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Abstract Ultrasonography with color Doppler is the most quantitative analysis method for intra-renal parameters. There is a wide variation between authors in the measurement site and referencing the inter-lobar resistivity index (RI) in felines. Our objective is to morphometrically and ultrasonographically investigate the normal renal dimensions and vasculatures and draw up a normal reference value for the renal inter-lobar artery resistivity index (RI) using a Pulsed wave-Doppler ultrasonography. A total of twelve adult domestic cats were sedated and treated according to IACUC regulation guidelines to be examined using Doppler ultrasound. The same cats were used for morphometric investigation and divided into three groups regarding the used technique. The size difference between the right and left kidneys is slight, measuring 17 g (weight), 3.65 ± 0.06 cm (length), 2.54 ± 0.08 cm (width), and 2.21 ± 0.03 cm (thickness) for the right kidney, and about 15 g, 3.42 ± 0.06 cm, 2.32 ± 0.05 cm, and 2.13 ± 0.03 cm for the left one, respectively. There are three patterns of renal arteries’ point of origin. The mean RI values of both kidneys were 0.57 ± 0.08 (0.50–0.67) in the right kidney and 0.60 ± 0.08 (0.51–0.69) in the left kidney. The gross examination and ultrasonography measurements did not have a statistically different effect on the actual renal dimensions. Moreover, 0.69 is considered the standard resistivity index (RI) threshold of the feline inter-lobar artery with no correlation to the animal’s body weight.

Abstract Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study’s main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections. Methods A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test. Results The prevalence of CT infections was 0.29% (95% CI, 0.10–0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results. Conclusions This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings. Trial registration: IRB no.: 17,400,017; WHO ERC Protocol Id. A66005.

Fish identification in the Red Sea, particularly in Saudi Arabia, has a long history. Because of the vast fish diversity in Saudi Arabia, proper species identification is required. Indeed, identifying fish species is critical for biodiversity conservation, food and drug safety, and sustainable fishery management. Numerous approaches have been used to identify fish species, including conventional morphological identification, next-generation sequencing (NGS), nanopore sequencing, DNA barcoding, and environmental DNA analysis. In this review, we collected as much scientific information as possible on species identification in Saudi Arabia. Our findings suggest that the identification process has advanced and spread rapidly and broadly, as evidenced by the discovery of new fish species in Saudi Arabia. The advantages and disadvantages of each method were discussed as part of a comprehensive comparison. This study aimed to provide further scientific knowledge to promote the growth of fish diversity worldwide.

The present study emphasizes the utilization ability of less expensive industrial waste adsorbents such as fly ash (FA) to adsorb heavy metals from wastewater r to remove its constituent pollutants, amazing eco-friendly technology guarantees benefits with the decrease in the formation of dangerous solid sludge. In the extended experimental work program: parameters such as pH, contact time, and adsorbent dosages were conducted. The results showed a remarkable treatment equilibrium time after two hours. From all the factors, the pH ranges from 5 to 8 significantly influenced the elimination of heavy metals removal efficiencies, and the highest achieved uptake efficiency during the whole three hours of the experiment period was found to be 93%, 90%, 85%, 79 %, 75 % and 70% for Cu, Fe, Ni, Zn, Pb, and Cd respectively with an optimum fly ash treatment dose of 15g/L. Based on several performance metrics and visual indicators, different predictive regression-based models for wastewater heavy metals removal efficiencies were developed and compared to the experimental data. The statistical validation indicators revealed that a high correlation was obtained. In addition, the experiment’s data were utilized using the Langmuir isotherm model. The results of adsorption data were highly satisfactory statistically match providence to Langmuir heavy metals kinetics removal with mean values of 8%, 11%, and 93% for Relative Mean Absolute Error (MAE) rel, Percent Bias (PBIAS), and Nash-Sutcliffe Efficiency (NSE) respectively.

Background and objective: More than 10% of patients with negative clinical metastatic status (cN0M0) on conventional imaging for prostate cancer (PCa) harbor lymph node involvement (pN+) at final pathology following radical prostatectomy (RP) and lymphadenectomy. Our aim was to assess outcomes of initial observation for cN0M0 pN+ PCa and identify prognostic factors that may help in clinical decision-making. Methods: We performed a retrospective multicenter study of patients with cN0M0 PCa on conventional imaging (computed tomography and/or magnetic resonance imaging, and a bone scan) who were found to have pN+ disease at RP between 2000 and 2021. Biochemical recurrence (BCR) and systemic progression/recurrence were the primary outcomes. Kaplan-Meier curves and Cox proportional hazards model were used for survival and multivariate analysis. Key findings and limitations: A total of 469 men were included in this retrospective multicenter trial. Median prostate-specific antigen (PSA) was 10.1 ng/ml (interquartile range [IQR] 6.6–18.0). Among these patients, 56% had grade group ≥4, 53.7% had stage ≥pT3b, 42.6% had positive margins, and 19.6% had PSA persistence. The median number of positive nodes and of nodes removed were 1 (IQR 1–3) and 20 (14–28), respectively. At median follow-up of 41 mo, 48.5% experienced BCR. The 5-yr BCR-free survival rate was 31.7% (95% confidence interval [CI] 26.33–37.1%). Salvage treatments were needed in 211 patients and included radiotherapy (RT; n = 53), RT + androgen deprivation therapy (ADT; n = 88), ADT alone (n = 68), and salvage lymphadenectomy (n = 2). The 5-yr estimated survival rates were 66.3% (95% CI 60.4–72.1) for metastasis-free survival, 97.7% (95% CI 95.5–99.8%) for cancer-specific survival, and 95.3% (95% CI 92.4–98.1%) for overall survival. On multivariable analysis, PSA persistence was an independent predictor of BCR (odds ratio [OR] 51.8, 95% CI 12.2–219.2), exit from observation (OR 8.5, 95% CI 4.4–16.5), and systemic progression (OR 3.0, 95% CI 1.771–4.971). Conclusions: Initial observation in the management of pN+ cN0M0 PCa is feasible and has excellent survival rates in the intermediate term. Patients with worse disease features, especially PSA persistence, have a higher likelihood of recurrence and progression and may be candidates for more aggressive upfront management. Patient summary: We investigated the value of initial observation for men with prostate cancer with negative scan findings for metastasis who were then found to have positive lymph nodes after surgery to remove the prostate. Our results show that initial observation is a good option for patients with less aggressive prostate cancer features.

Abstract Background Ventilator-associated pneumonia (VAP) is a challenging nosocomial problem in low- and middle-income countries (LMICs) that face barriers to healthcare delivery and resource availability. This study aimed to examine the incidence and predictors of VAP in Egypt as an example of an LMIC while considering death as a competing event. Methods The study included patients aged ≥ 18 years who underwent mechanical ventilation (MV) in an intensive care unit (ICU) at a tertiary care, university hospital in Egypt between May 2020 and January 2023. We excluded patients who died or were transferred from the ICU within 48 h of admission. We determined the VAP incidence based on clinical suspicion, radiological findings, and positive lower respiratory tract microbiological cultures. The multivariate Fine-Gray subdistribution hazard model was used to examine the predictors of VAP while considering death as a competing event. Results Overall, 315 patients were included in this analysis. Sixty-two patients (19.7%) developed VAP (17.1 per 1000 ventilator days). The Fine-Gray subdistribution hazard model, after adjustment for potential confounders, revealed that emergency surgery (subdistribution hazard ratio [SHR]: 2.11, 95% confidence interval [CI]: 1.25–3.56), reintubation (SHR: 3.74, 95% CI: 2.23–6.28), blood transfusion (SHR: 2.23, 95% CI: 1.32–3.75), and increased duration of MV (SHR: 1.04, 95% CI: 1.03–1.06) were independent risk factors for VAP development. However, the new use of corticosteroids was not associated with VAP development (SHR: 0.94, 95% CI: 0.56–1.57). Klebsiella pneumoniae was the most common causative microorganism, followed by Pseudomonas aeruginosa. Conclusion The incidence of VAP in Egypt was high, even in the ICU at a university hospital. Emergency surgery, reintubation, blood transfusion, and increased duration of MV were independently associated with VAP. Robust antimicrobial stewardship and infection control strategies are urgently needed in Egypt.

A network is an aggregation of nodes joined by edges, representing entities and their relationships. In social network clustering, nodes are organized into clusters according to their connectivity patterns, with the goal of community detection. The detection of community structures in networks is essential. However, existing techniques for community detection have not yet utilized the potential of the Fish School Search (FSS) algorithm and modularity principles. We have proposed a novel method, clustering with the Fish School Search algorithm and modularity function (FSC), that enhances modularity in network clustering by iteratively partitioning the network and optimizing the modularity function using the Fish School Search Algorithm. This approach facilitates the discovery of highly modular community structures, improving the resolution and effectiveness of network clustering. We tested FSC on well-known and unknown network structures. Also, we tested it on a network generated using the LFR model to test its performance on networks with different community structures. Our methodology demonstrates strong performance in identifying community structures, indicating its effectiveness in capturing cohesive communities and accurately identifying actual community structures.

Abstract Background Oculocutaneous albinism type1 (OCA1) is caused by the TYR gene's homozygous and compound heterozygous variants. TKFC gene variants cause triokinase & FMN cyclase deficiency syndrome with variable multisystemic disorders. Objectives To determine the potential disease-causing variants in two deceased patients presenting atypical OCA1 features by demonstrating three generations for a single family. The two deceased neonates had severe skeletal abnormalities and fatal hypertrophic cardiomyopathy. We also explored the potential mechanisms for the causative relationship between TKFC and multisystem disorders. Patients and methods Due to the new emerging symptoms that weren’t reported before with the TYR gene, the following methods were performed: Sanger sequencing for the TYR gene, followed by whole exome sequencing, co-segregation, and computational analyses. Results Extensive parental consanguinity was found, and consequently an autosomal recessive mode of inheritance was prioritized. Upon performing sequencing and segregation data, the following has been confirmed: positive co-segregation of nonsense homozygous NM_000372.5:c.346C > T p.(Arg116*) variant in TYR gene and multisystem disease-missense homozygous NM_015533.4:c.598G > A p.(Val200Ile) variant in TKFC gene in the two affected index patients who deceased due to hypertrophic cardiomyopathy. Using computational analysis, we found that c.598G > A p.(Val200Ile) pathogenicity has led to the failure of L2-K1 active site closure due to the potential differential fluctuation between valine and isoleucine residues. Subsequently, disruption of endogenous DHA phosphorylation was found. Two potential mechanisms exploring the causative relationship between TKFC gene and multisystem disorders have been suggested. Conclusions This study presented a first family with the co-existence of biallelic variants in TYR and TKFC genes associating severe skeletal abnormalities and lethal hypertrophic cardiomyopathy. Neither of these genes would have been pursued in the standard genetic counseling. Such discovery is paving the way for more efficient genetic counseling. Comparing TKFC results with literature data showed that our relevant expanded TKFC variant is the 3rd worldwide.

Abstract Background The use of IOUS is increasingly common in recent neurosurgical practice. IOUS has become very valuable in neurosurgery. It plays a key role in the localization of space-occupying lesion location and decreasing operation time and hence improves both surgical efficiency and safety. Ultrasound is very useful in the determination of the lesion location, its most superficial portion, and in differentiation between solid tumors and cystic components. Results Intraoperative ultrasonography has a significant edge over the other intraoperative aids for image guidance in brain surgery, especially in terms of independence, cost, and adaptability to multiple different clinical scenarios. Ultrasound-based neuro-navigation is an easy-to-use, fast, and safe technique of real-time imaging for various neurosurgical procedures. Conclusion We conclude that ultrasound-based neuro-navigation is an easy-to-use, fast, and safe technique of real-time imaging for various neurosurgical procedures.

Abstract Background Cardiac symptoms are a characteristic feature of chronic obstructive pulmonary disease (COPD), a disorder with lately achieved recognition as a systemic illness according to established standards. The research’s objective was aimed at investigating the transthoracic echocardiography role in assessing right ventricular (RV) dysfunction among individuals diagnosed with COPD, as well as to examine the potential correlation between blood pro B-type natriuretic peptide (BNP) concentrations + and this diagnostic procedure. Methods Arterial blood gasses, spirometry, echocardiography, and serum pro BNP were done for 80 COPD patients and 20 healthy smokers, and some echocardiographic parameters were correlated with degree of airflow limitation. Results 77.5% of COPD cases exhibited pulmonary hypertension (PHTN), and on classifying our COPD patients, it was found that 65% of patients in group II had PHTN and 90% of patients in group III had PHTN. Systolic pulmonary artery pressure (SPAP), mean pulmonary arterial pressure (MPAP), right ventricular mid diameter (RVMD), right ventricular basal diameter (RVBD), right ventricular longitudinal diameter (RVLD), right ventricular outflow tract (RVOT) above pulmonary and aortic valve, and tricuspid annular plane systolic excursion (TAPSE) along with RVEF exhibited a significant variance among all groups. A negative correlation was observed among forced expiratory volume (FEV) 1% and (RVMD as well as RVBD) and between Pro BNP and (TAPSE and RVEF). Conclusions PHTN was found in 77.5% of COPD patients and is negatively correlated with FEV1%. Serum pro BNP level exhibits a negative correlation with FEV1% in stable COPD patients.

This study presents a comprehensive investigation into the efficacy of advanced oxidation treatment methods, focusing on the photo-Fenton process for removing organic pollutants from wastewater. Despite prior research, significant knowledge gaps persist regarding the optimal operational conditions for maximizing pollutant removal efficiency. This manuscript fills those gaps through extensive batch experiments, meticulously evaluating the impacts of irradiation time, pH levels, and ferrous sulfate and hydrogen peroxide concentrations on treatment outcomes. Our results indicate that an irradiation time of 140 minutes and a pH of 3.1 are critical for achieving remarkable pollutant removal efficiencies: 91.57% for color, 85.14% for chemical oxygen demand (COD), and 79.87% for total organic carbon (TOC) over a 180-minute treatment period with optimal dosages. To further enhance understanding, we employed predictive models utilizing response surface methodology (RSM) and central composite design (CCD), rigorously assessing their statistical performance. The models demonstrated strong alignment with experimental data and existing literature, showcasing their reliability. This research not only provides novel insights into optimizing wastewater treatment processes but also holds significant practical value for industries aiming to implement effective strategies for mitigating organic pollution. By addressing critical knowledge gaps, this study lays a foundation for improved environmental remediation practices, offering a vital framework for industries committed to sustainable wastewater management.

Background and Study Aim. Chronic mechanical neck pain significantly impacts the quality of life and functional capacity of individuals, often necessitating long-term management strategies. Traditional stretching exercises are commonly prescribed, but their effectiveness compared to other interventions remains underexplored. The objective of this study was to compare the effectiveness of traditional stretching exercise regimens against thoracic spine and rib mobilization in patients with chronic mechanical neck pain. Material and Methods. This randomized controlled trial included 30 patients aged between thirty and fifty years, all suffering from mechanical neck pain. Patients were randomly assigned to one of two groups, with 15 in each group (Group A: n=15; Group B: n=15). Group A received thoracic spine mobilization coupled with standard passive stretching exercises, whereas Group B underwent a traditional stretching exercise regimen. Both groups were evaluated using the visual analogy scale for pain, active cervical range of motion (ROM), and chest expansion, both before and after a two-week therapy course. Results. Findings from this study were analyzed using a two-way mixed-model multivariate analysis of variance (MANOVA). The results showed no significant differences between Group A (thoracic spine mobilization and standard passive stretching) and Group B (traditional stretching regimen) regarding pain intensity, active cervical range of motion, and chest expansion after the two-week intervention period (p > 0.05). However, significant improvements were observed within each group across all measured outcomes, including reductions in pain intensity and increases in cervical range of motion and chest expansion (p < 0.001). Conclusions. The study confirms that both passive stretching exercises and thoracic spine mobilization are beneficial interventions for enhancing physical outcomes in patients with mechanical nonspecific neck pain. These approaches are equally effective in improving overall physical functionality, underscoring their value in therapeutic settings for neck pain management.

Abstract Background While many denture base materials are currently available on the market, little data exists regarding their dimensional stability after exposure to the oral environment. This study aimed to evaluate the effect of thermocycling on the trueness and precision of milled, 3-dimensional (3D)-printed, and conventional digitally fabricated complete denture bases (CDBs). Methods A completely edentulous maxillary stone model was scanned to generate a standard tessellation language (STL) file; this was imported into metal-milling-machine software (Redon Hybrid CAD-CAM metal milling machine, Redon, Turkey) to produce a metal model for fabricating 30 CDBs. These were divided into three groups (n = 10 in each) according to the construction technique: group 1, CAD-CAM milled CDBs; group 2, 3D-printed CDBs; and group 3, conventional compression molded CDBs. All CDBs were scanned after fabrication and evaluated before and after thermocycling using superimposition. The data were analyzed using a one-way ANOVA, Tukey’s post hoc test, and a paired t-test. Results The level of trueness between the CAD-CAM milled, 3D-printed, and compression molded CDBs showed significant differences before and after thermocycling (P

This study presents a novel approach to integrating combined cooling, heating, and power (CCHP) systems with water desalination for enhanced energy and water management in educational buildings. Two distinct layouts for CCHP and desalination systems are introduced: one prioritizing efficient power generation to meet electricity demands while providing waste heat for desalination, and the other focusing on balancing cooling and heating loads alongside water desalination. Both layouts are tailored to meet the building's energy and water demands while considering operational efficiency. Optimization of these layouts against traditional systems using the bat search algorithm emphasizes economic viability and the gas engine's operational flexibility, which are crucial for partial load operation. In addition, an environmental assessment compares the proposed CCHP-desalination systems with conventional setups, assessing CO2 emission reductions and overall sustainability. The evaluation encompasses key environmental metrics, such as resource consumption and the integration of renewable energy sources. Results highlight significant CO2 emission reductions across various gas engine capacities, with notable enhancements in economic and environmental performance achieved by selecting a 3,250 kW gas engine within the CCHP-desalination system. This choice not only maximizes the annual profit but also reduces CO2 emissions by 57% compared to conventional systems, underscoring the system's sustainability benefits. HIGHLIGHTS This study introduces a novel approach to integrate CCHP systems with water desalination specifically tailored for use in educational buildings.; Two distinct layouts for CCHP and desalination systems are introduced in the article, each tailored to meet the building's energy and water demands while considering operational efficiency.;

Omima Mohammed Ali Omima Mohammed,1 Omaima Abdel Majeed Mohamed Salih,2 Islamia Ibrahim Ahmed Omer,3 Yousra Ibrahim Abdallah Mohammed,4 Omer A Mohammed,4 Ammar Elgadi,4 Lina Hemmeda,4 Walaa Elnaiem,4 Malaz Tarig Abdalla Mohamed,4 Areeba Ahsan,5 Khabab Abbasher Hussien Mohamed Ahmed4 1Department of Pediatrics and Child Health, Mohamed Alamin Hamid Tertiary Pediatric Hospital, Omdurman, Sudan; 2Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Omdurman, Sudan; 3Pediatrics and Child Health Department, College of Medicine, Sulaiman Al Rajhi University, Al-Bukayriyah, Qassim Province, Saudi Arabia; 4Faculty of Medicine, University of Khartoum, Khartoum, Sudan; 5School of Health Sciences, Foundation University, Islamabad, PakistanCorrespondence: Khabab Abbasher Hussien Mohamed Ahmed, Email khabab9722@gmail.comBackground: Asthma is one of the most common non-communicable diseases. Childhood asthma has been increasing in Sudan, with a 13– 16% prevalence among Khartoum school children. To achieve and maintain good asthma control, proper diagnosis, assessment of severity, and appropriate medication administration are crucial, with phenotyping being a key factor in determining patients’ specific treatment.Objective: To study the frequency of severe asthma and the distribution of its different phenotypes and to investigate associations between age and gender and different phenotypes of asthma.Methodology: This descriptive cross-sectional hospital-based study was conducted in the Asthma Clinic of Mohamed Al-Amin Hamid Pediatrics Hospital. It included 229 patients who were presented to the clinic from September 2021 to April 2022. Data were collected from the patients and/or their caregivers using a modified validated standard questionnaire and were analyzed using SPSS version 26.0. A p-value of 0.05 or less was considered statistically significant.Results: In this study of 229 participants, 14.4% had severe asthma, with 44.5% and 41% exhibiting mild and moderate asthma, respectively. Most were effectively managed in steps 2 or 3. The cohort, primarily aged 5 or younger (40.2%) with a male majority (62%), showed a mean diagnosis age of 2.9 ± 2.8 years. Impressively, 90% maintained well-controlled asthma. Within severe asthma cases (87% atopic), 39.4% represented a severe allergic asthma phenotype. Elevated eosinophil counts were noted in 45.5% (serum) and 78.8% (sputum cytology), while 57.6% had normal serum IgE levels. The predominant symptom pattern in severe asthma was episodic multi-trigger wheezing (48.5%). Age and gender displayed no significant association with severe asthma phenotype.Conclusion: This study reveals a concerning rise in childhood asthma prevalence in Sudan, emphasizing the importance of tailored treatment strategies. Severe asthma, characterized by atopic eosinophilic involvement, necessitates targeted interventions in pediatric asthma care for specific phenotypes.Keywords: asthma, pediatrics, respiratory system, chronic obstructive pulmonary diseases, Sudan

Abstract Background Extracorporeal membrane oxygenation (ECMO) has been presented as a potential therapeutic option for patients with cardiogenic shock complicating myocardial infarction (CS-MI). We aimed to investigate the efficacy and safety of ECMO in CS-MI. Methods A systematic review and meta-analysis synthesizing evidence from randomized controlled trials obtained from PubMed, Embase, Cochrane, Scopus, and Web of Science until September 2023. We used the random-effects model to report dichotomous outcomes using risk ratio and continuous outcomes using mean difference with a 95% confidence interval. Finally, we implemented a trial sequential analysis to evaluate the reliability of our results. Results We included four trials with 611 patients. No significant difference was observed between ECMO and standard care groups in 30-day mortality with pooled RR of 0.96 (95% CI: 0.81–1.13, p = 0.60), acute kidney injury (RR: 0.65, 95% CI: 0.41–1.03, p = 0.07), stroke (RR: 1.16, 95% CI: 0.38–3.57, p = 0.80), sepsis (RR: 1.06, 95% CI: 0.77–1.47, p = 0.71), pneumonia (RR: 0.99, 95% CI: 0.58–1.68, p = 0.96), and 30-day reinfarction (RR: 0.95, 95% CI: 0.25–3.60, p = 0.94). However, the ECMO group had higher bleeding events (RR: 2.07, 95% CI: 1.44–2.97, p

Abstract Background Since the onset of the COVID-19 pandemic, multiple studies have reported a bidirectional between COVID-19 and dysfunction of the thyroid gland. These studies have identified various forms of thyroid dysfunction that have been found to affect the severity and outcome of COVID-19 infection. However, the data from these studies have been inconsistent and conflicting. Our objective was to assess the prevalence of various types of thyroid dysfunction among moderate to severe cases of COVID-19 pneumonia. In addition, the study aimed to evaluate the outcome of thyroid dysfunction after recovery from COVID-19 infection. Patient and methods In this observational prospective study data on the clinical features of individuals with moderate to severe COVID-19 pneumonia who were admitted to Zagazig University isolation hospitals from April to December 2022 and their laboratory results were gathered and examined. Thyroid function tests, including TSH, FT3, and FT4, were conducted for all patients upon admission. Follow-up testing was performed on patients who initially had aberrant thyroid lab results 90 days after recovering from COVID-19 infection. Results The study comprised a total of 136 patients who had moderate (44.1%) to severe (55.9%) COVID-19 infection. Sick euthyroid syndrome was the most prevalent form of thyroid dysfunction, accounting for 58.7% of patients with thyroid disorders on admission. After 90 days of post-COVID-19 examination, thyroid dysfunction recovery was observed in 61% of cases. A statistically significant correlation was noted between the severity of COVID-19 and the levels of TSH, free T3, and the ratio of free T3 to T4. A large percentage of patients who showed complete recovery had sick euthyroid syndrome. All patients diagnosed with primary hypothyroidism maintained their hypothyroidism condition, whereas those with hyperthyroidism showed complete recovery. Conclusion COVID-19 patients may experience several patterns of thyroid dysfunction, including nonthyroidal illness syndrome. These dysfunctions are associated with the intensity of the inflammatory response and the severity of the COVID-19 infection. Nevertheless, these alterations are predominantly reversible upon recovery from a COVID-19 infection.

Abstract Live bird markets (LBMs) are considered hotspots for Avian Influenza Viruses (AIVs). In such markets, AIVs pose threats to both poultry and public health. Within LBMs, AIVs spread through various routes, including direct contact, environmental contamination, and aerosol transmission. Unique factors in Egyptian LBMs, such as the coexistence of wild and domestic birds, increase transmission risks between birds as well as spill-overs into exposed humans. Understanding the transmission dynamics of AIVs is vital for implementing effective control measures. We conducted a study in four Egyptian LBMs located in Mediterranean coast cities from November 2021 to March 2023. In this study we tested 3,971 samples from poultry, wild birds, and the environment, out of which 692 (17.4%) were positive for AIV. Poultry exhibited a higher prevalence (42.2%) than wild birds (34.4%). Environmental samples, including water (30.8%), surfaces (17.2%), and air (18.2%), also tested positive for AIV. Diverse AIV subtypes, including H5N1, H9N2, H5/H9 co-infection, and H5N8, were detected among avian species and the environment. Temporal analysis revealed fluctuating IAV positivity rates from November 2021 to March 2023. These results emphasize the importance of continuous surveillance, resource allocation, and multisectoral collaboration to protect poultry and human health, and prevent novel influenza strains’ emergence in Egyptian LBMs.

Abstract Background Recently, trials have supported changes in deep caries management. However, reporting might lack details, affecting interpretation and implementation. Thus, we aimed to evaluate the adherence to the CONSORT statement and the risk of bias of randomized controlled trials (RCTs) on deep caries management published in pediatric dental journals. Methods We searched PubMed for RCTs in six pediatric dental journals between 2010 and 2022, focusing on deep caries lesion management. Adherence to the CONSORT guideline and the risk of bias were assessed using a modified tool with 19 items; each scored from 0 to 2 (maximum of 38 points), and the Cochrane risk-of-bias (RoB 2) tool. We performed descriptive and regression analyses (α = 5%). Results We analyzed 127 RCTs. The mean (standard deviation) CONSORT adherence score was 21.1 (6.7). Notably, 96.1% of the studies received a score of 2 for the "intervention" item, whereas 83.5% scored 0 for the "estimated effect size”. The risk of bias assessment revealed that 40.2% of the RCTs were at high risk, 59% were at low risk, and 0.8% were at low risk. RCTs with a high risk of bias had lower CONSORT scores (p

Abstract Diabetic nephropathy represents one of the main long-term complications in T2DM patients. Cigarette smoking represents one of modifiable renal risk factors to kidney damage due to lead (Pb) exposure in these patients. Our goal is to investigate serum copeptin and Kidney injury molecule-1 (KIM-1) and urinary lead (UPb) in type 2 diabetes mellitus (T2DM) patients even smokers and non-smokers groups and compared to corresponding health controls and assess its associations with Angiotensin-Converting enzyme Insertion/Deletion polymorphism [ACE (I/D)] polymorphism in diabetic nephropathy progression in those patients. In present study, 106 T2DM patients and 102 healthy control individuals were enrolled. Serum glucose, copeptin, KIM-1, total cholesterol (TChol), triglycerides (TG), estimated glomerular filtration rate (eGFR) and UPb levels and ACE (I/D) polymorphisms were assessed in both groups. Results mentioned to significant variations in all parameters compared to in T2DM group compared to control group. Serum copeptin and UPb demonstrated significant difference in diabetic smokers (DS) and diabetic non-smokers (DNS) groups while KIM-1 exhibited significant change between DNS and healthy control non-smokers (CNS) groups. Positive relation was recorded between serum glucose and KIM-1 while negative one was found between serum copeptin and TChol. D allele was associated with significant variation in most parameters in T2DM, especially insertion/deletion (ID) polymorphism. ROC curve analysis (AUC) for serum copeptin was 0.8, p

While existing research has extensively explored the individual impacts of energy consumption, industrialization, and urbanization on environmental sustainability, there remains a notable gap in understanding the synergistic effects of these factors within the context of rapidly developing regions, such as Somalia. Therefore, this study explores the impacts of energy consumption, industrialization, and urbanization on environmental sustainability in Somalia from 1990 to 2020. The long-run linkage among the variables of the study was confirmed using the bounds-testing approach. The findings from the ARDL model indicate that economic growth, energy consumption, and trade openness significantly exacerbate environmental pollution in Somalia in the short- and long-run. Conversely, while industrialization and urbanization reduce environmental pollution both the short- and long-run, urbanization does not demonstrate a statistically significant impact. The long-run findings of the study were validated using the DOLS and FMOLS approaches. The Granger causality analysis reveals unidirectional causalities from environmental pollution to GDP per capita, industrialization, and trade openness, as well as from energy consumption to environmental degradation. However, no causal linkage is detected between urbanization and environmental pollution within Somalia. Based on the results of the study, we propose the promotion of renewable energy sources, green industrialization strategies, urban planning and sustainable development, and enhanced monitoring and regulation to effectively address environmental degradation.

The experimental study presented in this research was conducted to understand the performance of rubberized concrete columns under axial loads and numerically analyze the conduct of rubberized reinforced concrete (RRC) columns under cyclic loads. Twelve large-scale columns with square and circular cross sections were utilized to carry out experimental testing. Under axial loading, fine aggregate was replaced in percentages of 0%, 10%, and 15% with crumb rubber (CR). Square RRC columns were examined by a finite element program (ABAQUS) under cyclic loading. The experimental results indicated that the columns with crumb rubber had a lower load capacity than those without crumb rubber when exposed to axial loads. The numerical results were in good alignment with the experimental results, indicating that the simulated model may simulate the behavior of rubberized concrete columns under both axial and cyclic loads. According to the numerical analyses, the lateral displacement was significantly improved for rubberized reinforced concrete columns with 10% and 15% replacement of fine aggregates compared to columns without CR. Adding 10% and 15% of crump rubber to the fine aggregate in reinforced concrete columns increased the displacement ductility. The equivalent viscous damping ratio was enhanced by 33.67% when increasing crumb rubber (CR) from 0% to 10%, and when crumb rubber (CR) replacement became 15%, the damping ratio increased to 44.02%.The rubberized reinforced concrete columns showed a more ductile reaction than the traditional reinforced concrete columns, as evidenced by their softer post-peak response.

Background: Feed additives are products used in poultry nutrition to improve the quality of feed and safety of food byproducts from animal origin. They are promising antibiotic alternatives for production of broilers. Aim: This study aimed to investigate the effect of sodium butyrate (SB) and rosemary leaves (RL) on growth performance, biochemical profile, immunity, and carcass traits of broilers. Methods: Five hundred-one-day old chicks of Hubbard breed were reared on floor pens in a privet farm, Giza. The chicks were weighed on arrival (each chick weighted 43-45 gm) and randomly assigned into five equal groups, with four replicates each (25 chicks/replicate). Group 1 was fed on a broiler diet without any additions (control). The diets of groups 2 and 3 were supplemented with 500 g/ton SB and 4 kg/ton RL, respectively. In group 4, the diet was enriched with 250g/ton SB plus 2 kg/ton RL. Chicks in group 5 were fed on diet fortified with 500 g/ton SB plus 4 kg/ton RL. Results: Supplementation of broiler diet with 500 g/ton SB plus 4 kg /ton RL increased Body weight gain (BWG) and feed efficiency ratio (FER) of birds. It decreased serum levels of aspartate aminotransferase, alanine aminotransferase, total cholesterol triglycerides, malondialdehyde, but increased superoxide dismutase, catalase, and immunoglobulins, phagocytic activity, lysozyme activity, and nitric oxide concentrations. Antibody titers against Newcastle disease virus were also elevated. Conclusion: Supplementation of broiler diet with 500 g/ton SB plus 4 kg/ton RL gives the best result regarding productive efficiency and immunity of broiler chickens. [Open Vet J 2024; 14(5.000): 1243-1250]

Introduction: The aluminum and vanadium contents of the titanium-aluminum-vanadium alloy (Ti-6Al-4V) surface are known to have cytotoxic effect, the use of laser grooving was thought to produce dental implants-controlled surface roughness and a better surface chemical composition. Aims: The aim of the current work was to test the titanium alloy machined and laser grooves surface content of the aluminum and vanadium, and their effect on cellular viability. Materials and Methods: Threaded titanium dental implants were designed, milled and micro-grooved using the Avia coherent pulsed ultraviolet laser and produced 10 µm grooves on their machined surface. The scanning electron microscope was used to evaluate the produced micro-grooves, and the X-ray diffraction to study the surface composition of the titanium alloy before and after laser grooving. And the MC3T3-E1 mouse osteoblasts were cultured on such surfaces to test their cytotoxic effect. Results and Discussion: The laser grooving significantly reduced the alloy surface content of the aluminum and vanadium as proved by the significantly better viability of the cells cultured on it as compared to the machined surface. Conclusion: The laser grooving reduced the Ti-6Al-4V alloy surface content of the cytotoxic elements.

Abstract Background Although the efficacy and safety of epidural block (EB) are fairly high, complications such as inadvertent dural puncture may limit its use. Ultrasound-guided quadratus lumborum block (QLB) is a relatively new regional technique that provides perioperative somatic and visceral analgesia for pediatric patients. This trial compared the quality of pain relief in pediatric patients undergoing abdominal surgery who received either QLB or EB. Methods Patients were randomly allocated into two equal groups: Group E(n = 29): received EB; Group QL(n = 29): received QLB. Both groups were injected with 0.25% bupivacaine (0.5 ml/kg). Assessment of total analgesia consumption was the primary outcome measure, whereas the secondary outcome measures were assessment of postoperative analgesic effect by Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) and time of first analgesic request. Results Our study showed that the mean total fentanyl consumption was comparable between both groups(38.67 ± 5.02 and 36.47 ± 5.13 µg in the E and QL groups, respectively, P = 0.246). Only five patients did not require rescue analgesia (3 in the E group,2 in the QL group, P = 0.378). The mean duration of analgesia showed no significant difference between the two groups (9.9 ± 1.58 and 11.02 ± 1.74 h in the E and QL groups, respectively, P = 0.212). Evaluation of CHEOPS score values immediately in PACU and for the initial 24 h following operation showed no significant difference between the two study groups(P > 0.05). Conclusion QLB can achieve analgesic effects comparable to those of EB as a crucial part of multimodal analgesia in children undergoing abdominal surgeries. Clinical trial registration number PACTR202203906027106.

Abstract Background Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma (NHL), constituting 31% of all NHL. Malignancy and inflammation are closely linked. Inflammatory processes have been identified to play an important role in the pathogenesis of lymphoma. Obesity is a well-known risk factor not only for the development of cardiovascular disease and diabetes but also for the development of several types of cancer, including lymphomas. Objective To find out the association of pan-immune-inflammation value (PIV) and body mass index (BMI) with survival in adults with diffuse large B-cell lymphoma. Patients and methods We conducted an observational retrospective study on 110 patients to unravel the association of PIV and BMI with survival outcome in a cohort of adults diagnosed as de novo DLBCL (NOS) and treated at the hematology units of International Medical Center, Helwan and Menoufia University Hospitals, in the period from 2014 to 2018. Results The mean age of the studied patients was 54.27 years, the mean BMI was 28.91, and the median and IQR for PIV were 195.84 (96.20–498.52). The cutoff value for detecting mortality in BMI was 29.74 kg/m2 with poor sensitivity (44.4%) and poor specificity (67.2%). The cutoff value for detecting mortality in PIV was 250.49 with poor sensitivity (50.0%) and poor specificity (67.2%). The mean duration of overall survival was 21.596 months. There was nonsignificant difference regarding 2-year overall survival according to BMI grouping (p-value = 0.195) and PIV grouping (p-value = 0.275). Conclusion Neither PIV nor BMI were associated with 2-year overall survival in patients with DLBCL.

Abstract Background Measurement of the circulating levels of long-non-coding RNAs (lncRNAs) in lupus nephritis (LN) patients could dramatically explore more insights about the disease pathogenesis. Hence, we aimed to quantify the level of expression of CTC-471J1.2 and NeST in LN patients and to correlate it with the disease activity. Method This case-control study was conducted on a group of children with juvenile LN attending to Mansoura University Children’s Hospital (MUCH). Demographics, clinical, and laboratory findings were collected besides the measurement of lncRNAs by quantitative real-time PCR. Results The expression level of lncRNAs-CTC-471J1.2 was significantly down-regulated in children with active LN versus inactive cases or controls. In contrast, the NeST was significantly up-regulated in active LN cases. A significant correlation was found between CTC-471J1.2 expression and LN activity parameters. Additionally, both lncRNAs showed a reasonable sensitivity and specificity in differentiation of active LN. A regression analysis model revealed that CTC-471J1.2 and NeST were independent predictors of active nephritis. Conclusion The expression level of circulatory lncRNAs-CTC-471J1.2 and NeST can be used as sensitive and specific biomarkers for active LN. Furthermore, both could serve as predictors for nephritis activity.

Abstract The emergence of microgrids arises from the growing integration of Renewable Energy Resources (RES) and Energy Storage Systems (ESSs) into Distribution Networks (DNs). Effective integration, coordination, and control of Multiple Microgrids (MMGs) whereas navigating the complexities of energy transition within this context poses a significant challenge. The dynamic operation of MMGs is a challenge faced by the traditional distributed hierarchical control techniques. The application of Artificial Intelligence (AI) techniques is a promising way to improve the control and dynamic operation of MMGs in future smart DNs. In this paper, an innovative hybrid optimization technique that originates from Cheetah Optimization (CHO) and Particle Swarm Optimization (PSO) techniques is proposed, known as HYCHOPSO. Extensive benchmark testing validates HYCHOPSO’s superiority over CHO and PSO in terms of convergence performance. The objective for this hybridization stems from the complementary strengths of CHO and PSO. CHO demonstrates rapid convergence in local search spaces, while PSO excels in global exploration. By combining these techniques, the aim is to leverage their respective advantages and enhance the algorithm's overall performance in addressing complex optimization problems. The contribution of this paper offering a unique approach to addressing optimization challenges in microgrid systems. Through a comprehensive comparative study, HYCHOPSO is evaluated against various metaheuristic optimization approaches, demonstrating superior performance, particularly in optimizing the design parameters of Proportional-Integral (PI) controllers for hierarchical control systems within microgrids. This contribution expands the repertoire of available optimization methodologies and offers practical solutions to critical challenges in microgrid optimization, enhancing the efficiency, reliability, and sustainability of microgrid operations. HYCHOPSO achieves its optimal score within fewer than 50 iterations, unlike CHO, GWO, PSO, Hybrid-GWO-PSO, and SSIA-PSO, which stabilize after around 200 iterations. Across various benchmark functions, HYCHOPSO consistently demonstrates the lowest mean values, attains scores closer to the optimal values of the benchmark functions, underscoring its robust convergence capabilities.the proposed HYCHOPSO algorithm, paired with a PI controller for distributed hierarchical control, minimizes errors and enhances system reliability during dynamic MMG operations. Using HYCHOPSO framework, an accurate power sharing, voltage/frequency stability, seamless grid-to-island transition, and smooth resynchronization are achieved. This enhances the real application's reliability, flexibility, scalability and robustness.

Background: Endoscopic ultrasound-guided biliary drainage is widely accepted due to its high success rate, minimal need for re-intervention, and low incidence of pancreatitis. Our objective was to investigate the feasibility, efficacy, and outcomes of primary EUS-guided choledochoduodenostomy (EUS-CDS) compared to endoscopic retrograde cholangiopancreatography (ERCP) in patients with malignant distal biliary obstruction (MDBO). Methods: In this prospective multicenter study conducted between May 2021 and April 2023, patients with unresectable MDBO were assigned to either EUS-CDS or ERCP. Technical and clinical success were the primary endpoints. Results: A total of 73 patients at three tertiary centers were enrolled, of whom 37 underwent EUS-CDS and 36 underwent ERCP. Pancreatic cancer was present in 62 patients (84.9%). The technical and clinical success rates were comparable (97.3% and 97.2% for EUS-CDS vs. 94.4% and 100% for ERCP, respectively), with nearly the same procedure duration (P = 0.982) and with no significant difference in adverse events between both groups. Pancreatitis occurred in one patient after ERCP. Short-term re-intervention (within 3 months) was only required in two patients in the EUS-CDS group. Conclusion: Primary EUS-CDS—even in developing countries—is feasible, with comparable safety and non-inferior efficacy to ERCP for palliation in MDBO cases if a highly experienced team is present.

Introduction: Single-implant Overdentures (1IODs) have gained popularity as a more economical protocol than Two-implant Overdentures (2IODs). However, concerns have existed about the longevity of using a single implant compared to two implants. Aim: To investigate the marginal bone loss and stress distribution around dental implants assisting 1IODs compared to 2IODs within five years of clinical service. Materials and Methods: This randomised clinical trial was conducted at the Department of Prosthetic Dental Sciences, College of Dentistry of Qassim University in the Kingdom of Saudi Arabia from June 2018 to September 2023. Total 40 completely edentulous male patients, aged 50 to 60 years, were blindly allocated to two groups. Group I included 20 patients who received two implants at the canines’ regions, and Group II included 20 patients who received one implant under their mandibular overdentures at the midline of the mandible. The implants in both groups were followed up immediately after loading, at six and 12 months, three years, and five years for probing depth, mobility, and vertical bone loss. Finite Element Analysis (FEA) was used for stress analysis around the implants. One-way Analysis of Variance (ANOVA) and Mann-Whitney tests were used for statistical analysis at a significance level of p

Abstract Background & aims Eosinophilic ascites is non-common and challenging disease. This study aimed to describe the clinical presentation and treatment of eosinophilic ascites. Methods This was a prospective single-center study that included cases with eosinophilic ascites who were admitted to Tropical Medicine and Gastroenterology Department, Assiut University Hospital, Assiut, Egypt, during the period between May 2020 to May 2023. The clinical presentation, investigations, treatment, and follow-up data of the included patients were collected and analyzed. Results Seventeen cases of eosinophilic ascites were included in the study. The main presenting manifestations were abdominal pain (47.1%), and abdominal pain with distension (29.4%). Two patients presented with a picture of intestinal obstruction. Moderate ascites was found in 10 patients (58.8%) by ultrasound. Eosinophilia in the peripheral hemogram was detected in 76.5% of the study population. Endoscopic examination showed gastro-duodenitis in 9 patients (52.9%) and duodenitis in 4 patients (23.5%). All patients showed complete improvement and disappearance of ascites after starting steroids within two weeks. Eleven patients (64.7%) relapsed after discontinuation of steroids. Conclusion Eosinophilic ascites is an uncommon cause of ascites that is often underdiagnosed. The relapse rate after stopping treatment is high but with excellent response to retreatment.

Iman Bashir Hamid Abashar,1,&ast; Omaima Abdel Majeed Mohamed Salih,2,&ast; Tarteel Abbas Abaker Joda,3,&ast; Mai Fathi Awadalla Alsedig,3,&ast; Alaa T Omer,3,&ast; Hayat A Ahmed,3,&ast; Lina Hemmeda,3,&ast; Mariam Alazraa M Esmaeel,3,&ast; Khabab Abbasher Hussien Mohamed Ahmed3,&ast; 1Asthma Clinic Mohammed Alamin Hamid Pediatric Hospital, Omdurman, Sudan; 2Departments of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Omdurman, Sudan; 3Faculty of Medicine, University of Khartoum, Khartoum, Sudan&ast;These authors contributed equally to this workCorrespondence: Mariam Alazraa M Esmaeel, Faculty of Medicine, University of Khartoum, ElQasr Avenue, Khartoum, Khartoum State, 11111, Sudan, Tel +249915077027, Email mariamrashad17@gmail.comBackground and Aims: It is essential to have proper treatment and management for asthma in order to minimise symptoms, lessen the burden, and lower the chance of exacerbations. To better control asthma, the purpose of this study was to evaluate and enhance paediatric registrars’ understanding and application of asthma treatment.Methods: The Sudan Medical Specialisation Board (SMSB) paediatric registrars provided data for this quasi-interventional study between April and September of 2021. Twice, both before to and following the intervention education sessions, the questionnaire was delivered. SPSS version 28 was used to analyse the data after it had been cleaned up in an Excel document.Results: 203 (or 77.8%) of the 261 were women. A substantial rise from 8.1 ± 4.12 SD to 18 ± 5.03 SD in the mean overall knowledge score of registrars between the pre-and post-intervention periods. A significant difference (p=0.001) was observed in the post-intervention phase, with first-year registrars (R1) demonstrating higher scores than their senior colleagues. The registrars’ total knowledge scores did not differ significantly from one another during the pre-intervention period. The Global Initiative of Asthma (GINA) guidelines of management were implemented to a certain extent, according to the study. Of the registrars, 148 (56.7%) and 203 (77.8%) evaluated step one management in children ages 5 and under; 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11; and 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11 in pre- and post-intervention, respectively.Conclusion: Given that the intervention in this study greatly increased registrars’ knowledge, doctors should obtain training on the GINA 2019 recommendations through conferences, workshops, and academic programmes. To find out why R1 outperforms their older counterparts, more investigation has to be done.Keywords: asthma, GINA, management of asthma, Sudan

Purpose Technical differences may explain why elite hurdles specialists (EHS) and elite decathletes (ED) perform differently in the 110-metre hurdles. This study aims to compare the hurdle-unit kinematic parameters in EHS and ED. Methods A total of 20 male athletes were recruited, including 10 EHS (age: 20.9 ± 2.2 years, body mass: 76.9 ± 7.0 kg, height: 1.85 ± 0.05 m) and 10 ED (age: 20.8 ± 2.27 years, body mass: 87.7 ± 6.9 kg, height: 1.91 ± 0.03 m). Their three-dimensional movement was analysed for hurdling sequences over the whole hurdle-crossing phase and the entire cycle of the first stride after the hurdle, with spatial, temporal, and angular characteristics compared between groups. Results EHS were characterised by faster hurdle crossing (p = 0.002), shorter stride length over the hurdle (p = 0.002), and a shorter support phase in the first stride post-hurdle (p = 0.005). The centre of mass (CM) path of ED was higher than that of EHS (p = 0.003). EHS attack the hurdle with the lead leg’s knee significantly more flexed (p = 0.001) and after crossing the hurdle, regain contact with the ground with the lead leg more flexed at the hip level (p = 0.004), the trunk more inclined forward (p = 0.01), and a relatively smaller positioning angle of the supporting leg (p = 0.021). Conclusions EHS can be identified by their reduced impulse time, abbreviated take-off phase over the hurdle, and accelerated landing. Furthermore, EHS achieved optimum speed between obstacles faster, resulting in less speed loss and enhanced performance.

Abstract Background Left ventricular hypertrophy (LVH) is associated with an increased risk of ventricular arrhythmias and cardiovascular mortality. The study objective was to investigate the effect of LVH severity on the complexity and severity of ventricular arrhythmias among a subset of Egyptian hypertensive patients. Results The study cohort consisted of 60 hypertensive patients with LVH as diagnosed by echocardiography. Their mean age was (53.7 ± 12.3) years. 36 males (40%) and 24 females (60%). Diabetes mellitus was found in 26 patients (43%), 41% of these cases were smokers. 48-h Holter monitoring was performed in all cases to assess the frequency of ventricular premature contractions (VPC) and their complexity using the Lown grading. Increasing posterior wall thickness end diastole (PWTd) was an independent predictor of increasing VPC frequency, each 1 mm increase in the PWTd is associated with a 1.26% increase in the VPC% among total heart beats (b = 12.6, p

Nine Magnetotelluric stations and 198 Land-Magnetic points were conducted within reclamation regions at the western and southwestern areas of the New Sphinx City, Egypt. The main target is to explore the deep groundwater aquifer (Nubian Aquifer), and its reserves. This was interpreted with integrated data available from thirteen water wells within the studied area. Their depths range from 160 to 773 m. We noticed that the wells don’t reach the Nubian Aquifer and the groundwater in the area comes from the Jurassic-Lower Cretaceous, the Upper Cretaceous-Eocene Limestone, and the Oligo-Miocene aquifers, which contain brackish/saline water. The groundwater table ranges between 128-170 m from the topographic-controlled ground surface. Structurally, the area is dissected by two major thrust faults trending in the NE-SW direction, while there is one major normal fault trending in the NW-SE direction. The results showed that the basement relief ranges between -2250 to -4650 m below mean sea level. The Nubian Aquifer extends through the central region within the area according to the results of Nine Magnetotelluric data. It is bounded by the two inverted faults within the Kattaniya inverted basin which is gradually thinning in the southward direction to disappear completely at the Gindi basin. It is partitioned into two units; the upper one was found at an average depth range between -1760 to -2245 m with an average thickness of about 485 m, while the lower unit depth ranges between -2800 to -3825 m with an average thickness of about 1025 m.

Background and Aim: Cardiovascular imaging plays an essential role in the early detection of cardiac injury and left ventricular (LV) function subclinical alterations. Non-invasively, speckle-tracking imaging provides objective and quantitative assessment of global and regional cardiac function. We investigated whether speckle tracking echocardiography (STE) can be used to distinguish between ischemic cardiomyopathy (ICM) and non-ischemic dilated cardiomyopathy (NICM) based on the pattern of cardiac deformation. Materials and Methods: This research involved cases of dilated cardiomyopathy during the period from January 2022 to December 2022 in 100 patients separated into two groups. Baseline clinical data were evaluated. Conventional and STE were done. The cases were separated into two groups: Group A involved 50 cases with a history of ischemia confirmed by coronary angiography and group B involved 50 cases with NICM who had normal coronary angiography. Results: Patients with NICM had significantly greater LV volumes, lower LV systolic function, and lower global longitudinal and circumferential strain. Basal longitudinal strain over the sum of mid and apical longitudinal strain was significantly lower in NICM (0.42 ± 0.03 vs. 0.49 ± 0.03, P < 0.001). Moreover, regional longitudinal strain decreased from apical to basal in NICM and was homogeneous throughout all segments in ICM. Conclusion: Two-dimensional-STE can help differentiate ICM from NICM. Patients with NICM had a specific strain pattern as basal worsening of LV systolic strain with relative apical sparing.

This study aimed to evaluate the chemical composition and impact of in vitro gastrointestinal digestion on the recovery, bioaccessibility, indices, and changes in the bioactive compounds of date pomace. Bioactive compounds were extracted using various solvents. The results revealed that pomace is a rich source of fiber. Methanol was found to be the most effective solvent for extraction of the bioactive compounds. A high recovery index for phenolic and flavonoid compounds and high antioxidant activity were obtained for the sample subjected to mouth-digestion. The bioaccessibility index revealed that a low percentage of phenols and flavonoids was available for absorption in the intestine. The TPC, TFC, and antioxidant activities (DPPH and ABTS) were positively correlated (r = 0.855-0.995) with oral, gastric, and intestinal digestion. Date pomace is an excellent source of bioactive compounds that can be utilized in the formulation of functional foods with health benefits.

We detected highly pathogenic avian influenza A(H5N1) virus in wild rats collected from a rural area in Giza, Egypt, near poultry farms, markets, and backyard flocks. Sequence and phylogenetic analyses indicated that the virus from the rats belonged to clade 2.3.4.4b, which has been the predominant virus genotype circulating in Egypt and worldwide since 2021-2022. Active surveillance of avian influenza viruses in wild and domestic mammals is recommended to prevent further spread to mammals and humans.

The extensive use of cement exacerbates the greenhouse effect by increasing carbon dioxide (CO2) emissions. So, many standards recommend using Portland-composite cement in construction as one of the methods for reducing CO2 emissions, especially cement CEM II/A-P. This paper presents an extensive experimental and numerical study to investigate the effect of micro and nano-silica on the flexural behavior and mechanical properties of Self-Compacted High-Performance Concrete (SCHPC) produced by cement CEM II/A-P. The extensive experimental work consisted of eight mixtures: three with micro-silica (MS), four with nano-silica (NS), and a reference mixture without silica. For both MS and NS, different percentages of adding or replacement content were tested to study their effect on the following: (a) the workability of fresh concrete, (b) concrete compressive strength, (c) splitting tensile strength, (d) flexural behavior including flexural tensile strength, and (e) the optimum percentage of each of the MS and NS to get the maximum structural and economic benefits of using for SCHPC with CEM II/A-P. Also, through a statistical program, these experimental results were used to obtain accurate formulae that could predict both the splitting tensile strength (fsp) and modulus of rupture (fctr) for SCHPC with adding nano-silica. In addition, the numerical study verified the experimental results based on the finite element program ANSYS. The flexure behavior of SCHPC beams is verified using the Microplane model (recently added to ANSYS). The experimental results showed that adding NS is more effective than replacing or adding MS for SCHPC mixture with CEM II/A-P to increase the concrete compressive strength, splitting tensile strength, and flexural tensile strength, especially for the mixture with adding NS content of 4 %. The numerical results showed the ability of the coupled damage-plasticity microplane model to simulate the flexural behavior of the tested SCHPC beams with MS or NS well. This research confirms nano-silica's structural and economical efficiency in the behavior of SCHPC beams. It was found that the optimum percentage of adding NS is 4 % for SCHPC mixtures with CEM II/A-P.

AbstractEnhancing environmental quality is regarded as a major concern globally. Fossil fuel energy utilization and economic growth are the main sources of environmental pollution. Hence, a paradigm shift from fossil fuels to cleaner energy is proposed. Hence, the objective of this study is to examine the validity of the environmental Kuznets curve (EKC) hypothesis in Kenya by controlling the effect of globalization and renewable energy. Contrary to previous attempts, this study utilized consumption-based carbon dioxide (CO2) emissions as an environmental pollution indicator. The autoregressive distributed lag (ARDL) technique and causality test are used with annual time series data spanning 1990-2018. The empirical results of the bound test revealed that globalization significantly enhances environmental quality, but renewable energy is insignificant in the long run. Economic growth impedes environmental quality, whereas squared growth boosts it. This result provides confirmatory evidence of the presence of the EKC hypothesis in Kenya. Besides, a unidirectional causality from consumption-based carbon emissions to economic growth, squared economic growth, and renewable energy is observed. The obtained findings underscore the need to prepare conducive environments that attract investments in clean energy sources, such as tax reductions and subsidies. Moreover, Kenya needs to enhance its involvement in the global commerce of commodities and services that exhibit minimal levels of greenhouse gas emissions.

ABSTRACTThe objective of this study is to ascertain the asymmetric impact of energy consumption on economic growth in Somalia for the period 1985–2017. A novelty econometric method of the Nonlinear Autoregressive distributed lag (NARDL) technique and the Granger causality test are employed to confirm the aim of the study. The empirical findings revealed the presence of asymmetric co-integration between energy consumption and economic growth in the long run. Both positive and negative shocks in energy consumption enhance economic growth in Somalia in the long run, even though, the positive shock has a stronger significant effect on economic growth in the long run. In contrast, a negative shock in energy consumption causes economic growth, thus, confirming the energy-led growth hypothesis. Hence, this calls for the policymakers to devise investment policies that are aimed at the improvement of foreign and local investments in energy sector.

BackgroundCerebrovascular diseases of the brain are usually defined by transient ischemic attacks and strokes. However, they can also cause brain injuries without neurological events. Silent brain infarcts (SBI) and leukoaraiosis are symptoms of both vascular and neurological abnormalities. This study aims to investigate the association between SBI, leukoaraiosis, and middle-aged patients with ischemic stroke.MethodsA single-center retrospective study of 50 middle-aged, ischemic stroke patients were studied from November 2022 and May 2023. The patients were divided into two groups based on the presence or absence of leukoaraiosis. History taking, physical examination, brain CT scan, and MRI were all part of the diagnostic process. Metabolic syndrome (MetS) was also assessed through various factors. The statistical analysis included descriptive statistics, logistic regression analysis, and chi-square test.ResultsOut of the cohort comprising 50 patients, characterized by a mean age of 52.26 years (SD 5.29), 32 were male, constituting 64% of the sample. Among these patients, 26 individuals exhibited leukoaraiosis, with 17 of them (65.4%) also presenting with SBI. Moreover, within this cohort, 22 patients were diagnosed with MetS, representing 84.6% of those affected. The Multivariate logistic regression analysis showed a strong and independent association between leukoaraiosis and SBI. Individuals with leukoaraiosis were nearly five times more likely to have SBI compared to those without leukoaraiosis.ConclusionThe study highlights leukoaraiosis as a significant risk factor for SBI, alongside MetS. Advanced imaging techniques have facilitated their detection, revealing a higher prevalence among stroke patients, particularly associated with age and hypertension. Further research is needed to fully understand their complex relationship and develop better management strategies for cerebrovascular diseases, ultimately improving patient outcomes.

Turbulent and non-turbulent analysis of thermomagnetic convection, heating rate and mass transport of Darcian radiating nanofluid flow through porous slanted sheet is the aim of present study. Influence of microgravity is more useful for the movement of thermophoresis nanoparticles with maximum temperature and density. Joule heating, porous medium, magnetic field and thermal radiations are incorporated for the performance of thermal convection. Governing equations are reduced in dimensionless form. Oscillatory stokes conditions are applied to separate the steady, real and imaginary equations. Finite difference, Primitive transformation, and Gaussian elimination techniques are applied for numerical outputs. For asymptotic results, the appropriate range of parameters such as 0.1≤JH≤15.0, 0.1≤Pr≤12.0, 0.1≤Rd≤25.0, 0.0≤λT≤5.0, 0.1≤NT≤1.0, 0.1≤Fr≥6.0, and 0.1≤δ≤1.0 is utilized. Main novelty of work is to examine the steady state and oscillatory behavior of friction-rate, heat/mass transport over slanted two-angles π/6 and π/4. Maximum amplitude in fluid velocity is observed by increasing radiations and buoyant forces. Temperature distribution and nanomaterial concentrations enhance as Joule-heating and Prandtl number increases under microgravity region. Amplitude and oscillation of heat and mass rate is increased as reaction rate, Joule heating and Forchheimer parameter increases. Enhancing behavior of energy transport is observed for maximum choice of Prandtl index with small magnetic effects. It is depicted that high rate of oscillating frequency in heat transmission is detected with maximum radiation effects.

The influence of thermal radiations and Soret/Dufour significantly increases the mass and heat transport in material science, geothermal process, chemical rectors and heat exchangers due to temperature and concentration variation of nanoparticles. Main objective is to enhance the amplitude, oscillation and frequency of heat transfer using the Soret and Dufour characteristics in Darcian radiating flow of thermophoretic nanoparticles along vertical porous surface. The dimensionless analysis is performed to develop the convenient form of governing thermodynamic Darcian nanofluid formulation. To develop the programming algorithm in FORTRAN language, the primitive variable formulation is used for both time-dependent and steady models. The numerical and graphical outcomes of primitive type equations under boundary conditions are explored by using implicit finite difference approach with Gaussian elimination scheme. Various pertinent parameters are used to elaborate the steady fluid velocity, surface temperature and steady concentrated nanoparticle volume fraction. Valuable novelty of current research is to use steady results for fluctuating shear stress, fluctuation heating rate and fluctuating mass rate. It is found that the influence of Soret and Dufour parameter enhances the fluid velocity and temperature distribution with maximum variations. It is noticed that the temperature distribution enhances as thermal radiation parameter increases. The oscillation and transient stability of heating rate enhances with prominent variations as thermal radiation and Soret/Dufour parameter increases. It is depicted that amplitude in shear stress and mass rate enhances as Soret and Dufour parameter enhances.

The production of fish waste is increasing dramatically, as more than 70% of captured fish require processing before being sold. These enormous amounts of fish by-products are mostly wasted, generating an undesirable environmental impact and a loss of value-added products. Recently, there has been a growing interest in utilizing fish scale waste as a low-cost source to produce natural nano-hydroxyapatite (HAp) ceramic growth and sustainability. On 1 April 2023, an electronic search was performed across four major databases (ScienceDirect, ProQuest, Scopus, and PubMed). Among the 1824 articles identified, only 27 met this review’s inclusion criteria. These studies not only extracted HAp from fish scales but conducted in vitro or in vivo assessments. The in vitro studies demonstrated the non-cytotoxic nature of the fish-scale derived HAp and its superior cell viability compared to control or synthetic HAp. Furthermore, histopathological evaluations revealed favorable bioavailability and biological responses. These findings indicate that HAp obtained from natural sources offers an environmentally friendly, sustainable, and cost-effective approach for manufacturing these materials and is fully utilized for commercial purposes. Such materials are promising for biomedical applications, contributing positively to the economy, environment, and overall community well-being.

Salinity is one of the most important abiotic stresses that significantly decreases the productivity of agricultural crops. Melatonin (MT) acts as an antioxidant and plays a vital role in overcoming oxidative damage. However, previous literature has not provided a clear understanding of the impact of MT on lettuce plants under salinity stress. So, we investigated the effect of exogenous MT at 0 μM, 50 μM, 100 μM and 150 μM on lettuce plants grown under salinity stress (0 mM NaCl, 50 mM NaCl and 100 mM NaCl) with respect to vegetative growth, photosynthetic pigments, relative water content (RWC), electrolyte leakage (EL), malondialdehyde (MDA), H2O2, O2•- and antioxidants enzymes. Results showed that NaCl stress significantly decreased vegetative growth, RWC and photosynthetic pigments and in contrast enhanced dry matter, EL, MDA, H2O2, O2•-, Na+, Cl-, peroxidase (POD), superoxide dismutase (SOD) and glutathione reductase (GR) of lettuce plants compared to non-salinized control. The results demonstrated that under salinity conditions, foliar applications of MT significantly alleviated the harmful effects of salinity and increased number of leaves, leaf area, fresh weight, chlorophyll (a), chlorophyll (b), total chlorophyll, carotenoids and RWC in comparison to untreated plants (control). Meanwhile, dry matter, MDA, H2O2, O2•-, Na+, Cl-, POD, SOD and GR were significantly decreased compared to untreated lettuce plants. In this respect, spraying MT at 150 μM ranked the first, then 100 μM, compared to the lower concentration (50 μM). In conclusion, MT application can be used to alleviate harmful effects of salinity stress.

Abstract Background Regional anesthesia is the favored choice in ruminant animals compared to general anesthesia, primarily due to its high safety margin and reduced demand for cost-intensive equipment in addition to its field applicability. Ultrasound-guided nerve block has gained significant attention in the field of veterinary medicine. This study utilized twenty-seven sheep of the native Rahmani breed to both demonstrate and evaluate the effectiveness of the ultrasound guided inferior alveolar nerve block technique. Methods The research comprised three phases: Phase 1 involved an anatomical examination of mandibles and sheep heads to locate the mandibular foramen and delineate the mandibular nerve course. Phase 2 included ultrasound-guided injection of methylene blue dye at specific sites along the mandibular nerve in cadaveric sheep heads. In Phase 3, clinical implementation of ultrasound-guided inferior alveolar nerve blocks was conducted in 27 live sheep, assessing efficacy, onset, and duration. Results Vertical extraoral ultrasound-guided nerve block was achieved successfully in 25 sheep (98%). A preliminary cadaveric study showed good distribution of the injectate at the mandibular nerve site. The mean onset time was 138 ± 18 s, and the mean duration time was 54 ± 4.1 min. Prominent analgesia of the ipsilateral mandible, medial surface of the cheek, and lateral border of the tongue was observed. Conclusions Ultrasound-guided mandibular nerve block holds promise as a technique for providing effective and safe anesthesia in sheep undergoing mandibular procedures.

This paper proposes a new modulation-driven pipelining approach for reducing the complexity of speculative decision feedback equalizers (DFEs). The scalable receiver architecture enables the detection and equalization of multiple pulse amplitude modulation (PAM) signaling schemes using same hardware. The receiver is architected into parallel slices of pipelined layers that achieve significant energy and area savings compared to conventional realizations. The fine modularity in two dimensions of the proposed receiver circuit facilitates the clock gating of unused components to ensure energy-proportional behavior. Simulink simulations were used to discuss the parallel and multi-layer operation of the proposed receiver in both detection and equalization modes. The results from the model also show no performance degradation from the new receiver architecture when configured for PAM8/6/4/3/2 operation. Transistor level design and physical layout of a 1-tap PAM4 DFE/3-tap PAM2 DFE were used to discuss design considerations and trade-offs. Pre-layout validation results indicate that seamless reconfigurability and complexity reduction can be achieved at comparable or better area and power to architectures that constrain the receiver intersymbol interference (ISI).