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The Electron-Ion Collider (EIC), a state-of-the-art facility for studying the strong force, is expected to begin commissioning its first experiments in 2028. This is an opportune time for artificial intelligence (AI) to be included from the start at this facility and in all phases that lead up to the experiments. The second annual workshop organized by the AI4EIC working group, which recently took place, centered on exploring all current and prospective application areas of AI for the EIC. This workshop is not only beneficial for the EIC, but also provides valuable insights for the newly established ePIC collaboration at EIC. This paper summarizes the different activities and R&D projects covered across the sessions of the workshop and provides an overview of the goals, approaches and strategies regarding AI/ML in the EIC community, as well as cutting-edge techniques currently studied in other experiments.

Assessing the feasibility of 2030 as a target date for global elimination of trachoma, and identification of districts that may require enhanced treatment to meet World Health Organization (WHO) elimination criteria by this date are key challenges in operational planning for trachoma programmes. Here we address these challenges by prospectively evaluating forecasting models of trachomatous inflammation-follicular (TF) prevalence, leveraging ensemble-based approaches. Seven candidate probabilistic models were developed to forecast district-wise TF prevalence in 11 760 districts, trained using district-level data on the population prevalence of TF in children aged 1-9 years from 2004 to 2022. Geographical location, history of mass drug administration treatment, and previously measured prevalence data were included in these models as key predictors. The best-performing models were included in an ensemble, using weights derived from their relative likelihood scores. To incorporate the inherent stochasticity of disease transmission and challenges of population-level surveillance, we forecasted probability distributions for the TF prevalence in each geographic district, rather than predicting a single value. Based on our probabilistic forecasts, 1.46% (95% confidence interval [CI]: 1.43-1.48%) of all districts in trachoma-endemic countries, equivalent to 172 districts, will exceed the 5% TF control threshold in 2030 with the current interventions. Global elimination of trachoma as a public health problem by 2030 may require enhanced intervention and/or surveillance of high-risk districts.

Abstract Background Due to the adverse effects of industrial chemicals and their carcinogenicity and toxicity for humans, the debates have increased on using natural preservatives. This study was conducted to investigate the inhibitory effect of pure nisin and nisin nanoparticles (nisin NPs) against Aspergillus flavus in vivo by inoculation in laboratory-manufactured Ras cheese. A novel, safe, and natural approach of nanoprecipitation using acetic acid was employed to prepare nisin nanoparticles. The prepared NPs were characterized using zeta-sizer, FTIR, and transmission electron microscopy (TEM). Furthermore, the cytotoxicity of nisin NPs on Vero cells was assessed. The minimum inhibitory concentrations (MICs) of nisin and its nanoparticles were determined in vitro against A. flavus isolates using the agar well-diffusion method. The sensory evaluation of manufactured Ras cheese was conducted over a 60-day storage period. Results The obtained results showed a strong antifungal activity of nisin NPs (0.0625 mg/mL) against A. flavus strain in comparison with pure nisin (0.5 mg/mL). Notably, the count decreased gradually by time from 2 × 108 at zero time and could not be detected at the 7th week. The count with pure nisin decreased from 2 × 108 at zero time and could not be detected at the 10th week where it’s enough time to produce aflatoxins in cheese. The MICs of nisin and nisin NPs were 0.25 and 0.0313 mg/mL, respectively. Nisin NPs used in our experiment had good biocompatibility and safety for food preservation. Additionally, the sensory parameters of the manufactured Ras cheese inoculated with nisin and nisin NPs were of high overall acceptability (OAA). Conclusions Overall, the results of this study suggested that adding more concentration (˃0.0625 mg/mL) from nisin nanoparticles during the production of Ras cheese may be a helpful strategy for food preservation against A. flavus in the dairy industry.

Abstract Purpose The conundrum of limited resources in developing countries leads to the abonnement and underutilization of percutaneous coronary intervention for chronic total occlusion, in addition to lack of expertise, limited supplies, and success rates. We embraced this challenge by initiating a dedicated program in a tertiary academic center in Egypt, aiming for optimum utilization of resources, limit cost, and gaining experience. We present our outcomes and the proficiency in establishing the program. Methods We enrolled all patients undergoing percutaneous coronary intervention for chronic total occlusion during the first year of initiating our dedicated program. Analysis of clinical data, angiographic findings, and procedural features were evaluated, aiming to evaluate outcomes. Our primary outcome was successful recanalization achievement, utilization of available resources and cost. Secondary outcomes such as peri-procedural myocardial infarction, coronary perforation, urgent need of coronary artery bypass grafting, cerebrovascular stroke, and mortality were assessed. Results Our study enrolled 64 patients electively admitted to the Critical Care Department, Cairo University, undergoing percutaneous coronary intervention for chronic total occlusion. The median J-CTO score was 2 (0–5). We achieved successful recanalization in 47 patients (73%). The mean procedural time was 123 ± 48.8 min, mean contrast volume was 359.03 ± 151.9 ml, and mean radiation dose was 9.4 ± 4.2 Gy. The mean number of wires per patient was 2.69 ± 1.32, and the most successful crossing strategy was antegrade wiring (56.3%). The commonest cause of failure was failure of re-entry (46.7%). One patient had peri-procedural MI (1.6%), and one patient required urgent CABG. There was no in-hospital mortality or cerebrovascular stroke. The cost ranged from 6520 Egyptian Pounds (EP) ($415) to 63,720 EP ($4058), with a mean of 26,213 EP ($1670). Conclusions Establishing a dedicated program for percutaneous coronary intervention for chronic total occlusion proved to be feasible and proficient, achieving high success rates with limited complications in view of limited resources, rationalized utilization of equipment, and limitation of hospital costs.

Bimetallic nanoparticles (BNPs) have garnered a great interest rather than monometallic nanoparticles (NPs) in terms of biotechnological applications due to their enhanced properties. They have a growing interest as promising biomedical agents for drug delivery, antibacterial, and anticancer treatments due to their significant permeability and retention effects. Both of nano-size copper (Cu) and selenium (Se) exhibited a significant activity in biological treatment and drug delivery systems. Consequently, the present work aimed to focus on the novel biogenic synthesis of Cu-Se BNPs using cell-free extract of a marine bacterium, and studying their anticancer and antioxidant activities. Based on 16S rDNA sequencing, the isolated marine bacterium was identified Bacillus amyloliquefaciens by phylogenetic analysis. Biogenic synthesis of Cu-Se BNPs was optimized by studying the effect of some physiological factors such as reaction time, pH, and temperature. Based on the reaction conditions, the biologically synthesized Cu-Se NPs was obtained with different particle size that ranged from 15.7-106.0 nm. The spherical small sized (15.7 nm) bimetallic Cu-Se BNPs displayed anticancer activity against HepG2 and MDA cell lines, while the cell viability was reduced by 87 % and 81 %, respectively. The estimated IC50 values were 696.4 µg/ ml for HepG2 and 273.9 µg/ ml for MDA, while scavenging capacity (SC) of Cu-Se BNPs (SC50 = 305.3 µM) showed lower ability to 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) scavenging compared to ascorbic acid (SC50 = 95.9 µM).

Abstract Background Binge-watching has become increasingly popular in recent years. Although it can provide a form of entertainment and mood regulation, it has also been associated with adverse mental health issues. In this study, we explored the association between binge-watching behavior and mental health. Methods Using a cross-sectional survey conducted from May to November 2018, we surveyed 535 participants over 18 years old from Ain Shams University by using a combination of online and pen-and-paper methods. Data on sociodemographic characteristics and TV series watching patterns were collected, and participants completed the Binge-Watching Engagement and Symptoms Questionnaire (BWESQ), the Brief Symptom Inventory (BSI-18), and the Subjective Happiness Scale (SHS). Results Among the 535 participants surveyed, 333 were retained and divided into three groups (i.e., non-binge-watchers, trouble-free binge-watchers, and problematic binge-watchers) in accordance with previous binge-watching research. Significant between-group differences were found in terms of relationship status, commonly used devices (mobile, laptop, TV), and perceived dependency on TV series watching. Problematic binge-watchers showed significantly higher scores for all BWESQ and BSI-18 subscales. Conclusion Trouble-free binge-watchers and problematic binge-watchers were more likely to be single than non-binge-watchers and demonstrated a marked preference for using mobile phones and laptops over traditional television. A significant positive relationship was found between problematic binge-watching and symptoms of depression, anxiety, and somatization.

Abstract Background Psychological repercussions resulting from coronavirus disease 2019 (COVID-19) have been encountered, such as anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD). The study aimed to assess the frequency and severity of PTSD, depression, and anxiety in a sample of Egyptian patients with COVID-19 infection and analyze potential risk factors. The current study is a descriptive cross-sectional, hospital-based study, conducted from August 2020 to June 2021. The sample was selected from patients diagnosed with COVID-19 infection at Ain Shams University hospitals (outpatient clinics and inpatient units). Patients underwent a COVID severity criteria scoring system, structured clinical interview for DSM-IV (SCID-I), PTSD checklist–Civilian Version (PCLC), Beck depression inventory, and Taylor’s manifest anxiety scale. Results PTSD was observed in 79.29% of the study sample, 61.43% had depression, and 18.57% had anxiety. The severity of COVID-19 infection was significantly associated with PTSD severity mean scores (P value = 0.027). Furthermore, a significant relationship was observed between the severity of depression and COVID-19 infection severity (P value = 0.028). The number of comorbid medical risk factors demonstrated significance to PTSD severity (P value = 0.014). Conclusion A significant portion of the study’s patients experienced psychiatric consequences following COVID-19 infection, with 79.29% developing PTSD, 61.43% suffering from depression, and 18.57% experiencing anxiety. Various factors, such as the presence of chronic medical illnesses and the number of co-morbid medical risk factors, were observed to contribute to these psychiatric outcomes. Therefore, comprehensive psychiatric assessment and management in COVID-19 patients especially with severe forms of the disease and hospitalized patients are mandatory.

Abstract Background The dynamic and demanding nature of healthcare environments necessitates that nurses not only possess clinical proficiency but also exhibit high levels of work readiness to adapt swiftly to changes. Authentic leadership has been recognized as a critical factor influencing various organizational outcomes. Aim Investigating the mediating role of nurses’ agility in the relation between authentic leadership and nurses’ work readiness. Design and method A correlational analytical research design was utilized following STROBE guidelines, and data were collected from 249 nurses at a hospital affiliated with Beni-Suef University, Egypt. Instruments included authentic leadership Questionnaire, work readiness scale, and workforce agility scale. Data was collected from the beginning of March to the end of April 2024. Results The findings indicate that authentic leadership was notably strong regarding morality/ethics dimension (mean score: 15.81), and nurses demonstrated relatively high agility levels, particularly in proactivity (mean score: 29.16). Organizational acumen scored highest in work readiness dimensions (mean score: 53.94). Nurses’ overall scores for study variables ranged from 72 to 80% of the maximum, with agility scoring highest (mean score: 85.77). Significant positive correlations were found between variables, especially between nurses’ agility and authentic leadership (r = 0.362). Conclusion Path analysis reveals nurses’ agility as a paramount mediator between authentic leadership and nurses’ work readiness, indicating its vital role in transmitting the positive effects of authentic leadership. Practical implications include establishing authentic leadership programs that foster nurses’ agility especially proactive behaviors. That in turn improve nurses’ readiness for various work responsibilities.

Abstract Background Cardiovascular disease (CVD) is the leading cause of death globally, with women at higher risk after menopause. This increased risk is attributed to both aging and hormonal changes. Prior research has established a link between CVD risk perception and adopting healthy behaviors to prevent CVD. This study aimed to assess the accuracy of self-perceived CVD risk in perimenopausal and postmenopausal women, and to identify factors that predict CVD risk underestimation among them. Methods A cross-sectional study was conducted in the administrative sectors of Suez Canal University campus in Ismailia, Egypt, over a period of eight months starting in July 2022. A total of 390 eligible women (employees and workers) were randomly selected. Participants were interviewed to obtain data on demographics, medical history, self-perceived risk of CVD, self-perceived general health, awareness of factors that increase the risk of developing CVD, perceived stress, health literacy, numeracy, and self-perceived 10-year risk of developing major cardiovascular events. They also underwent measurements of blood pressure, weight, and height. The updated 2019 WHO/CVD risk non-laboratory-based prediction chart for the North Africa and Middle East Region was used to predict the 10-year risk of major cardiovascular events for the study participants. Risk accuracy was measured by comparing self-perceived CVD risk with predicted CVD risk. Results The ratio of self-perceived to predicted moderate/high CVD risk was 27.7% to 44.3%, respectively. The accuracy of CVD risk perception was 68.2%. Kappa analysis results showed fair and significant agreement between self-perceived and predicted CVD risk (kappa ± SE = 35.9 ± 4.1%, p

Tackling sustainable development from a comprehensive approach still needs to be well yielded in academia and research in the undergraduate curricula of most urban studies. This paper presents teaching and learning experiences in architectural education in the sustainable development field. It experiences different theoretical and practical approaches given in an undergraduate elective course to students in the Architecture and Urban Design Program (ARUD) at Nile University. Different teaching processes are shown through class activities, a peer-to-peer review, linking with industries, group discussions, writing a critical review of scientific papers, outlining the urban challenges and proposing sustainable strategic approaches of "lost urban spaces" with a particular focus on Giza Zoo. Moreover, it raises the ability to mandate the effectiveness of proposed solutions into applicable and integrative solving scenarios. In summary, this research encompasses comprehensive sustainable development approaches in architectural education to highlight the potential and beneficiaries of the proposed methods in architectural pedagogy seeking urban development. The proposed teaching strategies address the potential for improvement in architectural education in the sustainability field and show initiatives for urban planners, urban designers and policymakers show initiatives for urban planners, urban designers and policymakers show initiatives for urban planners, urban designers and policymakers to enhance public space design through sustainable development considerations. لا يزال دمج التنمية المستدامة بنهج شامل بحاجة إلى تحقيق نتائج ملموسة في الأوساط الأكاديمية والبحثية ضمن المناهج الجامعية لمعظم الدراسات الحضرية. تعرض هذه الورقة البحثية تجارب عمليات التدريس والتعلم في التعليم المعماري في مجال التنمية المستدامة. و تشمل هذه الدراسه على اختبار مناهج نظرية وعملية مختلفة مقدمة في مادة دراسية اختيارية للطلاب الجامعيين في برنامج الهندسة المعمارية والتصميم العمراني (ARUD) بجامعة النيل. يتم عرض عمليات التدريس المختلفة من خلال الأنشطة الصفية، واستعراض النظائر، والربط مع الصناعات، والمناقشات الجماعية، كتابة تحليلات نقدية للأوراق البحثية، ثم تحديد التحديات الحضرية واقتراح مناهج استراتيجية مستدامة "للمساحات الحضرية المفقودة" مع التركيز على حديقة حيوان الجيزة .بالإضافة الى ذلك، يؤكد البحث على فعالية الحلول المقترحة المتكاملة في سيناريوهات الحل القابلة للتطبيق. يتضمن هذا البحث مناهج التنمية المستدامة الشاملة في التعليم المعماري لتسليط الضوء على فوائد وتأثيرات الأساليب المقترحة في التربية المعمارية التي تسعى إلى تعزيز التنمية الحضرية. تتناول استراتيجيات التدريس المقترحة إمكانية تحسين التعليم المعماري في مجال الاستدامة وتظهر مبادرات للمخططين الحضريين والمصممين الحضريين وصانعي السياسات لتعزيز تصميم الأماكن العامة من خلال اعتبارات التنمية المستدامة.

Background: Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes. PATIENTS AND METHODS: This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10–16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30). Results: A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle. Conclusions: Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.

Abstract Compressive sensing (CS) has been widely used to sense the wideband spectrum with fewer measurements by taking advantage of radio spectrum underutilization. As new smart devices, such as IoT devices, smart home devices, and wearables, use batteries and have limited memory, more research is needed to reduce the overuse of cognitive radio (CR) resources through spectrum sensing. To reduce the number of compressive measurements required for spectrum recovery, researchers proposed approaches like weighted and sequential compressive sensing. In this paper, we estimate the primary user’s (PU) behavior statistics and use the estimated information in a novel weighted sequential compressive spectrum sensing approach. Our proposed approach can reduce and adapt the number of measurements and the sensing time to the changing number of active channels in a dynamically changing wideband spectrum.

Abstract Background Acute pulmonary embolism is recorded as one of the most common and critical medical conditions, resulting in a notable mortality rate requiring a multidisciplinary management. In this series, we address the management of massive and sub-massive pulmonary embolism utilizing catheter-based intervention, in particular the conjunction of mechanical thrombus disruption and aspiration with pharmacological thrombolysis (pharmacomechanical thrombectomy). Results 37 patients were diagnosed with massive and sub-massive pulmonary embolism based on the clinical and radiological findings. Pre-procedural vital parameters were obtained, including oxygen saturation, pulse rate, and blood pressure. Under continuous monitoring and conscious sedation, a pulmonary angiography via right common femoral vein access was performed for pre-procedural assessment. Pharmacomechanical thrombectomy was performed using the AngioJet Ultra System (Boston Scientific). Using the power pulse option, a fibrinolytic agent was infused into the thrombus. After 5–10 min, mechanical thrombectomy is performed with a maximum 3 passes through the thrombus. This technique is performed in the main pulmonary artery and lower branch. The procedure is repeated on the other side. The maximum duration of thrombectomy is 2–3 min on each side. Procedure success was based on improvement of vital signs and not related to post-procedure angiographic findings. All patients showed immediate improvement of vital signs (blood pressure, 02 saturation, and pulse rate) with progressive improvement over the following days. There were no procedure-related complications. Conclusion Pharmacomechanical thrombectomy is a safe and effective technique in the treatment of massive and submassive pulmonary embolism. It can be a first-line treatment even in patients without absolute contraindication to systemic thrombolysis.

Abstract The aim of this study is to evaluate the role of serum level of Interleukin 6(IL-6) and Interleukin 17 (IL-17) in liver transplantation outcome for living recipients, Analyze the relation between the gene polymorphism and the occurrence of rejection after liver transplantation and Study the relation between the gene polymorphism and the occurrence of different infectious complications. The study was conducted in March 2023 and included 60 healthy volunteers from the National Liver Institute (NLI) blood bank at Menoufia University and 120 live donation liver recipient patients at NLI. During one month of liver transplantation, the cytokine levels (IL-17, IL-6 proteins, IL-6 G-174C, and IL-17 A rs2275913 gene polymorphism) and CD4 levels for 60 patients of 120 live donation liver recipient patients whom early reject transplanted tissue and the same parameters were measured after 6 months follow up for non-reject group. The main finding of this study was that the post-transplant rejection group and the post-transplant non-rejection and control groups differed significantly in the genotype frequency (CC, CG, and GG) or alleles of IL-6 G-174C (p = 0.011). On the other hand IL-17A rs2275913 gene polymorphism and its alleles (p = 0.71) showed no statistically significant difference. We also observed that serum IL-17 levels, with 100% specificity and 100% sensitivity threshold, will be more sensitive and specific than serum IL-6 and CD4 count in differentiating post-transplant rejection from non-rejection patients. The results showed that there was no significant relationship between the genotypes and serum levels of interleukins and the type and degree of rejection. Proinflammatory cytokines might be useful indicators for distinguishing and early identifying unfavorable outcomes after transplantation, allowing for prompt and effective treatment intervention. To evaluate these findings, prospective clinical trials are required.

Abstract Purpose Acute decompensated heart failure (ADHF) patients with a poor renal function have a worse prognosis. The urea-to-creatinine ratio (UCR) may be a valuable tool for assessing kidney function and stratifying patients with ADHF. We evaluated the value of an admission and follow-up UCR in predicting AKI, 28-day mortality, and rehospitalization in patients with ADHF. Methods This prospective research comprised sixty patients with ADHF. Based on the mean admission UCR, patients are classified into two groups: the high UCR group (UCR ≥ 42.33) and the low UCR group (UCR 34.85 (p

Abstract This is the primary study at Matrouh Governorate to unveil antibiotic resistance, biofilm formation, silver nanoparticles (Ag-NPs) effect using electron microscopy, and REP-PCR analysis of Staphylococcus aureus strains isolated from COVID-19 patients, contaminated food, and Morel’s diseased sheep and goats. A total of 15 S. aureus strains were isolated; five from each of the COVID-19 patients, Morel's diseased sheep and goats, and contaminated food. All strains were considered multidrug-resistant (MDR). All strains showed the presence of biofilm. Morphological changes in the cell surface of the bacterium were evidenced, and penetration with the rupture of some bacterial cells. Based on REP-PCR analysis, 4 clusters (C1-C4) with dissimilarity between clusters C1 and C2 8% and between C3 and C4 15%. Cluster I included 3 strains from contaminated food with a similarity of 97%, and Cluster II included 2 strains from contaminated food and 2 from COVID-19-infected patients with a similarity of 96% (confirming the zoonotic nature of this pathogen). Cluster III contained 4 strains isolated from Morel's diseased sheep & goats with a similarity ratio of 99% in comparison the 4th cluster contained 3 strains isolated from COVID-patients and one from Morel's diseased sheep & goats with a similarity ratio of 92%.

Abstract Atrazine is a widely used toxic herbicide that poses a threat to both the environment and human health. This study investigates the removal of Atrazine from water through armchair-hexagonal hexagonal graphene quantum dots (AHEX) simulations. The investigations are performed using density functional theory at the exchange–correlation hybrid functional B3LYP/3-21G level of theory. The activity of pristine AHEX, with a total dipole moment of 0.0 (debye), is enhanced by doping with boron (B), nitrogen (N), and sulfur atoms (S), resulting in increased total dipole moments of 8.99, 5.29, and 4.14 Debye respectively. This enhancement occurs without any structural deformation due to the doping process. Our results show significant adsorption capacity of the doped nanographene for Atrazine, evidenced by the high adsorption energies of 0.52 eV for boron, 0.62 eV for nitrogen, and 2.97 eV for sulfur. Charge distribution on the atrazine complexes further confirms effective interaction, with values of 0.03, − 0.018, and 0.032 (e). UV–vis spectroscopy reveals that the prominent absorption peaks of boron and nitrogen-doped samples, initially at ~ 658.8 and 431 nm, undergo a redshift to ~ 676 and 444.3 nm after adsorption, respectively. This redshift aligns with the dominant excitation moving to lower energies following adsorption. Conversely, the sulfurated nanographene shows a blue shift from 980.66 to 485.41 nm. These findings highlight the potential of doped nanographene as an effective treatment for atrazine-contaminated water.

Abstract Electric vehicles are considered as an emerging solution to mitigate the environmental footprint of transportation sector. Therefore, researchers and automotive developers devote significant efforts to enhance the performance of electric vehicles to promote broader adoption of such technology. One of the critical challenges of the electric vehicle is limited battery lifetime and entailed range anxiety. In his context, development of counter-aging control strategies based on precise battery modeling is regarded as an emerging approach that has a significant potential to address battery degradation challenges. This paper presents a combined trade-off strategy to minimize battery degradation while maintaining acceptable driving performance and charge retention in electric vehicles. A battery aging model has been developed and integrated into a full vehicle model. An optimal control problem has been formulated to tackle the afore-mentioned challenges. Non-dominant sorting genetic algorithms have been implemented to yield the optimal solution through the Pareto-front of three contending objectives, based upon which an online simulation has been conducted considering three standard driving cycles. The results reveal the ability of the proposed strategy to prolong the life cycle of the battery and extend the driving range by 25 % and 8 % respectively with minimal influence of 0.6 % on the driveability.

Abstract Background In low- and middle-income countries (LMICs), such as Tanzania, the competency of healthcare providers critically influences the quality of pediatric care. To address this issue, we introduced Pediatric Acute Care Education (PACE), an adaptive learning program to enhance provider competency in Tanzania’s guidelines for managing seriously ill children. Adaptive learning is a promising alternative to current in-service education, yet optimal implementation strategies in LMIC settings are unknown. Objectives (1) To evaluate the initial PACE implementation in Mwanza, Tanzania, using the construct of normalization process theory (NPT); (2) To provide insights into its feasibility, acceptability, and scalability potential. Methods Mixed-methods study involving healthcare providers at three facilities. Quantitative data was collected using the Normalization MeAsure Development (NoMAD) questionnaire, while qualitative data was gathered through in-depth interviews (IDIs) and focus groups discussions (FGDs). Results Eighty-two healthcare providers completed the NoMAD survey. Additionally, 24 senior providers participated in IDIs, and 79 junior providers participated in FGDs. Coherence and cognitive participation were high, demonstrating that PACE is well understood and resonates with existing healthcare goals. Providers expressed a willingness to integrate PACE into their practices, distinguishing it from existing educational methods. However, challenges related to resources and infrastructure, particularly those affecting collective action, were noted. Early indicators point toward the potential for long-term sustainability of the PACE, but assessment of reflexive monitoring was limited due to the study’s focus on PACE’s initial implementation. Conclusion This study offers vital insights into the feasibility and acceptability of implementing PACE in a Tanzanian context. While PACE aligns well with healthcare objectives, addressing resource and infrastructure challenges as well as conducting a longer-term study to assess reflexive monitoring is crucial for its successful implementation. Furthermore, the study underscores the value of the NPT as a framework for guiding implementation processes, with broader implications for implementation science and pediatric acute care in LMICs.

Abstract Despite recent advancements, artificial muscles have not yet been able to strike the right balance between exceptional mechanical properties and dexterous actuation abilities that are found in biological systems. Here, we present an artificial magnetic muscle that exhibits multiple remarkable mechanical properties and demonstrates comprehensive actuating performance, surpassing those of biological muscles. This artificial muscle utilizes a composite configuration, integrating a phase-change polymer and ferromagnetic particles, enabling active control over mechanical properties and complex actuating motions through remote laser heating and magnetic field manipulation. Consequently, the magnetic composite muscle can dynamically adjust its stiffness as needed, achieving a switching ratio exceeding 2.7 × 10³. This remarkable adaptability facilitates substantial load-bearing capacity, with specific load capacities of up to 1000 and 3690 for tensile and compressive stresses, respectively. Moreover, it demonstrates reversible extension, contraction, bending, and twisting, with stretchability exceeding 800%. We leverage these distinctive attributes to showcase the versatility of this composite muscle as a soft continuum robotic manipulator. It adeptly executes various programmable responses and performs complex tasks while minimizing mechanical vibrations. Furthermore, we demonstrate that this composite muscle excels across multiple mechanical and actuation aspects compared to existing actuators.

Abstract Chromosomal instability (CIN) is a pivotal factor in gliomas, contributing to their complexity, progression, and therapeutic challenges. CIN, characterized by frequent genomic alterations during mitosis, leads to genetic abnormalities and impacts cellular functions. This instability results from various factors, including replication errors and toxic compounds. While CIN’s role is well documented in cancers like ovarian cancer, its implications for gliomas are increasingly recognized. CIN influences glioma progression by affecting key oncological pathways, such as tumor suppressor genes (e.g., TP53), oncogenes (e.g., EGFR), and DNA repair mechanisms. It drives tumor evolution, promotes inflammatory signaling, and affects immune interactions, potentially leading to poor clinical outcomes and treatment resistance. This review examines CIN’s impact on gliomas through a narrative approach, analyzing data from PubMed/Medline, EMBASE, the Cochrane Library, and Scopus. It highlights CIN’s role across glioma subtypes, from adult glioblastomas and astrocytomas to pediatric oligodendrogliomas and astrocytomas. Key findings include CIN’s effect on tumor heterogeneity and its potential as a biomarker for early detection and monitoring. Emerging therapies targeting CIN, such as those modulating tumor mutation burden and DNA damage response pathways, show promise but face challenges. The review underscores the need for integrated therapeutic strategies and improved bioinformatics tools like CINdex to advance understanding and treatment of gliomas. Future research should focus on combining CIN-targeted therapies with immune modulation and personalized medicine to enhance patient outcomes.

Background: Trimethoprim-sulfamethoxazole (TMP-SMX) has long been considered the treatment of choice for infections caused by Stenotrophomonas maltophilia. Levofloxacin has emerged as a potential option for treating these infections. This study aimed to evaluate the clinical outcomes in patients who received TMP-SMX versus levofloxacin for treating S. maltophilia infections. Methods: A retrospective, cohort study was conducted in 4 tertiary centres and included patients who were treated with either TMP-SMX or levofloxacin for infections caused by S. maltophilia. The main study outcomes were overall in-hospital mortality, 30-d mortality, and clinical cure. Safety outcomes were also evaluated. Multivariate analysis using logistic regression was used to control for the effect of the covariables. Results: We included 371 patients in this study, 316 received TMP-SMX and 55 patients received levofloxacin. A total of 70% were in the intensive care unit and 21% presented with bacteraemia. No statistically significant differences were observed in overall in-hospital mortality (52% vs. 40%; P = 0.113; odd ratio [OR], 1.59; 95% confidence interval [CI], 0.89–2.86), 30-d mortality (28% vs. 25%; P = 0.712; OR, 1.13; 95% CI, 0.59–2.18), or clinical cure (55% vs. 64%; P = 0.237; OR, 0.70; 95% CI, 0.37–1.31). Rates of acute kidney injury were comparable between the two groups (11% vs. 7%; P = 0.413). Conclusion: Patients receiving levofloxacin for the treatment of infections caused by S. maltophilia demonstrated clinical outcomes similar to those receiving TMP-SMX. Our study suggests that levofloxacin can be a reasonable alternative to TMP-SMX to treat these infections.

Background Since the emergence of the pandemic, healthcare workers have been subjected to devastating psychological burden at all levels of healthcare. Depression, anxiety, and stress were greatly encountered in the era of the pandemic. Moreover, healthcare workers reported escalating levels of burnout syndrome compared to levels reported in the pre-pandemic era. They are exposed to multiple work-related stressors that have been exhausting to their mental and psychological well-being. The aim of the current study was to assess the impact of COVID-19 pandemic on the psychological well-being of healthcare workers.Methods A comparative cross-sectional study was conducted among 471 healthcare workers (245 front-line and 226 second-line healthcare workers) recruited from ten governmental hospitals. Data was collected using self-administered structured questionnaire, Depression, Anxiety and Stress Scale-21 Items (DASS-21) and Copenhagen Burnout Inventory (CBI).Results Symptoms suggestive of depression, anxiety, and stress were reported by 72.6%, 31.4%, and 18.6% of studied healthcare workers, respectively. Front-line healthcare workers had significantly higher mean anxiety and stress scores compared to second-line ones.Burnout syndrome was reported by 86.4% of the study subjects, with statistically significant differences between front-line and second-line healthcare workers. The most commonly adopted organizational interventions against work-related stressors were increased workforce (41.6%), frequent staff meetings (32.3%), shifts rescheduling (31.4%), frequent breaks during the working day (29.1%), and staff training (16.8%). As for individually adopted interventions, following strict protective measures (63.5%), gaining more knowledge about COVID-19 (54.1%), avoiding media news (44.8%), and relaxation activities such as prayers, music, and meditation (37.2%) were the most commonly adopted interventions.