particularly in low-income households and shared living conditions. There was significant penicillin resistance at meningitis breakpoint. Furthermore, non-PCV13 serotypes were gradually replacing PCV13 serotypes. The findings underscore the urgent need for enhanced surveillance and stewardship to improve vaccination and antibiotic policies in Yemen.

Does the marketing age impact growth performance, carcass traits, economic feasibility and hemato-biochemical properties of genetically-modified quails?

The meat of the quail is one of the most delicious types, as it is rich in minerals and vitamins, especially vitamin K, which is useful in treating nervous diseases. In the present investigation, based on their live body weight, 270 genetically-enhanced white quail chicks of mixed sex were randomly assigned to 3 groups, each with 90 chicks. The first group's birds were slaughtered at 28 d of age. The birds in the second group were slaughtered at 31 d, and the birds in the third group were slaughtered at 34 d. Results showed no significant difference between the various groups in the overall mortality rate index at the end of each fattening stage (P > 0.05). There were substantial variations (P ≤ 0.05) in the average live weight index between the first and both groups at each group's marketing age. With increasing marketing age, body weight increases. Quail chicks raised for 34 d received the lowest EPEF (28.90 points), followed by those raised for 31 d and 28 d, which received 33.37 and 37.32 points, respectively. The economic feasibility of the 3 groups, no significant differences in the profit index were observed at the age of 28 d. Compared to the marketing age of the other 2 groups, it was noted that the profit index decreased as the birds advanced in age. Delaying marketing to 31 d leads to a decrease in profit by 5.7%, and delaying marketing to 34 d reduces the profit index to 26.36% compared to marketing at 28 d. For blood hematology parameters, a significant increase in the studied indicators with the age of the birds was observed through the study of blood indicators. Still, it did not reach the significance level. It could be concluded that 28 d is the ideal marketing age for the enhanced white quails, as it yielded the highest economic return and the best performance.

STN localization using local field potentials based on wavelet packet features and stacking ensemble learning.

BACKGROUND: DBS entails the insertion of an electrode into the patient brain, enabling Subthalamic nucleus (STN) stimulation. Accurate delineation of STN borders is a critical but time-consuming task, traditionally reliant on the neurosurgeon experience in deciphering the intricacies of microelectrode recording (MER). While clinical outcomes of MER have been satisfactory, they involve certain risks to patient safety. Recently, there has been a growing interest in exploring the potential of local field potentials (LFP) due to their correlation with the STN motor territory. METHOD: A novel STN detection system, integrating LFP and wavelet packet transform (WPT) with stacking ensemble learning, is developed. Initial steps involve the inclusion of soft thresholding to increase robustness to LFP variability. Subsequently, non-linear WPT features are extracted. Finally, a unique ensemble model, comprising a dual-layer structure, is developed for STN localization. We harnessed the capabilities of support vector machine, Decision tree and k-Nearest Neighbor in conjunction with long short-term memory (LSTM) network. LSTM is pivotal for assigning adequate weights to every base model. RESULTS: Results reveal that the proposed model achieved a remarkable accuracy and F1-score of 89.49% and 91.63%. COMPARISON WITH EXISTING METHODS: Ensemble model demonstrated superior performance when compared to standalone base models and existing meta techniques. CONCLUSION: This framework is envisioned to enhance the efficiency of DBS surgery and reduce the reliance on clinician experience for precise STN detection. This achievement is strategically significant to serve as an invaluable tool for refining the electrode trajectory, potentially replacing the current methodology based on MER.

Two chromatographic methods for determination of cytarabine and dexamethazone; two co-administered drugs for the treatment of leukemia: green analytical perspective.

Two sensitive, straightforward and repeatable chromatographic techniques were developed for the determination of Cytarabine HCl and Dexamethazone in their pure form and spiked human plasma without prior separation. The drugs are used co-administered for the treatment of Leukemia, a certain type of blood cancer. Method (A) is an isocratic chromatographic HPLC method; separation was accomplished on C18 column using the eluting mixture of 6.9 g/L Monobasic Sodium Phosphate pH 3: methanol (70:30, v/v) and detection was at 275 nm. Concentrations were in the range of 0.2-15 µg/mL for both CYT and DEX. Method (B) is a HPTLC method in which separation was attained on HPTLC F254 plates using methanol: ethyl acetate: ammonia, (7.8:2:0.2, by volume) as eluting solvents and detection was at 275 nm. Concentrations were in the range of 0.1-4 µg/band for both CYT and DEX. The parameters for system suitability testing were evaluated to determine the effectiveness of the developed chromatographic procedures in terms of performance. The recently developed techniques were applied for the determination of the drugs under investigation in spiked human plasma. Validation parameters were examined in accordance with US-FDA criteria. All results were found to be within the acceptable ranges. To evaluate the greenness characters of the proposed methods to the environment; three greenness assessment tools including eco-scale assessments (ESA), green analytical procedure index (GAPI), and Analytical Greenness calculator (AGREE) were used. Acceptable and satisfying results that demonstrated the greenness characteristics of the suggested methods were attained.

Effect of Nano Spinel Ferrites Co0.9Cu0.1Fe2O4 on Non-Isothermal Cold Crystallization Behaviours and Kinetics of Its Composites with Polylactic Acid.

Nanoparticles of spinel ferrites with a composition of Co0.9Cu0.1Fe2O4 (AM NPs) were effectively synthesized via a hydrothermal route. The structure of ferrite nanoparticles was characterized with X-ray diffraction, which showed a single cubic spinel phase. Energy-dispersive X-ray (EDX) spectroscopy and field emission-scanning electron microscopy (FE-SEM) were employed to analyse elemental composition and surface morphology, respectively. Moreover, the effects of the Co0.9Cu0.1Fe2O4 on the morphology of [PLA = polylactic acid] nanocomposites were examined through polarized light optical microscopy (POM) and X-ray diffraction (XRD). The thermal behaviours for tested samples were studied through [DSC = differential scanning calorimetry] and [TGA = thermal gravimetric analysis]. A great number of minor PLA spherulites were detected using POM in the presence of the Co0.9Cu0.1Fe2O4 ceramic magnetic nanoparticles (AM), increasing with AM nanoparticle contents. X-ray diffraction (XRD) analysis showed that the presence of nanoparticles led to an increase in the intensity of diffraction peaks. The DSC findings implied that the crystallization behaviours for the efficient PLA as well as its nanocomposites were affected by the addition of AM nanoparticles. They act as efficient nucleating agents because they shift the temperature of crystallization to a lower value. The Avrami models were used to analyse kinetics data. The experimental data were well described using the Avrami method for all samples tested. The addition of AM to the PLA matrix resulted in a decrease in the crystallization half-time t1/2 values, indicating a faster crystallization rate. TGA data showed that the occurrence of AM nanoparticles decreased the thermal stability of PLA.

Selective targeting of chemically modified miR-34a to prostate cancer using a small molecule ligand and an endosomal escape agent.

Use of tumor-suppressive microRNAs (miRNAs) as anti-cancer agents is hindered by the lack of effective delivery vehicles, entrapment of the miRNA within endocytic compartments, and rapid degradation of miRNA by nucleases. To address these issues, we developed a miRNA delivery strategy that includes (1) a targeting ligand, (2) an endosomal escape agent, nigericin and (3) a chemically modified miRNA. The delivery ligand, DUPA (2-[3-(1,3-dicarboxy propyl) ureido] pentanedioic acid), was selected based on its specificity for prostate-specific membrane antigen (PSMA), a receptor routinely upregulated in prostate cancer-one of the leading causes of cancer death among men. DUPA was conjugated to the tumor suppressive miRNA, miR-34a (DUPA-miR-34a) based on the ability of miR-34a to inhibit prostate cancer cell proliferation. To mediate endosomal escape, nigericin was incorporated into the complex, resulting in DUPA-nigericin-miR-34a. Both DUPA-miR-34a and DUPA-nigericin-miR-34a specifically bound to, and were taken up by, PSMA-expressing cells in vitro and in vivo. And while both DUPA-miR-34a and DUPA-nigericin-miR-34a downregulated miR-34a target genes, only DUPA-nigericin-miR-34a decreased cell proliferation in vitro and delayed tumor growth in vivo. Tumor growth was further reduced using a fully modified version of miR-34a that has significantly increased stability.

Enhancing continence post holmium laser enucleation of the prostate: assessment of novel technique through randomized clinical trial.

BACKGROUND: Transient urinary incontinence (UI) is distressing event following holmium laser enucleation of the prostate (HoLEP). Novel technique namely, veil sparing HoLEP (VS-HoLEP), was proposed to improve early continence outcome. In this trial (NCT03494049), VS-HoLEP was compared to standard HoLEP (St-HoLEP). METHODS: VS-HoLEP entails early apical separation with sparing of ventral apical mucosal veil proximal to the verumontanum. Eligible symptomatic BPH patients were randomly allocated to St-HoLEP (91) and VS-HoLEP (89). The primary outcome was UI as depicted by one-hour pad test at one month postoperatively. Other outcome measures include all perioperative parameters, complications, and urinary outcome measures at different follow-up points. RESULTS: Median preoperative prostate size was 138 (50:282) and 128 (50:228) mL in St-HoLEP and VS-HoLEP groups respectively. At one month the number of patients with positive one-hour pad test was 21 (23.1%) and 10 (11.4%) in St-HoLEP and VS-HoLEP groups respectively (P 0.047). The difference was significantly in favor of VS-HoLEP considering the number of patients reporting UI, the number of patients with positive one-hour pad test as well as the grade of UI reported at one and 4 months. The difference was not statistically significant at 12 months. The median time to patients' reported continence was 8 (1-52) and 1.5 (1-52) weeks in St-HoLEP and VS-HoLEP groups respectively (P≤0.005). The technique independently predicted positive one-hour pad test at one and four months respectively. At twelve months presence of DM (diabetes mellitus) and more percent PSA reduction independently predicted positive one-hour pad test. CONCLUSIONS: Veil sparing HoLEP enhances significantly early postoperative urine continence both subjectively and objectively. Optimization of the surgical technique could cut short the number of leaking patients and reduce the degree as well as the duration of transient postoperative urine leak.

Experimental design and analysis of advanced three phase converter for PV application with WCO-P&O MPPT controller.

Photovoltaic (PV)-based power generation systems are becoming increasingly popular as a due to its high performance and cleanliness. Several factors influence the performance of a PV system, including shadowing effects. PV systems employ MPPT methodologies to obtain the power from PV array. Conventional MPPTs works well under normal conditions when there is no shadow effects or partial shading. The presence of partial shading affects the system performance and generates several power peaks. This complicates the process of finding out of the global peak (GMPP) with improved tracking efficiency and reduced settling time including conversion efficiency. This work proposes three hybrid MPPT techniques: Water Cycle Optimisation-Perturb and Observe (WCO-PO), Artificial Neural Network Supported Adaptable Stepped-Scaled Perturb and Observe (ANN-ASSPO), Grey Wolf Optimisation-Modified Fast Terminal Sliding Mode Controller (GWO-MFTSMC), and two conventional MPPT techniques WCO and P&O have been implemented. The proposed system utilizes interleaved boost converter with three phase. The performances of proposed hybrid MPPTs strategies were compared in terms of output voltage, output current and extracted power. The comparison also includes conversion efficiency and average settling time. To analyse the performances, four different cases have been used to test the efficacy of hybrid MPPTs under changing climatic conditions. The MATLAB/Simulink tool has been used to analyze the PV system performances. In the three hybrid MPPT techniques, WCO-PO has performed better when compared to other two hybrid MPPTs in terms of conversion efficiency (99.56%) and settling time (1.4 m).

Bariatric surgery tourism in the COVID-19 era.

Background: Since the start of the Covid-19 pandemic primary and secondary health care services in Northern Ireland have observed an increase in the number of patients who have had bariatric surgery outside of the UK. This study sought to estimate the frequency of bariatric surgery tourism and to audit indications, blood monitoring and medical complications. Methods: All primary care centres within the Western Health Social Care Trust (WHSCT) were invited to document the number of patients undergoing bariatric surgery between January 1, 2017 and December 31, 2022. For one primary care centre, patients who underwent bariatric surgery were assessed against the National Institute of Health and Clinical Excellence (NICE) guideline indications for bariatric surgery. In addition, the blood monitoring of these patients was audited against the British Obesity and Metabolic Surgery Society (BOMSS) guidelines for up to two years following surgery. Medical contacts for surgical complications of bariatric surgery were recorded. Results: Thirty-five of 47 (74.5%) GP surgeries replied to the survey, representing 239,961 patients among 325,126 registrations (73.8%). In the six year study period 463 patients had reported having bariatric surgery to their GP. Women were more likely to have had bariatric surgery than men (85.1% versus 14.9%). There was a marked increase in the number of patients undergoing bariatric surgery with each year of the study (p<0.0001 chi square for trend). Twenty-one of 47 patients (44.7%) evaluated in one primary care centre fulfilled NICE criteria for bariatric surgery. The level of three-month monitoring ranged from 23% (for vitamin D) to 89% (electrolytes), but decreased at two years to 9% (vitamin D) and 64% (electrolytes and liver function tests). Surgical complication prevalence from wound infections was 19% (9 of 44). Antidepressant medications were prescribed for 23 of 47 patients (48.9%). Conclusions: The WHSCT has experienced a growing population of patients availing of bariatric surgery outside of the National Health Service. In view of this and the projected increase in obesity prevalence, a specialist obesity management service is urgently required in Northern Ireland.

Prevalence of restless legs syndrome in adults with epilepsy: A systematic review and meta-analysis of observational studies.

INTRODUCTION: Epilepsy is a common neurological disorder that significantly contributes to the worldwide disease burden. Restless legs syndrome is sleep-related movement disorder that causes uncomfortable sensations in the legs with an irresistible urge to move them. The aim of this study is to comprehensively assess the current evidence to estimate the prevalence of restless legs syndrome (RLS) in adults with epilepsy (AWE) and to compare it to healthy controls. METHODS: PubMed, Medline, Scopus, and Web of Science databases were searched for observational studies reporting the prevalence of RLS in AWE. The modified Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the studies. Comprehensive Meta-Analysis software (version 3.0) was used to perform data analysis. The heterogeneity of the studies was assessed using the I2 index. The pooled prevalence of RLS in AWE and the odds ratio were calculated based on the random-effect model. Sensitivity analysis was assessed. A funnel plot and Egger's test were used to investigate publication bias. Subgroup analysis and univariate meta-regression analysis were done. RESULTS: Based on the analysis of 17 studies (2262 AWE patients), the prevalence of RLS was 14.9 % (95%CI, 10.4%-21 %). This rate was highest in the Americas (35.3 %; 95 % CI: 19.7-54.9 %) and lowest in Asian countries (11.6 %). The risk of RLS was significantly higher in AWE patients compared to health controls (12 studies, OR = 2.09; 95 % CI: 1.53-2.85, I2 = 91.69 %, P < 0.001). subgroup analysis showed Variations in RLS rates between studies depending on quality scores, methodology, and diagnostic criteria. The funnel plot and Egger's test suggest there was publication bias. Sensitivity analysis showed that none of the studies on their own significantly affected the results. CONCLUSIONS: This meta-analysis provides the first pooled estimate of RLS prevalence in AWE. RLS occurs in 15 out of every 100 AWE patients, and the risk is high compared to healthy controls. However, the findings need to be confirmed in future studies owing to limitations in the analysis and study design.