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Dentofacial deformities can significantly impact an individual's quality of life, affecting facial aesthetics, self-esteem, and overall well-being. The combined orthognathic surgery-orthodontic treatment is the preferred approach for correcting moderate-to-severe deformities. However, patient satisfaction following orthognathic surgery remains a crucial outcome measure, influenced by various factors, including the type of malocclusion, surgical procedure, and demographic characteristics. This systematic review aimed to synthesize the available evidence regarding patient satisfaction following orthognathic surgery, exploring the effects of the type of malocclusion, surgical procedure, age, and gender on satisfaction rates, addressing a gap left by previous outdated reviews. A comprehensive literature search was conducted across multiple databases, including PubMed®, Scopus®, Web of Science™, and Embase®. Eligibility criteria were defined using the PICOS (population, intervention, comparison, outcomes, and study design) framework. Cochrane's ROBINS-I (Risk of Bias In Non-randomized Studies-of Interventions) tool was employed for non-randomized intervention studies within clinical controlled trials to assess the risk of bias. In parallel, a revised version of the Newcastle-Ottawa scale determined the methodological quality of cohort and cross-sectional studies. Sixteen studies were analyzed, revealing satisfaction levels ranging from 83% to 100%. Findings indicate that class III malocclusion patients report higher satisfaction than class II patients and satisfaction varies based on surgical type, with bimaxillary procedures generally yielding better outcomes. While most studies found no significant correlation between satisfaction and demographic factors such as age and gender, some suggested younger patients may express higher satisfaction and that female patients might report lower satisfaction levels. The review highlights the importance of effective patient communication and expectation management in achieving optimal satisfaction outcomes in orthognathic surgery. Limitations such as memory bias and methodological diversity across studies restrict the ability to perform meta-analyses, underscoring the need for further research in this area., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Almasri et al.)

Background and Objectives: Fixed orthodontic appliances interfere with daily oral care procedures, causing more plaque accumulation and thus increasing the risk of periodontal diseases. Probiotics have been suggested to maintain oral health using beneficial bacteria. However, the evidence to determine the clinical benefits of probiotics as a supplement to oral health in orthodontic patients is still insufficient. This trial aimed to investigate the protective effect of probiotics on oral health and prevent the development of inflammation of the gingiva and periodontal tissues during orthodontic treatment using fixed orthodontic appliances., Materials and Methods: This was a single-blinded, single-center, two-arm randomized controlled trial conducted between March 2023 and June 2024. A total of 50 patients (13 males (26%) and 37 females (74%) with a mean age of 21.33±2.04) who required a non-extraction-based treatment using fixed orthodontic appliances were enrolled and randomly divided into two groups: the probiotics group (PG) who underwent orthodontic treatment with probiotic tablets of Lactobacillus reuteri and the control group (CG) who underwent orthodontic treatment without probiotics. The following periodontal parameters were recorded: plaque index (PI), gingival index (GI), papillary bleeding index (PBI), and probing depth (PD). These indices were assessed three times: before the start of orthodontic treatment (T0) and after three months (T1) and after six months (T2) of applying fixed appliances., Results: The mean values for PI, GI, PBI, and PD were statistically significantly lower in the PG compared to the CG at both time points T2 and T3 (p<0.05). In the PG, there was a significant difference in the PI between time points T0 and T1 (p<0.001), but there was no significant difference between T1 and T2 (p=0.074). The GI, PBI, and PD differences were also insignificant (p>0.05). Conversely, all studied periodontal parameters significantly increased during the assessment periods in the CG (p<0.001)., Conclusion: Using probiotic lozenges that contain Lactobacillus reuteri , alongside regular teeth brushing, during the first six months of fixed orthodontic treatment in adults can help maintain good oral hygiene. This approach reduces plaque buildup and helps prevent the onset of clinical signs associated with periodontal disease., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Local Research Ethics Committee of the Faculty of Dentistry, University of Damascus issued approval UDDS-528-19112020/SRC-1810. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Albardawel et al.)

Background: Gingival phenotype (GP), comprising gingival thickness (GT) and keratinized tissue width (KTW), plays a crucial role in preserving the integrity of gingival and periodontal tissues, thereby enhancing their resistance to trauma and mechanical irritation. This systematic review and meta-analysis aimed to evaluate the current evidence about the changes in GT and KTW following the injection of injectable platelet-rich fibrin (i-PRF) in patients with thin GP., Methods: A thorough search was conducted up to April 2024 across the following nine databases: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed ® , Scopus ® , Web of Science ® , Google Scholar, Trip, CINAHL via EBSCO, EMBASE via OVID, and ProQuest. This review covered parallel-group and split-mouth randomized controlled trials (RCTs) which investigated the changes in GT and KTW following i-PRF injection on the buccal anterior region in both jaws for individuals with thin GP. The risk of bias in the included studies was evaluated using Cochrane's tool (RoB 2), and the GRADE framework was utilized to assess the overall strength of evidence. Agreement between the authors was assessed using Cohen's kappa statistic., Results: Seven RCTs were included in this review, five of which were appropriate for the quantitative synthesis of data. The meta-analysis showed a statistically significant increase in the GT in the i-PRF group at all assessment times compared to baseline (MD ranged from 0.12 mm to 0.38 mm). Regarding KTW, 4-time injections led to a significant increase in KTW after 3-month and 6-month follow-ups compared to baseline (MD = 0.31 mm, and MD = 0.37 mm, respectively). In contrast, 3-time injections yielded a non-significant increase in KTW after 1 and 3 months of follow-up (MD = 0.14 mm at both assessment times). The strength of evidence supporting these findings ranged from low to moderate. However, when comparing the i-PRF group and the i-PRF + microneedling (MN) group, the pooled estimate exhibited significant differences in the GT at both assessment times, with superiority for the MN + i-PRF group (MD = 0.04 mm after 3 months, MD = 0.11 mm after 6 months). In contrast, there were no statistically significant differences in KTW between the two comparisons (MD = 0.03 mm at both assessment times). The strength of evidence supporting these findings was moderate., Conclusions: For patients with a thin GP, i-PRF administration resulted in a significant increase in GT at all assessment times compared to baseline. Regarding the KTW, the results varied depending on the number of injection sessions. When the injections were carried out four times, there was an observed increase in KTW, while repeating the intervention three times revealed a non-significant increase in KTW., Protocol Registration: The protocol was registered in the PROSPERO database (CRD42024543374) on 16 May 2024., Level of Evidence: According to the GRADE recommendations, the strength of evidence regarding the effect of i-PRF injection on GT and KTW ranged from low to moderate. The evidence strength for differences between the i-PRF group and the i-PRF + MN group in both GT and KTW was moderate. The overall quality of evidence for these outcomes is presented in Table 4., (© 2024. The Author(s).)

Synthetic microwave focusing methods have been widely adopted in qualitative medical imaging to detect and localize anomalies based on their electromagnetic scattering signatures. This paper discusses the principles, challenges, and limitations of synthetic microwave-focusing techniques in medical applications. It is shown that the various focusing techniques, including time reversal, confocal imaging, and delay-and-sum, are all based on the scalar solution of the electromagnetic scattering problem, assuming the imaged object, i.e., the tissue or object, is linear, reciprocal, and time-invariant. They all aim to generate a qualitative image, revealing any strong scatterer within the imaged domain. The differences among these techniques lie only in the assumptions made to derive the solution and create an image of the relevant tissue or object. To get a fast solution using limited computational resources, those methods assume the tissue is homogeneous and non-dispersive, and thus, a simplified far-field Green's function is used. Some focusing methods compensate for dispersive effects and attenuation in lossy tissues. Other approaches replace the simplified Green's function with more representative functions. While these focusing techniques offer benefits like speed and low computational requirements, they face significant ongoing challenges in real-life applications due to their oversimplified linear solutions to the complex problem of non-linear medical microwave imaging. This paper discusses these challenges and potential solutions.

Background and Aims: Patients with inflammatory bowel disease (IBD) receiving infliximab (IFX) commonly experience immunogenic loss of response (LOR) by formation of anti-drug antibodies (ADAs). An immunomodulator (IMM) used in combination with initial IFX induction is known to reduce ADA development and improve clinical outcomes. We aimed to assess the impact of reactively adding an IMM to patients on IFX monotherapy., Methods: We conducted a retrospective cohort study and systematic review with meta-analysis of patients with IBD demonstrating immunologic LOR, with or without clinical LOR, that had an IMM (azathioprine, 6-mercaptopurine, or methotrexate) reactively added (reactive combination therapy; rCT) to combat elevated ADAs and raise IFX level. Data were extracted for pooled effect size estimation using random-effects models, and ADA and IFX trough levels were compared pre- and post-IMM initiation., Results: We identified 6 patients who received rCT due to rising ADA titers and low IFX levels. Median ADA titer decreased from 506 ng/mL (interquartile range (IQR) [416-750]) to 76.5 ng/mL (IQR [25.8-232]), an 85% decrease (p = 0.031). Median IFX trough increased from 0.4 µg/mL (IQR [0.4-0.48]) to 8.25 µg/mL (IQR [3.7-9.6]), a 20.6-fold increase (p = 0.038). Meta-analysis pooled effect size of 7 studies with 89 patients showed an 87% ADA titer reduction [95% confidence interval (CI) = 72-94%], 6.7-fold increased IFX trough (95% CI = 2.4-18.7), and 76% clinical remission rescue rate (95% CI = 59-93%)., Conclusions: These results suggest rCT is a valid rescue strategy in patients with immunogenic LOR to IFX to reduce ADA titers, restore therapeutic IFX levels, and recapture clinical remission of IBD., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: A secondary loss of response (LOR) to infliximab (IFX) therapy for inflammatory bowel disease (IBD) is typically associated with low IFX trough levels, often with high levels of neutralizing antibodies to IFX (ATI). A small subset of patients on long-term therapy experience a "nonimmune" LOR, without ATI and with desired IFX trough levels ≥5 μg/mL, regarded as a LOR to the mechanism of action of IFX. However, this currently accepted IFX goal level is largely derived from observations of patients within the first year of therapy and may not apply to those on treatment beyond 1 year., Methods: Retrospective review of all IBD patients receiving IFX infusions for ≥12 months with at least 1 IFX trough and ATI measurement beyond 12 months was conducted. Chart review of all patients with absent ATI and an IFX trough ≥5 μg/mL classifies as LOR versus non-LOR based on physician assessment, with a comparison of IFX troughs between the two groups., Results: Of 167 patients using IFX ≥12 months, 13 (7.8%) experienced a nonimmune secondary LOR. The mean duration of IFX use was over 3 years for both LOR and non-LOR patients. The mean IFX trough for those with LOR was greater than for those without LOR, 18.5 μg/mL versus 13.1 μg/mL, p = 0.110., Conclusion: Our results did not demonstrate lower IFX levels among patients experiencing secondary nonimmune LOR on long-term therapy. Our results do not redefine the therapeutic IFX goal levels for those patients on long-term therapy and suggest that underdosing of IFX is not the cause of secondary LOR., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Peripheral nerve sheath tumors (PNSTs), while uncommon, can have a significant impact on appearance and quality of life, especially when they form in prominent areas such as the nose dorsum. We discuss a case of a 29-year-old woman who developed a benign PNST on the right side of her nasal ala. This tumor gradually grew, impairing her face appearance. Diagnostic tests, such as computed tomography (CT) and magnetic resonance imaging (MRI), revealed the tumor as a slowly growing, well-defined mass. The tumor was removed via open rhinoplasty under general anesthesia, and pathological investigation verified its benign nature. After surgery, the patient's quality of life improved significantly, and there were no evidence of tumor recurrence after eight months. This case emphasizes the need of including PNST in the differential diagnosis of nasal tumors., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 Sultan K. Kadasah et al.)

Drought poses a significant ecological threat that limits the production of crops worldwide. The objective of this study to examine the impact of soil applied biochar (BC) and peatmoss (PM) on the morpho-biochemical and quality traits of tobacco plants under drought conditions. In the present experiment work, a pot trial was conducted with two levels of drought severity (~ well-watered 75 ± 5% field capacity) and severe drought stress (~ 35 ± 5% field capacity), two levels of peatmoss (PM) @ 5% [PM+ (with peatmoss) and PM- (without peatmoss)] and three levels of rice straw biochar (BC 0  = no biochar; BC 1  = 150 mg kg - 1 ; and BC 2  = 300 mg kg - 1 of soil) in tobacco plants. The results indicate that drought conditions significantly impacted the performance of tobacco plants. However, the combined approach of BC and PM significantly improved the growth, biomass, and total chlorophyll content (27.94%) and carotenoids (32.00%) of tobacco. This study further revealed that the drought conditions decreased the production of lipid peroxidation and proline accumulation. But the synergistic approach of BC and PM application increased soluble sugars (17.63 and 12.20%), soluble protein (31.16 and 15.88%), decreased the proline accumulation (13.92 and 9.03%), and MDA content (16.40 and 8.62%) under control and drought stressed conditions, respectively. Furthermore, the combined approach of BC and PM also improved the leaf potassium content (19.02%) by limiting the chloride ions (33.33%) under drought stressed conditions. Altogether, the balanced application of PM and BC has significant potential as an effective approach and sustainable method to increase the tolerance of tobacco plants subjected to drought conditions. This research uniquely highlights the combined potential of PM and BC as an eco-friendly strategy to enhance plant resilience under drought conditions, offering new insights into sustainable agricultural practices., (© 2024. The Author(s).)

Background: Enamel conditioning with 37% phosphoric acid is the most common technique during orthodontic bracket bonding procedures. However, due to the repeated de-bonding of the orthodontic brackets during treatment, other methods were needed to condition the enamel surface and increase the bond strength. This study aimed to compare the effect of conditioning the enamel surface by sandblasting with aluminum oxide particles or 5.25% sodium hypochlorite gel in combination with acid etching compared to acid etching alone on shear bond strength (SBS)., Material and Methods: One hundred eight extracted upper premolars were randomly divided into three groups according to the conditioning enamel surface method. After the first and second bonding of metal brackets, new metal brackets were bonded with a total-etching adhesive after enamel conditioning using different methods: acid etching only (37% phosphoric acid for 30 seconds) (AE group), sodium hypochlorite associated with acid etching (5.25% NaOCl gel for 60 seconds and then acid etching for 30 seconds) (NaOCl-AE group), and sandblasting associated with acid etching (sandblasting for five seconds and then acid etching for 30 seconds) (SB-AE group). The shear bond strengths of the brackets were tested with a universal testing machine. One-way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) tests were used to detect significant differences in shear bond strength among groups at the third bonding. Repeated-measure ANOVA and Bonferroni's tests were used to detect significant differences in shear bond strength among the bonding attempts within each group., Results: 5.25% sodium hypochlorite associated with the acid etching method produced significantly greater shear bond strength than sandblasting associated with acid etching and acid etching only methods at the third bonding (16.40 ± 5.80 MPa, 13.60.47 ± 6.40 MPa, and 9.90 ± 4.40 MPa, respectively; P < 0.001). However, there was no significant difference between the AE and SB-AE groups (P = 0.247). In addition, we found a significant decrease in the shear bond strength within each group after each bonding attempt., Conclusion: Conditioning the enamel surface with 5.25% sodium hypochlorite associated with acid etching produced greater bond strength than conditioning by sandblasting associated with acid etching and acid etching only at the third bonding. The bond strength of the metal bracket decreased with increasing bonding attempts, even with the application of enamel surface conditioning methods., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Local Research Ethics Committee of the Faculty of Dentistry, University of Damascus, issued approval UDDS-4242-29082022/SRC-546. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Al-Daher et al.)

Objectives: To assess the level of satisfaction expressed for services rendered in the public health sector to clients who were seen at outpatient departments (OPDs) and primary healthcare (PHC) facilities in Al-Qassim Health Cluster in Saudi Arabia., Methods: This study used a comparative cross-sectional study design, and data were obtained as secondary data from The Patient's Experience Platform. Data analysis was carried out using Stata (version 16), and the significance level was 5%., Results: In comparing the mean satisfaction in 9 domains, statistically significantly higher means for the PHC facilities than the OPDs were seen across 7 domains: patients navigating health facilities ( p =0.008), nursing services ( p <0.001), physicians' services ( p =0.004), radiological services ( p <0.001), personal issues ( p =0.003), the pharmacy ( p =0.005), and general experience ( p =0.036)., Conclusion: This study's findings are significant. They indicate that client satisfaction with services at PHC facilities was significantly higher than with services at hospital OPDs in Al-Qassim region. This underscores the need to improve the quality of services provided at OPDs to bring them to the same level as those provided by PHC facilities. Policymakers and implementers should, therefore, sustain efforts to make OPDs and PHC facilities more desirable for clients., (Copyright: © Saudi Medical Journal.)

The aim of this work was to investigate the impact of nano selenium (N-Se) and compost on the growth, photosynthesis, enzymes activity, compatible solutes and metals accumulation in soybean grown under tannery effluent polluted soil. The plants were exposed to compost application (no compost and compost addition) and foliar application of N-Se (0, 25, 50, and 75 mg L -1 ). The results showed the addition of compost in soil and foliar applied N-Se alleviated the toxic effect of tannery effluent polluted soil. Furthermore, foliar application of N-Se with basal compost supply significantly improved antoxidant enzymes activity in soybean grown in tannery effluent polluted soil. Addition of compost increased the root dry weight (46.43%) and shoot dry weight (33.50 %), relative water contents by (13.74 %), soluble sugars (15.99 %), stomatal conductance (gs) (83.33 %), intercellular CO 2 concentration (Ci) (23.34 %), transpiration rate (E) (12.10 %) and decreased the electrolyte leakage (27.96 %) and proline contents by (20.34 %). The foliage application of N-Se at the rate of 75 mg L -1 showed the most promising results in control and compost amended tannery effluent polluted soil. The determined health risk index (HRI) values were recorded less than 1 for both adults and children under the application of compost and N-Se. In summary, the combined use of N-Se at 75 mg L⁻ 1 and basal supply of compost is an effective strategy for enhancing soybean productivity while minimizing the potential risks of metal accumulation in soybean grains grown in tannery effluent polluted soil., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Cryptogenic multifocal ulcerating stenosing enteropathy is a rare idiopathic small bowel enteropathy characterized by multiple small intestinal strictures and superficial ulcerations, often with clubbing. We present a case of a 25-year-old man who originally initially presented with small bowel obstruction believed to be secondary to suspected Crohn's disease who was ultimately diagnosed with cryptogenic multifocal ulcerating stenosing enteropathy., (© 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)

Background: This study's purposes were to evaluate the impact of biological therapies on outcomes in patients with severe asthma (SA) and chronic rhinosinusitis (CRS) and to compare these effects among those with NP (CRSwNP) versus those without NP (CRSsNP) in the "real-world" setting in Saudi Arabian patients., Methods: From March to September 2022, a retrospective observational cohort study was undertaken at the severe asthma clinics of the Armed Forces Hospital-Southern Region (AFHSR) and King Khalid University Hospital, Abha, Saudi Arabia, to delineate the effects of dupilumab therapy. Outcomes were assessed, including clinical outcomes, FEV1, and laboratory findings before and one year after dupilumab. Post-therapy effects were compared between CRSwNP and CRSsNP., Results: Fifty subjects were enrolled, with a mean age of 46.56. There were 27 (54%) females and 23(46%) males. Significant improvements in clinical parameters (frequency of asthma exacerbations and hospitalizations, the use of OCs, anosmia, SNOTT-22, and the ACT), FEV1, and laboratory ones (serum IgE and eosinophilic count) were observed 6 and 12 months after using dupilumab (p < 0.001), respectively. However, after 12 months of dupilumab therapy, there were no significant differences between those with and without NP with regards to clinical (anosmia, ACT, and OCs use), laboratory (eosinophilic count, serum IgE level) parameters, and FEV1%., Conclusions: Patients with CRS experienced significant improvements in clinical, FEV1, and laboratory outcomes after dupilumab therapy. However, these improvements were not maintained when comparing CRSwNP with CRSsNP. There were no significant differences between those with and without NP regarding ACT and OCs use or laboratory (eosinophilic count, serum IgE level) parameters. Further prospective multicenter studies are warranted., (© 2024. The Author(s).)

Inflammatory bowel disease (IBD) is entering a potentially new era of combined therapeutics. Triantafillidis et al provide an insightful review of the current state of combination therapy, with a focus on the use of a combined biologic and immunomodulator, as well as emerging data on the future potential of dual-biologic therapy (DBT). While current evidence for DBT is limited, encouraging safety profiles and ongoing trials suggest a brighter future for this approach. The importance of controlled trials should be stressed in establishing new treatment paradigms. Ongoing prospective randomized trials of DBT and perhaps future combinations of biologics and small molecule therapies will hopefully guide the next generation of IBD care., Competing Interests: Conflict-of-interest statement: The authors declare no conflicts of interest in relation to this letter., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

This review aimed to evaluate the currently available evidence regarding the best method of correcting deep bites in growing patients. In September 2023, a search was conducted electronically across the following databases: PubMed®, Web of Science™, Scopus®, Embase®, Google™ Scholar, and Cochrane Library. In this systematic review, randomized control trials (RCTs), controlled clinical trials (CCTs), and cohort studies of growing patients with deep bite malocclusion who received treatment with the primary objective of treating the deep bite were included. Risk of bias of the included studies was assessed using two different tools; one tool was applied for RCTs and the other one for the CCTs and cohort studies. One RCT, one CCT, and one cohort study were included (85 patients). The flat fixed acrylic bite plane was superior in terms of duration of treatment when compared to the inclined fixed acrylic bite plane and the utility arch with posterior intermaxillary elastics. Limited evidence indicates that the inclined fixed acrylic bite plane causes a significant increase in the lower incisor inclination and a significant increase in the angle between the mandible and the anterior cranial base (SNB). However, limited evidence indicates that the utility arch with posterior intermaxillary elastics causes a significant decrease in the angle between the maxilla and the anterior cranial base (SNA). Regarding the vertical skeletal changes, it was found that the three methods were comparable; in each case, the vertical dimension of the face increased because of a significant increase in the lower first molar height. There is a need for further studies to strengthen the evidence of the treatment efficacy of the employed methods, with more RCTs to be conducted in this regard., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Rasol et al.)

The aim of the present study was to assess the drinking water quality in the selected urban areas of Lahore and to comprehend the public health status by addressing the basic drinking water quality parameters. Total 50 tap water samples were collected from groundwater in the two selected areas of district Lahore i.e., Gulshan-e-Ravi (site 1) and Samanabad (site 2). Water samples were analyzed in the laboratory to elucidate physico-chemical parameters including pH, turbidity, temperature, total dissolved solids (TDS), electrical conductivity (EC), dissolved oxygen (DO), total hardness, magnesium hardness, and calcium hardness. These physico-chemical parameters were used to examine the Water Quality Index (WQI) and Synthetic Pollution Index (SPI) in order to characterize the water quality. Results of th selected physico-chemical parameters were compared with World Health Organization (WHO) guidelines to determine the quality of drinking water. A GIS-based approach was used for mapping water quality, WQI, and SPI. Results of the present study revealed that the average value of temperature, pH, and DO of both study sites were within the WHO guidelines of 23.5 °C, 7.7, and 6.9 mg/L, respectively. The TDS level of site 1 was 192.56 mg/L (within WHO guidelines) and whereas, in site 2 it was found 612.84 mg/L (higher than WHO guidelines), respectively. Calcium hardness of site 1 and site 2 was observed within the range from 25.04 to 65.732 mg/L but, magnesium hardness values were higher than WHO guidelines. The major reason for poor water quality is old, worn-out water supply pipelines and improper waste disposal in the selected areas. The average WQI was found as 59.66 for site 1 and 77.30 for site 2. Results showed that the quality of the water was classified as "poor" for site 1 and "very poor " for site 2. There is a need to address the problem of poor water quality and also raise the public awareness about the quality of drinking water and its associated health impacts., (© 2024. The Author(s).)

Background: Trichuris spp. (whipworms) are soil-transmitted helminths distributed worldwide, parasitizing several mammalian hosts such as ruminants, primates, and rodents. Trichuris spp. is one of the most common intestinal parasites affecting both humans and animals, and it can spread directly through the fecal-oral route, resulting in severe illness and financial loss. So, this work aims to detect the frequency of Trichuris spp. in camels in Beheira Governorate, Egypt, and to identify Trichuris spp. through morphometrical studies, molecular analysis, and phylogenetic analysis., Results: A total of 35 dromedaries out of 127 investigated had Trichuris spp. infection, meaning that the overall prevalence was 27.56%. The age of the camel affected the infection rate, older animals (> 5 years) having a higher prevalence of infection (24%) than animals of ages (< 3 years) (20%) than animals of ages (3-5 years) (19.14%). According to season: Trichuris spp. showed a unique pattern in camels in different seasons: summer (31.25%) > autumn (28.13%) > spring (25.8%) > winter (25%) indicating year-round infection. T. globulosa was identified morphometrically from camels in Beheira Governorate, Egypt. The BLAST analysis revealed the presence of T. globulosa isolate from camels using the Genbank database depending on nuclear small subunit ribosomal RNA (18s) and cytochrome b (Cytb) genes., Conclusion: A high prevalence of T. globulosa was found in camels in Beheira Governorate, Egypt. This is the first report to confirm the identification of T. globulosa from camel based on morphometrical studies and molecular and phylogenetic analysis in Egypt. More thorough studies on the incidence, molecular, and genetic analysis of Trichuris spp. in Egypt are required in addition to camel control programs., (© 2024. The Author(s).)

The integration of microfabrication and microfluidics techniques into cell culture technology has significantly transformed cell culture conditions, scaffold architecture, and tissue biofabrication. These tools offer precise control over cell positioning and enable high-resolution analysis and testing. Culturing cells in 3D systems, such as spheroids and organoids, enables recapitulating the interaction between cells and the extracellular matrix, thereby allowing the creation of human-based biomimetic tissue models that are well-suited for pre-clinical drug screening. Here, we demonstrate an innovative microfluidic device for the formation, culture, and testing of hepatocyte spheroids, which comprises a large array of patterned microwells for hosting hepatic spheroid culture in a reproducible and organized format in a dynamic fluidic environment. The device allows maintaining and characterizing different spheroid sizes as well as exposing to various drugs in parallel enabling high-throughput experimentation. These liver spheroids exhibit physiologically relevant hepatic functionality, as evidenced by their ability to produce albumin and urea at levels comparable to in vivo conditions and the capability to distinguish the toxic effects of selected drugs. This highlights the effectiveness of the microenvironment provided by the chip in maintaining the functionality of hepatocyte spheroids. These data support the notion that the liver-spheroid chip provides a favorable microenvironment for the maintenance of hepatocyte spheroid functionality., Competing Interests: The authors have no conflicts to disclose., (© 2024 Author(s).)

Background & Aims: In patients with inflammatory bowel disease (IBD) and a history of cancer, retrospective studies have suggested that exposure to immunosuppressive agents does not increase the risk of incident (recurrent or new) cancer compared with unexposed patients. SAPPHIRE is a prospective registry aimed at addressing this issue., Methods: Since 2016, patients with IBD and confirmed index cancer before enrollment were followed up annually. Patients receiving chemotherapy or radiation at enrollment, or recurrent cancer within 5 years, were excluded. The primary outcome was development of incident cancer related to exposure to immunosuppressive medications., Results: Among 305 patients (47% male, 88% white), the median age at IBD diagnosis and cancer were 32 and 52 years, respectively. Index cancers were solid organ (46%), dermatologic (32%), gastrointestinal (13%), and hematologic (9%). During a median follow-up period of 4.8 years, 210 patients (69%) were exposed to immunosuppressive therapy and 46 patients (15%) developed incident cancers (25 new, 21 recurrent). In unadjusted analysis, the crude rate of incident cancer in unexposed patients was 2.58 per 100 person-years vs 4.78 per 100 person-years (relative risk, 1.85; 95% CI, 0.92-3.73) for immunosuppression-exposed patients. In a proportional hazards model adjusting for sex, smoking history, age and stage at index malignancy, and nonmelanoma skin cancer, no significant association was found between receipt of immunosuppression and incident cancer (adjusted hazard ratio, 1.41; 95% CI, 0.69-2.90), or with any major drug class., Conclusions: In this interim analysis of patients with IBD and a history of cancer, despite numerically increased adjusted hazard ratios, we did not find a statistically significant association between subsequent exposure to immunosuppressive therapies and development of incident cancers., (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Background: Janus kinase (JAK) inhibitors tofacitinib and upadacitinib are effective therapies for inflammatory bowel disease and rheumatologic disorders but currently possess a warning for increased venous thromboembolism (VTE) risk. Some patients with a history of VTE may benefit from a JAK inhibitor, but the risk of recurrent VTE with JAK inhibitor use is unclear. Our goal was to observe rates of new VTE events after starting JAK inhibitor therapy in patients with a prior VTE, and observe whether concurrent anticoagulation (AC) reduces this risk., Methods: We conducted a review of adults prescribed tofacitinib or upadacitinib between January 1, 2000, and June 30, 2023, with a prior history of VTE. Patient charts were reviewed for demographic data, disease type, and VTE date(s), and to verify duration of JAK inhibitor use along with any concurrent AC. VTEs following JAK inhibitor initiation were identified by International Classification of Diseases-Tenth Revision code and verified by physician documentation and imaging., Results: We identified 79 patients with a documented VTE history before initiating JAK inhibitors, 47 of whom began a JAK inhibitor with concurrent AC. Of these, 15 patients discontinued AC while receiving JAK inhibitors. In total, 5 new VTE events were observed during 55.42 patient-years of JAK inhibitor treatment without concurrent AC (9.0 events per 100 patient-years), while no new VTE events occurred during 65.2 patient-years of JAK inhibitor treatment with concurrent AC, demonstrating a lower risk of recurrent VTE (P = .020)., Conclusions: These results suggest that for patients with a prior VTE history there is a high risk for recurrent VTE while receiving JAK inhibitors. Concurrent use of AC with JAK inhibitors appears to be protective against recurrent VTEs in this population., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background and Objective: Inflammatory bowel disease (IBD) is a chronic condition that has been increasing in prevalence and incidence worldwide. Although, most cases are described in Caucasian populations, there has been a rise in IBD diagnosis among other populations. In this article, we will discuss the disparities in the presentation, management, medical and surgical outcomes of IBD patients among different racial and ethnic groups., Methods: A literature search was conducted in PubMed, Medline, and Google Scholar. The search strategy included targeted keywords to identify specific studies that provided the current literature on disparities in IBD presentation and management. Articles for presentation were selected by the authors, in accordance with a narrative review format, favoring population-based studies, systematic reviews and meta-analysis over single or multicenter reports., Key Content and Findings: Epidemiological data has shown that there is an increasing incidence in IBD diagnosis among Black, Asian, and Hispanic populations over the past decade. Differences in genetic predispositions have been observed, however it is difficult to ascertain if the minor differences in presentation and medical/surgical management reported are due to innate differences or due to confounding factors such as access to health care., Conclusions: Differences in genetic predisposition, and clinical presentation have been observed to exist among IBD non-Caucasian populations. There were also differences observed in both surgical and medical management, but it is difficult to ascertain if these were innate differences or due to societal factors., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-23-43/coif). The series “Controversies and Updates in Inflammatory Bowel Disease” was commissioned by the editorial office without any funding or sponsorship. K.S. serves as an unpaid editorial board member of Translational Gastroenterology and Hepatology from September 2022 to August 2024 and served as the unpaid Guest Editor of the series. The authors have no other conflicts of interest to declare., (2024 Translational Gastroenterology and Hepatology. All rights reserved.)

Objectives: To evaluate the accuracy of a semi-automatic 3D digital setup process in predicting the orthodontic treatment outcome achieved by labial fixed appliances., Subjects and Methods: Twenty-five adult patients (18 to 24 years old) with class I malocclusion and moderate crowding were prospectively enrolled and received treatment on both jaws through the straight-wire technique. Prior to treatment commencement, a semi-automatic digital setup simulating the predicted treatment outcome was performed for each patient through Orthoanalyzer software (3Shape®, Copenhagen, Denmark) to obtain the prediction model. This was compared to the final outcome model through 3D superimposition methods. Metric variables and inspection of color-coded distance maps were used to detect how accurately the digital setup predicts the actual treatment outcome., Results: The mean absolute distances (MAD) between the superimposed dental arches of the predicted and the final models were: 0.77 ± 0.13 mm following superimposition on the palate, 0.52 ± 0.06 mm following superimposition on the maxillary dental arch, and 0.55 ± 0.15 mm following superimposition on the mandibular dental arch. The MAD at the palatal reference area was 0.09 ± 0.04 mm. Visualization of color-coded distance maps indicated that the digital setup accurately predicted the final teeth position in a few cases. Almost half of the cases had posteriorly wider upper and lower dental arches and palatally/lingually positioned or inclined anterior teeth, whereas the rest still showed errors within 2-3 mm, distributed over the entire dental arches with no distinct pattern., Conclusions: The accuracy of semi-automatic prediction of the labial fixed appliance treatment outcome in Class I cases with moderate crowding is not yet sufficient. While average measures showed deviations less than 1 mm, examination of individual color-coded distance maps revealed significant disparities between the simulated and the actual results., (© 2024. The Author(s).)

Ethylene Glycol (EG) and diethylene Glycol (DEG) are two contaminants known to cause various human health problems. These glycols might be present in drug syrups that are based on glycerol, sorbitol, or polyethylene glycol. In late 2022, several batches of cough, antipyretics, and antihistamine syrups were reported to contain toxic levels of EG and DEG in multiple countries; this incident concerned the World Health Organization (WHO). From an analytical perspective, several methods of glycols analysis in pharmaceuticals have been reported in the literature, with the majority being dedicated to raw material analysis. This study aims to develop a selective method capable of evaluating a wide range of paediatric syrups in order to assess the safety of commercially available paediatric syrups currently distributed in the local market. This research introduces a method for determining glycols utilizing gas chromatography-tandem mass spectrometry (GC-MS/MS), which offers significantly higher selectivity than conventional single quadrupole gas chromatography-mass spectrometry (GC-MS). The developed method meets the current International Council for Harmonisation (ICH) guidelines for validation. The absence of any interfering peaks in both the unspiked sample of promethazine syrup and the reference standard solutions proved the method's selectivity. Furthermore, 2,2,2-trichloroethanol was used as an internal standard, and a new GC-MS/MS method was developed to analyze it. The calibration curves for EG and DEG were linear within the selected concentration range of 1-10 μg/mL. The detection limit for both EG and DEG was 400 ng/mL, while the quantification limit was 1 μg/mL. Recovery values for both EG and DEG met the accuracy acceptance criterion. Thus, the developed method proved to be efficient and accurate for determining EG and DEG levels in suspected contaminated syrups., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

To solve the problem of excessive heavy metals in farmland soil, there is a dire need for research effort to screen for the soil passivator materials. This study aimed to develop a practical novel approach for improving the potato growth and remedial effectiveness of the metals by optimal combination and dosage of various passivators. Experimental treatments were comprised of various levels of passivating agents (sepiolite, quicklime and calcium magnesium phosphate) in individual and combined form. Results showed that application of passivating agents significantly enhanced growth by optimizing photosynthetic attributes, enzymatic antioxidants, and soil health. Balanced application of passivators effectively reduce the bioavailability of metals, curbing their uptake by potato plants. Sole application of all the agents results statistically similar outcomes as compared with combined form. Additionally, passivators indirectly enhance the activity of essential antioxidant enzymes. Synergistic effect of all the agents significantly improved the tuber quality by decreasing the accumulation of proline, malondialdehyde content, and bioaccumulation of Cu, Pb, Cd, and As in potato parts. In crux, combined usage of passivating agents proved to be of better growth, improvement in antioxidative defense system, and better quality of potato. By mitigating heavy metal contamination, passivators not only enhance crop quality and yield but also ensure heavy metal-free potatoes that meet stringent food safety standards., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Wide-angle mechanical beam steering for on-the-move satellite communications is presented in this paper based on a closed-form pillbox antenna system. It includes three main parts: a fixed-feed part, which is a substrate-integrated waveguide (SIW) horn with an extended aperture attached to a parabolic reflector; a novel quasi-optical system, which is a single coupling slot alongside and without spacing from the parabolic reflector; and a radiating disc, which is a leaky-wave metallic pattern. To make the antenna compact, pillbox-based feeding is implemented underneath the metallic patterns. The antenna is designed based on a substrate-guided grounded concept using leaky-wave metallic patterns operating at 20 GHz. Beam scanning is achieved using mechanical rotation of the leaky-wave metallic patterns. The proposed antenna has an overall size of 340 × 335 × 2 mm 3 , a gain of 23.2 dBi, wide beam scanning range of 120°, from -60° to +60° in the azimuthal plane, and a low side lobe level of -17.8 dB at a maximum scan angle of 60°. The proposed antenna terminal is suitable for next-generation ubiquitous connectivity for households and small businesses in remote areas, ships, unmanned aerial vehicles, and disaster management.

Non-invasive deep brain stimulation using transcranial magnetic stimulation is a promising technique for treating several neurological disorders, such as Alzheimer's and Parkinson's diseases. However, the currently used coils do not demonstrate the required stimulation performance in deep regions of the brain, such as the hippocampus, due to the rapid decay of the field inside the head. This study proposes an array that uses the cone coil method for deep stimulation. This study investigates the impact of magnetic core and shielding on field strength, focality, decay rate, and safety. The coil's size and shape effects on the electric field distribution in deep brain areas are also examined. The finite element method is used to calculate the induced electric field in a realistic human head model. The simulation results indicate that the magnetic core and shielding increase the electric field intensity and enhance focality but do not improve the field decay rate. However, the decay rate can be reduced by increasing the coil size at the expense of focality. By adopting an optimum cone structure, the proposed five-coil array reduces the electric field attenuation rate to reach the stimulation threshold in deep regions while keeping all other regions within safety limits. In vitro and in vivo experimental results using a head phantom and a dead pig's head validate the simulated results and confirm that the proposed design is a reliable and efficient candidate for non-invasive deep brain magnetic stimulation.

Dihydrofolate reductase (DHFR) has gained significant attention in drug development, primarily due to marked distinctions in its active site among different species. DHFR plays a crucial role in both DNA and amino acid metabolism by facilitating the transfer of monocarbon residues through tetrahydrofolate, which is vital for nucleotide and amino acid synthesis. This considers its potential as a promising target for therapeutic interventions. In this study, our focus was on conducting a virtual screening of phytoconstituents from the IMPPAT2.0 database to identify potential inhibitors of DHFR. The initial criterion involved assessing the binding energy of molecules against DHFR and we screened top 20 compounds ranging energy -13.5 to -11.4 (kcal/Mol) while Pemetrexed disodium bound with less energy -10.2 (kcal/Mol), followed by an analysis of their interactions to identify more effective hits. We prioritized IMPHY007679 ( Bismurrayaquinone-A ), which displayed a high binding affinity and crucial interaction with DHFR. We also evaluated the drug-like properties and biological activity of IMPHY007679. Furthermore, MD simulation was done, RMSD, RMSF, Rg, SASA, PCA and FEL explore the time-evolution impact of IMPHY007679 comparing it with a reference drug, Pemetrexed disodium. Collectively, our findings suggest that IMPHY007679 recommend further investigation in both in vitro and in vivo settings for its potential in developing anticancer and antibacterial therapies. This compound holds promise as a valuable candidate for advancing drug research and treatment strategies.Communicated by Ramaswamy H. Sarma.

Background: Pain is an unpleasant experience and annoying sensation. To control this pain during orthodontic separation, different pharmacological and non-pharmacological methods have been used., Objective: This systematic review and meta-analysis aimed to critically assess the evidence of the effectiveness of pharmacological and non-pharmacological methods in reducing pain induced by orthodontic separation., Search Strategy: An electronic search was conducted using the following databases: PubMed® (Medline), Scopus®, EMBASE®, Web of ScienceTM, Google ScholarTM, ProQuest, and Cochrane Central Register of controlled trials (CENTRAL) searching for the studies published between January 2012 and April 2023., Selection Criteria: Only randomized controlled trials (RCTs) were included, each experimental group included patients who received elastomeric separators and one kind of pharmacological or non-pharmacological interventions for pain reduction during the separation stage., Data Collection and Analysis: Cochrane's risk of bias tool (RoB2 tool) was applied. The Grading of Recommendations Assessment, Development, and Evaluation [GRADE] approach was used to evaluate the strength of the evidence., Results: Thirty-one studies (RCTs) were included in this systematic review. Nineteen of them were appropriate for quantitative synthesis and used VAS for pain assessment. Meta-analysis showed that low-level laser therapy (LLLT) was an effective approach for pain relief after separators placement with standard mean difference of 13.79 mm (95% confidence interval (CI): -15.64, -11.94) at 6 h and 23.34 mm at 24 h (95% CI: -25.91, -20.77). LLLT was also effective when applied in split-mouth and the standard mean difference was 8.9 mm at 6 h (95% CI: -12.86, -3.33) and 17.15 mm at 24 h (95% CI: -30.12, -4.17). Ibuprofen had a pain control effect at 6 h and at 24 h compared with the placebo group. The standard mean difference was 14.37 mm (95% CI: -20.54, -8.19) and 20.46 mm (95% CI: -27.79, -13.13), respectively. There was no difference in pain control between ibuprofen and acetaminophen. Naproxen had lower visual analog scale scores in pain perception at 6 h and the standard mean difference was 7.03 mm (95% CI: -12.67, -1.40)., Conclusions: The application of LLLT decreased the pain induced by the separation during the first day of teeth separation; the pain reduction showed an increase from 6 h to the end of the 24 h. However, the evidence is weak to moderate. The analgesics reduced the pain compared to placebo; this pain reduction had shown an increase from 6 h to the end of the 24 h. The strength of the evidence is moderate. Naproxen gel effectively reduced the pain compared to placebo; the evidence in this regard is moderate. Naproxen gel effectively reduced the pain compared to placebo, but it was less effective than the oral intake of non-steroidal anti-inflammatory drugs. However, the evidence in this regard is moderate., Registration: This systematic review was registered with PROSPERO (CRD42022335553) during the first stages of its conduction., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Tannery wastewater effluents contain many toxic and carcinogenic heavy metals and physiochemical parameters that need to be removed before these effluents enter in the main water bodies or rivers. In this study, the effluents from the tannery industry are treated through aeration, coagulation, and Chlorella vulgaris pond treatment processes for the removal of physiochemical: parameters only., Methods: The effect of removal efficiencies (%) was studied on the physicochemical parameters, including salinity, electrical conductivity (EC), total dissolved solids (TDS), turbidity, total suspended solids (TSS), biochemical oxygen demand (BOD), and chemical oxygen demand (COD)., Results: The key results showed that the removal of EC, TDS, turbidity, TSS, BOD, and COD was 80.2%, 67%, 81%, 80.8%, 68.6%, and 100%, respectively, in raw wastewater treatment having 25, 50, and 70 g of algae C. vulgaris doses. The removal efficiencies (%) of salinity, EC, TDS, turbidity, TSS, BOD, and COD were 83%, 87.1%, 77.1%, 80%, 40%, 97%, and 98%, respectively, during coagulated wastewater treatment with three doses of algae. The observed improvement in treated wastewater indicated that the removal efficiencies (%) of salinity, EC, TDS, turbidity, TSS, BOD, and COD were 85.7%, 39.3%, 81.3%, 67.8%, 50.3%, 97%, and 98%, with C. vulgaris., Conclusion: This study confirmed that the treatment of tannery wastewater by these processes increased the pollutant removal efficiencies as all the physiochemical parameters were exceeding the permissible limits., Results Contribution in Future: This research will be helpful to treat the industrial wastewaters or effluents before it further mixes up in the main water streams. In this way, water quality will be better, aquatic life will be saved, and further researchers can analyze more ways for efficient treatments as they have a baseline data through this study findings., Practitioner Points: One of the most pollutant sources in terms of both physical and chemical parameters is the produced wastewater from tannery industries. The effluents from tannery industry are treated through aeration, coagulation, and algae ponds treatment processes. These treatment made the tannery wastewater as environmental friendly., (© 2023 Water Environment Federation.)

Background: Investigating the possible changes in patients' expectations of and satisfaction with the orthodontic treatment outcomes when they were given the three-dimensional digital prediction of their teeth alignment before the beginning of treatment., Methods: A prospective non-controlled single-group clinical trial was conducted on 28 (18 females, 10 males, mean age: 20.68 ± 1.91 years) patients with Class I malocclusion and moderate dental crowding who required a nonextraction orthodontic treatment. Patients were given the expectations questionnaire on their first visit (T0). Then, patients were shown a three-dimensional digital setup-created by Orthoanalyzer software (3Shape, Copenhagen, Denmark)-of the proposed treatment results before orthodontic treatment (T1) and received two questionnaires, the second expectations questionnaire and the satisfaction with the proposed changes questionnaire. Treatment was then initiated using the fixed appliances and completed. After debonding, a question about patients' satisfaction with the achieved changes was completed (T2)., Results: Patients' expectations level significantly increased after watching the predicted alignment of teeth compared with the initial levels in terms of chewing (x¯ = 5.54 and x¯= 6.71), speech (x‾ =5.93 and x¯= 6.93), and oral hygiene improvement (x‾= 7.93 and x¯=8.61 ± 1.06; at T0 and T1, respectively). The remaining items showed no significant differences between the two assessment times. Patients had a higher level of satisfaction at the end of treatment than after watching the proposed outcome. There were significant statistical differences in the items related to teeth appearance (x¯= 9.12 and x¯= 9.60 at T1 and T2, respectively), and teeth engagement (x¯= 8.92 and x¯= 9.40 at T1 and T2, respectively) CONCLUSIONS: Watching the predicted alignment outcome increased patients' expectations of chewing, speech, and oral hygiene improvement compared with the initially recorded levels. Patients were more satisfied with the final result than what was recorded after viewing the predicted plan. However, these results were not clinically significant., (Copyright © 2023 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.)

In this study, a method for degrading PET-waste plastic bottles using ZnCl 2 :Urea as a catalyst was developed, resulting in high conversion (87%). The terephthalic acid obtained from the degradation of Waste PET Bottles (WPTs) was combined with copper and zinc salts to synthesize bimetallic metal-organic frameworks (MOF). The effectiveness of a bimetallic Cu-Zn(BDC)-MOF in catalyzing the reduction reaction of organic pollutant dyes (OPDs) was investigated, and the degradation efficiency of individual dyes was optimized, achieving over 95% degradation within 6-12 min under optimal conditions. Various techniques, including FT-IR, XRD, FE-SEM, EDS, and TEM were used to characterize the synthesized MOF. Results showed that the catalytic activity of Cu-Zn-MOF in reduction reaction of OPDs was enhanced by increasing the copper content. The reaction kinetics were investigated following pseudo-first-order kinetics with rate constants of 0.581, 0.43, 0.37, and 0.30 min -1 for Methylene Blue (MB), Methyl Orange (MO), 4-Nitrophenol (4-NP), and 4-Nitroaniline (4-NA), respectively. The investigations revealed that the produced catalyst exhibited excellent stability and recoverability, while its activity remained well-preserved even after undergoing three reuse cycles., (© 2023. The Author(s).)

Background COVID-19 infection has caused a global pandemic affecting a group of patients with chronic conditions including diabetes with exacerbating insulin resistance and hyperglycemia. Investigators noted that pre-existing diabetes and newly diagnosed diabetes are associated with an increased risk of all-cause mortality in hospitalized patients with COVID-19 infection. Aim To evaluate the relationship between ICU patients infected with COVID-19 and mortality among those with high versus low glucose levels. Methods This is a retrospective study of critically ill adult patients infected with COVID-19 who were admitted to the ICU from April 5, 2020, to October 14, 2020. The participants were from San Bernardino County which is a diverse and underserved community. Overall, 84 patients were included in the final analysis. The average age was 59.67 (standard deviation=15.55) with 59.5% being males. Overall mortality was 44.1%. Results Around one-fifth of patients had glucose under control as measured by peak glucose level of <180 mg/dL during hospital stay. A statistically significant association was seen between tighter serum glucose control and mortality (p=0.0354). Patients with serum glucose maintained <180 mg/dL were associated with significantly lower mortality than their counterparts (22.2% vs. 50%). Conclusions This study suggests that maintaining a tighter control of the glycemic index in critically ill COVID-19 patients will improve morbidity and mortality., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sultan et al.)

Acute kidney injury (AKI) is a sudden decline in renal function after cardiac surgery. It is characterized by a significant reduction in glomerular filtration rate, alterations in serum creatinine (S.Cr) levels, and urine output. This study aimed to retrospectively analyze a cohort of 704 patients selected using stringent inclusion and exclusion criteria. AKI was defined by an increase of 0.3 mg/dL in S.Cr levels compared to baseline. Data were collected from the hospital and analyzed using SPSS 16.0. Data analysis revealed that 22% (n = 155) of the patients developed AKI on the second post-operative day, accompanied by a substantial increase in S.Cr levels (from 1.064 ± 0.2504 to 1.255 ± 0.2673, P < .000). Age and cardiopulmonary bypass duration were identified as risk factors along with ejection fraction and days of hospital stay, contributing to the development of AKI. Early renal replacement therapy can be planned when the diagnosis of AKI is established early after surgery., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

The aim of this study is to elucidate the meaning of the skulls depicted in emblem books of the 17th century. Three emblem books of the 17th century were reviewed and analyzed: (1) Rollenhagen emblem: Gabrielis Rollenhagii Selectorum emblematum centuria secunda (1613), (2) Quarles' emblems; illustrations engraved by William Marshall and others (1635), and (3) Wither's emblem: A collection of emblemes, ancient and moderne: quickened with metricall illustrations, both morall and divine: and disposed into lotteries (1635). Among the 100 illustrations in Rollenhagen's book, 4 (4.0%) had skulls. Among the 76 illustrations in Quarles' book, 6 (7.9%) had skulls. Among the 256 illustrations in Wither's book, 12 (4.7%) had skulls. Thereafter, 22 (5.1%) of 432 illustrations had skulls. Four emblems in Rollenhagen's book were exactly identical to those in Wither's book. Therefore, 18 emblems (6 Quarles' emblem, 12 Wither's emblem) were analyzed. The most frequent meaning of skulls in 18 emblems was death (12, 66.7%), followed by resurrection (2, 11.2%). Other meanings were grief, the brevity of life, vanity of love, and pain, respectively (1 each). The most frequent of the theme of the emblems, which included skulls, was 'Memento mori' (remember death, 6, 33.3%), followed by an earnest desire for salvation or resurrection (3, 16.7%), and importance of knowledge or learning (2, 11.1%). Since these emblem books were published after Vesalius' Fabrica (1543), the drawing of the bones of the arm and legs had anatomic correlations. However, skulls were not sufficiently precise, showing each part of the facial bones., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)

To purify hydrogen gas from synthesis gas using a adsorption process, SAPO 34 adsorbent was used. Due to the strong adsorption of carbon dioxide in this adsorbent, it is not possible to recover the adsorbent by reducing the pressure alone, and it is necessary to use thermal operations for recovery. For this purpose, a temperature swing adsorption (TSA) process is used to increase the purity of hydrogen for use in fuel cells. To investigate the optimum operational conditions, various temperatures and different pressures of input gas were investigated to compare the purity and recovery of adsorption process. The TSA process was simulated for pressures of 11, 22 and 33 bars and the recovery percentage of each process was calculated. According to the results obtained, the recovery value at 33 bars is better than the other two pressures, but due to the fact that operational and initial costs increase at high pressures; 22 bar pressure was chosen to present the remaining results. In this work, the total amount of material and the molar rate are also reported. The average purity of the components in the product and waste outlet streams has also been presented. Accordingly, the average molar fraction of hydrogen in the product outlet stream is 99.96% in the temperature increase stage, 99.94% and in the stream used for temperature reduction is 99.96%., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Chemical mutagenesis has been successfully used for increasing genetic diversity in crop plants. More than 800 novel mutant types of rice ( Oryza sativa L.) have been developed through the successful application of numerous mutagenic agents. Among a wide variety of chemical mutagens, ethyl-methane-sulfonate (EMS) is the alkylating agent that is most commonly employed in crop plants because it frequently induces nucleotide substitutions as detected in numerous genomes., Methods: In this study, seeds of the widely consumed Basmati rice variety (Super Basmati, Oryza sativa L.) were treated with EMS at concentrations of 0.25%, 0.50%, 0.75%, 1.0%, and 1.25% to broaden its narrow genetic base., Results: Sensitivity to a chemical mutagen such as ethyl methanesulfonate (EMS) was determined in the M1 generation. Results in M1 generation revealed that as the levels of applied EMS increased, there was a significant reduction in the germination percent, root length, shoot length, plant height, productive tillers, panicle length, sterile spikelet, total spikelet, and fertility percent as compared to the control under field conditions. All the aforementioned parameters decreased but there was an increase in EMS mutagens in an approximately linear fashion. Furthermore, there was no germination at 1.25% of EMS treatment for seed germination. A 50% germination was recorded between 0.50% and 0.75% EMS treatments. After germination, the subsequent parameters, viz. root length and shoot length had LD 50 between 05.0% and 0.75% EMS dose levels. Significant variation was noticed in the photosynthetic and water related attributes of fragrant rice. The linear increase in the enzymatic attributes was noticed by the EMS mediated treatments. After the establishment of the plants in the M1 generation in the field, it was observed that LD 50 for fertility percentage was at EMS 1.0% level, for the rice variety., Conclusion: Hence, it is concluded that for creating genetic variability in the rice variety (Super Basmati), EMS doses from 0.5% to 0.75% are the most efficient, and effective., Competing Interests: The authors declare there are no competing interests., (©2023 Shamshad et al.)

Introduction This study aimed to evaluate the knowledge of tourniquet use among orthopedic surgeons in Saudi Arabia and assess the practical aspects of their use of tourniquets and the complications they have experienced in their practices. Materials and methods This cross-sectional study was conducted from December 2022 to February 2023. An online questionnaire was distributed among orthopedic surgeons and trainees in Saudi Arabia, and the surgeons' knowledge of tourniquet use was assessed using 17 questions. To investigate tourniquet usage, the participants were divided into three groups: orthopedic residents, specialists, and consultants. An upper limb cuff pressure (CP) of 200 mmHg and a lower limb CP of 250 mmHg were chosen as the cut-off values, and the doctors' choices were compared against literature recommendations using these measures. Result A total of 205 participants filled out the questionnaires; 130 residents, 15 consultants, and 60 specialists, with more males (175/205) than females responding. One hundred and twenty-one surgeons placed the cuff on patients by themselves, while 50 (24.3%) surgeons asked nurses for aid; 135 (65.6%) of them work in teaching hospitals, while 50 (24.3%) work in community hospitals. The incidence of post-tourniquet syndrome was unrelated to expertise (p=0.12). Conclusion When applied properly, tourniquets prevent excessive bleeding and keep the operative field clean during limb surgeries. This study aims to inspire the orthopedic community to reconsider long-held practices, especially regarding tourniquet pressure. The addition of ligature safety education to orthopedics training and outlining the settings and procedures for applying pressure should also be considered. The orthopedic community should set CP and process criteria to avoid complications. This study showed the importance of modifying the training of orthopedic residents to raise awareness and prevent unpleasant events from occurring., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Albaker et al.)

Plant mitochondria represent the largest group of respiring organelles on the planet. Plant mitochondrial messenger RNAs (mRNAs) lack Shine-Dalgarno-like ribosome-binding sites, so it is unknown how plant mitoribosomes recognize mRNA. We show that "mitochondrial translation factors" mTRAN1 and mTRAN2 are land plant-specific proteins, required for normal mitochondrial respiration chain biogenesis. Our studies suggest that mTRANs are noncanonical pentatricopeptide repeat (PPR)-like RNA binding proteins of the mitoribosomal "small" subunit. We identified conserved Adenosine (A)/Uridine (U)-rich motifs in the 5' regions of plant mitochondrial mRNAs. mTRAN1 binds this motif, suggesting that it is a mitoribosome homing factor to identify mRNAs. We demonstrate that mTRANs are likely required for translation of all plant mitochondrial mRNAs. Plant mitochondrial translation initiation thus appears to use a protein-mRNA interaction that is divergent from bacteria or mammalian mitochondria.

This study describes the craniofacial features of achondroplastic dwarfism in the paintings of Velázquez. In a PubMed search, using [Velázquez] and [dwarf], 13 titles were found. In a Google Image search, [Velázquez] and [dwarf] retrieved 5 paintings. The craniofacial manifestations of the dwarfs depicted in the paintings were analyzed. Frontal bossing, antimongoloid slant, depressed nasal bridge (saddle nose), bulbous tip, malar hypoplasia, malocclusion, and chin asymmetry were observed. The presence of each manifestation was checked. In 5 paintings, portraits of 6 dwarfs having craniofacial deformities were found: Mariabárbola Asquin (left) in Las Meninas , Nicolasito Pertusato (right) in Las Meninas , Portrait of Sebastián de Morra, Portrait of Francisco Lezcano, The Jester Don Diego de Acedo, and Prince Balthasar Charles with a Dwarf. The most frequent craniofacial manifestation was malar hypoplasia (100%), followed by a bulbous tip (83.3%), saddle nose (66.7%), and frontal bossing (50%). Antimongoloid slant, malocclusion, and chin asymmetry were relatively rare (16.7% each). Through an analysis of 6 dwarfs in Velázquez's paintings, we can show that he realized and frequently expressed the craniofacial manifestations of achondroplasia: malar hypoplasia, bulbous tip, saddle nose, and frontal bossing. Despite the rarity of these presentations, he was also aware of antimongoloid slant, malocclusion, and chin asymmetry. Velázquez was a famous painter in the 17th century (i.e., during the Baroque period). Based on his excellent expression of the craniofacial manifestations of dwarfism, we can assume that he had a sound knowledge of anatomy, as well as malformations., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)

Introduction: The traditional methods of deboning metal brackets exert excessive force, resulting in enamel scratches, fractures, and patient discomfort. The objective of this study was to evaluate the effectiveness of using two intensity levels of a diode laser for debonding metallic orthodontic brackets as an alternative to the conventional debonding method., Materials and Methods: Sixty intact, extracted human premolar teeth were used in this study, and metal orthodontic brackets were bonded to the buccal surface of these teeth. The teeth were divided into three groups for the experiment: (1) the control group, where conventional bracket debonding was performed using a debonding plier, (2) the first experimental group, where a diode laser (2.5W, 980nm) was utilized for laser debonding, and (3) the second experimental group, where a diode laser (5W, 980nm) was used for laser debonding. The laser was applied using a sweeping movement for 5 seconds. After debonding, the adhesive remnant index (ARI), the lengths, and the frequency of enamel cracks were compared among the groups. Additionally, an increase in intra-pulpal temperature was measured., Results: In all groups, there were no instances of enamel fractures. Laser debonding resulted in a significant reduction in both the frequency and length of newly formed enamel cracks compared to the conventional debonding method. The laser debonding group exhibited increases in intra-pulpal temperature of 2.37°C and 3.60°C in the second and third groups, respectively. These temperature increases were significantly lower than the threshold of 5.5°C. There were no significant differences observed in the ARI scores among the groups., Conclusion: With all debonding methods, an increase in the length and frequency of enamel cracks should be anticipated. However, laser-assisted debonding of metal brackets offers the advantage of reducing the risk of enamel damage while avoiding thermal damage to the pulp., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mousa et al.)

Background  Supracondylar fractures of the humerus (SCFHs) are the most common type of elbow fracture in children. Because of the influence on functional outcome, neuropraxia is one of the most common concerns at presentation. The impact of preoperative neuropraxia on surgery duration is not extensively probed. The clinical implications of several other risk factors associated with preoperative neuropraxia at presentation may contribute to longer surgical duration of SCFH. Hypothesis  Preoperative neuropraxia is likely to increase surgery duration in patients who sustained SCFH. Patients and Methods  This is a retrospective cohort analysis. Sixty-six patients who sustained surgical pediatric supracondylar humerus fracture were included in the study. Baseline characteristics including age, gender, the type of fracture according to Gartland classification, mechanism of injury, patient weight, side of injury, and associated nerve injury were included in the study. Logistic regression analysis was performed using mean surgery duration as the main dependent variable and age, gender, fracture type according to the mechanism of injury, Gartland classification, injured arm, vascular status, time from presentation to surgery, weight, type of surgery, medial K-wire use, and afterhours surgery as the independent variables. A follow-up of 1 year was implemented. Result  The overall preoperative neuropraxia rate was 9.1%. The mean surgery duration was 57.6 ± 5.6 minutes. The mean duration of closed reduction and percutaneous pinning surgeries was 48.5 ± 5.3 minutes, whereas the mean duration of open reduction and internal fixation (ORIF) surgeries was 129.3 ± 15.1 minutes. Preoperative neuropraxia was associated with an overall increase in the surgery duration ( p  < 0.017). Bivariate binary regression analysis showed a significant correlation between the increase of surgery duration and flexion-type fracture (odds ratio = 11, p  < 0.038) as well as ORIF (odds ratio = 26.2, p  < 0.001). Conclusion  Preoperative neuropraxia and flexion-type fractures convey a potential longer surgical duration in pediatric supracondylar fracture. Level of Evidence  Prognostic III., Competing Interests: Conflict of Interest The authors declare no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ).)

The aim of this study was to assess how the eyes of Kyrgyz beauties look through an anthropometric analysis of beauty pageant winners. Eleven winners of the Miss Kyrgyzstan contest (2011-2021) were included. Ten other beauty contest winners were added, resulting in a total of 21 beauties who were included. The horizontal corneal diameter, which is 11.75 mm, was used as a standard distance. Other distances were calculated in millimeters based on the proportions of the pixels measured. Twenty-six distances (face: 10, eyebrows: 2, eyes: 4, nose: 4, lips: 4, and chin: 2) and 9 angles (forehead-brow, cantal tilt, 5 face angles, the mandible angle, and the chin angle) were measured. Thereafter, 16 indices (forehead: 1, eyes: 5, nose: 4, lips and chin: 3, and contours 3) were calculated. The forehead-brow angle was 82.2±7.2 degrees. The canthal tilt was 9.0±2.0 degrees. The overall face angles 1 and 2 were 108.6±4.1 degrees and 69.6±2.3 degrees, respectively. The midface angles 1 and 2 were 129.9±3.8 degrees and 125.1±3.9 degrees, respectively. The lower face angle was 139.6±4.1 degrees. The mandible angle and chin angle were 136.9±4.0 degrees and 106.0±4.0 degrees, respectively. The ratio of forehead height to total face height was 0.33±0.03. The ratio of nose height to total face height was 0.25±0.02. The lower face width/face width ratio was 0.82±0.05. The ratio of face width to total face height was 0.72±0.03. The ratio of midface height to total face height was 0.34±0.02. The data from this study might serve as the recommended esthetic proportions for performing plastic surgical procedures., Competing Interests: The authors have no conflict of interest to declare., (Copyright © 2023 by Mutaz B. Habal, MD.)

Background Primary spontaneous pneumothorax (PSP) is a fairly prevalent disorder in emergency medicine. PSP most frequently affects tall, thin male smokers and is most prevalent during adolescence. Published literature contains a wide range of Primary Spontaneous Pneumothorax (PSP) recurrence rates, but there is limited information on the variables affecting recurrence. Objective To identify the descriptive features of PSP in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods This retrospective cross-sectional study was conducted in Surgery King Abdulaziz Medical City, Riyadh, Saudi Arabia. Including all PSP patients from 2016-2021, excluding pediatric and geriatric patients. Participants were selected using a simple random sampling technique, and data were collected from hospital records. Data analysis was conducted by using SPSS. Results In this study, we included a total of 131 participants. Most were males (93.1%), and most were aged between 21-30 years. Our findings showed that most PSP events occurred in winter (28.6%). Followed by fall (25.7%), summer (25.0%), and spring (20.7%). Concerning the smoking status of our respondents, our results revealed that most of them were active smokers (72.5%). Left-PSP was the most commonly reported type of PSP (43.5 %), followed by right-PSP (38.9%), non-simultaneous bilateral PSP (14.5%), and bilateral simultaneous PSP (3.1%). Moreover, we found that the recurrence rate of PSP was 42%. Regarding the management of PSP, almost half of the respondents were managed initially by Chest tube. The most frequently used surgical option was VATS- Bullectomy with Abrasion Pleurodesis. Finally, the recurrence rate of PSP was 42% among the patients. The percentage of patients with one recurrence only was 65.5% among the patients with recurrent PSP, second recurrence at 29.1%. Third, Fourth, and Fifth had the same recurrence percentage of 1.8%, and these percentages came to be statistically significant. (P value < 0.001) Conclusion Our study concluded that PSP was more prevalent in tall, thin, young male smokers. Almost half of the respondents suffered from at least one recurrence attack of PSP. The majority of the patients with recurrences experienced one recurrence only, and the second recurrence was estimated to be almost one-third. There is no significant association between the occurrence and seasons of the attack at a time. Most of the participants were managed initially by a chest tube. The most frequently used surgical option was Video Assisted Thoracoscopic Surgery (VATS) with abrasion pleurodesis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alruwaili et al.)

Since the CubeSats have become inherently used for the Internet of space things (IoST) applications, the limited spectral band at the ultra-high frequency (UHF) and very high frequency should be efficiently utilized to be sufficient for different applications of CubeSats. Therefore, cognitive radio (CR) has been used as an enabling technology for efficient, dynamic, and flexible spectrum utilization. So, this paper proposes a low-profile antenna for cognitive radio in IoST CubeSat applications at the UHF band. The proposed antenna comprises a circularly polarized wideband (WB) semi-hexagonal slot and two narrowband (NB) frequency reconfigurable loop slots integrated into a single-layer substrate. The semi-hexagonal-shaped slot antenna is excited by two orthogonal +/-45° tapered feed lines and loaded by a capacitor in order to achieve left/right-handed circular polarization in wide bandwidth from 0.57 GHz to 0.95 GHz. In addition, two NB frequency reconfigurable slot loop-based antennas are tuned over a wide frequency band from 0.6 GHz to 1.05 GH. The antenna tuning is achieved based on a varactor diode integrated into the slot loop antenna. The two NB antennas are designed as meander loops to miniaturize the physical length and point in different directions to achieve pattern diversity. The antenna design is fabricated on FR-4 substrate, and measured results have verified the simulated results.

This systematic review aimed to critically assess the available evidence regarding the effectiveness and efficiency of clear aligners in the comprehensive treatment of complex cases accompanied by premolars extraction. An electronic literature search by two reviewers was independently done on 27 February 2023 in the following databases without time and language limitations: Pubmed®, Scoups®, Google Scholar, Cochrane Library database, Web of Science™, and Proquest Database Open. Randomized controlled trials (RCTs) of any type, non-randomized clinical trials (CCT), cohort studies, and prospective, retrospective, and cross-sectional studies were reviewed. The risk of bias in included studies was assessed using the Risk of Bias (RoB 2.0) tool for randomized trials and the Risk of Bias in Non-randomized Studies (ROBINS-I) tool for non-randomized studies. After carefully searching the literature, six trials were included in this systematic review, three RCTs, two retrospective cohort studies, and one CCT. Two hundred eighty-three patients were included (186 females, 97 males). Three studies found that there were no differences between the clear aligners and fixed appliances when evaluations were done using the American Board of Orthodontists Objective Grading System (ABO-OGS) or the Peer Assessment Rating (PAR) index. Two studies found that there were some differences between predicted and achieved tooth movements when clear aligners were used in premolars extraction cases. Based on the included studies, the duration of treatment was shorter with fixed appliances than the clear aligners when applied to orthodontic extraction cases. Both clear aligners and fixed appliances were found effective in the orthodontic treatment of premolar extraction-based cases. Fixed appliances have the advantage of achieving better buccolingual inclination and occlusal contacts in a shorter treatment duration. Treatment with clear aligners might be associated with differences between predicted and achieved tooth movements. Therefore, the characteristics of these techniques should be considered when making a treatment decision., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Jaber et al.)