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Background: Due to the adverse effects of industrial chemicals and their carcinogenicity and toxicity for humans, the debates have increased on using natural preservatives. This study was conducted to investigate the inhibitory effect of pure nisin and nisin nanoparticles (nisin NPs) against Aspergillus flavus in vivo by inoculation in laboratory-manufactured Ras cheese. A novel, safe, and natural approach of nanoprecipitation using acetic acid was employed to prepare nisin nanoparticles. The prepared NPs were characterized using zeta-sizer, FTIR, and transmission electron microscopy (TEM). Furthermore, the cytotoxicity of nisin NPs on Vero cells was assessed. The minimum inhibitory concentrations (MICs) of nisin and its nanoparticles were determined in vitro against A. flavus isolates using the agar well-diffusion method. The sensory evaluation of manufactured Ras cheese was conducted over a 60-day storage period. Results: The obtained results showed a strong antifungal activity of nisin NPs (0.0625 mg/mL) against A. flavus strain in comparison with pure nisin (0.5 mg/mL). Notably, the count decreased gradually by time from 2 × 108 at zero time and could not be detected at the 7th week. The count with pure nisin decreased from 2 × 108 at zero time and could not be detected at the 10th week where it’s enough time to produce aflatoxins in cheese. The MICs of nisin and nisin NPs were 0.25 and 0.0313 mg/mL, respectively. Nisin NPs used in our experiment had good biocompatibility and safety for food preservation. Additionally, the sensory parameters of the manufactured Ras cheese inoculated with nisin and nisin NPs were of high overall acceptability (OAA). Conclusions: Overall, the results of this study suggested that adding more concentration (˃0.0625 mg/mL) from nisin nanoparticles during the production of Ras cheese may be a helpful strategy for food preservation against A. flavus in the dairy industry. [ABSTRACT FROM AUTHOR]

Highlights Additive manufacturing (AM) of continuous fiber reinforced polymer composites (cFRPCs) requires innovative tool‐pathing strategies that account for the anisotropic properties of the continuous fibers and ensure their continuous deposition as reinforcement along the designed structure, reducing fibers bending and cutting. Existing 3D printing slicing software, designed for isotropic materials like neat polymers, has been adapted for 3D printing of continuous fiber composites, resulting in a layer‐by‐layer approach that necessitates filament cutting after each layer deposition. This method introduces discontinuities, weakening the material and underutilizing continuous fibers strength. In this research, we propose a novel tool‐pathing strategy designed to address these challenges through (1) Ensuring fiber continuity across layers by allowing overlapping filaments and (2) Strategically positioning fiber cut points based on stress distribution, modeled using finite element analysis. A Multi‐Layer Continuous Fiber Path (ML‐CFP) approach was introduced and validated on a simple bracket structure featuring two load‐application inserts. 3D printed brackets using different tool paths were tested to failure under tension and compression after compression molding to improve interlayer adhesion. Mechanical investigations confirmed that the ML‐CFP approach enhances fiber utilization, improving tensile strength and work to fracture by up to 46% and 100% through promoting failure in fibers rather than at cut points. Introduced the multi‐layer continuous fiber path method (ML‐CFP) in AM of cFRPCs. Introduced the strategic cut point placement (SCPP) based on stress distribution. Maintaining fiber continuity and reduce fiber bending by allowing filament overlap. Mechanical testing to compare the ML‐CFP with conventional slicing methods. Enhanced tensile strength by up to 46% and work to fracture by 100%. [ABSTRACT FROM AUTHOR]

Background: Binge-watching has become increasingly popular in recent years. Although it can provide a form of entertainment and mood regulation, it has also been associated with adverse mental health issues. In this study, we explored the association between binge-watching behavior and mental health. Methods: Using a cross-sectional survey conducted from May to November 2018, we surveyed 535 participants over 18 years old from Ain Shams University by using a combination of online and pen-and-paper methods. Data on sociodemographic characteristics and TV series watching patterns were collected, and participants completed the Binge-Watching Engagement and Symptoms Questionnaire (BWESQ), the Brief Symptom Inventory (BSI-18), and the Subjective Happiness Scale (SHS). Results: Among the 535 participants surveyed, 333 were retained and divided into three groups (i.e., non-binge-watchers, trouble-free binge-watchers, and problematic binge-watchers) in accordance with previous binge-watching research. Significant between-group differences were found in terms of relationship status, commonly used devices (mobile, laptop, TV), and perceived dependency on TV series watching. Problematic binge-watchers showed significantly higher scores for all BWESQ and BSI-18 subscales. Conclusion: Trouble-free binge-watchers and problematic binge-watchers were more likely to be single than non-binge-watchers and demonstrated a marked preference for using mobile phones and laptops over traditional television. A significant positive relationship was found between problematic binge-watching and symptoms of depression, anxiety, and somatization. [ABSTRACT FROM AUTHOR]

Background: The dynamic and demanding nature of healthcare environments necessitates that nurses not only possess clinical proficiency but also exhibit high levels of work readiness to adapt swiftly to changes. Authentic leadership has been recognized as a critical factor influencing various organizational outcomes. Aim: Investigating the mediating role of nurses' agility in the relation between authentic leadership and nurses' work readiness. Design and method: A correlational analytical research design was utilized following STROBE guidelines, and data were collected from 249 nurses at a hospital affiliated with Beni-Suef University, Egypt. Instruments included authentic leadership Questionnaire, work readiness scale, and workforce agility scale. Data was collected from the beginning of March to the end of April 2024. Results: The findings indicate that authentic leadership was notably strong regarding morality/ethics dimension (mean score: 15.81), and nurses demonstrated relatively high agility levels, particularly in proactivity (mean score: 29.16). Organizational acumen scored highest in work readiness dimensions (mean score: 53.94). Nurses' overall scores for study variables ranged from 72 to 80% of the maximum, with agility scoring highest (mean score: 85.77). Significant positive correlations were found between variables, especially between nurses' agility and authentic leadership (r = 0.362). Conclusion: Path analysis reveals nurses' agility as a paramount mediator between authentic leadership and nurses' work readiness, indicating its vital role in transmitting the positive effects of authentic leadership. Practical implications include establishing authentic leadership programs that foster nurses' agility especially proactive behaviors. That in turn improve nurses' readiness for various work responsibilities. [ABSTRACT FROM AUTHOR]

Background: Psychological repercussions resulting from coronavirus disease 2019 (COVID-19) have been encountered, such as anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD). The study aimed to assess the frequency and severity of PTSD, depression, and anxiety in a sample of Egyptian patients with COVID-19 infection and analyze potential risk factors. The current study is a descriptive cross-sectional, hospital-based study, conducted from August 2020 to June 2021. The sample was selected from patients diagnosed with COVID-19 infection at Ain Shams University hospitals (outpatient clinics and inpatient units). Patients underwent a COVID severity criteria scoring system, structured clinical interview for DSM-IV (SCID-I), PTSD checklist–Civilian Version (PCLC), Beck depression inventory, and Taylor's manifest anxiety scale. Results: PTSD was observed in 79.29% of the study sample, 61.43% had depression, and 18.57% had anxiety. The severity of COVID-19 infection was significantly associated with PTSD severity mean scores (P value = 0.027). Furthermore, a significant relationship was observed between the severity of depression and COVID-19 infection severity (P value = 0.028). The number of comorbid medical risk factors demonstrated significance to PTSD severity (P value = 0.014). Conclusion: A significant portion of the study's patients experienced psychiatric consequences following COVID-19 infection, with 79.29% developing PTSD, 61.43% suffering from depression, and 18.57% experiencing anxiety. Various factors, such as the presence of chronic medical illnesses and the number of co-morbid medical risk factors, were observed to contribute to these psychiatric outcomes. Therefore, comprehensive psychiatric assessment and management in COVID-19 patients especially with severe forms of the disease and hospitalized patients are mandatory. [ABSTRACT FROM AUTHOR]

General relativity (GR) in its current classical formulation is fundamentally different from quantum mechanics (QM). We argue that the everlasting battle for exploring and understanding the Universe and then privileging a consistent perception of reality is therefore awaiting a consolidator rather than a conqueror. This should be capable of either unifying these two different benchmarks or at least bringing one closer to another! The latter conservatively describes the consolidating quantum geometric approach, which combines generalization of QM to relativistic energies and gravitational fields and continuous Riemann to discretized Finsler geometry. We found that this type of quantum geometric approach seems to unveil additional quantum-conditioned spacetime curvatures (QCC), sources of gravitation), which obviously could not be disclosed in Einstein's GR, especially at large scales. This study introduces analytical and numerical analyses of QCC. We conclude that (i) nature and characteristics of QCC are fundamentally distinguishable from the classical GR's spacetime curvatures, (ii) the QCC are intrinsic, real and essential, i.e. not artifacts that would be removed in a certain coordinate transformation and (iii) the magnitude of QCC are nonnegligible to be underestimated. We also conclude that the spacetime at quantum scales seems to be no longer smooth or continuous so that the proposed quantum geometric approach would be regarded as a novel mathematical framework for the emergence of quantum gravity. Last but not least, a maximal proper force is predicted as a new physical constant, which is responsible for the maximal and gravitational acceleration of a quantum particle that would live in the emerged spacetime curvatures. Thereby, the quantum geometric nature of QCC can be accessed and assessed. [ABSTRACT FROM AUTHOR]

Objectives: Esthetic crown lengthening (ECL) is commonly advocated to treat patients with altered passive eruption (APE). Since the introduction of the minimally invasive surgical concept, a limited number of studies have investigated this technique in a standardized manner, with further studies required to verify the validity and predictability of the minimally invasive FL‐technique. The current randomized trial compares a minimally invasive (ECL), using piezosurgery with flapless‐approach (FL), versus an open‐flap (OF) approach in the management of patients with APE Type 1B. Materials and Methods: Twenty‐four patients diagnosed with APE Type 1B were randomly assigned into test (FL) with tunneling approach or control (OF) group with minimally invasive flap reflection (n = 12/group). Postoperative pain was assessed during the first 48 h. Gingival margin (GM) level relative to a custom‐made stent (rGM) and patient satisfaction were assessed preoperative, immediately after surgery, at 3 and 6 months postsurgically. Postoperative swelling was reported for the first week postsurgically. Plaque index (PI), bleeding on probing (BoP), clinical attachment level (CAL), pocket depth (PD) and pink esthetic score (PES), were evaluated at baseline and 6 months. Linear regression analysis was conducted for pain. Results: OF‐group reported significantly higher pain and swelling scores than FL‐group during the first 48 h (p < 0.05). FL‐group showed no significant differences regarding rGM between 3 and 6 months, in contrast to OF‐group, where a significant decrease in rGM was notable (p < 0.05). No significant differences in PI, BoP, CAL, PD, PES, and patient satisfaction scores were evident between groups (p > 0.05). Regression analysis demonstrated that treatment and gender were significant predictors for pain (p < 0.05). Conclusions: Within the current study's limitations, piezo‐surgical ECL with FL‐approach presented significantly lower postoperative pain, swelling, and early GM stability compared to OF‐approach. Clinical Significance: Piezosurgical ECL with a FL‐approach can be considered a predictable technique with advantages over the OF‐approach in the management of patients with APE Type1B. [ABSTRACT FROM AUTHOR]

Electric vehicles are considered as an emerging solution to mitigate the environmental footprint of transportation sector. Therefore, researchers and automotive developers devote significant efforts to enhance the performance of electric vehicles to promote broader adoption of such technology. One of the critical challenges of the electric vehicle is limited battery lifetime and entailed range anxiety. In his context, development of counter-aging control strategies based on precise battery modeling is regarded as an emerging approach that has a significant potential to address battery degradation challenges. This paper presents a combined trade-off strategy to minimize battery degradation while maintaining acceptable driving performance and charge retention in electric vehicles. A battery aging model has been developed and integrated into a full vehicle model. An optimal control problem has been formulated to tackle the afore-mentioned challenges. Non-dominant sorting genetic algorithms have been implemented to yield the optimal solution through the Pareto-front of three contending objectives, based upon which an online simulation has been conducted considering three standard driving cycles. The results reveal the ability of the proposed strategy to prolong the life cycle of the battery and extend the driving range by 25 % and 8 % respectively with minimal influence of 0.6 % on the driveability. [ABSTRACT FROM AUTHOR]

Compressive sensing (CS) has been widely used to sense the wideband spectrum with fewer measurements by taking advantage of radio spectrum underutilization. As new smart devices, such as IoT devices, smart home devices, and wearables, use batteries and have limited memory, more research is needed to reduce the overuse of cognitive radio (CR) resources through spectrum sensing. To reduce the number of compressive measurements required for spectrum recovery, researchers proposed approaches like weighted and sequential compressive sensing. In this paper, we estimate the primary user's (PU) behavior statistics and use the estimated information in a novel weighted sequential compressive spectrum sensing approach. Our proposed approach can reduce and adapt the number of measurements and the sensing time to the changing number of active channels in a dynamically changing wideband spectrum. [ABSTRACT FROM AUTHOR]

Protein three-dimensional (3D) structure prediction is one of the most challenging issues in the field of computational biochemistry, which has overwhelmed scientists for almost half a century. A significant breakthrough in structural biology has been established by developing the artificial intelligence (AI) system AlphaFold2 (AF2). The AF2 system provides a state-of-the-art prediction of protein structures from nearly all known protein sequences with high accuracy. This study examined the reliability of AF2 models compared to the experimental structures in drug discovery, focusing on one of the most common protein drug-targeted classes known as G protein-coupled receptors (GPCRs) class A. A total of 32 representative protein targets were selected, including experimental structures of X-ray crystallographic and Cryo-EM structures and their corresponding AF2 models. The quality of AF2 models was assessed using different structure validation tools, including the pLDDT score, RMSD value, MolProbity score, percentage of Ramachandran favored, QMEAN Z-score, and QMEANDisCo Global. The molecular docking was performed using the Genetic Optimization for Ligand Docking (GOLD) software. The AF2 models' reliability in virtual drug screening was determined by their ability to predict the ligand binding poses closest to the native binding pose by assessing the Root Mean Square Deviation (RMSD) metric and docking scoring function. The quality of the docking and scoring function was evaluated using the enrichment factor (EF). Furthermore, the capability of using AF2 models in molecular docking to identify hits with key protein–ligand interactions was analyzed. The posing power results showed that the AF2 models successfully predicted ligand binding poses (RMSD < 2 Å). However, they exhibited lower screening power, with average EF values of 2.24, 2.42, and 1.82 for X-ray, Cryo-EM, and AF2 structures, respectively. Moreover, our study revealed that molecular docking using AF2 models can identify competitive inhibitors. In conclusion, this study found that AF2 models provided docking results comparable to experimental structures, particularly for certain GPCR targets, and could potentially significantly impact drug discovery. [ABSTRACT FROM AUTHOR]

In April 2021, Egypt and Sudan announced the failure of the African Union (AU)-led negotiations over the filling and operation of the Grand Ethiopian Renaissance Dam (GERD). Why did the AU fail to achieve progress on the contested issues in spite of the parties' rhetorical commitment to settle these issues, the mediation capacity that the AU developed over the last decade, and its comparative advantage as a regional organization close to the dispute? This article addresses this question. It integrates regional conflict resolution literature and water diplomacy approaches to identify the conditions of successful mediation in transboundary water conflicts, a task which contributes to ongoing AU efforts to learn from past mediation experiences. [ABSTRACT FROM AUTHOR]

Heavy metals are particularly damaging contaminants in the environment, and even trace concentrations represent a risk to human health due to their toxicity. To detect the heavy metals of Mn2+ and Co2+ ions, a novel selective reusable paper-based Fluorescence naked-eye sensor based on naphthalene cationic Schiff base (NCSB) was synthesized and confirmed using FT-IR, 1 H-NMR, and MS tools. Based on a blue to colorless color change in the aqueous solution, the NCSB sensor is utilized to Mn2+ and Co2+ cations selectively among other metal ions (Fe2+, Cu2+, Mg2+, Ni2+, Zn2+, Cd2+, Hg2+, Pb2+, Sn2+ and Cr3+). In the aqueous medium, the NCSB sensor displayed high sensitivity, with limits of detection (LOD) values of 0.014 µM (14.08 nM) and 0.041 µM (41.47 nM) for Mn2+ and Co2+ cations, respectively. The paper-based sensor naked-eye detected Mn2+ and Co2+ cations in water at concentrations as low as 0.65 µM (65 nM) and 0.086 µM (86 nM), respectively. It was discovered that 5 min of incubation time and a pH range of 7 to 11 were optimal for the complexation reaction between the Mn2+ and Co2+ ions and the NCSB sensor. Through a static quenching process, the interaction of the different metal ions with the Schiff base group in the NCSB molecule results in the development of a ground-state non-fluorescent complex. NCSB sensor was also successfully applied in analysis of Mn2+ and Co2+ in environmental water with good recoveries of 94.8–105.9%. The theoretical calculations based on density functional theory (DFT) studies are in support of experimental interpretations. The links between the input factors and the anticipated response were evaluated using the quadratic model of the response surface methodology (RSM) modeling. [ABSTRACT FROM AUTHOR]

We continue our review of on punctal stenosis by providing a detailed discussion of management modalities, their complications, and outcomes. There is a significant change in the understanding of punctal and peripunctal anatomy, puncto-canalicular junction, and the lacrimal pump mechanisms. While the snip punctoplasty procedures are still practiced, there is an increasing trend toward nonincisional procedures. The nonincisional procedures in select cases appear to be equally effective as the incisional ones. Although simple to use, punctal plugs never became the mainstay of treatment because of design issues and the inability to address the coexisting canalicular stenosis. Placing stents only in the lower punctum in cases of upper and lower punctal stenosis should be discouraged, and management needs to address punctal stenosis and not which punctum is involved. Several types of stents are used in the management of punctal stenosis, mostly based on surgeon's preference. The benefits of adjuvant mitomycin C are uncertain. In view of literature on how stent biofilms can themselves cause chronic inflammation, placing them for prolonged periods should be reviewed and debated. Enhanced understanding of the molecular pathogenesis of punctal stenosis and addressing the current controversies in management would help standardize the therapeutic interventions available in the lacrimal armamentarium. [ABSTRACT FROM AUTHOR]

The generalized uncertainty principle provides a promising phenomenological approach to reconciling the fundamentals of general relativity with quantum mechanics. As a result, noncommutativity, measurement uncertainty, and the fundamental theory of quantum mechanics are subject to finite gravitational fields. The generalized uncertainty principle (RGUP) on curved spacetime allows for the imposition of quantum-induced elements on general relativity (GR) in four dimensions. In the relativistic regimes, the determination of a test particle's spacetime coordinates, 〈 x μ 〉 , becomes uncertain. There exists a specific range of coordinates where the accessibility to 〈 (x μ) 2 〉 is notably limited. Consequently, the spacetime coordinates lack both smoothness and continuity. The quantum-mechanical calculations of the spacetime coordinates are directly linked to their measurement through the expectation value 〈 x μ 〉. This expectation value is dependent on 〈 (x μ) 2 〉 , which is itself limited by a minimum measurable length Δ x m i n 2 . A crucial finding presented in this script is the existence of a lower bound for the Hamiltonian, which implies the stability of the quantum nature of spacetime. The direct correlation between Δ x m i n and − 〈 g 〉 μ ν is a significant discovery, suggesting a proportional relationship. The conjecture is made that the primary metric g carries all essential information regarding spacetime curvature and serves a role akin to the Jacobian determinant in general relativity. Moreover, the linear relationship between Δ x m i n and the Planck length ℓ p is established with a proportionality factor of − 〈 g 〉 μ ν β 2 , where β 2 denotes the RGUP parameter. The discretization of spacetime coordinates results in the discontinuity of the test particle's wavefunction ψ (x , t) , leading to an unrealistic Δ p. It is also noted that the lower limit of 〈 (p μ) 2 〉 is directly proportional to the fundamental tensor. [ABSTRACT FROM AUTHOR]

In recent research, there has been a significant focus on establishing robust quantum cryptography using the continuous-variable quantum key distribution (CV-QKD) protocol based on Gaussian modulation of coherent states (GMCS). Unlike more stable fiber channels, one challenge faced in free-space quantum channels is the complex transmittance characterized by varying atmospheric turbulence. This complexity poses difficulties in achieving high transmission rates and long-distance communication. In this article, we thoroughly evaluate the performance of the CV-QKD/GMCS system under the effect of individual attacks, considering homodyne detection with both direct and reverse reconciliation techniques. To address the issue of limited detector efficiency, we incorporate the phase-sensitive amplifier (PSA) as a compensating measure. The results show that the CV-QKD/GMCS system with PSA achieves a longer secure distance and a higher key rate compared to the system without PSA, considering both direct and reverse reconciliation algorithms. With an amplifier gain of 10, the reverse reconciliation algorithm achieves a secure distance of 5 km with a secret key rate of 10 − 1 bits/pulse. On the other hand, direct reconciliation reaches a secure distance of 2.82 km. [ABSTRACT FROM AUTHOR]

This paper investigates the Ricci solitons of a sub-class of Bianchi type-I spacetimes in f(T) theory of gravity in the presence of perfect fluid. It is found that special sub-classes of perfect fluid Bianchi type-I metrics admit steady, shrinking and expanding Ricci solitons. To tackle the problem, RS equations are explored along with their integrability conditions. Field equations in f(T) theory are derived for the spacetime metric. By solving the field equations we derived general form for f(T). Ricci soliton equations and field equations are solved simultaneously to explore the corresponding Ricci soliton vector fields. We found Ricci soliton vector fields of dimension 4, 5, 6, 7, 8, 10 and 11. In some cases the corresponding metrics are Einstein metrics while in other cases non-Einstein metrics are also obtained which admit Ricci soliton vector fields. The physical quantities ρ , p, T and f(T) related to each solution are also calculated. Another interesting aspect of our results is that we obtained some non-linear f(T) functions for which field equations possess solutions and those solutions admit Ricci soliton vector fields. [ABSTRACT FROM AUTHOR]

The proliferation of Internet of Things (IoT) devices and fog computing architectures has introduced major security and cyber threats. Intrusion detection systems have become effective in monitoring network traffic and activities to identify anomalies that are indicative of attacks. However, constraints such as limited computing resources at fog nodes render conventional intrusion detection techniques impractical. This paper proposes a novel framework that integrates stacked autoencoders, CatBoost, and an optimised transformer-CNN-LSTM ensemble tailored for intrusion detection in fog and IoT networks. Autoencoders extract robust features from high-dimensional traffic data while reducing the dimensionality of the efficiency at fog nodes. CatBoost refines features through predictive selection. The ensemble model combines self-attention, convolutions, and recurrence for comprehensive traffic analysis in the cloud. Evaluations of the NSL-KDD, UNSW-NB15, and AWID benchmarks demonstrate an accuracy of over 99% in detecting threats across traditional, hybrid enterprises and wireless environments. Integrated edge preprocessing and cloud-based ensemble learning pipelines enable efficient and accurate anomaly detection. The results highlight the viability of securing real-world fog and the IoT infrastructure against continuously evolving cyber-attacks. [ABSTRACT FROM AUTHOR]

Background: Cardiac magnetic resonance imaging (CMR) is the modality of choice for quantification of myocardial iron overload in β-thalassemia major patients using the T2* sequence. CMR feature tracking (FT) is a recent magnetic resonance imaging tool that gives an idea about myocardial fibers deformation; thus, it can detect early impairment in myocardial function even before the reduction in ejection fraction. Methods: This study aims to assess the ability of left ventricular CMR-FT in the early detection of systolic dysfunction in β thalassemia major patients and to correlate it with the degree of myocardial iron overload measured by CMR T2*. This prospective study enrolled 57 β thalassemia major patients who received long-term blood transfusion and 20 healthy controls. CMR was used to evaluate left ventricular volumes, ejection fraction, and the amount of myocardial T2*. A two-dimensional left ventricular FT analysis was performed. Both global and segmental left ventricular strain values were obtained. Results: The mean global circumferential strain (GCS) and global radial strain (GRS) values were significantly lower in patients compared to control (P = 0.002 and P = 0.006, respectively). No correlation was found between T2* values and ejection fraction; however, there was a significant correlation between T2* values and GCS and GRS (P = 0.012 and P = 0.025, respectively) in thalassemia patients. Regional strain revealed significantly lower values of GCS and GRS in basal regions compared to apical ones (P = 0.000). Conclusions: Our study revealed that CMR-FT can play a role in the early detection of systolic impairment in thalassemia patients. [ABSTRACT FROM AUTHOR]

Genetic disorders affect over 6% of the global population and pose substantial obstacles to healthcare systems. Early identification of these rare facial genetic disorders is essential for managing related medical complexities and health issues. Many people consider the existing screening techniques inadequate, often leading to a diagnosis several years after birth. This study evaluated the efficacy of deep learning-based classifier models for accurately recognizing dysmorphic characteristics using facial photos. This study proposes a multi-class facial syndrome classification framework that encompasses a unique combination of diseases not previously examined together. The study focused on distinguishing between individuals with four specific genetic disorders (Down syndrome, Noonan syndrome, Turner syndrome, and Williams syndrome) and healthy controls. We investigated how well fine-tuning a few well-known convolutional neural network (CNN)-based pre-trained models—including VGG16, ResNet-50, ResNet152, and VGG-Face—worked for the multi-class facial syndrome classification task. We obtained the most encouraging results by adjusting the VGG-Face model. The proposed fine-tuned VGG-Face model not only demonstrated the best performance in this study, but it also performed better than other state-of-the-art pre-trained CNN models for the multi-class facial syndrome classification task. The fine-tuned model achieved both accuracy and an F1-Score of 90%, indicating significant progress in accurately detecting the specified genetic disorders. [ABSTRACT FROM AUTHOR]

A thiol‐functionalized MOF‐808 was produced and used to remove mercury by post‐synthetic modification using 6‐mercaponicotinic acid (6mna). Parent MOF‐808 was impregnated for varied periods in the 6mna solution to create modified MOF‐808 materials, known as MOF‐808‐6mna‐x, where x refers to the impregnation time. Diffraction and several spectroscopic techniques were employed to quantify and confirm the coordination of 6mna into MOF‐808 framework. The amount of grafted 6man and the ability for adsorption of mercury (Hg) was shown to be linearly associated; the functionalized MOF‐808‐6mna‐36 demonstrated improved Hg(II) removal, with an adsorption capacity of 250 mg/g. [ABSTRACT FROM AUTHOR]

Green hydrogen has an audible echo in the clean energy field. In this piece of work, pure and Mo-doped CuO thin films were deposited at different substrate temperatures on the Indium Tin Oxide (ITO) by the DC/RF sputtering technique. The prepared samples were utilized to generate hydrogen gas within the photoelectrochemical water-splitting mechanism. Crystallographic planes (−111), and (200) were the preferred orientations for pure and Mo-doped CuO thin films. Moreover, the average crystallite size was doubled by Mo doping reaching 25.8 nm. FE-SEM microscopic image exhibits that the pure and Mo–CuO thin films have a regular distribution with a small size. The optical band gap has rosed by doping from 1.8 eV to 2.05 eV. Then, it increased to 2.3 eV and 2.4 eV at temperatures of 100 °C and 200 °C respectively. Pure and Mo–CuO thin films were applied as photocathodes for hydrogen generation with water water-splitting technique. The photoelectrochemical application revealed a photocurrent density of ∼2.25 mA/cm2 for Mo-doped CuO photoelectrode at room temperature. This optimum photoelectrode was studied for stability and electrochemical impedance. In addition, the incident photon to current efficiency (IPCE%) was 4.47 % at 500 nm. The applied bias photon to current conversion efficiency (ABPE%) was 4.25 % at −0.38V. As a result of the above, pure and Mo-doped CuO photoelectrodes are low-cost thin films and have a high-efficiency performance for green hydrogen generation industrially. • Mo-doped CuO thin films were carefully sputtered on an ITO substrate at different temperatures. • Effect of doping and temperature on structural and optical properties of CuO thin films has been studied. • The efficiency of Mo-doped CuO photoelectrode at room temperature outperforms the rest. • Photocurrent density ∼2.25 mA/cm2 and (ABPE%) 4.25 % at −0.38V were revealed. • Mo–CuO photoelectrodes have a high level performance for green hydrogen generation. [ABSTRACT FROM AUTHOR]

The incapability of thermal models to accurately reproduce the horn-like structure of the Kaon-to-pion ratio measured at AGS, SPS, and low RHIC energies, as well as confirmed in the beam energy scan program, has long been a persistent problem. This issue is believed to have arisen due to the inappropriate application of statistics, particularly the extensive additive Boltzmann–Gibbs (BG) statistics. The assumption that the analysis of particle production, a dynamic non-equilibrium process, should be primarily conducted using extensive BG or non-extensive Tsallis statistics, has proven to be an unsuccessful approach that has been followed for several decades. By employing generic (non)extensive statistics, two equivalence classes (c,d) emerge, thereby undermining the validity of any ad hoc assumption. Consequently, the degree of (non)extensivity exhibited by the statistical ensemble is determined by its own characteristics. This encompasses both extensive BG statistics, characterized by (1,1), and non-extensive Tsallis statistics, characterized by (0,q). The energy dependence of light-, γq, and strange-quark occupation factor, γs, suggests that the produced particles are most appropriately described as a non-equilibrium ensemble. This is evidenced by a remarkable non-monotonic behavior observed in the K+/π+ horn, for instance. On the other hand, the resulting equivalence classes (c,d) are associated with a generic non-extensivity related to extended exponential and Lambert-W0 exponentially generating distribution function, which evidently arise from free, short- and long-range correlations. The incorporation of generic non-extensive statistics into the hadron resonance gas model yields an impressive ability to rightfully reproduce the non-monotonic K+/π+ ratio. [ABSTRACT FROM AUTHOR]

Cancer remains a leading cause of death worldwide, often resulting from uncontrolled growth in various organs. Protein kinase inhibitors represent an important class of targeted cancer therapies. Recently, the kinases BRAF and VEGFR-2 have shown synergistic effects on tumor progression. Seeking to develop dual BRAF/VEGFR-2 inhibitors, we synthesized 18 amino-benzothiazole derivatives with structural similarities to reported dual inhibitors. Four compounds—4a, 4f, 4l, and 4r—demonstrated remarkable cytotoxicity, with IC50 values ranging from 3.58 to 15.36 µM, against three cancer cell lines. Furthermore, these compounds showed IC50 values of 38.77–66.22 µM in the case of a normal cell line, which was significantly safer than the reference, sorafenib. Subsequent investigation revealed that compound 4f exhibited the capacity to inhibit the BRAF and VEGFR-2 enzymes, with IC50 values similar to sorafenib (0.071 and 0.194 µM, respectively). Moreover, compound 4f caused G2-M- and S-phase cycle arrest. Molecular modeling demonstrated binding patterns compatible with inhibition for both targets, where 4f exerted the critical interactions in the BRAF site and interacted in the VEGFR-2 site in a manner akin to sorafenib, demonstrating affinity similar to dabrafenib. [ABSTRACT FROM AUTHOR]

Genetic variability induced by cell and tissue culture techniques provides a new source of diversity for improvement of ornamental plants species. For this purpose, the effect of Thidiazuron (TDZ) on callus induction and number of subcultures of Salvia splendens was studied. The results showed that the MS medium supplemented with TDZ (0.5 mg/l) and Indole Acetic Acid IAA (0.1 mg/l) produced the highest percentage for explants producing callus (60%). For shoot multiplication, the best results were achieved when shoot tips were cultured on MS medium supplemented with TDZ (0.2 mg/l) alone. For subculture the same concentration of TDZ (0.2 mg/l) in media of eleven subcultures were performed at 21-day intervals over a total period of 231 days. For molecular variation detection, SCoT molecular markers were employed. Five SCoT primers were used and a total of 24 bands were obtained. The results showed high level of polymorphism between parent and their regenerated plants (subculture No. 11). These markers revealed distinctly different patterns of DNA fragments in all somaclones, and some distinctive bands were linked to the regenerated plants. For rooting, the best rooting percentage (100.00%), highest number of roots/shoot (7.00) and root length (2.58 cm) were observed when the shoots were cultured on MS hormonefree medium supplemented with 15 g sucrose/l. Plantlets were successfully acclimatized on Peat moss + perlite (1:1) with a survival rate of 100 %. [ABSTRACT FROM AUTHOR]

The high mortality rate in cattle and buffalo is a concern, especially in developing countries, such as Egypt. Under conditions of global change in climatic conditions, has caused the activation of some opportunistic microbes, causing deaths in cattle and buffalo farms. As a result of environmental stressors which lead to the activation of some bacterial agents which is the main reason for the increase in mortality in this article, we reported special spots on some bacterial agents causing sudden death in cattle and buffalo. Fecal and nasal discharge samples were collected for bacteriological examination from (60 diseased cattle and buffalo showing clinical signs of respiratory and diarrheic symptoms 30 from each of different ages and sexes (first group) and 40, slaughtered or dead animals (cattle and buffalo) from ruminal contents, tissue samples from liver, spleen, and lung 20 from each (second group). We collected samples from many locations at Assiut Governorate and were sent to the laboratory. The results of the first group indicated that (50) 30 cattle and 20 buffalo were positive for bacterial infection however 10 showed negative results of bacterial infection in buffalo. The incidence of bacterial infection in the first group was 83.5%, whereas the second group indicated that 100% (40) (20 cattle and 20 buffalo) were positive for bacterial infection. Bacteriological investigations of first group revealed that the isolated organisms were: Clostridium perfringens (46.7%), Pasteurella multocida (33.3%), Escherichia coli (13.3%), Salmonella sp.(6.7%) in cattle but in buffalo recorded that Clostridium perfringens (33.3%), Pasteurella multocida (23.3%), Escherichia coli (6.7%), Salmonella sp.( 3.3%), On other hand, bacteriological investigations of second group revealed that the isolated organisms were: Clostridium perfringens (50%), Pasteurella multocida (30%), Escherichia coli (15%) and, Salmonella sp.(5%) in cattle whereas in buffalo showed that Clostridium perfringens (40%), Pasteurella multocida (25%), Escherichia coli (25%), Salmonella sp.(10%), A total of 42 isolates of Clostridium perfringens isolated from first and second group 12 isolates examined for type of toxin by using of Multiscreen Ag ELISA Enterotoxemia The main often occurring toxin type was type A (buffaloes: 5/50; cows: 7/50) Out of 14 isolates of E coli from first and second group examined samples were serologically positive to O111, 0104, O26, O113, O91,0103 and O126. PCR results showed that ten strains from 28 isolates, from the first and second group, were isolates and some of them have Kmt1, BlaROB1, and tetH genes. Antibiogram was applied upon the isolated bacterial pathogens and found that Ofloxacin - oxytetracycline - Aztreonam (Clostridium perfringens) Gentamycin, Ceftriaxone, and Norfloxacin (Pasteurella multocida) garamycin and oxytetracycline (Escherichia coli) and ciprofloxacin and ceftriaxone were the most effective antibiotic against salmonella sp. were the drug of choice for treatment of infected animals. [ABSTRACT FROM AUTHOR]

Background: The fall armyworm (FAW), Spodoptera frugiperda (J.E. Nixon) (Lepidoptera: Noctuidae), is the major insect pest that infests cereal crops recently in African and Asian countries. The insect is polyphagous that attacks large numbers of host plants, especially maize and rice, causing considerable losses in their annual yield. The integrated pest management (IPM) of the insect depended mainly on insecticides and to some extent on biological control agents including insect pathogens (nematodes, fungi, bacteria and viruses). Results: Different species of entomopathogens (nematodes, fungi, viruses and bacteria) infecting the insect could be isolated in such newly invaded countries. Laboratory and field experiments indicated that the insect was found to be susceptible to the isolated entomopathogens, and thus, they could be promising biocontrol agents against this insect. Conclusion: This review article proved the susceptibility of S. frugiperda to the most of tested entomopathogens. However, more field studies have to be carried out in order to include such entomopathogens within integrated pest management programs against this insect pest. [ABSTRACT FROM AUTHOR]

Objectives: The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption. Materials: The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score. Results: Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results. Conclusion: Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long‐term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes. https://classic.clinicaltrials.gov/ct2/results?cond=&term=NCT04731545&cntry=EG&state=&city=&dist= [ABSTRACT FROM AUTHOR]

Purpose: In this study, we compared the effects of a single patient dialysis fluid delivery system (SPDDS) against a central dialysis fluid delivery system (CDDS) on inflammatory markers and endotoxemia in a population of patients receiving routine hemodialysis (HD). Materials & methods: 80 prevalent HD patients, aged from 18 to 60 years old, who were clinically stable and receiving thrice weekly dialysis treatments via an arteriovenous fistula were the subjects of a cross-sectional research. group I underwent HD using a CDDS water purification system that was implemented at El Demerdash Hospital two years prior, and group II underwent HD using an SPDDS water purification system at Ain Shams Specialized Hospital. Results: Pre-dialysis endotoxin levels were significantly lower in the CDDS group (0.07±0.05) compared to the SPDDS group (0.20±0.07), p-value<0.001, post-dialysis serum endotoxin levels were significantly lower in CDDS group (0.04±0.02) compared to SDDPS (0.15±0.03), p-value<0.001. Conclusions: CDDS group's circulating endotoxins had significantly decreased. [ABSTRACT FROM AUTHOR]

Background: Post-dural puncture headache (PDPH) is a debilitating condition that appears after puncturing the dura mater. The headache is severe, throbbing, frontal, radiates to the occiput; increases by standing, and decreases by lying down. Objectives: This study aimed to compare the effect of ondansetron compared to neostigmine on reducing the incidence of PDPH in parturients undergoing spinal anesthesia for elective cesarean section. Methods: Fifty-one parturients undergoing spinal anesthesia for elective cesarean section were allocated randomly into three equal groups; Group (n = 17) parturients received intravenous injection of 0.9% normal saline after delivery of the fetus as controls, Group (n = 17) parturients received intravenous injection of neostigmine and atropine after delivery of the fetus, Group (n = 17) parturients received intravenous injection of ondansetron after delivery of the fetus. Results: The incidence of headache, and median of VAS was higher among controls as compared to the neostigmine and the ondansetron group. Also, were higher in the neostigmine group compared to the ondansetron group. The control group (47.1%) required significantly more post-operative analgesia than the ondansetron group (11.8%; p=0.01). The patient's heart rate increased during spinal anesthesia, but it reduced throughout delivery and after drug infusion. The occurrence of headache and median visual analogue scale score at 48 and 7 days were postpartum differed significantly among the three groups. Conclusions: Intravenous injection of 0.08 mg/kg ondansetron is more effective in lowering the incidence and severity of post-dural puncture headache compared to 20g/kg neostigmine plus 10g/kg atropine intravenous injection in parturients undergoing spinal anesthesia for elective cesarean section. [ABSTRACT FROM AUTHOR]

Background: Continuous Spinal Anesthesia provides a good alternative to spinal anesthesia on hemodynamic and postoperative cognitive function for elderly patients undergoing lower limb surgeries. Objectives: To assess hemodynamic and postoperative cognitive function in elderly patients undergoing lower limb surgeries. Subjects and methods: This comparative randomized prospective clinical trial comprised 32 patients over 65 who was scheduled for elective lower limb surgeries estimated. Each patient received a regional anesthetic during the procedures, either through spinal anesthesia (SA) or continuous spinal anesthesia (CSA). Result: The results of the present study showed that there were no significant differences between groups regarding gender, age per years, Body mass index (BMI), American Society of Anesthesiologists (ASA status) or present of comorbidities among studied patients. There was a significantly lower dose of bupivacaine/mg needed in group CSA 11±1.03 versus 12±0 in group SA, p<0.05. Conclusion: the study compared continuous spinal anesthesia (CSA) and single-shot spinal anesthesia (SA) in elderly patients undergoing lower limb surgeries. The results showed that CSA provided better hemodynamic stability, longer-lasting analgesia, and required a lower dose of local anesthetic. However, SA seemed to be associated with improved early postoperative cognitive function. Both techniques were generally well-tolerated, but SA had a higher incidence of hypotension and bradycardia. Overall, the choice between CSA and SA should consider individual patient needs and surgical requirements. [ABSTRACT FROM AUTHOR]

We report findings from an eDelphi study that aimed to explore 16 expert panelists' perspectives regarding the key attributes of learning experience design (LXD) as it relates to the following: design, disciplines, methods, and theory. Findings suggest consensus was reached regarding LXD's focus on learner-centrism and incorporating human-centered design practices to design learning environments. LXD practitioners adapt methods and theories from fields such as human–computer interaction and user experience. Implications suggest a need to develop specific methods and theories within our own field. [ABSTRACT FROM AUTHOR]

To determine the correlations among symptoms and signs of dry eye disease (DED) in the Dry Eye Assessment and Management (DREAM) study. A total of 535 patients with moderate-to-severe DED were assessed for symptoms using the Ocular Surface Disease Index (OSDI) and four DED signs in both eyes (conjunctival lissamine green staining, corneal fluorescein staining, Schirmer's testing, and tear break-up time (TBUT)) following standardized protocols at baseline and follow-up visits (months 3, 6, and 12). Spearman correlation coefficients (rho) were calculated for correlations among symptoms and signs of DED at baseline and among changes in symptoms and signs from baseline at 12 months. The confidence intervals and p-values for correlation coefficients were calculated using a cluster bootstrapping to account for inter-eye correlation. At baseline, OSDI total score was not correlated with signs; however, OSDI subscale score of ocular symptoms was weakly correlated with corneal staining score (rho = 0.14, p =.002) and Schirmer test score (rho = 0.11, p =.01). There were statistically significant correlations among the four signs (p <.001), with absolute correlation coefficient ranging from 0.14 (conjunctival staining score vs. TBUT) to 0.33 (conjunctival staining score vs. cornea staining score). The correlations among changes in symptoms and signs were weaker, with the highest correlation between change in conjunctival staining and corneal staining (rho = 0.21, p <.001). Consistent with previous studies, among DREAM participants with moderate-to-severe DED at baseline, correlations of DED symptoms with signs were low and correlations among four objective signs were low to moderate. The correlations among changes in symptoms and signs were even weaker. [ABSTRACT FROM AUTHOR]

Background: Sacroiliac joint dysfunction (SIJD) is a common condition that is defined by pain in the back that is the result of musculoskeletal impairments. The efficacy of Proprioceptive Neuromuscular Facilitation (PNF) as well as Myofascial Release (MR) in the management of this condition has been investigated, with variable results in terms of functional disability, ROM, along with pain intensity. Purpose: The current study was carried out to investigate the efficacy of PNF versus MR for treating of SIJD. Subjects and Methods: Fifty male patients who had SIJD referred by Physician were enrolled in this study, the participants' ages varied between 35 and 45, and they were divided evenly into two groups, A and B, using a random assignment method. Twenty-five subjects in Group (A) were given PNF with bilateral symmetrical and lower extremities pattern of exercise trunk muscles while twenty-five subject in group (B) were given MR on the SIJ area. Patients participated in this study were assessed for pain and function by using pressure algometer, The FABER test, Visual analog scale (VAS) as well as Oswestry disability index (ODI) (%). The participants underwent pre- and post-treatment evaluations, with three sessions each week for a duration of 12 weeks. Results: The data obtained indicated substantial changes in all assessed variables between the two groups prior to and following treatment. There was a statistically significant difference in the average values of all measured variables among groups A and B. This difference favored group A, showing a substantial improvement. Conclusion: PNF as well as MR can be incorporated into the physical treatment regimen. PNF was found to be more efficacious than MR in reducing pain and improving functionality for patients having SIJD. [ABSTRACT FROM AUTHOR]

Background Aim Design and method Results Conclusion Implications for nursing and health policy Greening organizations have become a top priority for decision‐makers in the 21st century. Psychological ownership can be improved through responsible administration, which, in turn, improves green behavior.Investigating the mediating role of psychological ownership in the relationship between green human resources management (HRM) and green behavior among nursing faculty.A correlational analytical research design was utilized to conduct the study following the STROBE guidelines. A convenience sample of 204 academic staff was used. Four data collection tools were used: sociodemographic characteristics, the green HRM questionnaire, the Psychological Ownership Scale, and the Green Behaviour Scale.Faculty members who perceive strong green HRM practices are more likely to have heightened psychological ownership, positively influencing their engagement in green behavior. Conversely, weaker perceptions of green HRM are associated with lower levels of green behavior. Psychological ownership was found to act as a partial mediator between green HRM and green behavior. Even when considering the influence of psychological ownership, green HRM has a significant and direct impact on green behavior.Faculty members who perceive a high level of green HRM practices are more likely to have a high level of psychological ownership that, in turn, influences their green behavior.Workshops on psychological ownership and green behavior can foster environmental sustainability. Policies should integrate green HRM practices into nursing education and healthcare facilities, recognizing psychological ownership's role. Incentivizing green initiatives can motivate staff, aligning with broader conservation goals. Encouraging an ethos of environmental stewardship benefits both the healthcare and sustainable development agendas. [ABSTRACT FROM AUTHOR]

Background: An increased risk of dangerous emergence agitation (EA) has been linked to the use of sevoflurane. This study aims to compare the the use of preoperative ketamine, midazolam or Oral Dextromethorphan for reducing sevoflurane emergence agitation among preschool children undergoing adenotonsillectomy. Methods: This randomized controlled double-blinded study was carried out at Zagazig University Hospitals on 56 children who were divided into 4 equal groups; 14 patients in each: Group (C): received 10ml oral placebo (clear fluid) 1 hour before the general anesthesia induction. Group (D): Patients received at a dose of 0.5mg/kg 1 hour from oral dextromethorphan before the general anesthesia induction. Group (K): received a dose of 0.5mg/kg 1 hour of oral ketamine before the general anesthesia induction. Group (M): received a dose of 0.5 mg/kg 1 hour of oral Midazolam before the general anesthesia induction. Results: Regarding heart rate (HR); group (K) was significantly highest compared to other groups. (p<0.001). The postoperative agitation incidence >4 was significantly lowest in the ketamine group in comparison to the other groups (p=0.02). Group M was found to be significantly lowest in post-operative pain occurrence in comparison to the other groups (p=0.02). Group K was found to be significantly lowest in the amount of fentanyl consumption in comparison to the other groups (p=0.004). Conclusion: Ketamine premedication is more effective for EA prevention among children during the early emergence time after sevoflurane c ompared to midazolam and dextromethorphan anethesia. [ABSTRACT FROM AUTHOR]

The effects of emergence agitation (EA), also known as emergence delirium, can be clinically substantial. EA's mechanism is yet unknown. Age, male sex, the type of surgery, an emergency procedure, the use of inhalational anesthetics with low bloodgas partition coefficients, a lengthy procedure, anticholinergics, premedication with benzodiazepines, postoperative pain, and the presence of invasive devices are among the proposed risk factors for EA. There are numerous tools available for evaluating EA. However, there are no established best practices for clinical research. Preoperative instruction for surgery, parent-present induction, localized analgesia, multimodal analgesia, propofol, Nefopam, N-methyl-D-aspartate receptor antagonists, and opioid agonists, and total intravenous anesthesia may all aid in preventing EA. However, it might be challenging to recognize high-risk patients and implement preventative strategies in varied therapeutic settings. The techniques of studies and the patients evaluated affect the risk variables and outcomes of preventative interventions. In this review, we cover significant findings from EA research as well as prospective research directions. [ABSTRACT FROM AUTHOR]

BACKGROUND: SRS and SRT are precise treatments for brain metastases, delivering high doses while minimizing doses to nearby organs. Modern linear accelerators enable the precise delivery of SRS/SRT using different modalities like three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and Rapid Arc (RA). OBJECTIVE: This study aims to compare dosimetric differences and evaluate the effectiveness of 3DCRT, IMRT, and Rapid Arc techniques in SRS/SRT for brain metastases. METHODS: 10 patients with brain metastases, 3 patients assigned for SRT, and 7 patients for SRS. For each patient, 3 treatment plans were generated using the Eclipse treatment planning system using different treatment modalities. RESULTS: No statistically significant differences were observed among the three techniques in the homogeneity index (HI), maximum D2%, and minimum D98% doses for the target, with a p > 0.05. The RA demonstrated a better conformity index of 1.14±0.25 than both IMRT 1.21±0.26 and 3DCRT 1.37±0.31. 3DCRT and IMRT had lower Gradient Index values compared to RA, suggesting that they achieved a better dose gradient than RA. The mean treatment time decreased by 26.2% and 10.3% for 3DCRT and RA, respectively, compared to IMRT. In organs at risk, 3DCRT had lower maximum doses than IMRT and RA, but some differences were not statistically significant. However, in the brain stem and brain tissues, RA exhibited lower maximum doses compared to IMRT and 3DCRT. Additionally, RA and IMRT had lower V15Gy, V12Gy, and V9Gy values compared to 3DCRT. CONCLUSION: While 3D-CRT delivered lower doses to organs at risk, RA and IMRT provided better conformity and target coverage. RA effectively controlled the maximum dose and irradiated volume of normal brain tissue. Overall, these findings indicate that 3DCRT, RA, and IMRT are suitable for treating brain metastases in SRS/SRT due to their improved dose conformity and target coverage while minimizing dose to healthy tissues. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the degree of discrepancy between the clinical and pathological staging of laryngeal carcinoma, and the potential impact of this discrepancy on the outcomes and prognosis. Methods: This study was conducted on 127 patients who underwent total laryngectomy over five years (October 2016–October 2021). Data collected from pretherapeutic clinical staging regarding the extent of the tumor affection of different laryngeal subsites was compared to the postsurgical pathological assessment. Results: Overall, 12 out of 127 patients (9.4%) in the current study, were clinically over-staged from T3 to T4 due to radiological diagnosis of tumor infiltration of laryngeal cartilages that proved pathologically to be free of tumor. Additionally, discordance in the N stage was found in 12.6% (n = 16). However, stage discrepancy did not have a significant impact on the prognosis and survival. Conclusion: Discordance between clinical and pathological TNM staging of laryngeal carcinoma may affect the decision making and the choice of the treatment options. Some improvement can be probably achieved with advancements and higher accuracy of the preoperative diagnostic tools. [ABSTRACT FROM AUTHOR]

We aim to provide a detailed and updated literature review on the epidemiology, etiology, clinical presentations, histopathology, and ultrastructural features of punctal stenosis. There are inconsistencies in the definition and staging of punctal stenosis. While advanced optical coherence tomography imaging techniques have revolutionized the way the punctum and vertical canaliculi are assessed or monitored following treatment, the planes of measurement to characterize punctum anatomy need to evolve further. The current criteria for diagnosing and grading punctal stenosis are inadequate and based on empirical clinical findings. There is increasing evidence of the role of lymphocytes and myofibroblasts in the pathogenesis of punctal stenosis. There is a need for a uniform assessment of punctal stenosis and a uniform reporting of severity that would help standardize the several management options available in the lacrimal armamentarium. [ABSTRACT FROM AUTHOR]

The study aims to assess the marine environmental hazards resulting from some industrial activities areas being found at the Suez Bay. The survey was done to select five industrial locations along the studied areas where different water and sediment samples were collected during September 2020. The study methods showed that different concentrations were measured in the collected water and sediment samples, such as; Al, Fe, Mn, Hg, Cd, Cr, Co, Mo, V, Pb, Ni, Cu, Zn, where the digested samples were measured by using Inductively Coupled Argon Plasma spectroscopy (ICAP 6500 Duo), while the natural radioactivity concentrations of the selected radio-nuclides such as 238U, 226Ra, 232Th, 40K, were measured in both water and sediments samples by using Hyper germanium detector, as the radiological risk assessment of different samples was detected by using ERICA modeling software. The study results showed that the concentrations of the measured trace elements in the selected five industrial sites were slightly higher than the standard limits, while the measured radioactivity concentrations of the selected radio-nuclides in both water and sediment samples were below the standard limits. The results showed that the calculated distribution coefficient of the selected trace elements was (Kd Metal Pollution Index < 3), which indicated that the measured trace elements were more dissolved in the aqueous than the sediment medium. The study used the mean probable effect Level (m-PEL-Q) for estimating the metal concentration hazards in the sediment samples at the selected sites, where these values were ranged from 0.04 to 0.1, indicating that the combined concentration effects for these metals were caused 9% toxic probability. The study showed that both the calculated quotient risk (QR) and dose rate values of the marine organisms which were being calculated by the ERICA model were below the recommended limits. [ABSTRACT FROM AUTHOR]

Ultrasonic diagnostics is the earliest way to predict industrial faults. Usually, a contact microphone is employed for detection, but the recording will be contaminated with noise. In this paper, a dataset that contains 10 main faults of pipelines and motors is analyzed from which 30 different features in the time and frequency domains are extracted. Afterward, for dimensionality reduction, principal component analysis (PCA), linear discriminant analysis (LDA), and t-distributed stochastic neighbor embedding (t-SNE) are performed. In the subsequent phase, recursive feature elimination (RFE) is employed as a strategic method to analyze and select the most relevant features for the classifiers. Next, predictive models consisting of k-Nearest Neighbor (KNN), Logistic Regression (LR), Decision Tree (DT), Gaussian Naive Bayes (GNB), and Support Vector Machine (SVM) are employed. Then, in order to solve the classification problem, a stacking classifier based on a meta-classifier which combines multiple classification models is introduced. Furthermore, the k-fold cross-validation technique is employed to assess the effectiveness of the model in handling new data for the evaluation of experimental results in ultrasonic fault detection. With the proposed method, the accuracy is around 5% higher over five cross folds with the least amount of variation. The timing evaluation of the meta model on the 64 MHz Cortex M4 microcontroller unit (MCU) revealed an execution time of 11 ms, indicating it could be a promising solution for real-time monitoring. [ABSTRACT FROM AUTHOR]

Objective: Endoscopic ultrasound‐guided radiofrequency ablation (EUS‐RFA) has been constantly increasing, particularly in the treatment of pancreatic neuroendocrine neoplasms (pNENs). While emerging data in this field are accumulating, we aimed to assess the pooled efficacy and safety of EUS‐RFA for pNENs. Methods: The PubMed/Medline, Embase, and Cochrane Library databases search was conducted to identify studies reporting EUS‐RFA of pNENs with outcomes of interest (efficacy and safety). The primary outcome was radiological response. Efficacy was assessed by the pooled clinical response rate, whereas safety was assessed by the pooled adverse events (AEs) rate. Heterogeneity was assessed using I2. Pooled estimates and the 95% confidence interval (CI) were calculated using a random‐effect model. Results: Eleven studies involving 292 patients were included. The pooled technical success rate was 99.2% (95% CI 97.9–99.9%), with no heterogeneity. The pooled complete radiological response was 87.1% (95% CI 80.1–92.8%). The pooled partial response was 11.4% (95% CI 6.2–18.1%). The pooled clinical response rate for functional pNENs was 94.9% (95% CI 90.7–97.9%), with no heterogeneity. The pooled incidence of AEs was 20.0% (95% CI 14.0–26.7%); most AEs were mild to moderate in grade, while the pooled incidence of severe AEs was 0.9% (95% CI 0.2–2.3%). The most common AEs were transient mild abdominal pain in 19 patients (6.5%), and mild to moderate pancreatitis in 23 patients (7.9%). No cases of mortality were reported. Conclusion: Endoscopic ultrasound‐guided radiofrequency ablation resulted on a feasible approach for pNENs treatment, with excellent technical success, high radiological and clinical response, and acceptable AE rate. [ABSTRACT FROM AUTHOR]

Currently the Nile and the Orontes River basins are in the international spotlight as tension escalates between Egypt, Sudan and Ethiopia in the former and between Syria and Turkey in the latter. In this article we investigate the cooperation dynamics between nation states in the two basins. We analyze the obstacles to cooperation that prevent the improvement of these dynamics through a novel analytical framework that enables researchers and policymakers to understand the cooperation dynamics in these transboundary river basins through a common set of terminologies and definitions. [ABSTRACT FROM AUTHOR]

As technology develops, operators move into more remote regions, deeper offshore depths, and into regions that yield more challenges. The field of flow assurance, the coupling of multiphase flow and production chemistry, was born out of necessity as it has grown in concern to all operators. Mono Ethylene Glycol (MEG) which is commonly used to prevent hydrate formation, may assist in wax deposition and forming emulsion when combined with waxy crude. Nevertheless, once developed, it can tackle these issues as well. In this study the potential of using MEG is evaluated to release the excess pressure drop in pipeline caused by accumulation of highly viscous phase. Field trials over a gas field with condensate gas ratio around 30 that yields wax in the Mediterranean have been used for this study. MEG can be used as a heat transfer fluid that can be heated to temperature higher than water and keep its energy for longer time that helps in dissolving the deposited wax in the pipeline. The results from these trials demonstrate that cleaning the line of accumulated solids can be achieved by optimizing the volume of MEG injected with the shear force from water hammering effect while restarting the well. [ABSTRACT FROM AUTHOR]

The dominance of Boltzmann–Gibbs distribution (BG) in statistical physics appears to endow an impression that this would be the only statistical approach available. In fact, a large class of statistical approaches already exists. This is generalizing BG statistics referring to various types of nonextensivity, nonadditivity, nonequilibrium, nonlinearity, etc. For instance, log and exp functions play crucial roles in both extensive and nonextensive domains of statistical mechanics. Emerging in a physical system, BG statistics defines extensive entropy which relates the number of microstates to thermodynamic quantities or macroscopic states. In this regard, the Boltzmann distribution, extensive statistics, refers to a well-defined probability distribution, while the various types of nonextensive statistics categorically violate the fourth Shannon–Khinchen additivity axiom. The log and exp distribution functions in BG, Tsallis, and generic statistics are systematically compared. We focus on the mathematical properties of both distribution functions and conclude that their compatibility exclusively depends on the nonextensive parameters, i.e. the mathematical properties of both distribution functions depend on the nonextensive parameters either that of Tsallis- or that of the generic-type of nonextensivity. We also conclude that the statistical nature of the underlying ensemble should be taken into consideration when applying the statistical approach. [ABSTRACT FROM AUTHOR]

Two new series of oxadiazole and pyrazoline derivatives were designed and synthesized as promising EGFR-TK inhibitors. The in vitro antiproliferative activity was studied against three human cancer cell lines; HCT116, HepG-2 and MCF7 using MTT assay. Compound 10c showed the most potent anticancer activity against all cancer cell lines, with IC50 range of 1.82 to 5.55 μM, while proving safe towards normal cells WI-38 (IC50 = 41.17 μM) compared to the reference drug doxorubicin (IC50 = 6.72 μM). The most active candidates 5a, 9b, 10a, 10b and 10c were further assessed for their EGFR-TK inhibition. The best of which, compounds 5a and 10b showed IC50 of 0.09 and 0.16 μM respectively compared to gefitinib (IC50 = 0.04 μM). Further investigation against other EGFR family members, showed that 5a displayed good activities against HER3 and HER4 with IC50 values 0.18 and 0.37 µM, respectively compared to gefitinib (IC50 = 0.35 and 0.58 µM, respectively). Furthermore, 5a was evaluated for cell cycle distribution and apoptotic induction on HepG-2 cells. It induced mitochondrial apoptotic pathway and increased accumulation of ROS. Molecular docking study came in agreement with the biological results. Compounds 5a and 10b showed promising drug-likeness with good physicochemical properties. [ABSTRACT FROM AUTHOR]

Background: Traumatic injury of popliteal artery records the highest risk of lower extremity loss with amputation rates of 10% to 15%. A method to investigate the predictors of amputation is needed because previous scores could not be validated. The goal of this review is to investigate if POPSAVEIT (popliteal scoring assessment for vascular extremity injuries in trauma) may be used as a preoperative indicator of amputation risk in patients with traumatic injury of popliteal vessel. Methods: From 2017 to 2022, all patients who underwent surgical repair of popliteal arterial traumatic injuries at Zagazig University Hospitals were included in this retrospective study. Patients who needed amputation were assessed to those with limb salvage. Based on univariate analysis, the significant predictors of POPSAVEIT variables for amputation were included in a multivariable analysis. To determine low vs. high-risk scores, receiver operating characteristic (ROC)curve are created. Results: 76 patients were included in the study, with an overall amputation rate of 18.4%. The following risk factors were shown to be independently related with amputation: systolic blood pressure <90 mm Hg (OR, 5.3; P = 0.05), associated orthopedic injury (OR, 6.1; P = 0.009), and a lack of preoperative pedal Doppler signals (OR, 8.3; P = 0.001). For a high risk of amputation, a score of ≥3 was determined to have the best sensitivity (78.6%) and specificity (59%). Conclusions: POPSAVEIT is a preoperative simple and practical way to classify patients into low- and high-risk major amputation categories. [ABSTRACT FROM AUTHOR]

Background: Stenosis due to neointimal hyperplasia is the main reason of failing arteriovenous fistula (AVF). Percutaneous endovascular procedures are widely applied for treatment of failing dialysis circuit. Both drug-coated balloon (DCB) and non-compliant balloon (NCD) angioplasty can be employed to treat hemodialysis access dysfunction. Aim of the work: The goal of this trial is to assess the additional value of using DCB over NCB for the management of failing native AVF. Methods: This is a single-centre randomized clinical study, 53 patients presented with failing dialysis access are assessed for eligibility. The study was conducted at Vascular Surgery Department, Zagazig University Hospitals-Egypt from January 2017 to December 2020. A total of 27 patients presented with failing AVF, are randomized to 13 patients are treated with DCB and 14 patient are treated with NCB angioplasty. The primary endpoint of the study is anatomical success (less than 30% residual stenosis of the target lesion). Secondary endpoints include duplex assessment of dialysis circuit flow rate, complications (minor and major), target lesion primary patency (TLPP), target lesion assisted primary patency (TLAPP), target lesion secondary patency (TLSP), cumulative primary and assisted primary patency, as well as intervention free survival during 12 months follow up. Results: In DCB group, the mean age of 55.1 years; while the mean age in NCB group is 54.6 years. There are no preoperative differences in patient risk factors between both groups. Anatomical success rate is achieved in 100% of both groups. TLPP between DCB and NCB groups at 12 months (61.5% vs 57.1%) are comparable (P = 0.81), as well as TLAPP at 12 months (61.5% vs 64.3%; P = 0.88). TLSP between DCB and NCB at 12 months (69.2% vs 64.3%) are also comparable (P = 0.78). Successful endovascular angioplasty for all circuit restenosis are performed in one DCB patient and three NCB patients. Rates of overall fistula restenosis are higher in NCB than DCB group without significance difference. Conclusion: DCB is promising alternative for failing AVF treatment, as it clinically improves short term access patency, and reduces target lesion restenosis rate but this remains statistically insignificant. [ABSTRACT FROM AUTHOR]

Children with spinal muscular atrophy (SMA) frequently experience feeding intolerance and diminished growth. Although splicing modulators to prevent symptoms are available worldwide, adequate nutrition to support growth, development, and improved quality of life remains essential. We present a case study of a one-year-old malnourished male with SMA type I who achieved improved growth and feeding tolerance with a human milk (HM)-derived nutrition intervention. Despite feeding with appropriately balanced semielemental formula, he remained severely malnourished after two months of hospitalization. Feeds were partially replaced with HM-based diet plus a HM-based fat modular. Feeding tolerance, fecal calprotectin levels, and z scores for weight and length improved while receiving the HM-based intervention. We hypothesize that the HM-based feeding reduced intestinal inflammation by diminishing pathogenic elements of his microbiome. Owing to their aberrant fatty acid metabolism, patients with SMA are uniquely positioned to benefit from HM-based nutrient acquisition even while receiving splicing modulators to stabilize the disease process. [ABSTRACT FROM AUTHOR]

This mixed method study developed multiple question types to understand and measure women’s perceived benefit from adjuvant endocrine therapy. We hypothesis that patients do not understand this benefit and sought to develop the questions needed to test this hypothesis and obtain initial patient estimates. From 8/2022 to 3/2023, qualitative interviews focused on assessing and modifying 9 initial varied question types asking about the overall survival (OS) benefit from adjuvant endocrine therapy. Subsequent focus groups modified and selected the optimal questions. Patients’ self-assessment of their OS benefit was compared to their individualized PREDICT model results. Fifty-three patients completed the survey; 42% Hispanic, 30% rural, and 47% with income < $39,999 per year. Patients reported adequate health care literacy (61.5%) and average confidence about treatment and medication decisions 49.4 (95% CI 24.4–59.5). From the original 9 questions, 3 modified questions were ultimately found to capture patients’ perception of this OS benefit, focusing on graphical and prose styles. Patients estimated an OS benefit of 42% compared to 4.4% calculated from the PREDICT model (p < 0.001). In this group with considerable representation from ethnic minority, rural and low-income patients, qualitative data showed that more than one modality of question type was needed to clearly capture patients’ understanding of treatment benefit. Women with breast cancer significantly overestimated their 10-year OS benefit from adjuvant endocrine therapy compared to the PREDICT model. [ABSTRACT FROM AUTHOR]