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Uremic Encephalopathy results from the elevation of toxins and blood-brain barrier (BBB) disruption. Renal Ischemia/Reperfusion (I/R) injury is the principal cause of acute kidney injury and brain tissue injury. The present study was crafted to estimate the restorative impact of platelet-rich plasma (PRP) and exosome injection before the reperfusion phase on the kidney following renal I/R injury and its influence on brain tissue by tracking the histopathological, biochemical, and Doppler ultrasonography alternations in both kidney and brain tissue. Forty mature male rats were divided into five groups as follows: control, I/R, PRP, exosome, and Exosome + PRP. Renal Doppler ultrasonography was traced for all rats. Serum kidney functions and acetylcholine esterase enzyme (AchE) were evaluated. Both Gamma-aminobutyric acid (GABA) and glutamate were assessed in brain tissues. The oxidative stress (malondialdehyde), anti-oxidative (glutathione and catalase), and pro-inflammatory (Tumor necrosis factor- α and interleukin-6) markers were estimated in renal tissues. Additionally, morphometric histological examination was performed in both renal and brain tissues. Both PRP and exosome-received rats exhibited a significant improvement in both serum kidney functions and AchE compared to I/R rats. There was a 3.39-fold increase in GABA and a 2.27-fold decrease in glutamate levels in the brain tissue of PRP rats compared to the I/R rats. A significant elevation (P ≤ 0.0001) of glutathione and catalase besides a significant reduction in the expression of TNF-α and IL-6 was observed in renal tissue compared to I/R rats. A significant severe reduction (P < 0.0001) in the number of Purkinje cells, pyramidal cells in the cerebellar cortex, and the CA1 region in the hippocampus was observed in I/R rats which was significantly alleviated by both PRP and exosome. Furthermore, there was a significant improvement in Doppler parameters. PRP exerted a significant superior impact on the restoration of kidney functions and repairing uremic-induced damage in brain tissue. [ABSTRACT FROM AUTHOR]

Cellular senescence is a biological mechanism of aging and age‐related diseases. The aim of this study was to examine whether senescence biomarkers are associated with frailty and physical function trajectories in patients undergoing kidney transplantation (KT). We also discussed the relationship between senescence biomarkers and KT function. In this multicenter study, we prospectively assessed plasma levels of senescence biomarkers, frailty as measured by the Physical Frailty Phenotype, and physical function as measured by the Short Physical Performance Battery prior to KT. Frailty, physical function, and KT function were also measured 1 year after KT. Variable associations were assessed using Cox and relaxed least absolute shrinkage and selection operation regression. The cohort consisted of 197 participants (mean age 53 ± 13 years, 61.4% male, and 80.2% White race). Higher pre‐KT levels of macrophage‐derived chemokine (MDC/CCL22) and growth differentiation factor‐15 (GDF‐15) were independently associated with less improvement in frailty and/or physical function during the first year after KT. Higher pre‐KT levels tumor necrosis factor receptor superfamily member 6 (FAS) and MMP‐9 levels were independently associated with lower KT function one year after KT. Pre‐KT cellular senescence may contribute to frailty, physical function, and kidney function trajectories during the first year after KT. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae is a significant global public health burden, especially in low-income countries and regions with fragile healthcare infrastructures, due to its ability to cause severe infections, increase mortality rates, and its rising antimicrobial resistance. This study aimed to estimate the proportion of multidrug-resistant (MDR) K. pneumoniae infections and identify associated risk factors. Methods: Data were retrospectively collected from three academic hospitals in Beirut, Lebanon, between January 2021 and September 2023 using a standardized form. Binary logistic regression was used to determine risk factors associated with MDR, extended-spectrum beta-lactamase (ESBL)-producing, and carbapenem-resistant K. pneumoniae (CRKP) infections. Results: Out of 2,655 K. pneumoniae cases, 410 met the inclusion criteria. The primary infection sources were the urinary tract (58.3%) and the respiratory tract (12.4%). Among the isolates, 61% were MDR K. pneumoniae, with 7.3% being extensively drug-resistant, and 0.5% pandrug-resistant. Additionally, 36.8% were ESBL-producing, while 6.3% were CRKP. Predictors significantly associated with MDR K. pneumoniae infections included male sex (adjusted odds ratio [AOR] = 3.46, 95% CI = 1.01–11.86, P = 0.04), recent antibiotics use (AOR = 4.52, 95% CI = 1.65–12.36, P = 0.003), and recent cancer chemotherapy (AOR = 3.43, 95% CI = 1.25–9.42, P = 0.01). ESBL-producing infections were associated with age ≥ 65 years, higher Charlson Comorbidity Index (CCI), and recent antibiotic use. CRKP infections were linked to male sex, prior antibiotic use, and longer hospital stays prior to infection (all P < 0.05). Conclusions: MDR K. pneumoniae infections are steadily rising in Lebanon, along with an increase in ESBL-producing and CRKP cases. The main risk factors for MDR K. pneumoniae infections were male sex, recent antibiotic use, and cancer chemotherapy. ESBL-producing infections were associated with advanced age, higher CCI, and recent antibiotic use, while CRKP infections were linked to male sex, prior antibiotic use, and prolonged hospital stays. This situation is further exacerbated by inadequate healthcare infrastructure and suboptimal national surveillance. Strengthening local surveillance and implementing effective antibiotic stewardship programs are critical to managing this growing threat.. [ABSTRACT FROM AUTHOR]

The mean residual lifetime (MRL) of a unit is its expected additional lifetime provided that it has survived until time t. The MRL estimation problem has been frequently addressed in the literature since it has wide applications in statistics, reliability and survival analysis. In this paper, we consider the problem of estimating the MRL in ranked set sampling when actual quantifications of a concomitant variable are available. To exploit the additional information of the concomitant variable, we introduce several MRL estimators based on some regression techniques. We then compare them with the standard MRL estimator in simple random sampling using Monte Carlo simulation and a real dataset from the Surveillance, Epidemiology, and End Results Program. Our results indicate the superiority of the procedures that we have developed when the quality of ranking is fairly good. [ABSTRACT FROM AUTHOR]

Summary: Background & Aims: The development of acute kidney injury (AKI) in the setting of alcohol‐associated hepatitis (AH) portends a poor prognosis. Whether the presence of AH itself drives worse outcomes in patients with cirrhosis and AKI is unknown. Methods: Retrospective cohort study of 11 hospital networks of consecutive adult patients admitted in 2019 with cirrhosis and AKI. AKI phenotypes, clinical course, and outcomes were compared between AH and non‐AH groups. Results: A total of 2062 patients were included, of which 303 (15%) had AH, as defined by National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria. Patients with AH, compared to those without, were younger and had higher Model for End‐stage Liver Disease‐Sodium (MELD‐Na) scores on admission. AKI phenotypes significantly differed between groups (p < 0.001) with acute tubular necrosis occurring more frequently in patients with AH. Patients with AH reached more severe peak AKI stage, required more renal replacement therapy, and had higher 90‐day cumulative incidence of death (45% [95% CI: 39%–51%] vs. 38% [95% CI: 35%–40%], p = 0.026). Using no AH as reference, the unadjusted sHR for 90‐day mortality was higher for AH (sHR: 1.24 [95% CI: 1.03–1.50], p = 0.024), but was not significant when adjusting for MELD‐Na, age and sex. However, in patients with hepatorenal syndrome, AH was an independent predictor of 90‐day mortality (sHR: 1.82 [95% CI: 1.16–2.86], p = 0.009). Conclusions: Hospitalised patients with cirrhosis and AKI presenting with AH had higher 90‐day mortality than those without AH, but this may have been driven by higher MELD‐Na rather than AH itself. However, in patients with hepatorenal syndrome, AH was an independent predictor of mortality. [ABSTRACT FROM AUTHOR]

Water quality in land-based fish production can be controlled through either instantaneous water exchange or costly wastewater treatment followed by recirculation. Agricultural-aquaculture integration is an excellent alternative technique for reducing nutrient discharge levels, boosting profitability, and converting fish culture wastewater into valuable products. The current study employed a solar energy system to power two separate IMTA-aquaponics systems (Nutrient Film Technique, NFT, and Floating Raft Systems, FRS) for the cultivation of Nile tilapia, African catfish, thin-lipped grey mullet, freshwater crayfish, freshwater mussels, and a variety of vegetables. Tilapia and catfish were fed exclusively on diets under the IMTA system. All wastewater from tilapia and catfish ponds, both dissolved and solid, flows sequentially to ponds containing other cultivated species. The water then flows through the IMTA system's terminal point to the NFT and FRS systems before returning to the tilapia and catfish ponds, allowing complete control of the nutrient flow throughout this entire circular system. Two 147-day production cycles were concluded. The results from the second production cycle are reported. Total biomass gain for aquatic species in the IMTA system was 736.46 kg, compared to 145.49 kg in the tilapia and 271.01 kg in the catfish monoculture systems. The current IMTA system had a cumulative feed conversion ratio (FCR) of 0.90, while the FCRs for tilapia and catfish were 1.28 and 1.42, respectively. Nile tilapia and catfish consumed 571.90 kg of feed containing 25.70 kg of nitrogen (N) and 9.70 kg of phosphorus (P), reflecting, and gaining 11.41 and 3.93 kg of dietary N and P, representing 44.40 and 40.46% dietary N and P retention, respectively. In the IMTA system, the addition of mullet and prawn as detrivores aquatic animals improves dietary N and P utilization efficiency to 59.06 and 51.19%, respectively, while the addition of mussels as herbivore animals improves dietary N and P utilization efficiency to 65.61 and 54.67%, respectively. Finally, using FRS and NFT as hydroponic systems increased dietary N and P efficiency to 83.51% N and 96.82% P, respectively. This study shows that the IMTA-Aquaponic system, as a bio-integrated food production system, can convert the majority of fish-fed residues into valuable products suitable for desert, rural, and urban areas in impoverished and developing countries. [ABSTRACT FROM AUTHOR]

Holocellulose (HC) fraction extracted from date-pits was evaluated as a novel feed additive for ruminant feeding. This study was performed to investigate the effectiveness of the HC additive on rumen fermentation, methane (CH4) production, and diet degradability over 24 h of in vitro incubation. Three independent incubation trials were conducted over three consecutive weeks, employing the same in vitro methodology to assess four treatment doses in a completely randomized design. The experimental diet incorporated four increasing doses of HC, containing HC at 0 (HC0), 10 (HC10), 20 (HC20), and 30 (HC30) g/kg dry matter (DM). In vitro gas production (GP) and CH4 production, volatile fatty acids (VFAs) concentration, protozoa accounts, degraded organic matter (DOM), metabolizable and net energy (ME and NE), and hydrogen (H2) estimates were measured. No significant differences in ruminal pH were observed as the HC doses gradually increased. All incremental doses of HC additive over 24 h resulted in a linear increase in GP (P < 0.001), DOM (P < 0.001), total VFAs (P = 0.011), and propionate (P < 0.001) concentrations, as well as estimated energy (ME and NE) (P < 0.05) and microbial protein (P = 0.017) values. However, the inclusion of increasing doses of HC in the diet displayed linear reductions in the net CH4 production (ml/kg DOM; P = 0.002), protozoa abundance (P = 0.027); acetate (P = 0.029), and butyrate (P < 0.001) concentrations, the acetate-to-propionate ratio (P < 0.001), and the estimated net H2 production concentration (P = 0.049). Thus, the use of date-pits HC additive generated positive ruminal fermentability, including increased total VFAs and a reduction in the acetate-to-propionate ratio, leading to decreased CH4 output over 24 h of in vitro incubation. Hence, HC could be considered a potent feed additive (at up to 30 g/kg DM), demonstrating promising CH4-mitigating competency and thereby enhancing energy-use efficiency in ruminants. [ABSTRACT FROM AUTHOR]

Performance‐based measures of frailty are associated with healthcare utilization after kidney transplantation (KT) but require in‐person assessment. A promising alternative is self‐reported frailty. The goal of this study was to examine the ability of performance‐based and self‐reported frailty measures to predict 30‐day rehospitalizations after KT. We conducted a prospective, observational cohort study involving 272 adults undergoing KT at Mayo Clinic in Minnesota, Florida, or Arizona. We simultaneously measured frailty before KT using the physical frailty phenotype (PFP), the short physical performance battery (SPPB), and self‐report (the Patient‐Reported Outcomes Measurement Information System [PROMIS] 4‐item physical function short form v2.0). Both the PFP and self‐reported frailty were independently associated with more than a 2‐fold greater odds of 30‐day rehospitalizations, while the SPPB was not. To our knowledge, this is the first study to assess the prognostic value of all three of the above frailty measures in patients undergoing KT. The PFP is more prognostic than the SPPB when assessing the risk of 30‐day rehospitalizations; self‐reported frailty can complement the PFP but not replace it. However, the 4‐item survey assessing self‐reported frailty represents a simple way to identify patients undergoing KT surgery who would benefit from interventions to lower the risk of rehospitalizations. [ABSTRACT FROM AUTHOR]

Based on Boolean logic, molecular keypad locks secure molecular information, typically with an optical output. Here we investigate a rare example of a molecular keypad lock with a chemical output. To this end, the light‐activated release of biologically important nitric oxide from a ruthenium complex is studied, using proton concentration and photon flux as inputs. In a pH‐dependent equilibrium, a nitritoruthenium(II) complex is turned into a nitrosylruthenium(II) complex, which releases nitric oxide under irradiation with visible light. The precise prediction of the output nitric oxide concentration as function of the pH and photon flux is achieved with an artificial intelligence approach, namely the adaptive neuro‐fuzzy inference system. In this manner an exceptionally high level of control over the output concentration is obtained. Moreover, the provided concept to lock a chemical output as well as the output prediction may be applied to other (photo)release schemes. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is increasingly prevalent in biomedical and industrial development, capturing the interest of dental professionals and patients. Its potential to improve the accuracy and speed of dental procedures is set to revolutionize dental care. The use of AI in computer-aided design/computer-aided manufacturing (CAD/CAM) within the restorative dental and material science fields offers numerous benefits, providing a new dimension to these practices. This study aims to provide a concise overview of the implementation of AI-powered technologies in CAD/CAM restorative dental procedures and materials. A comprehensive literature search was conducted using keywords from 2000 to 2023 to obtain pertinent information. This method was implemented to guarantee a thorough investigation of the subject matter. Keywords included; "Artificial Intelligence", "Machine Learning", "Neural Networks", "Virtual Reality", "Digital Dentistry", "CAD/CAM", and "Restorative Dentistry". Artificial intelligence in digital restorative dentistry has proven to be highly beneficial in various dental CAD/CAM applications. It helps in automating and incorporating esthetic factors, occlusal schemes, and previous practitioners' CAD choices in fabricating dental restorations. AI can also predict the debonding risk of CAD/CAM restorations and the compositional effects on the mechanical properties of its materials. Continuous enhancements are being made to overcome its limitations and open new possibilities for future developments in this field. [ABSTRACT FROM AUTHOR]

The international benchmarking methodology has emerged as a crucial device for understanding global interconnectedness, and the need for countries and regional blocs to interact at various levels. When adapted for use in the business context mindful of intersectoral collaboration, it facilitates the development of standards to determine the nature and extent of international interactions, facilitating the development of avenues for conceptualizing differences and similarities in policies, actions, and national strategies. The adapted methodology focuses on power dynamics analysis, focusing on states' motivations and behaviors, and analyzing economic, diplomatic, and military factors. The emerging approach is tailored to the unique characteristics of G20 and Gulf Cooperation Council (GCC) countries, integrating theoretical insights with practical steps for supporting decision-making and intersectoral dynamics. The methodology also addresses cooperation and economic interdependence, leaning heavily towards liberalism theory, which emphasizes cooperation, institutions, and the interconnectedness of entities. It emphasizes the potential for collaboration, shared norms, and the role of international organizations. This adapted methodology involves evaluating existing economic collaborations, incorporating benchmark techniques for competitiveness, and assessing institutional roles and agreements. This approach aims to promote global cooperation, facilitate faster conflict resolution, and yield mutual benefits that is a forerunner for moving innovative and creative approaches forward within the context of transformation initiatives. [ABSTRACT FROM AUTHOR]

Bilastine, a new second generation antihistaminic drug, has been widely used for relieving symptoms of allergic rhinitis and urticaria without a sedative effect. A simple, cost‐effective, and highly sensitive fluorimetric method was developed for the estimation of bilastine in human plasma, in addition to its pure state and tablets. The suggested method depended on binary complex formation of eosin with bilastine in a buffered medium at pH 4.2. The formed complex resulted in quantitative quenching of eosin emission at 538 nm after excitation at 335 nm. This method demonstrates a broad range of linearity, spanning from 200 to 1000 ng/mL, and exhibits exceptional sensitivity, with a limit of detection and quantitation of 30.85 and 93.48 ng/mL, respectively. In addition, this spectrofluorimetric method may be employed to determine the amount of bilastine in human plasma and tablets with satisfactory accuracy and excellent precision. Furthermore, the content uniformity of bilastine in commercially available tablets was successfully tested by this approach. Compared with the reference method, there were no significant variations in terms of precision or accuracy. In conclusion, the proposed protocol is highly recommended to quantitatively estimate bilastine in different quality control settings. [ABSTRACT FROM AUTHOR]

Water quality in land-based fish production can be controlled through either instantaneous water exchange or costly wastewater treatment followed by recirculation. Agricultural-aquaculture integration is an excellent alternative technique for reducing nutrient discharge levels, boosting profitability, and converting fish culture wastewater into valuable products. The current study employed a solar energy system to power two separate IMTA-aquaponics systems (Nutrient Film Technique, NFT, and Floating Raft Systems, FRS) for the cultivation of Nile tilapia, African catfish, thin-lipped grey mullet, freshwater crayfish, freshwater mussels, and a variety of vegetables. Tilapia and catfish were fed exclusively on diets under the IMTA system. All wastewater from tilapia and catfish ponds, both dissolved and solid, flows sequentially to ponds containing other cultivated species. The water then flows through the IMTA system's terminal point to the NFT and FRS systems before returning to the tilapia and catfish ponds, allowing complete control of the nutrient flow throughout this entire circular system. Two 147-day production cycles were concluded. The results from the second production cycle are reported. Total biomass gain for aquatic species in the IMTA system was 736.46 kg, compared to 145.49 kg in the tilapia and 271.01 kg in the catfish monoculture systems. The current IMTA system had a cumulative feed conversion ratio (FCR) of 0.90, while the FCRs for tilapia and catfish were 1.28 and 1.42, respectively. Nile tilapia and catfish consumed 571.90 kg of feed containing 25.70 kg of nitrogen (N) and 9.70 kg of phosphorus (P), reflecting, and gaining 11.41 and 3.93 kg of dietary N and P, representing 44.40 and 40.46% dietary N and P retention, respectively. In the IMTA system, the addition of mullet and prawn as detrivores aquatic animals improves dietary N and P utilization efficiency to 59.06 and 51.19%, respectively, while the addition of mussels as herbivore animals improves dietary N and P utilization efficiency to 65.61 and 54.67%, respectively. Finally, using FRS and NFT as hydroponic systems increased dietary N and P efficiency to 83.51% N and 96.82% P, respectively. This study shows that the IMTA-Aquaponic system, as a bio-integrated food production system, can convert the majority of fish-fed residues into valuable products suitable for desert, rural, and urban areas in impoverished and developing countries. [ABSTRACT FROM AUTHOR]

This study examined the process of coming-out of selected Egyptian gay men using an interactionist sexual identity development model that described this process as a way of creating an identity through interactions with others, rather than independently discovering one's essence. Thematic analysis of these individuals' personal accounts of disclosing sexual identity via social media corroborated this sexual identity development model. Moreover, thematic analysis added cultural depth to this model by highlighting the role of collectivistic values, such as conformity to societal expectations and fear of disrupting family harmony, in creating experiences of regret and selectivity after disclosing sexual identity. Clinical recommendations for mental health professionals who help gay clients navigate the process of coming-out in a collectivistic cultural context are provided. [ABSTRACT FROM AUTHOR]

Simple Summary: Natural feed additives have gained significant scientific attention as growth-promoting substances instead of synthetic antibiotics. The objectives of this study were to develop and investigate the physicochemical properties and effects of Arabic gum–nano montmorillonite (AGNM) compared to monensin as feed additives in Holstein dairy cows. However, the practical application of gum Arabic as a production enhancer for ruminant feeding has not been widely adopted. In this study, the AGNM additive showed great promise for improving rumen fermentation, increasing nutrient digestibility and utilization, and benefiting the environment. The exploration of natural alternatives to antibiotics for enhancing productivity and performance in dairy cows is a crucial objective in farm animal management. This is the first study aimed at developing and evaluating the physicochemical properties and effects of Arabic gum–nano montmorillonite (AGNM) compost compared to ionophore monensin as feed additives on rumen fermentation, blood metabolites, and milk production of Holstein dairy cows. In a replicated 4 × 4 Latin square design, four multiparous mid-lactation Holstein dairy cows with an average body weight of 520 ± 15 kg were enrolled. The dietary treatments included a control diet (basal diet without feed additives), monensin diet [a basal diet supplemented with 35 mg/kg dry matter (DM) monensin], and AGNM diets comprising basal diet supplemented with two levels: low (L-AGNM) at 1.5 g/kg DM, and high (H-AGNM) at 3 g/kg DM. AGNM as a feed additive demonstrated promising physiochemical parameters, including containing highly bioactive components (α-amyrin and lupeol), functional groups (OH and Si-O), and essential mineral contents (Mg2+). Supplementations with H-AGNM significantly improved ruminal (p = 0.031) concentrations of total volatile fatty acids (VFAs), acetic (p = 0.05) and butyric (p = 0.05), enhanced (p < 0.05) digestibility of fiber and organic matter, while decreased (p = 0.013) estimated methane production. However, an increase (p = 0.04) in blood high-density lipoprotein levels and decrease (p < 0.05) in concentrations of creatinine (CREA), bilirubin (BILT), cholesterol (CHOL), and sodium (Na) were observed with H-AGNM supplementation. Both monensin and H-AGNM improved (p = 0.008) feed efficiency compared to L-AGNM; however, neither AGNM nor monensin affected the milk composition or energy status indicators of the dairy cows. The findings of this study highlight the potential of AGNM as a natural candidate to replace monensin in enhancing ruminal VFA production, nutrient digestibility, feed efficiency, blood metabolites, and milk yield in dairy cows. [ABSTRACT FROM AUTHOR]

Introduction: Neodymium-iron-boron magnets have been suggested as a contemporary method for accelerating the process of orthodontic tooth movement (OTM). A limited number of clinical trials evaluated their effectiveness in accelerating OTM which is desirable for both orthodontists and patients. The present study aimed to investigate the effectiveness of a low-intensity static magnetic field (SMF) in accelerating upper canine retraction movement. Materials and methods: Seventeen patients (mean age 20.76 ± 2.9 years) with their orthodontic treatment decision to extract the upper and lower first premolars due to bimaxillary protrusion malocclusion were included in this split-mouth study. Canine retraction was performed using Nickel-titanium (Ni-Ti) closed-coil springs (150 g of force on each side). The experimental side received SMF via an auxiliary wire that carried 4-neodymium iron-born magnets with an air gap of 2 mm between the magnets to produce a magnetic field density of 414 mT in the region corresponding to the lateral ligament of the upper canine. To determine the rate of upper canine retraction and upper molar drift, alginate impressions were taken once a month to create plaster casts, which were analyzed digitally via a three-dimensional method. Results: The rate of upper canine retraction was significantly greater (P < 0.05) on the SMF side than that on the control side during the first and second months, with an overall duration (19.16%) that was greater than that on the control side. The peak acceleration occurred during the second month (38.09%). No significant differences in upper molar drift were detected between the experimental and control sides (P > 0.05). Conclusion: A low-intensity static magnetic field was effective at accelerating upper canine retraction. The difference between the two sides was statistically significant but may not be clinically significant. The SMF did not affect upper molar drift during the upper canine retraction phase. Trial registration: The trial was retrospectively registered at the ISRCTN registry (ISRCTN59092624) (31/05/2022). [ABSTRACT FROM AUTHOR]

N-nitrosamine pollutants are probable carcinogens. Regulatory agencies declared their presence in the drugs unsafe for human consumption and demanded their recall. Using ultra-performance liquid chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry (UPLC-APCI-MS/MS) in tablet dosage form based on International Conference on Harmonization (ICH) tripartite guideline criteria, we aim to develop and test a new approach for identifying and validating nitrosamine-contaminants, N -nitrosodimethylamine (NDMA) and N -nitrosodiethylamine (NDEA) in irbesartan, olmesartan and metformin. The column was Phenomenex Luna-C18, 100 × 3.0 mm and 3.0 μm. A mobile gradient phase of formic acid in either water or methanol separated the impurities. NDMA and NDEA had retention times of 0.85 and 2.55 min, respectively. The detector's linearity was established at concentrations ranging from 0.6 to 100 ng/mL. R2 for NDMA and NDEA were 0.9996 and 0.9998, respectively, with a linear response function established at 0.6–100 ng/mL. Limit of detection and limit of quantification for NDMA and NDEA were 0.35, 0.29 and 0.55, 0.37 ng/mL, respectively. On average, recovery rates for NDMA and NDEA ranged from 96.0 to 98.4 and 96.2 to 98.0%, respectively. The relative standard deviation for NDMA and NDEA was 3.46 and 2.69, respectively. According to the ICH guidelines, the developed method was quick, sensitive and valid. The pharmaceutical formulations of irbesartan, olmesartan and metformin may be regularly examined using the approach provided here. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to analyze the stress distribution of fiber‐reinforced composite provisional fixed partial denture utilizing a finite element analysis model. Material and methods: Three anterior teeth were collected: upper right central, left central, and right lateral incisors. A fiber‐reinforced composite strip was applied to the palatal surfaces of the teeth. Micro‐computed tomographic scans were acquired of the models in order to generate three‐dimensional geometrical replicas. Finite element analysis was used to assess the stress distribution of fiber‐reinforced composite provisional fixed partial denture using different pontic types under static applied forces that were 100, 30, and 0 N. Results: The maximum stress values were found on the unprepared natural pontic. Stress values ranged from 92.2 to 909.8, 116.4 to 646.7, and 93.8 to 393.5 MPa for composite, naturally prepared, and natural unprepared pontic, respectively. Conclusions: Using unprepared natural tooth pontic in anterior provisional fixed partial denture to replace missing central incisors is considered superior to other types in terms of stress distribution. [ABSTRACT FROM AUTHOR]

Background: Simultaneous liver kidney (SLK) transplant protects against acute cellular rejection. In 2017, UNOS implemented a "safety net" policy to allow patients with renal recovery to avoid renal transplantation. Whether kidney after liver transplantation (KALT) increases the risk of rejection is unknown. Methods: We performed a retrospective analysis of the Organ Procurement and Transplantation Network (OPTN) database of adult patients who received liver transplant, SLK or KALT between 2010 and 2020. We examined rejection of the liver within 6 months and 1 year of the liver transplant, as well as rejection of the kidney within 6 months and 1 year of receiving the kidney, as well as patient and graft loss. Results: Sixty‐six thousand seventy‐nine patients were transplanted; 60 168 with liver transplant alone, 5627 with SLK, and 284 with KALT. Acute or chronic liver rejection rates within 6 or 12 months were statistically higher in the KALT group (10.0% and 10.9%) compared to the SLK group (6.1% and 7.5%), but comparable to the LTA group (9.3% and 11.1%). Kidney rejection and graft survival rates were not different. Liver graft survival was worse in KALT than SLK or LTA (Kaplan‐Meier estimates.61 vs..89 and.90), but these patients were more ill at the time of transplantation. KDPI and LDRI scores were notably lower in the SLK than KALT group. Patient survival was not clinically different between the groups. Conclusion: KALT does not increase the risk of acute or chronic kidney rejection. SLK has a lower risk of early liver rejection, but this effect diminishes by one year to being not clinically different compared to KALT. Given that KALT is immunologically safe, and potentially avoids unnecessary renal graft use, it should be preferred over SLK. Brief summary: Patients undergoing sequential kidney after liver transplant do not have an increased risk of liver or kidney rejection when compared to liver transplant alone or simultaneous liver and kidney transplant. [ABSTRACT FROM AUTHOR]

In the present study, a first validated and green spectrofluorimetric approach for its assessment and evaluation in different matrices was investigated. After using an excitation wavelength of 345 nm, Roxadustat (ROX) demonstrates a highly native fluorescence at an emission of 410 nm. The influences of experimental factors such as pH, diluting solvents, and different organized media were tested, and the most appropriate solvent choice was ethanol. It was confirmed that there was a linear relationship between the concentration of ROX and the relative fluorescence intensity in the range 60.0–1000.0 ng ml−1, with the limit of detection and limit of quantitation, respectively, being 17.0 and 53.0 ng ml−1. The mean recoveries % [±standard deviation (SD), n = 5] for pharmaceutical preparations were 100.11% ± 2.24%, whereas for plasma samples, they were 100.08 ± 1.08% (±SD, n = 5). The results obtained after the application of four greenness criteria, Analytical Eco‐Scale metric, NEMI, GAPI, and AGREE metric, confirmed its eco‐friendliness. In addition, the whiteness meter (RGB12) confirmed its level of sustainability. The International Council for Harmonisation (ICH) criteria were used to verify the developed method through the study in both spiked plasma samples and content uniformity evaluation. An appropriate standard for various applications in industry and quality control laboratories was developed. [ABSTRACT FROM AUTHOR]

Introduction: A lateral flow rapid diagnostic test (RDT) enables detection of measles specific immunoglobulin M (IgM) antibody in serum, capillary blood, and oral fluid with accuracy consistent with enzyme immunoassay (EIA). The objectives of the study were: 1) to assess measles RDT inter-reader agreement between two clinic staff; 2) to assess the sensitivity and specificity of the measles RDT relative to standard surveillance testing in a low transmission setting; 3) to evaluate the knowledge, attitudes, and practices of staff in clinics using the RDT; and 4) to assess the impact of RDT testing on the measles public health response in Malaysia. Materials and methods: The clinic-based prospective evaluation included all suspected measles cases captured by routine measles surveillance at 34 purposely selected clinics in 15 health districts in Malaysia between September 2019 and June 2020, following day-long regional trainings on RDT use. Following informed consent, four specimens were collected from each suspected case, including those routinely collected for standard surveillance [serum for EIA and throat swabs for quantitative reverse transcriptase polymerase chain reaction (RT-qPCR)] together with capillary blood and oral fluid tested with RDTs during the study. RDT impact was evaluated by comparing the rapidity of measles public health response between the pre-RDT implementation (December 2018 to August 2019) and RDT implementation periods (September 2019 to June 2020). To assess knowledge, attitudes, and practices of RDT use, staff involved in the public health management of measles at the selected sites were surveyed. Results: Among the 436 suspect cases, agreement of direct visual readings of measles RDT devices between two health clinic staff was 99% for capillary blood (k = 0.94) and 97% for oral fluid (k = 0.90) specimens. Of the total, 45 (10%) were positive by measles IgM EIA (n = 44, including five also positive by RT-qPCR) or RT-qPCR only (n = 1), and 38 were positive by RDT (using either capillary blood or oral fluid). Using measles IgM EIA or RT-qPCR as reference, RDT sensitivity using capillary blood was 43% (95% CI: 30%–58%) and specificity was 98% (95% CI: 96%–99%); using oral fluid, sensitivity (26%, 95% CI: 15%–40%) and specificity (97%, 95% CI: 94%–98%) were lower. Nine months after training, RDT knowledge was high among staff involved with the public health management of measles (average quiz score of 80%) and was highest among those who received formal training (88%), followed by those trained during supervisory visits (83%). During the RDT implementation period, the number of days from case confirmation until initiation of public response decreased by about 5 days. Conclusion: The measles IgM RDT shows >95% inter-reader agreement, high retention of RDT knowledge, and a more rapid public health response. However, despite ≥95% RDT specificity using capillary blood or oral fluid, RDT sensitivity was <45%. Higher-powered studies using highly specific IgM assays and systematic RT-qPCR for case confirmation are needed to establish the role of RDT in measles elimination settings. [ABSTRACT FROM AUTHOR]

This case report describes a therapeutic approach that was used with an Egyptian female client who sought treatment for persistent depressive disorder at an outpatient clinic in Cairo, Egypt. This approach was based on an integration of schema therapy, which examined the developmental origins of early maladaptive schemas acquired by individuals with depression, with Kleinman's cultural explanatory model, which emphasized the cultural meaning given to the cause, severity, and prognosis of this disorder. As shown in the case report, early maladaptive schemas adopted by the client were understood in their cultural and religious contexts, and this cultural understanding enhanced therapeutic connection and effectiveness. [ABSTRACT FROM AUTHOR]

The electrochemical reduction (ECR) of CO2 is a promising approach for CO2 removal and utilization, which is a critical component of the circular carbon economy. However, developing efficient and selective electrocatalysts is still challenging. Single-atom catalysts (SACs) have gained attention because they offer high metal atom utilization and uniform active sites. However, tuning the active metal centres to achieve high activity and selectivity in CO2 reduction remains a significant challenge. This study presents a novel electrocatalyst (Co–Ni–N–C) for CO2 ECR on the diatomic metal–nitrogen sites prepared through ion exchange using a zeolitic imidazolate framework (ZIF) as a precursor. During pyrolysis, nitrogen-doped graphitic carbon serves as the host material, anchoring the diatomic Co–Ni sites. The resulting bimetallic active sites demonstrate exceptional performance, achieving a high CO yield rate of 53.36 mA mgcat.−1 and an impressive CO faradaic efficiency of 94.1% at an overpotential of −0.27 V. Spectroscopic, microscopic, and density functional theory (DFT) analyses collectively unveil the crucial synergistic role of the Co–Ni–N6 moiety in promoting and sustaining exceptional electrocatalytic activities. The successful utilization of bimetallic sites in enhancing catalyst performance highlights the potential of this approach in developing efficient electrocatalysts for various other reactions. [ABSTRACT FROM AUTHOR]

Background: Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the mammalian brain and is a non-proteinogenic amino acid. Doxorubcin (DOX) or adriamycin is one of the most potent chemotherapy drugs for breast cancer. Purpose: This study focused on diminishing the brain injury and neurotoxicity of doxorubicin (DOX) by GABA administration. Methods: Rats were randomly divided into four groups (8 rats each), which were the control group, DOX group (3 mg/kg for 4 weeks, then 2 mg/kg for 2 weeks), GABA group (2 mg/kg for 21 days), and DOX + GABA group (treated as the second and third groups). Neurotoxicity and brain injury were assessed by determining CSF biomarkers, serum inflammatory markers, and histopathological evaluation of the cerebral cortex. Results: DOX treatment significantly increased the levels of all CSF biomarkers (S100B, IL-1β, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), glial fibrillary acidic protein (GFAP), spectrin breakdown products (SBDP145), and C-C motif chemokine ligand 2 (CCL2) and all inflammatory markers (IL-6, TNF-α, and IFN-γ), causing extensive neutrophilic infiltration and great alteration in the cerebral cortex architecture as evidence of neurotoxicity. The oral administration of GABA significantly reduced the levels of all CSF biomarkers and inflammatory markers and restored the normal architecture of the cerebral cortex, with observed ameliorations in neutrophilic infiltration. Conclusion: GABA administration can ameliorate neurotoxicity and protect the brain against the negative effects of DOX treatment. [ABSTRACT FROM AUTHOR]

The current study investigated the effect of adding different doses of galangal rhizome powder (Alpinia galanga) to the diets of lactating buffaloes on milk production, composition and in vitro ruminal fermentation kinetics. Twenty buffaloes were divided into four groups: (T1) a control diet comprising of concentrates, corn silage and rice straw at 50: 35: 15 on a DM basis, (T2) a control diet plus 15 g of galangal/animal/day and (T3) a control diet plus 30 g of galangal/animal/day and (T4) a control diet plus 45 g of galangal/animal/day. Results showed that inclusion of galangal in diets decreased (p < 0.05) the concentrations of butyrate, ammonia-nitrogen, CO2, and total protozoa count as compared with T1. Acetate concentration was lower in T4 as compared with other groups (p < 0.05). While propionate concentration was lower (p < 0.05) in T2 as compared with T1. T3 and T4 lowered (p < 0.05) methane, CO2 productions, and protozoa count. T3 increased (p < 0.05) milk yield, energy corrected milk (ECM), yield of total solids, total protein, and solids not fat (SNF) than recorded for T1. While T4 recorded the lowest values (p < 0.05) of milk yield, ECM, total solids, fat, and total protein. The current results support the hypothesis that the inclusion of galangal in lactating buffaloes' diets at 30 g per animal daily improved feed intake and milk yield. [ABSTRACT FROM AUTHOR]

Background: Although epilepsy has been acknowledged as an illness since ancient time, the public attitude toward epilepsy has not changed drastically due to the lack of appropriate information. This study aims to determine the public perceptions of epilepsy in five main regions of Saudi Arabia. Methods: In this cross-sectional questionnaire-based study, Saudi citizens living in the major cities of the five main regions of the Kingdom of Saudi Arabia (the central, eastern, western, northern, and southern regions) completed the survey that included 27 questions about epilepsy awareness. Results: A total of 7118 individuals from five regions participated in the survey: 6749 (94.8%) of respondents were Saudi, and 369 (5.2%) were non-Saudi. Of the 7118 respondents, 6897 respondents (96.9%) did not have epilepsy, and 3378 respondents (47.5%) stated that they had never witnessed an epileptic episode. In addition, 3749 (52.7%) respondents incorrectly attributed epilepsy to non-neurologic conditions, and 4865 (68.3%) respondents had an overall negative attitude toward people with epilepsy (PWE). They expressed objections to their child associating with PWE (2002; 28.1%) or their close relatives marrying PWE (3192; 44.8%), some believed that PWE are inferior (402; 5.6%), refused to hire a PWE (1126; 15.8%), and would feel discomfort around PWE (724; 10.3%). In addition, 2025 individuals (28.4%) believed that the health of PWE deteriorates over time; 1485 individuals (20.9%) believed that PWE get sick more often than others; 181 individuals (2.5%) believed that epilepsy could be transmitted; and 568 individuals (8.0%) believed that epilepsy could progress to malignant disease. Conclusions: In Saudi Arabia, there is a substantial need for increasing the awareness and improving education on epilepsy in order to reduce stigma and increase the understanding of epilepsy. Such efforts could help improve the lives of people afflicted with the disease and ultimately contribute to better health outcomes for the entire community. [ABSTRACT FROM AUTHOR]

Decompensated cirrhosis, defined by the overt manifestations of liver failure and portal hypertension (eg, ascites, hepatic encephalopathy, variceal bleeding), is the inflection point associated with increased morbidity and mortality in chronic liver disease. Acute kidney injury in the setting of cirrhosis (hepatorenal syndromer-acute kidney injury [HRS-AKI]) is a severe and often fatal complication. The goals of treatment of HRS-AKI are to reverse renal failure and prolong survival in these critically ill patients or perhaps to allow the transplant team to complete the pretransplant evaluation and bridge the patient to transplant. Historically, in the United States, standard-of-care treatments for HRS-AKI were chosen by default despite lack of data, off-label use, and suboptimal results. Terlipressin represents the first drug in the United States indicated for the treatment of HRS-AKI. This review provides an up-to-date overview of HRS-AKI, discusses terlipressin and how to incorporate this new treatment into patient care and streamline society guidelines on HRS diagnosis and treatment in a practical way for clinical use, and concludes with a sample order set that highlights the recommendations discussed throughout the supplement. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) is a kind of metabolic disorder, including abdominal obesity, hyperglycemia, dyslipidemia, hypertension, etc. Dietary intervention was thought to be one of the lifestyle strategies, along with others like nutritional intervention, psychological intervention, etc., that might effectively treat MetS. the ketogenic diet (KD) is a high-fat diet that has been shown to be helpful in a variety of diseases such as polycystic ovarian syndrome, acne, cancer, and respiratory distress. The study was conducted to investigate the therapeutic potential of a ketogenic diet on rat MetS models. In this study, 40 males' rats were divided into four groups, for a period of 24 weeks, the rats were received KD. Some biochemical, molecular parameters and histopathology of liver tissues were determined. Our results demonstrated that compared to rats in the MetS group, the KD group and MetS +KD group reduced glucose, insulin, HOMA-IR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) levels and malondialdehyde (MDA), while the KD group and MetS +KD group increased glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD) levels (P < 0.05). An upregulation was found in the gene expression levels of the homogenate of Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) and the Glucagon-like peptide-1 receptor (GLP-1R) in control group, KD group, and MetS +KD group compared with Mets group. In conclusion based on these results, KD can be suggested as a healthy weight loss diet with positive metabolic and hepatic benefits. [ABSTRACT FROM AUTHOR]

Background: Acinetobacter baumannii is a major nosocomial pathogen capable of causing life-threatening infections. This bacterium is highly resistant to antibiotics and associated with high mortality rates. Therefore, this study aimed to evaluate A. baumannii's susceptibility patterns to antimicrobials, assess the appropriateness of the initiated antimicrobial therapy, determine the mortality rate, and identify predictors associated with mortality. Methods: A retrospective observational study was conducted among patients infected with A. baumannii at a university hospital in Lebanon through the revision of medical records. Kaplan–Meier survival analysis and log-rank tests were used to analyze time-to-mortality. Binary logistic regression was performed to identify predictors of mortality. Results: The records of 188 patients were screened, and 111 patients with A. baumannii infection were enrolled. Almost all isolates were resistant to carbapenem, and 43% of the isolates were extensively-drug resistant. Almost half of the patients received initial inappropriate antimicrobial therapy (n = 50, 45.1%). The 30-day mortality rate associated with A. baumannii infection was 71.2% (79/111). The time to mortality in patients who received inappropriate antimicrobial therapy (5.70 ± 1.07 days) was significantly shorter than in those who received appropriate antimicrobial therapy (12.43 ± 1.01 days, P < 0.01). Binary logistic regression revealed that inappropriate antimicrobial therapy (adjusted odds ratio [AOR] = 16.22, 95% CI 2.68–9.97, P = 0.002), mechanical ventilation (AOR = 14.72, 95% CI 3.27–6.61, P < 0.001), and thrombocytopenia (AOR = 8.82, 95% CI 1.12–9.75, P = 0.003) were more likely associated with mortality. Conclusions: A. baumannii exhibits an alarming mortality rate among infected patients. Thrombocytopenia, mechanical ventilation, and inappropriate antibiotic administration are associated with mortality in patients infected with A. baumannii. The prompt initiation of appropriate antimicrobial therapy, infection control measures, and effective stewardship program are crucial to reduce the incidence of A. baumannii and improve the treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Suspicious F-18 fluciclovine PET/CT findings for osseous metastases from prostate cancer (PC) were targeted for core needle biopsy. We correlated the maximum standardized uptake value (SUVmax) of biopsied lesions, with biopsy results, other diagnostic outcomes, and blood and tissue molecular analysis (TMA). Material and Methods: Patients with castrate resistant prostate cancer (CRPC) were recruited from a university oncology clinic. SUVmax, histology, blood, and TMA were correlated. Results: Fifteen patients were enrolled and 12 underwent bone biopsies. Fifty percent of bone biopsies demonstrated malignancy. Higher SUVmax was associated with positive biopsies for adenocarcinoma (P = .003), and lesions with SUVmax ≥ 5.1 were all positive for malignancy. Significant correlation between blood and somatic TMA (P = .002) was also found. Conclusion: Higher uptake of F-18 fluciclovine was associated with higher predictive value for osseous metastasis on biopsy. There was a significant correlation between blood and TMA. This study provides a valuable model for amino acid PET, as well as important molecular data on tumors. ctDNA correlates with tissue next-generation sequencing in prostate cancer. [ABSTRACT FROM AUTHOR]

This study reports on the synthesis and characterization of novel perfluorinated organic polymers with azo- and azomethine-based linkers using nucleophilic aromatic substitution. The polymers were synthesized via the incorporation of decafluorobiphenyl and hexafluorobenzene linkers with diphenols in the basic medium. The variation in the linkers allowed the synthesis of polymers with different fluorine and nitrogen contents. The rich fluorine polymers were slightly soluble in THF and have shown molecular weights ranging from 4886 to 11,948 g/mol. All polymers exhibit thermal stability in the range of 350–500 °C, which can be attributed to their structural geometry, elemental contents, branching, and cross-linking. For instance, the cross-linked polymers with high nitrogen content, DAB-Z-1h and DAB-Z-1O, are more stable than azomethine-based polymers. The cross-linking was characterized by porosity measurements. The azo-based polymer exhibited the highest surface area of 770 m2/g with a pore volume of 0.35 cm3/g, while the open-chain azomethine-based polymer revealed the lowest surface area of 285 m2/g with a pore volume of 0.0872 cm3/g. Porous structures with varied hydrophobicities were investigated as adsorbents for separating water-benzene and water-phenol mixtures and selectively binding methane/carbon dioxide gases from the air. The most hydrophobic polymers containing the decafluorbiphenyl linker were suitable for benzene separation, while the best methane uptake values were 6.14 and 3.46 mg/g for DAB-Z-1O and DAB-A-1O, respectively. On the other hand, DAB-Z-1h, with the highest surface area and being rich in nitrogen sites, has recorded the highest CO2 uptake at 298 K (17.25 mg/g). [ABSTRACT FROM AUTHOR]

Cirrhosis, or advanced scarring of the liver, represents the end stage of chronic liver disease and is associated with high morbidity and mortality. Hepatorenal syndrome--acute kidney injury (HRS-AKI), a condition causing functional and progressive kidney failure, is a complication of cirrhosis that contributes to its high mortality rate. In the United States, the standard-of-care treatments for HRS-AKI have historically been suboptimal. Recently, terlipressin became the first drug approved for HRS-AKI in the United States, and the American Association for the Study of Liver Diseases updated its guidance document on HRS diagnosis and management. Clinical practice guidelines and guidance documents have a variable effect on physician behavior owing to a lack of awareness, familiarity, and education. The implementation of standardized order sets can improve guidance adherence and the quality of care delivered by encouraging data-driven treatment administration, especially for new therapies. This review seeks to facilitate improvements in the management of HRS-AKI by discussing early HRS-AKI interventions, which will streamline diagnosis and treatment in a practical way for clinical use, and how to incorporate new treatments into patient care to improve survival in this subset of patients. Finally, these recommendations are integrated into a sample order set developed by members of the Chronic Liver Disease Foundation and experts in the management of HRS-AKI. [ABSTRACT FROM AUTHOR]

Purpose of Review: Cholangiocarcinoma remains difficult to treat with a poor prognosis. Nevertheless, the treatment landscape is rapidly evolving to include chemotherapy, immunotherapy, and targeted therapies. This paper will summarize recent developments in targeted therapies. Recent Findings: Gemcitabine/cisplatin plus durvalumab or pembrolizumab is the standard first-line treatment for patients with advanced cholangiocarcinoma. Multiple alterations have been identified with corresponding approved targeted agents, including fibroblast growth factor receptor inhibitors pemigatinib, infigratinib, and futibatinib; the isocitrate dehydrogenase 1 inhibitor ivosidenib; and the inhibitors of encoded kinases of NTRK1-3 entrectinib and larotrectinib. In tumors with microsatellite instability or deficient mismatch repair, pembrolizumab is approved. Dabrafenib and trametinib also received tumor agnostic approval for BRAF V600E mutations. Additional emerging targets include HER2 and DNA repair pathways. Summary: Multiple targeted therapies are currently approved in the treatment of advanced cholangiocarcinoma, and many more molecular alterations or pathways have been identified as promising therapeutic targets. [ABSTRACT FROM AUTHOR]

In vitro and in vivo experiments were carried out to investigate the effects of the supplementation of different levels of humic and fulvic acids alone or their combination (2:1 ratio) on ruminal fermentation constituents, and nutrients digestibility in goats. The treatments in Exp. 1 were the following: (1) basal substrate (50% concentrate: 50% forage) was incubated humic at 0, 2, 4, and 6 g/kg DM; (2) fulvic at 0, 1, 2, and 3 g/kg DM; and (3) a combination of humic and fulvic (in a 2:1 ratio) at 0, 3, 6, and 9 g/kg DM" of treatments. The results of Exp. 1 revealed that methane (CH4) production was linearly decreased (P < 0.001) upon increasing humic doses. Whereas, the combination of fulvic acid with humic acid resulted in a quadratic decrease (P < 0.001) in net CH4 production. Supplementing humic and fulvic acids, either separately or in combination, resulted in reduced (P < 0.05) ammonia nitrogen (NH3-N) and total volatile fatty acid (VFA) concentrations. In Exp. 2 to further examine the findings obtained in Exp. 1, forty Damascus non-lactating goats (2–3 years of age and body weight 29 ± 1.5 kg) were fed the same basal diet as in Exp. 1, plus one of four treatments. Treatments were the following: (1) control (no supplement); (2) basal diet plus 5 g humic alone; (3) basal diet plus 2.5 g fulvic alone, and (4) basal diet plus 7.5 g their combination. Goats fed diets supplemented with humic acid, fulvic acid, either alone or in combination, increased concentrations of butyrate (P = 0.003), total VFA (P < 0.001), and improved (P < 0.001) digestibility of nutrients, but reduced (P < 0.001) ruminal NH3-N concentrations. In conclusion, applying humic and fulvic acids alone or in combination attenuated in vitro CH4 production, while improved intake and diet digestibility without adverse effect on rumen fermentation profiles in Damascus goats. [ABSTRACT FROM AUTHOR]

With the increasing use of coated functionally graded materials (FGMs) in various industrial engineering, their accurate modeling is very theoretically challenging and therefore has attracted the attention of many scholars, especially for multilayer coated FGM nanostructures. To address this challenge, a new nanoplate model is proposed herein to characterize the buckling behavior of bilayer FG porous plates, which is capable of both geometrically thickness-stretching and physically microstructure-dependent effects. The materials are graded continuously through 2-directional by using a power law function. Two types of coated FG plates are investigated, Hardcore and Softcore FG plates. Based on the generalized field of displacement, a Quasi-3D higher-order shear deformation plate theory is proposed in this work by reducing the number of variables from six to five variables. The equilibrium equations are performed based on the virtual work principle and solved using the Galerkin method to cover various boundary conditions. The accuracy of the proposed solution was validated and it is in good agreement with the counterparts available in the open literature. The effects of microstructure-dependent length parameters, geometric parameters, and material property changes on the critical buckling load are studied in detail. [ABSTRACT FROM AUTHOR]

Two in vitro and in vivo experiments were accomplished to investigate the impacts of integrated feed additives (IFA, combination of protected fat, lysine, and methionine plus yucca extract, eucalyptus essential oil, and direct-fed microbial) on gas production (GP), ruminal fermentation and degradability parameters and lamb performance, digestibility, and nitrogen balance. In the in vitro experiment, responses of graded doses (0, 25, 50, 75, 100, and 125 g IFA/kg DM) were evaluated. In the in vivo experiment, 15 Barki male lambs (30.43 ± 0.74 kg BW ± SE) were individually allotted in complete randomized design into three treatments (five animal/treatment) as control (basal diet without additive), low dose (50 g/kg DM) and high dose (100 g/kg DM) for 120 days. In vitro results showed that both doses (100 and 125 g/kg DM) quadratically decreased (p < 0.001) GP and ammonia nitrogen (NH-3N) concentration. In vivo experiment revealed that dry matter intake was increased (p = 0.016) with low dose compared to high dose. Inclusion of high dose decreased blood serum glucose concentrations (p > 0.05) and ruminal protozoal populations (p = 0.094) compared with low dose and control diet. Both doses of IFA increased (p < 0.05) serum urea, creatinine, and triglyceride concentrations, while decreased (p < 0.001) ruminal NH3-N concentrations. These results suggested that, although IFA was effective to modify in vitro ruminal fermentation process and feed degradability, such aspects did not improve in vivo performance of growing lambs. [ABSTRACT FROM AUTHOR]

Background: Excessive use of mobile phones leading to development of symptoms suggestive of dependence syndrome with teenagers are far more likely to become dependent on mobile phones as compared to adults. COVID-19 pandemic has had an impact on the mental health of several groups in society, especially university students. This study aimed to explore the prevalence of mobile phone dependence among university students and its associated factors. Methods: Between September 2021 and January 2022, a cross-sectional study was conducted at universities in Jordan, Lebanon, Egypt, Bahrain, and Saudi Arabia utilizing an online and paper-based self-administered questionnaire. We employed a previously developed questionnaire by Aggarwal et al. Results: A total of 5,720 university students were involved in this study (Egypt = 2813, Saudi Arabia = 1509, Jordan = 766, Lebanon = 432, and Bahrain = 200). The mean estimated daily time spent on using mobile phone was 186.4 (94.4) minutes. The highest mobile dependence score was observed for the university students from Egypt and the lowest mobile dependence score was observed for the university students from Lebanon. The most common dependence criteria across the study sample was impaired control (55.6%) and the least common one was harmful use (25.1%). Females and those reported having anxiety problem or using a treatment for anxiety were at higher risk of developing mobile phone dependence by 15% and 75%, respectively. Conclusion: Mobile phone dependence is common among university students in Arab countries in the Middle East region. Future studies exploring useful interventions to decrease mobile phone dependence are warranted. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is common in cirrhotic patients affecting almost 20% of these patients. While multiple etiologies can lead to AKI, pre-renal azotemia seems to be the most common cause of AKI. Irrespective of the cause, AKI is associated with worse survival with the poorest outcomes observed in those with hepatorenal syndrome (HRS) and acute tubular necrosis (ATN). In recent years, new definitions, and classifications of AKI in cirrhosis have emerged. More knowledge has also become available regarding the benefits and drawbacks of albumin and terlipressin use in these patients. Diagnostic tools such as urinary biomarkers and point-of-care ultrasound (POCUS) became available and they will be used in the near future to differentiate between different causes of AKI and direct management of AKI in these patients. In this update, we will review these new classifications, treatment recommendations, and diagnostic tools for AKI in cirrhotic patients. [ABSTRACT FROM AUTHOR]

Objectives: Approaches for combining scores have been based on weighted mean (WM) without consideration for psychometric characteristics of each individual assessments. This study evaluates consequences of WM and composite score (CS) approach. Methods: Data from two longitudinal cohorts (n = 219) were utilized for performance in three Operative Dentistry courses as basis to compare the two score‐combining methods. Four assessments (two written and two practical exams) from each course were combined using WM and CS approaches. WM scores were calculated by multiplying the score by its weight and summing across assessments. The CS approach follow a modification of the Kane and Case method, by standardizing scores, taking into account the reliability and associations between each assessment score. t‐Tests and Pearson's correlation were used to evaluate the consequences of the WM and CS approaches. In addition, changes in each student's rank across WM and CS were determined. Results: Combining scores using CS method produced lower scores and higher percentage failure in all courses compared to WM. Students ranks were changed significantly when CS was used with only 15% of the cohorts retained their ranks. Conclusions: CS produced a composite that is correlated with WM but still being substantively different providing meaningful and psychometrically rigorous information. [ABSTRACT FROM AUTHOR]

Monkeypox virus has remained the most virulent poxvirus since the elimination of smallpox approximately 41 years ago, with distribution mostly in Central and West Africa. Monkeypox (Mpox) in humans is a zoonotically transferred disease that results in a smallpox-like disease. It was first diagnosed in 1970 in the Democratic Republic of the Congo (DRC), and the disease has spread over West and Central Africa. The purpose of this review was to give an up-to-date, thorough, and timely overview on the genomic diversity and evolution of a re-emerging infectious disease. The genetic profile of Mpox may also be helpful in targeting new therapeutic options based on genes, mutations, and phylogeny. Mpox has become a major threat to global health security, necessitating a quick response by virologists, veterinarians, public health professionals, doctors, and researchers to create high-efficiency diagnostic tests, vaccinations, antivirals, and other infection control techniques. The emergence of epidemics outside of Africa emphasizes the disease's global significance. Increased monitoring and identification of Mpox cases are critical tools for obtaining a better knowledge of the ever-changing epidemiology of this disease. [ABSTRACT FROM AUTHOR]