The impact of physical therapy intervention of dysphagia on preventing pneumonia in acute stroke patients: A randomized controlled trial.

BACKGROUND AND OBJECTIVES: Dysphagia is a common complication following stroke. It corresponds to the development of pneumonia, which is always associated with bad prognosis, longer hospital stays and increased mortality. The aim of the study was to assess the impact of physical therapy intervention of dysphagia on preventing pneumonia in acute stroke patients. METHODS: A single-blind randomized controlled trial was carried out on 70 ischemic stroke patients with oropharyngeal dysphagia, age ranged from 49 to 65 years. They were randomly assigned to two groups (control and study) of equal number. Patients in the control group received oral care and nasogastric tube feeding, while patients in the study group received the same program in addition to the designed physical therapy program (exercises and neuromuscular electrical stimulation). The intervention program was applied for 40 min/session, 1 session/day, and 5 days/week for 4 weeks. Gugging swallowing screen (GUSS), and stroke associated pneumonia (SAP) control and prevention criteria were used to assess dysphagia and incidence of pneumonia at baseline, after two and 4 weeks of intervention for both groups. RESULTS: Before treatment, all patients were susceptible to pneumonia after two and 4 weeks of intervention; there were a significant increase in GUSS score in both groups with more improvement in favor of the study group (p < 0.05) and a statistically significant increase in incidence of SAP after 2 weeks of intervention only in the control group (p < 0.05). The results also showed a significant negative correlation between GUSS score and SAP (r = - 0.3662, p = 0.0018) IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE: adding physical therapy (exercise therapy and neuromuscular electrical stimulation) to oral care and nasogastric tube feeding is effective in improving oropharyngeal dysphagia and decreasing the incidence of aspiration pneumonia in acute ischemic stroke patients.

Advancing the Frontier: Neuroimaging Techniques in the Early Detection and Management of Neurodegenerative Diseases.

Alzheimer's and Parkinson's diseases are among the most prevalent neurodegenerative conditions affecting aging populations globally, presenting significant challenges in early diagnosis and management. This narrative review explores the pivotal role of advanced neuroimaging techniques in detecting and managing these diseases at early stages, potentially slowing their progression through timely interventions. Recent advancements in MRI, such as ultra-high-field systems and functional MRI, have enhanced the sensitivity for detecting subtle structural and functional changes. Additionally, the development of novel amyloid-beta tracers and other emerging modalities like optical imaging and transcranial ultrasonography have improved the diagnostic accuracy and capability of existing methods. This review highlights the clinical applications of these technologies in Alzheimer's and Parkinson's diseases, where they have shown improved diagnostic performance, enabling earlier intervention and better prognostic outcomes. Moreover, the integration of artificial intelligence (AI) and longitudinal research is emerging as a promising enhancement to refine early detection strategies further. However, this review also addresses the technical, ethical, and accessibility challenges in the field, advocating for the more extensive use of advanced imaging technologies to overcome these barriers. Finally, we emphasize the need for a holistic approach that incorporates both neurological and psychiatric perspectives, which is crucial for optimizing patient care and outcomes in the management of neurodegenerative diseases.

Hepatitis C risk score as a tool to identify individuals with HCV infection: a demonstration and cross-sectional epidemiological study in Egypt.

OBJECTIVES: Hepatitis C virus (HCV) infection poses a global health challenge. By the end of 2021, the WHO estimated that less than a quarter of global HCV infections had been diagnosed. There is a need for a public health tool that can facilitate the identification of people with HCV infection and link them to testing and treatment, and that can be customised for each country. METHODS: We derived and validated a risk score to identify people with HCV in Egypt and demonstrated its utility. Using data from the 2008 and 2014 Egypt Demographic and Health Surveys, two risk scores were constructed through multivariable logistic regression analysis. A range of diagnostic metrics was then calculated to evaluate the performance of these scores. RESULTS: The 2008 and 2014 risk scores exhibited similar dependencies on sex, age and type of place of residence. Both risk scores demonstrated high and similar areas under the curve of 0.77 (95% CI: 0.76 to 0.78) and 0.78 (95% CI: 0.77 to 0.80), respectively. For the 2008 risk score, sensitivity was 73.7% (95% CI: 71.5% to 75.9%), specificity was 68.5% (95% CI: 67.5% to 69.4%), positive predictive value (PPV) was 27.8% (95% CI: 26.4% to 29.2%) and negative predictive value (NPV) was 94.1% (95% CI: 93.5% to 94.6%). For the 2014 risk score, sensitivity was 64.0% (95% CI: 61.5% to 66.6%), specificity was 78.2% (95% CI: 77.5% to 78.9%), PPV was 22.2% (95% CI: 20.9% to 23.5%) and NPV was 95.7% (95% CI: 95.4% to 96.1%). Each score was validated by applying it to a different survey database than the one used to derive it. CONCLUSIONS: Implementation of HCV risk scores is an effective strategy to identify carriers of HCV infection and to link them to testing and treatment at low cost to national programmes.

Transcatheter Axial Pump Use in Pediatric Patients on Veno-Arterial Extracorporeal Membrane Oxygenation: An ACTION Collaborative Experience.

We report the largest pediatric multicenter experience with Impella pump use and peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. Utilizing the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) collaborative database, we conducted a retrospective, multicenter study of all patients with cardiogenic shock requiring VA-ECMO support with subsequent Impella implant between October 2014 and December 2021. The primary outcome was defined as death while on Impella support. Secondary outcomes were recovery, transplantation, and transition to durable ventricular assist device (VAD) at the time of Impella explantation. Adverse events were defined according to the ACTION registry criteria. Twenty subjects were supported with Impella; Impella 2.5 (n = 3), CP (n = 12), 5.0/5.5 (n = 5). The median Interquartile range (IQR) age, weight, and body surface area at implantation were 15.6 years (IQR = 13.9-17.2), 65.7 kg (IQR = 53.1-80.7), and 1.74 m2 (IQR = 1.58-1.98). Primary cardiac diagnoses were dilated cardiomyopathy/myocarditis in nine (45%), congenital heart disease in four (20%), graft failure/rejection in four (20%), and three (15%) others. Most common adverse events included hemolysis (50%) and bleeding (20%). There were two deaths (10%) in the cohort. Nine patients (45%) were explanted for recovery, eight (40%) were transitioned to a durable VAD, and one (5%) underwent heart transplantation. Impella percutaneous pump support should be considered in the older pediatric population supported with peripheral VA-ECMO, as a means of left heart decompression, and a strategy to come off ECMO to achieve endpoints of myocardial recovery, transition to a durable VAD, or transplantation.

Reduction of organic contaminants from industrial effluent using the advanced oxidation process, chemical coagulation, and green nanotechnology.

Municipal wastewater treatment systems use the chemical oxygen demand test (COD) to identify organic contaminants in industrial effluents that impede treatment due to their high concentration. This study reduced the COD levels in tannery wastewater using a multistage treatment process that included Fenton oxidation, chemical coagulation, and nanotechnology based on a synthetic soluble COD standard solution. At an acidic pH of 5, Fenton oxidation reduces the COD concentration by approximately 79%. It achieves this by combining 10 mL/L of H2O2 and 0.1 g/L of FeCl2. Furthermore, the author selected the FeCl3 coagulant for the coagulation process based on the best results of comparisons between different coagulants. At pH 8.5, the coagulation dose of 0.15 g/L achieved the maximum COD removal efficiency of approximately 56.7%. Finally, nano bimetallic Fe/Cu was used to complete the degradation and adsorption of the remaining organic pollutants. The XRD, SEM, and EDX analyses proved the formation of Fe/Cu nanoparticles. A dose of 0.09 g/L Fe/Cu NPs, 30 min of contact time, and a stirring rate of 200 rpm achieve a maximum removal efficiency of about 93% of COD at pH 7.5. The kinetics studies were analyzed using pseudo-first-order P.F.O., pseudo-second-order P.S.O., and intraparticle diffusion models. The P.S.O. showed the best fit among the kinetic models, with an R2 of 0.998. Finally, the authors recommended that technique for highly contaminated industrial effluents treatment for agriculture or industrial purposes.

Evolution of natural myocardial shear wave behavior in young hearts: determinant factors and reproducibility analysis.

BACKGROUND: Myocardial diastolic function assessment in children by conventional echocardiography is challenging. Recent high frame rate (HFR) echocardiography facilitates the assessment of myocardial stiffness (MS) -a key factor of diastolic function- by measuring the propagation velocities of myocardial shear waves (SWs). However, normal values of natural SWs in children are currently lacking. OBJECTIVES: To explore the behavior of natural SW among children and adolescents, their reproducibility, and the factors affecting SW velocities from childhood into adulthood. METHODS: 106 healthy children (2-18 years) and 62 adults (19-80 years) were recruited. HFR images were acquired using a modified commercial scanner. An anatomical M-mode was drawn along the ventricular septum, and propagation velocities of natural SWs after mitral valve closure (MVC) were measured in the tissue acceleration coded M-mode display. RESULTS: Throughout life, SW velocities after MVC exhibited pronounced age dependency (r= 0.73; P<0.001). Among the pediatric population, SW velocities correlated significantly with measures of cardiac geometry (septal thickness and left ventricular end-diastolic dimension), local hemodynamics (systolic blood pressure), as well as with echocardiographic parameters of systolic and diastolic function (global longitudinal strain (GLS), mitral E/e', isovolumetric relaxation time and mitral deceleration time) (P <0.001). In a multivariate analysis including all these factors, the predictors of SW velocities were age, mitral E/e', and GLS (r= 0.81). CONCLUSIONS: Natural myocardial SW velocities in children can be detected and measured. SW velocities showed significant dependence on age and diastolic function. Natural SWs could be a promising additive tool for assessment of diastolic function among children.

Identifying genomic regions associated with C4 photosynthetic activity and leaf anatomy in Alloteropsis semialata.

C4 photosynthesis is a complex trait requiring multiple developmental and metabolic alterations. Despite this complexity, it has independently evolved over 60 times. However, our understanding of the transition to C4 is complicated by the fact that variation in photosynthetic type is usually segregated between species that diverged a long time ago. Here, we perform a genome-wide association study (GWAS) using the grass Alloteropsis semialata, the only known species to have C3, intermediate, and C4 accessions that recently diverged. We aimed to identify genomic regions associated with the strength of the C4 cycle (measured using δ13C), and the development of C4 leaf anatomy. Genomic regions correlated with δ13C include regulators of C4 decarboxylation enzymes (RIPK), nonphotochemical quenching (SOQ1), and the development of Kranz anatomy (SCARECROW-LIKE). Regions associated with the development of C4 leaf anatomy in the intermediate individuals contain additional leaf anatomy regulators, including those responsible for vein patterning (GSL8) and meristem determinacy (GIF1). The parallel recruitment of paralogous leaf anatomy regulators between A. semialata and other C4 lineages implies the co-option of these genes is context-dependent, which likely has implications for the engineering of the C4 trait into C3 species.

Further Refinements in Otoplasty Surgery: a modified approach to prevent suture extrusion in cartilage-suturing otoplasty using a postauricular dermofascial flap.

BACKGROUND: Suture extrusion has been reported to be the most common complication following cartilage-sparing otoplasty. Several studies have described various designs of postauricular flaps to cover the cartilage sutures and reduce the incidence of suture extrusion. PATIENTS AND METHODS: One hundred consecutive patients with prominent ears were operated between January 2018 and February 2023 using a de-epithelialized postauricular dermofascial flap that is performed as an adjunct to our cartilage-sparing otoplasty technique which is essentially a combined modified Mustardé and Furnas technique. The flap is used to cover the cartilage holding sutures with an extra layer of vascularized tissue to avoid the scar being directly over these sutures. RESULTS: The median age of patients was 12 (IQR 9-15) years. One out of the 100 patients (1%) developed a postauricular skin infection requiring surgical removal of sutures. Primary suture extrusion did not occur, compared to our earlier study of cartilage-sparing technique without the postauricular flap in which 17 out of 200 patients had suture extrusion (p=0.001). No hematoma occurred that necessitated return to the theatre. Skin necrosis and wound dehiscence did not occur in any case. No patients developed cartilage deformities or relapse requiring surgical correction. CONCLUSIONS: Combining cartilage-sparing otoplasty using sutures and the described postauricular dermofascial flap is simple to perform and has significantly reduced the complication rate and improved the outcome compared to cartilage-sparing otoplasty alone. We recommend using this flap for both primary and revisional otoplasty.

Dynamic assemblies of parvalbumin interneurons in brain oscillations.

Brain oscillations are crucial for perception, memory, and behavior. Parvalbumin-expressing (PV) interneurons are critical for these oscillations, but their population dynamics remain unclear. Using voltage imaging, we simultaneously recorded membrane potentials in up to 26 PV interneurons in vivo during hippocampal ripple oscillations in mice. We found that PV cells generate ripple-frequency rhythms by forming highly dynamic cell assemblies. These assemblies exhibit rapid and significant changes from cycle to cycle, varying greatly in both size and membership. Importantly, this variability is not just random spiking failures of individual neurons. Rather, the activities of other PV cells contain significant information about whether a PV cell spikes or not in a given cycle. This coordination persists without network oscillations, and it exists in subthreshold potentials even when the cells are not spiking. Dynamic assemblies of interneurons may provide a new mechanism to modulate postsynaptic dynamics and impact cognitive functions flexibly and rapidly.

The implementation of conscious sedation by dental professionals in Egypt: an analytical cross-sectional study.

Conscious sedation is widely considered one of the techniques most commonly used to manage anxiety in both children and adults during dental procedures. The application of procedural sedation exhibits considerable variation globally. The purpose of the study was to determine the prevalence of conscious sedation in the current situation in the dental healthcare sector in Egypt and to identify the factors influencing it. An online cross-sectional analytical survey, consisting of nine multiple choice questions, was distributed through the contact lists of national dentists and social media platforms. 163 respondents completed the survey. Regarding the use of conscious sedation, only 25 (15.3%),95% confidence interval (10-21) utilized it. The percentage of participants who used conscious sedation was higher among dentists practicing pediatric dental specialists (n = 19, 76%). Academic qualification correlates significantly with the practice of conscious sedation (P = 0.002), but this was not reflected in multiple logistic regression. Indeed, while conscious sedation is part of the dental study curriculum in Egypt, its application rate is relatively low compared to other countries. This discrepancy could be attributed to a variety of factors, including resource availability, lack of training, reflecting the need to develop strategies to improve the implementation of conscious sedation in Egyptian dental practices.

The Interplay of Lipid Signaling in Musculoskeletal Cross Talk: Implications for Health and Disease.

The intricate interplay between the muscle and bone tissues is a fundamental aspect of musculoskeletal physiology. Over the past decades, emerging research has highlighted the pivotal role of lipid signaling in mediating communication between these tissues. This chapter delves into the multifaceted mechanisms through which lipids, particularly phospholipids, sphingolipids, and eicosanoids, participate in orchestrating cellular responses and metabolic pathways in both muscle and bone. Additionally, we examine the clinical implications of disrupted lipid signaling in musculoskeletal disorders, offering insights into potential therapeutic avenues. This chapter aims to shed light on the complex lipid-driven interactions between the muscle and bone tissues, paving the way for a deeper understanding of musculoskeletal health and disease.

Nanoparticles and Their Applications in Lipid Signaling.

This chapter provides an overview of the diverse range of applications associated with nanoparticles. The application of nanoparticles in the medical field has garnered considerable attention due to their unique properties and versatile compositions. They have shown promise in the treatment of cancer, fungal and viral infections, and pain management. These systems provide numerous benefits, such as increased drug stability, improved bioavailability, and targeted delivery to specific tissues or cells. The objective of this chapter is to provide a brief analysis of the differences between nanoparticles and lipid particles, focusing particularly on the importance of nanoparticle size and composition in their interactions with lipids. Additionally, the applications of nanoparticles in lipid signaling will be discussed, considering the vital roles lipids play in cellular signaling pathways. Nanoparticles have shown immense potential in the regulation and control of medical pathways. In this case, we will focus on the manufacture of liposomes, a type of nanoparticle composed of lipids. The reason behind the extensive investigation into liposomes as drug delivery vehicles is their remarkable biocompatibility and adaptability. This section will provide insights into the methods and techniques employed for liposome formulation.

Ecological and health risk assessment of heavy metals in interior dust from college campus.

Contamination of college campus dust with heavy metals and the calculation of their ecological and health risks to the students and staff did not receive much attention except in recent years. This study aims to assess the ecological and human health risks of Cd, Cr, Cu, Pb, and Zn in interior dust of College of Science/University campus. An atomic absorption spectrophotometer was utilized to estimate the samples that were collected from 46 locations of the college campus including: classrooms, offices, and laboratories. The Pb, Cu, Cr and Zn metals in the interior dust of the College of Science pose low potential ecological risk, whereas Cd generates medium potential ecological risk. The gained results showed that the student and staff of the College are exposed to low non-cancerous health risks (HI < 1) caused by Cd, Cr, Cu, Pb, and Zn in interior dust. The total lifetime carcinogenic risks (TLCR) of Cd, Cr, and Pb are within the acceptable safe limit (10-6-10-4). The low non-carcinogenic health risks of Cd, Cr, Cu, Pb, and Zn and that the carcinogenic health risks of Cd, Cr and Pb fall within acceptable safe limits, measured in the interior dust of the campus of the College of Science, does not mean neglecting the continuous assessment of those risks.

Market Needs and Methodologies Associated with Patient Lipidomic Diagnoses and Analyses.

This chapter conducts an in-depth exploration of the impact of musculoskeletal (MSK) disorders and injuries, with a specific emphasis on their consequences within the older population demographic. It underscores the escalating demand for innovative interventions in MSK tissue engineering. The chapter also highlights the fundamental role played by lipid signaling mediators (LSMs) in tissue regeneration, with relevance to bone and muscle recovery. Remarkably, Prostaglandin E2 (PGE2) emerges as a central orchestrator in these regenerative processes. Furthermore, the chapter investigates the complex interplay between bone and muscle tissues, explaining the important influence exerted by LSMs on their growth and differentiation. The targeted modulation of LSM pathways holds substantial promise as a beneficial way for addressing muscle disorders. In addition to these conceptual understandings, the chapter provides a comprehensive overview of methodologies employed in the identification of LSMs, with a specific focus on the Liquid Chromatography-Mass Spectrometry (LC-MS). Furthermore, it introduces a detailed LC MS/MS-based protocol tailored for the detection of PGE2, serving as an invaluable resource for researchers immersed in this dynamic field of study.

Detailed Protocol for Solid-Phase Extraction for Lipidomic Analysis.

Developing robust analytical techniques is a vital phase to facilitate understanding the roles and impacts of various omic profilings in cellular functions. The comprehensive analysis of various biological molecules within a biological system requires a precise sample preparation technique. Solid-Phase Extraction (SPE) has proven to be an indispensable method in lipidomic analysis, providing an uncomplicated and user-friendly technique for extraction and purification of lipid components from complex biological matrices. Of all the factors influencing the reliability and success of SPE, column or adsorbent materials, flow rate, and storage conditions are paramount in terms of their significance. In this chapter, we will discuss in detail the SPE steps for lipidomic analysis in biofluid samples (serum and plasma) and muscle tissues.

Enhancement of porous asphalt mixtures modified with various fibers and ethylene-vinyl acetate polymer.

Porous asphalt mixture is conventional hot mix asphalt (HMA) with substantially decreased fines, which produces an open-graded mixture that enables the water to flow through an interconnected void space. Porous asphalt is a permeable system that has a lot of benefits. However, because of its open structure, the durability of this mixture decreases, and both its stability and resilient modulus are much lower compared to the dense conventional asphalt mixtures. Also, the high void percentage may lead to an increase in the draindown proportion. Fibers (cellulose or mineral) and polymer-modified binders are recommended for porous asphalt mixtures, especially in hot and moderate climates. The objective of this study is to improve the porous asphalt mixture's performance by using ethylene-vinyl acetate (EVA) polymer-modified bitumen. Two types of fibers (cellulose fibers and glass wool fibers) were used, separately to determine the control mixture. Four different proportions of EVA polymer were added to the bitumen (1%, 2%, 3%, and 4%) and Scanning Electron Microscopy (SEM) was used for better investigating of the bitumen microstructure, then The Marshall mix design was used to determine the optimum EVA content (OEC) for the porous asphalt mixture. Several performance tests were conducted to investigate the characteristics of the porous asphalt mixture, such as the infiltration rate, binder draindown, the wheel track and the cantabro abrasion tests. The findings of the study conclude that the addition of EVA polymer to the porous asphalt mixtures enhances the performance as it increases stability by 20.8% and the infiltration rate by 20.6%. It decreases binder draindown proportion by 33.3%, cantabro abrasion loss by 25.1% and the rut depth at 5,000 cycles and 10,000 cycles by 29.8% and 19.7%, respectively.

Advanced extraction of PV parameters' models based on electric field impacts on semiconductor conductivity using QIO algorithm.

This article presents a novel approach for parameters estimation of photovoltaic cells/modules using a recent optimization algorithm called quadratic interpolation optimization algorithm (QIOA). The proposed formula is dependent on variable voltage resistances (VVR) implementation of the series and shunt resistances. The variable resistances reduced from the effect of the electric field on the semiconductor conductivity should be included to get more accurate representation. Minimizing the mean root square error (MRSE) between the measured (I-V) dataset and the extracted (V-I) curve from the proposed electrical model is the main goal of the current optimization problem. The unknown parameters of the proposed PV models under the considered operating conditions are identified and optimally extracted using the proposed QIOA. Two distinct PV types are employed with normal and low radiation conditions. The VVR TDM is proposed for (R.T.C. France) silicon PV operating at normal radiation, and eleven unknown parameters are optimized. Additionally, twelve unknown parameters are optimized for a Q6-1380 multi-crystalline silicon (MCS) (area 7.7 cm2) operating under low radiation. The efficacy of the QIOA is demonstrated through comparison with four established optimizers: Grey Wolf Optimization (GWO), Particle Swarm Optimization (PSO), Salp Swarm Algorithm (SSA), and Sine Cosine Algorithm (SCA). The proposed QIO method achieves the lowest absolute current error values in both cases, highlighting its superiority and efficiency in extracting optimal parameters for both Single-Crystalline Silicon (SCS) and MCS cells under varying irradiance levels. Furthermore, simulation results emphasize the effectiveness of QIO compared to other algorithms in terms of convergence speed and robustness, making it a promising tool for accurate and efficient PV parameter estimation.