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Abstract Background Diabetic myocardial disorder (DbMD, evidenced by abnormal echocardiography or cardiac biomarkers) is a form of stage B heart failure (SBHF) at high risk for progression to overt HF. SBHF is defined by abnormal LV morphology and function and/or abnormal cardiac biomarker concentrations. Objective To compare the evolution of four DbMD groups based on biomarkers alone, systolic and diastolic dysfunction alone, or their combination. Methods The Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) trial was a Phase 3 randomised trial of an aldose reductase inhibitor in patients with well-controlled type 2 diabetes mellitus (T2DM). The 1858 potential participants (age 67 ± 7 years; 50% women) were screened for SBHF based on abnormal echocardiography or biomarkers (N-terminal pro-B-type natriuretic peptide ≥ 40 ng/L or high sensitivity cardiac troponin T ≥ 10 ng/L [women] and ≥ 16 ng/L [men]). Exercise capacity (peak VO2) was reduced in 669 with DbMD (age 68 ± 7, 50% women), and peak VO2 was reassessed at 15 months. Results The 1463 (79%) participants with DbMD were allocated to four clusters; 907 (49%) showed isolated elevation of cardiac biomarkers, 301 (16%) with systolic dysfunction/hypertrophy, 162 (9%) with diastolic dysfunction and 93 (5%) comprised an overlap cluster (combined diastolic, systolic or LV geometric abnormalities). Reduced VO2 (

Double skin composite (DSC) shear wall is composed of two exterior steel faceplate connected to each other by connectors and infilled with concrete. In terms of axial and lateral strengths, stiffness, ductility, and energy dissipation capacity, DSC wall performs better than standard Reinforced Concrete (RC). There are two patterns DSC faceplate of DSC, namely flat and corrugated which offers significantly higher out-of-plane bending stiffness. Therefore, this study aimed to explore the effect of faceplate configuration on cyclic behavior of DSC shear wall. Comparison was made regarding the patterns of faceplate including trapezoidal, zig-zag, and curved profiles with flat. This was followed by finite element analysis with ANSYS software to investigate the response of DSC towards cyclic loading. The results showed that among the four profiles, trapezoidal profiles had better energy dissipation and ductility ratio. Trapezoidal pattern offered several advantages in the manufacturing field, including better contact between concrete and good aesthetic appearance. Energy dissipation of DSC wall with trapezoidal faceplate was found to be 37.57%, 23%, and 42.66% more than zigzag, curve, and flat, respectively. There was a reduction in stress by providing corrugated profiles, where the maximum of 54.3% was induced in DSC wall with flat faceplate compared to trapezoidal. This showed that optimizing faceplate configuration further increased the benefits of DSC wall, offering a robust option for seismic design.

Background/aim Ellagic acid (EA) is widely recognized as a natural compound with pharmacological potency as a polyphenolic molecule, possessing antioxidant, anti-inflammatory, antimutagenic, and antiproliferative characteristics. The present study aims to evaluate the potential neuroprotective effect of EA in retinal degeneration induced experimentally in rabbits. Material and methods A total of 27 male white New Zealand rabbits, with an average weight ranging from 1.5 to 2 kg, were divided into three groups (nine each). Group I served as the control group, while group II and group III, the macular degeneration (MD) induction groups that received a single intravitreal injection of sodium iodate (SI). Following the injection, group III was given 50 mg/kg of EA powder for 21 days, starting immediately after MD induction. Ophthalmic examinations of the retinas were conducted on days 7, 14, and 21 using a fundus camera, followed by electroretinogram (ERG) recording after MD induction. Apoptotic caspase-3 and caspase-7 activities in the retina tissues were also measured postdecapitation. Results The results showed a significant decrease (P≤0.05) in electroretinogram ‘a- and b-waves’ following intravitreal SI injection in group II and III comparing with control group. The pattern of internucleosomal fragmentation, indicating apoptosis, was time-dependent. The injection also increased relative caspase-3 and caspase-7 activity. However, group III of rabbits that is treated with EA exhibited noticeable improvements in these outcomes in comparing with group of MD-induced rabbits. Conclusions The administration of EA demonstrated a notable impact in improving the retina’s function, and decreased the apoptosis levels in MD model of rabbits

The study aims to assess soil degradation the northeastern part of Kirkuk Governorate includes the districts of (Shwan) and (Altun Kopri) extends between longitudes (44̊ 22ʹ 29ʺ-44̊ 38ʹ 22ʺ) and latitudes (35̊ 42ʹ16ʺ-35̊ 43ʹ 53ʺ) with a total area of (117,683.96 hectares). Spectral comparative indicators for the years (1997, 2014, 2020, 2023) were used to monitor the deterioration during these years using landsat 5 MSS, landsat 8 OLI and Arc GIS 10.4.1 software for mapping. The NDVI (low vegetation) decreased in 2023 compared to 1997, while the percentage of (medium vegetation) and (dense vegetation) in 2023 increased compared to previous years., As for the SAVI, class (very few) has decreased its area in 2023 compared to 1997, while for the rest of classes (few), (moderate), (good) and (very good), their areas have increased in 2023 compared to previous years. As for CI class, the (medium) class increased in 2023 compared to 1997, while the (strong) class was the opposite of the aforementioned class, as it decreased in 2023 compared to previous years, As for the BSI, the (no degradation), as it decreased in 2023 compared to 1997, while the class (little degradation) increased in 2023 compared to previous years, while the class (medium degradation) increased its percentage compared to 1997, As for the NDMI indicator, the class (dry lands) in the year 2023 has decreased compared to 1997, as for the second class (low moisture lands), a noticeable increase was observed in the year 2023 compared to 1997

Herbal plants have gained enormous interest due to their immune, antioxidant, and antibacterial activities. The present study proposed that white poplar (Populus alba) leave extract (WPE) might provide a promising alternative to traditional antibiotics to treat Aeromonas veronii infection in Nile tilapia (Oreochromis niloticus). WPE showed an in vitro antibacterial activity [22 ± 0.45 mm inhibition zone, with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of 60 µg/mL] against A. veronii. For the in-vivo study, a factorial (2 × 2) design was used to investigate the therapeutic effects of WPE on the antioxidant/immune status and blood biochemical parameters of Nile tilapia challenged with A. veronii. One-hundred sixty fish (33 ± 1.5 g) were assigned into four experimental groups, each with four replicates (4 glass tanks/group, 40 fish/group, 10 fish/tank) for 10 days. In the first (1st) and 2nd groups, 0 and 1.5 mg/L WPE were applied in tank water, respectively, without fish being challenged. In the 3rd and 4th groups, 0 and 1.5 mg/L WPE were applied in tank water, respectively, with fish intraperitoneal inoculated with 0.2 mL of A. veronii (0.5 × 107 CFU). Aeromonas veronii infection significantly diminished the survivability, hepatic catalase, lysozyme activity, nitric oxide, immunoglobulin M, phagocytic %, total protein, albumin, and globulin. Moreover, a significant rise in the hepatic malondialdehyde, serum hepatorenal function indicators, cortisol, and glucose levels were consequences of A. veronii challenge. Interestingly, the interaction between bacterial challenge and WPE application increased the survivability, antioxidant activity, and immune responses and reduced ALT levels of fish treated with WPE during the bacterial challenge. The serum creatinine, cortisol, and glucose levels were decreased in fish treated with WPE during the infection but still higher than in the non-infected fish either treated or not treated with WPE. In conclusion, WPE (1.5 mg/L) can be used as an antibacterial substance in fish farming to alleviate the detrimental impacts of A. veronii infection by enhancing the antioxidant/immune status of the infected fish. These outcomes could help reduce antibiotic usage in fish farms, which is conducive to the sustainable development of aquaculture.

Abstract Background Cellulose is the major part of lignocellulosic biomass. It can be hydrolyzed into glucose units via specific enzymes called cellulases that have been applied in many commercial fields. There are several studies illustrate the influence of enzymes on apple juice clarification. However, to the best of our knowledge, the effect of microbial cellulase on volatile compounds of apple juice is not well known. The present study aimed to assess the effect of cellulase from a new bacterial isolate on the physicochemical properties of apple juice as well as volatile compounds. The hydrolysis of some polysaccharides (cellulose, hemicellulose, pectin) and polyphenols during apple juice production is necessary to reduce cloud sedimentation or color deterioration and increase the yield of juice. So, enzymes from new microbial isolates serve as processing aids to obtain clear juice with a high yield. Results Cellulase-producing bacterium was isolated, characterized and molecularly identified as Bacillus licheniformis strain-MA1 with an accession number of ON840115. Optimization of medium parameters was implemented using Plackett–Burman design (PBd) followed by Box-Behnken design (BBd) of response surface methodology (RSM). The PBd revealed the three most important (significant) variables including carboxymethyl cellulose (CMC), corn cob, and peptone that had positive impact on cellulase production. Additionally, using the agricultural residue (corn cob) by the bacterial strain as a carbon source helps in reducing the costs of enzyme production, recycling the by-products, and preserving the environment. The optimized medium using PBd and BBd enhanced cellulase production from B. licheniformis strain-MA1 by 6.8-fold. A remarkable increase was observed in juice yield in enzyme treated-juice sample (88.2 ± 0.15%) in comparison with control juice (75.4 ± 0.09%). The total phenolic contents in cloudy and clarified apple juices were 0.957 ± 0.09 and 0.412 ± 0.03 mg/mL, respectively. Also, DPPH and FRAP assays showed a remarkable increase in antioxidant activity (Low IC50) in the control sample compared to enzyme treatment. Twenty-seven volatile compounds were extracted using headspace solid-phase microextraction-gas and analysis was performed by GC–MS. The identified volatile constituents belonged to several chemical classes: 15 esters; 6 alcohols; 4 aldehydes and 2 acids. The predominant class in apple juice volatile fraction was esters with a sweet and fruity odor. Conclusion The crude cellulase obtained from the novel bacterial isolate B. licheniformis strain-MA1 was successfully applied as a clarifying agent in apple juice.

Members of research ethics committees (RECs) face a number of ethical challenges when reviewing genomic research. These include issues regarding the content and type of consent, the return of individual research results, mechanisms of sharing specimens and health data, and appropriate community engagement efforts. This article presents the findings from a survey that sought to investigate the opinions and attitudes of REC members from four Arab countries in the Middle East and North Africa (Egypt, Morocco, Sudan, and Jordan) toward these ethical issues. Our findings suggest that efforts are required to better familiarize REC members with the requirements for ethical biobank research. Additionally, we recommend that further research is undertaken with REC members regarding the main items that should be present in the Material Transfer Agreements/Data Transfer Agreements in their corresponding countries and the type of consent that should be used in genomic research.

Summary:. Giant congenital melanocytic nevi are large pigmented premalignant lesions present at birth that have an associated risk of malignant transformation. Full-thickness excision of these lesions would be required to eliminate this risk. However, giant nevi can leave behind large defects that can be challenging to reconstruct. We present the case of a pediatric patient with a lesion occupying the entirety of the back, or around 18% total body surface area, and in whom Integra and meshed skin grafts were successfully used. This represents the largest defect size in the literature resulting from a giant nevus that has been treated by this method. Full take of the skin grafts was observed 26 days from the excision of the lesion with satisfactory functional outcomes.

Background: Heart failure (HF) is increasing in the United States, and awareness is needed for prevention. Hypertension is the leading cause of HF, and adherence to antihypertensive medication is critical for reducing HF risk. Self-efficacy positively influences health-promoting behaviors. Objectives: Assess HF awareness, test associations with antihypertensive medication adherence, and self-efficacy for managing chronic conditions. Design: We conducted a cross-sectional, observational survey research study. Methods: We leveraged data from participants enrolled in the American Heart Association’s Research Goes Red™ registry, an online platform powered by Verily. Three surveys ascertained HF awareness, blood pressure management, and self-efficacy. Chi-squared and Wilcoxon rank sum determined associations between survey domains and participant characteristics. Results: Two thousand three hundred twenty women took the HF awareness survey, 678 the blood pressure management survey, and 755 the self-efficacy survey (response rates: 12%, 78%, and 76%, respectively). Participants were predominantly non-Hispanic White (78%), with a median age of 51 (interquartile range (IQR): 39, 62). Median HF awareness score was 4/5 (IQR: 4, 5). Participants with high HF awareness versus low were more likely to be older ( p

Objectives: Distant liver injury is a complication of renal ischemia-reperfusion (I/R) injury, which imposes mortality and economic burden. This study aimed to elucidate the cross-talk of endoplasmic reticulum (ER) stress and mitochondrial perturbations in renal I/R-induced liver injury, and the potential hepatoprotective effect of azilsartan (AZL).Methods: Male albino Wister rats were pre-treated with AZL (3 mg/kg/day, PO) for 7 days then a bilateral renal I/R or sham procedure was performed. Activities of liver enzymes were assessed in plasma. The structure and ultra-structure of hepatocytes were assessed by light and electron microscopy. Markers of ER stress, mitochondrial biogenesis and apoptosis were analyzed in livers of rats.Results: Renal ischemic rats showed higher plasma levels of liver enzymes than sham-operated rats, coupled with histological and ultra-structural alterations in hepatocytes. Mechanistically, there was up-regulation of ER stress markers and suppression of mitochondrial biogenesis-related proteins and enhanced apoptosis in livers of renal ischemic rats. These abnormalities were almost abrogated by AZL pretreatment.Discussion: Our findings uncovered the involvement of mitochondrial perturbations, ER stress and apoptosis in liver injury following renal I/R, and suggested AZL as a preconditioning strategy to ameliorate remote liver injury in patients susceptible to renal I/R after adequate clinical testing.

Background During the coronavirus disease 2019 pandemic, mask wearing was obligatory in many countries to decrease infection risk among individuals. However, long-term mask wearing was associated with the development of various adverse skin reactions. Objective To assess possible dermatological complications due to mask wear during the coronavirus disease 2019 pandemic among a sample of the Egyptian population. Patients and methods The present hospital-based cross-sectional study included 320 patients who had attended outpatient dermatology clinic of the university hospitals with any dermatological symptoms. Patients wore face surgical masks during the pandemic for at least 3 months during outdoor activity. All patients were subjected to detailed history taking about onset, duration of the skin condition, whether an initial attack or pre-existing condition, and complete dermatological examination to confirm the diagnosis and evaluate severity level. Results This study showed that long‐term mask use caused new-onset skin diseases and increased dermatological facial diseases. The most common skin finding was Maskne (46.9%), followed by contact dermatitis, perioral dermatitis, and rosacea (14.1, 9.4, and 7.8%, respectively), while the remaining 21.9% were complaining of nonmask-related dermatoses. There was a significant positive correlation between mask-wearing duration and disease severity (P

Abstract Introduction Persons with diabetes are at risk for developing a cardiomyopathy through several pathophysiological mechanisms independent of traditional risk factors for heart failure. Among those with diabetic cardiomyopathy (DbCM), the relationship between natriuretic peptides, cardiac structural abnormalities and functional capacity is largely unknown. Methods In this prespecified subgroup analysis of the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) trial, 685 participants with asymptomatic DbCM underwent baseline echocardiography data, laboratory investigations, and functional assessments. Participants were stratified by N-terminal pro-B type natriuretic peptide (NT-proBNP) quartiles, and correlation with echocardiographic and functional parameters were assessed using Spearman correlation test. Results The median NT-proBNP was 71 (Q1, Q3: 33, 135) ng/L. No association was observed between NT-proBNP concentrations and echocardiographic parameters of either diastolic or systolic dysfunction including global longitudinal strain, left ventricular ejection fraction, left ventricular mass index, left atrial volume index, E/E’, or right ventricular systolic pressure. In contrast, NT-proBNP was significantly correlated with overall Kansas City Cardiomyopathy Questionnaire score (rho = − 0.10; p = 0.007), the Physical Activity Scale in the Elderly (rho = − 0.12; p = 0.004), duration of cardiopulmonary exercise testing (rho = − 0.28; p 95 for females or > 115 for males or E/e’ >13 or left atrial volume index > 34. †Normal ECHO is defined as the absence of these abnormalities. Low NT-proBNP is defined as

Abstract Background The inappropriate use of pesticides including fungicides creates severe biological hazards that can endanger fish health and impede sustainable aquaculture. Objective This study investigated the negative impacts of metiram (MET), a fungicide on the health status of Nile tilapia (Oreochromis niloticus) for a 96-hour duration as an acute exposure in a static renewal system. Methods Three hundred fish (average body weight: 37.50 ± 0.22 g) were assigned into six groups (50 fish/group) with five replicates (10 fish/replicate). Fish were exposed to various six concentrations (0, 1.5, 3, 4.5, 6, and 7.5 mg/L) of MET as a water exposure to for 96-hour without water exchange. The fish’s behavior, clinical signs, and mortalities were documented every day of the exposure period. Additionally, MET’s impact on blood profile, stress biomarkers, hepato-renal functions, immune-antioxidant status, and brain biomarker were closely monitored. Results The lethal concentration (LC50) of MET estimated using Finney’s probit technique was 3.77 mg/L. The fish’s behavior was severely impacted by acute MET exposure, as clear by an increase in surfacing, loss of equilibrium, unusual swimming, laterality, abnormal movement, and a decline in aggressive behaviors. The survivability and hematological indices (white and red blood cell count, differential white blood cell count, hematocrit value, and hemoglobin) were significantly reduced in a concentration-dependent manner following MET exposure. Acute exposure to MET (1.5–7.5 mg/L) incrementally increased stress biomarkers (nor-epinephrine, cortisol, and glucose), lipid peroxides (malondialdehyde), and brain oxidative DNA damage biomarker (8-hydroxy-2-deoxyguanosine). A hepato-renal dysfunction by MET exposure (4.5–7.5 mg/L) was evidenced by the significant increase in the alanine and aspartate aminotransferases and creatinine values. Moreover, a substantial decline in the immune parameters (lysozyme, complement 3, serum bactericidal activity, and antiprotease activity) and antioxidant variables (total antioxidant capacity, superoxide dismutase, and glutathione peroxidase) resulted from acute MET exposure. Conclusion According to these findings, the 96-hour LC50 of MET in Nile tilapia was 3.77 mg/L. MET exposure triggered toxicity in Nile tilapia, as seen by alterations in fish neuro-behaviors, immune-antioxidant status, hepato-renal functioning, and signifying physiological disturbances. This study emphasizes the potential ecological dangers provoked by MET as an environmental contaminant to aquatic systems. However, the long-term MET exposure is still needed to be investigated.

Abstract Environmental stressors (such as ammonia) in aquaculture could increase the risk of pathogenicity, posing a more severe threat to farmed fish. The aim of this study was to investigate the effects of ammonia stress on the pathogenicity of Shewanella spp. in Oreochromis niloticus. First, a 96-hour static test was used to determine the median lethal concentration (LC50) of unionized ammonia to Nile tilapia. After 96 h of exposure, the Un-ionized ammonia (UIA) LC50 was estimated to be 4.26 mg/L. Second, an experiment was conducted to test the effect of unionized ammonia stress on the pathogenicity of Shewanella spp. in O. niloticus for 30 days. A study involved 180 fish divided into six groups, with the first group serving as a control. The second group (AMN1/10) and the third group (AMN1/20) were not challenged and were exposed to 1/10 (0.42 mg/L) and 1/20 (0.21 mg/L) of the 96-hour LC50 of UIA, respectively. Then 0.2 mL (0.14 × 105) of Shewanella spp. was intraperitoneally injected into the fourth (SH), fifth (SH + AMN1/10), and sixth (SH + AMN1/20) groups, which were subjected to 0, 1/10 (0.42 mg/L), and 1/20 (0.21 mg/L) of the 96-hour LC50 of UIA, respectively. The survival rate, hematological indices, immunological parameters, and antioxidant activity of the fish significantly decreased when they were exposed to ammonia and Shewanella infection separately or together. Histopathological changes were also observed in the kidney and liver. Furthermore, both individual and combined exposures significantly altered renal and hepatic function, with notable increases in glucose and cortisol levels, as well as in the expression of proinflammatory cytokine genes (TNF-α and IL-1ß). However, the detrimental effects of co-exposure to ammonia stress and Shewanella infection were greater than those of separate exposures. As a result, we may say that increased ammonia concentrations enhance the infection of Shewanella spp. These findings could contribute to a better understanding of Shewanella infection in Nile tilapia.

الملخص: أهداف البحث: تزيد استراتيجية التعلم المرتكز على الطالب من احتمالية تخريج أطباء أكفاء ومعتمدين على أنفسهم وقادرين على حل المشكلات. اعتمدت كلية الطب بجامعة بيشة التعلم الموجه ذاتيا ممثلا بالتعلم القائم على حل المشكلات، والتعلم الذاتي الموجه ممثلا بالتعلم القائم على الفريق. طريقة البحث: تم جمع ما مجموعه 502 سؤالا من أسئلة متعددة الخيارات من اختبارات منتصف المقرر والامتحانات النهائية من قبل خبراء المواد ذات الصلة من تسع دورات خلال الفترة من سبتمبر 2020 حتى يونيو 2023 والتي اعتمدت التعلم القائم على حل المشكلات والتعلم القائم على الفريق؛ 247 سؤالا متعدد الأسئلة تتعلق بالتعلم القائم على حل المشكلات و255 سؤالا يتعلق بالتعلم القائم على الفريق. تم استخدام التحليل السيكومتري لتحديد الأسئلة الصعبة والسهلة والأمثل. نقطة ثنائية حيث تشير إلى نقطة ثنائية ضعيفة وهامشية وجيدة وممتازة على التوالي. وأخيرا، تمت محاولة عدد المشتتات الوظيفية بنسبة تزيد عن 5% من المرشحين. النتائج: لا توجد فروق ذات دلالة إحصائية في أداء الطلاب في الاسئلة متعددة الاختيارات المتعلقة بالتعلم المبني على المشكلات (يمثل أداة التعلم الموجه ذاتيا للمجموعات الصغيرة)، والتعلم المبني على الفريق (يمثل أداة التعلم الموجه ذاتيا للمجموعات الكبيرة) فيما يتعلق بمؤشر الصعوبة، ووظائف تشتيت الانتباه. الاستنتاجات: لوحظ أنه لا يوجد فرق في أداء الطلاب سواء تم استخدام التعلم القائم على حل المشكلات أو التعلم القائم على الفريق لتعلم مقررات العلوم الطبية الأساسية. يحتاج التعلم في مجموعات صغيرة مثل التعلم القائم على حل المشكلات إلى موارد أكثر مقارنة بالتعلم في مجموعات كبيرة كما هو الحال في التعلم القائم على الفريق، وبالتالي يمكن لأي كلية أن تقرر استراتيجية التعلم المعتمدة على مواردها وعدد طلابها. Abstract: Background: Student-centered learning strategy increases the likelihood of graduation of competent, self-dependent, and problem-solving physicians. The University of Bisha, College of Medicine (UBCOM) adopted self-directed learning (SDL) represented by problem-based learning (PBL), and directed self-learning (DSL) represented by team-based learning (TBL). Aim: To compare the students’ performance in SDL and DSL among UBCOM students. Methodology: A total of 502 multiple choice questions (MCQs) from the mid-course and final exams were collected by the relevant subject experts from nine courses during the period from September 2020 till June 2023 that adopted PBL and TBL; 247 MCQs related to PBL and 255 related to TBL. Psychometric analysis was used to determine difficult, easy, and optimum questions (≤25%, ≥90%, and 26–89%, respectively). Point biserial as 0.40 which indicate poor, marginal, good, and excellent point biserial, respectively. Finally, the number of functional distractors was attempted by >5% of the candidates. Results: No significant differences were noted for the students’ performance in MCQs related to PBL (representing self-directed, small group learning tool), and TBL (representing directed-self, large group learning tool) regarding difficulty index (DI), point biserial, and distractors functionality. Conclusion: It has been observed that there is no difference in students’ performance whether PBL or TBL is used for learning Basic Medical Science courses. Small group learning such as PBL needs more resources in comparison to large group learning as in TBL, therefore any institute can decide on the adopted learning strategy depending on its resources and the number of students.

Much attention has been focused on the potential application of industrial by-products as feed supplements in fish diets. The current study examines the effects of feeding pumpkin (Cucurbita pepo) peel powder (CPP) on growth, digestive processes, immune-antioxidant parameters, and gene expression that regulates these processes in Nile tilapia (Oreochromis niloticus). Additionally, fish resistance to Aeromonas veronii was assessed. Fish (n = 200; 34.93 ± 0.11 g) were split equally into four groups and kept for 60 days. Fish were given diets supplemented with different CPP levels: 0 (CPP0 was the control diet), 5 (CPP5), 10 (CPP10), and 15 (CPP15) g CPP/kg diet. The findings showed that CPP meals significantly increased (P˂0.05) growth, intestinal morphometrics, and digestive enzyme activity. The optimum dietary level of CPP was 12 g/kg diet according to the broken line regression analysis based on the data of weight gain and feed conversion ratio. CPP diets up-regulated (P˂0.05) the intestinal and muscular gene expression (trypsin, solute carrier family 6, member 18, fatty acid-binding proteins-2, cluster of differentiation 36, insulin growth factor-1, carnitine palmitoyl-transferase-1alpha, pyruvate kinase, and glucokinase). CPP diets improved the immune-antioxidant indices (P˂0.001) (lysozyme, complement 3, myeloperoxidase, superoxide dismutase, reduced glutathione content, and total antioxidant capacity). Moreover, CPP diets increased (P˂0.05) the splenic expression of heme oxygenase-1, interleukins (IL-6 and IL8), tumor necrosis factor-alpha, and nuclear factor erythroid-related factor 2. CPP diets caused down-regulation (P˂0.05) of the splenic expression of the tumor suppressor gene (P53), mitogen-activated protein kinase (P38), caspase-9, and mechanistic target of rapamycin. During the A. veronii challenge, the fish survival percentage increased with CPP diets. Noteworthy, CPP diets could improve Nile tilapia immunity, growth, and disease resistance. Moreover, the best dietary level of CPP was 12 g/kg diet for sustainable Nile tilapia aquaculture.

The present investigation proposed an innovative trial at the probable beneficial effects of nano-Bacillus amyloliquefaciens (NBA) dietary incorporation on the Nile tilapia (Oreochromis niloticus). The investigation included the impact on the growth, digestive functions, immune-antioxidant indices, and resistance to Aeromonas hydrophila challenge. A total of 135 fish (35.14 ± 0.12 g) were equally allocated into three groups (45 fish/group; 15 fish/replicate) in triplicates for 70 days. The control, NBA2, and NBA4 groups were fed basal diets enriched with 0, 102, and 104 CFU/kg NBA, respectively. Following the feeding experiment, all experimental groups were injected with 0.1 mL (1.5 × 106) A. hydrophila, and the fish mortalities were observed for 14 days. The outcomes showed that dietary NBA (NBA4 followed by the NBA2 diet) augmented the growth variables (final body weight, total weight gain, and specific growth rate) and condition factor and declined the feed conversion ratio. The intestinal digestive enzyme (amylase and lipase) and growth hormone levels were increased and the serum glucose level was decreased by dietary NBA. Furthermore, NBA diets enhanced the immune (total protein, globulin, lysozyme, complement 3, myeloperoxidase, and phagocytic activity) and antioxidant (superoxide dismutase, catalase, and total antioxidant capacity) parameters. The intestinal histology revealed no pathological lesions with a significant improvement in the intestinal histomorpho-measures (villus height and width, villus surface area, lamina propria thickness, and tunica muscularis thickness) by NBA diets in a dose-dependent manner. In the fish intestine, the B. amyloliquefaciens count was increased in the NBA groups (NBA4 group followed by NBA2 group) with no discernible difference in the total bacterial count. Fish resistance to the A. hydrophila challenge was increased by increasing the survival % in the NBA4 group (91.70 %) followed by the NBA2 group (83.30 %) compared to the control group (70.80 %). Overall, dietary NBA (especially 104 CFU/kg diet) could be a promising feed supplement in the Nile tilapia diets for improving their growth, health, and resistance to bacterial challenges.

Thermal performance of building materials is often improved by introducing air voids through foaming. However, this typically results in a reduction in compressive strength. To address this issue, an experimental study was conducted to develop thermally efficient geopolymer blocks using three grades of crumb rubber (CR), without compromising compressive strength. Tests such as compressive strength, tensile strength, thermal conductivity, water absorption, and porosity were carried out to assess the performance of these blocks in comparison to conventional geopolymer blocks. The CR-incorporated geopolymer blocks demonstrated low thermal conductivity, ranging from 0.63 to 0.43 W/mK, along with a reduced environmental impact and carbon footprint. Importantly, they exhibited high compressive strength, ranging from 25 to 52 MPa, which exceeds the required strength for first-class bricks (12 MPa). A computational conjugate heat transfer analysis was also carried out to evaluate the strength of heat transferred through the solid media to the internal fluid media. It contributes to the advancement of environmentally conscious building materials, emphasizing the potential benefits of crumb rubber-incorporated geopolymer composites as a novel material for building construction purpose.

Background:. Unfortunately, current beauty trends greatly advertised by social media are trespassing recognized cannons of beauty. Of particular interest are patients’ expectations of soft tissue volume augmentation of the face, specifically of the lips. Methods:. An artificial intelligence picture of a White female face was generated. With the fixed standard golden upper-to-lower (U/L) lip ratio, a first set of pictures was generated with varying lip fullness. A second set of pictures was generated with various U/L ratios and lip fullness. In a survey format, the 2 sets of pictures were rated for attractiveness from the most to the least attractive by adult men and women. Results:. Rating the first set of pictures clearly demonstrates that overinflation of lips with upper lip height in excess of 30% of hemi-lip width is highly regarded as unaesthetic and unattractive, with a net preference of 20%–25%. For the second set, U/L ratios between 0.618:1 and 1:1 are still regarded to be most aesthetic. Conclusions:. Though social media have an influence on perception of beauty, data provided by the survey confirm that golden standards of aesthetics remain constant and that exaggerated requests of some patients may not be attributed solely to social media influence but probably to social media in combination with additional personal predisposing factors. Patients must be made aware that how they are perceived by others is essential for them to be satisfied with their appearance.

This study addresses the inherent brittleness of ultra-high-performance fiber re-inforced concrete (UHPFRC) by introducing a U-shaped specimen and investigating the impact strength of U-shaped UHPFRC retrofitted with polyurethane (PU) grout overlays. A drop-weight impact test was conducted on the U-shaped specimens utilizing a 2.1 kg weight. Various PU overlay thicknesses (5 mm, 10 mm, and 15 mm) were applied to the specimens. Machine learning techniques, specifically artificial neural networks (ANN) and support vector regression (SVR) were utilized to analyze the experimental data. Results indicate that UHPFRC cast with PU grout overlaid exhibit decrease in flexural strength compare to reference specimens. On the other hand, significance improvement in impact resistance were observed, with overlaid thickness. The addition of 5 mm, 10 mm, and 15 mm PU grout layers substantially improved the first crack strength of UHPFRC-5PU, UHPFRC-10PU, and UHPFRC-15PU specimens by 94 %, 340.3 %, and 600 %, respectively, compared to UHPFRC-0PU. Machine learning models accurately predicted failure crack strength (N2), with ANN and SVR achieving determination correlation (R2) values of 0.9838 and 0.9816 during the training and testing phases, respectively.

Grouper fish are among the most important components of the fisheries of many countries because they are found in warm water throughout the world. There are 15 genera and 159 species known worldwide; 8 genera and 66 species are exclusively found in the western Indian Ocean, Red Sea, and Arabian Gulf. The Summan grouper, Epinephelus summana, constitutes a considerable portion of these fisheries; therefore, this study aimed to evaluate the reproductive strategy of this important fish species. The fish samples were collected monthly for one year (from November 2020 to October 2021), and 217 fish were collected from the Red Sea of Jeddah, Saudi Arabia. The sex ratio, sexual maturation process, and spawning season were analyzed. Across all samples, landing consisted of 36.2 ± 4.7 % males, 64.0 ± 5.0 % females, and 3.4 ± 1.8 % transitional-stage fish, with an overall significantly different male-to-female sex ratio of 1:3.3. Furthermore, males were larger than females. The maturation index (MI), gonadosomatic index (GSI), and ovarian maturation rate (OMR) values fluctuated throughout the year, indicating that E. summana has extended spawning and spawns in batches during different months of the year. However, April to May is the main spawning season, with the highest female GSI recorded. Based on the microscopic histological examination of gonads, the maturation process can be classified into five stages in both males and females. In conclusion, this fish species has a complex reproductive biology. It undergoes sexual transformation and protogynous hermaphroditism, during which individuals mature first as female and then change sex to male. The obtained data is essential for successful fishery stock conservation, management, and aquaculture development.

Epididymo-orchitis (EO) is a common genitourinary clinical syndrome in men, and delayed investigation and improper management can lead to complications. This study aimed to analyze clinical and laboratory findings and treatment outcomes in EO patients. We conducted a retrospective record-based study at King Abdullah Hospital in southern Saudi Arabia from 2018 to 2022, reviewing data from 63 EO patients who had a median age of 34 years (range: 16–82 years). The results showed that the most common complaints were scrotal pain and swelling (54%), followed by testicular pain (44.4%). Scrotal ultrasonography showed increased vascularity in both testes and epididymis in 49 patients (77.8%), while 14 patients (22.2%) had epididymal involvement alone. Reactive hydrocele was observed in 15 patients (23.8%), abscesses in seven (11.1%), and hypoechoic lesions in three (3.8%). Anti-Brucella antibody titers (≥1:80) were detected in 22 cases, and 14.3% had positive urine cultures. Of the patients, 87.3% responded well to the initial treatment course, while four (6.3%) were cured after a second course of treatment. EO complications occurred in three cases (4.8%), and one patient (1.6%) succumbed to septicemia. Of the 15 patients treated with ceftriaxone and ciprofloxacin, one required orchiectomy due to non-response. Relapse occurred in one of the 10 patients treated with triple therapy (doxycycline, rifampicin and gentamicin). Among the nine patients treated with ceftriaxone and co-trimoxazole, one did not respond, developed a testicular abscess, and underwent incision and drainage. In conclusion, our study highlights that most cases of EO can be effectively resolved with appropriate antibiotic therapy, particularly combinations containing cefuroxime and/or ciprofloxacin. Clinicians in Brucella-endemic regions should consider the possibility of brucellosis as an underlying cause of EO.

In this study Neem and Yellow oleander biodiesels were blended in some given proportions and characterized. An F165 diesel engine was ran with each blend and its performance parameters evaluated and compared to those obtained when the engine ran on Automotive Gas Oil (AGO). The produced neem oil biodiesel (NOB) and yellow Oleander biodiesel (YOB) were blended together in a percentage ratio of 20:80, 40:60, 60:40 and 50:50 percentages for Neem and Yellow oleander biodiesels respectively. Results show that brake power of the blends is close to that of AGO at lower torques but developed higher power at higher torques (2.69 kWh at 10Nm for N10Y40 and 2.68 kWh for AGO). The blends exhibited close comparison with the AGO in thermal efficiency. The results of the study show a diesel engine perform well with pure biodiesel blends as fuels as it does with fossil AGO, thus new biofuel was produced capable of replacing conventional diesel fuel in the transportation industry.

In this study, we discussed the photothermal effect on a microelongated thermoelastic plate under the influence of acoustic pressure. This study is very important in many fields and has a wide application in industries. The problem is studied in the two-dimensional plane to obtain the thermoacoustic and mechanical waves behavior. Normal mode analysis is used to get the exact solution of the problem. Many comparisons between the physical quantities are made according to the different values of physical constants of many semiconductor materials. Graphical illustrations depict the numerical outcomes for the examined fields both with and without microelongation parameters.

The cement industry contributes about 7–8 % of the global CO2 emissions. Therefore, to reduce the embodied CO2 emission from cement, its usage in concrete needs to be reduced. Agricultural waste from date palm trees is one of the major waste materials in middle east countries like Saudi Arabia. In this study, the date palm waste was processed to date palm ash (DPA) and used as supplementary cementitious material (SCM) in concrete to reduce the embodied CO2 emissions. Due to the weak pozzolanic reaction of the DPA, it was blended with eggshell powder (ESP) owing to its high calcium oxide content. Cement was replaced with DPA at 0 %, 10 %, 20 %, 30 % and 40 % by weight. ESP was added in proportions of 0 %, 1 %, 2 %, 3 % and 4 % by mass of binder. Response surface methodology (RSM) was used to carryout experimental design and sustainability analysis. The findings showed that using either DPA as SCM or blends of DPA and ESP as binder materials significantly reduced embodied CO2 emissions and cost, enhanced eco-strength efficiency of the concrete. The mathematical models developed for predicting the embodied CO2 and cost of the concrete were higher significant with very good accuracy. From the optimization results, an eco-sustainable concrete in terms of lower cost and embodied CO2 was achieved by blending 21.3 % DPA as SCM and 2.3 % ESP by mass of binder in the concrete.DPA can be considered an environmentally sustainable and cost-effective SCM, and its performance was significantly enhanced when blended with ESP.

This study addressed the critical problem of repairing cracks in aging aircraft structures, a safety concern of paramount importance given the extended service life of modern fleets. Utilized a finite element (FE) method enhanced by the design of experiments (DOE) and adaptive neuro-fuzzy inference system (ANFIS) approaches to analyze the efficacy of piezoelectric actuators in mitigating stress intensity factors (SIF) at crack tips—a novel integration in structural repair strategies. Through simulations, we examined the impact of various factors on the repair process, including the plate, actuator, and adhesive bond size and characteristics. In this work, initially, the SIF estimation used the FE approach at crack tips in aluminum 2024-T3 plate under the uniform uniaxial tensile load. Next, numerous simulations have been performed by changing the parameters and their levels to collect the data information for the analysis of the DOE and ANFIS approach. The FE simulation results have shown that changing the parameters and their levels will result in changing of SIF. Several DOE and ANFIS optimization cases have been performed for the depth analysis of parameters. The current results indicated that optimal placement, size, and voltage applied to the piezoelectric actuators are crucial for maximizing crack repair efficiency, with the ability to significantly reduce the SIF by a quantified percentage under specific conditions. This research surpasses previous efforts by providing a comprehensive parameter optimization of piezoelectric actuator application, offering a methodologically advanced and practically relevant pathway to enhance aircraft structural integrity and maintenance practices. The study innovation lies in its methodological fusion, which holistically examines the parameters influencing SIF reduction in aircraft crack repair, marking a significant leap in applying intelligent materials in aerospace engineering.

Background:. Prompt coverage of vascular repairs in the extremities is needed to protect from desiccation and trauma. In the absence of local soft tissues to provide early coverage pending demarcation of the tissues and the zone of injury, there is no clear data in the literature on the ideal coverage method. This article is the first to review the use of dermal substitutes for temporary coverage of extremity vascular repairs pending definitive coverage. Methods:. We conducted a review of the literature to identify previous articles indexed in PubMed and Ovid using these search terms: [(skin) OR (artificial skin) OR (Integra) OR (dermal substitute) OR (dermal substitute matrix) OR (dermal regeneration) OR (dermal regeneration matrix) OR (dermal regeneration template)] AND [(bypass) OR (graft) OR (vascular surgery) OR (revascularization) OR (salvage) OR (limb salvage) OR (vascular repair) OR (artery repair) OR (arterial repair)] AND [(limb) OR (extremity) OR (leg) OR (arm) OR (vascular injury) OR (amputation)]. Results:. Of the 32 articles retrieved for initial review, five case reports with six patients of dermal substitute use for direct coverage of extremity repairs were identified. In all cases, the dermal substitute was able to provide stable coverage pending definitive coverage or was allowed to heal secondarily. Conclusions:. Dermal substitute matrices are a potential means of temporary coverage of exposed extremity vascular repairs when there is a paucity of local soft tissues pending more definitive coverage.

Predicting concrete’s compressive strength (CS) is a crucial and challenging task in civil engineering as it directly impacts the longevity and structural integrity of infrastructure initiatives. Precise estimation of the water–cement ratio (W/C) is essential for guaranteeing the structural integrity of structures since it is a critical parameter that greatly affects concrete’s CS. This study carries out an extensive investigation of the prediction of the W/C of concrete, utilizing the enormous potential of machine learning, including the backpropagation neural network (BPNN), bilayer neural network, boosted tree algorithm, bagged tree algorithm (BGTA), and support vector regression (SVR), using 108 datasets. We integrate artificial intelligence models with traditional engineering techniques to develop a reliable, precise, and efficient forecasting system. The study input includes curing days (D), fiber (F), cement (C), fine and coarse aggregate (FA and CA), density (Den), CS, water (W), and W/C as the output variables. The result shows that, in comparison to the other models, BGTA-M3 achieved the best performance evaluation criterion. In the calibration and verification phases, NSE, PCC, R, and WI = 1 and MAPE = 0.00, respectively. BPNN-M3 had an MAPE of 0.0004 in the verification phase. The study uses SHapley Additive exPlanations (SHAP), an explainable artificial intelligence (AI) technique, to improve decision-making in complex systems, with cement “C” significantly contributing to higher predictions in SVR-M2. Future studies should expand the dataset to include information from diverse geographic areas, environmental conditions, and concrete mixes to enhance the applicability and dependability of the models.

Abstract Background Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency. Methods We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire. Results All residents had at least one painful site on the WPI (range 1–11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = − 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents. Conclusion WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.

Abstract Background Diabetic cardiomyopathy (DbCM) is a form of Stage B heart failure (HF) at high risk for progression to overt disease. Using baseline characteristics of study participants from the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) Trial we sought to characterize clinical characteristics of individuals with findings consistent with DbCM. Methods Among study participants meeting inclusion criteria, clinical characteristics, laboratory testing, imaging, Kansas City Cardiomyopathy Questionnaire (KCCQ), Physical Activity Scale of the Elderly (PASE) and cardiopulmonary exercise testing (CPET) results were tabulated. Cluster phenogroups were identified. Results Among 691 study participants (mean age 67.4 years; 50% were female), mean duration of type 2 diabetes mellitus (T2DM) was 14.5 years. The median (Q1, Q3) N-terminal pro-B type natriuretic peptide and high sensitivity cardiac troponin T were 71 (35, 135) ng/L and 9 [6, 12] ng/L. The most common echocardiographic abnormalities were reduced global longitudinal strain in 25.3% and impaired diastolic relaxation in 17.7%. Despite rather well-preserved KCCQ scores the average PASE score was markedly impaired at 155 accompanied by an average maximal oxygen consumption of 15.7 mL/Kg/minute on CPET. In K-means clustering, 4 phenogroups were identified including a higher-risk group with more advanced age, greater elevation of cardiac biomarkers, and more prevalent evidence for diastolic dysfunction and left ventricular hypertrophy. Conclusions Baseline data from the ARISE-HF Trial provide clinical characterization of individuals with T2DM and features of stage B HF, and may help clarify the diagnosis of DbCM. Trial Registration ARISE-HF, NCT04083339.

The study was aimed to assess the effect of drying methods on physicochemical properties of Khaya senegalensis gum. Gum exudates obtained from the bark of Khaya senegalensis plant was extracted and subjected to freeze drying and vacuum oven drying. Gel permeation chromatography, Elemental analysis, attenuated total reflectance Fourier transforms Infra red spectroscopy were used to characterize the gum. The effect of drying methods on the gum samples were assessed based on Differential scanning calorimetry, Scanning electron microscopy, Dynamic vapour sorption, particle size analysis via laser diffraction techniques, colour and density measurements. An average molecular weight of 60 KDa expressed as the Dextran equivalent and a polydispersity of 2.17 with a retention time of 18,485 min was recorded for the vacuum dried gum. The vacuum dried gum occurred as irregular discreet coarse particles, containing both amorphous and crystalline portions due to a glass transition of 65◦ and melting temperature of 182.35◦C. It also displayed excellent flow and compressibility properties whereas the freeze-dried gum appeared flaky, porous with large surface area. The mechanism of water sorption was found to be initial surface adsorption and subsequently bulk absorption for both freeze dried and vacuum dried gum samples. The coarseness, water sorption and retention ability of the vacuum dried gum provides a potential for its use as a disintegrant in solid dosage formulations whereas the freeze-dried gum will be suitable for use as a binding agent due to its smaller particle sizes that enhanced solubility. Furthermore, the presence of nitrogen in Khaya senegalensis gum structure explains its partial solubility and the azo aromatic group suggests biodegradability and candidature for drug delivery to the colon. Keywords: Khaya senegalensis Gum; Average Molecular Weight; Amorphous; Crystalline; Direct Compression Excipient; Disintegrant 2 Freeze and vacuum dried Khaya senegalensis gum characterization

The rising population and demand for plastic materials lead to increasing plastic waste (PW) annually, much of which is sent to landfills without adequate recycling, posing serious environmental risks globally. PWs are grinded to smaller sizes and used as aggregates in concrete, where they improve environmental and materials sustainability. On the other hand, PW causes a significant reduction in the mechanical properties and durability of concrete. To mitigate the negative effects of PW, highly reactive pozzolanic materials are normally added as additives to the concrete. In this study, PW was used as a partial substitute for coarse aggregate, and graphene nanoplatelets (GNPs) were used as additives to high-volume fly-ash concrete (HVFAC). Utilizing PW as aggregates and GNPs as additives has been found to enhance the mechanical properties of HVFAC. Hence, this study employed two machine-learning (ML) models, namely Gaussian Process Regression (GPR) and Elman Neural Network (ELNN), to forecast the mechanical properties of HVFAC. The study input variables were PW, FA, GNP, W/C, CP, density, and slump, where the target variables are compressive strength (CS), modulus of elasticity (ME), splitting tensile strength (STS), and flexural strength (FS). A total of 240 datasets were employed in this study and divided into calibration (70%) and validation (30%) sets. During the prediction of the CS, it was found that GPR-M3 outperforms all other models with an R-value equal to 0.9930 and PCC value of 0.9929 in the calibration phase, and R-value = 0.9505 and PCC = 0.9339 in the verification phase. Additionally, during the modeling of FS, it was also noticed that GPR-M3 surpasses all other combinations with R = 0.9973 and PCC = 0.9973 in calibration and R = 0.9684 and PCC = 0.9428 in the verification phase. Moreover, in ME modeling, GPR-M3 is the best modeling combination and shows high accuracy with R = 0.9945 and PCC = 0.9945 in calibration and R = 0.9665 and PCC = 0.9584 in the verification phase. On the other hand, GPR-M3 outperforms all other models during the modeling of STS with R = 0.9856 and PCC = 0.9855 in calibration, and R = 0.9482 and PCC = 0.9353 in the verification phase. Further quantitative analysis shows that, in the prediction of CS, the GPR improves the prediction accuracy of ELNN by 0.49%, while during the prediction of the splitting tensile strength, it was also found that the GPR improved the accuracy of ELNN by 1.54%. In FS prediction, it was also improved by 7.66%, while in ME, it was improved by 4.9%. In conclusion, this AI-based model proves how accurate and effective it was to employ an ML-based model in forecasting the mechanical properties of HVFAC.

This study investigated the combined effects of calcium carbide waste (CCW) and lateritic soil (LS) on sustainable concrete’s fresh and mechanical properties as a construction material for infrastructure development. The study will explore the possibility of using easily accessible materials, such as lateritic soils and calcium carbide waste. Therefore, laterite soil was used to replace some portions of fine aggregate at 0% to 40% (interval of 10%) by weight, while CCW substituted the cement content at 0%, 5%, 10%, 15%, and 20% by weight. A response surface methodology/central composite design (RSM/CCD) tool was applied to design and develop statistical models for predicting and optimizing the properties of the sustainable concrete. The LS and CCW were input variables, and compressive strength and splitting tensile properties are response variables. The results indicated that the combined effects of CCW and LS improve workability by 18.2% compared to the control mixture. Regarding the mechanical properties, the synergic effects of CCW as a cementitious material and LS as a fine aggregate have improved the concrete’s compressive and splitting tensile strengths. The contribution of LS is more pronounced than that of CCW. The established models have successfully predicted the mechanical behavior and fresh properties of sustainable concrete utilizing LS and CCW as the independent variables with high accuracy. The optimized responses can be achieved with 15% CCW and 10% lateritic soil as a substitute for fine aggregate weight. These optimization outcomes produced the most robust possible results, with a desirability of 81.3%.

This study examined the impact properties of ultra-high-performance concrete (UHPC) mixtures with steel fiber (SF) and retrofitted with polyurethane (PU) grouting using repeated drop-weight tests. Micro-steel fiber was added to UHPC mixes from 0 to 3% Vf, and PU grouting overlays of 5 mm, 10 mm, and 15 mm were applied. Digital image correlation (DIC) was used to analyze failure modes. The results showed significant impact durability and energy absorption improvements with increased SF content and thicker PU overlays. UHPC-15PU exhibited 363% and 449% higher first crack and failure strengths than UHPC-5PU. DIC analysis confirmed the failure patterns of the U-shaped UHPC specimen under impact load conditions.

The inherent brittle behavior of cementitious composite is considered one of its weaknesses in structural applications. This study evaluated the impact strength and failure modes of composite U-shaped normal concrete (NC) specimens strengthened with polyurethane grout material (NC-PUG) subjected to repeated drop-weight impact loads (USDWIT). The experimental dataset was used to train and test three machine learning (ML) algorithms, namely decision tree (DT), Naïve Ba yes (NB), and K-nearest neighbors (KNN), to predict the three failure modes exhibited by U-shaped specimens during testing. The uncertainty of the failure modes under different uncertainty degrees was analyzed using Monte Carlo simulation (MCS). The results indicate that the retrofitting effect of polyurethane grout significantly improved the impact strength of concrete. During testing, U-shaped specimens demonstrated three major failure patterns, which included mid-section crack (MC), crushing foot (CF), and bend section crack (BC). The prediction models predicted the three types of failure modes with an accuracy greater than 95%. Moreover, the KNN model predicted the failure modes with 3.1% higher accuracy than the DT and NB models, and the accuracy, precision, and recall of the KNN model have converged within 300 runs of Monte Carlo simulation under different uncertainties.

Abstract Aim To assess the effect of parental and peer support on children's self‐esteem during the isolation period in COVID‐19‐infected children is the main objective of this study. Design This is a descriptive cross‐sectional study. One hundred ninety children with a confirmed diagnosis of COVID‐19 were included. Methods A survey questionnaire to assess family and children's demographic characteristics was used for this study. A 13‐item scale to assess parental support during the isolation period and a 10‐item scale to assess peers' support during the isolation period were evaluated. Along with it, a 10‐item scale to assess self‐esteem during the isolation period was also measured. Results Home isolation was associated with higher parental and peer support scores than hospital isolation. The mean age of study participants was 13.23 ± 4.05 years; 52.6% were isolated at home versus 47.4% in hospital isolation. Phone calling and WhatsApp/messenger chat were methods of communication for 44.2% and 33.2% of patients, respectively. 6.3% of them had no method of communication. Child self‐esteem was significantly affected by both parental and peer support during isolation. The increase in pronounced negative psychological effects such as disorientation, anger, low self‐esteem and post‐traumatic distress may be caused by a lack of parental care. No patient or public contribution to this study Patients or the general public were not involved in the design, analysis or interpretation of the data in this study. The study's aim and objectives were developed based on children's self‐esteem, which was limited by questionnaire data information, so the researchers completed demographic and disease‐related questionnaires by interviewing them.

BACKGROUND AND OBJECTIVES: The rising number of vehicles used for transportation, which is attributed to the steady increase in population, is known to be a major contributor of air pollution, which, in turn, can have adverse effects on the environment and human health. Therefore, in this study, we aimed to evaluate the concentration of carbon monoxide and fine particulate matter in the air and their potential health risks and further examine the use of probabilistic methods to simulate the sensitivity of people living in communities and school children to these pollutants.METHODS: This study collected carbon monoxide and fine particulate matter samples from 32 stations near community houses and 14 sites near schools located along roads. Hazard quotient and target hazard quotient calculations were used to estimate the non-carcinogenic health risks associated with exposure to these substances for both community adults and school children. Finally, Monte Carlo simulations were applied to analyze the sensitivity and uncertainty risks. FINDINGS: As per the results, the highest level of carbon monoxide was recorded in station 22, with 6729 microgram per cubic meter, while the lowest was in station 24, with 1037 microgram per cubic meter. Station 10 had the highest concentration of fine particulate matter at 116 microgram per cubic meter, as opposed to station 2 with the lowest level at 10 microgram per cubic meter. In children, the hazard quotient value for carbon monoxide was found to be highest at 3.013, with the lowest at 0.614. Similarly, the highest level of target hazard quotient for carbon monoxide in children was 7.370, whereas the lowest was 1.522. For fine particulate matter, the highest risk level was 0.180. Additionally, the highest, and lowest levels of target hazard quotient for fine particulate matter were 0.311 and 0.037, respectively. Deterministic and probabilistic approaches were used to assess the risks these pollutants impose on adults and school children based on their daily inhalation rate. The results revealed that the 5th and 95th percentiles of cancer risk for carbon monoxide in adults were 2.85 and 6.11, respectively, indicating medium risks. However, for fine particulate matter, the 5th, and 95th percentiles were 0.09 and 0.19, respectively, signifying lower risks. For school children, the percentiles for carbon monoxide and fine particulate matter were 1.20 and 2.50, respectively, demonstrating higher risks.CONCLUSION: As per the results, it was determined that the hazard quotient risk for carbon monoxide in adults exceeded the standard, >1, thus posing a risk. Only three stations had hazard quotient values lower than 1, which is deemed of safe level. Most of the fine particulate matter risk assessment results had hazard quotient values lower than 1, indicating a safe level. However, all other 30 stations had exceeded the World Health Organization standard (>1), thus demonstrating risks. The likelihood of the inhabitants being at risk increased as the frequency of discrete exposure occurrences increased; this is evidenced by target hazard quotient calculation results for both carbon monoxide and fine particulate matter at the 32 monitored station areas. These results warrant that future research should focus on reducing carbon monoxide and fine particulate matter in the environment by fostering awareness among local and national stakeholders as well as the academe; this may allow South Tangerang to become a center of excellence for green schools in the area.

Abstract Date palm fiber (DPF) is normally used as fiber material in concrete. Though its addition to concrete leads to decline in durability and mechanical strengths performance. Additionally, due to its high ligno-cellulose content and organic nature, when used in concrete for high temperature application, the DPF can easily degrade causing reduction in strength and increase in weight loss. To reduce these effects, the DPF is treated using alkaline solutions. Furthermore, pozzolanic materials are normally added to the DPF composites to reduce the effects of the ligno-cellulose content. Therefore, in this study silica fume was used as supplementary cementitious material in DPF reinforced concrete (DPFRC) to reduce the negative effects of elevated temperature. Hence this study aimed at predicting the residual strengths of DPFRC enhanced/improved with silica fume subjected to elevated temperature using different models such as artificial neural network (ANN), multi-variable regression analysis (MRA) and Weibull distribution. The DPFRC is produced by adding DPF in proportions of 0%, 1%, 2% and 3% by mass. Silica fume was used as partial substitute to cement in dosages of 0%, 5%, 10% and 15% by volume. The DPFRC was then subjected to elevated temperatures between 200 and 800 °C. The weight loss, residual compressive strength and relative strengths were measured. The residual compressive strength and relative strength of the DPFRC declined with addition of DPF at any temperature. Silica fume enhanced the residual and relative strengths of the DPFRC when heated to a temperature up to 400 °C. To forecast residual compressive strength (RCS) and relative strength (RS), we provide two distinct ANN models. The first layer's inputs include DPF (%), silica fume (%), temperature (°C), and weight loss (%). The hidden layer is thought to have ten neurons. M-I is the scenario in which we use RCS as an output, whereas M-II is the scenario in which we use RS as an output. The ANN models were trained using the Levenberg–Marquardt backpropagation algorithm (LMBA). Both neural networking models exhibit a significant correlation between the predicted and actual values, as seen by their respective R = 0.99462 and R = 0.98917. The constructed neural models M-I and M-II are highly accurate at predicting RCS and RS values. MRA and Weibull distribution were used for prediction of the strengths of the DPFRC under high temperature. The developed MRA was found to have a good prediction accuracy. The residual compressive strength and relative strength followed the two-parameter Weibull distribution.

Uhl anomaly is characterized by the morphologic absence of right ventricular myocardium and is an exceedingly rare cause of nonischemic cardiomyopathy. We report the first case of a successful heart transplantation in a 41-year-old patient who presented in cardiogenic shock from Uhl anomaly causing decompensated right ventricular failure.

We report a case of epididymo-orchitis (EO) in a 12-day-old Saudi boy. The neonate, initially diagnosed with hydrocele post-delivery, presented with left scrotal swelling. Doppler ultrasound revealed normal testicles but an enlarged, echogenic left epididymis with pyocele. Despite initial therapy with amoxicillin and cefotaxime, a repeated ultrasound indicated compromised testicular vascularity, necessitating emergency surgical exploration. This revealed purulent discharge and inflammation, with Escherichia coli as a causative agent. Post-surgery, the patient showed significant improvement and was discharged in good condition after a ten-day of hospitalization. The study emphasizes the significance of including EO in the possible diagnoses for neonatal scrotal swelling.

Lean management is a strategic approach that is used in construction industry, specifically aims at minimizing and ultimately eliminating non-value-adding activities, commonly referred to as waste, within construction projects. However, an increase in non-value added (NVA) activities within the precast industry has the potential to diminish both productivity and efficiency. The aim of this paper is to investigate the use of lean tools for minimizing NVA activities in the construction industry. A comprehensive literature review, the study identified Unnecessary Inventory (UI), Waiting Time (WT), Overproduction (OP), and Unnecessary Movement (UM) as major NVA activities that affect the precast industry. A structured questionnaire was designed and conducted among precast industry professionals and lean experts to collect data. The data was then analyze using partial least square test–structural equation modelling, including reliability and validity tests, to ensure data quality. Results indicated that the precast industry professionals widely utilized Just-in-time (JIT), Continuous Improvement (CI), and Total Quality Management (TQM) as lean tools to reduce NVA activities. A conceptual path model was developed to assess the impact of Lean tools on NVA activities. The results of the analysis reveal a strong positive relationship between Lean tools and NVA activities, with a β value of 0.654. The findings of this study can be used for improving the productivity of construction projects by focusing on how to minimize NVA activities using lean tools in precast industry.

This study was designated to look into the toxicological effects of long-term exposure of African catfish (Clarias gariepinus) to a heavy metal (copper) on the growth, hematology, immune-antioxidant functions and their regulating genes, and resistance to Aeromonas sobria. Furthermore, the efficiency of dietary zinc oxide nanoparticles (ZNPs) to ameliorate copper toxicity was assessed. Fish (n=300: average body weight: 90.56±0.20 g) were equally allocated into six groups in five replicates (10 fish/replicate; 50 fish/ group) for 60 days at a water temperature of 25 ± 1.2 ◦C. Three diets were formulated with varying ZNPs levels: control (0 mg kg−1), ZNPs20 (20 mg kg−1), and ZNPs30 (30 mg kg−1), with actual zinc concentrations of 45, 65, and 75 mg kg−1, respectively. The experimental groups were named, control, ZNPs20, and ZNPs30 groups which were fed on the control, ZNPs20, and ZNPs30 diets, respectively without copper exposure. Additionally, the CuCL2, CuCL2+ZNPs20, and CuCL2+ZNPs30 groups were received the same feeding regime as the control, ZNPs20, and ZNPs30 groups, respectively and exposed to copper chloride, CuCL2 (10 mg L−1). At the end of the exposure trial (60 days), all experimental groups were challenged with 0.2 mL of A. sobria (1×108 CFU mL−1) and the mortalities were recorded daily for additional 7 days. The results displayed that copper exposure resulted in lower growth metrics and survivability. The final body weight, weight gain, feed intake, and survivability were reduced in the CuCL2 group by 39.29%, 23.79%, 63.37%, and 20%, respectively with increasing the feed conversion ratio by 52.13% compared to the control group. In addition, reduced hematological (red blood cells (58.40%), hemoglobin (48.11%), packed cell volume (40.59%), white blood cells (46.85%), total proteins (43.12%), albumin (41.98%), and globulin (44.23%)), immune (lysozymes (59.74%), complement 3 (41.89%), nitric oxide (57.14%), and phagocytic activity (38.75%)), and antioxidant parameters (glutathione peroxidase (82.95%), catalase (74.08%), and superoxide dismutase (48.59%)), as well as higher oxidative (malondialdehyde) (200.30%) indicator were observed in the CuCL2 group compared to the control group. A down-regulation of the antioxidant (glutathione peroxidase-1) and immune (lysozyme-G, lysozyme-C, transforming growth factor-beta, and myeloperoxidase) genes with up-regulation of the inflammatory cytokines (interleukin-1ß, interleukin-8, tumor necrosis factor-alpha, nuclear factor kappa β, and Toll-like receptor 5) was noticed in the CuCL2 group. In addition, the survivability of the CuCL2 group during A. sobria challenge was reduced (25%) compared to the control group. Noticeably, ZNPs diets modulated the growth, survival, and antioxidant/immune functions and their associated genes of the copper-exposed fish. In addition, ZNPs increased the resistance of the copper-exposed fish to A. sobria challenge. ZNPs diets especially at 30 mg kg−1 level proposed a promising feed additive for mitigating the stress consequences of copper exposure in African catfish.

Agricultural waste products are one of the major solid wastes disposed into landfills without treatment or recycling. In this study, date palm ash (DPA) was processed from date tree waste and used to partly substitute cement in dosages of 0 %, 10 %, 20 %, 30 %, and 40 %. To counteract the slow pozzolanic reaction of the DPA, eggshell powder (ESP) was added in amounts of 0 %, 1 %, 2 %, 3 %, and 4 % by mass of binder. Response surface methodology (RSM) was used for designing experimental mixes, optimization and establishing statistical models for predicting the properties of the concrete. Blending DPA and ESP as hybrid binder materials in concrete improved its mechanical properties and reduced its water absorption. The RSM models established were very significant, having high accuracy and average error lower than 6 %. From the optimization, blending 14.77 % DPA and 2.2 % ESP gave the best performance in the concrete properties with desirability of 91.1 %.

Due to advancements in telecommunications, towers need special attention in terms of the analysis and design under wind loads. The Telecommunications Industry Association (TIA) in 2005 released a standard “TIA-222-G” which has gained a widespread reference for the analysis and design of communication towers. In 2018, TIA released the latest standard TIA-222-H. The latest TIA-222-H standard has some additional features, e.g. limit states for analysis of mounting systems, enhanced climber safety requirements, construction-related loading, etc. To date, not many studies are available describing how much change in member axial forces occurs with the tower height while using the latest standard for analysis. This study’s main objective is to provide guidelines for wind load calculation on tower body, appurtenances, and other structures and compare the member axial forces induced by the wind loads on different tower heights (40, 60, and 80 m) as per TIA-222-G and TIA-222-H standards. The procedure presented in the paper about the design calculations of wind load is a useful guide for structural engineers involved in the analysis and design of communication towers. The analysis results showed that the member axial forces increased by 22% to 37%, which can assist the practitioner in more optimized design.

Abstract Over the last decades, the prevalence of multidrug-resistant (MDR) Klebsiella pneumoniae in clinical settings has increased progressively. This study determined the prevalence and risk factors associated with MDR K. pneumoniae infection among hospitalized patients in a referral hospital located in southern Saudi Arabia. A prospective cross-sectional study was conducted in King Abdullah Hospital from April 2021 to March 2022. K. pneumoniae (n = 211) bacteria were recovered from clinical samples of adult patients and examined for antibiotic susceptibility. Univariate and multivariate logistic regressions were applied to determine the factors associated with MDR K. pneumoniae infection. MDR K. pneumoniae strains was found in 66.8% (142/211) of the patients. Among MDR K. pneumoniae, the highest resistance rate was determined for ampicillin (100%), cefuroxime (97.9%), ceftriaxone (94.3%), and aztreonam (92.2%). The lowest resistance rate was determined for colistin (16.3%), and tigecycline (6.4%). Further, the patients’ gender, age group, intensive care unit (ICU) admission, invasive medical devices, and chronic illness were found to be significantly associated with MDR K. pneumoniae infection. The independent risk factors associated with MDR K. pneumoniae infection were the male gender (adjusted odds ratio [AOR] 2.107, 95% confidence interval CI 1.125‒3.945, p = 0.02), patients ≥ 65 years of age (AOR 1.905; CI 1.003‒3.616, p = 0.049), ICU admission (AOR 1.963; CI 1.033‒3.732, p = 0.04), diabetes (AOR 1.95; CI 1.02‒3.727, p = 0.043) and chronic obstructive pulmonary disease (AOR 7.172; CI 1.557‒33.032, p = 0.011). The study offered a vision of MDR K. pneumoniae infection in our setting and provided essential indications for further studies that may lead to the prevention and reduction of MDR bacteria.

Abstract The study proposes a dynamic spatio‐temporal profile of the distribution of tuberculosis incidence and air pollution in Romania, where this infectious disease induces more than 8,000 new cases annually. The descriptive analysis for the years 2012–2021 assumes an identification of the structuring patterns of mycobacterium tuberculosis risk in the Romanian population, according to gender and age, exploiting spatial modeling techniques of time series data. Through spatial autocorrelation, the degree of similarity between the analyzed territorial systems was highlighted and the relationships that are built between the analysis units in spatial proximity were investigated. By modeling the geographical distribution of tuberculosis, the spatial correlation with particulate matter (PM2.5) pollution was revealed. The identification of clusters of infected persons is an indispensable step in the construction of efficient tuberculosis management systems. The results highlight the link between the distribution of tuberculosis, air pollution and socio‐economic development, which requires a detailed analysis of the epidemiological data obtained in the national tuberculosis surveillance and control program from the perspective of geographical distribution.

Normal concrete-polyurethane grout (NC-PUG) composite U-shaped and beam specimens were developed in this study to evaluate the capability and efficacy of PU grouting material prepared from mixing bio-based polyurethane (PU) and quartz sand as a coating material. The composite specimens were subjected to dynamic and flexural loads using U-shaped drop-weight impact test (USDWIT) and three-point bending test, respectively. Various PUG overlaid thicknesses and configurations were adopted to improve the impact and flexural behavior of the concrete. Weibull distribution analysis was performed on the USDWIT result. The result indicated that the reference NC-PUG beam exhibited the highest load-carrying capacity of 18.26 kN and the lowest ultimate deflection of 0.52 mm compared to the composite NC-PUG specimens. While, the NC beam retrofitted with a 10 mm thickness overlaid at the top surface (NC-PUGT10) revealed a reduced ultimate load-carrying capacity compared to the reference NC-PUG specimen. The impact performance of the composite U-shaped NC-PUG specimen have remarkably improved due to the influence of PU grouting materials overlaid, with a higher ductility index, which tends to change the brittle nature of concrete to a ductile state. The energy absorption capacity at the failure stage of the NC-PUGT5 is 16 times that of the reference U-shaped NC-PUG specimen. The NC-PUGTB5 and NC-PUGT10 revealed impact strength, which is 52.28 times and 68.1 times more than the reference specimens, respectively. Reliability analysis indicated that about 80% of the U-shaped NC-PUG specimen can withstand 63 impact times at the failure stage. The finding showed that retrofitting concrete structures with PUG material is a promising and sustainable method to protect the concrete structure against dynamic loads

New series of triazolopyrimidine derivatives were designed, synthesized and fully characterized by spectroscopic tools. The new compounds were investigated as antimicrobial agents against two bacterial and two fungal strains. The antimicrobial results revealed that the triazolopyrimidine derivative 3b exhibited excellent antibacterial and antifungal activity higher than the standard drug (Neomycin). Additionally, we studied the antiviral activity of the three compounds against two different viruses (Corona Virus 229E, and herpes). The fluoro triazolopyrimidine derivatives 3a,b showed significant antiviral activity against low pathogenic Corona virus (229E) with selective index of 25.87 and 18.15 respectively. The same compounds showed good antiviral activity against human herpes type 2 with selective index of 17.7 and 11. The molecular dynamics simulation (MD) studies were also implemented to assign the interaction as well as the stability of the protein–ligand complex in motion.

Background and aim: Malnutrition is one of the most troublesome comorbidities among hemodialysis patients (HD). Myostatin (MSTN) belongs to the transforming growth factor-β superfamily. In HD patients, MSTN effects are not limited to skeletal muscle growth. The present study aimed to assess MSTN levels in HD patients and its relation to various clinical and biochemical parameters. Patients and methods: The present case control study included 60 patients on HD for at least three years. In addition, there were age and sex-matched healthy subjects who constitutes the control group. Nutritional status was evaluated using the malnutrition inflammation score (MIS). Muscle wasting in the present study was evaluated using the lean tissue index (LTI) as assessed by the body composition monitor (BCM). Rectus Femoris Muscle (RFM) thickness was also measured as indicator for nutritional status of patient. Results: The present study included 60 HD patients, and ageand sex-matched healthy controls. Patients expressed significantly higher myostatin levels when compared to controls [median (IQR): 221.3 (153.5-688.2) versus 144.8 (97.0-281.7), p < 0.001]. According to MIS, patients were classified into those with no/mild malnutrition (n = 22) and others with moderate/severe malnutrition (n = 38). Comparison between the two subgroups revealed that the former group had significantly lower myostatin levels [167.7 (150.3-236.3) versus 341.7 (160.9-955.9), p = 0.004]. According to LTI, patients were classified into those with muscle wasting (n = 23) and others without muscle wasting (n = 37). Comparative analysis showed that patients in the former group had significantly higher myostatin levels [775.1 (325.1-2133.7) versus 161.8 (142.6-302.3), p < 0.001]. Conclusions: Myostatin seems to be a promising marker for identification of malnutrition and muscle wasting in HD patients.

Abstract Background Saccharomyces cerevisiae (S. cerevisiae) has been demonstrated in vitro to sensitize several breast cancer cell lines and to be a safe, non-toxic drug with anti-skin cancer action in mice. Furthermore, plasmonic photothermal treatment using gold nanorods has been authorized as a novel method for in vitro and in vivo cancer therapy. Results When compared to tumor-free rats, the treatment with S. cerevisiae conjugated to gold nanospheres (GNSs) lowered Bcl-2 levels while increasing FasL, Bax, cytochrome c, and caspases 8, 9, and 3 levels. Histopathological results showed changes reflecting the ability of nanogold conjugated heat-killed yeast to induce apoptosis is greater than heat-killed yeast alone as the nanogold conjugated with heat-killed yeast showed no tumor, no hyperplasia, no granulation tissue formation, no ulceration, and no suppuration. Nanogold conjugated with heat-killed yeast-treated breast cancer group displayed normal levels of ALT and AST, indicating relatively healthy hepatic cells. Conclusion Our results proved that nanogold conjugated heat-killed yeast can initiate apoptosis and can be used as a safe non-invasive method for breast cancer treatment more effectively than the yeast alone. This, in turn, gives us new insight and a future hope for the first time that breast cancer can be treated by non-invasive, simple, safe, and naturally originated method and achieves a hopeful treatment and a novel method for in vivo cancer therapy.