Deletion of low molecular weight protein tyrosine phosphatase (Acp1) protects against stress-induced cardiomyopathy.

The low molecular weight protein tyrosine phosphatase (LMPTP), encoded by the ACP1 gene, is a ubiquitously expressed phosphatase whose in vivo function in the heart and in cardiac diseases remains unknown. To investigate the in vivo role of LMPTP in cardiac function, we generated mice with genetic inactivation of the Acp1 locus and studied their response to long-term pressure overload. Acp1(-/-) mice develop normally and ageing mice do not show pathology in major tissues under basal conditions. However, Acp1(-/-) mice are strikingly resistant to pressure overload hypertrophy and heart failure. Lmptp expression is high in the embryonic mouse heart, decreased in the postnatal stage, and increased in the adult mouse failing heart. We also show that LMPTP expression increases in end-stage heart failure in humans. Consistent with their protected phenotype, Acp1(-/-) mice subjected to pressure overload hypertrophy have attenuated fibrosis and decreased expression of fibrotic genes. Transcriptional profiling and analysis of molecular signalling show that the resistance of Acp1(-/-) mice to pathological cardiac stress correlates with marginal re-expression of fetal cardiac genes, increased insulin receptor beta phosphorylation, as well as PKA and ephrin receptor expression, and inactivation of the CaMKIIδ pathway. Our data show that ablation of Lmptp inhibits pathological cardiac remodelling and suggest that inhibition of LMPTP may be of therapeutic relevance for the treatment of human heart failure

Complications of Patients Who Underwent Total Hip Replacement Surgery According to Their Severity, Type, And Ct Findings

Background: Total hip replacement surgery can be defined as the most performed and successful surgeries in recent times. The use of computed tomography technology has greatly improved the accuracy of determining the condition of the hip joint. Objective: This study was aimed to determine and assess the complications and CT scan outcomes related to patients with total hip replacement surgery. Patients and methods: A cross-sectional study was conducted which occurred in different hospitals in Iraq, recruiting 106 patients who had undergone total hip replacement surgery through February 8th, 2022, and August 16th, 2023. Clinical data were collected into patients who diagnosed under CT imaging where it was determined the status of the hip joint. The clinical and demographic characteristics were determined into male and female patients aged between 20 and over 50. Postoperative complications were diagnosed using CT scans. Additionally, this study was assessed the pain levels of patients through ten days after total hip surgery by (NRS) scale, which ranged between (0 – 10) where 0 can indicate no pain while 10 can indicate severe pain. Results: clinical results can indicate that most of the patients (41) with total hip replacement surgery were over 50 years old.  The number of male patients was higher than that of female patients, with 70 and 36 patients, respectively. Osteoporosis was present in 34 patients, while fractures or dislocations of the hip joint were observed in 28 patients. In this study, 51.89% of participants were smokers. The most common symptoms reported were stiffness (27 cases), pain (20 cases), and limping (24 cases). The most prevalent concomitant diseases were hypertension (42 patients) and diabetes (32 patients). The study found that the most common complications after surgery, as recorded by a CT scan, were infections (5 cases), blood clots (3 cases), and bleeding (3 cases), with a mortality rate of only 4 cases. Pain scores of patients were assessed within ten days after surgery, and the success of the surgery technique in controlling patients was examined. The study concluded that the NRS scale reached a score of 1 in the last few days. Conclusions: This study demonstrates the effectiveness of total hip replacement surgery in improving patients' quality of life, as determined by their ability to move with better performance, lower pain levels, and fewer complications associated with the surgery, as shown by CT scans

Awareness and factors influencing breast reconstruction in the Gaza Strip: a cross-sectional study

Background Women are usually given two options after a mastectomy. They can either wear a prosthesis or have a breast reconstruction. Unfortunately, many women in the Gaza Strip are unaware of these options. The aim of this study was to shed light on the awareness and sociocultural factors in women who underwent mastectomy before choosing between options. Methods In this cross-sectional study, we recruited patients who underwent mastectomy in the Gaza Strip. All participants completed a face-to-face questionnaire between Aug 1, 2015, and April 30, 2016. Verbal consent was obtained from all participants. Findings 173 women with a mean age 51 years (SD 10) were enrolled in this study. 90 (52%) women had low income, and 36 (21%) women had a first-degree relative with breast cancer. 133 (77%) women underwent radical mastectomy, and 29 (17%) women had breast-conserving surgery. 96 (55

Impact of mastectomy on the social well-being and family dynamics of breast cancer female patients in the Gaza Strip

Background: The impact of mastectomy on social well-being (SWB) and family dynamics (FD) may involve the individual, social role and perception of the usefulness of social and family support affects. The purpose of the current study is to identify that impact and its related implications on SWB and FD. Methods: This was a cross-sectional study in which a total of 173 female patients who had mastectomy in GS hospitals completed a face-to-face questionnaire designed by the researchers; which contains 3 sections including: socio-demographic data, SWB and FD. All measures utilized a five-point Likert-type scale ranging from 1 (worst outcome) to 5 (best outcome). The study was conducted at European Gaza Hospital (n= 60) and Alshifaa Hopsital (n= 113) in the GS from August 2015 to September 2016. The data was analyzed using SPSS software. Results: Among 173 female patients, the mean age was 51 years

Trends of Tuberculosis Treatment Outcomes of Notified Cases in Three Refugee Camps in Sudan: A Four-year Retrospective Analysis, 2014–2017

Background: Refugees are vulnerable to tuberculosis (TB) infection. Tracking of program performance is needed to improve TB care and prevention. The objective of this study was to assess the trends of TB treatment outcomes of notified cases in three refugee camps in Sudan from 2014 to 2017. Methods: This study was a historical cohort study. Sex, age, type of TB, TB patient category, and treatment outcome of all TB cases registered in three refugee camps (Al Kashafa, Shagarab, Wadsherify) from January 1, 2014 to December 31, 2017 were collected from the TB register. Multivariable logistic regression was performed to explore factors for unsuccessful TB treatment. Results: A total of 710 TB cases of which 53.4% were men, 22.1% children (<15 years), and 36.2% extrapulmonary TB (EPTB) were registered. Overall, the TB treatment success rate was 75.7% with a declining trend from 86.2% in 2015 to 63.5% in 2017. On average, 11.4% were lost to follow-up (LTFU), 6.6% died, 5.9% were not evaluated, and in 0.3% the treatment failed. Being 15–24 years old and having EPTB were significantly associated with unsuccessful treatment outcome. Conclusion: The treatment success rate in the refugee camp in 2017 (63.5%) was far lower than the national treatment success rate (78%) and the End TB global target (≥90%) that needs to be improved. LTFU, died, and not evaluated outcomes were high which indicated the necessity to improve the TB treatment program

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Artificial neural networks-based ultrasonic pulse velocity prediction model for concrete structures

Accurately predicting the Ultrasonic Pulse Velocity (UPV) in concrete is important invarious fields, including construction, engineering and non-destructive testing. This research paper proposes a novel mathematical model based on Artificial Neural Networks (ANN) applied to accurately predict the UPV of concrete. The proposed model was formulated and validated through comprehensive experimental measurements, which were divided into three subsets for training, validating and testing the model. The training process involved adjusting the model’s parameters through iterative optimization techniques to minimize prediction errors. A separate group of measurements was used to validate the model’s precision and generality. The results demonstrate that the suggested equation matches the data from experiments well. Remarkably, the model achieved a high level of accuracy in predicting UPV values, with an error rate of less than 2% when compared to the measured experimental values. These results validate the effectiveness of the developed ANN model for accurate UPV predictions in concrete structures. The practical applications of the model extend to concrete characterization and non-destructive testing, enabling efficient quality control and assessment of structural integrity. Additionally, the model facilitates concrete characterization and mix design optimization, developing more durable and sustainable structures