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Abstract Background During diabetes, prorenin is highly produced by the renal collecting ducts. The binding of prorenin to (pro)renin receptor (PRR) on the apical plasma membrane triggers intracellular profibrotic genes, including TGF-β and CTGF. However, the underlying mechanisms contributing to the stimulation of these pathways remain unclear. Hence, we hypothesize that the glucose transporter-1 (GLUT1) favors the PRR-dependent stimulation of TGF-β and CTGF in the distal nephron segments during high glucose (HG) conditions. Methods To test this hypothesis, primary cultured renal inner medullary collecting duct (IMCD) cells were treated with normal glucose (NG, 5 mM) or high glucose (HG, 25 mM) for 48 h in the presence or absence of the GLUT1-specific inhibitor BAY 876 (2 nM). Additionally, IMCD cells were treated with the PRR antagonist PRO20. The expression of TGF-β and CTGF was quantified by immunoblot and qRT-PCR. Results HG increased GLUT1 mRNA and protein abundance, while BAY 876 inhibited these responses. HG treatment upregulated PRR, but the concomitant treatment with BAY 876 partially prevented this effect. TGF-β and CTGF expressions were augmented in IMCD cells treated with HG. However, PRO20 prevented the increases in TGF-β but not those of CTGF. GLUT1 inhibition partially prevented the increases in reactive oxygen species (ROS) during HG while PRO20 did not. ROS scavenging impaired CTGF upregulation during HG conditions. Additionally, long-term exposure to HG increases lipid peroxidation and reduced cell viability. Conclusions The data indicate that glucose transportation via GLUT1 is implicated in the PRR-dependent upregulation of TGF-β while CTGF is mediated mainly via a mechanism depending on ROS formation in renal medullary collecting duct cells.

Abstract The progressive increase in the rate of production of plastic bottles by the beverage and food industries in Nigeria has increased considerably over time, constituting large volume of waste generations from plastic waste bottles. Also, increasing demand for eco-friendly soil improvement materials and the growing desire to minimize waste generated daily, prompted the need for this study to look into ways to use such wastes and other sustainable materials in soil improvement. This study investigated the potential use of sisal fiber and plastic waste strips as partial replacement for cement to enhance the geotechnical characteristics of lateritic soils. Various laboratory experiments were conducted, encompassing specific gravity determination, grain size distribution, compaction assessment, Atterberg limit, unconfined compressive strength (UCS), and microscopic analysis. Sisal fiber and plastic waste strips were each varied at 0, 0.5, 1.0, 1.5, 2.0 and 2.5% while maintaining a constant 5% cement added to all the mix proportions. Results of investigation revealed an enhancement in plasticity of the soils with both treatment methods. Liquid limit shows a steady drop from 43% in its natural state to 42% and 41% at 1% sisal fiber and 1% plastic strips content respectively, while plasticity index showed a decline from 14.8% in its natural form to 12.69% and 10.8% at 2% sisal fiber and 1% plastic waste strips content respectively. Strength properties of the treated soil increased with increase in admixtures content. Microanalysis of the natural and optimally modified soils showed alteration in the fabric arrangement of the particles of soils. Based on the results of the study, optimally 1–1.5% sisal fiber/5%cement and 1–1.5% plastic waste strips/5%cement meaningfully improved the soil strength and can both be used as sub-base materials for light trafficked roads.

Abstract Upper gastrointestinal bleeding (UGIB) is a common cause of hospital admission worldwide and several risk scores have been developed to predict clinically relevant outcomes. Despite the geriatric population being a high-risk group, age is often overlooked in the assessment of many risk scores. In this study we aimed to compare the predictive accuracy of six pre-endoscopic risk scoring systems in a geriatric population hospitalised with UGIB. We conducted a multi-center cross-sectional study and recruited 136 patients, 67 of these were 65–81.9 years old (“

Abstract Conjugation to a carrier protein is essential to give rise to the antigenicity of hapten. Three carrier proteins e.g. KLH (Keyhole Limpet hemocyanin), BSA (bovine serum albumin), and OVA (Ovalbumin) were used mostly. KLH is advantageous to the others, majorly owing to its strong immunogenicity and limited usage in other biological assays. However, the cost of obtaining Keyhole Limpet is high and the solubility of KLH is not as well as the other carriers, especially after hapten conjugation. Here, we extracted the shrimp hemocyanin (SHC) from Litopenaeus vannamei (L. vannamei), which is a commonly sea product worldwide. The high pure SHC could be acquired by two-step purification, with a production yield of > 1 g proteins (98% pure) per 1 kg shrimp. Compared to KLH, the peptide-SHC conjugates exhibit higher solubility after hapten conjugation. Meanwhile, compared with KLH, SHC induces comparable antibody production efficiency in mammals, with or without conjugation. Furthermore, rabbit polyclonal antibodies or mouse monoclonal antibodies were generated by immunizing SHC-peptide conjugates, and the subsequent antibodies were confirmed to be used in western blot, immunofluorescence and immunohistochemistry. Therefore, we demonstrated that SHC may be used as a substitute for KLH in future antibody and vaccine development.

IntroductionComplex Percutaneous coronary intervention (PCI) for the treatment of ischemic heart disease has increased significantly. We aimed to evaluate sex-related differences in patients undergoing complex PCI.Methodssingle-center prospective observational study including patients undergoing complex PCI between 2017 and 2023. Baseline and procedural features, and mid-term outcomes were compared according to the gender distribution. The combined primary endpoint included stroke, myocardial infarction, need for a new coronary revascularization, and all-cause mortality. Propensity score (PS) matching with an inverse probability of treatment weight (IPW) approach was used to adjust for differences in baseline characteristics.Results1,283 patients were included, 983 (76.6%) male and 300 (23.4%) female. Median follow-up was 2.4 (IQR: 1–3.8) years. There was a higher rate of no-reflow phenomenon (4% vs. 1.8%, p = 0.03) among female patients. In the overall cohort, female patients had a greater risk for the combined primary endpoint (HR 1.28, 95% CI: 1.02–1.59). In the matched cohort, female patients exhibited a higher risk for the combined primary endpoint (HR 1.23, 95% CI: 1.06–1.42), as well as for myocardial infarction (HR 1.34, 95% CI 1.03–1.75), and all-cause mortality (HR 1.21, 95% CI 1.02–1.45), and a trend towards a higher risk for the need of a new coronary revascularization (HR 1.22, 95% CI 0.92–1.61).Conclusionsin a contemporary cohort of patients undergoing complex PCI procedures, female patients are associated with a higher risk of early complications.

IntroductionThis study addresses the urgent need for standardized frameworks in Continuing Engineering Education (CEE) to support lifelong learning in the rapidly evolving global workforce. Significant events, such as the Digital Transformation and the rise of artificial intelligence, have highlighted the demand for adaptable and diverse learning systems, especially in engineering education. On the one hand, the World Economic Forum's, 2023 Future of Jobs Report predicts a transformation in 44% of workers’ core skills within 5 years, with engineering facing substantial labor shortages. On the other hand, the Paris Agreement’s call for sustainable development necessitates a workforce with skills aligned with the green transition.MethodsThe research introduces an innovative framework taxonomy that categorizes and organizes CEE programs by integrating standardized terminologies. It focuses on critical elements such as resourcing, organizational models, and program development strategies to provide a comprehensive structure that supports consistency and comparability across diverse educational contexts.ResultsUnlike existing models, the proposed framework enhances cross-institutional learning and dissemination of best practices. It identifies key components required for effective CEE management, filling a critical gap in the literature. The study’s output is a taxonomy for discussing and comparing CEE institutional approaches and practices to advance the field and foster a global CEE community committed to excellence in engineering education.DiscussionsThis study equips educators, policymakers, and industry leaders with a practical tool to design, implement, and scale CEE programs. It ultimately fosters a skilled workforce prepared to meet the challenges of future technological and sustainable transitions, supporting the development of a standardized approach to CEE.

The EFAST technique is a rapid ultrasound method introduced into ATLS guidelines since 2006 for the evaluation of trauma patients. It allows for the detection of free fluid in the abdomen, pericardial tamponade, and pneumothorax within 2 to 3 minutes without impacting management times in pre-hospital settings. Recently, the EFAST-PS protocol has been introduced, which includes an additional scan of the pubic symphysis to identify “open book” pelvic fractures. This mini review examines the efficacy of the EFAST-PS protocol in pre-hospital environments through a literature review and analysis of a clinical case. It is demonstrated that EFAST has high specificity and sensitivity in detecting free fluid in abdominal and thoracic recesses, improving the management of trauma patients and reducing time to definitive intervention. The addition of the pubic symphysis scan did not cause any issues but increased safety in managing patients with suspected fractures and hemodynamic instability. Emergency ultrasound assessment, including the EFAST-PS protocol, should be integrated into the overall clinical picture to provide useful data for the decision-making process.

Background. The concept of TO is expanding across various surgical disciplines to establish a standardized, comprehensive quality benchmark. Traditional metrics such as 1-y patient and graft survival have been key for evaluating transplant program performance but are now deemed inadequate because of significant field advancements. This systematic review aims to provide a comprehensive understanding of the applicability and validity of textbook outcome (TO) in the setting of solid organ transplantation. Methods. A structured search, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, was conducted across PubMed, Embase, and Scopus databases on March 10, 2024. Results. Fourteen articles were identified for inclusion in this review. Of these, 2 studies addressed TO in heart transplantation, 3 in lung transplantation, 2 in kidney transplantation, and 7 in liver transplantation. A subgroup analysis was conducted to categorize the different definitions of TOs and identify the most common reasons for TO failure. Conclusions. Our systematic review highlights the ongoing efforts in the field of solid organ transplantation to define TO and emphasizes the importance of developing a universally recognized set of TO criteria for each type of transplant. TO provides a valuable framework for transplant centers to benchmark their performance against similar institutions on a risk-adjusted basis and to pinpoint specific areas for enhancing patient outcomes. Even the most successful programs may discover aspects within the composite outcome with scope for improvement.

Abstract Background Unhealthy lifestyles represent a key element fueling Non-alcoholic fatty liver disease (NAFLD) onset and worsening. We aimed to evaluate the effects of forced acute lifestyle changes on NAFLD evolution. Methods 187 NAFLD patients were followed two years pre- and two years during the lockdown social restrictions in three Italian medical centers. For each patient, biochemical, clinical, non-invasive liver fibrosis, nutritional, and body composition data were collected. Results An increase in fats and carbohydrate intake associated with impaired weekly physical activity during the lockdown was demonstrated as well as an increase in body mass index and waist-hip-ratio (p

This meta-analysis examines the effects of sorting secondary students into different tracks ("between-school" tracking) or classrooms ("within-school" tracking) on the efficiency and inequality levels of an educational system. Efficiency is related to the overall learning achievement of students, whereas inequality can refer to "inequality of achievement" (i.e., the dispersion of outcomes) or "inequality of opportunity" (i.e., the strength of the influence of family background on student achievement). The selected publications are 53 analyses performed in the period from 2000 to 2021, yielding 213 estimates on efficiency and 230 estimates on inequality. The results show that the mean effect size (Hedge's G) of tracking on efficiency is not statistically significant (G = -0.063), whereas it is significantly positive (G = 0.117) on inequality. We further set out to explain variation in effect sizes by (a) policy characteristics, (b) the operationalization of main variables, (c) the research design, (d) the set of control variables included in the statistical analyses, and (e) the quality of the study, year of publication, and publication status (peer reviewed or not peer reviewed).

The St. Nicolas House Analysis (SNHA) is a new graph estimation method for detection of extensive interactions among variables. It operates by ranking absolute bivariate correlation coefficients in descending order thereby creating hierarchic association chains. The latter characterizes dependence structures of interacting variables which can be visualized in a corresponding network graph as a chain of end-to-end connected edges representing direct relationships between the connected nodes. The important advantage of this relatively new approach is that it produces less false positive edges resulting from indirect or transitive associations than expected with standard correlation or linear model-based approaches. Here we aim to improve the detection of ramifications in graphs by addition of different data processing layers to SNHA. They include the combinations of the extensions R-squared gaining(RSG) and linear model check(LMC). SNHA together with these so-called extensions were benchmarked against default SNHA and other reference methods available for the programming language R. In the end combinations of RSG, LMC and Bootstrapping improve SNHA performance across different network types, albeit at the cost of longer computation time.

El proyecto se ejecutó en el corregimiento de Leticia, una de las zonas más importantes de Montería en la producción de leche y que se caracteriza por sus malos indicadores, generando esto brechas tecnológicas en comparación con otros sistemas ganaderos. Con la implementación de las escuelas de campo, estrategia de educación no formal, se generó un ambiente de aprendizaje entre productores y técnicos. El objetivo fue determinar el efecto de dicha intervención educativa en buenas prácticas de ordeño, sobre la salud de la ubre y la calidad microbiológica de la leche en fincas de pequeños productores de Montería, Córdoba, Colombia. La recolección de la información de campo se desarrolló en tres fases: pretest, donde se hizo una encuesta y una primera toma de muestras; intervención, donde se efectuó una capacitación mediante escuelas de campo en diferentes protocolos y postest, donde se hizo una evaluación final mediante una encuesta y una segunda toma de muestras para valorar la sanidad de las ubres y la calidad microbiológica; todas estas mediciones se analizaron en un laboratorio certificado. Mediante un estudio analítico, se recolectaron 144 encuestas y 144 muestras de leche cruda en el pretest, de igual manera sucedió en el postest, y los datos fueron procesados mediante estadística descriptiva e inferencial en el software Infostat. Como resultado, las variables células somáticas y mesófilos fueron menores en el postest. El acompañamiento técnico permitió implementar buenas prácticas de ordeño y vincular a pequeños productores con mercados formales de la cadena láctea.

Cet article propose de formaliser le texte littéraire – ici, l’écriture et la lecture de poésie – non seulement comme un simple tissu mais bien plutôt comme une maille dans le tissage des relations au vivant, de nos liens et attaches avec les territoires et les co-habitants, notamment ruraux. Les poèmes d’Estelle Ceccarini, d’Aurélie Olivier, de Sonia Moretti, de Laetitia Gaudefroy Colombot, écrits depuis et sur les campagnes, enrichissent nos cartographies rurales – vidées ou biaisées par nos modes de pensée urbains – de récits intimes, d’attaches profondes, de vies fourmillantes. Ces textes, dont l’écriture est située dans des lieux précis du vécu, dont la fabrication et la diffusion sont plutôt régionales, appellent à être prolongés par des rencontres – avec des lieux rapprochés, leurs faunes, flores, habitants, acteurs et actrices de la culture, tissant des liens sociaux autour du livre-nœud, objet qui nécessite la rencontre, le tissage social, et appelle à la continuer. Ces poèmes nouent ensemble arpentage de l’espace et du langage et montrent que se jouent, dans la pratique poétique, un apprentissage de la curiosité, de l’observation, du décentrement. La lecture de ces textes pourrait alors aisément se prolonger de sorties-ateliers d’écriture avec les élèves.

Abstract Many amniote vertebrate species including humans can form identical twins from a single embryo, but this only occurs rarely. It has been suggested that the primitive-streak-forming embryonic region emits signals that inhibit streak formation elsewhere but the signals involved, how they are transmitted and how they act has not been elucidated. Here we show that short tracks of calcium firing activity propagate through extraembryonic tissue via gap junctions and prevent ectopic primitive streak formation in chick embryos. Cross-regulation of calcium activity and an inhibitor of primitive streak formation (Bone Morphogenetic Protein, BMP) via NF-κB and NFAT establishes a long-range BMP gradient spanning the embryo. This mechanism explains how embryos of widely different sizes can maintain positional information that determines embryo polarity. We provide evidence for similar mechanisms in two different human embryo models and in Drosophila, suggesting an ancient evolutionary origin.

Abstract Background The remarkable resistance to ionizing radiation found in anhydrobiotic organisms, such as some bacteria, tardigrades, and bdelloid rotifers has been hypothesized to be incidental to their desiccation resistance. Both stresses produce reactive oxygen species and cause damage to DNA and other macromolecules. However, this hypothesis has only been investigated in a few species. Results In this study, we analyzed the transcriptomic response of the bdelloid rotifer Adineta vaga to desiccation and to low- (X-rays) and high- (Fe) LET radiation to highlight the molecular and genetic mechanisms triggered by both stresses. We identified numerous genes encoding antioxidants, but also chaperones, that are constitutively highly expressed, which may contribute to the protection of proteins against oxidative stress during desiccation and ionizing radiation. We also detected a transcriptomic response common to desiccation and ionizing radiation with the over-expression of genes mainly involved in DNA repair and protein modifications but also genes with unknown functions that were bdelloid-specific. A distinct transcriptomic response specific to rehydration was also found, with the over-expression of genes mainly encoding Late Embryogenesis Abundant proteins, specific heat shock proteins, and glucose repressive proteins. Conclusions These results suggest that the extreme resistance of bdelloid rotifers to radiation might indeed be a consequence of their capacity to resist complete desiccation. This study paves the way to functional genetic experiments on A. vaga targeting promising candidate proteins playing central roles in radiation and desiccation resistance.

Abstract Background Mucosal Melanomas (MM) are highly aggressive neoplasms arising from mucosal melanocytes. Current treatments offer a limited survival benefit for patients with advanced MM; moreover, the lack of pre-clinical cellular systems has significantly limited the understanding of their immunobiology. Methods Five novel cell lines were obtained from patient-derived biopsies of MM arising in the sino-nasal mucosa and designated as SN-MM1-5. The morphology, ultrastructure and melanocytic identity of SN-MM cell lines were validated by transmission electron microscopy and immunohistochemistry. Moreover, in vivo tumorigenicity of SN-MM1-5 was tested by subcutaneous injection in NOD/SCID mice. Molecular characterization of SN-MM cell lines was performed by a mass-spectrometry proteomic approach, and their sensitivity to PI3K chemical inhibitor LY294002 was validated by Akt activation, measured by pAkt(Ser473) and pAkt(Thr308) in immunoblots, and MTS assay. Results This study reports the validation and functional characterization of five newly generated SN-MM cell lines. Compared to the normal counterpart, the proteomic profile of SN-MM is consistent with transformed melanocytes showing a heterogeneous degree of melanocytic differentiation and activation of cancer-related pathways. All SN-MM cell lines resulted tumorigenic in vivo and display recurrent structural variants according to aCGH analysis. Of relevance, the microscopic analysis of the corresponding xenotransplants allowed the identification of clusters of MITF-/CDH1-/CDH2 + /ZEB1 + /CD271 + cells, supporting the existence of melanoma-initiating cells also in MM, as confirmed in clinical samples. In vitro, SN-MM cell lines were sensitive to cisplatin, but not to temozolomide. Moreover, the proteomic analysis of SN-MM cell lines revealed that RICTOR, a subunit of mTORC2 complex, is the most significantly activated upstream regulator, suggesting a relevant role for the PI3K-Akt-mTOR pathway in these neoplasms. Consistently, phosphorylation of NDRG1 and Akt activation was observed in SN-MM, the latter being constitutive and sustained by PTEN loss in SN-MM2 and SN-MM3. The cell viability impairment induced by LY294002 confirmed a functional role for the PI3K-Akt-mTOR pathway in SN-MM cell lines. Conclusions Overall, these novel and unique cellular systems represent relevant experimental tools for a better understanding of the biology of these neoplasms and, as an extension, to MM from other sites.

Teachers' evaluations of students do not consider only academic competence, but are imbued with social considerations related to individual teacher and student characteristics, their interactions, and the surrounding context. The aim of this paper is understanding the extent to which teachers grade girls more generously than boys, and which characteristics of teachers and classrooms are likely to reduce this gender grading gap. We use Italian data from INVALSI-SNV, providing information on 10th-grade students linked with their teachers. The analysis relies on grade equation models in multilevel regression analysis, with students as first level, teachers/classrooms as second level, and schools as third level. Results show that, when comparing students who have identical subject-specific competence, teachers are more likely to give higher grades to girls. Furthermore, they demonstrate for the first time that this grading premium favouring girls is systemic, as teacher and classroom characteristics play a negligible role in reducing it.

This preliminary study aimed to examine improvement in eye contact among children with autism spectrum disorder (ASD) following an innovative technological intervention integrated with meta-cognitive guidance. Eighteen ASD participants, ages 5-9 years, were divided into two equal intervention groups--one received metacognitive guidance, and one did not. An eye-contact assessment was conducted pre-intervention and post-intervention by tracing the children's head and eye movements using a built-in laptop camera. The intervention included six 30-min sessions in which the participants played a computer game (C-Me) that required them to make eye contact with cartoon characters who needed assistance in solving a problem or completing a task. The results indicate that the technological intervention effectively promoted eye contact among all participants, especially those in the metacognitive intervention group.

Objetivo. Esta investigación tuvo como objetivo describir la morfología cualitativa y faneróptica de hembras Ovino de Pelo Criollo Colombiano (OPC) Sudán. Materiales y métodos. Se evaluaron seis características fanerópticas y siete morfológicas cualitativas en 115 hembras Sudán Bayo y Sudán Blanco, de los departamentos Córdoba, Cesar y La Guajira. Los datos obtenidos se analizaron a través del programa estadístico InfoStat. y se estimaron las frecuencias relativas y absolutas para cada uno de los caracteres evaluados. Resultados. Los OPC Sudán Bayo se distinguieron por ser de un color de capa bayo amarillo. Los Sudán Blanco fueron de capa overo castaño, pero predominando siempre el blanco sobre el castaño. Estos ovinos se caracterizaron por poseer mucosas negra-rosadas y en menor proporción habían individuos con mucosas rosadas. Además, presentaron orejas horizontales siempre, perfiles subconvexos en más del 80% de los casos, cuellos generalmente medianos y poco musculados, grupas usualmente inclinadas, ubres parcialmente pigmentadas y también despigmentadas. Asimismo, se caracterizaron por ostentar pezuñas veteadas mayoritariamente, aunque con un alto porcentaje de pezuñas claras en las Sudán Blanco. Conclusiones. Este trabajo ha permitido caracterizar de manera específica a las OPC Sudán desde la morfología y la faneróptica, obteniéndose así información de importancia para delimitar los parámetros de pertenencia a este grupo y para la propuesta de creación de un estándar racial.

Cancer survivorship was recently identified as a prostate cancer (PCa) research priority by PIONEER, a European network of excellence for big data in PCa. Despite being a research priority, cancer survivorship lacks a clear and agreed definition, and there is a distinct paucity of patient-reported outcome (PRO) data available on the subject. Data collection on cancer survivorship depends on the availability and implementation of (validated) routinely collected patient-reported outcome measures (PROMs). There have been recent advances in the availability of such PROMs. For instance, the European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) is developing survivorship questionnaires. This provides an excellent first step in improving the data available on cancer survivorship. However, we propose that an agreed, standardised definition of (prostate) cancer survivorship must first be established. Only then can real-world data on survivorship be collected to strengthen our knowledge base. With more men than ever surviving PCa, this type of research is imperative to ensure that the quality of life of these men is considered as much as their quantity of life. Patient summary: As there are more prostate cancer survivors than ever before, research into cancer survivorship is crucial. We highlight the importance of such research and provide recommendations on how to carry it out. The first step should be establishing agreement on a standardised definition of survivorship. From this, patient-reported outcome measures can then be used to collect important survivorship data.

Abstract Antibody–drug conjugates (ADCs) have emerged as a novel therapeutic strategy that has successfully reached patient treatment in different clinical scenarios. ADCs are formed by an antibody against a specific tumor-associated antigen (TAA), a cytotoxic payload, and a chemical linker that binds both. To this regard, most efforts have been focused on target identification, antibody design and linker optimization, but other relevant aspects for clinical development have not received the necessary attention. In this article using data from approved ADCs, we evaluated all characteristics of these agents, including payload physicochemical properties, in vitro potency, drug antibody ratio (DAR), exposure–response relationships, and clinical development strategies. We suggest that compounds with best options for clinical development include those with optimal payload physicochemical properties and cleavable linkers that would lead to a bystander effect. These modalities can facilitate the development of ADCs in indications with low expression of the TAA. Early clinical development strategies including changes in the schedule of administration with more frequent doses are also discussed in the context of an efficient strategy. In conclusion, we highlight relevant aspects that are needed for the optimal development of ADCs in cancer, proposing options for improvement.

Abstract Background Despite the benefits attributed to the use of local anesthesia (LA) for open hemorrhoidectomy (OH) in developed countries, this technique is still not considered as the first line technique in low-income countries such as Uganda; therefore, we aimed at comparing the cost of OH under LA versus Saddle block among patients with 3rd or 4th degree hemorrhoids. Methods This trial was conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. The operating time, and direct costs in (US$) including medical and non-medical were recorded. We analysed the cost in the two groups (local anesthesia versus saddle block) using SPSS version 23.0. Results Findings of fifty-eight patients were analysed including 29 participants per group. There was a significant difference in operating time and cost among the two groups (p

Abstract Background Musculoskeletal ultrasound imaging (MSUI) is an efficient monitoring and re-evaluation tool used for the management of musculoskeletal conditions in several clinical domains. Its utilization among physiotherapists, particularly in African countries, is yet to be explored. Objective This study investigated the knowledge, attitude, and perception of physiotherapists on the utilization of MSUI in the clinical management of musculoskeletal conditions. Methods One hundred and ninety-two consenting Nigerian-based physiotherapists practicing in public and private health institutions participated in this cross-sectional survey. They responded to a three-sectioned structured questionnaire, investigating socio-demographic and occupational characteristics, knowledge, attitude, and utilization of MSUI for the management of musculoskeletal conditions. Data were analyzed with descriptive statistics and Pearson’s chi-square test at a significant level of 0.05. Results The majority (79.2%) of the respondents had positive knowledge of MSUI and its benefits as a clinical modality for managing MSCs. However, only 4.2% had utilized MSUI in clinical practice. Non-utilization of MSUI was commonly attributed to a lack of access to MSUI (60.3%) and its unavailability in most diagnostic centers (42.9%). Almost all (99.0%) of them agreed to the necessity for increased availability of MSUI to physiotherapists for enhancement of physiotherapy interventions in the management of MSCs. Conclusion Knowledge of MSUI among Nigerian-based physiotherapists is adequate, but its utilization as a clinical tool is poor. Improved availability of MSUI to physiotherapists is necessary as well as specialty training on the utilization and interpretation of MSUI.

Abstract Background Differentiating unipolar depression from bipolar depression is clinically important. The identification of biomarkers that characterize the pathophysiology of each disorder may provide biological targets for treatment. The objective of the study was to demonstrate a relationship between CRP level and the severity of depressive symptoms and see if C-reactive protein (CRP) levels can be used as a biomarker to distinguish between unipolar and bipolar depression. A convenience sample of 90 individuals was consecutively recruited from the psychiatry outpatient clinic at Beni-Suef University Hospital, Egypt. They were divided into three equal groups: patients with major depressive disorder (MDD) (group 1), bipolar depression (group 2), and a healthy volunteer group (group 3). Patient groups were assessed using semi-structured interviews, and CRP levels were measured. Results Patients with bipolar depression and MDD showed a significantly higher score on the Beck Depression Inventory scale than the control group (32.97 ± 2.4 vs. 31.93 ± 2.3 vs. 8.00 ± 2.3 in all groups respectively) (P-value

Aim The study was designed to establish the relationship between hamstrings–quadriceps (H–Q) strength ratio and the performance of tasks in Berg’s Balance Scale among stroke survivors.Method Twenty-five stroke survivors participated in the study. The hamstrings and quadriceps muscle strengths of both the paretic and non-paretic sides were determined at 60° knee flexion with an electronic tensiometer. The participants undertook the tasks in Berg’s Balance Scale.Results The moment of correlation between the paretic H–Q strength ratio and the total score of the Berg’s Balance Scale was 0.630, while the non-paretic was −0.144. Tasks such as standing unsupported (0.360), sitting unsupported (0.348) and standing with eyes closed (0.262) showed a weak correlation with the paretic H–Q strength ratio. Sitting to standing (0.469), standing to sitting (0.405), transfers (0.470), standing with feet together (0.565), retrieving an object from the floor (0.544), turning to look behind (0.400), turning 360° (0.589) and one leg stance (0.649) showed moderate correlation with the paretic H–Q strength ratio; while reaching forward (0.768), placing alternate foot on stool (0.710) and tandem standing (0.744) showed strong correlation with the paretic H–Q strength ratio.Conclusion The study concluded that the H–Q strength ratios of the paretic limbs of stroke survivors showed significant relationships with the performance of tasks in Berg’s Balance Scale. It is recommended that the H–Q strength ratio is considered as a clinical measurement tool in the balance rehabilitation of stroke survivors.

ABSTRACTFungal infections are a growing global health concern due to the limited number of available antifungal therapies as well as the emergence of fungi that are resistant to first-line antimicrobials, particularly azoles and echinocandins. Development of novel, selective antifungal therapies is challenging due to similarities between fungal and mammalian cells. An attractive source of potential antifungal treatments is provided by ecological niches co-inhabited by bacteria, fungi, and multicellular organisms, where complex relationships between multiple organisms have resulted in evolution of a wide variety of selective antimicrobials. Here, we characterized several analogs of one such natural compound, collismycin A. We show that NR-6226C has antifungal activity against several pathogenic Candida species, including C. albicans and C. glabrata, whereas it only has little toxicity against mammalian cells. Mechanistically, NR-6226C selectively chelates iron, which is a limiting factor for pathogenic fungi during infection. As a result, NR-6226C treatment causes severe mitochondrial dysfunction, leading to formation of reactive oxygen species, metabolic reprogramming, and a severe reduction in ATP levels. Using an in vivo model for fungal infections, we show that NR-6226C significantly increases survival of Candida-infected Galleria mellonella larvae. Finally, our data indicate that NR-6226C synergizes strongly with fluconazole in inhibition of C. albicans. Taken together, NR-6226C is a promising antifungal compound that acts by chelating iron and disrupting mitochondrial functions.IMPORTANCEDrug-resistant fungal infections are an emerging global threat, and pan-resistance to current antifungal therapies is an increasing problem. Clearly, there is a need for new antifungal drugs. In this study, we characterized a novel antifungal agent, the collismycin analog NR-6226C. NR-6226C has a favorable toxicity profile for human cells, which is essential for further clinical development. We unraveled the mechanism of action of NR-6226C and found that it disrupts iron homeostasis and thereby depletes fungal cells of energy. Importantly, NR-6226C strongly potentiates the antifungal activity of fluconazole, thereby providing inroads for combination therapy that may reduce or prevent azole resistance. Thus, NR-6226C is a promising compound for further development into antifungal treatment.