Purpose of review
The current systematic review aims to provide novel insights into the distinct pathological features of acute coronary syndrome (ACS) with intact fibrous cap, also known as ‘plaque ...erosion’. A more detailed understanding of its underlying pathomechanisms provides the basis for future personalized therapeutic approaches to ACS.
Recent findings
In the past years, a mounting proportion of evidence point towards the concept of plaque erosion being responsible for more than one-third of all cases of ACS and representing an autonomous ACS-causing entity driven by biomechanical forces, immunological alternations and systemic elevation of inflammatory mediators. First pilot studies proved a therapeutic paradigm shift from primary PCI at the ACS-causing culprit lesion to systemic therapies in patients with ACS caused by plaque erosion.
Summary
This review provides the current status of the broad basic and clinical studies focused to the topic of plaque erosion: a new ACS-causing pathophysiology with different pathological aspects providing appropriate implications for personalized therapies in ACS.
Objectives The present study was done at Damanhour Teaching Hospital to identify the following aims: To estimate the prevalence rate % of NI among different dept. in the hospital. To determine the ...influence of the number of sinks on the NI rate %. To assess the knowledge of the medical staff regarding the importance and the proper way of hand washing. To focus on the importance of hospital design in developing countries. Patients and Methods The target population for this study consisted of 217 patients admitted at the hospital ς< = 48 hours. A questionnaire was developed by the researchers after reviewing literature. This questionnaire composed of two parts, the first part elicited the clinical examination supported by the laboratory and x-rays investigations to assure the exactly number of the nosocomial infected patients among 217 patients the, second part included questions covering the number of sinks, number of occupied beds, number of medical staff in the chosen hospital departments. Samples were taken from the wounds aerobically and nonaerobically. Results and discussion The sinks are completely insufficient for hand washing (about one sink for every 40 medical staff). The data showed that E.coli is the microorganism most commonly isolated from nosocomial infected patients which improve the improper hand washing and the poor personal hygiene.
Metastable γ-CsPbI3 is a promising solar cell material due to its suitable band gap and chemical stability. While this metastable perovskite structure can be achieved via introducing external ...pressure or strain, experimenting with this material is still challenging due to its phase instability. In this work, we present the first instance of exploiting various machine learning (ML) models to efficiently predict the band gap and enthalpy of metastable γ-CsPbI3 under pressure or strain while identifying key structural features that determine these properties. ML models trained on experimentally benchmarked, first-principles calculation datasets exhibit excellent performance in predicting the behavior of tuned systems, comparable to predictions made for ambient material databases. In particular, graph neural networks (GNNs) that explicitly include a graph encoding the bond angle information outperform other ML models in most scenarios. The pressure-tuned system demonstrates a strong linear relationship between structural features and properties, effectively captured by global structural features using linear regression models. In contrast, the strain-tuned system shows a non-linear relationship, exhibiting superior prediction performance using GNNs trained on local environments. This study opens up opportunities to apply and develop ML models for understanding and designing materials under extreme conditions.
Objective To review complications of robot-assisted partial nephrectomy (RAPN) at 5 centers, as classified by the Clavien system. Materials and Methods A multi-institutional analysis of prospectively ...maintained databases assessed RAPN complications. From June 2007 to November 2011, 886 patients at 5 United States centers underwent RAPN. Patient demographics, perioperative outcomes, and complications data were collected. Complication severity was classified by Clavien grade. Results Mean (standard deviation) data were patient age, 59.4 (11.4) years; age-adjusted Charlson Comorbidity Index, 3.0 (1.9); radiographic tumor size, 3.0 (1.6) cm; nephrometry score, 6.9 (2.0); and warm ischemia time, 18.8 (9.0) minutes. Median blood loss was 100 mL (interquartile range, 100-250 mL). Of the 886 patients, intraoperative complications occurred in 23 patients (2.6%) and 139 postoperative complications occurred in 115 patients (13.0%) for a total complication rate of 15.6%. Among the 139 postoperative complications, 43 (30.9%) were classified as Clavien 1, 64 (46.0%) were Clavien 2, 21 (15.1%) were Clavien 3, and 11 (7.9%) were Clavien 4. No complication-related deaths occurred. Intraoperative hemorrhage occurred in 9 patients (1.0%) and postoperative hemorrhage in 51 (5.8%). Forty-one patients (4.6%) required a perioperative blood transfusion, 10 (1.1%) required angioembolization, and 2 (0.2%) required surgical reexploration for postoperative hemorrhage. Urine leaks developed in 10 patients (1.1%): 3 (0.3%) required ureteral stenting, and 2 (0.2%) required percutaneous drainage. Acute postoperative renal insufficiency or renal failure developed in 7 patients (0.8%), 2 of whom required hemodialysis. The RENAL (radius, exophytic/endophytic properties of the tumor, nearness of tumor deepest portion to the collecting system or sinus, anterior/posterior descriptor and the location relative to polar lines) nephrometry scoring system accurately predicted RAPN complication rates. Conclusion Complication rates in this large multicenter series of RAPN appear to be acceptable and comparable with other nephron-sparing modalities. Most complications (77.0%) are Clavien 1 and 2 and can be managed conservatively.
The Egyptian lower Eocene carbonate rocks (Thebes Formation) are part of an extensive carbonate platform formed during an eustatic regression along the Tethyan Ocean's southern margin. These rocks ...are essential in developing Egypt's petroleum system because they can operate as vertical seals in specific basins or as source-reservoir rocks. However, few in-depth studies have been conducted to explore the diagenetic history, pore system, petrophysical characteristics, and sequence stratigraphic framework of these rocks and its relationship to the global sequences. Multiple datasets (foraminiferal assemblages, petrographic, and petrophysical data) from the lower Eocene strata exposed in Wadi El-Dakhl and El-Sheikh Fadl sections on the western side of the Gulf of Suez were integrated. The biostratigraphic examination of the planktic foraminifera shows that three Eocene biozones (E5–E7) were identified in the studied successions. The reservoir quality index and the flow zone indicator show that reservoir quality ranges from poor to fair and good. The primary reservoir porosity was resulted from diagenetic processes, including dissolution, fracturing, and meteoric diagenesis, which enhanced reservoir quality. The inferred benthic foraminifera and petrographic studies indicate a shallowing upward trend and deposition in fluctuating settings ranging from upper slope to middle shelf. This progressive reduction in the relative sea level corresponds to a gradual eustatic decline and demonstrates the enhanced control of tectonic activity and eustasy. Consequently, the Thebes Formation was deposited due to Tethyan sea-level changes, and its pore system was influenced by tectonics associated with the Syrian Arc system and Gulf of Suez rifting.
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Dates have been consumed since ancient times as functional foods which beside their high nutritional value possess various biological activities. Phoenix rupicola T. Anderson (Cliff ...date palm) produces non-conventional edible dates, however, due to low natural abundance, these dates aren’t commercially important as the dates of Phoenix dactylifera L. The present study was designed to evaluate the phytochemical constituents as well as the estrogenic activity of P. rupicola dates. UPLC-ESI-MS/MS approach was used to study the metabolite profile of the 70% aqueous methanol extracts of P. rupicola dates (pulps and seeds) for the first time. A total of fifty-five metabolites were tentatively identified in both extracts, belonging to different classes, chiefly phenolic compounds viz. procyanidins, flavonoid glycosides, hydroxycinnamic acid derivatives, as well as, fatty acids, organic acids and sphingolipids. Acute toxicity studies revealed that the studied extracts were safe at oral doses up to 2 g/kg. Besides, they possessed significant (P < 0.05) estrogenic activity in ovariectomized rat model, as compared to ovariectomized (OVX) and reference standard (17β-estradiol; OVX-E) groups. Moreover, the extracts showed significant improvement on bone metabolism, lipid profile, liver and kidney functions. In silico docking study revealed that various metabolites possessed high binding affinities to both ERs, where 2-palmitoyl glycerol (-10.28 Kcal/mol) and aminotetradecanetriol (-9.61 Kcal/mol) showed the strongest affinities to Erα and Erβ, respectively. Thus, it can be concluded that P. rupicola pulp and seeds possess bioactive phytoconstituents comparable to those in P. dactylifera and can be used as a safe and efficient natural estrogen substitute in postmenopausal women.
The chemical composition of
bark essential oil (PRO) was qualitatively and quantitatively determined using GC/FID and GC/MS. The anti-inflammatory activity was assessed in vitro by evaluating the ...binding percentages on the cannabinoids and opioids receptors. Bleomycin (BLM)-induced pulmonary inflammation in
mice was adopted to assess PRO anti-inflammatory efficacy in vivo. In silico molecular modelling of its major components was performed on human glucocorticoids receptor (GR). Seventy-five components were identified in which longifolene (33.13%) and palmitic acid (9.34%) constituted the predominant components. No binding was observed on cannabinoid receptor type 1 (CB1), whereas mild binding was observed on cannabinoid receptor type 2 (CB2),
,
, and
receptors accounting for 2.9%, 6.9%, 10.9% and 22% binding. A significant in vivo activity was evidenced by reduction of the elevated malondialdehyde (MDA), nitric oxide (NO), myeloperoxidase (MPO), interleukin-6 (IL-6), and tumor necrosis factor-
(TNF-
) levels by 55.56%, 55.66%, 64.64%, 58.85% and 77.78% with concomitant elevation of superoxide dismutase (SOD) and catalase (CAT) activities comparable to BLM-treated group at 100 mg/kg body weight. In silico studies showed that palmitic acid exerted the fittest binding. PRO could serve as a potent anti-inflammatory natural candidate that should be supported by further clinical trials.
Purpose
The purpose of this study is to examine determinants of profitability of non-financial firms listed small- and medium-sized enterprises (SMEs) in the UK from 2012 till 2020. It has been ...argued that profitability plays a key role in economic development and growth. Despite the important role that SMEs play in developed economies like UK, academic research into SMEs profitability determinants in developed countries is not extensive.
Design/methodology/approach
The methodologies used include dynamic panel data estimation techniques. Relationship of nine independent variables with profitability was examined. Two models are created using return on assets (ROA) and return on equity (ROE) as dependent variables. Size, age, efficiency, working capital, liquidity, leverage and volatility of the firm represent firm-specific independent variables. Two macroeconomic variables, namely, gross domestic product and inflation are also used as independent variables. Data obtained from Thomson Reuters Data Stream for 93 listed SMEs companies in the UK from 2012 to 2020. Fixed effects, random effects and generalized method of moments were used in data analysis.
Findings
All variables showed significant influence on profitability, except liquidity reflecting insignificant impact on profitability in two regression models conducted for 93 firms under study. Efficiency, liquidity and leverage are the only three independent variables with similar impact on both ROA and ROE.
Practical implications
Identifying determinants of profitability will help stakeholders and corporate executive make sound decisions to ensure sustainability and stability at the firm level. This is particularly important given the key role played by SMEs in economic development and growth. The findings of this study would help direct financial management practices to ensure a favorable sustainable organizational performance.
Originality/value
This study differs from previous studies that focused mainly on developing countries; with limited research conducted on profitability of SMEs in developed economies. To the best of the author’s knowledge, this is the first study to examine factors influencing profitability of SMEs in UK. Previous studies concentrated on service sector like insurance and hotel firms.
Abstract Background Ongoing efforts are focused on minimizing or eliminating renal ischemia during robot-assisted partial nephrectomy (RPN). Although various techniques allowing the elimination of ...renal hilar clamping have been described, large multi-institutional studies assessing perioperative and functional outcomes of this approach are lacking. Objective To evaluate perioperative and functional outcomes of RPN without hilar clamping and to assess comparative effectiveness relative to clamped RPN. Design, setting, and participants A multi-institutional data analysis of prospectively collected records of 886 RPNs performed by high-volume surgeons across five academic institutions between 2007 and 2011 was carried out. A total of 66 patients who underwent RPN without hilar clamping were identified. After the exclusion of 17 patients, perioperative results of 49 patients were compared against propensity score matched clamped controls. Intervention RPN without hilar clamping. Outcome measurements and statistical analysis Descriptive statistics and propensity score matching. Results and limitations Patients undergoing off-clamp RPN had a mean tumor size of 2.5 cm (standard deviation SD: ±2.1) and a mean RENAL nephrometry score of 5.3 (SD: ±1.5). The mean preoperative estimated glomerular filtration rate (eGFR) was 81 (SD: ±29). The mean estimated blood loss (EBL) was 210 ml (SD: ±212), and the mean operative time was 155 min (SD: ±46). No Clavien 3–5 complications were recorded. The mean postoperative change in eGFR was 3% at first follow-up (1–3 mo), and no patient required postoperative dialysis. The positive surgical margin rate was 3% ( n = 2), with no disease recurrence reported at a mean follow-up of 21 mo. In propensity score matched analyses, the off-clamp RPN patients had a significantly shorter mean operative time (156 min compared with 185 min, p < 0.001), a higher EBL (228 ml compared with 157 ml, p = 0.009), and a smaller decrease in eGFR (2% compared with −6%, p = 0.008). The retrospective analysis was the main limitation of this study. Conclusions With appropriately selected patients and adequate surgeon experience, off-clamp RPN is safe and feasible. Off-clamp RPN was associated with higher EBL, shorter operative times, and smaller decrease in renal function.
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