Journals
2025 EN
Ibrahim Aya Mohamed Ahmed · Abd ElFattah Abeer I. · Shaker Olfat Gamil
+1 more
ABSTRACT The immunological microenvironment in hepatocellular carcinoma (HCC) is characterized by impaired immune responses. Significantly, LAIR‐2 levels correlate with immune cell subtype infiltration, T cell exhaustion, and its prognostic potential in HCC. This study aims to assess the diagnostic and prognostic significance of expression levels of Pax8‐AS1 and LAIR‐2 in patients with HCV and their association with susceptibility to HCC. Pax8‐AS1 and LAIR‐2 expression levels in the serum of patients were analyzed using reverse transcription‐quantitative PCR (RT‐PCR), while the efficacy of biomarkers in prognostic prediction was assessed by using bioinformatics. The current research showed that Pax8‐AS1 had low expression levels in the blood and a positive correlation with portal vein diameter in HCC, which is predictive of portal vein thrombosis (PVT) development. The expression levels of LAIR‐2 were elevated in HCV and HCC cases. In HCC, there was an inverse correlation among LAIR‐2 and hematology laboratory tests, albumin, tumor nodules, ascites, and splenomegaly. However, there was a positive correlation among LAIR‐2, spleen diameter, AFP, and bilirubin. Pax8‐AS1 and LAIR‐2 showed remarkable diagnostic efficacy, with sensitivity and specificity values, respectively ( p < 0.001) (80%, 80% and 90%, 100%) in HCV and (96.7%, 80% and 93%, 100%) in HCC. LAIR‐2 overexpression positively correlates with several critical genes associated with exhausted T cells immune infiltration, T cells, CD4+, and CD8+ T cells. The present data support a novel diagnostic and prognostic function for LAIR2 and PAX8‐AS1 in HCC, and its significant association with T cell exhaustion contributes to its promotion in HCC. LAIR‐2 detection could provide a new prognosis prediction method, and regulation within T‐cell exhaustion, optimizing anti‐HCC treatments.
Journals
2025 EN
Shahid Mahek · Pham Hoang Nhat · Ibrahim Ramzi
+4 more
Abstract Background Chronic kidney disease (CKD) increases cardiac arrest (CA) risk because of renal and cardiovascular interactions. Methods Using Centers for Disease Control and Prevention (CDC) data from 1999 to 2020, we analyzed CKD‐related CA mortality and the impact of social vulnerability index (SVI). Results We identified 336 494 CKD‐related CA deaths, with stable age‐adjusted mortality rates over time. Disparities were observed across gender, racial/ethnic, and geographic subpopulations, with higher mortality among males, Hispanic and non‐Hispanic Black populations, and those in urban and Western regions. Higher SVI correlated with increased mortality. Conclusions CKD‐related CA mortality rates are stable, with disparities across demographics; higher SVI correlates with increased mortality, highlighting needed interventions.
Journals
2025 EN
Sainbayar Enkhtsogt · Ibrahim Ramzi · Noh Sangkyu
+9 more
Abstract Introduction Gastrointestinal bleeding (GIB) is often encountered among patients with atrial fibrillation (AF) due to the use of anticoagulation. This study assesses disparities in GIB‐related mortality among decedents with AF in the United States. Methods GIB mortality data in patients with AF from 1999 to 2020 was queried from the CDC database. Decedent demographic information (age, sex, race and ethnicity, and geographic residence) was obtained from death certificates. We calculated age‐adjusted mortality rates (AAMRs) through the direct method and estimated the annual percentage change (APC) in mortality using log‐linear regression models. Results From 11,209 GIB‐related deaths among AF decedents, we observed an increase in AAMR from 0.12 in 1999 to 0.21 in 2020, particularly during the 2009 to 2020 period (APC +4.8, p < .001). Disproportionate mortality rates were noted in males (AAMR 0.18) and White populations (AAMR 0.15) as compared to females (AAMR 0.13) and Black populations (AAMR 0.10), respectively. Rural regions also reported higher mortality (AAMR 0.18) than urban areas (AAMR 0.14). Mortality shifts in urban regions remained stagnant from 1999 to 2009 (APC –0.15, p = .806) followed by an increase from 2009 to 2020 (APC +4.83, p < .001). However, mortality increased consistently from 1999 to 2020 in rural regions (APC +4.08, p < .001). The Northeast US exhibited the highest mortality rate (AAMR 0.18), followed by the Midwest (AAMR 0.16), West (AAMR 0.14), and South (AAMR 0.13). Conclusions Disparities in GIB mortality among AF decedents were identified. These findings accentuate the need for targeted interventions to mitigate GIB risks in vulnerable subgroups.
Journals
2025 EN
Antoun Ibrahim · Abdelrazik Ahmed · Li Xin
+4 more
ABSTRACT Background Pulmonary vein isolation (PVI) is central to controlling paroxysmal atrial fibrillation (AF). Pulsed‐field ablation (PFA) offers a non‐thermal alternative to conventional thermal techniques. The study compares changes in P‐wave parameters following PFA, radiofrequency ablation (RF), and cryoballoon ablation (Cryo). Methods We retrospectively analysed 283 patients undergoing first‐time PVI (RF 101, Cryo 125, PFA 57). Digital electrocardiograms (ECGs) were evaluated for P‐wave duration (PWD), voltage (PWV), dispersion (PWDisp), and terminal force in lead V1 (PTFV1) before and immediately after ablation. AF recurrence was assessed at 12 months. Analyses were adjusted for left atrial volume index (LAVI) and post‐procedural anti‐arrhythmic drug (AAD) use. Results At 12 months, 215 patients (76%) remained free of AF (RF 76%, Cryo 74%, PFA 79%; p = 0.78). Baseline PWD was 128.5 ± 14 ms (RF), 123.7 ± 15 ms (Cryo), and 124.2 ± 16 ms (PFA). Post‐ablation, mean ΔPWD was +12.2 ms (RF), +8.5 ms (Cryo), and + 4.7 ms (PFA). PTFV1 decreased after all modalities: RF −3.3 to −4.6 mm·ms ( p < 0.001), Cryo −3.4 to −5.3 mm·ms ( p = 0.002), PFA −3.6 to −5.2 mm·ms ( p = 0.005). No significant intergroup differences were observed ( p = 0.39). Patients with AF recurrence ( n = 68) had longer baseline PWD (128 ± 16 vs. 125 ± 14 ms, p = 0.12), longer post‐procedural PWD (138 ± 17 vs. 129 ± 15 ms, p = 0.004), and larger LAVI (29.1 ± 7.9 vs. 25.3 ± 8.5 mL/m 2 , p = 0.03). In multivariable Cox models, increased post‐procedural PWD independently predicted recurrence (HR: RF 1.17, Cryo 1.14, PFA 1.13; all p < 0.05). Conclusions PFA, RF, and Cryo produce similar acute ECG changes. Post‐procedural PWD was the strongest predictor of AF recurrence, independent of atrial size and AAD use.
Journals
2025 EN
Aydin Ertan · Öğütveren Muhammed Mürsel · Mert Gurbet Özge
+6 more
ABSTRACT Objective To compare demographic, clinical, and laboratory profiles and short‐term outcomes between pre‐existing (chronic) atrial fibrillation (AF) and newly diagnosed AF among patients admitted to coronary care units (CCUs) in Turkey, and to identify factors associated with in‐hospital mortality within AF subtypes. Methods This multicenter, prospective national registry analysis included 540 consecutive AF patients from 50 CCU centers across seven geographic regions in Turkey (MORCOR‐TURK National Registry; September 1–30, 2022). Patients were categorized as pre‐existing AF (documented AF prior to or at admission) or newly diagnosed AF (first detected during hospitalization). Demographics, comorbidities, admission diagnoses, laboratory biomarkers (including NT‐proBNP and hs‐troponin I), management, and outcomes were recorded. Multivariable logistic regression identified independent predictors of in‐hospital mortality. Results Pre‐existing AF ( n = 324) had higher prevalences of diabetes mellitus (42.3% vs. 31.5%; p = 0.012) and acute coronary syndromes (58.6% vs. 34.7%; p < 0.001). Newly diagnosed AF ( n = 216) more frequently presented with heart failure (45.8% vs. 28.4%; p < 0.001) and dyspnea (67.1% vs. 48.5%; p < 0.001). Newly diagnosed AF exhibited higher inflammatory burden (CRP median 28.4 vs. 12.6 mg/L; p < 0.001) and lower hemoglobin (11.8 ± 2.1 vs. 12.9 ± 1.8 g/dL; p < 0.001). NT‐proBNP was elevated in both groups and higher in newly diagnosed AF (median 4850 vs. 3240 pg/mL; p = 0.003). In‐hospital mortality was greater with newly diagnosed AF (12.0% vs. 6.8%; p = 0.042). Independent mortality predictors included age, chronic kidney disease, cardiogenic shock, and log‐transformed NT‐proBNP, hs‐troponin I, and CRP. Conclusion In Turkish CCUs, pre‐existing and newly diagnosed AF constitute distinct clinical phenotypes with differing presentations, biomarker profiles, and short‐term risk. Newly diagnosed AF is associated with greater inflammatory and hemodynamic stress and higher in‐hospital mortality. Biomarker‐enriched risk stratification may refine prognostication and guide targeted management within AF subtypes.
Journals
2025 EN
Danish Mohammad · Shahid Mohammad · Ibrahim Sobhy M.
+1 more
ABSTRACT Excessive cobalt (Co) levels in agricultural soil cause significant toxicity, reducing crop growth and yield. This study aimed to assess the potential of Klebsiella sp. SRB‐5 (Accession no. OR715782), in mitigating cobalt toxicity and enhancing the growth of garden peas under cobalt stress. Strain SRB‐5, tolerant to 4000 ppm of Co(II), was evaluated for producing growth‐regulating substances, including indole‐3‐acetic acid (IAA), ammonia, siderophore, ACC deaminase, and solubilized phosphate, under cobalt stress. The optimal conditions for Co‐(II) biosorption by SRB‐5 were determined to be 25°C, pH 6.0, and an incubation time of 72 h. The strain's ability to mitigate Co‐(II) toxicity was tested by inoculating peas grown in soil treated with 1000, 2000, and 3000 ppm Co‐(II). Inoculation with Co‐tolerant SRB‐5 alleviated cobalt toxicity and significantly enhanced the physiological and biochemical properties of plants. Notably, SRB‐5 increased root length (19.2%), root biomass (29%), seedling vigor index (18.4%), total chlorophyll (52%), nodule biomass (41%), leghaemoglobin content (38%), root nitrogen (27%), and phosphorous content (19.3%) in 1000 ppm Co‐stressed peas. Additionally, bacterial inoculation reduced proline, malondialdehyde (MDA), hydrogen peroxide (H 2 O 2 ), and membrane injury by 85%, 57.3%, 90%, and 75%, respectively, in 1000 ppm Co‐exposed plants. Priming with SRB‐5 also reduced cobalt uptake in roots (88%), shoots (53.7%), and grains (79.6%) compared to uninoculated treatments. Metal‐tolerant beneficial soil bacteria, such as Klebsiella sp. strain SRB‐5, could serve as an effective alternative for enhancing pea production in metal‐contaminated soils. The use of Co‐tolerant PGPR strains holds potential for development as biofertilizers in future agricultural practices.
Journals
2025 EN
Mohammadzadeh Roghayeh · Shahbazi Shahla · Khodaei Niloufar
+1 more
ABSTRACT Antimicrobial resistance (AMR) is a serious global health issue. This review aims to explore alternative therapeutic strategies for combating AMR. The goal is to evaluate emerging treatments that target resistant pathogens through novel mechanisms, bypassing the limitations of traditional antibiotics. Recent researches highlight several promising alternatives, including antibodies, antimicrobial peptides, bacteriocins, bacteriophages, and probiotics (in the clinical trials) and synthetic antimicrobial peptides, anti‐virulence strategies, genetically modified phages, antibacterial oligonucleotides, CRISPR‐Cas9, and predatory bacteria (in the research stage). These therapies demonstrate potential to overcome AMR by targeting specific bacterial mechanisms, reducing toxicity, and evading resistance. Alternative therapies for AMR present significant promise, offering new avenues for treatment. Despite challenges in optimization and delivery, these therapies could revolutionize the way bacterial infections are treated. Continued research is crucial to address hurdles and ensure these therapies can be safely and effectively implemented in clinical settings, shaping the future of infection management.
Journals
2025 EN
Kalkan Bilal · Akmese Ibrahim · Shanhouse Laura
ABSTRACT This article examines the implications of limited legal status for displaced individuals under Türkiye's Temporary Protection Regulation. Although refugee status extends beyond a legal label to influence access to basic rights and protections, temporary or conditional protections often lead to prolonged uncertainty and restricted access to employment, healthcare, education, and social services. These limitations heighten vulnerability to economic hardship, exploitation, and psychological distress. The article discusses the structural challenges in accessing mental health services under temporary protection and emphasizes the importance of multicultural counseling strategies. Key areas of focus include addressing language and communication challenges and implementing culturally responsive counseling interventions. The article concludes with implications for mental health professionals working with refugee populations in Türkiye, highlighting the need to consider both legal and cultural contexts when supporting displaced individuals.
Journals
2025 EN
Ibrahim Mudathir · McKenney Ceilidh · Rossi Camilla Sophia
+8 more
Abstract Background Certain guidelines consider feeding within 4 h of percutaneous endoscopic gastrostomy tube (PEG) placement to be safe. However, the evidence supporting the recommendations has been questioned and variation in feeding initiation practices persists, with feeding delayed up to 24 h after PEG placement. Our objective was to systematically review the current literature on early vs delayed feeding after PEG placement and compare their outcome in a meta‐analysis. Methods Ovid MEDLINE, EMBASE, Cochrane Library, CINAHL, and Web of Science were searched from inception until December 4, 2023. Randomized and nonrandomized studies comparing feeding initiation ≤4 vs >4 h post‐PEG in adults were included. Independent extraction was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis reporting guidelines and data were pooled using fixed or random‐effects models. Measured outcomes were the odds of postoperative vomiting, diarrhea, stoma leakage, stoma infection, bleeding, intra‐abdominal infection, aspiration pneumonia, and 30‐day mortality. Assessment of risk of bias was completed using the Cochrane risk of bias tool 2 (RoB 2) for randomized studies and the Newcastle‐Ottawa scale for nonrandomized studies. GRADE was used to assess evidence certainty. PROSPERO registration: CRD42023483520. Results Of 4751 studies, 11 with 2880 patients met inclusion. There was no significant difference in all the measured outcomes between groups, but the evidence certainty was low to very low. Intra‐abdominal infection couldn't be examined because of scarce reporting by authors. Conclusion This robust meta‐analysis suggests early feeding after PEG placement is likely safe but uncertain, highlighting the need for a high‐quality randomized trial.
Journals
2025 EN
Nik Mustaffa Shapri Nik Aisyah Najwa · Samsudin Nurul Syazfeeza · Abd Wahab Mohd Shahezwan
+1 more
Abstract Background Several questionnaires are available to evaluate immunosuppressant knowledge among kidney transplant recipients (KTRs). However, most contain a mixture of questions about different aspects of health management before and after kidney transplantation and do not specifically assess immunosuppressant knowledge. Aim This study aimed to generate preliminary items for a questionnaire to assess immunosuppressant knowledge among KTRs, validate the items, and translate the items into Malay. Method Preliminary items were generated from domains and subdomains identified through a review of previous questionnaires. Then, the item content was validated in a three‐round Delphi study by an expert panel of 11 renal pharmacists. The experts rated the relevance of the items and provided feedback on their comprehensibility and comprehensiveness. Items that attained ≥75% expert agreement on their relevance were considered relevant. Finally, the relevant items were translated into Malay through a forward–backward translation process by three external translators and two researchers. Ethical approval was granted by the Universiti Teknologi MARA Research Ethics Committee (Reference no: REC (PH)PG/027/2022) and the study conforms with the Declaration of Helsinki. Participants were approached electronically, and informed consent was obtained from all participants via distribution of a project information sheet, explaining their participation was voluntary and a gift card would be provided as an incentive upon completion of all three rounds of the Delphi study and completion of a written consent form. Results A total of 24 preliminary items were generated. In Round 1 of the Delphi study, four items needed revision, and nine new items were suggested for Round 2 ( n = 13). In Round 2, only five of the 13 items were carried forward to Round 3. In the final round, only one of the five items was relevant. The final experts' revision produced 27 items. A Malay‐language questionnaire equivalent to the English version was produced. Conclusion A content‐validated questionnaire consisting of 27 items in English and Malay was produced. This questionnaire serves as a reliable tool to identify immunosuppressant knowledge gaps and evaluate the impacts of educational interventions.