Diagnostic Value of Serum Neuron-Specific Enolase Level in Patients With Acute Ischemic Stroke; A Systematic Review and Meta-Analysis

Background: We aim to assess the predictive value of serum neuron-specific enolase (NSE) level in patients with acute ischemic stroke referring to the emergency department.Methods: This systematic review and meta-analysis performed, considering the PRISMA and MOOSE statement guidelines. A computerized literature search of the known medical database conducted by using the relevant keywords. We included studies published before November 2016 in which stroke patients compared with non-stroke controls and also studies evaluating the serum levels of NSE in the study groups. Statistical analysis was pooled in a random effect model analysis using the Comprehensive Meta-Analysis software.Results: We included 12 articles in the qualitative and quantitative analysis, that their quality acceptable based on the Newcastle Ottawa Scale (NOS scale). The pooled effect estimates showed that NSE is significantly higher in ischemic stroke patients in comparison with their controls with a high effect estimate [OR 9.68, 95% CI (3.06 to 30.6)]. The effect estimate remained statistically significant under the fixed and random effects model.Conclusion: Our results show higher levels of NSE in patients with stroke than in the control group, indicating that NSE plays a role in the diagnosis of stroke. In terms of prognosis, there is evidence regarding the direct and indirect relationship; and it founded that serum levels of NSE is higher in larger stroke volume, which needs further research

Punching Capacity of UHPC Post Tensioned Flat Slabs with and Without Shear Reinforcement: An Experimental Study

Punching capacity is one of the main items in the design of both pre-stressed and non-pre-stressed flat slabs. All international design codes include provisions to prevent this type of failure. Unfortunately, there is no code provision for UHPC yet, and hence, the aim of this research is to experimentally investigate the impact of column dimensions and punching reinforcement on the punching capacity of post-tensioned slabs and compare the results with the international design codes’ provisions to evaluate its validity. The test program included five slabs with a compressive strength of 120 MPa: one as a control sample, two to study the effect of column size, and the last two to study the effect of punching reinforcement. Comparing the results with the design codes showed that ACI-318 is more accurate with an average deviation of about 5%, while EC2 is more conservative with an average deviation of about 20%. Besides that, punching reinforcement reduces the size of the punching wedge by increasing the crack angle to 28° instead of 22° for slabs without punching reinforcement. Also, the results assure that both ductility and stiffness are enhanced with the increased column dimensions and punching reinforcement ratio. Doi: 10.28991/CEJ-2023-09-03-06 Full Text: PD

Efficacy and safety of misoprostol for intrauterine device insertion in women with no previous vaginal delivery: a systematic review and meta-analysis of randomized controlled trials

Introduction: The efficacy of misoprostol use for cervical priming before intrauterine device insertion (IUD) is controversial. This review aims to evaluate the evidence from published randomized controlled trials about the efficacy and safety of misoprostol before IUD insertion for pain relief in women with no previous vaginal delivery. Materials and methods: We searched the following electronic databases: Web of Science, Cochrane CENTRAL, SCOPUS, and PubMed for relevant studies using the following Mesh terms: (misoprostol) AND (intrauterine device OR IUD). The primary outcome was the mean pain score during insertion. Secondary outcomes included the ease of insertion score, the rate of successful IUD insertion, the rate of IUD insertion failure, and the adverse effects. Results: Ten randomized controlled trials (RCTs) (misoprostol: n=698 and placebo: n=689) were pooled in the analysis. The overall Standardized Mean Difference (SMD) of pain score did not favor either of the two groups (SMD= -0.09, 95%CI [-0.50, 0.33], p=0.007). Pooled results were highly heterogeneous (I2=93%, P<0.001). The total MD of the ease of insertion score favored the misoprostol group (MD= -1.36, 95% CI [-2.20, -0.52], p =0.002). The overall risk ratio (RR) of the number of failed insertions showed that misoprostol is associated with less IUD insertion failures compared to placebo (RR=0.55, 95% CI [0.38, 0.81], p=0.002). Finally, the overall risk showed that misoprostol is associated with more shivering, diarrhea and pelvic pain. Conclusions: Misoprostol facilitates IUD insertion in women with no previous vaginal delivery, and is associated with 50% less chance for IUD insertion failure despite inducing mild adverse effect

HTTU-Net: Hybrid Two Track U-Net for Automatic Brain Tumor Segmentation

Brain cancer is one of the most dominant causes of cancer death; the best way to diagnose and treat brain tumors is to screen early. Magnetic Resonance Imaging (MRI) is commonly used for brain tumor diagnosis; however, it is a challenging problem to achieve higher accuracy and performance, which is a vital problem in most of the previously presented automated medical diagnosis. In this paper, we propose a Hybrid Two-Track U-Net(HTTU-Net) architecture for brain tumor segmentation. This architecture leverages the use of Leaky Relu activation and batch normalization. It includes two tracks; each one has a different number of layers and utilizes a different kernel size. Then, we merge these two tracks to generate the final segmentation. We use the focal loss, and generalized Dice (GDL), loss functions to address the problem of class imbalance. The proposed segmentation method was evaluated on the BraTS’2018 datasets and obtained a mean Dice similarity coefficient of 0.865 for the whole tumor region, 0.808 for the core region and 0.745 for the enhancement region and a median Dice similarity coefficient of 0.883, 0.895, and 0.815 for the whole tumor, core and enhancing region, respectively. The proposed HTTU-Net architecture is sufficient for the segmentation of brain tumors and achieves highly accurate results. Other quantitative and qualitative evaluations are discussed, along with the paper. It confirms that our results are very comparable expert human-level performance and could help experts to decrease the time of diagnostic.This work was supported in part by the Robotics and Internet-of-Things Laboratory of Prince Sultan University, Saudi Arabia, and in part by the National Natural Science Foundation of China under Grant 61375081.info:eu-repo/semantics/publishedVersio

Silver-Doped Cadmium Selenide/Graphene Oxide-Filled Cellulose Acetate Nanocomposites for Photocatalytic Degradation of Malachite Green toward Wastewater Treatment

Silver-doped cadmium selenide/graphene oxide (GO) (Ag-CdSe/GO) nanocomposites have been synthesized, loaded in cellulose acetate (CA) to form Ag-CdSe/GO@CA heterostructure nanofibers, and characterized in terms of structural, morphological, photocatalytic properties, among others. The photocatalytic degradation of malachite green (MG) was estimated using cadmium selenide-filled CA (CdSe@CA), silver-doped cadmium selenide-filled CA (Ag-CdSe@CA), cadmium selenide/GO-filled CA (CdSe/GO@CA), and silver-doped cadmium selenide/GO-filled CA (Ag-CdSe/GO@CA) nanocomposite materials. The Ag-CdSe/GO@CA nanocomposites exhibit and retain an enhanced photocatalytic activity for the degradation of MG dye. This amended performance is associated with the multifunctional supporting impacts of GO, Ag, and CA on the composite structure and properties. The superior photocatalytic activity is related to the fact that both Ag and GO can act as electron acceptors that boost the separation efficiency of photogenerated carriers and the loading of the combined nanocomposite (Ag-CdSe@GO) on CA nanofibers, which can augment the adsorption of electrons and holes and facilitate the movement of carriers. The stability of Ag-CdSe/GO@CA nanocomposite photocatalysts demonstrates suitable results even after five recycles. This study establishes an advanced semiconductor-based hybrid nanocomposite material for efficient photocatalytic degradation of organic dyes.The Academy of Scientific Research and Technology (ASRT), Egypt, Grant No. 6510, supported this project financially

Double negative alpha beta T cells in pediatric hemophagocytic syndromes

Introduction: Autoimmune lymphoproliferative syndrome (ALPS) and hemophagocytic lymphohistiocytosis (HLH) share clinical and laboratory features including lymphadenopathy, splenomegaly, and pancytopenia. We sought to measure αβ double negative T cells (αβ DNT) in a group of patients with established diagnosis of HLH in relation to disease activity and severity.Methods: We conducted a follow-up, controlled study that comprised 25 patients with HLH and 25 healthy matched controls. Patients were subjected to clinical evaluation and flowcytometric measurement of αβ DNT Cells at presentation and 9 weeks after start of HLH induction treatment.Results: In 17 (68%) patients, infection was the trigger of HLH while the cause was malignancy in three (12%), and rheumatological disorders in two patients (8%). At enrollment, 15 patients (60%) had αβ DNT cells levels [median (IQR): 1.71 (1.25-2.12)] that were significantly higher than the control values [median (IQR): 0.7 (0.4-0.8)] (p&lt;0.001). The αβ DNT counts of patients were also higher at enrollment as compared to values at the end of week 9 [median (IQR): 0.76 (0.45-1.17)]; p=0.018. Survivors (n=8) and non-survivors (n=17) had comparable levels of αβ DNT cells at enrollment (p=0.861). αβ DNT cell count correlated positively with ALT (p=0.019) and negatively with CD4/CD8 ratios (p=0.023).Conclusion: Elevated αβ DNT cell counts might be related to the HLH process and this implies that mild elevation can exist in HLH and are not specific to ALPS. Wider scale studies with longer periods of follow up are needed to validate the results and properly outline the correlation between both medical conditions.Keywords: Hemophagocytic lymphohistiocytosis, Double negative T cells, mortality, ALP

Comparative Metabolite Fingerprinting of Four Different Cinnamon Species Analyzed via UPLC–MS and GC–MS and Chemometric Tools

The present study aimed to assess metabolites heterogeneity among four major Cinnamomum species, including true cinnamon (Cinnamomum verum) and less explored species (C. cassia, C. iners, and C. tamala). UPLC-MS led to the annotation of 74 secondary metabolites belonging to different classes, including phenolic acids, tannins, flavonoids, and lignans. A new proanthocyanidin was identified for the first time in C. tamala, along with several glycosylated flavonoid and dicarboxylic fatty acids reported for the first time in cinnamon. Multivariate data analyses revealed, for cinnamates, an abundance in C. verum versus procyandins, dihydro-coumaroylglycosides, and coumarin in C. cassia. A total of 51 primary metabolites were detected using GC-MS analysis encompassing different classes, viz. sugars, fatty acids, and sugar alcohols, with true cinnamon from Malaysia suggested as a good sugar source for diabetic patients. Glycerol in C. tamala, erythritol in C. iners, and glucose and fructose in C. verum from Malaysia were major metabolites contributing to the discrimination among species

Circulating dendritic cells in pediatric patients with nephrotic syndrome

Background: Dendritic cells (DCs) represent one of the most extensively studied topics in immunology, because of their central role in the induction and regulation of adaptive immunity, and because of their therapeutic potential for manipulating immune responses. Objectives: To evaluate circulating DC levels in pediatric patients with idiopathic nephrotic syndrome (NS) and its relation to disease activity in these patients. Methods: Fifteen nephrotic patients in relapse (proteinuria&gt;40mg/m2/hour, hypoalbuminemia, and edema) before initiating steroid therapy (Group I), and another15 nephrotic patients in remission after withdrawal of steroid therapy (Group II) were compared to 15 age- and sex- matched healthy children. Besides clinical evaluation and routine laboratory investigations of nephrotic syndrome, circulating DCs were measured by flowcytometry. Results: Circulating DC count was lower in nephrotic patients in both proteinuria and remission groups [(48.89±13.52) and (64.64±7.69) X106/liter respectively] than in the control group (78.54±9.8) X106/liter with highly significant statistical difference (p &lt; 0.001), and lower in proteinuria group than the remission group with highly significant statistical difference (p &lt; 0.001). There was a positive correlation between DC count and serum albumin (moderate association) (p=0.002) and a negative correlation between DC count and urine protein /creatinine ratio (strong association) (p=0.001). Conclusion: Nephrotic syndrome was associated with decreased number of circulating DCs and the decrease was more apparent in patients with active disease. The positive correlation between DC counts and total protein, and serum albumin, and the negative correlation between DC count and urine protein/creatinine ratio point to the link between the decrease in DC count and the severity of the disease process.Keywords: Denderitic cells, nephrotic syndrome, immune deficiencyEgypt J Pediatr Allergy Immunol 2011;9(1):41-4