Thermal and structural characteristics of date-pits as digested by Trichoderma reesei.

The objective of this study was to develop functional date-pits by mold digestion for the potential use in food products. Whole date-pits (WDP) and defatted date-pits (DDP) were digested by mold Trichoderma reesei at 20 °C. T. reesei consumed date-pits as nutrients for their growth, and DDP showed higher growth of molds as compared to the WDP. The mold digested WDP and DDP samples showed an increased water solubility and hygroscopicity as compared to the samples prepared by autoclaved. This indicated that the mold digestion transformed date-pits to hydrophilic characteristics. Thermal analysis indicated a structural change at -3.2 °C for the untreated WDP and it was followed by a glass transition shift (i.e. onset: 138 °C and a specific heat change: 295 J/kg oC), and an endothermic peak at 196 °C with enthalpy of 68 J/g for the solids melting-decomposition. Similar characteristics were also observed for treated samples with the two glass transitions. The total specific heat changes for WDP, autoclaved-WDP, and digested-WDP were observed as 295, 367, and 328 J/kg oC, respectively. The total specific heat changes for DDP, autoclaved-DDP, and digested-DDP were observed as 778, 1329, and 1877 J/kg oC, respectively. This indicated that mold digestion transformed more amorphous fraction in the DDP. The energy absorption intensities of the Fourier Transform Infrared (FTIR) spectra for the selected functional groups decreased by the mold digestion.

Updates on the Causes, Diagnosis, and Management of Peritoneal Abscesses: A Systematic Review.

Intra-abdominal complications such as peritoneal abscesses pose significant medical challenges. Over recent years, there has been a heightened focus on refining treatments for these conditions, such as optimal surgical techniques, drug therapies, and intervention methods. This paper aims to present a comprehensive overview of 10 research studies spanning various countries to highlight recent advancements and findings in the treatment and management of peritoneal abscesses. The paper reviewed 10 trials involving a total of 942 participants, covering diverse methodologies including randomized controlled trials, retrospective analyses, and phase 3 clinical trials. The research spanned countries such as the USA, Finland, Japan, Turkey, India, and China. Key findings included the notable benefits of laparoscopic interventions in appendiceal abscess treatments, which led to quicker recoveries and reduced readmissions compared to conservative approaches. Additionally, certain drug combinations, such as tazobactam/ceftolozane with metronidazole, showcased high clinical efficacy, particularly against resistant bacterial strains. Challenges persist in the early detection of intra-abdominal infections, emphasizing the pivotal role of antimicrobial treatments. Unique therapeutic approaches, like the use of strong acid-electrolyzed water (SAEW) in pediatric appendicitis cases, have proven effective in reducing surgical site infections. Intrabdominal complications such as peritoneal abscesses pose a real challenge. Early detection plays a critical role, which relies on using imaging techniques such as CT scans. Poorly managed mild intra-abdominal diseases can lead to the development of abscesses. Therefore, the implication of highly effective antibiotic combinations such as tazobactam/ceftolozane and metronidazole/ceftriaxone from the start can effectively combat challenging bacterial infections such as Gram-negative and anaerobic bacteria. Surgical procedures remain the most effective method to treat abscesses, and they are usually used as the last resort when drainage, laparoscopy, and other methods fail.

A secure routing approach based on league championship algorithm for wireless body sensor networks in healthcare.

Patients must always communicate with their doctor for checking their health status. In recent years, wireless body sensor networks (WBSNs) has an important contribution in Healthcare. In these applications, energy-efficient and secure routing is really critical because health data of individuals must be forwarded to the destination securely to avoid unauthorized access by malicious nodes. However, biosensors have limited resources, especially energy. Recently, energy-efficient solutions have been proposed. Nevertheless, designing lightweight security mechanisms has not been stated in many schemes. In this paper, we propose a secure routing approach based on the league championship algorithm (LCA) for wireless body sensor networks in healthcare. The purpose of this scheme is to create a tradeoff between energy consumption and security. Our approach involves two important algorithms: routing process and communication security. In the first algorithm, each cluster head node (CH) applies the league championship algorithm to choose the most suitable next-hop CH. The proposed fitness function includes parameters like distance from CHs to the sink node, remaining energy, and link quality. In the second algorithm, we employs a symmetric encryption strategy to build secure connection links within a cluster. Also, we utilize an asymmetric cryptography scheme for forming secure inter-cluster connections. Network simulator version 2 (NS2) is used to implement the proposed approach. The simulation results show that our method is efficient in terms of consumed energy and delay. In addition, our scheme has good throughput, high packet delivery rate, and low packet loss rate.

Homozygous Mutations in GDAP1 and MFN2 Genes Resulted in Autosomal Recessive Forms of Charcot-Marie-Tooth Disease in Consanguineous Pakistani Families.

Charcot-Marie-Tooth disease (CMT) is a heritable neurodegenerative disease of peripheral nervous system diseases in which more than 100 genes and their mutations are associated. Two consanguineous families Dera Ghazi Khan (PAK-CMT1-DG KHAN) and Layyah (PAK-CMT2-LAYYAH) with multiple CMT-affected subjects were enrolled from Punjab province in Pakistan. Basic epidemiological data were collected for the subjects. Nerve conduction study (NCS) and electromyography (EMG) were performed for the patients. Whole-exome sequencing (WES) followed by Sanger sequencing was applied to report the genetic basic of CMT. The NCS findings revealed that sensory and motor nerve conduction velocities for both families were <38 m/s. EMG presented denervation, neuropathic motor unit potential, and reduced interference pattern of peripheral nerves. WES identified that a novel nonsense mutation (c. 226 G>T) in GADP1 gene and a previously known missense mutation in MFN2 gene (c. 334 G>A) cause CMT4A (Charcot-Marie-Tooth disease type 4A) in the PAK-CMT1-DG KHAN family and CMT2A (Charcot-Marie-Tooth disease type 2A) in the PAK-CMT2-LAYYAH family, respectively. Mutations followed Mendelian pattern with autosomal recessive mode of inheritance. Multiple sequence alignment by Clustal Omega indicated that mutation-containing domain in both genes is highly conserved, and in situ analysis revealed that both mutations are likely to be pathogenic. We reported that a novel nonsense mutation and a previously known missense mutation in GAPD1 gene and MFN2 gene, respectively, cause CMT in consanguineous Pakistani families.

Innovative Foods: The Future Food Supply, Nutrition and Health.

In the coming decades, feeding the growing world population is going to become a global food-supply challenge for our existing food systems [...].

Prevalence and Awareness of Obesity and Bariatric Surgeries in the Northern Borders Region, Saudi Arabia.

Introduction Obesity is a complex health issue affecting millions worldwide, characterized by excessive body fat accumulation, often leading to various health complications. Bariatric surgeries are effective interventions for severe obesity, assisting patients in attaining substantial weight reduction and enhancing their overall well-being. This study aimed to assess obesity patterns and bariatric surgery prevalence in the Northern Borders region of Saudi Arabia to increase community knowledge and awareness about obesity and bariatric surgery. Methods This cross-sectional study included 386 residents in the Northern Borders region, Saudi Arabia. The participants completed a previously validated self-administered electronic questionnaire, and the confidentiality of the collected data was ensured. Results Nearly 58.3% of the participants (31-40 years), with a predominance of females, had a body mass index (BMI) >30, and 33.7% had undergone bariatric surgery. Most participants (92.5%) were aware that obesity is associated with significant medical issues, 98.2% appreciated that there is a surgical method to reduce weight, and 58.8% indicated that the procedure was not safe. Additionally, the majority of the respondents (57.0%) were not sure about the complications of weight-loss surgeries, and only 28.0% knew that surgeries for obesity and their complications may lead to death. Significant associations were found between age, education level, and BMI concerning the knowledge of obesity/bariatric surgery (p=0.003, 0.001, 0.002), respectively. However, gender and work status did not show such associations (p> 0.05). Conclusion Our study highlighted a lack of knowledge among the community regarding the safety, potential complications, and survival outcomes associated with obesity and bariatric surgery that could be due to ignorance and reluctance to pursue bariatric surgery to overcome morbid obesity. Significantly, the study found a relationship between age, education level, BMI, and knowledge of obesity and bariatric surgery.

A Missense Mutation (c.1037 G > C, p. R346P) in PAPSS2 Gene Results in Autosomal Recessive form of Brachyolmia Type 1 (Hobaek Form) in A Consanguineous Family.

BACKGROUND: Brachyolmia is a skeletal disorder with an autosomal mode of inheritance (both dominant and recessive) in which the patients have a short height, scoliosis and a reduced trunk size. METHODS: From the Muzaffargarh District in Pakistan, a consanguineous family with multiple Brachyolmia-affected subjects were enrolled in the present study. Basic epidemiological data and radiographs were collected for the subjects. Whole exome sequencing (WES) which was followed by Sanger sequencing was applied to report the geneticbasic of Brachyolmia. RESULTS: The WES identified a missense mutation (c.1037 G > C, p. R346P) in exon 9 of the PAPSS2 gene that was confirmed by the Sanger sequencing in the enrolled subjects. The mutation followed a Mendalian pattern with an autosomal recessive inheritance mode. Multiple sequence alignment by Clustal Omega indicated that the PAPSS2 mutation-containing domain is highly conserved. The HEK293T whole-cell extract that was transfected with the Myc-tagged PCMV6-PAPSS2 of both the wild and mutant constructs were resolved by SDS-PAGE as well as by a Western blot, which confirmed that there are different PAPSS2 protein expression patterns when they were compared between the control and Brachyolmia patients. This difference between the normal and mutated protein was not evident when the three-dimensional computational structures were generated using homology modeling. CONCLUSION: We report a missense mutation (c.1037 G > C, p. R346P) in the PAPSS2 gene that caused Brachyolmia in a consanguineous Pakistani family.

SecAODV: A Secure Healthcare Routing Scheme Based on Hybrid Cryptography in Wireless Body Sensor Networks.

In recent decades, the use of sensors has dramatically grown to monitor human body activities and maintain the health status. In this application, routing and secure data transmission are very important to prevent the unauthorized access by attackers to health data. In this article, we propose a secure routing scheme called SecAODV for heterogeneous wireless body sensor networks. SecAODV has three phases: bootstrapping, routing between cluster head nodes, and communication security. In the bootstrapping phase, the base station loads system parameters and encryption functions in the memory of sensor nodes. In the routing phase, each cluster head node calculates its degree based on several parameters, including, distance, residual energy, link quality, and the number of hops, to decide for rebroadcasting the route request (RREQ) message. In the communication security phase, a symmetric cryptography method is used to protect intra-cluster communications. Also, an asymmetric cryptography method is used to secure communication links between cluster head nodes. The proposed secure routing scheme is simulated in the network simulator version 2 (NS2) simulator. The simulation results are compared with the secure multi tier energy-efficient routing scheme (SMEER) and the centralized low-energy adaptive clustering hierarchy (LEACH-C). The results show that SecAODV improves end-to-end delay, throughput, energy consumption, packet delivery rate (PDR), and packet loss rate (PLR).

miRNAs and the Hippo pathway in cancer: Exploring the therapeutic potential (Review).

Cancer is recognized as the leading cause of death worldwide. The hippo signaling pathway regulates organ size by balancing cell proliferation and cell death; hence dysregulation of the hippo pathway promotes cancer­like conditions. miRNAs are a type of non­coding RNA that have been shown to regulate gene expression. miRNA levels are altered in various classes of cancer. Researchers have also uncovered a crosslinking between miRNAs and the hippo pathway, which has been linked to cancer. The components of the hippo pathway regulate miRNA synthesis, and various miRNAs regulate the components of the hippo pathway both positively and negatively, which can lead to cancer­like conditions. In the present review article, the mechanism behind the hippo signaling pathway and miRNAs biogenesis and crosslinks between miRNAs and the hippo pathway, which result in cancer, shall be discussed. Furthermore, the article will cover miRNA­related therapeutics and provide an overview of the development of resistance to anticancer drugs. Understanding the underlying processes would improve the chances of developing effective cancer treatment therapies.

Salbutamol-Induced QT Interval Prolongation in a Two-Year-Old Patient.

Salbutamol-induced QT interval prolongation is a relatively rare adverse effect of beta2-agonists. We report a case of a two-year-old female patient with no known past medical history, brought by her parents to the ED 30 minutes after ingesting a total dose of 97 mg of salbutamol solution. ECG was done for the patient when she arrived and showed sinus tachycardia with prolonged QTc (509 ms) and normal QRS complex. The patient was admitted to the Pediatric Intensive Care Unit (PICU) with persistent tachycardia and tachypnea in the initial reassessment. ECG was repeated with normal QT interval after IV Mg sulfate. The patient was observed in PICU for 12 hours with serial ECG and venous blood gas (VBG). IV potassium chloride (KCL) infusion started, and serial VBG showed normal potassium and lactate. The patient was doing well in the next six hours, with normal serial ECG, labs, and vital signs. In conclusion, salbutamol-induced QT prolongation has infrequently been reported in the literature. Although inhaled salbutamol is commonly used in clinical practice, physicians have limited experience with the severe features of its toxicity. Salbutamol is known to cause minimal side effects, which may be under-recognized and progress to serious manifestations such as hypokalemia, QT prolongation, and sudden cardiac death.

Retraction: Association Between Ureteral Double J Stent Colonization and Lower Urinary Tract Symptom Severity: A Cross-Sectional Study.

[This retracts the article DOI: 10.7759/cureus.19354.].

Retraction: Predictors of Quality of Life Among People Living With Multimorbidity in Karachi, Pakistan: A Cross-Sectional Study.

[This retracts the article DOI: 10.7759/cureus.18803.].

An approximation of one-dimensional nonlinear Kortweg de Vries equation of order nine.

This research presents the approximate solution of nonlinear Korteweg-de Vries equation of order nine by a hybrid staggered one-dimensional Haar wavelet collocation method. In literature, the underlying equation is derived by generalizing the bilinear form of the standard nonlinear KdV equation. The highest order derivative is approximated by Haar series, whereas the lower order derivatives are attained by integration formula introduced by Chen and Hsiao in 1997. The findings are shown in the form of tables and a figure, demonstrating the proposed technique's convergence, robustness, and ease of application in a small number of collocation points.

Tips for Managing Resistance to Innovation in Medical Education

@#Resistance to innovation is a natural protective mechanism and it should be perceived as a “conditional acceptance” rather than outright rejection. The change agents need to take a number of steps to convert the conditional acceptance to a “welcome change”. The aim of this article is to equip the staff members in the institutions of higher learning with tools for effectively managing the resistance to innovations in medical education. We examined the published literature in the area of managing the resistance to change and combined it with our own experiences in the established as well as new medical schools in two Asian countries and developed 12 tips to assist the change agents to manage the resistance to innovations effectively. Application of these tips will help change agents to use their time and efforts efficiently and effectively to achieve credible and lasting changes in the field of medical education.

Association Between Ureteral Double J Stent Colonization and Lower Urinary Tract Symptom Severity: A Cross-Sectional Study.

Introduction Double J stents (DJS) are commonly used in urological practice, but they do have a risk of complications, such as infection and hematuria. This study explored the association between ureteral double J stent colonization and lower urinary tract symptom (LUTS) severity. Methodology This cross-sectional study was conducted from January 2021 to June 2021 in patients admitted to a tertiary care hospital in Karachi, Pakistan, who required double J stent (DJS) insertion. Patients who came to the site for stent removal were invited to participate in the study and enrolled using a consecutive sampling technique between January 15, 2021, and March 15, 2021. Results The study enrolled 176 patients, of whom 73.33% had colonization and the remaining had no colonization. The factors significantly associated with symptom severity included colonization of the DJS (P-value = 0.001) and the patients' ages (P-value = 0.046). The two groups have significantly different symptoms, which included incontinence (P-value = 0.001), polyuria (P-value = 0.001), and nocturia (P-value = 0.001). Conclusion Our study found more severe symptoms in DJS patients with colonization than in those without colonization. Irritative voiding symptoms, including nocturia and dysuria, are more common in DJS patients with colonization.

Predictors of Quality of Life Among People Living With Multimorbidity in Karachi, Pakistan: A Cross-Sectional Study.

Introduction Multimorbidity is defined as the coexistence of more than one chronic condition in one individual. It is related to enhanced rates of disability and mortality, enhanced disease burden, decreased function levels, and it can affect the wellbeing and daily activities of people, including loss of autonomy and independence. The aim of the current study is to determine the predictors of quality of life among patients with multimorbidity in Karachi, Pakistan. Methodology It was a cross-sectional study conducted in 12 health care facilities of six districts in Karachi, Pakistan. Two health care facilities were selected from each district using a convenient sampling technique. The total sample size of this study was 690, equally distributed among 12 health care facilities. Results The majority of participants (33.47%) belonged to the age group of 40 to 49 years, while 29.85% of participants had an age between 30 to 39 years. More than half of the participants were females (50.87%). Overall, the multivariate analysis showed being male, married, younger, high educational status and employed were positively associated with quality of life. While having lower family income is negatively associated with quality of life. Conclusion The findings of this study had important implications for identifying distinct multimorbidity individuals who were at risk of a lower quality of life, and they emphasized the need for disease detection and treatment at an early stage. The study can also give important evidence for decision-makers when it comes to allocating health resources more efficiently, and health administrative departments can improve chronic disease management.

A reliable algorithm to compute the approximate solution of KdV-type partial differential equations of order seven.

The approximate solution of KdV-type partial differential equations of order seven is presented. The algorithm based on one-dimensional Haar wavelet collocation method is adapted for this purpose. One-dimensional Haar wavelet collocation method is verified on Lax equation, Sawada-Kotera-Ito equation and Kaup-Kuperschmidt equation of order seven. The approximated results are displayed by means of tables (consisting point wise errors and maximum absolute errors) to measure the accuracy and proficiency of the scheme in a few number of grid points. Moreover, the approximate solutions and exact solutions are compared graphically, that represent a close match between the two solutions and confirm the adequate behavior of the proposed method.

Successful Academic Remediation of Undergraduate Medical Students for Exit Examination: Lessons Learned

@#Introduction: To ensure that they will be the safe health-care providers, the medical schools must guarantee that their students meet the predetermined criteria before graduating. To fulfil this condition, usually a small proportion of students, need remedial training before they could graduate. In October 2018 we designed an academic remediation programme for 24 students who were to re-appear in their Final Professional MBBS Examination (FPE) in March/ April 2019. Aim of the remediation programme was not only to help the students to pass the examination but also to train them as safe future doctors. Methods: A rotational programme was drawn to cover all the relevant disciplines. A number of well-planned interventions were applied. A clinical examination in various combinations of a long case, short cases and OSCE stations was conducted at the end of each rotation and the written examination was conducted after completing the full 24 weeks of the programme before they sat in the FPE. Results: The five most useful interventions identified in the students’ feedback included: “Patient to book approach”; Mentoring; Group study; Mock examinations and Flipped class-rooms. Eighteen of the 24 (75%) students passed the FPE. The five of the six students failed because of the poor performance in the clinical examination. Conclusion: Remedial interventions can be successful by having clear goals and directions. Individualized approach in identifying and addressing the issues and by seeking help from the relevant professionals ensures the success.

The Utility of Nucleolar Organizer Regions Quantitation in Early Prediction of Lung Neoplastic Transformation.

BACKGROUND:  Cancer burden can be reduced by early detection of early neoplastic changes applying suitable screening methods. This study aimed to assess the utility of nucleolar organizer regions (NORs) quantitation in early prediction of lung neoplastic transformation. METHODOLOGY: This study investigated 200 apparently healthy individuals categorized into two groups; smoking exposed individuals (N=100), and were categorized as cases, and smoking nonexposed (N=100), and were ascertained as controls. Sputum specimen was attained from each participant (paying all indispensable safety precautions and sample adequacy processes).  Results: Out of the 200 volunteers assessed in the present study, mean NORs counts of >2.00 were identified in 16/200(8%) of the study subjects. All 16/16(100%) cases were found with lung epithelial metaplasia (squamous metaplasia). Out of the 100 cases, mean NORs counts of >2.00 were identified in 16/100(16%), hence, all the controls were identified with mean NORs counts of <2.00. The risk of lung cellular proliferative changes associated with smoking exposure are odds ratio (OR) (95% confidence interval, CI) = 39.2485 (2.3199-664.0052), p = 0.0110, z statistic = 2.543. CONCLUSION: NORs count is a simple, specific, cost-effective, and reliable method that can give a quantitative measurement for the risk of lung neoplastic transformation. For at risk-population (tobacco users), it is recommended to perform the argyrophilic NORs (AgNORs) method beside sputum cytology.

Exposure to variable doses of nickel oxide nanoparticles disturbs serum biochemical parameters and oxidative stress biomarkers from vital organs of albino mice in a sex-specific manner.

INTRODUCTION: This study was designed to report the biological effect of nickel oxide nanoparticles (NiO NPs) in albino mice. MATERIAL AND METHODS: Five weeks old albino mice of both sex were intraperitoneally injected either with 20 mg (low dose) or 50 mg/mL saline/kg body weight (high dose) of NiO NPs for 14 days. Saline-treated controls were maintained in parallel. Complete blood count, selected serum biochemical parameters and oxidative stress biomarkers from vital organs were determined in all subjects. RESULTS: Male mice treated with NiO NPS had increased blood urea nitrogen, elevated superoxide dismutase (SOD) in liver elevated MDA in liver, kidney and heart and reduced catalase activity in heart and kidney. Female mice treated with NiO NPs had significantly reduced serum albumin and total proteins, SOD in lungs and elevated MDA in liver. DISCUSSION: We are reporting that intraperitoneal injections of NiO NPs for 14 days drastically affect blood serum parameters and oxidative stress biomarkers from vital organs of albino mice. CONCLUSION: Toxic effects of NiO NPs were dose and sex dependent and they were more pronounced at higher dose and in male mice.