METHOD: Docking simulation resulted in three top binding free energy tripeptides (WWF, WPW, and YWF) with comparable affinity towards a known S100A9 inhibitor (polyphenol oleuropein aglycone; OleA). Subsequently, pentapeptides that consist of the three core tripeptides were selected from a pre-constructed pentapeptide library for further evaluation with docking simulation. Based on best docked binding free energy, two pentapeptides (WWPWH and WPWYW) were selected and subjected to 500 ns molecular dynamics (MD) simulation to study the important features that lead to the binding with S100A9. MMGBSA binding free energy calculation estimated - 30.38, - 24.58, and - 30.31 kcal/mol for WWPWH, WPWYW, and OleA, respectively. The main driving force for pentapeptide-S100A9 recognition was contributed by the electrostatic interaction. The results demonstrate that at in silico level, this workflow is able to design potential pentapeptides that are comparable with OleA and might be the lead molecule for future use to disaggregate S100A9 fibrils.
METHODS: We conducted a cross-sectional survey of 408 health care providers from 42 LMICs. The survey collected data on the presence of dedicated neurointensive care units, workforce composition, access to critical care technologies, and adherence to evidence-based protocols. Data were analyzed using descriptive statistics, and comparisons were made across different geographical regions (East Asia and the Pacific, Europe and Central Asia, Latin America and the Caribbean, the Middle East and North Africa, and South Asia and sub-Saharan Africa) and economic strata [low-income countries (LICs), lower middle-income countries (LoMICs), and upper middle-income countries (UMICs)].
RESULTS: Only 36.8% of respondents reported access to dedicated neurointensive care units: highest in the Middle East (100%), lowest in sub-Saharan Africa (11.5%), highest in LoMICs (42%), and lowest in LICs (13%). Access to critical care technologies, such as portable computed tomography scanners (9.3%; UMICs 11%, LICs 0%) and tele-intensive care unit services (14.9%; UMICs 19%, LICs 10%), was limited. Workforce shortages were evident, with many institutions relying on anesthesia residents for 24-h care. Adherence to protocols, including those for acute ischemic stroke (61.7%) and traumatic brain injury (55.6%), was highest in Latin America and the Caribbean (72% and 73%, respectively) and higher in UMICs (66% and 60%, respectively) but remained low in LICs (22% and 32%, respectively).
CONCLUSIONS: The study highlights critical gaps in infrastructure, workforce, and technology across LMICs, yet it also underscores the potential for improvement. Strategic investments in neurointensive care unit capacity, workforce development, and affordable technologies are an unmet need in resource-limited settings. These findings offer a road map for policymakers and global health stakeholders to prioritize neurocritical care and reduce the disparities in patient outcomes globally.
METHODS: This is a single surgeon series of 14 cases of moderate and severe valgus osteoarthritic knees who underwent robotic-assisted TKA, utilizing the robotic surgical assistant ROSA® System.
RESULTS: All patients were restored to within 3° of the planned alignment. 8 patients were implanted with cruciate retaining implants, 2 had ultracongruent implants, 3 had posterior stabilized implants, and 1 had a constrained posterior stabilized implant. No patients required release of the popliteus tendon or origin of the lateral collateral ligament. No perioperative complications were encountered in all cases. All patients reported an improvement in the Forgotten Joint Score of > 10.8 at 1year follow up with a 100% satisfaction rate.
CONCLUSION: In this case series, the utilization of robotic assisted the surgeon to achieve a final limb alignment to within 3° of the planned alignment with minimal use of constrained prostheses and good patient-reported outcomes in moderate and severe valgus deformities.
METHODOLOGY: The research involved five subjects receiving mandibular advancement surgery (MAS). The quantification of TKE was performed both before and throughout the method using a combination of computational fluid dynamics (CFD) models and empirical measurements. A suitable grid size of 2.6 million cells for CFD simulations was determined by grid sensitivity analysis and corroborated with physical measurements.
RESULTS: The findings indicated a significant increase in TKE for each individual post-procedure, with increments varying from 23 % to 460 %. The elevated TKE indicates a more rapid airflow in the upper airway post-surgery. This is probably attributable to alterations in the airway's morphology resulting from the surgery. The observed rise in speed and turbulence is theoretically supported by Bernoulli's principle, which elucidates the relationship between air flow velocity and the pressure it generates.
CONCLUSIONS: This study demonstrates that mandibular advancement surgery efficiently alleviates OSA by markedly enhancing airflow and diminishing turbulence in the upper airway post-treatment. The use of physical validation and grid sensitivity analysis in computational fluid dynamics simulations underscores the meticulous technique utilised, offering a comprehensive assessment of the efficacy of the surgical interventions for OSA.
OBJECTIVE: This study aimed to assess in-hospital early mortality and analyze the factors associated with in-hospital early mortality among patients who underwent ViV TAVR.
METHODS: Using the all-payer, nationally representative National Readmission Database, our study included patients aged 18 years or older who had ViV TAVR between 2017 and 2020. We categorized the cohort into two groups depending on the occurrence of in-hospital early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of in-hospital early mortality after ViV TAVR and further analyzed the significant factors associated with it.
RESULTS: After adjustment, a total of 11,009 patients who had ViV TAVR were included in this study. 329 (3.0 %) had in-hospital early mortality and 10,680 (97.0 %) without. There was a decreasing trend in in-hospital early mortality from 3.3 % in 2017 to 1.0 % in 2020, but it was insignificant (p = 0.71). In multivariable analysis, the independent factors associated with in-hospital early mortality were chronic liver disease (adjusted odds ratio [aOR]: 3.62; 95 % confidence interval [CI]: 1.96-6.71, p
METHODS: A comprehensive literature search was conducted across five international databases and one national database, resulting in 3,652 identified records. After screening and applying eligibility criteria, 230 articles were included in this review. Data extraction focused on publication year, study design, sample types, diagnostic methods, reported pathogens, and geographic distribution. The aetiology of reported NTDs was categorized into four groups: viruses, bacteria, protozoa, and helminths.
RESULTS: Viral NTDs were the most frequently reported, accounting for 39% of the articles, followed by bacterial (26%), helminthic (21%), and protozoal NTDs (15%). Dengue virus, hepatitis B and C viruses were the most prominent viral pathogens, while bacterial NTDs were primarily caused by Escherichia coli, cholera, and Salmonella. Schistosomiasis and ascariasis were the most reported helminth infections, whereas leishmaniasis and malaria were the leading protozoal NTDs. Geographically, over 69% of the reported studies focused on northern Yemen, with the highest concentrations in Sana'a, Al Hudaydah, and Taiz. The review identified multiple risk factors, including poor sanitation, inadequate water quality, and urbanization, exacerbating NTD prevalence.
CONCLUSIONS: The findings highlight the significant burden and regional disparities of NTDs in Yemen, emphasizing the need for targeted interventions. Prioritizing improvements in sanitation, water quality, and vector control measures, alongside community engagement, is critical. Policymakers must allocate resources effectively to address the root causes of NTDs and strengthen Yemen's healthcare infrastructure.
MATERIALS AND METHODS: In this single-center, single-blinded parallel control trial, 27 participants were assigned to three groups using block randomization with a 1:1:1 allocation ratio; fixed bonded retention (FBR), vacuum-formed retention (VFR), and dual retention (DR) comprising both types. Data were collected every 3-months from debond (T0) for 12 months (T4). The primary outcomes measured changes in soft and dental tissue parameters on traced lateral cephalograms. Secondary outcomes included intra-arch changes and the oral health impact profile (OHIP-14[M]). This trial was registered with Clinicaltrial.gov (NCT04578704).
RESULTS: At T4, the upper lip, lower lip, and upper incisors moved anteriorly (mean difference (MD) of 1.63 mm (SD 3.7), 0.48 mm (SD 1.1), and 0.54 mm (SD 0.97), respectively). The upper and lower incisors were proclined by 0.96 degrees (SD 2.1) and 1.11 degrees (SD 2.63), respectively. The interincisal angle was reduced by 0.56 degrees (SD 1.23). Only the upper incisor inclination (UII) change showed significant differences between groups (η² = 0.296; p = 0.015). Post-hoc comparisons revealed that the FBR and VFR groups exhibited greater proclination than the DR group (UII, MD = 3.33 degrees and 3.22 degrees, respectively). No differences were observed in OHIP-14[M] scores between the groups.
CONCLUSION: All three retention protocols showed statistically small but clinically insignificant changes.
CLINICAL RELEVANCE: Dual retention offers better control in preventing upper incisor proclination in bimaxillary proclination cases.
TRIAL REGISTRATION: This trial was registered with Clinicaltrial.gov (NCT04578704).
METHODS: This cross-sectional online survey involved patients with asthma and physicians managing such patients from Southeast Asia (Indonesia, Malaysia, Philippines, Thailand and Vietnam) and the Middle East (Saudi Arabia and United Arab Emirates) included in the Asthma Patients' and Physicians' Perspectives on the Burden and Management of Asthma (APPaRENT) 3 study. Patients and physicians shared their attitudes and beliefs regarding treatment and adherence in asthma management.
RESULTS: Most patients (82%, 1108/1354) reported having ever received treatment with daily controller inhalers, whereas 38% used inhaled relievers at least once daily for symptomatic relief. Among those prescribed maintenance and reliever therapy, 93% were prescribed a separate inhaled reliever, with significant variation by country (P