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Abstract Background This study investigated the effect of B. Subtilis bacteria on the properties of cement mortar. This was done by using soil samples from Sharkia, Egypt, to isolate 48 bacterial strains, after which they were cultured using the Johnson method and various media. Bacteria were then added to the cement mortar in amounts of 5% and 10% by weight to evaluate their effect on the mechanical and chemical properties of the modified mortar. Results The study examined the compressive and flexural strength of the modified mortar over time, as well as its microscopic properties and chemical composition after 28 days. The results indicated that bacterial additions of 5% and 10% increased the compressive strength of the mortar after 28 and 56 days compared to the control. A 5% bacteria concentration resulted in significant improvements in strength, showing the best concentration for increasing mortar strength. The addition of 5% bacteria significantly enhanced the early flexure strength, while the 10% showed superior long-term strength after 56 days. Scanning electron microscopy (SEM) revealed high CaCO3 deposits in the bacterial samples, indicating microbial-induced calcite precipitation that filled the small cracks and increased strength. Fourier-transform infrared spectroscopy (FTIR) confirmed the presence of hydroxyl, carbonate, and silicate groups, with bacterial samples having a higher carbonate content, indicating an increase in calcium carbonate formation and microstructure. Conclusions The ideal bacterial concentration was 5% as it improved the compressive and flexural strength while also promoting a more flexible microstructure. This study supports the employment of microorganisms in the production of more durable and environmentally friendly building materials, enhancing the sustainability of building practices.

Abstract Background Acute pulmonary embolism (PE) is a serious and potentially fatal condition that is relatively rare in the pediatric population. In patients presenting with massive/submassive PE, catheter-directed Therapy (CDT) presents an emerging therapeutic modality by which PE can be managed. Methods Electronic databases were systematically searched through May 2024. This systematic review was performed in line with recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines and was registered in PROSPERO (Reg. no. CRD42024534229). Results Sixteen case reports/series were included in the quantitative analysis with a total population of 40 children diagnosed with PE. Of them, 21 were females and 19 were males. Massive PE was diagnosed in 15 patients and submassive PE was diagnosed in 17 patients. Complete resolution of PE happened at a rate of 68% (95%CI = 46–80%). Mortality was encountered at a rate of 18% (95%CI = 0.7–36%). PE recurred after CDT at a rate of 15% (95%CI = 2–28%). Non-major bleeding complicated CDT at a rate of 46% (95%CI = 25–66%, p = 0.163). Conclusion CDT can be utilized in the management of PE in children as a potential therapeutic option for selected patients. While the results of CDT interventions for pediatric PE are promising, further research -including well-conducted cohort studies- is required to validate those results.

Abstract 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 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.

In the dynamic field of cybersecurity within intelligent vehicle systems, the sophistication of threats necessitates continual advancemenThe purpose of this study is to: (1) evaluate the technological skills of the final-year undergraduate students, (2) how such abilities influence their likelihood of getting employed and (3) student opinions on whether a computer lab-based specialization in software training can boost employability. This study is a survey-based methodology. The sample size encompasses 140 final year students in the College of Business Administration at Prince Sattam bin Abdulaziz University during the academic year 2023-2024. Descriptive statistical analyses indicate that most students believe they have sufficient technical skills but not enough for securing better jobs. Moreover, it is clear among them that expertise in specialized software packages enhances career prospects significantly. The research results also show a huge gap between technological competencies learners have now and what employers demand currently. In response, this study suggests that PSAU should establish software laboratories in their colleges for specialized training on software as required by the job market and workplace. The Vice Rectorate for Academic and Educational Affairs launches a program called “Graduate and Professional Skills Development Program (PSAU-GPSDP)”, which emphasizes student employability as it develops, implements, and evaluates mechanisms to enhance students’ chances of getting jobs upon graduation. The results of this study are in line with SDG No. 8 (Decent Work and Economic Growth), SDG No. 4 (Quality Education), and Saudi Vision 2030. Therefore, this study has practical implications for decision-makers at the Ministry of Education and university levels, university professors, researchers on how employability skills of students could be enhanced in the higher education institutions.

Seizures, characterized by excessive electrical discharges in the brain, can lead to severe complications, including cardiac arrhythmias and Takotsubo syndrome, a form of stress-induced cardiomyopathy mimicking acute coronary syndrome. We present a case of a 66-year-old female with epilepsy and postcerebrovascular accident status who experienced a 45-minute seizure resulting in elevated troponin levels and ECG changes. Echocardiography revealed severe hypokinesia and hyperkinesia with a left ventricular ejection fraction of 30%-35%, and coronary angiography was normal, leading to the diagnosis of a variant of Takotsubo syndrome characterized by basal rather than apical dysfunction. The patient showed significant improvement after 96 hours in the coronary care unit following adjusted anti-seizure medications and supportive cardiac care. This case highlights the importance of recognizing and managing cardiac complications such as Takotsubo syndrome in patients with neurological events, emphasizing the need for close collaboration between neurology and cardiology to improve patient outcomes.

Addressing high carbon footprints is a critical global problem in cement production. Using environmentally friendly materials has proven to be a solution to environmental challenges. In this study, High-Strength Concrete of M60 is produced with Natural Zeolite and industrial waste materials. The combinations of 5 % zeolite and varying percentages of industrial wastes such as Silica Fume, Metakaolin, and Fly Ash are tested for mechanical properties. The laboratory test data is compared with numerical simulations to assess the accuracy and determine the error percentage for concrete strength predictions. The process involves the development of numerical solutions by ANSYS to predict strength. The developed numerical solution determines the accuracy of identifying the difference between the experimental and numerical data. The present research on the comparison of experimental and numerical data by ANSYS showed the lowest error percentage, which is acceptable for all the strength properties of concrete.

Abstract 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 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

Abstract 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.

This paper presents the morphology of the metakaolin/dolomite geopolymer after being exposed to high temperature and compare the findings with the morphology that has not been exposed to the temperature. The geopolymers were exposed at temperatures from 200°C up to 800°C. The geopolymer was a constant mix of 90% metakaolin and 10% dolomite with 10 NaOH molarity, 0.8 solid to liquid ratio, and 2.0 by mass of alkaline activator. The morphology of geopolymer exposed to high temperature contains many pores and as the temperature rises, the pores become huge, and a higher quantity of pores can be observed. The surface analysis, compressive strength, and water absorption test were also done to support the findings. The compressive strength calculation was based on weight loss. The lowest compressive strength loss was at 200°C temperature exposure with 10.98%. Meanwhile, the highest compressive strength loss was at 800°C temperature exposure with 48.54%. In comparison, this metakaolin/dolomite geopolymer archive better properties compared to the concrete and metakaolin past studies.

Lead, a hazardous environmental metal, has been widely used in various applications, either pure or alloyed with other metals. This study investigates the impact of foaming agents and surfactants content on the physical properties of metakaolin-based alkali activated materials. Additionally, it seeks to assess the effectiveness of metakaolin-based AAM adsorbent in removing lead ions. The research uses varying percentages of foaming agents (1 wt.%, 1.25 wt.%, and 1.5 wt.%) and surfactants (1 wt.%, 3 wt.%, and 5 wt.%). Water absorption, density and porosity tests were used to evaluate the metakaolin-based alkali activated adsorbent’s physical properties. Scanning Electron Microscopy (SEM) was used to study the morphology of the adsorbent. In addition, the adsorption test was investigated to determine the lead ion removal in the AAM adsorbent. The ion removal performance of metakaolin based alkali activated materials was evaluated based on different amounts of foaming agent and surfactant. A lead (II) solution was prepared in distilled water and used in the adsorption test. An adsorption test was carried out to determine the effectiveness of AAM with a foaming agent and surfactant, which showed that it could be suited to many harsh conditions. This study successfully identified the optimal parameters for achieving maximum efficiency in lead ion removal, featuring a concentration of 1.25 wt.% of foaming agent and 3 wt.% of surfactants. These findings hold significant promise for the advancement of effective adsorbents, particularly in the realm of wastewater treatment processes.

The presence of nickel ions in wastewater is a significant environmental concern due to its toxicity, which can cause severe health problems. Metakaolin is a pozzolanic material that can be activated by alkali to produce a highly porous and reactive material that can be utilised as a heavy metal ion adsorbent. However, the adsorption capacity of metakaolin-based adsorbents is limited by their surface chemistry and porosity. Metakaolin-based alkali-activated materials adsorbent modified with hydrogen peroxide can effectively remove nickel ions from wastewater. The modification process increases the surface area and porosity of the adsorbent, enhancing its adsorption capacity. The modified adsorbent (1.00 wt.% H2O2) showed a higher sorption capacity of 26.57 mg/g and efficiency of 85.22% compared to the non-modified adsorbent (10.55 mg/g) sorption capacity and 45.63% nickel removal efficiency, indicating the potential of hydrogen peroxide-modified adsorbents as an economical and ecologically sustainable solution for environmental applications, particularly for metal immobilization.

The degradation of the condition of wastewater is becoming more and more serious due to the endless development. One of the main reasons is heavy metal contamination, which causes significant harm to the climate and humanity, such as bad health consequences, environmental degradation, and air pollution. Adsorption, which uses proven adsorbents such as activated carbon, is one of the most common methods for heavy metal removal in wastewater. However, since activated carbon is very expensive to build and repair due to complex production, most people choose another material to overcome this problem. Researchers have recently focused on finding low-cost adsorbents, which are typically industrial, agricultural and food wastes that can generate in large quantities. However, Alkali-Activated Materials (AAMs) have been recognized as a novel possible adsorbent because they are cheap, made from solid aluminosilicate and extremely alkaline activator solution, making them appropriate for usage in the civil engineering specialty. Moreover, they have become an option for various applications due to their unique geopolymer structure, which is highly mechanically, chemically and thermally stable. Hydroxyapatite (HAP) can be extremely useful in this application, as it is a promising biomaterial that has great potential for a low-cost AAMs adsorbent. The purpose of this study is to analyze the present development of a potential economic alternative adsorbent, particularly based on alkali-activated materials (known as geopolymers), for the elimination of heavy metal pollutants in wastewater using adsorption techniques.

Abstract 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 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

Exploring hidden patterns in medical data sets is made possible by the huge potential of medical data mining. A clinical diagnosis can be made with the help of these patterns. Research on bio-inspired algorithms is a recent development. Its primary benefit is its ability to weave together social behavior, emergence, and connectionism subfields. In a nutshell, it involves modeling live phenomena using computers while studying life to make better computer applications. This chapter describes the application of five bio-inspired algorithms, including metaheuristics, to classify seven distinct real health-related information sets. While the other two of these methods rely on random population creation to create classification rules, the other two rely on the computation of similarity between the data used for training and testing. The outcomes demonstrated that bio-inspired supervised medical data classification methods were incredibly effective.

Introduction: Neck ultrasonography (US) and fine-needle aspiration (FNA) biopsy are usually used to evaluate thyroid nodules. This study aimed to evaluate the performance of two popular thyroid imaging reporting systems in detecting thyroid malignancy and to evaluate the correlation between thyroid autoimmunity, nodule site, and size in the development of malignancy. Methods: This prospective study was conducted from January 2019 to July 2021 in Basrah, Iraq. The American Thyroid Association (ATA) and American College of Radiology-Thyroid Imaging Reporting and Data (ACR-TIRAD) systems were used to evaluate the malignant potential of 143 thyroid nodules in 131 patients. Results: The sensitivity and positive predictive value (PPV) of the ATA system for detecting malignancy were 96% and 20.8% for low-risk and 100% and 4.3% for high-risk nodules, respectively. ACR-TIRAD sensitivity and PPV were 84% and 22.1% for low-risk and 80% and 4.2% for high-risk nodules, respectively. The specificity and negative predictive value (NPV) of the ATA system for detecting malignancy were 11.6% and 92.3% for low-risk and 10.5% and 100% for high-risk nodules, respectively. The ACR-TIRAD specificity and NPV were 28% and 87.8% for low-risk and 26% and 96.9% for high-risk nodules, respectively. The strength of the correlation between FNA performed across different Bethesda categories and age, sex, nodule size, and positive thyroid peroxidase (TPO) antibodies were 0.25, 0.01, 0.22, and 0.4, respectively. Conclusion: Both systems are effective; however, adopting TI-RADS stratification results in fewer biopsies being performed for thyroid nodule assessment. Only sex was found to be significantly correlated with FNA performance in thyroid-nodule evaluation.

Abstract Background Radiologic evaluation is crucial in minimizing transplant complications and guaranteeing the donor’s safety, as a variety of anatomical variations characterizes hepatic vascularity. Computed tomographic angiography (CTA) is the gold standard in hepatic vascularity evaluation in donors before liver transplantation. Still, the procedure necessitates intravenous contrast medium injection, which entails nephrotoxicity risk and hypersensitivity reactions. These concerns about contrast medium safety encouraged new developments in non-contrast-enhanced magnetic resonance angiography (NC-MRA) techniques for imaging the vascular anatomy of the liver. Results This study was conducted on 40 patients of potential liver donors. Thirty-six cases (90%) showed excellent image quality by CTA versus 14 cases (35%) by NC-MRA; on the other hand, 21 cases (52.5%) showed good image quality by NC-MRA while versus 2 cases (5%) by CTA and NC-MRA documented 5 cases (12.5%) with fair image quality versus two cases documented by CTA. Both modalities provided diagnostic image quality in all cases. Michel’s classification was employed to identify four distinct kinds of hepatic artery anatomy using CTA. Thirty-nine cases out of 40 were successfully identified using NC-MRA. Segment IV hepatic artery origin could not be identified in 6 cases using NC-MRA versus one case using CTA. Artifacts were noted in 20 cases (50%) using NC-MRA versus 2 cases (5%) using CTA. Conclusion CTA is the gold standard for pre-liver transplant donor evaluation. The emerging technology of non-contrast MRA has an added value with fewer patient complications. It may function as an additional donor examination when CTA is unable to provide adequate diagnostic information. Non-contrast MRA yields reliable results and eliminates the necessity for contrast medium and additional radiation exposure.

Background Celiac disease (CD) is an autoimmune disorder in which genetically susceptible individuals cannot digest gluten (wheat) and its homologs such as Scalin (rye) and Hordein (barley). Aim This systematic review and meta‐analysis aimed to investigate the measures of associations between CD and psychiatric disorders, specifically anxiety and depression, and explore the relationship between adherence to a Gluten‐Free Diet (GFD) and the psychiatric aspects of the disease. Methods We searched PubMed, Scopus and Web of Science for articles investigating anxiety and depression in CD patients. The following inclusion criteria were implemented: Primary research articles (either observational or experimental) that include participants with a CD diagnosis ‐confirmed either serologically, with anti‐endomysial antibodies, anti‐tissue transglutaminase antibodies, or with duodenum biopsy, whether on a GFD or not,—who have depression or anxiety symptoms identified through self‐report or clinician‐administered scales. Results CD patients are at a higher odds of developing anxiety, as the odds ratio was (OR: 2.26, 95% CI: [1.10, 4.67]) and depression symptoms (OR: 3.36, 95% CI: [1.36, 8.32]). Results of both State‐Trait Anxiety Inventory Y‐1 and Y‐2 improved after 1 year of GFD with mean difference of 3.48, 95% CI: (0.26, 6.71), and MD: 3.45, 95% CI: (1.39, 5.52), respectively. Conclusion Anxiety and depression are prevalent among adults and children CD patients as they are observed to have high odds of anxiety and depression as expressed by various scales. It is reported that GFD is associated with decreased levels of anxiety and depression, however, further studies are required to confirm these findings and to investigate the main mechanism of psychiatric disorders among CD patients.

Abstract 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 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

Abstract 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. Graphical Abstract

Background: Type I diabetes mellitus (T1DM) is one of the most common chronic autoimmune diseases worldwide. miRNAs are a class of small non-coding RNA molecules that have been linked to immune system functions, β-cell metabolism, proliferation, and death, all of which contribute to pathogenesis of TIDM. Dysregulated miRNAs have been identified in Egyptian TIDM patients. Aim: Several miRNAs were profiled in Egyptian TIDM patients to determine whether they can be used as molecular biomarkers for T1DM. The relationship between the investigated miRNAs and pro-inflammatory cytokines (TNF-α and IL-6) has also been evaluated in the development of TIDM, in addition to the creation of a proposed model for TIDM prediction. Patients & methods: Case-control study included 177 Egyptian patients with confirmed type I diabetes mellitus and 177 healthy individuals. MiRNA-34 and miRNA-146 were detected in serum samples using real-time PCR, whereas TNF-α and IL-6 levels were assessed using ELIZA. Results: Patients with TIDM showed a significant decrease in the expression of miRNA-146, with a cut-off value ≤ 3.3, 48 % specificity, and 92.1 % sensitivity, whereas miRNA-34 had the highest sensitivity (95.5 %) and specificity (97.2 %) for differentiating diabetic patients from controls. Furthermore, other diagnostic proinflammatory markers showed lower sensitivity and specificity. Conclusion: Serum levels of miRNA-34a, miRNA-146, IL-6, and TNF-α provide new insights into T1DM pathogenesis and could be used for screening and diagnosis purposes. They can be also a potential therapeutic target, as well as allowing for more strategies to improve T1DM disease outcomes.

Background: Childhood cancer rates in Africa are lower than in high-income countries but increasing, making pediatric cancers a significant public health concern. The purpose of this study was to provide an overview of the publication of pediatric cancer research in Africa, including publication types and citation trends over time. Methods: The Science Citation Index Expanded database within the Web of Science Core Collection was searched for articles published from 1991 to 2022 in the topic domain, using title, abstract, author keywords, and KeyWords Plus. Indicators used to assess publications performance of the countries included: total number of publications, single-country publications, collaborative publications with African countries, collaborative publications with non-African countries, first-author publications, corresponding-author publications, and single-author publications. Results: A total of 4461 relevant documents were retrieved, with 2770 original research articles. Annual number of articles rose from 13 articles in 1991 to 287 in 2022. Most articles were produced by Egypt (28 %) in North Africa, followed by South Africa (20 %) in sub-Saharan Africa. Collaboration between African countries remains low; however, international collaborations have enhanced the average number of citations per article. Most of the first authors (65 %) and corresponding authors (67 %) of these international collaborative articles were affiliated with non-African institutions. Conclusions: The number of publications sharply increased over the study period and diversely represents African countries. Collaborations with international partners increased citations; however, few of these publications had African first authors. Conversely, inter-institutional partnerships between African countries were relatively low, highlighting the need for better collaboration within Africa.

Multiple system atrophy is a rare and quickly progressing neurological condition characterized by autonomic failure, parkinsonism, or cerebellar ataxia. It is classified into two subtypes: MSA with predominant parkinsonism (MSA-P) and MSA with predominant cerebellar ataxia (MSA-C). We are presenting here a 54-year-old male with parkinsonism, ataxia, and dysarthria. He was diagnosed with parkinson disease and was given a maximum dose of levodopa but has not responded. After a close neurological evaluation with magnetic resonance imaging of the brain, which shows atrophy of the cerebellum and a brainstem with a hot cross bun sign of the pons, suggestive of multiple system atrophy, he was diagnosed with multiple system atrophy cerebellar type, which is the first time to have this diagnosis in Somalia, which is a low-resource country.

Objective: This study investigated the ability of Large Language Models (LLMs) to provide accurate and consistent answers by focusing on their performance in complex gynecologic cancer cases. Background: LLMs are advancing rapidly and require a thorough evaluation to ensure that they can be safely and effectively used in clinical decision-making. Such evaluations are essential for confirming LLM reliability and accuracy in supporting medical professionals in casework. Study design: We assessed three prominent LLMs—ChatGPT-4 (CG-4), Gemini Advanced (GemAdv), and Copilot—evaluating their accuracy, consistency, and overall performance. Fifteen clinical vignettes of varying difficulty and five open-ended questions based on real patient cases were used. The responses were coded, randomized, and evaluated blindly by six expert gynecologic oncologists using a 5-point Likert scale for relevance, clarity, depth, focus, and coherence. Results: GemAdv demonstrated superior accuracy (81.87 %) compared to both CG-4 (61.60 %) and Copilot (70.67 %) across all difficulty levels. GemAdv consistently provided correct answers more frequently (>60 % every day during the testing period). Although CG-4 showed a slight advantage in adhering to the National Comprehensive Cancer Network (NCCN) treatment guidelines, GemAdv excelled in the depth and focus of the answers provided, which are crucial aspects of clinical decision-making. Conclusion: LLMs, especially GemAdv, show potential in supporting clinical practice by providing accurate, consistent, and relevant information for gynecologic cancer. However, further refinement is needed for more complex scenarios. This study highlights the promise of LLMs in gynecologic oncology, emphasizing the need for ongoing development and rigorous evaluation to maximize their clinical utility and reliability.

Background. Q fever is the one of the best-studied zoonoses, which is widespread throughout almost the entire territory of Africa, excluding the territory of the Sahara. However, the current data on the incidence of coxiellosis and the circulation of Coxiella burnetii on this continent are limited and vary according different sources. In 1980–1990, the Soviet-Guinean Research Virology and Microbiology Laboratory conducted studies to estimate the distribution of the Q fever pathogen, assess the herd immunity in humans and identify specific antibodies in the sera of livestock. However, in subsequent years, the research was suspended. The aim of this study is to obtain up-to-date data on the distribution of C. burnetii in all landscape and geographical zones of the Republic of Guinea. Materials and methods. The study was carried out in the laboratory of the Russian-Guinean Center for Epidemiology and Prevention of Infectious Diseases (Kindia, Republic of Guinea). The study involved 332 sera of febrile patients and 3156 sera from practically healthy volunteers, 1074 blood samples of livestock, 1648 suspensions of ticks, 319 specimens of small mammals and 298 of bats. The study was carried out using ELISA and PCR methods, selected samples were subjected to in-depth genetic analysis. Results and discussion. The study of the distribution of C. burnetii on the territory of all landscape-geographical zones of the Republic of Guinea was carried out. For the first time, an officially registered case of human Q fever case has been identified. The role of livestock, small mammals and bats in the circulation of the pathogen has been established. It has been shown that the main vectors in Guinea are ixodid ticks of the Amblyomma variegatum, Hyalomma truncatum and Rhipicephalus decoloratus species. Employing molecular methods, C. burnetii strains carrying the QpH1 plasmid, capable of causing diseases in humans and animals were identified. For the first time, the complete nucleotide sequence of 16S rRNA of the Q fever pathogen (OQ152497–OQ152500) identified on the territory of Guinea was determined and registered in the GenBank database. Conclusion. Taking into account the high epidemiological significance of Q fever, the study of the specifics of C. burnetii circulation in Guinea remains an urgent task. Regular monitoring and assessment of risk factors for diseases caused by coxiella are necessary for the development of an algorithm for laboratory diagnosis and recommendations for clinicians.

Background: Infectious bovine rhinotracheitis (IBR) is a global contagious respiratory disease of ruminants caused by Bovine Herpes virus-1(BoHV-1). It causes substantial financial losses in the dairy industry worldwide and is considered one of the most important causative agents of abortion and reproductive problems in dairy cattle. Aim: This study aimed to estimate the seroprevalence of IBR and the related risk factors in the dairy population in Gharbia governorate, Egypt. Methods: A cross-sectional study was conducted to investigate the seroprevalence and associated risk factors of IBR in bovine dairy herds in Qutur district, Gharbia governorate, Egypt from March 2023 to February 2024. A total of 12 smallholder farms and six commercial dairy farms that didn't use vaccination protocol against BoHV-1 were randomly selected. Serum samples (n = 400) were collected from 360 cattle and 40 Italian buffaloes and were subjected to evaluation of the serological status of BoHV-1 using indirect ELISA. A multivariate logistic regression model was implemented to evaluate the strength of the risk factors associated with the infection. Results: The overall seroprevalence of IBR was 22.5% (95% CI: 18.5% - 26.9%). The prevalence of IBR in animals reared under traditional and commercial systems was 28.04% and 21.06%, respectively. The multivariate logistic regression revealed that the risk of infection with IBR in winter months was significantly higher than in autumn [OR = 5.9, CI 95%: 2.22-16.16]. The seroprevalence of IBR was higher in weaned and yearling calves than in adult cattle (P- value = 0.000). The risk of exposure to IBR infection was higher in free stall houses than in tie stall houses [OR = 3.7, CI 95%: 1.11-12.35]. The risk of seropositivity to IBR was significantly higher in animals with a history of recent respiratory manifestation than those without a history of recent respiratory problems (P- value = 0.000) Conclusion: This research study revealed that IBR is prevalent among dairy cattle reared under both production systems in the Gharbia governorate. Introducing an appropriate vaccination protocol becomes inevitable to protect our dairy industries from potential economic losses due to this disease. [Open Vet J 2024; 14(11.000): 2960-2969]

Abstract Breast cancer remains a leading cause of mortality among women worldwide. Our current research focuses on identifying effective therapeutic agents by targeting the human aromatase enzyme. Aromatase inhibitors (AIs) have been effective in treating postmenopausal breast cancer but face challenges such as drug resistance and long-term side effects like cognitive decline and osteoporosis. Natural products, especially from marine organisms, are emerging as potential sources for new drug candidates due to their structural diversity and pharmacological properties. This study aims to discover marine natural products capable of inhibiting human aromatase by combining ligand-based and structure-based pharmacophore models for virtual screening against the Comprehensive Marine Natural Products Database. From the initial virtual screening of more than 31,000 compounds, 1,385 marine natural products were identified as possible candidates. Following initial molecular docking analysis, only four compounds managed to pass the criteria this research has introduced to confirm strong binding affinity to aromatase. All four compounds yielded acceptable binding affinities, with CMPND 27987 having the highest −10.1 kcal/mol. All four hits were subjected to molecular dynamics, and CMPND 27987 was further confirmed to be the most stable at the protein’s active site, with an MM-GBSA free binding energy of −27.75 kcal/mol. Our in silico studies indicate that CMPND 27987 interacts effectively within the binding site of the human aromatase, maintaining high affinity and stability. Based on these findings, we propose that CMPND 27987 could hold significant potential for further lead optimization and drug development.

Abstract Objective This systematic review analyzed the recently available information regarding the efficacy of rigid taping in alleviating pain and improving functional status in subacromial impingement syndrome. Introduction Rigid taping is commonly utilized in the rehabilitation of subacromial impingement syndrome (SIS). It is proposed to have positive effects on alleviating pain and shoulder function, but the scientific evidence of its efficacy is still not clear. Methods An electronic search was conducted on Scopus, CINAHL, Cochrane Library, Web of Science, MEDLINE, Embase, EBSCO, Google Scholar databases, and a manual search from the bibliography of the included studies. Randomized trials (published between March 2010 and November 2023), which included rigid taping as an experimental or control treatment for the pain function state in subacromial impingement syndrome, assessed pain using the visual analog scale (VAS) or numeric pain rating scale (NPRS), and assessed functional status using Shoulder Pain and Disability Index (SPADI) or the Disabilities of the Arm, Shoulder and Hand (DASH), were included. The quality of the included studies was assessed using PEDro scale. Conclusion There is a moderate level of evidence that using rigid tape in treating patients with shoulder impingement syndrome has no positive effect in reducing pain intensity, while there is a moderate level of evidence that using rigid tape in treating patients with shoulder impingement syndrome has a positive effect in reducing disability and improving the function. Systematic review registration Submitted to PROSPERO.org.

Globally, nations are moving away from the usage of fossil fuels toward cleaner energy sources, hydropower is one of the most significant green energy sources to reduce greenhouse gasses. This study aims to select suitable locations for dam construction in Northeastern Nigeria using geospatial analysis for green energy. The Geographic information system and analytical hierarchy process were used to integrate ten thematics layers: geology, soil, slope, elevation, land use, precipitation, flow accumulation, stream power index, topographic wetness index, and drainage density. To generate a suitability model, ten hydro-physical criteria were used and went through several processing steps. AHP was used to rank and weight each criterion. Five classes were identified from the composite suitability map that was generated: very high, high, moderate, low, and very low. Flow accumulation holds the highest importance, followed by rainfall and drainage density, while slope was the least important in determining the suitability of the region. According to the composite suitability map, roughly 38 % of the region is of the highly suitable category, 54.17 % is moderately suitable while the least was highly suitable class with 0.21 %. Among the six states in the region, Taraba state has the highest potential dam site with three sites while the other has one each except Yobe state with none. Millions of people could have access to green energy by building dams in highly practical and economically viable locations identified. GIS is an effective technique for sustainable dam site location.

Abstract Background In Yemen, effective early detection and a comprehensive grasp of breast cancer symptoms and risk factors are vital in preventing its potentially deadly spread. However, challenges arise in combating breast cancer in Yemen due to the lack of patient registries, national strategies, and structured cancer treatment plans. Objective This research sought to evaluate the awareness levels of breast cancer and the perceived obstacles to breast cancer screening among adult Yemeni women. Methods A community-based cross-sectional questionnaire study was conducted from September 2023 to January 2024 from two teaching and largest hospitals in the capital municipality, Sana’a, Yemen, where 533 women (≥ 18 years old) were conveniently selected in this study. Data were analyzed using SPSS software (version 23).. The Chi-square test was used to test associations. The factors associated with breast cancer awareness and barriers to breast cancer screening were analyzed separately, using multivariable logistic regression. Results The study revealed that 88.6% of women were familiar with breast cancer, and 61.9% being knowledgeable about screening methods such as clinical breast examination (CBE) or mammography. The primary hindrance to screening (84.1%, n = 53) was the absence of symptoms or pain. The second most common reason for not undergoing screening was a lack of understanding about breast cancer and its treatment (61.9%, n = 39). Conclusion To enhance breast cancer screening rates among Yemeni women consistently, targeted educational programs emphasizing the benefits of early detection and dispelling misconceptions and barriers related to the disease are essential.

Abstract Background This evaluation research utilized both qualitative and quantitative methods to assess the implementation of the National Primary Health Care Development Agency (NPHCDA) gateway of the Basic Health Care Provision Fund (BHCPF) across six states in Northern Nigeria: Bauchi, Borno, Kaduna, Kano, Sokoto, and Yobe. Methods This was a mixed-method research that utilized longitudinal surveys and Key informant interviews to gather information about the implementation status of the BHCPF-NPHCDA gateway. Checklists were developed based on the BHCPF’s national guidelines to gather quantitative data, while simple open-ended questionnaires were used to collect qualitative data from the state BHCPF Program Implementation Unit (PIU) focal persons as key informants. Results The result revealed that the NPHCDA had accredited these six states to use one Primary Health Care (PHC) facility in each political ward to implement the BHCPF. Factors that contributed to the success achieved in some states included the early completion of contingent start-up activities, well-established coordination structures, strong support from partners, and the availability of established financial management systems. However, the delays in the submission of quarterly business plans by the BHCPF facilities affected timely approval and fund disbursement. Other challenges included staff capacity gaps, inadequate human resources, and poor management and supervision from the state health agency teams. Conclusion There was suboptimal implementation of the BHCPF in at least one thematic area across all states. Therefore, actions such as government commitment for improved coordination, continuous capacity building, effective monitoring and evaluation, and targeted supportive supervision using innovative approaches should be undertaken to improve the program’s implementation. In a broader setting, the insights from BHCPF implementation are valuable for LMICs, offering guidance on overcoming implementation challenges associated with PHC financing. This research provides a resource for enhancing healthcare financing strategies in similar contexts.

Abstract Functionalization of cellulose with nanomaterials and functional groups is essential for enhancing its properties for specific applications, such as flexible sensors and printed electronics. This study employs Hartree Fock (HF) and Density Functional Theory (DFT) calculations to investigate the vibrational spectra of cellulose, identifying DFT: B3LYP/3–21 g** as the optimal model aligning with experimental spectra. Using this model, we examined the impact of functionalizing cellulose with various groups (OH, NH2, COOH, CH3, CHO, CN, SH) and graphene oxide (GO) on its electronic properties. The results indicate that cellulose functionalized with GO (Cellulose-GO) has the lowest bandgap energy (0.1687 eV), and improvements in reactivity, stability, and electronic properties were confirmed through Molecular Electrostatic Potential (MESP) and Total Dipole Moment (TDM) analyses. The spectrum of Density of States (DOS) for the cellulose functionalized with different groups shows several peaks, indicating various energy levels where electronic states are concentrated. The Projected Density of States (PDOS) analysis reveals how different functional groups affect the electronic structure of cellulose. Moreover, the (Cellulose-GO) composite was characterized using an Attenuated Total Reflection Fourier Transform Infrared (ATR-FTIR) spectrometer, revealing interaction through the OH group of CH2OH, as indicated by a new band at 1710 cm−1, consistent with theoretical predictions. Overall, this study demonstrates that functionalization with GO enhances cellulose’s responsiveness, degradation, and electrical properties, making it suitable for applications in flexible electronic devices and protective barriers against corrosion.

Abstract Architect-HIV Ag/Ab combo chemiluminescence assay is globally recognized for its sensitivity but has a notable false-positive rate. In this study, we aim to evaluate the performance of a new cost-effective screening alternative, the chemiluminescence Ag/Ab combo assay (CL-900i-HIV) from Mindray, China. We selected 195 archived samples categorized according to the INNO-LIA™ HIV I/II, the gold standard confirmatory assay. These samples included true positive (n = 38; positive by Architect-HIV & INNO-LIA-HIV), true negative (n = 101; negative by Architect-HIV & INNO-LIA-HIV), false positive (n = 20; positive by Architect-HIV & negative by INNO-LIA-HIV), and indeterminate results (n = 26). We tested all samples using the Mindray CL-900i-HIV and all positive Architect-HIV samples (n = 80) were confirmed by PCR. Compared to INNO-LIA™ HIVI/II line immunoassay confirmatory assay, Mindray CL-900i-HIV demonstrated a sensitivity of 100% (95% CI 90.7–100), specificity of 100% (95% CI 97.0–100), overall percent agreement (OPA) of 100% (95% CI 97.7–100.0), and perfect agreement with the INNO-LIA confirmatory assay (κ = 1.00). Additionally, Mindray’s CL-900i-HIV exhibited a significantly lower false-positive rate (8.75%) compared to Architect-HIV’s (55%). Mindray CL900i demonstrated high sensitivity and very low false-positive rate, thus, has the potential to serve as an excellent, cost-effective surrogate for HIV screening, overcoming the limitations of existing automated assays.

Abstract Moving towards a cleaner, greener, and more sustainable future, expanding electric vehicles (EVs) adoption is inevitable. However, uncontrolled charging of EVs, especially with their increased penetration among the utility grid, imposes several negative technical impacts, including grid instability and deteriorated power quality in addition to overloading conditions. Hence, smart and coordinated charging is crucial in EV electrification, where Vehicle-to-Grid (V2G) technology is gaining much interest. Owing to its inherited capability of bi-directional power flow, V2G is capable of enhancing grid stability and resilience, load balancing, and congestion alleviation, as well as supporting renewable energy sources (RESs) integration. However, as with most emerging technologies, there are still technical research gaps that need to be addressed. In addition to these technical impacts, other multidisciplinary factors must be investigated to promote EVs adoption and V2G implementation. This paper provides a detailed demonstration of the technical problems associated with EVs penetration in distribution networks along with quantifiable insights into these limitations and the corresponding mitigation schemes. In addition, it discusses V2G benefits for power systems and consumers, as well as explores their technical barriers and research directions to adequately regulate their services and encourage EV’s owners to its embracement. Moreover, other factors, including regulatory, social, economic and environmental ones that affect EV market penetration are being studied and related challenges are analyzed to draw recommendations that aid market growth.

Background: The white cane and other conventional mobility aids for the visually impaired are inadequate for navigating. Visually impaired people may become much more self-sufficient and safer as technology advances. Objective: The present study aims to introduce and evaluate the LTE-Connected Smart Blind Stick. This unique assistive device leverages LTE connectivity and sensor technologies to give visually impaired and blind persons complete mobility choices. Methodology: The Smart Blind Stick was outfitted with sensors that could detect obstructions, changes in topography, and incoming vehicles, offering a 360-degree sensory picture of the area. The gadget offers real-time GPS navigation, distress signaling, and remote monitoring by caregivers via an LTE connection. The stick's interaction with smartphone apps and voice assistants enables audible and haptic feedback while adjusting to user requirements and preferences. Performance parameters were evaluated in controlled conditions and real-world circumstances to test the device's effectiveness and user satisfaction. Results: The Smart Blind Stick beat typical canes in obstacle detection accuracy, user confidence, and navigational efficiency in testing. Real-time data transfer, including GPS and traffic updates, was flawless, boosting the user's situational awareness. User comments emphasized the stick's usefulness in arduous travels and its contribution to increasing independence. Conclusion: The LTE-Connected Smart Blind Stick is an essential advancement in assistive technology for the visually impaired. The technology gives users more freedom by delivering better spatial awareness, real-time information, and a multi-sensory approach to navigation. Its versatility and constant connection portend a bright future for assistive devices, potentially significantly enhancing the quality of life for those with visual impairments.

Abstract Background Asthma is the most prevalent chronic airway condition in children. It is characterised by hyperresponsiveness of the small airways leading to airway narrowing, which is usually reversible, with or without treatment. Asthma is known to cause right ventricular dysfunction, but not much is known of this effect among children with highest burden of asthma. The aim of this study is to compare the right ventricular functions of children with asthma, aged 6– ≤ 13 years, with those of their age and sex-matched apparently healthy control using transthoracic echocardiography. The systolic and global right ventricular functions were assessed using Tricuspid Annular Plane Systolic Function (TAPSE) and Tei index, respectively. Results Seventy cases and 68 controls were included in the final analysis of the results. The male-to-female ratios are 1.9:1 and 2:1 for the cases and controls, respectively, and their mean age were 8.82 (± 2.28) and 9.05 (2.50) years. There was no statistically significant difference between their sex ( $${X}^{2}$$ X 2 /P = 0.810/0.85) and their mean age (P = 0.554). The mean TAPSE of the cases (20.16 ± 2.15 mm) and the controls (20.28 ± 2.71 mm) did not differ significantly (P = 0.74), but the mean Tei index of the cases (0.56 ± 0.16) was significantly higher than that of the control (0.50 ± 0.10) (P = 0.007). Among the asthmatics, 17.1% (12/70) and 2.9% (2/70) had global and systolic RV dysfunctions, respectively; 2.9% (2/70) of the controls had RV global dysfunctions, but none had RV systolic dysfunction. The global dysfunction among the asthmatics was significantly associated with their age range and frequency of hospitalisation ( $${X}^{2}$$ X 2 /p of 6.051/0.014 and 7.209/0.021, respectively), and significantly correlates with their Body Mass Index, and peripheral oxygen saturation (r/P of −0.236/0.049 and − 2.490/0.038, respectively). None of the participants had right ventricular systolic dysfunction. Conclusion This study shows that asthmatic patients have global RV dysfunction, and it is suggested that better control of asthma would preserve cardiac function.

Abstract Due to its appealing qualities, such as its miniature size and the ability to modify physical properties through chemical synthesis and molecular design, polymer material offers considerable advantages over traditional inorganic material-based electronics. Conjugate polymers are particularly interesting because of their molecular design capabilities, which enable the synthesis of conducting polymers with a variety of ionization potentials and electron affinities (EA), and their ability to control the energy gap and electronegativity (χ). Accordingly, density functional theory (DFT) at the B3LYP/SDD model was used to present possible interactions between polyaniline (PANi) and both alkali and heavy metal oxides. Total dipole moment (TDM), HOMO–LUMO band gap energy (ΔE), ionization energy (IE), EA, chemical hardness (η), chemical potential (μ), electrophilicity index (ω), chemical softness (S), and χ are calculated. TDM of PANi increased while ΔE decreased due to functionalization. The distribution of electronic charge density in molecular electrostatic potential (MESP) maps together with the results of ω reflected the electrophilic nature. The obtained results confirmed that the addition of metal oxides significantly improves the TDM, ΔE, and reactivity descriptors. A strong correlation between the experimental and calculated IR spectra was observed. Additionally, PANi–2MgO and PANi–2MnO model molecules exhibited the highest reactivity. Accordingly, PANi functionalized with MgO and MnO are promising candidates for energy storage devices.

Abstract This paper introduces a Hybrid Plasmonic Nano-Antenna (HPNA) with a gradient-index dielectric flat lens modeled with different materials to enhance and steer the radiation in a particular direction based on a phase shift array. Firstly, the design of hybrid plasmonic Nano-Antenna (NA) is introduced and analyzed considering different horn-shapes such as diamond, hexagonal, circular, rectangular, and square shapes. The commercial software Computer Simulation Technology-Microwave Studio (CST-MWS) is used to analyze the radiation characteristics of the plasmonic NAs at the standard telecommunication wavelength of 1,550 nm. The produced horn-shaped nano-antenna made up from gold cladding with low- and high-index dielectric materials of SiO2 and InGaAs, respectively. The gain of the Square Horn shape Hybrid Plasmonic Nano-Antenna (SHHPNA) achieves the greatest gain with a value of 10.7 dBi at the desired frequency and the return loss reached -18.09 dB due to the wide aperture area for SHHPNA, which results in a narrower beam-width and higher gain. Moreover, by using two different shapes of dielectric flat lens to enhance the antenna’s performance by improving directivity while correspondingly reducing beam-width, the gain is enhanced and reaches 16.7 for SHHPNA with a circular lens and 16.9 for SHHPNA with a rectangular lens compared with the traditional NA that equal to 9.03 dBi. The main lobe for SHHPNA with each lens is more directed, with Side Lobe Level (SLL) and Half Power Beam-Width (HPBW) of -13.1 dB and 16.5° for SHHPNA with a circular lens and -15.1 dB and 15.4° for SHHPNA with a rectangular lens, respectively. In addition, the array configuration was investigated, and the gain was found to be 21 dBi for the single row array of 4×1 and 23.2 dB for the array of 3×3. Moreover, the array of 4×1 and 3×3 with +90° showed gains of 18.6 dBi and 20.7 dBi, respectively, compared to traditional paper with gains of 11.20 dBi and 13.1 dBi.

Abstract Integrating Large Language Models (LLMs) with Knowledge Graphs (KGs) enhances the interpretability and performance of AI systems. This research comprehensively analyzes this integration, classifying approaches into three fundamental paradigms: KG-augmented LLMs, LLM-augmented KGs, and synergized frameworks. The evaluation examines each paradigm’s methodology, strengths, drawbacks, and practical applications in real-life scenarios. The findings highlight the substantial impact of these integrations in fundamentally improving real-time data analysis, efficient decision-making, and promoting innovation across various domains. In this paper, we also describe essential evaluation metrics and benchmarks for assessing the performance of these integrations, addressing challenges like scalability and computational overhead, and providing potential solutions. This comprehensive analysis underscores the profound impact of these integrations on improving real-time data analysis, enhancing decision-making efficiency, and fostering innovation across various domains.

Abstract Background Oral health is closely linked to systemic conditions, particularly non-communicable diseases (NCDs), which can exacerbate oral issues. Essential oils (EOs) have emerged as potential alternatives for oral health due to their antibacterial, anti-inflammatory, and antioxidant properties. Among these, rosemary essential oil (REO) shows promise due to its various biological activities. This study investigates the potential of REO in dental applications using microfluidic devices and electrochemical impedance spectroscopy (EIS) to analyze the electrical properties of REO in artificial saliva (AS) mixtures. Results The study demonstrated significant variations in impedance across different REO concentrations and their mixtures with AS. Higher impedance was observed in REO mixtures, particularly at lower frequencies, indicating distinct electrical properties compared to pure AS. The impedance of REO was influenced by its concentration, with a 1% REO solution showing higher impedance than a 4% solution, possibly due to micelle formation and changes in dielectric properties. Additionally, microfluidic devices enabled precise control over fluid interactions and real-time monitoring, offering valuable insights into REO's behavior in a simulated oral environment. The impedance data demonstrated significant differences in REO–AS mixtures, highlighting potential interactions critical for oral care applications. Conclusions Rosemary essential oil exhibits unique electrical properties, making it a promising candidate for dental applications, particularly in preventing and treating oral diseases. Microfluidic devices enhance the accuracy and reliability of studying REO's interactions with AS, providing a robust platform for future dental research. The findings suggest that REO could be effectively incorporated into oral care products, offering a natural alternative for combating oral pathogens, reducing inflammation, and protecting against oxidative stress. Future research should focus on clinical trials to validate these findings and explore the synergistic effects of REO with other essential oils.

Abstract Background Drug-coated balloons (DCB) have promising results in the management of in-stent restenosis (ISR), still their role remains a major challenge, and not well established in contemporary clinical practice. Aims To provide a comprehensive appraisal of the efficacy and safety of DCBs in patients with in-stent restenosis (ISR). Methods We searched PubMed, Scopus, web of Science, Ovid, and Cochrane Central from inception until 30 March, 2023. We included randomized controlled trials (RCTs) that compared DCB versus DES in ISR patients. Our primary endpoints were major adverse cardiac events (MACE) and late lumen loss (LLL). Secondary clinical endpoints were all-cause death, cardiac death, MI, TLR, TVR, and stent thrombosis, and angiographic outcomes were MLD, and in-stent binary restenosis. Results Ten RCTs comprising 1977 patients were included in this meta-analysis. The incidence of MACE was 15.57% in the DCB group compared to 14.13% in the DES group, with no significant difference in the risk of MACE following DCB (odds ratio [OR] 1.04, 95% confidence interval [CI]: 0.87 to 1.44). Compared with the DES intervention, the risk of LLL was comparable to the DCB intervention (mean difference [MD] -0.08, 95% CI: -0.18 to 0.02), while the incidence of TLR was increased in the DCB intervention (OR: 1.54, 95% CI: 1.2 to 1.99). Conclusion DCB was comparable to DES implantation is ISR patients regarding clinical outcomes, however it showed an increase in TLR events. Moreover, a RCT with large sample size and longer follow-up duration is warrened to validate these results.

Summary: Background: Acute malnutrition is a nutritional insufficiency resulting from either inadequate energy or protein intake. It is categorized into severe acute malnutrition and moderate acute malnutrition. Globally, acute malnutrition is still a prevalent public health issue. Objective: To identify determinants of acute malnutrition among 6 to 59-month-old children in public health facilities. Methods and materials: A hospital-based, unmatched case-control study was conducted from 1st March to 30th April 2023. Three hundred ninety (130 cases and 260 controls) participants were included in the study. Data was collected using pretested, semi-structured questionnaires by using Kobo Collect. The analysis was done using SPSS version 20. Both bi-variable and multivariable logistic regressions were done. An adjusted odds ratio with a 95% confidence interval was computed to determine levels of significance. All variables with a p-value less than 0.05 were declared as determinants of acute malnutrition. Results: In this study, estimated average family income, 1001–5000 Ethiopian birr (AOR=3.32, 95%CI=1.27, 8.72), 5001–10000 Ethiopian birr (AOR=3.82, 95%CI=1.56, 9.36), family size ≥5 (AOR=2.33, 95%CI=1.33, 4.084), private employee (AOR=4.62, 95%CI=2.18, 9.76), government employee (AOR=3.77, 95%CI=1.69, 8.42), non-governmental organization employee (AOR= 17.14, 95%CI=2.53, 16.27), food insecurity (AOR=1.46, 95%CI=1.08,1.97), bottle-feeding (AOR=2.64, 95%CI=1.22,5.68), and lack of latrines (AOR=3.30, 95%CI=1.04, 10.49) were identified as determinants of acute malnutrition. Conclusion: Estimated average family income, family size, lack of latrine, maternal or caregiver occupation, food security status, and bottle feeding were all predictors of acute malnutrition in this study. Promoting exclusive breastfeeding, raising awareness about the health issues of bottle-feeding and open defecation, improving access to clean water and sanitation, strengthening healthcare systems, and encouraging collaboration among agencies can effectively address acute malnutrition.

In this paper, we explore multi positive solutions together with their existence and uniqueness, which is properly defined for delta fractional version of Riemann–Liouville difference operators. Our exploration encompasses two distinct directions. In the first direction, we construct the Green’s function formula for the proposed delta fractional boundary value problems of order δ∈(1,2), and we present some essential properties of this function. The last and main results suggest using the well-known fixed point theorems in a Banach space for testing the existing and uniqueness of multi-positive solutions of such problems.

The exponential growth of intelligent systems technologies, including Artificial Intelligence (AI), Internet of Things (IoT), Machine Learning (ML), and Smart Connected Products, has intensified the difficulties of data governance. Organizations adopting these technologies face challenges in managing the volume, variety, and velocity of data while ensuring quality, security, compliance, and ethical integrity. This study investigates the state of big data governance (BDG) programs in organizations leveraging intelligent systems technologies, using a systematic literature review guided by PRISMA. A synthesis of insights from 74 peer-reviewed articles, conferences, and industry reports reveals both the significant benefits of BDG such as enhanced decision-making, operational efficiency, and regulatory compliance and persistent challenges, including fragmented governance frameworks, limited scalability, data quality issues, and ethical concerns. To address these gaps, this study proposes the big data governance maturity assessment model (BDG MAM), a novel framework developed to assess and enhance the maturity of BDG programs. The BDG MAM evaluates governance maturity across four key dimensions: people, process, data, and technology. It provides a structured roadmap for organizations to benchmark governance practices, prioritize improvements, and implement effective strategies. The model was validated through a pilot study conducted with a public higher learning institution, demonstrating its practical applicability and effectiveness in real-world scenarios. By bridging theoretical insights with practical implementation, this study advances academic discourse and provides practitioners with a robust approach to navigate the challenges of modern data governance practices, ensuring sustainable and effective management of heterogeneous data environment.

From different fields in Mosul city, we collected sixteen samples of soil surrounding the rhizosphere zone to isolate and characterize rhizobacterial species based on biochemical tests, 16S rRNA gene primer amplification using PCR and nucleotide sequence analysis, and similarity to global isolates in the gene bank. All isolates were bacilliform, with clear differences in their response to Gram staining and biochemical tests. On the other hand, the results showed that root colonizing bacteria could produce different amounts of indole-3-acetic acid (IAA). Molecular analysis tests based on the 16S rRNA primer gene were carried out to characterize the isolated bacteria at the molecular level and showed 99% homology with Azotobacter tropicalis SC39, Azotobacter chroococcum A11, Bacillus subtilis N22 and Ralstonia pickettii ULM005, which are registered worldwide in GenBank. It should be noted that in the diagnostic isolate R. pickettii both A and T were deleted, G was replaced by C and T was added at position 508. On the other hand, in the B. subtilis isolate, the nitrogenous bases A, G and G were deleted and the nitrogenous base G was replaced by the base C. The data for the third isolate, A. tropicalis, showed deletion of the nitrogenous bases C and T and replacement of G by A and A by T. In the fourth isolate, A. chroococcum, deletion of the nitrogenous base, replacement of C by A and C by T and addition of G, T and A in three positions were observed. These will be used as the basis for future scientific experiments to develop new biofertilizers from the rhizobacteria studied for the production of environmentally sustainable crops.

Objective: This study aimed to investigate the effect of empowerment-based interventions on self-efficacy and self-care capacity among adults with sickle cell disease (SCD). Methods: A randomized control trial was conducted [NCT06296654]. A total of 76 patients were recruited by using a cluster sampling technique in the two health centers in Bahrain from February to May 2022 and randomly allocated to the intervention group (n = 38) or control group (n = 38). The intervention group received the empowerment-based intervention implemented through structured small-group discussion sessions, individualized consultations (5A model: assess, advise, agree, assist, and arrange), and follow-up sessions, while the control group received routine health education. The Sickle Cell Self-Efficacy Scale (SCSES) and the Appraisal of the Self-Care Agency Scale-Revised (ASA-R) were measured at baseline and one month after the intervention among two groups of patients. Results: A total of 68 patients completed the study (36 patients in the intervention group and 32 patients in the control group). After the intervention, the score of SCSES in the intervention group was 37.0 (35.0, 39.8) higher than the control group 28.0 (25.2, 32.0) (U = − 6.121, P

Abstract Background Our understanding of osteoarthritis (OA) has evolved from a degenerative disease to one in which low-grade, chronic inflammation plays a central role. In addition, evidence suggests that OA is accompanied by both peripheral and central nervous system sensitization that can cause pain. It has been demonstrated that transcutaneous vagus nerve stimulation (tVNS) can relieve pain, inflammation, and central sensitization in other conditions including fibromyalgia, pelvic pain, and headaches. We aimed to assess the efficacy and safety of tVNS on nociceptive pain, central sensitization, and physical function in knee OA. Methods In this 12-week study, we stimulated the auricular branch of the vagus nerve with an auricular electrode connected to a transcutaneous electrical nerve stimulation device once a day for 3 days each week for 12 weeks. A total of 68 patients with chronic knee OA were randomly assigned to the active and sham groups (34 patients in each group). We used a variety of outcome measures, including the visual analog scale (VAS), pressure pain threshold (PPT), knee injury and osteoarthritis outcome score (KOOS), PainDETECT (PD-Q) and Douleur Neuropathique 4 (DN4) questionnaires. Outcome measures were recorded at baseline, At the end of the stimulation period, and then after 4 weeks. Results In the active group, compared to baseline, there was a significant improvement in VAS scores between the first and second follow-up visits (P