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Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor, has been shown to significantly reduce cardiovascular mortality, heart failure hospitalizations, and all-cause mortality in patients with heart failure with reduced ejection fraction. This study aims to investigate the long-term impact of the sacubitril/valsartan combination on lipid parameters in patients with heart failure with reduced ejection fraction.For this single-center retrospective cross-sectional study, data of patients using sacubitril/valsartan because of heart failure with reduced ejection fraction were collected. In addition to routine controls, the patients' lipid levels were measured at 3-month intervals. The parameters that were obtained over 3 years included total cholesterol, high-density lipoprotein cholesterol, triglyceride, and N-terminal pro-B-type natriuretic peptide levels.A total of 192 patients with a functional capacity New York Heart Association II-V, and who were using sacubitril/valsartan because of heart failure with reduced ejection fraction, were included in this study. Independent of statin use, there was a decrease in total cholesterol levels (196.1 ± 44.8 mg/dL vs 161.5 ± 41.7 mg/dL, p0.001) and triglyceride levels (159.1 ± 10.4 mg/dL vs 121.4 ± 6.9 mg/dL, p0.001), and there was an improvement in high-density lipoprotein cholesterol levels (44.9 ± 1.9 mg/dL vs 48.2 ± 2.4 mg/dL, p0.001) when comparing baseline levels with third-year levels.Sacubitril/valsartan in patients with heart failure with reduced ejection fraction, independent of statin use, may cause a decrease in total cholesterol and triglyceride levels and an improvement in high-density lipoprotein cholesterol levels.

Sustainable cities are envisioned to have economic and industrial steps toward reducing pollution. Many real-world applications such as autonomous vehicles, transportation, traffic signals, and industrial automation can now be trained using deep reinforcement learning (DRL) techniques. These applications are designed to take benefit of DRL in order to improve the monitoring as well as measurements in industrial internet of things for automation identification system. The complexity of these environments means that it is more appropriate to use multi-agent systems rather than a single-agent. However, in non-stationary environments multi-agent systems can suffer from increased number of observations, limiting the scalability of algorithms. This study proposes a model to tackle the problem of scalability in DRL algorithms in transportation domain. A partition-based approach is used in the proposed model to reduce the complexity of the environment. This partition-based approach helps agents to stay in their working area. This reduces the complexity of the learning environment and the number of observations for each agent. The proposed model uses generative adversarial imitation learning and behavior cloning, combined with a proximal policy optimization algorithm, for training multiple agents in a dynamic environment. We present a comparison of PPO, soft actor-critic, and our model in reward gathering. Our simulation results show that our model outperforms SAC and PPO in cumulative reward gathering and dramatically improved training multiple agents.

In this study for the very first time, zinc tetraphenylporphyrin (ZnTPP) was loaded into MIL-101 (Zn[TPP]@MIL-101) to perform an adsorptive and photocatalytic dye removal. The physicochemical attributes of the catalyst were thoroughly determined by the usage of XRD, FTIR, FESEM, BET, UV-vis, and inductively coupled plasma (ICP). The obtained XRD pattern exhibited the phase purity of MIL-101 and its structural stability. The solid-phase diameter of the catalyst was observed to be ~ 270.76 ± 119.95 nm, while its gas adsorption data was indicative of a decrease in the specific surface area after the loading of ZnTPP. The ICP analysis displayed the amount of encapsulated Zn[TPP] (~ 17%) in MIL-101. The UV-vis confirmed the presence of Zn[TPP] in MIL-101 with the lack of any interferences or overlaps with the λ

Preservation of the brain is important to reducing recurrent seizures and other neurological sequelae after status epilepticus (SE). Medical ozone (MedO3) shows antioxidant, anti-inflammatory and anti-apoptotic properties in the human body. In this study, it was aimed to understand the neuroprotective potential of MedO3 in the acute period after SE. Mature rats of Wistar Albino were used for the study. Group design O3 + SE: SE induced after MedO3, O3: MedO3 alone was given, SE: SE only induced, SE + O3; MedO3 given after SE, C: control and S: sham control group. SE was induced with lithium-pilocarpine experimental model and evaluated on the Racine scale. Peripheral blood samples and brain tissue samples were taken before decapitation. Histopathological evaluation of the hippocampus of the rats given medical O3 before and after SE were studied. The highest peripheral blood oxidative stress index (OSI) was found in SE group. The OSI level in O3 + SE and SE + O3 was significantly higher than SE/C/S. Gene expressions of TNF-α and IL-1β mRNA were significantly higher in SE compared to other groups. Histopathologically; eosinophilia, cellular shrinkage and interstitial oedema were detected in the most severe SE and to a lesser extent in O3 + SE/ SE + O3. MedO3 reduced SE-induced oxidative damage, neuroinflammation and neuronal injury and contributed positively to neuroprotection.

In this recent work, a new two-step iterative method for solving nonlinear equations that have a fifth-order convergence is suggested and analyzed. This new iterative method is free from second derivative of functions and based on Halley’s method and Taylor’s expansion together by using Hermite orthogonal polynomials basis to implement a suitable approximation of second derivative of functions. In addition, the order of convergence and the corresponding error equations of the new method are proved. Finally, some numerical examples are given to show the efficiency and the performance of the new method as well as a comparison with the original well-known Newton’s method and some other relevant methods are illustrated.

Berberis integerrima with various secondary metabolites is used in the treatment of various diseases. In this project, silver nanoparticles (AgNPs) were prepared through a green process using a fruit extract of B. integerrima. Several techniques such as UV–Vis absorption spectroscopy, TEM, PXRD, FTIR and zeta potential analysis were used in characterization of biosynthesized AgNPs. The biosynthesized AgNPs were in spherically shaped with a mean diameter of 30 nm. Moreover, the biosynthesized AgNPs seemed to exhibit a higher bactericidal and antifungal activity against infective bacteria (S. aureu s, E. coli, P. aeruginosa) and pathogendic fungi (Candida species). Also, green fabricated nanoparticles show suitable photocatalytic activity that AgNPs destroyed up to 82.5% of the methylene blue dye from aqueous environment. Antioxidant test based on total phenolic compounds showed the content of total phenol in the B. integerrima extract and AgNPs was 51 and 21 mg gallic acid equivalent, respectively. The anticancer effect against human liver cancer cell line (HepG2) showed that high anticancer effects depend on the time and concentration of extract and AgNPs. These results suggest that the these nanoparticles could be efficiently apply as an alternate antimicrobial/anticancer agent in contrast to infections and cancerous cell lines, and is beneficial for purification of water and pollutants solutions in environment.

Thyroid ultrasonography (US) is the first-step noninvasive and easily accessible diagnostic method widely used in the detection and characterization of nodular thyroid disease. We aimed to develop a TI-RADS, which is easy to apply and only relies on the counting of suspicious criteria. In order to measure the reliability of the system, we investigated its correlation with fine needle aspiration biopsy (FNAB) and post-surgery histological results. In this prospective study, 242 patients who had undergone FNAB with simultaneous cytopathologist in the radiology department between April and August 2016 were analyzed. Before FNAB, the thyroid gland was re-evaluated with US, and TI-RADS classification was made. Demographic characteristics, family thyroid cancer history and radiotherapy history to the neck region were noted. Of the 242 patients, 17.3% were male (42 males/200 females). US-guided FNAB was applied to all patients. Mean age was 50 ± 13 years (min: 19, max: 82). Both FNAB and final post-surgery histology results showed that sex and age were not statistically significantly associated with malignancy (p = 0.193) TI-RADS criteria and FNAB results revealed a statistically significant association between irregular contours, the state of anteroposterior diameter being longer than transverse diameter, microcalcifications, marked hypoechogenicity, and malignancy (p

Diagnosis of right ventricular (RV) infarction in the setting of acute inferior wall myocardial infarction (IWMI) has important prognostic implications. We sought to assess the role of 2-D speckle tracking echocardiography (2-D STE) for the assessment of RV involvement in acute IWMI. We included 100 consecutive patients with a diagnosis of recent IWMI, of which 73 had an RCA culprit lesion, undergoing primary percutaneous coronary intervention (PPCI). Patients (n = 73) were classified into 2 groups based on angiographic evidence of RV involvement (lesions proximal to or involving RV branch versus distal lesions). Echocardiographic features of RV dysfunction were assessed using conventional 2-D echocardiographic, and Tissue Doppler parameters as well as 2-D speckle tracking echocardiography. Out of the 73 patients, 42 had RCA lesion proximal to or involving RV branch, while 31 patients had RCA culprit distal to RV branch. Among different parameters assessing RV function, only RV-FWLS was significantly lower among the former group (− 14.2 ± 4.6 vs. − 17.7 ± 4.2, p = 0.026). Receiver-operator characteristic (ROC) analysis showed that RV-FWLS had the strongest discriminatory capability to identify RV infarction (AUC = 0.7, p = 0.02, 95% CI 0.53–0.78). A cut-off value of RV-FWLS ≤ − 20.5% had 88% sensitivity and 33% specificity for diagnosis of RV infarction. STE-derived RV-FWLS with cutoff ≤ − 20.5% could be a reliable and promising tool for prediction of RV involvement in the setting of acute IWMI, which could guide proper risk stratification and tailored acute management strategy.