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Abstract Microhabitat associated fishes are expected to be negatively affected by coral reef degradation, given that many species are coral dwellers. However, the factors underlying this negative impact and the spatial scale(s) at which it occurs are poorly understood. We explored how habitat quality metrics and host preferences influence fish abundance across multiple spatial scales, using the functionally important cleaner fish Elacatinus evelynae as a study species. We surveyed fish at 10 sites in Curaçao that varied in coral cover and health. At the microhabitat scale, we found that E. evelynae group size increases on large, healthy corals and on some coral host species, namely Montastraea cavernosa. We also found that, although E. evelynae can occupy at least 10 coral host species, it selectively inhabits just three corals: M. cavernosa, Colpophyllia natans, and Diploria labrynthiformis. Scaling up to explore goby abundance along 30‐m transects, we did not find a clear relationship between live coral cover and goby abundance. However, goby abundance was substantially higher at one location with elevated coral cover and a high relative abundance of E. evelynae host species. Collectively, these results confirm that E. evelynae abundance is impacted by reef health. They also indicate that the species' long‐term persistence may depend on both the maintenance of healthy coral hosts and the gobies' plasticity in host preferences on changing reefscapes. Cryptobenthic fishes such as E. evelynae play a vital role in the ecosystem and understanding drivers of their abundance is important as reefs face increased degradation.

Abstract Avoiding financial losses requires preventing catastrophic oil‐filled power transformer breakdowns. Continuous online transformer monitoring is needed. The authors use paper insulation to evaluate transformer health for continuous online transformer monitoring. The study suggests a new artificial intelligence method for estimating paper insulation residual life in oil‐immersed power transformers. The four artificial intelligence models use backpropagation‐based neural networks to predict paper insulation lifespan. Four primary transformer insulating paper failure indices—degree of polymerisation, 2‐furfuraldehyde, carbon monoxide, and carbon dioxide—form the basis of these models. Each model, including the backpropagation‐based neural networks, estimates paper insulation life using one failure index, along with moisture and temperature data. Optimisation techniques enhance hidden layer neurons and epoch count for improved performance. Results are validated against literature‐based life models, establishing a precise input–output correlation. This method accurately predicts the remaining useable life of power transformer paper insulation, enabling utilities to take proactive measures for safe and efficient transformer operation.

Abstract Objectives This bibliometric analysis aimed to evaluate the leading nations, authors, journals, institutes, highly cited publications, and most commonly used keywords concerning scientific publications based on root and root canal morphology using the CBCT. Material and Methods For this bibliometric analysis, an extensive search was carried out on September 25, 2023 using the Scopus database. Pertinent articles in the field were scrutinized after applying inclusion and exclusion criteria. Data were evaluated using Vosviewer and Microsoft Excel. Results A literature search revealed the initiation of scientific publication in 2008. Significant contributions made by Saudi Arabia, India, and China concerning the number of publications were seen. Similarly, Jazan University from SA was recognized as the leading institute. The Journal of Endodontics was the leading journal, while authors JNR Martins and G Gambarini produced the highest number of papers. Conclusions This bibliometric analysis demonstrated that scientific publications have increased tremendously since 2008. Significant contributions have been made by developing and developed nations. The Journal of Endodontics and Jazan University have been identified as the leading journal and institute.

Abstract Multi‐walled carbon nanotubes (MWCNTs) were successfully synthesized and functionalized by chemical vapour deposition and acid reflux methods, respectively. Chitosan (CTS) was prepared by a chemical extraction method from waste prawn shells. Various weight fractions of functionalized multi‐walled carbon nanotubes (f‐MWCNTs) have been used as reinforcing agent in CTS biopolymer matrix. Fourier transform infrared spectroscopy analysis was done, which confirms the presence of absorption bands of the various functional groups of chitin, CTS, and MWCNTs. Raman spectra revealed the quality of MWCNTs, the extent of their functionalization, and the quality of nanocomposites. The X‐ray diffraction analysis showed the distinctive peaks for f‐MWCNTs’ and also revealed the formation of CTS/f‐MWCNTs nanocomposites. Transmission Electron Microscopy (TEM) analysis also exhibited that the CTS/f‐MWCNTs nanoparticles have a well‐defined crystalline structure. The highest coercivity and magnetization (Ms) of the CTS/5%f‐MWCNTs nanocomposite are 602 Oe and 0.1202 emu/g, respectively that have been enhanced by 3.83 and 5.27 times compared to the pure CTS respectively. It showed that the conductivity is getting higher with the addition of f‐MWCNTs in the CTS matrix. CTS/5% f‐MWCNTs composites exhibit the highest conductivity than other composites and the conductivity of CTS/5% f‐MWCNTs composite is 4.0×10−4 S/m.

Abstract Background and Aim Non‐alcoholic fatty liver disease (NAFLD) is a growing concern, affecting about 45 million of the Bangladeshi population. There is a paucity of research on the economic burden of NAFLD. The study aims to estimate the cost of illness of NAFLD in Bangladesh. Methods In this prospective, cross‐sectional study, a total of 250 patients of NAFLD, non‐alcoholic steatohepatitis (NASH), and NASH cirrhosis were included from public and private hospitals. Costs of hospitalization, physician fees, investigation costs, expenditures on medical procedures, drugs; and nonmedical costs such as transport expenses and other informal payments (tips) were estimated. Results The overall cost per patient per evaluation was (16.90–46 942.00) USD. The cost in public and private hospitals was 384.76 and 1146.93 USD, respectively. The cost per patient of NAFLD was 157.91 (16.90–955.08) USD, and for NASH cirrhosis was 1783.80 (422.48–46 942) USD. The cost of illness increased to USD 281.18 for diabetics and 254.52 USD for hypertensive. If all the NAFLD patients are evaluated once in healthcare settings, the projected cost will be 7.11 billion USD. In NAFLD, cost for investigations, medicines, transportation, and consultation of physicians was 49.08%, 32.41%, 11.11%, and 6.67%, respectively. Conclusions NAFLD is causing a huge economic burden to the healthcare system. The cost of illness is increased with NASH cirrhosis. Overall, this study provides valuable insights into the economic burden of NAFLD in Bangladesh and emphasizes the several ways of intervention to reduce the cost by preventive measures and accessible healthcare for affected individuals.

Abstract Inherited metabolic disorders (IMDs) comprise a heterogeneous class of genetic disorders characterized by impaired biochemical functions in metabolism. However, incidences and outcomes of patients hospitalized with IMDs are largely unknown. We conducted a population‐based cohort study using nationwide in‐hospital claims data in Switzerland from 2012 to 2020. We assessed incidence rates of hospitalizations and hospital‐associated outcomes, stratified in five age groups (0–9, 10–19, 20–39, 40–59, and 60–90 years) and three types of IMDs (peptide, amine and amino acid metabolism disorders [AD], carbohydrate metabolism disorders [CD], fatty acid, and ketone body metabolism disorders [FD]). A total of 7293 hospitalizations with IMD were identified, of which 3638 had AD, 3153 CD, and 502 FD. Incidence rates for hospitalizations per 100 000 person‐years were highest under the age of 10 years across all types of IMDs (8.69 for AD, 5.73 for CD, 3.71 for FD) and decreased thereafter. In patients with AD and CD, hospitalization rates increased again in adults aged 60–90 years (7.28 for AD, 7.25 for CD), while they remained low in patients with FD (0.31). Compared to inpatients without IMD, adult IMD patients had a higher burden of hospital‐associated adverse outcomes including an increased risk of in‐hospital mortality, intensive care unit admission, mechanical ventilation, and longer length of hospital or intensive care unit stay. Incremental risk of 30‐day, 1‐year, and 2‐year hospital readmission was highest among children and adolescents with IMD.

Abstract Most of the vaccines that are effective against SARS‐CoV‐2 have used the following functional strategies: inactivated viruses, live attenuated viruses, viral vector‐based vaccines, subunit vaccines, recombinant proteins, and DNA/RNA vaccines. Among the vaccines that stimulate the host's immune system with the help of DNA are: undergoing Phase 2/3 trials including INO‐4800 (International Vaccine Institute; Inovio Pharmaceuticals), Symvivo, Canada‐COVID19 (AnGes, Inc.); GX‐19 (Genexine, Inc.). BNT162b2 and mRNA‐1273 vaccines were made by BioNTech/Pfizer/Fosun Pharma group and Moderna/NIAID group, respectively, which are considered as types of RNA vaccines. Vaccines that are based on the viral vector are AstraZeneca, Sputonium, and Johnson‐Jensen. Among the inactive viral vaccines, the following can be mentioned: CoronaVac (Sinovac) WIBP vaccine (Wuhan Institute of Biological Products, Sinopharm), BBIBPCorV (Beijing Institute of Biological Products, Sinopharm), BBV152/Covaxin (Bharat Biotech, ICMR, National Institute of Virology) And among the protein‐based/subunit vaccines, the following can be counted: NVX‐CoV2373: (Novavax); SCB‐2019 vaccine (Clover Biopharmaceuticals AUS Pty Ltd.); Covax‐19 (GeneCure Biotechnologies; Vaxine Pty Ltd.) mRNA vaccines, viral vector vaccines, and protein subunit vaccines cannot cause disease because these vaccines stimulate the immune system to produce antibodies against virus proteins instead of the virus itself (or its antigen). MRNA vaccines increase SARS‐CoV‐2 proteins and ultimately stimulate the production of T and B lymphocytes. The epidemic of HCoVs and their destructive and harmful effects on life has caused the scientific community to seek the production of an effective and efficient vaccine before its catastrophic release. We all need to know that none of us will be healed until the other is healed. The purpose of this review article is to present a selection of existing knowledge in the field of fighting and preventing the coronavirus.

Key Clinical Message Our case report demonstrates extremely uncommon data associated with MIS‐A, such as cholestatic jaundice, anemia, and quickly progressing pneumonia. IVIG and pulse steroid medications are the best treatments for improving clinical outcomes. Abstract We report a case of multiple organ dysfunctions due to MIS‐A in an adult with a history of suspected COVID‐19. Our case demonstrates extremely uncommon data associated with MIS‐A, such as cholestatic jaundice, anemia, and quickly progressing pneumonia. IVIG and pulse steroid medications are the best treatments for improving clinical outcomes.

Key Clinical Message Illustrating F‐quad helix with extension arms that simultaneously expand maxillary arch and rotate its central incisor adjacent to the alveolar cleft while aligning palatally ectopic canines. Incisor rotation occurred before alveolar grafting, while canine traction was performed after alveolar grafting. The construction of this appliance is shown in detail.

Abstract Although numerous works have been done, most of the studies in fault diagnosis are limited to single fault type at a time. Majority of the works reported in the literature do not extend the diagnosis of the root cause of the fault for simultaneous faults specifically in the distillation column. However, an industrial system is susceptible to more than one fault at a time, which may or may not be interrelated. These faults not only reduce the diagnosis performance but also increase the computational complexity of the diagnosis algorithm. In this work, therefore, a multiple kernel support vector machine (MK‐SVM) algorithm is proposed to diagnose simultaneous faults in the distillation column. In the developed MK‐SVM algorithm, multilabel approach based on various kernel functions has been utilized for the classification of simultaneous faults. Dynamic simulation of a pilot‐scale distillation column using Aspen Plus® is used for generating data in normal and faulty operation. Eight different fault types are considered, including valve sticking at reflux and reboiler, tray upsets, loss of feed flow, feed composition, and feed temperature changes. In the classification of simultaneous faults, a combination of two, three, and four faults is introduced for the performance evaluation of the proposed MK‐SVM algorithm. The result showed that the proposed MK‐SVM has a high fault detection rate (FDR) of 99.51% and a very low misclassification rate (MR) of 0.49%. The MK‐SVM–based classification is better with the F1 score of >97% for all combinations of faults. Moreover, it is observed that the proposed MK‐SVM shows better fault diagnosis for single, multiple, and simultaneous faults as compared to other established machine‐learning algorithms.

Abstract The performance of a multistage centrifugal compressor is highly influenced by the ambient conditions, especially during the summer seasons; their capacity shrinks and thus the power requirement for compression will increase. The prime cause of these constraints is the interstage cooling limitations. This study simulates various suction conditions of a multistage compressor on Aspen HYSYS® and suggests its debottlenecking by making the suction temperatures comparable to winter seasons. This is achieved by installing an additional exchanger at the downstream of each interstage cooler, cooling down the gas further by using absorption refrigeration chillers. These chillers are powered up by the waste heat recovered from the exhaust steam coming from the prime mover, steam turbine, of the same compressor. This modification will save a considerable amount of power (663 kW), net savings (Gross Savings – OPEX: 72 289 $/y), and reduce the carbon footprint (954 ton/y) of the overall process.

Objective: To find out the type of bacteria colonising the tracheostomy tube and to determine the antibiotic sensitivity pattern and resistance in patients who have had tracheostomy in intensive care unit (ICU) set up and to initiate proper empirical treatment in such patients. Methods: The study was a retrospective review of patients who underwent tracheostomy at Ministry of Health, Sur Hospital, Oman January 2005 and December 2015. The Hospital has 4 bedded pediatric intensive care unit (PICU) and 10 bedded adult ICU which is headed by consultant anaesthetists, consultant physicians, ICU trained nurses and respiratory therapists. All patients who required mechanical ventilation and were therefore subject to an orotracheal intubation and those who underwent a conventional tracheostomy were considered for inclusion. Patients who had been intubated in other hospitals or ICUs, other airways infection issues were excluded from this study. Data's were collected from computer based hospital management system, operation theatre and registers in Medical records department and entered in a preformed questionnaire before thorough analysis. The specimens for swab was obtained from the cut tracheostomy tube tips and the samples were sent to microbiology laboratory for isolation of the organism and obtain an antibiogram to know the susceptibility and resistance to antibiotics. Data were analyzed by Statistical Package for Social Sciences (SPSS, version 16, Chicago, Inc) and the values are reported as number (%). The commonest isolated organism was Pseudomonas followed by Acinetobacter. Results: During the ten year retrospective study, there were 108 patients included in our study with 56 males and 51 females. Fourteen different microorganisms were isolated during our study which included Pseudomonas aeruginosa (n = 39), Acinetobacter baumanii (n = 28), Klebsiella (n = 10) and coagulase negative staphylococcus (n = 6). The most commonest organisms in both genders was Pseudomonas aeruginosa closely followed by Acinetobacter baumanii. In children under age of 12, it was Pseudomonas aeruginosa and in adults the impending organism was Acinetobacter baumanii. In terms of antiobiograms, 89% of Acinetobacter, 38% of Staphylococcus aureus, 37% of Klebsiella and 54% of Proteus mirabilis were resistant to ciprofloxacin. These organisms were resistant to ceftazidime in 97%, 83%, 89% and 57% of the cases, respectively and resistant to imipenem in 7.4%, 18.2%, 1.8% and 8.1%. Conclusions: In summary, this study presents the most common microorganisms colonized from tracheostomy of hospitalized patients and their pattern of antibiotic resistance. As our study showed, Pseudomonas is the most common microorganism isolated from tracheostomy tube. Ciprofloxacin was also the most prevalent antibiotic revealing resistant pattern. Moreover, most of the microorganisms were sensitive to imipenem and pipracillin-tazobactam.

Abstract There is an urgent need for developing new immunosuppressive agents due to the toxicity of long‐term use of broad immunosuppressive agents after organ transplantation. Comprehensive sample analysis revealed dysregulation of FGL1/LAG‐3 and PD‐L1/PD‐1 immune checkpoints in allogeneic heart transplantation mice and clinical kidney transplant patients. In order to enhance these two immunosuppressive signal axes, a bioengineering strategy is developed to simultaneously display FGL1/PD‐L1 (FP) on the surface of small extracellular vesicles (sEVs). Among various cell sources, FP sEVs derived from mesenchymal stem cells (MSCs) not only enriches FGL1/PD‐L1 expression but also maintain the immunomodulatory properties of unmodified MSC sEVs. Next, it is confirmed that FGL1 and PD‐L1 on sEVs are specifically bound to their receptors, LAG‐3 and PD‐1 on target cells. Importantly, FP sEVs significantly inhibite T cell activation and proliferation in vitro and a heart allograft model. Furthermore, FP sEVs encapsulated with low‐dose FK506 (FP sEVs@FK506) exert stronger effects on inhibiting T cell proliferation, reducing CD8+ T cell density and cytokine production in the spleens and heart grafts, inducing regulatory T cells in lymph nodes, and extending graft survival. Taken together, dual‐targeting sEVs have the potential to boost the immune inhibitory signalings in synergy and slow down transplant rejection.

Objective: Choanal atresia is a rare congenital disorder due to failed recanalization of the nasal fossae during fetal development. This article focuses on our experience in dealing with choanal atresia and its management. Here we discuss the varied clinical symptoms that the patients presented with, the clinical tests and investigations that were specific in diagnosing this condition and surgical management of these cases with endoscopic transnasal choanaplasty with stenting and follow up topical Mitomycin C application. Material and methods: This is a retrospective study based on computerized medical record review of the patients born in Department of ENT of Sur Hospital between 2002 and 2017. The patients were assessed with detailed history, presentation of clinical symptoms and all underwent nasal endoscopy and CT scans for assessing the atretic type. These patients underwent transnasal endoscopic choanaplasty under general anesthesia using microdebrider and stented using endotracheal tube. The patients were regularly followed up for review with nasal endoscopy after discharge between 4th and 7th postoperative period. The parents were educated on nursing care and the stent was removed in 4 weeks, all patients had Mitomycin C applied to the neochoana and were on regular follow up for a year with no recurrence. Results: Fifteen patient records were analyzed, 10 females and 5 males, ages varying from newborns up to 14 years old. Unilateral to bilateral choanal atresia was 4:1 ratio and female-male showed 2:1 ratio. Right malformation was predominant in both sexes in unilateral atresia. Mixed imperforation (bone-membranous) was the most frequently observed type, followed by bone malformation. The commonest symptom during diagnosis was rhinorrhea and the least one was respiratory failure. Majority of cases were diagnosed by CT scans of sinuses. Around 10% patients presented with cardiac problems. None had restenosis in one year follow up. Conclusions: Neonates with acute respiratory insufficiency due to choanal atresia can be diagnosed with simple bedside tests like cold spatula test, less invasive tests like failure to pass intranasal catheter, CT scan. Surgical correction with endoscopic intranasal choanaplasty is the way to address this problem and could avoid radical palatal approach, less morbidity and high success rate. Keywords: Choanal atresia, Congenital, Stent

Background and objectives: An auricular pseudocyst is not uncommon in routine ENT clinical practice, it occurs when fluid accumulates between the intracartilaginous spaces of the auricle. Many treatment modalities have been proposed such as incision and drainage of the cyst, simple needle aspiration, tight bandaging with dental rolls, however recurrence and cosmetic problems are still noted in some cases. The aim of this article was to discuss our experience of surgical treatment of intractable auricular pseudocysts with marsupialisation, deroofing and anterior cartilage leaflet removal along with compression suture therapy. Materials and methods: Twenty patients were included in the study conducted at ENT department, Sur Ministry of Health Hospital between January 2012 and January 2014 after prior consent and ethical approval. Those following trauma and other pinna conditions like relapsing polychondritis were excluded from our study. The clinical appearances were noted and all patients underwent surgical deroofing with removal of anterior cartilage leaflet and compression suture therapy using buttons for two weeks. Results and observations: There were 8 males and 12 females out of the 20 and right sided pinna (n = 14) involvement in the region of the scaphoid fossa (n = 12) was more than the triangular fossa (n = 3) or conchal bowl involvement (n = 5). Mostly patients between 30 and 40 years of age were affected (Mean age of 37 years and standard deviation of 8). The overall success rate with deroofing and compression suture therapy was 98%. Conclusions: Auricular pseudocysts are not an uncommon condition affecting middle aged patients without identifiable etiology. Conservative modalities may be the first choice of treatment for auricular pseudocysts although varied recurrence and failure rates have been published in the literature. However, the deroofing surgical technique with anterior cartilage leaflet removal with compression suture therapy is a reliable and easy procedure which can achieve an acceptable appearance of the pinna without recurrence when conservative management fails or is refused by the patient. Keywords: Pinna, Pseudocyst, Surgical deroofing, Perichondritis

Abstract Acute kidney injury induced by nephrotoxic agents is common, increasing in incidence and associated with considerable morbidity and mortality in developing countries. MicroRNAs are stable biomarkers that can be detected in extracellular fluids. This systematic scoping review aims to describe published research on urinary and circulating microRNAs in toxic acute kidney injury in both animal and human studies. We conducted a literature search, using EMBASE and Medline, for articles on urinary and circulating microRNA in nephrotoxic injuries to February 2020. A total of 21 publications studied acute kidney injury from 12 different toxic agents. Cisplatin was the most common nephrotoxic agent (n = 10), followed by antibiotics (n = 4). There were no randomized controlled trials. An increase in urinary miR‐218 predicted acute kidney injury in six different studies, suggesting it is a promising biomarker for nephrotoxin‐induced acute kidney injury. There were many factors that prevented a more comprehensive synthesis of microRNA performance including highly variable models, no consistent protocols for RNA isolation, cDNA synthesis and PCR amplification, and variability in normalization methods using reference controls. In conclusion, while microRNAs are promising biomarkers to study nephrotoxic acute kidney injury, the replication of most positive findings is not assessable due to deficient reporting of negative outcomes. A very narrow range of poisons have been studied, and more human data are required. In particular, further studies are needed on the most important causes of nephrotoxic injury, such as pesticides, chemicals, snake envenoming, and medicines other than aminoglycosides and cisplatin.