Solar steam generation (SSG) is a potential approach for resolving the global water and energy crisis while causing the least amount of environmental damage. However, using adaptable photothermal ...absorbers with salt resistance through a simple, scalable, and cost-effective production approach is difficult. Herein, taking advantage of the ultra-fast water transportation in capillaries, and the large seawater storage capacity of wood, we develop a highly efficient natural evaporator. The wood wastes (sawdust) were carbonized at low temperatures to fabricate a green and low-cost carbonaceous porous material (CW). To enhance the salt resistance in high saline water, this evaporator was coated with polyaniline emeraldine salt (ES-PANI) which was synthesized through facile and cost-effective one-step oxidation of aniline. Furthermore, the composite was decorated with silver sulfide to increase the evaporation rate which reached up to 1.1 kg m
−2
h
−1
under 1 sun irradiation with 91.5% efficiency. Besides, the evaporator performs exceptionally well over 10 cycles due to the salt resistance capability of ES-PANI which generates a "Donnan exclusion" effect against cations in saline water. The Ag
2
S@PANI/CW evaporator may be a viable large-scale generator of drinking water due to its high efficiency for energy conversion, simple and low-cost fabrication approach, salt-resistance, and durability.
Solar steam generation (SSG) is a potential approach for resolving the global water and energy crisis while causing the least amount of environmental damage.
Sildenafil was first prescribed for angina pectoris and then for erectile dysfunction from its effects on vascular smooth muscle relaxation and vasodilatation. Recently, sildenafil has been proposed ...for congenital heart diseases induced pulmonary hypertension, which constitutes a huge burden on children's health and can attribute to fatal complications due to presence of unoxygenated blood in the systemic circulation. Therefore, our meta-analysis aims to further investigate the safety and efficacy of sildenafil on children population.
We searched the following electronic databases: PubMed, Cochrane CENTRAL, WOS, Embase, and Scopus from inception to April 20th, 2022. Randomized controlled trials that assess the efficacy of using sildenafil in comparison to a placebo or any other vasodilator drug were eligible for inclusion. The inverse variance method was used to pool study effect estimates using the random effect model. Effect sizes are provided in the form of mean difference (MD) with 95% confidence intervals (CI).
Our study included 14 studies with (n = 849 children) with a mean age of 7.9 months old. Sildenafil showed a statistically significant decrease over placebo in mean and systolic pulmonary artery pressure (PAP) with MD -7.42 (95%CI -13.13, -1.71, P = 0.01) and -8.02 (95%CI -11.16, -4.88, P < 0.0001), respectively. Sildenafil revealed a decrease in mean aortic pressure and pulmonary artery/aortic pressure ratio over placebo with MD -0.34 (95%CI -2.42, 1.73, P = 0.75) and MD -0.10 (95%CI -0.11, -0.09, P < 0.00001), respectively. Regarding post corrective operations parameters, sildenafil had a statistically significant lower mechanical ventilation time, intensive care unit stay, and hospital stay over placebo with MD -19.43 (95%CI -31.04, -7.81, s = 0.001), MD -34.85 (95%CI -50.84, -18.87, P < 0.00001), and MD -41.87 (95%CI -79.41, -4.33, P = 0.03), respectively. Nevertheless, no difference in mortality rates between sildenafil and placebo with OR 0.25 (95%CI 0.05, 1.30, P = 0.10) or tadalafil with OR 1 (95%CI 0.06, 17.12, P = 1).
Sildenafil is a well-tolerated treatment in congenital heart diseases induced pulmonary hypertension, as it has proven its efficacy not only in lowering both PAP mean and systolic but also in reducing the ventilation time, intensive care unit and hospital stay with no difference observed regarding mortality rates.
Tenecteplase (TNK) is a promising candidate to replace alteplase as the standard of care for acute ischemic stroke (AIS); however, the optimal dosage is still to be investigated. Therefore, we aim to ...evaluate the safety and efficacy of TNK versus alteplase and to investigate the optimal TNK dosage. A systematic review, pairwise, and network meta-analysis synthesizing randomized controlled trials (RCTs) from WOS, SCOPUS, EMBASE, and PubMed until July 26
th
, 2022. We used the risk ratio (RR) for dichotomous outcomes presented with the corresponding 95% confidence interval (CI). We registered our protocol in PROSPERO with ID: CRD42022352038. Nine RCTs with a total of 3,707 patients were included. TNK significantly led to complete recanalization (RR: 1.27 with 95% CI 1.02, 1.57, P = 0.03); however, we found no difference regarding early neurological improvement (RR: 1.07 with 95% CI 0.94, 1.21, P = 0.33) and excellent neurological recovery (RR: 1.03 with 95% CI 0.96, 1.10, P = 0.42). Also, TNK was similar to alteplase regarding mortality (RR: 0.99 with 95% CI 0.82, 1.18, P = 0.88), intracranial haemorrhage (RR: 1.00 with 95% CI 0.85, 1.18, P = 0.99), and parenchymal hematoma (RR: 1.13 with 95% CI 0.83, 1.54, P = 0.44). TNK in the dose of 0.25 mg is a viable candidate to displace alteplase as the standard of care in patients with an AIS within 4.5 h of presentation due to its better rate of early neurological recovery and non-inferiority in terms of safety outcomes. However, the evidence regarding TNK’s role in AIS presenting after 4.5 h from symptoms onset, wake-up stroke, and minor stroke/TIA is still lacking, necessitating further double-blinded pragmatic RCTs in this regard.
Accumulating evidence has been reported regarding the effect of curcumin as a dietary antiviral on patients with COVID-19; however, findings are controversial. Our systematic review aimed to evaluate ...the effects of curcumin in patients with COVID-19. Electronic databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Central, and Google Scholar) were systematically searched to identify only randomized clinical trials (RCTs) that assessed curcumin in patients with COVID-19 from inception to September 23, 2021 relevant keywords. The Cochrane risk-of-bias tool for randomized trials was used to evaluate the risk of bias. After a critical review of 1,098 search hits, only six RCTs were selected for discussion. A total of 480 patients were included, with 240 amongst the curcumin groups and 240 in the control group. The lymphocyte count was significantly higher in the curcumin group compared to the placebo group. Curcumin was found to decrease the number of T-helper 17 cells, downregulate T-helper-17 cell‐related factors, reduce levels of T-helper-17 cell‐related cytokines, yet increase the gene expression of Treg transcription factor forkhead box P3 (FOXP3), and decrease T-Box transcription factor 21 (TBX21). Our review revealed that curcumin might have a positive effect on relieving COVID-19 related inflammatory response due to its powerful immune‐modulatory effects on cytokines production, T-cell responses, and gene expression. These findings suggest that curcumin confers clinical benefits in patients with COVID-19. However, due to the limited number of the included studies, further high-quality studies are needed to establish the clinical efficacy of the curcumin.
The promising features of most bacterial celluloses (BC) promote the continuous mining for a cost-effective production approach toward wide and sustainable applications. Herein, cantaloupe peels (CP) ...were successfully implemented for sustainable BC production. Results indicated that the enzymatically hydrolyzed CP supported the maximum BC production of approximately 3.49 g/L when used as a sole fermentation media. The produced BC was fabricated with polyvinyl alcohol (PVA) and chitosan (Ch), and loaded with green synthesized copper oxide nanoparticles (CuO-NPs) to improve its biological activity. The novel composite showed an antimicrobial activity against several human pathogens such as Staphylococcus aureus, Streptococcus mutans, Salmonella typhimurium, Escherichia coli, and Pseudomonas fluorescens. Furthermore, the new composite revealed a significant in vitro anticancer activity against colon (Caco-2), hepatocellular (HepG-2), and breast (MDA) cancer cells, with low IC
of 0.48, 0.27, and 0.33 mg/mL for the three cell lines, respectively. On the other hand, the new composite was remarkably safe for human skin fibroblast (HSF) with IC
of 1.08 mg/mL. Interestingly, the composite membranes exhibited lethal effects against all stages of larval instar and pupal stage compared with the control. In this study, we first report the diverse potential applications of BC/PVA/Ch/CuO-NPs composites based on green synthesized CuO-NPs and sustainably produced BC membrane.
Patients with heart failure (HF) and iron deficiency are at increased risk of adverse clinical outcomes. We searched databases for randomised controlled trials that compared IV iron to placebo, in ...patients with HF with reduced ejection fraction (HFrEF). A total of 7,813 participants, all having HFrEF with 3,998 receiving IV iron therapy, and 3,815 control recipients were included. There was a significant improvement in Kansas City Cardiomyopathy Questionnaire favouring IV iron with MD 7.39, 95% CI 3.55, 11.22, p = 0.0002. Subgroup analysis, based on acute and chronic HF, has displayed a sustained statistical significance. Additionally, a significant increase in the left ventricular ejection fraction % was observed, with MD 3.76, 95% CI 2.32, 5.21, p < 0.00001. A significant improvement in 6-min walk test was noted, with MD 34.87, 95% CI 20.02, 49.72, p < 0.00001. Furthermore, IV iron showed significant improvement in NYHA class, peak VO2, serum ferritin, and haemoglobin levels. Finally, despite the lack of difference in terms of all-cause hospitalisation and HF-related death, IV iron was associated with a significant reduction in HF-related, any cardiovascular reason hospitalisations, and all-cause death; which supports the need for implementation of IV iron as a standard of care in patients with HF and iron deficiency.
Patients with severe uncontrolled asthma still experience acute asthma symptoms and exacerbations, particularly those with non-eosinophilic inflammation who take the maximum amount of standard drug ...therapy. Tezepelumab, a human monoclonal antibody, can improve lung function and enhance control of asthma symptoms in those patients, regardless of the disease's baseline characteristics. This study aims to investigate the safety and efficacy of using tezepelumab in controlling severe symptoms of uncontrolled asthma. We performed a comprehensive literature search in several databases, including PubMed, Scopus, Web of Science, Cochrane Library, and clinicaltrial.gov, using a well-established search strategy to include all relevant publications. According to our inclusion criteria, we searched for randomized controlled trials comparing tezepelumab versus placebo in patients with severe, uncontrolled asthma. We analyzed the data using The Revman 5.4 program software. The search identified 589 potential articles. After excluding studies inconsistent with selection criteria, four studies were included and analyzed qualitatively and quantitatively. The pooled effect demonstrated the better performance of tezepelumab over the placebo regarding the decrease in annualized asthma exacerbation rate (MD = - 0.74, (95% CI - 1.04, - 0.44, p < 0.00001)), asthma control questionnaire-6 (ACQ-6) Score MD = - 0.32, (95% CI - 0.43, - 0.21, p < 0.00001)), blood eosinophil count (MD = - 139.38 cells/mcL, (95% CI - 150.37, - 128.39, p < 0.00001)), feNO (MD = - 10 ppb, (95% CI - 15.81, - 4.18, p = 0.0008)) and serum total IgE (MD = - 123.51 UI/ml, (95% CI - 206.52, - 40.50, p = 0.004)). All tezepelumab groups had higher pre-bronchodilator forced expiratory volume in 1 s than the placebo group (MD = 0.16, (95% CI 0.10, 0.21, p < 0.00001)). Higher efficacy and safety profile was detected for tezepelumab to control the exacerbations of severe uncontrolled adult asthmatics.
Abstract Introduction While right ventricular pacing (RVP) is the conventional temporary pacing modality used for transcatheter aortic valve replacement (TAVR), this approach possesses inherent risks ...and procedural challenges. We aim to assess and compare the safety and efficacy of left ventricular pacing (LVP) and RVP during TAVR and balloon aortic valvuloplasty (BAV). Methods Following PRISMA guidelines, a comprehensive literature search was conducted in four databases from inception to December 15th, 2023. We included observational studies and clinical trials comparing LVP with RVP during TAVR and BAV procedures. Primary outcomes included short‐term mortality, mortality due to cardiac tamponade, and procedural complications including bleeding, vascular complications, and cardiac tamponade. Secondary outcomes comprised procedure duration and length of hospital stay. Results Five studies involving 830 patients with RVP and 1577 with LVP were included. Short‐term mortality was significantly higher in the RVP group (RR 2.32, 95% CI: 1.37–3.93, P = .002), as was the incidence of cardiac tamponade (RR 2.19, 95% CI: 1.11–4.32, P = .02). LVP demonstrated shorter hospital stays (MD = 1.34 d, 95% CI: 0.90, 1.78, P < .001) and reduced procedure duration (MD = 7.75 min, 95% CI: 5.08, 10.41, P < .00001) compared to RVP. New pacemaker implantation was higher in the RVP group (RR 2.23, 95% CI: 1.14, 4.39, P = .02). Conclusion LVP during TAVR and BAV emerges a safer alternative to RVP, offering reduced mortality, hospital stays, and procedure durations.
Postoperative complications pose significant challenges in cardiac surgery and with the evolution of selenium as a potential anti-inflammatory agent, some studies reported its inefficiency. Thus, we ...conducted our meta-analysis to evaluate the impact of selenium supplementation on cardiac surgery patients.
Different databases such as PubMed, Embase, and Cochrane Library from inception till January 2024 were searched identifying a total of seven randomized-controlled trials involving selenium supplementation after cardiac surgery. Risk ratio (RR) and Mean difference (MD) were calculated with a 95% confidence interval (CI).
The selenium intervention significantly raised the incidence of Acute Kidney injury (RR 0.76; 95% CI: 0.59, 0.98; P = 0.04) while significantly reducing the duration of hospital stay (MD -1.33; 95% CI: -2.51, -0.16; P = 0.03) and postoperative CRP levels (SMD -0.18; 95% CI: -0.34, -0.02; P = 0.03). The effect of selenium intervention on days spent in ICU (MD -0.01; 95% CI: -0.28, 0.25; P = 0.92), mortality (RR 1.07; 95% CI: 0.84, 1.37; P = 0.57) and incidence of hospital acquired infections (RR 0.98; 95% CI: 0.76, 1.26; P = 0.88) is insignificant.
Selenium supplementation did not significantly reduce major postoperative complications in cardiac surgery patients. However, its ability to modulate inflammation, as reflected in decreased C-reactive protein levels, highlights its potential role in managing the inflammatory response. Future investigations should focus on optimized selenium supplementation strategies in conjunction with other antioxidants to enhance its benefits.
•Heart failure (HF) is the most common cardiovascular cause of hospitalization in people over 60 years affecting about 64.3 million people worldwide.•In patients with diabetes, SGLT2Is significantly ...reduced cardiovascular mortality, HHF, and serious adverse events. However, in patients without, despite showing a significant reduction in HHF, SGLT2I reduced cardiovascular mortality or serious adverse events but without statistical significance.
Heart failure (HF) is the most common cardiovascular cause of hospitalization in patients over 60 years, affecting about 64.3 million patients worldwide. Few studies have investigated the role of sodium glucose cotransporter inhibitors (SGLT2Is) in patients with HF without and without diabetes. Thus, we conducted our meta-analysis to further investigate the role of SGLT2I role in patients with HF without and without diabetes. PubMed, Scopus, Web of Science, and Embase were searched. All clinical trials that compared the effect of SGLT2Is versus placebo on patients with HF were included. Dichotomous data were extracted, pooled as risk ratio (RR) with 95% confidence interval (CI), and analyzed using RevMan version 5.3 for windows using the Mantel-Haenszel method. A total of 13 randomized clinical trials were included for analysis, with a total number of 75,287 patients. SGLT2Is significantly lowered the risk of hospitalization for HF in patients with (RR = 0.68, 95% CI 0.63 to 0.74) and without diabetes (RR = 0.75, 95% CI 0.62 to 0.89). Furthermore, they lowered the mortality risk in both patients with diabetes with statistical significance (RR = 0.87, 95% CI 0.77 to 0.99), yet without statistical significance in patients without diabetes (RR = 0.93, 95% CI 0.70 to 1.23). Further analyses for serious adverse events were conducted, and SGLT2I showed a significant lower risk in patients with diabetes (RR = 0.94, 95% CI 0.90 to 0.98) and without diabetes (RR = 0.72, 95% CI 0.38 to 1.39). in patients with diabetes, SGLT2Is significantly reduced cardiovascular mortality, HHF, and serious adverse events. However, in patients without, despite showing a significant reduction in HHF, SGLT2I reduced cardiovascular mortality or serious adverse events but without statistical significance.
