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Abstract Ovarian insufficiency is one of the common reproductive disorders affecting women with limited therapeutic aids. Mesenchymal stem cells have been investigated in such disorders before yet, the exact mechanism of MSCs in ovarian regeneration regarding their epigenetic regulation remains elusive. The current study is to investigate the role of the bone marrow-derived mesenchymal stem cells (BM-MSCs) lncRNA (Neat-1 and Hotair1) and miRNA (mir-21-5p, mir-144-5p, and mir-664-5p) in mitigating ovarian granulosa cell apoptosis as well as searching BM-MSCs in altering the expression of ovarian and hypothalamic IGF-1 – kisspeptin system in connection to HPG axis in a cyclophosphamide-induced ovarian failure rat model. Sixty mature female Sprague Dawley rats were divided into 3 equal groups; control group, premature ovarian insufficiency (POI) group, and POI + BM-MSCs. POI female rat model was established with cyclophosphamide. The result revealed that BM-MSCs and their conditioned media displayed a significant expression level of Neat-1, Hotair-1, mir-21-5p, mir-144-5p, and mir-664-5p. Moreover, BM-MSCs transplantation in POI rats improves; the ovarian and hypothalamic IGF-1 – kisspeptin, HPG axis, ovarian granulosa cell apoptosis, steroidogenesis, angiogenesis, energy balance, and oxidative stress. BM-MSCs expressed higher levels of antiapoptotic lncRNAs and microRNAs that mitigate ovarian insufficiency.

Abstract Estimation of cochlear length is gaining attention in the field of cochlear implants (CIs), mainly for selecting of CI electrode lengths. The currently available tools to estimate the cochlear duct length (CDL) are only valid for normal inner anatomy. However, inner ear malformation (IEM) types are associated with different degrees of cystic apices, limiting the application of CDL equations of normal anatomy inner ear. Therefore, this study aimed to understand the degree to which the outer wall (OW) is observed in different malformation types and to formulate mathematical equations to estimate the OW length (OWL) from cochlear parameters, namely the basal turn diameter (A-value) and width (B-value). Three-dimensional (3D) segmentation of promontory and fluid parts of the inner ear was performed to understand the extent to which the OW is visible to measure the OWL manually. Enlarged vestibular aqueduct syndrome (EVAS) was diagnosed in 37 ears, which consistently showed the extent of the OW to an angular depth of 540°, beyond which the cystic apex starts. Incomplete partition (IP) type I was observed in 30 ears, with the OW extending to only 360° of angular depth. IP type II was observed in 35 ears, with the OW extending to 450° of angular depth. IP type III was identified in 24 ears, with the OW observed for 540° of angular depth. Cavity-type malformations were observed in 36 ears, and circumference was measured in the axial view. A strong positive linear correlation was observed between the manually measured OWL and cochlear parameters for all malformation types analyzed. A multiple linear regression model was applied to formulate mathematical equations, which was further used to create a software application for estimating OWLs in IEM types, using cochlear parameters as inputs.

Abstract The impact of Bariatric Surgery (BS) on maternal and neonatal outcomes among pregnant women is not fully understood, especially in comparison to different weight categories. The primary aim of this study is to assess the factors associated to women who have undergone BS. The study also investigates the maternal and neonatal outcomes amongst this group in comparison to the three Body Mass Index (BMI) groups (women with obesity, overweight and normal weight). A 12-month population-based retrospective study was conducted using registry data from the PEARL-Peristat Study at the Women's Wellness and Research Center (WWRC) in Qatar from January 1, 2017, through December 31, 2017. Both univariate and multivariable regression analyses were employed to scrutinize risk factors and maternal and neonatal outcomes. The study included 6212 parturient women, of which 315 had a history of BS, while 5897 with no BS history. Qatari women, aged 35 and higher, with parity > 1, diabetes, and hypertension were more likely to be in the post-BS group. Women in the post-BS group were found to be more likely to have a cesarean delivery (37.5% vs. 24%, Adjusted Odds Ratio (aOR) = 1.59, CI 1.18–2.14), preterm babies (10% vs. 7%, aOR = 1.66, CI 1.06–2.59), and stillbirth (1.6% vs. 0.4%, aOR = 4.53, CI 1.33–15.50) compared to the normal weight women group. Moreover, post-BS women had a higher risk of low-birth-weight neonates than women with obesity (15% vs. 8%, aOR = 1.77, CI 1.153–2.73), overweight (15% vs. 7%, aOR = 1.63, CI 1.09–2.43), and normal weight (15% vs. 8%, aOR = 1.838, CI 1.23–2.75). Finally, women in the post-BS group were more likely to have low-birth-weight neonates amongst term babies than women with obesity and overweight. Pregnancies with post-BS should be considered a high-risk group for certain medical outcomes and should be monitored closely. These findings may guide the future clinical decisions of antenatal and postnatal follow-up for post-BS women.

Abstract The COVID-19 pandemic has led to an increase in the prevalence of anxiety, stress and depression among affected people. This study was conducted with the aim of investigating the clinical effectiveness of guided breathing exercises in reducing anxiety, stress and depression in patients with COVID-19. A quasi-experimental study design was used, involving a sample of COVID-19 patients who underwent guided breathing exercises as a complementary therapy. After simple sampling, eligible subjects were randomly divided into two groups: intervention (30 patients) and control (30 patients) using random block method. The Depression Anxiety Stress Scale-21 (DASS-21) questionnaire was administered before and after the intervention to evaluate changes in anxiety, stress, and depression levels. The results of this study demonstrated that clinically guided breathing exercises had a significant effect on reducing anxiety and stress in COVID-19 patients. The intervention significantly reduced anxiety and stress scores (p

Abstract Background Malignant mesothelioma is an aggressive cancer with poor prognosis. Programmed cell death protein-1 (PD-1) and its ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) have recently presented as a viable option in some first line but primarily as a second-line treatment of advanced-stage malignant mesothelioma (asMM). Therefore, this systematic review and meta-analysis aims to assess the safety and efficacy of PD-1/L-1 ICIs in advanced-stage malignant mesothelioma. Methods PubMed, Scopus, and Cochrane databases were searched for all studies assessing the safety and efficacy of anti PD-1/PD-L1 agents. Primary outcomes were objective response rate (ORR) and disease control rate (DCR). Secondary outcomes were median progression free (mPFS) and overall survival (mOS). Safety outcomes were treatment- (TRAEs) and immune-related adverse events (IRAEs). A random-effects meta-analysis was performed to pool medians and to derive event rates. Results A total of 15 studies were included with total of 1064 asMM patients. ORR and DCR were 16% and 57%, respectively. A pooled mPFS was 4.53 (CI: 3.40–5.65) and mOS was 10.51 (CI: 9.03-12.00). Overall TRAEs had an event rate of 0.69 (0.50–0.83) whereas IRAEs had an event rate of 0.28 (0.15–0.46). There were no significant differences between pembrolizumab, nivolumab primarily, and avelumab subgroups for all the outcomes. Additionally, meta-regression found no covariate to be a significant factor in ORR and DCR. Conclusion In this meta-analysis we found that anti-PD1/PD-L1 treatment could be useful in pretreated asMM as they had at least comparable or greater mPFS, mOS, ORR, and DCR than other second-line agents currently being used. Registration number This systematic review was registered at PROSPERO prior to the literature search, CRD42023442350.

Context: About 10% of all the dermatological conditions are comprised nail disorders. It is challenging for the dermatologists to diagnose nail disorders quickly without the help of invasive procedures. Aims: The aim of the study was to evaluate onychoscopic patterns associated with various nail disorders. Settings and Designs: Hospital-based cross-sectional observational study was conducted at a tertiary care teaching institute in Maharashtra, India from November 2019 to May 2021. Materials and Methods: One hundred and fifty patients, with a history and clinical presentation suggestive of nail disorders, were recruited in the study after confirming the clinical diagnosis. Patients having secondarily modified lesions were excluded. Dry as well as wet onychoscopy using polarized and nonpolarized modes was performed with the help of DermLite 4 dermoscope with an attached OnePlus 8T mobile phone camera to capture and save the dermoscopic images. Data were compiled and statistically analyzed using SPSS version 21.0. Statistical Analysis Used: Categorical variables were expressed in frequency and percentages. Data were entered in Microsoft Excel and analyzed using SPSS version 20. P value (using Z-test for proportions) was calculated wherever needed. Results: The majority of the patients were in the age group of 21–50 years with slight male preponderance. Overall most common onychoscopic findings studied in all the disorders were the nail plate alterations followed by chromonychia. The most common nail changes associated with connective tissue disorders were changes in the proximal nail fold capillaries along with changes in the curvature. The most common change observed in onychomycosis was chromonychia. Aurora borealis, spikes, and jagged edges of onycholytic plate with ruin pattern of hyperkeratosis were specific to onychomycosis. Inflammatory disorders of the nail unit (e.g., lichen planus and nail psoriasis) showed nail plate alterations with increased nail plate fragility. Conclusions: Some onychoscopic patterns are observed consistently with certain diseases, and these can be used for their diagnosis, hence, avoiding unnecessary biopsies, thus improving the patient outcome.

Abstract Basic yellow 28 dye, used extensively in the textile and leather industries, poses significant environmental and health risks, including allergic reactions, skin irritation, and respiratory problems. This study reports the Pechini sol-gel synthesis of novel ZnO/Mg3B2O6 nanostructures for the decontamination of basic yellow 28 dye from aqueous solutions. The nanostructures were synthesized by calcining at 650 and 850 °C for 5 h, producing ZM650 and ZM850, respectively. The average crystallite sizes were 39.28 nm for ZM650 and 51.03 nm for ZM850. BET surface areas were 70.71 m2/g for ZM650 and 48.13 m2/g for ZM850. FE-SEM and HR-TEM analyses revealed distinct morphological structures, with ZM650 exhibiting a dense aggregation of rod-like particles and ZM850 showing larger clusters. The maximum adsorption capacities were 381.68 mg/g for ZM650 and 303.03 mg/g for ZM850. The optimum adsorption was observed at a pH of 10, a contact time of 70 min, and a temperature of 298 K. Regeneration using a 6 M HCl solution demonstrated efficient reusability over five cycles. The adsorption process followed pseudo-second-order kinetics and the Langmuir isotherm, indicating monolayer adsorption. Also, the adsorption process was found to be physical and exothermic.

الملخص: أهداف البحث: تناولت هذه الدراسة التحقيق في العلاقة بين ثلاثة متغيرات جينية: آر اس 4671393 و آر اس 1427407 و آر اس 11886868 تقع داخل جين ''بي سي ال 11 أ'' ومتغير واحد آر اس 9399137 في جين ''اتش بي اس 1 ال-ام واي بي''، وارتباطهم المحتمل بمرض الثلاسيميا لدى المرضى من سكان البنجاب، باكستان. طريقة البحث: تم استقطاب مجموعة مكونة من 600 مشارك من مستشفيات مختلفة في البنجاب، باكستان. وقد ضمت المجموعة 300 مريض بالثلاسيميا و300 من الضوابط الأصحاء المطابقين في العمر والجنس. وتم استخراج الحمض النووي من عينات الدم الكاملة لجميع المشاركين. وتم تضخيم مناطق الحمض النووي المحددة التي تحتوي على أربعة متغيرات وراثية ذات أهمية باستخدام تفاعل البوليميراز المتسلسل. النتائج: تشير الترددات الجينية تعدد أشكال النوكليوتيد المفردة لـ آر اس 4671393 من جين ''بي سي ال 11 أ'' إلى أن النمط الجيني المتغاير (أ ج) لـ تعدد أشكال النوكليوتيد المفردة كان مرتبطا بشكل كبير بزيادة خطر الإصابة بالثلاسيميا بمقدار الضعف تقريبا مقارنة بالمجموعة المرجعية. كما أكد الجمع بين جميع الأنماط الجينية في نموذج مشترك وجود ارتباط كبير بزيادة خطر الإصابة بالثلاسيميا. وعلى غرار آر اس 4671393، أظهر النمط الجيني المتغاير(س ت) لـ آر اس 11886868 أيضا ارتباطا كبيرا بزيادة خطر الإصابة بالثلاسيميا بمقدار الضعف تقريبا. كشف تحليل كلا النمطين الجينيين معا عن ارتباط طفيف مع زيادة بمقدار ضعف واحد في خطر الإصابة بالثلاسيميا للأفراد الذين يحملون أي أليل متغير من آر اس 11886868. أظهرت حالات التوزيع الأليلي لـ آر اس 1427407 للجين ''بي سي ال 11 أ'' أن النمط الجيني المتغاير (ت ج) لـ آر اس 1427407 أظهر ارتباطا مهما بزيادة في خطر الإصابة بالثلاسيميا بمقدار الضعف تقريبا مقارنة بالمجموعة المرجعية. أكد الجمع بين جميع الأنماط الجينية في نموذج مشترك وجود ارتباط مهم بين وجود أي أليل متغير لـ آر اس 1427407 وزيادة في خطر الإصابة بالثلاسيميا بمقدار الضعف. أظهرت ترددات التوزيع الجيني المتغاير (ت س) لـ آر اس 9399137 لجين ''اتش بي اس 1 ال-ام واي بي'' مشابهة لـ آر اس 1427407، أظهر النمط الجيني المتغاير (س ت) لـ آر اس 9399137 ارتباطا مهما للغاية بزيادة في خطر الإصابة بالثلاسيميا بمقدار الضعف تقريبا. أظهر تحليل كلا النمطين الجينيين معا وجود ارتباط كبير مع زيادة خطر الإصابة بالثلاسيميا بمقدار ضعف واحد للأفراد الذين يحملون أي متغير من أليل آر اس 9399137. Abstract: Objectives: This study investigated the associations of the rs4671393, rs1427407, and rs11886868 genetic variants of the BCL11A gene and the rs9399137 variant of the HBS1L-MYB gene with thalassemia in patients from the population of Punjab, Pakistan. Methods: A cohort of 600 participants, comprising 300 patients with thalassemia and 300 age- and sex-matched healthy controls, was recruited from various hospitals in Punjab, Pakistan. DNA was extracted from whole blood samples from all participants. Specific DNA regions containing four genetic variants of interest were amplified with polymerase chain reaction. Results: The genotypic frequencies of the rs4671393 SNP of BCL11A indicated that the heterozygous (AG) genotype of this SNP was significantly associated with a nearly two-fold increased thalassemia risk, with respect to the control group (OR = 1.77; 95% CI = 1.77–2.80; p = 0.01). Combining all genotypes into a joint model further confirmed their significant association with thalassemia risk. Similarly to the findings for rs4671393, the heterozygous (CT) genotype of rs11886868 exhibited a significant association with thalassemia risk (approximately two-fold increased risk. Analysis of both genotypes together revealed a marginally significant association (one-fold increased risk) with thalassemia in individuals carrying any variant allele of rs11886868. The allelic distribution of the rs1427407 SNP of BCL11A indicated that the heterozygous (GT) genotype of this SNP was significantly associated with thalassemia (approximately two-fold increased risk, with respect to the control group). Combining all genotypes into a joint model confirmed a significant association between the presence of any variant allele of rs1427407 and thalassemia (two-fold increased risk). The genotypic distribution frequencies of the heterozygous (CT) genotype for the rs9399137 SNP of HBS1L-MYB was similar to that of rs1427407, and exhibited a highly significant association with thalassemia risk (nearly two-fold increased risk). Analysis of both genotypes together revealed a significant association with thalassemia risk (one-fold increase) for individuals carrying any variant allele of rs9399137. Conclusion: BCL11A and HBS1L-MYB polymorphisms were significantly associated with increased thalassemia risk.

Introduction: This cross-sectional study investigates the prevalence of knowledge and awareness of Helicobacter pylori (H. pylori) infection among the urban population of the Kingdom of Saudi Arabia (KSA). The study is motivated by the need to understand the specific demographic segments within the urban setting and their awareness levels of this prevalent bacterial infection affecting the digestive system. Methodology: The cross-sectional study, employing a purposive sampling method and involving 840 participants from major cities in the KSA, utilized a structured survey questionnaire to gather data on demographic factors, awareness levels, attitudes, and experiences related to H. pylori infection, with subsequent statistical analysis and adherence to ethical guidelines for participant confidentiality and privacy protection. Result: The study involved 840 participants from major cities, revealing that 59.16 ​% were aware of H. pylori. Demographic variations included higher participation from Jeddah and Riyadh, with the majority being females aged 18–25, Saudi nationals, and individuals with undergraduate education. About 57.02 ​% reported experiencing suspected H. pylori symptoms, and 49.16 ​% had prior infections, with varying severity. Hesitancy toward screening (42.61 ​%), but 72.97 ​% believed in preventability. Limited awareness of treatments (15.35 ​%) and identification of factors like water and food were noted. Participants perceived the seriousness of H. pylori in the mid-range (5–7). Conclusion: The findings shed light on variations in awareness, knowledge gaps, and attitudes, emphasizing the need for targeted public health interventions, educational campaigns, and policy measures to address the challenges associated with H. pylori infections in urban areas.

Abstract Background Cervical radiculopathy (CR) is a common condition, often associated with cervicogenic headache (CGH), a secondary headache arising from cervical spine disorders. Mechanical intermittent cervical traction (MICT) is frequently prescribed to treat CR symptoms. The purpose of the study was to make a preliminary estimate of efficacy of adding MICT to conventional rehabilitation on CGH in patients with cervical radiculopathy. Methods A total of 36 CR patients with CGH were randomly allocated to 3 equally sized groups (A, B and C). The treatment consisted of twelve sessions of conventional rehabilitation (4 weeks) combined with MICT (2 kg for group A, 8 kg for group B and 12 kg for group C). Primary outcomes were CGH intensity (visual analog scale) and frequency (days per week). Secondary outcomes were radicular pain intensity (visual analog scale), cervical range of motion (cervical range of motion instrument), proprioception (cervical range of motion instrument) and muscle strength (MicroFET2 dynamometer), handgrip strength (handheld dynamometer), function (Neck Disability Index), kinesiophobia (Tampa Scale for KInesiophobia), anxiety and depression (Hospital Anxiety and Depresion questionnaire), and quality of life (World Health Organization Quality of Life). Patients were assessed at baseline, one, three and six months after the beginning of treatment. The post hoc Dunn testing was used to determine which traction load had the better effect on CGH symptoms. Results At one, three and six months follow-ups, Group C exhibited the highest improvement in CGH intensity and frequency compared to the other groups (p = 0.021 and p = 0.023; p = 0.012 and p = 0.01; p = 0.005 and p = 0.005). Both groups C and B showed a significant improvement in radicular pain compared to group A at one month follow-up (p = 0.05).The improvement in group C was significantly better in terms of function (p = 0.049) and anxiety (p = 0.011) at three months and quality of life at six months (Psychological p = 0.046 and Environment p = 0.006). Conclusions The blend of conventional rehabilitation alongside 12 kg MICT seems to be efficacious in diminishing both the intensity and frequency of CGH in patients with CR. These advantages appear to last for up to six months following the treatment period, potentially leading to decreased CGH severity and occurrence rates, heightened functionality, reduced anxiety levels, and an overall enhancement in quality of life. These findings are preliminary and require confirmation in larger trials. Trial registration The study protocol was retrospectively registered at the Pan African Clinical Trial Registry (PACTR202401838955948). Date of registration is 16/01/2024.

Abstract Objectives Trauma registries are essential tools for improving trauma care quality and efficiency, but many fail to capture long-term patient-reported outcome measures (PROMs). Focusing on these outcomes is crucial for understanding the extent of disability patients experience and identifying potential post-discharge interventions to optimize recovery. Studies reflecting the experience from low- and middle-income countries in this area are limited. Therefore, we aim to develop a digital trauma registry in Pakistan to prospectively capture patient-reported outcome measures at one, three, six, and twelve months post-injury. Methods We will develop and implement a digital trauma registry at two tertiary care facilities in Karachi, Pakistan: Aga Khan University Hospital and Jinnah Postgraduate Medical Center. The registry will include all admitted adult trauma patients (≥ 18 years). Data collection will be conducted digitally using tablets, with mortality, level of disability, functional status, and quality of life as primary outcomes. Follow-up data will be collected through telephone interviews with patients and caregivers. We will employ descriptive statistics to summarize participant’s socio-demographic and clinical characteristics. Additionally, we will perform survival analysis using Kaplan-Meier curves and Cox proportional hazard models and utilize mixed-effects linear regression to adjust for potential confounders for primary outcomes. Discussion The trauma registry will fill the current gap in knowledge regarding long-term outcomes among trauma patients in low- and middle-income countries (LMICs). This study will delineate future direction for capturing post-discharge data, enhancing our understanding of recovery, and informing the design of interventions aimed at improving long-term outcomes.

Abstract Smartphones store valuable personal information, necessitating robust authentication methods to protect user data. This research proposes a lightweight bi-model fallback authentication technique that combines dynamic security questions and finger pattern recognition using inertial measurement units. The dynamic security questions are generated based on the smartphone’s usage behavior, while the owner’s finger movements are captured using four different inertial sensors: accelerometer, gyroscope, gravity sensor, and magnetometer. By combining the answers to the questions and the owner’s finger movements, the user can be authenticated even if the primary authentication method fails. In this study, data was collected from 24 participants, including 12 primary phone users and 12 close adversaries, over a span of 28 days. The dynamic security questions, derived from call, SMS, battery charging events, application usage, location, and physical activity categories, achieved high accuracy rates, with call, SMS, and application usage surpassing $$90\%$$ 90 % . Incorporating the inertial measurement units significantly improved the accuracy of all question types, increasing from a maximum of $$76\%$$ 76 % to $$90.99\%$$ 90.99 % , while also enhancing the True Positive Rate from 0.79 to 0.99 compared to a previous study. This research presents a promising lightweight bi-model fallback authentication technique that leverages dynamic security questions and inertial measurement units data, demonstrating its effectiveness for enhancing smartphone security.

Abstract Background The knee is the most commonly afflicted weight-bearing joint. Osteoarthritis of the knee is regarded as one of the most commonly diagnosed causes of disability in the elderly. Knee joint replacement can be regarded as a final solution for Osteoarthritis of the knee in which the joint is worn out, accompanied by clinical symptoms such as pain, deformity, and limited movement. Aim this study sought to estimate the economic burden of knee joint replacement procedures carried out in Iran. Method This cross-sectional descriptive study utilized the Incidence-based approach to assess the economic burden of knee joint replacement surgeries conducted in Iran during 2022, estimating the costs of the disease from a societal perspective. The sampling method employed was random sampling, and the sample size consisted of 300 patients. Direct costs were calculated employing the top-down approach, while indirect costs were estimated using the human capital approach. Microsoft Excel was employed for data analysis. Result The average direct medical costs of the knee replacement procedure per patient were $10,076.87 and $13,099.93 in the public and private sectors, respectively. The average direct non-medical costs of knee joint replacement surgery are $1123.64, with companion costs constituting most of the direct non-medical costs. Finally, the economic burden of the knee joint replacement surgery was estimated at $67340417.28. Conclusion Despite insurance coverage, knee joint replacement surgery in Iran incurs substantial costs. With the anticipated rise in the elderly population, the frequency of these procedures is expected to increase, amplifying the economic burden on the Iranian public.

Abstract Background Fracture of the femur is one of the most common fractures that, if not stabilized and treated properly, may lead to severe disability, impairment of the individual’s efficiency, and numerous complications. This study aimed to evaluate the treatment results of femoral shaft fracture with two methods intramedullary nail (IMN) and Plate. Materials and methods In this cross-sectional study, 60 patients with femoral bone fractures were admitted to Imam Khomeini Hospital in Jiroft in 2020 and were treated for at least one year after discharge. They were divided into two treatment groups - Plate fracture fixation (n = 30) and IMN fracture fixation (n = 30). Data were collected using a researcher-made checklist including patient demographics and treatment outcomes. The collected data were analyzed using SPSS-v 26 statistical software and descriptive and inferential statistical tests at a significance level of p

Abstract Background Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphomas that remains a major diagnostic challenge due to the variety of its clinical presentations. This case highlights the importance of early biopsy of oral lesions without tendency to heal to attain the diagnosis more quickly. To the best of our knowledge, this study is the first to focus on both oral and pulmonary involvements in a patient with diffuse large B-cell lymphoma. Case presentation The presented case describes an Iranian 18-year-old girl with chronic cough and dyspnea referred for evaluation of the upper jaw due to bone exposure, bone loss, and soft tissue ulceration. Her medical history revealed mediastinal mass, cavitary lesion, and mediastinal lymphadenopathy. However, cytologic and immunohistochemical analysis did not show any evidence of malignancy. In this case a lymphoproliferative disease was suspected but ultimately the oral biopsy diagnosed diffuse large B-cell lymphoma and chemotherapy could be started. Conclusions Systemic conditions should be considered as a possible cause of oral lesions and a biopsy should also be performed immediately if there is any doubt concerning the nature of the lesion. Moreover, some conditions necessitate multiple biopsies to attain an accurate diagnosis.

Abstract Background In COVID-19 management, a variety of pharmaceutical interventions (PI) and non- pharmaceutical interventions (NPI) were adopted to limit the spread of the disease and its associated deaths. We aimed to evaluate the impact of PI and NPI on risks of COVID-19 transmission and deaths. Method We collected aggregate data from March 2nd, 2020, to December 1, 2022 from the Tunisian Ministry of Health's website and OurWorldInData.org site. NPI Periods (NPIP: March 2020 to March 2021) and PI Periods (PIP) were distributed to NPIP1, 2, 3 and 4 and to PIP1, 2, 3 and 4, respectively. We calculated the Relative Risks (RR) and 95% Confidence Intervals (CI) by comparing the subsequent period with previous one. Results The risk of SARS-CoV-2 transmission increased progressively from the zero cases period (NPIP2) to the mitigate strategy period (NPIP3) (RR = 14.0; 95% CI: 12.4–15.8) and to the stop-and-go epidemic control period (NPIP4) (RR = 23.1 (95% CI: 22.4–23.9). It was stabilized in the targeted vaccination period (PIP1) (RR = 1.08, 95% CI: 1.07–1.08) and reduced during the mass vaccination period (PIP2) (RR: 0.50, 95% CI: 0.50–0.51). SARS-CoV-2 transmission, increased during PIP3 concomitant with the Omicron wave (RR = 2.65, 95% CI: 2.64–2.67). It remained at a low level in PIP4 (RR = 0.18; 95% CI: 0.18–0.18). Compared to NPIP2, NPIP3 and NPIP4 were associated with a higher risk of COVID-19 mortality (RR = 3.337; 95% CI: 1.797–6.195) and (RR = 72.63 (95% CI: 54.01–97.68), respectively. Since the start of the immunization program, the risk of COVID-19 death has consistently decreased. In comparison to each previous period, the risk transitioned in PIP1 to RR = 0.91; 95% CI: 0.88–0.93, then to RR = 0.85; 95% CI: 0.83–0.88 in PIP2, to RR = 0.47; 95% CI: 0.45–0.50 in PIP3, and to RR = 0.19; 95% CI: 0.18–0.24 during PIP4. Conclusion In terms of lowering the risk of transmission and mortality, the NP strategy at the beginning of the epidemic outperformed the IP strategy during the outbreak.

This research paper attempts to test the applicability of the Purchasing Power Parity theory to the Algerian economy. Annual data from 1990 to 2023, specifically concerning the official exchange rate and the consumer price index, were used. By conducting a series of econometric tests, such as stationarity tests, cointegration tests, and causality studies, the study concludes that there is a long-term equilibrium relationship between the official exchange rate and the consumer price index. Hence, it can be inferred that the PPP theory holds true for the Algerian context. This implies that purchasing power parity is maintained in the long run, and therefore, this theory can be relied upon to determine and interpret the exchange rate of the Algerian dinar in the current scenario. The results of the error correction model estimation from the joint integration test also showed a direct relationship between the nominal exchange rate and the consumer price index, such that a relative change in the exchange rate by one unit leads to a relative change in the consumer price index by 0.14. The error correction model coefficient, estimated at 0.024, reveals the speed of the return to the equilibrium position and is a relatively weak correction coefficient. Based on the R² value, it can be said that exchange rates represent 69% of the changes in the consumer price index. The Granger causality test revealed a causal relationship running from the official exchange rate to the consumer price index for the Algerian economy.

Abstract Recent research has identified multiple immune systems that bacteria use to protect themselves from viral infections. However, little is known about the mechanisms by which these systems horizontally spread, especially among bacterial pathogens. Here, we investigate antiviral defenses in staphylococci, opportunistic pathogens that constitute leading causes of antibiotic-resistant infections. We show that these organisms harbor a variety of anti-phage defenses encoded within or near SCC (staphylococcal cassette chromosome) mec cassettes, mobile genomic islands that confer methicillin resistance. Importantly, we demonstrate that SCCmec-encoded recombinases mobilize not only SCCmec, but also tandem SCC-like cassettes enriched in genes coding for diverse defense systems. Further, we show that phage infection stimulates cassette mobilization (i.e. excision and circularization). Thus, our findings indicate that SCC/SCCmec cassettes not only spread antibiotic resistance but can also play a role in mobilizing anti-phage defenses.

Abstract The p53 mutation is the most common genetic mutation associated with human neoplasia. TP53 missense mutations, which frequently arise early in breast cancer, are present in over thirty percent of breast tumors. In breast cancer, p53 mutations are linked to a more aggressive course of the disease and worse overall survival rates. TP53 mutations are mostly seen in triple-negative breast cancer, a very diverse kind of the disease. The majority of TP53 mutations originate in the replacement of individual amino acids within the p53 protein's core domain, giving rise to a variety of variations referred to as "mutant p53s." In addition to gaining carcinogenic qualities through gain-of-function pathways, these mutants lose the typical tumor-suppressive features of p53 to variable degrees. The gain-of-function impact of stabilized mutant p53 causes tumor-specific dependency and resistance to therapy. P53 is a prospective target for cancer therapy because of its tumor-suppressive qualities and the numerous alterations that it experiences in tumors. Phenotypic abnormalities in breast cancer, notably poorly differentiated basal-like tumors are frequently linked to high-grade tumors. By comparing data from cell and animal models with clinical outcomes in breast cancer, this study investigates the molecular mechanisms that convert gene alterations into the pathogenic consequences of mutant p53's tumorigenic activity. The study delves into current and novel treatment approaches aimed at targeting p53 mutations, taking into account the similarities and differences in p53 regulatory mechanisms between mutant and wild-type forms, as well. Graphical Abstract

Abstract Background Healthcare waste (HCW) poses a global hazard, particularly in developing country hospitals where mismanagement is common due to poor practices among staff. Training healthcare workers has shown promise in enhancing practices and behaviors. The aim of this study was to assessHCW management at Sahloul University Hospital (2019–2021) before and after training sessions. Methods This study was conducted at Sahloul University in Sousse, Tunisia, spanned two years (2019–2021) and consisted of three distinct stages. Two audits of Healthcare Waste Management (HCWM) were conducted using a predetermined assessment framework derived from ANGED’s guidelines, with an educational session separating the two audits. Results In terms of sorting practicesthere was a substantial improvement in sorting practices following training. Specifically, the overall compliance rate for sorting sharps increased from 60.3 to 77.6% (p

Abstract Background Craniofacial bone regeneration represents a dynamic area within tissue engineering and regenerative medicine. Central to this field, is the continual exploration of new methodologies for template fabrication, leveraging established bio ceramic materials, with the objective of restoring bone integrity and facilitating successful implant placements. Methods Photopolymerized templates were prepared using three distinct bio ceramic materials, specifically a wet chemically synthesized bioactive glass and two commercially sourced hydroxyapatite variants. These templates underwent comprehensive characterization to assess their physicochemical and mechanical attributes, employing techniques including Fourier transform infrared spectroscopy, scanning electron microscopy, and nano-computed tomography. Evaluation of their biocompatibility was conducted through interaction with primary human osteoblasts (hOB) and subsequent examination using scanning electron microscopy. Results The results demonstrated that composite showed intramolecular hydrogen bonding interactions with the photopolymer, while computerized tomography unveiled the porous morphology and distribution within the templates. A relatively higher porosity percentage (31.55 ± 8.70%) and compressive strength (1.53 ± 0.11 MPa) was noted for bioactive glass templates. Human osteoblast cultured on bioactive glass showed higher viability compared to other specimens. Scanning micrographs of human osteoblast on templated showed cellular adhesion and the presence of filopodia and lamellipodia. Conclusion In summary these templates have the potential to be used for alveolar bone regeneration in critical size defect. Photopolymerization of bioceramics may be an interesting technique for scaffolds fabrication for bone tissue engineering application but needs more optimization to overcome existing issues like the ideal ratio of the photopolymer to bioceramics.

Abstract Objective To characterize the experience of people with epilepsy and aligned healthcare workers (HCWs) during the first 18 months of the COVID‐19 pandemic and compare experiences in high‐income countries (HICs) with non‐HICs. Methods Separate surveys for people with epilepsy and HCWs were distributed online in April 2020. Responses were collected to September 2021. Data were collected for COVID‐19 infections, the effect of COVID‐related restrictions, access to specialist help for epilepsy (people with epilepsy), and the impact of the pandemic on work productivity (HCWs). The frequency of responses for non‐HICs and HICs were compared using non‐parametric Chi‐square tests. Results Two thousand one hundred and five individuals with epilepsy from 53 countries and 392 HCWs from 26 countries provided data. The same proportion of people with epilepsy in non‐HICs and HICs reported COVID‐19 infection (7%). Those in HICs were more likely to report that COVID‐19 measures had affected their health (32% vs. 23%; p

Abstract Objectives The primary objective of this project was to develop a comprehensive COVID-19 non-pharmaceutical interventions’ index for the province of Québec (QCnPI-Index). The resulting database systematically categorizes, multiple non-pharmaceutical interventions implemented in the 17 administrative regions (AR) of the province of Québec to mitigate the spread of COVID-19 in the form of an index. Data description Data represent interventions and groups of interventions implemented during the COVID-19 period in Québec. They are a compilation of policies, guidelines, and governmental interventions related to COVID-19, considering temporal and geographical dimensions. Data were collected for all 17 AR of Québec using dates as unit of analysis, from March 2020 to April 2022. They were first collected and then coded by an interdisciplinary research team to form the foundation of the QCnPI-Index. Contribution This quantitative instrument offers the necessary granularity for nuanced spatial and temporal studies within the province of Québec, using AR, for instance, as unit of analysis. With this database, pre-, during-, and post-COVID periods can thus be better analyzed. Additionally, the innovative methodologies employed for data collection, coding, and weighting offer valuable insights that may have broader applications in public health, epidemiology, and other research domains. The QCnPI-Index could be instrumental for public health, epidemiology, and transportation researchers investigating the multifaceted impacts of non-pharmaceutical interventions on various societal domains, such as road safety, alcohol and cannabis consumption, and/or mental health, in the province of Québec.

Abstract This manuscript proposes an automatic reading detection system for an analogue gauge using a combination of deep learning, machine learning, and image processing. The study suggests image-processing techniques in manual analogue gauge reading that include generating readings for the image to provide supervised data to address difficulties in unsupervised data in gauges and to achieve better accuracy using DenseNet 169 compared to other approaches. The model uses artificial intelligence to automate reading detection using deep transfer learning models like DenseNet 169, InceptionNet V3, and VGG19. The models were trained using 1011 labeled pictures, 9 classes, and readings from 0 to 8. The VGG19 model exhibits a high training precision of 97.00% but a comparatively lower testing precision of 75.00%, indicating the possibility of overfitting. On the other hand, InceptionNet V3 demonstrates consistent precision across both datasets, but DenseNet 169 surpasses other models in terms of precision and generalization capabilities.

Abstract Background There are limited treatment options for metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic Fatty Liver Disease (MASLD) in children and adolescents. Aim To evaluate the effectiveness of the Mediterranean diet in improving liver function in children and adolescents with MASLD. Methods In this systematic review and meta-analysis, we searched PubMed, Scopus, Embase, CINAHL, and Cochrane CENTRAL for interventional studies investigating the effect of Mediterranean diet on MASLD in children and adolescents. The primary outcome was a change in liver function measured using these liver enzymes; Alanine Transaminase (ALT), Aspartate Transaminase (AST) and Gamma-glutamyl transferase (GGT). The secondary outcomes were lipid profile, body weight, and insulin resistance. The risk of bias was assessed using the MASTER scale. Bias-adjusted inverse variance heterogeneity models were used to synthesize overall weighted mean differences for the treatment effect (WMD) and their 95% confidence intervals. Heterogeneity and publication bias were evaluated using the I2 statistics, Tau-squared and Doi plots, respectively. Result Out of 5915 study records identified from database searches, five studies with 308 participants, two randomized controlled trials, and three quasi-experimental studies, met the inclusion criteria. In overall synthesis, the Mediterranean diet was associated with moderate improvements in liver function as shown by reductions in the liver enzymes [ALT - WMD − 10.85 U/L, 95% CI -20.03 to -1.68, I2 = 42, T 2 = 38.8, AST - WMD − 9.26 U/L, 95% CI -17.14 to -1.38, I2 = 70.7, T 2 = 42.7, and GGT - WMD − 1.99 95% CI -5.09 to 1.11)], but changes in body weight, lipid profile and insulin resistance were small and insignificant. Conclusion The Mediterranean diet may improve liver function in children with MASLD. More randomized controlled trials are needed to develop high-certainty evidence on these findings. Registration This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) CRD42023426939. 31/05/2023.

الملخص: أهداف البحث: قام الباحثون بفحص العديد من خصائص الأسنان لتحديد الاختلافات في شكل الأسنان بين الذكور والإناث في مجموعات سكانية مختلفة. ومع ذلك، لم يتم إجراء أي بحث للتأكد من إزدواج الشكل الجنسي وتطوير نموذج للتنبؤ بالجنس باستخدام نمط الأخاديد وعدد الحدبات ونمط الإطباق في أي مجموعة. وبذلك توصلت هذه الدراسة إلى الفروق الجنسية والقدرة على التنبؤ بالجنس بناء على هذه الخصائص للأسنان العلوية في المجتمع الباكستاني. طرق البحث: تم اختيار 130 قالبا سنيا (65 ذكر و65 أنثى). تم التقاط صور رقمية للسطح الإطباقي للضاحك الأول والثاني والطاحن الأول العلوي باستخدام كاميرا رقمية. تم تسجيل عدد الحدبات، ونمط الأخاديد، والنمط الإطباقي لكل نوع من الأسنان. تم تحليل البيانات باستخدام اختبار ''مربع كاي'' وتحليل الانحدار اللوجستي. النتائج: أظهر نمط الأخاديد والنمط الإطباقي للضاحك الأول والطاحن الأول العلوي تباينا جنسيا كبيرا. كما أظهر عدد الحدبات في الطاحن الأول العلوي فرقا كبيرا ذا دلالة إحصائية بين الذكور والإناث. بلغت دقة التنبؤ بالجنس للعينات التدريبية 76.7%، بينما كانت 70% للعينات الاختبارية. الاستنتاجات: وجد تباين جنسي كبير في نمط الأخاديد والنمط الإطباقي للضاحك الأول والطاحن الأول العلوي، وكذلك في عدد الحدبات للطاحن الأول العلوي. أظهر نموذج التنبؤ دقة جيدة بنسبة 76.7%، وبالتالي يمكن استخدامه للتنبؤ بالجنس في المجتمع الباكستاني. Abstract: Objective: Researchers have examined several dental characteristics to identify differences in tooth morphology between males and females in various populations. Nevertheless, no research has been undertaken to ascertain sexual dimorphism and develop a sex prediction model by using the groove pattern, cusp number and occlusal pattern in any population group. Therefore, this study accessed the sexual differences and the ability to predict sex according to these characteristics of maxillary teeth in the Pakistani community. Method: A total of 130 dental casts were selected (65 each from males and females). Digital images of the occlusal surface of the maxillary first premolar, second premolar and first molar were captured with a Canon Powershot A2200 14.1 MP digital camera with 4× optical zoom. Cusp number, groove pattern and occlusal pattern were recorded for each tooth type. Data were analysed with chi-square tests and logistic regression analysis. Results: The groove pattern and occlusal pattern of the maxillary first premolar and first molar showed significant sexual dimorphism (p

Hydatidosis, caused by the larval stage of Echinococcus granulosus, is a zoonotic disease typically affecting the liver and lungs. Cerebral localizations are rare, especially in the brainstem. We present a case of a 9-year-old boy with a brainstem hydatid cyst. The patient exhibited progressive walking difficulties and limb impairment. MRI revealed a brainstem mass consistent with a hydatid cyst. Due to the lesion's size and location, surgical intervention was necessary. The cyst was decompressed and removed without complications, followed by albendazole treatment. Postoperative recovery was uneventful, and the patient showed no signs of recurrence after 2 years. This case highlights the importance of early diagnosis, precise surgical techniques, and thorough postoperative care in managing rare cerebral hydatid cysts.

Behcet's disease is a multisystem inflammatory disorder, whose vascular involvement is very rare. Aneurysmal arterial involvement is the severe form of the disease, it constitutes a therapeutic challenge given its severity, and frequent secondary complications. Profunda femoral artery aneurysms (PFAAs) are extremely rare. The systematic immunosuppressive drug treatment and endovascular or surgical technique thoroughness can reduce relapse rate. We report the case of a young man in whom a false aneurysm of the profunda femoral artery revealed Behcet's disease. He underwent an endovascular treatment by embolization using coils; with good control after 3 months.

Foodborne diseases are a significant global public health concern due to their high prevalence, mortality, and economic losses. The aim of this study was to conduct a systematic review of identified foodborne pathogens and outbreaks in Iran over the past 23 years to provide an overview of the risk assessment and prevention approaches in the country. Using appropriate keywords and searching major databases, such as ScienceDirect, Scopus, PubMed, Google Scholar, and the Iranian Scientific Knowledge Database, we initially identified 4,740 articles. Finally, 328 articles were selected for evaluation. Among these articles, publications on Salmonella, Staphylococcus aureus, and Listeria were the most numerous. Poultry meat was found to be the main source of major foodborne pathogens in Iran, including Campylobacter (46.21%), Listeria monocytogenes (38.45), Salmonella (24.83%), and Yersinia enterocolitica (16.81%). Given the high prevalence of foodborne bacteria in Iranian foods, it is crucial to implement effective control measures to reduce the risk and burden of foodborne diseases. In particular, poultry meat, which poses a high risk for the occurrence of foodborne diseases in Iran, should be subjected to further risk assessment and control measures throughout the food chain.

The purpose of the study was to provide a comprehensive overview of the transformative applications of artificial intelligence (AI) in ophthalmology, with a focus on its impact on screening, diagnosis, and treatment planning. A comprehensive literature search was conducted to identify relevant studies on the applications of AI in ophthalmology. PubMed, Embase, and Scopus were searched using appropriate keywords, with inclusion criteria focusing on studies related to image analysis, diagnostic algorithms, predictive models, and treatment planning. Limited to English-language articles, both original research and review articles were considered, while studies emphasizing nonophthalmic applications of AI or lacking sufficient detail were excluded. AI algorithms, powered by deep learning models, have demonstrated remarkable accuracy in the automated screening and detection of various ocular diseases. The potential implications of AI include revolutionizing screening programs for early identification of individuals at risk, facilitating timely interventions, and improving patient outcomes. The integration of AI with teleophthalmology and remote monitoring systems has the potential to alleviate the burden on health-care systems, particularly in underserved areas. The applications of AI in ophthalmology hold significant potential for transforming the field by enhancing diagnostic accuracy, optimizing treatment strategies, and increasing access to eye care. However, successful implementation requires addressing challenges such as diverse and representative datasets, ensuring interpretability and explainability of AI models, and addressing ethical considerations related to patient privacy and data security. Collaborative efforts between ophthalmologists, data scientists, and regulatory bodies are deemed crucial to fully leverage the potential of AI in ophthalmology.

Background: The past decade has witnessed a revolution in smartphones owing to their growing importance and various applications. However, excessive usage can lead to addiction and joint pain in the wrist/thumb area. Despite these negative effects, smartphones offer medical students access to the resources they need. OBJECTIVE: To determine the association between smartphone addiction and thumb/wrist pain among undergraduate students of Jazan University. Methods: A cross-sectional self-administrated, online survey and online convenience sample technique was used. The collected data were analyzed using SPSS Software. Results: This survey included 337 participants, of which two-thirds were female (66.8%) and the rest male (33.2%); 32.6% of the respondents were studying in the College of Medicine. Of the 337 participants, 32% reported experiencing pain in their wrists or at the back of their neck while using a smartphone. The study found an average Smartphone Addition Scale-Short Version (SAS-SV) score of 32.5 ± 8.0 out of 50 and a total Patient-Rated Wrist Evaluation score of 48.8 ± 14.7, with a pain score of 13.3 ± 11.0 and a function score of 35.5 ± 11.7. The study also revealed a significant association between smartphone addiction and thumb/wrist pain (P value = 0.029), with females and students of the College of Applied Medical Science associated with higher SAS-SV scores, thereby indicating higher smartphone addiction. Conclusion: Significant correlation exists between smartphone addiction and thumb/wirst pain among medical students of Jazan University.

Background: Serum vitamin B12 plays a crucial role in cellular growth, DNA synthesis, and maintaining a healthy nervous system. Its deficiency can lead to various health issues, including cardiovascular problems. The reference range for vitamin B12 varies between populations due to cultural, genetic, and dietary differences. Methods: A cross-sectional study was conducted on 127 healthy An-Najah National University students aged between 18 and 25. Blood samples were collected, and a questionnaire assessed factors affecting vitamin B12 levels. Serum vitamin B12 levels were measured using ACCUBIND ELIZA microwells. Results: The study found a reference range for serum vitamin B12 of 136–640 pg/mL (5th to 95th percentile) among the studied population, which differed from the manufacturer’s claimed range of 200–835 pg/mL. Gender did not significantly affect the reference intervals. Conclusion: The study highlights the importance of establishing local reference values for laboratory tests like vitamin B12 due to variations in demographics. Further research in different Palestinian regions and age groups with larger sample sizes is recommended to refine these reference values.

Abstract Traditional herbalists have been relied on for many years by Algerians to cure a wide range of diseases. Regardless of their nutritional values, mushrooms have chemical properties that make them attractive, beneficial, and more likely to be studied by researchers, according to ethnobotanical literature on traditional phytotherapy. Among all the edible mushrooms, tubers are a type of fungus that are traditionally used in fine dining and have garnered attention recently because of their many therapeutic applications. This research delves into a meticulous analysis of bioactive constituents in Bunium bulbocastanum tubers, sourced from Mostaganem and Relizane regions, with a keen focus on polyphenols, flavonoids, and condensed tannins. The quantification of total phenolic content was executed through the Folin-Ciocalteu assay, while flavonoids were assessed via the aluminum chloride colorimetric method. In addition, condensed tannins were evaluated in this study. Antioxidant capacities were scrutinized employing the 2,2′-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay. Microbial inhibition studies were conducted against five benchmark bacterial strains, utilizing the agar disc diffusion technique. Furthermore, a comprehensive liquid chromatography–mass spectrometry (LC–MS) analysis was performed to identify and quantify bioactive compounds. The findings underscore that the Mostaganem extracts were particularly rich in polyphenols (11.65 mg GAE/g of extract) and tannins (1.30 mg CE/g of extract), while the Relizane extracts boasted significant flavonoid concentrations (9.421 mg QE/g of extract). Notably, 4-methylguaiacol (82.04 mg/L), caffeic acid dimethyl ether (27.76 mg/L), syringic acid (20.48 mg/L), and naringenin (16.05 mg/L) emerged as the predominant volatile compounds. Compositional investigation of the extracts by LC–MS confirmed the presence of various compounds that were linked to the bioactivities exhibited by B. bulbocastanum tubers. These findings demonstrate the effective antibacterial and antioxidant properties of B. bulbocastanum tubers, indicating their potential use in pharmaceutical and nutraceutical applications.

Abstract Crystal violet dye poses significant health risks to humans, including carcinogenic and mutagenic effects, as well as environmental hazards due to its persistence and toxicity in aquatic ecosystems. This study focuses on the efficient removal of crystal violet dye from aqueous media using novel Co3O4/Co3(BO3)2 nanostructures synthesized via the Pechini sol–gel approach. The nanostructures, which were abbreviated to EN600 and EN800, were fabricated at calcination temperatures of 600 and 800 °C, respectively. X-ray diffraction (XRD) analysis revealed that the synthesized samples have a cubic Co3O4 phase and an orthorhombic Co3(BO3)2 phase, with mean crystal sizes of 43.82 nm and 52.93 nm for EN600 and EN800 samples, respectively. The Brunauer–Emmett–Teller (BET) surface areas of EN600 and EN800 samples were 65.80 and 43.76 m2/g, respectively, indicating a significant surface area available for adsorption. Optimal removal of crystal violet dye was achieved at a temperature of 298 K, a contact time of 70 min, and a pH of 10. The maximum adsorption capacities were found to be 284.09 mg/g for EN600 and 256.41 mg/g for EN800, which are notably higher compared to many conventional adsorbents. The adsorption process followed the pseudo-second-order kinetic model and fitted well with the Langmuir isotherm. The adsorption was exothermic, spontaneous, and physical in nature. Moreover, the adsorbents exhibited excellent reusability, retaining high efficiency after multiple regeneration cycles using 6 mol/L hydrochloric acid. These findings highlight the potential of these Co3O4/Co3(BO3)2 nanostructures as effective and sustainable materials for water purification applications.

Abstract In this article, we explore exact solitary wave solutions to the van der Waals equation which is crucial for numerous applications involving a variety of physical occurrences. This system is used to define the behavior of real gases taking into consideration finite size of molecules and also has some applications in industry for granular materials. The model is studied under the effect of fractional derivatives by employing two different definitions: $$\beta$$ β , and M-truncated. Further, new extended direct algebraic method is employed to construct the solitary wave solutions for the model. The solutions transmit several novel solutions, such as dark-singular, dark–bright, singular-periodic and dark solutions, and this method establishes the conditions required for the formation of these structures. To show the comparative analysis between two different fractional operators, results are graphically represented in the form of 2-dimensional and 3-dimensional visualizations.

Abstract Background Oral mucosa lesions are the third most prevalent oral pathology, following caries and periodontal diseases. Teledentistry offers an effective way to manage patients with these lesions. The accuracy of remote diagnoses and consultations relies heavily on the quality of the information and photos sent to remote specialists. This study aims to evaluate the usability and reliability of a teledentistry tool for the remote diagnosis of oral lesions. Methods The cross-sectional study included both usability evaluation and reliability assessment. The teledentistry platform, "OralMedTeledent", facilitated synchronous and asynchronous interactions, allowing for patient consultations, remote follow-ups, and doctor-to-doctor consultations. Usability was evaluated by 5 experts using the Nielsen heuristic checklist. Reliability was assessed from August 2022 to September 2023 with 109 patients, using Cohen's kappa coefficient to measure agreement between examiners and the gold standard in diagnosing oral lesions. Results The findings revealed 66 usability issues, most of which were related to helping users recognize, diagnose, and recover from errors, as well as issues with help and documentation. Among these, 11 issues were of minor severity. The reliability test, conducted with 109 participants (57.8% female, 42.2% male) showed that the web-based teleconsultation system performed significantly well. The system demonstrated significant substantial performance (0.81 ≤ κ 0.05). Conclusion Overall, the web-based teleconsultation system has proven to be reliable for the remote diagnosis of oral lesions, making it a valuable alternative during emergencies such as the COVID-19 pandemic. However, several usability issues have been identified and need to be addressed.

Abstract Background Nowadays, inclusive education is becoming an increasingly important method in the education of people with various types of disabilities. This study is aimed at investigating the effectiveness of utilizing collaborative digital mind-mapping techniques in the practical work of students in inclusive educational groups, as well as examining how the use of AI-provided prompts influences the development of creative skills. Methods The study involved 163 participants, among whom 28 had neurodevelopmental disorders. The application of the proposed methodology resulted in an improvement in the indicators of creative thinking as measured by the Torrance Figural Creativity Test, specifically in terms of Fluency, Originality, Elaboration, and overall creativity score; the observed increase was statistically significant according to the Wilcoxon signed-rank test (p = 0.05). Results This increase in indicators was observed both in students with neurodevelopmental disorders and in students without developmental disorders, with a notably stronger impact observed on students with neurodevelopmental disorders. Furthermore, a slightly higher effectiveness of the applied methodology was recorded when AI prompts were used for both categories of students. Students with neurodevelopmental disorders largely perceived the usefulness of the prompts they received subjectively. Conclusions The present research may contribute to further study of various creativity development methodologies in inclusive education, as well as regarding the influence of AI utilization on creative skills. The obtained results can be utilized in the development of educational programs for students in higher education institutions that support inclusive forms of learning.

Abstract The recent over production of municipal solid waste (MSW) poses a significant threat to both the ecosystem and human health. Utilizing MSW for agricultural purposes has emerged as a promising strategy to reduce solid waste disposal while simultaneously increasing soil fertility. To explore this potential solution further, an experiment was designed to assess the impact of varying concentrations of MSW (25%, 50%, and 75%) on the proximate composition of 15 different vegetable species. The experiment, conducted between 2018 and 2019, involved treating soil with different levels of solid waste and analyzing the proximate components, such as crude protein, dry matter, crude fiber, crude fat, and moisture content, in the 15 selected crops. The results indicate that the application of 25% MSW significantly increased the levels of crude protein, crude fiber, dry matter, and fat in Spinacia oleracea, Solanum tuberosum, Solanum melongena, and Abelmoschus esculentus. Conversely, the addition of 75% MSW notably elevated the moisture and ash content in Cucumis sativus. Correlation and scatter matrix analyses were conducted to elucidate the relationships between the protein, fiber, dry matter, ash, and fat contents. Principal component analysis and clustering confirmed the substantial impact of Treatment_1 (25% MSW) and Treatment_3 (75% MSW) on the proximate composition of the aforementioned vegetables, leading to their categorization into distinct groups. Our study highlights the efficacy of using 25% MSW to enhance the proximate composition and nutritional value of vegetables. Nonetheless, further research is warranted to investigate the mineral, antioxidant, vitamin, and heavy metal contents in the soil over an extended period of MSW application.

Abstract In vivo fluorescent imaging represents a potent means for real-time probe quantification, facilitating insights into disease pathophysiology and therapeutic responses. Nonetheless, accurate signal quantification remains challenging due to inherent factors like light scattering and tissue absorption. Existing imaging systems, though sophisticated, often entail high costs and are typically restricted to well-funded laboratory settings. This study introduces BrightMice, an innovative in vivo fluorescent imaging system that harnesses 3D printing and consumer-grade digital cameras. Tailored for various fluorophores such as EYFP and E2-crimson, the system showcases both adaptability and effectiveness in detecting in vivo fluorescent signals in several reporter mouse strains. Comparative analyses against commercial instruments confirm BrightMice’s sensitivity and underscore its potential to democratize in vivo fluorescence imaging. By providing a cost-effective and accessible solution, BrightMice stands to benefit diverse research environments.

Abstract Background Faculty development programs (FDPs) in health professions education (HPE) are instrumental in supporting, promoting, and improving HPE curricula and activities that target individual- and system-level capacity strengthening. FAIMER, a division of Intealth, has been offering FDPs for global health professions educators in HPE and leadership for over two decades through the International FAIMER Institute in the USA and FAIMER Regional Institutes located globally. This paper explores perceptions of former program participants (Fellows) of FAIMER global FDPs by eliciting their success stories. Methods The study utilized a modified Success Case Method approach. Study participants recruited were 14 FAIMER Fellows nominated as exemplars of success cases by program directors and faculty members from seven global sites, using extreme case sampling technique. Of the 14 Fellows, two were from Africa, nine from Asia and three from Latin America. In-depth interviews were conducted with each Fellow to understand their self-perceived success, and factors from both their local context and FAIMER’s FDPs that have contributed to their success. Theoretical thematic analysis method was used to analyze the data. Results The top three areas of success perceived by Fellows were career advancement & recognition, professional development, and advancement of HPE. Fellows identified both institutional-level factors and personal attributes as contributing to their success. They also reported that FAIMER global FDPs have substantially contributed to their success by expanding professional networks, fostering academic achievement, and enhancing interpersonal development and leadership skills. Conclusions The findings show that Fellows perceive that there are multiple pathways for them to succeed in advancing the field of HPE. The Fellows’ stories highlight the continuing value of FAIMER global FDPs for HPE educators worldwide in professional development and leadership. The study also proposes recommendations for enhancing faculty development activities in HPE.

Abstract Background Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that is significantly increasing, resulting in severe distress. The approved treatment for ASD only partially improves the sympoms, but it does not entirely reverse the symptoms. Developing novel disease-modifying drugs is essential for the continuous improvement of ASD. Because of its pleiotropic effect, atorvastatin has been garnered attention for treating neuronal degeneration. The present study aimed to investigate the therapeutic effects of atorvastatin in autism and compare it with an approved autism drug (risperidone) through the impact of these drugs on TLR4/NF-κB/NOX-2 and the apoptotic pathway in a valproic acid (VPA) induced rat model of autism. Methods On gestational day 12.5, pregnant rats received a single IP injection of VPA (500 mg/kg), for VPA induced autism, risperidone and atorvastatin groups, or saline for control normal group. At postnatal day 21, male offsprings were randomly divided into four groups (n = 6): control, VPA induced autism, risperidone, and atorvastatin. Risperidone and atorvastatin were administered from postnatal day 21 to day 51. The study evaluated autism-like behaviors using the three-chamber test, the dark light test, and the open field test at the end of the study. Biochemical analysis of TLR4, NF-κB, NOX-2, and ROS using ELISA, RT-PCR, WB, histological examination with hematoxylin and eosin and immunohistochemical study of CAS-3 were performed. Results Male offspring of prenatal VPA-exposed female rats exhibited significant autism-like behaviors and elevated TLR4, NF-κB, NOX-2, ROS, and caspase-3 expression. Histological analysis revealed structural alterations. Both risperidone and atorvastatin effectively mitigated the behavioral, biochemical, and structural changes associated with VPA-induced rat model of autism. Notably, atorvastatin group showed a more significant improvement than risperidone group. Conclusions The research results unequivocally demonstrated that atorvastatin can modulate VPA-induced autism by suppressing inflammation, oxidative stress, and apoptosis through TLR4/NF-κB/NOX-2 signaling pathway. Atorvastatin could be a potential treatment for ASD. Graphical Abstract

Objective: To determine the prevalence of cheiloscopic patterns in Pakistani population. Study Design: Cross-sectional study. Place and Duration of Study: The study was conducted at Post Graduate Medical Institute (PGMI), Lahore, Capital diagnostic Centre CDC Islamabad, HITEC Taxilla for a duration of 12 months from 1 September 2021 to 31 August 2022. Materials and Methods: The lip prints of 320 males and females were taken by applying lip shades and then cellophane tapes (2 inches). They were transferred to an A4 sheet (white A4 ROCO Premium 80g copy papers) and then observed with magnifying hand lenses Deluxe magnifier (70mm diameter). The data was analyzed by IBM SPSS statistics 27.0. Chi square test was applied and a p value of ≤ 0.05 was considered statistically significant. Results: The results showed differences in all individuals in both lip prints. The predominant lip pattern was type III, observed in 159 (99.4%) male participants while it was observed in all the female participants. Type I' observed in 37 (23.1%) female participants and IV are greater in females 160(100%) than males. Type II (was) greater in males 152 (95.0%) than females. Conclusion: Lip prints are useful tool that can be used as biometric markers in dentistry and forensic odontology.

Abstract Due to the global impact of COVID-19, businesses and supply chains worldwide have been disrupted, leading to challenges for manufacturing firms and customers. Social media usage (SMU) is a vital and valuable tool that builds customer-centric supply chains by effectively communicating large volumes of valuable data. This study examines the influence of social media usage on the development of dynamic capabilities, including supply chain sensing capabilities (SCSC), knowledge sharing capability (KSC), and social capital (SC), which are crucial for constructing agile and resilient supply chains that can effectively respond to dynamic and turbulent environments, ultimately enhancing sustainable business performance. To assess the proposed investigation model, data was gathered through a structured questionnaire administered to supply chain members currently engaged with manufacturing firms. The evaluation of the proposed hypotheses is carried out through the application of structural equation modeling (SEM). The results of this study offer empirical evidence supporting the proposition that SMU within manufacturing firms promotes the development of sensing capabilities, knowledge-sharing capability, and social capital. Furthermore, this study tests the moderation role of environmental dynamism in the relationship between social media use and sustainable business performance. This underscores the pivotal role played by SMU in facilitating the adaptation and responsiveness of the supply chain to dynamic and uncertain environments, thereby contributing to the long-term sustainability and competitiveness of organizations.

Abstract Bryophyllum pinnatum is used to cure infections worldwide. Although the flavonoids of this plant are well known, it is still unknown how much of the plant’s Ag and ZnO nanoparticles are beneficial. In the current research work, silver and zinc oxide nanoparticles were prepared using Bryophyllum pinnatum extract. The synthesized particles were characterized by UV-visible spectroscopy, SEM, EDS, XRD and FTIR. Synthesized particles were subjected to evaluation of their bactericidal and antifungal activity at various doses. Uv vis spectra at 400 nm corresponding to AgNPs confirmed their synthesis. Strong peaks in the EDS spectra of Ag and ZnO indicate the purity of the sample. The scanning electron microscopic images of ZnONPs showed a size of about 60 nm ± 3 nm, which demonstrated the presence of triangular-shaped ZnO nanoparticles. Green synthesized nanoparticles showed bactericidal activity against both Gram-positive (Micrococcus luteus, Staphylococcus aureus, Bacillus subtilis) and Gram-negative (Agrobacterium tumifaciens, Salmonella setubal, Enterobacter aerogenes) strains. AgNPs proved to be more effective against Gram-negative bacterial strains compared to Gram-positive owing to MIC values (10 ppm and 20 ppm respectively). Whereas, ZnONPs were found more effective against Gram-positive bacteria with lower MIC values (10 ppm) as compared to Gram-negative ones (20 ppm). Also, the synthesized nanoparticles exhibited moderate dose-dependent antifungal activity against tested fungal strains ranging from 10 to 70%. Cytotoxicity of nanoparticles was found significant using Brine shrimp’s lethality assay with IC50 values of 4.09 ppm for AgNPs, 13.72 ppm for ZnONPs, and 24.83 ppm for plant extract. Conclusively, Ag and ZnO nanoparticles were more effective than plant extract and AgNPs had higher activities than those of ZnONPs. Further research is warranted to explore the precise mechanism of action and the potential applications of these nanoparticles in the medical field.

Abstract Background Segmentation of skin lesions remains essential in histological diagnosis and skin cancer surveillance. Recent advances in deep learning have paved the way for greater improvements in medical imaging. The Hybrid Residual Networks (ResUNet) model, supplemented with Ant Colony Optimization (ACO), represents the synergy of these improvements aimed at improving the efficiency and effectiveness of skin lesion diagnosis. Objective This paper seeks to evaluate the effectiveness of the Hybrid ResUNet model for skin lesion classification and assess its impact on optimizing ACO performance to bridge the gap between computational efficiency and clinical utility. Methods The study used a deep learning design on a complex dataset that included a variety of skin lesions. The method includes training a Hybrid ResUNet model with standard parameters and fine-tuning using ACO for hyperparameter optimization. Performance was evaluated using traditional metrics such as accuracy, dice coefficient, and Jaccard index compared with existing models such as residual network (ResNet) and U-Net. Results The proposed hybrid ResUNet model exhibited excellent classification accuracy, reflected in the noticeable improvement in all evaluated metrics. His ability to describe complex lesions was particularly outstanding, improving diagnostic accuracy. Our experimental results demonstrate that the proposed Hybrid ResUNet model outperforms existing state-of-the-art methods, achieving an accuracy of 95.8%, a Dice coefficient of 93.1%, and a Jaccard index of 87.5. Conclusion The addition of ResUNet to ACO in the proposed Hybrid ResUNet model significantly improves the classification of skin lesions. This integration goes beyond traditional paradigms and demonstrates a viable strategy for deploying AI-powered tools in clinical settings. Future work Future investigations will focus on increasing the version's abilities by using multi-modal imaging information, experimenting with alternative optimization algorithms, and comparing real-world medical applicability. There is also a promising scope for enhancing computational performance and exploring the model's interpretability for more clinical adoption.

Abstract For centuries, cannabinoids have been utilized for their medicinal properties, particularly in Asian and South-Asian countries. Cannabis plants, known for their psychoactive and non-psychoactive potential, were historically used for spiritual and remedial healing. However, as cannabis became predominantly a recreational drug, it faced prohibition. Recently, the therapeutic potential of cannabinoids has sparked renewed research interest, extending their use to various medical conditions, including cancer. This review aims to highlight current data on the involvement of cannabinoids in cancer signaling pathways, emphasizing their potential in cancer therapy and the need for further investigation into the underlying mechanisms. A comprehensive literature review was conducted using databases such as PubMed/MedLine, Google Scholar, Web of Science, Scopus, and Embase. The search focused on peer-reviewed articles, review articles, and clinical trials discussing the anticancer properties of cannabinoids. Inclusion criteria included studies in English on the mechanisms of action and clinical efficacy of cannabinoids in cancer. Cannabinoids, including Δ9-THC, CBD, and CBG, exhibit significant anticancer activities such as apoptosis induction, autophagy stimulation, cell cycle arrest, anti-proliferation, anti-angiogenesis, and metastasis inhibition. Clinical trials have demonstrated cannabinoids’ efficacy in tumor regression and health improvement in palliative care. However, challenges such as variability in cannabinoid composition, psychoactive effects, regulatory barriers, and lack of standardized dosing remain. Cannabinoids show promising potential as anticancer agents through various mechanisms. Further large-scale, randomized controlled trials are essential to validate these findings and establish standardized therapeutic protocols. Future research should focus on elucidating detailed mechanisms, optimizing dosing, and exploring cannabinoids as primary chemotherapeutic agents.

Abstract Introduction Sleep disorders, particularly insomnia and obstructive sleep apnea, are associated with dyslipidemia in the general population. The study’s aim was to explore the association between pathological Cholesterol and Triglyceride levels, and sleep and nighttime behavior disorders (SNBD) in older adults, whether they might predict SNBD onset, and to emphasize the role of body mass index (BMI) in this association. Methods Alzheimer’s Disease Neuroimaging Initiative (ADNI) population with complete Cholesterol, Triglyceride, SNBD, and neurocognitive data were included. Logistic regression was performed to study the association between hypercholesterolemia, hypertriglyceridemia, and SNBD at baseline and at 12 months. Relevant confounders, particularly BMI, were adjusted for. Results Among the 2,216 included cases, 1,045 (47%) were females, and the median age was 73 years (IQR: 68, 78). At baseline, 357 (16%) had SNBD and 327 (18%) at 12 months; 187 of them were incident cases. There were more cases of baseline SNBD in the hypertriglyceridemia group than in those without (19% vs. 14%, P-value = 0.003). Similarly, more follow-up SNBD cases had hypertriglyceridemia at baseline (21% vs. 16%, P-value = 0.025). SNBD cases at baseline had significantly higher serum Triglyceride levels than those without (132 vs. 118mg/dL, P-value

Background This study aimed to examine the prevalence of burnout, determine burnout-related factors, investigate resilience levels, and assess the relationship between burnout and resilience among physical therapy (PT) students at King Saud University (KSU) in Saudi Arabia. Material and Methods This cross-sectional study involved 153 PT students studying at KSU between January and March 2023. The participants completed an online questionnaire, a Maslach Burnout Inventory , and a Brief Resilience Scale . Results Low-to-moderate levels of Emotional Exhaustion (EE) were observed in 85% of the participants and high Depersonalization (DP) levels were reported by 34.2%. Female participants reported higher levels of EE and DP, whereas males had a greater prevalence of low Personal Achievement (PA) levels. Approximately 6.5% of the study participants reported high burnout levels (a combination of high DP, high EE, and low PA). Academic stress, followed by sleeping difficulties and changes in the academic year structure, were the most important factors contributing to higher levels of burnout (75.2%, 56.9%, and 43.8%, respectively). Most study participants around (66.0%) reported normal resilience levels. A significant correlation was detected between resilience and 2 domains of burnout (DP and PA), with the correlation being negative and weak for DP and positive and moderate for PA. Conclusions Overall, low-to-moderate levels of burnout were observed among the PT students who took part. Related factors that contributed to burnout were academic stress, sleeping difficulties, and academic year structure. A normal level of resilience was found to be significantly related to DP and PA but not to EE on the burnout subscales. Higher levels of resilience can be considered to play a protective role against burnout among PT students. Med Pr Work Health Saf. 2024;75(4):343–354

Abstract This study has undertaken a scrutiny of research pertaining to enrichment programs based on future problem-solving skills, aimed at enhancing the cognitive dimensions of gifted students between the years 2010 and 2023. The study used a sample of 10 studies; 3 correlational studies and 7 quasi-experimental studies. The study employed the descriptive-analytical approach by following a meta-analysis method. The study aimed to discern the effectiveness of enrichment programs based on future problem-solving skills in developing the cognitive dimensions of the gifted. The study's findings have indicated a significant impact of enrichment programs based on future problem-solving skills in the development of the cognitive dimensions of the gifted, as per both correlational and quasi-experimental designs. Moreover, statistically significant differences were found related to the variables of educational level and gender in accordance with both correlational and quasi-experimental designs. The study also advocates the need for further research in this domain to facilitate the generalization of the novel findings of this study within the gifted field.