Search

Abstract Introduction The use of cartilage in type I tympanoplasty is associated with concern about a poor audiological outcome. Slicing the cartilage could be a tool to overcome such a feared problem. Objective To compare the healing and hearing outcomes of using sliced cartilage to full-thickness cartilage in type I tympanoplasty. Methods Seventy patients with small to medium-sized central dry tympanic membrane perforation were included in this prospective study. The patients were randomly assigned to one of these two groups: group A: full-thickness cartilage tympanoplasty was done, and group B: partial thickness cartilage tympanoplasty was done. The assessment of healing and hearing was done at 3 and 12 months postoperatively. Results The healing was achieved in 88.2% and 90.9% in group A and group B, respectively. In group A, the mean ABG was 23.44 dB preoperatively and 14.2 dB, and 12.6 dB in the first and second follow-ups, respectively. In group B, preoperative ABG was 23.58 dB compared to 7.9 dB and 6.93 dB in the two follow-ups, respectively. The results were significantly better in group B rather than group A at both follow-ups. Conclusion Hearing results are better when sliced cartilage is used in tympanoplasty type I than full-thickness cartilage.

Multiple myeloma (MM) is typically characterized by the neoplastic proliferation of plasma cells producing a monoclonal immunoglobulin. Pleural effusion in MM is uncommon and usually caused by heart failure, pulmonary embolus, and nephrotic syndrome [Arch Intern Med. 1978;138(5):727–30; Chest. 1994;105(2):622–4]. Here, we report a case of myelomatous pleural effusion as part of the initial presentation of MM in a patient with the IgG-lambda subtype, which is extremely uncommon.

Data transmission of Virtual Reality (VR) plays an important role in delivering a powerful VR experience. This increasing demand on both high bandwidth and low latency. 6G emerging technologies like Software Defined Network (SDN) and resource slicing are acting as promising technologies for addressing the transmission requirements of VR users. Efficient resource management becomes dominant to ensure a satisfactory user experience. The integration of Deep Reinforcement Learning (DRL) allows for dynamic network resource balancing, minimizing communication latency and maximizing data transmission rates wirelessly. Employing slicing techniques further aids in managing distributed resources across the network for different services as enhanced Mobile Broadband (eMBB) and Ultra-Reliable and Low Latency Communications (URLLC). The proposed VR-based SDN system model for 6G cellular networks facilitates centralized administration of resources, enhancing communication between VR users. This innovative solution seeks to contribute to the effective and streamlined resource management essential for VR video transmission in 6G cellular networks. The utilization of Deep Reinforcement Learning (DRL) approaches, is presented as an alternative solution, showcasing significant performance and feature distinctions through comparative results. Our results show that implementing strategies based on DRL leads to a considerable improvement in the resource management process as well as in the achievable data rate and a reduction in the necessary latency in dynamic and large scale networks. [ABSTRACT FROM AUTHOR]

Globally, hepatitis C virus (HCV) and coronavirus disease 2019 (COVID‐19) are the most common causes of death due to the lack of early predictive and diagnostic tools. Therefore, research for a new biomarker is crucial. Inflammatory biomarkers are critical central players in the pathogenesis of viral infections. IL‐18, produced by macrophages in early viral infections, triggers inflammatory biomarkers and interferon production, crucial for viral host defense. Finding out IL‐18 function can help understand COVID‐19 pathophysiology and predict disease prognosis. Histamine and its receptors regulate allergic lung responses, with H1 receptor inhibition potentially reducing inflammation in severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. angiotensin‐converting enzyme 2 (ACE‐2) receptors on cholangiocytes suggest liver involvement in SARS‐CoV‐2 infection. The current study presents the potential impact of circulating acetylcholine, histamine, IL‐18, and interferon‐Alpha as diagnostic tools in HCV, COVID‐19, and dual HCV‐COVID‐19 pathogenesis. The current study was a prospective cross‐section conducted on 188 participants classified into the following four groups: Group 1 COVID‐19 (n = 47), Group 2 HCV (n = 47), and Group 3 HCV‐COVID‐19 patients (n = 47), besides the healthy control Group 4 (n = 47). The levels of acetylcholine, histamine, IL‐18, and interferon‐alpha were assayed using the ELISA method. Liver and kidney functions within all groups showed a marked alteration compared to the healthy control group. Our statistical analysis found that individuals with dual infection with HCV‐COVID‐19 had high ferritin levels compared to other biomarkers while those with COVID‐19 infection had high levels of D‐Dimer. The histamine, acetylcholine, and IL‐18 biomarkers in both COVID‐19 and dual HCV‐COVID‐19 groups have shown discriminatory power, making them potential diagnostic tests for infection. These three biomarkers showed satisfactory performance in identifying HCV infection. The IFN‐Alpha test performed well in the HCV‐COVID‐19 group and was fair in the COVID‐19 group, but it had little discriminative value in the HCV group. Moreover, our findings highlighted the pivotal role of acetylcholine, histamine, IL‐18, and interferon‐Alpha in HCV, COVID‐19, and dual HCV‐COVID‐19 infection. Circulating levels of acetylcholine, histamine, IL‐18, and interferon‐Alpha can be potential early indicators for HCV, COVID‐19, and dual HCV‐COVID‐19 infection. We acknowledge that further large multicenter experimental studies are needed to further investigate the role biomarkers play in influencing the likelihood of infection to confirm and extend our observations and to better understand and ultimately prevent or treat these diseases. [ABSTRACT FROM AUTHOR]

Aims We sought to characterize sex-related differences in cardiovascular magnetic resonance-based cardiovascular phenotypes and prognosis in patients with idiopathic non-ischaemic cardiomyopathy (NICM). Methods and results Patients with NICM enrolled in the Cardiovascular Imaging Registry of Calgary (CIROC) between 2015 and 2021 were identified. Z -score values for chamber volumes and function were calculated as standard deviation from mean values of 157 sex-matched healthy volunteers, ensuring reported differences were independent of known sex-dependencies. Patients were followed for the composite outcome of all-cause mortality, heart failure admission, or ventricular arrhythmia. A total of 747 patients were studied, 531 (71%) males. By Z -score values, females showed significantly higher left ventricular (LV) ejection fraction (EF; median difference 1 SD) and right ventricular (RV) EF (difference 0.6 SD) with greater LV mass (difference 2.1 SD; P < 0.01 for all) vs. males despite similar chamber volumes. Females had a significantly lower prevalence of mid-wall striae (MWS) fibrosis (22% vs. 34%; P < 0.001). Over a median follow-up of 4.7 years, 173 patients (23%) developed the composite outcome, with equal distribution in males and females. LV EF and MWS were significant independent predictors of the outcome (respective HR [95% CI] 0.97 [0.95–0.99] and 1.6 [1.2–2.3]; P = 0.003 and 0.005). There was no association of sex with the outcome. Conclusion In a large contemporary cohort, NICM was uniquely expressed in females vs. males. Despite similar chamber dilation, females demonstrated greater concentric remodelling, lower reductions in bi-ventricular function, and a lower burden of replacement fibrosis. Overall, their prognosis remained similar to male patients with NICM. [ABSTRACT FROM AUTHOR]

Purpose: Comparison of early microvascular changes detected by optical coherence tomography angiography (OCTA) in patients with mild non-proliferative diabetic retinopathy (NPDR) with healthy volunteers. Patients and Methods: Forty-four eyes of 44 type-2 diabetic patients with mild non-proliferative diabetic retinopathy and 30 eyes of 30 age-matched healthy controls were imaged using OCTA to quantify microvascular changes and the FAZ quantitative parameters (area, perimeter, and circularity index); the values of patients and controls were then compared. Results: Macular vessel density, perfusion index, and circularity index values were reduced and positively correlated with visual acuity in patients (15.4 ± 2.6, 38.0 ± 6.7, 0.6 ± 0.06 and p = 0.003, 0.001, and 0.003, respectively). However, FAZ area and perimeter were found to be larger in patients than controls (0.30 ± 0.08, 2.5 ± 0.3 and p < 0.001). Conclusion: OCTA quantified vessel density and perfusion density were found to be correlated with visual acuity and FAZ parameters in patients with early NPDR; this could help in detecting early disease progression and modifying treatment decisions. [ABSTRACT FROM AUTHOR]

Epoxy granite (EG) as a composite material has been attempted to be used in machine foundation. EG demonstrates similar mechanical properties and specific density to light metals, such as aluminium and its alloys. In the present study, we developed light and cost-effective EG composite materials as a new machine element foundation. The EG composite was prepared by blending the epoxy resin (12 wt%) and granite particles by casting route method. The crushed granite particles were sieved and separated into coarse particles 1.18-2.36 mm, medium particles 0.6-1.18 mm and fine particles ≤ 0.6 mm. The mechanical properties such as compression, bending and single edge notch bending tests were assessed. The results show that the EG composite materials containing the fine granite particles induced the highest compressive (18.1 MPa) and bending (20.1 MPa) strength. In addition, the fracture toughness had the highest value which was about 24.73 Mpa√m of the same EG composite material. Our results suggest that the EG composite contains fine granite particles with good mechanical and fracture properties might have a high potential in machine foundation application as an inexpensive material. [ABSTRACT FROM AUTHOR]

Aims: We sought to characterize sex-related differences in cardiovascular magnetic resonance-based cardiovascular phenotypes and prognosis in patients with idiopathic non-ischaemic cardiomyopathy (NICM)., Methods and Results: Patients with NICM enrolled in the Cardiovascular Imaging Registry of Calgary (CIROC) between 2015 and 2021 were identified. Z-score values for chamber volumes and function were calculated as standard deviation from mean values of 157 sex-matched healthy volunteers, ensuring reported differences were independent of known sex-dependencies. Patients were followed for the composite outcome of all-cause mortality, heart failure admission, or ventricular arrhythmia. A total of 747 patients were studied, 531 (71%) males. By Z-score values, females showed significantly higher left ventricular (LV) ejection fraction (EF; median difference 1 SD) and right ventricular (RV) EF (difference 0.6 SD) with greater LV mass (difference 2.1 SD; P < 0.01 for all) vs. males despite similar chamber volumes. Females had a significantly lower prevalence of mid-wall striae (MWS) fibrosis (22% vs. 34%; P < 0.001). Over a median follow-up of 4.7 years, 173 patients (23%) developed the composite outcome, with equal distribution in males and females. LV EF and MWS were significant independent predictors of the outcome (respective HR [95% CI] 0.97 [0.95-0.99] and 1.6 [1.2-2.3]; P = 0.003 and 0.005). There was no association of sex with the outcome., Conclusion: In a large contemporary cohort, NICM was uniquely expressed in females vs. males. Despite similar chamber dilation, females demonstrated greater concentric remodelling, lower reductions in bi-ventricular function, and a lower burden of replacement fibrosis. Overall, their prognosis remained similar to male patients with NICM., Competing Interests: Conflict of interest: J.A.W. receives funding from the Canadian Institute of Health Research (CIHR), receives research support from Siemens Healthineers, and is a shareholder of Cohesic Inc. A.G.H. receives consulting fees from Amgen and is a shareholder of Cohesic Inc. J.F. is a shareholder of Cohesic Inc. R.J.H.M. has received research support and consulting fees from Pfizer., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)