Identification Of Low Molecular Weight Metabolites That Can Predict Low Dose Aspirin Induced Gastric Toxicity And Resistance In Rats And Stable Coronary Artery Disease Patients Using Nmr-Based Pharmacometabonomics

Low Dose Aspirin (LDA) is the cornerstone of secondary prevention in coronary artery disease (CAD). Despite its established efficacy, it suffers a major setback of causing gastrointestinal toxicity. In addition, some patients still experience atherothrombotic events while on aspirin secondary prophylaxis, a term known as aspirin resistance. The reasons why some people experience its serious gastric toxicity while others do not is still poorly understood. Likewise, the reason why some patients are adequately protected from a secondary event while others experience another event is yet to be adequately understood. The aim of this project was to evaluate the use of pharmacometabonomics, in finding novel metabolites that can predict aspirin-induced gastric toxicity and aspirin resistance in rats. It also aimed at validating such metabolites in CAD patients. The study involved 2 phases, namely the discovery phase in rats and the validation phase in humans. Pre-dose models were developed using H-NMR spectroscopic data from the biofluids of Sprague Dawley (SD) rats and the respective class identities of the rats. The data were initially subjected to multivariate statistical analysis including principal component analysis and orthogonal-partial least square discriminant analysis. The class identities were either gastric toxic versus non-gastric toxic or aspirin resistant versus aspirin sensitive for the gastric toxicity and aspirin resistance studies respectively

Evaluation of the Impact of Antibiotic Stewardship Program on Antibiotics Utilization As Surgical Prophylaxis at a Secondary Hospital in United Arab Emirates

Background: Overuse or misuse of antibiotics, especially broad-spectrum antibiotics, may result in nosocomial infections, leading to increased mortality rate, extended hospital stay, and cost. The antibiotic stewardship program (ASP) is introduced to combat the irrational use of antibiotics. Objective: To evaluate the effectiveness of the newly implemented surgical antibiotics prophylaxis (SAP) guidelines. Materials & Methods: This study was a retrospective, hospital-based study conducted over five years (2017 to 2022), one year before and four years after implementation of ASP at Dibba hospital, United Arab Emirates. The study included adult patients who undergo surgical operations during the study period. Results: Out of 3290 patients included in the study,1756 received SAP. The percentage of patients who received SAP improved from pre-ASP 53.6% to 56.7% four years post-ASP. The most frequently used SAP in pre-ASP was amoxicillin with clavulanic acid (decreased from 44% to 0%), in contrast to Cefazolin (increased from 0% to 83%). The appropriate selection of SAP was improved from 42% to 97%, appropriate SAP timing increased from 81% to 98%, appropriate SAP duration was noticeably enhanced from 46% to 98%. The incidence of surgical site infection (SSI) decreased from 34.82% in pre-ASP to 7.99%, 17.91%, 5.40%, and 3.71% in the first, second, third, and fourth post-ASP years, respectively. Conclusions: Four years Implementation of SAP guidelines have significantly improved the rational use of antibiotics resulting in improved clinical outcomes

Obstacle Avoidance Scheme Based Elite Opposition Bat Algorithm for Unmanned Ground Vehicles

Unmanned Ground Vehicles (UGVs) are intelligent vehicles that operate in an obstacle environment without an onboard human operator but can be controlled autonomously using an obstacle avoidance system or by a human operator from a remote location. In this research, an obstacle avoidance scheme-based elite opposition bat algorithm (EOBA) for UGVs was developed. The obstacle avoidance system comprises a simulation map, a perception system for obstacle detection, and the implementation of EOBA for generating an optimal collision-free path that led the UGV to the goal location. Three distance thresholds of 0.1 m, 0.2 m, and 0.3 m was used in the obstacle detection stage to determine the optimal distance threshold for obstacle avoidance. The performance of the obstacle avoidance scheme was compared with that of bat algorithm (BA) and particle swarm optimization (PSO) techniques. The simulation results show that the distance threshold of 0.3 m is the optimal threshold for obstacle avoidance provided that the size of the obstacle does not exceed the size of the UGV. The EOBA based scheme when compared with BA and PSO schemes obtained an average percentage reduction of 21.82% in terms of path length and 60% in terms of time taken to reach the target destination. The uniqueness of this approach is that the UGV avoid collision with an obstacle at a distance of 0.3 m from nearby obstacles as against taking three steps backward before avoiding obstacl

A Specific Routing Protocol for Flying Adhoc Network

This paper presents a novel data and timed control routing protocol which is Flying Adhoc Network (FANET) specific. The developed FANET specific routing protocol laid emphasis on the route connectivity in the network by considering the captured data size, minimum allowable distance between randomly moving nodes and connection time. The performance of the proposed FANET specific routing protocol was simulated using NS3. The obtained throughput value for the routing protocol fluctuated between 742.064kbps and 755.083kbps as data are exchanged between nodes. This showed that when all the UAVs are on the network and communicating with one another, the throughput is flatline and not plummet. This implies consistency as nodes join and leave the network. The packet delivery ratio obtained for the FSRP during simulation was 96.13%. These results implied that data is successfully transmitted between the UAV acting as server and UAV acting as client on the network

A Hybrid Fuzzy Time Series Technique for Forecasting Univariate Data

In this paper a hybrid forecasting technique that integrates Cat Swarm optimization Clustering (CSO-C) and Particle Swarm Optimization (PSO) with Fuzzy Time Series (FTS) forecasting is presented. In the three stages of FTS, CSO-C found application at the fuzzification module where its efficient capability in terms of data classification was utilized to neutrally divide the universe of discourse into unequal parts. Then, disambiguated fuzzy relationships were obtained using Fuzzy Set Group (FSG). In the final stage, PSO was adopted for optimization; by tuning weights assigned to fuzzy sets in a rule. This rule is a fuzzy logical relationship induced from FSG. The forecasting results showed that the proposed method outperformed other existing methods; using RMSE and MAPE as performance metrics.            

The management of myocardial injury related to SARS-CoV-2 pneumonia

The global evolution of the SARS-CoV-2 virus is known to all. The diagnosis of SARS-CoV-2 pneumonia is expected to worsen, and mortality will be higher when combined with myocardial injury (MI). The combination of novel coronavirus infections in patients with MI can cause confusion in diagnosis and assessment, with each condition exacerbating the other, and increasing the complexity and difficulty of treatment. It would be a formidable challenge for clinical practice to deal with this situation. Therefore, this review aims to gather literature on the progress in managing MI related to SARS-CoV-2 pneumonia. This article reviews the definition, pathogenesis, clinical evaluation, management, and treatment plan for MI related to SARS-CoV-2 pneumonia based on the most recent literature, diagnosis, and treatment trial reports. Many studies have shown that early diagnosis and implementation of targeted treatment measures according to the different stages of disease can reduce the mortality rate among patients with MI related to SARS-CoV-2 pneumonia. The reviewed studies show that multiple strategies have been adopted for the management of MI related to COVID-19. Clinicians should closely monitor SARS-CoV-2 pneumonia patients with MI, as their condition can rapidly deteriorate and progress to heart failure, acute myocardial infarction, and/or cardiogenic shock. In addition, appropriate measures need to be implemented in the diagnosis and treatment to provide reasonable care to the patient

The Effect of Dead-Time and Damping Ratio on the Relative Performance of MPC and PID on Second Order Systems

Most industrial processes are regulated using PID control. However, many such processes often operate far from optimally because PID may not be the most suitable control method. Moreover, second-order models represent a large class of all controlled systems. This work studies the performance of some commonly used industrial PID controllers relative to MPC to understand when it is more suitable to use Model predictive control. MPC is used for this comparison because it has been the most successful industrial controller after PID. It can be concluded from the studies that improved performance can be achieved with MPC, even for modest dead time and when the damping ratio is relatively low. These improvements are prominent for dead-time dominant systems, whose dead-time to time-constant ratio is at least three

Wind farm layout optimisation considering commercial wind turbines using parallel reference points, radial space division and reference vector guided EA-based approach

In this study, a new multiobjective optimisation-based approach for Wind Farm Layout Optimisation (WFLO) is developed. The proposed approach combines four distinct Evolutionary algorithms (EA) based on multiobjective optimisation methods into a more powerful parallel method. The four combined algorithms are: the Radial Space Division based EA (RSEA), the Reference Points based EA (RPEA), RVEA embedded with the reference vector regeneration strategy (RVEAa) and the Reference Vector Guided EA (RVEA). The proposed approach is PRPSVEAa, where the letter P stands for parallel, and the remaining letters are used from different combined methods. In this research, four case studies have been investigated using four different commercial wind turbines where the hub heights of Wind Turbines (WT) are kept the same in some cases and varied in some. The results indicate that the Pareto set of solutions varies from each other with different numbers of WT as they spread over a wide region. This offers the designer the most suitable layout solution based on technical and economic factors. The obtained result can also be used to plan for future extensions of the research work

Association between CYP3A4/CYP3A5 genetic polymorphisms and treatment outcomes of atorvastatin worldwide: is there enough research on the Egyptian population?

Abstract Introduction Atorvastatin is regarded as the most frequently prescribed statin worldwide for dyslipidemia. However, clinical response and risk of adverse effects to statin therapy are associated with genetic variations. Numerous research linked statins pharmacokinetics (PK) variations to genetic polymorphisms in cytochromes P450 (CYPs) metabolic enzymes. Objective This article reviews the association between CYP3A4/5 genetic variations and response to atorvastatin therapy globally, which includes atorvastatin PK, and the risk for adverse reactions, with a hint to the Egyptians. Methods Up to March 30, 2022, electronic medical databases like PubMed, Web of Science, MEDLINE, and Egyptian Knowledge Bank (EKB) were searched. All articles that highlighted the relationship between CYP3A4/5 genetic polymorphisms and atorvastatin efficacy/safety profile were included in this review. Results Initially, 492 articles were retrieved after an exhaustive search. There were 24 articles included according to the inclusion criteria. Findings of association studies of CYP3A4/5 genetic polymorphisms with response to atorvastatin varied among different ethnicities. CYP3A4*1B was associated with better therapeutic outcomes after atorvastatin therapy in Chileans and vice versa in Americans. Caucasians with myalgia while using atorvastatin were at significant risk of suffering severe muscle damage if they were carriers of CYP3A5*3/*3. As far as we can report for the Egyptian population, the impact of CYP3A4/5 genetic variations on the response to atorvastatin therapy was understudied. Conclusion More pharmacogenetic studies amongst diverse populations worldwide, like the Egyptian population, are necessary to detect further atorvastatin-gene interactions. Graphical Abstrac

Antibiotics self-medication among undergraduate pharmacy students in Northern Nigeria

Introduction: The burden of antibiotic self-medication (ASM) is increasing and becoming a global health threat due to antibiotics resistance. However, little is known about ASM among undergraduate pharmacy students who are the future custodians of medicines including antibiotics. Therefore, this study aims to develop, validate and utilize an online survey tool to investigate the prevalence of ASM among undergraduate pharmacy students in Northern Nigeria. Methods: A cross-sectional online survey form was developed, validated by face validity, content validity, and pilot study. The hyperlink to the online survey form was shared with undergraduate pharmacy students in northern Nigeria via WhatsApp, Facebook, and Twitter. Data were collected from eligible participants and analyzed using descriptive statistic. Results: A total of 217 students responded to the online survey, with a completion rate of 100%. Of the total number of respondents, 200 (92.2%) reported practicing ASM at least once in their lifetime. The major reasons for ASM were previous knowledge (40.4%) and having no time to see a doctor or pharmacist (27.5%). Amoxicillin (32.6%), Amoxicillin/Clavulanic acid (32.1%), Ampicillin/Cloxacillin (21.7%) and Ciprofloxacin (22.6%) were the most commonly implicated antibiotics in ASM. Cough, diarrhea, typhoid, and wound were the most frequently involved conditions. Patent medicine vendors (75.4%) and community pharmacies (29.4%) were the common source of antibiotics subjected to ASM. Conclusion: A research tool to assess ASM among undergraduate pharmacy students has been developed, validated and utilized. The prevalence of ASM is high among undergraduate pharmacy students in Northern Nigeria. Interventions to improve knowledge and awareness on ASM are needed among undergraduate pharmacy students to ensure antibiotic stewardship