Alzheimer’s Disease(AD)is a progressive neurodegenerative disorder that significantly affects cognitive function,making early and accurate diagnosis essential.Traditional Deep Learning(DL)-based approaches often stru...Alzheimer’s Disease(AD)is a progressive neurodegenerative disorder that significantly affects cognitive function,making early and accurate diagnosis essential.Traditional Deep Learning(DL)-based approaches often struggle with low-contrast MRI images,class imbalance,and suboptimal feature extraction.This paper develops a Hybrid DL system that unites MobileNetV2 with adaptive classification methods to boost Alzheimer’s diagnosis by processing MRI scans.Image enhancement is done using Contrast-Limited Adaptive Histogram Equalization(CLAHE)and Enhanced Super-Resolution Generative Adversarial Networks(ESRGAN).A classification robustness enhancement system integrates class weighting techniques and a Matthews Correlation Coefficient(MCC)-based evaluation method into the design.The trained and validated model gives a 98.88%accuracy rate and 0.9614 MCC score.We also performed a 10-fold cross-validation experiment with an average accuracy of 96.52%(±1.51),a loss of 0.1671,and an MCC score of 0.9429 across folds.The proposed framework outperforms the state-of-the-art models with a 98%weighted F1-score while decreasing misdiagnosis results for every AD stage.The model demonstrates apparent separation abilities between AD progression stages according to the results of the confusion matrix analysis.These results validate the effectiveness of hybrid DL models with adaptive preprocessing for early and reliable Alzheimer’s diagnosis,contributing to improved computer-aided diagnosis(CAD)systems in clinical practice.展开更多
Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor ...Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.展开更多
Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband networks.However,they consume important a...Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband networks.However,they consume important and scarce network resources such as bandwidth and processing power.There have been several reports of these control signaling turning into signaling storms halting network operations and causing the respective Telecom companies big financial losses.This paper draws its motivation from such real network disaster incidents attributed to signaling storms.In this paper,we present a thorough survey of the causes,of the signaling storm problems in 3GPP-based mobile broadband networks and discuss in detail their possible solutions and countermeasures.We provide relevant analytical models to help quantify the effect of the potential causes and benefits of their corresponding solutions.Another important contribution of this paper is the comparison of the possible causes and solutions/countermeasures,concerning their effect on several important network aspects such as architecture,additional signaling,fidelity,etc.,in the form of a table.This paper presents an update and an extension of our earlier conference publication.To our knowledge,no similar survey study exists on the subject.展开更多
Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosupp...Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.展开更多
Particle Swarm Optimization(PSO)has been utilized as a useful tool for solving intricate optimization problems for various applications in different fields.This paper attempts to carry out an update on PSO and gives a...Particle Swarm Optimization(PSO)has been utilized as a useful tool for solving intricate optimization problems for various applications in different fields.This paper attempts to carry out an update on PSO and gives a review of its recent developments and applications,but also provides arguments for its efficacy in resolving optimization problems in comparison with other algorithms.Covering six strategic areas,which include Data Mining,Machine Learning,Engineering Design,Energy Systems,Healthcare,and Robotics,the study demonstrates the versatility and effectiveness of the PSO.Experimental results are,however,used to show the strong and weak parts of PSO,and performance results are included in tables for ease of comparison.The results stress PSO’s efficiency in providing optimal solutions but also show that there are aspects that need to be improved through combination with algorithms or tuning to the parameters of the method.The review of the advantages and limitations of PSO is intended to provide academics and practitioners with a well-rounded view of the methods of employing such a tool most effectively and to encourage optimized designs of PSO in solving theoretical and practical problems in the future.展开更多
BACKGROUND An echocardiogram is an essential tool in the evaluation of potential kidney transplant recipients(KTRs).Despite cardiac clearance,potential KTRs still have structural and functional abnormalities.Identifyi...BACKGROUND An echocardiogram is an essential tool in the evaluation of potential kidney transplant recipients(KTRs).Despite cardiac clearance,potential KTRs still have structural and functional abnormalities.Identifying the prevalence of these abnormalities and understanding their predictors is vital for optimizing pretransplant risk stratification and improving post-transplant outcomes.AIM To determine the prevalence of left ventricular hypertrophy(LVH),left ventricular systolic dysfunction(LVSD),diastolic dysfunction(DD),pulmonary hypertension(PH),and their predictors,and to assess their impact on graft function in pre-transplant candidates.METHODS The study included all successful transplant candidates older than 14 who had a baseline echocardiogram.Binary logistic regression models were constructed to identify factors associated with LVH,LVSD,DD,and PH.RESULTS Out of 259 patients,LVH was present in 64%(166),12%(31)had LVSD,27.5%(71)had DD,and 66(25.5%)had PH.Independent predictors of LVH included male gender[odds ratio(OR):2.51;95%CI:1.17-5.41 P=0.02],PH(OR=2.07;95%CI:1.11-3.86;P=0.02),DD(OR:2.47;95%CI:1.29-4.73;P=0.006),and dyslipidemia(OR=1.94;95%CI:1.07-3.53;P=0.03).Predictors for LVSD included patients with DD(OR=3.3,95%CI:1.41-7.81;P=0.006)and a family history of coronary artery disease(OR=4.50,95%CI:1.33-15.20;P=0.015).Peritoneal dialysis was an independent predictor for DD(OR=10.03;95%CI:1.71-58.94,P=0.011).The presence of LVH(OR=3.32,95%CI:1.05-10.55,P=0.04)and mild to moderate or moderate to severe mitral regurgitation(OR=4.63,95%CI:1.45-14.78,P=0.01)were significant factors associated with PH.These abnormalities had no significant impact on estimated glomerular filtration at discharge,6 months,1 year,or 2 years post-transplant.CONCLUSION Significant echocardiographic abnormalities persist in a potential transplant candidate despite cardiac clearance,although they don’t affect future graft function.Understanding the risk factors associated with these abnormalities may help clinicians address these factors pre-and post-transplant to achieve better outcomes.展开更多
Developing effective and long-term treatment strategies for rare and complex neurodegenerative diseases is challenging. One of the major roadblocks is the extensive heterogeneity among patients. This hinders understan...Developing effective and long-term treatment strategies for rare and complex neurodegenerative diseases is challenging. One of the major roadblocks is the extensive heterogeneity among patients. This hinders understanding the underlying disease-causing mechanisms and building solutions that have implications for a broad spectrum of patients. One potential solution is to develop personalized medicine approaches based on strategies that target the most prevalent cellular events that are perturbed in patients. Especially in patients with a known genetic mutation, it may be possible to understand how these mutations contribute to problems that lead to neurodegeneration. Protein–protein interaction analyses offer great advantages for revealing how proteins interact, which cellular events are primarily involved in these interactions, and how they become affected when key genes are mutated in patients. This line of investigation also suggests novel druggable targets for patients with different mutations. Here, we focus on alsin and spastin, two proteins that are identified as “causative” for amyotrophic lateral sclerosis and hereditary spastic paraplegia, respectively, when mutated. Our review analyzes the protein interactome for alsin and spastin, the canonical pathways that are primarily important for each protein domain, as well as compounds that are either Food and Drug Administration–approved or are in active clinical trials concerning the affected cellular pathways. This line of research begins to pave the way for personalized medicine approaches that are desperately needed for rare neurodegenerative diseases that are complex and heterogeneous.展开更多
This article revisits the concept of epistemological rupture by questioning the stark division between scientific and non-scientific thought. Drawing on the theory of representation, it contends that both forms of kno...This article revisits the concept of epistemological rupture by questioning the stark division between scientific and non-scientific thought. Drawing on the theory of representation, it contends that both forms of knowledge are socially constructed, moulded by communication, norms and group dynamics. Rather than labelling non-scientific thought as flawed or regressive, the discussion shows how decontextualization and recontextualization processes apply equally to everyday ‘natural' knowledge and formal science,exposing the social and historical contingencies shaping concepts. Consequently, rupture appears less a sudden break than a gradual threshold reached through dialectical transformations in cognition and society. Rather than conferring total superiority on science, ruptures highlight how certain discourses gain legitimacy while others become ‘non-knowledge'. The article concludes that science's dominance reflects broader power relationships and evolving modes of production and validation. By situating epistemological rupture within these processes, it illuminates how different knowledge forms coexist, evolve and sometimes conflict in stratified social fields—ultimately challenging a simplistic binary between scientific progress and supposedly primitive or natural thought. This viewpoint opens new possibilities for examining the shifting boundaries between rational explanations and the shared beliefs shaping collective reality and daily life.展开更多
This article discusses the innovative use of computed tomography radiomics combined with clinical factors to predict treatment response to first-line transarterial chemoembolization in hepatocellular carcinoma.Zhao et...This article discusses the innovative use of computed tomography radiomics combined with clinical factors to predict treatment response to first-line transarterial chemoembolization in hepatocellular carcinoma.Zhao et al developed a robust predictive model demonstrating high accuracy(area under the curve 0.92 in the training cohort)by integrating venous phase radiomic features with alphafetoprotein levels.This noninvasive approach enables early identification of patients unlikely to benefit from transarterial chemoembolization,allowing a timely transition to alternative therapies such as targeted agents or immunotherapy.Such precision strategies may improve clinical outcomes,optimize resource utilization,and increase survival in advanced hepatocellular carcinoma management.Future studies should emphasize external validation and broader clinical adoption.展开更多
BACKGROUND Gastric antral vascular ectasia(GAVE)accounts for up to 4%of nonvariceal upper gastrointestinal bleeding.Argon plasma coagulation and radiofrequency ablation have been primary treatment modalities for patie...BACKGROUND Gastric antral vascular ectasia(GAVE)accounts for up to 4%of nonvariceal upper gastrointestinal bleeding.Argon plasma coagulation and radiofrequency ablation have been primary treatment modalities for patients with linear and punctate subtypes,with a newer trend of utilization of endoscopic band ligation(EBL).This study evaluates the outcomes of patients undergoing treatment for nodular GAVE.We hypothesize that patients treated initially with EBL will achieve higher rates of clinical remission with fewer endoscopic treatments and a shorter treatment interval.AIM To investigate the effects of EBL as an initial treatment therapy on outcomes associated with nodular GAVE.METHODS A total of 37 patients at a tertiary medical center with nodular GAVE were included in this retrospective study.The study population was divided between those treated initially with EBL(initial EBL)and initial endoscopic thermal therapy.Pretreatment and post-treatment hemoglobin values,the model for end-stage liver disease scores,hospitalization rates,and other outcomes.Additionally,endoscopic treatment modality type and frequency were recorded,including radiofrequency ablation,argon plasma coagulation,and EBL.Continuous variables were compared using a t-test,while categorical variables were compared using Fisher’s exact.RESULTS Linear regression analysis displayed a positive relationship between the time interval from initial therapeutic esophagogastroduodenoscopy to first EBL treatment and overall treatment interval(t=7.39,P<0.001),as well as between the number of endoscopic treatments(t=8.09,P<0.001).Hemoglobin levels increased in both the initial EBL group(8.7 vs 11.4,P<0.001)and the initial endoscopic thermal therapy group(8.6 vs 10.4,P=0.042).Clinical remission rates were higher in the initial EBL group(90%vs 69%P=0.041),with a non-significant trend of higher endoscopic remission rates(57.1%vs 37.5%,P=0.270).CONCLUSION The observed trend favoring EBL,combined with its association with improved clinical remission and reduced treatment burden,supports its consideration as a preferred initial treatment approach.展开更多
BACKGROUND Congenital hallux varus(CHV)is a rare form of hallux varus deformity,characterized by medial deviation of the first toe at the metatarsophalangeal joint.It may be primary or secondary and presents clinicall...BACKGROUND Congenital hallux varus(CHV)is a rare form of hallux varus deformity,characterized by medial deviation of the first toe at the metatarsophalangeal joint.It may be primary or secondary and presents clinically with pain and asymmetry with footwear.CASE SUMMARY We documented a case of a 6-year-old girl with bilateral CHV,accompanied by adduction of the toes in the left foot.Clinical diagnosis was made by physical examination and X-ray imaging based on Bleck’s classification.Conservative treatment did not show any noticeable improvement,so the child underwent corrective surgeries on both feet.CONCLUSION The patient’s family history is positive,which requires us to take into account the importance of checking for a family history with any complaint of CHV,and both feet must be evaluated to confirm whether the deformity is unilateral or bilateral.展开更多
BACKGROUND Hip dysplasia is a widespread and debilitating musculoskeletal disorder that affects children.Its prevalence varies across different nations.AIM To evaluate the prevalence of developmental hip dysplasia(DDH...BACKGROUND Hip dysplasia is a widespread and debilitating musculoskeletal disorder that affects children.Its prevalence varies across different nations.AIM To evaluate the prevalence of developmental hip dysplasia(DDH)within the pediatric population of Al Jouf province.METHODS From January 2018 to December 2023,children with DDH from all cities of Al Jouf were included in this retrospective cross-sectional study.The disease prevalence was calculated for the entire province as well as for individual cities within the territory.RESULTS The study included 427 patients with DDH with an overall prevalence of 0.50%,or 5.0 per 1000 live births.At the city level,Sakaka had the highest prevalence at 14.2 per 1000 Live births followed by Qurayyat at 2.2 per 1000 live births.In contrast,cities like Suwayr,Abu Ajram,and Meegowa did not show any incidence of DDH.Significant differences were observed in the sociodemographic characteristics,such as age,sex,and nationality,across the different cities(P<0.05).CONCLUSION The prevalence of DDH in the Al Jouf province is high.The data delivers invaluable insights into the epidemiology of DDH in the Al Jouf locality.The findings highlight the need for targeted screening of DDH across the province.展开更多
Fractional differential equations(FDEs)provide a powerful tool for modeling systems with memory and non-local effects,but understanding their underlying structure remains a significant challenge.While numerous numeric...Fractional differential equations(FDEs)provide a powerful tool for modeling systems with memory and non-local effects,but understanding their underlying structure remains a significant challenge.While numerous numerical and semi-analytical methods exist to find solutions,new approaches are needed to analyze the intrinsic properties of the FDEs themselves.This paper introduces a novel computational framework for the structural analysis of FDEs involving iterated Caputo derivatives.The methodology is based on a transformation that recasts the original FDE into an equivalent higher-order form,represented as the sum of a closed-form,integer-order component G(y)and a residual fractional power seriesΨ(x).This transformed FDE is subsequently reduced to a first-order ordinary differential equation(ODE).The primary novelty of the proposed methodology lies in treating the structure of the integer-order component G(y)not as fixed,but as a parameterizable polynomial whose coefficients can be determined via global optimization.Using particle swarm optimization,the framework identifies an optimal ODE architecture by minimizing a dual objective that balances solution accuracy against a high-fidelity reference and the magnitude of the truncated residual series.The effectiveness of the approach is demonstrated on both a linear FDE and a nonlinear fractional Riccati equation.Results demonstrate that the framework successfully identifies an optimal,low-degree polynomial ODE architecture that is not necessarily identical to the forcing function of the original FDE.This work provides a new tool for analyzing the underlying structure of FDEs and gaining deeper insights into the interplay between local and non-local dynamics in fractional systems.展开更多
BACKGROUND External gastrointestinal fistulas(EGIFs)are serious postoperative complications associated with prolonged hospital stays,sepsis,malnutrition,and high mortality rates.Reducing gastrointestinal secretions wi...BACKGROUND External gastrointestinal fistulas(EGIFs)are serious postoperative complications associated with prolonged hospital stays,sepsis,malnutrition,and high mortality rates.Reducing gastrointestinal secretions with somatostatin or its analogues may facilitate fistula closure.The clinical effectiveness of these therapies,however,remains uncertain.AIM To investigate the effectiveness of somatostatin-based therapy for EGIFs.METHODS A systematic review and meta-analysis(Prospero CRD420251054344)of nine randomized controlled trials(442 patients)compared somatostatin-based therapies with standard care in tertiary care settings.Protocols included somatostatin,octreotide,or lanreotide,administered at various dosages(250 micrograms/hour intravenous infusion or 100 micrograms subcutaneous injection three times daily)for 7 to 56 days.Primary outcomes were fistula closure rates and time to closure.Secondary outcomes were hospital length of stay,complications,need for surgical intervention,and mortality.Mean differences and risk ratios(RRs)with 95%confidence intervals(CIs)were calculated using random-effects models.Risk of bias was assessed with the Cochrane RoB 2 tool.RESULTS There was no statistically significant difference in closure rate(RR:1.11,95%CI:0.95-1.28,P=0.19,I^(2)=0%)between 134/193 patients receiving somatostatin-based therapy and 99/170 control patients.Time to closure was reduced by 6.16 days(mean difference-6.16,95%CI:-7.44 to-4.88,P<0.001,I^(2)=0%)in 126 patients in intervention group vs 114 in control group.Hospital stay was shortened by 4.00 days(mean difference-4.00,95%CI:-7.99 to-0.01,P=0.05,I^(2)=0%)in 56 vs 62 patients.There were no differences in complications(RRs:0.76,95%CI:0.55-1.05),need for surgical intervention(RRs:0.67,95%CI:0.38-1.19),or mortality(RRs:0.77,95%CI:0.44-1.35).Limitations include small sample sizes,heterogeneity in treatment regimens,and inconsistent outcome definitions,which may affect generalizability.Limited data for some outcomes,such as hospital stay,and exclusion of some datasets for methodological reasons reduced statistical power.CONCLUSION Somatostatin-based therapies did not significantly improve fistula closure rates but were associated with shorter time to closure and hospital stay.Mortality,complications,and surgical intervention requirements remained unchanged,suggesting that these therapies may serve only as an adjunctive option in selected patients.展开更多
Third-space endoscopy(TSE)has emerged as an effective treatment modality for various gastrointestinal motility diseases and gastrointestinal tumors.TSE is based on the concept of working in the submucosa using a mucos...Third-space endoscopy(TSE)has emerged as an effective treatment modality for various gastrointestinal motility diseases and gastrointestinal tumors.TSE is based on the concept of working in the submucosa using a mucosal flap valve technique,which is the underlying premise for all TSE procedures;thus,some complications are shared across the spectrum of TSE procedures.Despite the high safety profiles of most TSE procedures,studies have reported various adverse events,including insufflation-related complications,bleeding,perforation,and infection.Although the occurrence rate of those complications is not very high,they sometimes result in critical conditions.No reports of chylous effusion following TSE procedures,particularly per-oral endoscopic myotomy,have been documented previously.We are presenting the first reported case of chylous pleural effusion after per-oral endoscopic myotomy.Additionally,we aim to present a comprehensive overview,discuss the existing data,and provide insights into pulmonary post-endoscopic complications in light of recent advancements in endoscopic procedures,especially TSE.展开更多
Cancer is one of the most complex diseases and the second leading cause of mortality worldwide.Due to its poor prognosis and challenges in diagnosis,eradicating cancer remains highly difficult.The limitations associat...Cancer is one of the most complex diseases and the second leading cause of mortality worldwide.Due to its poor prognosis and challenges in diagnosis,eradicating cancer remains highly difficult.The limitations associated with conventional therapies have led to the emergence of copious therapeutic strategies such as chemotherapy,phototherapy,starvation therapy,radiotherapy and immunotherapy;however,limited therapeutic efficacy,poor tumor cell selectivity and substantial adverse effects remain significant concern.Attributed to the expeditious advancement of nanotechnology,the amalgamation of nanomaterials with therapeutic approaches provides an opportunity to address the shortcomings of conventional chemotherapy.Metal-organic frameworks(MOFs),which consist of bridging ligands and ions/clusters connected by coordination bonds,have been widely used in cancer therapy to address the limitations of currently therapeutic interventions,such as poor efficacy,low stability and severe side effects.This potential arises from their tuneable porosities,high specific surface area-to-volume ratio,tailorable diameters,tractable morphologies,variegated compositions,biocompatibility and facile functionalization.We summarized the role of MOF-based nanoplatforms along with mechanistic insights into emerging avenues-such as cuproptosis,ferroptosis,cell-penetrating and biomimetic MOFs,and tumor microenvironment-responsive MOFs-alongside recent advancements in mono-and multifunctional cancer therapeutics.Theragnostic and imaging functionalities,as well as regulatory considerations and future prospects of MOF-based nanoplatforms utilized in cancer treatment,are also discussed.展开更多
BACKGROUND Children with autism spectrum disorder(ASD)face unique challenges in maintaining oral health due to sensory sensitivities,communication difficulties,and behavioral barriers.These factors,along with limited ...BACKGROUND Children with autism spectrum disorder(ASD)face unique challenges in maintaining oral health due to sensory sensitivities,communication difficulties,and behavioral barriers.These factors,along with limited access to ASD-trained dental professionals,increase their risk of dental caries,periodontal disease,bruxism,and other oral health issues.Despite growing awareness of these challenges,a comprehensive synthesis of evidence-based solutions remains lacking.AIM To review synthesizes existing research on dental problems in ASD,barriers to care,management strategies,and future directions for improved oral health outcomes.METHODS A systematic search of PubMed,Cochrane Library,and Scopus was conducted using predefined search terms.Related to ASD,dental health,and management strategies.Inclusion criteria encompassed studies focusing on children with ASD,dental health issues,and interventions.Data extraction included study design,participant characteristics,key findings,and intervention outcomes.The quality of studies was assessed using appropriate tools such as the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale.A narrative synthesis approach,incorporating thematic analysis,was utilized to evaluate the findings.RESULTS A total of 165 studies met the inclusion criteria.Children with ASD exhibited a higher prevalence of dental caries,gingivitis,bruxism,and malocclusion compared to neurotypical peers.Barriers to dental care included sensory sensitivities,communication difficulties,financial constraints,and a shortage of ASD-trained dental professionals.Effective interventions included desensitization programs,behavioral therapy,digital applications,and interdiscip-linary collaboration.Parental education and professional training were crucial for improving oral health outcomes.CONCLUSION Tailored dental care strategies,including sensory adaptations,behavioral interventions,and interdisciplinary collaboration,are essential for children with ASD.Standardized guidelines and long-term studies are needed to refine evidence-based protocols.Future research should explore digital interventions and probiotic applications in ASD dental care.展开更多
Objective:To study the relationship between qi stagnation constitution and suboptimal health status(SHS)or lifestyle.Methods:From 2012 to 2013,we conducted a cross-sectional survey of 24159 Chinese individuals aged 12...Objective:To study the relationship between qi stagnation constitution and suboptimal health status(SHS)or lifestyle.Methods:From 2012 to 2013,we conducted a cross-sectional survey of 24159 Chinese individuals aged 12-80 years.The qi stagnation constitution was assessed using the Constitution in Chinese Medicine Questionnaire.Health status was evaluated through medical records and the Subhealth Measurement Scale V1.0(SHMS V1.0).Health-promoting lifestyles were measured using the Health-Promoting Lifestyle Profile Ⅱ(HPLP-Ⅱ).Results:Of the 24159 participants,16.1%and 15.2%were classified as“always”and“sometimes”having the qi stagnation constitution,respectively.Those classified as“rarely”having the qi stagnation constitution scored higher on both the HPLP-Ⅱ and SHMS V1.0.The participants classified as“always”having the qi stagnation constitution showed a significant association with SHS or disease compared to other imbalanced constitutions.Those in the“always”category were approximately 21 times more likely to be classified as having SHS(odds ratio[OR]:21.17,95%confidence interval[CI]:15.74-28.45),whereas those in the“sometimes”category were approximately six times more likely(OR:5.89,95%CI:5.04-6.90).Accordingly,the qi stagnation constitution score was significantly associated with the diagnosis of SHS,with an area under the curve of 0.77(P<.001).A score of 18.75 yielded the highest Youden Index(0.407),with a sensitivity of 60.5%and a specificity of 80.3%.Significant associations were observed between health-promoting lifestyles and qi stagnation constitution severity in an ordinal regression analysis(P<.001).Protective factors included stress management(OR:1.59),self-actualization(OR:1.57),and exercise(OR:1.36).In contrast,poorer interpersonal relationships(OR:0.79),greater health responsibilities(OR:0.86),and poorer nutrition(OR:0.91)were associated with increased severity.Conclusion:Modulating the qi stagnation constitution through lifestyle interventions may help prevent the progression of SHS to disease,which aligns with core preventive principles in traditional Chinese medicine.展开更多
BACKGROUND Malakoplakia is a rare chronic granulomatous disease associated with gramnegative infection,predominantly by Escherichia coli.It is induced by defective phagolysosomal activity of the macrophages.Malakoplak...BACKGROUND Malakoplakia is a rare chronic granulomatous disease associated with gramnegative infection,predominantly by Escherichia coli.It is induced by defective phagolysosomal activity of the macrophages.Malakoplakia commonly affects the urinary bladder but has been shown to affect any solid organ,including the native and transplanted kidney.However,isolated malakoplakia of the kidney allograft is rare.Transplant recipients with compromised immune systems are more likely to develop malakoplakia.CASE SUMMARY We report three cases of kidney allograft parenchymal malakoplakia in kidney transplant recipients on immunosuppression that were successfully managed with good outcomes.We described the clinical characteristics of all the kidney allograft malakoplakia cases documented in the literature.A total of 55 cases of malakoplakia were reported in recipients with a history of kidney transplant.A total of 27 recipients had malakoplakia involving the allograft,and others had malakoplakia in other organs.The common presentations included allograft dysfunction,pyelonephritis,and allograft or systemic mass.Most recipients had favorable outcomes with appropriate management that included prolonged antibiotic therapy and adjustment of immunosuppression.We reviewed the published literature on all the cases of malakoplakia in kidney transplant recipients so far and summarized the etiology,management,and outcomes.CONCLUSION This case series provides an overview of the etiology,presentation,pathogenesis,and management of malakoplakia in kidney transplant recipients.展开更多
BACKGROUND The hepatosplenic schistosomiasis(HSS)with portal hypertension can cause vascular complications such as hepatopulmonary syndrome(HPS).HPS increases the risk of mortality in patients with cirrhosis;however,t...BACKGROUND The hepatosplenic schistosomiasis(HSS)with portal hypertension can cause vascular complications such as hepatopulmonary syndrome(HPS).HPS increases the risk of mortality in patients with cirrhosis;however,there is no data on the mortality of patients with HSS and HPS.AIM To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic(schistosomiasis)portal hypertension.METHODS From August 2023 to January 2024,medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed.Survival curves were created using the Kaplan-Meier method,and comparisons were performed using the log-rank test.Cox regression models estimated the hazard ratios(HR).RESULTS Overall,data of 113 patients were analyzed;most(55.8%)had HSS and concomitant cirrhosis(HSS/cirrhosis).Meanwhile,HPS was present in 39(34.5%)patients.Death occurred in 65 patients[57.5%];95%confidence interval(CI):48%-67%.The average time to death was lower in those with HPS when compared to those without HPS(3.37 years vs 5.65 years;P=0.017).According to the cause of liver disease,patients with HSS/cirrhosis died earlier,and their risk of death was twice as high compared with patients with HSS without cirrhosis(HR:2.17;95%CI:1.3-3.60;P=0.003).Meanwhile,there were no differences when comparing the two groups with and without HPS(HR:1.01;95%CI:0.59-1.73;P=0.967).CONCLUSION Patients with HSS and concomitant cirrhosis had a lower survival rate,but there was no difference in survival regardless of the presence of HPS.展开更多
基金funded by the Deanship of Graduate Studies and Scientific Research at Jouf University under grant No.(DGSSR-2025-02-01295).
文摘Alzheimer’s Disease(AD)is a progressive neurodegenerative disorder that significantly affects cognitive function,making early and accurate diagnosis essential.Traditional Deep Learning(DL)-based approaches often struggle with low-contrast MRI images,class imbalance,and suboptimal feature extraction.This paper develops a Hybrid DL system that unites MobileNetV2 with adaptive classification methods to boost Alzheimer’s diagnosis by processing MRI scans.Image enhancement is done using Contrast-Limited Adaptive Histogram Equalization(CLAHE)and Enhanced Super-Resolution Generative Adversarial Networks(ESRGAN).A classification robustness enhancement system integrates class weighting techniques and a Matthews Correlation Coefficient(MCC)-based evaluation method into the design.The trained and validated model gives a 98.88%accuracy rate and 0.9614 MCC score.We also performed a 10-fold cross-validation experiment with an average accuracy of 96.52%(±1.51),a loss of 0.1671,and an MCC score of 0.9429 across folds.The proposed framework outperforms the state-of-the-art models with a 98%weighted F1-score while decreasing misdiagnosis results for every AD stage.The model demonstrates apparent separation abilities between AD progression stages according to the results of the confusion matrix analysis.These results validate the effectiveness of hybrid DL models with adaptive preprocessing for early and reliable Alzheimer’s diagnosis,contributing to improved computer-aided diagnosis(CAD)systems in clinical practice.
文摘Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.
基金the Deanship of Graduate Studies and Scientific Research at Qassim University for financial support(QU-APC-2024-9/1).
文摘Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband networks.However,they consume important and scarce network resources such as bandwidth and processing power.There have been several reports of these control signaling turning into signaling storms halting network operations and causing the respective Telecom companies big financial losses.This paper draws its motivation from such real network disaster incidents attributed to signaling storms.In this paper,we present a thorough survey of the causes,of the signaling storm problems in 3GPP-based mobile broadband networks and discuss in detail their possible solutions and countermeasures.We provide relevant analytical models to help quantify the effect of the potential causes and benefits of their corresponding solutions.Another important contribution of this paper is the comparison of the possible causes and solutions/countermeasures,concerning their effect on several important network aspects such as architecture,additional signaling,fidelity,etc.,in the form of a table.This paper presents an update and an extension of our earlier conference publication.To our knowledge,no similar survey study exists on the subject.
文摘Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.
文摘Particle Swarm Optimization(PSO)has been utilized as a useful tool for solving intricate optimization problems for various applications in different fields.This paper attempts to carry out an update on PSO and gives a review of its recent developments and applications,but also provides arguments for its efficacy in resolving optimization problems in comparison with other algorithms.Covering six strategic areas,which include Data Mining,Machine Learning,Engineering Design,Energy Systems,Healthcare,and Robotics,the study demonstrates the versatility and effectiveness of the PSO.Experimental results are,however,used to show the strong and weak parts of PSO,and performance results are included in tables for ease of comparison.The results stress PSO’s efficiency in providing optimal solutions but also show that there are aspects that need to be improved through combination with algorithms or tuning to the parameters of the method.The review of the advantages and limitations of PSO is intended to provide academics and practitioners with a well-rounded view of the methods of employing such a tool most effectively and to encourage optimized designs of PSO in solving theoretical and practical problems in the future.
文摘BACKGROUND An echocardiogram is an essential tool in the evaluation of potential kidney transplant recipients(KTRs).Despite cardiac clearance,potential KTRs still have structural and functional abnormalities.Identifying the prevalence of these abnormalities and understanding their predictors is vital for optimizing pretransplant risk stratification and improving post-transplant outcomes.AIM To determine the prevalence of left ventricular hypertrophy(LVH),left ventricular systolic dysfunction(LVSD),diastolic dysfunction(DD),pulmonary hypertension(PH),and their predictors,and to assess their impact on graft function in pre-transplant candidates.METHODS The study included all successful transplant candidates older than 14 who had a baseline echocardiogram.Binary logistic regression models were constructed to identify factors associated with LVH,LVSD,DD,and PH.RESULTS Out of 259 patients,LVH was present in 64%(166),12%(31)had LVSD,27.5%(71)had DD,and 66(25.5%)had PH.Independent predictors of LVH included male gender[odds ratio(OR):2.51;95%CI:1.17-5.41 P=0.02],PH(OR=2.07;95%CI:1.11-3.86;P=0.02),DD(OR:2.47;95%CI:1.29-4.73;P=0.006),and dyslipidemia(OR=1.94;95%CI:1.07-3.53;P=0.03).Predictors for LVSD included patients with DD(OR=3.3,95%CI:1.41-7.81;P=0.006)and a family history of coronary artery disease(OR=4.50,95%CI:1.33-15.20;P=0.015).Peritoneal dialysis was an independent predictor for DD(OR=10.03;95%CI:1.71-58.94,P=0.011).The presence of LVH(OR=3.32,95%CI:1.05-10.55,P=0.04)and mild to moderate or moderate to severe mitral regurgitation(OR=4.63,95%CI:1.45-14.78,P=0.01)were significant factors associated with PH.These abnormalities had no significant impact on estimated glomerular filtration at discharge,6 months,1 year,or 2 years post-transplant.CONCLUSION Significant echocardiographic abnormalities persist in a potential transplant candidate despite cardiac clearance,although they don’t affect future graft function.Understanding the risk factors associated with these abnormalities may help clinicians address these factors pre-and post-transplant to achieve better outcomes.
基金funded by NIH-NIA R01AG061708 (to PHO)Patrick Grange Memorial Foundation (to PHO)+1 种基金A Long Swim (to PHO)CureSPG4 Foundation (to PHO)。
文摘Developing effective and long-term treatment strategies for rare and complex neurodegenerative diseases is challenging. One of the major roadblocks is the extensive heterogeneity among patients. This hinders understanding the underlying disease-causing mechanisms and building solutions that have implications for a broad spectrum of patients. One potential solution is to develop personalized medicine approaches based on strategies that target the most prevalent cellular events that are perturbed in patients. Especially in patients with a known genetic mutation, it may be possible to understand how these mutations contribute to problems that lead to neurodegeneration. Protein–protein interaction analyses offer great advantages for revealing how proteins interact, which cellular events are primarily involved in these interactions, and how they become affected when key genes are mutated in patients. This line of investigation also suggests novel druggable targets for patients with different mutations. Here, we focus on alsin and spastin, two proteins that are identified as “causative” for amyotrophic lateral sclerosis and hereditary spastic paraplegia, respectively, when mutated. Our review analyzes the protein interactome for alsin and spastin, the canonical pathways that are primarily important for each protein domain, as well as compounds that are either Food and Drug Administration–approved or are in active clinical trials concerning the affected cellular pathways. This line of research begins to pave the way for personalized medicine approaches that are desperately needed for rare neurodegenerative diseases that are complex and heterogeneous.
文摘This article revisits the concept of epistemological rupture by questioning the stark division between scientific and non-scientific thought. Drawing on the theory of representation, it contends that both forms of knowledge are socially constructed, moulded by communication, norms and group dynamics. Rather than labelling non-scientific thought as flawed or regressive, the discussion shows how decontextualization and recontextualization processes apply equally to everyday ‘natural' knowledge and formal science,exposing the social and historical contingencies shaping concepts. Consequently, rupture appears less a sudden break than a gradual threshold reached through dialectical transformations in cognition and society. Rather than conferring total superiority on science, ruptures highlight how certain discourses gain legitimacy while others become ‘non-knowledge'. The article concludes that science's dominance reflects broader power relationships and evolving modes of production and validation. By situating epistemological rupture within these processes, it illuminates how different knowledge forms coexist, evolve and sometimes conflict in stratified social fields—ultimately challenging a simplistic binary between scientific progress and supposedly primitive or natural thought. This viewpoint opens new possibilities for examining the shifting boundaries between rational explanations and the shared beliefs shaping collective reality and daily life.
文摘This article discusses the innovative use of computed tomography radiomics combined with clinical factors to predict treatment response to first-line transarterial chemoembolization in hepatocellular carcinoma.Zhao et al developed a robust predictive model demonstrating high accuracy(area under the curve 0.92 in the training cohort)by integrating venous phase radiomic features with alphafetoprotein levels.This noninvasive approach enables early identification of patients unlikely to benefit from transarterial chemoembolization,allowing a timely transition to alternative therapies such as targeted agents or immunotherapy.Such precision strategies may improve clinical outcomes,optimize resource utilization,and increase survival in advanced hepatocellular carcinoma management.Future studies should emphasize external validation and broader clinical adoption.
文摘BACKGROUND Gastric antral vascular ectasia(GAVE)accounts for up to 4%of nonvariceal upper gastrointestinal bleeding.Argon plasma coagulation and radiofrequency ablation have been primary treatment modalities for patients with linear and punctate subtypes,with a newer trend of utilization of endoscopic band ligation(EBL).This study evaluates the outcomes of patients undergoing treatment for nodular GAVE.We hypothesize that patients treated initially with EBL will achieve higher rates of clinical remission with fewer endoscopic treatments and a shorter treatment interval.AIM To investigate the effects of EBL as an initial treatment therapy on outcomes associated with nodular GAVE.METHODS A total of 37 patients at a tertiary medical center with nodular GAVE were included in this retrospective study.The study population was divided between those treated initially with EBL(initial EBL)and initial endoscopic thermal therapy.Pretreatment and post-treatment hemoglobin values,the model for end-stage liver disease scores,hospitalization rates,and other outcomes.Additionally,endoscopic treatment modality type and frequency were recorded,including radiofrequency ablation,argon plasma coagulation,and EBL.Continuous variables were compared using a t-test,while categorical variables were compared using Fisher’s exact.RESULTS Linear regression analysis displayed a positive relationship between the time interval from initial therapeutic esophagogastroduodenoscopy to first EBL treatment and overall treatment interval(t=7.39,P<0.001),as well as between the number of endoscopic treatments(t=8.09,P<0.001).Hemoglobin levels increased in both the initial EBL group(8.7 vs 11.4,P<0.001)and the initial endoscopic thermal therapy group(8.6 vs 10.4,P=0.042).Clinical remission rates were higher in the initial EBL group(90%vs 69%P=0.041),with a non-significant trend of higher endoscopic remission rates(57.1%vs 37.5%,P=0.270).CONCLUSION The observed trend favoring EBL,combined with its association with improved clinical remission and reduced treatment burden,supports its consideration as a preferred initial treatment approach.
文摘BACKGROUND Congenital hallux varus(CHV)is a rare form of hallux varus deformity,characterized by medial deviation of the first toe at the metatarsophalangeal joint.It may be primary or secondary and presents clinically with pain and asymmetry with footwear.CASE SUMMARY We documented a case of a 6-year-old girl with bilateral CHV,accompanied by adduction of the toes in the left foot.Clinical diagnosis was made by physical examination and X-ray imaging based on Bleck’s classification.Conservative treatment did not show any noticeable improvement,so the child underwent corrective surgeries on both feet.CONCLUSION The patient’s family history is positive,which requires us to take into account the importance of checking for a family history with any complaint of CHV,and both feet must be evaluated to confirm whether the deformity is unilateral or bilateral.
文摘BACKGROUND Hip dysplasia is a widespread and debilitating musculoskeletal disorder that affects children.Its prevalence varies across different nations.AIM To evaluate the prevalence of developmental hip dysplasia(DDH)within the pediatric population of Al Jouf province.METHODS From January 2018 to December 2023,children with DDH from all cities of Al Jouf were included in this retrospective cross-sectional study.The disease prevalence was calculated for the entire province as well as for individual cities within the territory.RESULTS The study included 427 patients with DDH with an overall prevalence of 0.50%,or 5.0 per 1000 live births.At the city level,Sakaka had the highest prevalence at 14.2 per 1000 Live births followed by Qurayyat at 2.2 per 1000 live births.In contrast,cities like Suwayr,Abu Ajram,and Meegowa did not show any incidence of DDH.Significant differences were observed in the sociodemographic characteristics,such as age,sex,and nationality,across the different cities(P<0.05).CONCLUSION The prevalence of DDH in the Al Jouf province is high.The data delivers invaluable insights into the epidemiology of DDH in the Al Jouf locality.The findings highlight the need for targeted screening of DDH across the province.
基金Research Council of Lithuania(LMTLT),agreement No.S-PD-24-120Research Council of Lithuania(LMTLT),agreement No.S-PD-24-120funded by the Research Council of Lithuania.
文摘Fractional differential equations(FDEs)provide a powerful tool for modeling systems with memory and non-local effects,but understanding their underlying structure remains a significant challenge.While numerous numerical and semi-analytical methods exist to find solutions,new approaches are needed to analyze the intrinsic properties of the FDEs themselves.This paper introduces a novel computational framework for the structural analysis of FDEs involving iterated Caputo derivatives.The methodology is based on a transformation that recasts the original FDE into an equivalent higher-order form,represented as the sum of a closed-form,integer-order component G(y)and a residual fractional power seriesΨ(x).This transformed FDE is subsequently reduced to a first-order ordinary differential equation(ODE).The primary novelty of the proposed methodology lies in treating the structure of the integer-order component G(y)not as fixed,but as a parameterizable polynomial whose coefficients can be determined via global optimization.Using particle swarm optimization,the framework identifies an optimal ODE architecture by minimizing a dual objective that balances solution accuracy against a high-fidelity reference and the magnitude of the truncated residual series.The effectiveness of the approach is demonstrated on both a linear FDE and a nonlinear fractional Riccati equation.Results demonstrate that the framework successfully identifies an optimal,low-degree polynomial ODE architecture that is not necessarily identical to the forcing function of the original FDE.This work provides a new tool for analyzing the underlying structure of FDEs and gaining deeper insights into the interplay between local and non-local dynamics in fractional systems.
文摘BACKGROUND External gastrointestinal fistulas(EGIFs)are serious postoperative complications associated with prolonged hospital stays,sepsis,malnutrition,and high mortality rates.Reducing gastrointestinal secretions with somatostatin or its analogues may facilitate fistula closure.The clinical effectiveness of these therapies,however,remains uncertain.AIM To investigate the effectiveness of somatostatin-based therapy for EGIFs.METHODS A systematic review and meta-analysis(Prospero CRD420251054344)of nine randomized controlled trials(442 patients)compared somatostatin-based therapies with standard care in tertiary care settings.Protocols included somatostatin,octreotide,or lanreotide,administered at various dosages(250 micrograms/hour intravenous infusion or 100 micrograms subcutaneous injection three times daily)for 7 to 56 days.Primary outcomes were fistula closure rates and time to closure.Secondary outcomes were hospital length of stay,complications,need for surgical intervention,and mortality.Mean differences and risk ratios(RRs)with 95%confidence intervals(CIs)were calculated using random-effects models.Risk of bias was assessed with the Cochrane RoB 2 tool.RESULTS There was no statistically significant difference in closure rate(RR:1.11,95%CI:0.95-1.28,P=0.19,I^(2)=0%)between 134/193 patients receiving somatostatin-based therapy and 99/170 control patients.Time to closure was reduced by 6.16 days(mean difference-6.16,95%CI:-7.44 to-4.88,P<0.001,I^(2)=0%)in 126 patients in intervention group vs 114 in control group.Hospital stay was shortened by 4.00 days(mean difference-4.00,95%CI:-7.99 to-0.01,P=0.05,I^(2)=0%)in 56 vs 62 patients.There were no differences in complications(RRs:0.76,95%CI:0.55-1.05),need for surgical intervention(RRs:0.67,95%CI:0.38-1.19),or mortality(RRs:0.77,95%CI:0.44-1.35).Limitations include small sample sizes,heterogeneity in treatment regimens,and inconsistent outcome definitions,which may affect generalizability.Limited data for some outcomes,such as hospital stay,and exclusion of some datasets for methodological reasons reduced statistical power.CONCLUSION Somatostatin-based therapies did not significantly improve fistula closure rates but were associated with shorter time to closure and hospital stay.Mortality,complications,and surgical intervention requirements remained unchanged,suggesting that these therapies may serve only as an adjunctive option in selected patients.
文摘Third-space endoscopy(TSE)has emerged as an effective treatment modality for various gastrointestinal motility diseases and gastrointestinal tumors.TSE is based on the concept of working in the submucosa using a mucosal flap valve technique,which is the underlying premise for all TSE procedures;thus,some complications are shared across the spectrum of TSE procedures.Despite the high safety profiles of most TSE procedures,studies have reported various adverse events,including insufflation-related complications,bleeding,perforation,and infection.Although the occurrence rate of those complications is not very high,they sometimes result in critical conditions.No reports of chylous effusion following TSE procedures,particularly per-oral endoscopic myotomy,have been documented previously.We are presenting the first reported case of chylous pleural effusion after per-oral endoscopic myotomy.Additionally,we aim to present a comprehensive overview,discuss the existing data,and provide insights into pulmonary post-endoscopic complications in light of recent advancements in endoscopic procedures,especially TSE.
基金funding support by the Department of Pharmaceuticals(DoP),Ministry of Chemicals and Fertilizers,Govt.of India to“Pharmaceutical Innovation and Translational Research Lab”(PITRL),National Institute of Pharmaceutical Education and Research(NIPER),Hyderabad,INDIA.
文摘Cancer is one of the most complex diseases and the second leading cause of mortality worldwide.Due to its poor prognosis and challenges in diagnosis,eradicating cancer remains highly difficult.The limitations associated with conventional therapies have led to the emergence of copious therapeutic strategies such as chemotherapy,phototherapy,starvation therapy,radiotherapy and immunotherapy;however,limited therapeutic efficacy,poor tumor cell selectivity and substantial adverse effects remain significant concern.Attributed to the expeditious advancement of nanotechnology,the amalgamation of nanomaterials with therapeutic approaches provides an opportunity to address the shortcomings of conventional chemotherapy.Metal-organic frameworks(MOFs),which consist of bridging ligands and ions/clusters connected by coordination bonds,have been widely used in cancer therapy to address the limitations of currently therapeutic interventions,such as poor efficacy,low stability and severe side effects.This potential arises from their tuneable porosities,high specific surface area-to-volume ratio,tailorable diameters,tractable morphologies,variegated compositions,biocompatibility and facile functionalization.We summarized the role of MOF-based nanoplatforms along with mechanistic insights into emerging avenues-such as cuproptosis,ferroptosis,cell-penetrating and biomimetic MOFs,and tumor microenvironment-responsive MOFs-alongside recent advancements in mono-and multifunctional cancer therapeutics.Theragnostic and imaging functionalities,as well as regulatory considerations and future prospects of MOF-based nanoplatforms utilized in cancer treatment,are also discussed.
文摘BACKGROUND Children with autism spectrum disorder(ASD)face unique challenges in maintaining oral health due to sensory sensitivities,communication difficulties,and behavioral barriers.These factors,along with limited access to ASD-trained dental professionals,increase their risk of dental caries,periodontal disease,bruxism,and other oral health issues.Despite growing awareness of these challenges,a comprehensive synthesis of evidence-based solutions remains lacking.AIM To review synthesizes existing research on dental problems in ASD,barriers to care,management strategies,and future directions for improved oral health outcomes.METHODS A systematic search of PubMed,Cochrane Library,and Scopus was conducted using predefined search terms.Related to ASD,dental health,and management strategies.Inclusion criteria encompassed studies focusing on children with ASD,dental health issues,and interventions.Data extraction included study design,participant characteristics,key findings,and intervention outcomes.The quality of studies was assessed using appropriate tools such as the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale.A narrative synthesis approach,incorporating thematic analysis,was utilized to evaluate the findings.RESULTS A total of 165 studies met the inclusion criteria.Children with ASD exhibited a higher prevalence of dental caries,gingivitis,bruxism,and malocclusion compared to neurotypical peers.Barriers to dental care included sensory sensitivities,communication difficulties,financial constraints,and a shortage of ASD-trained dental professionals.Effective interventions included desensitization programs,behavioral therapy,digital applications,and interdiscip-linary collaboration.Parental education and professional training were crucial for improving oral health outcomes.CONCLUSION Tailored dental care strategies,including sensory adaptations,behavioral interventions,and interdisciplinary collaboration,are essential for children with ASD.Standardized guidelines and long-term studies are needed to refine evidence-based protocols.Future research should explore digital interventions and probiotic applications in ASD dental care.
基金supported by the National Natural Science Foundation of China(T2341019)NSFC-Guangdong Joint Fund(U1132001)+9 种基金General Program of the National Natural Science Foundation of China(82174243 and 82204948)Natural Science Foundation of Guangdong Province,China(2023A1515110757)Guangzhou Science and Technology Plan Project(2024B03J1343)Major Scientific and Technological Project of Guangzhou Municipal Health Commission(20252D003)Research Project of Traditional Chinese Medicine Bureau of Guangdong Province(20241208)General project of Beijing Natural Science Foundation(7242227)Fundamental Research Funds for the Central Universities(BZY-JMZY-2022-001 and 2023-JYB-JBZD-009)High-level Key Discipline of the National Administration of Traditional Chinese Medicine-Traditional Chinese Constitutional Medicine(zyyzdxk-2023251)Major Science and Technology Special Projects in Hubei Province(2023BCA005)the Chief Scientist Research Project of Hubei Shizhen Laboratory(HSL2024SX0002).
文摘Objective:To study the relationship between qi stagnation constitution and suboptimal health status(SHS)or lifestyle.Methods:From 2012 to 2013,we conducted a cross-sectional survey of 24159 Chinese individuals aged 12-80 years.The qi stagnation constitution was assessed using the Constitution in Chinese Medicine Questionnaire.Health status was evaluated through medical records and the Subhealth Measurement Scale V1.0(SHMS V1.0).Health-promoting lifestyles were measured using the Health-Promoting Lifestyle Profile Ⅱ(HPLP-Ⅱ).Results:Of the 24159 participants,16.1%and 15.2%were classified as“always”and“sometimes”having the qi stagnation constitution,respectively.Those classified as“rarely”having the qi stagnation constitution scored higher on both the HPLP-Ⅱ and SHMS V1.0.The participants classified as“always”having the qi stagnation constitution showed a significant association with SHS or disease compared to other imbalanced constitutions.Those in the“always”category were approximately 21 times more likely to be classified as having SHS(odds ratio[OR]:21.17,95%confidence interval[CI]:15.74-28.45),whereas those in the“sometimes”category were approximately six times more likely(OR:5.89,95%CI:5.04-6.90).Accordingly,the qi stagnation constitution score was significantly associated with the diagnosis of SHS,with an area under the curve of 0.77(P<.001).A score of 18.75 yielded the highest Youden Index(0.407),with a sensitivity of 60.5%and a specificity of 80.3%.Significant associations were observed between health-promoting lifestyles and qi stagnation constitution severity in an ordinal regression analysis(P<.001).Protective factors included stress management(OR:1.59),self-actualization(OR:1.57),and exercise(OR:1.36).In contrast,poorer interpersonal relationships(OR:0.79),greater health responsibilities(OR:0.86),and poorer nutrition(OR:0.91)were associated with increased severity.Conclusion:Modulating the qi stagnation constitution through lifestyle interventions may help prevent the progression of SHS to disease,which aligns with core preventive principles in traditional Chinese medicine.
文摘BACKGROUND Malakoplakia is a rare chronic granulomatous disease associated with gramnegative infection,predominantly by Escherichia coli.It is induced by defective phagolysosomal activity of the macrophages.Malakoplakia commonly affects the urinary bladder but has been shown to affect any solid organ,including the native and transplanted kidney.However,isolated malakoplakia of the kidney allograft is rare.Transplant recipients with compromised immune systems are more likely to develop malakoplakia.CASE SUMMARY We report three cases of kidney allograft parenchymal malakoplakia in kidney transplant recipients on immunosuppression that were successfully managed with good outcomes.We described the clinical characteristics of all the kidney allograft malakoplakia cases documented in the literature.A total of 55 cases of malakoplakia were reported in recipients with a history of kidney transplant.A total of 27 recipients had malakoplakia involving the allograft,and others had malakoplakia in other organs.The common presentations included allograft dysfunction,pyelonephritis,and allograft or systemic mass.Most recipients had favorable outcomes with appropriate management that included prolonged antibiotic therapy and adjustment of immunosuppression.We reviewed the published literature on all the cases of malakoplakia in kidney transplant recipients so far and summarized the etiology,management,and outcomes.CONCLUSION This case series provides an overview of the etiology,presentation,pathogenesis,and management of malakoplakia in kidney transplant recipients.
文摘BACKGROUND The hepatosplenic schistosomiasis(HSS)with portal hypertension can cause vascular complications such as hepatopulmonary syndrome(HPS).HPS increases the risk of mortality in patients with cirrhosis;however,there is no data on the mortality of patients with HSS and HPS.AIM To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic(schistosomiasis)portal hypertension.METHODS From August 2023 to January 2024,medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed.Survival curves were created using the Kaplan-Meier method,and comparisons were performed using the log-rank test.Cox regression models estimated the hazard ratios(HR).RESULTS Overall,data of 113 patients were analyzed;most(55.8%)had HSS and concomitant cirrhosis(HSS/cirrhosis).Meanwhile,HPS was present in 39(34.5%)patients.Death occurred in 65 patients[57.5%];95%confidence interval(CI):48%-67%.The average time to death was lower in those with HPS when compared to those without HPS(3.37 years vs 5.65 years;P=0.017).According to the cause of liver disease,patients with HSS/cirrhosis died earlier,and their risk of death was twice as high compared with patients with HSS without cirrhosis(HR:2.17;95%CI:1.3-3.60;P=0.003).Meanwhile,there were no differences when comparing the two groups with and without HPS(HR:1.01;95%CI:0.59-1.73;P=0.967).CONCLUSION Patients with HSS and concomitant cirrhosis had a lower survival rate,but there was no difference in survival regardless of the presence of HPS.
