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Background: The four muscles that support the humeral head and come from the anterior and posterior sides of the scapula with their tendons situated in the smaller and larger tuberosities are collectively known as the "rotator cuff." The teres minor, supraspinatus, infraspinatus, and subscapularis are among these muscles. Objectives: This study compares dynamic high-resolution ultrasonography to MRI, which was the gold standard to assess the value of each technology in identifying rotator cuff injury. Patients and methods: This was prospective study for fifty patients were sent to the Diagnostic and Interventional Radiology Clinic in Qena City suspected to have rotator cuff injury. . Results: Patients' ages ranged from 19 to 70, with a mean age of 36 years, a standard deviation of 16.35 years. In our study, there were a total of 32 affected males (64%) and 18 affected females (36%) with a male to female ratio of 1.78:1. In identifying complete tears in our patients, in general, we found that USG has 100% overall sensitivity, 92.68% overall specificity, and 94% overall diagnostic accuracy. Positive predictive value was 75%, whereas the negative predictive value was 100%. Conclusion: MRI and ultrasound have similar levels of sensitivity and specificity. When high-resolution imaging is feasible, trained radiologists are on hand, and rotator cuff integrity is the main concern, US may be thought of as the screening method because it is less expensive and more widely available.

Introduction: Carbohydrate compounds serve multifaceted roles, from energy sources to stress protectants, found across diverse organisms including bacteria, fungi, and plants. Despite this broad importance, the molecular genetic framework underlying carbohydrate biosynthesis pathways, such as starch, sucrose, and glycolysis/gluconeogenesis in Salvia guaranitica, remains largely unexplored. Methods: In this study, the Illumina-HiSeq 2500 platform was used to sequence the transcripts of S. guaranitica leaves, generating approximately 8.2 Gb of raw data. After filtering and removing adapter sequences, 38 million reads comprising 210 million high-quality nucleotide bases were obtained. De novo assembly resulted in 75,100 unigenes, which were annotated to establish a comprehensive database for investigating starch, sucrose, and glycolysis biosynthesis. Functional analyses of glucose-6-phosphate isomerase (SgGPI), trehalose-6-phosphate synthase/phosphatase (SgT6PS), and sucrose synthase (SgSUS) were performed using transgenic Arabidopsis thaliana. Results: Among the unigenes, 410 were identified as putatively involved in these metabolic pathways, including 175 related to glycolysis/gluconeogenesis and 235 to starch and sucrose biosynthesis. Overexpression of SgGPI, SgT6PS, and SgSUS in transgenic A. thaliana enhanced leaf area, accelerated flower formation, and promoted overall growth compared to wild-type plants. Discussion: These findings lay a foundation for understanding the roles of starch, sucrose, and glycolysis biosynthesis genes in S. guaranitica, offering insights into future metabolic engineering strategies for enhancing the production of valuable carbohydrate compounds in S. guaranitica or other plants. [ABSTRACT FROM AUTHOR]

Objectives Precise literature recommendation and summarization are crucial for biomedical professionals. While the latest iteration of generative pretrained transformer (GPT) incorporates 2 distinct modes—real-time search and pretrained model utilization—it encounters challenges in dealing with these tasks. Specifically, the real-time search can pinpoint some relevant articles but occasionally provides fabricated papers, whereas the pretrained model excels in generating well-structured summaries but struggles to cite specific sources. In response, this study introduces RefAI, an innovative retrieval-augmented generative tool designed to synergize the strengths of large language models (LLMs) while overcoming their limitations. Materials and Methods RefAI utilized PubMed for systematic literature retrieval, employed a novel multivariable algorithm for article recommendation, and leveraged GPT-4 turbo for summarization. Ten queries under 2 prevalent topics ("cancer immunotherapy and target therapy" and "LLMs in medicine") were chosen as use cases and 3 established counterparts (ChatGPT-4, ScholarAI, and Gemini) as our baselines. The evaluation was conducted by 10 domain experts through standard statistical analyses for performance comparison. Results The overall performance of RefAI surpassed that of the baselines across 5 evaluated dimensions— relevance and quality for literature recommendation, accuracy , comprehensiveness , and reference integration for summarization, with the majority exhibiting statistically significant improvements (P -values <.05). Discussion RefAI demonstrated substantial improvements in literature recommendation and summarization over existing tools, addressing issues like fabricated papers, metadata inaccuracies, restricted recommendations, and poor reference integration. Conclusion By augmenting LLM with external resources and a novel ranking algorithm, RefAI is uniquely capable of recommending high-quality literature and generating well-structured summaries, holding the potential to meet the critical needs of biomedical professionals in navigating and synthesizing vast amounts of scientific literature. [ABSTRACT FROM AUTHOR]

Salvia guaranitica is considered one of the most significant medicinal and aromatic herbs in terms of nutritional and medical benefits due to its wealth of important active components. Among these compounds, terpenoids are the most prominent and abundant, particularly monoterpenes (C10), sesquiterpenes (C15), and diterpenes (C20). They are biologically advantageous to plants and perform a multitude of functions. The current study aimed to clone the S. guaranitica gene that encodes for geranyllinalool synthases (SgGES, EC: 4.2.3.144), with consideration for these features. The open reading frame of the 867-amino-acid protein encoded by SgGES consists of 2.721 base pairs. In addition, the SgGES protein has five domains that belong to the terpene synthase family, which are related to the terpene and terpenoid synthase domains. We manipulated and overexpressed the SgGES gene in Nicotiana tabacum to explore its function. When compared to the GUS control, the transgenic N. tabacum plants displayed an increase in leaf production and diameter when compared with the wild-type plants. Finally, analysis of transgenic plants using gas chromatography/mass spectrometry (GC-MS) showed that SgGES is responsible for producing various terpene species, especially diterpenes. [ABSTRACT FROM AUTHOR]

This research aims to provide a systematic scientific picture of the design and production of printed advertising integrated in the daily newspaper where advertising is different in our time is a necessity of life indispensable, as the main process in communication between the advertiser and the recipient, one of the most important marketing and promotional activities of products And services where it contributes to strengthen the personality of the service or product and affirms it in the minds of the masses and affects their purchasing power, and therefore deserves the design and production of printed advertising integrated in the newspaper to pay due attention and attention in terms of keeping pace with development, innovation and trade The hand which would attract the attention of the forum is always to follow the announcement and keep it.The integrated advertising in the newspaper is one of the important advertising areas that must be addressed by study and research, where it is not rarely shed light where it allows the advertisement integrated newspaper newspaper advertisers to address their products by explaining and analyzing and clarify its advantages and influence the target audience in order to benefit the advertiser may not be available in the ad problem The printed advertising in the newspaper is an important part of the policy of advertising campaigns planning, as it is an important communication medium between the advertiser and the forum. Targeted to convey the advertising message in order to change and enhance the views of recipients.The printed advertising integrated in the newspaper is of great importance to both the recipient and the advertiser and the press institutions.The printed advertising integrated in the newspaper is considered one of the most important advertising media because of its wide spread and regular attachment and distribution with newspapers

Background and Aim: Vitamin D has anti-viral, anti-inflammatory, and metabolic effects. The goal of this study was to evaluate the link between vitamin D level and COVID-19 incidence and to identify the result of short-term vitamin D deficiency correction in decrease the risk of COVID-19 infection. Patients and Methods: A prospective open-label controlled trial was carried out on 897 enrolled subjects who had contact with relatives infected by COVID-19 disease randomized into two arms according to baseline vitamin D level; the first arm of which 816 subjects (90.97% vitamin D deficiency) received 200,000 IU cholecalciferol/vitamin D3 every other day with a total of 3 doses, whereas the second arm, 81 subjects (9.03% normal vitamin D) didn't receive vitamin D supplementation. Serum calcium and serum vitamin D were measured at baseline and 2 weeks after treatment. CBC, ESR, CRP, ferritin, and D-dimer were performed in suspected cases. Results: Symptoms compatible with COVID-19 were 17.3% in the second arm and 16.4% in the first arm, Laboratory-confirmed diagnosis were 3.7% in the second arm and 5.4% in the first arm. Hospitalization was 1.2% in the second arm and 0.4% in the first arm. Deficient vitamin D levels increased the risk of symptoms compatible with COVID-19 disease by 1.66 folds.correlation was detected between P300 amplitude with IQ or language age (P > 0.05). Conclusion: Rapid correction of vitamin D deficiency decrease the risk of COVID-19 infection. [ABSTRACT FROM AUTHOR]

The infection caused by the hepatitis C virus (HCV) is a significant global health concern. The prevailing genotype of HCV in Egypt is 4a, commonly referred to as GT‐4a. A significant proportion exceeding 50% of patients infected with HCV experience extrahepatic manifestations (EHMs), encompassing a diverse range of clinical presentations. These manifestations, including essential mixed cryoglobulinemia (MC), can serve as initial and solitary indicators of the disease. The complete understanding of the pathogenesis of EHM remains unclear, with autoimmune phenomena being recognized as the primary causative factor. In this study, we examined the predictive significance of T‐cell subpopulations in relation to the occurrence and prognosis of cryoglobulinemia in HCV patients. A total of 450 CHC genotype four treatment naïve patients were enrolled in this analytic cross‐sectional study after thorough clinical, laboratory, and radiological examinations. All patients underwent laboratory investigations, including testing for cryoglobulin antibodies and measurements of CD4 and CD8 levels; two groups were described according to their test results: Group 1 consists of patients who have tested positive for cryoglobulin antibodies and Group 2 consists of patients who have tested negative for cryoglobulin antibodies. The exclusion criteria encompassed individuals with HIV infection or chronic HBV infection. Additionally, pelvi‐abdominal ultrasonography was performed. Our study included 450 treatment naïve CHC patients (59% male, mean age 50.8 years). The patients were categorized according to their cryoglobulin antibodys test results into two groups: group A, CHC patients with cryoglobulin antibodies (Abs) negative (364 patients), and group B, CHC patients with cryoglobulin Ab positive (86 patients). Group B demonstrated a higher average age, elevated international normalized ratio, more prolonged duration of HCV infection, lower albumin, higher alanine aminotransferase, higher aspartate aminotransferase, higher bilirubin, lower CD8, lower CD4, and lower CD4:CD8 ratio. In contrast, 27 out of 86 (31.40%) patients in group B had symptoms; 85.8% had purpura and arthralgia, 74.3% had paresthesias, 86.7% had weakness, and 12.2% had non‐Hodgkin's lymphoma. The levels of CD4 and CD8 were found to be decreased in chronic HCV patients with MC. T‐cell subpopulation serves as a reliable indicator for assessing the prevalence and prognosis of MC in individuals with genotype 4 chronic hepatitis C. However, additional research is needed to further understand the development and spread of various emerging infectious diseases. Nevertheless, it is noteworthy that a critical threshold may exist beyond which EHM reaches a point of no return. [ABSTRACT FROM AUTHOR]

Novel 5-deazaflavins were designed as potential anticancer candidates. Compounds 4j, 4k, 5b, 5i, and 9f demonstrated high cytotoxicity against MCF-7 cell line with IC50 of 0.5–190nM. Compounds 8c and 9g showed preferential activity against Hela cells (IC50: 1.69 and 1.52 μM respectively). However, compound 5d showed notable potency against MCF-7 and Hela cell lines of 0.1 nM and 1.26 μM respectively. Kinase profiling for 4e showed the highest inhibition against a 20 kinase panel. Additionally, ADME prediction studies exhibited that compounds 4j, 5d, 5f, and 9f have drug-likeness criteria to be considered promising antitumor agents deserving of further investigation. SAR study showed that substitutions with 2-benzylidene hydra zino have a better fitting into PTK with enhanced antiproliferative potency. Noteworthy, the incorporation of hydrazino or ethanolamine moieties at position 2 along with small alkyl or phenyl at N-10, respectively revealed an extraordinary potency against MCF-7 cells with IC50 values in the nanomolar range. [ABSTRACT FROM AUTHOR]

Background: Patients who undergo primary percutaneous coronary intervention (PCI), are at great risk of contrast-induced nephropathy (CIN). The PRECISE-DAPT score had been implemented nowadays to determine the best period of dual anti-platelet therapy after PCI. This Study aim To determine the predictive value of the admission PRECISE-DAPT score in the early diagnosis of CIN. Methods: A prospective cohort study carried out in the cardiology department at Zagazig university hospital and national heart institute, Cairo, during the period from January 2020 to August 2020. The study included 200 patients admitted with first acute ST segment elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention. All patients were subjected to complete history taking. General examination for all body systems and local cardiological examination were done. We also did full lab investigations as complete blood count (CBC), Creatine kinase-myocardial band (CK-MB), Troponin, creatinine (at admission and within 72h post PCI) and glomerular filtration rate (GFR). Patient's resting Electrocardiogram (ECG) and transthoracic echocardiography (TTE) were done. PRECISE-DAPT score was calculated for all cases. Coronary angiography and PCI were performed. Results: We detected a high statistically significant increase in precise DAPT score (23.6 ± 10.4) p <0.001 among CIN patients. CKMB, Platelet distribution width (PDW), contrast volume, left anterior descending (LAD) culprit vessel and PREISE-DAPT score are significant predictors for CIN among studied patients. Conclusion: The PRECISE-DAPT score can be a valuable tool to predict acute kidney injury in cases of STEMI undergoing PCI. [ABSTRACT FROM AUTHOR]

Background: Flexor tendon injuries represent a significant per-centage of admissions in emergency departments in Egypt. A bloodless surgical field is important to perform a hand surgery. Traditionally, a tourniquet is used for hemostasis, and the standered anesthetic techniques utilized in hand surgery were general anesthesia, intravenous regional anesthesia, or brachial plexus block. Recently the evolving Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique where patient is operated on under local anesthesia and hemostasis is achieved via adrenaline could be a better choice. Aim of this work is to compare the intraoperative pain scores, induction time, operating time, blood loss, postoperative pain scores, and patient satisfaction with WALANT versus supraclavicular brachial plexus block (SC-BPB ) with tourniquet, in patients under-going flexor tendon repair. Patients and Methods: In the current study 52 patients who underwent flexor tendon intervention were divided randomly into two groups, each group consisting of 26 patients. Group A: Patients in this group received WALANT. Group B: Patients in this group received SC-BPB with a tourniquet applied to the arm. Results: Intraoperative Wong-Baker Faces scale revealed no statistically significant difference in intraoperative pain scores in both groups, except during injection (p = 0.04). Tourniquet-related pain was reported in 23% of patients of SC-BPB group (p = 0.001). Induction time was significantly shorter in WALANT (p < 0.01) but time needed to obtain sufficient hemostasis is sig-nificantly more in WALANT than SC-BPB (p < 0.01) while surgical time was similar in both groups (p = 0.538). Blood loss in spite of being minimal it was statistically significant higher in WALANT (p < 0.01). Conclusion: WALANT anesthesia was found to be better alter-native to SC-BPB in flexor tendon repair surgeries in adults being more simple technique and no need for special skills or ultrasound device, less time consumed in induction and less injection pain also no tourniquet-related pain, intraoperative active motion of the hand is preserved facilitating surgical technique, better effect on postoperative analgesia and more patient and surgeon satisfaction. [ABSTRACT FROM AUTHOR]

Over the last few decades, electroencephalogram (EEG) has become one of the most vital tools used by physicians to diagnose several neurological disorders of the human brain and, in particular, to detect seizures. Because of its peculiar nature, the consequent impact of epileptic seizures on the quality of life of patients made the precise diagnosis of epilepsy extremely essential. Therefore, this article proposes a novel deep-learning approach for detecting seizures in pediatric patients based on the classification of raw multichannel EEG signal recordings that are minimally pre-processed. The new approach takes advantage of the automatic feature learning capabilities of a two-dimensional deep convolution autoencoder (2D-DCAE) linked to a neural network-based classifier to form a unified system that is trained in a supervised way to achieve the best classification accuracy between the ictal and interictal brain state signals. For testing and evaluating our approach, two models were designed and assessed using three different EEG data segment lengths and a 10-fold cross-validation scheme. Based on five evaluation metrics, the best performing model was a supervised deep convolutional autoencoder (SDCAE) model that uses a bidirectional long short-term memory (Bi-LSTM) – based classifier, and EEG segment length of 4 s. Using the public dataset collected from the Children's Hospital Boston (CHB) and the Massachusetts Institute of Technology (MIT), this model has obtained 98.79 ± 0.53% accuracy, 98.72 ± 0.77% sensitivity, 98.86 ± 0.53% specificity, 98.86 ± 0.53% precision, and an F1-score of 98.79 ± 0.53%, respectively. Based on these results, our new approach was able to present one of the most effective seizure detection methods compared to other existing state-of-the-art methods applied to the same dataset. [ABSTRACT FROM AUTHOR]

Objective: To detect the potential risk factors associated with early mortality in patients who received extensive surgical management, in the form of total arch replacement plus frozen elephant trunk and arch debranching (hybrid repair technique), for acute type A aortic dissection. Methods: The clinical and surgical data of 452 surgically treated patients with acute type A aortic dissection at our center, between March 2010 and December 2016, have been retrieved. Uni and multivariate logistic regression analyses were carried out to detect the effect of various preoperative demographics and different perioperative variables on early mortality. Results: Overall 30-day mortality occurred in 70 out of 452 patients (15.4%). The principal causes of death were multiple organ failure (n=38), cardiac failure (n=18), and severe pulmonary infection (n=10). Risk factors for early mortality were identified with multivariate analysis. Preoperatively, overweight (P<0.025), alcohol drinking (P<0.002), coronary artery disease (P<0.014), hemodynamic shock (P<0.006), and elevated white blood cells count (P<0.002) were associated with higher mortality rate. Postoperatively, prolonged operation time (P<0.008), stroke (P<0.0001), and acute renal dysfunction (P<0.0001) were highly associated with death. Conclusion: Considering the advantages of extensive surgical management for acute type A aortic dissection over the other less aggressive surgical approaches, it should be advised whenever indicated, provided that being carried out by experts in the field of adult aortic surgery in high-volume centers. The surgeon should be aware of the patient’s preoperative comorbidities and other risk factors for early mortality, in particular, prolonged operation time. [ABSTRACT FROM AUTHOR]

In the past few decades, measuring and recording the brain electrical activities using Electroencephalogram (EEG) has become a standout amongst the tools utilized for neurological disorders’ diagnosis, especially seizure detection. In this letter, a novel epileptic seizure detection system based on classifying raw EEG signals’ recordings, eliminating the overhead of engineered feature extraction, is proposed. The system employs a mixing of unsupervised and supervised deep learning utilizing a one-dimensional convolutional variational autoencoder. To ascertain the robustness of the system against classifying unseen data, the evaluation of the proposed system is done using k-fold cross-validation. The classification results between normal and ictal cases have achieved a 100% accuracy while the classification results between the normal, inter-ictal and ictal cases accomplished a 99% overall accuracy which makes our system one of the most efficient among other state-of-the-art systems. [ABSTRACT FROM AUTHOR]

Background: The objectives were to describe the frequency of clinical presentation at the onset of type 1 diabetes mellitus (T1DM) and to estimate the prevalence of T1DM among children and adolescents in the AL-Baha region, Saudi Arabia, aiming for early diagnosis of T1DM. Methods: The clinical and laboratory data of 471 children and adolescents who presented with T1DM and received medical care at an AL-Baha diabetic center during the period from 2007 to 2016 were retrospectively analyzed based on the records. Results: The prevalence of T1DM in the AL-Baha region was 355 per 100,000 population in participants aged from 0 to 19 years. T1DM was more common among girls than boys (57.5% vs. 42.5%, respectively; p=0.3), and the female/male ratio was 1.36 in favor of girls. Hyperglycemic symptoms were the most frequent symptoms at presentation [59.2% vs. 40.8% with diabetic ketoacidosis (DKA)], and 37% of them presented with loss of weight. Most of the ketoacidosis was mild to moderate (80.2%), while only 19.8% of children had the severe type and DKA was more common (55.2%) among females. The mean age at diagnosis of T1DM was 8.2±3.5 years for all patients, and 8.3±3.9 and 8.9±3.6 years for boys and girls, respectively (p=0.06). Hyperglycemic symptoms were more common in spring (15.9%). Conclusions: The prevalence of type 1 diabetes in the AL-Baha region was 355 per 100,000 population, which is one of the highest reported prevalences in this age group. Hyperglycemic symptoms were the most encountered symptoms at the onset of the presentation of T1DM and this may help in early detection of diabetic symptoms by patients and physicians to avoid the more severe types of presentation. [ABSTRACT FROM AUTHOR]

Objective: to determine the outcome of day cases tubeless PCNL with only 12 hours hospital stay regarding vital data, postoperative bleeding and pain. Materials and Methods: We prospectively reviewed 50 patients presenting to our university hospital with renal pelvic radioopaque stones less than 2 cm underwent tubeless PCNL discharged within 12 hours postoperatively. Operation time,Occurrence of intraoperative complications and Post operative vital data, hemoglobin level were recorded Results: All 50 patient,16 female,34 male patient underwent totally tubeless PCNL, intraoperatively, the operation time ranging from 45 to 85 minutes . postoperatively, the study revealed that 3 patients were found hypotensive( 6%), fever more than 38 degree occurred in 7 patients (14%) . Hemoglobin level dropped more than 1gm/dl in only 4 patients 8%, blood transfusion needed in only 2 patients, hospital readmission was needed by 7 patients (14%) within 1 week postoperatively. Outpatient follow up of the patients underwent daycase PCNL revealed that 39 patient returned to normal activities within 4 days (78%) but 11 patients took 4-7 days( 12%) Conclusions: Tubeless PCNL is safe, feasible, and less morbid alternative to classic PCNL . decreased period of hospital stay, rapid return to normal social activities decreasing the economic burden regarding person and society. [ABSTRACT FROM AUTHOR]

The floating absorber for safety at transient (FAST) was proposed as a solution for the positive coolant temperature coefficient in sodium-cooled fast reactors (SFRs). It is designed to insert negative reactivity in the case of coolant temperature rise or coolant voiding in an inherently passive way. The use of the original FAST design showed effectiveness in protecting the reactor core during some anticipated transients without scram (ATWS) events. However, oscillation behaviors of power due to refloating of the absorber module in FAST were observed during other ATWS events. In this paper, we propose an improved FAST device (iFAST), in which a constraint is imposed on the sinking (insertion) limit of the absorber module in FAST. This provides a simple and effective solution to the power oscillation problem. Here, we focus on an oxide fuel-loaded SFR that is characterized by a more negative Doppler reactivity coefficient and higher operating temperature than the metallic-loaded SFR cores. The study is carried out for the 1000 MWth advanced burner reactor with an oxide fuel-loaded core during postulated ATWS events that are unprotected transient over power, unprotected loss of flow, and unprotected loss of the heat sink. It was found that the iFAST device has promising potentials for protecting the oxide SFR core during the various studied ATWS events. [ABSTRACT FROM AUTHOR]

The non-base load operation of nuclear power plants is expected to be unavoidable in future due to the increasing shares of the intermittent renewables. In this paper, the physics conditions required for a passively autonomous frequency control operation (PAFO) in a 3400 MWt conventional pressurized water reactor (PWR) design is investigated. The PAFO scheme allows a PWR to passively achieve the requested power maneuverability for primary and secondary frequency regulations on the electrical grid. This study is carried out for a conventional coolant system with a typical critical boron concentration, which yields a less negative coolant temperature coefficient (CTC) than that in a soluble-boron-free (SBF) core. The PAFO scheme is expected to be more challenging in the conventional PWRs than in an SBF small modular reactor, particularly for the secondary frequency regulation. This is mainly due to the weaker coolant reactivity feedback and the higher fuel temperature, which yields a stronger Doppler reactivity feedback during the passive power transients. Numerical simulations of PAFO are performed, for typical power ranges and power ramping rates required for frequency regulations, using a lumped PWR model that is solved by an in-house Fortran-95 computer code. In conventional PWRs, the progressive dilution of the soluble-boron throughout the cycle and the fuel depletion vary the reactivity coefficients. Therefore, we perform sensitivity analyses on CTC, FTC, and Xe worth to assess the feasibility of PAFO throughout the fuel cycle. In addition, sensitivity analysis on the fuel temperature is done to study its role in altering the reactor performance during PAFO. [ABSTRACT FROM AUTHOR]

AbstractResearchers who are actively developing nuclear microreactors are planning to employ innovative designs and features using traditional commercial modeling tools that may be inadequate for their design and licensing activities. The codes developed under the U.S. Department of Energy Office of Nuclear Energy Advanced Modeling and Simulation (NEAMS) program provide flexibility in terms of geometry modeling and multiphysics coupling and are particularly well suited for modeling novel microreactor concepts. To test the maturity of these codes, this paper introduces a conceptual heat pipe microreactor (HP-MR) designed to gather various technologies of interest to microreactor developers such as control drums, heat pipes, and hydride moderators. The objective of this effort is to demonstrate NEAMS tools capability to perform high-fidelity multiphysics simulations, using coupled neutronics (via the Griffin code), heat conduction (via the BISON code), heat pipe modeling (via the Sockeye code), and hydrogen redistribution in hydride metal moderator (via the SWIFT code). Codes are coupled in-memory through the Multiphysics Object-Oriented Simulation Environment (MOOSE) framework, which permits flexible multiphysics data transfer schemes. The analysis confirmed two key aspects of the HP-MR concept: (1) its ability to follow the power load requested from the heat pipe and (2) its ability to avoid heat pipe cascading failure unless designed with high power close to operating failure limits of its heat pipes. The developed computational model was distributed publicly on the Virtual Test Bed for training purposes to accelerate adoption by industry and to provide a high-fidelity multiphysics solution for benchmarking against other tools. Additional multiphysics analyses including other transients and coupled physics were identified as necessary future work, together with a focus on validating multiphysics behavior against experiments. [ABSTRACT FROM AUTHOR]

With the next generation of nuclear reactors under development, modeling and simulation tools are being developed by the U.S. Department of Energy to support their design, licensing, and future operation. Mirroring the physical test beds currently under construction (i.e., Demonstration and Operation of Microreactor Experiments, known as DOME, and Laboratory for Operating and Testing in the United States, known as LOTUS), the Virtual Test Bed was launched by the National Reactor Innovation Center in collaboration with the Nuclear Energy Advanced Modeling and Simulation (NEAMS) program to support the advanced reactor community. This collaborative effort, which involves multiple teams at both Idaho National Laboratory and Argonne National Laboratory, aims to use state-of-the-art simulation tools to model a wide range of reactor designs. These models are automatically tested to ensure their continued functionality as the tools are further developed. Examples are extensively documented, each acting as a tutorial for applying the relevant NEAMS tools to that reactor design. Currently, five advanced reactor types (with a total of 12 specific design subvariants) are simulated by a variety of models. These models range from steady-state, core multiphysics simulations to integrated plant analysis during loss-of-flow transients. To our knowledge, this is the first publicly available library of multiphysics advanced reactor models distributed with extensive documentation and maintained through continuous integration. [ABSTRACT FROM AUTHOR]

Investigates the genetic control of severe hepatic fibrosis in schistosoma mansoni infection in Sudan. Factors contributing to the prevalence of hepatic fibrosis; Examinations on the linkage of the disease on the interferon-y chromosome; Infection levels of schistosoma mansomi.

Background: The rapid evolution of artificial intelligence (AI) in conjunction with recent updates in dual antiplatelet therapy (DAPT) management guidelines emphasizes the necessity for innovative models to predict ischemic or bleeding events after drug-eluting stent implantation. Leveraging AI for dynamic prediction has the potential to revolutionize risk stratification and provide personalized decision support for DAPT management., Methods and Results: We developed and validated a new AI-based pipeline using retrospective data of drug-eluting stent-treated patients, sourced from the Cerner Health Facts data set (n=98 236) and Optum's de-identified Clinformatics Data Mart Database (n=9978). The 36 months following drug-eluting stent implantation were designated as our primary forecasting interval, further segmented into 6 sequential prediction windows. We evaluated 5 distinct AI algorithms for their precision in predicting ischemic and bleeding risks. Model discriminative accuracy was assessed using the area under the receiver operating characteristic curve, among other metrics. The weighted light gradient boosting machine stood out as the preeminent model, thus earning its place as our AI-DAPT model. The AI-DAPT demonstrated peak accuracy in the 30 to 36 months window, charting an area under the receiver operating characteristic curve of 90% [95% CI, 88%-92%] for ischemia and 84% [95% CI, 82%-87%] for bleeding predictions., Conclusions: Our AI-DAPT excels in formulating iterative, refined dynamic predictions by assimilating ongoing updates from patients' clinical profiles, holding value as a novel smart clinical tool to facilitate optimal DAPT duration management with high accuracy and adaptability.

The current meta-analysis aims to explore the effect of metformin use on vitamin B12 deficiency in patients with type 2 diabetes mellitus (T2DM) and the factors associated with it. This meta-analysis followed the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines and the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. We searched PubMed and EMBASE from January 1, 2010, to October 31, 2022, to collect the studies that reported the effect of metformin on the deficiency of vitamin B12 in patients with T2DM and the factors associated with it. A total of 17 studies were included in the current meta-analysis. Among all the included studies, 13 were cross-sectional studies, 3 were retrospective cohorts, and one was a case-control study. The pooled rate of deficiency of vitamin B12 in patients receiving metformin (23.16%) was significantly higher compared to patients who were not on metformin (17.4%) (OR: 2.95, 95% CI: 2.18-4.00, p-value: 0.001). Factors significantly associated with vitamin B12 deficiency in patients with T2DM and receiving metformin include the duration of metformin use and a greater dose of metformin. In conclusion, our meta-analysis found that the prevalence of vitamin B12 deficiency is greater in patients receiving metformin compared to patients who did not receive metformin. Given the importance of vitamin B12 in nutrition, metformin-induced B12 decrease may be harmful to patients with T2DM. Supplemental vitamin B12 may be advantageous for those on metformin., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Kakarlapudi et al.)

Due to the limitations of existing medications, there is a critical need for new drugs to treat visceral leishmaniasis. Since arylimidamides and antifungal azoles both show oral activity in murine visceral leishmaniasis models, a molecular hybridization approach was employed where arylimidamide and azole groups were separated by phenoxyalkyl linkers in an attempt to capitalize on the favorable antileishmanial properties of both series. Among the target compounds synthesized, a greater antileishmanial potency against intracellular Leishmania donovani was observed as the linker length increased from two to eight carbons and when an imidazole ring was employed as the terminal group compared to a 1,2,4-triazole group. Compound 24c ( N -(4-((8-(1 H -imidazol-1-yl)octyl)oxy)-2-isopropoxyphenyl) picolinimidamide) displayed activity against L. donovani intracellular amastigotes with an IC 50 value of 0.53 μM. When tested in a murine visceral leishmaniasis model, compound 24c at a dose of 75 mg/kg/day p.o. for five consecutive days resulted in a modest 33% decrease in liver parasitemia compared to the control group, indicating that further optimization of these molecules is needed. While potent hybrid compounds bearing an imidazole terminal group were also strong inhibitors of recombinant CYP51 from L. donovani , as assessed by a fluorescence-based assay, additional targets are likely to play an important role in the antileishmanial action of these compounds.

Soil moisture (SM) plays a significant role in determining the probability of flooding in a given area. Currently, SM is most commonly modeled using physically-based numerical hydrologic models. Modeling the natural processes that take place in the soil is difficult and requires assumptions. Besides, hydrologic model runtime is highly impacted by the extent and resolution of the study domain. In this study, we propose a data-driven modeling approach using Deep Learning (DL) models. There are different types of DL algorithms that serve different purposes. For example, the Convolutional Neural Network (CNN) algorithm is well suited for capturing and learning spatial patterns, while the Long Short-Term Memory (LSTM) algorithm is designed to utilize time-series information and to learn from past observations. A DL algorithm that combines the capabilities of CNN and LSTM called ConvLSTM was recently developed. In this study, we investigate the applicability of the ConvLSTM algorithm in predicting SM in a study area located in south Louisiana in the United States. This study reveals that ConvLSTM significantly outperformed CNN in predicting SM. We tested the performance of ConvLSTM based models by using a combination of different sets of predictors and different LSTM sequence lengths. The study results show that ConvLSTM models can predict SM with a mean areal Root Mean Squared Error (RMSE) of 2.5% and mean areal correlation coefficients of 0.9 for our study area. ConvLSTM models can also provide predictions between discrete SM observations, making them potentially useful for applications such as filling observational gaps between satellite overpasses., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 ElSaadani, Habib, Abdelhameed and Bayoumi.)

Hepatitis C virus (HCV) infection can affect the neurological system, and neuropathy is one of these manifestations. Hepatitis C virus infection is associated with diabetes mellitus (DM) type II, and diabetic patients are at higher risk of acquiring HCV infection. Sweat function has been proposed to assess early autonomic neuropathy. This study aimed to evaluate small fiber neuropathy in asymptomatic HCV-related cirrhotic patients with or without DM through sweat function assessment by Sudoscan test. Three groups were involved: 47 healthy controls, 48 HCV-related cirrhotic patients without DM (group 1), and 49 HCV-related cirrhotic patients with DM type II (group 2). All participants were subjected to liver panel tests, renal function tests, cell blood counts, HbA1c, and abdominal ultrasound. Sweat function was assessed in all patients and controls by measuring hand and feet electrochemical skin conductance (ESC, microSiemens [µS]) using Sudoscan. Peripheral neuropathy was detected in none of the controls, 39% of group 1 patients, and 62% of group 2 patients (P < 0.0001). The mean feet ESC (FESC) was 88.3 ± 6.8 µS in controls, 67.2 ± 19.2 µS in group 1, and 57.9 ± 19.4 µS in group 2 (P < 0.0001). A significant correlation was observed between FESC and bilirubin, albumin, creatinine, international normalized ratio, transaminases, and splenic size. Electrochemical skin conductance measurement is a valuable, noninvasive method for early detection of small fiber neuropathy in asymptomatic HCV-related cirrhosis, with or without DM.

Aim: The study was conducted to evaluate the effect of combined low energy laser application and Micro-Osteoperforations versus the effect of the application of each technique separately on the rate of orthodontic tooth movement., Patients and Methods: Three parallel groups (each group contained 10 patients) were performed; Group A: In which one side was controlled side, and the other side received micro-osteoperforations (MOPs), Group B: In which one side was controlled side, and the other side received low-level laser therapy (LLLT), Group C: In which one side was controlled side, and the other side received both MOPs and LLLT., Results: Significant statistical differences were obvious in the rate of canine retraction between each intervention and the control sides as following; the MOPs increased the rate of canine retraction by 1.6 fold more than the control side, LLLT increased the rate of canine retraction by 1.3 fold than the control side, and combination of both techniques resulted in an increase in the rate of canine retraction by 1.8 fold more than the control side., Conclusion: Combination of MOPs and LLLT proved to be more efficient regarding increasing the rate of canine retraction than the application of each technique separately.