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Ureteropelvic Junction Obstruction (UPJO), is a major cause of pathological hydronephrosis in children. Minimally invasive surgery (MIS), including laparoscopic pyeloplasty (LP) and robot-assisted laparoscopic pyeloplasty (RALP), has gained popularity due to its known advantages. LP faces technical difficulties and a steep learning curve. RALP has overcome these limitations, making it safer and more effective for children. The study aims to assess the safety and effectiveness of LP and RALP in infants weighing ≤15 kg. This is a retrospective analysis (2010–2022). The study included pediatric patients who had a confirmed diagnosis of UPJO and weighed ≤15 kg. The patients were divided into two groups: LP and RALP. The study evaluated preoperative, intraoperative, perioperative, and follow-up data, including complications. Success was defined as no worsening of hydronephrosis on postoperative ultrasound in the first year of follow-up. The total patients were 94: 42 in the LP group, and 52 in the RALP group. The median age at the intervention was 17.5 months (LAP group) versus 29 months (RALP group) (p = 0.01). The median weight at the time of intervention was 9.5 Kg (LP group), and 11.6 Kg (RALP group) (p = 0.44). The median operative time was significantly longer in the LP group: 245 min versus 125.5 min in the RALP group (p = 0.001). The median length of hospitalization was comparable: 4.3 days (LP group) and 3.5 days (RALP group) (p = 0.42). No intraoperative complications were reported in either group. There were no statistically significant differences regarding postoperative complications. During follow-up, all patients remained asymptomatic, with no episodes of urinary tract infection or abdominal pain, and none of them had a recurrence of UPJ obstruction. Consequently, the two techniques are equally effective and safe in the short term. Both procedures offer excellent outcomes with comparable postoperative complications. LOS was similar for both groups, with no intraoperative complications or conversions, and a non-significant increase in postoperative complications. A notable finding was the significant difference in operation times between the procedures, emphasizing the importance of reduced surgical time in pediatric patients for minimizing anesthetic and intubation durations. For the absence of intra- and postoperative complications and recurrences, RALP is as effective as LP in pyeloplasty in children weighing 15 kg or less. This finding reinforces the idea that RALP can be safely executed, benefiting from its advanced technology and the learning curve, for patients of any age regarding pyeloplasty for UPJO. [Display omitted] [ABSTRACT FROM AUTHOR]

The effects of mindfulness-based interventions (MBIs) on anthropometrics remain obscure. This review quantitatively synthesizes the effects of MBIs on decreasing body mass index (BMI), waist circumference (WC), weight, and percent body fat (%BF). Seven databases, including CINAHL Plus with Full Text, PubMed, PsycINFO, Cochrane, Web of Science Core Collection, Embase, and Sociological Abstracts were searched; studies with a comparison group were selected. Random-effects models were then applied to estimate the pooled effects (Hedge's g), while exploratory moderation analyses with mixed-effects models were performed to explore potential moderators of MBIs on anthropometrics. The pooled effect size was −0.36 (p <.001) on BMI, −0.52 (p <.001) on WC, −1.20 (p <.004) on weight loss, and −0.43 (p =.389) on %BF. The long-term effects from baseline to follow-up and from post-intervention to follow-up were sustained on BMI (−0.37, p =.027; −.24, p =.065) and weight loss (−1.91, p =.027; −0.74, p =.011) respectively. For weight loss, adding mindful movement had greater effects than those without (−2.65 vs −0.39, p <.001). Our findings support the short-term MBI effects on BMI reduction, WC, weight, and %BF, and long-term effects on reducing BMI and weight. Future efforts should focus on sustaining effects on reducing WC and %BF. [ABSTRACT FROM AUTHOR]

• Machine learning enhances Autism Spectrum Disorder (ASD) detection accuracy. • The proposed ASDD framework applies AutoML tools across diverse datasets. • Ensemble methods boost ASD prediction with 100% accuracy in several cases. • Advanced optimization techniques improve feature selection and model performance. • The study introduces DB8, a synthesized dataset with strong diagnostic outcomes. Autism Spectrum Disorder (ASD) presents a complex neurodevelopmental challenge with diverse behavioral symptoms that overlap with other mental disorders, complicating diagnosis. Challenges in existing systems include the complexity and diversity of ASD symptoms, as well as the need for innovative and efficient detection strategies across different age groups. The application of machine learning (ML) offers a promising avenue for revolutionizing ASD prediction and diagnosis. The proposed work aims to overcome these challenges by leveraging ML and Automated Machine Learning (AutoML) techniques, combined with comprehensive datasets and advanced analytics, to enhance ASD detection and prediction capabilities. This study introduces the Autism Spectrum Disorder Detection (ASDD) Framework, which systematically applies ML and AutoML across text-based datasets for various age groups. A combined dataset is generated through the concatenation of various data sources, enriching the diagnostic scope. The framework incorporates AutoML tools such as Lazy Predict, TPOT, and AutoKeras, alongside feature selection methods like Principal Component Analysis (PCA) and Chi-Square. It also employs robust hyperparameter optimization techniques, including Bayesian optimization, Random Search, and genetic algorithms, and uses advanced ensemble methods like voting and bagging to boost prediction accuracy. An empirical evaluation of 27 distinct ML models across seven datasets, including a synthesized dataset named DB8, demonstrates exceptional performance, with many models achieving 100% accuracy and perfect F1 scores in various contexts. These outcomes highlight the effectiveness of the proposed framework in advancing ASD detection and prediction methodologies. [ABSTRACT FROM AUTHOR]

Heavy metals are toxic environmental pollutants with serious health effects on humans and animals. Cadmium (Cd) is known for its serious nephrotoxic effect and its toxicity involves oxidative stress (OS) and inflammation. Diallyl disulfide (DADS), a main constituent of garlic, exhibites cytoprotective and antioxidant activities. This study investigated the effect of DADS on OS, inflammation, and fibrosis induced by Cd in rat kidney, pointing to the involvement of transforming growth factor-β (TGF-β)/Smad3 and nuclear factor erythroid 2–related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling, and peroxisome proliferator-activated receptor gamma (PPARγ). Rats received DADS for 14 days and Cd on day 7 and blood and kidney samples were collected. Cd elevated serum creatinine, urea and uric acid, provoked kidney histopathological alterations and collagen deposition, increased kidney malondialdehyde (MDA) level, and decreased glutathione (GSH) and antioxidant enzymes. Nuclear factor-kappaB (NF-κB) p65, interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-1β, and CD68 were upregulated in Cd-administered rat kidney. DADS prevented kidney injury, mitigated OS, suppressed NF-κB, CD68 and pro-inflammatory mediators, and boosted antioxidants. DADS downregulated TGF-β1, Smad3 phosphorylation and Kelch-like ECH-associated protein-1 (Keap1), and increased Nrf2, HO-1, cytoglobin, and PPARγ. In conclusion, DADS protects the kidney against Cd toxicity by attenuating OS, inflammation, and TGF-β1/Smad3 signaling, and enhancement of Nrf2/HO-1 signaling, antioxidants, and PPARγ. • Cadmium induces oxidative stress, inflammation and fibrosis in rat kidney. • Diallyl disulfide prevents cadmium-induced nephrotoxicity. • Diallyl disulfide mitigates cadmium-induced oxidative stress and inflammation. • Diallyl disulfide downregulates TGF-β1/Smad3 and upregulated Nrf2/HO-1 signaling. [ABSTRACT FROM AUTHOR]

Cadmium (Cd) is a heavy metal environmental pollutant that can cause serious health problems. Cd can cause structural changes in the testes and exposure to this heavy metal is associated with the loss of sperms and male infertility. The role of oxidative stress and inflammation in Cd toxicity has been acknowledged. Diallyl disulfide (DADS), an organo-sulfur compound found in garlic, possesses antioxidant, anti-inflammatory, and cytoprotective effects. This study evaluated the protective effect of DADS against Cd reproductive toxicity in male rats, emphasizing the involvement of redox imbalance, TLR-4/NF-κB and JAK1/STAT3 signaling, and SIRT1. DADS (10 mg/kg body weight) was administered orally to rats for 14 days and a single dose of Cd (1.2 mg/kg) was injected intraperitoneally on day 7. Blood and samples from the testes were collected for analysis. Cd caused testicular injury manifested by multiple histopathological changes and loss of sperms from seminiferous tubules. Circulating levels of gonadotropins and testosterone were decreased in Cd-administered rats. DADS prevented Cd-induced testicular injury and ameliorated serum levels of gonadotropins and testosterone. Cd increased testicular reactive oxygen species (ROS) and malondialdehyde (MDA) and upregulated TLR-4, NF-κB, pro-inflammatory cytokines, JAK1 and STAT3 phosphorylation, Bax and caspase-3, while decreased antioxidants and Bcl-2. DADS effectively decreased ROS and MDA, downregulated TLR-4, NF-κB, JAK1, STAT3, pro-inflammatory cytokines and pro-apoptosis markers in Cd-administered rats. In addition, DADS enhanced antioxidants, Bcl-2, SIRT1 and cytoglobin in the testis of Cd-administered rats. DADS prevents Cd-induced testicular injury by attenuating oxidative stress, apoptosis, and TLR-4/NF-κB and JAK1/STAT3 signaling, and upregulating SIRT1 and antioxidants. • Cadmium caused testicular tissue injury, oxidative stress and apoptosis. • Cadmium upregulated testicular TLR4/NF-κB and JAK1/STAT3 signaling and cytokines. • Diallyl disulfide attenuated cadmium testicular toxicity and oxidative stress. • Diallyl disulfide prevented inflammation and upregulated SIRT1 and antioxidants. [ABSTRACT FROM AUTHOR]

Heavy metals are environmental pollutants that can harm animals and humans even at low concentrations. Cadmium (Cd) is known for its serious health effects on different organs and its toxicity is associated with oxidative stress (OS) and inflammation. Farnesol (FAR), a sesquiterpene alcohol found in many vegetables and fruits, possesses promising anti-inflammatory and antioxidant activities. This study evaluated the effect of FAR on Cd-induced kidney injury, pinpointing its effect of the redox status, inflammation, fibrosis and necroptosis. Rats in this study received FAR for 14 days and Cd on day 7. Elevated serum creatinine, urea and uric acid, and several kidney histopathological alterations were observed in Cd-administered rats. Cd increased MDA, decreased antioxidants, downregulated PPARγ and upregulated NF-κB p65, IL-6, TNF-α, and IL-1β. Necroptosis mediators (RIP1, RIP3, MLKL, and caspase-8) and α-SMA were upregulated, and collagen deposition was increased in Cd-administered rats. FAR ameliorated kidney injury markers and tissue damage, attenuated OS, suppressed NF-κB and inflammatory mediators, and enhanced antioxidants. In addition, FAR suppressed RIP1, RIP3, MLKL, caspase-8, and α-SMA, and enhanced kidney cytoglobin and PPARγ. In conclusion, FAR protects against Cd nephrotoxicity by suppressing OS, inflammatory response and necroptosis, effects associated with enhanced antioxidants, cytoglobin, and PPARγ. • Farnesol attenuated cadmium induced kidney oxidative stress and inflammation in rats. • Farnesol prevented cadmium-induced necroptosis and fibrosis in rat kidney. • Farnesol upregulated kidney PPARγ and antioxidants in cadmium-administered rats. [ABSTRACT FROM AUTHOR]

Hemogram parameters have been recently proposed as markers of inflammation in various studies from different parts of the world. Two of these hemogram parameters are red cell distribution width (RDW) and mean platelet volume (MPV). To evaluate the relation between RDW and MPV with disease activity of rheumatoid arthritis. To assess whether RDW and MPV can be used to follow disease activity in RA patients. This is an observational cross-sectional study that was carried out on 60 rheumatoid arthritis patients who fulfilled the ACR/EULAR2010 classification criteria of RA attending to Rheumatology and Rehabilitation inpatient and outpatient clinics at Zagazig University Hospitals. All cases were subjected to full history taking, clinical examination, and laboratory investigations; differential complete blood picture (CBC), acute phase reactants (CRP and ESR), rheumatoid factor (RF) and anti-cyclic-citrullinated peptide (anti-CCP) antibodies. Disease activity was measured by disease activity score 28 (DAS28). The cut-off levels of RDW and MPV were 14.85 and 11.25. Patients with RDW > 14.85 had higher Disease Activity Score 28 (DAS28; p = 0.0003), ESR (p = 0.0001) and CRP (p = 0.0001). RDW was positively correlated with disease activity markers (ESR, CRP and DAS28) in rheumatoid arthritis patients. But, DAS28 was not different between patients with MPV > 11.25 and <11.25. RDW was strongly correlated with disease activity. Also, RDW was better than ESR and CRP in detecting RA disease activity. According to these findings we suggest that RDW can be used in clinics to follow disease activity. In addition, RDW is widely available; as it's usually included in routine complete blood picture and there will be no need for further cost. [ABSTRACT FROM AUTHOR]

Keloid scars result from excess collagen deposition in the dermis or subcutaneous tissue in response to surgery or tissue trauma. The penis is a rare site for keloid formation, even in predisposed individuals. Only few cases of penile keloids have been reported so far. In this report, we present penile keloids complicating neonatal circumcision in twin brothers. Risk of recurrence in previous reports and measures to guard against its occurrence are also discussed. [ABSTRACT FROM AUTHOR]

O-(2-[ 18 F]fluoroethyl)- L -tyrosine ([ 18 F]FET) is the most promising radio-labeled amino acid tracer for brain tumor imaging due to the limitation of 2-deoxy-2-[ 18 F]fluoro- D -glucose ([ 18 F]FDG) and L-methyl-[ 11 C]methionine ( 11 C-MET). However, it has some limitations in radiosynthesis and related quality control that make it less frequently used in many PET centers, in this study, we report a new modification of [ 18 F]FET production using a commercially available fully automated GRP SCINTOMICS module overcoming some of the existing limitations along with a suggestion of a simplified quality control procedure with special focus placed on enantiomeric and radiochemical purity. ([ 18 F]FET) was produced in high radiochemical and enantiomeric purity more than 99% and non-decay corrected yield 25±5% in about 55 min. [ABSTRACT FROM AUTHOR]

Regular blood transfusion therapy remains the primary treatment in thalassemia major (TM). Transfusion-transmitted infections (TTIs) and iron overload are considered to be the major drawbacks of this therapy. This cross-sectional study aimed to update the prevalence of the hepatitis C virus (HCV) antibody, PCR-confirmed HCV, hepatitis B surface antigen (HBsAg), and human immunodeficiency virus (HIV) antibody among TM children. Clinical and epidemiological factors that can affect HCV infection prevalence rate were studied. This study evaluated 121 children with βTM, including 61 males and 60 females with a mean age of 7.99 ± 3.57 years. Patients were evaluated for the HCV, HBsAg, and HIV-1 & 2 antibodies. All tests were performed using ELISA. HCV positive cases were confirmed by RT-PCR. Twenty-five patients were positive for the HCV antibody (20.7%); 22 were confirmed positive by PCR. Six patients (5%) were HBsAg-positive. No patients were HIV-positive. Older age were associated with an increased frequency of HCV positive infection (P < 0.003). More frequent transfusion, ≥10 times/year, and older age, ≥10 years, were reported as predictors of HCV infection (P = 0.018 and 0.011, respectively). A significant association of HCV between HBV infections was reported (P value = 0.01). There was no significant effect of the pre-transfusion or post-transfusion hemoglobin level on the frequency of HCV positive cases. HCV still represents a major health challenge for frequently transfused Egyptian patients. The prevalence rate of HBV infection remains relatively high. Therefore, it is necessary to implement measures to improve blood transfusion screening. [ABSTRACT FROM AUTHOR]

• An automatic diagnosis system for breast cancer based on machine learning models is needed. • The study proposes an efficient classification method based on ML techniques to help doctors diagnose and distinguish between malignant and benign tumors. • Seven AutoML techniques were evaluated and applied to eight different datasets to assess their classification accuracy. • Lazy Predict and MATLAB Classification Learner were found to be the best-performing ML techniques for binary classification tasks. • The study identifies the best ML model within each AutoML technique and compares the performance of state-of-the-art ML techniques. • The proposed approach has the potential to improve the accuracy of breast cancer detection and diagnosis, ultimately enabling earlier detection and more effective treatment. Breast cancer is the second leading cause of death among women worldwide. Early detection is crucial for a high possibility of recovery, but current diagnostic procedures rely on visual inspection by doctors, which is time-consuming, requires consultation, and lacks reliable automatic detection systems. Therefore, an automatic diagnosis system based on machine learning (ML) models is highly required to improve the accuracy of detection and prediction. In this study, an efficient classification method based on ML techniques was proposed to help doctors diagnose and distinguish between malignant and benign tumors relevant to breast cancer prediction. Seven AutoML techniques, including Orange, Lazy Predict, TPOT, MLJAR, MATLAB classification learner, and AutoKeras, were examined and applied to eight different datasets to evaluate their performance in terms of classification accuracy. The experimental results demonstrate a significant improvement using state-of-the-art techniques, with Lazy Predict and MATLAB Classification Learner outperforming all other ML techniques for binary classification tasks. The contribution of this work is the identification of the best ML model among multiple models inside each AutoML technique applied to different breast cancer datasets. All datasets and codes used in this study are freely available from https://github.com/amrrashed/breast-cancer-datasets-and-codes. [ABSTRACT FROM AUTHOR]

Complex urological anomalies often require continued care as patients reach adulthood. Adequate transition for adolescents with ongoing urological care needs is critical to allow for seamless care in adult hospitals. Studies have shown that this can lead to improved patient and parental satisfaction, and lower utilisation of unplanned inpatient beds and emergency department visits. There is currently no ESPU-EAU consensus on the adequate mechanism and very few individual papers examining the role of urological transition for these patients in a European setting. This study aimed to identify current practice patterns in paediatric urologists providing adolescent/transitional care, to assess their opinions towards formal transition and to look for variations in care. This has implications for long-term patient health and specialist care. An 18-item cross-sectional survey was compiled and pre-approved through the EAU-EWPU and ESPU board offices prior to dissemination to all registered ordinary members affiliated with the ESPU. This was created using a mini-Delphi method through the EWPU research meetings to provide current semi-quantitative data relating to current opinions and attitudes of this cohort. A total of 172 respondents (55% paediatric general surgery; 45% urology) across 28 countries completed the survey. The majority of respondents were in practice >10 years and spent >80% time in paediatric urology. There was no formal transition process according to 50% respondents and over half of those that did have less than 1/month, with <10% using validated questionnaires. More than two-thirds respondents continued to provide care after transition, as >70% units had no designated corresponding adult service. Furthermore, 93% paediatric believe a formal transition service to be very important, using a multidisciplinary framework. A pareto chart demonstrated 10 specific conditions to be of most interest in transition to adulthood. This is the first study to assess the requirements of paediatric urologists for adequate transitional care, however due to the nature of the survey's distribution, this was a non-scientific poll based on a convenience sample of respondents. It is critical that dual-trained or adult-trained urologists with a specific interest in paediatric urology work with current paediatric urologists in a multidisciplinary fashion to facilitate early transition based on the adolescent's developmental and biopsychosocial requirements. National urological and paediatric surgical societies need to make transitional urology a priority. The ESPU and EAU should collaboratively consider developing transitional urology guidelines to allow a framework by which this can occur. [Display omitted] [ABSTRACT FROM AUTHOR]

Mesenchymal stem cell-derived exosomes (MSC-EXOs) have emerged as a promising approach in regenerative medicine for management of different diseases. However, the maintenance of their efficacy after in vivo transplantation is still a major concern. The present investigation aimed to assess the modulatory effect of rupatadine (RUP) on MSC-EXOs in diethylnitrosamine (DEN)-induced liver fibrosis (LF), and to explore the possible underlying mechanisms. LF was induced in rats by i.p. injection of DEN (100 mg/kg) once per week for 6 successive weeks. Rats were then treated with RUP (4 mg/kg/day, p.o.) for 4 weeks with or without a single i.v. administration of MSC-EXOs. At the end of the experiment, animals were euthanized and serum and liver were separated for biochemical, and histological measurements. The combined MSC-EXOs/RUP therapy provided an additional improvement towards inhibition of DEN-induced LF compared to MSC-EXOs group alone. These outcomes could be mediated through anti-oxidant, anti-inflammatory, anti-necroptotic, and anti-fibrotic effects of RUP which created a more favorable environment for MSC-EXOs homing, and action. This in turn would enhance more effectively miR-200a expression which reduced oxidative stress, inflammation, necroptosis, and subsequently fibrosis as revealed by turning off TGF-β1/α-SMA expression, and hedgehog axis. The present findings reveal that RUP enhanced the anti-fibrotic efficacy of MSC-EXOs when used as a combined therapy. This was revealed through attenuation of PAF/RIPK3/MLKL/HMGB1, and TGF-β1/hedgehog signaling pathways with a significant role for miR-200a. [Display omitted] [ABSTRACT FROM AUTHOR]

Ischemic cardiomyopathy (ICM) is the leading cause of heart failure worldwide, yet the cellular and molecular signature of this disease is largely unclear. Using single-nucleus RNA sequencing (snRNA-seq) and integrated computational analyses, we profile the transcriptomes of over 99,000 human cardiac nuclei from the non-infarct region of the left ventricle of 7 ICM transplant recipients and 8 non-failing (NF) controls. We find the cellular composition of the ischemic heart is significantly altered, with decreased cardiomyocytes and increased proportions of lymphatic, angiogenic, and arterial endothelial cells in patients with ICM. We show that there is increased LAMININ signaling from endothelial cells to other cell types in ICM compared with NF. Finally, we find that the transcriptional changes that occur in ICM are similar to those in hypertrophic and dilated cardiomyopathies and that the mining of these combined datasets can identify druggable genes that could be used to target end-stage heart failure. [Display omitted] • Cellular expression and composition are altered in ischemic cardiomyopathy • LAMININ signaling from endothelial cells to other cell types increases in disease • Cell-type transcriptional profiles converge across multiple cardiomyopathy subtypes • Potential druggable targets identified for end-stage heart failure Simonson et al. compare non-failing and ischemic cardiomyopathy human left ventricles using snRNA-seq and identify an increase in lymphatic and angiogenic endothelial cells in disease. Transcriptionally, ischemic cardiomyopathy is similar to other cardiomyopathies. Gene targets from this shared expression profile could be explored for therapeutic benefit in end-stage heart failure. [ABSTRACT FROM AUTHOR]