Nanotechnology encompasses a wide range of devices derived from biology, engineering, chemistry, and physics, and this scientific field is composed of great collaboration among researchers from several fields. It has diverse implications notably smart sensing technologies, effective disease diagnosis, and sometimes used in treatment. In medical science, the implications of nanotechnology include the development of elements and devices that interact with the body at subcellular (i.e., molecular) levels exhibiting high sensitivity and specificity. There is a plethora of new chances for medical science and disease treatment to be discovered and exploited in the rapidly developing field of nanotechnology. In different sectors, nanomaterials are used just because of their special characteristics. Their large surface area of them enables higher reactivity with greater efficiency. Furthermore, special surface chemistry is displayed by nanomaterials which compare to conventional materials and facilitate the nanomaterials to decrease pollutants efficiently. Recently, nanomaterials are used in some countries to reduce the levels of contaminants in water, air, and soil. Moreover, nanomaterials are used in the cosmetics and medical industry, and it develops the drug discovery (DD) system. Among a huge number of nanomaterials, Cu, Ag, TiO, ZnO, FeO, and carbon nanotubes (CNTs) are extensively used in different industries for various purposes. This extensive review study has introduced the major scientific and technical features of nanotechnology, as well as some possible clinical applications and positive feedback in environmental waste management and drug delivery systems.

STUDY DESIGN: Cadaver study.

OBJECTIVES: Assess the feasibility of robot-assisted cervical pedicle screw (RA-CPS) placement and understand the anatomical considerations of this technique.

METHODS: Four cadaver specimens free from bony pathology were acquired. Anatomical considerations, such as pedicle width (PW) and height (PH), transverse pedicle angle (TPA), and maximal screw length (MSL), were recorded from preoperative computational tomography (CT) scans. Intraoperative cone-beam CT was acquired and registered to the robotic system. After cervical levels were segmented, screw sizes and trajectories were planned, and RA-CPS were placed. Accuracy was assessed using Gertzbein and Robbin's classification on postoperative CT scans.

RESULTS: Thirty-five RA-CPS were placed. Major breaches (≥Grade C) occurred in 28.57% screws. Grade A or B accuracy was found in 71.43% of screws, with the most common direction of breach being medial (81.3%). The greatest proportion of breach per level occurred in the upper subaxial levels, (C3:71.4%, C4 66.6%, C5:50%) which had the smallest PW (C3: 4.34 ± .96 mm, C4: 4.48 ± .60, C5: 5.76 ± 1.11). PH was greatest at C2 (8.14 ± 1.89 mm) and ranged subaxial from 6.36 mm (C3) to 7.48 mm (C7). The mean PW was 5.37 mm and increased caudally from 4.34 mm (C3) to 6.31 mm (C7). The mean TPA was 39.9° and decreased moving caudally 46.9°) to C7 (34.4°). The MSL was 37.1 mm and increased from C2 (26.3 mm) to C7 (41.0 mm).

CONCLUSION: RA-CPS has the potential to be feasible, but technological and instrument modifications are necessary to increase the accuracy in the cervical region.

Antibiotics are used to both prevent and treat bacterial infections. When bacteria adapt to the use of antibiotics, antibiotic resistance develops. Antibiotic resistance develops in bacteria, not in people or other animals. Both people and animals are susceptible to infection from these germs, and their illnesses are more difficult to treat than those caused by non-resistant bacteria. Antibiotic resistance causes greater mortality, longer hospital stays and higher medical expenses. The way antibiotics are prescribed and used worldwide has to alter immediately. Antibiotic resistance will continue to pose a serious hazard even if new medications are created. Additionally, behavioral changes must focus on improving food cleanliness, hand washing, practicing safer sex and being vaccinated in order to stop the spread of diseases. This chapter discusses the history, evolution and epidemiology of antibiotic resistance, antibiotic resistance mechanisms and their methods of detection, prevention of antibiotic-resistant organisms in healthcare settings and the role of artificial intelligence in prevention of antimicrobial resistance and drug discovery.

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Leptomeningeal disease (LMD) occurs when tumors seed into the leptomeningeal space and cerebrospinal fluid (CSF), leading to severe neurological deterioration and poor survival outcomes. We utilized comprehensive multi-omics analyses of CSF from patients with lymphoma LMD to demonstrate an immunosuppressive cellular microenvironment and identified dysregulations in proteins and lipids indicating neurodegenerative processes. Strikingly, we found a significant accumulation of toxic branched-chain keto acids (BCKA) in the CSF of patients with LMD. The BCKA accumulation was found to be a pan-cancer occurrence, evident in lymphoma, breast cancer, and melanoma LMD patients. Functionally, BCKA disrupted the viability and function of endogenous T lymphocytes, chimeric antigen receptor (CAR) T cells, neurons, and meningeal cells. Treatment of LMD mice with BCKA-reducing sodium phenylbutyrate significantly improved neurological function, survival outcomes, and efficacy of anti-CD19 CAR T cell therapy. This is the first report of BCKA accumulation in LMD and provides preclinical evidence that targeting these toxic metabolites improves outcomes.

Extracellular vesicles (EVs) have been established to play important roles in cell-cell communication and shown promise as therapeutic agents. However, we still lack a basic understanding of how cells respond upon exposure to EVs from different cell sources at various doses. Thus, we treated fibroblasts with EVs from 12 different cell sources at doses between 20 and 200,000 per cell, analyzed their transcriptional effects, and functionally confirmed the findings in various cell types in vitro, and in vivo using single-cell RNA sequencing. Unbiased global analysis revealed EV dose to have a more significant effect than cell source, such that high doses down-regulated exocytosis and up-regulated lysosomal activity. However, EV cell source-specific responses were observed at low doses, and these reflected the activities of the EV's source cells. Last, we assessed EV-derived transcript abundance and found that immune cell-derived EVs were most associated with recipient cells. Together, this study provides important insights into the cellular response to EVs.

Mycobacterium avium subspecies paratuberculosis (M. paratuberculosis) is the causative agent of Johne's disease, a chronic debilitating condition affecting ruminants causing significant economic losses to the dairy industry. Available inactivated vaccines are not effective in controlling the disease and vaccinated animals can continue to infect newly born calves. Recently, we have shown that a live-attenuated vaccine candidate (pgsN) is protective in goats and calves following challenge with virulent strains of M. paratuberculosis. To decipher the dynamics of the immune responses elicited by both live-attenuated and inactivated vaccines, we analyzed key immunological parameters of goats immunized through different routes when a marker-less pgsN vaccine was used. Within a few weeks, the inactivated vaccine triggered the formation of granulomas both at the site of inoculation and in regional lymph nodes, that increased in size over time and persisted until the end of the experiment. In contrast, granulomas induced by the pgsN vaccine were small and subsided during the study. Interestingly, in this vaccine group, histology demonstrated an initial abundance of intra-histiocytic mycobacterial bacilli at the site of inoculation, with recruitment of very minimal T lymphocytes to poorly organized granulomas. Over time, granulomas became more organized, with recruitment of greater numbers of T and B lymphocytes, which coincided with a lack of mycobacteria. For the inactivated vaccine group, mycobacterial bacilli were identified extracellularly within the center of caseating granulomas, with relatively equal proportions of B- and T-lymphocytes maintained across both early and late times. Despite the differences in granuloma-specific lymphocyte recruitment, markers for cell-mediated immunity (e.g., IFN-γ release) were robust in both injected pgsN and inactivated vaccine groups. In contrast, the intranasal live-attenuated vaccine did not elicit any reaction at site of inoculation, nor cell-mediated immune responses. Finally, 80% of animals in the inactivated vaccine group significantly reacted to purified protein derivatives from M. bovis, while reactivity was detected in only 20% of animals receiving pgsN vaccine, suggesting a higher level of cross reactivity for bovine tuberculosis when inactivated vaccine is used. Overall, these results depict the cellular recruitment strategies driving immune responses elicited by both live-attenuated and inactivated vaccines that target Johne's disease.

This paper provides an overview of the circular economy in Egypt. With the country facing significant environmental challenges, a circular economy approach can offer sustainable solutions to Egypt's environmental challenges by addressing issues like limited resources, waste generation, and a growing population in an eco-friendly and long-term perspective. This research employs a mixed-methods approach, including a literature review, surveys, and consultations with key stakeholders. The analysis reveals that although there are numerous challenges to establishing a circular economy in Egypt, such as limited understanding, insufficient government backing, and inadequate infrastructure, there are also opportunities, such as increasing demand for eco-friendly goods and services, as well as a receptive business environment. The paper recommends various policy and practical interventions to overcome these barriers and capitalize on these opportunities, including increasing awareness and understanding of the circular economy, developing supportive programs and regulations, investing in infrastructure and technology, and fostering stakeholder collaboration. This paper provides valuable insights into the potential for a circular economy in Egypt and the steps that can be taken to create a more sustainable future for the country. As such, it will interest policymakers, researchers, and practitioners working in the sustainability and environmental management field. The successful implementation of a circular economy in Egypt will require collective efforts from stakeholders to promote long-term sustainability and environmental stewardship.

To characterize clinical and laboratory signs of patients with Still's disease experiencing macrophage activation syndrome (MAS) and identify factors associated with MAS development. Patients with Still's disease classified according to internationally accepted criteria were enrolled in the AutoInflammatory Disease Alliance (AIDA) Still's Disease Registry. Clinical and laboratory features observed during the inflammatory attack complicated by MAS were included in univariate and multivariate logistic regression analysis to identify factors associated to MAS development. A total of 414 patients with Still's disease were included; 39 (9.4%) of them developed MAS during clinical history. At univariate analyses, the following variables were significantly associated with MAS: classification of arthritis based on the number of joints involved (p = 0.003), liver involvement (p = 0.04), hepatomegaly (p = 0.02), hepatic failure (p = 0.01), axillary lymphadenopathy (p = 0.04), pneumonia (p = 0.03), acute respiratory distress syndrome (p < 0.001), platelet abnormalities (p < 0.001), high serum ferritin levels (p = 0.009), abnormal liver function tests (p = 0.009), hypoalbuminemia (p = 0.002), increased LDH (p = 0.001), and LDH serum levels (p < 0.001). At multivariate analysis, hepatomegaly (OR 8.7, 95% CI 1.9-52.6, p = 0.007) and monoarthritis (OR 15.8, 95% CI 2.9-97.1, p = 0.001), were directly associated with MAS, while the decade of life at Still's disease onset (OR 0.6, 95% CI 0.4-0.9, p = 0.045), a normal platelet count (OR 0.1, 95% CI 0.01-0.8, p = 0.034) or thrombocytosis (OR 0.01, 95% CI 0.0-0.2, p = 0.008) resulted to be protective. Clinical and laboratory factors associated with MAS development have been identified in a large cohort of patients based on real-life data.