Search

Amro Omari,1,2 Momin Samad,3 Saaquib R Bakhsh,1,2 Jahan Tajran,4 George A Williams1,2 1Beaumont Eye Institute, Royal Oak, MI, USA; 2Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 3Michigan State College of Human Medicine, Grand Rapids, MI, USA; 4Wayne State University School of Medicine, Detroit, MI, USACorrespondence: Amro Omari, Beaumont Eye Institute, 3535 West 13 Mile Road Suite #555, Royal Oak, MI, 48073, USA, Tel +1 248-551-2020, Email Amro.omari@beaumont.orgBackground and Objective: To assess the use of a smartphone-based fundus camera in diagnosing acute posterior segment disease in the emergency room (ER) of an academic center, where standard fundus cameras are currently unavailable.Study Design/Patients and Methods: Images were obtained on 10 eyes with various types of posterior segment pathology. These were analyzed retrospectively by 35 reviewers (21 residents and 14 attending physicians). Accuracy of diagnosis was compared to in-office fundus photography.Results: The average probability of correct diagnosis was over 78%. There was no difference between resident and attending reviewers, except for one of the vitreous hemorrhage cases where residents performed better (p=0.039).Conclusion: Smartphone-based cameras are effective in screening for ocular diseases in the ER of academic centers, where residents and fellows are often the first providers to see various types of vision and life-threatening pathology.Keywords: fundus camera, emergency room, posterior segment, smartphone, retina

PurposeAn accurate determination of the natural history of a cerebral aneurysm has implications on management. Few risk factors other than female gender and cigarette smoking have been identified to be associated with cerebral aneurysm progression, particularly rapid progression.Materials and MethodsThis case series and literature review serves to illustrate a relationship between spontaneous carotid occlusion and rapid enlargement of cerebral aneurysms.ResultsIn our case series, we demonstrated that increased hemodynamic stress on collateral vessels caused by a spontaneous carotid occlusion may contribute to unusually rapid aneurysm growth and/or rupture.ConclusionSpontaneous carotid occlusive disease may be considered a risk factor for rapid cerebral aneurysm progression and/or rupture that may warrant more aggressive management options, including more frequent surveillance imaging in previously treated aneurysms.

Background: Tumor lysis syndrome (TLS) is a critical and potentially fatal complication linked to specific types of cancer. Rasburicase stands as a crucial medication necessary for the prevention and treatment of hyperuricemia, a condition commonly associated with TLS. Due to a shortage of rasburicase during the COVID-19 pandemic, a fixed-dose strategy of 3 mg rasburicase was used in many adult cancer patients in our center., Objective: The objective of this study was to assess the effectiveness of a fixed dose of 3 mg rasburicase in preventing and managing hyperuricemia associated with TLS in adult cancer patients., Methods:  We conducted a retrospective, observational cohort study between March 2020 and February 2022. The study included adult patients who received a fixed dose of 3 mg rasburicase. The primary outcome measure was the reduction in serum uric acid (UA) levels at 24 and 48 hours after treatment, with the aim of achieving and maintaining normal UA levels., Results:  Seventeen patients in the treatment group and 20 patients in the prevention group were included. In the treatment group, 15 (88%) patients had normalization of serum UA, which is considered to be <7 mg/dL (median: 4.48 mg/dL) at 24 hours, and 16 (94%) patients had achieved normal UA at 48 hours (median: 2.78 mg/dL) after receiving the rasburicase dose. In the prevention group, all 20 (100%) patients achieved normal UA at 24 hours after receiving the rasburicase dose., Conclusion: Based on these findings, a single fixed dose of 3 mg rasburicase is effective for preventing and managing hyperuricemia associated with TLS in high-risk patients., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bakhsh et al.)

Electronic and structural properties of calcium clusters with a varying size range of 2-20 atoms are studied using a two-step scheme within the GW and density functional theory (DFT) with generalized gradient approximation (GGA). The GGA overestimates the binding energies, optimized geometries, electron affinities, and ionization potentials reported in the benchmark. The ground-state structure geometry and binding energy were obtained from the DFT for the ground-state structure of each cluster. The binding energy of the neutral clusters of the calcium series follows an increasing trend, except for a few stable even and odd clusters. The electronic properties of the calcium cluster were studied with an all-electron FHI-aims code. In the G 0 W 0 calculation, the magic cluster Ca 10 has relatively high ionization potential and low electron affinity. The obtained ionization potentials from the G 0 W 0 @ PBE calculation showed that the larger cluster has less variation, whereas the electron affinities of the series have an increasing trend. The ionization potentials from the G 0 W 0 benchmark for the calcium cluster series have not yet been described in the literature., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024, Bakhsh et al.)

The change in composition and pressure, both of which lead to new desired properties by altering the structure, is particularly important for improving device performance. Given this, we focused here on the mechanical, elastic, and optoelectronic characteristics of the Cd 0.75 Zn 0.25 Se alloy using density functional theory at various pressures from 0 GPa to 20 GPa. It is found that the bulk modulus of the material rises with increasing pressure and exhibits mechanical stability as well as cubic symmetry. In addition, the increased pressure leads to a rise in the direct bandgap energy of the material from 2.03 eV to 2.48 eV. The absorption coefficient of the alloy also increases as the pressure increases, where the effective range of absorption covers the broad spectrum of light in the visible range from orange to cyan. This is due to the electronic transitions caused by the altered pressure. The optical parameters, including optical conductivity, extinction coefficient, reflection, and refractive index, are also analyzed under the influence of pressure. Based on this research, effective applications of the Cd substituted Zn-chalcogenides (CdZnSe) alloys in the fields of optoelectronics and photovoltaics are outlined, especially concerning fabricating solar cells, photonic devices, and pressure sensors for space technology., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Iqbal, Javeed, Bakhsh, Arellano-Ramírez, Khalid, Morsy, Shati and Choi.)

The optoelectronic and structural characteristics of the Zn 1-x Cr x Se (0 ≤ x ≤ 1) semiconductor are reported by employing density functional theory (DFT) within the mBJ potential. The findings revealed that the lattice constant decreases with increasing Cr concentration, although the bulk modulus exhibits the opposite trend. ZnSe is a direct bandgap material; however, a change from direct to indirect electronic bandgap has been seen with Cr presence. This transition is caused by structural alterations by Cr and defects forming, which results in novel optical features, including electronic transitions. The electronic bandgap decreases from 2.769 to 0.216 eV, allowing phonons to participate and improving optical absorption. A higher concentration of Cr boosts infrared absorption and these Cr-based ZnSe (ZnCrSe) semiconductors also cover a wider spectrum in the visible range from red to blue light. Important optical parameters such as reflectance, optical conductivity, optical bandgap, extinction coefficient, refractive index, magnetization factor, and energy loss function are discussed, providing a theoretical understanding of the diverse applications of ZnCrSe semiconductors in photonic and optoelectronic devices., (© 2024. The Author(s).)

The structural and electronic properties of zinc clusters (Zn n ) for a size range of n = 2-15 are studied using density functional theory. The particle swarm optimization algorithm is employed to search the structure and to determine the ground-state structure of the neutral Zn clusters. The structural motifs are optimized using the density functional theory approach to ensure that the structures are fully relaxed. Results are compared with the literature to validate the accuracy of the prediction method. The binding energy per cluster is obtained and compared with the reported literature to study the stability of these structures. We further assess the electronic properties, including the ionization potential, using the all-electron FHI-aims code employing G 0 W 0 calculations, and the G 0 W 0 Г 0 (1) correction for a few smaller clusters, which provides a better estimation of the ionization potential compared to other methods., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024, Bakhsh et al.)

Purpose: To report the development of bilateral cystoid macular edema after bimatoprost implant (Durysta) injections in both eyes to treat primary open-angle glaucoma., Methods: Case report., Results: A 93-year-old woman with a history of primary open-angle glaucoma received bimatoprost implant (Durysta) injections in both eyes 4 weeks apart. The patient subsequently developed progressively decreased visual acuity in both eyes because of bilateral cystoid macular edema, which improved with topical corticosteroid therapy., Conclusion: Bimatoprost implant (Durysta) can cause cystoid macular edema in susceptible individuals. Patients who received the implant should be assessed for the presence of cystoid macular edema after any decline in visual acuity, particularly in high-risk patients.

The global increase in temperature and climate change signals the need for humanity to reduce greenhouse gas emissions and to adopt eco-friendly lifestyles. The 2023 United Nations Climate Change Conference (COP28) in the UAE emphasized this, urging nations to commit to the Paris Agreement and pursue a greener, carbon-free future. In recent decades, climate change has become a critical issue, primarily because of the extensive use of fossil fuels and conventional energy resources. Economic growth has led to an increase in energy consumption and widespread environmental damage. The present study empirically explores whether any changes in environmental governance, economic complexity, geopolitical risk, and the interaction term influence energy transition and environmental stability in OECD economies over the period 1990-2021. Novel econometric methods, including Westerlund co-integration and the Method of Moments Quantile Regression (MMQR), are employed to address complexities such as cross-sectional dependency and panel causality. The key findings from the MMQR technique showed a positive link between environmental governance and economic complexity in driving sustainable energy transitions, thus bolstering environmental resilience in OECD countries. However, economic complexity counterbalances environmental stability. Significantly, geopolitical risk acts as a moderating variable, enhancing the effects of governance and complexity on sustainable energy practices and environmental stability. Based on these insights, this study recommends strategic initiatives, including investment in eco-friendly technologies, to fast-track the shift to clean energy and strengthen environmental resilience in OECD countries. These strategies align with the broader objectives of global sustainable development, offering a path towards a greener and more sustainable future., Competing Interests: Declaration of competing interest The authors have no financial and non-financial competing interests. This manuscript has not been published or presented elsewhere in part or in entirely and is not under consideration by another journal. There is no conflict of interest to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: We report a novel method of intraoperative localization of a retained anterior intraocular foreign body (IOFB), using a combination of ultrasound biomicrosopy and an insulated needle., Methods: A retrospective case report of a 56-year-old man who presented with a right eye IOFB., Results: On presentation, vision was decreased in the right eye to count fingers with a small subconjunctival hemorrhage, but no other signs of a penetrating laceration. Orbital CT revealed an IOFB, and the initial vitrectomy failed to retrieve the IOFB. Then, during the subsequent vitrectomy, using an ultrasound compatible needle and an ultrasound biomicrosopy, we were able to precisely locate and remove the small anterior IOFB., Conclusion: Retained IOFBs can lead to severe irreversible vision loss if not promptly removed. Ancillary imaging modalities and localization techniques can help locate occult IOFBs in difficult cases.

A change in the composition and dopant content of selective atoms in a material leads to their new desired properties by altering the structure, which can significantly improve the performance of relevant devices. By acknowledging this, we focused on characterizing the optoelectronic and structural properties of cadmium-substituted zinc selenide (Zn 1-x Cd x Se; 0 ≤ X ≤ 1) semiconductors using density functional theory (DFT) within the generalized gradient approximation (GGA), EV-GGA, and mBJ approximations. The results proved the cubic symmetry of the investigated materials at all Cd concentrations (0, 0.25, 0.50, 0.75, and 1). Although a linear surge in the lattice constant is observed with the change in Cd content, the bulk modulus exhibits a reverse trend. These materials are observed to be direct bandgap semiconductors at all Cd concentrations, with a decrease in electronic bandgap from 2.76 eV to 1.87 eV, and have isotropic optical properties, showing their potential applicability as a blue-to-red display. The fundamental optical properties of the materials, such as optical conductivity, reflectance, refractive index, absorption, and extinction coefficient, are also discussed. These outcomes provide a computational understanding of the diverse applications of Zn 1-x Cd x Se semiconductors in optoelectronic, photonic, and photovoltaic devices, particularly for a visible-range display., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Iqbal, Bakhsh, Ikram, Sohail, Islam, Manoharadas and Choi.)

Three-dimensional nanofiber scaffolds offer a promising method for simulating in vivo conditions within the laboratory. This study aims to investigate the influence of a bilayer amniochorionic membrane/nanofibrous fibroin scaffold on the differentiation of human menstrual blood mesenchymal stromal/stem cells (MenSCs) into female germ cells. MenSCs were isolated and assigned to four culture groups: (i) MenSCs co-cultured with granulosa cells (GCs) using the scaffold (3D-T group), (ii) MenSCs using the scaffold alone (3D-C group), (iii) MenSCs co-cultured only with GCs (2D-T group), and (iv) MenSCs without co-culture or scaffold (2D-C group). Both MenSCs and GCs were independently cultured for two weeks before co-culturing was initiated. Flow cytometry was employed to characterize MenSCs based on positive markers (CD73, CD90, and CD105) and negative markers (CD45 and CD133). Additionally, flow cytometry and immunocytochemistry were used to characterize the GCs. Differentiated MenSCs were analyzed using real-time PCR and immunostaining. The real-time PCR results demonstrated significantly higher levels of VASA expression in the 3D-T group compared to the 3D-C, 2D-T, and 2D-C groups. Similarly, the SCP3 mRNA level in the 3D-T group was notably elevated compared to the 3D-C, 2D-T, and 2D-C groups. Moreover, the expression of GDF9 was significantly higher in the 3D-T group when compared to the 3D-C, 2D-T, and 2D-C groups. Immunostaining results revealed a lack of signal for VASA, SCP3, or GDF9 markers in the 2D-T group, while some cells in the 3D-T group exhibited positive staining for all these proteins. These findings suggest that the combination of a bilayer amniochorionic membrane/nanofibrous fibroin scaffold with co-culturing GCs facilitates the differentiation of MenSCs into female germ cells., Competing Interests: Conflicts of interest Authors Afshin Zare and Amin Tamadon were employed by the PerciaVista R&D Co. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

This study explores the relationship between environmental taxation, environmental technologies, energy resources, and consumption-based carbon emissions in five leading green economies from 2000 to 2019. The study applied the Cross-Sectional Auto-Regressive Distributed Lag (CS-ARDL) model to derive benchmark results, with Augmented Mean Group (AMG) and Common Correlated Effect Mean Group (CCEMG) techniques being utilized for conducting robustness analyses. The empirical findings suggest that environmental taxation, environmental innovations, and the consumption of renewable energy are associated with a reduction in consumption-based carbon emissions, thereby contributing to enhanced environmental sustainability. Conversely, the utilization of non-renewable energy is linked to an increase in consumption-based carbon emissions. These results align with the objectives outlined in the Sustainable Development Goals' 2030 agenda, particularly SDG 7 (Affordable and Clean Energy), SDG 9 (Industry, Innovation, and Infrastructure), and SDG 13 (Climate Action), offering valuable policy implications., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a diagnostic procedure that allows clinicians to stage lung cancer by sampling lymph nodes in the mediastinum. EBUS-TBNA is recommended as a first step prior to mediastinoscopy for lung cancer mediastinal staging. This procedure has greatly aided pulmonologists in diagnosing mediastinal pathologies with substantial progress. In this study, our aim is to analyze how cell blocks affect the diagnostic yield of mediastinal and hilar lymphadenopathy using an EBUS cytology needle. Methods This retrospective study was conducted at King Abdulaziz University Hospital between May 2021 and September 2021. Patients with mediastinal and hilar lymphadenopathy in the absence of known or suspected primary lung cancer were included. The EBUS procedure was performed using a flexible bronchoscope equipped with a working channel suitable for transbronchial needle aspiration under direct ultrasound guidance. Data were recorded using Microsoft Excel and analyzed using Statistical Package for the Social Sciences (SPSS) v. 26.0 (IBM Corp., Armonk, NY). Diagnostic accuracy measures were determined, and a p-value of 0.05 was established as the final threshold for statistical significance. Results The total number of patients in our study was 151. The sensitivity for cytology specimens, histology specimens, and a combined evaluation for the full group of patients was 77.14%, 83.33%, and 87.5%, respectively, with a negative predictive value of 27.22%, 25%, and 21.42%. The diagnostic accuracy for cytology specimens, histology specimens, and a combined evaluation was 71.42%, 76.19%, and 80%, respectively. Conclusion Our study found that the combined examination of specimens for both cytology and histology in the diagnosis of lung cancer, sarcoidosis, and tuberculosis resulted in a higher diagnostic yield compared to cytological assessment alone using EBUS-TBNA., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Aljohaney et al.)

This study explores the nuclear magnetic shielding, chemical shifts, and the optoelectronic properties of the BiMnVO 5 compound using the full-potential linearized augmented plane wave method within the generalized gradient approximation by employing the Hubbard model (GGA + U). The 209 Bi and 51 V chemical shifts and bandgap values of the BiMnVO 5 compound in a triclinic crystal structure are found to be directly related to Hubbard potential. The relationship between the isotropic nuclear magnetic shielding σ iso and chemical shift δ iso is obtained with a slope of 1.0231 and - 0.00188 for 209 Bi and 51 V atoms, respectively. It is also observed that the bandgap, isotropic nuclear magnetic shielding, and chemical shifts increase with the change in Hubbard potentials (U) of 3, 4, 5, 6, and 7., (© 2023. The Author(s).)

This study reports light energy harvesting characteristics of bismuth ferrite (BiFeO 3 ) and BiFO 3 doped with rare-earth metals such as neodymium (Nd), praseodymium (Pr), and gadolinium (Gd) dye solutions that were prepared by using the co-precipitation method. The structural, morphological, and optical properties of synthesized materials were studied, confirming that 5-50 nm sized synthesized particles have a well-developed and non-uniform grain size due to their amorphous nature. Moreover, the peaks of photoelectron emission for bare and doped BiFeO 3 were observed in the visible region at around 490 nm, while the emission intensity of bare BiFeO 3 was noticed to be lower than that of doped materials. Photoanodes were prepared with the paste of the synthesized sample and then assembled to make a solar cell. The natural and synthetic dye solutions of Mentha, Actinidia deliciosa, and green malachite, respectively, were prepared in which the photoanodes were immersed to analyze the photoconversion efficiency of the assembled dye-synthesized solar cells. The power conversion efficiency of fabricated DSSCs, which was confirmed from the I-V curve, is in the range from 0.84 to 2.15%. This study confirms that mint (Mentha) dye and Nd-doped BiFeO 3 materials were found to be the most efficient sensitizer and photoanode materials among all the sensitizers and photoanodes tested., (© 2023. The Author(s).)

Over the last few years, global warming and rapid climate change have become major risk factors that pose a serious threat to global security. A key factor behind these risk factors is greenhouse gases, which emit mainly carbon dioxide (CO 2 ). The existing literature seeks to determine the economic and non-economic aspects of CO 2 emissions to prevent environmental degradation. However, the effects of economic policy uncertainty and foreign direct investment on CO 2 emissions are undeniable. This study examines the impact of economic policy uncertainty and foreign direct investment on CO 2 emissions in the panel of 24 developed and developing nations from 2001 to 2019. After verifying cross-sectional dependency and co-integration among parameters, the dynamic seemingly unrelated regression and panel vector error correction model (VECM) Granger causality methods are used for long-run estimates and verify the causal link among variables. Our findings show that economic policy uncertainty, economic growth, trade, and energy consumption adversely impact the environment, while foreign direct investment enhances sample countries' environmental quality. Furthermore, a bidirectional relationship exists between CO 2 , economic policy uncertainty, economic growth, trade, and energy consumption. In addition, this study observed similar results in a robustness analysis using the dynamic common correlated effects and fixed effect panel quantile regression frameworks. Based on the inclusive outcomes, this study forms significant suggestions for policy implications. Specifically, policymakers should design environmental-friendly trade policies, explore renewable energy options, and implement green investment and financing strategies to improve the environment., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The study examines the moderating role of institutional quality and technological innovation on the empirical relationship between FDI inflows and four indicator variables of CO 2 emissions in 40 Asian countries for the period 1996-2016, by using generalized method of moment (GMM) estimation. First, from non-interactive regression, FDI inflows have positive impacts on CO 2 emissions; over all, from our empirical results, we conclude that the moderating role of institutional quality and technological innovation is crucial in the nexus between FDI and carbon CO 2 emissions and the interaction between institutional quality indicators and FDI inflows significantly reduce the level of CO 2  emissions. Furthermore, the significant moderating effect of technological innovation is observed on the association between FDI and CO 2 emissions. The results are important for policy makers in setting up long- and short-term policy to protect environmental quality.

We study the structural and electronic properties of beryllium (Be) and magnesium (Mg) clusters for sizes 2-20 using a two-step approach. In the first step, a global search of the stable and low-lying metastable isomer structures is carried out on the basis of first-principles potential energy surfaces at the level of the generalized gradient approximation (GGA) of density functional theory (DFT). In the second step, vertical ionization potentials (VIPs) and energy gaps between the highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) are determined using the G 0 W 0 methods for up to the fourth-lowest-energy isomers. Novel globally lowest-energy isomer structures are identified for Be 14 , Mg 14 , and Mg 16 clusters. The van der Waals interactions are found to have a stronger influence on Mg clusters than on Be clusters. A second-difference analysis for both the binding energies and HOMO-LUMO gaps reveals a close relationship between the structural stability and chemical hardness for both types of clusters.

The increase in greenhouse gas emission has a major global issue, catching the attention of the researcher and policymakers around the world. The combustion of fossil fuel is the main cause of the rising greenhouse gas emission particularly in developing countries including Vietnam. Meanwhile, the purpose of the study is to evaluate the linkage between fossil fuel consumption, financial development, industrial progression, and CO 2 emission over the period from 1970 to 2019, particularly in Vietnam. The study applied the ARDL econometric technique and Bayer-Hanck cointegration approach with structural break to confirm long run relationship and the EKC hypothesis between industrial growth and CO 2 emission, in Vietnam, which assume the U-shaped link between CO 2 emission and industrial growth in Vietnam. Which further confirmed by Lind and Mehlum U test in addition, the Granger causality exists between fossil fuel consumption and CO 2 emission in both short run and long run. The causal relationship is unidirectional in the short run running from fossil fuel consumption and carbon dioxide emission; therefore, the study proposed to adopt low-carbon emission technology.

Objectives: Acute kidney injury (AKI) is a major cause of morbidity and mortality. Whether aminophylline administration can prevent or treat AKI among pediatric patients are not clear. This meta-analysis aimed to assess the efficacy and effectiveness of aminophylline for pediatric AKI., Methods: We carried out a systematic search of six databases: PubMed, EMBASE/Excerpta Medica, Scopus, Cochrane library, and Google Scholar from January 1995 up till May 2019. Summary measures of risk ratios and standard mean difference were calculated using the random effects model., Results: We identified seven papers containing data on aminophylline use in children with AKI. Meta-analysis of single-arm studies indicated no statistically significant difference in mean rate of serum creatinine clearance (-0.39 [-0.80-1.58], P = 0.52), mean urine output (1.99 [-1.43-5.42]; P = 0.25), or mean blood urea nitrogen levels (0.83 [-1.86-3.03], P = 0.54) before and after aminophylline administration. However, among double-arm studies, aminophylline administration in the intervention arm significantly reduced the serum creatinine level as compared to control arm (mean diff = -34 [-55.18--12.83]; P = 0.002). Mean urine output (-112.68 [-27.43-48.9], P = 0.17), incidence of AKI (RR = 1.05 [0.80-1.37], P = 0.72), and mortality rates (RR = 0.79 [0.42-1.47], P = 0.45) were found to be statistically insignificant., Conclusions: Aminophylline administration in children with AKI reduces serum creatinine level without significant adverse effects or effect on the incidence of AKI, urine output, or mortality. Further, large-scale well-planned randomized controlled trials are needed to evaluate its use and its potential long-term effects., (Copyright: © International Journal of Health Sciences.)

Background: Wilson disease (WD) is a disorder of copper metabolism that results in accumulation of copper in tissues. In acute WD, patients present with fulminant hepatic failure, encephalopathy, and hemolytic anemia due to copper release from necrotic hepatocytes. Many will require life-saving liver transplantation. Extracorporeal liver support systems can provide a bridge to transplantation for critically ill patients. We report our experience with 2 patients for whom we used a combination of plasma exchange (PLEX) and single pass albumin dialysis (SPAD), or SPAD alone as a bridge to liver transplantation., Case Reports: A 17-year-old girl (patient 1) and a 12-year-old boy (patient 2) presented with fulminant hepatic failure, hemolytic anemia, and acute kidney injury. Patient 1 received SPAD on days 2 and 3 (total 32 h). Serum copper decreased from 22.3 to 15.9 µmol/L (28.7% decrease), measured after 28 h of continuous SPAD. She underwent successful liver transplantation on day 4 after presentation. Patient 2 was treated with PLEX on days 1, 3, 4, and 5 and with SPAD on days 3-6. Serum copper decreased from 48.7 to 25.8 µmol/L (47% decrease) after the first session of PLEX and from 35.5 to 21.5 µmol/L (39.4% decrease) after the second session. The serum copper level was 16.2 µmol/L after 4 sessions of PLEX (and ongoing SPAD), with an overall 66.7% reduction in copper levels over 5 days combining both therapies. He underwent successful liver transplantation on day 6., Conclusion: We conclude that SPAD, with or without PLEX, is effective in reducing serum copper levels as a bridge to liver transplantation in WD. PLEX may be more efficient at removing copper but is associated with a rebound increase in copper levels between sessions., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2019 by The Author(s). Published by S. Karger AG, Basel.)

During current project, antibacterial and antibiofilm properties of traditional medicinal plant Ziziphus nummularia leaf extract and various fractions was investigated. The plant leaves were dried and extracted using 90% methanol followed by sequential fractionation using liquid-liquid fractionation. The fractions of a diverse polarity including chloroform, n-hexane, methanol and ethyl acetate and aqueous extracts were obtained that was further analysed by using HPLC. The phytochemical screening indicated presence of saponins, triterpenes and flavonoids. During DPPH assay, the methanolic fraction presented highest activity (IC 50 193.1μg/mL), followed by ethyl acetate (IC 50 220μg/mL) and chloroform (IC 50 263μg/mL) fractions respectively. During FRAP assay, FRAP value for Z. nummularia extract 20.43μM. Among fractions, ethyl acetate fraction presented highest FRAP value (370.2μM), followed by chloroform (204μM) and methanolic (249μM) fractions. The antimicrobial activity of chloroform fraction was significantly high against P. aureginosa (6mm), L. monocytogenes, S. aureus (5mm), K. pneumoniae, B. Subtillus and E. coli (4mm). The ethyl acetate part presented significant activity (MIC 4mg/mL) against S. aureus, B. Subtillus and L. monocytogenes. The total extract and fractions were further tested for MBC and the MBC for ethyl acetate fractions was 4mg/mL, whereas all other fractions exhibited MBC >10mg/mL. No activity was recorded against Aspergillus niger. During antibiofilm assay, n-hexane fraction presented highest inhibition (88%) followed by ethyl acetate (69%) chloroform (65%) fractions. It was concluded that Z. nummularia possess moderate antimicrobial and antibiofilm activities. Further a synergistic effect is suggested in formulation having Z. nummularia.

Colonization by Staphylococcus aureus (S. aureus) has been implicated in many infectious and wound healing disorders. This study was performed to characterize the pathogenic role of S. aureus alpha-hemolysin (alpha-toxin) in corneal epithelial wound healing and infectious keratitis in the setting of a corneal wound. The effect of wild-type and isogenic Hla mutant (α-hemolysin gene deleted) S. aureus bacteria and conditioned media on corneal epithelial wound healing was tested in vitro using a scratch assay and in vivo using a murine epithelial debridement model. The invasiveness of wild-type and Hla mutant S. aureus was evaluated in vitro in human corneal epithelial cells and in vivo in a murine model of infectious keratitis following total epithelial debridement. S. aureus and its conditioned media significantly delayed epithelial wound closure both in vitro (P < 0.05) and in vivo (P < 0.05). The effect of S. aureus on wound healing was significantly diminished with the Hla mutant strain (P < 0.05). Likewise, compared to the wild-type strain, the Hla mutant strain demonstrated significantly reduced ability to invade corneal epithelial cells in vitro (P < 0.05) and infect murine corneas following total epithelial debridement in vivo (P < 0.05). In conclusion, S. aureus alpha-hemolysin plays a major role in the pathologic modulation of corneal epithelial wound healing and the intracellular invasion of the bacteria. Limiting colonization by S. aureus and/or blocking alpha-hemolysin may provide a therapeutic approach for corneal wound healing and infectious disorders., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: Intracellular and extracellular oxidative stress triggered by free radicals promotes skin aging, which is designated by atypical pigmentation and wrinkles. The consumption of antioxidants is an efficacious measure to avert symptoms involved in skin aging., Aim: The current research was commenced to explore the anti-aging potential of antioxidants present in Tamarindus indica seeds extract., Material and Methods: Tamarindus indica seeds extract was obtained by concentrating the ethanolic extract of seeds. The antioxidant activities of the extract were measured by nitric oxide radical scavenging assay, 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay, hydroxyl radical scavenging assay and superoxide radical scavenging assay. Formulation comprising 4% of the concentrated extract of seeds was formulated by loading it in the internal aqueous phase of water-in-oil (W/O) cosmetic emulsion. The base, used as control, consisted of the same emulsion but without loading Tamarindus indica seeds extract. The cosmetic emulsions were applied to the cheeks of 11 healthy male volunteers for duration of 12 weeks. Both base and formulation were assessed for their antioxidant effects on different skin parameters i.e. skin moisture contents, elasticity and surface evaluation of living skin (SELS)., Results: The formulation showed statistically significant ( p ≤ 0.05) and the base showed insignificant ( p > 0.05) effects on skin elasticity and skin moisture contents. There is a significant decline in SELS, skin scaliness (SEsc), skin wrinkles (SEw), skin smoothness (SEsm), and skin roughness (SEr) parameters after application of the formulation., Conclusions: Topical application of the cosmetic emulsion entrapped with Tamarindus indica seeds extract containing various antioxidants exerts potential skin antiaging effects., Competing Interests: The authors declare no conflict of interest.

Marine bacteria have been exceptional sources of halotolerant enzymes since decades. The aim of the present study was to isolate bacteria producing hydrolytic enzymes from seven different mangroves collected from the coastal area of Thuwal, Jeddah, Saudi Arabia, and to further screen them for other enzymatic and antifungal activities. We have isolated 46 different rhizo- and endophytic bacteria from the soil, roots, and leaves of the mangroves using different enzymatic media. These bacterial strains were capable of producing industrially important enzymes (cellulase, protease, lipase, and amylase). The bacteria were screened further for antagonistic activity against fungal pathogens. Finally, these bacterial strains were identified on the basis of the16S rDNA sequence. Taxonomic and phylogenetic analysis revealed 95.9-100% sequence identity to type strains of related species. The dominant phylum was Gammaproteobacteria (γ-Proteobacteria), which comprised 10 different genera - Erwinia, Vibrio, Psychrobacter, Aidingimonas, Marinobacter, Chromohalobacter, Halomonas, Microbulbifer, and Alteromonas. Firmicutes was the second dominant phylum, which contained only the genus Bacillus. Similarly, only Isoptericola belonged to Actinobacteria. Further these enzyme-producing bacteria were tested for the production of other enzymes. Most of the active strains showed cellulytic and lipolytic activities. Several were also active against fungal pathogens. Our results demonstrated that the mangroves represent an important source of potentially active bacteria producing enzymes and antifungal metabolites (bioactive products). These bacteria are a source of novel halophilic enzymes and antibiotics that can find industrial and medicinal use.

Adenoid cystic carcinoma is a rare malignant tumor that usually arises in the major and minor salivary glands and other locations containing secretory glands, including the lower female genital tract. Lower female genital tract carcinomas with adenoid cystic differentiation can be subclassified into 2 distinct groups based on the presence or absence of high-risk HPV. Cervical mixed carcinomas with some adenoid cystic differentiation are high-risk HPV-related but pure adenoid cystic carcinomas of vulvar and cervical origin appear to be unrelated to high-risk HPV. Mechanisms by which normal cells give rise to an HPV-unrelated adenoid cystic carcinoma remain largely unknown. Studies demonstrate that chromosomal translocation involving the genes encoding the transcription factors MYB and NFIB functions as a driving force of adenoid cystic carcinomas development regardless of anatomic site. The current study used fluorescence in situ hybridization with 3 different probes including MYB break-apart probe, NFIB break-apart probe, and MYB-NFIB fusion probe to assess for the presence of gene rearrangements in adenoid cystic carcinomas of the vulva. Six (66.7%) of 9 vulvar adenoid cystic carcinomas demonstrated NFIB rearrangement. Of these 6 cases with a disturbed NFIB, only 2 cases (33.3%) were positive for a MYB rearrangement that was also confirmed by a positive MYB-NFIB fusion pattern. NFIB-associated gene rearrangement is a frequent genetic event in vulvar adenoid cystic carcinomas. Chromosome translocations involving NFIB but with an intact MYB indicate the presence of novel oncogenic mechanisms for the development of adenoid cystic carcinomas of the vulva.

Background: Anastomotic leak (AL) increases costs and cancer recurrence. Studies show decreased AL with side-to-side stapled anastomosis (SSA), but none identify risk factors within SSAs. We hypothesized that stapler characteristics and closure technique of the common enterotomy affect AL rates., Methods: Retrospective review of bowel SSAs was performed. Data included stapler brand, staple line oversewing, and closure method (handsewn, HC; linear stapler [Barcelona technique], BT; transverse stapler, TX). Primary endpoint was AL. Statistical analysis included Fisher's test and logistic regression., Results: 463 patients were identified, 58.5% BT, 21.2% HC, and 20.3% TX. Covidien staplers comprised 74.9%, Ethicon 18.1%. There were no differences between stapler types (Covidien 5.8%, Ethicon 6.0%). However, AL rates varied by common side closure (BT 3.7% vs. TX 10.6%, p = 0.017), remaining significant on multivariate analysis., Conclusion: Closure method of the common side impacts AL rates. Barcelona technique has fewer leaks than transverse stapled closure. Further prospective evaluation is recommended., (Copyright © 2017. Published by Elsevier Inc.)

Background: Vitiligo is a repugnant and odious dermatological malady of the time. It has an detrimental impact on the pigmentation of the human skin as a result of the destruction of cutaneous melanocytes. It affects 1%-2% of the population worldwide. Different therapeutic regimens have been deployed to treat vitiligo, but none of them could stand alone to be stated as a perfect cure. Recently, a change has been observed through novel experimental-designed optimization leading to the development of an anti-vitiligo ointment containing Psoralea corylifolia (PC) seed powder., Aim: The aim of this study was to explore the clinical outcomes of ointment containing powdered seeds of PC., Materials and Methods: Guided by the protocol Response Surface Methodology, 13 formulations of concentration variance of permeation enhancers were prepared. The formulation fulfilling the required criteria (pH; temperature stability tests at 8°C±0.1°C, 25°C±0.1°C and 40°C±0.1°C; and the physical properties such as color, bleeding and rheology) was selected for clinical trials. Fourier transform infrared spectroscopy studies of seed powder of PC and selected formulation of the seed powder were performed. After obtaining informed consents and with prior approval of university and hospital ethical review boards, 20 patients (age range 25-65 years) were included in the present study. Formulations were applied on the affected body parts of patients, and some affected portion of the same patient was taken as control (self-control study design). The pigmentation of white spots of vitiligo was photographically evaluated before, during and after 12 weeks of treatment. Analysis of the measured values was performed using GraphPad Prism version 5 statistical software. A paired sample t -test was performed to observe variation between repigmented patches and white patches of self-control., Results: Hydrophilic ointment (10% w/w) prepared with seed powder of PC was fabricated. The ointment was found effective for small circular white lesions of vitiligo as compared to self-control. Pre- and post-treatment differences in the levels of pigmentation were statistically significant ( P ≤0.05)., Conclusion: Ointment containing seed powder of PC could be an effective monotherapy for small circular white lesions of vitiligo., Competing Interests: The authors declare no conflicts of interest in this research work.

Background: Exposure to welding fume increases the risk of pneumococcal infection; whether such susceptibility extends to other respiratory infections is unclear. We report findings from a survey and from medical consultation data for workers in a large shipyard in the Middle East., Methods: Between January 2013 and December 2013, we collected cross-sectional information from 529 male workers variously exposed to welding fume. Adjusted ORs for respiratory symptoms (cough, phlegm, wheezing, shortness of breath and 'chest illness') were estimated using multivariable logistic regression. Subsequently, we examined consultation records from 2000 to 2011 for 15 954 workers who had 103 840 consultations for respiratory infections; the associations between respiratory infections and levels of welding exposure were estimated using a count regression model with a negative binomial distribution., Results: 13% of surveyed workers reported respiratory symptoms with a higher prevalence in winter, particularly among welders. The adjusted OR in welders versus other manual labourers was 1.72 (95% CI 1.02 to 3.01) overall and 2.31 (1.05 to 5.10) in winter months; no effect was observed in summer. The risk of consultation for respiratory infections was higher in welders than in manual labourers, with an adjusted incidence rate ratio of 1.45 (1.59 to 1.83) overall, 1.47 (1.42 to 1.52) in winter and 1.33 (1.23 to 1.44) in summer (interaction, p<0.001)., Conclusions: The observation that respiratory symptoms and consultations for respiratory infection in welders are more common in winter may indicate an enhanced vulnerability to a broad range of infections. If confirmed, this would have important implications for the occupational healthcare of a very large, global workforce., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Aims: To characterize the histomorphological features of endometrial carcinomas (ECs) harbouring polymerase ε (POLE) mutations., Methods and Results: Forty-three ECs with POLE mutations were compared with a cohort of 202 ECs. Most POLE-mutated ECs were endometrioid [34/43 (79%)]; the remaining tumours were mixed [6/43 (14%)], serous [2/43 (5%)], and clear cell [1/43 (2%)]. The endometrioid carcinomas were predominantly International Federation of Gynecology and Obstetrics grade 3 (27/43, 63%). The histotype distribution did not differ from that of control ECs (P = 0.69), but the grade of the EC was higher (P < 0.0005). Both nuclear grade and mitotic index were significantly higher in POLE-mutated ECs than in the comparison cohort. POLE-mutated ECs were associated with peritumoral lymphocytes and numerous tumour-infiltrating lymphocytes. Lymphovascular invasion was present in 20 of 43 tumours. Adjuvant radiotherapy and adjuvant chemotherapy would be offered in up to 80% and 40% of patients, respectively, on the basis of stage, grade, lymphovascular invasion, and histotype., Conclusions: POLE-mutated ECs are typically of high grade, with prominent lymphocytic infiltration, but they are not sufficiently distinctive to allow accurate diagnosis based on routine haematoxylin and eosin staining. Even though POLE-mutated tumours are associated with an excellent prognosis, current guidelines for giving adjuvant treatment for EC result in most patients receiving adjuvant therapy., (© 2015 John Wiley & Sons Ltd.)

The present study was conducted to formulate controlled release dosage forms containing Ibuprofen with Eudragit® S 100 polymer. The tablets were formulated at three different ratios with the polymer to investigate the effect of different concentrations of polymer on in vitro drug release patterns/kinetics and in vivo absorption/pharmacokinetics. Pre-formulation studies were conducted including bulk density, tapped density, compressibility index, Hausner ratio and angle of repose. In vitro studies were conducted using phosphate buffer (pH 7.4) as dissolution medium. In vivo performance was evaluated using albino rabbits. Physico-chemical characteristics (i.e. dimensional tests, weight variation, hardness, friability and drug content determination) fell in the USP acceptable limits. The compressibility index was found to range between 12.02 ± 0.01% and 18.66 ± 0.03%, the Hausner ratio varied between 1.02 ± 0.01 and 1.19 ± 0.10 and the angle of repose ranged from 15.19 ± 0.01 to 24.52 ± 0.10, all indicating better flow properties than the bulk-reference standard. Both bulk and tapped densities also fell in the USP acceptable range. Ibuprofen market tablets showed Tmax of 2.1 ± 0.4h, which was significantly (P-value <0.05) lower compared to that of the reference standard (i.e. 4.09 ± 1.3h). Ibuprofen test formulation has a half-life (t1/2) of 16.9 ± 2.5h, which was significantly (P-value<0.001) higher compared to that of the reference standard (i.e. 9.23 ± 2.9h). Eudragit® S 100 polymers can be used efficiently to develop directly compressed prolonged release tablets.