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Background: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) presents significant treatment challenges due to its chronic nature, varied clinical presentations, and rarity. Subcutaneous immunoglobulin (SCIG) has emerged as a maintenance therapy, offering potential advantages in administration and patient experience over the previously recognized intravenous immunoglobulin (IVIG). Methods: We included all clinical studies involving CIDP patients treated with SCIG from eleven databases up to March 2024. Results: 50 clinical studies were included in the systematic review, with 22 involved in the meta-analysis. These studies offer clinical data on around 1400 CIDP patients. Almost all studies considered SCIG a maintenance therapy, with the majority of results suggesting it as a viable substitute that may offer comparable or enhanced advantages. Studies covered aspects such as efficacy, safety, quality of life, practicality, economic evaluation, and patient preference. Meta-analysis showed SCIG significantly improved muscle strength and sensory function, had fewer and milder side effects, reduced relapse rates, and received a strong preference. Conclusions: Findings suggest that SCIG for CIDP maintenance not only provides a more feasible alternative, with economic evaluations showing considerable cost reductions over time, and patient preference for SCIG being pronounced, but may also deliver comparable or superior health outcomes. Ongoing research lines on formulations, techniques, and direct comparative studies are critical to further illuminate, enhance, and expand SCIG's role in treatment. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the peri-implant parameters of immediately placed and loaded mandibular overdentures over a 5-year follow-up period. Materials and Methods: All subjects who had been advised and planned for two-implant mandibular overdenture treatment were included in this study. The peri-implant parameters –including plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) as well as marginal bone loss (MBL) – were assessed. In addition, prosthodontic parameters including abutment-, implant- and denture-related complications were assessed. Patients were evaluated at follow-up visits, scheduled at 1, 12, 24, 36, 48, and 60 months. The data distribution was analysed with the Shapiro-Wilk test. Data within follow-up categories were compared using ANOVA and the Tukey-Kramer test. A p-value < 0.05 was considered statistically significant. Results: Among the 32 participants, 19 were males and 13 were females, with a mean age of 60.5 ± 7.33. The mean plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) varied over time. However, no statistically significant difference was observed in the plaque index, bleeding index and peri-implant pocket depth over time (p > 0.05). The mean value at baseline was found to be -0.9 ± 0.3. The values increased over time, with the highest value observed at 60 months 2.6 ± 0.7, which was statistically significant (p < 0.001). Conclusion: Immediately placed and loaded mandibular implant overdentures using two un-splinted implants with locator attachments showed acceptable PI, BI and PIPD at the 5-year follow-up. Statistically significantly greater marginal bone loss was observed from baseline to follow-up, but it was within acceptable limits. A moderate number of restorative and abutment complications were observed during the follow-up of IODs. [ABSTRACT FROM AUTHOR]

To investigate the association between anti-prothrombin IgM and IgG antibodies and recurrent pregnancy loss (RPL) in a cohort of Lebanese women, and their impact on pregnancy outcomes. This was a retrospective case–control study involving 207 women with RPL and 179 age-matched multiparous controls. Quantitative sandwich ELISA assayed anti-prothrombin IgM and IgG antibodies. Univariate and multivariate logistic regression were employed to assess the risk imparted by anti-prothrombin antibodies, while ROC analysis was used to determine their sensitivity and specificity. Our study revealed that women with RPL had significantly higher serum levels of anti-prothrombin IgM and IgG than controls. Univariate regression analysis demonstrated that elevated anti-prothrombin IgM (OR = 1.13; 95% CI = 1.07, 1.19; P < 0.001) and IgG (OR = 1.05; 95% CI = 1.03, 1.08; P < 0.001) were associated with increased RPL risk. Multivariate analysis confirmed these findings, indicating that anti-prothrombin IgM (aOR = 1.13; 95% CI = 1.05, 1.20; P < 0.001) and IgG (aOR = 1.08; 95% CI = 1.05, 1.11; P < 0.001) are independent risk factors. ROC analysis yielded an AUC of 0.720 for IgM and 0.649 for IgG, underscoring their predictive value and offering hope for improved risk assessment and management of RPL. Elevated levels of anti-prothrombin IgM and IgG are significantly associated with RPL, suggesting an autoimmune component to pregnancy loss. These findings highlight the importance of screening for these antibodies in women with unexplained RPL to guide management and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Purpose: The huge Muslim population has increased the demand for halal tourism products and destination factors in this niche tourism segment. Despite the growing body of research conducted regarding ChatGPT's revolutionary impact on the tourism industry, the use of such an artificial intelligence (AI) tool in halal tourism needs more attention. This study aims to provide a comprehensive an overview of using ChatGPT in the tourism industry, specifically in halal tourism, and offer an agenda for further essential research questions exploration. Design/methodology/approach: Through the intensive examination of the tourism literature dealing with AI and halal tourism, this review identifies the implications related to the use of ChatGPT for Muslim travelers and future trends in halal tourism. Findings: This paper identified the possible utilization of ChatGPT in assisting Muslim travelers across various stages of their journey, encompassing pre-trip, staying and post-trip phases. Subsequently, this paper identified the opportunities and challenges associated with implementing ChatGPT in the context of halal tourism. Finally, the paper delves into potential avenues for future research. Practical implications: The findings serve as crucial implications, contributing to the theory of halal tourism development and the applications of ChatGPT in halal tourism. Originality/value: This paper provides essential foundational knowledge for upcoming research on halal tourism theory, ChatGPT and the development of halal tourism sector. [ABSTRACT FROM AUTHOR]

Haploidentical hematopoietic cell transplants (haplo-HCT) with donor-specific anti-HLA antibodies (DSAs) are associated with high rates of primary graft failure and poor overall survival (OS). Limited data exists regarding the effect of desensitization. Our institution began routine desensitization for patients with DSAs in 2014. Adult patients undergoing haplo-HCT at Washington University from 2009–2021 were identified and divided into three cohorts: no DSA, untreated DSA (2009–2014) or treated DSA (2014–2021). Desensitization therapy using plasmapheresis and IVIg was performed. Retrospectively, 304 patients were identified. 14 of 30 patients with DSAs underwent desensitization. By day +2, 57% of patients cleared all DSAs. After multivariable analysis, OS was similar between treated DSA and no DSA (HR: 0.69, p = 0.37). Untreated DSA had significantly lower OS compared to no DSA group (HR 1.80, p = 0.046). Desensitization with a backbone of plasmapheresis and IVIg before haplo-HCT may produce similar outcomes to patients without DSAs. [ABSTRACT FROM AUTHOR]

Optimal diagnosis and management of interstitial lung diseases (ILDs) needs access to specialized centers, frequent monitoring, and complex therapeutic options. In underprivileged areas, these necessities can often lead to barriers in delivering care. What are the ILD mortality disparities in the regions along the US-Mexico (US-MX) border? We obtained ILD mortality information through death certificate queries from the Centers for Disease Control and Prevention repository. Death data were adjusted for age and stratified by US-MX border regions and nonborder regions in the United States. Log-linear regression models were used to analyze mortality trends in the period from 1999 to 2020 followed by calculation of annual percentage changes (APCs). Age-adjusted mortality rates (AAMRs) were compared across cumulative and subdemographic populations. ILD-related mortality among border regions (AAMR, 5.31) was higher than nonborder regions (AAMR, 4.86). Mortality within border regions remained unchanged from 1999 to 2020 (APC, 0.3; P =.269). Nonborder regions experienced a significant rise in mortality rates (APC, 2.6; P =.017) from 1999 to 2005 and remained unchanged from 2005 to 2020. Mortality was higher within both men (AAMR, 6.57) and women (AAMR, 4.36) populations among border regions compared with their nonborder counterparts (AAMR, 6.27 and 3.87, respectively). Hispanic populations among the border regions experienced higher mortality rates (AAMR, 6.15) than Hispanic populations within nonborder regions (AAMR, 5.44). Non-Hispanic populations encountered similar mortality rates between the two regions. Mortality rates among Hispanic (APC, 0.0; P =.938) and non-Hispanic (APC, 0.2; P =.531) populations in the border regions remained unchanged from 1999 to 2020. These results revealed ILD-related mortality disparities among the US-MX border regions, emphasizing the importance of public health measures to increase access to equitable medical care and implement targeted interventions among these vulnerable populations. [ABSTRACT FROM AUTHOR]

This essay argues that Inside Out 2's critical success lies in its canny translation of three contemporary mental health discourses including Tibetan Buddhist mindfulness, holistic medicine, and the internal family systems model of the psyche. By presenting human emotions as a series of autonomous but interconnected parts struggling against being repressed and compartmentalized, the film models for viewers what a healthy relationship to one's affective life might look like in an increasingly mentally distressed world. In so doing, it materially enacts the discourses of mental health, namely the injunction to reject emotional denial and compassionately embrace all one's part, as an everyday way of life capable of offering viewers equipment for living. [ABSTRACT FROM AUTHOR]

Antithrombotic treatment in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) poses a dilemma. We compared outcomes of dual antithrombotic therapy (DAT) (direct oral anticoagulants (DOACs)/warfarin + antiplatelets) vs triple antithrombotic therapy (TAT) (DOACs/warfarin, aspirin, and P2Y12 inhibitor) in this population. Multiple databases were searched from inception to December 17, 2023 to identify randomized controlled trials (RCTs) comparing DAT vs TAT in patients with AF and ACS. Outcomes included major adverse cardiac events (MACE), bleeding events, stroke, stent thrombosis, and myocardial infarction (MI). Relative risk and 95% confidence intervals were estimated with a random-effects model using the inverse-variance technique. We assigned I 2 > 50% as an indicator of statistical heterogeneity. p -Value <0.05 was considered significant. Ten RCTs comprising 6186 patients on TAT (female 26%, mean age 71 ± 9 years) and 6800 patients on DAT (female 27%, mean age 71 ± 9 years) were included. Patients receiving DAT experienced lower rates of bleeding events compared to those receiving TAT, with relative risks of 0.69 [0.55–0.87] (p < 0.001), 0.65 [0.40–1.06] (p = 0.09), and 0.62 [0.46–0.84] (p < 0.001) for TAT durations of 3, 6, and 12 months, respectively. No difference was seen in the occurrence of MACE, MI, stroke, or stent thrombosis between DAT and TAT across all three durations of TAT. This is the largest pooled analysis comparing TAT to DAT stratified by the duration of antithrombotic therapy. Our results revealed that DAT was associated with reduced bleeding risk despite no difference in other outcomes. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review aims to synthesize the latest evidence focused on therapies related to comorbid obesity and heart failure, with particular attention to lifestyle, pharmacological, and surgical modalities. Recent Findings: Obesity is a common risk factor for heart failure, which can also exacerbate symptom burden of heart failure. Emerging treatments, such as the use of GLP-1 analogs like semaglutide, have shown promising results in improving symptoms and physical limitations in the setting of comorbid heart failure with preserved ejection fraction and obesity. Conversely, the efficacy of such treatments in heart failure with reduced ejection fraction remains uncertain, with some studies suggesting potential adverse outcomes. Lifestyle interventions, including dietary changes and structured exercise programs, may be associated with benefits in terms of functional capacity and symptom burden, and retrospective cohort studies of surgical weight loss have raised the possibility of improvements in medium term survival for patients with baseline HF, challenging the previous notions of the "obesity survival paradox". Summary: The management of comorbid obesity and heart failure is a rapidly evolving field. The interplay of pharmacological, lifestyle, and surgical interventions highlights the need for personalized treatment plans to mitigate the risks and enhance the quality of life for patients with heart failure. It is hoped that future guidelines will integrate these findings to address the nuances of optimally treating both heart failure and obesity in patients with both conditions. [ABSTRACT FROM AUTHOR]

Introduction: In Japan, patients with chronic obstructive pulmonary disease (COPD) can be escalated to treatment with inhaled triple therapy. Two single-inhaler triple therapies combining an inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β2-agonist (ICS/LAMA/LABA) are approved maintenance therapies for patients with COPD, and multiple-inhaler triple therapies (MITTs) are also available. There is limited evidence regarding real-life treatment patterns and characteristics of patients with COPD initiating triple therapies. Methods: This observational, retrospective cohort study identified patients with COPD in Japan from an administrative claims database (May 2018–December 2021). Demographics, clinical characteristics, and healthcare resource utilization (HCRU) were assessed in four cohorts initiating a triple therapy: budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) early adopters (initiated ≤ 12 months after market approval [September 1, 2019]), contemporary BGF users (initiated > 12 months after market approval), fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) users, and any MITT users. Results: A total of 636 patients were BGF early adopters, 2558 were contemporary BGF users, 11,187 used FF/UMEC/VI, and 5931 used MITT. The percentage of patients with concomitant asthma in each cohort was 73.0%, BGF early adopter; 74.2%, contemporary BGF; 75.7%, FF/UMEC/VI; and 84.5%, MITT. During the 12-month baseline period, the frequency of patients with ≥ 1 moderate/severe exacerbation was 18.2%, BGF early adopter; 14.3%, contemporary BGF; 13.1%, FF/UMEC/VI; and 14.0%, MITT. ICS/LABA treatment during baseline was the most frequent pathway to triple therapy, ranging from 38.2% to 51.7% across cohorts. HCRU was relatively high across cohorts (range of hospital outpatient visits/patient during the 12-month baseline period, 11.0–14.1). Multimorbidity was observed in > 80% of patients in all cohorts; cardiovascular diseases were among the most common. Conclusion: Many patients initiating triple therapy for COPD had concomitant asthma and had previously received ICS/LABA maintenance therapy. Patients prescribed BGF in the initial post-launch period were more likely to have a previous exacerbation history versus other cohorts, indicating more severe disease. Plain Language Summary: In Japan, single inhalers containing three medicines, known as single-inhaler triple therapies, are approved for people with chronic obstructive pulmonary disease (COPD). These inhalers include one medicine that reduces inflammation (a corticosteroid) and two medicines that expand the airways in the lung (bronchodilators). There are two approved single-inhaler triple therapies for long-term COPD treatment in Japan, consisting of active substances referred to as budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) or fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI). Although guidance is available to doctors on when to prescribe single-inhaler triple therapy, two important questions related to use in routine clinical practice remain: when are these medicines prescribed, and what types of patients receive them. To answer these questions, we assessed anonymized medical claims of people with COPD obtained from a large database in Japan. People with COPD who had used triple therapy were split into four groups: early BGF users (started treatment within 1-year of approval in Japan), contemporary BGF users (started treatment over 1-year after approval in Japan), FF/UMEC/VI users, and users of any multiple-inhaler triple therapy. Our findings showed that the majority of patients starting any triple therapy had diagnoses of both asthma and COPD, and multiple other medical conditions, including heart-related conditions. Healthcare use, including outpatient hospital clinic visits, was high across all groups before starting triple therapy. As early BGF users were more likely to have previous flare-ups (acute worsening of COPD symptoms) than the other groups, upon approval in Japan, doctors may have initially prescribed BGF to people with more severe COPD. [ABSTRACT FROM AUTHOR]

Incorporating renewable energy sources (RESs) introduces a notable amount of uncertainty in the optimal planning and operation of electrical power grids. Under these circumstances, this paper proposes the application of a recently introduced metaheuristic optimization technique to solve the stochastic optimal power flow (OPF) problem involving wind and solar power sources. The self-adaptive bonobo optimizer (SaBO) is used to minimize three distinct objective functions: (i) Total generation cost (TGC) minimization, including both thermal and wind/solar generation costs, (ii) Power loss minimization, (iii) Combined generation cost and emissions effect minimization. The costs associated with the stochastic generation of wind and solar power included direct costs, reserves and penalty costs from the overestimation and underestimation of available wind and solar power, respectively. The performance of the proposed algorithm is evaluated on two power systems: the modified IEEE 30-bus and the Algerian DZA 114-bus test systems. To demonstrate the efficacy of the SaBO, the obtained results have been compared with those obtained from the Kepler optimization algorithm (KOA) and other recently published optimizers under the same case studies and constraints. The comparative results clearly show the superiority of the SaBO algorithm over all other well-known optimization algorithms provided in the literature for solving the OPF problem. This is evidenced by minimizing total generation costs of 781.2363 $/h for the modified IEEE 30-bus and 16,706.1630 $/h for the Algerian DZA-114-bus system. Furthermore, the integration of RES led to a notable 2.33% and 11.67% reduction in total generation cost for the IEEE 30-bus and Algerian DZA 114-bus systems, respectively, compared to their initial configurations without RESs. The promising findings highlight the powerful of the optimizer to solve non-linear and complex optimization problems in power systems. [ABSTRACT FROM AUTHOR]

Background: epidural analgesia has emerged as one of the best methods that can be used to reduce labour pain. this study was conducted to assess awareness, attitudes, and practices of pregnant women who visited maternity and antenatal healthcare clinics about epidural analgesia during normal vaginal birth. Methods: this multicentre study was conducted in a cross-sectional design among pregnant women using a pre-tested questionnaire. the study population in this study was pregnant women who visited maternity and antenatal healthcare clinics in Palestine. Results: in this study, a total of 389 pregnant women completed the questionnaire. Of the pregnant women, 381 (97.9%) were aware of the existence of epidural analgesia, 172 (44.2%) had already used epidural analgesia, and 57 (33.1%) experienced complications as a result of epidural analgesia. Of the pregnant women, 308 (79.2%) stated that epidural analgesia should be available during vaginal birth. Of the pregnant women, 243 (62.5%) stated that they would use epidural analgesia if offered for free or covered by insurance. Multivariate logistic regression showed that women who were younger than 32 years, who have used epidural analgesia, and those who stated that epidural analgesia should be available during vaginal birth were 2.78-fold (95% Cl: 1.54-5.04), 4.96-fold (95% Cl: 2.71-9.10), and 13.57-fold (95% Cl: 6.54-28.16) more likely to express willingness to use epidural analgesia, respectively. Conclusions: Pregnant women had high awareness of the existence, moderate knowledge, and positive attitudes towards epidural analgesia for normal vaginal birth. Future studies should focus on educating pregnant women about all approaches that can be used to reduce labour pain including their risks and benefits. [ABSTRACT FROM AUTHOR]

Introduction: Carrot (Daucus carota) is a nutrient-dense root vegetable, and carrot pomace is a by-product of the juice extraction procedure, which is recognized a source of phytochemicals and functional components. Almonds (Prunus dulcis) are packed with a decent amount of nutrients and bioactives. Methods: This study investigates the utilization of carrot pomace powder (CPP) and almond powder (AP) as partial substitutes for straight grade white flour (SGWF) in cakes to enhance their nutritional value and sensory appeal, while reducing waste from carrot processing. The aim is to assess the effects of incorporating CPP (at 5%, 10%, and 15%) and AP (at 5%) on the chemical composition and properties of cakes. Results and discussion: Comparative analysis reveals that AP is rich in fat (13.8 ± 0.6%) and protein (31 ± 0.6%), while CPP excels in ash (5.0 ± 0.5%) and fiber (43.3 ± 3.3%) content. Furthermore, SGWF exhibits the highest moisture content. Water holding capacities for CPP and AP are 5.2 ± 0.2% and 5.0±0.1%, respectively, and oil holding capacities are 1.3 ± 0.1% and 1.8 ± 0.2%, respectively. Additionally, CPP contains higher levels of sodium, potassium, and calcium, while AP contains higher levels of magnesium, iron, and zinc compared to SGWF. The addition of CPP and AP increases the ash, fat, fiber, and protein contents of the cakes. Notably, cakes containing 80% SGWF, 15% CPP, and 5% AP show significantly higher total phenolic content (TPC) (125.5 ± 3.8 mg GAE/100 g), total flavonoid content (TFC) (58.4 ± 1.4 mg QE/100 g), and DPPH activity (17.6 ± 2.7%) compared to control cakes. Furthermore, a significant increment in mineral content is observed in cakes with high levels of CPP and AP. Sensory evaluations reveal high acceptance of cakes containing 15% CPP and 5% AP. In conclusion, this study suggests that the incorporation of CPP and AP into cakes can improve their nutritional profile, antioxidant activity, and sensory characteristics, offering a sustainable approach to bakery product development. [ABSTRACT FROM AUTHOR]

This study aimed to characterize the cervical cancer diagnosis experience of Kenyan women undergoing treatment for cervical cancer. We analyzed qualitative interviews with 29 women living in rural Kenya who were currently undergoing cervical cancer treatment at Machakos Cancer Care and Research Centre at Machakos Level 5 Referral Hospital in eastern Kenya. Semistructured qualitative interviews were conducted in Kiswahili and English and then de-identified and translated to English during transcription. The main themes generated were identified through an inductive approach to determine how women experienced cervical cancer symptoms and their process of navigating healthcare. Three themes emerged from the qualitative interviews: (1) delaying seeking care, (2) misinterpreting or misdiagnoses, and (3) grappling with the costly diagnosis process. Women misattributed early signs of cervical cancer to benign conditions. Women sought care only after experiencing severe symptoms. When they sought care, women reported facing lengthy and costly screening processes before receiving a cervical cancer diagnosis. There is a need to educate women on the early symptoms of cervical cancer and to increase the institutional capacity and availability of cervical cancer screening resources in healthcare facilities. [ABSTRACT FROM AUTHOR]

Background/Objectives: Tobacco use remains a significant public health issue, particularly among individuals with low incomes, including Medicaid recipients who often face multiple barriers to quitting. This study aimed to identify barriers, from the perspective of Medicaid managed care organizations (MCOs), influencing Medicaid recipient participation in tobacco cessation programs. Methods: Focus group interviews were conducted with Florida Medicaid MCOs to elicit processes for case identification, outreach, referral, program participation, and incentives. Answers were synthesized into themes. Results: Medicaid recipients were primarily identified through nicotine dependency claim codes or Health Risk Assessments (HRAs). Individuals were referred to state and local community tobacco cessation programs through text messaging and outreach by MCO case managers. The MCOs identified the following as barriers: primary care physicians (PCPs) with limited knowledge about cessation programs and pharmacologic treatments for nicotine dependence, low availability of health coaches, long wait times for entry into cessation programs, weak coordination between MCOs and cessation programs, and insufficient incentives for individuals for program participation. Suggested strategies to overcome barriers were continuing medical education (CME) for PCPs about tobacco cessation programs and prescription therapies, increasing the training of health coaches, more investment in quitlines, increasing data sharing between MCOs and cessation programs, and increasing incentives for individuals. Conclusions: These findings highlight the importance of engaging MCOs in discussions about policy and program improvements, as their insights can drive meaningful changes in how tobacco cessation and other preventive health programs are structured and implemented. Targeted interventions are needed to enhance tobacco cessation program participation among Medicaid recipients. [ABSTRACT FROM AUTHOR]

We theoretically investigated the electron–surface optical phonon interaction across the long-range Fröhlich coupling in monolayer transition metal dichalcogenides, such as WS2, WSe2, MoS2, and MoSe2 monolayers, on S i C and hexagonal BN dielectric substrates. We employed the effective Hamiltonian in the K + (K −) valley of the hexagonal Brillouin zone to assess the electronic energy shifts induced by the interaction between electronic states and surface polar optical phonons. Our results indicate that the interaction between electrons and surface optical phonons depends upon the polar nature of the substrate. We have also calculated the polaronic oscillator strength, as well as the polaronic scattering rate of the lower polaron state in monolayer WS2, WSe2, MoS2, and MoSe2 on S i C and hexagonal BN dielectric substrates. As a result, we have theoretically proved the following: firstly, the enhancement of the polaronic scattering rate with temperature, and secondly, the notable influence of the careful selection of surrounding dielectrics on both the polaronic oscillator strength and the polaronic scattering rate. Thus, optimal dielectrics would be those exhibiting both elevated optical phonon energy and a high static dielectric constant. [ABSTRACT FROM AUTHOR]

The development of composite materials with fewer interface problems always helps to obtaining good properties. Two types of insulating biopolymers (7% w/w) were incorporated into a conductive matrix (polyaniline) during polymerization. The synthesis method, inspired by the synthesis of polyaniline and the coating of chitosan for the development of flexible electrodes, produces thermosets that are more thermally stable than the matrix until 350 °C. While one (gum) reduces the electrical conductivity, the other (lignin) increases the basic value of the raw material (~ 0.72 S Cm–1) by a factor of 10. The physicochemical and morphological analyses show the formation of the polymer on the surface of the biopolymer with the appearance of new chemical bonds by interactions between hydroxyls of the biopolymer and the nitrogen of amine function from the polyaniline. [ABSTRACT FROM AUTHOR]

Background: With the increasing global prevalence of type 2 diabetes (T2D) and obesity, there is a pressing need for novel therapeutic interventions. Lavandula stoechas, a medicinal plant traditionally used for various ailments, holds promise as a potential agent for T2D management, particularly in Morocco, where it is commonly used to treat diabetes. This study aims to evaluate the pharmacological potential of L. stoechas aqueous extract (AqLs) by assessing its lipase inhibition antioxidant and anti-inflammatory activities, identifying phenolic compounds, and examining its efficacy in reducing diabetic complications. Methods: The pharmacological potential of L. stoechas aqueous extract was investigated using in vitro assays. The inhibitory effect on pancreatic lipase, antioxidant power (FRAP), and anti-inflammatory activity (albumin denaturation method) was assessed. High-performance liquid chromatography (HPLC) analysis identified phenolic compounds. Additionally, albumin glycation was evaluated by estimating fructosamine, carbonyl groups, and amyloid β-structures to assess efficacy in mitigating diabetic complications. Results: The extract demonstrated concentration-dependent inhibition of pancreatic lipase (IC50 = 0.132 ± 0.006 mg/mL), potent antioxidant activity (IC50 = 604.99 ± 1.01 μg/mL), and dose-dependent anti-inflammatory effects (IC50 = 207.01 ± 34.94 mg/mL). HPLC analysis revealed phenolic compounds: naringin (38.28%), syringic acid (25.72%), and cinnamic acid (15.88%) were the most abundant, with 4-hydroxybenzoic acid, hydrated catechin, and catechin ranging from 9.60% to 5.24%, and p-coumaric acid (1.73%). Furthermore, the extract inhibited albumin glycation and fructosamine production, suggesting efficacy in mitigating diabetic complications. Conclusion: These findings highlight the multifaceted pharmacological potential of L. stoechas aqueous extract in T2D management, suggesting that this plant can be highly beneficial for diabetic individuals. [ABSTRACT FROM AUTHOR]

Psoriasis is chronic immune-mediated inflammatory disorder characterized by various comorbidities, erythematous plaques with silvery scale which can lead to psoriatic arthritis. The phosphodiesterase 4 (PDE4) protein is a potential drug target to control Psoriasis. In the current study, pharmacophore-based virtual screening of Diversity library of ChemDiv database was first performed, and then the screened hits were docked to the active site of PDE4 to choose the best binding modes. Forty-six hits generated during the virtual screening were prepared and docked to the PDE4 receptor by SP docking module of glide. The binding affinities of the selected hits were calculated by molecular docking and based on the affinities, ten hits were selected for the bioactivity scores prediction and ADMET analysis. Based on the ADMET profiling, four hits D356-2630, C700-2058, G842-0420 and F403-0203 were processed to MD simulations for stability analysis. The outcomes showed that these compounds showed strong binding with proteins with better binding free energies. Based on the results of our study, we proposed that these hits can function as lead in the biological assays and in vitro studies are required to develop the novel drug candidates. [ABSTRACT FROM AUTHOR]

Introduction: Melons are highly sought after worldwide due to their exquisite and delectable taste. However, the peels of these fruits, which are rich in phytochemicals and sustainable components for innovative culinary formulations, are often discarded as waste. Methods: This study explored the phytochemistry and valorization of three melon fruit, i.e., canary melon (Cucumis melo , var. Fonzy), watermelon (Citrullus lanatus , var. Augusta), and muskmelon (Cucumis melo , var. Cantaloupe), peels in food applications by incorporating into wheat flour biscuits. Peels of fruits were separated, dried and powders were extracted with 70% ethanol. Results and discussion: Comparing the muskmelon fruit peel to the peels of the other two fruits, the muskmelon fruit peel had the significantly (p < 0.05) high ash (8.36%), fiber (12.06%), fat (1.21%), protein (5.02%), mineral contents (Mg 233, Ca 364, K 1605, Fe 49.72, and Zn 2.39 mg/100 g), total phenolic content (167.49 mg GAE/100 g), total flavonoid content (79.16 mg QE/100 g) and total antioxidant activity (56.92 mg Trolox equivalent/100 g). Results of the antimicrobial experiments of three melon peels showed that extracts from all peels showed enough antimicrobial activities, nearly comparable to the reference drugs (ampicillin and nystatin), which still showed the highest inhibition zones. Among three extracts, highest zone of inhibition against three bacterial species, i.e., Bacillus cereus (12.03 mm), Escherichia coli (10.02 mm), and Streptococcus aureus (18.08 mm), and fungal species, i.e., Candida albicans (8.09 mm), Aspergillus niger (7.06 mm), and Mucor meihi (7.02 mm) was exhibited by muskmelon peel extract. Moisture, ash, fat, fiber, minerals, phenolics, flavonoids, and antioxidant activities of biscuits were increased as a result of incorporating peel flours. Correlation showed TPC and TAA were highly correlated in watermelon (10%; 1). Using principal component analysis, adding 5% canary watermelon peel powder to biscuits improved their healthful and active elements while maintaining sensory features. Baking with 10% muskmelon or watermelon peel powder boosted nutrition and antioxidant activity. After the control, biscuits fortified with 5% melon peel powder exhibited significantly (p < 0.05) high sensory scores. These findings highlight the value of melon peels as sustainable ingredients, promoting waste reduction and enhancing the dietary and functional benefits of food products. [ABSTRACT FROM AUTHOR]

Background: Malignant ureteral obstruction (MUO) is a serious health condition in which a malignant tumor compresses the ureter. The optimal decompressive intervention in MUO remains unclear. This study was conducted to assess and compare renal function, the occurrence of ureterohydronephrosis (UHN), intraoperative, and postoperative complications among patients with MUO who underwent double J stenting (DJS) and percutaneous nephrostomy (PCN) in the Palestinian practice. Methods: This study was conducted in retrospective design in one of the main tertiary care hospitals in the West Bank of Palestine. The data were collected from the electronic health information system of the hospital for the patients with MUO who received either DJS or PCN as a decompressive intervention from January 2018 to January 2024. Results: In this retrospective analysis, 62 patients who had stage 2 to stage 4 cancer and suffered MUO were included. The mean age of the patients was 60.8 ± 13.6 years. Of the patients, 40 (64.5%) were male and 22 (35.5%) were female. Of the patients, 26 (41.9%) had urinary bladder cancer. Of the patients, 23 (37.1%) had flank pain and 16 (25.8%) had lower urinary tract symptoms. Of the patients, 34 (54.8%) experienced bilateral UHN and 28 (45.2%) experienced unilateral UHN. In this study, 43 patients (69.4%) received PCN, and 19 (30.6%) received DJS as a decompressive intervention. Of the patients, 36 (58.1%) suffered postoperative complications. Stent migration/slip, UTIs, and urosepsis were the most commonly reported postoperative complications. There were no statistically significant differences in the occurrence of intraoperative complications, postoperative complications, time elapsed from receiving the decompression intervention to the diagnosis of complications, ICU admission, prognosis of UHN, serum creatinine, and serum BUN between both decompressive interventions. Conclusion: Despite improvements in renal functions, creatinine and BUN levels remained abnormal even after receiving a decompressive intervention. Postoperative complications were frequently reported among patients who received DJS or PCN as decompressive interventions. Larger prospective studies are still needed to determine the optimal interventions to improve outcomes, quality of life, and survival rates of patients with DJS or PCN. [ABSTRACT FROM AUTHOR]

Citrobacter koseri causes infection in people who are immunocompromised. Without effective antibiotics, these infections can become severe and life-threatening, so effective drugs are essential to treat these infections. Utilizing subtractive genomics, 2699 ORFs were predicted and translated into amino acid sequences. Metabolic pathway analysis and subcellular localization helped define the roles of key bacterial proteins. Two druggable proteins, WP_012000829.1 and WP_275157394.1, were discovered as promising targets. Alpha Fold provided 3D structures, and a library of 1600 echinoderm metabolites was docked against these proteins, with Ampicillin, Levofloxacin, and Doxycycline as controls. Notably, CMNPD13085 and CMNPD15632 exhibited the highest binding affinities for WP_012000829.1 and WP_275157394.1, respectively. Molecular dynamics simulations and MM-GBSA binding free energy complemented docking results. However, acknowledging the reliance on computational validations, the study emphasizes the need for essential in-vitro research to transform these potential inhibitors into therapeutic drugs. [ABSTRACT FROM AUTHOR]

Background: In vitro fertilization (IVF) the technique is useful for understanding early mammalian development and maximizing and speeding up genetic improvement in livestock. Genes that function as genetic markers and are involved in the pre-implantation development of embryos may be used to evaluate the quality of an embryo and the expression of these genes is correlated with the timing of embryonic genomic activation. Methods: Maturing the oocytes of bovine, then fertilizing these matured oocytes and finally culturing the fertilized oocytes to develop into embryos. Determined the gene expression of different certain genes HSP70, OCT4, GLUT1, BAX and DNMT1 in these different cell stages of embryos that were produced. Result: The mRNA expression of these genes was estimated after collecting the embryos listed above that were produced by the in vitro technique. The results showed statistically significant differences in the relative abundance between some of the genes mentioned above in each embryo stage. The timing of the zygotic genome activation process (ZGA) can result in differences in gene expression levels between the early embryonic genes in each developmental stage of in vitro-produced bovine embryos. [ABSTRACT FROM AUTHOR]

The exposome encompasses the full range of environmental exposures throughout a person's lifetime and plays an important role in cardiovascular health. Interactions with the social, natural, and built components of the exposome significantly impact cardiovascular disease prevalence and mortality. Robust data analytics, including machine learning and geospatial analysis, have advanced our understanding of how these factors converge to influence cardiovascular disease risk. The integration of multiomics platforms and advanced computational approaches enhances our ability to characterize the exposome, leading to targeted public health interventions and innovative risk reduction strategies aimed at improving cardiovascular health globally. These multiomics platforms that integrate factors such as genomics, epigenomics, clinical data, social factors, environmental factors, and wearable technology will characterize the exposome in greater detail concerning cardiovascular health. In this review, we aimed to elucidate the components of the exposome and discuss recent literature regarding their relationship to cardiovascular health. [ABSTRACT FROM AUTHOR]

Background/Objectives: Stroke survivors have a significantly increased likelihood of developing osteoporosis, a condition characterized by weak and brittle bones as well as an elevated risk of bone fractures. However, previous studies on exercise intervention have mostly been on stroke survivors who are able to walk. The objective of this study was to examine the effect of walking exercise on bone health in non-ambulatory stroke survivors. Methods: This pre- and post-test study enrolled a group of chronic non-ambulatory stroke survivors. They were instructed to complete an 8-week aerobic walking exercise program, three sessions per week. Serum concentrations of osteocalcin (OC) and carboxy-terminal telopeptides of type I collagen (ICTP) were evaluated at baseline and after completing the walking exercise program. In addition, we assessed the ambulation capacity and balance control using the functional ambulation category (FAC) and Berg Balance Scale (BBS), respectively. Results: A total of 9 out of 10 non-ambulatory stroke survivors who were recruited completed the intervention. The serum concentration of OC significantly increased from 8.51 ± 2.28 ng/mL to 9.39 ± 2.97 ng/mL (p < 0.10). The serum concentration of ICTP significantly increased from 4.45 ± 2.58 ng/mL to 5.31 ± 2.92 ng/mL (p < 0.10). Both FAC and BBS scores significantly improved from 1.0 ± 0 to 1.33 ± 0.5 (p < 0.1) and from 7.22 ± 10.02 to 15.78 ± 14.81 (p < 0.01), respectively. Conclusions: The findings of this pilot study suggest that walking exercise may improve bone health by initiating a bone remodeling process in chronic non-ambulatory stroke survivors. [ABSTRACT FROM AUTHOR]

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This study models the rainfall-runoff relationship in the Kebir-Rhumel River watershed in the Constantine Highlands, Algeria, using data from three concomitant rainfall and hydrometric stations. Statistical tests confirmed the absence of breaks in the series. We applied four conceptual models (GR4J, IHAC6, MORDOR, TOPMO8) and neural network models (RNN, NARX, LSTM) over three- and ten-year periods. Among the conceptual models, GR4J provided the best fit, highlighting the non-stationary nature of the relationship. The PMC neural network model performed well over three years but was less effective over ten years due to low flow influence. Notably, the NARX-RNN and RNN-LSTM models showed excellent predictive accuracy, with NARX-RNN perfectlycapturing flow dynamics and RNN-LSTM achieving minimal RMSE and high correlation coefficients. This study lies the comparative analysis of conceptual and neural network models, specifically the NARX-RNN and RNN-LSTM models, which have not been extensively applied in this context. This research fills the gap in understanding the effectiveness of neural network models in modelling non-stationary rainfall-runoff relationships in the region. [ABSTRACT FROM AUTHOR]

Background and Objective: Pakistan, a South Asian developing country, is experiencing a rapid increase in number of diabetes cases. High prevalence ratio of diabetes in Pakistani population and lack of genetic research studies prompted us to design this study. This present study investigated Pakistani Pashtun population for (known and novel SNPs) and its possible correlation with Type-2 Diabetes Mellitus (T2DM). Methods: This two stage (discovery & validation stage), case-control association study included one thousand individuals (Patients with T2DM=500 & controls=500) from eight districts of Khyber Pakhtunkhwa Pakistan. The study duration/period was from March 2018 to January 2020. In the first stage (the discovery stage) the target population was screened for known and novel T2DM-associated genetic markers. In the validation stage, identified variants were confirmed for T2DM association using MassARRAY genotyping and association analysis. Results: Exome sequencing detected eleven known and four novel/new genetic markers in the study population. Novel variants were preferred over the known for follow-up analysis/validation. Among the identified variants strong associations were confirmed for the following variants; rs1781133/ANKRD65 (OR=2.10, 95%Cl=1.06-3.08, P=0.003) rs2274791/TTLL10 (OR=1.97, 95%Cl=1.36-2.62, P=0.025), rs71628928/RNF223 (OR=1.82, 95%Cl=0.97-1.92, P=0.041), and rs609805/SCNN1D (OR=2.21, 95%Cl=1.92-3.09, P=0.001) with T2DM; other reported variants showed no noticeable association (having P>0.05) with T2DM. Conclusion: This study reports new genetic risk variants for T2DM in Pashtun population providing valuable insights into the genetic basis of T2DM in this group. [ABSTRACT FROM AUTHOR]

Objectives Examine electronic health record (EHR) use and factors contributing to documentation burden in acute and critical care nurses. Materials and Methods A mixed-methods design was used guided by Unified Theory of Acceptance and Use of Technology. Key EHR components included, Flowsheets , Medication Administration Records (MAR), Care Plan , Notes , and Navigators. We first identified 5 units with the highest documentation burden in 1 university hospital through EHR log file analyses. Four nurses per unit were recruited and engaged in interviews and surveys designed to examine their perceptions of ease of use and usefulness of the 5 EHR components. A combination of inductive/deductive coding was used for qualitative data analysis. Results Nurses acknowledged the importance of documentation for patient care, yet perceived the required documentation as burdensome with levels varying across the 5 components. Factors contributing to burden included non-EHR issues (patient-to-nurse staffing ratios; patient acuity; suboptimal time management) and EHR usability issues related to design/features. Flowsheets , Care Plan , and Navigators were found to be below acceptable usability and contributed to more burden compared to MAR and Notes. The most troublesome EHR usability issues were data redundancy, poor workflow navigation, and cumbersome data entry based on unit type. Discussion Overall, we used quantitative and qualitative data to highlight challenges with current nursing documentation features in the EHR that contribute to documentation burden. Differences in perceived usability across the EHR documentation components were driven by multiple factors, such as non-alignment with workflows and amount of duplication of prior data entries. Nurses offered several recommendations for improving the EHR, including minimizing redundant or excessive data entry requirements, providing visual cues (eg, clear error messages, highlighting areas where missing or incorrect information are), and integrating decision support. Conclusion Our study generated evidence for nurse EHR use and specific documentation usability issues contributing to burden. Findings can inform the development of solutions for enhancing multi-component EHR usability that accommodates the unique workflow of nurses. Documentation strategies designed to improve nurse working conditions should include non-EHR factors as they also contribute to documentation burden. [ABSTRACT FROM AUTHOR]

Background: Nurses play a critical role in delivering healthcare services, and their perception of the quality of those services is critical to better patient care. This study aimed to capture nurses' perceptions of healthcare services in India. Materials and Methods: An exploratory study design was adopted. 554 nurses from selected public and private hospitals in Kerala, India, were randomly selected for the study. The data were analyzed quantitatively with SPSS 23.0. Results: The perception of nurses in all dimensions of the HQP is observed as high (>3.5), with the exception of their involvement in quality management, which is reported as medium (2.5–3.49). Further, a significant difference between public and private hospitals (p < 0.05) is observed for all variables, except for the perceived effectiveness of quality improvement (p = 0.81) and the availability of training and development opportunities (p = 0.80). Additionally, nurses working in accredited hospitals (mean = 3.78) have more positive perceptions than non-accredited hospitals (mean = 3.69) (p < 0.05). Female nurses show a significantly more positive attitude toward the quality of health services than their male colleagues. Conclusion: The participating nurses were aware of various aspects of the quality management systems in their respective hospitals. In addition, the public and private hospitals and the accredited and non-accredited hospitals differed in their quality practices, as reflected in the nurses' voices. This study would help healthcare policy planners enhance the quality of the public sectors in India. [ABSTRACT FROM AUTHOR]

Purpose: To investigate functional, oncological and complication outcomes in women undergoing robot-assisted cystectomy (RARC) with intracorporeal orthotopic neobladder. Methods: From a multi-institutional database, we identified females with bladder cancer treated with RARC and intracorporeal orthotopic neobladder. We evaluated the continence rate, short-term oncological outcomes, and complication rates. Analyses were repeated and stratified by the status of preserving gynecological organs. Results: The study involved 146 patients with the median age 60 years (IQR, 51–66 years). Pelvic organ-preserving procedure (POP) was performed in 77 patients (53%). Overall daytime and nighttime continence rates were 54% and 53%, respectively. For POP, the continence rate was 58% for both daytime and nighttime continence. In the non-POP cohort, the continence rate was 50% for daytime and 49% for nighttime continence. Both groups had balanced positive surgical margin rates (5,3% for POP and 4,7% for non-POP). In the whole cohort, high-grade (Clavien-Dindo ≥3) early and late complication rate was 7,5% and 7,5%, respectively. Conclusions: Robot-assisted radical cystectomy with intracorporeal orthotopic neobladder in females demonstrate excellent functional and complication outcomes. Pelvic organ-preserving cystectomy enhances urinary continence rates without adversely affecting surgical margins. Orthotopic neobladder in selected women with bladder cancer, along with pelvic organ-preserving cystectomy may be used for improved functional outcomes without compromising oncological results. [ABSTRACT FROM AUTHOR]

Background: Burnout syndrome is marked by three primary domains: emotional exhaustion, depersonalization, and low personal accomplishment. This study assessed the prevalence of burnout syndrome among anesthesiologists, anesthesia technicians, and intensive care unit (ICU) nurses in Palestinian hospitals. In addition, this study also sought to assess associations and identify the factors that can predict higher burnout among anesthesiologists, anesthesia technicians, and ICU nurses. Methods: This study was conducted in a cross-sectional design using a questionnaire between October 2023 and December 2023. The questionnaire collected the demographic variables of the healthcare providers, their living conditions, lifestyle, working conditions, job satisfaction, and intention to change the profession. The healthcare providers were included from 12 different hospitals. Burnout syndrome was assessed using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS-MP). Results: A total of 250 healthcare providers were invited to participate in this study, of those, 212 completed the questionnaire, giving a response rate of 84.8%. Of the healthcare providers, 72 (34.0%) were anesthesiologists, 41 (19.3%) were anesthesia technicians, and 99 (46.7%) were ICU nurses. Of all healthcare providers, 151 (71.2%) reported emotional exhaustion, 125 (59%) reported depersonalization and 145 (68.4%) reported a lack of personal achievement based on the MBI-HSS-MP criteria for burnout. Multiple linear regression showed that higher emotional exhaustion scores could be predicted by the number of working hours per day (p-value = 0.039) and higher depersonalization scores could be predicted by having children (p-value = 0.001). On the other hand, lower personal achievement scores could be predicted by having children (p-value = 0.006), not owning a car (p-value = 0.036), and having more night shifts (p-value = 0.049). Conclusions: The findings of this study indicated that burnout syndrome was prevalent among anesthesiologists, anesthesia technicians, and ICU nurses in Palestinian hospitals. Healthcare authorities and professional bodies should consider designing interventions to reduce burnout and improve the psychological well-being of anesthesiologists, anesthesia technicians, and ICU nurses. Further studies are required to identify the most effective interventions for reducing burnout among anesthesiologists, anesthesia technicians, and ICU nurses in Palestine. [ABSTRACT FROM AUTHOR]

This research aims to develop a perovskite ceramic with optimized electrical and dielectric properties for applications in energy storage, medical technologies, and electronic devices. A bismuth ferric titanate compound, Bi0.9Ba0.1Fe0.8Ti0.2O₃, doped with barium at the A-site, was successfully synthesized using the sol–gel method. X-ray diffraction at room temperature confirmed a rhombohedral structure within the R3́C space group. Scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX) revealed an average grain size of 273 nm with uniform grain distribution and chemical composition. The study identified a clear correlation between temperature, frequency, and the material’s electrical characteristics. Impedance spectroscopy and electrical modulus analysis, conducted over a frequency range of 1 kHz to 1 MHz and temperatures between 260 and 340 K, indicated non-Debye relaxation behavior. Additionally, the material’s frequency-dependent electrical conductivity, analyzed through Jonscher’s law at various temperatures, showed that barium doping significantly enhanced conductivity and dielectric properties compared to undoped BiFeTiO₃. Consistent conduction and relaxation mechanisms were observed across the entire temperature range, highlighting the material's potential for use in capacitors and electric fields over a wide range of conditions. [ABSTRACT FROM AUTHOR]

This research aims to develop a perovskite ceramic with optimized electrical and dielectric properties for applications in energy storage, medical technologies, and electronic devices. A bismuth ferric titanate compound, Bi0.9Ba0.1Fe0.8Ti0.2O₃, doped with barium at the A-site, was successfully synthesized using the sol–gel method. X-ray diffraction at room temperature confirmed a rhombohedral structure within the R3́C space group. Scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX) revealed an average grain size of 273 nm with uniform grain distribution and chemical composition. The study identified a clear correlation between temperature, frequency, and the material’s electrical characteristics. Impedance spectroscopy and electrical modulus analysis, conducted over a frequency range of 1 kHz to 1 MHz and temperatures between 260 and 340 K, indicated non-Debye relaxation behavior. Additionally, the material’s frequency-dependent electrical conductivity, analyzed through Jonscher’s law at various temperatures, showed that barium doping significantly enhanced conductivity and dielectric properties compared to undoped BiFeTiO₃. Consistent conduction and relaxation mechanisms were observed across the entire temperature range, highlighting the material's potential for use in capacitors and electric fields over a wide range of conditions. [ABSTRACT FROM AUTHOR]

Background: Worldwide, breast cancer has replaced lung cancer and has become the most commonly diagnosed malignancy. Breast cancer poses a significant burden on the health and quality of life of women and can lead to substantial physical burdens and significant psychological problems, including distress, anxiety, depression, and sexuality-related issues, including negative body image. This study was conducted to assess how women diagnosed with, treated, and/or receiving treatment for breast cancer perceived their body image. Methods: A cross-sectional study design was used to assess body image perceptions among Palestinian women diagnosed with breast cancer. The study was conducted in four different hospitals located in the West Bank of Palestine where women with breast cancer received their treatments or visited for follow-up care in the period between November 2023 and March 2024. An interviewer-administered questionnaire was used to collect the data. Body perception was assessed using the body image self-rating questionnaire for breast cancer (BISQ-BC). Results: In this study, 376 women with breast cancer completed the interviewer-administered questionnaire (response rate = 75.2%. The mean age of the women was 44.0 ± 5.3 years. Of the women, 74.7% agreed or strongly agreed that they cared about their body image. On the other hand, 43.1% of the women were not satisfied with their body image and 58.8% did not think that their body image was attractive. Multiple linear regression showed that younger age, employment status, living in cities, marital status, educational level, presence of comorbidities, and longer time passes since diagnosis with breast cancer were associated with the different aspects of body image perception and behavior. Conclusion: The findings of this study indicated that Palestinian women with breast cancer were concerned about their body image. The findings also indicated that breast cancer and its treatment posed a significant burden on the physical and psychosocial well-being of the affected women and impacted the different dimensions of their lives, including their perceptions of their body image. Patients with significant physical and body image changes might benefit from reconstructive surgeries, psychosocial support, cognitive behavioral therapy, and nutritional, and physical activity interventions. [ABSTRACT FROM AUTHOR]

In the present work, we study a fractional elliptic Kirchhoff-type problem that has a singular term. More precisely, we start by proving some properties related to the energy functional associated with the studied problem. Then, we use the variational method combined with the min–max method to prove that the energy functional reaches its global minimum. Finally, since the energy functional has a singularity, we use the implicit function theorem to show that the point where the minimum is reached is a weak solution for the main problem. To illustrate our main result, we give an example at the end of this paper. [ABSTRACT FROM AUTHOR]

Introduction: Melons are highly sought after worldwide due to their exquisite and delectable taste. However, the peels of these fruits, which are rich in phytochemicals and sustainable components for innovative culinary formulations, are often discarded as waste. Methods: This study explored the phytochemistry and valorization of three melon fruit, i.e., canary melon (Cucumis melo, var. Fonzy), watermelon (Citrullus lanatus, var. Augusta), and muskmelon (Cucumis melo, var. Cantaloupe), peels in food applications by incorporating into wheat flour biscuits. Peels of fruits were separated, dried and powders were extracted with 70% ethanol. Results and discussion: Comparing the muskmelon fruit peel to the peels of the other two fruits, the muskmelon fruit peel had the significantly (p < 0.05) high ash (8.36%), fiber (12.06%), fat (1.21%), protein (5.02%), mineral contents (Mg 233, Ca 364, K 1605, Fe 49.72, and Zn 2.39 mg/100 g), total phenolic content (167.49 mg GAE/100 g), total flavonoid content (79.16 mg QE/100 g) and total antioxidant activity (56.92 mg Trolox equivalent/100 g). Results of the antimicrobial experiments of three melon peels showed that extracts from all peels showed enough antimicrobial activities, nearly comparable to the reference drugs (ampicillin and nystatin), which still showed the highest inhibition zones. Among three extracts, highest zone of inhibition against three bacterial species, i.e., Bacillus cereus (12.03 mm), Escherichia coli (10.02 mm), and Streptococcus aureus (18.08 mm), and fungal species, i.e., Candida albicans (8.09 mm), Aspergillus niger (7.06 mm), and Mucor meihi (7.02 mm) was exhibited by muskmelon peel extract. Moisture, ash, fat, fiber, minerals, phenolics, flavonoids, and antioxidant activities of biscuits were increased as a result of incorporating peel flours. Correlation showed TPC and TAA were highly correlated in watermelon (10%; 1). Using principal component analysis, adding 5% canary watermelon peel powder to biscuits improved their healthful and active elements while maintaining sensory features. Baking with 10% muskmelon or watermelon peel powder boosted nutrition and antioxidant activity. After the control, biscuits fortified with 5% melon peel powder exhibited significantly (p < 0.05) high sensory scores. These findings highlight the value of melon peels as sustainable ingredients, promoting waste reduction and enhancing the dietary and functional benefits of food products. [ABSTRACT FROM AUTHOR]

Background: Oral dose formulations must be soluble in gastrointestinal fluids for systemic absorption. The solubility of meloxicam was determined in 16 different age-specific simulated gastric and intestinal media that mirrored the microenvironments in pediatrics and adults. Methods: The solubility of meloxicam in the 16 different age-specific simulated gastric and intestinal biorelevant media was assessed using the standard US pharmacopeial method. The molecular descriptors of meloxicam were used to assess its intestinal permeability. Results: Meloxicam exhibited low solubility in the age-specific simulated gastric media for fasted and fed states and in pediatrics and adults. Similarly, meloxicam exhibited low solubility in the age-specific simulated media that mirrored neonates fed cow milk-based formula. On the other hand, meloxicam exhibited high solubility in the rest of the age-specific pediatric and adult intestinal media that simulated the fasted and fed states. The pediatric-to-adult solubility ratios were outside the 80–125% range in 7 (58.3%) and was borderline in 1 (8.3%) out of the 12 calculated ratios. These findings indicated that the solubility of meloxicam showed clinically significant differences in 8 (66.7%) of the compared media. Conclusion: Meloxicam exhibited low solubility in the age-specific simulated gastric media and high solubility in the simulated intestinal media for adults and pediatrics. Moreover, the pediatric-to-adult solubility ratios may have clinically significant implications. These differences can be translated into a higher likelihood of failing to demonstrate bioequivalence of different formulations containing meloxicam and variabilities in the performance of these formulations. [ABSTRACT FROM AUTHOR]

Modern electrical power networks make extensive use of high voltage direct current transmission systems based on voltage source converters due to their advantages in terms of both cost and flexibility. Moreover, incorporating a direct current link adds more complexity to the optimal power flow computation. This paper presents a new meta-heuristic technique, named self-adaptive bonobo optimizer, which is an improved version of bonobo optimizer. It aims to solve the optimal power flow for alternating current power systems and hybrid systems AC/DC, to find the optimal location of the high voltage direct current line in the network, with a view to minimize the total generation costs and the total active power transmission losses. The self-adaptive bonobo optimizer was tested on the IEEE 30-bus system, and the large-scale Algerian 114-bus electric network. The obtained results were assessed and contrasted with those previously published in the literature in order to demonstrate the effectiveness and potential of the suggested strategy. [ABSTRACT FROM AUTHOR]

The primary aim of this investigation is to shed light on potential targets within the main protease Mpro, spike protein of SARS-CoV-2, and Angiotensine converting enzyme 2 (ACE2) for the exploration of novel inhibitors derived from therapeutic natural compounds originating from Atriplex halimus (AH). Many constituents were discerned within AH extracts through comprehensive gas chromatography/mass spectrometry (GC/MS). Notably, compounds, such as oleocanthal and methyl stearate, exhibited promising attributes across various biological activities, including inhibition of key proteins associated with SARS-CoV-2. Furthermore, absorption, distribution, metabolism, excretion, and toxicity (ADMET) settings were evaluated to explore the potential safety and viability of these compounds for pharmaceutical application, affirming their non-interference with human physiology and thus suggesting their suitability for pharmaceutical use. Catechin, epigallocatechin, and methyl stearate were discovered to be the compounds with the highest affinity to the studied protein showing a great potential to be inhibitors to COVID-19. Consequently, this discovery highlights Atriplex halimus as a promising candidate for utilization in combating the virus. In our study, several compounds from Atriplex halimus showed a significant inhibition activity against SARS-COV-2 Mpro and Spike protein, which promotes Atriplex halimus as a potential agent that can be used in the treatment of COVID-19. [ABSTRACT FROM AUTHOR]

Healthcare researchers are increasingly utilizing smartphone sensor data as a scalable and cost-effective approach to studying individualized health-related behaviors in real-world settings. However, to develop reliable and robust digital behavioral signatures that may help in the early prediction of the individualized disease trajectory and future prognosis, there is a critical need to quantify the potential variability that may be present in the underlying sensor data due to variations in the smartphone hardware and software used by large population. Using sensor data collected in real-world settings from 3000 participants' smartphones for up to 84 days, we compared differences in the completeness, correctness, and consistency of the three most common smartphone sensors—the accelerometer, gyroscope, and GPS— within and across Android and iOS devices. Our findings show considerable variation in sensor data quality within and across Android and iOS devices. Sensor data from iOS devices showed significantly lower levels of anomalous point density (APD) compared to Android across all sensors (p  <  1 × 10−4). iOS devices showed a considerably lower missing data ratio (MDR) for the accelerometer compared to the GPS data (p  <  1 × 10−4). Notably, the quality features derived from raw sensor data across devices alone could predict the device type (Android vs. iOS) with an up to 0.98 accuracy 95% CI [0.977, 0.982]. Such significant differences in sensor data quantity and quality gathered from iOS and Android platforms could lead to considerable variation in health-related inference derived from heterogenous consumer-owned smartphones. Our research highlights the importance of assessing, measuring, and adjusting for such critical differences in smartphone sensor-based assessments. Understanding the factors contributing to the variation in sensor data based on daily device usage will help develop reliable, standardized, inclusive, and practically applicable digital behavioral patterns that may be linked to health outcomes in real-world settings. [ABSTRACT FROM AUTHOR]

Corosolic acid (CA) is a well-known natural pentacyclic triterpene found in numerous therapeutic plants that can exhibit many bioactivities including anti-inflammatory and anti-tumor actions. The current investigation explores the chemoprotective roles of CA against azoxymethane (AOM)-induced colonic aberrant crypt foci (ACF) in rats. Thirty Sprague Dawley rats were grouped in 5 cages; Group A, normal control rats inoculated subcutaneously (sc) with two doses of normal saline and fed orally on 10% tween 20; Groups B-E received two doses (sc) of azoxymethane in two weeks and treated with either 10% tween 20 (group B) or two intraperitoneal injections of 35 mg/kg 5-fluorouracil each week for one month (group C), while group D and E treated with 30 and 60 mg/kg, respectively, for 2 months. The toxicity results showed lack of any behavioral abnormalities or mortality in rats ingested with up-to 500 mg/kg of CA. The present AOM induction caused a significant initiation of ACF characterized by an increased number, larger in size, and well-matured tissue clusters in cancer controls. AOM inoculation created a bizarrely elongated nucleus, and strained cells, and significantly lowered the submucosal glands in colon tissues of cancer controls compared to 5-FU or CA-treated rats. CA treatment led to significant suppression of ACF incidence, which could be mediated by its modulatory effects on the immunohistochemical proteins (pro-apoptotic (Bax) and reduced PCNA protein expressions in colon tissues). Moreover, CA-treated rats had improved oxidative stress-mediated cytotoxicity indicated by increased endogenous antioxidants (SOD and CAT) and reduced lipid peroxidation indicators (MDA). In addition, CA ingestion (30 and 60 mg/kg) suppressed the inflammatory cascades, indicated by decreased serum TNF-α and IL-6 cytokines and increased anti-inflammatory (IL-10) cytokines consequently preventing further tumor development. CA treatment maintained liver and kidney functions in rats exposed to AOM cytotoxicity. CA could be a viable alternative for the treatment of oxidative-related human disorders including ACF. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) has emerged as a promising tool for detecting and characterizing colorectal polyps during colonoscopy, offering potential enhancements in traditional colonoscopy procedures to improve outcomes in patients with inadequate bowel preparation. Aims: This study aimed to assess the impact of an AI tool on computer-aided detection (CADe) assistance during colonoscopy in this population. Methods: This case–control study utilized propensity score matching (PSM) for age, sex, race, and colonoscopy indication to analyze a database of patients who underwent colonoscopy at a single tertiary referral center between 2017 and 2023. Patients were excluded if the procedure was incomplete or aborted owing to poor preparation. The patients were categorized based on the use of AI during colonoscopy. Data on patient demographics and colonoscopy performance metrics were collected. Univariate and multivariate logistic regression models were used to compare the groups. Results: After PSM patients with adequately prepped colonoscopies (n = 1466), the likelihood of detecting hyperplastic polyps (OR = 2.0, 95%CI 1.7–2.5, p < 0.001), adenomas (OR = 1.47, 95%CI 1.19–1.81, p < 0.001), and sessile serrated polyps (OR = 1.90, 95%CI 1.20–3.03, p = 0.007) significantly increased with the inclusion of CADe. In inadequately prepped patients (n = 160), CADe exhibited a more pronounced impact on the polyp detection rate (OR = 4.34, 95%CI 1.6–6.16, p = 0.049) and adenomas (OR = 2.9, 95%CI 2.20–8.57, p < 0.001), with a marginal increase in withdrawal and procedure times. Conclusion: This study highlights the significant improvement in detecting diminutive polyps (< 5 mm) and sessile polyps using CADe, although notably, this benefit was only seen in patients with adequate bowel preparation. In conclusion, the integration of AI in colonoscopy, driven by artificial intelligence, promises to significantly enhance lesion detection and diagnosis, revolutionize the procedure's effectiveness, and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Esophageal food impaction (EFI) is a common complaint of patients presenting to the emergency department. EFI requires urgent evaluation by the gastroenterology service and often necessitates esophagogastroduodenoscopy (EGD) for management. Timing of EGD in patients with EFI that does not improve with medical management remains a point of contention. We aim to evaluate outcomes of EFI in the context of time to intervention. Methods: A retrospective cohort study was performed among patients who presented to a multicenter health system with EFI between 2018 and 2022. Patients with EFI that did not resolve after medical management and required EGD were included. Outcome analysis evaluated rates of complications and hospitalizations. Results: Two hundred eighty sis unique patient presentations were included. 175 (61.2%) of patients underwent EGD within six hours of presentation, 59 (20.6%) underwent EGD six to twelve hours after presentation, and 52 (18.2%) underwent EGD beyond twelve hours after presentation. Complication rates did not differ between patients depending on timing of EGD (p = 1.000). Admission rates were higher among patients in whom EGD was performed longer after presentation (p = 0.003). Complication rates were higher among patients with advanced age (p = 0.037), prior impaction (p = 0.004), and those who have not received glucagon (p = 0.007). Conclusion: Timing of EGD after presentation in patients with EFI was not associated with a difference in complication rates. Delayed intervention was associated with a higher rate of hospitalization which should be taken into consideration when assessing the cost of EFI to the healthcare system. [ABSTRACT FROM AUTHOR]

Background: Individuals with disabilities are more likely to use substances and have cardiovascular disease (CVD) than individuals without disabilities. CVD is associated with drug use, which increases the risk for poor CVD outcomes. Our aim was to test the association between CVD and lifetime drug use (LDU) among those with vision loss (VL) and/or hearing loss (HL) and assess if disability type moderated this association. Methods: Multivariable logistic regression incorporating complex survey design was used to estimate adjusted odds ratios (AOR) using data from NHANES 2013–2018. Results: Although not quite statistically significant (p ≥.05), the magnitude of effect modification was large. The effect was positive among those with VL (AOR = 1.55, 95% confidence interval (CI) = 0.73, 3.30) or HL (AOR = 1.69, 95% CI = 0.56, 5.11), but among those with both CVD was associated with 75% lower odds of LDU (AOR = 0.25, 95% CI = 0.06, 1.05). After adjusting for multiple comparisons, the CVD effect was significantly different between those with VL versus both VL and HL (p <.05), and nearly significantly different between those with HL versus both (p ≥.05). Conclusions: Additional research could focus on the relationship between CVD and LDU among persons with sensory disabilities. [ABSTRACT FROM AUTHOR]