Utilizing Siamese 4D-AlzNet and Transfer Learning to Identify Stages of Alzheimer's Disease.

Alzheimer's disease (AD) is the general form of dementia, leading to a progressive neurological disorder characterized by memory loss due to brain cell damage. Artificial Intelligence (AI) assists in the early identification and prediction of AD patients, determining future risks and benefits for radiologists and doctors to save time and cost. Since deep learning (DL) approaches work well with massive datasets and have recently become helpful for AD detection, there remains an area for improvement in automating detection performance. Present approaches somehow addressed the challenges of limited annotated data samples for binary classification. This contrasts with prior state-of-the-art techniques, which were constrained by their incapacity to capture abstract-level information. In this paper, we proposed a Siamese 4D-AlzNet model comprised of four parallel convolutional neural network (CNN) streams (Five CNN layer blocks) and customized transfer learning models (Frozen VGG-19, Frozen VGG-16, and customized AlexNet). Siamese 4D-AlzNet was vertically and horizontally stored, and the spatial features were passed to the final layer for classification. For experiments, T1-weighted MRI images comprised of four distinct subject classes, normal control (NC), mild cognitive impairment (MCI), late mild cognitive impairment (LMCI), and AD, have been employed. Our proposed models achieved outstanding accuracy, with a remarkable 95.05% accuracy distinguishing between normal and AD subjects. The performance across remaining binary class pairs consistently exceeded 90%. We thoroughly compared our model with the latest methods using the same dataset as our reference. Our proposed model improved NC-AD and MCI-AD classification accuracy by 2% 7%.

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.

Low-grade fibromyxoid sarcoma in laryngopharynx: the first case report in the literature.

Low-grade fibromyxoid sarcoma is a rare mesenchymal neoplasm with distinctive histopathological features. Although it typically arises in the deep soft tissues of the trunk and extremities, its occurrence in the head and neck region is exceedingly rare. We present the first documented case of low-grade fibromyxoid sarcoma in the laryngopharynx, expanding the spectrum of this rare tumor's anatomical localization. The clinical, radiological, and histopathological features of this unique case are discussed, highlighting the diagnostic challenges and therapeutic considerations associated with this uncommon presentation.

Fabrication of cellulose nanocrystals/carboxymethyl cellulose/zeolite membranes for methylene blue dye removal: understanding factors, adsorption kinetics, and thermodynamic isotherms.

This study introduces environmentally-friendly nanocellulose-based membranes for AZO dye (methylene blue, MB) removal from wastewater. These membranes, made of cellulose nanocrystals (CNCs), carboxymethyl cellulose (CMC), zeolite, and citric acid, aim to offer eco-friendly water treatment solutions. CNCs, obtained from sugarcane bagasse, act as the foundational material for the membranes. The study aims to investigate both the composition of the membranes (CMC/CNC/zeolite/citric acid) and the critical adsorption factors (initial MB concentration, contact time, temperature, and pH) that impact the removal of the dye. After systematic experimentation, the optimal membrane composition is identified as 60% CNC, 15% CMC, 20% zeolites, and 5% citric acid. This composition achieved a 79.9% dye removal efficiency and a 38.3 mg/g adsorption capacity at pH 7. The optimized membrane exhibited enhanced MB dye removal under specific conditions, including a 50 mg adsorbent mass, 50 ppm dye concentration, 50 mL solution volume, 120-min contact time, and a temperature of 25°C. Increasing pH from neutral to alkaline enhances MB dye removal efficiency from 79.9% to 94.5%, with the adsorption capacity rising from 38.3 mg/g to 76.5 mg/g. The study extended to study the MB adsorption mechanisms, revealing the chemisorption of MB dye with pseudo-second-order kinetics. Chemical thermodynamic experiments determine the Freundlich isotherm as the apt model for MB dye adsorption on the membrane surface. In conclusion, this study successfully develops nanocellulose-based membranes for efficient AZO dye removal, contributing to sustainable water treatment technologies and environmental preservation efforts.

The use of instructional videos to compensate for flexible physiology learning during the pandemic of COVID 19.

BACKGROUND: This study aimed at using instructional videos in physiology created by students to improve the process of learning Physiology especially during the COVID-19 Pandemic which enforced the lectures to be online. Additionally, it allowed students to visualize and understand clinical scenarios and the physiological reasons behind them while assessing how much they stand to gain from the experience. METHODS: This study is a project to implement FAIMER, ASU MENA-FRI Institute, Cairo, Egypt. In a foundation course for first-year medical students, the instructor utilized a variety of instructional methods including lecture, small group discussion, individual assignments, and reflection. Students were randomly allocated into 18 groups, then a topic in their physiology curriculum was chosen and they formulated a related case scenario, thereafter a video was made by themselves. This intervention was rewarded by activity mark in their course. Post-project questionnaire was used, and an external reviewer evaluated the videos presented by students. This study obtained IRB approval from the Faculty of Medicine, Ain Shams Medical Ethics committee. RESULTS: the project helped students to improve their skills in problem-solving, teamwork, active learning, communication, planning, and time management. In addition, it also increased their confidence in their abilities to learn, face unexpected challenges, and achieve goals, while considering new life opportunities, those which became an option when the students searched by themselves and learned more about the different angles of medicine. CONCLUSION: Compared to the traditional lecture format that focuses on memorizing definitions and theoretical structures, instructional videos can be regarded as an innovative teaching tool and a unique medical education method that allowed students to participate more in the learning process even if their lectures were online. This article proposes an active learning method in undergraduate medical education which compensate for limited face-to-face attended during the pandemic.

Auditory function assessment in patients with chronic obstructive pulmonary disease.

Background: Chronic obstructive pulmonary disease is a multisystem disease with multiple comorbidities. Hearing is dependent on the cochlear functions that may be affected by oxygenation. Affection of hearing is problematic and represents a major concern that should be seriously investigated as an important comorbidity in chronic obstructive pulmonary disease patients. Objective: To assess auditory status among chronic obstructive pulmonary disease patients. Methodology: The current study was carried out at Al-Azhar University Hospitals, Cairo, from 1 August 2021 to 2022, including 120 participants. In addition to the control group (60 healthy participants), there were two study groups: chronic obstructive pulmonary disease patients with respiratory failure group (30 patients) and non-respiratory failure group (30 patients). Hearing functions were studied using pure tone audiometry, and auditory brain stem response. Results: There was statistically significant hearing impairment in chronic obstructive pulmonary disease patients in comparison to control group. The hearing impairment was more significant in chronic obstructive pulmonary disease with respiratory failure group in comparison to chronic obstructive pulmonary disease without respiratory failure group. The auditory impairment shows a negative interrelationship with oxygen tension (PaO2) and a positive interrelationship with the smoking index. Conclusion: Hearing affection was meaningfully higher among chronic obstructive pulmonary disease patients and more prominent in patients with respiratory failure. Hypoxia results in deterioration of pure tone audiometry and increased absolute and interpeak latencies in auditory brain stem response. At every frequency, the mean pure tone audiometry thresholds were higher for chronic obstructive pulmonary disease groups than control group albeit remaining in the mild to moderate area of hearing loss. Retro-cochlear affection was suggested among patients with chronic obstructive pulmonary disease as evidenced with the prolongation of auditory brain stem response waves latencies.

Increased Expression of Neprilysin Is Associated with Inflammation in Preeclampsia.

Preeclampsia (PE) is associated with a finely tuned equilibrium between trophoblast cell invasion and fetal-maternal immunological tolerance. An imbalance between proinflammatory (IL-6) and anti-inflammatory (IL-10) cytokines is a hallmark of PE. Neprilysin (NEP), a membrane-bound metalloprotease, is vulnerable to the inflammatory environment and plays a significant role in modulating vascular tone. The aim of this study was to determine the correlation between NEP (mRNA and protein) levels and the inflammatory status in PE patients compared to healthy pregnant women and to identify the role of NEP in evaluating the severity of preeclampsia. The study group comprised 52 pregnant women with PE while the control group comprised 47 normotensive pregnant women. After a caesarean section, placental tissue samples from patients and controls were collected to measure the expression levels of IL-6, TGF-ß, IL-10, and NEP mRNA. In addition, an enzyme-linked immunosorbent assay was used to assess the quantity of NEP protein in blood samples. Our results revealed a significant positive correlation between NEP (mRNA and protein) and proinflammatory markers IL-6 and TGF-ß levels in patients compared to controls and a significant inverse correlation between NEP and anti-inflammatory cytokine IL-10. Moreover, this is the first study to find a strong positive correlation between NEP level and PE severity. In conclusion, in PE patients, there is a substantial relationship between NEP, the degree of inflammation, and PE severity. NEP could act as a potential biomarker for diagnosis and prognosis of PE.

Prognostic value of arterial lactate index in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention: a prospective cohort study.

Aim: Limited knowledge exists on the pathophysiological cascade beyond serum lactate's association with myocardial injury. Method: Assessed the prognostic value of lactate index on periprocedural variables and its impact on 30-day major adverse cardiovascular events (MACE) in 300 prospective ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Results: Significant correlations were observed between admission lactate and Killip class, periprocedural time intervals, postprocedure thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG; p < 0.01). Lactate levels correlated with diminished ST-deviation resolution, cardiac enzymes (CK-MB, troponin; p < 0.001; 0.004), and lower ejection fraction (p < 0.001). This relationship impacted 30-day MACE (p < 0.001). Conclusion: Hyperlactatemia in STEMI patients undergoing pPCI is associated with worse Killip class, unsatisfactory TIMI flow, MBG, larger infarct size and higher 30-day MACE. Serum lactate aids risk stratification in pPCI for STEMI patients.

Combined Effects of Yellow Mealworm (Tenebrio molitor) and Saccharomyces cerevisiae on the Growth Performance, Feed Utilization Intestinal Health, and Blood Biomarkers of Nile Tilapia (Oreochromis niloticus) Fed Fish Meal-Free Diets.

Aquafeed quality is the most critical factor for aquaculture sustainability. However, limitations of traditional feed ingredients such as fishmeal (FM) need alternative strategies to ensure the nutritional requirements for aquatic animals. In this trial, four test diets were formulated (2 × 2 factorial design), where FM was incorporated in two diets at 10% with or without Saccharomyces cerevisiae (SC) at 1 g/kg. At the same time, FM was replaced with yellow mealworm (Tenebrio molitor) meal (TM) with or without SC at 1 g/kg. The growth performance indices (final weight, weight gain, and SGR), and the feed utilization indices (FCR and PER) were markedly affected by the protein source (FM or TM) and dietary SC (P < 0.05). The protein source (FM or TM) significantly (P < 0.05) affected the whole-body protein and lipid contents, while the moisture and ash contents were unaffected (P > 0.05) by TM or SC. The growth of the intestinal villi showed a marked increase in both height and branching in the treated groups with SC along the whole length of the intestine. Furthermore, the immune cell infiltration was prominent near the intestinal crypts of the middle intestinal segments in the supplemented groups by SC. Dietary TM and SC revealed improved hepatic parenchyma in the liver tissue better than other groups. The hematological indices, including hemoglobulin, hematocrit, red blood cells, and white blood cells, were markedly affected by dietary SC (P < 0.05). The lysozyme activity and phagocytic index were markedly affected by dietary SC, while phagocytic activity was affected by dietary TM (P < 0.05). The catalase, glutathione peroxidase, and malondialdehyde were markedly affected by the interaction between dietary protein source and SC, while superoxide dismutase was affected by dietary SC (P < 0.05). In conclusion, adding SC could enhance the utilization of TM by Nile tilapia with positive effects on the intestinal and liver histological features and the immune and antioxidative responses.

Clinical versus radiological method for adjusting rotational alignment during femoral shaft fractures intramedullary nailing and the malrotation impact on the functional outcomes: early results from a prospective cohort study.

OBJECTIVES: The primary objective of the current study is to assess which is better for obtaining the proper femoral rotation during IMN of femoral fractures, the radiological or clinical method. The secondary objectives were to document malrotation's incidence and its effect on the hip and knee functional outcomes. METHODS: Thirty-three patients with unilateral femoral shaft fractures were treated using intramedullary nails (IMN) on a usual radiolucent operative table. Intraoperative rotation adjustment was performed using a radiological method (relying on the contralateral lesser trochanter profile) in 16 patients (group A), while in 17 patients, a clinical method was used (group B). Postoperative assessment of malrotation was performed using a CT scan, and 15 degrees was the cutoff value where below is an acceptable rotation (group I) and above is true malrotation (group II). Functional assessment was performed using the Harris hip score (HHS), the Tegner Lysholm Knee Scoring Scale (TLKSS), and the Neer score. RESULTS: The patients' mean age was 30.7 ± 9.3 years; 81.8% were males, and the left side was injured in 63.6% of patients. After a mean follow up of 18.2 ± 6.9 months, all fractures were united, and the overall mean amount of rotational difference between the fractured and the contralateral side was 14.7° ± 6.0 (3-29.4), 84.8% were in external rotation. No difference in the mean rotational deformity in group A compared to group B. Measurements were 13.9 ± 6.7 and 15.7 ± 5.5, respectively (p = 0.47). Seventeen (51.5%) patients in group I with a mean deformity of 9.8 ± 3.4 (3-14.7), while group II consisted of 16 (48.5%) patients with a mean deformity of 19.6 ± 3.7 (15.3-29.4). There was no difference in the functional scores between group I and group II; HHS was 89.4 ± 7.4 versus 87.7 ± 8.9 (p = 0.54), TLKSS was 84.6 ± 9.6 versus 80.4 ± 13.9 (p = 0.32), and Neer score was 87.9 ± 9.5 versus 83 ± 12.5 (p = 0.21) for group I and group II, respectively. CONCLUSION: There was no difference in malrotation incidence after unilateral femoral fractures IMN with either an intraoperative clinical or radiological method for rotational adjustment; furthermore, malrotation did not affect the functional outcomes.

HDR-EfficientNet: A Classification of Hypertensive and Diabetic Retinopathy Using Optimize EfficientNet Architecture.

Hypertensive retinopathy (HR) and diabetic retinopathy (DR) are retinal diseases closely associated with high blood pressure. The severity and duration of hypertension directly impact the prevalence of HR. The early identification and assessment of HR are crucial to preventing blindness. Currently, limited computer-aided methods are available for detecting HR and DR. These existing systems rely on traditional machine learning approaches, which require complex image processing techniques and are often limited in their application. To address this challenge, this work introduces a deep learning (DL) method called HDR-EfficientNet, which aims to provide an efficient and accurate approach to identifying various eye-related disorders, including diabetes and hypertensive retinopathy. The proposed method utilizes an EfficientNet-V2 network for end-to-end training focused on disease classification. Additionally, a spatial-channel attention method is incorporated into the approach to enhance its ability to identify specific areas of damage and differentiate between different illnesses. The HDR-EfficientNet model is developed using transfer learning, which helps overcome the challenge of imbalanced sample classes and improves the network's generalization. Dense layers are added to the model structure to enhance the feature selection capacity. The performance of the implemented system is evaluated using a large dataset of over 36,000 augmented retinal fundus images. The results demonstrate promising accuracy, with an average area under the curve (AUC) of 0.98, a specificity (SP) of 96%, an accuracy (ACC) of 98%, and a sensitivity (SE) of 95%. These findings indicate the effectiveness of the suggested HDR-EfficientNet classifier in diagnosing HR and DR. In summary, the HDR-EfficientNet method presents a DL-based approach that offers improved accuracy and efficiency for the detection and classification of HR and DR, providing valuable support in diagnosing and managing these eye-related conditions.

An overview on the use of ultraviolet radiation to disinfect air and surfaces.

Background and aim Ultraviolet radiation (UV) is the portion of the electromagnetic spectrum of wavelengths between 200 and 400 nm divided into three bands called UVA, UVB and UVC. Due its well-described antimicrobial activity, UVC can represent a useful tool for disinfect surfaces, water, and air. The aim of this study was to illustrate the studies over time ultraviolet germicidal irradiation (UVGI) to disinfect air and surfaces. Methods Articles on Scopus published until April 14, 2023, were considered. Many issues involving UV were deepened crosschecking with e.g., "air", "surfaces", "disinfection", "bacteria", "fungi", "operating theatres". According to the case, the following variables were considered: years and related number of articles, sources of publications, subject areas, type of document published, type of journal, nationalities of the authors. Results Since 30's, 287 448 articles on UV have been published. Among UVGI, 22 159 articles covered bacteria issue, followed by fungi and viruses with about 12000 both. UVGI was addressed by 1941 and 931 articles for surfaces and air respectively. Of these, 122 were performed in operating theatres. Since 1987 works have been published on spacecraft and since 2000, on the use of UVGI robots for disinfect air and surfaces. Conclusions Our study shows the studies on UVGI and related issues. It also shows most recently perspectives about the applications e.g. during prolonged human-crewed missions on spacecrafts, to inactivate microorganisms in environments where the exchange of air is impossible.

Basaloid squamous cell carcinoma of the larynx: A rare case report.

INTRODUCTION AND IMPORTANCE: Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive subtype of squamous cell carcinoma. BSCC in the larynx is an extremely rare occurrence, with only a few cases reported in the medical literature. This case report aims to shed light on the clinical presentation, diagnostic challenges, histopathological features, and therapeutic considerations associated with this rare entity. CASE PRESENTATION: This case report describes a 65-year-old male patient who presented with hoarseness and dyspnea. Laryngoscopy revealed a 2.5 cm pedunculated lesion on the left vocal cord. The patient underwent a laryngectomy, and the histopathological examination of the excised specimen confirmed the diagnosis of BSCC. CLINICAL DISCUSSION: BSCC of the larynx is a rare malignancy comprising less than 1 % of laryngeal cancers. Clinical features often overlap those of squamous cell carcinoma, such as hoarseness, progressive breathing difficulties, and swallowing issues. Treatment approaches vary, with some opting for neo-adjuvant radiotherapy before surgery, like in this case, while others favor surgical excision as the primary treatment, supplemented by adjuvant chemo- or radiotherapy in certain cases. CONCLUSION: Basaloid squamous cell carcinoma is a rare variant of squamous cell carcinoma. Clinicians and pathologists should be aware of the distinctive characteristics of BSCC and its potential clinical aggressiveness. While rare, early recognition and appropriate management are essential for achieving favorable outcomes in patients with this challenging condition.

Management of Incidental Uncontrolled Elevation of Intraoperative Blood Pressure: A Comparative Study on Nitroglycerine Versus Dexmedetomidine Infusion.

Background: Uncontrolled elevation of intraoperative blood pressure can result in deleterious effects with increased risk of morbidity and mortality. Objectives: We aimed to compare nitroglycerine infusion with dexmedetomidine infusion in controlling accidental intraoperative uncontrolled hypertension. Methods: This comparative study was conducted on 73 hypertensive patients undergoing cancer surgeries who experienced uncontrolled intraoperative hypertension. The data of 38 patients were retrieved from the medical records for the nitroglycerine group and 35 patients were prospectively enrolled for the dexmedetomidine group. Group N received nitroglycerine infusion (0.3 - 1 µg/kg/min), while group D received dexmedetomidine infusion (0.2 - 0.7 µg/kg/h). Results: Both groups were comparable regarding their demographic data and clinical characteristics. Systolic, diastolic, and mean arterial pressure (MAP) values were significantly lower in group N compared to group D during the period between 60 and 120 minutes intraoperatively (P < 0.001). Heart rate values were significantly lower in group D than in group N (P < 0.001). Postoperative sedation scores were better for group D with lower analgesic requirements (P < 0.001). Conclusions: Dexmedetomidine infusion can be used to manage the uncontrolled intraoperative elevation of blood pressure in selected patient population.

A Residual-Dense-Based Convolutional Neural Network Architecture for Recognition of Cardiac Health Based on ECG Signals.

Cardiovascular disorders are often diagnosed using an electrocardiogram (ECG). It is a painless method that mimics the cyclical contraction and relaxation of the heart's muscles. By monitoring the heart's electrical activity, an ECG can be used to identify irregular heartbeats, heart attacks, cardiac illnesses, or enlarged hearts. Numerous studies and analyses of ECG signals to identify cardiac problems have been conducted during the past few years. Although ECG heartbeat classification methods have been presented in the literature, especially for unbalanced datasets, they have not proven to be successful in recognizing some heartbeat categories with high performance. This study uses a convolutional neural network (CNN) model to combine the benefits of dense and residual blocks. The objective is to leverage the benefits of residual and dense connections to enhance information flow, gradient propagation, and feature reuse, ultimately improving the model's performance. This proposed model consists of a series of residual-dense blocks interleaved with optional pooling layers for downsampling. A linear support vector machine (LSVM) classified heartbeats into five classes. This makes it easier to learn and represent features from ECG signals. We first denoised the gathered ECG data to correct issues such as baseline drift, power line interference, and motion noise. The impacts of the class imbalance are then offset by resampling techniques that denoise ECG signals. An RD-CNN algorithm is then used to categorize the ECG data for the various cardiac illnesses using the retrieved characteristics. On two benchmarked datasets, we conducted extensive simulations and assessed several performance measures. On average, we have achieved an accuracy of 98.5%, a sensitivity of 97.6%, a specificity of 96.8%, and an area under the receiver operating curve (AUC) of 0.99. The effectiveness of our suggested method for detecting heart disease from ECG data was compared with several recently presented algorithms. The results demonstrate that our method is lightweight and practical, qualifying it for continuous monitoring applications in clinical settings for automated ECG interpretation to support cardiologists.

Innovative Hybrid Approach for Masked Face Recognition Using Pretrained Mask Detection and Segmentation, Robust PCA, and KNN Classifier.

Face masks are widely used in various industries and jobs, such as healthcare, food service, construction, manufacturing, retail, hospitality, transportation, education, and public safety. Masked face recognition is essential to accurately identify and authenticate individuals wearing masks. Masked face recognition has emerged as a vital technology to address this problem and enable accurate identification and authentication in masked scenarios. In this paper, we propose a novel method that utilizes a combination of deep-learning-based mask detection, landmark and oval face detection, and robust principal component analysis (RPCA) for masked face recognition. Specifically, we use pretrained ssd-MobileNetV2 for detecting the presence and location of masks on a face and employ landmark and oval face detection to identify key facial features. The proposed method also utilizes RPCA to separate occluded and non-occluded components of an image, making it more reliable in identifying faces with masks. To optimize the performance of our proposed method, we use particle swarm optimization (PSO) to optimize both the KNN features and the number of k for KNN. Experimental results demonstrate that our proposed method outperforms existing methods in terms of accuracy and robustness to occlusion. Our proposed method achieves a recognition rate of 97%, which is significantly higher than the state-of-the-art methods. Our proposed method represents a significant improvement over existing methods for masked face recognition, providing high accuracy and robustness to occlusion.

Assist-Dermo: A Lightweight Separable Vision Transformer Model for Multiclass Skin Lesion Classification.

A dermatologist-like automatic classification system is developed in this paper to recognize nine different classes of pigmented skin lesions (PSLs), using a separable vision transformer (SVT) technique to assist clinical experts in early skin cancer detection. In the past, researchers have developed a few systems to recognize nine classes of PSLs. However, they often require enormous computations to achieve high performance, which is burdensome to deploy on resource-constrained devices. In this paper, a new approach to designing SVT architecture is developed based on SqueezeNet and depthwise separable CNN models. The primary goal is to find a deep learning architecture with few parameters that has comparable accuracy to state-of-the-art (SOTA) architectures. This paper modifies the SqueezeNet design for improved runtime performance by utilizing depthwise separable convolutions rather than simple conventional units. To develop this Assist-Dermo system, a data augmentation technique is applied to control the PSL imbalance problem. Next, a pre-processing step is integrated to select the most dominant region and then enhance the lesion patterns in a perceptual-oriented color space. Afterwards, the Assist-Dermo system is designed to improve efficacy and performance with several layers and multiple filter sizes but fewer filters and parameters. For the training and evaluation of Assist-Dermo models, a set of PSL images is collected from different online data sources such as Ph2, ISBI-2017, HAM10000, and ISIC to recognize nine classes of PSLs. On the chosen dataset, it achieves an accuracy (ACC) of 95.6%, a sensitivity (SE) of 96.7%, a specificity (SP) of 95%, and an area under the curve (AUC) of 0.95. The experimental results show that the suggested Assist-Dermo technique outperformed SOTA algorithms when recognizing nine classes of PSLs. The Assist-Dermo system performed better than other competitive systems and can support dermatologists in the diagnosis of a wide variety of PSLs through dermoscopy. The Assist-Dermo model code is freely available on GitHub for the scientific community.

Use of albumin infusion for cirrhosis-related complications: An international position statement.

Background & Aims: Numerous studies have evaluated the role of human albumin (HA) in managing various liver cirrhosis-related complications. However, their conclusions remain partially controversial, probably because HA was evaluated in different settings, including indications, patient characteristics, and dosage and duration of therapy. Methods: Thirty-three investigators from 19 countries with expertise in the management of liver cirrhosis-related complications were invited to organise an International Special Interest Group. A three-round Delphi consensus process was conducted to complete the international position statement on the use of HA for treatment of liver cirrhosis-related complications. Results: Twelve clinically significant position statements were proposed. Short-term infusion of HA should be recommended for the management of hepatorenal syndrome, large volume paracentesis, and spontaneous bacterial peritonitis in liver cirrhosis. Its effects on the prevention or treatment of other liver cirrhosis-related complications should be further elucidated. Long-term HA administration can be considered in specific settings. Pulmonary oedema should be closely monitored as a potential adverse effect in cirrhotic patients receiving HA infusion. Conclusions: Based on the currently available evidence, the international position statement suggests the potential benefits of HA for the management of multiple liver cirrhosis-related complications and summarises its safety profile. However, its optimal timing and infusion strategy remain to be further elucidated. Impact and implications: Thirty-three investigators from 19 countries proposed 12 position statements on the use of human albumin (HA) infusion in liver cirrhosis-related complications. Based on current evidence, short-term HA infusion should be recommended for the management of HRS, LVP, and SBP; whereas, long-term HA administration can be considered in the setting where budget and logistical issues can be resolved. However, pulmonary oedema should be closely monitored in cirrhotic patients who receive HA infusion.

Voltage-dependent anion channels: Key players in viral infection.

Viruses control the host cell by exploiting its molecular machinery to facilitate viral replication and propagation. Understanding different viral mechanisms and biochemical pathways is crucial for finding promising therapeutic solutions to viral infections. The mitochondrion is a vital organelle targeted by various types of viruses. More specifically, viruses interact with the voltage-dependent anion channel (VDAC), a porin protein found in the outer mitochondrial membrane. VDAC controls metabolite flux, regulates reactive oxygen species production, and promotes mitochondrial-mediated apoptosis by releasing pro-apoptotic proteins. Hence, a common pathogenic strategy used by many viruses seems to exploit natural pathways that VDAC regulates. This review aims to address the inhibition and enhancement roles of VDAC in viral pathogenesis and outlines multiple links and interactions between VDAC and viral proteins as potential antiviral targets.

Green Synthesis and Characteristics of Cellulose Nanocrystal/Poly Acrylic Acid Nanocomposite Thin Film for Organic Dye Adsorption during Water Treatment.

Nanocellulose shows potential as an effective natural adsorbent for removing harmful contaminants from wastewater. This paper describes the development of innovative nanocellulose thin films made of cellulose nanocrystals (CNCs), polyacrylic acid (PAA), and active carbon (AC) as adsorbent materials for absorbing azo dyes from wastewater. The CNCs were recovered from sugarcane bagasse using alkali treatment and acid hydrolysis. The composition and processing parameters of the thin films were optimized, and their adsorption capacity was determined using thermodynamic isotherms and adsorption kinetics. Adsorption characteristics such as the methylene blue (MB) dye concentration, contact time, temperature, and pH were investigated to determine how they affected adsorption. The results show that the adsorption process follows pseudo-second-order kinetics. At an adsorbent mass of 50 mg, dye concentration of 50 ppm in 50 mL, and contact period of 120 min at 25 °C, the thin film comprising 64 wt% CNC, 16 wt% PAA, and 20 wt% AC showed high dye removal efficiency (86.3%) and adsorption capacity (43.15 mg/g). The MB removal efficiency increased to 95.56% and the adsorption capacity to 47.78 mg/g when the medium's pH was gradually increased from neutral to alkaline. The nontoxicity, low production cost, water stability, easy recovery, and high adsorption capacity of these membranes make them suitable for water treatment systems.