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The magnetic performance of NdFeB permanent magnets rapidly decreases as their operation temperature increases. This limits the power output of electric motors as their internal temperature quickly increases with the power demand. This is particularly problematic for applications where high peak power is required for a short period of time, for example during automobile highway acceleration or during an airplane lift-off. With the advances in additive manufacturing, one can envision to fabricate more complex motor geometries and magnetic structures, without additional costs, allowing for enhanced functionalities such as better thermal management. In this context, this paper investigates the feasibility of using phase changing materials (PCMs) to mitigate the temperature rise in permanent magnets (PMs) fabricated by additive manufacturing. The potential of PCM and its relevance was validated by modeling the thermal response of an electric motor during a representative electric vehicle driving scenario. It was found that segmented magnets with embedded phase changing materials would allow to efficiently control temperature rise. To validate the simulation results, PM test pieces with and without embedded PCMs were fabricated using cold spray additive manufacturing and tested using a custom laser thermal cycling setup. [ABSTRACT FROM AUTHOR]

Purpose: To identify the technical complications associated with maxillary complete-arch implant-supported fixed prostheses (ISFPs) and to evaluate the survival rates of both dental implants and prostheses. In addition, we sought to analyze the impact that the presence of cantilevers, the type of prosthetic abutment, and the number of implants have on the occurrence of complications. Materials and Methods: Data were obtained from standardized clinical assessments carried out in a single appointment by two calibrated professionals (F.B.A. and I.A.Y.) using information from dental records. Results: The sample consisted of 64 patients rehabilitated with ISFPs classified as hybrid prostheses (metal-resin). The survival rate for implants was 98.6% after 1 to 12 years (5.2 years ± 36.6 months) and was 100% for the prostheses after a follow-up of 12 to 144 months (mean: 48.1 ± 33.94 months). The most frequent complications were occlusal wear (82.8% of patients) as well as loosening of prosthetic screws (16.6%) and abutments (8.1%). The screw loosening frequency was significantly greater in 30-degree abutments compared with straight abutments (P = .008), but no significant difference was found between 17-degree and 30-degree abutments. Prostheses with a higher occurrence of screw loosening had a greater average cantilever length/anteroposterior spread (CL/AP) ratio (0.9 ± 0.5). In addition, abutments placed on distal implants were more likely to loosen (P < .001). The absence of mutually protected occlusion did not significantly influence the loosening of prosthetic screws and abutments. Conclusions: Implant-supported fixed maxillary complete-arch rehabilitations have high survival rates but are subject to technical complications. [ABSTRACT FROM AUTHOR]

Understanding the changes in running mechanics caused by fatigue is essential to assess its impact on athletic performance. Changes in running biomechanics after constant speed conditions are well documented, but the adaptive responses after a maximal incremental test are unknown. We compared the spatiotemporal, joint kinematics, elastic mechanism, and external work parameters before and after a maximal incremental treadmill test. Eighteen recreational runners performed 2-minute runs at 8 km·h−1 before and after a maximal incremental test on a treadmill. Kinematics, elastic parameters, and external work were determined using the OpenCap and OpenSim software. We did not find differences in spatiotemporal parameters and elastic parameters (mechanical work, ankle, and knee motion range) between premaximal and postmaximal test conditions. After the maximal test, the runners flexed their hips more at contact time (19.4°–20.6°, P =.013) and presented a larger range of pelvis rotation at the frontal plane (10.3°–11.4°, P =.002). The fatigue applied in the test directly affects pelvic movements; however, it does not change the lower limb motion or the spatiotemporal and mechanical work parameters in recreational runners. A larger frontal plane motion of the pelvis deserves attention due to biomechanical risk factors associated with injuries. [ABSTRACT FROM AUTHOR]

We present an isotropic ab initio (para − H 2 ) 4 four-body interaction potential energy surface (PES). The electronic structure calculations are performed at the correlated coupled-cluster theory level, with single, double, and perturbative triple excitations. They use an atom-centered augmented correlation-consistent double zeta basis set, supplemented by a (3 s 3 p 2 d) midbond function. We use a multilayer perceptron to construct the PES. We apply a rescaling transformation to the output energies during training to improve the prediction of weaker energies in the sample data. At long distances, the interaction energies are adjusted to match the empirically derived four-body dispersion interaction. The four-body interaction energy at short intermolecular separations is net repulsive. The use of this four-body PES, in combination with a first principles pair potential for para − H 2 [J. Chem. Phys. 119, 12551 (2015)] and an isotropic ab initio three-body potential for para − H 2 [J. Chem. Phys. 156, 044301 (2022)], is expected to provide closer agreement with experimental results. [ABSTRACT FROM AUTHOR]

In this paper, the effects of hydrostatic stress on the magnetic properties of Mn-Zn power ferrites are discussed. Ring cores were embedded in cement and the curing process gradually exerted pressure on the core. A novel testing method was developed to continuously measure the power losses and the magnetic susceptibility in dependence on magnetic excitation at a fixed frequency and room temperature with a vector network analyzer. After 450 h, a maximum compressive stress of 120 MPa was reached. Power loss up to 300% was observed, while magnetic susceptibility dropped by 35%. The magneto-mechanical effect on core losses was simulated with the Hodgdon–Esguerra hysteresis model, showing excellent agreement with tested results, which allows us to predict the behavior of ferrite tiles embedded in load-bearing surfaces for wireless power transfer (WPT) applications. [ABSTRACT FROM AUTHOR]

We describe a method to compute photon–matter interaction and atomic dynamics with x-ray lasers using a hybrid code based on classical molecular dynamics and collisional-radiative calculations. The forces between the atoms are dynamically determined based on changes to their electronic occupations and the formation of a free electron cloud created from the irradiation of photons in the x-ray spectrum. The rapid transition from neutral solid matter to dense plasma phase allows the use of screened potentials, reducing the number of non-bonded interactions. In combination with parallelization through domain decomposition, the hybrid code handles large-scale molecular dynamics and ionization. This method is applicable for large enough samples (solids, liquids, proteins, viruses, atomic clusters, and crystals) that, when exposed to an x-ray laser pulse, turn into a plasma in the first few femtoseconds of the interaction. We present four examples demonstrating the applicability of the method. We investigate the non-thermal heating and scattering of bulk water and damage-induced dynamics of a protein crystal using an x-ray pump–probe scheme. In both cases, we compare to the experimental data. For single particle imaging, we simulate the ultrafast dynamics of a methane cluster exposed to a femtosecond x-ray laser. In the context of coherent diffractive imaging, we study the fragmentation as given by an x-ray pump–probe setup to understand the evolution of radiation damage in the time range of hundreds of femtoseconds. [ABSTRACT FROM AUTHOR]

Background: Slipped Capital Femoral Epiphysis (SCFE) is a prevalent pediatric orthopedic condition. Treatment options range from in situ pinning to various osteotomies, with the Modified Dunn procedure gaining significant attention over the past two decades. However, the suitability of this procedure for different SCFE subtypes and the risk of avascular necrosis (AVN), particularly in moderate and severe cases, remains controversial. This study aims to report the midterm clinical and radiographic outcomes of the Modified Dunn procedure in treating SCFE, emphasizing the factors contributing to AVN development. Patients and methods: We conducted a prospective case series between 2014 and 2022, enrolling patients with moderate and severe SCFE who were treated using the Modified Dunn procedure by a single experienced hip surgeon. Patients were followed up clinically and radiologically for a minimum of two years. Results: Thirty-six patients (29 males, 7 females) with moderate and severe SCFE were included, with an average age of 14 years and a mean follow-up of 49.28 months (range: 24–118 months). Statistically significant improvements were observed in clinical and radiographic parameters at the final follow-up compared to pre-operative data. Five patients developed AVN, though no specific risk factor reached statistical significance regarding AVN development. While most AVN cases occurred early in the learning curve, this trend was not statistically significant. Conclusion: Modified Dunn is a safe and effective option for treating moderate to severe SCFE, offering superior femoral head realignment and patient-reported outcomes. When performed by experienced surgeons, it results in acceptable complication rates, including AVN. Level of evidence: Level IV Prospective Case series. [ABSTRACT FROM AUTHOR]

Background: Coronary artery bypass graft (CABG) is a common intervention for managing coronary artery disease, which is often accompanied by postoperative psychological challenges such as anxiety and depression. This systematic review aims to evaluate the benefits of cognitive behavioral therapy (CBT) in reducing anxiety and depression symptoms and improving overall health outcomes in patients' post-coronary artery bypass graft (CABG) surgery. Methods: A search of Science Direct, PsycINFO, PubMed, Google Scholar, VHL, Cochrane, and Scopus databases was conducted until October 2023. Inclusion criteria encompassed randomized controlled trials reporting on CBT or CBT-based interventions tailored for CABG patients, with anxiety and depression symptoms, as well as quality of life, as primary outcomes. Hospital stay and satisfaction with therapy were considered secondary outcomes. Results: The findings highlighted that CBT led to improvements in anxiety and depression symptoms, as well as reduced hospital stays, lowered hopelessness levels, and increased satisfaction with therapy. The long-term effects of CBT on CABG patients need to be studied, focusing on larger samples and patient compliance. Furthermore, assessment of CBT implementation in real-world clinical settings is important for feasibility, acceptability, and effectiveness across different regions. Conclusion: This review underscores the positive impact of CBT on mitigating depression and anxiety symptoms and boosting the quality of life of individuals post-CABG surgery. [ABSTRACT FROM AUTHOR]

The study aimed to measure the role of positive motivation policy in developing the performance of employees in the Saudi Red Crescent Authority: an applied study. The researcher used the descriptive analytical approach. The study sample consisted of (278) employees out of the total employees in the Saudi Red Crescent Authority. The study tools were a questionnaire form. The results of the study concluded that there is no sufficient statistical evidence to reject the first hypothesis: which states: Employees agree on the availability of positive motivation policies in the Saudi Red Crescent Authority, at a significance level of (5%). There is also no sufficient statistical evidence to reject the second hypothesis: which states: There is a statistically significant relationship between material motivation and the development of employee performance in the Saudi Red Crescent Authority, at a significance level of (5%). There is also no sufficient statistical evidence to reject the third hypothesis: which states: There is a statistically significant relationship between moral motivation and the development of employee performance in the performance of employees in the Saudi Red Crescent Authority, at a significance level of (5%). There is also no sufficient statistical evidence to reject the fourth hypothesis: which states: There is a statistically significant relationship between social motivation and the development of employee performance in the Red Crescent Authority, at a significance level of (5%). (5%), and the study recommended the need to enhance material incentive policies: The Authority should review and develop material incentive programs to be more competitive and appropriate to the needs of employees. This can be done by providing financial rewards, bonuses, and promotions that are in line with good performance. It is also necessary to develop moral incentive strategies: It is recommended to enhance the culture of recognition and gratitude in the workplace, such as organizing events to honor outstanding employees and providing positive feedback regularly, this can lead to increased job satisfaction and commitment. [ABSTRACT FROM AUTHOR]

This study aims to investigate the improvement of ionic conductivity and other electrical parameters of a polyethylene oxide/sodium bromide (PEO:NaBr) complex electrolyte with the use of glycerol as a plasticizer. The PEO:NaBr electrolyte was modified by insertion of various concentrations (0, 8, 16, 24, and 32 wt.%) of glycerol to boost the ionic conductivity. The structural and electrical properties of the prepared electrolyte films were examined by x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and electrochemical impedance spectroscopy (EIS). The results showed that the highest ionic conductivity 2.3 × 10 - 4 was attained in the sample containing 24 wt.% glycerol synthesized at room temperature. This increased conductivity may be attributed to the plasticizing effect of glycerol, which made the PEO matrix less crystalline, as evidenced by the broader and less defined XRD peaks. The dielectric constant was enhanced relative to the dielectric loss by increasing the glycerol content in the low-frequency applied electric field. Also, the maximum loss tangent shifted to higher frequencies, indicating that the addition of glycerol shortened the dipole relaxation time. The dissociation of the NaBr in the PEO was confirmed by the FTIR spectra. In addition, a shift in the absorption band showed the interaction between the PEO, NaBr, and glycerol, which contributed to the enhanced amorphous nature and ion transport properties. These findings suggest that glycerol can play a crucial role in modifying the structural and electrical properties of PEO-based electrolytes, paving the way for more efficient solid-state electrolytes for future energy storage applications. [ABSTRACT FROM AUTHOR]

The optimization challenge known as the optimal reactive power dispatch (ORPD) problem is of utmost importance in the electric power system owing to its substantial impact on stability, cost-effectiveness, and security. Several metaheuristic algorithms have been developed to address this challenge, but they all suffer from either being stuck in local minima, having an insufficiently fast convergence rate, or having a prohibitively high computational cost. Therefore, in this study, the performance of four recently published metaheuristic algorithms, namely the mantis search algorithm (MSA), spider wasp optimizer (SWO), nutcracker optimization algorithm (NOA), and artificial gorilla optimizer (GTO), is assessed to solve this problem with the purpose of minimizing power losses and voltage deviation. These algorithms were chosen due to the robustness of their local optimality avoidance and convergence speed acceleration mechanisms. In addition, a modified variant of NOA, known as MNOA, is herein proposed to further improve its performance. This modified variant does not combine the information of the newly generated solution with the current solution to avoid falling into local minima and accelerate the convergence speed. However, MNOA still needs further improvement to strengthen its performance for large-scale problems, so it is integrated with a newly proposed improvement mechanism to promote its exploration and exploitation operators; this hybrid variant was called HNOA. These proposed algorithms are used to estimate potential solutions to the ORPD problem in small-scale, medium-scale, and large-scale systems and are being tested and validated on the IEEE 14-bus, IEEE 39-bus, IEEE 57-bus, IEEE 118-bus, and IEEE 300-bus electrical power systems. In comparison to eight rival optimizers, HNOA is superior for large-scale systems (IEEE 118-bus and 300-bus systems) at optimizing power losses and voltage deviation; MNOA performs better for medium-scale systems (IEEE 57-bus); and MSA excels for small-scale systems (IEEE 14-bus and 39-bus systems). [ABSTRACT FROM AUTHOR]

Background: Extracorporeal membrane oxygenation (ECMO) through the femoral artery and vein can lead to significant vascular complications. We retrospectively studied the acute vascular complications of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) in COVID-19 patients compared to non-COVID patients during the period from January 2020 to July 2023. Results: Seventy-eight patients underwent VA-ECMO for various indications from January 2020 to July 2023. The studied patients had a mean age of 59.6 ± 6.9 years for non-COVID patients (38 patients), and 62.2 ± 7.6 years for COVID patients (40 patients), with a P = 0.268. In non-COVID patients, The baseline characteristics were similar in both groups. The primary indications for ECMO were cardiac diseases, followed by respiratory failure (78.9% vs 10.5%). Conversely, in COVID patients, respiratory failure due to COVID-19 infection was the main indication (45% vs 40%). The overall incidence of general complications, including cerebrovascular stroke, acute kidney injury, intracardiac thrombi, and wound infection, was comparable in both groups (31.6% vs 45%). The overall incidence of vascular complications in both groups was 33.3%. Ipsilateral acute lower limb ischemia occurred in 5.3% vs 10% of non-COVID and COVID patients, respectively. Thrombosis of the distal perfusion catheter (DPC) occurred in 10.5% vs 15%, respectively. Conclusion: During the COVID-19 pandemic, an increasing number of patients required VA-ECMO due to associated respiratory failure. Patients undergoing VA-ECMO are at high risk of developing various vascular complications. COVID-19 significantly increases the risk of acute limb ischemia and distal perfusion catheter thrombosis in both upper and lower limbs. However, other VA-ECMO-related vascular complications are comparable between COVID-19 and non-COVID patients. [ABSTRACT FROM AUTHOR]

Background: An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult. Methods: We searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary endpoints included time to infection, source of infection, ECMO duration, Intensive care and hospital length of stay (LOS), ECMO survival and overall survival. Incidence of NI was reported as pooled proportions and 95% confidence intervals (CIs), while dichotomous outcomes were presented as risk ratios (RR) as the effective index and 95% CIs using a random-effects model. Results: Among the 4,733 adult patients who received ECMO support in the 30 included studies, 1,249 ECMO-related NIs per 1000 ECMO-days was observed. The pooled incidence of NIs across 18 studies involving 3424 patients was 26% (95% CI 14–38%).Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the most common NI sources. Infected patients had lower ECMO survival and overall survival rates compared to non-infected patients, with risk ratio values of 0.84 (95% CI 0.74–0.96, P = 0.01) and 0.80 (95% CI 0.71–0.90, P < 0.001), respectively. Conclusion: Results showed that 16% and 20% lower of ECMO survival and overall survival in patients with NI than patients without NI, respectively. However, NI increased the risk of in-hospital mortality by 37% in infected patients compared with non-infected patients. In addition, this study identified the significant positive correlation between ECMO duration and ECMO-related NI. [ABSTRACT FROM AUTHOR]

Background: Anaphylaxis is a severe, life-threatening allergic reaction requiring prompt treatment with epinephrine. However, gaps in public understanding exist globally. To guide future education efforts, this study assessed anaphylaxis awareness among adults in Al-Ahsa, Saudi Arabia. Methods: A cross-sectional survey assessed knowledge among 380 adults using a validated questionnaire. Convenience sampling was used with data collected via online platforms. Descriptive statistics were calculated, and associations were tested. We analyzed the data using SPSS software. Results: Knowledge was suboptimal, with a mean score of 34.5/60. Most identified the anaphylaxis definition (76.1%) and rapid symptom onset (78.9% within minutes). But just 37.9% recognized epinephrine as a first-line treatment and only 17.4% had auto-injector training. Nearly half (48.4%) needed to learn the proper EpiPen injection site. Under half understood the need for long-term allergen avoidance. Older age, more education, and Job status were associated with higher scores. Conclusion: This study reveals critical gaps in anaphylaxis knowledge among adults in Al-Ahsa, Saudi Arabia. Poor understanding of emergency treatment and long-term management highlights the urgent need for improved public awareness. Targeted educational initiatives must emphasize prompt epinephrine administration, proper auto-injector use, and allergen avoidance. Collaborative efforts engaging healthcare professionals, schools, and policymakers are essential to enhance anaphylaxis preparedness through focused training and tailored awareness campaigns. This will empower the Saudi public to recognize symptoms quickly and respond effectively, saving lives from this dangerous allergic reaction. [ABSTRACT FROM AUTHOR]

Purpose: Chronic systemic inflammation from human immunodeficiency virus (HIV) may cause metabolic abnormalities in lipid metabolism. Additionally, the development of metabolic syndrome has been associated with specific anti-retroviral therapy, particularly dolutegravir. This study aimed to determine the prevalence and associated factors of metabolic syndrome among people living with HIV on dolutegravir-based anti-retroviral therapy. Methods: This was an analytical cross-sectional study conducted between October 1, 2022, and March 31, 2023, among 312 people living with HIV. A structured questionnaire was used to collect socio-demographic and clinical characteristics including anthropometric indices and a blood pressure reading. A blood sample was collected to measure plasma glucose levels and serum lipid levels. The outcome being metabolic syndrome, odds ratios were evaluated using logistic regression analysis, and a P -value of <.05 was considered statistically significant. Results: The prevalence of metabolic syndrome was 42.3%. Waist circumference (73%) and reduced high-density lipoprotein cholesterol (59.9%) were the most prevalent components. Factors associated with metabolic syndrome were patients aged 18–44 years (aOR: 3.10; 95% CI: 1.24–7.79; P =.016), female gender (aOR: 5.40; 95% CI: 2.07–14.13; P =.001), no physical activity (aOR: 4.00; 95% CI: 1.05–15.10; P =.042), and patients who earned >300 000 Tanzanian shillings per month (aOR: 2.15; 95% CI: 1.07–4.32; P =.032). Conclusion: The prevalence of metabolic syndrome among patients on dolutegravir-based therapy is high. There is a need to adhere to routine screening of metabolic syndrome among people living with HIV on dolutegravir-based anti-retroviral therapy. [ABSTRACT FROM AUTHOR]

Developing and creating novel antibiotics is one of the most important targets in treating infectious diseases. Novel coumarins were synthesized and characterized using different spectroscopic techniques such as Fourier Transform Infrared (FTIR), Nuclear magnetic resonance1H and 13C and mass spectroscopy (MS). All of the synthesized compounds have been tested for activity and sensitivity against the microbial strains of B. subtilis, S. aureus, E. coli, P. aeruginosa, S. typhi, and C. albicans. All compounds showed substantial results against the tested microbes except S. typhi, which was not affected in any way by these coumarins. Exceptional results were shown by compounds 4, 6d, and 8b, which made them the best candidates for loading to the vicinity of nanostructure lipid carrier and coated by chitosan nanocapsule (NLC-Cs). Transmission electron microscope (TEM) confirmed spherical morphology with particles size less than 500 nm. Also, dynamic light scattering (DLS) were utilized to measure the average particle size (between 100 and 200 nm) and the stability assessed by zeta potential were found to be more positive confirming the chitosan encapsulation. Antimicrobial activity assessments were performed for both synthetic compounds and their NLCs analogues. The nanoformulation of 4-NLC-Cs, 6d-NLC-Cs, and 8b-NLC-Cs manifested unique biological results, especially 8b-NLC-Cs, which revealed powerful effects over all the tested organisms including S. typhi. The increasing biological effect of the drugs in their nanoscale form is reflected in the increasing value of inhibition zone diameter and suppressing the value of MIC to reach record levels like 8b-NLC-Cs disclosed MIC = 0.48 and 0.24 µg/ml against S. aureus and C. albicans, respectively, by the mean 8b-NLC-Cs nanoformulation suppressed the MIC by 65 folds of its initial value before nano. In continuation, it was proven that the compounds 4, 6d and 8b were found to make noticeable changes on the DNA-Gyrase levels with reduced IC50 values particularly 8b showed excellent inhibitory effect with IC50 = 4.56 µM. TEM was used to pursue the morphological changes that occur in bacterial cells of P. aeruginosa. The weakness of the cell wall in most bacterial cells treated with nanomaterials, 8b-NLC-Cs, has reached the point of the cell wall rupture and the cell components spilling out of the cells causing necrotic cell death. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is a form of cancer that is responsible for the largest incidence of deaths attributed to cancer worldwide. Non-small cell lung cancer (NSCLC) is the most prevalent of all the subtypes of the disease. Treatment with tyrosine kinase inhibitors (TKI) may help some people who have been diagnosed with non-small cell lung cancer. The presence of actionable mutations in the epidermal growth factor receptor (EGFR) gene is a key predictor of how a patient will respond to a TKI. Thus, the frequency of identification of mutations in EGFR gene in patients with NSCLC can facilitate personalized treatment. Objective: The objective of this study was to screen for mutations in the EGFR gene and to investigate whether there is a correlation between the screened mutations and various clinical and pathological factors, such as gender, smoking history, and age, in tissue samples from patients with NSCLC. Methods: The study comprised 333 NSCLC tissue samples from 230 males and 103 females with an average age of 50 years. Exons 18–21 of the EGFR gene have been examined using real-time PCR. Using SPSS, correlations between clinical and demographic variables were examined, and EGFR mutation and clinical features associations were studied. Results: The study's findings revealed that the incidence rate of EGFR mutation was 24.32% (81/333), with partial deletion of exon 19 (19-Del) and a point mutation of L858R in exon 21 accounting for 66.67% (P < 0.001) and 28.40% (P < 0.001) of the mutant cases, respectively. Patients who had the T790M mutation represent 4.94% (P = 0.004) of total number of patients. Females harbored EGFR mutations (54.32%) with higher frequency than men (45.68%) (P < 0.001), while nonsmokers had EGFR mutations (70.37%) more frequently than current smokers (29.63%) (P < 0.001). Conclusion: The screening study conducted in Egypt reported that the EGFR mutations prevalence was 24.32% among Egyptians with NSCLC. The study also found a slight gender bias, with females having an incidence rate of these mutations higher than males. Additionally, nonsmokers had higher rates of mutations in EGFR gene compared to smokers. According to the findings, somatic EGFR mutations can be employed as a diagnostic tool for non-small cell lung cancer in Egypt, and they can be implemented in conjunction with clinical criteria to identify which patients are more likely to respond favorably to TKIs. [ABSTRACT FROM AUTHOR]

Background: Integrating digital health and telemedicine technologies is transforming healthcare delivery. In light of this transition, it is critical to ascertain the efficacy of patient safety protocols and evaluate the awareness of healthcare professionals, particularly nurses, regarding the integration of digital health technologies. Aim: This study examines the factors influencing the successful adoption of digital health and telemedicine technologies from the nurses' perspective, focusing on ensuring patient safety and enhancing organizational readiness for digital health integration. Methods: A cross-sectional study included 246 nurses from outpatient healthcare centers in Egypt. The data collected included demographic information and responses to a series of questionnaires, namely the Patient Safety Culture Survey (PSCS), the Telemedicine Risk Assessment and Mitigation Matrix (TRAMM), the Digital Health Adoption Readiness Assessment (DHARA), and the Digital Health Impact Assessment Tool (DHIA). The descriptive statistical analyses were conducted using the IBM SPSS Statistics software, version 26. Results: The sample was predominantly composed of nurses aged 18–35 (40.65%) and 36–55 (44.72%), with a near-equal gender distribution (48.78% male, 51.22% female). Most nurses held college degrees (73.17%) and were familiar with telemedicine (73.17%). The PSCS indicated positive scores for Communication Openness (4.5), Leadership Support (4.2), Teamwork (4.3), and Organizational Learning (4.1), with an overall mean score of 4.275. The TRAMM scores were notably high (total mean score 4.9), indicating effective risk management. The DHARA demonstrated considerable preparedness, as evidenced by a Total Mean Score of 7.85. The DHIA further substantiated this readiness, indicating a robust anticipated impact, particularly in Patient Engagement (9.0) and Usability (8.2). Conclusion: The favorable assessment scores indicate a strong awareness of integrating digital health and telemedicine, suggesting the potential for enhanced patient care and healthcare delivery. It is recommended that healthcare organizations prioritize providing ongoing training and support for nurses, enabling them to utilize digital health tools and thereby enhance patient safety effectively. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Diabetes is one of the most common chronic diseases that severely reduce a patient's quality of life. Effective self-care and management are critical for maintaining blood glucose levels and preventing complications. Aim: This study evaluates the effectiveness of a structured diabetes self-management education program on patients' self-management behaviors, empowerment, and activation levels. Methods: This study employed a quasi-experimental design involving 100 participants aged 30–65 to improve diabetes self-management and empowerment. Over 16 weeks, the program included three phases: a two-week pre-test phase for recruitment and baseline assessments using the Diabetes Self-Management Questionnaire (DSMQ), Diabetes Empowerment Scale (DES), and Patient Activation Measure (PAM); a 12-week intervention phase featuring weekly 90-minute educational sessions on topics such as diet, exercise, medication adherence, stress management, and self-empowerment; and a two-week post-test phase for follow-up assessments using the same tools. Data were analyzed using descriptive statistics, chi-square tests for PAM levels, and paired t-tests for DSMQ and DES scores, with statistical significance set at p < 0.05. Results: The study demonstrated significant improvements in participants' self-management, empowerment, and activation levels after the intervention. DSMQ scores increased from 64.5 to 68.6 (p < 0.001), DES scores rose from 65.4 to 70.0 (p = 0.001), and the number of participants at the highest PAM activation level (Level 4) grew from 30 to 50 (p = 0.016). Positive correlations among DSMQ, DES, and PAM scores suggest these improvements are interrelated. Conclusion: The structured diabetes self-management education programme significantly impacted participants' self-management behaviors, empowerment, and activation levels. The findings underscore healthcare professionals' need to implement targeted interventions that facilitate patient engagement in diabetes care. Recommendation: Future interventions should be designed to address the specific needs of diverse populations, paying attention to those facing socio-economic challenges. It is vital to facilitate greater access to diabetes self-management education to enhance health outcomes for these demographic groups. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the management of cancer patients, but the emergence of ICI-related endocrinopathies (IREs) has introduced new clinical challenges. Despite worldwide recognition of these adverse effects, data from the Middle East is scarce. Methods: This retrospective-observational study included adult cancer patients who received at least one dose of ICI between January 2015 and January 2023. Descriptive statistics and multivariable regression (MVR) models were applied to delineate the incidence and clinical impact of IREs. Results: The median age of 649 included patients was 55 years, with male preponderance (70.7%). The incidence of IREs was 26.7%, dominated by primary hypothyroidism (62.4%), insulin deficiency (15%), and primary hyperthyroidism (13.9%). Pembrolizumab (62%) was the most utilized ICI among the study cohort, followed by nivolumab (23.7%), atezolizumab (12.5%), durvalumab (0.9%), avelumab (0.6%) and ipilimumab (0.1%). The mortality rates in the cohort and the IRE subgroup were 43.4% and 42.2%. MVR revealed age (OR 1.02, 95% CI (1.003–1.03), P = 0.02), pre-ICI white-cell (WBC) count (OR 0.94, 95% CI (0.89–0.99), P = 0.04), pembrolizumab (OR 2.6, 95% CI (1.05–6.3), P = 0.04), and nivolumab use (OR 2.6, 95% CI (1.04–6.6), P = 0.04) as significant predictors of IREs. After MVR, factors influencing mortality in the subgroup with IREs included a higher age (OR 1.1, 95% CI 1.04–1.2, P = 0.001) and platelet-to-lymphocyte ratio (OR 1.004, 95% CI 0.7–1.4, P = 0.006). Conclusions: This first extensive Middle Eastern and South Asian cohort reported a higher-than-previously known incidence of IREs. Hypothyroidism, insulin deficiency, and hyperthyroidism were the commonest IREs, with pembrolizumab being the commonest ICI. IRE development was associated with higher age, a low WBC count, pembrolizumab, and nivolumab use. The development of IREs did not seem to influence mortality. Further research on IREs is imperative to optimize management guidelines in the era of precision medicine. [ABSTRACT FROM AUTHOR]

Background/Objectives: Troponin level elevation without an obstructive culprit lesion is caused by heterogenous entities. The effect of aging on this condition has been poorly investigated. Methods: After screening 24,775 patients between 2010 and 2021, this study included a total of 373 patients with elevated troponin levels without an obstructive culprit lesion or suspected myocardial infarction with non-obstructive coronary arteries (MINOCAs) categorized into four age groups containing 78 patients (<51 years), 72 patients (51–60 years), 81 patients (61–70 years), and 142 patients (>70 years). This study analyzed the baseline characteristics, the in-hospital complications, in-hospital mortality, and the long-term outcomes. Results: The older patients exhibited a higher rate of major adverse cardiovascular in-hospital events than those of the other age groups (15.4% in the <51-year-old group vs. 36.1% in the 51–60-year-old group vs. 33.3% in the 61–70-year-old group vs. 47.2% in the >70-year-old group; p < 0.001). However, the rate of non-sustained ventricular tachycardia (nsVT) was higher in the 51–60-year-old patients than those of the other age groups (5.6% in the 51–60-year-old group vs. 1.3% in the 61–70-year-old group vs. 0.7% in the >70-year-old group; p = 0.027). At the 11-year follow-up, cardiovascular mortality was higher among the older patients compared to that of the younger patients (3.9% in the 61–70-year-old group vs. 4.2% in the >70-year-old group, p = 0.042), while non-cardiovascular mortality was comparable between the age groups. Conclusions: The older patients with troponin level elevation without an obstructive culprit lesion experienced a higher incidence of major adverse cardiovascular events during hospitalization compared to that of the younger groups. Additionally, higher cardiovascular mortality rates were revealed in the older patients at a long-term follow-up. [ABSTRACT FROM AUTHOR]

Background: Treatments that combine both elastic and rigid taping in knee osteoarthritis have not yet been investigated in the literature. Thus, the purpose of the present study is to investigate how the combination taping technique affects functional status, disability, and quadricep isokinetic torque in cases of knee osteoarthritis. Patient Methods: A total of fifty-four patients were assigned to the experimental group or control group. Conventional physical therapy was provided to both groups, in addition, participants in the experimental group also received combination taping. Disability, functional status, and isokinetic quadriceps torque were assessed at baseline, six weeks (post-intervention), and twelve weeks (follow-up). Results: MANOVA showed that post-intervention measurements were significantly better than baseline measurements of both groups, except for isokinetic quadriceps torque, which showed a nonsignificant difference in the control group. The control group's follow-up measurements revealed nonsignificant differences from those taken after the intervention, whereas the experimental group's differences were significant excluding isokinetic quadriceps torque. Measurements taken at post-intervention and follow-up revealed that the experimental group had significantly improved compared to the control groups. Conclusions: Combination taping was found to be more beneficial when used in addition to conventional physical therapy than when used alone in knee OA. [ABSTRACT FROM AUTHOR]

Foods, especially medicinal foods, play a vital role in providing nutrients for healthy growth and in the management of clinical disorders. Unfortunately, half of the global population lacks access to affordable healthcare and a nutritious diet. Therefore, it is important to identify traditional and scientifically proven therapeutic foods for disease management and the prevention of micronutrient deficiencies. Baobab, one of nature 's gifts to mankind, is the focus of this study. The aim was to provide an overview of its medicinal and nutritional benefits through a literature search. Research indicates that baobab fruit pulp is a rich source of fiber, calcium, magnesium, potassium, and notably vitamin C, about five to 10 times the content found in oranges. Additionally, baobab fruit pulp has been found to possess various therapeutic properties, including antibacterial, anti-inflammatory, antidiabetic, anticancer, and antiulcer characteristics. Furthermore, it is considered safe for consumption. These findings emphasize the importance of increasing baobab plantations and raising public awareness about the health benefits of the fruit through educational initiatives. Further research is necessary to explore the potential of baobab fruit pulp as a therapeutic agent for improved health. [ABSTRACT FROM AUTHOR]

Background: Populations affected by humanitarian crises likely experience high burdens of pneumococcal disease. Streptococcus pneumoniae carriage estimates are essential to understand pneumococcal transmission dynamics and the potential impact of pneumococcal conjugate vaccines (PCV). Over 100 million people are forcibly displaced worldwide, yet here we present only the second pneumococcal carriage estimates for a displaced population. Methods: In October 2019, we conducted a cross-sectional survey among internally displaced people (IDP) living in Digaale, a permanent IDP camp in Somaliland where PCV has not been implemented. We collected nasopharyngeal swab samples from 453 residents which were assessed for presence of pneumococci and serotyped using DNA microarray. Results: We found that pneumococcal carriage prevalence was 36% (95%CI 31–40) in all ages, and 70% (95%CI 64–76) in children under 5. The three most common serotypes were vaccine serotypes 6B, 19F, and 23F. We estimated that the serotypes included in the 10-valent PNEUMOSIL vaccine were carried by 41% (95%CI 33–49) of all pneumococcal carriers and extrapolated that they caused 52% (95%CI 35–70) of invasive pneumococcal disease. We found some evidence that pneumococcal carriage was associated with recent respiratory symptoms, the total number of physical contacts made, and with malnutrition in children under 5. Through linking with a nested contact survey we projected that pneumococcal exposure of children under 2 was predominantly due to contact with children aged 2–5 (39%; 95%CI 31–48) and 6–14 (25%; 95%CI 17–34). Conclusions: These findings suggest considerable potential for direct and indirect protection against pneumococcal disease in Digaale through PCV use in children and potentially adolescents. [ABSTRACT FROM AUTHOR]

Copyright of Zagazig University Medical Journal is the property of Association of Arab Universities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Rheumatoid arthritis (RA) is a chronic autoimmune condition that causes synovitis and functional impairment. Currently, the most often utilized biomarkers for monitoring disease activity and severity are acute phase proteins, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). However, discrepancies have been found between the clinical inflammation and their levels. Therefore, there is a strong need for a novel biomarker to forecast how RA will proceed clinically and monitor the response to therapy. This study assessed the diagnostic value of serum cystatin D in RA patients and its potential as a biomarker for disease activity monitoring. Results: RA patients had considerably greater serum levels of cystatin D than the control group. These values showed a positive correlation with Disease Activity Score-28 (DAS28), ESR, CRP, grayscale synovitis, power Doppler synovitis, grayscale tenosynovitis (p < 0.001), and erosions, sum scores (p < 0.05). Nonetheless, no noteworthy association was observed between the serum cystatin D levels and sociodemographic data, rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP). Conclusion: Cystatin D serum levels are higher in RA patients compared to healthy subjects and are strongly correlated with the activity of RA. It can be a valuable biomarker for evaluating RA disease activity. [ABSTRACT FROM AUTHOR]

To find an effective inhibitor for SARS-CoV-2, Quercetin's chemical structure was compared to nine ligands associated with nine key SARS-CoV-2 proteins. It was found that Quercetin closely resembles Remdesivir, the co-crystallized ligand of RNA-dependent RNA polymerase (RdRp). This similarity was confirmed through flexible alignment experiments and molecular docking studies, which showed that both Quercetin and Remdesivir bind similarly to the active site of RdRp. Molecular dynamics (MD) simulations over a 200 ns trajectory, analyzing various factors like RMSD, RG, RMSF, SASA, and hydrogen bonding were conducted. These simulations gave detailed insights into the binding interactions of Quercetin with RdRp compared to Remdesivir. Further analyses, including MM-GBSA, Protein-Ligand Interaction Fingerprints (ProLIF) and Profile PLIP studies, confirmed the stability of Quercetin's binding. Principal component analysis of trajectories (PCAT) provided insights into the coordinated movements within the systems studied. In vitro assays showed that Quercetin is highly effective in inhibiting RdRp, with an IC50 of 122.1 ±5.46 nM, which is better than Remdesivir's IC50 of 21.62 ±2.81 μM. Moreover, Quercetin showed greater efficacy against SARS-CoV-2 In vitro, with an IC50 of 1.149 μg/ml compared to Remdesivir's 9.54 μg/ml. The selectivity index (SI) values highlighted Quercetin's safety margin (SI: 791) over Remdesivir (SI: 6). In conclusion, our comprehensive study suggests that Quercetin is a promising candidate for further research as an inhibitor of SARS-CoV-2 RdRp, providing valuable insights for developing an effective anti-COVID-19 treatment. [ABSTRACT FROM AUTHOR]

Background: Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal condition that has a detrimental impact on one's quality of life because of acid reflux causing damage to the esophagus. Primary symptoms consist of heartburn and regurgitation, although patients may also encounter chest pain, nausea, and dysphagia. Medical students may be particularly susceptible due to stressful lifestyles and unhealthy habits. This study investigates the prevalence of GERD among medical students in Egypt and explores associated risk factors. Subjects and Methods: This is a cross-sectional observational study that was conducted among undergraduate medical students at 21 medical schools across Egypt. The study included 602 participants from medical schools. The study utilized a pre-designed, self-administered questionnaire that includes questions about sociodemographic and lifestyle attributes, accompanied by the GERDQ questionnaire used to diagnose gastroesophageal reflux disease. Results: A total of 602 undergraduate medical students completed the questionnaire. The prevalence of GERD was found to be 28.4%, with heartburn and regurgitation being the most prevalent symptoms among participants. Univariate and multivariate logistic regression revealed family history of GERD and stress after medical school enrollment as significant predictors of GERD symptoms (p=0.043 and p=0.044, respectively). Conclusion: GERD has become increasingly common among medical students in Egypt. Contributing factors include medical students' stressful lifestyles and familial predispositions. To address this, it is essential to implement counseling programs and raise awareness as initial steps toward reducing GERD prevalence. [ABSTRACT FROM AUTHOR]

This study aims at evaluating the factors influencing guidance and counselling programmes and possible strategies to address them in some selected secondary schools in Sokoto metropolis, Sokoto state, Nigeria. Descriptive survey design was used to obtain descriptive and self-reported data and/or information from the participants in this study. The sample size was 400 participants comprising a total of 200 students, 150 teachers, 30 school counsellors, and 20 school administrators. Questionnaire was used for data collection. The data were analyzed using descriptive statistics. The result showed that lack of professional counsellors, lack of formal training for counsellors, lack of support from school administrators/government, lack of materials/facilities, lack of parental support, and lack or inadequate public awareness were some of the factors influencing guidance and counselling programmes in secondary schools. The result also indicated that strategies such as employing professional counsellors, creating public awareness, assigning only counselling services to counsellors, allocation of sufficient time to counselling services, and provision of adequate support by school administrators/government among others will significantly curb the problems facing guidance and counselling programmes in secondary schools. Many factors significantly influenced the guidance and counselling programmes in secondary schools. For effective guidance and counselling, strategies should be applied to curb the major factors that influenced the guidance and counselling programmes. [ABSTRACT FROM AUTHOR]

Introduction About 80% of patients receiving chemotherapeutics suffer from side effects related to the gastrointestinal tract. Irinotecan (CPT-11) is a chemotherapeutic agent usually used in treating solid tumors. Quercetin (QRT), a bioflavonoid, is an antioxidant and scavenger reactive oxygen species scavenger. Objective The current study explored the possible protective effects of QRT against mucosal tongue injury caused by CPT-11. Methods The study included four equal groups: group 1/control, group 2/QRT, group 3/CPT-11, and group 4/CPT-11 + QRT. Results CPT-11-induced tongue injury in the form of non-healed ulcers, absent lingual papillae, mononuclear cells infiltration, marked deposition of collagen fibers, and overexpression of CD86 and tumor necrosis factor- α (TNF-α). The increased malondialdehyde levels, decreased superoxide dismutase and total antioxidant capacity revealed that there was an oxidative stress. Also, there was a decreased countenance of Ki-67 and Bcl-2 and an increased countenance of NF-κB. The QRT-treated group showed complete ulcer healing, with histological features almost like the control group, along with minimal collagen fiber deposition, decreased reactivity to CD86 and TNF-α and improvement of oxidative stress status and the molecular study results as well. Conclusion QRT possess protective properties against CPT-11-triggered tongue injury. [ABSTRACT FROM AUTHOR]

Antiphospholipid syndrome (APS), also known as Hughes syndrome, is a systemic autoimmune disorder characterized by recurrent thrombosis and pregnancy complications, accompanied by the presence of antiphospholipid antibodies (aPLs). These antibodies target anionic phospholipids or protein–phospholipid complexes within cell membranes, contributing to the underlying mechanisms of the disease. Although anticoagulation therapy remains the cornerstone of APS management, it often fails to prevent complications, particularly in obstetric and thrombotic cases. As autoimmune diseases become increasingly linked to alterations in the gut microbiome, this study investigates the complex interaction between gut bacteria and immune modulation in APS. We explore how disruptions in the gut microbiome may influence the development of autoimmune conditions, with a specific focus on APS. By identifying key microorganisms potentially involved in this gut–immune axis, we aim to provide insights into novel preventive and control approaches. Future research should focus on harnessing the gut microbiome to develop more effective treatments that target both the immune system and microbial populations in APS patients. [ABSTRACT FROM AUTHOR]

Copyright of Jordan Medical Journal is the property of University of Jordan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pyrolysis is gaining recognition as a sustainable solution for biosolid management, though scaling it commercially presents challenges. To address this, RMIT developed a novel integrated pyrolysis and gasification technology called PYROCO™, which was successfully tested in pilot-scale trials. This study introduces PYROCO™ and its application to produce biochar, highlighting the biochar properties of the results of the initial trials. In addition, an energy analysis using semi-empirical Aspen Plus modelling, paired with a preliminary techno-economic assessment, was carried out to evaluate the feasibility of this technology. The results show that the PYROCO™ pilot plant produced biochar with a ~30 wt% yield, featuring beneficial agronomic properties such as high organic carbon (210–220 g/kg) and nutrient contents (total P: 36–42 g/kg and total N: 16–18 g/kg). The system also effectively removed contaminants such as PFASs, PAHs, pharmaceuticals, and microplastics from the biochar and scrubber water and stack gas emissions. An energy analysis and Aspen Plus modelling showed that a commercial-scale PYROCO™ plant could operate energy self-sufficiently with biosolids containing >30% solids and with a minimum calorific value of 11 MJ/kg. The process generates excess energy for drying biosolids and for electricity generation. Profitability is sensitive to biochar price; prices rise from AUD 300 to AUD 1000 per tonne, the NPV improves from AUD 0.24 million to AUD 4.31 million, and the payback period shortens from 26 to 12 years. The low NPV and high payback period reflect the use of a relatively high discount rate of 8%, chosen to be on the conservative side given the novel nature of the technology. [ABSTRACT FROM AUTHOR]

Lenalidomide is a drug that has immune-modulating, anti-angiogenic, and anti-inflammatory properties. In this study, we developed green HPLC and spectrophotometric methods to determine the concentration of lenalidomide in pure and pharmaceutical formulations. In the HPLC method, 10 mM potassium dihydrogen phosphate solution (pH: 2.0) and ethanol (50:50, V/V) were used as mobile phases, isocratic elution was applied at a flow rate of 1.0 mL min−1 and detection was made at 304 nm. In the spectrophotometric method, the spectral patterns of standard solutions in different solvents were comprehensively examined, the best spectra were obtained with ultrapure water, and a wavelength of 304 nm was selected for detection. Both methods have been validated according to ICH guidelines for various parameters. Correlation coefficients greater than 0.999 were determined for both methods in the concentration range of 5–30 μg mL−1. The developed methods were applied to commercial formulations, and comparisons of the results were made using the Student (t) test for means and the Fischer (F) test for standard deviations. No statistically significant difference was observed between the methods. The greenness evaluation of these methods was carried out using AGREE software. The developed methods are proposed as excellent environmental and operator-friendly alternatives for the quantification of Lenalidomide in pharmaceutical formulations. [ABSTRACT FROM AUTHOR]

Polymethyl methacrylate (PMMA) has been widely used as a material in dentistry. The deterioration of pure PMMA denture teeth is a significant issue that can alter the vertical dimensions of dentures. This study investigates the effect of aluminum oxide (Al2O3) nano-ceramic addition as reinforcements into the heat-cure acrylic resin denture teeth. The PMMA was reinforced with Al2O3 concentrations of 1, 3, 5, and 10 wt.%. The PMMA without ceramic addition is produced for comparison purposes. The color change, densification, microhardness, and compressive properties of the produced PMMA resin and its composites were investigated to detect the effect of Al2O3 nano ceramic addition on the physical and mechanical properties. Furthermore, the microstructure was also performed using scanning electron microscopy (SEM) analysis. A chewing simulator was utilized to conduct two-body wear testing, employing a human enamel antagonist. The wear behavior of the PMMA and their composites were assessed by measuring the weight loss after submitting them to 37,500 cycles. The SEM microstructure analysis revealed sound specimens of PMMA reinforced with 0, 1, 3, and 5 wt.% Al2O3 without any porosity and micro defects using the applied production procedures. In contrast, the aggregated sites and propagation of cracks were detected for the PMMA/10 wt.% Al2O3 specimen. The densification and hardness properties of the produced PMMA composites improved with increasing the Al2O3 additions. The microhardness of PMMA/10 wt.% Al2O3 improved by around 233% compared to the PMMA matrix. The higher compressive properties were detected for the PMMA/5 wt.% Al2O3 composite specimen with ultimate compressive strength (UCS) of 54.75 MPa and yield strength (YS) of 45.6 MPa and improved than the PMMA matrix by around 98 % and 117 %, respectively. In addition, incorporating Al2O3 nano-ceramic particles into a PMMA matrix revealed a significant improvement in the wear resistance of the produced composites compared to the PMMA matrix. [ABSTRACT FROM AUTHOR]

Purpose: Health technologies are advancing rapidly and becoming more expensive, posing a challenge for financing healthcare systems. Health technology assessment (HTA) improves the efficiency of resource allocation by facilitating evidence-informed decisions on the value of health technologies. Our study aims to create a customized HTA roadmap for Oman based on a gap analysis between the current and future status of HTA implementation. Design/methodology/approach: We surveyed participants of an advanced HTA training program to assess the current state of HTA implementation in Oman and explore long-term goals. A list of draft recommendations was developed in areas with room for improvement. The list was then validated for its feasibility in a round table discussion with senior health policy experts to conclude on specific actions for HTA implementation. Findings: Survey results aligned well with expert discussions. The round table discussion concluded with a phasic action plan for HTA implementation. In the short term (1–2 years), efforts will focus on building capacity through training programs. For medium-term actions (3–5 years), plans include expanding the HTA unit and introducing multiple cost-effectiveness thresholds while from 6–10 years, publishing of HTA recommendations, critical appraisal reports, and timelines is recommended. Originality/value: Although the HTA system in Oman is still in its early stages, strong initiatives are being taken for its advancement. This structured approach ensures a comprehensive integration of HTA into the healthcare system, enhancing decision-making and promoting a sustainable, evidence-based system addressing the population's needs. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a neurological ailment that is progressive and incurable. Enzymes, including acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), and tyrosinase, are essential to AD pathogenesis. Inflammation and elevated oxidative stress also increase the progression of AD. Cordia dichotoma G. Forst. (C. dichtoma) family, Boraginaceae, is an Indian herb scientifically proven to perform various biological activities such as antioxidants and anti-inflammatory activities/ This research intended to provide a foundational understanding of the potential of C. dichotoma against AD through a series of in vitro studies and HPLC analyses. Ethanol (80%) extract (Extract-1) and aqueous extract (Extract-2) were prepared and subjected to in vitro AChE, BChE, and tyrosinase inhibition assay. Extracts were subjected to COX-1 and COX-2 inhibition assay, lipid peroxidation (LP) inhibition and free radical scavenging capacity (FRS) assay. An investigation was conducted to determine the presence of bioactive chemical constituents, vitamins and minerals using high-pressure liquid chromatography (HPLC) of C. dichtoma ethanol extract. Both extracts inhibited AChE, BChE, tyrosinase, COX-1 and COX-2 enzymes with IC50 of 34.19, 54.19; 52.44, 37.33; 81.87, 612.33; 17.31, 20.42 and 19.67, 10.26), µg/mL for extract-1 and extract-2, respectively. They also reduced oxidative stress by inhibiting LP and FRS capacity, justifying the potential action against AD. The chemical investigation showed the presence of caffeic acid and p-hydroxybenzoic acid, vitamins such as nicotinic acid and nicotinamide, and nutrients responsible for the anti-AD of C. dichtoma extracts. The study justified the anti-Alzheimer activity of C. dichtoma extracts at the in vitro scale supported by the HPLC results. [ABSTRACT FROM AUTHOR]

Gastric ulcers are the most common chronic gastrointestinal tract disorders, marked by an inflamed break of the mucus membrane covering the alimentary tract. According to recent research, stress-induced ulcers are widespread in our society. A stress ulcer is a mucosal defect that may become complicated due to upper gastrointestinal tract bleeding. The underlying cause of this condition is pH. Physiological stress leads to severe sickness by triggering the excessive secretion of peptic juices or gastric acid. There is a never-ending quest for safe and affordable medication for this disorder. Nature offers many medicinal plants that can be used to treat a wide range of human ailments. Due to their relatively harmless and comparatively free of harmful effects, health-promoting features, pharmacological practices, and affordability to common people to regulate various diseases, medicinal plants, and herbal preparations are gaining a lot of interest in scientific communities these days. Many studies have recently been performed to classify extracts and their constituents that may have a therapeutic effect on peptic ulcers. Therefore, this review aims to address the molecular mechanisms and pharmacological effects of various phytochemicals related to stress-induced gastric ulcers. Combining phytochemical constituents with modern drugs and treatment methods can lead to the development of therapeutic drugs for gastric ulcers. Gastric ulcers and other related diseases may be treated permanently with this approach. [ABSTRACT FROM AUTHOR]

Mycobacterium tuberculosis is a bacterium that causes disease known as Tuberculosis. Tuberculosis is highly contagious and can result in high mortality rate if left untreated. In order to screen individuals suspected of the disease, medical expert relies on several conventional approaches which are hindered by several limitations which include time consuming, high workload, false positive results, etc. This calls for the need to develop smart and automatic approaches that can address these challenges. Majority of existing studies reported the use of 1 or 2 pretrained models and the use of SoftMax as the classifier. Moreover, majority of the studies trained models using a single type of dataset which are mostly curated from public accessible domains. Thus, this study addressed these challenges by: (1) The use of several pretrained models (2) The use of 2 classifiers which include SVM and KNN and (3) Training and validating pretrained models fused with classifiers on microscopic slide and chest X-ray images. The result achieved in this study highlights the prospect of computer-assisted techniques in triaging and screening of TB. The integration of Internet of Everything (IoE) in medical diagnosis has the potential to increase healthcare outcome, boost productivity, and reduce workload. [ABSTRACT FROM AUTHOR]

Background: Understanding PIK3CA mutations and co-mutations in non-small cell lung carcinoma (NSCLC) is critical to developing personalized treatment strategies. Therefore, this study aims to investigate PIK3CA mutations and the accompanying somatic variations in NSCLC. Methods: This retrospective study included 98 patients over 18 years of age who were diagnosed with NSCLC, operated on, and referred to the Molecular Pathology Laboratory between January 2019 and June 2024 for next-generation sequencing panel tests and ALK-ROS1 FISH analysis. Results: All patients were found to carry PIK3CA mutations. Among the 98 NSCLC patients analyzed, 16 (16.33%) were female and 82 (83.67%) were male. The average age of the patients was 64.53 ± 9.63 years, with an age range of 38–84 years, and the majority were 50 years or older. Of the cases, 51 presented the adenocarcinoma subtype, while the remaining 47 showed the squamous cell carcinoma subtype. A smoking history was present in 77 (78.57%) patients, while 21 (21.43%) had no smoking history. The most frequently detected pathogenic or likely pathogenic PIK3CA variations were c.1633G>A p.E545K (32.65%), c.1624G>A p.E542K (11.22%), c.3140A>G p.H1047R (11.22%), c.3140A>T p.H1047L (5.10%), c.1357G>C p.E453Q (4.08%), and c.3143A>G p.H1048R (2.04%). The top 10 mutations that most commonly accompanied PIK3CA variations were KRAS, NF1, TP53, EGFR, PTEN, BRAF, KIT, CDKN2A, SMARCA4, and ATM mutations, respectively. Conclusions: PIK3CA variations, along with other gene variations, may influence cancer progression and thus may play a crucial role in the determination of targeted treatment strategies. [ABSTRACT FROM AUTHOR]

Thalassemia represents a diverse group of inherited hematological disorders characterized by defective globin chain synthesis, leading to chronic anemia and associated complications. The complicated pathophysiology of beta-thalassemia involves genetic mutations or rarely deletions of the beta-globin gene on chromosome 11 whereas alpha-thalassemia involves deletions in the HBA1 and HBA2 genes or occasionally alterations to the DNA sequence in or around these genes. These mutation and deletion effects disrupt the balance of α/β-globin chain production, resulting in ineffective erythropoiesis, hemolysis, and a cascade of clinical manifestations including anemia, bone deformities, and iron overload. Advances in diagnostic techniques have enhanced our ability to detect and characterize these mutations, facilitating early and accurate diagnoses. Current management strategies encompass regular blood transfusions, the use of hydroxyurea to improve hemoglobin levels, and iron chelation therapy to prevent iron-related organ damage. Moreover, other therapeutics such as thalidomide for those not responding to hydroxyurea, Sirolimus for patients with immunodeficiencies, and use of vitamin E as an antioxidant have proven to be effective. Innovative therapies such as gene therapy and bone marrow transplantation offer promising curative potential, opening a new era in the treatment of thalassemia. This review focuses on pathophysiological mechanisms underlying thalassemia, explores the diagnostic methodologies, and highlights recent advancements in therapeutic approaches. [ABSTRACT FROM AUTHOR]

The isotropic Cauchy distribution is a member of the central α -stable family that plays a role in the set of heavy-tailed distributions similar to that of the Gaussian density among finite second-moment laws. Given a sequence of n observations, we are interested in characterizing the performance of Likelihood Ratio Tests, where two hypotheses are plausible for the observed quantities: either isotropic Cauchy or isotropic Gaussian. Under various setups, we show that the probability of error of such detectors is not always exponentially decaying with n, with the leading term in the exponent shown to be logarithmic instead, and we determine the constants in that leading term. Perhaps surprisingly, the optimal Bayesian probabilities of error are found to exhibit different asymptotic behaviors. [ABSTRACT FROM AUTHOR]

This work investigates the validation of the SW-ASV method for the determination of malathion organophosphorus pesticide based on an electrochemically modified (CPE) carbon paste electrode with copper metal. The surface of the modified CPE was constructed by electrodepositing the copper layer at the accumulation step in 1-mM CuSO4.5H2O, PBS at pH 6.6, E accumulation: − 0.8 V, and Taccumulation 240 s. The determining step was performed by adding different concentrations of malathion pesticide and applying the potential toward more positive potential at (− 0.8–+ 1.4 V) to enhance the oxidation of Cu0 metal. It was noticed that the malathion concentration gradient enhances the oxidation peak current of copper at + 0.03 V gradually. SW-ASV method validation was performed at a linearity range confined in (1–10 µM). An analytical curve was constructed and R2 was equal to 0.99995 with good fitted linear relationship. LOD and LOQ were calculated to be 0.0247 and 0.08236 µM, respectively. ANOVA for two sets of measurements using the standard gas chromatographic method and the suggested SW-ASV method was demonstrated via the calculations of F-value and t-value. F and t-values were calculated to be 1.698 and 0.289, respectively, which did not exceed the tabulated F and t-values resulting in the great similarity of results and ensuring the reliability of the suggested test method. This valid SW-ASV method was used to perform the routine analysis of the 95% technical grade and the pesticide formulation 57% emulsion concentrate of the malathion. Valid results were achieved with satisfactory limits of accuracy and precision. [ABSTRACT FROM AUTHOR]

Background: Pediatric orthopedic nursing requires specialized competencies to optimize patient outcomes, particularly in the complex realm of pediatric surgery. This study explores the effectiveness of the Pediatric Nursing Excellence (PNE) Model in enhancing nurses' knowledge and clinical practice in providing perioperative care for pediatric orthopedic patients in tertiary care inpatient settings. Methods: A double-blind, randomized controlled trial was conducted from February to July 2024, involving 100 nurses from two tertiary care hospitals in Tanta, Egypt. Participants were randomly assigned to receive PNE Model training (n = 50) or routine care (n = 50). Nurses' knowledge, practical skills, and adherence to PNE principles were assessed at baseline, immediately post-intervention, and after one, three, and six months using validated tools. Results: The intervention group showed significantly greater improvements in knowledge (20.62 ± 6.7 vs. 8.16 ± 5.5, p < 0.001) and practice scores (62.28 ± 4.1 vs. 40.06 ± 14.7, p < 0.001) post-intervention, sustained over six months. Path analysis revealed that the PNE Model enhanced nursing practice directly (β = 0.25, p < 0.001) through improvements in engagement and adherence to excellence principles and indirectly (β = 0.53, p < 0.001) by significantly enhancing nurses' knowledge (β = 0.70, p < 0.001), which in turn positively influenced their clinical practice (β = 0.75, p < 0.001). Post-intervention, 82% of nurses in the intervention group achieved high levels of professional excellence, compared to 8% at baseline (p < 0.001). Conclusions: The PNE Model demonstrates robust effectiveness in enhancing nurses' knowledge, clinical practice, and professional excellence in pediatric orthopedic surgery care, with sustained long-term benefits. This evidence supports implementing specialized nursing education models to improve pediatric care quality in orthopedic settings. [ABSTRACT FROM AUTHOR]