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INTRODUCTION: The devastating outcome of orthopaedic surgical site infections (SSI) are largely preventable if its risk factors, causative organisms and antimicrobial susceptibility patterns in the regional area are known. MATERIALS AND METHODS: We conducted a retrospective study to address the lack of epidemiological and microbiological data on orthopaedic SSI in Malaysia. All the 80 patients diagnosed and treated for microbiologically proven orthopaedic SSIs in a tertiary hospital in Malaysia from April 2015 to March 2019 were included in a 1:2 case control study. RESULTS: The prevalence of SSI in clean and clean- contaminated surgeries was 1.243%, which is consistent with most of the studies worldwide, but is low compared to other studies done in Malaysia. The most common type of orthopaedics SSI were internal fixation infections (46.25%), superficial SSIs (25.2%) and Prosthetic joint infections (18.75%). Obesity and tobacco use were found to be significant risk factors of orthopaedic SSI. The most common perioperative prophylaxis used was IV cefuroxime. Majority of the cases (86.5%) received prolonged prophylactic antibiotics. The most common causative agent was Staphylococcus aureus (31.25%), followed by Pseudomonas aeruginosa (26.25%) and Enterobacter spp (7.5%). Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 20% of the S. aureus infections. Up to 19.4% of the Gram-negative organisms are multidrug resistant. The higher rate of isolation of organisms resistant to the prophylactic antibiotics being used may be related to the prolonged use of prophylactic antibiotics, which exerted selective pressure for the acquisition of resistant organisms. CONCLUSION: Despite its relatively low prevalence in our local institution and worldwide, the prevention of SSI in orthopaedic practice is crucial to avoid morbidity, mortality and high healthcare cost. This may be achieved by control of modifiable risk factors such as obesity and tobacco use, appropriate use of prophylactic antibiotics and implementation of good surgical and infection control practices.

The management of solid waste poses a worldwide obstacle in the pursuit of a sustainable society. This issue has intensified with the increase in waste production caused by rapid population expansion, industrialization, and urbanization. The continuously growing volume of municipal solid waste, particularly the substantial volume of organic waste, along with improper disposal practices, results in the release of greenhouse gases and other harmful airborne substances which simultaneously causes health risks and socioeconomic concerns. This article examines various waste-to-energy (energy production in the form of heat and electricity) concepts as well as waste-to-materials (various value-added materials including biofuel, biochemical, char, bio-oil, soil fertilizer, etc.) methods of converting municipal solid waste into environmentally friendly fuels, which appear to be economically feasible and attractive. It starts with a thorough analysis of the characteristics of municipal solid waste followed by the generation procedure. The study provides an overview of different thermochemical conversion methods including incineration, pyrolysis, co-pyrolysis, liquefaction, hydrothermal carbonization, gasification, combustion for transformation of municipal solid waste, and their recent advancement. The review comprehensively discussed the pros and cons of each method highlighting their strength, weakness, opportunities, and threats to transforming MSW. The current state of municipal solid waste management, including effective dumping and deviation, is comprehensively assessed, along with the prospects and challenges involved. Energy justice concepts and fuzzy logic tool is used to address the selection criteria for choosing the best waste treatment techniques. Moreover, several recommendations are offered to enhance the existing solid waste management system. This review could assist scholars, researchers, authorities, and stakeholders in making informed decisions regarding MSW management.

Having access to real-world information and accurate data is a key factor in improving auditor performance, which in turn impacts business performance and decision-making. Consequently, this research aims to determine how financial institutions' levels of experience impact the accuracy of the information they disclose. The present statistical population consists of all 127 businesses listed on the United Arab Emirates Stock Exchange. This type of research is categorized as applied studies in relation to the research methods used in the UAE stock market. Using a systematic deletion procedure, 46 companies were chosen based on the study's inclusion criteria. The findings revealed that in the UAE, the quality of financial information disclosure for companies listed on the UAE stock exchange is significantly affected by the auditor's decision-making experience, the duration of their job, and the size of the auditor.

Conventional methods of crop yield estimation are costly, inefficient, and prone to error resulting in poor yield estimates. This affects the ability of farmers to appropriately plan and manage their crop production pipelines and market processes. There is therefore a need to develop automated methods of crop yield estimation. However, the development of accurate machine-learning methods for crop yield estimation depends on the availability of appropriate datasets. There is a lack of such datasets, especially in sub-Saharan Africa. We present curated image datasets of coffee and cashew nuts acquired in Uganda during two crop harvest seasons. The datasets were collected over nine months, from September 2022 to May 2023. The data was collected using a high-resolution camera mounted on an Unmanned Aerial Vehicle . The datasets contain 3000 coffee and 3086 cashew nut images, constituting 6086 images. Annotated objects of interest in the coffee dataset consist of five classes namely: unripe, ripening, ripe, spoilt, and coffee_tree. Annotated objects of interest in the cashew nut dataset consist of six classes namely: tree, flower, premature, unripe, ripe, and spoilt. The datasets may be used for various machine-learning tasks including flowering intensity estimation, fruit maturity stage analysis, disease diagnosis, crop variety identification, and yield estimation.

Changing the nature of behavioral knowledge in the auditing profession from purely classical processes in the development of auditors' functions to philosophical and cognitive processes has increased the quality of work life in this field. The purpose of this study is to present a model of auditors' psychological well-being and evaluate identified themes in the auditing profession. This study employs an exploratory methodology with analytical elements. Because of the lack of an integrated framework regarding the recognition of auditors' psychological well-being dimensions, we identified the study's themes through 12 interviews and coded them using thematic analysis. Then, using two processes of fuzzy Delphi analysis and classic Delphi, we analyzed the reliability of the organizing and basic themes. In the quantitative part, to explain the themes confirmed from the Delphi analysis stage in the audit professional functions, we applied the fuzzy network analysis. In this study, according to the theoretical saturation point in thematic analysis, 12 accounting experts participated, and in the quantitative part, 30 auditors with more than five years of experience in the auditing profession who had work experience and technical knowledge participated. The results of the study in the qualitative part indicate the existence of three overarching themes, six organizing themes, and 38 basic themes. Also, based on the result of the Delphi analysis, it was determined that from the total of 38 basic themes, 17 final themes were entered into the fuzzy network analysis in the form of six organizing themes, and the findings showed that the most effective organizing theme of psychological well-being in the context of professional auditing functions is the theme of perception stimulation of auditors. Findings also revealed that strengthening the internal locus of control is the most effective aspect of psychological well-being in auditing. 1- IntroductionExpanding behavioral sciences' influence on auditing in recent decades has transformed auditors' traditional approaches and professional roles, enhancing the quality of auditing reports. This is due to the interplay between professional judgment and auditing standards within the auditors' behavioral and cognitive domains. (Zhao et al,2023). A significant development in auditing knowledge is the concept of psychological well-being. Psychological well-being encompasses auditors' emotional and mental states, their overall life and career satisfaction, as well as their mental efficiency and functionality (Broberg et.al, 2020). According to Chen et al. (2022), well-being is closely tied to an individual's perception of their experiences, leading to higher mental satisfaction and more qualified roles in professional responsibilities. In essence, psychological well-being results in positive emotions, a sense of purpose, autonomy, and the ability to form meaningful relationships with others (Mahmoudi and Sajadi Nejad, 2022). Literature ReviewWhen investigating the findings of a study in the field of Disease Psychology, a group of psychologists, guided by Seligman et al. (1999), concluded that despite significant achievements in developing effective therapies, focusing on the causes of diseases, especially mental ones, can lead to a reduction in fatal diseases in society. They aimed to explore the factors contributing to increased productivity in people's lives and embarked on a new cycle of studies to assess individual capabilities. This effort ultimately led to the development of a gradual psychological well-being approach within the domain of positive psychology. Therefore, one prominent focus in recent years has been on psychological well-being, which seeks to redefine the professional life of individuals through the lens of positive psychology (Haghayeghi and Moghaddam Zadeh, 2022). O’Driscoll et al. (2004) were pioneers in formalizing the concept of psychological well-being within the framework of positive psychology. They emphasized the infusion of happiness and satisfaction into personal performance as a fundamental achievement of this concept.On the other hand, Gurel (2009) emphasizes active participation in the professional environment as key to defining psychological well-being. It involves individuals striving to experience positive self-efficacy and creating a balanced career while attributing meaning to their work relationships. Furthermore, Clark et al. (2007) view psychological well-being as an affective state. They assert that motivation in one's job is driven by the happiness and vitality derived from personal performance, which in turn fosters emotional attachment to one's job. Despite varying definitions of psychological well-being, it is evident that a deeper understanding of this concept is essential for greater effectiveness in the profession. MethodologyThe current study serves a developmental purpose and has an exploratory nature in its results. Furthermore, it adopts a combined approach in data collection. Given the lack of a coherent framework in previous studies for the phenomenon under investigation within the auditing profession, our study aims to present a multi-dimensional model using thematic analysis and the approach outlined by Attride-Stirling (2001) across three coding stages and interviews. In other words, in the first stage, it is attempted to present the themes of the auditors’ psychological well-being model in the form of a multi-dimensional model via analyzing the qualitative part and relying on thematic analysis process. The underlying philosophy of our study combines elements of volunteerism in the universe philosophy with structuralism in the philosophy of science. ResultsGiven the inductive and comparative nature of this study, the basic themes of auditors' psychological well-being are identified in the qualitative phase through thematic analysis. The reliability of these themes is then assessed using both Delphi Fuzzy and Delphi Classic analyses. The study proceeds to identify the most influential themes within the auditors' psychological well-being model through network analysis, specifically employing Fuzzy Analytic Network in the field of auditing. Therefore, thematic analysis was used in the first step to determine the themes related to the auditors’ psychological well-being. Thematic analysis serves as an administrative process that examines the foundations and concepts of the current issue through concurrent content analysis in related studies and interviews to define its dimensions. Typology of thematic analysis according to Attride-stirling (2001) is applied in the present study. The results indicated that strengthening the internal locus of control within the auditing profession (C13) is considered the most critical theme in enhancing psychological well-being in the auditing profession. This theme draws attention to bolstering the professional functions of independent auditors. This basic theme is considered among the organizing themes which stimulate the auditors’ perception and pervasive theme of individual mechanisms in reinforcing psychological well-being. DiscussionThe aim of this study is to conduct a network analysis within the auditors' psychological well-being model to define key factors in the auditing profession. Thematic analysis was chosen to present the model since there was no existing theoretical framework for developing the dimensions of psychological well-being in auditors' professional roles in this study. In total, a hexagonal model was constructed, consisting of three overarching themes, six organizing themes, and 38 basic themes. These themes were developed through 12 interviews with experts and three coding stages, guided by the theoretical saturation point, and were introduced as contributing factors to the development of auditors' psychological well-being. Confirming reliability of the organizing and basic themes was required as two important constructs in the presented model in the qualitative part with the purpose of determining the most effective theme in the auditors’ psychological well-being. Through two separate Delphi Fuzzy and Delphi Classic processes, it was initially found that the six organizing themes displayed high generalizability within recognized categories as pervasive themes. Secondly, out of the 38 primary themes, 21 basic themes were eliminated during two rounds of Delphi Classic analysis based on two criteria: mean and agreement coefficient. As a result, 17 basic themes were confirmed and incorporated into the Fuzzy Analytic Network process. ConclusionTwo key results emerged from the prioritization of organizing and basic themes in the analytical process. Prioritizing organizing themes revealed that the most impactful theme on psychological well-being in the field of professional auditing is 'stimulating the auditors’ perception' (C1), with a relative weight of 0.286, placing it at the top of the matrix. Conversely, 'reinforcing internal locus of control' (C13) was identified as the most crucial basic theme for enhancing psychological well-being in the auditing profession, highlighting its potential significance in strengthening the professional functions of independent auditors.

Emotion labor is defined as any conflict between institutional demands and teachers’ professional beliefs and preferences. Engaging in emotion labor is an inevitable aspect of becoming a language teacher. Scholars agree that language teacher agency and identity are closely tied to emotion labor. This fact particularly looms large for novice language teachers, who tend to perceive contradictions between what they imagine prior to entering the profession and what they actually experience in their teaching contexts. This case study applied activity theory (Engeström, 2015) and Gee’s (2000) identity framework to explore how the emotion labor experienced by a novice Iranian female teacher of English as a foreign language (EFL) over a five-year career period at three private language institutes affected her language teacher agency and identity. The findings, obtained from class observations and semi-structured interviews, highlight two major sources of emotion labor: 1) profit-oriented policy, and 2) performance-constraining factors within the institute, which caused the participant to contemplate quitting her job. Implications and further research are discussed in line with the interplay among emotion labor, language teacher identity, and well-being.

The melting enthalpy and melting temperature have a significant impact on the latent heat that results from phase change materials (PCMs) used for thermal energy storage. Among the PCMs that are currently on the market, inorganic salt hydrates have greater thermal conductivity and latent heat than organic PCMs. However, the problem of salt hydrates' degree of supercooling limits their use in energy storage devices. Using sodium carbonate decahydrate (SCD) and sodium phosphate dibasic dodecahydrate (SPDD), a low temperature inorganic-inorganic eutectic salt hydrate PCM with a higher melting enthalpy and intended phase transition temperature is developed in this research study. The eutectic SCD/SPDD salt hydrate PCM eutectic point and the eutectic composition of salt hydrate PCMs to operate at low temperature range is numerically determined using Schrader equation. By numerical methods we obtain the 68 wt% of SCD with 32 wt% of SPDD to exhibit eutectic SCD/SPDD composite with eutectic melting temperature of 26.2 °C and melting enthalpy of 210.6 J/g. The synthesised eutectic PCM are characterised to explore their chemical stability, latent heat, melting point and their shortcoming due to degree of supercooling. A good way to get around the problem of the supercooling degree is to disperse the nucleating agents. In order to assess the type and degree of supercooling, the produced eutectic PCM composition is experimentally evaluated at 1–10% utilising borax, alumina, and sodium sulphate dodecahydrate as nucleating agents. However, for building cooling applications PCM with minimal degree of supercooling, with the ability to release low enthalpy during discharging is an advantage.

Persons with disabilities (PwD) are believed to be a group that had a greater risk during the pandemic. While PwD are vulnerable to the spread of COVID-19 due to their high dependence on physical contact, a series of policies restricting public movement during the pandemic had the potential to place PwD in increasingly marginalized situations. This situation reinforces the urgency of crisis communication as one of the critical parts of the COVID-19 response to ensure that all levels and groups of society can accept and understand the flow of information. Using a qualitative approach, this research was conducted through in-depth interviews with PwD age 17-50 in the city of Makassar, Indonesia. The results of this study suggest that crisis communication during the pandemic should involve participatory communication, which focuses on collaboration with empowerment. The PwD communities need to be actively engaged during the communication process of a pandemic crisis to ensure that inclusiveness is always taken into account. During the distribution of information, the relevant health officers or the government at the regional level need to carry out more frequent socialization and special services for PwD based on the characteristics of their disabilities.

The epistemological tenets of sociocultural theory view teacher professional development as a continuous and reflective analysis of pedagogical practices and learner development. Accordingly, inquiry-based approaches to teacher professional development and specifically reflective journals can be an asset for teachers, in their endeavor for self-empowerment, by creating a mediational space in which they can exercise their agency and achieve more productive instructional practices. The purpose of this longitudinal study was to investigate the professional development of ten Iranian EFL student teachers through narrative inquiry, “which is conducted for and by the teacher” during one year of attending practicum. To this end, 100 reflective writings of 10 EFL student teachers, which were written during one year, were analyzed based on three functions of narratives as “externalization”, “verbalization” and “systematic examination” (Johnson & Golombek, 2011). The results indicated the importance of narrative inquiry in the development of the professional identity of student teachers. The results also implied the value of responsive mediation in L2 teacher education.

The present study investigated the interplay between language anxiety, locus of control, and language proficiency of EFL students in online classes. The participants of the study were 67 upper-intermediate students between 18 to 30 years old and were selected randomly from a few language institutes in Shiraz. Two questionnaires and a proficiency test were used: Chametzky’s Online World Language Anxiety Scale, Rotter’s Locus of control questionnaire, and The Examination for the Certificate of Proficiency in English. Pearson-product-moment correlation, multiple regression analysis, and independent-samples t-test were run to answer the research questions. The results of the study revealed a strong negative correlation between locus of control and language proficiency, meaning that those who had higher scores on the proficiency test were internal. In addition, a strong negative correlation was found between language anxiety and language proficiency, indicating that anxiety has adverse effects on language proficiency. Thirdly, both locus of control and language anxiety could predict language proficiency, but the former was a better predictor. This means that the effect of locus of control is much higher than anxiety on the language proficiency of Iranian EFL learners in online classes. This research can help students and teachers to recognize individual differences better.

Therapeutic discourse is a special type of organizational discourse which is used by psychotherapists when treating their patients. The present study uses the conversation analysis approach to find the principles of turn taking in the therapeutic situation. This study specifically examines the therapeutic discourse of treatment sessions for patients with generalized anxiety disorder (GAD) based on the Cognitive-Behavioral Therapy (CBT) approach. The method used in this research is qualitative. The corpus used in this study included 2520 minutes of conversation in psychotherapy sessions. The participants in this study were 16 people of both sexes. ATLAS ti. computer software has been used to construct and present the verbal pattern. The results of this study show that most of turn taking were related to female clients and psychotherapists. This result is related to the relationship between clients and psychotherapists, women's verbal habits, excessive curiosity, and their challenging personality. The presence of overlap in the speech of female psychotherapists and clients and pause in other conversations have been the most widely used signs of turn taking in this type of conversation. The present study has faced some limitations. One of the most important limitations of this research was the prevalence of Covid 19 virus. Also, obtaining the consent of some psychologists and clients to record their videos and voices in psychotherapy sessions has been another limitation of this research. Given the importance of communication and linguistic studies in psychotherapy, it is suggested that future research be conducted on the following topics: “Comparison of GAD Patients’ Speech Pattern with Speech Pattern of Other Anxiety Disorders” and “The effect of direct and indirect expression on anxiety in patients with anxiety disorders”.

AbstractRaisin factories face a problem called waste and unusable waste in their industry. Due to the richness of industrial waste in this industry from carbon, in this work, we synthesized activated carbon by chemical method from raisin waste. For the synthesis of activated carbon, a chemical method with a zinc chloride activating agent was used in one to one mass ratio. After the optimization of various parameters such as type of activation agent, the ratio of activating agent, carbonization temperature and carbonization time, the best conditions for activated carbon were obtained. Then, in order to evaluate the efficiency of the synthesized activated carbon, a methylene blue dye removal test as a model was performed. Optimal conditions for the removal of methylene blue dye using the activated carbon including neutral pH, ambient temperature and the amount of adsorbent 0.01 g in 10 mL of solution with a concentration of 20 mg L-1 were obtained. In these conditions, the removal efficiency is more than 99%. The adsorption capacity is about 20 mg g-1 and the reaction kinetics is quasi-second order and according to thermodynamic studies the endothermic reaction is spontaneous and with increasing entropy. The dye adsorption mechanism on the adsorbent also follows the Langmuir isotherm, which indicates the uniformity of the adsorbent surface and the monolayer adsorption. Finally, in order to compare the performance of synthetic activated carbon, the amount of dye removal under optimal conditions was compared with the commercial activated carbon including Merck, Jacobi and activated carbon obtained from the almond shell. The results showed that synthetic activated carbon can compete with commercial samples.

This quantitative study aimed to investigate the combined effects of two types of strategic planning, namely collaborative and teacher-led planning conditions and task complexity on Iranian intermediate language learners' oral production in terms of complexity, accuracy, and fluency. To achieve this purpose, 90 EFL learners were selected through convenience sampling from a language institute in Shiraz, Iran, and randomly assigned to two control and four experimental groups. The study adopted a quasi-experimental design in the form of pretest, treatment, and posttest. In the first step, all participants took part in a speaking pretest in which they were required to narrate a story based on a series of picture description tasks. While the experimental groups underwent 10 treatment sessions of picture description task performance along with two planning types i.e., teacher-led and collaborative planning conditions, the control groups were not allowed to plan the task performance. In the last session, the language learners took a posttest whose results were compared with those of the pretest. The findings revealed that the language learners in the collaborative planning groups outperformed the other groups in terms of both fluency and complexity. Further, teacher-led groups did better than the other groups in terms of accuracy. This study carries crucial implications for EFL teachers, material developers, syllabus designers, and speaking skill examiners.

Teachers need to keep up to date with a set of clear and common expectations and formidable challenges that arise in classroom assessment practices. Defining and conceptualizing of language assessment literacy have been the subject of much debate, especially with regard to detecting and defining the main components of language assessment literacy for language teachers (Levi & Inbar-Lourie, 2019). The main aim of the study was to pinpoint and define the main comments of LAL in the EFL context of Iran. The researchers conducted semi-structured interviews and focus group interviews with high school EFL teachers, and reviewed existing literature, documents on language assessment literacy as well as utilized the grounded theory approach to explore EFL teachers’ perception and insights into language assessment literacy and define the main components of language assessment literacy based on the EFL teachers' perceptions. The proposed model consists of three elements, namely awareness of language pedagogy, assessment principles and interpretation, assessment policy and local practices. In the second stage of the present study, to ensure reliability and validity of the scale, 203 Iranian EFL teachers with the age range between 22 to 55 were asked to complete the newly-developed instrument. Finally, to measure the EFL teachers’ language assessment literacy, 41 five-point Likert-scale items were developed. Based on all validation and statistical procedures, the newly-developed scale can be considered a valuable tool for measuring high school EFL teachers’ language assessment literacy.

Abstract Transportation sector is one of the core parts of modern civilization. Proper utilization of energy and exergy in this sector is necessary to ensure energy loss and environmental sustainability. Increasing exergy efficiency will reduce carbon emissions from this sector. Since 1970, Reistad estimates have been widely used to determine the energy and exergy efficiencies of this sector. However, the modern transport sector has undergone significant changes in recent decades. Hence, it is necessary to apply new Reistad estimates in determining the energy and exergy efficiencies. This is the first study to apply updated Reistad estimates to explore the energy and exergy efficiencies in the transportation sector of Bangladesh based on the data from 2000 to 2017. The overall exergy efficiency is significantly lower than the energy efficiencies as it ranges from 27.7% to 30.0%. Efficiencies are lower as the maximum portion of input exergy is lost to the environment. The road subsector needs major improvements as it is responsible for major amount of exergy loss. A comparison is made between conventional and updated estimates which highlights that the updated estimates provide more accurate results. Thus, it is recommended to apply updated Reistad estimates in determining the energy and exergy efficiencies of the transport sector.

Abstract Background Carbon dots (C-dots) are photoluminescent nanoparticles with less than 10 nm in size. Today, many studies are performed to exploit the photoluminescence (PL) property of carbon dots, and our focus in this study is to estimate the dipole moment of carbon dots. For reaching our aims, C-dots were synthesized and dissolved in the different solvents. Results Carbon dots with intense photoluminescence properties have been synthesized by a one-step hydrothermal method from a carbon bio-source. In this research, we report on the effect of aprotic solvents on absorption and fluorescence spectra and dipole moments of C-dots dispersed in a range of many aprotic solvents with various polarity and dielectric constant at room temperature. The change in the value of dipole moment was estimated by using the Stokes shifts. The difference between the dipole moment of the excited state and the ground state was shown using an extended form of Lippert equations by Kawski and co-workers. Conclusions The values found for μg = 1.077 D, and μe = 3.157 D, as well as the change in the dipole moments. The results showed that the dipole moment of the excited state is more than the ground state, indicating a high density and redistribution of electrons in the excited state. Finally, the quantum yield of C-dots in the eclectic aprotic solvents was communicated and discussed.

MXenes possess unique features that are useful for broader industrial development. However, although many different compositions of MXenes have been discovered, little research has been conducted on the optimal synthesis strategy for producing the best MXenes yield. Therefore, substantial work is performed on the synthesis’ structure and property relationship for direct methanol fuel cell (DMFC) applications since MXenes have been successfully hybridised with rice husk ash (RHA). In this study, to produce titanium-based MXene, Ti3C2 nanopowders are added to the rice husk ash matrix to synthesise hybrid RHA/MXene composites (R-MX). Using different weight percentages of MXene hybridised with rice husk ash (2 wt. % R-MX, 4 wt. % R-MX and 6 wt. % R-MX), different electrochemical properties are obtained. Meanwhile, electrochemical analysis is undertaken to investigate the methanol oxidation performance using Linear Sweep Voltammetry (LSV). The highest percentage of the R-MX hybrid composite, 6 wt. % MXene, showed the lowest Tafel slope (148 mV/dec) and the highest ionic exchange current density in the same Tafel analysis. Moreover, the incorporation of MXene into RHA produced good results from the chronoamperometry analysis (CA), with the highest percentage of the hybrid composite, R-6MX, showing the highest retention rate of 97.28%. Meanwhile, the Nyquist plot analysis showed an increasing semicircle arc diameter at the lower-frequency region, implying a lower interfacial charge resistance upon the addition of MXene into RHA. This outcome corresponded to the CA and LSV analysis findings, R-6MX showed a remarkable performance in terms of having the highest peak current density of 0.9454 mA/cm2 and retention rate of 97.28%. Both of these values show that hybrid R-6MX was able to maintain a high current for the entire duration. The current is maintained in a stable form for some time, proving that R-6MX was the most stable, with a minimal corrosion reaction and tolerance in a methanol medium. The results from this study enabled an evaluation of the possibility of utilising low-cost, green RHA material for fuel cell applications to promote sustainability. The novelty of this work is that a cheap source of silica-based RHA, a type of waste material, is incorporated with MXene through hybridisation processes.

The current research focuses on formulating a new class of Therminol55-based nanofluids that incorporates an MXene/Al2O3 nanocomposite as the new class of dispersant at three different concentrations of 0.05, 0.10, and 0.20 wt%. The optical and thermophysical properties of the formulated nanofluid are assessed experimentally. Zeta potential and FTIR analyses are employed to evaluate the composite particles' surface charge and chemical stability, respectively. Thermal conductivity is observed to increase with nanoparticle loading and maximally augmented by 61.8% for 0.20 wt%, whereas dynamic viscosity increased with adding nanoparticles but remarkably dropped with increasing temperature. In addition, the prepared TH55/MXene + Al2O3 samples are thermally stable up to 200 °C according to TGA analyses. Moreover, the proposed correlations for the thermal conductivity and viscosity showed good agreement with the experimental data. The study’s findings suggest that the formulated nanofluid could be a viable contender to be used as a heat transfer fluid in the thermal sector.

Introduction: Trapdoor fractures of the orbital floor occur almost exclusively in the paediatric population. Despite being widely discussed in the literature, their management remains controversial. The objective of this retrospective study was to analyse the surgical experiences on paediatric trapdoor fractures in the maxillofacial centres participating in the WORMAT project., Materials and Methods: 14 centres collected data for patients aged ≤16 years operated between January 2011 and December 2022. The demographic, cause and type of fracture, timing from injury to surgery, surgical approach, type of floor repair and outcomes were recorded. Diplopia, surgical wound infection, hardware loosening and dysesthesia in the infraorbital nerve area were recorded at follow-up., Results: 43 patients were included: 25 children (0-12 y) and 18 adolescents (13-16 y) (mean age, 11.1 years). Surgical treatment was performed within 24 h in 51 % of the patients, within 24-72 h in 33 %, and beyond 72 h in the remaining. The orbital floor was repaired with a resorbable implant/membrane in 63 % of the patients, open reduction without an implant in 30 %, a titanium mesh implant in 3 adolescent patients. At follow-up (mean 16.3 months), 14 patients had residual diplopia in the upper fields, only two of these resolved within 6 months., Discussion: A tendency toward an increased incidence of postoperative diplopia with longer intervals between trauma and surgery was observed. This study showed different choices regarding the material placed on the floor, with a preference for open reduction without implants in children, compared to the use of resorbable implants or membranes in adolescents., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Objective: The aim of this study was to quantify LNM risk and outcomes following treatment of early esophago-gastric (EG) adenocarcinoma., Background: The standard of care for early T1N0 EG cancer is endoscopic resection (ER). Radical surgical resection is recommended for patients perceived to be at risk of lymph node metastasis (LNM). Current models to select organ-preserving vs. surgical treatment are inconsistent., Methods: CONGRESS is a UK-based multicentre retrospective cohort study. Patients diagnosed with clinical or pathological T1N0 EG adenocarcinoma from 2015-2022 were included. Outcomes and rates of LNM were assessed. Cox regression was performed to assess the impact of prognostic and treatment factors on overall survival., Results: 1,601 patients from 26 centres were included, with median follow-up 32 months(IQR 14-53). 1285/1612(80.3%) underwent ER, 497/1601(31.0%) underwent surgery. Overall rate of LNM was 13.5%. On ER staging, tumour depth (T1bsm2-3 17.6% vs. T1a 7.1%), lymphovascular invasion (17.2% vs. 12.6%), or signet cells (28.6% vs. 13.0%) were associated with LNM. In multivariable regression analysis, these were not significantly associated with LNM rates or survival. Adjusting for demographic and tumour variables, surgery after ER was associated with significant survival benefit, HR 0.33(0.15-0.77),P=0.010., Conclusion: This large multicentre dataset suggests that early EG adenocarcinoma is associated with significant risk of LNM. This data is representative of current real clinical practice with ER-based staging, and suggests previously held beliefs regarding reliability of predictive factors for LNM may need to be reconsidered. Further research to identify patients who may benefit from organ-preserving vs. surgical treatment is urgently required., Competing Interests: Conflicts of interest: Authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Study Objectives: Menopause is associated with nighttime sleep fragmentation, declining estradiol, and impaired cognition. In a model of pharmacologically induced estradiol suppression mimicking menopause, we examined the impact of menopause-pattern sleep fragmentation on daytime neurobehavioral performance and sleepiness in premenopausal women., Methods: Twenty premenopausal women completed two five-night inpatient studies in the mid-to-late follicular phase (estrogenized) and after pharmacological estradiol suppression (hypo-estrogenized). During each study, participants had an uninterrupted 8-hour sleep opportunity for two nights, followed by three nights where sleep was experimentally fragmented to mimic menopause-pattern sleep disturbance, and during which the sleep opportunity was extended to prevent shortening of the sleep duration. Neurobehavioral performance and subjective sleepiness were measured using the Psychomotor Vigilance Task and Karolinska Sleepiness Scale (KSS)., Results: Compared to unfragmented sleep, sleep fragmentation increased attentional lapses (+ 0.6 lapses, p < .05), slowed reaction time (+ 9.4 milliseconds, p < .01), and increased daytime sleepiness (+ 0.5 KSS score, p < .001). Estradiol suppression increased attentional lapses (+ 0.8; p < .001) and reaction time (+ 12.3, p < .01) but did not significantly affect daytime sleepiness. The effect of sleep fragmentation on neurobehavioral performance differed by estradiol state, such that the adverse effects of sleep fragmentation on attentional lapses (+ 0.9, trend p = .06) and reaction time (+ 15, p < .05) were observed only when estrogenized., Conclusions: Menopause-pattern sleep fragmentation and estradiol suppression worsened neurobehavioral performance and daytime sleepiness, even while sleep duration was not reduced. The adverse effects of sleep fragmentation in the context of an adequate sleep duration highlight the importance of sleep continuity as a vital aspect of good sleep health., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: This study aims to evaluate the epidemiology of asthma among children and adolescents in the Eastern Mediterranean Region., Methods: Exhaustive searches were conducted across databases, including PubMed, Scopus, Web of Knowledge Core Collection, Embase, and Google Scholar. The selection criteria included studies reporting asthma prevalence in individuals aged 0 to 19 years, using validated questionnaires. Data were extracted and synthesized using the DerSimonian and Laird random effects model., Results: The overall prevalence of asthma in Eastern Mediterranean Regional Office (EMRO) countries, among the 514,468 children and adolescents included in this meta-analysis, was 10.61%, synthesized from 95 studies. Among the countries studied, Qatar exhibited the highest prevalence at 16.69%, followed by Saudi Arabia at 16.57%, Iraq at 16.22%, Oman at 15.20%, and Afghanistan at 14.90%. Adolescents showed a slightly higher prevalence of asthma at 10.10% compared to children at 9.70%. Boys exhibited a higher prevalence at 11.48% compared to girls at 9.75%. Urban areas demonstrated a higher prevalence at 11.27% than rural areas at 8.29%., Conclusion: Efforts to reduce asthma prevalence in Arab countries and address underdiagnosis in African nations within the EMRO are crucial. Targeted interventions should focus on addressing environmental triggers and improving access to healthcare. Enhanced diagnostic capabilities and healthcare infrastructure are necessary in African countries. Collaborative action is essential to alleviate the asthma burden and promote respiratory health across the EMRO region., (© 2024. The Author(s).)

The COVID-19 pandemic was one of the deadliest global public health events. In the United States, over 1.1 million individuals have died, and now COVID-19 is the third leading cause of death (CDC, 2023). Vaccine uptake has stalled among different demographics. Vaccine hesitancy, a delay in accepting or refusing vaccines, poses a significant challenge regardless of the availability of safe and effective COVID-19 vaccines. This study aimed to identify disparate COVID-19 vaccine uptake among individuals in Western New York. The primary objective was to identify the factors contributing to lower rates of COVID-19 vaccination within this population.Data were collected from 585 adults recruited from 20 Niagara and Erie Counties sites using a self-administered survey on vaccine hesitancy, vaccination status, and COVID-19-related characteristics. The survey included the adult Vaccine Hesitancy Scale (aVHS) and acquired information on demographic characteristics and COVID-19 impact, knowledge, and information sources. Data were analyzed using descriptive statistics, a chi-squared test, a Wilcoxon rank-sum test, and a logistic regression model.Findings suggest that unvaccinated participants (n = 35) were concerned about vaccine side effects (48.6%). For vaccinated/unboosted participants (n = 52), they (40.0%) reported clinical concerns. After adjusting for gender and age, healthcare provider guidance and family guidance remained significant predictors of vaccination status, while clinical research studies were significant predictors of booster status. Findings from this study suggest public health interventions that target vaccine education and facilitate well-informed decisions about COVID-19 vaccines lead to less vaccine hesitancy., (© 2024. The Author(s).)

Introduction: The aim of this 11-year retrospective multicentric study is to evaluate the policy of 14 maxillofacial surgery divisions in terms of titanium plate removal from paediatric patients who had undergone open reduction and internal fixation (ORIF) to treat maxillofacial fractures., Material and Methods: Patients ≤ 16 years undergoing surgical treatment for fractures of middle and lower third of the face between January 2011 and December 2022, with a minimum follow-up of 6 months, were included. Age (group A: ≤ 6 years, B: 7-12 years, C: 13-16 years), sex, fracture location and type, surgical approach, number, and location of positioned and removed plates, timing and indications for removal were recorded., Results: 191/383 (50 %) patients (median age, 10 years; M:F ratio 2.1:1) underwent removal of 319/708 (45 %) plates. Maxillary dentoalveolar process (91 %), angle/ramus (63 %) and mandibular body (61 %) had a significantly higher removal rate than other fracture sites (p < 0.001). A significant decreasing trend in removal with increasing age was observed, from 83 % in Group A to 24 % in Group C (p < 0.001). On the total of positioned plates, 11 % were removed for symptomatic reasons (5 % infections, 6 % discomfort/pain) and 34 % for other reasons (28 % scheduled removal)., Discussion: This multicentric study showed that plate removal was not performed routinely in the paediatric population. The incidence and causes of symptomatic plates removal were consistent with the literature, while the plate removal rate from asymptomatic patients was lower. A correlation was found between increasing age and a reduction in the frequency of plate removal procedures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Background/aim: Paediatric maxillozygomatic complex (MZC) fractures are uncommon, and there is a scarcity of data regarding their surgical treatment. The aim of this study was to analyse choices and outcomes of open reduction and internal fixation (ORIF) for MZC fractures among 14 maxillofacial centers around the world., Materials and Methods: This multicentric retrospective observational study included patients ≤16 years of age with quadripod MZC fractures treated with ORIF from January 2011 and December 2022. The following data were collected: age, gender, dentition stage (deciduous, mixed, and permanent), cause of injury, type of fracture, surgical approach, site of osteosynthesis (infraorbital rim, zygomaticomaxillary buttress, frontozygomatic, and zygomaticotemporal sutures), material (titanium or resorbable) and number of plates used, and outcome. The minimum follow-up was 6 months. Statistical analyses were performed with Fisher's exact test or chi-squared test, as appropriate., Results: Sixty-four patients (mean age, 12.3 years) with quadripod MZC fractures were included. Seventy-two percent of patients received a single-point fixation. The zygomaticomaxillary buttress was the most common site for fixation, both in single-point and two-point fixation schemes, especially in combination with the frontozygomatic suture. Increasing age was associated with a higher rate of plate removal (p < .001). Postoperative complications included 5 (7.8%) cases of wound infections, 2 (3.1%) infraorbital paraesthesia, 1 (1.6%) ectropion. Residual facial asymmetry was found in 5 (7.8%) patients and was not associated with the type of fixation (p > .05)., Conclusions: This study highlights the possibility of using ORIF, even with a single point of fixation, for the treatment of displaced quadripod MZC fractures in the paediatric population. The zygomaticomaxillary buttress was the preferred site of fixation and allowed for adequate stabilization with no external scars and a low risk of tooth damage. Future prospective studies with long-term follow-up are needed to establish definitive surgical protocols and clarify the surgical decision-making., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

New sublineages of SARS-CoV-2 variants-of-concern (VOCs) continuously emerge with mutations in the spike glycoprotein. In most cases, the sublineage-defining mutations vary between the VOCs. It is unclear whether these differences reflect lineage-specific likelihoods for mutations at each spike position or the stochastic nature of their appearance. Here we show that SARS-CoV-2 lineages have distinct evolutionary spaces (a probabilistic definition of the sequence states that can be occupied by expanding virus subpopulations). This space can be accurately inferred from the patterns of amino acid variability at the whole-protein level. Robust networks of co-variable sites identify the highest-likelihood mutations in new VOC sublineages and predict remarkably well the emergence of subvariants with resistance mutations to COVID-19 therapeutics. Our studies reveal the contribution of low frequency variant patterns at heterologous sites across the protein to accurate prediction of the changes at each position of interest., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rojas Chávez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

COVID-19 self-testing is essential for enabling individuals to self-care, screen themselves and, if positive, isolate themselves. Since 2021, COVID-19 self-tests have been extensively used in high-income countries, however, their programmatic implementation in low- and middle-income countries has been delayed. An implementation pilot, mixed-methods study, was conducted in four industrial manufacturing companies, in Kedah State between November 2022 and May 2023. Participants were asked to take COVID-19 self-tests home for themselves and their household members and to use the tests according to national guidelines. At enrolment and at the end of the study, participants completed an online sociodemographic, knowledge and satisfaction survey. Data were cleaned and analysed using SPSS Statistics V28.0. Qualitative data were collected through semi-structured interviews and focus group discussions. Thematic analysis was conducted. A total of 1768 employees from four manufacturing industries enrolled in the pilot, representing 60% of the total employees and more than 50% of employees at each site. There were 40 COVID-19-positive cases detected in participants from the manufacturing industries, and 100 positive household members. Participants reported 27 invalid test results. Individuals aged 30 or less [adjusted odds ratio (AOR): 2.65; 95% CI: 1.63 to 4.31; p<0.001] and males (AOR: 1.54; 95% CI: 1.09 to 2.17; p = 0.014) showed a significant higher likelihood of self-testing compared to older and female participants. Additionally, individuals who received three or more doses of a COVID-19 vaccine had higher odds of using self-tests (OR 1.56 (95% CI: 1.03 to 2.36, p = 0.037)). There was a significant increase in participants' knowledge on how to correctly collect a self-sample using a nasal swab from 36,9% at baseline to 43,6% post-implementation (p = 0.004) and correct interpretation of a positive result from 80,5% at baseline to 87,6% post-implementation (p<0.001). Furthermore, there was a notable increase in the correct understanding of actions following a positive result, especially regarding self-isolation, which rose from 59.1% to 71.9% (p<0.001). A total of 44 SSIs, and 4 FGDs with a total of 14 participants, were performed. The five main themes explored were: 1) previous experiences with COVID-19, 2) COVID-19 ST experiences during the pilot study, 3) advantages of COVID-19 ST, 4) feelings related to COVID-19 ST, 5) willingness to use COVID-19 ST again, and 6) ST for other diseases. This research shows the feasibility of a self-testing model in the community through workplaces due to participants' high acceptability to enrol and high self-tests' uptake. Lessons learnt can inform operational aspects of the introduction and scale-up of self-care strategies in low- and middle-income countries, in particular the South-East Asia region., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: There is strong evidence showing the association between obesity, type 2 diabetes mellitus (T2DM), and knee pain resulting from osteoarthritis. Regular exercise has been reported as a foundational piece of the preventive therapy puzzle for knee osteoarthritis (KOA) patients. Nonetheless, evidence-based exercise protocols for people with comorbidities, such as obesity, T2DM, and KOA are limited. Therefore, the present trial aimed to assess the effectiveness of a 12-week home-based circuit training (HBCT) protocol on various indices related to cardiometabolic health, musculoskeletal fitness, and health-related quality of life (HRQoL) among overweight/obese older adult patients with KOA and T2DM during the COVID-19 lockdown., Methods: This is a randomized controlled trial study registered at the National Medical Research Register (ID: RSCH ID-21-01180-KGTNMRR ID-21-02367-FUM) and obtained approval on December 9, 2021. Seventy overweight or obese patients with KOA and T2DM (62.2 ± 6.1 years; 56% female) were randomly assigned to the intervention group (n = 35, HBCT) or the no-exercise control group (n = 35, CON). HBCT performed a 12-week progressive protocol (seven exercises; 15-30 repetitions per exercise, 1 min passive rest between exercises; 2-4 rounds per session; 20-60 min total session duration). Blood samples were collected, and assays were performed to assess the lipid profile, liver function, and fasting blood glucose (FBG). In addition, the 30-s Chair Stand Test (30CST) was used to evaluate lower body muscular strength and endurance while the Timed Up and Go (TUG) test was used to evaluate lower limb function, mobility, and the risk of falls for all the participants. HRQoL was assessed using the Osteoarthritis Knee and Hip Quality of Life (OAKHQoL). All the assessments were conducted at pre-, mid-, and post-training stages during the application or practice of the exercise protocol, rather than during the training sessions themselves., Results: HBCT significantly reduced total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), aminotransferase, alanine aminotransferase, FBG and knee pain (p < 0.05). Furthermore, HBCT induced meaningful increases in high-density lipoprotein (HDL-C), lower body muscular strength, endurance, function, mobility, and HRQoL in overweight/obese older adults with T2DM and KOA (p < 0.05)., Conclusion: The present outcomes recommend that an injury-free HBCT program may improve various indicators related to cardiometabolic health, musculoskeletal fitness, and HRQoL in elderly with overweight/obesity, T2DM and KOA. These findings offer valuable insights for clinicians and practitioners seeking evidence-based exercise interventions tailored for patients managing substantial metabolic and musculoskeletal health challenges in clinical practice., (© 2024. The Author(s).)

Study Objectives: We previously reported that during a 45-day simulated space mission, a dynamic lighting schedule (DLS) improved circadian phase alignment and performance assessed once on selected days. This study aimed to evaluate how DLS affected performance on a 5-minute psychomotor vigilance task (PVT) administered multiple times per day on selected days., Methods: Sixteen crewmembers (37.4 ± 6.7 years; 5F) underwent six cycles of 2 × 8-hour/night followed by 5 × 5-hour/night sleep opportunities. During the DLS ( n  = 8), daytime white light exposure was blue-enriched (~6000 K; Level 1: 1079, Level 2: 76 melanopic equivalent daytime illuminance (melEDI) lux) and blue-depleted (~3000-4000 K; L1: 21, L2: 2 melEDI lux) 3 hours before bed. In the standard lighting schedule (SLS; n  = 8), lighting remained constant (~4500K; L1: 284, L2 62 melEDI lux). Effects of lighting condition (DLS/SLS), sleep condition (5/8 hours), time into mission, and their interactions, and time awake on PVT performance were analyzed using generalized linear mixed models., Results: The DLS was associated with fewer attentional lapses (reaction time [RT] > 500 milliseconds) compared to SLS. Lapses, mean RT, and 10% fastest/slowest RTs were worse following 5 compared to 8 hours of sleep but not between lighting conditions. There was an effect of time into mission on RTs, likely due to sleep loss. Overall performance differed by time of day, with longer RTs at the beginning and end of the day. There were more lapses and slower RTs in the afternoon in the SLS compared to the DLS condition., Conclusions: Future missions should incorporate DLS to enhance circadian alignment and performance. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society.)

Blocking the immunosuppressive function of T-cell immunoglobulin mucin-3 (TIM-3) is an established therapeutic strategy to maximize the efficacy of immune checkpoint inhibitors for cancer immunotherapy. Currently, effective inhibition of TIM-3 interactions relies on monoclonal antibodies (mAbs), which come with drawbacks such as immunogenicity risk, limited tumor penetration, and high manufacturing costs. Guided by the X-ray cocrystal structures of TIM-3 with mAbs, we report an in silico structure-based rational design of constrained peptides as potent TIM-3 inhibitors. The top cyclic peptide from our study ( P2 ) binds TIM-3 with a K D value of 166.3 ± 12.1 nM as determined by surface plasmon resonance (SPR) screening. Remarkably, P2 efficiently inhibits key TIM-3 interactions with natural TIM-3 ligands at submicromolar concentrations in a panel of cell-free and cell-based assays. The capacity of P2 to reverse immunosuppression in T-cell/cancer cell cocultures, coupled with favorable in vitro pharmacokinetic properties, highlights the potential of P2 for further evaluation in preclinical models of immuno-oncology., Competing Interests: The authors declare no competing financial interest., (© 2024 American Chemical Society.)

Background: Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses' sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study., Methods: A qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes., Results: During their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students' clinical experiences. We extracted three main themes that described students' stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies., Conclusions: This qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum., (© 2024. The Author(s).)

Objective: A well-established bidirectional relationship exists between sleep and epilepsy. Patients with epilepsy tend to have less efficient sleep and shorter rapid eye movement (REM) sleep. Seizures are far more likely to arise from sleep transitions and non-REM sleep compared to REM sleep. Delay in REM onset or reduction in REM duration may have reciprocal interactions with seizure occurrence. Greater insight into the relationship between REM sleep and seizure occurrence is essential to our understanding of circadian patterns and predictability of seizure activity. We assessed a cohort of adults undergoing evaluation of drug-resistant epilepsy to examine whether REM sleep prior to or following seizures is delayed in latency or reduced in quantity., Methods: We used a spectrogram-guided approach to review the video-electroencephalograms of patients' epilepsy monitoring unit admissions for sleep scoring to determine sleep variables., Results: In our cohort of patients, we found group- and individual-level delay of REM latency and reduced REM duration when patients experienced a seizure before the primary sleep period (PSP) of interest or during the PSP of interest. A significant increase in REM latency and decrease in REM quantity were observed on nights where a seizure occurred within 4 h of sleep onset. No change in REM variables was found when investigating seizures that occurred the day after the PSP of interest. Our study is the first to provide insight about a perisleep period, which we defined as 4-h periods before and after the PSP., Significance: Our results demonstrate a significant relationship between seizures occurring prior to the PSP, during the PSP, and in the 4-h perisleep period and a delay in REM latency. These findings have implications for developing a biomarker of seizure detection as well as longer term seizure risk monitoring., (© 2024 International League Against Epilepsy.)

Spermidine is a poly-cationic molecule belonging to the family of polyamines and is ubiquitously present in all organisms. Salmonella synthesizes, and harbours specialized transporters to import spermidine. A group of polyamines have been shown to assist in Salmonella Typhimurium's virulence and regulation of Salmonella pathogenicity Inslad 1 (SPI-1) genes and stress resistance; however, the mechanism remains elusive. The virulence trait of Salmonella depends on its ability to employ multiple surface structures to attach and adhere to the surface of the target cells before invasion and colonization of the host niche. Our study discovers the mechanism by which spermidine assists in the early stages of Salmonella pathogenesis. For the first time, we report that Salmonella Typhimurium regulates spermidine transport and biosynthesis processes in a mutually inclusive manner. Using a mouse model, we show that spermidine is critical for invasion into the murine Peyer's patches, which further validated our in vitro cell line observation. We show that spermidine controls the mRNA expression of fimbrial (fimA) and non-fimbrial adhesins (siiE, pagN) in Salmonella and thereby assists in attachment to host cell surfaces. Spermidine also regulated the motility through the expression of flagellin genes by enhancing the translation of sigma-28, which features an unusual start codon and a poor Shine-Dalgarno sequence. Besides regulating the formation of the adhesive structures, spermidine tunes the expression of the two-component system BarA/SirA to regulate SPI-1 encoded genes. Thus, our study unravels a novel regulatory mechanism by which spermidine exerts critical functions during Salmonella Typhimurium pathogenesis., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Background: Attention deficit hyperactivity disorder (ADHD), a globally prevalent behavioural disorder, remains underdiagnosed, particularly among adults. This issue is exacerbated in the Arab region due to stigma and insufficient healthcare facilities and professionals. Despite the United Arab Emirates (UAE) efforts to improve mental healthcare, shortcomings persist. No studies in the UAE currently assesses the appropriateness of the screening system for ADHD and other behavioural issues. Furthermore, prevalence rates of ADHD, particularly within the young adult population, are absent., Aim: To estimate the prevalence of ADHD amongst young adults attending university in UAE and examine its relationship with gender and academic outcomes., Methods: A cross-sectional, correlational design was used. Young adults in their first year at university were recruited from different academic institutions across the UAE. The study utilized the Adult ADHD Self-Report Scale (ASRS) for data collection., Results: A sample of 406 young adults, aged between 18 and 20 years of age were recruited. Approximately, 34.7% (n = 141) reported symptoms suggestive of probable ADHD. Significantly lower grade point average marks were observed in participants with ADHD symptoms (M = 3.15) compared to those without (M = 3.35). Females reported symptoms of probable ADHD at higher rates than males, indicating possibly a potential screening deficiency and a potential stigma consequence., Conclusions: The study demonstrates a high prevalence of probable ADHD in young adults, particularly among females attending university in the United Arab Emirates. Implications for early screening, service provision, and greater professional health training on this disorder are required., (© 2023. The Author(s).)

Objectives: Mathematical models of human neurobehavioral performance that include the effects of acute and chronic sleep restriction can be key tools in assessment and comparison of work schedules, allowing quantitative predictions of performance when empirical assessment is impractical., Methods: Using such a model, we tested the hypothesis that resident physicians working an extended duration work roster, including 24-28 hours of continuous duty and up to 88 hours per week averaged over 4weeks, would have worse predicted performance than resident physicians working a rapidly cycling work roster intervention designed to reduce the duration of extended shifts. The performance metric used was attentional failures (ie, Psychomotor Vigilance Task lapses). Model input was 169 actual work and sleep schedules. Outcomes were predicted hours per week during work hours spent at moderate (equivalent to 16-20 hours of continuous wakefulness) or high (equivalent to ≥20 hours of continuous wakefulness) performance impairment., Results: The model predicted that resident physicians working an extended duration work roster would spend significantly more time at moderate impairment (p = .02, effect size=0.2) than those working a rapidly cycling work roster; this difference was most pronounced during the circadian night (p < .001). On both schedules, performance was predicted to decline from weeks 1 + 2 to weeks 3 + 4 (p < .001), but the rate of decline was significantly greater on extended duration work roster (p < .01). Predicted performance impairment was inversely related to prior sleep duration (p < .001)., Conclusions: These findings demonstrate the utility of a mathematical model to evaluate the predicted performance profile of schedules for resident physicians and others who experience chronic sleep restriction and circadian misalignment., Competing Interests: Declaration of conflict of interest Dr. Phillips has received research funding from Versalux and Delos, and he is co-founder and co-director of Circadian Health Innovations PTY LTD. He also holds a patent (US20150080756A1) for estimating arousal states from ambulatory recordings by using sleep and wake models. Dr. St Hilaire has received grant/research support from NIH, NASA, and Merrimack College. Dr. Barger reports honorariums from AAA Foundation, University of Arizona and University of British Columbia. Mr. O’Brien has no COI to report from the past 3 years. Dr. Rahman holds patents for (1) Method and device for preventing alterations in circadian rhythm (U.S. patent application Ser. No. 10/525,958), and (2) Methods and devices for improving sleep performance in subject exposed to light at night (U.S. Application No. 61/810,985); owns equity in Melcort Inc; has provided paid consulting services to Sultan & Knight Limited, Bambu Vault LLC, Lucidity Lighting Inc; and has received honoraria as an invited speaker and travel funds from Starry Skies Lake Superior, University of Minnesota Medical School, PennWell Corp, and Seoul Semiconductor Co Ltd, FALK FOUNDATION E.V.; and has received grant/research support from Seoul Semiconductor Co Ltd, Biological Innovation and Optimization Systems, LLC, Merck & Co, Inc, Pfizer Inc, Vanda Pharmaceuticals Inc, Lighting Science Group, NIH, and NASA. These interests were reviewed and managed by Brigham and Women's Hospital and Mass General Brigham in accordance with their conflict-of-interest policies. Dr. Landrigan holds equity in and has consulted with the I-PASS Patient Safety Institute, which seeks to train institutions in best handoff practices and aid in their implementation. In addition, Dr. Landrigan has received monetary awards, honoraria, and travel reimbursement from multiple academic and professional organizations for teaching and consulting on sleep deprivation, physician performance, handoffs, and safety, and has served as an expert witness in cases regarding patient safety and sleep deprivation. Dr. Lockley reports consulting fees from the Hintsa Performance AG, Stantec and View Inc, and has consulting contracts with Absolute Rest, Akili Interactive, Apex 2100 Ltd, Ashurst Risk Advisory, Consumer Sleep Solutions, KBR Wyle Services, Light Cognitive; Lighting Science Group Corporation/HealthE; and Mental Workout/Timeshifter. He has received honoraria and travel or accommodation expenses from Bloxhub, Clifton College, Danish Centre for Lighting, and University of Toronto; and travel or accommodation expenses (no honoraria) from Wiley; and royalties from Monash University and Oxford University Press. He holds equity in iSleep pty. He has received an unrestricted equipment gift and investigator-initiated grant from F. Lux Software LLC, and a Clinical Research Support Agreement and Clinical Trial Agreement with Vanda Pharmaceuticals Inc. He is an unpaid Board Member of the Midwest Lighting Institute (non-profit). He was a Program Leader for the CRC for Alertness, Safety and Productivity, Australia, through an adjunct professor position at Monash University (2015-2019). He is part-time adjunct professor at the University of Surrey, UK. He holds several pending patents (US2019366032A1; USD943612S1; US2021162164A1, US20220151552A1). He has served as a paid expert in legal proceedings related to light, sleep, and health. His interests are reviewed and managed by Mass General Brigham in accordance with their conflict-of-interest policies. Dr. Czeisler reports that he serves as the incumbent of an endowed professorship provided to Harvard Medical School by Cephalon, Inc and reports institutional support for a Quality Improvement Initiative from Delta Airlines and Puget Sound Pilots; education support to Harvard Medical School Division of Sleep Medicine and support to Brigham and Women’s Hospital from: Jazz Pharmaceuticals PLC, Inc, Philips Respironics, Inc, Optum, and ResMed, Inc; research support to Brigham and Women’s Hospital from Axsome Therapeutics, Inc, Dayzz Ltd, Peter Brown and Margaret Hamburg, Regeneron Pharmaceuticals, Sanofi SA, Casey Feldman Foundation, Summus, Inc, Takeda Pharmaceutical Co, LTD, Abbaszadeh Foundation, CDC Foundation; educational funding to the Sleep and Health Education Program of the Harvard Medical School Division of Sleep Medicine from ResMed, Inc, Teva Pharmaceuticals Industries, Ltd, and Vanda Pharmaceuticals; personal royalty payments on sales of the Actiwatch-2 and Actiwatch-Spectrum devices from Philips Respironics, Inc; personal consulting fees from Axsome Therapeutics, Bryte Foundation, With Deep, Inc and Vanda Pharmaceuticals; honoraria from the Associated Professional Sleep Societies, LLC for the Thomas Roth Lecture of Excellence at SLEEP 2022, from the Massachusetts Medical Society for a New England Journal of Medicine Perspective article, from the National Council for Mental Wellbeing, from the National Sleep Foundation for serving as chair of the Sleep Timing and Variability Consensus Panel, for lecture fees from Teva Pharma Australia PTY Ltd and Emory University, and for serving as an advisory board member for the Institute of Digital Media and Child Development, the Klarman Family Foundation, and the UK Biotechnology and Biological Sciences Research Council. CAC has received personal fees for serving as an expert witness on a number of civil matters, criminal matters, and arbitration cases, including those involving the following commercial and government entities: Amtrak; Bombardier, Inc; C&J Energy Services; Dallas Police Association; Delta Airlines/Comair; Enterprise Rent-A-Car; FedEx; Greyhound Lines, Inc/Motor Coach Industries/FirstGroup America; PAR Electrical Contractors, Inc; Puget Sound Pilots; the San Francisco Sheriff’s Department; Schlumberger Technology Corp; Union Pacific Railroad; United Parcel Service; and Vanda Pharmaceuticals. CAC has received travel support from Merck, Sharpe and Dohme for travel to Japan and Australia; equity interest in Vanda Pharmaceuticals, With Deep, Inc, WHOOP, Inc, and Signos, Inc; and institutional educational gifts to Brigham and Women’s Hospital from Johnson & Johnson, Mary Ann and Stanley Snider via Combined Jewish Philanthropies, Alexandra Drane, DR Capital, Harmony Biosciences, LLC, San Francisco Bar Pilots, Whoop, Inc, Harmony Biosciences LLC, Eisai Co, LTD, Idorsia Pharmaceuticals LTD, Sleep Number Corp, Apnimed, Inc, Avadel Pharmaceuticals, Bryte Foundation, f.lux Software, LLC, Stuart F. and Diana L. Quan Charitable Fund. Dr. Czeisler's interests were reviewed and are managed by the Brigham and Women's Hospital and Mass General Brigham in accordance with their conflict-of-interest policies. Dr. Klerman reports consulting for the American Academy of Sleep Medicine Foundation, Circadian Therapeutics, National Sleep Foundation, Puerto Rico Science, Technology, and Research Trust, Pfizer Pharmaceuticals, Sanofi-Genzyme, Sleep Research Society Foundation, and Yale University Press; travel support from the DGSM (Germany Sleep Society), EPFL Pavilions, European Biological Rhythms Society, Gordon Research Conference, Santa Fe Research Institute, Sleep Research Society, and World Conference of Chronobiology; and being on the Scientific Advisory Board (unpaid) for Chronsulting. Other: Partner is founder, director, and chief scientific officer of Chronsulting., (Copyright © 2024 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Compared to small molecules and antibodies, cyclic peptides exhibit unique biochemical and therapeutic attributes in the realm of pharmaceutical applications. The interaction between the inducible costimulator (ICOS) and its ligand (ICOSL) plays a key role in T-cell differentiation and activation. ICOS/ICOSL inhibition results in a reduction in the promotion of immunosuppressive regulatory T cells (Tregs) in both hematologic malignancies and solid tumors. Herein, we implement the computational cPEPmatch approach to design the first examples of cyclic peptides that inhibit ICOS/ICOSL interaction. The top cyclic peptide from our approach possessed an IC 50 value of 1.87 ± 0.15 μM as an ICOS/ICOSL inhibitor and exhibited excellent in vitro pharmacokinetic properties as a drug candidate. Our work will lay the groundwork for future endeavors in cancer drug discovery, with the goal of developing cyclic peptides that target the ICOS/ICOSL interaction., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Emergency general surgery (EGS) admissions account for a large proportion of surgical care and represent the majority of surgical patients who suffer in-hospital mortality. Health care systems continue to experience growing demand for emergency services: one way in which this is being increasingly addressed is dedicated subspecialty teams for emergency surgical admissions, most commonly termed "emergency general surgery" in the United Kingdom. This study aims to understand the impact of the emergency general surgery model of care on outcomes from emergency laparotomies., Methods: Data was obtained from the National Emergency Laparotomy Audit database. Patients were dichotomized into EGS hospital or non-EGS hospital. Emergency general surgery hospital is defined as a hospital where >50% of in-hours emergency laparotomy operating is performed by an emergency general surgeon. The primary outcome was in-hospital mortality. Secondary outcomes were intensive therapy unit (ITU) length of stay and duration of hospital stay. A propensity score weighting approach was used to reduce confounding and selection bias., Results: There were 115,509 patients from 175 hospitals included in the final analysis. The EGS hospital care group included 5,789 patients versus 109,720 patients in the non-EGS group. Following propensity score weighting, mean standardized mean difference reduced from 0.055 to <0.001. In-hospital mortality was similar (10.8% vs. 11.1%, p = 0.094), with mean length of stay (16.7 days vs. 16.1 days, p < 0.001) and ITU stay (2.8 days vs. 2.6 days, p < 0.001) persistently longer in patients treated in EGS systems., Conclusion: No significant association between the emergency surgery hospital model of care and in-hospital mortality in emergency laparotomy patients was seen. There is a significant association between the emergency surgery hospital model of care and an increased length of ITU stay and overall hospital stay. Further studies are required to examine the impact of changing models of EGS delivery in the United Kingdom., Level of Evidence: Prognostic and Epidemiological; Level III., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Tuberculosis (TB), also known as Koch's disease, is a chronic granulomatous disease typically caused by Mycobacterium tuberculosis ( M. tuberculosis ). On 24 th March 1882, Dr Robert Koch discovered M. tuberculosis that caused TB. In humans, M. bovis and atypical mycobacterium may also cause this disease. According to the World Health Organization (WHO) Global Report 2022, published on 27 th October 2022, the incidence of TB in India for the year 2022 is 210/100,000 population. Primarily, TB affects the pulmonary region in humans, whereas secondarily, it may affect extrapulmonary sites such as the bones and intestines via lymph nodes. In this article, we are reporting a rare case of tubercular osteomyelitis of the mandible, in which the patient reported swelling of the cheek, mimicking an odontogenic infection that led to mandibular osteomyelitis. The definitive diagnosis of tubercular osteomyelitis was made by cartridge-based nucleic acid amplification test (CB-NAAT) when the cheesy material was found during surgical debridement and curettage of the mandible. Following that diagnosis, antitubercular treatment (ATT) was started immediately for the patient, which led to the complete resolution of the disease. The patient has been on regular follow-up for the last six months with no evidence of relapse of disease. Primary TB of the mandible is very rare, with only a few reported cases in the literature., How to Cite This Article: Khan MA, Rahman SA, Danish M, et al. A Rare Case of Tubercular Osteomyelitis of Mandible in a 5-year-old Child. Int J Clin Pediatr Dent 2024;17(2):202-205., Competing Interests: Source of support: Nil Conflict of interest: None Patient consent statement: The author(s) have obtained written informed consent from the patient's parents/legal guardians for publication of the case report details and related images., (Copyright © 2024; The Author(s).)

Objective: To examine effects of menstrual phase and nighttime light exposure on subjective sleepiness and auditory Psychomotor Vigilance Task performance., Methods: Twenty-nine premenopausal women (12 =Follicular; 17 =Luteal) completed a 6.5-hour nighttime monochromatic light exposure with varying wavelengths (420-620 nm) and irradiances (1.03-14.12 µW/cm 2 ). Subjective sleepiness, reaction time, and attentional lapses were compared between menstrual phases in women with minimal (<33%) or substantial (≥33%) light-induced melatonin suppression., Results: When melatonin was not suppressed, women in the follicular phase had significantly worse reaction time (mean difference=145.1 ms, 95% CI 51.8-238.3, p < .001, Cohen's D=1.9) and lapses (mean difference=12.9 lapses, 95% CI 4.37-21.41, p < .001, Cohen's D=1.7) compared to women in the luteal phase. When melatonin was suppressed, women in the follicular phase had significantly better reaction time (mean difference=152.1 ms, 95% CI 43.88-260.3, p < .001, Cohen's D=1.7) and lapses (mean difference=12.3 lapses, 95% CI 1.14-25.6, p < .01, Cohen's D=1.6) compared to when melatonin was not suppressed, such that their performance was not different (p > .9) from women in the luteal phase. Subjective sleepiness did not differ by menstrual phase (mean difference=0.6, p > .08) or melatonin suppression (mean difference=0.2, p > .4)., Conclusions: Nighttime light exposure sufficient to suppress melatonin can also mitigate neurobehavioral performance deficits associated with the follicular phase. Despite the relatively small sample size, these data suggest that nighttime light may be a valuable strategy to help reduce errors and accidents in female shift workers., (Copyright © 2024 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Glioblastoma (GBM), the most aggressive astrocytic glioma, remains a therapeutic challenge despite multimodal approaches. Immunotherapy holds promise, but its efficacy is hindered by the highly immunosuppressive GBM microenvironment. This review underscores the urgent need to comprehend the intricate interactions between glioma and immune cells, shaping the immunosuppressive tumor microenvironment (TME) in GBM. Immunotherapeutic advancements have shown limited success, prompting exploration of immunomodulatory approaches targeting tumor-associated macrophages (TAMs) and microglia, constituting a substantial portion of the GBM TME. Converting protumor M2-like TAMs to antitumor M1-like phenotypes emerges as a potential therapeutic strategy for GBM. The blood-brain barrier (BBB) poses an additional challenge to successful immunotherapy, restricting drug delivery to GBM TME. Research efforts to enhance BBB permeability have mainly focused on small molecules, which can traverse the BBB more effectively than biologics. Despite over 200 clinical trials for GBM, studies on small molecule immunomodulators within the GBM TME are scarce. Developing small molecules with optimal brain penetration and selectivity against immunomodulatory pathways presents a promising avenue for combination therapies in GBM. This comprehensive review discusses various immunomodulatory pathways in GBM progression with a focus on immune checkpoints and TAM-related targets. The exploration of such molecules, with the capacity to selectively target key immunomodulatory pathways and penetrate the BBB, holds the key to unlocking new combination therapy approaches for GBM.

Retinoic acid receptor-related orphan receptor γt (RORγt) is a nuclear receptor found in various tissues that plays a crucial role in the differentiation and proliferation of T helper 17 (Th17) cells, as well as in their generation of the pro-inflammatory cytokine IL-17A. RORγt represents a promising therapeutic target for autoimmune diseases, metabolic disorders, and multiple tumors. Despite extensive research efforts focused on the development of small molecule RORγt modulators, no drug candidates have advanced to phase 3 clinical trials owing to a lack of efficacy or safety margin. This outcome highlights the unmet need to optimize small molecule drug candidates targeting RORγt to develop effective therapies for autoimmune and inflammatory diseases. In this study, we synthesized and evaluated 3-oxo-lithocholic acid amidates as a new class of RORγt modulators. Our evaluation entailed biophysical screening, cellular screening in different platforms, molecular docking, and in vitro pharmacokinetic profiling. The top compound from our study (3-oxo-lithocholic acid amidate, A2) binds to RORγt at an equilibrium dissociation constant ( K D ) of 16.5 ± 1.34 nM based on microscale thermophoresis (MST). Assessment of the efficacy of A2 in the cellular RORγt reporter luciferase assay revealed a half-maximal inhibitory concentration (IC 50 ) value of 225 ± 10.4 nM. Unlike 3-oxo-lithocholic acid, A2 demonstrated the ability to reduce the IL-17A mRNA expression levels in EL4 cells with RORγt expression using quantitative reverse transcriptase PCR (RT-PCR). Validation of the desirable physicochemical properties and stability of A2 sets the stage for the preclinical evaluation of this new class of RORγt modulators in animal models of autoimmune diseases., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Competing Interests: Competing interests: We have read and understood the BMJ policy on declaration of interests and declare no competing financial interests.

Background: Colorectal cancer (CRC) is the third most frequent and the second most fatal cancer. The search for more effective drugs to treat this disease is ongoing. A better understanding of the mechanisms of CRC development and progression may reveal new therapeutic strategies. Ubiquitin-specific peptidases (USPs), the largest group of the deubiquitinase protein family, have long been implicated in various cancers. There have been numerous studies on the role of USPs in CRC; however, a comprehensive view of this role is lacking., Aim: To provide a systematic review of the studies investigating the roles and functions of USPs in CRC., Methods: We systematically queried the MEDLINE ( via PubMed), Scopus, and Web of Science databases., Results: Our study highlights the pivotal role of various USPs in several processes implicated in CRC: Regulation of the cell cycle, apoptosis, cancer stemness, epithelial-mesenchymal transition, metastasis, DNA repair, and drug resistance. The findings of this study suggest that USPs have great potential as drug targets and noninvasive biomarkers in CRC. The dysregulation of USPs in CRC contributes to drug resistance through multiple mechanisms., Conclusion: Targeting specific USPs involved in drug resistance pathways could provide a novel therapeutic strategy for overcoming resistance to current treatment regimens in CRC., Competing Interests: Conflict-of-interest statement: Dr. Abdel-Rahman has nothing to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: HIV remains a global public health concern, and women continue to be disproportionately affected. Understanding the factors associated with pre-exposure prophylaxis awareness among women is crucial as an effective HIV prevention strategy., Objectives: We investigated the prevalence and associated factors of pre-exposure prophylaxis awareness among women in Burkina Faso., Design: This was a cross-section study that used population-based data., Methods: A total of 17,659 women of reproductive age (15-49 years) from the 2021 Burkina Faso Demographic and Health Survey were analyzed. Percentage and multivariable logistic regression model were used to examine the prevalence and factors associated with pre-exposure prophylaxis awareness., Results: The prevalence of pre-exposure prophylaxis awareness was 8.2% (95% confidence interval = 7.8%-8.6%). Women's age was positively associated pre-exposure prophylaxis awareness. Women with primary and secondary education had 39% and 48% higher odds of pre-exposure prophylaxis awareness, when compared with women with no formal education. The odds of pre-exposure prophylaxis awareness were 1.40 (95% confidence interval = 1.19-1.66) times higher among Christians when compared with the Muslims. Women who were exposed to mass media including newspaper or magazine, radio, TV, and Internet had higher odds of pre-exposure prophylaxis awareness, when compared with those without exposure to mass media channels. Women who have previously tested for HIV had 37% higher odds of pre-exposure prophylaxis awareness, when compared with those who have not been tested (adjusted odds ratio = 1.37; 95% confidence interval = 1.09-1.72)., Conclusion: This study found women's age, geographical region, education, religion, exposure to mass media channels, employment, and HIV testing to be associated with pre-exposure prophylaxis awareness. These findings can inform the development of targeted interventions and public health campaigns to increase awareness and practice to pre-exposure prophylaxis, particularly among key population.

Aim: The aim of the present study was to assess the stain removal ability and color stability of three distinct dentifrices on artificially stained enamel surface., Materials and Methods: This study included 75 intact, healthy premolars free of dental caries that were extracted during orthodontic therapy. The samples were allowed to dry for 6 hours after being submerged in the prepared tea solution for roughly 18 hours every day. Then this procedure was repeated for seven successive days. All samples were randomly divided into three experimental groups with 25 samples in each group. Group I: control dentifrice, group II: dentifrice containing hydrogen peroxide, group III: dentifrice containing papain and bromelain. A specially designed toothbrushing simulator was used to brush every sample in the relevant group. Using a spectrophotometer and a measurement program, color measurement was evaluated after staining process after 4 weeks and 8 weeks of teeth cleaning. Using a profilometer, the surface roughness values (Ra) were assessed., Results: After 8 weeks of brushing of stained samples, the color stability was better in dentifrice containing hydrogen peroxide (1.14 ± 0.11) followed by dentifrice containing papain and bromelain (1.22 ± 0.08) and control group (1.30 ± 0.09). And after 8 weeks of brushing of stained samples, the surface roughness was more in dentifrice containing hydrogen peroxide (0.237 ± 0.02) followed by dentifrice containing papain and bromelain (0.229 ± 0.13) and control group (0.207 ± 0.05)., Conclusion: The present study concluded that the dentifrice containing hydrogen peroxide showed a superior whitening effect on the stained enamel surface than dentifrice containing papain and bromelain and control dentifrice., Clinical Significance: The development of various dentifrice products has been greatly aided by the increased demand for an improved esthetic appearance. Teeth's natural color and any external stains that could accumulate on the tooth surface combine to determine a tooth's color. Additionally, the use of whitening dental pastes to remove external stains has grown in favor. With the development of these whitening toothpastes, dentifrices' ability to lessen or eliminate extrinsic dental stains has increased. How to cite this article: Mishra D, Kamath DG, Alagla M, et al . Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study. J Contemp Dent Pract 2024;25(1):68-71.

Objective: Equine herpes viruses (EHVs) are considered one of the most important respiratory pathogens in equids, resulting in serious outcomes for equine health worldwide. The objectives of the current research were the detection, molecular characterization, and isolation of EHV-1 and EHV-4 circulating within different equine populations in Egypt, either clinically or in apparently healthy horses., Material and Methods: A total of 120 field samples were collected, and DNA was extracted. Screening and typing of extracted DNA were done by consensus and conventional PCR assays for detection of EHV-1 and EHV-4, followed by sequencing and phylogenetic analysis to confirm the virus identity. Selected positive samples for both EHV-1 and EHV-4 were subjected to Madin-Darby bovine kidney (MDBK) cell lines for virus isolation., Results: The obtained results revealed that 58/120 (48%) samples were positive for EHVs. Typing of positive samples showed that EHV-1 was detected in (48/120) 40% of samples and EHV-4 was detected in (15/120) 12% of samples, while dual infection by both EHV-1 and 4 was detected in five samples., Conclusion: The current study revealed new data on the continuous circulation of EHV-1 and EHV-4 within equine populations in Egypt, and individual horses could be infected by multiple EHVs. In addition, latently infected horses are acting as potential reservoirs for frequent virus reactivation., Competing Interests: The authors manifested that they have no conflicts of interest., (Copyright: © Journal of Advanced Veterinary and Animal Research.)