COVID-19 vaccination and acute infection result in cellular and humoral immune responses with various degrees of protection. While most studies have addressed the difference in humoral response between vaccination and acute infection, studies on the cellular response are scarce. We aimed to evaluate differences in immune response among vaccinated patients versus those who had recovered from COVID-19. This was a prospective study in a tertiary medical centre. The vaccinated group included health care workers, who had received a second dose of the BNT162b2 vaccine 30 days ago. The recovered group included adults who had recovered from severe COVID-19 infection (<94% saturation in room air) after 3-6 weeks. Serum anti-spike IgG and cytokine levels were taken at entry to the study. Multivariate linear regression models were applied to assess differences in cytokines, controlling for age, sex, BMI, and smoking status. In total, 39 participants were included in each group. The mean age was 53 ±14 years, and 53% of participants were males. Baseline characteristics were similar between the groups. Based on multivariate analysis, serum levels of IL-6 (β=-0.4, p<0.01), TNFα (β=-0.3, p=0.03), IL-8 (β=-0.3, p=0.01), VCAM-1 (β=-0.2, p<0.144), and MMP-7 (β=-0.6, p<0.01) were lower in the vaccinated group compared to the recovered group. Conversely, serum anti-spike IgG levels were lower among the recovered group (124 vs. 208 pg/mL, p<0.001). No correlation was identified between antibody level and any of the cytokines mentioned above. Recovered COVID-19 patients had higher cytokine levels but lower antibody levels compared to vaccinated participants. Given the differences, these cytokines might be of value for future research in this field.

Primary Sjögren syndrome (pSS) is a systemic autoimmune disorder that affects various systems in the body, resulting in symptoms such as dry eyes and mouth, pain, and fatigue. Inflammation plays a critical role in pSS and its associated complications, with chronic inflammation being a common occurrence in patients with pSS. This review of the literature highlights inflammatory markers that could serve as indicators to predict disease progression in pSS. Laboratory markers are frequently and significantly increased in pSS patients, including erythrocyte sedimentation rate, C-reactive protein, complement proteins, S100 proteins, cytokines (IFNs, CD40 ligand, soluble CD25, rheumatoid factors, interleukins, and TNF-α), and chemokines (CXCL13, CXCL10, CCL2, CXCL11, and CCL25). These inflammatory markers can be used as prognostic indicators for disease progression in pSS. In conclusion, the results from the studies reported in this review indicate that high levels of inflammatory markers may serve as markers for disease progression of pSS, which, in turn, may be valuable in predicting disease outcome.

UNASSIGNED: Cigarette smoking can lead to a host of adverse health effects such as lung and heart disease. Increased lung cancer risk is associated with inhalation of carcinogens present in a puff of smoke. These carcinogenic compounds deposit in the lung at different sites and trigger a cascade of events leading to adverse outcomes. Understanding the site-specific deposition of various smoke constituents will inform the study of respiratory diseases from cigarette smoking. We previously developed a deposition model for inhalation of aerosol from electronic nicotine delivery systems. In this study, the model was modified to simulate inhalation of cigarette smoke consisting of soluble and insoluble tar, nicotine, and cigarette-specific constituents that are known or possible human carcinogens.
UNASSIGNED: The deposition model was further modified to account for nicotine protonation and other cigarette-specific physics-based mechanisms that affect smoke deposition. Model predictions showed a total respiratory tract uptake in the lung for formaldehyde (99%), nicotine (80%), and benzo[a]pyrene (60%).
UNASSIGNED: The site of deposition and uptake depended primarily on the constituent\'s saturation vapor pressure. High vapor pressure constituents such as formaldehyde were preferentially absorbed in the oral cavity and proximal lung regions, while low vapor pressure constituents such as benzo[a]pyrene were deposited in the deep lung regions. Model predictions of exhaled droplet size, droplet retention, nicotine retention, and uptake of aldehydes compared favorably with experimental data.
UNASSIGNED: The deposition model can be integrated into exposure assessments and other studies that evaluate potential adverse health effects from cigarette smoking.

Depression is a global health concern, particularly in the geriatric population. The increasing number of hospital admissions among older individuals highlights the need for healthcare professionals, particularly nurses, to understand and treat geriatric depression. Nurses play a crucial role in caring for older adults with depressive symptoms or depression. This study aimed to assess knowledge and attitudes regarding geriatric depression among primary care nurses in Jazan Region, Saudi Arabia. A cross-sectional study was conducted among 210 primary healthcare nurses in Jazan City using a validated self-administered questionnaire. Knowledge scores were measured and compared among selected demographic variables as well as attitudes toward geriatric depression. Data obtained were analyzed using the Statistical Package for the Social Sciences, version. 20.0. Chi-square test, fisher\'s exact test were used for comparison of variables with categorical data. Most primary care nurses were interested in caring for older patients with depression; however, they never attended training courses focused on geriatric depression. Where the study indicated that 38.1% of participants have poor knowledge about geriatric depression while 25.2% have good knowledge. Where the majority had a high understanding of the potential side effects of antidepressant medications, while they had limited knowledge about symptoms, diagnosis, and medications, the majority of participants demonstrated a positive attitude regarding feeling comfortable dealing with depressed patients\' needs (56.7%) and considered their profession as a well-placed to assist patients (83.3%) However, 15.2% had a negative attitude citing a lack of self-discipline and willpower.
La dépression est un problème de santé mondial, en particulier dans la population gériatrique. Le nombre croissant d’hospitalisations chez les personnes âgées met en évidence la nécessité pour les professionnels de santé, en particulier les infirmières, de comprendre et de traiter la dépression gériatrique. Les infirmières jouent un rôle crucial dans la prise en charge des personnes âgées présentant des symptômes dépressifs ou une dépression. Cette étude visait à évaluer les connaissances et les attitudes concernant la dépression gériatrique parmi les infirmières de soins primaires de la région de Jazan, en Arabie Saoudite. Une étude transversale a été menée auprès de 210 infirmières de soins primaires de la ville de Jazan à l\'aide d\'un questionnaire auto-administré validé. Les scores de connaissances ont été mesurés et comparés parmi certaines variables démographiques ainsi que les attitudes à l\'égard de la dépression gériatrique. Les données obtenues ont été analysées à l’aide du progiciel statistique pour les sciences sociales, version. 20,0. Le test du Chi carré et le test exact de Fisher ont été utilisés pour comparer les variables avec les données catégorielles. La plupart des infirmières de soins primaires souhaitaient soigner des patients âgés souffrant de dépression ; cependant, ils n’ont jamais suivi de formation axée sur la dépression gériatrique. L\'étude indique que 38,1 % des participants ont de mauvaises connaissances sur la dépression gériatrique tandis que 25,2 % ont de bonnes connaissances. Alors que la majorité des participants avaient une bonne compréhension des effets secondaires potentiels des médicaments antidépresseurs, alors qu\'ils avaient une connaissance limitée des symptômes, du diagnostic et des médicaments, la majorité des participants ont démontré une attitude positive et se sentaient à l\'aise pour répondre aux besoins des patients déprimés (56,7 %). et considéraient leur profession comme bien placée pour assister les patients (83,3 %). Toutefois, 15,2 % avaient une attitude négative citant un manque d\'autodiscipline et de volonté.

The Rives-Stoppa (RS) procedure is a gold standard treatment of midline abdominal wall hernias. Comparability of pain control and outcomes to the enhanced-view totally extraperitoneal prosthetic (eTEP) repair remain unclear. A single-centre retrospective surgical cohort was selected including 30 RS repairs (January 2019-November 2021) and 30 consecutive eTEP procedures (September 2021-August 2022) for midline abdominal wall hernia(s) with rectus abdominis diastasis. Postoperative pain and outcomes were compared up to 1 month. Presence and median duration of patient-controlled analgesia were, respectively, 90% and 3 nights with RS, versus 30% and 0 nights with eTEP. Median switch to only oral analgesics occurred at postoperative day (POD) 3 after RS and at POD 2 after eTEP. Postoperative analgesics and opioid prescription at discharge were comparable. Median length of hospital stay was six nights after RS versus 3 nights after eTEP. Median duration of surgery was 110.5 and 164.5 min for RS and eTEP, respectively. After RS, 30 patients had postoperative drain(s) compared to 3 patients after eTEP. Conversion was needed in 3 eTEP procedures. Postoperative complications were comparable. No early recurrences were observed. Minimal residual diastasis was seen at postoperative consultation in 11 patients after eTEP. Compared to RS, eTEP is a minimally invasive alternative treatment of midline abdominal wall hernias with rectus abdominis diastasis and is associated with a shorter length of hospital stay, less postoperative pain and a comparable risk of short-term complications. At 1 month after eTEP, minimal residual diastasis can be present. ClinicalTrials.gov: NCT05446675. Secondary identifying number: EC/EH/220608-SK. Date of Registration: June 24, 2022.

Ammonia nitrogen (AN) pollution frequently occurs in urban rivers with the continuous acceleration of industrialization. Monitoring AN pollution levels and tracing its complex sources often require large-scale testing, which are time-consuming and costly. Due to the lack of reliable data samples, there were few studies investigating the feasibility of water quality prediction of AN concentration with a high fluctuation and non-stationary change through data-driven models. In this study, four deep-learning models based on neural network algorithms including artificial neural network (ANN), recurrent neural network (RNN), long short-term memory (LSTM), and gated recurrent unit (GRU) were employed to predict AN concentration through some easily monitored indicators such as pH, dissolved oxygen, and conductivity, in a real AN-polluted river. The results showed that the GRU model achieved optimal prediction performance with a mean absolute error (MAE) of 0.349 and coefficient of determination (R2) of 0.792. Furthermore, it was found that data preprocessing by the VMD technique improved the prediction accuracy of the GRU model, resulting in an R2 value of 0.822. The prediction model effectively detected and warned against abnormal AN pollution (> 2 mg/L), with a Recall rate of 93.6% and Precision rate of 72.4%. This data-driven method enables reliable monitoring of AN concentration with high-frequency fluctuations and has potential applications for urban river pollution management.

Effort and the perception of effort (PE) have been extensively studied across disciplines, resulting in multiple definitions. These inconsistencies block scientific progress by impeding effective communication between and within fields. Here, we present an integrated perspective of effort and PE that is applicable to both physical and cognitive activities. We define effort as the energy utilized to perform an action. This definition can be applied to biological entities performing various voluntary or involuntary activities, irrespective of whether the effort contributes to goal achievement. Then, we define PE as the instantaneous experience of utilizing energy to perform an action. This definition builds on that of effort without conflating it with other subjective experiences. We explore the nature of effort and PE as constructs and variables and highlight key considerations in their measurement. Our integrated perspective aims to facilitate a deeper understanding of these constructs, refine research methodologies, and promote interdisciplinary collaborations.

The absence of a definitive cure for amyotrophic lateral sclerosis (ALS) emphasizes the crucial need to explore new and improved treatment approaches for this fatal, progressive, and disabling neurodegenerative disorder. As at the end of 2023, five treatments - riluzole, edaravone, dextromethorphan hydrobromide + quinidine sulfate (DHQ), tofersen, and sodium phenylbutyrate-tauroursodeoxycholic acid (PB-TUDCA) - were FDA approved for the treatment of patients with ALS. Among them PB-TUDCA has been shown to impact DNA processing impairments, mitochondria dysfunction, endoplasmic reticulum stress, oxidative stress, and pathologic folded protein agglomeration defects, which have been associated with ALS pathophysiology. The Phase 2 CENTAUR trial demonstrated significant impact of PB-TUDCA on the ALS Functional Rating Scale-Revised (ALSFRS-R) risk of death, hospitalization, and the need for tracheostomy or permanent assisted ventilation in patients with ALS based on post hoc analyses. More recently, contrasting with the CENTAUR trial results, results from the Phase 3 PHOENIX trial (NCT05021536) showed no change in ALSFRS-R total score at 48 weeks. Consequently, the sponsor company initiated the process with the US FDA and Health Canada to voluntarily withdraw the marketing authorizations for PB-TUDCA. In the present article, we review ALS pathophysiology, with a focus on PB-TUDCA\'s proposed mechanisms of action and recent clinical trial results and discuss the implications of conflicting trial data for ALS and other neurological disorders.

The presence of elevated levels of heavy metals in soil poses a significant environmental concern with implications for human health and other organisms. The main objective of our study was to reduce the gap information of seasonal abundance, distribution of heavy metals in soil, leaf litter, and some macroinvertebrates in a citrus orchard (Citrus sinensis) in Sohag Governorate, Egypt. The heavy metals copper (Cu), zinc (Zn), lead (Pb), and cadmium (Cd) were determined by atomic absorption spectrometry. Degree of contamination (DC) was determined for both soil and leaf litter contamination. However, the bioaccumulation factor (BAF) was estimated to determine metal accumulation in the macroinvertebrates including earwigs Anisolabis maritima, chilopoda Scolopendra moristans, spider Dysdera crocata, and earthworm Aporrectodea caliginosa. The study area had clay-loam with varying organic matter, salinity, and pH levels. The degree of contamination varied among seasons, with the highest levels typically observed in autumn in both soil and leaf litter. The soil ranged from low contamination (1.82) to high contamination levels (4.4), while the leaf litter showed extremely high (30.03) to ultra-high (85.92) contamination levels. The mean ecological risk index results indicated that the sampling area had moderate ecological risk levels for Cd (44.3), Zn (42.17), and Pb (80.05), and extremely high levels for Cu (342.5). Heavy metal concentrations in the selected fauna were the highest in autumn, and the bioaccumulation factor varied among species and seasons with some species classified as e-concentrators, micro-concentrators, and macro-concentrators of certain heavy metals. Scolopendra moristans exhibited the highest mean metal concentrations (Cd, Pb, and Zn), while Aporrectodea caliginosa had the lowest. Thus, the differences in heavy metal concentrations found in different soil taxa highlight the significance of taxing a holistic understanding of feeding mechanisms into account when evaluating the potential risk for animals that consume invertebrates.

OBJECTIVE: The primary objective was to detect the number of women developing isthmocele following lower segment caesarean section. The secondary objectives included analysing the risk factors associated with developing isthmocele and measuring the agreement between Transvaginal Ultrasonography (TVS) and Saline infusion Sonohysterography (SIS) in diagnosing Isthmocele.
METHODS: This study was conducted in the Department of Obstetrics and Gynecology and focused on women who had undergone Lower Segment cesarean Section (LSCS). The study aimed to detect any indentation of at least 2 mm in the scar site, known as isthmocele, using Transvaginal Ultrasound (TVS) and Saline Infusion Sonography (SIS) between 6 weeks and 6 months after delivery. Along with the primary objective, the study also evaluated several secondary outcomes such as maternal comorbidities, closure techniques, and labor details. The evaluation of isthmocele followed the 2019 modified Delphi consensus approach.
RESULTS: In our study, we found that 30% of our study population had isthmocele. We also observed that the number of previous caesarean deliveries, maternal BMI, duration of surgery, and characteristics of the previous CD scar were significantly associated with the development of isthmocele. When we compared the diagnostic methods, we found that TVS and SIS had similar limits of agreement for clinically important isthmocele parameters. However, we noticed a difference in the length and distance of isthmocele from the internal os, which we observed through Bland Altman plots.
CONCLUSIONS: Our research has shown that women who have undergone multiple caesarean deliveries, have a higher maternal body mass index (BMI), and experienced longer surgery duration are at a significantly higher risk of developing isthmocele. To prevent its development, it is recommended to promote vaginal birth after caesarean delivery whenever feasible, manage maternal obesity early on, and provide adequate surgical training to medical professionals. Additionally, transvaginal ultrasound (TVS) is an effective method for detecting isthmocele and can be used interchangeably with saline-infused sonography (SIS).