Colonoscopy screening for colorectal cancer in Egypt: a nationwide cross-sectional study.

BACKGROUND: Current guidelines advocate for colorectal cancer (CRC) screening in adults who are at risk by using direct visualization methods such as colonoscopy. However, in Egypt, there is a paucity of data regarding the current practice of colonoscopy screening. Moreover, more information is needed about the knowledge and attitudes of potential participants regarding the procedure and possible barriers that can limit their participation. METHODS: We conducted a nationwide cross-sectional study using an interview-based survey of patients aged 45 years or above who presented to outpatient clinics of nine university hospitals throughout Egypt. Participants were surveyed to assess their compliance with CRC colonoscopy screening guidelines, their knowledge of and attitude towards colonoscopy screening, and their perspective on potential barriers to colonoscopy screening. RESULTS: A total of 1,453 participants responded to our survey in the nine study centers. Only a minority of participants (2.3%) were referred for CRC screening. Referral rates were higher among those who knew someone with a history of CRC (5.3% vs 1.5%, p < 0.001) or had a discussion with their physician about CRC (25.8% vs 0.7%, p < 0.001). Few responders (3.2%) had good knowledge regarding CRC screening. After introducing the concept of CRC screening to all participants, most patients (66.7%) showed a positive attitude towards having the procedure. Financial burden and fear of results were the two most frequently cited barriers to undergoing CRC screening (81.1%; and 60.1%, respecteively). CONCLUSIONS: Despite the positive attitude, there is insufficient knowledge about CRC screening among eligible participants in Egypt. This has probably contributed to low compliance with current CRC screening guidelines and needs to be addressed at the national level.

Natural dyes developed by microbial-nanosilver to produce antimicrobial and anticancer textiles.

Developing special textiles (for patients in hospitals for example) properties, special antimicrobial and anticancer, was the main objective of the current work. The developed textiles were produced after dyeing by the novel formula of natural (non-environmental toxic) pigments (melanin amended by microbial-AgNPs). Streptomyces torulosus isolate OSh10 with accession number KX753680.1 was selected as a superior producer for brown natural pigment. By optimization processes, some different pigment colors were observed after growing the tested strain on the 3 media. Dextrose and malt extract enhanced the bacteria to produce a reddish-black color. However, glycerol as the main carbon source and NaNO3 and asparagine as a nitrogen source were noted as the best for the production of brown pigment. In another case, starch as a polysaccharide was the best carbon for the production of deep green pigment. Peptone and NaNO3 are the best nitrogen sources for the production of deep green pigment. Microbial-AgNPs were produced by Fusarium oxysporum with a size of 7-21 nm, and the shape was spherical. These nanoparticles were used to produce pigments-nanocomposite to improve their promising properties. The antimicrobial of nanoparticles and textiles dyeing by nanocomposites was recorded against multidrug-resistant pathogens. The new nanocomposite improved pigments' dyeing action and textile properties. The produced textiles had anticancer activity against skin cancer cells with non-cytotoxicity detectable action against normal skin cells. The obtained results indicate to application of these textiles in hospital patients' clothes.

Intra-arterial Fractional Flow Reserve Measurements Provide an Objective Assessment of the Functional Significance of Peripheral Arterial Stenoses.

OBJECTIVE: Peripheral arterial stenoses (PAS) are commonly investigated with duplex ultrasound (DUS) and angiography, but these are not functional tests. Fractional flow reserve (FFR), a pressure based index, functionally assesses the ischaemic potential of coronary stenoses, but its utility in PAS is unknown. FFR in the peripheral vasculature in patients with limb ischaemia was investigated. METHODS: Patients scheduled for angioplasty and or stenting of isolated iliac and superficial femoral artery stenoses were recruited. Resting trans-lesional pressure gradient (Pd/Pa) and FFR were measured after adenosine provoked hyperaemia using an intra-arterial 0.014 inch flow and pressure sensing wire (ComboWire XT, Philips). Prior to revascularisation, exercise ABPI (eABPI) and DUS derived peak systolic velocity ratio (PSVR) of the index lesion were determined. Calf muscle oxygenation was measured using blood oxygenation level dependent cardiovascular magnetic resonance prior to and after revascularisation. RESULTS: Forty-one patients (32, 78%, male, mean age 65 ± 11 years) with 61 stenoses (iliac 32; femoral 29) were studied. For lesions < 80% stenosis, resting Pd/Pa was not influenced by the degree of stenosis (p = .074); however, FFR was discriminatory, decreasing as the severity of stenosis increased (p = .019). An FFR of < 0.60 was associated with critical limb threatening ischaemia (area under the curve [AUC] 0.87; 95% CI 0.75 - 0.95), in this study performing better than angiographic % stenosis (0.79; 0.63 - 0.89), eABPI (0.72; 0.57 - 0.83), and PSVR (0.65; 0.51 - 0.78). FFR correlated strongly with calf oxygenation (rho, 0.76; p < .001). A greater increase in FFR signalled resolution of symptoms and signs (ΔFFR 0.25 ± 0.15 vs. 0.13 ± 0.09; p = .009) and a post-angioplasty and stenting FFR of > 0.74 predicted successful revascularisation (combined sensitivity and specificity of 95%; AUC 0.98; 0.91 - 1.00). CONCLUSION: This pilot study demonstrates that FFR can objectively measure the functional significance of PAS that compares favourably with visual and DUS based assessments. Its role as a quality control adjunct that confirms optimal vessel patency after angioplasty and or stenting also merits further investigation.

Bundle care approach to reduce device associated infections in post-living-donor-liver transplantation in a tertiary care hospital, Egypt.

BACKGROUND: Device-associated infections (DAIs) are a significant cause of morbidity following living donor liver transplantation (LDLT). We aimed to assess the impact of bundled care on reducing rates of device-associated infections. METHODS: We performed a before-and-after comparative study at a liver transplantation facility over a three-year period, spanning from January 2016 to December 2018. The study included a total of 57 patients who underwent LDLT. We investigated the implementation of a care bundle, which consists of multiple evidence-based procedures that are consistently performed as a unified unit. We divided our study into three phases and implemented a bundled care approach in the second phase. Rates of pneumonia related to ventilators [VAP], bloodstream infections associated with central line [CLABSI], and urinary tract infections associated with catheters [CAUTI] were assessed throughout the study period. Bacterial identification and antibiotic susceptibility testing were performed using the automated Vitek-2 system. The comparison between different phases was assessed using the chi-square test or the Fisher exact test for qualitative values and the Kruskal-Wallis H test for quantitative values with non-normal distribution. RESULTS: In the baseline phase, the VAP rates were 73.5, the CAUTI rates were 47.2, and the CLABSI rates were 7.4 per one thousand device days (PDD). During the bundle care phase, the rates decreased to 33.3, 18.18, and 4.78. In the follow-up phase, the rates further decreased to 35.7%, 16.8%, and 2.7% PDD. The prevalence of Klebsiella pneumonia (37.5%) and Methicillin resistance Staph aureus (37.5%) in VAP were noted. The primary causative agent of CAUTI was Candida albicans, accounting for 33.3% of cases, whereas Coagulase-negative Staph was the predominant organism responsible for CLABSI, with a prevalence of 40%. CONCLUSION: This study demonstrates the effectiveness of utilizing the care bundle approach to reduce DAI in LDLT, especially in low socioeconomic countries with limited resources. By implementing a comprehensive set of evidence-based interventions, healthcare systems can effectively reduce the burden of DAI, enhance infection prevention strategies and improve patient outcomes in resource-constrained settings.

Adenosquamous carcinoma of the vulva: Rare tumor with unusual clinical presentation.

A 52-year-old female presented with labial ulcer of 4-month duration. Examination showed 1 cm × 1 cm single superficial ulcer in the right labium majus. Excision was done, and histopathologic examination revealed surface ulceration and dermal invasion by epithelial neoplasm formed of biphasic proliferation of squamoid and gland-forming cells. Immunohistochemical staining with p63 showed nuclear staining of the squamoid nests and was negative in areas with glandular differentiation, while epithelial membrane antigen and carcinoembryonic antigen highlighted the glandular elements. The case was diagnosed as primary cutaneous adenosquamous carcinoma (ASC). ASC is an uncommon malignant cutaneous neoplasm that is more aggressive than conventional squamous cell carcinoma. There are a few reports of ASC that presented as an erythematous papule or plaque with a preference for the head, neck, or upper extremities. We report a novel case of vulval ASC presented as a superficial ulcer, which is considered a unique site, and its clinical presentation.

Postoperative Spinal Cord Ischemia Monitoring: A Review of Techniques Available after Endovascular Aortic Repair.

BACKGROUND: Spinal cord ischemia is one of the complications that can occur after open and endovascular thoracoabdominal aortic repair. This occurs despite various perioperative approaches, including distal aortic perfusion, hybrid procedures with extra anatomical bypasses, motor-evoked potential, and cerebrospinal fluid drainage. The inability to recognize spinal ischemia in a timely manner remains a devastating complication after thoracoabdominal aortic repair.This review aims to look at novel technologies that are designed for continuous monitoring to detect early changes that signal the development of spinal cord ischemia and to discuss their benefits and limitations. METHODS: We conducted a systematic review of the technologies available for continuous monitoring in the intensive care unit for early detection of spinal cord ischemia. Studies were eligible for inclusion if they used different technologies for monitoring spinal ischemia during the postoperative period. All articles that were not available in English were excluded. To ensure that all relevant articles were included, no other significant restrictions were imposed. RESULTS: We identified 59 studies from the outset to December 2022 to be included in our study. New techniques have been studied as potentially useful monitoring tools that could provide simple and effective monitoring of the spinal cord. These include near-infrared spectroscopy, contrast-enhanced ultrasound, magnetic resonance imaging, fiber optic monitoring of the spinal cord, and cerebrospinal fluid biomarkers. CONCLUSIONS: Despite the development of new techniques to monitor for postoperative spinal cord ischemia, their use remains limited. We recommend more future research to ensure rapid intervention for our patients.

Quality of life and nutritional status in peritoneal dialysis patients: a cross-sectional study from Palestine.

BACKGROUND: End-stage renal disease (ESRD) is a growing cause of morbidity worldwide. Protein malnutrition is common among patients with ESRD. Peritoneal dialysis (PD) offers greater lifestyle flexibility and independence compared to the widely used treatments for ESRD. This study aimed to assess the nutritional status and the quality of life (QOL) of Palestinian patients undergoing PD, as well as the variables affecting these two outcomes. METHODS: A cross-sectional study was conducted on patients receiving PD at An-Najah National University Hospital, Palestine. The malnutrition-inflammation scale (MIS) was used to measure malnutrition, and the QOL score was evaluated using the Dutch WHOQOL-OLD module. Univariate and multivariate linear regressions were performed to check the association between the QOL and MIS scores. RESULTS: The study included 74 patients who were undergoing PD, with an average age of 50.5 ± 16.38. The majority of the patients were females. The study found a significant correlation between malnutrition and lower quality of life (QOL) scores, as measured by the WHOQOL-OLD questionnaire (p < 0.001). Furthermore, younger patients and those who had an occupation were more likely to report a good QOL (p = 0.01). Conversely, patients with pitting edema and diabetes were at higher risk of reporting a lower QOL (p < 0.001). CONCLUSIONS: Given the elevated risk of malnutrition and diminished QOL among elderly patients, those with pitting edema, and individuals with diabetes, it is imperative to conduct thorough assessments for these groups. We strongly recommend that general practitioners, dietitians, and specialists collaborate to develop tailored programs and interventions to provide these patients with the focused care and attention they require.

Feasibility and Perioperative Outcomes of Minimally Invasive Higher Order Myomectomy.

STUDY OBJECTIVE: To investigate perioperative outcomes of minimally invasive higher order myomectomy as defined by removal of 10 or more fibroids. DESIGN: A retrospective cohort study between January 2018 and December 2022. SETTING: A tertiary academic medical center. PATIENTS: Women who underwent minimally invasive myomectomy via laparoscopic or robotic approach. INTERVENTIONS: Surgical intervention in the form of minimally invasive myomectomy. MEASUREMENTS AND MAIN RESULTS: A total of 735 women met inclusion criteria of whom 578 had fewer than 10 fibroids removed, and 157 patients had 10 or more removed (average number of fibroids removed 3.8 vs 14.7, p <.001; specimen's weight 317.4 g vs 371.0 g, p = .07). Body mass index was similar in both groups (p = .66) and patients with higher order myomectomy were more likely to have a history of myomectomy (12.0% vs 26.8%, p <.001). The average estimated blood loss (EBL) was 246 mL vs 470 mL in each group (p <.001). There were no significant differences in packed red blood cell transfusion (1.0% vs 0.6%, p = .65), conversion to laparotomy (0.5% vs 0.6%, p = .86), or complications including visceral injury, wound complication, venous thromboembolism, ileus, or readmission (5.9% vs 4.5%, p = .49). The hospital length of stay was similar in both groups (0.5 days vs 0.5 days, p = .63). On linear regression analysis, after adjusting for specimen's weight, operative time, and history of myomectomy, EBL remained significantly higher in patients with 10 or more fibroids removed (p = .02). CONCLUSION: EBL is increased in higher order myomectomy; however, blood transfusions, conversion to laparotomy, complication rates, and length of hospital stay did not differ compared with patients with fewer than 10 fibroids removed, highlighting the feasibility of minimally invasive higher order myomectomy.

Cardiovascular collapse during laparoscopy: a brief overview.

This review article considers the physiology, differential diagnosis and immediate management of vasovagal response, vascular injury and carbon dioxide embolism caused during the creation of the laparoscopic pneumoperitoneum. These pathologies account for over half of all laparoscopic complications and therefore, by taking a systematic approach to these possibly life-threatening events, laparoscopy can become even safer.

Natural Peroxides from Plants: Historical Discovery, Biosynthesis, and Biological Activities.

Naturally occurring peroxides received great interest and attention from scientific research groups worldwide due to their structural diversity, versatile biological activities, and pharmaceutical properties. In the present review, we describe the historical discovery of natural peroxides from plants systematically and update the researchers with recently explored ones justifying their structural caterogrization and biological/pharmaceutical properties intensively. Till the end of 2023, 192 peroxy natural products from plants were documented herein for the first time implying most categories of natural scaffolds (e.g. terpenes, polyketides, phenolics and alkaloids). Numerically, the reported plants' peroxides have been classified into seventy-four hydro-peroxides, hundred seven endo-peroxides and eleven acyl-peroxides.  Endo-peroxides (cyclic alkyl peroxides) are an important group due to their high variety of structural frameworks, and we have further divided them into "four-, five-, six and seven"-membered rings. Biosynthetically, a shedding light on the intricate mechanisms behind the formation of plant-derived peroxides are addressed as well.

Biocontrol of Rice Seed-Associated Fungal Pathogens Using Green Synthesis Approaches.

Rice (Oryza sativa) is a major cereal crop that balances the food demand of the worldwide population. The crop quality drops daily due to their exposure to biotic and abiotic stresses, especially pathogens. It needs to be improved to maintain the consumption level to cope with increasing population demands for food. The current study was designed to analyze the comparison of the effects of green synthesis approaches on pathogens associated with rice seeds. In this study, essential oils were extracted from Cymbopogon citratus, Thymus vulgaris, and Origanum vulgaris medicinal plants and used as fungicides on fungal strains of Aspergillus spp. T. vulgaris effectively controlled the growth of Aspergillus niger, Aspergillus flavus, and Aspergillus terreus as compared with O. vulgaris and Cymbopogon. Further, silica nanoparticles (SiNPs) were synthesized from rice husk to evaluate their antifungal activities. SiNPs were characterized by ultraviolet-visible spectroscopy with a broad peak at 281.62 nm. Fourier-transform infrared spectroscopy spectrum confirms the presence of Si-H, Si-OH, and Si-O-Si bonds functional groups, and SiO4 tetrahedral coordination unit. X-ray diffraction pattern describes the crystalline structure with a sharp peak at 2θ = 22°. Scanning electron microscopy and energy-dispersive spectroscopy confirmed the spherical shape, size 70-115 nm, and elemental composition with pure silica contents. SiNPs showed no significant antifungal activity against Aspergillus strains. Moreover, Trichoderma was isolated from the rhizosphere of rice fields and showed a surprising antifungal effect against A. terreus, A. niger, and A. flavus. The current study successfully revealed environment-friendly and cost-effective green synthesizing approaches for analyzing biocontrol potential against rice seed-related Aspergillus spp. They will also help to improve pathogen control strategies in other cereals.

Quinazoline-chalcone hybrids as HDAC/EGFR dual inhibitors: Design, synthesis, mechanistic, and in-silico studies of potential anticancer activity against multiple myeloma.

Two new series of quinazoline-chalcone hybrids were designed, synthesized as histone deacetylase (HDAC)/epidermal growth factor receptor (EGFR) dual inhibitors, and screened in vitro against the NCI 60 human cancer cell line panel. The most potent derivative, compound 5e bearing a 3,4,5-trimethoxyphenyl chalcone moiety, showed the most effective growth inhibition value against the panel of NCI 60 human cancer cell lines. Thus, it was selected for further investigation for NCI 5 log doses. Interestingly, this trimethoxy-substituted analog inhibited the proliferation of Roswell Park Memorial Institute (RPMI)-8226 cells by 96%, at 10 µM with IC50 = 9.09 ± 0.34 µM and selectivity index = 7.19 against normal blood cells. To confirm the selectivity of this compound, it was evaluated against a panel of tyrosine kinase enzymes. Mechanistically, it successfully and selectively inhibited HDAC6, HDAC8, and EGFR with IC50 = 0.41 ± 0.015, 0.61 ± 0.027, and 0.09 ± 0.004 µM, respectively. Furthermore, the selected derivative induced apoptosis via the mitochondrial apoptotic pathway by raising the Bax/Bcl-2 ratio and activating caspases 3, 7, and 9. Also, the flow cytometry analysis of RPMI-8226 cells showed that the trimethoxy-substituted analog produced cell cycle arrest in the G1 and S phases at 55.82%. Finally, an in silico study was performed to explore the binding interaction of the most active compound within the zinc-containing binding site of HDAC6 and HDAC8.

Green solutions: evaluating the impact of Chlorella sorokiniana and Anabaena laxa on captan phycoremediation.

This study explores the use of algae for phycoremediation, focusing on how Chlorella sorokiniana and Anabaena laxa detoxify water contaminated with captan, a common fungicide. The efficiency of these species in absorbing captan and the associated biochemical changes were evaluated to assess their potential for environmental protection. Microalgae were exposed to captan concentrations of 15 and 30 mg/L, and various parameters, including captan uptake, chlorophyll (Chl) a, carotenoid levels, and changes in metabolic profiles (soluble carbohydrates, organic acids, amino acids, and fatty acids), were measured. Results showed Anabaena had a higher captan absorption capacity (141.7 µg/g at 15 mg/L and 239.3 µg/g at 30 mg/L) compared to Chlorella (74.43 µg/g and 162 µg/g). Increased captan uptake reduced the growth of both species, as indicated by lower Chl a levels. Both species accumulated osmo-protectants and antioxidants as defense mechanisms, with soluble sugars increasing by 83.49% in Chlorella and 68.87% in Anabaena, and carotenoids increasing by 60.42% and 46.24%, respectively. Principal component analysis revealed distinct species-level responses, with Anabaena showing greater tolerance. The study concludes that both species can effectively remediate captan, with Anabaena being more efficient, indicating their potential for mitigating agrochemical impacts in aquatic environments and promoting sustainable agriculture and water management.

This study uniquely demonstrates the superior capability of Anabaena laxa over Chlorella sorokiniana in remediating captan-contaminated water, highlighting distinct biochemical responses and enhanced tolerance mechanisms. By detailing species-specific metabolic adaptations, it underscores the potential of Anabaena for more effective phycoremediation. This novel insight into the differential resilience of microalgae species offers a promising approach to mitigating agrochemical pollution, advancing sustainable agriculture, and improving water management practices.

Assessing thallium phycoremediation by applying Anabaena laxa and Nostoc muscorum and exploring its effect on cellular growth, antioxidant, and metabolic profile.

Thallium (Tl), a key element in high-tech industries, is recognized as a priority pollutant by the US EPA and EC. Tl accumulation threatens aquatic ecosystems. Despite its toxicity, little is known about its impact on cyanobacteria. This study explores the biochemical mechanisms of Tl(I) toxicity in cyanobacteria, focusing on physiology, metabolism, oxidative damage, and antioxidant responses. To this end, Anabaena and Nostoc were exposed to 400 µg/L, and 800 µg/L of Tl(I) over seven days. Anabaena showed superior Tl(I) accumulation with 7.8% removal at 400 µg/L and 9.5% at 800 µg/L, while Nostoc removed 2.2% and 7.4%, respectively. Tl(I) exposure significantly reduced the photosynthesis rate and function, more than in Nostoc. It also altered primary metabolism, increasing sugar levels and led to higher amino and fatty acids levels. While Tl(I) induced cellular damage in both species, Anabaena was less affected. Both species enhanced their antioxidant defense systems, with Anabaena showing a 175.6% increase in SOD levels under a high Tl(I) dose. This suggests that Anabaena's robust biosorption and antioxidant systems could be effective for Tl(I) removal. The study improves our understanding of Tl(I) toxicity, tolerance, and phycoremediation in cyanobacteria, aiding future bioremediation strategies.

This study presents novel insights into thallium (Tl) phycoremediation using Anabaena laxa and Nostoc muscorum, crucial for addressing the increasing contamination concerns stemming from high-tech industries. Elucidating the tolerance mechanisms and physiological responses of these cyanobacterial species to Tl(I) exposure. It highlights the potential of Anabaena laxa as an effective bio-remediator, offering a sustainable solution to mitigate Tl(I) environmental impact.

Magnetic nanocomposite of maize offal biomass for effective sequestration of Congo red and methyl orange dyes from contaminated water: modeling, kinetics and reusability.

The current study aims to use a facile and novel method to remove Congo red (CR) and Methyl Orange (MO) dyes from contaminated water with Maize offal biomass (MOB) and its nanocomposite with magnetic nanoparticles (MOB/MNPs). The MOB and MOB/MNPs were characterized with Fourier-transform infrared (FTIR), scanning electron microscopy (SEM), BET, XRD and point of zero charge (pHPZC). The influence of initial CR and MO levels (20-320 mg/L), adsorbent dosage (1-3 g/L), pH (3-9), co-exiting ions, temperature (25-45 °C) and time (15-180 min) was estimated. The findings demonstrated that MOB/MNPs exhibited excellent adsorption of 114.75 and 29.0 mg/g for CR and MO dyes, respectively while MOB exhibited 81.35 and 23.02 mg/g adsorption for CR and MO dyes, respectively at optimum pH-5, and dose 2 g/L. Initially, there was rapid dye removal which slowed down until equilibrium was reached. The interfering/competing ions in contaminated water and elevated temperature favored the dyes sequestration. The MOB/MNPs exhibited tremendous reusability and stability. The dyes adsorption was spontaneous, and exothermic with enhanced randomness. The adsorption effects were well explained with Freundlich model, pseudo second order and Elovich models. It is concluded that MOB/MNPs showed excellent, eco-friendly, and cost-effective potential to decontaminate the water.

Nanocomposite of Maize offal biomass demonstrated higher dyes removal.FTIR, SEM, BET, XRD and pH_PZC provided vital evidence for dyes adsorption.MOB/MNPs displayed excellent stability and reusability for dyes adsorption.Groundwater samples exposed a higher dyes removal.Results were validated with equilibrium and kinetic adsorption models.

Interstitial decoration of Ag linking 3D Cu2O octahedron and 2D CaWO4 for augmented visible light active photocatalytic degradation of rifampicin and genotoxicity studies.

A morphological oriented highly active Cu2O-Ag-CaWO4 (CAC) nano-heterojunction was fabricated for the visible light driven degradation of rifampicin (RFP). Octahedron shaped Cu2O being a base material, where the Tagetes shaped CaWO4 and Ag were embedded on it. The shape-controlled morphology of Cu2O and CaWO4 as well as Ag decoration influence high degree of adsorption of RFP and interfacial charge transfer between the nano-heterojunction. Further, the larger specific surface area (129.531 m2/g) and narrow band gap energy (2.57 eV) of CAC nano-heterojunction than the controls support the statement. Positively, CAC nano-heterojunction following Z-scheme-type charge transport mechanism attained 96% of RFP degradation within 100 min. O2•- and •OH are the primarily involved reactive oxidation species (ROS) during the photocatalytic reactions, determined by scavenger study and ESR analysis. The stability and reusability of the CAC nano-heterojunction was assessed through performing cyclic experiment of RFP degradation and it holds 96.8% of degradation even after 6th cycle. The stability of CAC nano-heterojunction after photodegradation was further confirmed based on crystalline pattern (XRD analysis) and compositional states (XPS analysis). Intermediates formed during RFP degradation and its toxicity was discovered by using GC-MS/MS and ECOSAR analysis respectively. The end-product toxicity against bacterial system and genotoxicity of CAC nano-heterojunction against Allium cepa were evaluated and the results were seemed to have no negative causes for the aquatic lives.

The Role of Nanomedicine in Benign Gynecologic Disorders.

Nanomedicine has revolutionized drug delivery in the last two decades. Nanoparticles appear to be a promising drug delivery platform in the treatment of various gynecological disorders including uterine leiomyoma, endometriosis, polycystic ovarian syndrome (PCOS), and menopause. Nanoparticles are tiny (mean size < 1000 nm), biodegradable, biocompatible, non-toxic, safe, and relatively inexpensive materials commonly used in imaging and the drug delivery of various therapeutics, such as chemotherapeutics, small molecule inhibitors, immune mediators, protein peptides and non-coding RNA. We performed a literature review of published studies to examine the role of nanoparticles in treating uterine leiomyoma, endometriosis, PCOS, and menopause. In uterine leiomyoma, nanoparticles containing 2-methoxyestradiole and simvastatin, promising uterine fibroid treatments, have been effective in significantly inhibiting tumor growth compared to controls in in vivo mouse models with patient-derived leiomyoma xenografts. Nanoparticles have also shown efficacy in delivering magnetic hyperthermia to ablate endometriotic tissue. Moreover, nanoparticles can be used to deliver hormones and have shown efficacy as a mechanism for transdermal hormone replacement therapy in individuals with menopause. In this review, we aim to summarize research findings and report the efficacy of nanoparticles and nanotherapeutics in the treatment of various benign gynecologic conditions.

Neuroprotective effect of curcumin against experimental autoimmune encephalomyelitis-induced cognitive and physical impairments in mice: an insight into the role of the AMPK/SIRT1 pathway.

Multiple sclerosis (MS) is an incurable chronic neurodegenerative disease where autoimmunity, oxidative stress, and neuroinflammation collaboration predispose myelin sheath destruction. Interestingly, curcumin, a natural polyphenol, showed a neuroprotective effect in numerous neurodegenerative diseases, including MS. Nevertheless, the influence of curcumin against MS-induced cognitive impairment is still vague. Hence, we induced experimental autoimmune encephalomyelitis (EAE) in mice using spinal cord homogenate (SCH) and complete Freund's adjuvant, which eventually mimic MS. This study aimed not only to evaluate curcumin efficacy against EAE-induced cognitive and motor dysfunction, but also to explore a novel mechanism of action, by which curcumin exerts its beneficial effects in MS. Curcumin (200 mg/kg/day) efficacy was evaluated by behavioral tests, histopathological examination, and biochemical tests. Concisely, curcumin amended EAE-induced cognitive and motor impairments, as demonstrated by the behavioral tests and histopathological examination of the hippocampus. Interestingly, curcumin activated the adenosine monophosphate (AMP)-activated protein kinase/silent mating type information regulation 2 homolog 1 (AMPK/SIRT1) axis, which triggered cyclic AMP response element-binding protein/brain-derived neurotrophic factor/myelin basic protein (CREB/BDNF/MBP) pathway, hindering demyelination of the corpus callosum. Furthermore, AMPK/SIRT1 activation augmented nuclear factor erythroid 2-related factor 2 (Nrf2), a powerful antioxidant, amending EAE-induced oxidative stress. Additionally, curcumin abolished EAE-induced neuroinflammation by inhibiting Janus kinase 2 /signal transducers and activators of transcription 3 (JAK2/STAT3) axis, by various pathways, including AMPK/SIRT1 activation. JAK2/STAT3 inhibition halts inflammatory cytokines synthesis. In conclusion, curcumin's neuroprotective effect in EAE is controlled, at least in part, by AMPK/SIRT1 activation, which ultimately minimizes EAE-induced neuronal demyelination, oxidative stress, and neuroinflammation.

Evaluation of the accuracy of automated tooth segmentation of intraoral scans using artificial intelligence-based software packages.

INTRODUCTION: The accuracy of tooth segmentation in intraoral scans is crucial for performing virtual setups and appliance fabrication. Hence, the objective of this study was to estimate and compare the accuracy of automated tooth segmentation generated by the artificial intelligence of dentOne software (DIORCO Co, Ltd, Yongin, South Korea) and Medit Ortho Simulation software (Medit Corp, Seoul, South Korea). METHODS: Twelve maxillary and mandibular pretreatment dental scan sets comprising 286 teeth were collected for this investigation from the archives of the Department of Orthodontics, Faculty of Dentistry, Alexandria University. The scans were imported as standard tessellation language files into both dentOne and Medit Ortho Simulation software. Automatic segmentation was run on each software. The number of successfully segmented teeth vs failed segmentations was recorded to determine the success rate of automated segmentation of each program. Evaluation of success and/or failure was based on the software's identification of the teeth and the quality of the segmentation. The mesiodistal tooth width measurements after segmentation using both tested software programs were compared with those measured on the unsegmented scan using Meshmixer software (Autodesk, San Rafael, Calif). The unsegmented scans served as the reference standard. RESULTS: A total of 288 teeth were examined. Successful identification rates were 99% and 98.3% for Medit and dentOne, respectively. Success rates of segmenting the lingual surfaces of incisors were significantly higher in Medit than in dentOne (93.7% vs 66.7%, respectively; P <0.001). DentOne overestimated the mesiodistal width of canines (0.11 mm, P = 0.032), premolars (0.22 mm, P < 0.001), and molars (0.14 mm, P = 0.043) compared with the reference standard, whereas Medit overestimated the mesiodistal width of premolars only (0.13 mm, P = 0.006). Bland-Altman plots showed that mesiodistal tooth width agreement limits exceeded 0.2 mm between each software and the reference standard. CONCLUSIONS: Both artificial intelligence-segmentation software demonstrated acceptable accuracy in tooth segmentation. There is a need for improvement in segmenting incisor lingual tooth surfaces in dentOne. Both software programs tended to overestimate the mesiodistal widths of segmented teeth, particularly the premolars. Artificial intelligence-segmentation needs to be manually adjusted by the operator to ensure accuracy. However, this still does not solve the problem of proximal surface reconstruction by the software.

A Comparison of Systematic, Targeted and Combined Biopsy Using Machine Learning for Prediction of Prostate Cancer Risk: A Multi-Center Study.

OBJECTIVES: To construct a new prognostic prediction model for detecting Prostate Cancer (PCa) patients using Machine Learning (ML) techniques and to compare those models across systematic and target biopsy detection techniques. METHODS: The records of the two main hospitals in Riyadh, Saudi Arabia, were analyzed for data on diagnosed PCa from 2019 - 2023. Four ML algorithms were utilized for the prediction and classification of PCa. RESULTS: 528 patients with prostate-specific antigen (PSA) greater than 3.5 ng/mL who had undergone transrectal ultrasound-guided prostate biopsy (TRUS) were evaluated. The total number of confirmed PCa cases was 234. Age, prostate volume, PSA, Body Mass Index (BMI), multiparametric Magnetic Resonance Imaging (mpMRI) score, number of regions of interest detected in MRI, and the diameter of the largest size lesion were significantly associated with PCa. Random Forest (RF) and XG Boost (XGB) (ML algorithms) accurately predicted PCa. Yet, their performance for classification and prediction of PCa was higher and more accurate for cases detected by targeted and combined biopsy (systematic and targeted together) compared to systematic biopsy alone. F1, the Area Under the Curve (AUC), and the accuracy of XGB and RF models for targeted biopsy and combined biopsy ranged from 0.94 - 0.97 compared to the AUC of systematic biopsy for RF and XGB algorithms, respectively. CONCLUSIONS: The Random Forest (RF) model generated and presented an excellent prediction capability for the risk of PCa detected by targeted and combined biopsy compared to systematic biopsy alone. ML models can prevent missed PCa diagnoses by serving as a screening tool.