Understanding the Multifaceted Process of Aging: Theories, Mechanisms, and Implications for Treatment

The aging process is a multifaceted biological phenomenon characterized by alterations at the molecular, cellular, and organ levels that culminate in a gradual, unavoidable, and unavoidable reduction in the body's capacity to react suitably to internal and/or external stimuli. Aging is a complex process that involves different mechanisms as The "Wear and Tear" Theory ,The Genetic Control Theory ,The Neuroendocrine Theory ,Waste Accumulation Theory ,Divisions Theory, Autoimmune Theory, Thymic-Stimulating Theory ,Mitochondrial Theory Mitochondria, Errors and Repairs Theory, Redundant DNA Theory Cross-Linkage Theory , Death Hormone Theory (DECO), Caloric Restriction Theory ,The Rate of Living Theory ,Gene Mutation Theory, Accumulated mutations Theory, Theory, Order to Disorder Theory, Disposable soma Theory, Antagonistic pleiotropy theory, The Telomerase Theory ,The free radical Theory. The two main categories of aging theories that explain cellular aging are structural damage and programmed theories. Different types of cells experience physiological stressors due to a range of circumstances. Notably, post-mitotic and mitotic cells have different capacities for proliferation and age differently in response to these pressures through different processes of cellular senescence and death, respectively. Over time, these aging cells build up and eventually cause old tissues to malfunction. The aim of this review is to throw light upon the effected of aging and who to treatment it

HDKD: Hybrid Data-Efficient Knowledge Distillation Network for Medical Image Classification

Vision Transformers (ViTs) have achieved significant advancement in computer vision tasks due to their powerful modeling capacity. However, their performance notably degrades when trained with insufficient data due to lack of inherent inductive biases. Distilling knowledge and inductive biases from a Convolutional Neural Network (CNN) teacher has emerged as an effective strategy for enhancing the generalization of ViTs on limited datasets. Previous approaches to Knowledge Distillation (KD) have pursued two primary paths: some focused solely on distilling the logit distribution from CNN teacher to ViT student, neglecting the rich semantic information present in intermediate features due to the structural differences between them. Others integrated feature distillation along with logit distillation, yet this introduced alignment operations that limits the amount of knowledge transferred due to mismatched architectures and increased the computational overhead. To this end, this paper presents Hybrid Data-efficient Knowledge Distillation (HDKD) paradigm which employs a CNN teacher and a hybrid student. The choice of hybrid student serves two main aspects. First, it leverages the strengths of both convolutions and transformers while sharing the convolutional structure with the teacher model. Second, this shared structure enables the direct application of feature distillation without any information loss or additional computational overhead. Additionally, we propose an efficient light-weight convolutional block named Mobile Channel-Spatial Attention (MBCSA), which serves as the primary convolutional block in both teacher and student models. Extensive experiments on two medical public datasets showcase the superiority of HDKD over other state-of-the-art models and its computational efficiency. Source code at: https://github.com/omarsherif200/HDK

Oviduct anatomy and histology: A comparative study in four adult female Iraqi birds (review article)

The anatomy and histology of the oviduct among different birds’ species is vitally ascribed to its functional role in eggs production, eggs quality, and fertilization. Therefore, understanding the morphological parameters of the adult female oviduct facilitates the accurate diagnosis of many diseases and prevents mortalities and production losses, the current article aims to review the morphological differences of the oviduct in four local domesticated birds: (Chickens) Gallus gallus domesticus, (Ducks) Ansa ansa domesticus, (Geese) Anser anser and (Turkey) Meleagris gallopavo. The results showed that the shape, length, width and weight of the oviduct varied among different bird species. Moreover, there were significant differences in the anatomical and histological measurements of the oviduct, such as the length of mucosal folds, the thickness of oviduct wall tunics and the distribution of glands. These differences were attributed to the relationship between the oviduct and egg weight, egg shape, fertility, and the size of pelvic bones. This review has effectively summarized the similarities and differences in oviduct morphological and histological parameters. providing valuable information on species reproductive traits and potential reproductive challenges

Assessing the Extent of Kindergarten Childrens Interaction with Listening and Speaking during Distance Language Skills Learning

The present study aims to assess how kindergarten children interact with listening and speaking skills during distance learning from the teachers point of view. The analysis was applied to 132 teachers from governmental and private kindergartens in Al-Ahsa Governorate, KSA. The descriptive analytical method was used in this study. An electronic questionnaire was built that comprised two axes: The first is the listening skill (auditory excellence, classification, deductive reasoning, and judging the correctness of the content), and the second is the speaking skill (phonological awareness, grammatical structure in the complete sense, linguistic communication, and verbal expression). The results concluded that the degree of the effect of distance learning on the listening skills of kindergarten children came to a medium level at the standard (2.17), and the degree of the impact of distance learning on the speaking skills of kindergarten children came to a high degree at the mean (2.41). The results did not show any statistically significant differences at the levels (0.05) in the impact of distance learning on kindergarten children’s listening and speaking skills, attributed to the kindergarten variable (government vs. private)

Constructing quantum dots sensitized TiO2 nanotube p-n heterojunction for photoelectrochemical hydrogen generation

Photoelectrochemical (PEC) water splitting is a promising approach to convert solar radiation into hydrogen (H2) as a clean fuel. The PEC device performance depends on the light harvesting efficiency of the photoanode and the carrier dynamics (i.e. separation/transport rate) at the photoanode/electrolyte interface. Herein, we report a photoanode architecture consisting of self-organized TiO2 nanotubes (NTs) sensitized by CdS/CdSe quantum dots (QDs) and treated with a Cu-based solution to create a p-n heterojunction. Our results demonstrate that the TiO2 NTs/QDs PEC device yields a photocurrent density of 4.18 mA.cm−2 at 0.5 V vs RHE, which is 51 times higher than the device based on TiO2 NTs only (i.e., 0.08 mA.cm−2) and 7 times compared to TiO2/QDs nanoparticles (NPs) (i.e. 0.45 mA.cm−2) under one sun illumination. The p-type CuSe coating over the TiO2/QDs NTs photoanodes forms a p-n heterojunction that improves the carrier dynamics. The resulting PEC device shows a 13% improvement in the photocurrent density. In addition, employing longer TiO2 NTs improves the device's stability. Our results offer a simple and scalable method for the design and optimization of the photoanodes to enhance the performance of PEC and other optoelectronic devices

Evaluation of Performance & Complications of pacemakers in children; A single center study

Background: Permanent pacing is now a common treatment strategy used to treat rhythm abnormalities in pediatric patients with congenital heart disease (CHD). This study aimed to assess the outcome, effectiveness, and complications of permanent pacemakers. Between March 2020 and February 2021, a total of 148 participants with permanent cardiac pacing were enrolled in the study. Their charts were reviewed pro- and retrospectively for anthropometric measurements, pacing indications, pacing measurements and pacing complications. Their mean age was 4.26 ± 3.56 years, their mean weight 16.38 ± 10.18 kg. There were 83 males (56.1%) and 65 females (43.9%). Post operative AV block was the most common pacing indication followed by congenital AV block. The majority of patients were paced using VVIR (ventricular pacing, ventricular sensing, inhibition response and rate adaptive) mode devices in 146 patients (98.6%). DDDR (dual chamber pacing, dual chamber sensing, dual chamber response and rate adaptive) mode device was used in 2 patients (1.35%). Endocardial pacing was done in 136 patients while epicardial pacing was done in 12 patients. During intensified follow up, lead failure related complications were detected in 8 patients (7.2 %). Lead failure related complications has occurred in 33.3 % of epicardial leads and in 4 % of endocardial leads   Conclusion: our findings suggest that endocardial pacing is associated with lower rates of lead related problems compared to epicardial pacing

Effectiveness of Mirror Therapy, Electrical Stimulation, and CIMT in Restoring Upper Extremity Function after Stroke

Objective: This study aimed to compare the effectiveness of mirror therapy (MT), electrical stimulation (EMS) combined with MT, and Constraint-Induced Movement Therapy (CIMT) in improving upper extremity function among stroke survivors. Methodology: A randomized controlled trial was conducted involving n=45 stroke patients undergoing rehabilitation at Wah International Hospital. The inclusion criteria for the study required participants to be above 45 years of age, to have survived either an ischemic or haemorrhagic stroke, and to have at least 10° wrist extension. Participants were excluded if they had an implanted electrical device such as an artificial pacemaker, paresis instead of paralysis, hemiplegia due to causes other than ischemic or haemorrhagic stroke (such as trauma, tumor, or coordination problems), or impaired sensory integration. Participants were divided into three groups: EMS combined with MT, CIMT alone, and Mirror therapy alone. Treatment sessions were administered four times a week for three months. Outcome measures included the Fugl-Meyer Assessment Scale (FMA) and Motor Assessment Scale (MAS). Results: Analysis revealed significant improvements in upper extremity function across all groups. However, the CIMT group exhibited the most substantial enhancement, with a mean difference of -68.5 (p < 0.05) on the FMA and -24.1 (p < 0.05) on the MAS compared to the other groups. Conclusion: The findings highlight the superior efficacy of CIMT in improving upper extremity function among stroke survivors. Incorporating CIMT into rehabilitation protocols is crucial for optimizing outcomes in this patient population. Further research is warranted to explore the long-term benefits and optimal implementation strategies of CIMT in diverse rehabilitation setting

Microneedling With Topical Insulin Versus Microneedling With Non-Cross-Linked Hyaluronic Acid for Atrophic Post-Acne Scars: A Split-Face Study

Introduction: Post-acne scars are a prevalent cosmetic complaint that usually requires multi-modality treatment to achieve accepted results. Objectives: The target of this research was to evaluate and compare the efficacy and safety of microneedling with topical insulin against microneedling with non-cross-linked hyaluronic acid in atrophic post-acne scars treatment. Methods: The current comparative split-face research included 30 patients with atrophic facial acne scars. Each patient received 6 sessions of microneedling with topical insulin on one side of the face and microneedling with non-cross-linked hyaluronic acid on the other side. Sessions were done 3 weeks apart and digital photographs were taken before and 3 months after the last treatment session. Goodman and Baron qualitative and quantitative grading system was used to evaluate the improvement across both sides of the face, along with patient satisfaction. Results: After 3 months of the last session, a statistically significant improvement in qualitative acne scars grading on both sides of the face (p-value <0.001) was reported, with non-significant difference between the two sides (p-value =0.864). Moreover, the mean percentage of improvement in quantitative acne scars grading was 49.18 ± 13.22 on insulin side and 47.72 ± 15.08 on hyaluronic acid side, with non-significant difference between the two sides after treatment (p-value = 0.235). Conclusion: Both microneedling with topical insulin and with non-cross-linked hyaluronic acid have achieved comparable significant improvement of atrophic post-acne scars

Minimally invasive parathyroidectomy guided by intraoperative parathyroid hormone monitoring (IOPTH) and preoperative imaging versus bilateral neck exploration for primary hyperparathyroidism in adults

Background: Bilateral neck exploration (BNE) is the traditional approach to sporadic primary hyperparathyroidism. With the availability of the preoperative imaging techniques and intraoperative parathyroid hormone assays, minimally invasive parathyroidectomy (MIP) is fast becoming the favoured surgical approach. Objectives: To assess the effects of minimally invasive parathyroidectomy (MIP) guided by preoperative imaging and intraoperative parathyroid hormone monitoring versus bilateral neck exploration (BNE) for the surgical management of primary hyperparathyroidism. Search methods: We searched CENTRAL, MEDLINE, WHO ICTRP and ClinicalTrials.gov. The date of the last search of all databases was 21 October 2019. There were no language restrictions applied. Selection criteria: We included randomised controlled trials comparing MIP to BNE for the treatment of sporadic primary hyperparathyroidism in persons undergoing surgery for the first time. Data collection and analysis: Two review authors independently screened titles and abstracts for relevance. Two review authors independently screened for inclusion, extracted data and carried out risk of bias assessment. The content expert senior author resolved conflicts. We assessed studies for overall certainty of the evidence using the GRADE instrument. We conducted meta-analyses using a random-effects model and performed statistical analyses according to the guidelines in the latest version of the Cochrane Handbook for Systematic Reviews of Interventions. Main results: We identified five eligible studies, all conducted in European university hospitals. They included 266 adults, 136 participants were randomised to MIP and 130 participants to BNE. Data were available for all participants post-surgery up to one year, with the exception of missing data for two participants in the MIP group and for one participant in the BNE group at one year. Nine participants in the MIP group and 11 participants in the BNE group had missing data at five years. No study had a low risk of bias in all risk of bias domains. The risk ratio (RR) for success rate (eucalcaemia) at six months in the MIP group compared to the BNE group was 0.98 (95% confidence interval (CI) 0.94 to 1.03; P = 0.43; 5 studies, 266 participants; very low-certainty evidence). A total of 132/136 (97.1%) participants in the MIP group compared with 129/130 (99.2%) participants in the BNE group were judged as operative success. At five years, the RR was 0.94 (95% CI 0.83 to 1.08; P = 0.38; 1 study, 77 participants; very low-certainty evidence). A total of 34/38 (89.5%) participants in the MIP group compared with 37/39 (94.9%) participants in the BNE group were judged as operative success. The RR for the total incidence of perioperative adverse events was 0.50, in favour of MIP (95% CI 0.33 to 0.76; P = 0.001; 5 studies, 236 participants; low-certainty evidence). Perioperative adverse events occurred in 23/136 (16.9%) participants in the MIP group compared with 44/130 (33.9%) participants in the BNE group. The 95% prediction interval ranged between 0.25 and 0.99. These adverse events included symptomatic hypocalcaemia, vocal cord palsy, bleeding, fever and infection. Fifteen of 104 (14.4%) participants experienced symptomatic hypocalcaemia in the MIP group compared with 26/98 (26.5%) participants in the BNE group. The RR for this event comparing MIP with BNE at two days was 0.54 (95% CI 0.32 to 0.92; P = 0.02; 4 studies, 202 participants). Statistical significance was lost in sensitivity analyses, with a 95% prediction interval ranging between 0.17 and 1.74. Five out of 133 (3.8%) participants in the MIP group experienced vocal cord paralysis compared with 2/128 (1.6%) participants in the BNE group. The RR for this event was 1.87 (95% CI 0.47 to 7.51; P = 0.38; 5 studies, 261 participants). The 95% prediction interval ranged between 0.20 and 17.87. The effect on all-cause mortality was not explicitly reported and could not be adequately assessed (very low-certainty evidence). There was no clear difference for health-related qua ity of life between the treatment groups in two studies, but studies did not report numerical data (very low-certainty evidence). There was a possible treatment benefit for MIP compared to BNE in terms of cosmetic satisfaction (very low-certainty evidence). The mean difference (MD) for duration of surgery comparing BNE with MIP was in favour of the MIP group (–18 minutes, 95% CI –31 to –6; P = 0.004; 3 studies, 171 participants; very low-certainty evidence). The 95% prediction interval ranged between –162 minutes and 126 minutes. The studies did not report length of hospital stay. Four studies reported intraoperative conversion rate from MIP to open procedure information. Out of 115 included participants, there were 24 incidences of conversion, amounting to a conversion rate of 20.8%. Authors' conclusions: The success rates of MIP and BNE at six months were comparable. There were similar results at five years, but these were only based on one study. The incidence of perioperative symptomatic hypocalcaemia was lower in the MIP compared to the BNE group, whereas the incidence of vocal cord paralysis tended to be higher. Our systematic review did not provide clear evidence for the superiority of MIP over BNE. However, it was limited by low-certainty to very low-certainty evidence. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd

Effect of high-tone external muscle stimulation on fatigue and functional outcomes in multiple sclerosis: A randomized controlled trial

A major symptom experienced by subjects with multiple sclerosis is fatigue, which induces a decline in physical, cognitive, and functional capacity. Exercise and electrotherapy are cornerstones of rehabilitation that elicit acceptable effects on feelings of fatigue and on performing activities of daily living. A randomized controlled trial was conducted to investigate the effects of high-tone external muscle stimulation on fatigue and functional outcomes in multiple sclerosis patients. A total of 40 multiple sclerosis patients were allocated randomly to either: the study or control groups. The study group received high-tone external muscle stimulation, while the control group received a conventional selected exercise training program. Both groups received 3 sessions per week for one month. Both groups showed a significant improvement post-study compared with pre-study. There was a significant reduction in Disability Status Scale (p=0.002), Fatigue Severity Scale scores (p=0.004), and total scores of Modified Fatigue Impact Scale (p=0.001) of the study group compared with that of the control group. High-tone external muscle stimulation showed an important improvement effect for both fatigue and functional outcomes in multiple sclerosis patients, being more effective than the conventional exercise training program; therefore, it should be considered a beneficial treatment method for patients with multiple sclerosis