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Background: Heart Failure with Preserved Ejection Fraction (HFPEF) accounts for more than half of the cases of heart failure.Long regarded as an abnormality of left ventricular diastolic function, recent studies using longitudinal strain (two-dimensional speckle tracking mode) have suggested that left ventricular longitudinal systolic function is altered in HFPEF.Despite these interesting pathophysiological perspectives, the data in the literature on the prognostic value of the alteration of longitudinal strain are controversial. Given these conflicting results, it is difficult to confirm the magnitude and prevalence of impaired LV longitudinal systolic function in patients with HFPEF and its prognostic relevance. Purposes: This work aims to study the prognostic value of Global the left ventricle’s Global Longitudinal Strain (GLS) Algerian cohort of patients with HFPEF. Patients and methods: We conducted a monocentric prospective observational study from April 2018 to April 2020, with a minimum follow-up of 1 year for each recruited patient. We included patients over the age of 18 referred to the echocardiography laboratory for chronic or acute HFpEF, defined according to the criteria of ESC 2016. 153 consecutive patients underwent clinical examination, biological tests, and echocardiography with measurement of GLS at rest, in addition to routine management by the attending physicians.Results: 153 patients were collected. The average age of our patients is 73 +/- 11 years ranging from 42 to 91 years old. The female population is predominant with a rate of 67%. Comorbidities are predominant mainly by arterial hypertension (86%) and diabetes (64%), with a history of atrial fibrillation (46%).63% of patients have impaired GLS (< 16%). Contrary to our hypothesis, GLS was not shown to be a powerful predictor of cardiovascular events in HFPEF patients either in dichotomous analysis (OR = 0.79; p = 0.64) or in continuous analysis (OR = 0.97; p = 0.69).We were able to identify that congestive venous signs, anemia, and pulmonary hypertension, are the main independent prognostic factors in our Algerian population study. Conclusion: We were unable to demonstrate the prognostic role of mpaired GLS in our population of patients with HFPEF.

Fungus belonging to the genus Aspergillus is considered highly important in the production of various types of enzymes and organic acids. Aspergillus species produce organic acids such as citric acid, itaconic acid, and malic acid, which are one of the most important alternate techniques for chemical processes. Citric acid is an important component in the manufacturing process of food and beverages, pharmaceuticals, cosmetics, toiletries, detergents, and other industries. In this work, A.niveus was isolated from the agricultural waste collected in Kotagiri, The Nilgiris, India. Submerged batch fermentation with a range of low-cost substrates, such as wheat flour, corn starch, and sweet potato, was used to successfully synthesize citric acid by the isolated fungus. In addition, production-related factors such as substrate concentration and incubation time were optimized. The maximum yield of citric acid was produced using A. niveus from corn starch at a concentration 7of 120 g/L after 168 hours at pH 3.2. Furthermore, with a degree of extraction of 91.96, citric acid was extracted from fermentation.

Recently announced centralized aerobic-anaerobic energy balance compensation (CAAEBC) theory has already demonstrated achievements in the treatment of arterial hypertension (AHT), diabetes myelitis (DM) and osteochondrosis. Such demonstration lifts the necessity to check the applicability of this theory to other non-communicable diseases (NCDs) and develop the proper way to model the main idea of CAAEBC.

It is utterly important to ensure the safety of stem cell donors and limit the incidence of long-term adverse events. Additionally, the willingness to donate the potentially life-saving stem cells, depends among other reasons, on the donor’s trust in the safety of the procedure as our case highlights. Here we present the case of a 35-year-old patient who developed macrohematuria and proteinuria following peripheral blood stem cell (PBSC) donation. 4 years later he was diagnosed with IgA-nephropathy (IgAN) and the disorder was causally attributed to the PBSC donation. He discouraged his family and friends from registering as donors because of this. In the current case report, we review the literature on the relationship between IgAN and PBSC donation and suggest under which conditions stem cell donation can still be performed even with a prior diagnosis of IgAN.

The SARS-CoV-2 pandemic is still ongoing. Previously, several studies have been conducted to investigate laboratory markers as a tool for severity assessment during COVID-19 infections. Biological markers such as Platelet count, D-dimer and IL-6, Lymphocytopenia and others have been used for assessment of severity in COVID-19 disease patients (infected by SARS-CoV-2 Alpha, Beta, Gamma, Delta, Epsilon, and other variants). We observed a significant drop in lymphocyte count among suspected SARS-CoV-2 clinical patients with symptoms of fever, running nose, breathing discomfort, cough, and others during Omicron and Centaurus variants spread in Pakistan. A multicenter, cross-sectional study was conducted from Jan 2021 to Aug 2022, on 118,561 subjects to evaluate hematological abnormalities among suspected patients. Of note, significantly decreased lymphocyte levels (lymphocytopenia) were observed among 43.05% of infected patients. Also, the levels of NA (39.03%), HGB (28.27%), MCV (22.62%), PLT (8.17%), and ALB (4.30%) were also reduced among infected patients. This suggests that lymphopenia can be used as an alternative, cost-effective, early diagnostic biomarker for clinical COVID-19 patients, even before the diagnosis via real-time PCR. In resource-limited countries, the current study is critical for policy-making strategic organizations for prioritizing lymphocytopenia-based screening (as an alternative, cost-effective diagnostic test) in clinical COVID-19 patients, before real-time PCR-based diagnosis.

Recent studies on boron neutron capture therapy (BNCT) have focused on investigating the appropriate neutron sources based on accelerators for neutron production, such as 7Li(p,n)7 Be. The therapeutic abilities of BNCT have been studied for the possible treatment of lung cancer using thermal and epithermal neutron beams. For neutron transport, the Monte Carlo N-particle transport code was used, and doses in the organs of different Oak Ridge National Laboratory phantoms were evaluated. The right lung was meshed with voxels to obtain depth-dose distributions using 1 eV, 10 eV, 100 eV, 1 keV, 5 keV, 8 keV and 10 keV energy sources. These results suggest that BNCT with an epithermal neutron beam can be used to treat lung cancer. By evaluating the biological dose rate and dose-depth distribution curves in healthy tissues and tumors by simulating a lung phantom, the quantities in the phantom were also evaluated. Our calculations show that with increasing boron concentration applied to the tumor, the dose is increased and the 100 eV energy source has the greatest effect on the tumor dose.

Objectives: The sural nerve is the most tested sensory nerve in the lower extremities in the electrodiagnostic assessment of peripheral neuropathies. This study presents the reference values of the sural nerve conduction study (NCS) from a significant sample of the Algerian population. Methods: This is a prospective study of right sural NCS in healthy subjects based on the later recommendations of AANEM-NDTF. The nature of the distribution of each electrophysiological parameter was therefore determined. The lower and upper limits were calculated by using the 5th and 95th percentiles respectively and a logarithmic transformation was performed for Sensory Nerve Action Potential (SNAP) amplitude distribution. Results: 115 subjects aged between 20 and 60 years were selected, including 58 women and 57 men. Unlike Sensory Nerve Conduction Velocity (SNCV), the distribution of SNAP amplitude is not Gaussian. The lower limit of SNAP amplitude was 7.70 µV when using the 5th percentile and 6.80 µV by using the Standard Deviation (SD) method after log transformation. Similarly, the lower limit of SNCV was 43 m/s. The SNAP amplitude was greater in women and decreased with age, height and BMI. Conclusion: The values found in this study are comparable to those published in the literature. It may be more appropriate to determine the reference values using percentiles as recently recommended by several authors.

Peritonitis is a common and serious complication of Peritoneal Dialysis (PD) and its prevention and treatment are very important to reduce patient morbility and mortality. PD-related peritonitis can be caused by many germs; in most cases Gram-Positive Cocci (GPC) are responsible. In our report instead, we present the first case, to our knowledge, of peritonitis due to Chryseobacteriumgleum in a peritoneal dialysis patient.Our aim is to make known this type of opportunistic pathogen that can survive in a hospital environment so as to prevent C.gleum-related peritonitis. The rapid identification of this pathogen in the laboratory is very important for guiding therapy and preventing further complications.

In general, nanotechnology can be understood as a technology of design, fabrication and applications of nanostructures and nanomaterials, as well as a fundamental understanding of the physical properties and phenomena of nanomaterials and nanostructures. In recent years the development of industries like textile, leather, paint, food, plastics, and cosmetics is enlarged and these industries are connected with the discarding of a vast number of organic pollutants which are harmful to microbes, aquatic systems, and human health by influencing the different parameters. So the fabrication of those nanomaterials (coupled or doped) to form heterojunctions provides an effective way to better harvest solar energy and facilitate charge separation and transfer, thus enhancing the photocatalytic activity and stability. We expect this review to provide a guideline for readers to gain a clear picture of the fabrication and application of different types of heterostructured photocatalysts. In this review, starting from the photocatalytic reaction mechanism and the preparation of the photocatalyst, we review the classification of current photocatalysts, preparation methods, a factor that affects photocatalytic reaction, characterization of photocatalysts, and the methods for improving photocatalytic performance. This review also aims to provide basic and comprehensive information on the industrialization of photocatalysis technology.

Introduction: Oral habit is common in childhood and it is proven to cause multiple adverse effects on oral and general health, while oral habits in the adult population are under looked. The prevalence of oral habits varied among different societies. The extent of these effects varies depending on a wide range of variables including the actual habit, the duration, and the intensity of the oral habit. Objectives: The primary objective is to determine the prevalence of oral habits in adults in Riyadh, Saudi Arabia, and the secondary objective is awareness of different types of oral habits and their adverse effects.Methods: Descriptive cross-sectional study using questionnaire through google form which will address the prevalence of 5 Oral habits in the adult population, Riyadh, Saudi Arabia such as nail biting, chewing on pens/pencils/Miswak, using the teeth as a tool, chewing ice, and teeth clenching/grinding and bruxism. Also, it will address the awareness of these 5 oral habits and their adverse effects on oral health and prevention modalities. Results: There were 220 participants. The majority were Saudi (52.7%), females (83.2%) with bachelor’s degrees (63.6%) and around fifty percent with age below 30 years old. The most prevalent pattern was using teeth as a tool (46.8%), followed by chewing ice (43.6%) and nail-biting (39.1%). All five habits were mainly started in childhood; however, a respectable percentage of beginning is still reported during adulthood, particularly for clenching/grinding/ bruxism and chewing ice, with a ratio of 36.4% and 25%, respectively. Most participants who reported clenching/grinding/ bruxism and nail-biting were related to stress (75.3%, 48.8%, respectively). The majority reported that oral habits could harm teeth (82.3%) and could be preventable (78.6%).Discussion: Most of the studies concentrate on oral habits in children while few studies had concentrated on oral habits in adults. Oral habit is not uncommon in adults, they have either to continue childhood bad habits or practice new oral habit. The adverse effect varies widely on oral and general health. Although the adult population is aware of these side effects few only seek medical advice.Conclusion: In Saudi Arabia, oral habit is not uncommon in adults. So the recommendation for the prevention of oral habits is to embed it in all public services, at strategic and operational levels.

The fiber characteristics and basic density of Acacia melanoxylon were investigated for its potential as a raw material for pulp and paper production. Six trees from the even-aged stand and similar diameter class were selected randomly from the Chencha district of Ethiopia. Wood disks were systematically cross-cut from a log along tree height levels, at the bottom (10%), middle (50%) and top (90%) of the merchantable height and blocks of wood (2 cm x 2 cm x 2 cm)were taken from pith to periphery at near pith (10%), middle (50%) and near bark (90%) of disk radius. Fiber maceration and basic density were determined, by 50% nitric acid solution and water displacement method respectively. All the data were analyzed using a two-way analysis of variance at α = 0.05. The fiber characteristics of the selected trees; the fiber length, fiber diameter, lumen diameter and cell wall thickness were measured while the-slenderness ratio, Runkel ratio, flexibility coefficient and wall coverage ratio of the fibers were derived from the measured fiber dimensions. The result showed that- the overall mean were, 1.04 mm, 21.60 µm, 15.36 µm, 3.75 µm, 0.48, 48.05%, 71.10%, 0.34 and 0.56 g/ml, for fiber length, fiber width, lumen diameter, cell wall thickness, Runkle ratio, slenderness ratio, flexibility ratio, wall coverage ratio and basic density, respectively. Generally, Acacia melanoxylon wood is suitable for pulp-and-paper-production, to due-to-its adequate-fiber dimension, derived fiber value and basic density. Therefore, attention should be given to tree growers, government and non-governmental organizations on the plantation expansion of Acacia melanoxylon.

Immunization with human recombinant EGF chemically bound to the P64k protein of Neisseria meningitides (hrEGF-P64k) and adjuvanted in Montanide ISA 51 VG (Montanide) is an efficient strategy to induce polyclonal antibodies (PAbs) response targeting this self -antigen in cancer patients, which is the basis of the CIMAvax-EGF vaccine. The neutralizing potential of EGF-specific induced PAbs supports promising clinical data obtained to date with this vaccine. Herein, we evaluated a combination of very small-size proteoliposomes (VSSP) and aluminum hydroxide (Alum) as a novel adjuvant to induce specific PAbs with neutralizing and anti-proliferative properties on tumor cells, considering EGF as a model antigen. Toxicity at the injection site was not detected for the vaccine formulation containing VSSP/Alum, and it was immunogenic in BALB/c mice, as evidenced by the induction of high titers of EGF-specific polyclonal antibodies (PAbs). While schedule optimization increased the magnitude of the PAbs response induced by VSSP/Alum, induced PAbs’s avidity and intrinsic neutralizing potential were comparable to the humoral response induced by Montanide. Also, VSSP addition switched IgG subclasses distribution into a Th1-like pattern, as obtained with Montanide and desirable for a cancer vaccine. Finally, equivalent PAbs titers were induced by the vaccine formulations adjuvanted in VSSP/Alum or Montanide in tumor-bearing-mice, and immunosuppressed mice, suggesting the feasibility of the VSSP/Alum combined adjuvant for inducing anti-EGF antibodies in cancer patients at advanced stages of the disease.

Aim of the study: Conduct long-term monitoring of recovered patients with pulmonary TB and study the frequency of relapses of pulmonary TB and factors contributing to their development in the Republic of Tajikistan.Material and research methods: Of the total number of patients with pulmonary TB, 820 people in 2010-2011 after successful treatment, were transferred for further dispensary observation to PHC facilities, whose health status we monitored for 10 years (including 2020). Of the 820 patients, we were able to track the health status for 10 years in 622 patients (320 men and 302 women, age groups 19-44 years old - 330 people and 45-69 years old - 292 people). The rest - for various reasons were lost from further dispensary observation. All patients in PHC facilities annually during the period of dispensary observation underwent clinical, instrumental, laboratory, and X-ray examinations to exclude the recurrence of TB. Data for each patient were tracked using the National TB Registry OpenMRS data.Research results: The elimination of preventive anti-relapse measures in people with residual post-tuberculosis changes in the lungs led to an increase in the number of relapses of the disease. The analysis of the conducted studies shows that the incidence of relapses of pulmonary TB does not depend on the regions and the severity of TB burden, they often develop with insufficient follow-up after the end of treatment and inadequate preventive measures in dispensaries patients.The study of the reasons for the development of relapses makes it possible to timely identify a group of patients who need anti-relapse measures and prolongation of dispensary observation.Conclusion: Thus, the results of this observation revealed the occurrence of relapses within 10 years in 19.3% of cases. A retrospective analysis of the initial forms of the disease showed that relapses of pulmonary tuberculosis occurred more often in patients who had had fibrous-cavernous pulmonary tuberculosis, than in patients who had disseminated pulmonary TB, and less often after suffering infiltrative pulmonary TB. Relapses of the disease occurred more often in men aged 19-44 years. The results obtained indicate the development of relapses of pulmonary tuberculosis has a statistically significant dependence on the form of the initial disease, the presence of RPTCL, comorbid diseases such as HIV, diabetes mellitus, COPD, and the regularity of taking anti-TB drugs. At the same time, it turned out that the social status of all patients with relapses corresponds to the level of poverty, which should also be taken into account.

Acute Q fever is a worldwide zoonotic infection due to C. burnetii that may be associated with hepatitis. Nonspecific clinical and biological manifestations may accompany liver involvement, including hepatomegaly and elevated liver biological tests. However, the presence of jaundice is rare. Therefore, making a diagnosis of Q fever hepatitis may be difficult in an afebrile patient with jaundice of recent onset, altered liver function tests, excessive alcohol intake and no reported contact with animals. We report here the diagnostic work-up and complex clinical management of a patient presenting with acute hepatitis resulting from both C. burnetii infection and severe alcoholic steatohepatitis. Positive serology together with a detailed examination of the liver biopsy was able to reveal the coexistence of both Q fever hepatitis with typical fibrin-ring granulomas as well as florid lesions of alcoholic steatohepatitis. A combination of antibiotics, hydroxychloroquine and steroids, guided by the helpful description of changes in histological alterations on repeated liver biopsies during the course of the disease contributed to the slow but favorable outcome.

Heterologous expression of proteins often pursues high expression levels, but it can easily result in misfolding and loss of biological function. L-α-glycerophosphate oxidase (GlpO) is a flavin adenine dinucleotide (FAD)-dependent oxidase which is widely used in the clinical determination of triglycerides. We found that the total enzymatic activity of GlpO expressed in Escherichia coli (E. coli) was extremely low, probably due to the absence of FAD cofactors and the misfolding of GlpO at a high synthesis rate. Therefore, decreasing the expression rate was used to improve the activity of GlpO. The specific activity of GlpO expressed on the pUC19 vector with lac promotor was approximately 30 times higher than that expressed on the pET28a vector with T7 promotor, but the expression levels of GlpO on the two vectors were completely opposite. It indicated that the specific activity of GlpO was increased as the expression level decreased. However, too low expression greatly influences the total amount and activity of the functional enzyme. In order to resolve this problem, two new plasmids, GlpO-CG4 and GlpO-CG6, were constructed by inserting 4 or 6 nucleotides, respectively, between the ribosome binding site (RBS) and the start code (ATG) on pET28a. Compared with the expression on the GlpO-pET vector, the expression rates of GlpO on the GlpO-CG4 and GlpO-CG6 were dramatically decreased. The total activity of GlpO expressed on GlpO-CG6 was 11 times and 1.5 times higher than that expressed on the GlpO-pET and GlpO-pUC, respectively. Results suggest that the activity of GlpO can be improved by decreasing the expression rate. 

Background: Persistent contrast staining is highly associated with stent thrombosis. Case summary: A 75-year-old woman presented with new-onset effort angina. A coronary angiogram revealed a 90% blockage of the distal left main trunk (LMT) and a 99% blockage of the ostial left anterior descending coronary artery (LAD). A 3.0 × 18-mm CYPHER™ the stent had previously been implanted into the dominant proximal circumflex artery (LCx) in 2009 because of unstable angina. The patient developed pulseless ST elevation myocardial infarction after the withdrawal of antiplatelet therapy before a scheduled CABG. The patient recovered with VA-ECMO and PCI using aspiration thrombectomy and urgent CABG.Discussion: This case highlighted that a preoperative patient may develop thrombosis at a previous stent site with peri-stent contrast staining and withdrawal of an antiplatelet regimen in certain settings poses an imminent risk for preoperative deterioration. A bridging strategy using intravenous PY12 inhibitor before CABG should be considered in this setting. The revascularization strategy should be selected based on coronary anatomy, hemodynamic status and baseline risk for CABG. A hybrid revascularization approach should be considered in this patient population.

Background: Diabetes mellitus is a serious long-term condition with a major impact on the lives and well-being, of societies worldwide. Poor disposal practices of devices potentially result in personal injury and injuries to people in the household and the general community. This study aimed to assess the knowledge and self-reported practice of insulin injection device disposal and associated factors among diabetes patients in TASH, Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted among 182 adults with diabetes. The study participants were selected through systematic random sampling. Data were collected from March/17/2020 - May/18/2020. Patients were interviewed using a structured questionnaire. Data were entered into Epi-data version 4. 6 and exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. Good practice and adequate knowledge were defined based on median calculation; a result above the median value of good practice and adequate knowledge with a p - value < 0.05 was considered to declare a result as statistically significant.Results: About 54% of the participants had inadequate knowledge about safe insulin injection waste disposal. More than two-thirds (73%) of respondents had poor practice and 92.3% of respondents did not know how to dispose of lancets after use.Conclusion: This study revealed that the knowledge and practice of diabetic patients were inadequate and poor towards safe insulin injection waste disposal in the study area. Educating patients and awareness creation training on proper insulin injection device disposal should be considerable. 

Viruses becoming day by day dominate over humans, as a covid-19 pandemic is not jet over, new monkeypox virus infection cases emerged in the month of May 2020. On 13th May 2020 WHO reported monkeypox virus cases from 12 member states that are epidemic for this virus. In the past monkeypox virus are rarely seen outside of west and central Africa. Investigations are going to establish a travel link between reported cases and epidemic areas. There are very little data regarding viral mechanism or time of shading and still, we have no licensed treatment. Two smallpox-approved drugs brincidofovir and tecovirimat have efficacy against monkeypox shown in animals. Now two smallpox-recommended vaccinations JYNNEOS and ACAM2000 are also available and are efficient to prevent the monkeypox virus. Two second- and third-generation Vaccinations are recommended by WHO for people that are immunocompromised and children’s MVA-BN, LC16. This article aims to raise awareness of virus spread, providing information regarding virus detail, severity, precautions, and detection.

An established side-effect of neck dissection (ND) for head and neck (HNC) tumour management includes shoulder dysfunction (SD), which can impact quality of life (QOL). Shoulder strength and range of movement (ROM) are key parameters to be monitored in SD. However, such evaluations are not routinely conducted in the clinical setting. The aim of this study was to evaluate objectively the impact of ND on shoulder functions. Methods: This is a pilot exploratory study in a tertiary cancer centre. Five participants with unilateral ND and advanced HNC, completed the study. Outcome measures consisted of self-reported QOL questionnaires, C2–T1 dermatomes and shoulder ROM and strength testing. Data was collected at baseline, 1.5-months after surgery and 6-months after diagnosis (after adjuvant treatment completion). Results: Most outcome measures on the surgically affected side were negatively impacted post-operatively, with varied recovery seen at follow-up. Sensory loss was noted at C3–4 dermatome levels. Shoulder ROM and strength was reduced on the surficial side for all participants, with some recovery after six months except for two participants.Conclusion: Results of SD after ND are diverse and unique to each patient. Findings from this pilot study indicate that regular rehabilitation/exercise may facilitate recovery of shoulder function post HNC surgery. However, customised rehabilitation may yield better outcomes. Future studies with a larger sample are indicated to validate the findings of this study.

Introduction and aim: The most accurate way of measuring kidney function in GFR. Clinical formulas based on creatinine measurement may be inaccurate mainly in elderly patients (over 80 years of age). In this study we evaluated the accuracy of commonly used clinical formulas by comparing them with a direct measurement with [99mTc]-DTPA ([99mTc]-diethylene-triamine-peracetic acid) in a population of patients aged eighty and older.Material and methods: 47 patients (27 males and 20 females) with an average age of 81.9 ± 1.7 years, 80% already diagnosed with Chronic Kidney Disease (CKD), were investigated. Two plasma samples were collected between 60-90 and 165-190 minutes after the injection of [99mTc]-DTPA and GFR were calculated. Results: When comparing the GFR values obtained from the various formulae by creatinine levels with the GFR value obtained by measuring [99mTc]-DTPA residue, the following concordance values emerged: (1) MDRD: 55.3%, (2) Cockroft-Gault 55.3% (3) CKD-EPI 57.5% (4) BIS-1 51.1%Conclusion: Our data show a poor correlation between all clinical methods and [99mTc]-DTPA, which remains a gold standard for the direct measurement of GFR.