Kikuchi-Fujimoto Disease: A Case Report of Prolonged Fever and Lymphadenopathy in a Young Girl.

Kikuchi-Fujimoto disease (KFD) is a benign and self-limited disorder that usually presents with regional cervical lymphadenopathy and fever. We report a case of a 12-year-old female who complained of fever, night sweating, significant weight loss, and tender right cervical lymph node enlargement for 2 months. A full workup including laboratory tests and imaging studies, an excisional biopsy, and histopathological analysis were done, and the diagnosis of KFD was confirmed. The patient was treated with analgesia and oral prednisolone, resulting in good improvement. A high degree of clinical suspicion is imperative for physicians, given the rarity of the disease and the associated diagnostic challenges.

Recent Advancements and Prospects in Carbon-Based Nanomaterials Derived from Biomass for Environmental Remediation Applications.

The conversion of waste biomass into a value-added carbonaceous nanomaterial highlights the appealing power of biomass valorization. The advantages of using sustainable and cheap biomass precursors exhibit the tremendous opportunity for boosting energy production and their application in environmental remediation processes. This review emphasis the development and production of carbon-based nanomaterials derived from biomass, which possess favourable characteristics such as biocompatibility and photoluminescence. The advantages and limitations of various nanomaterials synthesized from different precursors were also discussed with insights into their physicochemical properties. The surface morphology of the porous nanomaterials is also explored along with their characteristic properties like regenerative nature, non-toxicity, ecofriendly nature, unique surface area, etc. The incorporation of various functional groups confers superiority of these materials, resulting in unique and advanced functional properties. Further, the use of these biomass derived nanomaterials was also explored in different applications like adsorption, photocatalysis and sensing of hazardous pollutants, etc. The challenges and outcomes obtained from different carbon-based nanomaterials are briefly outlined and discussed in this review.

Paper-based sensors: affordable, versatile, and emerging analyte detection platforms.

Paper-based sensors, often referred to as paper-based analytical devices (PADs), stand as a transformative technology in the field of analytical chemistry. They offer an affordable, versatile, and accessible solution for diverse analyte detection. These sensors harness the unique properties of paper substrates to provide a cost-effective and adaptable platform for rapid analyte detection, spanning chemical species, biomolecules, and pathogens. This review highlights the key attributes that make paper-based sensors an attractive choice for analyte detection. PADs demonstrate their versatility by accommodating a wide range of analytes, from ions and gases to proteins, nucleic acids, and more, with customizable designs for specific applications. Their user-friendly operation and minimal infrastructure requirements suit point-of-care diagnostics, environmental monitoring, food safety, and more. This review also explores various fabrication methods such as inkjet printing, wax printing, screen printing, dip coating, and photolithography. Incorporating nanomaterials and biorecognition elements promises even more sophisticated and sensitive applications.

Study of Cation Distribution and Photocatalytic Activity of Nonthermal Plasma-Modified NiZnFe2O4 Magnetic Nanocomposites.

In this study, NiZnFe2O4 composite was synthesized using a sol-gel route and subjected to nonthermal plasma treatment for tailoring their cations' distribution and physicochemical, magnetic, and photocatalytic properties. Microwave plasma treatment was given to the composites for 60 min in support of postsynthesis sintering at 700 °C for 5 h. X-ray diffraction (XRD) analysis was conducted on pre- and postplasma-modified ferrite composites to identify phase-pure cubic spinel structure and cations' distribution. The cation distributions were measured from the ratio of XRD intensity peaks corresponding to (220), (311), (422) and (440) planes. The intensity ratio of plasma-treated ferrite composites decreased compared to that of pristine composites. The crystallite size and lattice constant were increased on plasma treatment of the composite. The morphological analysis showed nanoflower-like structures of the particles with an increased surface area in the plasma-treated composites. The plasma oxidation and sputtering effects caused a reduction in the nanoflower size. The energy bandgap increased with a decrease in particle size due to plasma treatment. The rhodamine B dye solution was then irradiated with a light source in the presence of the nanocomposites. The dye degradation efficiency of the composite photocatalyst increased from 80 to 96% after plasma treatment.

Real-Time Prediction of Petrophysical Properties Using Machine Learning Based on Drilling Parameters.

The prediction of rock porosity and permeability is crucial for assessing reservoir productivity and economic feasibility. However, traditional methods for obtaining these properties are time-consuming and expensive, making them impractical for comprehensive reservoir evaluation. This study introduces a novel approach to efficiently predict rock porosity and permeability for reservoir assessment by leveraging real-time machine learning models. Utilizing readily available drilling parameters, this approach offers a cost-effective alternative to traditional time-consuming methods to predict formation petrophysical parameters in real-time. The data set used in this study was collected from two vertical wells located in the Middle East. It encompasses drilling parameters such as the rate of penetration (ROP), gallons per minute (GPM), revolutions per minute (RPM), strokes per minute (SPP), torque, and weight on bit (WOB), along with the corresponding measurements of porosity (ϕ) and permeability (k) obtained through core analysis. Three machine learning models, namely, decision trees (DTs), random forest (RFs), and support vector machines (SVMs), were employed and evaluated for their effectiveness in predicting porosity and permeability. The results demonstrate promising performance across the different data sets. All three models achieved correlation coefficients (R) higher than 0.91 in predicting porosity. The RF model exhibited accurate predictions of permeability, achieving R values surpassing 0.92 in the various data sets. While the DT model displayed slightly lower performance, with the R-value decreasing to 0.88 in the testing data set, the SVM model suffered from overfitting, with R values dropping to 0.83 in the testing data set. The novelty of this work lies in the successful application of machine learning models to the real-time prediction of reservoir properties, providing a practical and efficient solution for the oil and gas industry. By achieving correlation coefficients exceeding 0.91 and showcasing the models' efficacy in a dynamic testing data set, this study paves the way for improved decision-making processes and enhanced exploration and production activities. The innovative aspect lies in the utilization of drilling parameters for timely and cost-effective estimation, transforming conventional reservoir evaluation methods.

Clinical Characteristics and Prognostic Factors of Endometrial Cancer Patients With Liver Metastasis: A Surveillance, Epidemiology, and End Results Database (SEER)-Based Study of 1,034 Women.

Background There are several patterns of metastatic spread from endometrial cancer (EC). Although studies have been conducted to study the EC population with distant metastasis in the bone and lungs, there is still a lack of studies on liver metastasis. This study aims to evaluate and assess the clinical features and prognostic factors of EC patients with liver metastasis. Methodology We conducted a retrospective cohort study adhering to the guidelines for reporting observational research. We utilized the Surveillance, Epidemiology, and End Results database to gather data on female patients diagnosed with EC and reported liver metastasis. We estimated survival curves using the Kaplan-Meier method and evaluated differences in survival using the log-rank test. We also conducted univariable and multivariable Cox proportional hazards regression analyses to determine the hazard ratios with 95% confidence intervals for overall survival (OS) and identify factors that impact survival. Results We analyzed data from 1,034 EC patients with liver metastasis. Median OS after liver metastasis was six months, and cancer-specific survival was seven months. Univariate Cox regression analysis revealed several factors associated with decreased OS in EC patients. These included age (≥60 years), non-endometrioid and sarcoma histological subtypes, absence of surgery, no chemotherapy, and the presence of distant metastasis to the lung, brain, and bone. Conversely, married marital status and white race were linked to a better prognosis. Subsequent multivariate Cox regression analysis identified age (≥60 years), non-endometrioid histological subtype, absence of surgery, no chemotherapy, and the presence of distant metastasis to lung, brain, and bone remaining as independent risk factors for decreased OS. In contrast, the white race still emerged as an independent prognostic factor for better OS. Conclusions Various risk factors, such as age, race, lung, bone, or brain metastasis, as well as chemotherapy and surgery, may influence the prognosis of individuals with primary EC liver metastases.

Exploring the therapeutic mechanism of potential phytocompounds from Kalanchoe pinnata in the treatment of diabetes mellitus by integrating network pharmacology, molecular docking and simulation approach.

Since ancient times, bioactive phytocompounds from different parts of medicinal plants have been used to heal various disease ailments and they are now regarded as a valuable source of disease prevention globally. Kalanchoe pinnata is a member of the Crassulaceae family; it has a long history of usage in traditional ayurvedic treatment. Analysis of bioactive compounds for their potential anti-type-2 diabetes mellitus (T2DM) mechanism along with in-vitro and in-silico approaches was studied in the present research. The alpha-amylase and alpha-glucosidase inhibitory activity of methanolic extract of Kalanchoe pinnata (α-amylase: IC50 29.50 ± 0.04 µg/ml; α-glucosidase IC50 32.04 ± 0.35 µg/ml) exhibit a high degree of similarity to the standard drug acarbose (IC50 35.82 ± 0.14 µg/ml). Different biological databases were used to list phytocompounds from the plant, and ADME analysis using swissADME was carried out to screen compounds that obeyed the Lipinski rule of 5 and were employed further. STRING and KEGG pathway analysis was performed for gene enrichment analysis followed by network pharmacology to identify key target proteins involved in DM. AMY2A, NOX4, RPS6KA3, ADRA2A, CHRM5, and IL2 were identified as core targets for luteolin, kaempferol, alpha amyrin, stigmasterol compounds by modulating neuroactive ligand interaction, P13-AKT, MAPK, and PPAR signaling pathways. Molecular docking was performed to study the binding affinity among bioactive compounds of K. pinnata against aldose reductase, alpha-amylase, alpha-glucosidase, and dipeptidyl peptidase IV. Alpha-amylase-friedelin [FRI] and alpha-amylase-acarbose [STD] complexes were subjected to molecular simulation for a 200 ns duration that depicted the stability of the compounds and proteins. In the current study, employing dual approach in-silico and in-vitro enzyme assays has yielded a comprehensive and strong understanding of its potential therapeutic properties, making a significant step towards the development of novel anti-diabetic treatment.

Crimean-Congo haemorrhagic fever virus uses LDLR to bind and enter host cells.

Climate change and population densities accelerated transmission of highly pathogenic viruses to humans, including the Crimean-Congo haemorrhagic fever virus (CCHFV). Here we report that the Low Density Lipoprotein Receptor (LDLR) is a critical receptor for CCHFV cell entry, playing a vital role in CCHFV infection in cell culture and blood vessel organoids. The interaction between CCHFV and LDLR is highly specific, with other members of the LDLR protein family failing to bind to or neutralize the virus. Biosensor experiments demonstrate that LDLR specifically binds the surface glycoproteins of CCHFV. Importantly, mice lacking LDLR exhibit a delay in CCHFV-induced disease. Furthermore, we identified the presence of Apolipoprotein E (ApoE) on CCHFV particles. Our findings highlight the essential role of LDLR in CCHFV infection, irrespective of ApoE presence, when the virus is produced in tick cells. This discovery holds profound implications for the development of future therapies against CCHFV.

Debye Temperature Evaluation for Secondary Battery Cathode of α-SnxFe1-xOOH Nanoparticles Derived from the 57Fe- and 119Sn-Mössbauer Spectra.

Debye temperatures of α-SnxFe1-xOOH nanoparticles (x = 0, 0.05, 0.10, 0.15 and 0.20, abbreviated as Sn100x NPs) prepared by hydrothermal reaction were estimated with 57Fe- and 119Sn-Mössbauer spectra measured by varying the temperature from 20 to 300 K. Electrical properties were studied by solid-state impedance spectroscopy (SS-IS). Together, the charge-discharge capacity of Li- and Na-ion batteries containing Sn100x NPs as a cathode were evaluated. 57Fe-Mössbauer spectra of Sn10, Sn15, and Sn20 measured at 300 K showed only one doublet due to the superparamagnetic doublet, while the doublet decomposed into a sextet due to goethite at the temperature below 50 K for Sn 10, 200 K for Sn15, and 100 K for Sn20. These results suggest that Sn10, Sn15 and Sn20 had smaller particles than Sn0. On the other hand, 20 K 119Sn-Mössbauer spectra of Sn15 were composed of a paramagnetic doublet with an isomer shift (δ) of 0.24 mm s-1 and quadrupole splitting (∆) of 3.52 mm s-1. These values were larger than those of Sn10 (δ: 0.08 mm s-1, ∆: 0.00 mm s-1) and Sn20 (δ: 0.10 mm s-1, ∆: 0.00 mm s-1), suggesting that the SnIV-O chemical bond is shorter and the distortion of octahedral SnO6 is larger in Sn15 than in Sn10 and Sn20 due to the increase in the covalency and polarization of the SnIV-O chemical bond. Debye temperatures determined from 57Fe-Mössbauer spectra measured at the low temperature were 210 K, 228 K, and 250 K for Sn10, Sn15, and Sn20, while that of α-Fe2O3 was 324 K. Similarly, the Debye temperature of 199, 251, and 269 K for Sn10, Sn15, and Sn20 were estimated from the temperature-dependent 119Sn-Mössbauer spectra, which were significantly smaller than that of BaSnO3 (=658 K) and SnO2 (=382 K). These results suggest that Fe and Sn are a weakly bound lattice in goethite NPs with low crystallinity. Modification of NPs and addition of Sn has a positive effect, resulting in an increase in DC conductivity of almost 5 orders of magnitude, from a σDC value of 9.37 × 10-7 (Ω cm)-1 for pure goethite Sn (Sn0) up to DC plateau for samples containing 0.15 and 0.20 Sn (Sn15 and Sn20) with a DC value of ~4 × 10-7 (Ω cm)-1 @423 K. This non-linear conductivity pattern and levelling at a higher Sn content suggests that structural modifications have a notable impact on electron transport, which is primarily governed by the thermally activated via three-dimensional hopping of small polarons (SPH). Measurements of SIB performance, including the Sn100x cathode under a current density of 50 mA g-1, showed initial capacities of 81 and 85 mAh g-1 for Sn0 and Sn15, which were larger than the others. The large initial capacities were measured at a current density of 5 mA g-1 found at 170 and 182 mAh g-1 for Sn15 and Sn20, respectively. It is concluded that tin-goethite NPs are an excellent material for a secondary battery cathode and that Sn15 is the best cathode among the studied Sn100x NPs.

A novel micropeptide, Slitharin, exerts cardioprotective effects in myocardial infarction.

PURPOSE: Micropeptides are an emerging class of proteins that play critical roles in cell signaling. Here, we describe the discovery of a novel micropeptide, dubbed slitharin (Slt), in conditioned media from Cardiosphere-derived cells (CDCs), a therapeutic cardiac stromal cell type. EXPERIMENTAL DESIGN: We performed mass spectrometry of peptide-enriched fractions from the conditioned media of CDCs and a therapeutically inert cell type (human dermal fibrobasts). We then evaluated the therapeutic capacity of the candidate peptide using an in vitro model of cardiomyocyte injury and a rat model of myocardial infarction. RESULTS: We identified a novel 24-amino acid micropeptide (dubbed Slitharin [Slt]) with a non-canonical leucine start codon, arising from long intergenic non-coding (LINC) RNA 2099. Neonatal rat ventricular myocytes (NRVMs) exposed to Slt were protected from hypoxic injury in vitro compared to a vehicle or scrambled control. Transcriptomic analysis of cardiomyocytes exposed to Slt reveals cytoprotective capacity, putatively through regulation of stress-induced MAPK-ERK. Slt also exerted cardioprotective effects in rats with myocardial infarction as shown by reduced infarct size 48 h post-injury. Conclusions and clinical relavance: Thus, Slt is a non-coding RNA-derived micropeptide, identified in the extracellular space, with a potential cardioprotective function.

Synthesis and characterization of nanocomposite based polymeric membrane (PES/PVP/GO-TiO2) and performance evaluation for the removal of various antibiotics (amoxicillin, azithromycin & ciprofloxacin) from aqueous solution.

The escalating global concern regarding antibiotic pollution necessitates the development of advanced water treatment strategies. This study presents an innovative approach through the fabrication and evaluation of a Polyethersulfone (PES) membrane adorned with GO-TiO2 nanocomposites. The objective is to enhance the removal efficiency of various antibiotics, addressing the challenge of emerging organic compounds (EOCs) in water systems. The nanocomposite membranes, synthesized via the phase inversion method, incorporate hydrophilic agents, specifically GO-TiO2 nanocomposites and Polyvinylpyrrolidone (PVP). The resultant membranes underwent comprehensive characterization employing AFM, EDS, tensile strength testing, water contact angle measurements, and FESEM to elucidate their properties. Analysis revealed a substantial improvement in the hydrophilicity of the modified membranes attributed to the presence of hydroxyl groups within the GO-TiO2 structure. AFM images demonstrated an augmentation in surface roughness with increasing nanocomposite content. FESEM images unveiled structural modifications, leading to enhanced porosity and augmented water flux. The pure water flux elevated from 0.980 L/m2.h-1 for unmodified membranes to approximately 6.85 L/m2.h-1 for membranes modified with 2 wt% nanocomposites. Membrane performance analysis indicated a direct correlation between nanocomposite content and antibiotic removal efficiency, ranging from 66.52% to 89.81% with 4 wt% nanocomposite content. Furthermore, the nanocomposite-modified membrane exhibited heightened resistance to fouling. The efficacy of the membrane extended to displaying potent antibacterial properties against microbial strains, including S. aureus, E. coli, and Candida. This study underscores the immense potential of GO-TiO2 decorated PES membranes as a sustainable and efficient solution for mitigating antibiotic contamination in water systems. The utilization of nanocomposite membranes emerges as a promising technique to combat the presence of EOC pollutants, particularly antibiotics, in water bodies, thus addressing a critical environmental concern.

Intensive Blood Pressure Control After Endovascular Thrombectomy for Acute Ischemic Stroke: a Systematic Review and Meta-Analysis.

BACKGROUND AND PURPOSE: Optimal clinical outcome with successful recanalization from endovascular thrombectomy (EVT) requires optimal blood pressure (BP) management. We aimed to evaluate the efficacy and safety of the intensive BP target (< 140 mm Hg) versus the standard BP target (< 180 mm Hg) after EVT for acute ischemic stroke. METHODS: We conducted a systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Embase Cochrane, Scopus, and WOS until September 7th, 2023. We used the fixed-effect model to report dichotomous outcomes using risk ratio (RR) and continuous outcomes using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: CRD42023463206. RESULTS: We included four RCTs with 1559 patients. There was no difference between intensive BP and standard BP targets regarding the National Institutes of Health Stroke Scale (NIHSS) change after 24 h [MD: 0.44 with 95% CI (0.0, 0.87), P = 0.05]. However, the intensive BP target was significantly associated with a decreased risk of excellent neurological recovery (mRS ≤ 1) [RR: 0.87 with 95% CI (0.76, 0.99), P = 0.03], functional independence (mRS ≤ 2) [RR: 0.81 with 95% CI (0.73, 0.90), P = 0.0001] and independent ambulation (mRS ≤ 3) [RR: 0.85 with 95% CI (0.79, 0.92), P < 0.0001]. CONCLUSIONS: An intensive BP target after EVT is associated with worse neurological recovery and significantly decreased rates of functional independence and independent ambulation compared to the standard BP target. Therefore, the intensive BP target should be avoided after EVT for acute ischemic stroke.

Efficacy and safety of high-power short-duration ablation for atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: High-power short-duration (HPSD) ablation has emerged as an alternative to conventional standard-power long-duration (SPLD) ablation. We aim to assess the efficacy and safety of HPSD versus SPLD for atrial fibrillation (AF) ablation. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL were performed through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42023471797. RESULTS: We included six RCTs with a total of 694 patients. HPSD was significantly associated with a decreased total procedure time (MD: -22.88 with 95% CI [-36.13, -9.63], P = 0.0007), pulmonary vein isolation (PVI) time (MD: -19.73 with 95% CI [-23.93, -15.53], P < 0.00001), radiofrequency time (MD: -10.53 with 95% CI [-12.87, -8.19], P < 0.00001). However, there was no significant difference between HPSD and SPLD ablation with respect to the fluoroscopy time (MD: -0.69 with 95% CI [-2.00, 0.62], P = 0.30), the incidence of esophageal lesions (RR: 1.15 with 95% CI [0.43, 3.07], P = 0.77), and the incidence of first pass isolation (RR: 0.98 with 95% CI [0.88, 1.08], P = 0.65). CONCLUSION: HPSD ablation was significantly associated with decreased total procedure time, PVI time, and radiofrequency time compared with SPLD ablation. On the contrary, SPLD ablation was significantly associated with low maximum temperature.

Comparative Study between Gluteal Artery Perforator Flaps and Local Fasciocutaneous Flaps in Reconstruction of Gluteal Pressure Ulcers.

Background: Gluteal pressure ulcers are a common problem, associated with great morbidity and cost, and their surgical treatment includes debridement with complete bursectomy, followed by soft tissue coverage. Gluteal artery perforator flaps and gluteal fasciocutaneous flaps are commonly preferred for reconstruction because they preserve the gluteal muscle, allowing for revision in recurrent cases. The aim of this study was to evaluate the differences between these two flaps in the reconstruction of gluteal pressure ulcers regarding operative time, postoperative hospital stay, postoperative complications, and recurrence. Methods: This prospective comparative study was conducted on 30 patients who presented with stage IV gluteal pressure ulcers. Patients were randomly allocated into two equal groups: each group consisted of 15 patients. Cases in group A were reconstructed using gluteal artery perforator flaps, and those in group B were reconstructed using local fasciocutaneous flaps. Results: There was statistically significant long operative time and short postoperative hospital stay in gluteal artery perforator flaps when compared with local fasciocutaneous flaps. Also, the fasciocutaneous group reported a higher nonsignificant complication rate when compared with the gluteal perforator group. No recurrent cases were reported, and most patients had satisfactory outcomes in both groups. Conclusion: Both techniques are safe, reliable, and effective and can be considered as a first-line option in the reconstruction of gluteal pressure ulcers.

Immediate Implants in Posterior Extraction Sites: A Case Series Applying the Dual-Zone Therapeutic Concept With a Three-Year Follow-Up.

The study aims to present 11 immediately placed implants in posterior extraction sockets applying the dual-zone therapeutic concept. Five patients with non-restorable molars or premolars were treated with single or multiple immediate implants after atraumatic tooth extraction using a piezotome. The dual-zone therapeutic concept included grafting the jumping gap adjacent to the implant up to the gingival margin with a bovine xenograft. A screw-retained customized healing abutment was used to allow healing, and the implant loading was delayed for four to six months. All the patients were followed up for three years. Surgical complications, implant or prosthesis loss, and peri-implant marginal tissue health were assessed annually. No surgical complications or implant loss were observed during the follow-up visits. Peri-implant marginal tissue health showed excellent results with minimal marginal bone loss. Bone gain was evident in some cases. Using the dual-zone therapeutic concept with immediate implant placement in posterior extraction sockets showed promising results over three years.

Nature-inspired polymer photocatalysts for green NADH regeneration and nitroarene transformation.

Photocatalysis has emerged as a promising approach for generating solar chemical and organic transformations under the solar light spectrum, employing polymer photocatalysts. In this study, our aim is to achieve the regeneration of NADH and fixation of nitroarene compounds, which hold significant importance in various fields such as pharmaceuticals, biology, and chemistry. The development of an in-situ nature-inspired artificial photosynthetic pathway represents a challenging task, as it involves harnessing solar energy for efficient solar chemical production and organic transformation. In this work, we have successfully synthesized a novel artificial photosynthetic polymer, named TFc photocatalyst, through the Friedel-Crafts alkylation reaction between triptycene (T) and a ferrocene motif (Fc). The TFC photocatalyst is a promising material with excellent optical properties, an appropriate band gap, and the ability to facilitate the regeneration of NADH and the fixation of nitroarene compounds through photocatalysis. These characteristics are necessary for several applications, including organic synthesis and environmental remediation. Our research provides a significant step forward in establishing a reliable pathway for the regeneration and fixation of solar chemicals and organic compounds under the solar light spectrum.

The burden of end-stage renal disease in Khartoum, Sudan: cost of illness study.

BACKGROUND AND PURPOSE: The incidence of end-stage renal disease (ESRD) in Sudan is increasing, affecting the economic status of patients, caregivers and society. This study aimed to measure ESRD's costs, including direct and morbidity indirect expenditures, and to investigate any associated factors and financial consequences. MATERIALS AND METHODS: This cross-sectional study used a standardized questionnaire to collect data from 150 ESRD patients who had been receiving dialysis for at least one year before the time of data collection at 13 specialized renal centres in Khartoum state. Data about sociodemographic, clinical, and economic factors were gathered, and their relationship to the cost of ESRD was examined using both bivariate (Man Whitney test, Kruskal Wallis test and Spearman correlation) and multivariate analytical procedures (multivariate linear regression). RESULTS: This study reported a median direct per capita ESRD cost of 38 600 SDG ($1 723.2 PPP) annually with an interquartile range of 69 319.3 SDG ($3 094.6 PPP). The median morbidity indirect cost was estimated to be 0.0 ± 3 352 SDG ($ 0.0 ± 149.6 PPP) per annum. In 28.8% of cases, the patients were their family's primary income earner and over 85% were covered by medical insurance. Our study found that none of the study variables were significantly associated with the total cost of ESRD. CONCLUSION AND LIMITATIONS: Our findings point out considerable direct out-of-pocket expenses and productivity losses for patients and their households. However, these results should be carefully applied for comparison between the different countries due to differences in the cost of medical interventions and insurance coverage. Further longitudinal studies and studies on health finance and insurance policies are recommended.

As medical care costs continue to rise in Sudan, this study aimed to estimate direct and indirect costs associated with end-stage renal disease (ESRD) from the patient's perspective. Accurate information on the cost of illness (COI) helps policymakers prioritize healthcare services and resources, optimize public well-being, and determine health policy effectiveness. Future research should include a longitudinal design and understand ESRD costs from caregivers' and healthcare providers' perspectives.

Utilizing machine learning for flow zone indicators prediction and hydraulic flow unit classification.

Reservoir characterization, essential for understanding subsurface heterogeneity, often faces challenges due to scale-dependent variations. This study addresses this issue by utilizing hydraulic flow unit (HFU) zonation to group rocks with similar petrophysical and flow characteristics. Flow Zone Indicator (FZI), a crucial measure derived from pore throat size, permeability, and porosity, serves as a key parameter, but its determination is time-consuming and expensive. The objective is to employ supervised and unsupervised machine learning to predict FZI and classify the reservoir into distinct HFUs. Unsupervised learning using K-means clustering and supervised algorithms including Random Forest (RF), Extreme Gradient Boosting (XGB), Support Vector Machines (SVM), and Artificial Neural Networks (ANN) were employed. FZI values from RCAL data formed the basis for model training and testing, then the developed models were used to predict FZI in unsampled locations. A methodical approach involves 3 k-fold cross-validation and hyper-parameter tuning, utilizing the random search cross-validation technique over 50 iterations was applied to optimize each model. The four applied algorithms indicate high performance with coefficients determination (R2) of 0.89 and 0.91 in training and testing datasets, respectively. RF showed the heist performance with training and testing R2 values of 0.957 and 0.908, respectively. Elbow analysis guided the successful clustering of 212 data points into 10 HFUs using k-means clustering and Gaussian mixture techniques. The high-quality reservoir zone was successfully unlocked using the unsupervised technique. It has been discovered that the areas between 2370-2380 feet and 2463-2466 feet are predicted to be high-quality reservoir potential areas, with average FZI values of 500 and 800, consecutively. The application of machine learning in reservoir characterization is deemed highly valuable, offering rapid, cost-effective, and precise results, revolutionizing decision-making in field development compared to conventional methods.

The efficacy and safety of exercise regimens to mitigate chemotherapy cardiotoxicity: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Cardiotoxicity is one of the most common adverse events of the chemotherapy. Physical exercise was shown to be cardioprotective. We aim to estimate the efficacy and safety of exercise in cancer patients receiving cardiotoxic chemotherapy. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, Web of Science, SCOPUS, Cochrane, Clinical Trials.gov, and MedRxiv through July 17th, 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: CRD42023460902. RESULTS: We included thirteen RCTs with a total of 952 patients. Exercise significantly increased VO2 peak (MD: 1.95 with 95% CI [0.59, 3.32], P = 0.005). However, there was no significant effect regarding left ventricular ejection fraction, global longitudinal strain, cardiac output, stroke volume, left ventricular end-diastolic volume, left ventricular end-systolic volume, E/A ratio, resting heart rate, peak heart rate, resting systolic blood pressure, and resting diastolic blood pressure. Also, there was no significant difference regarding any adverse events (AEs) (RR: 4.44 with 95% CI [0.47, 41.56], P = 0.19), AEs leading to withdrawal (RR: 2.87 with 95% CI [0.79, 10.43], P = 0.11), serious AEs (RR: 3.00 with 95% CI [0.14, 65.90], P = 0.49), or all-cause mortality (RR: 0.25 with 95% CI [0.03, 2.22], P = 0.21). CONCLUSION: Exercise is associated with increased VO2 peak in cancer patients receiving cardiotoxic chemotherapy. However, there was no significant difference between exercise and usual care regarding the echocardiographic and safety outcomes.

Short-Term and Long-Term Impact of COVID-19 on Quality of Life and Psychological Outcomes in Saudi Arabia: A Comparative Cross-Sectional Study.

Background: Prior research has revealed notable declines in health-related quality of life (HRQoL) and substantial psychological impacts among individuals infected with COVID-19. However, there is a noticeable gap in studies addressing the enduring long-term effects of COVID-19 on HRQoL and psychological well-being. Objective: The current study investigated and compared short and long-term effects of COVID-19 on HRQoL and psychological outcomes among the Saudi population. Methods: The Arabic version of the SF-36 questionnaire was used to assess HRQoL while Anxiety and depression were evaluated by the Hamilton Anxiety (HAM-A) and Depression Scales (HDRS). Participants (n=292) were categorized into three groups: the "never-been-infected" group (n=134), the "one-year infected group" (n=43), and the "more than one year infected" group (n=115). Descriptive statistics were presented using numerical values and frequencies. To compare the groups, a one-way analysis of variance (ANOVA) test was used. Results: Most SF-36 domains exhibited lower values while HAM-A and HDRS values were higher in individuals infected during last year compared to those who never infected. Social functioning subscale of the SF-36 showed a significant difference between the groups (F (2.289) = 6.094, p = 0.01) and the effect size was d = 0.95. Pairwise comparison showed a significant reduction in the social functioning component of SF-36 in "one-year group" compared to both groups "never-been-infected" group (mean difference -13.58 (4.40-22.76) p < 0.01) and "more than one year infected" group (mean difference -10.80 (1.44-20.16) p = 0.02). HAM-A and HDRS scores showed mild levels of anxiety (<17 score) and depression (8 to 16 score) in all groups. Conclusion: The influence of COVID-19 on psychological well-being and HRQoL is significant regardless of whether individuals infected with the virus. Overall, the consistent presence of mild anxiety and depression across all groups highlights the need for a holistic approach to mental health.