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

Abstract Duchenne muscular dystrophy (DMD) is a genetic muscular disease and is the most common type of muscular dystrophy in Japan. Noninvasive magnetic resonance imaging (MRI) can be used for follow-up evaluation of myositis and muscular dystrophy, including DMD and inflammation is evaluated based on the increased muscle water as evaluated by T2-weighted MR images. However, in MDM, the redox status has not been evaluated non-invasively during the disease progression. We assessed the inflammation via the redox status in experimental animal disease models using in vivo dynamic nuclear polarization MRI (DNP-MRI) with a redox probe. The current study aimed to evaluate the skeletal muscle of mdx mice, a DMD model, in which muscle fiber necrosis, inflammation, and muscle regeneration were chronically repeated. Results showed that the reduction rate of Carbamoyl-PROXYL (CmP), one of the redox probes, radicals in mdx mice increased compared with that in normal mice. In vitro, more mitochondria or macrophages enhanced the radical form decay reaction by reducing CmP. Due to muscle fiber damage, the mdx mice had a lower mitochondrial concentration in the gastrocnemius muscle than the normal mice. However, the in vivo DNP-MRI results strongly reflected the increased reduction of CmP radicals by macrophages. In conclusion, in vivo DNP-MRI, a noninvasive imaging method is useful for locally evaluating skeletal muscle inflammation.

Small ruminants and camels are important livestock species in the United Arab Emirates (UAE), although Brucella infection can limit their productivity. This study aimed to investigate the seroprevalence of Brucella infection and its associated risk factors in small ruminants and camels in the Emirate of Abu Dhabi. Additionally, seropositive animals were tested for the DNA of Brucella. Multispecies competitive enzyme-linked immunosorbent assay (c-ELISA) and multispecies indirect (i-ELISA) were used to test 3,086 animals from 2022 to 2023. Brucella cell surface 31 kDa protein (bcsp31) gene-based real-time polymerase chain reaction (q-PCR) was used to detect Brucella DNA. Multivariate logistic regression was used to assess the association between seroprevalence and potential risk factors. The overall seroprevalences of Brucella infection were 1.7% (95% confidence interval [CI], 1.2%–2.2%) and 5.8% (95% CI, 5.0%–6.7%) based on serial and parallel testing, respectively. The DNA of Brucella was detected in 13 of the 51 seropositive animals. The overall seroprevalence of Brucella infection was associated with the region, type of animal holding, species, and age of the animals. In conclusion, this study documented Brucella infection in small ruminants and camels in the Emirate of Abu Dhabi, warranting necessary intervention strategies to eliminate Brucella infections in livestock populations.

Abstract Background Functional endoscopic sinus surgery (FESS) is minimally invasive, ambulatory endoscopic surgical procedure usually performed in most paranasal sinus diseases. Controlled hypotension during anaesthesia (hypotensive anesthesia) improves surgical field visibility and reduces risk of injuring surrounding structures. Clonidine (C) and dexmedetomidine (D) are both used to reduce blood pressure and heart rate while maintaining tissue perfusion. This study was conducted to evaluate the efficacy of clonidine compared to dexmedetomidine for controlled hypotension during FESS. Methods After ethical approval, 80 patients undergoing elective FESS were included in the study and randomly allocated to Group C or Group D. In Group C, 40 patients received intravenous clonidine with a loading dose of 3µg/Kg for 10 min and titrated maintenance dose of 0.4–0.8 µg/Kg/hour. In Group D patients received intravenous dexmedetomidine with a loading dose of 1µg/Kg for 10 min and titrated maintenance dose of 0.4–0.8µg/Kg/hour. The target was mean arterial blood pressure (MAP) between 55 and 65 mmHg and heart rate (HR) above 50 beats per minute. The primary outcome was blood loss. The secondary outcomes were surgical field quality assessed by Fromme Bezooart score, variations in MAP and HR intraoperatively, duration of surgery and anesthesia, and post-operative sedation assessed by Ramsay Sedation Score (RSS). Results Demographic data of both groups were comparable. The difference between both groups in terms of blood loss and surgical field quality was not statistically significant (p = 0.579, 1.000). MAP and HR were statistically significantly reduced to targeted level in both groups compared to baseline (p

Abstract Groundwater levels vary from region to another and sometimes in different zones in the same country due to different boundary conditions and extraction rates. Therefore, understanding intricate aquifer systems and predicting how they will react to hydrological changes require the use of groundwater models. In Egypt, the groundwater levels in the Nile Delta aquifer decrease causing problems to the delta ecosystem while it is rising in Aswan area due to the presence of Nasser Lake causing several damages to the city’s buildings and infrastructures. In order to maximize its benefits and lessen the harm brought on by inadequate groundwater management in the city of Aswan, the height of the groundwater level in that city was examined, appraised, and groundwater management scenarios were established in this study. To achieve the objectives of the study, a simulation of Aswan aquifer’s groundwater system is built based on a quasi-three-dimensional transient groundwater flow model using MODFLOW. The model was calibrated and verified. Four management scenarios are tested. The fifth scenario, in this scenario, the four scenarios combined together at the same time and with the same conditions and ratios were proposed to be implemented. The results of the proposal to implement the four scenarios together showed that the rates of decline in groundwater levels in the last stage will be 12.44%. The study results reveal that a better understanding of the simulated long-term average spatial distribution of water balance components is useful for managing and planning the available water resources in the Aswan aquifer.

Abstract Background The detection and early diagnosis of root fractures can be challenging; this difficulty applies particularly to newly qualified dentists. Aside from clinical examination, diagnosis often requires radiographic assessment. Nonetheless, human fallibility can introduce errors due to a lack of experience. Aim The proposed system aimed to assist in detecting root fractures through the integration of artificial intelligence techniques into the diagnosis process as a step for automating dental diagnosis and decision-making processes. Materials and method A total of 400 radiographic images of fractured and unfractured teeth were obtained for the present research. Data handling techniques were implemented to balance the distribution of the samples. The AI-based system used the voting technique for five different pretrained models namely, VGG16, VGG19, ResNet50. DenseNet121, and DenseNet169 to perform the analysis. The parameters used for the analysis of the models are loss and accuracy curves. Results VGG16 exhibited notable success with low training and validation losses (0.09% and 0.18%, respectively), high specificity, sensitivity, and positive predictive value (PPV). VGG19 showed potential overfitting concerns, while ResNet50 displayed progress in minimizing loss but exhibited bias toward unfractured cases. DenseNet121 effectively addressed overfitting and noise issues, achieving balanced metrics and impressive PPVs for both fractured and unfractured cases (0.933 and 0.898 respectively). With increased depth, DenseNet169 demonstrated enhanced generalization capability. Conclusion The proposed AI- based system demonstrated high precision and sensitivity for detecting root fractures in endodontically treated teeth by utilizing the voting method.

Abstract Purpose The aim was to investigate the effect of surgeon handedness on acetabular cup positioning, functional outcomes, and dislocation incidence during primary THA. Methods A systematic review was conducted according to the PRISMA guidelines. Studies published in English were searched in three databases (PubMed, Embase, and Scopus). A dominant side is a right-handed (RHD) or left-handed (LHD) surgeon who operates on the right or left hip, respectively. The opposite is considered to be the non-dominant side. We used odds ratios for dichotomous data and mean differences for continuous data, with 95% confidence intervals for quantitative data synthesis. Heterogeneity was assessed using the I² test, with outcomes graphically represented in a forest plot and a p-value of . Result Four observational studies were included out of 98 articles. Ten experienced surgeons participated (8 RHD and 2 LHD) and operated on 822 patients (1484 hips), divided equally between dominant and non-dominant sides, and the posterolateral approach was utilized in 80.9% of THAs. RHD surgeons operated on 1404 (94.6%) THAs. The pooled synthesis for inclination indicated no significant difference between either side [MD: 0.10 (95% CI -2.10 to 2.30, P = 0.93, I² = 91%)]. While the difference was significant for anteversion [MD: -2.37 (95% CI -3.82 to -0.93, P = 0.001, I² = 31%)]. The functional outcome was better on the dominant side [MD: 1.44 (95% CI 0.41 to 2.48, P = 0.006, I² = 0%)], and the dislocation incidence was significantly higher on the non-dominant side [OR: 0.45 (95% CI 0.25 to 0.81, P = 0.008, I² = 0%)]. Conclusion Surgeon handedness and whether operating on the dominant or non-dominant side could affect the acetabular cup positioning and outcomes during primary THAs, even in the hands of high-volume surgeons.

Abstract The sorghum agricultural sector in Al-Qadarif State, Sudan, plays a pivotal role in ensuring regional food security. However, its productivity is hindered by significant constraints. Substantial improvements in sorghum yield are impeded by the intricate complexities that characterize this sector's financial resources, and agricultural practices. This study in Al-Qadarif State, Sudan, explores the relationship between financial resources and sorghum agrarian productivity. Data were collected from 200 sorghum farmers using standardized questionnaires during the 2022 season, and regression analysis was employed to investigate the association between financial factors and sorghum productivity. The findings indicate that financial accessibility considerations significantly influence sorghum productivity. This emphasizes the importance of improved financial resources for farmers to adopt innovative farming technologies and practices, leading to higher sorghum productivity levels. The study recommends the integration of digital financial services and precision agriculture technologies as a creative solution to enhance financial accessibility and sorghum productivity. By leveraging mobile money platforms and digital credit services, farmers can conveniently access financial resources, enabling them to invest in modern agricultural inputs and technologies. Additionally, the adoption of precision agriculture techniques, such as soil moisture sensors, drone-based crop monitoring, and variable rate application of inputs, can optimize resource utilization, increase yield, and reduce production costs. The combination of these innovative approaches has the potential to bridge the financial and knowledge gaps, promoting the widespread adoption of sustainable agricultural practices. This synergistic approach could significantly improve sorghum productivity, enhance farmer livelihoods, and contribute to regional food security.

Abstract Background Kidney transplantation for chronic kidney disease (CKD) in children is the best treatment option. It needs special medical and surgical expertise highly skilled in management of pediatric age group. Our Egyptian profile for causes of end-stage renal failure (ESRF) in transplanted children reflects prevalence of inherited kidney diseases IKD (43%), urologic causes (26%), glomerulonephritis (GN) (17%), and unknown causes (14%). Renal graft availability remains a great challenge. Aim We need pediatric kidney transplantation (PKT) guideline since children have unique causes for ESRF compared to adults. Their transplant team should be skilled in management of children challenges. Recipients may not have one transplant per life. Long-standing immunosuppression will have its toxicity and need regular monitoring. Lots of data are extracted from adult guidelines lacking paediatric background. Young paediatric nephrologists need short version guidelines rich in educational figures for management plans. Children and their families need Arabic orientation booklets and supportive programmes. National Insurance System sponsors should be guided by National Pediatric Guidelines to minimize the centre’s variations. Methods Our National Pediatric Guidelines are evidence based adapted from international four source guidelines with permissions [KDIGO-2020, RA/BTS 2022-2018, EAU 2018] that were appraised with Agree 2 plus tool using PIPOH format health questions. We followed the ‘adapted ADAPTE’ CPG formal adaptation methodology that consists of three phases and 24 steps and tools. It was registered on the practice guideline registration international guideline registry with a registration number IPGRP-2023-12-27 CN 312. Results Summary includes recommendations for assessment of (1) potential living adult donors for age, medical, surgical, immunologic, familial, metabolic, malignancy, and any donor morbidities and (2) transplant recipient assessment for age, weight, nutritional, psychosocial, immunological, infection states, primary native kidney disease, associated morbidities, the presence of genetic, immunologic, infection, and malignancy risks. Conclusion Pediatric kidney transplantation guidelines aim for better donor, recipient, and graft survival. Recommendations are tailored as adopted or adapted statements from evidence-based source guidelines to suit our local pediatric CKD profile.