Nursing-Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review.

BACKGROUND: Sleep is a fundamental prerequisite for physical and mental health. Poor quality of sleep is common among post-cardiac surgery patients and leads to serious health conditions. OBJECTIVE: To conduct a systematic review that investigates the effectiveness of eye masks, earplugs and deep-breathing exercise on sleep quality among post-cardiac surgery patients. DESIGN: A systematic review of interventional studies was established to meet the PRISMA guidelines. METHODS: PRISMA guidelines were used to assess the findings of 11 selected studies that met the inclusion criteria, published between 2007 and 2023 across four databases: CINAHL, JDNR, MEDLINE and PubMed. The search was conducted on 23 November 2023. RESULTS: The 11 most eligible studies were analysed. All of them were interventional, encompassing a total of 787 participants. Randomised controlled trials were the most common design. Interventions included eye masks, earplugs and deep-breathing exercises. The Richards-Campbell Sleep Questionnaire was the most used assessment scale. Most of the reviewed studies found that the use of non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) significantly improves the quality of sleep. These interventions were also found to have potentially positive effects on reducing pain and delirium experienced by patients after undergoing cardiac surgery. CONCLUSIONS: Non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) were found to be cost-effective interventions that could be easily applied in the clinical setting and are effective in improving the quality of sleep among patients after cardiac surgery.

Recent progress and applications of single-cell sequencing technology in breast cancer.

Single-cell RNA sequencing (scRNA-seq) technology enables the precise analysis of individual cell transcripts with high sensitivity and throughput. When integrated with multiomics technologies, scRNA-seq significantly enhances the understanding of cellular diversity, particularly within the tumor microenvironment. Similarly, single-cell DNA sequencing has emerged as a powerful tool in cancer research, offering unparalleled insights into the genetic heterogeneity and evolution of tumors. In the context of breast cancer, this technology holds substantial promise for decoding the intricate genomic landscape that drives disease progression, treatment resistance, and metastasis. By unraveling the complexities of tumor biology at a granular level, single-cell DNA sequencing provides a pathway to advancing our comprehension of breast cancer and improving patient outcomes through personalized therapeutic interventions. As single-cell sequencing technology continues to evolve and integrate into clinical practice, its application is poised to revolutionize the diagnosis, prognosis, and treatment strategies for breast cancer. This review explores the potential of single-cell sequencing technology to deepen our understanding of breast cancer, highlighting key approaches, recent advancements, and the role of the tumor microenvironment in disease plasticity. Additionally, the review discusses the impact of single-cell sequencing in paving the way for the development of personalized therapies.

Comparing E-Cigarettes and Traditional Cigarettes in Relation to Myocardial Infarction, Arrhythmias, and Sudden Cardiac Death: A Systematic Review and Meta-Analysis.

BACKGROUND: The use of electronic cigarettes (e-cigarettes) as a perceived safer alternative to traditional cigarettes has grown rapidly. However, the cardiovascular risks associated with e-cigarettes compared to regular cigarettes remain unclear. OBJECTIVE: To systematically review and compare the cardiovascular outcomes of e-cigarette use versus traditional cigarette use, focusing on the risks of myocardial infarction, arrhythmias, and sudden death. METHODS: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed studies published in English were included if they reported cardiovascular outcomes related to e-cigarette or traditional cigarette use. A total of 20 studies were included, covering observational and interventional studies focusing on heart rate variability, myocardial infarction, arrhythmias, and sudden cardiac events. The quality of the evidence was assessed using the GRADE criteria, and data were extracted and analyzed based on the PICOS (Population, Interventions, Comparisons, Outcomes, and Study designs) framework. RESULTS: The systematic review found that both e-cigarettes and traditional cigarettes pose significant cardiovascular risks, with traditional cigarettes linked to a higher incidence of myocardial infarction, arrhythmias, and sudden cardiac death. E-cigarette users also face increased risks of arrhythmias and myocardial infarction compared to non-smokers, primarily due to the constituents of aerosolized e-liquid, including nicotine and flavorings, which contribute to adverse cardiac effects. Regular e-cigarette use, particularly in combination with traditional cigarette use, was associated with a heightened risk of myocardial infarction. Studies also reported heart function abnormalities, such as systolic and diastolic dysfunction, and reduced ejection fractions. Additionally, changes in heart rate variability, heart rate, and blood pressure were observed, indicating both acute and chronic effects of e-cigarettes on cardiovascular autonomic regulation. CONCLUSIONS: While e-cigarettes may present a lower cardiovascular risk compared to traditional cigarettes, they are not without harm. Both products are linked to increased risks of myocardial infarction and arrhythmias, though traditional cigarettes pose a higher overall threat. Given the limitations in the current evidence base, particularly concerning the long-term effects of e-cigarette use, further research is needed to clarify these cardiovascular risks and inform public health guidelines.

A combined trade-off strategy of battery degradation, charge retention, and driveability for electric vehicles.

Electric vehicles are considered as an emerging solution to mitigate the environmental footprint of transportation sector. Therefore, researchers and automotive developers devote significant efforts to enhance the performance of electric vehicles to promote broader adoption of such technology. One of the critical challenges of the electric vehicle is limited battery lifetime and entailed range anxiety. In his context, development of counter-aging control strategies based on precise battery modeling is regarded as an emerging approach that has a significant potential to address battery degradation challenges. This paper presents a combined trade-off strategy to minimize battery degradation while maintaining acceptable driving performance and charge retention in electric vehicles. A battery aging model has been developed and integrated into a full vehicle model. An optimal control problem has been formulated to tackle the afore-mentioned challenges. Non-dominant sorting genetic algorithms have been implemented to yield the optimal solution through the Pareto-front of three contending objectives, based upon which an online simulation has been conducted considering three standard driving cycles. The results reveal the ability of the proposed strategy to prolong the life cycle of the battery and extend the driving range by 25 % and 8 % respectively with minimal influence of 0.6 % on the driveability.

A Comparison of the Use of Propofol versus Midazolam for Pediatric Magnetic Resonance Imaging Sedation: Retrospective Cohort Study.

THE AIM OF THE PRESENT STUDY: The aim of the present study was to do a comparison of the recovery profiles and airway-related adverse events of pediatric magnetic resonance imaging (MRI) sedation patients who received propofol alone to those who received midazolam alone. METHODS: This retrospective cohort study was approved by the Mutah University Ethical Approval Committee (No. 2378). A search of the patients' medical records was performed between September 2021 and April 2022 to identify children aged 4 months-11 years who received propofol or midazolam for MRI sedation. The patients were subdivided into two groups: Those who had propofol alone (propofol group) and those who received midazolam (midazolam group) for pediatric MRI sedation. In propofol group, a 1-2 mg/kg of propofol bolus was given to have a deep sedation (Ramsay Sedation Scale score of 5). Patients in midazolam group received 0.05 mg/kg of midazolam. During the maintenance state of sedation, the patient received 150 µg/kg/min of propofol, and the infusion rate was adjusted in 25 µg/kg/min increments up or down at the discretion of the anesthesiologists to maintain a state of deep sedation. The major targets of this study were recovery profiles (time to awake and time to discharge) and airway-related intervention ratios in pediatric MRI sedation patients. Patient demographics, MRI sedation, and recovery data, including propofol induction dose, airway intervention, and sedation-related adverse events from the pediatric sedation recovery unit were also collected. RESULTS: The mean (standard deviation [SD]) propofol induction dose was higher compared to midazolam group (2.4 [0.7] mg vs. 1.3 [0.5] mg; mean difference, 1.1 mg; P < 0.001). The mean (SD) infusion rate was higher in propofol group compared to midazolam group (161.3 [37.6] µg/min/kg vs. 116.2 [25.6] µg/min/kg; mean difference 45.1 µg/min/kg; P < 0.001). The mean (SD) propofol total dose was higher in propofol group compared to midazolam group (236.3 [102.4] mg vs. 180.7 [80.9] mg; mean difference, 155.4 mg; P < 0.001). The mean (SD) time to awake was longer in midazolam group compared to propofol group (21.2 [5.6] min vs. 23.0 [7.1] min; mean difference, 1.8 min; P < 0.001). The mean (SD) time to discharge was longer in midazolam group compared to propofol group (34.5 [6.9] min vs. 38.6 [9.4] min; mean difference, 4.1 min; 95% confidence interval, 3.0-5.1; P < 0.001). CONCLUSION: The administration of midazolam during pediatric MRI sedation can decrease the frequency of airway complications without prolonging the clinically significant recovery profile.

Résumé Objectif de l'étude:L'objectif de la présente étude était de comparer les profils de récupération et les événements indésirables liés aux voies respiratoires chez les patients pédiatriques sous sédation pour une imagerie par résonance magnétique (IRM) ayant reçu du propofol seul à ceux ayant reçu du midazolam seul.Méthodes:Cette étude de cohorte rétrospective a été approuvée par le Comité d'éthique de l'Université de Mutah (No. 2378). Une recherche dans les dossiers médicaux des patients a été réalisée entre septembre 2021 et avril 2022 pour identifier les enfants âgés de 4 mois à 11 ans ayant reçu du propofol ou du midazolam pour une sédation en IRM. Les patients ont été subdivisés en deux groupes : ceux ayant reçu uniquement du propofol (groupe propofol) et ceux ayant reçu du midazolam (groupe midazolam) pour la sédation pédiatrique en IRM. Dans le groupe propofol, un bolus de 1 à 2 mg/kg de propofol a été administré pour atteindre une sédation profonde (score de 5 sur l'échelle de sédation de Ramsay). Les patients du groupe midazolam ont reçu 0,05 mg/kg de midazolam. Pendant la phase de maintien de la sédation, les patients ont reçu 150 µg/kg/min de propofol, et la vitesse de perfusion a été ajustée par paliers de 25 µg/ kg/min, à la discrétion des anesthésistes, pour maintenir un état de sédation profonde. Les principaux objectifs de cette étude étaient les profils de récupération (temps de réveil et temps de sortie) et les taux d'interventions liées aux voies respiratoires chez les patients pédiatriques sous sédation pour IRM. Les données démographiques des patients, les détails de la sédation en IRM et les données de récupération, y compris la dose d'induction de propofol, les interventions liées aux voies respiratoires, et les événements indésirables liés à la sédation dans l'unité de récupération pédiatrique ont également été collectés.Résultats:La dose moyenne (écart-type [ET]) d'induction de propofol était plus élevée par rapport au groupe midazolam (2,4 [0,7] mg contre 1,3 [0,5] mg; différence moyenne, 1,1 mg; P<0,001). Le taux de perfusion moyen (ET) était plus élevé dans le groupe propofol par rapport au groupe midazolam (161,3 [37,6] µg/min/kg contre 116,2 [25,6] µg/min/kg; différence moyenne, 45,1 µg/min/kg; P<0,001). La dose totale moyenne (ET) de propofol était plus élevée dans le groupe propofol par rapport au groupe midazolam (236,3 [102,4] mg contre 180,7 [80,9] mg; différence moyenne, 155,4 mg; P<0,001). Le temps moyen (ET) pour se réveiller était plus long dans le groupe midazolam par rapport au groupe propofol (21,2 [5,6] min contre 23,0 [7,1] min; différence moyenne, 1,8 min; P<0,001). Le temps moyen (ET) de sortie était plus long dans le groupe midazolam par rapport au groupe propofol (34,5 [6,9] min contre 38,6 [9,4] min; différence moyenne, 4,1 min; intervalle de confiance à 95 %, 3,0­5,1; P<0,001).Conclusion:L'administration de midazolam lors de la sédation pédiatrique pour IRM peut diminuer la fréquence des complications des voies respiratoires sans prolonger de manière significative le profil de récupération clinique.

A comparative study of readiness and confidence in online teaching among faculty members in health and non-health colleges within the United Arab Emirates.

INTRODUCTION: This study explores and compares the levels of readiness and confidence among faculty members in health and non-health colleges regarding online teaching in the United Arab Emirates (UAE). MATERIALS AND METHODS: The study adopted a cross-sectional research design and utilized a comprehensive survey instrument. A convenience sampling method was employed to enlist 412 faculty members from varied academic disciplines, comprising 278 from non-health programs and 134 from health programs. These participants offered valuable insights into their levels of preparedness and confidence for engaging in online teaching. RESULTS: The study uncovered nuanced differences in readiness and confidence levels between health and non-health colleges regarding online teaching preparedness. Significant gender-based variations were found, with female participants in health colleges reporting lower readiness (mean = 4.13) and confidence (mean = 4.11) compared to their counterparts in non-health colleges (mean = 4.43; mean = 4.52) (out of 5) (P < 0.05). Male participants in non-health colleges demonstrated higher readiness and confidence (P < 0.05). Academic rank and teaching experience (>5 years) positively influenced readiness and confidence (P < 0.05). Marital status, spouse working status, and years teaching online showed no significant differences. Teaching multiple online courses before and during the coronavirus disease 2019 (COVID-19) pandemic significantly enhanced readiness and confidence (P < 0.05). Professional development before and during the COVID-19 pandemic did not yield significant differences. CONCLUSION: The study contributes to the existing literature on online education, offering valuable insights into the specific challenges and opportunities faced by faculty in health and non-health colleges. The results inform decision-making processes for educational institutions and policymakers in the UAE, emphasizing the evolving global landscape of online teaching.

Perception and acceptance of medical photography among Arab dermatology patients: a cross-sectional analysis.

Medical photography has been utilized in clinical, academic, and research settings. In conservative countries, such as Saudi Arabia, limited data reflect patients' viewpoints on medical photography. The aim of this paper was to assess patients' opinions on medical photography and the factors influencing its acceptability. A cross-sectional study utilizing a self-distributed paper-based questionnaire was performed in the dermatology clinics at King Abdulaziz Medical City (Riyadh, Saudi Arabia) between February 2020 and January 2021. The response rate is 100% as only willing participants were handed a hard-copy survey and then retrieved once completed. A total of 414 Saudi adults were enrolled. Medical photography was highly acceptable, fairly acceptable, and poorly acceptable in 36.7%, 11.6%, and 14.3% of the patients, respectively. Females were more accepting of medical photography than males (p=0.041). Physicians were the most preferred choice as photographers (83%). Stating all intended use of the photographs was favored by most patients. Using a department-owned camera was essential to 84%. Patients who never had their photographs taken previously were more unaccepting of medical photography than those with prior experience (p=0.037). The main limitation of the study was that it was conducted at a single center; therefore, it may not represent the entire population. Medical photography is acceptable to the majority of patients. Meeting popular preferences, including physicians as photographers, using department-owned cameras, and stating all possible uses of the photographs may enhance patients' experience. The findings offer insight for developing a standardized framework that is suitable for both patients and physicians.

The Association Between Emotional Intelligence and Academic Performance of Dental Students at King Saud University, Riyadh, Saudi Arabia.

INTRODUCTION: Emotional intelligence (EI) is reported to be associated with better academic performance. However, few studies from the Middle East have assessed whether EI affects academic performance in dental students. The objective of this study was to evaluate the relationship between EI and academic performance in a sample of Saudi Arabian dental students. METHODS: This cross-sectional, questionnaire-based study included first-year to fifth-year dental students and dental interns who were enrolled at King Saud University (KSU) in Riyadh, Saudi Arabia, for the 2023-2024 academic year. Eligible students were invited to complete the self-administered Schutte Self-Report Emotional Intelligence Test (SSEIT) and a demographic questionnaire between October 2023 and January 2024. Academic performance was assessed based on each student's self-reported overall current grade point average (GPA) and was dichotomized into high GPA (between 4.5 and 5) and low GPA (less than 4.5). RESULTS: Of the 437 eligible students, 330 (75.5%) completed the questionnaires. The logistic regression analysis, after sequentially adjusting for various risk factors, showed significantly better academic performance for those who had higher EI (OR=2.6, P-value=0.02). CONCLUSION: The findings of this study suggest a significant association between EI and academic success. EI is essential for improving academic performance in dental education.

Bio-inspired EEG signal computing using machine learning and fuzzy theory for decision making in future-oriented brain-controlled vehicles.

One kind of autonomous vehicle that can take instructions from the driver by reading their electroencephalogram (EEG) signals using a Brain-Computer Interface (BCI) is called a Brain-Controlled Vehicle (BCV). The operation of such a vehicle is greatly affected by how well the BCI works. At present, there are limitations on the accuracy of BCI recognition, the number of distinguishable command categories, and the execution duration of command recognition. Consequently, vehicles that are exclusively controlled by EEG signals demonstrate suboptimal control performance. To address the difficulty of improving the control capabilities of brain-controlled cars while maintaining BCI performance, a fuzzy logic-based technique called as Fuzzy Brain-Control Fusion Control is introduced. This approach uses Fuzzy Discrete Event System (FDES) supervisory theory to verify the accuracy of the driver's brain-controlled directives. Concurrently, a fuzzy logic-based automatic controller is developed to generate decisions automatically in accordance with the present state of the vehicle via fuzzy reasoning. The final decision is then reached through the application of secondary fuzzy reasoning to the accuracy of the driver's instructions and the automated decisions to make adjustments that are more consistent with human intent. A clever BCI gadget known as the Consistent State Visual Evoked Potential (SSVEP) is utilized to show the viability of the proposed technique. We recommend that additional research should be conducted at this time to confirm that our recommended system may further improve the control execution of BCI-fueled cars, regardless of whether BCIs have special limitations.

The known and unknown about attention deficit hyperactivity disorder (ADHD) genetics: a special emphasis on Arab population.

Attention deficit hyperactivity disorder (ADHD) is a clinically and genetically heterogeneous neurodevelopmental syndrome characterized by behavioral appearances such as impulsivity, inattention, and hyperactivity. The prevalence of ADHD is high in childhood when compared to adults. ADHD has been significantly advanced by genetic research over the past 25 years. However, it is logically conceivable that both genetic and/or non-genetic factors, such as postnatal environmental and social influences, are associated with ADHD phenotype in Arab populations. While genetic influences are strongly linked with the etiology of ADHD, it remains obscure how consanguinity which is an underlying factor for many genetic diseases, contributes to ADHD subtypes. Arabian Gulf Nations have one the highest rates of consanguineous marriages, and consanguinity plays an important contributing factor in many genetic diseases that exist in higher percentages in Arabian Gulf Nations. Therefore, the current review aims to shed light on the genetic variants associated with ADHD subtypes in Arabian Gulf nations and Saudi Arabia in particular. It also focuses on the symptoms and the diagnosis of ADHD before turning to the neuropsychological pathways and subgroups of ADHD. The impact of a consanguinity-based understanding of the ADHD subtype will help to understand the genetic variability of the Arabian Gulf population in comparison with the other parts of the world and will provide novel information to develop new avenues for future research in ADHD.

Inappropriate Emergency Department Visits: Insights on Incidence, Associated, and Predictive Factors From 5,429 Visits.

INTRODUCTION: Inappropriate visits (IVs) and overcrowded emergency departments (EDs) can result in many complications for patients and medical staff. This study aimed to assess the incidence, associated factors, and predictive factors of IVs to ED. METHODS: This retrospective cohort single-center study was conducted in the ED of King Abdulaziz Medical City, Jeddah, Saudi Arabia. All ED visits in February 2023 were included. They were considered appropriate if the patient required investigation tests, underwent a procedure, was admitted to an inpatient ward, was admitted to the short-stay unit, was referred for follow-up at a specialist outpatient clinic after discharge from the ED, or was referred to the ED of another hospital. Failure to have at least one of these factors led to the visit being considered inappropriate. RESULTS: A total of 5,429 visits were included. The incidence rate of IVs was 1128 (20.7%). Of the visits, 1,028 (18.9%) were attended by patients aged <10 years, and 2,825 (52.0%) by female patients. The most reported complaints were pulmonological in 1,029 visits (18.9%). Patients with appropriate visits (AVs) had significantly higher median BMI scores than those with IVs (25.9 (20 - 3) vs. 23.7 (16.36 - 29), P = <0.0001). Visits with pulmonological (447 (39.6%) vs. 582 (13.5%)) and otorhinolaryngologic (54 (4.7%) vs. 94 (2.1%)) complaints were significantly more likely to be inappropriate (P = <0.0001). In multiple logistic regression, being a male (OR: 1.3, CI: 1.1 - 1.5, P = <0.0001), being non-Saudi (OR: 2.7, CI: 2.0 - 3.6, P = <0.0001), and visiting on the weekend (OR: 1.1, CI: 1.0 - 1.3, P = 0.0366) were significantly predictive of the visits being inappropriate. CONCLUSIONS: Our findings revealed a high incidence of IVs in the ED, with several factors predictive of IVs. Highlighting these factors can help minimize the incidence of IVs and, therefore, improve the quality of healthcare delivered to patients in need and their clinical outcomes.

Primary pulmonary mucosa-associated lymphoid tissue lymphoma with extensive lung involvement and negative autoimmune and inflammatory background: A case report and literature review.

Primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is a very rare presentation of MALT lymphoma. The presence of a completely negative autoimmune and inflammatory background makes it a real challenge and very rare presentation (probably the second reported case in the literature). We report a case of primary pulmonary MALT lymphoma with negative autoimmune background, demonstrating as multifocal bulky variceal masses causing significant clinical symptoms.

Cerebral microbleeds in acute ischemic stroke after intravenous thrombolysis and their impact on short term outcome of stroke.

OBJECTIVES: Strong evidence suggests the occurrence of cerebral microbleeds (CMBs) in 5-13% of stroke patients within the first week after stroke onset. The aim of this work was to study risk factors associated with occurrence of CMBs in patients with stroke who received intravenous thrombolysis, and to clarify their impact on the clinical outcome. METHODS: This prospective observational study was conducted on 61 acute ischemic stroke patients eligible for treatment with recombinant tissue plasminogen activator (rt-PA). Assessment of stroke-related neurologic deficit was done using National Institute of Health Stroke Scale (NIHSS). Assessment of stroke related disability after 3 months from stroke onset was done using Modified Rankin Scale (mRS). CMBs were detected by T2*-weighed gradient-recalled echo (T2*-GRE) and susceptibility-weighted imaging (SWI) magnetic resonance imaging (MRI) sequences. RESULTS: There was a statistically significant impact of age, mean arterial pressure (MAP) at stroke onset, history of hypertension (HTN), and white matter changes assessed by Fazekas scale on the occurrence of CMBs in the included stroke patients (P-value= 0.002, <0.001, <0.001, 0.008 respectively). There was no statistically significant difference between patients with favorable and those with unfavorable outcome regarding the total number of CMBs (P-value =0.542). There was also no statistically significant difference between patients who developed complications from rt-PA and those who didn't develop regarding the total number of CMBs (P-value =0.186). CONCLUSION: Cerebral microbleeds are more likely to occur in older stroke patients and in those who had high MAP at stroke onset, history of HTN, and white matter changes.

Molecular Dynamical and Quantum Mechanical Exploration of the Site-Specific Dynamics of Cy3 Dimers Internally Linked to dsDNA.

Performing spectroscopic measurements on biomolecules labeled with fluorescent probes is a powerful approach to locating the molecular behavior and dynamics of large systems at specific sites within their local environments. The indocarbocyanine dye Cy3 has emerged as one of the most commonly used chromophores. The incorporation of Cy3 dimers into DNA enhances experimental resolution owing to the spectral characteristics influenced by the geometric orientation of excitonically coupled monomeric units. Various theoretical models and simulations have been utilized to aid in the interpretation of the experimental spectra. In this study, we employ all-atom molecular dynamics simulations to study the structural dynamics of Cy3 dimers internally linked to the dsDNA backbone. We used quantum mechanical calculations to derive insights from both the linear absorption spectra and the circular dichroism data. Furthermore, we explore potential limitations within a commonly used force field for cyanine dyes. The molecular dynamics simulations suggest the presence of four possible Cy3 dimeric populations. The spectral simulations on the four populations show one of them to agree better with the experimental signatures, suggesting it to be the dominant population. The relative orientation of Cy3 in this population compares very well with previous predictions from the Holstein-Frenkel Hamiltonian model.

Fighting sepsis-induced liver damage with biosynthesized silver nanoparticles.

Sepsis is a potentially fatal disease that arises from an infection and is characterized by an uncontrolled immune system reaction. Global healthcare systems bear a heavy financial burden from treating sepsis. This study aimed to provide information on the effective properties of silver nanoparticles derived from pomegranate peel extract (P-AgNP) against sepsis-induced hepatic injury. P-AgNPs were spherical with a diameter of ~19 nm. The animals were placed into four groups, each with seven rats. Group 1 functioned as the control group, receiving only saline for 7 days. Group 2 received only P-AgNPs at a dose of 20 mg/kg. To induce sepsis, groups 3 and 4 were given an intraperitoneal injection of 200 mg/mL cecal slurry. Sixty min later, group 4 was given 20 mg/kg of P-AgNPs daily for 7 days. The concentrations of reduced glutathione, nitric oxide, lipid peroxidation, and superoxide dismutase in liver homogenate were measured to determine the oxidative status. In addition, enzyme activities (alanine aminotransferase, aspartate amino transferase, and alkaline phosphatase) were measured. Furthermore, we investigated the histological changes, immunohistochemical expression of nuclear factor-κB, and mRNA levels of IL1ß, IL-6, TNF-α, Bax, BCl2, and Casp-3. P-AgNPs functioned as regulators in a sepsis model, successfully controlling altered gene expression. Following treatment, P-AgNPs improved tion and oxidative state, indicating a role in sepsis management. Based on our findings, we conclude that P-AgNPs have antioxidant activity and may be useful in preventing sepsis-induced liver inflammation, oxidative damage, and apoptosis. RESEARCH HIGHLIGHTS: Pomegranate peel-derived silver nanoparticles (P-AgNPs) enhanced liver function and oxidative state in rats with sepsis-induced hepatic damage. P-AgNPs reduced oxidative stress and liver inflammation via regulating inflammatory and apoptotic gene expression. P-AgNPs enhanced liver enzyme activities, histological structure, and immunohistochemistry expression of nuclear factor-κB.

Supersolubilization and Amorphization of a Weakly Acidic Drug, Flurbiprofen, by applying Acid-Base supersolubilization (ABS) principle.

Improvement in drug solubility is a major challenge for developing pharmaceutical products. It was demonstrated earlier that aqueous solubilities of weakly basic drugs could be increased greatly by interaction with weak acids that would not form salts with the drugs, and the highly concentrated solutions thus produced converted to amorphous solids upon drying. The technique was called acid-base supersolubilization (ABS). The current investigation explored whether the ABS principle could also be applied to weakly acidic drugs. By taking flurbiprofen (pKa 4.09; free acid solubility 0.011 mg/mL) as the model weakly acidic drug and tromethamine, lysine, meglumine, and NaOH as bases, it was studied which of the bases would result in ABS. While in the presence of NaOH and tromethamine, flurbiprofen converted to salts having aqueous solubility of 11-19 mg/mL, the solubility increased to > 399 mg/mL with lysine and > 358 mg/mL with meglumine, producing supersolubilization. However, crystallization of lysine salt was observed with time, followed by some decrease in solubility after reaching maximum solubility with lysine. In contrast, the supersolubilization was maintained with meglumine, and no crystallization of meglumine salt was observed. Upon drying, flurbiprofen-meglumine solutions produced amorphous materials that dissolved rapidly and produced high drug concentrations in aqueous media. Thus, the ABS principle also applies to acidic drugs depending on the weak base used.

The Arabic Version of Compulsive Exercise Test among Saudi Population; Translation and Validation.

Compulsive exercise is a condition characterized by uncontrollable exercise behaviour that may lead to severe and harmful physical and psychological consequences. Indeed, compulsive exercise is among the early symptoms of eating disorders that may affect different age groups. Globally and among Arab countries, compulsive exercise is common, while the screening methods used to assess compulsive exercise are limited. Thus, the Compulsive Exercise Test (CET) has emerged as a tool to assess cognitive, behavioural, and emotional factors related to compulsive exercise. The CET is a self-report, Likert-type scale comprising five distinct subscales. The increase in the CET scores is more likely associated with worsened pathology. Since the Arab countries lack such an assessment tool, we aimed to translate the CET into Arabic, validate the translated version, confirm the factor structures, and assess the internal consistency of the different subscales. Herein, we used the forward-backward translation method as recommended by the World Health Organization (WHO). The overall validity index of the translated version showed a score higher than 0.78, while the scale-level content validity index based on the average calculating method (S-CVI/Ave) and the agreement method (S-CVI/UA) were 0.91 and 0.58, respectively. Moreover, we recruited 399 Arabs living in Saudi to measure the internal consistency, and the value of the substantive internal consistency with Cronbach's α was 0.81. Subsequently, four of the Arabic-CET subscales had substantive internal consistency with Cronbach's α values higher than or equal to 0.70. Furthermore, the exploratory factor analysis results supported the substantial use of the five-subscale model. Taken together, our study supports using the Arabic-CET version to measure exercise compulsiveness among Arabs.

An overview of RAF kinases and their inhibitors (2019-2023).

Protein kinases (PKs) including RAF, perform a principal role in regulating countless cellular events such as cell growth, differentiation, and angiogenesis. Overexpression and mutation of RAF kinases are significant contributors to the development and spread of cancer. Therefore, RAF kinase inhibitors show promising outcomes as anti-cancer small molecules by suppressing the expression of RAF protein, blocking RAS/RAF interaction, or inhibiting RAF enzymes. Currently, there are insufficient reports about approving drugs with minimal degree of toxicity. Therefore, it is an urgent need to develop new RAF kinase inhibitors correlated with increased anticancer activity and lower cytotoxicity. This review outlines reported RAF kinase inhibitors for cancer treatment in patents and literature from 2019 to 2023. It highlights the available inhibitors by shedding light on their chemical structures, biochemical profiles, and current status. Additionally, we highlighted the hinge region-binding moiety of the reported compounds by showing the hydrogen bond patterns of representative inhibitors with the hinge region for each class. In recent years, RAF kinase inhibitors have gained considerable attention in cancer research and drug development due to their potential to be studied under clinical trials and their demonstration of various degrees of efficacy and safety profiles across different cancer types. However, addressing challenges related to drug resistance and safety represents a major avenue for the optimization and enhancement of RAF kinase inhibitors. Strategies to overcome such obstacles were discussed such as developing novel pan-RAF inhibitors, RAF dimer inhibitors, and combination treatments.

Histopathological risk assessment in multisite epithelial dysplasia: A meta-analysis.

OBJECTIVE: Histopathological grading of oral epithelial dysplasia (OED) is the current standard for stratifying cancer progression risk but is associated with subjectivity and variability. This problem is not commonly seen regarding the grading of epithelial dysplasia in other sites. This systematic review aims to compare grading systems for oral, anal, penile, and cervical epithelial dysplasia to determine their predictive accuracy for recurrence and malignant transformation (MT) outcomes. METHODS: The review protocol was registered in PROSPERO (CRD42023403035) and was reported according to the PRISMA checklist. A comprehensive search was performed in the main databases and gray literature. The risk of bias in individual studies was analyzed using the Joanna Briggs Institute checklist for each study design. RESULTS: Forty-six studies were deemed eligible and included in this systematic review, of which 45 were included in the quantitative analysis. Meta-analysis revealed that the binary system demonstrated a higher predictive ability for MT/recurrence of OED compared to multilevel systems. Higher predictive accuracy of MT was also observed for binary grading systems in anal intraepithelial neoplasia. CONCLUSIONS: No significant difference was found between the current grading systems of epithelial dysplasia in different body parts. However, binary grading systems have shown better clinical outcomes.

Insights of early feeding regime supplemented with glutamine and various levels of omega-3 in broiler chickens: growth performance, muscle building, antioxidant capacity, intestinal barriers health and defense against mixed Eimeria spp infection.

Early nutritional management approach greatly impacts broilers' performance and resistance against coccidiosis. The current study explored the impact of post-hatch feeding with a combination of glutamine (Glut) and different levels of omega-3 on broiler chickens' growth performance, muscle building, intestinal barrier, antioxidant ability and protection against avian coccidiosis. A total of six hundred Cobb 500 was divided into six groups: first group (fed basal diet and unchallenged (control) and challenged (negative control, NC) groups were fed a basal diet without additives, and the other groups were infected with Eimeria spp and supplemented with 1.5% Glut alone or with three different levels of omega-3 (0.25, 0.5 and 1%) during the starter period. Notable improvement in body weight gain was observed in the group which fed basal diet supplemented with glut and 1% omega 3 even after coccidia infection (increased by 25% compared challenged group) while feed conversion ratio was restored to control. Myogeneis was enhanced in the group supplemented with Glut and omega-3 (upregulation of myogenin, MyoD, mechanistic target of rapamycin kinase and insulin like growth factor-1 and downregulating of myostatin genes). Groups supplemented with Glut and higher levels of omega-3 highly expressed occluding, mucin-2, junctional Adhesion Molecule 2, b-defensin-1 and cathelicidins-2 genes. Group fed 1% Glut + omega-3 showed an increased total antioxidant capacity and glutathione peroxidase and super oxide dismutase enzymes activities with reduced levels of malondialdehyde, reactive oxygen species and H2O2. Post-infection, dietary Glut and 1% omega-3 increased intestinal interleukin-10 (IL) and secretory immunoglobulin-A and serum lysozyme, while decreased the elevated inflammatory mediators comprising interleukin IL-6, tumor necrosis factor-alpha, nitric oxide (NO) and inducible NO synthase. Fecal oocyst excretion and lesions score severity were lowered in the group fed 1% Glut and omega 3. Based on these findings, dietary Glut and omega-3 supplementation augmented restored overall broilers' performance after coccidial challenge.