Multivalvular Endocarditis With in a 2-Year-Old Boy With Ventricular Septal Defect.

A 2-year-old boy with a hemodynamically insignificant ventricular septal defect was found to have polyvalvular endocarditis, eventually requiring replacement of the pulmonary and mitral valves with a pulmonary conduit and a mechanical valve. Cultures grew , listed on the microbiological criterion of the updated Duke International Society for Cardiovascular Infectious Diseases criteria.

Off-label uses of the Amplatzer Piccolo Occluder in children with congenital and acquired heart diseases.

The Amplatzer Piccolo Occluder (APO) is approved for patent ductus arteriosus (PDA) occlusion in infants weighing >700 g but could offer versatility to treat other lesions. Retrospective review of children in whom APO was utilized for defects other than PDA between January 2022 and June 2023. The APO was used in nine patients; three for ventricular septal defects, four with coronary fistulas, one for a ventricular pseudoaneurysm and one where APO deployed within a fenestration of a previously placed Amplatzer Septal Occluder.

Heparosan biosynthesis in recombinant Bacillus megaterium: Influence of N-acetylglucosamine supplementation and kinetic modeling.

Heparosan, an unsulfated polysaccharide, plays a pivotal role as a primary precursor in the biosynthesis of heparin-an influential anticoagulant with diverse therapeutic applications. To enhance heparosan production, the utilization of metabolic engineering in nonpathogenic microbial strains is emerging as a secure and promising strategy. In the investigation of heparosan production by recombinant Bacillus megaterium, a kinetic modeling approach was employed to explore the impact of initial substrate concentration and the supplementation of precursor sugars.

Early intervention and care for Diabetic Foot Ulcers in Low and Middle Income Countries: Addressing challenges and exploring future strategies: A narrative review.

Background And Aims: Diabetic Foot Ulcers (DFUs) are a significant health concern, particularly in Low- and Middle-Income Countries (LMICs). This review explores key strategies for managing DFUs in LMICs, including integrating podiatry, endocrinology, and wound care services, educating patients, promoting self-care, and preventive measures to reduce amputation rates.

Methods: A comprehensive literature review was conducted, focusing on studies conducted in Low and Middle Income Countries to facilitate a qualitative analysis.

Optimizing Recovery: A Systematic Scoping Review of Upper Extremity Exercise Immediately after Cardiac Implantable Electronic Device Implantation.

Introduction: Cardiac implantable electronic devices (CIEDs), including pacemakers, defibrillators, and resynchronization devices, significantly enhance patient outcomes, reduce sudden cardiac death, and improve health-related quality of life. CIED implantation is associated to persistent shoulder dysfunction in a considerable number of patients one-year post-implantation. This may result in disability, diminished quality of life, work absenteeism, and negative psychological effects.

Data-driven models and digital twins for sustainable combustion technologies.

We highlight the critical role of data in developing sustainable combustion technologies for industries requiring high-density and localized energy sources. Combustion systems are complex and difficult to predict, and high-fidelity simulations are out of reach for practical systems because of computational cost. Data-driven approaches and artificial intelligence offer promising solutions, enabling renewable synthetic fuels to meet decarbonization goals.

Photo-activated dynamic isomerization induced large density changes in liquid crystal polymers: A molecular dynamics study.

We use molecular dynamics simulations to unravel the physics underpinning the light-induced density changes caused by the dynamic trans-cis-trans isomerization cycles of azo-mesogens embedded in a liquid crystal polymer network, an intriguing experimental observation reported in the literature. We employ two approaches, cyclic and probabilistic switching of isomers, to simulate dynamic isomerization. The cyclic switching of isomers confirms that dynamic isomerization can lead to density changes at specific switch-time intervals.

Structural and practical identifiability analysis in bioengineering: a beginner's guide.

Advancements in digital technology have brought modelling to the forefront in many disciplines from healthcare to architecture. Mathematical models, often represented using parametrised sets of ordinary differential equations, can be used to characterise different processes. To infer possible estimates for the unknown parameters, these models are usually calibrated using associated experimental data.

Bring it on again: antimicrobial stewardship in transplant infectious diseases: updates and new challenges.

Advancement in solid organ transplantation and hematopoietic stem cell transplant continues to improve the health outcomes of patients and widens the number of eligible patients who can benefit from the medical progress. Preserving the effectiveness of antimicrobials remains crucial, as otherwise transplant surgeries would be unsafe due to surgical site infections, and the risk of sepsis with neutropenia would preclude stem cell transplant. In this review, we provide updates on three previously discussed stewardship challenges: febrile neutropenia, infection, and asymptomatic bacteriuria.

Geometry Controlled Oscillations in Liquid Crystal Polymer Films Triggered by Thermal Feedback.

Light-induced oscillatory behavior of liquid crystal polymer network (LCN) films has been demonstrated by several researchers in the past decade. Similarly, oscillations in LCN films under constant thermal stimulus have been reported recently, although the mechanism and the factors that govern the oscillatory behavior are not well understood. In this work, we study the dynamics of self-sustained oscillations exhibited by LCN films under a constant thermal stimulus through experiments and simulations.

Transplantid.net: A Pilot Crowdsourced, Living, Online Library of Resources for the Teaching and Practice of Transplant Infectious Diseases.

The field of transplant infectious diseases is rapidly evolving, presenting a challenge for clinical practice and trainee education. Here we describe the construction of transplantid.net, a free online library, crowdsourced and continuously updated for the dual purpose of point-of-care evidence-based management and teaching.

The effect of narrative element incorporation on physical activity and game experience in active and sedentary virtual reality games.

Unlabelled: Narratives are pervasive in video games and have been found to increase physical activity in active video games. However, the effect of incorporating narrative elements has seldom been examined in fully immersive virtual reality games. We investigated the effect of narrative element incorporation (between-subject: narrative vs.

Tibial Bone Transport With a Single Implant All-Internal Bone Transport Nail.

A single implant all-internal magnet-driven bone transport nail (BTN-NuVasive Specialized Orthopaedics Inc) has recently been introduced as a treatment method for segmental tibial bone defects. This innovation provides promise in the management of segmental bone defects because it negates numerous complications associated with circular external fixation and the need for multiple implants when considering hybrid plate-assisted bone segment transport constructs. Given the novelty of the BTN, description of the surgical application and patient outcome measures are scarce in the current literature.

A comparison of physiotherapy students' perception about blended learning with online learning during COVID-19 pandemic: A mixed method of study.

Background: The COVID-19 pandemic has affected face-to-face teaching across the globe. The sudden shift in learning methods has impacted learning experiences significantly. Students' perception about online compared to blended learning might affect learning.

Bring it on: Top five antimicrobial stewardship challenges in transplant infectious diseases and practical strategies to address them.

Antimicrobial therapies are essential tools for transplant recipients who are at high risk for infectious complications. However, judicious use of antimicrobials is critical to preventing the development of antimicrobial resistance. Treatment of multidrug-resistant organisms is challenging and potentially leads to therapies with higher toxicities, intravenous access, and intensive drug monitoring for interactions.

Long-Term Cardiovascular Outcomes of Multisystem Inflammatory Syndrome in Children Associated with COVID-19 Using an Institution Based Algorithm.

Cardiovascular involvement is a major cause of inpatient and intensive care unit morbidity related to Multisystem inflammatory syndrome in children (MIS-C). The objective of this study was to identify long-term cardiovascular manifestations of MIS-C. We included 80 consecutive patients admitted to the intensive care unit with MIS-C who were evaluated for a year in our follow-up clinic using an institution protocol.

Empyema Thoracis-A Post-COVID-19 Complication.

The COVID-19 pandemic is associated with a significant increase in the incidence of invasive mycosis, including pulmonary aspergillosis, mucormycosis, and candidiasis. Fungal empyema thoracis (FET) is an uncommon clinical presentation of invasive fungal disease (IFD) associated with significant mortality. Here, we describe the first report of a patient with post-COVID-19 multifocal necrotizing pneumonia complicated by a polymicrobial empyema that included empyemas represent another manifestation of a COVID-19-associated fungal opportunistic infection, and this infrequently encountered entity requires a high degree of clinical suspicion for timely identification and management.

and variants synergistically influence the atorvastatin treatment response in South Indian coronary artery disease patients.

Atorvastatin exhibits wide interindividual variability in treatment response, limiting the drug efficacy in coronary artery disease patients. To study the effect of genetic variants involved in atorvastatin transport/metabolism and correlate their lipid-lowering efficacy. Genotyping was performed using 5'-hydrolysis probe method (n = 412), and the study evaluated the treatment response in 86 patients.

Reproductive Tract Bleeding in Adolescent and Young Adult Females with Inherited Bleeding Disorders: An Underappreciated Problem.

Reproductive tract bleeding is an underappreciated health care problem among adolescent and young adult (AYA) females with inherited bleeding disorders (IBDs) comprising von Willebrand disease, platelet disorders, hemophilia carriership, and rare factor deficiencies. IBDs are prevalent in women of all ages and have been detected in about 50% of women with menorrhagia or heavy menstrual bleeding (HMB) and about 20% of women with postpartum hemorrhage (PPH). The clinical spectrum of gynecologic and obstetric bleeding in AYA with IBDs ranges from HMB, ovulation bleeding, and surgical bleeding to miscarriages and life-threatening PPH.

Running an active gaming-based randomized controlled trial during the COVID-19 pandemic: Challenges, solutions and lessons learned.

Objectives: The COVID-19 pandemic has created significant obstacles for clinical trials and human subject research. This paper discusses the challenges our study team encountered while implementing an eHealth intervention during the pandemic, including: increased dropout, cancellation and rescheduling rates, increased mailing returns and delays, social distancing impediments, COVID-19 positive team members, and restricted training access.

Study Design: This is a short paper on research protocol for a six-month randomized controlled single-blind trial.

Electrocardiographic Changes in Ostium Secundum Atrial Septal Defect- Before and After Shunt Closure- A Retrospective Cohort Analysis.

Introduction: Atrial Septal Defect by virtue of its left to right shunt induces geometric and electrical remodeling of the right sided chambers of the heart which produces prototypical changes in the Electrocardiogram. Various patterns produced by ASD in the ECG can give a clue in diagnosing the defect. Reversal of remodeling after the shunt closure and its accompanying changes in ECG are also helpful in follow up of these patients Methodology: This is a retrospective cohort analysis, wherein, ECG of the patients who have undergone ASD closure by percutaneous device closure or surgical closure during the study period,were obtained from hospital records and they were followed up.