timi

Spontaneous Coronary Artery Dissection (SCAD) represents a significant cause of acute coronary syndrome (ACS) in patient populations with low-risk cardiovascular profiles and, therefore can be sometimes underdiagnosed. On the other hand, it often preserves the typical clinical presentation of ACS which makes coronary artery angiography (CAG) execution mandatory. A 62-year-old woman with a history of recurrent SCAD presented to the emergency department for a new episode of acute chest pain with troponin elevation. CAG revealed an ambiguous angiography image suggesting a sub-occlusive type 2 SCAD involving the distal segment of the left circumflex artery. The patient was managed conservatively due to the absence of ongoing ischemia or hemodynamic instability. At the seven-day follow-up, a computed tomography coronary angiography (CTCA) was performed to better assess SCAD and detect concomitant associated arteriopathies. Optimized medical therapy was prescribed at the discharge and at one-month follow-up, no recurrence of symptoms was referred.

This editorial explores the crucial yet often overlooked role of sleep in enhancing student-athlete performance and well-being. It highlights sleep’s impact on physical recovery, cognitive function, and emotional stability, emphasizing the unique benefits for athletes. The editorial examines the detrimental effects of early school start times on adolescent sleep patterns and their subsequent impact on academic and athletic performance. By advocating for policy changes that prioritize sleep, such as delaying school start times, this editorial presents a novel approach to optimizing student-athlete success. Through a synthesis of current research and practical insights, it urges stakeholders in education and sports to recognize and act upon the foundational importance of sleep, positioning it as a key component of athletic and academic excellence.

This study presents a comprehensive simulation and analysis of photonic band gaps in one-dimensional (1D) photonic crystals using the open-source software MEEP. Photonic crystals, with their periodic structures, exhibit photonic bandgaps that prevent the propagation of specific wavelengths of light, making them crucial for various optical applications. Unlike previous studies that primarily focused on theoretical and experimental methods, this research introduces a novel computational approach that enhances the accuracy and flexibility of modeling these bandgaps. Through detailed simulations, we explore the impact of different structural parameters on the photonic bandgap properties, providing valuable insights into optimizing these crystals for practical use. Our findings demonstrate significant improvements in the design and understanding of 1D photonic crystals, particularly in tailoring bandgaps for specific applications in optical devices. This work contributes to the advancement of photonic crystal technology by offering a robust framework for their analysis and application.

Chronic obstructive pulmonary disease (COPD) is a heterogeneous, progressive disease characterized not only by pathological changes in the lungs but also by significant extrapulmonary manifestations and serious concomitant diseases. The current problem for the study is the features of the relationship between COPD and adipose tissue since there are contradictory data in the literature. This review presents studies that claim that obesity aggravates the course of COPD, as well as the results of studies that describe the “obesity paradox” in patients with COPD. Due to the lack of unambiguous data, it is necessary to continue studying this problem to optimize the tactics of managing this group of patients and draw up clear recommendations for patients with COPD.

The torsional deformation behavior of an elastic bar with a circular cross-section was investigated by applying invariant dyadic analysis, where the small finite displacement functions advocated by Saint-Venant (1855) were fully employed. It was found that the previously overlooked circumferential shear force field generated by pure torsion on the side walls of a bar produces an unusual torque term induced by the skew-symmetric part of the deformation tensor and exhibits quadratic length dependence along the z-axis of the bar. The adaptation of this torque term for a helical conformation of α-peptides creates moments acting on the circular cross-sections and is directed along the surface normal of circular cross-sections, which coincides with the tangent vector of the helix. The projection of this torque along the z-axis of the helix varies quadratically with the azimuthal angle. The radial component of the unusual torque, which also lies along the principal normal vector of the helix, starts to perform a precession motion by tracking a spiral orbit around the z-axis, whereas its apex angle decreases asymptotically with the azimuthal angle and finally reaches a finite value depending on the height of the helix along the z-axis. The ordinary torque terms, which are also deduced from the self- and anti-self-conjugate parts of the deformation tensor, have magnitudes half that of the full torque term reported in the literature. The present results were applied to the helical conformation of α-peptides designated by {3.611} to show that the mechanical stability of strained open-ended helical conformations can be successfully achieved by spontaneous readjustments of the surface and bulk Helmholtz free energies under isothermal isochoric conditions. It has been demonstrated that the main contribution to the mechanical stability of α-peptide 3.611 cannot come alone from the electrostatic dipole-dipole interaction potential of the anti-align excess dipole pairs but also from the surface Helmholtz free energy, which is characterized by a binding free energy of -15.5 eV/molecule (-32.56 Kcal/mole) for an alpha-peptide composed of 11 amino acid residues with a critical arc length of approximately 10 nm, assuming that the shear modulus is G = 1GPa and the surface Helmholtz specific free energy density is fs = 800 erg/cm2. This result was in excellent agreement with the experimental observations of the AH-1 conformation of (Glu)n Cys at pH 8. The present theory indicates that only two excess permanent anti-align dipole pairs for one α-Helical peptide molecule is requirement to stabilize the whole secondary structure of the protein that is exposed to heavy torsional deformation during the folding processes which amounts to 7.75 eV/molecule stored electrostatic energy compared to the interfacial Helmholtz free energy of -23.25 eV/molecule, which is exposed to hydrophobic environments.

Carbon footprint refers to the total amount of greenhouse gas emitted in the atmosphere by an individual or by an organization causing global warming. There are various causes of greenhouse gas emissions and anaesthetic gases are one amongst them. Greenhouse gases warm the earth by absorbing infrared energy and slowing the rate at which the energy escapes into space. Each greenhouse gas has two important properties. One is the amount of infrared energy that a gas can absorb and the other is the lifetime of that gas in the atmosphere. Anaesthesia as a speciality contributes to carbon footprinting in three ways: direct emission, energy use, and operating room wastes and supplies. Direct emission of Waste Anaesthetic Gases (WAG) from anaesthesia workstations can either be scavenged and thrown out into the environment causing a green greenhouse gas effect or can pollute the operating room due to poor scavenging. Various techniques such as reducing direct emissions, energy use optimisation, and waste management have been tried in minimising carbon footprint in anaesthesia practice but providing safety to the patient is considered of utmost importance.

Objective: Caesarean Scar Ectopic Pregnancies (CSEP) pose distinct diagnostic and management challenges. This study investigates the risk factors, treatment options, and outcomes for CSEP cases treated at Prince Sultan Medical Military City, Riyadh.Methods: Over a two-year period, medical records of 28 patients with CSEP were reviewed, collecting data on patient demographics, obstetric history, and treatment outcomes. This analysis aimed to identify influential risk factors and assess the effectiveness of various management strategies.Results: Treatment success was achieved in 85.7% of cases, with Methotrexate (MTX) proving effective in over half of the cases. The findings suggest significant risk factors and best practices for managing this rare condition.Conclusion: Early detection, risk factor awareness, and tailored treatment strategies are key to optimizing outcomes in patients with CSEP.

Children who experience Adverse Childhood Experiences (ACEs)—including trauma, family instability, or significant loss—are at increased risk for enduring mental, emotional, and physical challenges, including conditions such as depression, anxiety, and chronic health issues. Without effective support, these adverse experiences can have lasting effects on a child’s well-being, often persisting into adulthood and impacting mental, emotional, and physical health outcomes over the long term. Storytelling is a powerful method to support resilience in these children by enabling them to process emotions, make sense of complex experiences, and view themselves as active agents in their lives. By framing their experiences within personal narratives, children can create coherent stories that aid emotional regulation and support mental well-being. Through storytelling, children can frame their struggles as part of a larger, purposeful journey, fostering a sense of agency and self-worth. Techniques such as narrative therapy, story circles, and resilience-themed books-exemplified by The Adventures of Gabriel—help children explore their experiences, visualise positive outcomes, and strengthen social bonds. Moreover, storytelling is an accessible tool that aids in perspective—taking, allowing children to relate their challenges to those of characters, which reinforces their ability to overcome adversity and navigate life’s complexities with strength and optimism.

Background: Microorganisms belonging to Streptomyces sp. are Gram-positive bacteria known for their unsurpassed capacity for the production of secondary metabolites with diverse biological activities. The aim of this study was to evaluate the antimicrobial and antioxidant properties of ethyl acetate Streptomyces sp. PERM2 extract, its potential modes of action and bioactive secondary metabolites.Results: The ethyl acetate PERM2 extract showed antimicrobial activity more pronounced on both Gram-positive and Gram-negative bacteria and fungi with a Minimum Inhibitory Concentration value (MIC) of 0.5 mg/mL and Minimum Bactericidal Concentration (MBC) of 2 - 4 mg/mL against bacterial pathogens. MIC value against pathogenic fungi was 2 mg/mL and Minimum Fungicidal Concentration (MFC) of 0.01 - 0.05 mg/mL against pathogenic fungi. PERM2 crude extract showed the ability to inhibit bacteria cell wall synthesis at 0.5 and 1 MIC. The extract was found to possess dose-dependent 2,2-Diphenyl-picrylhadrazyl (DPPH) free radical scavenging and Ferric reducing activity. The gas chromatography-mass spectrometry (GC-MS) analysis revealed the presence of three major compounds identified as 9,12-octadecadienoic acid (Z, Z) (29.75%), tridecyl trifluoroacetate (24.82%) and 1-(+)-ascorbic acid 2, 6-dihexadecanoate (22.34%). The liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis revealed the presence of 22 non-volatile metabolites in PERM2 extract and only the compound 3, 30-O-dimethylellagic acid was identified. Conclusion: The results of this study indicate that ethyl acetate Streptomyces sp. PERM2 extract possesses antibacterial, antifungal, and antioxidant activities; inhibits bacteria cell wall and protein synthesis; and contains significant bioactive secondary metabolites which could be used as an alternative to multi-resistance antibiotics.

This review aims to emphasize the scientific focus on platelet therapies by presenting the results already obtained in mares susceptible to Persistent Breeding-Induced Endometritis (PBIE), as well as highlighting opportunities for further improvement. The recent publication demonstrating the absence of bacterial growth in susceptible mares treated with PRP underscores the potential of regenerative therapies to control infections without promoting the emergence of multidrug-resistant bacteria. Alternative therapies have gained prominence in the current public health context, with the World Health Organization listing antimicrobial resistance among the ten most significant global threats. Endometritis is the leading cause of subfertility in mares, and empirical antibiotic therapies are commonly used in the field due to market pressures related to the high financial value of embryos, along with logistical challenges in obtaining laboratory-dependent diagnostic results. Platelet-Rich Plasma (PRP) is an alternative therapy derived from whole blood plasma with a high concentration of platelets. Its anti-inflammatory, regenerative, and antimicrobial properties are particularly tested when traditional therapies fail to achieve the desired effect. In recent years, research on the use of PRP in equine reproduction has primarily focused on endometritis, with a particular emphasis on persistent breeding-induced endometritis (PBIE). However, there is a growing interest in other platelet derivatives, such as lyophilized platelet-rich plasma and platelet lysate, which offer practical field applications.

Background: Sickle cell anaemia (SCA) in children demonstrates a broad range of clinical manifestations and serious complications. Assessment of disease severity in specific populations is necessary to plan services and optimise care. Aim: To describe the clinical severity of SCA and associated sociodemographic and clinical factors in children in Gambia.Methods: The presence of lifetime complications was confirmed by history and review of medical charts. We determined clinical severity using a validated scoring system and related the severity to sociodemographic and clinical factors.Results: In 130 study participants, ages ranged from 5 to 15 years with a mean (SD) age of 9.74 (2.81) years. Eleven (8.5%) children had had acute chest syndrome, 7 (5.4%) avascular necrosis of the femoral head, 6 (4.6%) gallstones, 5 (3.8%) stroke and 1 (0.8%) priapism over their lifetime. Disease severity was classified as mild in 108 (83.1%) children, moderate in 17 (13.1%) and severe in 5 (3.8%). Age, age at diagnosis, sex, ethnicity, social class, and treatment with hydroxyurea was not significantly correlated with SCA clinical severity (P values 0.10-0.84).Conclusion: The high proportion of children with mild disease may be due to the high prevalence of Senegalese β-haemoglobin haplotype in the Senegambia subregion. However, the presence of moderate or severe disease in almost 1 in 5 children calls for concerted efforts in SCD care in this region.

Alginate, a naturally occurring biopolymer extracted from brown algae, presents a promising avenue for developing sustainable and efficient membranes for wastewater treatment. This review comprehensively examines recent advancements in the fabrication, modification, and application of alginate-based membranes for effective water purification. The paper delves into various fabrication techniques, including casting, electrospinning, and 3D printing, which influence the structural and functional properties of the resulting alginate membranes. To enhance performance, strategies such as crosslinking, incorporation of porogens, and surface functionalization are employed. These modifications optimize crucial properties like mechanical strength, porosity, selectivity, and antifouling resistance. Furthermore, Response Surface Methodology (RSM) has emerged as a valuable tool for systematically optimizing fabrication parameters, enabling researchers to identify optimal conditions for achieving desired membrane characteristics. The integration of alginate membranes with biological treatment processes, such as phycoremediation (utilizing microalgae) and mycoremediation (employing fungi), offers a synergistic approach to enhance wastewater treatment efficiency. By immobilizing these microorganisms within the alginate matrix, their bioremediation capabilities are amplified, leading to improved pollutant degradation and nutrient removal. In conclusion, alginate-based membranes demonstrate significant potential as a sustainable and effective technology for wastewater treatment. Continued research and development, focusing on optimizing fabrication processes and exploring innovative integration strategies with biological systems, will further advance the application of alginate membranes in addressing the pressing global challenge of water pollution.

Introduction: Behçet’s disease is a rare, systemic, inflammatory condition that primarily affects young adults. It is characterized by a variety of clinical manifestations. However, neurological and cardiac presentations remain uncommon and often delayed in diagnosis. This disease can lead to severe complications, such as ischemic strokes and myocarditis, highlighting the systemic and complex nature of the condition.Case presentation: A 27-year-old patient was hospitalized after experiencing an ischemic stroke and myocarditis, which revealed Behçet’s disease. He had a history of oral and cutaneous ulcers, without a prior diagnosis of Behçet. Upon admission, brain imaging confirmed an ischemic stroke, and echocardiography and cardiac MRI showed acute myocarditis. Biological tests confirmed elevated systemic inflammation, which guided the treatment plan. The initial treatment included corticosteroids, immunosuppressors (azathioprine), and cardioprotective therapy. The patient showed significant clinical improvements, although mild deficits persist.Discussion: Myocarditis in Behçet’s disease is a rare but severe manifestation resulting from inflammation of the heart walls, often associated with other systemic vascular involvement. Although less common than oral or cutaneous ulcers, myocarditis can lead to acute heart dysfunction and even heart failure if not treated promptly. It is generally caused by an excessive inflammatory response, often associated with immune system activation, which affects the coronary circulation and damages the cardiac muscle. Treatment for myocarditis in this context relies on high-dose corticosteroids to control inflammation, followed by long-term immunosuppressive medications like azathioprine. While the initial treatment often leads to a rapid improvement in cardiac function, the risk of long-term complications, such as dilated cardiomyopathy or heart failure, remains high. Close follow-up is therefore essential to prevent these complications and optimize the long-term cardiac prognosis of patients with this rare disease.Conclusion: The progression of myocarditis in Behçet’s disease can be favorable if diagnosed and treated early, with significant improvement in cardiac function achieved through the use of corticosteroids and immunosuppressive therapy. However, the long-term prognosis remains uncertain due to the risk of chronic cardiac complications, such as dilated cardiomyopathy or heart failure.

This review underscores the transformative impact of Computer-Aided Engineering (CAE) on modern engineering, emphasizing its role in advancing sustainable and efficient technological solutions. The CAE industry is further analyzed, focusing on market trends and future directions. The CAE market is projected to grow significantly in the next five years in industries like automotive, aerospace, and energy, especially with the rapid advancements in High-Performance Computing (HPC), Artificial Intelligence (AI), Internet of Things (IoT), and Digital Twin technologies that enhance real-time optimization and predictive capabilities, thus fostering innovation in sustainable product design and performance. Lastly, this review presents KYAMOS Software and its state-of-the-art CAE solutions for tackling high-demand engineering problems, mainly concerning green technologies.

Bifurcation analysis and Multiobjective Nonlinear Model Predictive Control (MNLMPC) calculations were performed on a model of circadian oscillations of the Period (PER) and Timeless (TIM) proteins in Drosophila. The MATLAB program MATCONT was used to perform the bifurcation analysis. The optimization language PYOMO was used along with the state-of-the-art global optimization solvers IPOPT and BARON for the MNLMPC calculations. The bifurcation analysis revealed oscillation causing Hopf bifurcations while the MNLMPC calculations revealed the existence of spikes in the control profiles. Both Hopf bifurcation points and the control profile spikes were eliminated using an activation factor involving the hyperbolic tangent function.

Introduction: Research provides a framework for Anesthesia residents who are critical thinkers who approach clinical practice with an open mind. The goal of this study was to determine current attitudes regarding performing research during residency as well as perceived obstacles to doing so. A resident physician should be ready to face the challenges of the growing technology, tons of journals published in different portals, and increasing sophistication of the health care delivery system. Practice-based learning, systems-based practices, and medical knowledge are the vital core directly affected by strong research skill set. Methods: The study was done through a survey of all 15 current residents in Vicente Sotto Memorial Medical Center Anesthesia Resident. They answered a 13 self-administered survey, which was adopted from previous similar research. Data was collected for 1 week to give time to the busy schedule of the resident. Results: Respondents cited that the lack of time in balancing clinical and research responsibilities is the most common obstacle encountered by 86.7% of respondents. Researchers feel they have inadequate research skills and a lack of time in balancing responsibilities between family and work was among the most common answers by the respondents. 2nd prevalent barrier to research during residency was a lack of mentoring. Conclusion: The top barriers to research are lack of time and inadequate access to research mentors. These barriers can be addressed to optimize the current research environment for residents. Anesthesia residents identified several critical aspects that they believe are obstacles to research. These findings can be used by programs to overcome hurdles and increase the inclusion of research into residency training.

The global menace of cancer requires supplementary treatments beyond standard medical approaches for effective medical intervention. The Ketogenic Diet (KD) composed of high fats combined with moderate proteins and low carbohydrates has become popular as a metabolic therapy for cancer. The anti-cancer mechanism of KD works through metabolic stress induction in cancer cells, reduced insulin and IGF-1 signaling pathways, improved mitochondrial function, inflammation, and immune regulation. Standard cancer treatments receive enhanced outcomes through KD synergistic action which simultaneously decreases treatment-related side effects. To achieve optimized treatment outcomes in cancer, ketogenic diet practitioners need to use personalized nutritional planning in combination with metabolic tracking and exogenous ketone supplements. It is essential to find solutions for diet adherence issues and nutrient deficiencies because they determine KD’s effectiveness as a cancer treatment. The fight against cancer needs sustained and multipronged clinical research and validation to establish the proper implementation of this method.

The integration of deep learning and genetic analysis has transformed the assessment of elite sports performance, particularly in competitive swimming. This study examines the fusion of deep learning techniques with DNA markers, physiological biometrics, and performance analytics to enhance the prediction and optimization of swimmer performance. A structured dataset comprising genetic sequences, physiological parameters, and biomechanical attributes was utilized to train a neural network model capable of categorizing swimmers based on genetic predisposition and athletic potential. The model achieved high classification accuracy, demonstrating a strong link between genetic markers, physiological traits, and competitive swimming outcomes. The findings emphasize the potential of AI-driven analytics in talent identification, customized training adaptations, and injury prevention. Furthermore, the study highlights the effectiveness of deep learning in analyzing complex genomic and physiological data to generate meaningful insights for performance enhancement. While the results validate the feasibility of using genetic and AI-based models for performance prediction, further studies are needed to broaden dataset diversity, integrate epigenetic influences, and test the model across varied athlete populations. This research contributes to the expanding field of AI-driven sports science and provides a solid foundation for incorporating genomics with deep learning to enhance elite athletic performance.

Background: Full-field Digital Mammography (FFDM) is essential for the early detection of breast cancer. Digital Breast Tomosynthesis (DBT) has improved cancer diagnosis and reduced false positives in mammography . This study evaluated DRLs for FFDM and DBT at various ranges of Compressed Breast Thickness (CBT).Material and methods: We evaluated the parameters like Average Glandular Dose (AGD), kVp, mAs, Entrance Surface Dose (ESD), and CBT in a retrospective analysis of FFDM and DBT. We computed the mean, median, range, and 75th percentile for Craniocaudal (CC) and Mediolateral Oblique (MLO) views at various breast thicknesses.Results: The DRLs were 0.70 mGy to 2.55 mGy for FFDM and 0.94 mGy to 3.67 mGy for DBT for breast thickness in the range from 20 mm to 89 mm.Conclusion: This analysis revealed that DRLs were significantly lower than international benchmarks . Mammography radiation dose optimisation enhances diagnostic accuracy and patient safety.