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Shahid Akhtar,1 Birgitte Berg,2 Johan Medina,3 Maya Nicole Gonczi,4 Sophie Hamilton,5 Emily Hildebrand,4 Nicky Kelepouris,6 Jesper Skov Neergaard,7 Claus Sværke,8 Gitte Ter-Borch,2 Niklas Kahr Rasmussen3 1Devices & Digital Health, Novo Nordisk A/S, Søborg, Denmark; 2Clinical Operations, Obesity, Liver Diseases & Devices, Novo Nordisk A/S, Søborg, Denmark; 3Medical & Science, Devices & Digital Health, Novo Nordisk A/S, Søborg, Denmark; 4Human Factors, Research Collective, Tempe, AZ, USA; 5Rare Endocrine Rare Renal Diseases, Novo Nordisk Inc, Plainsboro, NJ, USA; 6Rare Endocrine Disorders, Novo Nordisk Inc, Plainsboro, NJ, USA; 7Safety Surveillance, Cardiovascular Disease, Novo Nordisk A/S, Søborg, Denmark; 8Global Development, Novo Nordisk A/S, Søborg, DenmarkCorrespondence: Shahid Akhtar, Medical & Science, Devices & Digital Health, Novo Nordisk A/S, Vandtårnsvej 108– 110, Søborg, DK-2860, Denmark, Email SAHT@novonordisk.comPurpose: Adherence to growth hormone treatment is known to affect growth outcomes. Both device preference and ease of use have been shown to affect treatment adherence. In this study, we assessed device preference and ease of use with two long-acting growth hormones, somapacitan (Sogroya®, Novo Nordisk A/S) and somatrogon (Ngenla®, Pfizer).Patients and Methods: In a randomized, crossover study conducted between September 20 and November 2, 2023, we recruited 33 adolescents with a growth-related disorder, and 37 caregivers, at six locations in the United States. Each participant was trained in the use of both devices and asked to perform a simulated injection. Device training time, preparation and injection time, and injection completeness were recorded. Participants also completed the Device Handling and Preference Questionnaire (DHPAQ) to indicate their device preference and ease of use opinions. Following conclusion of the “standard” visit, 10 adolescents and 10 caregivers were randomly selected to participate in a sub-study to validate the relevance, comprehensiveness, and comprehension of the DHPAQ.Results: The majority of participants (84.3%; 95% confidence interval [CI]: 74;92) preferred the somapacitan device to the somatrogon device (p

Abstract For the first time, axial and circumferential (diametral) strains are measured directly on Berea sandstone cylindrical samples at different high temperatures as a function of confining pressure. The maximum compressive principal stress was in the direction perpendicular to the bedding plane. Tri-axial compression tests have been conducted under confining pressures ranging from atmospheric pressure to 12,000 psi “82.73 MPa” (gage), and the temperature was varied from room temperature (RT) to 250°F (121.11 °C). In all the experiments, specimens are dry, and no pore pressure is applied. Uniaxial axial force (100 lbs/min or 444.82 N/min) and strains in the three directions ( $$\varepsilon$$ ε 1, $$\varepsilon$$ ε 2, $$\varepsilon$$ ε 3) is directly measured from the strain gages mounted on the specimen; hence the study reflects the behavior of the Berea sandstone up to the initiation of the failure only. The experimental observations involving yield, failure, transition from brittle to ductile behavior, and their dependence on temperature and confining pressure are presented. Parameters like ductility and dilatancy (reflecting volumetric behavior before failure) and their variation with temperature and confining pressure are given. The initial yield and failure of Berea sandstone are presented in terms of the generalized von-Mises criteria, i.e., variation of octahedral shear stress ( ) with the mean stress. The loads at yield and failure are found to decrease with increasing temperature and augment with increasing confining pressure. The ductility and dilatancy reduction are computed using measured strains with increasing temperature. With an increase in temperature, the volume decreases first, partly due to the initial closure of micro cracks and voids, then increases due to generation of additional microcracks and voids (damage). There is less volume decrease in the uniaxial test response at higher temperature as compared to the corresponding ambient temperature response. A monotonic increase in the octahedral shear stress at yield and failure is observed with increasing confining pressure.

Hafiz Muhammad Zubair,1 Muhammad Arslan Khan,2 Faisal Gulzar,1 Musaed Alkholief,3 Abdul Malik,3 Suhail Akhtar,4 Ali Sharif,5 Muhammad Furqan Akhtar,6 Muhammad Abbas7 1Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan; 2Department of Pharmacy Services, The University of Lahore Teaching Hospital, Lahore, Pakistan; 3Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Department of Biochemistry, A.T. Still University of Health Sciences, Kirksville, MO, USA; 5Department of Pharmacology, Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan; 6Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore Campus, Lahore, Pakistan; 7Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, PakistanCorrespondence: Hafiz Muhammad Zubair, Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan, Email dr.zubair83@gmail.comPurpose: This study aimed to explore patients’ experiences of palliative chemotherapy for non-small cell lung cancer (NSCLC), how patients adapt to their new and challenging life after chemotherapy, their beliefs, and their quality of life.Patients and Methods: The study used an exploratory descriptive qualitative approach that was designed to explore the experiences and side effects of NSCLC patients on chemotherapy in Pakistan. The study was designed to obtain a deeper understanding of 22 NSCLC patients’ experiences, using a face-to-face approach and interviews were conducted. Patients who have completed chemotherapy agreed to participate in semi-structured interviews.Results: The data were arranged into five themes: hospital facilities and environment, patient’s beliefs in alternative treatments, presenting a positive/negative face, life is for living, and health insurance coverage. The major complaints related to bad experiences of chemotherapy-induced side effects, but these patients still managed to complete the full course of their respective chemotherapy. Additionally, the current study revealed the real experience of patients with NSCLC which had been less studied. The patient’s experience was summarized into four themes and several subthemes.Conclusion: This study aid healthcare providers when deciding on treatment options that will improve shared decision-making between clinicians and treatment outcomes.Keywords: chemotherapy, NSCLC, qualitative research, semi-structured interview

Mohammad Azam Ansari,1 Sultan Akhtar,2 Mohd Ahmar Rauf,3 Mohammad N Alomary,4 Sami AlYahya,4 Saad Alghamdi,5 MA Almessiere,2,6 Abdulhadi Baykal,7 Firdos Khan,8 Syed Farooq Adil,9 Mujeeb Khan,9 Mohammad Rafe Hatshan9 1Department of Epidemic Disease Research, Institute for Research & Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia; 2Department of Biophysics, Institute for Research & Medical Consultation (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia; 3Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA; 4National Centre for Biotechnology, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia; 5Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 6Department of Physics, College of Science, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia; 7Department of Nanomedicine Research, Institute for Research & Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia; 8Department of Stem Cell Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia; 9Department of Chemistry, College of Science, King Saud University, Riyadh, 11451, Kingdom of Saudi ArabiaCorrespondence: Mohammad Azam Ansari; Syed Farooq Adil Email maansari@iau.edu.sa; sfadil@ksu.edu.saBackground: The constant rise of microbial biofilm formation and drug resistance to existing antimicrobial drugs poses a significant threat to community health around the world because it reduces the efficacy and efficiency of treatments, increasing morbidity, mortality, and health-care expenditures. As a result, there is an urgent need to develop novel antimicrobial agents that inhibit microbial biofilm formation.Methods: The [Ni0.4Cu0.2Zn0.4](Fe2-xDyx)O4(x≤ 0.04) (Ni-Cu-Zn) nano spinel ferrites (NSFs) have been synthesized by the sol–gel auto-combustion process and were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive x-ray (EDX) and transmission electron microscopy (TEM). The antimicrobial, antibiofilm and antiproliferative activities of Ni-Cu-Zn NSFs were also examined.Results: The XRD pattern confirms the secondary phase DyFeO3 and Fe2O3 for substituted Dy3+ samples, and the crystallite size ranged from 10 to 19 nm. TEM analysis of NSFs revealed that the particles were cube-shaped and 15nm in size. NSFs exhibited significant antimicrobial, antibiofilm and antiproliferative activity. At concentration of 1 mg/mL, it was found that the NSFs (ie, x=0.0, x=0.01, x=0.02, x=0.03 and x=0.04) inhibit biofilm formation by 27.6, 26.2, 58.5, 33.3 and 25% for methicillin-resistant Staphylococcus aureus (MRSA) and 47.5, 43.5, 48.6, 58.3 and 26.6% for Candida albicans, respectively. SEM images demonstrate that treating MRSA and C. albicans biofilms with NSFs significantly reduces cell adhesion, colonization and destruction of biofilm architecture and extracellular polymeric substances matrices. Additionally, SEM and TEM examination revealed that NSFs extensively damaged the cell walls and membranes of MRSA and C. albicans. Huge ultrastructural alteration such as deformation, disintegration and separation of cell wall and membrane from the cells was observed, indicating significant loss of membrane integrity, which eventually led to cell death. Furthermore, it was observed that NSF inhibited the cancer cell growth and proliferation of HCT-116 in a dose-dependent manner.Conclusion: The current study demonstrated that the synthesized Ni-Cu-Zn NSFs could be used to develop potential antimicrobial surface coatings agents for a varieties of biomedical-related materials and devices in order to prevent the biofilms formation and their colonization. Furthermore, the enhanced antiproliferative properties of manufactured SNFs suggest a wide range of biomedical applications.Keywords: biomedical application, nano spinel ferrites, MRSA, Candida albicans, biofilm, ultrastructural alteration

Rehman Zafar,1,2 Humaira Naureen,3 Muhammad Zubair,4 Khadija Shahid,1 Muhammad Saeed Jan,5 Samar Akhtar,2 Hammad Ahmad,2 Wajeeha Waseem,6 Ali Haider,4 Saqib Ali,4 Muhammad Tariq,7 Abdul Sadiq8 1Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Riphah International University, Islamabad, 44000, Pakistan; 2Yusra Institute of Pharmaceutical Sciences, Islamabad, 44000, Pakistan; 3Department of Pharmacognosy, Faculty of Pharmaceutical Sciences, Riphah International University, Islamabad, 44000, Pakistan; 4Department of Chemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan; 5Department of Pharmacy, University of Swabi, Swabi, KP, Pakistan; 6Department of Basic Medical Sciences, Faculty of Pharmaceutical Sciences, Riphah International University, Islamabad, 44000, Pakistan; 7Department of PCB, Rokhan University, Jalalabad, Nangrahar, Afghanistan; 8Department of Pharmacy, University of Malakand, Chakdara, KP, PakistanCorrespondence: Abdul SadiqDepartment of Pharmacy, University of Malakand, Chakdara, 18000 Dir (L), KP, PakistanTel +92-332-50 46 485Email sadiquom@yahoo.comSaqib AliDepartment of Chemistry, Quaid-i-Azam University, Islamabad, 45320, PakistanEmail drsa54@hotmail.comBackground: Alzheimer’s disease (AD) is a neurodegenerative illness described predominantly by dementia. Even though Alzheimer’s disease has been known for over a century, its origin remains a mystery, and researchers are exploring many therapy options, including the cholinesterase technique. A decreased acetylcholine ACh neurotransmitter level is believed to be among the important factors in the progression of Alzheimer’s disease.Methods: In continuation of synthesizing potential anti-Alzheimer agents and known appreciative pharmacological potential of amide-containing compounds, this study presents the synthesis of two novel amide-based transition metal zinc (II) complexes, AAZ7 and AAZ8, attached with a heterocyclic pyridine ring, which was synthesized and characterized by Fourier transform infrared spectroscopy (FT-IR), elemental analysis, 1H_NMR, and 13C_NMR. FT-IR spectroscopic records showed the development of bidentate ligand as Δν value was decreased in both complexes when compared with the free ligand. Both of the synthesized complexes were analyzed for acetylcholinesterase and butyrylcholinesterase inhibitory potential along with the antioxidizing activity.Results: Importantly, the complex of AAZ8 exhibited more potent activity giving IC50 values of 14 μg/mL and 18μg/mL as AChE and BChE cholinesterase inhibitors, respectively, when compared with standard positive control galantamine. Interestingly, AAZ8 also displayed promising antioxidant potential by showing IC50 values of 35 μg/mL for DPPH and 29 μg/mL for ABTS in comparison with positive control ascorbic acid.Conclusion: Herein, we report two new amide carboxylate zinc (II) complexes which were potentially analyzed for various biological applications like acetylcholinesterase (AChE), butyrylcholinesterase (BChE) inhibitory potentials, and antioxidant assays. Computational docking studies also simulated results to understand the interactions. Additionally, thermodynamic parameters utilizing molecular dynamic simulation were performed to determine the ligand protein stability and flexibility that supported the results. Studies have shown that these compounds have the potential to be good anti-Alzheimer candidates for future studies due to inhibition of cholinesterase enzymes and display of free radical scavenging potential against DPPH as well as ABTS free radicals.Keywords: Zn(II) carboxylate, acetylcholinesterase, butyrylcholinesterase, elemental analysis, docking studies

Fawzi Babiker,1 Ibrahim F Benter,2 Saghir Akhtar3 1Department of Physiology, Faculty of Medicine, Health Science Center, Kuwait University, Kuwait City, Kuwait; 2Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Republic of Cyprus; 3College of Medicine, QU Health, Qatar University, Doha, QatarCorrespondence: Fawzi BabikerDepartment of Physiology, Faculty of Medicine, Health Science Center, Kuwait University, PO Box 24923, Safat 13110, Kuwait, Tel +965 24636360Fax +965 25338937Email Fawzi.b@hsc.edu.kwSaghir AkhtarCollege of Medicine, QU Health, Qatar University, PO Box 2713, Doha, QatarTel +974-4403 7865Email s.akhtar@qu.edu.qaAim: The effects of polyamidoamine (PAMAM) dendrimers on the mammalian heart are not completely understood. In this study, we have investigated the effects of a sixth-generation cationic dendrimer (G6 PAMAM) on cardiac function in control and diabetic rat hearts following ischemia-reperfusion (I/R) injury.Methods: Isolated hearts from healthy non-diabetic (Ctr) male Wistar rats were subjected to ischemia and reperfusion (I/R). LV contractility and hemodynamics data were computed digitally whereas cardiac damage following I/R injury was assessed by measuring cardiac enzymes. For ex vivo acute exposure experiments, G6 PAMAM was administered during the first 10 mins of reperfusion in Ctr animals. In chronic in vivo studies, nondiabetic rats (Ctr) received either vehicle or daily i.p. injections of G6 PAMAM (40 mg/kg) for 4 weeks. Diabetic (D) animals received either vehicle or daily i.p. injections of G6 PAMAM (10, 20 or 40 mg/kg) for 4 weeks. The impact of G6 PAMAM on pacing-postconditioning (PPC) was also studied in Ctr and D rats.Results: In ex vivo studies, acute administration of G6 PAMAM to isolated Ctr hearts during reperfusion dose-dependently impaired recovery of cardiac hemodynamics and vascular dynamics parameters following I/R injury. Chronic daily i.p. injections of G6 PAMAM significantly (P< 0.01) impaired recovery of cardiac function following I/R injury in nondiabetic animals but this was not generally observed in diabetic animals except for CF which was impaired by about 50%. G6 PAMAM treatment completely blocked the protective effects of PPC in the Ctr animals.Conclusion: Acute ex vivo or chronic in vivo treatment with naked G6 PAMAM dendrimer can significantly compromise recovery of non-diabetic hearts from I/R injury and can further negate the beneficial effects of PPC. Our findings are therefore extremely important in the nanotoxicological evaluation of G6 PAMAM dendrimers for potential clinical applications in physiological and pathological settings.Keywords: PAMAM, postconditioning, diabetes, ischemia, reperfusion

Shayaan Akhtar, Musab Hasan, Haseeb Iqbal Faculty of Medicine, Department of Medicine, Imperial College School of Medicine, London, UKCorrespondence: Shayaan AkhtarFaculty of Medicine, Imperial College London, Sir Alexander Fleming Building, Imperial College Road, London, SW7 2AZ, UKEmail shayaan.akhtar16@imperial.ac.uk View the original paper by Dr Ganesananthan and colleagues

Mohammed M Gad,1 Reem Abualsaud,1 Ahmed Rahoma,2,3 Ahmad M Al-Thobity,1 Khalid S Al-Abidi,1 Sultan Akhtar4 1Department of Substitutive Dental Sciences, 2Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Dental Materials, College of Dentistry, Al-Azhar University, Assuit, Egypt; 4Department of Biophysics, Institute for Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia Background: Polymethyl methacrylate (PMMA) is widely used for the fabrication of removable prostheses. Recently, zirconium oxide nanoparticles (nano-ZrO2) have been added to improve some properties of PMMA, but their effect on the optical properties and tensile strength are neglected.Objective: The aim of this study was to investigate the effect of nano-ZrO2 addition on the translucency and tensile strength of the PMMA denture base material.Materials and methods: Eighty specimens (40 dumbbell-shaped and 40 discs) were prepared out of heat-polymerized acrylic resin and divided into four groups per test (n=10). The control group for each test included unreinforced acrylic, while the test groups were reinforced with 2.5, 5, and 7.5 wt% nano-ZrO2. Acrylic resin was mixed according to manufacturer’s instructions, packed, and processed by conventional method. After polymerization, all specimens were finished, polished, and stored in distilled water at 37°C for 48±2 hours. Tensile strength (MPa) was evaluated using the universal testing machine while the specimens’ translucency was examined using a spectrophotometer. Statistical analysis was carried out by SPSS using the paired sample t-test (p≤0.05). A scanning electron microscope was used to analyze the morphological changes and topography of the fractured surfaces.Results: This study showed that the mean tensile strength of the PMMA in the test groups of 2.5%NZ, 5%NZ, and 7.5%NZ was significantly higher than the control group. The tensile strength increased significantly after nano-ZrO2 addition, and the maximum increase seen was in the 7.5%NZ group. The translucency values of the experimental groups were significantly lower than those of the control group. Within the reinforced groups, the 2.5%NZ group had significantly higher translucency values when compared to the 5%NZ and 7.5%NZ groups.Conclusion: The addition of nano-ZrO2 increased the tensile strength of the denture base acrylic. The increase was directly proportional to the nano-ZrO2 concentration. The translucency of the PMMA was reduced as the nano-ZrO2 increased.Clinical significance: Based on the results of the current study, the tensile strength was improved with different percentages of nano-ZrO2 additions. However, translucency was adversely affected. Therefore, it is important to determine the appropriate amount of reinforcing nano-ZrO2 that will create a balance between achieved properties – mechanical and optical. Keywords: denture base, PMMA, tensile strength, translucency, zirconium oxide nanoparticles

Emphysematous bullae in a lung can coalesce into a large lucency and may cause a shift of mediastinal structures. The present report describes a case of multiple emphysematous bullae in a 35 years old man that occupied the entire left hemi-thorax with mediastinal compression of the right lung. The patient underwent a left sided thoracotomy with a left pneumonectomy. The patient had an uneventful recovery.

Fourier transform is undoubtedly one of the cornerstones of digital signal processing (DSP). The introduction of the now famous FFT algorithm has not only breathed a new lease of life into an otherwise latent classical DFT algorithm, but also led to an explosion in applications that have now far transcended the confines of the DSP field. For a good accuracy, the digital implementation of the FFT requires that the input and/or the 2 basis functions be finely quantized. This paper exploits the use of coarse quantization of the FFT signals with a view to further improving the FFT computational efficiency while preserving its computational accuracy and simplifying its architecture. In order to resolve this apparent conflict between preserving an excellent computational accuracy while using a quantization scheme as coarse as can be desired, this paper advances new theoretical results which form the basis for two new and practically attractive FFT estimators that rely on the principle of 1 bit nonsubtractive dithered quantization (NSDQ). The proposed theory is very well substantiated by the extensive simulation work carried out in both noise-free and noisy environments. This makes the prospect of implementing the 2 proposed 1 bit FFT estimators on a chip both practically attractive and rewarding and certainly worthy of a further pursuit.