Search

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

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

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

Abstract Objective The study aims to explore the perceived outcomes of Medical Teaching Institution (MTI) reforms on autonomy and overall performance within tertiary healthcare institutions in Khyber Pakhtunkhwa (KP) province, Pakistan. Methodology A cross-sectional study was carried out from September 2023 to March 2024, involving interviews with frontline staff, administrative personnel, and senior management within MTI-affiliated institutions. The methodology employed, using both qualitative and quantitative data analysis techniques. Results The study showed that institutional staff members’ knowledge and understanding of the MTI changes differed. Some observed very minor adjustments, while others saw advances in hospital operations and service delivery. Administrative complexity, political meddling, and resource allocation problems were noted as challenges. Positive results were also observed, though, and they included improved infrastructure, possibilities for staff training, and decision-making procedures. Conclusion Despite significant improved, there are still challenges, such as inconsistent staff comprehension, mixed impacts on service delivery, resource allocation issues, and political meddling. Addressing these issues necessitates improved communication, continuous evaluation, and coordinated efforts to improve administrative systems and obtain consistent funding.

This paper examines the difference between pure contagion and financial interconnection by studying the U.S. and some American and Asian markets in the subprime crisis context. These markets are affected by the mortgage crisis, with data available from January 1, 2003 to December 30, 2011. The paper first identifies the turmoil period via the wavelet technique and adopts cointegration and Granger causality approaches by estimating vector autoregressive (VAR) and vector error correction models (VECM) models. Based on daily returns from stock market indices in five American countries (Mexico, Brazil, Canada, Argentina, and the U.S.) and eight Asian ones (Hong Kong, Japan, India, Indonesia, Malaysia, Singapore, Korea, and China), the results show eight cases of pure contagion and 10 cases of financial interconnection. In addition, there were high co-movements in the short term and low co-movements in the long term for financial interconnection cases. These findings have several implications for investors looking to diversify their portfolios internationally and for portfolio managers to expect and limit market risk. The results provide additional guidance to regulators and policymakers.

IntroductionSoil contamination with heavy metals is one of the most important challenges related to the protection of water and soil resources. Heavy metals are metals that have a density of more than 5 grams per cubic centimeter. Among heavy metals, cadmium is of special importance due to its high solubility in water and quick and easy absorption by the plant root system. This element has been introduced as the fourth dangerous element for vascular plants (Kok et al., 2010). By accumulating in the root environment, cadmium can cause a decrease in growth, respiration, damage to the mechanisms involved in photosynthesis, and inhibit the activity of enzymes and the lack of nitrogen and phosphorus in the plant. Borage (Borago officinalis L.) is a valuable annual medicinal herb suitable for cultivation in many countries, including Iran. Borage (Borago officinalis L.) is considered as a native of both Europe and Asia. Several species around the globe fall under the denomination of “borage”. The presence of the highest γ-linolenic acid content in the seeds of borage makes borage distinctively important mainly for the nutraceutical and pharmaceutical research. γ-Linolenic acid is an omega-6 polyunsaturated fatty acid which cannot be synthesized in the body and hence falls into the category of essential fatty acids (Evesh et al., 2019). The present study was carried out with the aim of investigating the physiologic and biochemical responses of the medicinal plant Borage (Borago officinalis L.) to cadmium stress. Materials and methodsThis experiment was conducted in the form of a completely random design in the greenhouse of Shahid Bahnar University, Bardsir College of Agriculture, Shahid Bahnar University, Kerman, at an average temperature of 25 degrees Celsius during the day and 20 degrees Celsius during the night, with a relative humidity of 60%. First, concentrations of cadmium (0, 1.25, 2.5, 5, 10, 20, 40, 80, 120, 160 mg kg-1) were prepared using cadmium chloride (Merck company) and the soil was uniformly contaminated with cadmium. The contaminated soil was incubated under constant humidity and temperature conditions for 30 days and then poured into pots with a capacity of 3 kg of soil. Plant seeds were disinfected with alcohol and 5% sodium hypochlorite solution and immediately washed several times with distilled water. Five seeds were planted in the pots containing the studied treatments and at a depth of 2 to 3 cm. Two months after planting, when the plant was in the 50% flowering stage, the growth and performance characteristics of the plant including the number of flowers, number of leaves, branch length, root length, shoot weight, root weight, flower weight were measured. Some biochemical characteristics (catalase, ascorbate peroxidase, guaiacyl peroxidase, protein, proline and photosynthetic pigments) were measured. Results and discussionThe studied treatments significantly (p≤0.01) affected the biochemical, physiologic and performance characteristics of European borage. Increasing the concentration of cadmium had an inhibitory effect on the growth parameters of the plant, and this effect was clearly evident in pollution above 80 mg kg-1. Number of flowers, number of leaves, flower weight, root weight, total weight, root length and branch length decreased significantly with increasing cadmium concentration. The flowering of the plant was 71% at the pollution level of 120 mg per kilogram. At this level of pollution, the root weight was reduced by 69.9%. The weight of aerial parts decreased by 59.7% at the pollution level of 160 mg kg-1. The activity of ascorbate peroxidase enzyme increased up to 20 mg kg-1 treatment and after that the activity of ascorbate peroxidase enzyme decreased with the increase of cadmium concentration. Proline concentration increased with increasing cadmium contamination. Photosynthetic pigments also decreased in high concentrations of cadmium. The cause of the adverse effects of cadmium on plants in contaminated soils can be attributed to more absorption of cadmium by the plant and growth disturbance caused by cadmium toxicity in the plant, reduction of growth rate, reduction of water absorption and absorption of other ions affecting the activities plant growth (Veselov et al., 2003), the reduction of cytokinin hormone activity, which has a significant effect on cell proliferation and growth, or the negative effect of cadmium on energy production in mitochondria was attributed (Fotohi et al., 2011). Cadmium causes disturbances in the overall metabolism of cells. (Xie et al., 2021) Cadmium toxicity in plants can lead to negative effects on the photosynthesis process. This action takes place through damage to some photosynthetic enzymes, especially those involved in the Kelvin cycle and chlorophyll biosynthesis (Mishra et al., 2006). ConclusionThe results showed that the yield of European borage was not affected by cadmium up to a concentration of 1.25 mg kg-1. The activity of antioxidant enzymes increased up to the treatment of 20 mg kg-1 and then decreased with increasing cadmium concentration, which indicates oxidative stress. Photosynthetic pigments and chlorophyll fluorescence index decreased with increasing cadmium concentration. Considering the tolerance and resistance of some medicinal plants to the conditions in soils contaminated with heavy metals, it is possible to use the cultivation of some medicinal plants as a solution for the management and exploitation of lands that have medium contamination with heavy metals. Considering the number of flowers, flower durability and high yield, the European borage plant can be a suitable candidate for cultivation in polluted areas, of course, additional studies with the approach of reducing the adverse effects of stress and reducing the concentration of cadmium element in the soil are needed.

Abstract Background Nonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual’s poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion. Methods It is a single-blinded randomized clinical trial with 60 patients aged 18–40 years, with moderate intensity NSNP for > 3 weeks and 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement. Conclusion Between NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP. Trial Registration Registered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered.

Abstract Background The direct and indirect costs of chronic kidney disease (CKD) are substantial and increase over time. Concerns regarding our capacity to manage the financial burden that CKD) places on patients, caregivers, and society are raised by its increasing prevalence and progression. Lack of awareness of CKD’s economic effects is a major reason that lawmakers and administrators pay little attention to this chronic illness. Objective We aimed to analyze the direct burden of CKD across Asian countries and evaluate the main cost drivers among all mentioned cost centers in previous studies. Methodology Related works evaluating the expenditures of CKD from the perspective of the patient were interpreted by a thorough search of PUBMED and GOOGLE SCHOLAR. Results Country-wise, in Asia, the direct mean average medical costs in RRT patients were reported in 8 studies as $4574, $18668, $2901, $6848, $16669, $3489, $5945, and $6344 in Singapore, Korea, Taiwan, China, Jordan, Vietnam, Lebanon, and India respectively and the direct mean average medical costs in non-RRT patients were reported in six studies as $3412, $2241, $4534, $290 and $1500 in Singapore, Japan, China, Vietnam, and India respectively. Conclusion Hemodialysis is the main cost driver having an average mean cost of $23,358 per patient per year while the average mean cost of disease management is $4977 per patient per year. More research is needed to understand the specific economic challenges disadvantaged populations face, including the impact of income, education, and access to healthcare resources on the financial burden of CKD.

Abstract Purpose Globally, colorectal cancer (CRC) is among the most prevalent cancers. One distinctive feature of colorectal cancer is its close relationship to the gut microbiota, which is a crucial component of the tumor microenvironment. Over the last ten years, research has demonstrated that colorectal cancer is accompanied with dysbiosis of gut bacteria, fungi, viruses, and Archaea, and that these alterations may be causal. Objectives: This study aimed to evaluate the disruption of the microorganism composition in the intestine, especially bacteria and to determine their relationship with colorectal cancer. Methods An evaluation system for determining colorectal cancer (CRC) risk and prognosis can be established more easily with the help of accurate gut microbiota profiling. Stool samples from 14 CRC patients and 13 controls were collected and the flora relative abundance was measured using targeted quantitative PCR (qPCR) assays to evaluate diagnostic potential of selected biomarkers: Streptococcus gallolyticus and Enterococcus faecalis. Culture and MALDI-TOF mass spectrometry were coupled to identify the gut microbiota in both colorectal cancer and control groups. Results Compared with controls, the gut microbiota of CRC patients showed an increase in the abundance of Enterococcus, Fusobacterium and Streptococcus. At the species level, the CRC enriched bacterium including Escherichia coli, Enterococcus faecalis, Fusobacterium nucleatum, Streptococcus gallolyticus, Flavoni fractorplautii and Eggerthella lenta acted as promising biomarkers for early detection of CRC. Conclusion This study highlights the potential of gut microbiota biomarkers as a promising non-invasive tool for the accurate detection and distinction of individuals with CRC.

Abstract Objective The present study sought to assess the prevalence and determinants of tobacco use (cigarette smoking and shisha use) and khat chewing among Yemeni adolescents, and to evaluate their knowledge and attitudes toward these habits. Methods This school-based cross-sectional study was conducted among 13 to 19-year-old students attending middle/high schools (both private and public) across five main cities in Yemen. Data were collected using self-administered questionnaires comprising questions/items related to sociodemographic data, cigarette smoking, shisha use, khat chewing, and knowledge on and attitudes toward these habits. Bivariate and multivariate analyses were used to explore the most determinant factors. Results A total of 7505 students were recruited from 42 schools across five major cities in Yemen. The prevalence rates of khat chewing, cigarette smoking, and shisha use were 42.4%, 6.8%, and 19.3%, respectively. Compared to females, male subjects reported significantly higher prevalence of khat chewing (51.4% vs. 23.5%, p

The present study focuses on the synthesis and structural characterization of a novel dinuclear CuII complex, [trichloridocopper(II)]-μ-chlorido-{bis[2-hydroxy-N′-(propan-2-ylidene)benzohydrazide]copper(II)} monohydrate, [Cu2Cl4(C10H12N2O2)2]·H2O or [Cu(H2L)2(μ-Cl)CuCl3]·H2O [H2L = 2-hydroxy-N′-(propan-2-ylidene)benzohydrazide]. The complex crystallizes in the monoclinic space group P21/n with one molecule of water, which forms interactions with the ligands. The first copper ion is penta-coordinated to two benzohydrazine-derived ligands via two nitrogen and two oxygen atoms, and one bridging chloride, which is also coordinated by the second copper ion alongside three terminal chlorines in a distorted tetrahedral geometry. The arrangement around the first copper ion exhibits a distorted geometry intermediate between trigonal bipyramidal and square pyramidal. In the crystal, chains are formed via intermolecular interactions along the a-axis direction, with subsequent layers constructed through hydrogen-bonding interactions parallel to the ac plane, and through slipped π–π stacking interactions parallel to the ab plane, resulting in a three-dimensional network. The intermolecular interactions in the crystal structure were quantified and analysed using Hirshfeld surface analysis. Residual electron density from disordered methanol molecules in the void space could not be reasonably modelled, thus a solvent mask was applied.

The use of herbal bio-actives and phyto-contents to increase livestock productivity is a revived interest in veterinary research. The effect of wild strawberry {Fragaria vesca (FV)} pulp extract (PE) as antioxidant supplement in bovine semen cryopreservation diluent was explored. The experiment involved three fertile bulls. Three semen ejaculates per animal were collected. Each sample was diluted with Semen Transportation Diluent (STD) in 1:2 ratio. The (semen + STD) sample was vortexed and centrifuged (at 32g for 15 min) to remove 50 % supernatant. The remaining sample was re-diluted with semen cryopreservation diluent (SCD) in the ratio 1:4. Three aliquots of 0.3 ml were set aside from each (semen + STD + SCD) sample and were further treated with; 1: 0.7 mL of SCD (SCD group); 2: 0.7 mL SCD and 0.8 % FV-PE (FV-PE 0.8) and; 3: 0.7 mL SCD and 1.6 % FV-PE (FV-PE 1.6). Sperm quality parameters were evaluated before and after 48 h of cryopreservation. Results showed significantly enhanced mean percentage of sperm viability, progressive motility, velocity and fertilizability in FV-PE 0.8 and FV-PE 1.6 groups as compared with SCD group. The findings propose the protective and ameliorative potential of FV-PE for cryopreserved bovine sperms.

Introduction The effectiveness of nicotine replacement therapy (NRT) in critically ill patients remains uncertain, as conflicting research results have been reported. Despite potential side effects and inconsistent data on safety and efficacy, NRT is still prescribed in intensive care units (ICUs) to prevent withdrawal symptoms and manage agitation in patients who are smokers. This meta-analysis aimed to assess the effectiveness of nicotine replacement therapy in critically ill smoking patients. Methods A systematic review and meta-analysis of randomized controlled trials investigated the outcomes of smokers admitted to ICUs and were randomized either to receive or not receive nicotine replacement therapy (NRT) during their ICU stay. The MEDLINE and Embase databases were searched from inception through 13 February 2023 using OVID. The primary outcome was ICU length of stay (LOS) for this systematic review and meta-analysis. Meta-analysis was conducted using both random-effects and fixed-effect models; the latter is recommended when meta-analysis is restricted to just a few studies. The study was registered in the Prospective International Register of Systematic Reviews (PROSPERO) under reference number CRD42023407804. Results Of 28 studies initially identified, three, with 67 patients on NRT and 72 controls, were deemed eligible for pooled analysis. Patients who received NRT experienced a shorter LOS (mean difference, MD= -3.06; 95% CI: -5.88 – -0.25, p=0.0, I 2 =0%). The mechanical ventilation (MV) duration was also shorter in the NRT group, but this difference was not statistically significant (MD= -1.24; 95% CI: -3.21–0.72, p=0.22, I 2 =12.69%). Delirium duration was reported by two studies, from which pooled analysis revealed an MD of -0.50 (95% CI: -1.63–0.62, I 2 =0%). The vasopressor duration was assessed in two studies, and the overall MD for vasopressor duration was not statistically different between NRT patients and controls in the fixed-effects model (MD=0.11; 95% CI: -0.75–0.96, I 2 =0%). Conclusions Critically ill smoker patients who received NRT experienced a significantly shorter ICU LOS but no significant differences in the durations of MV, vasopressor use, or delirium.

Abstract Understanding the realities of feedback practices and activity uses in writing classrooms is key to optimizing them. This study attempted to profile Saudi university English writing teachers’ uses of feedback delivery modes, error correction strategies, and learner-centered feedback activities. The study drew upon the qualitative approach by using an open-ended questions to explore and gain an in-depth understanding of teachers’ feedback provision practices and activity uses. Open-end questionnaire responses were collected from 74 English writing teachers working at eight Saudi universities. The results revealed that handwritten and oral feedback modes are more dominant in the teachers’ practices than electronic and audio-recorded modes. Additionally, a relatively larger number of the teachers reported using direct and comprehensive error correction strategies more than indirect and selective ones. A considerable number of the teachers were found to use combinations of feedback modes, direct-indirect and comprehensive-selective error correction forms. With regard to their use of learner-centered feedback activities, a larger number of the teachers reported making use of peer feedback in their classes but neglecting student self-evaluation and automated writing evaluation activities. The paper discusses the implications pertinent to improving feedback provision practices and activity uses in the Saudi university context.

Abstract Surface-active ionic liquids (SAILs) have gained much attention due to their green, stable, and efficient properties. The high costs associated with SAILs have raised concerns in their applications; however, blending with conventional surfactants like sodium dodecyl benzene sulfonate (SDBS) can bring about desired outcomes. Gemini surface-active ionic liquids (GSAILs) have been recognized as more efficient surfactants. Accordingly, this study investigates the influence of a mixture of an imidazolium-based GSAIL, [C4im-C6-imC4][Br2], and SDBS on different aspects of crude oil−water interfacial properties. The findings show remarkable synergy in interfacial tension (IFT) reduction up to 98.8% together with incredibly low IFT value of 0.05 mN m−1. This was with an optimal GSAIL mole fraction of 0.2 in the mixture. Further, the surfactant mixture gives synergies of 52.6% in emulsification and 51.8% in wettability of a quartz surface. These amazing results can be explained by the dominant interactions between the oppositely charged components. In theoretical study, the adsorption of individual surfactants and their mixtures was analyzed based on the Frumkin isotherm and the Rosen model, respectively, further supporting the findings.

Abstract Background Socioeconomic status (SES) is a social classification factor that takes into account income, parental education and occupation. SES has been shown to play an important role in shaping students’ academic performance, including in medical schools, but there still remains significant variation in findings around SES and academic achievement worldwide. We aim to assess and explore socioeconomic disparities and their effects on medical school performance at Sudanese public and private universities. Objectives The objective of our study was to assess the effects of age, sex, living conditions, parental education and income level on the academic achievement of medical students from universities in Sudan. Methods This cross-sectional study was conducted among undergraduate medical students at ten public universities in Sudan between September and December 2023. Participants were included if they were older than 18 years and were studying in their 2nd year or older. The data were collected using an online questionnaire with open- and closed-ended questions measuring age, living conditions, parental income level and education. A convenience sampling method was used to recruit participants from universities. The data were analyzed using SPSS v28.0.0, and a p value less than 0.05 was used to indicate statistical significance. Results We received 832 responses, 516 (62%) from females and 307 (36.9%) from males. The median age was 23 years. Most students lived with their families (61.1%), followed by student housing (28.2%). This study revealed age (p = .024) (95% Cl: 0.025- 0.023) andhigh family income (p = .019) (95% Cl: 0.018- 0.02) are associated with academic achievement in the long term, as demonstrated through cumulative grade point average (cGPA). Conclusion The findings underscore the importance of targeted support systems to bridge the socioeconomic gaps that exist among medical students, allowing all students to thrive academically regardless of their background. Clinical trial number None.

Amylases are one of the biotechnologically important enzymes that have multiple applications in the food, pharmaceutical, cosmetics, textile, detergent, paper and pulp, bioremediation and nano-biotechnology industries. Amylases can be isolated from animals, plants and microbial regions, but nowadays enzymes from prokaryotic species have gained more importance. Among the microbes, amylases from Bacillus cereus have gained considerable demand in various industrial sectors. Growing industrial demand for enzymes compels the availability of enzymes in large quantities that can only be achieved by employing efficient fermentation techniques. Therefore, the current study is aimed at the statistical optimisation of the production conditions for extracellular amylase production from Bacillus strain AS2. In a recent study, the optimum amylase producing AS2 strain was identified on a molecular level, and it was found that it has close relation with the already reported strains of Bacillus cereus. The further enzyme production was optimised by using a statistical optimisation tool. A full-factorial central composite design (CCD) consisting of 53 experiments was designed using six significant variables (incubation period, pH, temperature, carbon and nitrogen source and metal ion). The analysis revealed that the optimal media concentrations were 54.34 g.L-1 starch, 0.63 g.L-1 CaCl2, 1 g.L-1 glycine, pH 7.0, 76 h, and 40 °C, respectively. A 1.23-fold increase in the enzyme yield (1 050 IU.mL-1.min-1) was noticed as compared to the original production level. The statistical optimisation approach gives the exact variables that influence the enzyme production and, hence, offers the best way to optimise the bioprocess. The optimised enzyme can be used in industries for various purposes such as de-sizing, de-inking, hydrolysing starch residues, etc.

We apply the basic Lie symmetry method to investigate the time-dependent negative-order Calogero-Bogoyavlenskii-Schiff (vnCBS) equation‎. ‎In this case‎, ‎the symmetry classification problem is answered‎. ‎We obtain symmetry algebra‎ ‎and create the optimal system of Lie subalgebras. We obtain the symmetry reductions and invariant solutions of the considered equation using these vector fields‎. ‎Finally‎, ‎we determine the conservation laws of the vnCBS equation via the Bluman-Anco homotopy formula‎.

Objective(s): Convulsions caused by fever in children and parents not knowing about the nature of this disease cause severe anxiety and inappropriate performance in parents. Due to the cost-effectiveness of the telenursing method, nurses can use it to provide a large amount of information in a short period with distance education. Therefore, the present study was conducted with the aim of determining the effect of telenursing training on the anxiety of mothers with children suffering from febrile convulsions. Methods: This quasi-experimental intervention study was conducted in 2020-2021 among 60 mothers with children suffering from febrile seizures in the hospitals of Birjand, Iran. The sampling method was accessible and then people were randomly divided into two intervention and control groups. After being discharged from the hospital, the intervention group received telenursing (for 2 weeks and 3 sessions each week for 15 minutes via mobile phone and by calling the mothers and sending an educational video). The control group received routine training at discharge. The data collection questionnaire included the demographic and background information and the Spielberger anxiety questionnaire. The Spielberger questionnaire was completed at the beginning and after the end of the intervention. SPSS software version 16 and paired t, independent t and chi-square statistical tests were used for data analysis. Results: Stait and trait anxiety before the intervention was not significant between the control and intervention groups (P=0.865 and P=0.153, respectively). There was a statistically significant difference between the two intervention and control groups in Stait and trait anxiety after the intervention, and it was reduced in the intervention group (P

Abstract Objectives The objective of this in vitro study was to evaluate the effects of different preparation designs on the mean colour change (ΔE*), marginal adaptation, fracture resistance, and fracture types of maxillary and mandibular premolar endocrowns (ECs). Methodology A total of 40 extracted maxillary and mandibular premolars were treated endodontically, and each type was subdivided according to the remaining axial height (remaining walls on all surfaces; 2–4 mm) and 2 mm inside the pulp chamber. Specimens were immersed in coffee for 14 days, ΔE* was determined, marginal adaptation was observed, fracture forces test was conducted, and the samples were examined visually at 10× magnification to evaluate failure type and identify fracture origin. The data were entered and analyzed using Statistical Package for Social Sciences, and significance between and within groups was evaluated through ANOVA. The p-value ≤ 0.05 was considered statistically significant. Results The ΔE* values of the maxillary premolar with 2 mm axial height were the highest (6.8 ± 0.89 units), whereas the lowest value was observed in the mandibular premolar with 4 mm axial height (2.9 ± 0.53 units). Significant differences (p

Abstract Background Patients perceive effective patient-doctor communication as an important metric when evaluating their satisfaction with health systems. Hence, optimal patient-physician communication is fundamental for quality healthcare. High-income countries (HICs) have extensively studied patient-resident communication. However, there is a dearth of similar studies in low- and middle-income countries (LMICs). Therefore, we aimed to explore the current state of and barriers to practicing good patient-resident communication and explore possible solutions to mitigate these challenges at one of the largest Academic Medical Centers in an LMIC. Methods This study employed an exploratory qualitative study design and was conducted at the Aga Khan University Hospital in Pakistan. Through purposive maximum variation sampling, 60 healthcare workers from diverse cohorts, including attendings, fellows, residents, and medical students, participated in eight focus group discussions. Results We identified three key themes from the data: Status-quo of residents’ communication skills and learning (Poor verbal and non-verbal communication, inadequate training programs, and variable sources of learning), Barriers to effective communication (Institutional barriers such as lack of designated counselling spaces, lack of resident insight regarding effective communication and deficits in intra-team communication), and the need for developing a communication skills curriculum (Design, implementation and scaling to other cohorts of healthcare workers). Conclusions Findings from this study show that multifaceted factors are responsible for inadequate patient resident-physician communication, highlighting the need for and importance of developing a formal communication skills training curriculum for residents. These insights can be used to create standardized training for equipping residents with adequate skills for effectively communicating with patients which can improve healthcare service delivery and patient outcomes.

Abstract Recently, the area devoted to fractional calculus has given much attention by researchers. The reason behind such huge attention is the significant applications of the mentioned area in various disciplines. Different problems of real world processes have been investigated by using the concepts of fractional calculus and important and applicable outcomes were obtained. Because, there has been a lot of interest in fractional differential equations. It is brought on by both the extensive development of fractional calculus theory and its applications. The use of linear and quadratic perturbations of nonlinear differential equations in mathematical models of a variety of real-world problems has received a lot of interest. Therefore, motivated by the mentioned importance, this research work is devoted to analyze in detailed, a class of fractal hybrid fractional differential equation under Atangana- Baleanu- Caputo ABC derivative. The qualitative theory of the problem is examined by using tools of non-linear functional analysis. The Ulam-Hyer’s (U-H) type stability criteria is also applied to the consider problem. Further, the numerical solution of the model is developed by using powerful numerical technique. Lastly, the Wazewska-Czyzewska and Lasota Model, a well-known biological model, verifies the results. Several graphical representations by using different fractals fractional orders values are presented. The detailed discussion and explanations are given at the end.

Abstract Herein we have reported a fluorescent probe (MB-M) based on MB derivative for Cu2+ ions detection. The probe was well characterized by 1H NMR, 13C NMR and HR-MS spectrum. Probe MB-M showed naked-eyes recognition to Cu2+ as color change from colorless to indigo. The probe exhibited promising features such as high fluorescence and UV–vis selectivity, fast response (5 mint), workable at pH 2–7, and low limit of detection (LOD = 0.33 µM). Probe MB-M was also used for Cu2+ ions imaging in HepG-2 cells and detection in daily life (Test Strip and lake water). Moreover, non-covalent interaction (NCI) and quantum theory of atoms in molecules (QTAIM) analysis were used to study the interaction between MB-M and Cu2+ ions. By examining the electronic characteristics of the complex using natural bond orbital (NBO), electron density difference (EDD), and frontier molecular orbital (FMO) analysis, the sensitivity of MB-M towards Cu2+ ions were investigated. The results illustrated that the interactions between MB-M and Cu2+ ions involved chemisorption.

Abstract We formulate the variance-based uncertainty relations (URs) via the Robertson’s inequality, for a 2-particle entangled system constrained on a torus and subject to a stationary magnetic field $$\mathcal {\vec {B}}$$ B → . We explore the system’s parameter space and show that these new URs have field-tunable uncertainty bounds. Our analysis reveals that $$\mathcal {\vec {A}}$$ A → (vector potential) induces a phase shift in the state, due to the Aharonov–Bohm effect, leading to a perturbed system dynamics which results in asymmetric product of variance ( $$\mathcal {POV}$$ POV ). Additionally, we give the critical range of $$\mathcal {\vec {A}}$$ A → and $$\mathcal {\vec {B}}$$ B → where the system acts as an entanglement amplifier; this amplification is also discussed under various geometric parameters. The possibility of reducing the $$\mathcal {POV}$$ POV of the conjugate pair [q, p] below the known benchmark value by the Generalized Uncertainty Relation (GUR) is also demonstrated. Finally, we check the susceptibility of state coherence to $$\mathcal {\vec {B}}$$ B → by saturating the angular momentum uncertainty relation and identify the critical coherence value $${\mathcal {B}}_c$$ B c such that when $${\mathcal {B}}\ne {\mathcal {B}}_c$$ B ≠ B c , the state decoheres.

More than half of diabetic patients finally develop hypertension which remarkably increases the risk of multiple complications. This study aims to assess the association between dietary indices, antioxidant intake and bioactive foods, and hypertension in diabetic patients. Methods: This was a cross-sectional population-based study on baseline data of Fasa PERSIAN cohort study which was conducted on adults in Sheshdeh town and its 24 villages, in Iran from 2014 to 2016. This research included 1229 patients with diabetes. A food frequency questionnaire was used to assess three dietary indices (phytochemical index, dietary inflammatory index, and alternative healthy eating index-2010), antioxidant intake, and consumption of bioactive foods. Other lifestyle and demographic factors were also assessed. Multivariable binary logistic regression was performed to assess the associations between independent variables and hypertension. Results: Higher intake of garlic was significantly associated with lower odds of having hypertension after adjusting for potential confounders [adjusted odds ratio (AOR):0.84, 95% confidence interval (CI):0.73-0.97]. Furthermore, female gender [AOR:1.77, 95% CI:1.26-2.49], being older [AOR:1.09, 95% CI:1.08-1.11], having a family history of hypertension [AOR:2.42, 95% CI:1.86-3.16] and higher body mass index (BMI) [AOR:1.1, 95% CI:1.07-1.13] were predictors of having hypertension. Neither dietary indices nor antioxidant intakes were associated with having hypertension in the crude or adjusted models. Conclusion: Garlic consumption is negatively associated with hypertension in diabetic patients. However, female gender, old age, family history of hypertension and higher BMI are positively associated with this condition. Therefore, modifying diet and weight management are recommended for controlling hypertension in this group of patients.

Abstract The research purpose is to evaluate the effectiveness of leadership in the process of distance learning from the perspective of the psychological theories of leadership, gender, and cross-cultural issues. The present research is based on such methods as surveys, testing, quantitative and qualitative analysis, and statistical data processing. The subjective (the experience of the respondents) and objective (machine calculation of clusters) assessments allowed the scholars to generate more arguments on leadership in the learning process. The sample consisted of 600 female and male students (300 from each sex, respectively) aged 18–20 years from Abu Dhabi University, American University in The Emirates, and the United Arab Emirates University. The research stated that the majority of students, regardless of gender, suppose that both sexes can develop similar leadership traits (80%). The research claims that female leaders have to be more dynamic and demonstrate higher intelligence (26% vs. 20%) and confidence (20% vs. 15%) than male leaders. Cultural and socio-demographic characteristics do not play a significant role in leadership development (10%). The main cause for the choice of a leader is behavioural and communication characteristics (50%) as well as personal qualities (35%). These results can be used for the online design of distance learning courses in universities (both group and individual), as well as for psychologists to study the aspect of individuals’ predisposition to leadership. It makes sense for further research to explore the issue of differences in the perception of educational leadership in Asian and Western European countries based on the cross-cultural aspect, that is, the influence of national culture on the choice of leader in the educational environment.

Abstract Background Medical diagnostic laboratories are an essential work environment that plays an important role in diagnosing, treating, and being sensitive to diseases. One way to evaluate laboratories’ performance is to calculate their efficiency. This study investigates the efficiency of laboratories that are related to health centers in the south of Iran. Methods This study was conducted in 2021. The input numbers include: the number of technical personnel and the number of cell counters, and the output data includes: the scores obtained from the level 2 health laboratory evaluation list. And efficiency was calculated with DEAP software. The analysis is accomplished by the assumption of input-oriented. Findings The efficiency of laboratories of Orzueeyeh and Ravar Cities had the highest efficiency with the assumption of variable returns to scale efficiency 1, and the model of all laboratories is the laboratory of Ravar City. The laboratories of Kuhbanan and Rabor cities had the lowest efficiency with the assumption of variable returns to scale efficiency of 0.859 and 0.899, respectively. The average scale efficiency, Variable returns to scale, and constant returns to scale for laboratories in the cities of Kerman province are 0.842, 0.943, and 0.895, respectively. Conclusions To increase the efficiency of laboratories, significant resources and funds should be used, as well as few studies have been done on the efficiency of laboratories, which requires more attention.

Abstract NR2F2 encodes COUP-TFII, an orphan nuclear receptor required for the development of the steroidogenic lineages of the murine fetal testes and ovaries. Pathogenic variants in human NR2F2 are associated with testis formation in 46,XX individuals, however, the function of COUP-TFII in the human testis is unknown. We report a de novo heterozygous variant in NR2F2 (c.737G > A, p.Arg246His) in a 46,XY under-masculinized boy with primary hypogonadism. The variant, located within the ligand-binding domain, is predicted to be highly damaging. In vitro studies indicated that the mutation does not impact the stability or subcellular localization of the protein. NR5A1, a related nuclear receptor that is a key factor in gonad formation and function, is known to physically interact with COUP-TFII to regulate gene expression. The mutant protein did not affect the physical interaction with NR5A1. However, in-vitro assays demonstrated that the mutant protein significantly loses the inhibitory effect on NR5A1-mediated activation of both the LHB and INSL3 promoters. The data support a role for COUP-TFII in human testis formation. Although mutually antagonistic sets of genes are known to regulate testis and ovarian pathways, we extend the list of genes, that together with NR5A1 and WT1, are associated with both 46,XX and 46,XY DSD.

Abstract Multidrug efflux pumps have been found to play a crucial role in drug resistance in bacteria and eukaryotes. In this study, we investigated the presence of functional multidrug and toxic compound extrusion (MATE) efflux pumps, inferred from whole genome sequencing, in the halophilic archaeon Halorubrum amylolyticum CSM52 using Hoechst 33342 dye accumulation and antimicrobial sensitivity tests in the presence and absence of efflux pump inhibitors (EPIs). The whole genome sequence of H. amylolyticum CSM52 contained two putative MATE-type efflux pump genes, which may contribute to the inherent resistance to conventional antimicrobial agents reported in archaea. Antimicrobial susceptibility of the wild-type H. amylolyticum CSM52 testing revealed a lack of sensitivity to a wide range of antimicrobials, including glycopeptides, aminoglycosides, macrolides, fluoroquinolones, tetracycline, and chloramphenicol. However, the presence of EPIs, such as thioridazine, fluoxetine, and chlorpromazine, significantly increased the susceptibility of H. amylolyticum CSM52 to a number of these antimicrobials, indicating the potential involvement of efflux pumps in the observed resistance. A molecular modelling study with EPIs and substrate antimicrobials provided important insights into the molecular interactions with the putative transporter. It suggests that the occupancy of the transporter channel by EPIs has the potential to impact the efflux of antimicrobials. Phylogenetic analysis of the amino acid sequences of both MATE pumps showed low similarity with bacterial representatives, suggesting the presence of novel and distinct MATE efflux pumps in archaea. Our findings provide the first experimental evidence of active antibiotic efflux mechanisms in archaea and their potential roles in antimicrobial resistance, broadening our understanding of mechanisms of archaeal antimicrobial resistance, an overlooked aspect of AMR research.

Abstract Background Despite the importance of enhancing exercise, exercising can cause injuries that lead to disability and increase the load on the medical sector. This study aimed to estimate the prevalence of exercise-related injuries among gym members in the Kingdom of Saudi Arabia (KSA) and evaluate the more common types of such injuries. It also investigated the association between injury prevalence and the factors selected. Methods A cross-sectional study with a self-reported survey was conducted targeting members of Fitness Time gyms across the KSA. The survey consisted of three parts: part one concerns participant demographic data and part two contains four questions regarding the participants’ training experience. Part three contains ten questions targeting those with a history of injury. Descriptive statistical analysis was performed using frequencies and percentages for categorical variables. Crosstabs and chi-squared tests were used to assess the prevalence of exercise-related injuries when appropriate. Binary logistic regression was employed to investigate the association between injury prevalence and the potential associated factors. Odds ratios and their 95% confidence intervals were calculated and the threshold for statistical significance was set at p ≤ 0.05. Results A total of 713 subjects participated in the study. The mean age was 36.5 ± 11.2 years and (n = 422, 59.2%) of the participants were female. The study found a prevalence of injury among gym members of about (n = 404, ~57%). The most commonly reported types of injuries were muscle strain (n = 126, 37%) and bruising (n = 45, 13%). The most prevalent anatomical location of injury was the knee (n = 287, 84.3%), followed by the shoulder (n = 283, 83.3%), and the least common was the head/neck (n = 7, 2.1%). The present study suggests some factors associated with exercise-related injury. A significant statistical association (p

Background: Chronic liver disease (CLD) significantly impacts global health, affecting nearly 1.5 billion individuals. Sodium disturbances are common in CLD and can lead to severe systemic effects. However, the relationship between these disturbances and CLD-related complications such as diarrhea and dehydration is complex and not fully understood. Objective: To assess the sodium disturbances in chronic liver disease patients suffering from diarrhea with dehydration presenting at a tertiary care hospital, in Karachi, Pakistan. Methodology: A cross-sectional study was conducted from October 2022 to July 2023, including individuals aged >18 years diagnosed with CLD, experiencing diarrhea and dehydration, and on diuretic therapy. The blood sample was collected from all of the participants and sent to a laboratory for analysis. The blood is then tested to measure the concentration of sodium in milliequivalents per liter (meq/L). The normal range for sodium levels in the blood typically falls between 135 to 145 meq/L. Levels below or above this range can indicate sodium imbalances. Descriptive statistics and inferential statistics were performed on SPSS. Results: The mean age of the participants was 33.35 years, with a standard deviation of 8.01. Of 126 patients, 38.1% were male, 27% had hypertension, and 15.1% had diabetes. The mean sodium concentration was found as 132.17±14.23 meq/L, with 42.9% of CLD patients experiencing diarrhea and dehydration having sodium levels

Introduction: The prevalence of asymptomatic fever among children is high and may be confused with fever caused by corona. The purpose of this study is to investigate the characteristics of inflammatory factors and cardiac enzymes in children with Covid-19 hospitalized with the initial manifestation of fever without other symptoms. Methods: In this descriptive-analytical cross-sectional study, all 200 children with positive Covid-19 were hospitalized in Hazrat Ali-Asghar Hospital in Tehran between 2018 and 2019. For gathering data, clinical records and demographic information of patients were noted in the made-researcher’s checklist and the collected data were analyzed using SPSS software version 24 Results: It was found that the relationship between the degrees of fever of the patients with the number of platelets was also inverse and significant. In addition, there was a significant relationship between the degree of fever of the patients and the LDH number, ALT number and segment and lymphocyte percentage of the patients. In addition, it was found that the passing time of fever has a significant relationship with ALT and ESR in such a way that with the passage of time, there is a higher probability of seeing an increase in ESR, but in the case of ALT, it increases in a shorter period of time and decreases more after the passage of time. Conclusion: According to the results of the present study, in case of suspected to Covid and fever in patients, along with other tests, AST, ALT, D-dimer, and CKMB can be used to diagnose Covid, in such a way that in Covid, AST is probably normal and mentioned other tests can be higher than normal.

Aim: Type 2 diabetes mellitus (T2DM) is a common disease that imposes a substantial burden on the healthcare system and patients. Lifestyle modification such as sleep hygiene plays a crucial role in glycemic control. Sleep disorders impact many aspects of health. In this study, we aimed to investigate the correlation between sleep quality and glycemic control in T2DM. Method: This cross-sectional study was performed on 163 T2DM patients, attending Shahid Beheshti Hospital in Hamadan, Iran from March 2020 to 2021. Besides recording the demographic data and HbA1c level of participants, they were asked the Pittsburgh Sleep Quality Index questionnaire for evaluating sleep quality. We employed SPSS ver. 21 for data analysis and considered 0.05 as a significant level Results: Among all participants, 62 (38%) were female and 30.7% were illiterate. The mean age was 56.67 ± 12.90 years, and HbA1c was 9.03 ± 1.92 mg/dL. Among sleep metrics, mean waking time was 8.74 ± 1.74 hours, and average sleep time was 12.90 ± 4.90 hours. Overall, 58.2% of the participants had poor glycemic control and 44.8% were suffering from poor sleep quality. We found that patients with poor glycemic control exhibited significantly higher levels of sleep disturbances compared to those with good glycemic control (P < 0.001). Conclusion: Sleep quality is associated with glycemic control in patients with T2DM. Sleep disorders are common among diabetic patients. Thus, healthcare providers need to consider sleep quality improvement in their holistic approach to diabetes management.

Aims: The primary aim of this study was to assess the feasibility of recruiting and retaining patients to a patient-blinded randomized controlled trial comparing corticosteroid injection (CSI) to autologous protein solution (APS) injection for the treatment of subacromial shoulder pain in a community care setting. The study focused on recruitment rates and retention of participants throughout, and collected data on the interventions’ safety and efficacy. Methods: Participants were recruited from two community musculoskeletal treatment centres in the UK. Patients were eligible if aged 18 years or older, and had a clinical diagnosis of subacromial impingement syndrome which the treating clinician thought was suitable for treatment with a subacromial injection. Consenting patients were randomly allocated 1:1 to a patient-blinded subacromial injection of CSI (standard care) or APS. The primary outcome measures of this study relate to rates of recruitment, retention, and compliance with intervention and follow-up to determine feasibility. Secondary outcome measures relate to the safety and efficacy of the interventions. Results: A total of 53 patients were deemed eligible, and 50 patients (94%) recruited between April 2022 and October 2022. Overall, 49 patients (98%) complied with treatment. Outcome data were collected in 100% of participants at three months and 94% at six months. There were no significant adverse events. Both groups demonstrated improvement in patient-reported outcome measures over the six-month period. Conclusion: Our study shows that it is feasible to recruit to a patient-blinded randomized controlled trial comparing APS and CSI for subacromial pain in terms of clinical outcomes and health-resource use in the UK. Safety and efficacy data are presented. Cite this article: Bone Jt Open 2024;5(7):534–542.

Receptor protein kinases (RPKs) critically provide the basic infrastructure to sense, perceive, and conduct the signalling events at the cell surface of organisms. The importance of LRR-RLKs has been well studied in plants, but much less information has been reported in oomycetes. In this work, we have silenced the PcLRR-RK3 and characterised its functional importance in Phytophthora capsici. PcLRR-RK3 was predicted to encode signal peptides, leucine-rich repeats, transmembrane, and kinase domains. PcLRR-RK3-silenced transformants showed impaired colony growth, decreased deformed sporangia, and reduced zoospores count. The mycelium of silenced transformants did not penetrate within the host tissues and showed defects in the pathogenicity of P. capsici. Interestingly, gene silencing also weakens the ability of zoospores germination and penetration into host tissues and fails to produce necrotic lesions. Furthermore, PcLRR-RK3 localisation was found to be the plasma membrane of the cell. Altogether, our results revealed that PcLRR-RK3 was required for the regulation of vegetative growth, zoospores penetration, and establishment into host leaf tissues.

Abstract Background Adolescent pregnancy is one of the public health problems that both mother and baby suffer from its consequences. This study was conducted to estimate the prevalence and consequences of adolescent pregnancy in the Eastern Mediterranean region. Methods In this systematic review and meta-analysis, four databases (PubMed, ProQuest, Web of Science and Scopus) were systematically searched for relevant articles published from 1990 to 2022. The screening process for articles was conducted in accordance with the PRISMA guidelines. Joanna Briggs checklists were used to assess the quality of included studies. A random effects model was performed for the meta-analysis. Narrative synthesis of adolescent pregnancy prevalence, as well as a meta-analysis of adolescent pregnancy prevalence was performed using STATA 14. Results The review included 12 studies and 94,189 study participants. The prevalence of adolescent pregnancy was [9% (95% CI 6.9, 11.2, p

Abstract Backgrounds Restless legs syndrome (RLS) is an unpleasant condition that affects the quality of life of patients. Its prevalence in increased in women with premenstrual syndrome (PMS). Vitamin D plays a key role in female reproduction through its impact on calcium homeostasis and neurotransmitters. We aimed to evaluate the effect of dairy products fortified with Vitamin D3 on RLS in women with PMS. Materials and methods We conducted a 2.5-month, randomized, total-blinded clinical trial to evaluate the effectiveness of low-fat milk and yogurt fortified with vitamin D on RLS in women with PMS. Among 141 middle-aged women with abdominal obesity, 71 and 70 cases received fortified and non-fortified low-fat dairy products, respectively. All subjects completed a Symptoms Screening Tool (PSST) and RLS questionnaires. Results The results showed that in the women with severe PMS (PSST > 28), serum levels of vitamin D increased significantly following vitamin D fortification. The mean restless legs score in the severe PMS subgroup (PSST > 28) was significantly lower after the intervention (p 28) (p 0.05). Conclusion Fortifying dairy products with vitamin D3 can increase the serum levels of vitamin D and reduce the RLS severity in women with severe PMS, but not in other groups.

Abstract Objective Vitamin D deficiency and variations in the vitamin D binding protein (VDBP) gene may play a role in the development of Polycystic ovary syndrome (PCOS). This study aims to investigate the association of the rs4588 polymorphism with PCOS in Iranian women, as well as its association with infertility and recurrent pregnancy loss (RPL) in these patients. Results The analysis revealed statistically significant differences in the distributions of genotypes and alleles of the rs4588 polymorphism among the three groups (p

Abstract Background Macular holes (MHs) constitute a vitreoretinal interface disorder that occurs when structural abnormalities in the fovea lead to impaired central vision. The standard treatment for MHs is mainly surgical. Using an inverted internal limiting membrane (ILM) flap has enhanced the success rates of MH surgeries. This systematic review and meta-analysis aimed to compare the classical inverted ILM flap technique to modified ILM flap techniques for managing large MHs. Methods We searched Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared the classic inverted ILM flap technique to modified ILM flap techniques as initial surgical treatment of eyes with large MHs of more than 400 microns. We sought to evaluate the following outcomes: (1) MH closure. (2) Best-corrected visual acuity (BCVA). (3) Foveal closure type (4) Rate of ellipsoid zone (EZ) defects and external limiting membrane (ELM) defects. The standardized mean difference (SMD) was used to represent continuous outcomes, while the risk ratio (RR) was used to represent dichotomous outcomes. Results Four RCTs that enrolled 220 participants were deemed eligible. The analysis revealed no statistically significant differences in MH closure between both groups (95% CI: 0.20, 7.96; P = 0.81). No statistically significant differences in mean BCVA were found at 1 and 3 months between both groups (SMD: 0.04; 95% CI: −0.16, 0.23; P = 0.70 and SMD: −0.167; 95%CI: −1.240, 0.906; P = 0.760, respectively). In addition, there were no significant differences between the two groups in the pattern of foveal closure, namely U-shape, V-shape, and flap open at 3, 6, and 12 months (RR: 0.87; 95% CI: 0.67, 1.12; P = 0.28, RR: 0.96; 95% CI: 0.58, 1.61; P = 0.89, and RR: 1.95, 95% CI: 0.26, 14.50; P = 0.51, respectively). Finally, the analysis showed no statistically significant difference in both groups’ EZ and ELM defect rates at 3, 6, and 12 months (RR: 1; 95% CI: 0.85; 1.18: P = 1 and RR: 1.14; 95% CI: 0.90, 1.45; P = 0.27). Conclusion Macular holes (MHs) constitute a vitreoretinal interface disorder that occurs when structural abnormalities in the fovea lead to impaired central vision. The standard treatment for MHs is mainly surgical. Using an inverted internal limiting membrane (ILM) flap has enhanced the success rates of MH surgeries. This systematic review and meta-analysis aimed to compare the classical inverted ILM flap technique to modified ILM flap techniques for managing large MHs.

Abstract The inhibition effect of symmetrical Ball − type Zinc Phthalocyanine on Aluminum in 1mol/L hydrochloric acid was analyzed by electrochemical techniques. A novel ball-type zinc phthalocyanine (Zn-Pc) inhibitor has been synthesized and verified utilizing FTIR, nuclear magnetic resonance (1H NMR and 13C NMR), MALDI-TOF MS, and absorption spectroscopy (UV-Vis). In addition, laser-induced breakdown and photoluminescence spectroscopy were employed for additional study. Weight loss technique was employed to investigate the corrosion inhibition effectiveness of the synthesized Zn-Pc on Aluminum in 1mol/L hydrochloric acid at the range of variation temperatures (293–333 K). The inhibition efficiency of Zn-Pc increased with higher concentrations of Zn-Pc and decreased as the temperature increased. Furthermore, Zn-Pc demonstrated outstanding outcomes, achieving 72.9% at a very low inhibitor concentration (0.4 mmol/L) at 298 K. The experimental data for Zn-Pc Aluminum in 1mol/L hydrochloric acid obeys the Langmuir adsorption isotherm. Moreover, the corrosion system’s thermodynamic parameters and activation energy were determined. Quantum chemical calculations applying the (DFT) Density Functional Theory method was conducted and applied in this study. These calculations played a pivotal role in elucidating molecular structures and reactivity patterns. Through DFT, numerous reactivity indicators were computed, providing valuable insights into the chemical behavior of the studied compounds. These indicators, such as frontier molecular orbitals, electron density, and molecular electrostatic potential, were subsequently correlated with experimental data.

Abstract Background Quality sleep is vital for well-being, especially for healthcare workers facing high risks of fatigue and burnout. Sleep deprivation impairs cognitive and motor functions, contributing to medical errors. Addressing sleep disorders among healthcare professionals is crucial for enhancing patient care. Tailored interventions are needed to support their well-being and improve healthcare outcomes. Objective To evaluate the effect of Sleep Quality and its Deprivation on Sudanese Healthcare Professionals amidst conflict in Sudan. Methods A cross-sectional online survey of Sudanese doctors was conducted using convenience sampling. The questionnaire covered sleep quality, daytime sleepiness, and psychological well-being. Pilot testing ensured questionnaire clarity. Data collection utilized Google Forms distributed through social media and professional networks. A minimum sample size of 384 was calculated. Statistical analysis included descriptive statistics and various tests for significance. Data were securely stored and analyzed using SPSS and R software. Results Among 649 participants, 404 (62.2%) were women, with a mean age of 30.34 years. Most were single (434, 66.9%). General practitioners constituted the largest professional group (267, 41.1%), followed by registrars/residents (142, 21.9%). Participants took an average of 43.70 minutes to fall asleep and slept an average of 5.90 hours per night. According to the PSQI, 300 (46.2%) reported mild sleep disturbance, 287 (44.2%) moderate, 42 (6.5%) severe, and only 20 (3.1%) normal sleep. The ESS revealed 285 (43.9%) with lower normal daytime sleepiness, 188 (29.0%) with higher normal, and various levels of excessive daytime sleepiness. Stress levels varied, with 398 (61.3%) reporting normal stress, while anxiety ranged from 248 (38.2%) normal to 148 (22.8%) extremely severe. Conclusion This study emphasizes the importance of addressing sleep quality, mental health, and performance challenges among Sudanese healthcare professionals. It highlights the need for hospitals to implement measures enabling more time off, adequate sleep, and reduced on-call service days. Healthcare workers must recognize the significance of these factors for their well-being and patient care quality. The research outcomes can raise awareness about the necessity of regulating healthcare practitioners' working hours and ensuring adequate sleep.

Abstract Microtubule associated proteins (MAPs) are widely expressed in the central nervous system, and have established roles in cell proliferation, myelination, neurite formation, axon specification, outgrowth, dendrite, and synapse formation. We report eleven individuals from seven families harboring predicted pathogenic biallelic, de novo, and heterozygous variants in the NAV3 gene, which encodes the microtubule positive tip protein neuron navigator 3 (NAV3). All affected individuals have intellectual disability (ID), microcephaly, skeletal deformities, ocular anomalies, and behavioral issues. In mouse brain, Nav3 is expressed throughout the nervous system, with more prominent signatures in postmitotic, excitatory, inhibiting, and sensory neurons. When overexpressed in HEK293T and COS7 cells, pathogenic variants impaired NAV3 ability to stabilize microtubules. Further, knocking-down nav3 in zebrafish led to severe morphological defects, microcephaly, impaired neuronal growth, and behavioral impairment, which were rescued with co-injection of WT NAV3 mRNA and not by transcripts encoding the pathogenic variants. Our findings establish the role of NAV3 in neurodevelopmental disorders, and reveal its involvement in neuronal morphogenesis, and neuromuscular responses.

Abstract This study presents a comprehensive analysis of a nonlinear telecommunications model, exploring bifurcation, stability, and wave solutions using Hamiltonian and Jacobian techniques. The investigation begins with a thorough examination of bifurcation behavior, identifying critical points and their stability characteristics, leading to the discovery of diverse bifurcation scenarios. The stability of critical points is further assessed through graphical and numerical methods, highlighting the sensitivity to parameter variations. The study delves into the derivation of both numerical and analytical wave solutions, aligning them with energy orbits depicted in phase portraits, revealing a spectrum of wave behaviors. Additionally, the analysis extends to traveling wave solutions, providing insights into wave propagation dynamics. Notably, the study underscores the efficacy of the planar dynamical approach in capturing system behavior in harmony with phase portrait orbits. The findings have significant implications for telecommunications engineers and researchers, offering insights into system behavior, stability, and signal propagation, ultimately advancing our understanding of complex nonlinear dynamics in telecommunications networks.

Abstract Studies on the association between coffee consumption and risk of lung cancer have been conflicting. The aim of this study was to systematically review the current evidence on the association between coffee consumption and risk of lung cancer and to quantify this association by performing a meta-analysis. A comprehensive systematic search was performed on online databases up to July 2023 investigating the association between coffee consumption and risk of lung cancer. All prospective cohort studies reporting odds ratios (ORs), rate or risk ratios (RRs), or hazard ratios (HRs) and 95% confidence intervals (CIs) in this context were included. The overall effect size was calculated using the random-effects model and statistical between-studies heterogeneity was examined using Cochrane’s Q test and I2. A total of 14 prospective cohort studies were included in this systematic review and meta-analysis. We found a significant positive association between coffee consumption and risk of lung cancer (RR: 1.28; 95% CI: 1.12, 1.47). This association remained significant when we included a pooled analysis paper and excluded 5 cohort studies (RR: 1.37; 95% CI: 1.12, 1.66). We observed no proof of significant publication bias using Egger’s test (P = 0.58). Moreover, dose–response analysis showed that each one cup/day increase in coffee consumption was related with a 6% higher lung cancer risk (RR: 1.06; 95% CI: 1.03, 1.09). In conclusion, we found a significant positive association between coffee consumption and risk of lung cancer.

Objective: Benign fibroosseous lesions (BFOLs) encompass a heterogenous collection of bone conditions characterized by replacing normal bone with fibro-collagenous tissue with osteoid or woven bone, and cementicles. Despite their clinical significance, the frequency of BFOLs in Saudi Arabia still needs to be assessed. Methods: This retrospective study investigated the frequency and demographics of BFOLs in Riyadh, Saudi Arabia, by retrieving all cases recorded between January 1984 and January 2013 from a single Oral Pathology Laboratory archive. Results: A total of 64 cases were classified as BFOLs, with a predominance in females (67.2 %) and a median age of 21.5 years. The most prevalent condition identified was fibrous dysplasia (45.31 %), followed by cemento-ossifying fibroma (26.56 %). There were significant sex differences between BFOLs, with a p-value of 0.03. FD was predominantly located in the maxilla (65.5 %), whereas COF was predominantly found in the mandible (82.3 %). Recurrence was observed in 17.2 % of patients with FD, in contrast to no reported recurrence in patients with COF. Conclusion: This study represents the first exploration of BFOL frequency and demographics in Riyadh, Saudi Arabia, highlighting the need for further investigations to comprehensively understand the nature of these lesions in our population.

Extra-medullary plasmacytoma (EMP) is a rare tumor that most frequently occur in the head and neck region, with the paranasal sinuses, nasopharynx and tonsils being the most common sites. Diagnostic criteria for EMP include histological confirmation of a solitary plasma cell lesion, the presence of fewer than 5% plasma cells in the bone marrow, and the absence of end-organ damage commonly associated with multiple myeloma. CT scans and MRI features are nonspecific and can mimic those of other conditions. EMP of the nasopharynx presents as a slow-growing, radiosensitive mass with a favorable prognosis.We present the case of a 55-year-old male patient who sought medical attention for recurrent epistaxis. An endoscopic examination revealed a tumor located in the nasopharynx, which was confirmed by MRI as a confined nasopharyngeal mass. Subsequent pathology studies, laboratory results, and bone marrow biopsy were consistent with a solitary EMP of the nasopharynx.

Core needle biopsy is a common diagnostic procedure in breast cancer patients, but it can occasionally lead to serious complications. We report a rare case of pseudoaneurysm formation following a core needle biopsy in a 54-year-old female patient diagnosed with breast cancer. Despite the routine nature of the procedure, the patient developed a palpable mass at the biopsy site, which prompted further diagnostic imaging and interventions. The pseudoaneurysm was effectively treated using a percutaneous approach with ultrasound-guided thrombin injection, demonstrating a minimally invasive solution that promptly addressed the complication without the need for surgical intervention. This case highlights the critical importance of detecting complications early in the biopsy process, as they have significant implications for disease staging and treatment initiation. It also underscores the importance of being prepared for immediate intervention in case of biopsy-related complications like pseudoaneurysms, to prevent severe consequences.

Jeune syndrome, a rare autosomal recessive disorder, is characterized by skeletal abnormalities, particularly a narrow, bell-shaped chest, leading to severe respiratory distress in newborns. This case report details a full-term female neonate presenting with significant respiratory challenges, typical skeletal features, and early-onset renal dysfunction. Despite normal initial imaging, persistent renal abnormalities were observed, underscoring the need for early diagnosis, vigilant monitoring, and a multidisciplinary management approach to optimize outcomes for patients with Jeune syndrome.