Background
Interstitial lung diseases (ILDs) are parenchymal lung conditions that are chronic, progressive, and have a high morbidity and mortality rate. Due to restrictions in their gas exchange and ...ventilatory dysfunction, ILD patients are probably at risk for sleep-disordered breathing (SDB).
Methodology
Sixty-nine patients with diffuse parenchymal lung diseases identified by high-resolution computed tomography (HRCT) chest were included in the study. All patients were assessed by the STOP-BANG questionnaire (SBQ), Epworth sleepiness scale (ESS), and full-night polysomnography (PSG) for diagnosis and classification of SDB. The aim of the study is to examine the prevalence and risk factors for SDB in ILD.
Results
Among the study group hypersensitivity pneumonitis (HP) was the most prevalent ILD, accounting for 63.8% of cases. Out of 69 individuals, 42 (60.9%) had SDB, 57.1% of those with SDB had obstructive sleep apnea (OSA), and the majority of those with OSA had mild degrees (21.7%,
n
= 15).
Conclusion
OSA is significantly common in ILD patients. Higher left atrium diameter and oxygen desaturation index (ODI) are predictive factors of SDB. To facilitate early diagnosis and therapy, PSG should be performed on ILD patients at high risk (such as males, individuals with high ESS scores, SBQ scores, and left atrium diameter).
Trial registration
Retrospectively registered, registration number is NCT06012526, date of registration August 25, 2023.
Backgrounds
Although metered‐dose inhalers (pMDI) therapy is convenient and widely prescribed, its use usually results in repetitive inhalation technique errors.
One of the most repetitive errors is ...inhaling too fast through the pMDI. The present study aimed to evaluate the effect of Clip‐tone® along with smartphone visual feedback application on the subject's inhalation time.
Methods
Two hundred subjects were included in the study. They were randomised into four groups. Group 1 received only verbal counselling; group 2 received verbal counselling with resistance (a modified Clip‐tone® that does not produce whistle attached to their pMDI); group 3 received verbal counselling plus whistle (as audio feedback) from ordinary Clip‐tone® and group 4 received verbal counselling plus audio feedback (whistle) from Clip‐tone® and visual feedback (smartphone application). Inhalation time through the pMDI for each subject was recorded three times and inter and intra‐subjects variations were calculated.
Results
Verbal counselling plus audio feedback and verbal counselling plus audio and visual feedbacks groups had 45/50 (90%) and 37/50 (74%) subjects respectively, having correct inhalation flow (inhaling at between 3 to 7 seconds). Verbal counselling plus audio feedback and verbal counselling plus audio and visual feedbacks groups' inter and intra‐subjects variations were lower than that of verbal counselling and verbal counselling with resistance groups which had 28/50 (52%) and 20/50 (40%) subjects respectively, with inhalation time between 3 and 7 seconds.
Conclusions
Providing audio feedback by the Clip‐tone® along with smartphone visual feedback application maintained the deep and slow inhalation through pMDI much better compared to verbal counselling only. We recommend the patients to take all their inhaled doses using pMDI attached to a training device like Clip‐tone® along with a smartphone visual feedback application for optimisation of the aerosol delivery from the pMDI.
Introduction
Aerosol delivery from DPIs could be affected by different factors. This study aimed to evaluate and predict the effects of different factors on drug delivery from DPIs.
Methods
Modelling ...and optimisation for both in vitro and in vivo data of different DPIs (Diskus, Turbohaler and Aerolizer) were carried out using neural networks associated with genetic algorithms and the results are confirmed using a decision tree (DT) and random forest regressor (RFR). All variables (the type of DPI, inhalation flow, inhalation volume, number of inhalations and type of subject) were coded as numbers before using them in the modelling study.
Results
The analysis of the in vitro model showed that Turbohaler had the highest emitted dose compared with the Diskus and the Aerolizer. Increasing flow resulted in a gradual increase in the emitted dose. Little differences between the inhalation volumes 2 and 4 litres were shown at fast inhalation flow, and interestingly two inhalations showed somewhat higher emitted doses than one‐inhalation mode with Turbohaler and Diskus at slow inhalation flow. Regarding the in vivo model, the percent of drug delivered to the lung was highly increased with Turbohaler and Diskus in healthy subjects where continuous contour lines were observed. The Turbohaler showed increased lung bioavailability with the two‐inhalation modes, the Diskus showed a nearly constant level at both one and two inhalations at slow inhalation. The Turbohaler and Aerolizer showed little increasing effect moving from one to two inhalations at slow inhalation.
Conclusions
Modelling of the input data showed a good differentiating and prediction power for both in vitro and in vivo models. The results of the modelling refer to the high efficacy of Diskus followed by Turbohaler for delivering aerosol. With two inhalations, the three DPIs showed an increase in the percent of drug excreted at slow inhalations.
Cyclophosphamide (CP) is used to treat a variety of cancers and autoimmune illnesses. CP has been found to frequently cause premature ovarian failure (POF). The study's objective was to assess ...LCZ696's potential for protection against CP-induced POF in a rat model.
Rats were randomly assigned into seven groups as follows: control, valsartan (VAL), LCZ696, CP, CP + VAL, CP + LCZ696, and CP + triptorelin (TRI). Ovarian malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD), interleukin-18 (IL-18), IL-1β, and tumor necrosis factor-alpha (TNF-α) were assessed using ELISA. Serum anti-mullerian hormone (AMH), estrogen, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were also measured using ELISA. The expression of NLRP3/Caspase-1/GSDMD C-NT and TLR4/MYD88/NF-B P65 proteins was estimated using western blot assay. The histopathology of the ovaries was also investigated. The estrous cycle, body, and ovarian weights were also monitored.
CP treatment significantly elevated levels of MDA, IL-18, IL-1β, TNF-α, FSH, LH, and up-regulated TLR4/NF-κB/NLRP3/Caspase-1 proteins, as compared to the control group, however, ovarian follicles count, and levels of GSH, SOD, AMH, and estrogen were reduced with CP administration. All the aforementioned biochemical and histological abnormalities were considerably alleviated by the LCZ696 therapy compared to valsartan alone.
LCZ696 effectively mitigated CP-induced POF, offering promising protection that could be related to its suppression power on NLRP3-induced pyroptosis and TLR4/NF-B P65 pathway.
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Antioxidants given concurrently with chemotherapy offer an effective strategy for reducing the negative effects of the drug. One remaining obstacle to the use of doxorubicin (DOX) in chemotherapy is ...cardiotoxicity. Using vitamin E (Vit. E) as a reference standard, our study focuses on the potential preventive benefits of oxyresveratrol (ORES) and/or dapagliflozin (DAPA) against DOX-induced cardiac injury. Acute cardiotoxicity was noticed after a single intravenous injection of a male rat's tail vein with 10 mg/kg of DOX. Oral doses of ORES (80 mg/kg), DAPA (10 mg/kg), and Vit. E (1 g/kg) were given, respectively. Pretreatment of animals with Vit. E, ORES and/or DAPA revealed a considerable alleviation of heart damage, as evidenced by histopathological change mitigation and a notable drop in serum AST, LDH, CK, CK-MB, and cardiac contents of MDA and NO2−. Also, serum TAC, tissue GSH, and SOD showed substantial increases. Additionally, tissue caspase-3, serum IL-6, and TNF-α were considerably reduced. Moreover, a downregulation in cardiac gene expression of ATG-5, Keap-1, and NF-κB in addition to an upregulation of Bcl-2 gene expression and HO-1, Nrf-2, and PPAR-γ protein expression clearly appeared. Ultimately, ORES and/or DAPA have an optimistic preventive action against severe heart deterioration caused by DOX.
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•The most often administered anthracycline antibiotic during chemotherapy is doxorubicin (DOX).•Acute cardiotoxicity is one of DOX's primary adverse effects.•Oxyresveratrol (ORES) and/or dapagliflozin (DAPA) have a number of biological and pharmacological activities.•Either ORES or DAPA inhibited the expression of TNF-α, IL-6, Keap-1, NF-κB, caspase-3, and ATG-5.•HO-1, Bcl-2, PPAR-γ, and Nrf-2 were all elevated by ORES and/or DAPA.
The recent coronavirus disease (COVID-19) pandemic is associated with increasing morbidity and mortality and has impacted the lives of the global populations. Human behavior and knowledge assessment ...during the crisis are critical in the overall efforts to contain the outbreak. To assess knowledge, attitude, perceptions, and precautionary measures toward COVID-19 among a sample of medical students in Jordan. This is a cross-sectional descriptive study conducted between the 16th and 19th of March 2020. Participants were students enrolled in different levels of study at the six medical schools in Jordan. An online questionnaire which was posted on online platforms was used. The questionnaire consisted of four main sections: socio-demographics, sources of information, knowledge attitudes, and precautionary measures regarding COVID-19. Medical students used mostly social media (83.4%) and online search engines (84.8%) as their preferred source of information on COVID-19 and relied less on medical search engines (64.1%). Most students believed that hand shaking (93.7%), kissing (94.7%), exposure to contaminated surfaces (97.4%), and droplet inhalation (91.0%) are the primary mode of transmission but were indecisive regarding airborne transmission with only 41.8% in support. Participants also reported that elderly with chronic illnesses are the most susceptible group for the coronavirus infection (95.0%). As a response to the COVID-19 pandemic more than 80.0% of study participants adopted social isolation strategies, regular hand washing, and enhanced personal hygiene measures as their first line of defense against the virus. In conclusion, Jordanian medical students showed expected level of knowledge about the COVID-19 virus and implemented proper strategies to prevent its spread.
Many techniques have been and are being made to find alternatives to water-saving practices. Among them, Partial root drying (PRD), one effective approach, plays a major role in reducing the harmful ...effects of water deficit stress. Field experiments were carried out on mango trees for a private farm in Egypt over the course of two years, 2020/2021 to 2021/2022, in an area with sandy soil, hot summer conditions, and cold and rainy winter conditions. In the experiment that was carried out, the experimental design included using different irrigation strategies (I1, 100% full irrigation “FI”; I2, 75% FI; I3, 50% FI; and I4 (PRD), 50% FI) in the main plot and different amounts of organic mulch in the soil (L0, no layers of organic soil mulch, used as a control; L1, a single layer of organic soil mulch; L2, two layers of organic soil mulch; and L3, three layers of organic soil mulch) in subplots of the main plot in order to inspect the impact of the treatments on yield, water productivity, and energy usage under arid conditions. To meet the study’s objective, two field experiments were carried out at a private farm. Our results demonstrate a general decrease in water stress and salt accumulation inside the root-zone area with PRD and L3. During the 2020/2021 and 2021/2022 seasons the PRD strategy increased fruit yields by 3.7 and 7.3% and water productivity by 51.9 and 53.1%, respectively, compared with the control treatment (I1) while reducing the amount of applied irrigation water by 50%. The PRD strategy along with organic mulching showed superior results with respect to increasing mango yields and water productivity. In general, PRD can be used as a good technique to save water and energy by up to 50% while enhancing productivity, ultimately improving mango yields under arid climatic conditions. Thus, it may prove a good adaptation strategy for current and future water shortage scenarios involving climate change.
Deregulation of noncoding RNAs, microRNAs (miRNAs) and long noncoding RNA (lncRNA), are implicated in the initiation and progression of gastric cancer (GC). This study is a pilot case‐control study ...carried out on 75 subjects, 40 of them were Helicobacter pylori‐gastric ulcer patients and 35 were GC patients recruited from the Gastrointestinal Endoscopy Unit in Al‐Kasr Al‐Aini Hospital, Cairo University in Egypt. Real‐time PCR was performed to evaluate the expression level of serum miR‐204, miR‐182, and lncRNA H19 in patients with peptic ulcer‐progressed GC vs nonprogressed peptic ulcer patients. Fibroblast growth factor 18 (FGF‐18)/FGF receptor 2 (FGFR2) expression and their downstream immunological and inflammatory signaling markers were assessed and their association with the addressed noncoding RNAs investigated. As regards miR‐204 and miR‐182, they were significantly increased (12.5 and 2.6 folds, respectively) in GU samples, compared with those of healthy control levels. The elevated levels of these miRNAs were significantly de‐escalated in GC samples compared with GU and the fold decrease valued 2.2 fold for miR‐204 and 1.8 folds for miR‐182. On the other hand, the significant escalation in the level of lnRNA H19 in GU recorded a 16.6 fold increase and further elevation in its levels was evident in GC samples. The herein assessed miRNAs are correlated with disease duration and FGFR2 with miR‐182 being significantly correlated with all inflammatory markers, TAC, INF‐γ, matrix metallopeptidase 9, and FGF‐18. In terms of diagnostic accuracy of assessed miRNAs (stages III to IV), the receiver operating characteristic analysis indicated that serum lncRNA H19 showed the highest diagnostic accuracy (95.5%), specificity (100%), and sensitivity (90.9%), compared with miR‐204 and miR‐182, which showed the same specificity (60%), sensitivity (72.7%), and diagnostic accuracy (68.8%). Our findings conclude that lnRNA H19, miR‐204, and miR‐182 may function as novel prospective plasma biomarkers to detect GC and its progression from H. pylori‐peptic ulcer, which would be helpful to improve the theranostics of GC.
This study is a case‐control study aiming to evaluate the expression level of serum miR‐204, miR‐182, and long noncoding RNA (lncRNA) H19 in patients with peptic ulcer‐progressed gastric cancer (GC) (35) vs nonprogressed peptic ulcer patients (40).
As regards the selected noncoding RNAs, miR‐204 and miR‐182, they all were significantly increased in GU samples compared with healthy control levels and the levels of increase were 12.5 and 2.6 folds, respectively. The elevated levels of these microRNAs (miRNAs) were significantly de‐escalatd in GC samples compared with GU and the fold decrease valued (2.2‐1.8 folds).
On the other hand, the significant escalation in the level of lnRNA H19 in GU was a 16.6 fold increase and further elevation in its levels was evident in GC samples.
The herein assessed miRNAs are correlated with disease duration and fibroblast growth factor receptor 2, with miR‐182 being significantly correlated with all inflammatory markers; TAC, INF‐γ, matrix metallopeptidase 9, fibroblast growth factor 18.
In terms of the diagnostic accuracy of assessed miRNAs (stages III to IV), the receiver operating characteristic analysis indicated that serum lnRNA H19 showed the highest diagnostic accuracy (95.5%), specificity (100%), and sensitivity (90.9%), compared with miR‐204, and miR‐182, which showed the same specificity (60%), sensitivity (72.7%), and diagnostic accuracy (68.8%).
In desert regions, several environmental challenges have the potential to reduce solar energy production. These are the formation of thinly crusted mud and/or carbonates coatings caused from ...deposited dust aerosols during humid conditions and other weather conditions. These challenges that profoundly affect photovoltaic panel surfaces as well as wind turbines were delineated to conclude the potential feasibility to establish solar and/or wind energy systems in Kuwait. The study concluded that photovoltaic (PV) cells are not the most suitable energy source for Kuwait due to the above mentioned environmental challenges; therefore, alternative renewable energy sources are considered more feasible. After one year of operation at solar units and wind farms in Kuwait, the results clearly show that wind energy records energy production numbers that exceed the industry average. This was associated with high capacity factors throughout the year, resulting in an annual power production that is 2.3 times higher than that of PV; powering 450 homes compared to 199 homes for PV. West of the state of Kuwait and the Bubiyan Island are the recommended potential sites for wind farm establishment.
•The photovoltaic (PV) cells are not the most suitable energy source for Kuwait due to certain environmental challenges.•The solar power efficiency was highly affected by environmental challenges.•The wind energy production records exceed the industry average.•The potential sites for wind farm establishment were identified.
A main challenge hindering the development of efficient solar fuel cell systems is the identification of robust, cost-effective, and abundant catalysts. Herein, we demonstrate the ability to ...synthesize photoactive, relatively cheap and abundant catalyst for the solar-assisted water splitting. The proposed catalyst is a composite of CoCu/graphene immobilized on hierarchical hollow mesoporous Titania. Diffuse Reflectance analysis showed visible light absorption for (CoCu) 2%TiO2/RGO with an estimated band gap of 2.41 eV, as compared to 3.13 eV for Titania. Photoluminescence spectra showed a significant decreasing in recombination rate of photogenerated electron-hole pair for (CoCu) 2%TiO2/RGO nanocomposites. Upon their use as photoanodes in solar fuel cells, the fabricated nanocomposites show 14-fold increase in photocurrent density compared to Titania. This enhancement was confirmed via the measurement of electron and phonon life times. The results attained in this study demonstrate a step toward using non-precious co-catalysts to boost the performance of photocatalysts in solar fuel cells.
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•(Cu0Co0)xTiO2/RGO hybrid composite photoanodes were fabricated.•The water splitting performance increases with increasing co-catalyst content.•The composite showed 14-fold increase in the photocurrent.•Electron lifetimes in the hybrid composite are longer than those in pristine titania.•RGO stabilizes the co-catalysts and shuttle the electrons.
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