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Background: Computed tomography pulmonary angiography (CTPA) is a non-invasive imaging method that can quickly diagnose pulmonary embolism. This study aimed to compare test bolus and bolus track contrast enhancement protocols to determine the optimal technique for CTPA in the diagnosis of pulmonary embolism. Methods and Results: This retrospective study was conducted at the King Abdul-Aziz Specialist Hospital (KASH) in Taif city from September 2022 to March 2023. Ninety-eight patients with suspected PE were included in the study: underwent CTPA using the test bolus (TB) approach, and 49 patients underwent CTPA using the bolus tracking (BT) approach. The examination was performed using a 128-slice CT scanner. Densities of pulmonary arteries were measured based on the Hounsfield unit (HU) and compared between two groups (TB and BT) based on gender and age. The mean HU of the pulmonary arteries was significantly higher in the TB group than that of the BT group (392.06±110.77 HU and 298.9±93.098 HU, respectively, P=0.001). There was no statistically significant difference in the mean HU between females of the two groups [P=0.062]. In contrast, men in the TB group had a substantially greater density (384.7±116 HU) than men in the BT group (273.0±88.0 HU) [P=0.001]. There were no statistically significant differences between the two groups based on age except for the age subgroup 46-55 years; the TB group exhibited considerably higher density (421.54±138.148 HU) than the BT group (255.2±82.155 HU) [P=0.003]. The ANOVA test showed no statistically significant correlation between the effects of tracking systems, gender, and age on tracking intensity [P=0.640]. Conclusion: Both TB and BT procedures are accurate for diagnosing pulmonary embolism. A TB protocol results in significantly better opacification of the pulmonary arteries in men aged 46 to 55 than the BT protocol.

Emerging from the confluent processes of translation, research, and discussion that shaped Ghassan Kanafani: Selected Political Writings (2024), this article consists of a set of reflections on the notebooks composed by Kanafani during an earlier, formative period of his political thought. The analyses that follow are based on three unpublished translations of texts from the mid to late 1950s: “A Methodology for Implementing Arab Socialism,” “The Arab cause during the era of the United Arab Republic,” and “Marxism in Theory and Practice: A Discussion.” Setting the context for the distinct themes that occupied Kanafani as a young Arabist, contributors to this study trace the engagement of the writer with socialism, as a dynamic process with the most oppressed sections of humanity as its basis. Read together, the reflections offer new grounding to understandings of political development, and the role played by Marxism in the transformation of the Arab Nationalist Movement and its adherents.

Abstract Background Pericardiocentesis offers a definitive diagnostic and a life-saving therapeutic modality through removal of pericardial fluid and relief of high intrapericardial pressure. Percutaneous pericardiocentesis has been performed via different approaches depending on different institutional experiences. In this paper, we present our institutional experience and review the current literature of the different approaches for performing percutaneous pericardiocentesis. Materials and methods We evaluated consecutive patients who underwent echocardiographic-guided pericardiocentesis via the apical approach for pericardial effusion between the period of April 1st, 2022, and April 1st, 2023, at University of Arkansas for Medical Sciences (UAMS). Health records were reviewed for clinical presentations, available imaging findings, procedural outcomes, and short-term follow up. Results A total of eight consecutive cases of pericardiocentesis via the apical approach were found. Seven were successful. No complications were reported. Six patients had evidence of tamponade physiology on echocardiogram. Conclusion Historically, pericardiocentesis has been most performed via the subxiphoid approach. However, an ultrasound-guided apical approach offers a safe and effective alternative and may be preferable in patients with challenging anatomies.

Over one million Syrian refugees have been residing in substandard living conditions in Lebanon for the past decade. Non-invasive biomonitoring of fractional exhaled nitric oxide (FeNO) as a pulmonary inflammation biomarker was conducted following and preceding indoor environmental assessments (which revealed elevated mould counts in informal tented settlements and non-residential shelters) to further evaluate effects of environmental exposure to indoor contaminants. Results of biomonitoring (n = 57) provided some insight regarding existing respiratory conditions and the possible implementation of minimally invasive methods to establish susceptibility profiles in Syrian refugees amid limited access to healthcare. The clinical interpretation of FeNO results suggested possible persistent exposure to allergens in addition to significant type 2 inflammation in some subjects. These findings warrant the need to expand this study, investigate other biomarkers, and attempt to correlate findings with environmental conditions to evaluate if a dose–response relationship exists.

Abstract Knee osteoarthritis (OA) and obesity are major public health concerns that are closely intertwined. This intimate relationship was documented by considering obesity as the most significant preventable risk factor associated with knee OA. To date, however, the effects of obesity on the knee joint's passive-active structure and cartilage loading have been inconclusive. Hence, this study investigates the intricate relationship between obesity and knee OA, centering on the biomechanical changes in knee joint active and passive reactions during the stance phase of gait. Using a subject-specific musculoskeletal and finite element approach, muscle forces, ligament stresses, and articular cartilage contact stresses were analyzed among 60 individuals with different body mass indices (BMI) classified under healthy weight, overweight, and obese categories. Our predicted results showed that obesity significantly influenced knee joint mechanical reaction, increasing muscle activations, ligament loading, and articular cartilage contact stresses, particularly during key instances of the gait cycle—first and second peak loading instances. The study underscores the critical role of excessive body weight in exacerbating knee joint stress distribution and cartilage damage. Hence, the insights gained provide a valuable biomechanical perspective on the interaction between body weight and knee joint health, offering a clinical utility in assessing the risks associated with obesity and knee OA.

This study focuses on the development of a cement-based phase change material (CBPCM) to improve thermal performance in construction applications. The CBPCM was synthesised by blending 90 wt% of myristic acid with 10 wt% of paraffin wax, absorbed into 10 wt% of silica fume to prevent leakage. Additionally, 5 wt% of zinc oxide was added to improve thermal conductivity. A leakage test conducted with 10 wt% of SF exhibited no signs of leakage during thermal cycling. Scanning electron microscopy (SEM) established the uniform dispersion of the nano-enhanced phase change material (NEPCM) within the cement. Fourier transform infrared spectroscopy (FTIR) analysis revealed no chemical structure changes after 100 thermal cycles. Thermogravimetric analysis (TGA) confirmed thermal stability in the temperature range of 74.8–236.64 °C with a mass loss of 6.3 wt%. The material demonstrated minimal variation in phase change temperatures and latent heats after 100 cycles. The latent heat of the CBPCM was 1.09 J/g during melting and 1.887 J/g during solidification. Incorporating NEPCM into the cement increased the thermal conductivity of the cement matrix to 0.559 W/m K. These findings underline the potential of the CBPCM for energy-efficient construction, offering enhanced thermal storage, stability, and conductivity.

Despite the metaverse's potential to transform digital business, there remains a scarcity of research investigating on how content marketing affects users' intention to use the metaverse. This study aimed to identify if entertainment content marketing affects users to adapt the metaverse. by adapting the Spice framework, incorporating variables like continuity, sense of presence, interoperability, concurrence, and economic flow. Data was collected via an online survey of 454 online gamers from Jordan who were purposefully selected. Structural equation modelling using partial least squares analysis revealed that all five factors positively affected metaverse intention. Overall, the study contributes to the knowledge by examining the Spice Framework in the context of metaverse technologies. Beyond the academic realm, our findings carry practical significance for marketers, policymakers, and stakeholders shaping the dynamic landscape of digital interactions within the metaverse.

Abstract Topic modeling methods proved to be effective for inferring latent topics from short texts. Dealing with short texts is challenging yet helpful for many real-world applications, due to the sparse terms in the text and the high dimensionality representation. Most of the topic modeling methods require the number of topics to be defined earlier. Similarly, methods based on Dirichlet Multinomial Mixture (DMM) involve the maximum possible number of topics before execution which is hard to determine due to topic uncertainty, and many noises exist in the dataset. Hence, a new approach called the Topic Clustering algorithm based on Levenshtein Distance (TCLD) is introduced in this paper, TCLD combines DMM models and the Fuzzy matching algorithm to address two key challenges in topic modeling: (a) The outlier problem in topic modeling methods. (b) The problem of determining the optimal number of topics. TCLD uses the initial clustered topics generated by DMM models and then evaluates the semantic relationships between documents using Levenshtein Distance. Subsequently, it determines whether to keep the document in the same cluster, relocate it to another cluster, or mark it as an outlier. The results demonstrate the efficiency of the proposed approach across six English benchmark datasets, in comparison to seven topic modeling approaches, with 83% improvement in purity and 67% enhancement in Normalized Mutual Information (NMI) across all datasets. The proposed method was also applied to a collected Arabic tweet and the results showed that only 12% of the Arabic short texts were incorrectly clustered, according to human inspection.

The rupture of the gravid uterus is a rare complication of trauma. It is reported in less than one percent of pregnant women who are victims of road accidents. The authors report the case of a 26-year-old nulliparous patient presented with a uterine rupture resulting in fetal death at 32 weeks of gestation following a nonpenetrating abdominal trauma in a road traffic accident. An extreme emergency operation and abdominal laparotomy confirmed the imaging findings and led to conservative treatment of the uterus and a splenectomy.

Abstract Background The ophthalmology workforce is an integral component of any health care system. However, the demand for eye care has imposed a heavy burden on this system. Hence, this study aimed to estimate the trends, demographic characteristics, distribution, and variation between Saudi and non-Saudi ophthalmologists and the future challenges of the ophthalmology workforce in the Kingdom of Saudi Arabia (KSA). Methods This study was conducted in the KSA and included ophthalmologists practicing from 2010 to 2023. From the Saudi Commission for Health Specialties, we obtained the number, gender, nationality, and rank of ophthalmologists. The geographic distribution of ophthalmologists in the KSA was obtained from the Ministry of Health Statistical Yearbook 2021. Results As of January 2023, the KSA had a total of 2608 registered ophthalmologists, with approximately 81.06 ophthalmologists per 1,000,000 people. Only 38% of all ophthalmologists in the country were Saudis. The percentage of Saudi female graduates increased from 13.3% to 37.2% over 12 years [Sen’s estimator of slope for median increase per year = 1.33 (95% CI 1.22–1.57) graduates; trend test P

Mosquito-borne diseases (MBDs), like malaria and mosquito-borne viruses (MBVs), have caused the deaths of millions of people. Their threat resides in the variety of transmission modes that they possess, along with the wide selection of favorable hosts, such as humans, cattle, and rodents. MBDs are increasingly gaining a reputation as one of the most dangerous threats to public health in recent years. Mosquito numbers have been increasing in recent years as a result of multiple factors such as climate change and deforestation. This situation highlights the urgent need for actions to mitigate mosquito and MBD pathogen distributions. In the Middle East, many outbreaks of MBDs have been reported in the region. However, there are no reports of any endemic episodes of MBDs. The Middle East has faced many challenges over the years; however, the Syrian refugee crisis may be strongly related to the spread of infectious diseases. As mass gatherings and high-density populations are common features in the region, it is possible to understand why MBDs can spread easily. This review summarizes the state of MBDs in the Middle East, highlighting the different types of MBDs that have been reported in the region and discussing how to move forward with controlling their spread and limiting the risks they pose. According to the data reported by the electronic State Parties Self-Assessment Annual Reporting Tool (e-SPAR), the capacity to anticipate MBVs varies among Middle East countries. Therefore, the Middle East is on the frontline in the challenge to control a potential public health crisis. Consequently, the countries of the Middle East should be encouraged to improve their health and research capacities to mitigate the threat posed by MBDs.

Purpose Green practices recently gained attention for performance whereas financial and market performance has hardly been addressed by the researchers. Based on dynamic capability theory and resource-based view, we hypothesized that green entrepreneurial orientation and green transformational leadership have a significant impact over green product innovation as well as overall performance.Methodology The researchers collected data from 384 entrepreneurial firms using adopted questionnaires. The analysis has been made by applying structural equation modelling using a bootstrapping sample of 5000 with the help of SMART PLS 3.Findings The study results revealed that green entrepreneurial orientation and green transformational leadership have a significant impact over performance. Moreover, intervening effect of green product innovation is significant between green entrepreneurial orientation and performance of entrepreneurial firms, where green product innovation failed to mediate between green transformational leadership and performance of entrepreneurial firms.Research Limitations The sample was collected from limited cities and only from one developing country where the consumers do not have an elevated level of awareness for environmental concerns.

Abstract Background and Aims Vitamin D deficiency impacts a significant proportion of the world's population, and this deficiency has been linked to various conditions characterized by imbalanced serotonin regulation. The objective of this systematic review and meta‐analysis was to evaluate the effect of vitamin D supplementation on serum serotonin levels. Methods We conducted a comprehensive search of PubMed, Scopus, Cochrane Central for Randomized Clinical Trials, and Web of Science up to September 2022, without any language restrictions. The effect sizes were calculated using the standard mean difference (SMD) and 95% confidence interval (CI). Results Six randomized clinical trials involving 356 participants were included in the analysis. Our findings indicated no significant changes in serotonin levels between the intervention and control groups (SMD: 0.24 ng/mL, 95% CI: −0.28, 0.75, p > 0.10). Subgroup analysis also did not reveal any significant changes in serotonin levels among children, participants with autism spectrum disorders, interventions lasting 10 weeks or longer, or those receiving vitamin D doses below 4000 IU/day. Conclusion Although the results obtained in this systematic review are inconclusive, they support the need for further well‐designed randomized trials to assess the potential role of vitamin D supplementation in regulating serotonin levels and potentially ameliorating depression and related disorders.

Abstract INTRODUCTION Commercially available plasma p‐tau217 biomarker tests are not well studied in ethnically diverse samples. METHODS We evaluated associations between ALZPath plasma p‐tau217 and amyloid‐beta positron emission tomography (Aβ‐PET) in Hispanic/Latino (88% of Cuban or South American ancestry) and non‐Hispanic/Latino older adults. One‐ and two‐cutoff ranges were derived and evaluated to assess agreement with Aβ‐PET. RESULTS A total of 239 participants underwent blood draw and Aβ‐PET (age 70.8 ± 7.8, 55.2% female, education 15.6 ± 3.4 years, 48.9% Hispanic/Latino, 94.9% white). Plasma p‐tau217 showed excellent discrimination of Aβ‐PET positive and negative participants (visual read: AUC = 0.91 [0.87–0.95], p

A large-scale cloud data center must have a low failure incidence rate and great service dependability and availability. However, due to several issues, such as hardware and software malfunctions that regularly cause task and job failure, large-scale cloud data centers still have high failure rates. These mistakes can have a substantial impact on cloud service dependability and need a large resource allocation to recover from failures. Therefore, it is important to have an efficient management of data recovery to protect organizations data from loss. This paper aims to study some factors that may improve the management of data recovery by using quantitative research design as a methodology. The results of hypothesis testing give strong evidence supporting the positive and significant correlations between the proposed hypotheses and the efficiency of data management recovery. This study finds that the presence of a data center in an organization demands the development of a solid plan for the most effective usage of a software program to handle data recovery.

Previously, studies reported inconclusive findings while analyzing the influence of factors affecting online purchase intention. Also, most studies were conducted in the context of developed countries, limiting us to a specific context. Hence, for comprehensive understanding, this study aims at examining the factors affecting the online purchase intention in the e-commerce industry of Jordan. The survey was conducted to collect data from university students in Jordan. Structural equation modeling was employed to analyze the data. Findings show that attitude, subjective norms, perceived behavioral control are positively associated with online purchase intention. However, perceived risks are negatively associated with online purchase intention. Although all factors are significantly related to online purchase intention, the attitude has a greater influence. This study adds value to the theory of planned behavior and consumer behavior by examining attitude, subjective norm, perceived behavioral control, and perceived risks as important predictors of online purchase intention. Besides, this study suggests that online retailers must keep their commitments, promises, and customers’ interests in mind while developing e-commerce strategies.

Abstract Background To discuss the impact of overactive bladder (OAB) on medical students. overactive bladder. is a chronic condition that causes sudden and intense urges to urinate, which can have significant physical and psychological effects on patients’ lives. The prevalence of OAB among medical students is relatively high, with some studies reporting rates as high as 35.4%. This research aims to shed light on the prevalence rates and risk factors associated with OAB among medical students in Jordan. Methods A cross-sectional study was conducted using an online self-reported questionnaire as the study tool. The questionnaire collected the sociodemographic, health, and academic characteristics of medical students, as well as the new 7-item OABSS score. Results Out of the total sample of medical students surveyed (n = 525), 44.5% reported experiencing symptoms of OAB. Furthermore, the analysis also revealed that there was a significant difference in the prevalence of OAB between the ages of medical students. In addition, the study also found that there was a significant association between OAB symptoms and basic years, positive history of diagnostic UTI, positive history of recent trauma, high stress, and taking certain medications. Conclusions The study highlights the need for further research in this area and emphasizes the possible implications of OAB for medical students, including the need for additional support and resources to manage the condition.

Accents, or changes in how different people speak the same word/sentence in the same language, pose substantial communication issues in most spoken languages. This is a well-known fact, but how does the accent of one language affect learning/speaking another? In this paper, we look at how Arab accents influence the English language. To that end, we built a deep machine-learning system for Arabic accent recognition that was learned from an in-house English speech database of four Arabic accents collected from Jordan, Iraq, Saudi Arabia, and Tunisia. The proposed system employs Mel spectrograms of an English-spoken paragraph to train an LSTM neural network to recognize the accent in each sound signal. Although the collected data was extremely difficult to learn due to the presence of both males and females and fluent speakers in each class, the proposed system could recognize speakers with various accents by up to 79%. This answers the study’s main question, demonstrating that speakers with an Arabic accent have their way of speaking English, which varies by country. As a result, if trained on appropriate and adequate data, the proposed system can also be used to recognize accents in any language.

Abstract Background Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. Methods This quasi-experimental study included 100 individuals with head lice infestation from comprehensive urban health centers in Ardabil as the intervention group, and 400 individuals from East Azerbaijan and West Azerbaijan provinces as the control group, from April to March 2019. The data collection tools included a demographic questionnaire and an examination recording sheet, which documented the presence of adult lice or nits. Due to the inability to perform random assignment and control for numerous observed covariates, propensity score matching (PSM) was used. Results The outcome of treatment included elimination of head lice infestation on is 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. The results showed that the educational intervention program had a significant positive effect on the efficacy of both treatments. The likelihood of improvement was approximately three times greater in the intervention group compared to the control group. Conclusion Participants who received the training intervention (OR = 3.29; CI 95%: 2.21–4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

Abstract Background Obesity is a pathology and a leading cause of death worldwide. Obesity can harm multiple organs, including the heart. In this study, we aim to investigate the effect of bariatric surgery and following weight loss on cardiac structure and functions using echocardiography parameters in patients with morbid obesity. Methods In this cohort study, 30 patients older than 18 with BMI > 40 or BMI > 35 and comorbidity between March 2020 to March 2021 were studied. The patients underwent transthoracic echocardiography before and after six months of the bariatric surgery. Results In total, 30 patients (28 women, 93.3%) with a mean age of 38.70 ± 9.19 were studied. Nine (30%) were diabetic, and 9 (30%) had hypertension. After six months of bariatric surgery, all physical measurements, including weight, Body mass index, and Body surface area, decreased significantly (p

The study presents a method for iterative parameter tuning of tree ensemble-based models using Bayesian hyperparameter tuning for states prediction, using breast cancer as an example. The proposed method utilizes three different datasets, including the Wisconsin Diagnostic Breast Cancer (WDBC) dataset, the Surveillance, Epidemiology, and End Results (SEER) breast cancer dataset, and the Breast Cancer Coimbra dataset (BCCD), and implements tree ensemble-based models, specifically AdaBoost, Gentle-Boost, LogitBoost, Bag, and RUSBoost, for breast cancer prediction. Bayesian optimization was used to tune the hyperparameters of the models iteratively, and the performance of the models was evaluated using several metrics, including accuracy, precision, recall, and f1-score. Our results show that the proposed method significantly improves the performance of tree ensemble-based models, resulting in higher accuracy, precision, recall, and f1-score. Compared to other state-of-the-art models, the proposed method is more efficient. It achieved perfect scores of 100% for Accuracy, Precision, Recall, and F1-Score on the WDBC dataset. On the SEER BC dataset, the method achieved an accuracy of 95.9%, a precision of 97.6%, a recall of 94.2%, and an F1-Score of 95.9%. For the BCCD dataset, the method achieved an accuracy of 94.7%, a precision of 90%, a recall of 100%, and an F1-Score of 94.7%. The outcomes of this study have important implications for medical professionals, as early detection of breast cancer can significantly increase the chances of survival. Overall, this study provides a valuable contribution to the field of breast cancer prediction using machine learning.

Despite the potential of meta-education to transform higher education, there remains a scarcity of research investigating students' adoption intentions. This study aimed to identify factors influencing students' intentions to adopt meta-education using an extended Decomposed Theory of Planned Behavior model (DTPB). Data was collected via an online survey of 596 higher education students from Jordan who were purposefully selected. Structural equation modeling using partial least squares analysis revealed attitude, social influence, and perceived behavioral control as key antecedents of adoption intention. Furthermore, newly added variables including perceived enjoyment, herd behavior, student autonomy, and student innovativeness showed efficiency in explaining variance in attitude, social influence, and perceived behavioral control. Overall, the extended model provided meaningful insights on factors driving students' willingness to adopt meta-education. The study contributes to theory by extending the decomposed TPB model in the context of emerging educational technologies. It also provides practical implications for policymakers and educators aiming to encourage meta-education adoption.

BackgroundIn Tunisia, the number of cardiac implantable electronic devices (CIEDs) is increasing, owing to the increase in patient life expectancy and expanding indications. Despite their life-saving potential and a significant reduction in population morbidity and mortality, their increased numbers have been associated with the development of multiple early and late complications related to vascular access, pockets, leads, or patient characteristics. ObjectiveThe study aims to identify the rate, type, and predictors of complications occurring within the first year after CIED implantation. It also aims to describe the demographic and epidemiological characteristics of a nationwide sample of patients with CIED in Tunisia. Additionally, the study will evaluate the extent to which Tunisian electrophysiologists follow international guidelines for cardiac pacing and sudden cardiac death prevention. MethodsThe Tunisian National Study of Cardiac Implantable Electronic Devices (NATURE-CIED) is a national, multicenter, prospectively monitored study that includes consecutive patients who underwent primary CIED implantation, generator replacement, and upgrade procedure. Patients were enrolled between January 18, 2021, and February 18, 2022, at all Tunisian public and private CIED implantation centers that agreed to participate in the study. All enrolled patients entered a 1-year follow-up period, with 4 consecutive visits at 1, 3, 6, and 12 months after CIED implantation. The collected data are recorded electronically on the clinical suite platform (DACIMA Clinical Suite). ResultsThe study started on January 18, 2021, and concluded on February 18, 2023. In total, 27 cardiologists actively participated in data collection. Over this period, 1500 patients were enrolled in the study consecutively. The mean age of the patients was 70.1 (SD 15.2) years, with a sex ratio of 1:15. Nine hundred (60%) patients were from the public sector, while 600 (40%) patients were from the private sector. A total of 1298 (86.3%) patients received a conventional pacemaker and 75 (5%) patients received a biventricular pacemaker (CRT-P). Implantable cardioverter defibrillators were implanted in 127 (8.5%) patients. Of these patients, 45 (3%) underwent CRT-D implantation. ConclusionsThis study will establish the most extensive contemporary longitudinal cohort of patients undergoing CIED implantation in Tunisia, presenting a significant opportunity for real-world clinical epidemiology. It will address a crucial gap in the management of patients during the perioperative phase and follow-up, enabling the identification of individuals at particularly high risk of complications for optimal care. Trial RegistrationClinicalTrials.gov NCT05361759; https://classic.clinicaltrials.gov/ct2/show/NCT05361759 International Registered Report Identifier (IRRID)RR1-10.2196/47525

Abstract Aim To assess the social cognitive elements of the stigma of mental illness (knowledge, attitudes and behaviours) among healthcare professionals (HCPs) in Jordan. Design A cross‐sectional descriptive design. Methods A total of 206 HCPs were conveniently recruited from general hospitals in Jordan. The mental attitude, knowledge and intended behaviours scales were used to measure stigma elements. Results Participants reported a moderate level of knowledge, a moderate negative attitude and a moderate or not greater interest to deal with people with mental health illnesses. The bivariate correlation revealed a negative significant correlation between HCPs' knowledge and attitude, indicating that HCPs with more knowledge significantly have more positive attitude (lower average score) towards those suffering from the illness. A more significant correlation was found between HCPs' knowledge and behaviour. The HCPs who had more knowledge were holding more interest and willingness towards dealing with persons with mental illness. Patient or Public Contribution Negative attitudes among HCPs demand awareness programmes pertaining to the stigma of mental illness to afford higher standards of practice for patients with mental problems.

Introduction: This study aimed to investigate the effectiveness of the tactical games model on self-efficacy, physical activity enjoyment, and learning of badminton long serve in adolescent female students.Methods: The current research method was a quasi-experimental type with a pre-test and post-test research design that included two experimental and control groups. Thirty female students aged 9 to 12 years old voluntarily participated in the research. After being homogeneous according to anthropometric features, they were randomly assigned to two tactical games model (n=15) and traditional training (n=15) groups. The training program included a badminton training program that was conducted for eight weeks and three 60-minute sessions per week using two traditional and tactical games methods. The tools used in this study included the Physical Activity Enjoyment Scale, the General Self-Efficacy Scale, and the badminton long serve test.Results: The results of the analysis of covariance and independent samples t-test showed that the tactical games model group had a significant increase in self-efficacy, physical activity enjoyment, and badminton long serve scores compared with the traditional training group.Conclusion: Overall, these findings suggest that a training course with a tactical games model has advantages in some psychological variables and motor skills learning of badminton long serve compared with the traditional method.

Chronic obstructive pulmonary disease (COPD) and lung cancer represent formidable challenges in global health, characterized by intricate pathophysiological mechanisms and multifaceted disease progression. This comprehensive review integrates insights from diverse perspectives to elucidate the intricate roles of long non-coding RNAs (lncRNAs) in the pathogenesis of COPD and lung cancer, focusing on their diagnostic, prognostic, and therapeutic implications. In the context of COPD, dysregulated lncRNAs, such as NEAT1, TUG1, MALAT1, HOTAIR, and GAS5, emerge as pivotal regulators of genes involved in the disease pathogenesis and progression. Their identification, profiling, and correlation with the disease severity present promising avenues for prognostic and diagnostic applications, thereby shaping personalized disease interventions. These lncRNAs are also implicated in lung cancer, underscoring their multifaceted roles and therapeutic potential across both diseases. In the domain of lung cancer, lncRNAs play intricate modulatory roles in disease progression, offering avenues for innovative therapeutic approaches and prognostic indicators. LncRNA-mediated immune responses have been shown to drive lung cancer progression by modulating the tumor microenvironment, influencing immune cell infiltration, and altering cytokine production. Their dysregulation significantly contributes to tumor growth, metastasis, and chemo-resistance, thereby emphasizing their significance as therapeutic targets and prognostic markers. This review summarizes the transformative potential of lncRNA-based diagnostics and therapeutics for COPD and lung cancer, offering valuable insights into future research directions for clinical translation and therapeutic development.

Repeated exposure to tobacco smoke causes neuroinflammation and neuroplasticity, which correlates with smoking withdrawal-induced anxiety. The purpose of this study was to investigate the anticipated involvement of antioxidant-rich nanoparticles (NPs) prepared by oxidation-triggered polymerization of green tea catechins in impacting these effects in a rat model of tobacco smoke exposure. Exposure to tobacco smoke was carried out for 2 h a day, 5 days a week, for a total of 36 days. Weekly behavioral tests were conducted prior to recommencing the exposure. Following a 20-day exposure period, rats were administered either distilled water or green tea (GT) NPs (20 mg/kg, orally) for an additional 16 days. Our findings revealed that tobacco smoke exposure induced anxiety-like behavior indicative of withdrawal, and this effect was alleviated by GT NPs. Tobacco smoke exposure caused a marked increase in the relative mRNA and protein expression of nuclear factor-kappa B (NF-κB) and reduced the relative mRNA and protein expression of brain-derived neurotrophic factor (BDNF) in the hippocampus (HIP) and hypothalamus (HYP) brain subregions. The intervention of GT NPs effectively inhibited these effects. Our findings demonstrate the potent protective role of GT NPs in reducing withdrawal-induced anxiety-like behavior, neuroinflammation, and neuroplasticity triggered by tobacco smoke exposure.

Introduction: Hearing impairment is a type of children's sensory disorder that cause problems in the daily life of children and parents. This research aimed to determine the effect of sensory-motor training on fine motor skills and the psychological well-being of children with hearing impairment.Methods: This applied research was a quasi-experimental type with a pre-test and post-test design. The statistical population included children with a hearing impairment from the elementary exceptional student education center in Ardabil City. To participate in this research, the hearing threshold of each student was measured using an audiometer. By using the convenience sampling method, 20 samples were selected and assigned to two control (N=10) and experimental (N=10) groups. The measurement tools included Peabody Developmental Motor Scale (PDMS) for fine motor skills and the Strengths and Difficulties Questionnaire (SDQ) for psychological well-being assessment. No training was given to the groups before the intervention. The experimental group performed 45-minute sessions of sensory-motor integration training for eight weeks and six days a week, by imitating the coach's movements and trying to coordinate with the group at the same time. The control group participated in daily activities. The analysis of the covariance (ANCOVA) test was used for statistical analysis.Results: sensory-motor integration training had a significant effect on improving children's fine motor skills and well-being and cause improvement in the levels of both factors.Conclusion: Participating in sensory-motor training can be of great help in reducing motor and psychological problems of children with hearing impairment.

Background: Considering the prevalence of stroke, an economical and reliable questionnaire is needed for use in research and rehabilitation to measure the amount of burden on caregivers of stroke patients. True to our knowledge, there is no exclusive Persian language instrument for assessing the burden of stroke caregivers. The current study investigated the validity and reliability of the Burden Scale for Family Caregivers-short version (BSFC-s) for stroke patients’ caregivers.Methods: In this cross-sectional study, 51 stroke patients and their caregivers were studied using the above-named questionnaire translated from English into Persian. Construct validity of the questionnaire was evaluated by Spearman and Eta correlation. Cronbach’s Alfa was used to assess internal consistency. Factorial structure was evaluated by exploratory analysis.Results: The test-retest reliability of the questionnaire was calculated to be 0.93, and the questionnaire’s internal consistency was 0.93. The construct validity of the questionnaire was acceptable.Conclusions: In general, it can be said that this questionnaire has a good structure for assessing the burden of caregivers. In addition, by 10 items we can consider this questionnaire as an economically viable option in research and practice.

Objectives: To determine the proportion of diabetic retinopathy (DR) among individuals with diabetes mellitus in the Gulf Cooperation Council (GCC) countries. Methods: This study was executed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Online databases including Scopus, Web of Sciences, PubMed, Index Medicus for the eastern Mediterranean region, Medline, and ProQuest, were utilized to retrieve studies on the prevalence of DR in GCC countries that were conducted from 2003 to 2019. Results: Twenty articles were included in the meta-analysis, involving 61 855 patients. The prevalence of DR was 20.5% (95% CI: 20.212–20.850). The highest prevalence rate was observed in Saudi Arabia (69.8%; 95% CI: 64.989–74.216) and the lowest in the UAE (6.0%; 95% CI: 2.780–11.084). There was a significant heterogeneity between the reviewed studies (p < 0.001). Conclusions: The prevalence of DR was high in the GCC countries. Our findings provide crucial information for the public healthcare systems in these countries to actively educate the public and screen at-risk populations for undiagnosed cases of diabetes, detect early stages of retinopathy, and provide required care to minimize the number of untreated cases.

IntroductionThis study investigated the role of proactive semantic interference (frPSI) in predicting the progression of amnestic Mild Cognitive Impairment (aMCI) to dementia, taking into account various cognitive and biological factors.MethodsThe research involved 89 older adults with aMCI who underwent baseline assessments, including amyloid PET and MRI scans, and were followed longitudinally over a period ranging from 12 to 55 months (average 26.05 months).ResultsThe findings revealed that more than 30% of the participants diagnosed with aMCI progressed to dementia during the observation period. Using Cox Proportional Hazards modeling and adjusting for demographic factors, global cognitive function, hippocampal volume, and amyloid positivity, two distinct aspects of frPSI were identified as significant predictors of a faster decline to dementia. These aspects were fewer correct responses on a frPSI trial and a higher number of semantic intrusion errors on the same trial, with 29.5% and 31.6 % increases in the likelihood of more rapid progression to dementia, respectively.DiscussionThese findings after adjustment for demographic and biological markers of Alzheimer’s Disease, suggest that assessing frPSI may offer valuable insights into the risk of dementia progression in individuals with aMCI.

BackgroundEarly identification of a patient with infection who may develop sepsis is of utmost importance. Unfortunately, this remains elusive because no single clinical measure or test can reflect complex pathophysiological changes in patients with sepsis. However, multiple clinical and laboratory parameters indicate impending sepsis and organ dysfunction. Screening tools using these parameters can help identify the condition, such as SIRS, quick SOFA (qSOFA), National Early Warning Score (NEWS), or Modified Early Warning Score (MEWS). We aim to externally validate qSOFA, SIRS, and NEWS/NEWS2/MEWS for in-hospital mortality among adult patients with suspected infection who presenting to the emergency department.Methods and analysisPASSEM study is an international prospective external validation cohort study. For 9 months, each participating center will recruit consecutive adult patients who visited the emergency departments with suspected infection and are planned for hospitalization. We will collect patients' demographics, vital signs measured in the triage, initial white blood cell count, and variables required to calculate Charlson Comorbidities Index; and follow patients for 90 days since their inclusion in the study. The primary outcome will be 30-days in-hospital mortality. The secondary outcome will be intensive care unit (ICU) admission, prolonged stay in the ICU (i.e., ≥72 hours), and 30- as well as 90-days all-cause mortality. The study started in December 2021 and planned to enroll 2851 patients to reach 200 in-hospital death. The sample size is adaptive and will be adjusted based on prespecified consecutive interim analyses.DiscussionPASSEM study will be the first international multicenter prospective cohort study that designated to externally validate qSOFA score, SIRS criteria, and EWSs for in-hospital mortality among adult patients with suspected infection presenting to the ED in the Middle East region.Study registrationThe study is registered at ClinicalTrials.gov (NCT05172479).

Abstract Extensive prior work has provided methods for the optimization of routing based on weights assigned to travel duration, and/or travel cost, and/or the distance traveled. Routing can be in various modalities, such as by car, on foot, by bicycle, via public transit, or by boat. A typical method of routing involves building a graph comprised of street segments, assigning a normalized weighted value to each segment, and then applying the weighted-shorted path algorithm to the graph in order to find the best route. Some users desire that the routing suggestion include consideration pertaining to the scenic-architectural quality of the path. For example, a user may seek a leisure walk via what they might deem as visually attractive architecture. Here, we are proposing a method to quantify such user preferences and scenic quality and to augment the standard routing methods by giving weight to the scenic quality. That is, instead of suggesting merely the time and cost-optimal route, we will find the best route that is tailored towards the user’s scenic quality preferences as an additional criterion to the time and cost. The proposed method uniquely weighs the scenic interest or residential street segments based on the property valuation data.

Background: The One Health concept (OHC) seeks to improve the health of plants, animals, and humans because improving animal and plant health will increase the capacity for improving human health. Many risks such as plant and animal biotechnology applications have the potential to generate new diseases that can be transmitted to humans. In this way, the health of humans, animals, and plants is interrelated and depends on one another. However, it has been difficult to apply the OHC in some countries, such as those in the Middle East. The absence of financial support in the region is a major hindrance to applying this concept in the region. The application of the OHC requires the support of specialists who can advocate the government for support in launching OHC-related projects. Here, we discuss the OHC in the context of antimicrobial resistance, zoonotic diseases, and biosafety/biosecurity, which are important public health issues. Furthermore, we describe the current status of the OHC in the Middle East and recent research conducted related to this concept. There has been recent international solidarity in the application of the OHC to reduce risks that threaten the health of organisms. Several countries jointly launched the Global Health Security Agenda in 2014 with the aim of realizing a world that is free of infectious disease-related health risks. However, no previous review articles have examined the applications of the OHC in the Middle East region. This article discusses the OHC in terms of its needs and current applications in the Middle East. Methodology: The following keywords were used in the search: “One Health,” “Middle East,” “medicinal plants,” “viruses,” “rabies,” “MERS,” and “antimicrobial resistance.” Related papers were obtained by searching for these keywords using available search engines, such as PubMed, Google Scholar, and Google search, as well as international organization websites. Conclusion: The concept of One Health is relatively new and has not been applied in most countries, possibly because the value of this concept for improving human health is not well understood. The key principle defining this concept and its importance is the interdependency of plants, animals, and human health. By applying the OHC, humans can benefit from healthy plants and animals by enhancing their growing conditions, medications, and environments. This would in turn improve general human health by allowing the safe extraction of therapeutics and food resources.

While the availability of low-cost micro electro-mechanical systems (MEMS) accelerometers, gyroscopes, and magnetometers initially seemed to promise the possibility of using them to easily track the position and orientation of virtually any object that they could be attached to, this promise has not yet been fulfilled. Navigation-grade accelerometers and gyroscopes have long been the basis for tracking ships and aircraft, but the signals from low-cost MEMS accelerometers and gyroscopes are still orders of magnitude poorer in quality (e.g., bias stability). Therefore, the applications of MEMS inertial measurement units (IMUs), containing tri-axial accelerometers and gyroscopes, are currently not as extensive as they were expected to be. Even the addition of MEMS tri-axial magnetometers, to conform magnetic, angular rate, and gravity (MARG) sensor modules, has not fully overcome the challenges involved in using these modules for long-term orientation estimation, which would be of great benefit for the tracking of human–computer hand-held controllers or tracking of Internet-Of-Things (IoT) devices. Here, we present an algorithm, GMVDμK (or simply GMVDK), that aims at taking full advantage of all the signals available from a MARG module to robustly estimate its orientation, while preventing damaging overcorrections, within the context of a human–computer interaction application. Through experimental comparison, we show that GMVDK is more robust to magnetic disturbances than three other MARG orientation estimation algorithms in representative trials.

The aim of this paper is to study experimentally and numerically heat transfer enhancement and friction factor inside a counter flow concentric tube heat exchanger using different volume fractions of CuO, Al2O3, and TiO2 nanofluids. Using nanofluids increases the thermal conductivity and conductive heat transfer coefficients compared to the base fluids. Increased heat transfer coefficients reduce the required tube length leading to reduced pressure drop in heat exchangers. Nanofluids have a high specific surface area, and therefore more heat transfer surface between particles and fluids is available. A standard k-ε turbulence model based on two equations was used in this investigation to solve the momentum and energy equations of nanofluids. The results were presented for Reynolds number range between 2000 and 12,000 and two different volume fractions of 0.05 and 0.2%, respectively. The numerical results illustrated that all the tested nanofluids exhibited better heat transfer coefficients compared with pure water. Particularly, CuO nanofluid illustrated the highest performance index for both concentrations. The performance index varied from 4.25, 3, and 2.5 to 1.5 for CuO, Al2O3, and TiO2 nanofluids, respectively, for the whole range of Reynold numbers. The results of this investigation may be used in designing heat exchangers-based nanofluids that can be used in many energy applications such as solar, energy production systems, and any industrial process.

Introduction Knowledge of the clinical liver anatomy has evolved with advanced imaging modalities and laparoscopic surgery. Therefore, precise anatomical resection knowledge has become the standard treatment for primary and secondary liver cancer. Segmentectomy, a parenchymal-preserving approach, is regarded as an option for anatomical resections in patients with impaired liver. Indocyanine green (ICG) staining is a promising method for understanding the anatomical borders of the liver segments. There are two methods of ICG staining (positive and negative), and the superiority of either approach has not been determined to date.Methods and analysis This is a prospective randomised controlled superiority clinical trial performed in a single centre tertiary hospital in Japan. A comparison between the accuracy of positive and negative ICG staining in guiding laparoscopic anatomical liver resection is planned in this study. Possible candidates are patients with liver malignant tumours in whom laparoscopic monosegmentectomy or subsegmentectomy is planned. Fifty patients will be prospectively allocated into the following two groups: group A, ICG-negative staining group, and group B, ICG-positive staining group. The optimal dose of ICG for positive staining will be determined during the preparation phase. To assess the ability of the ICG fluorescence guidance in anatomical resection, the primary endpoint is the success rate of ICG staining, which consists of a subjective optical scoring (SOS) based on three components: superficial demarcation in the liver surface, visualisation of the parenchymal borders and consistency with the preoperative three-dimensional simulation. The secondary endpoints are the evaluation of short-term surgical outcomes and recurrence-free survival.Ethics and dissemination The study was approved by Ageo Central General Hospital Clinical Research Ethical Committee (No: 1044) and it carried out following the Declaration of Helsinki (2013 revision). Informed consent will be taken from the patients before participating. The findings will be disseminated through peer-reviewed publications, scientific meetings and conferences.Trial registration number UMIN000049815.

Cyberbullying detection has attracted many researchers to detect negative comments deployed on communication platforms as cyberbullying can take many forms: verbal, implicit, explicit, or even nonverbal. The successful growth of social media in recent years has opened new perspectives on the detection of cyberbullying, although related research still encounters several challenges, such as data imbalance and expression implicitness. In this paper, we propose an automated cyberbullying detection framework designed to produce satisfactory results, especially when imbalanced short text and different dialects exist in the Arabic text data. In the proposed framework a new method to solve the imbalance problem is suggested, where the modified simulated annealing optimization algorithm is used to find the optimal set of samples from the majority class to balance the training set. This method has been evaluated using traditional machine learning algorithms including support vector machine, and deep learning algorithms including Long Short-Term Memory (LSTM) and Bidirectional LSTM (Bi-LSTM). To generate a framework that can detect Arabic written cyberbullying on communication platforms, the accuracy, recall, specificity, sensitivity and mean squared error are used as the main performance indicators. The results indicate that the proposed framework can improve the performance of the tested algorithms, and Bi-LSTM outperforms other methods for cyberbullying classification.

Abstract Purpose Dyslipidemia is considered as a known risk factor for cardiovascular disease. Yet various trials with wide ranges of doses and durations have reported contradictory results. We undertook this meta-analysis of randomized controlled trials (RCTs) to determine whether omega-3 supplementation can affect lipid profile in children and adolescents. Methods Cochrane Library, Embase, PubMed, and Scopus databases were searched up to March 2021. Meta-analysis was performed using random-effect method. Effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Heterogeneity was assessed using the I 2 index. In order to identification of potential sources of heterogeneity, predefined subgroup and meta-regression analysis was conducted. Results A total of 14 RCTs with 15 data sets were included. Based on the combination of effect sizes, there was a significant reduction in TG levels (WMD: -15.71 mg/dl, 95% CI: -25.76 to -5.65, P=0.002), with remarkable heterogeneity (I2=88.3%, P

This study aims to examine the influence of brand image as a mediator between social media marketing activity and tourist intentions to visit tourist sites in Jordan. To test the hypotheses, we utilized the partial least square method and distributed a questionnaire survey to 400 visitors, receiving 289 responses for analysis using SMART-PLS4 software. The study made significant contributions to the literature on social media marketing by developing a research model that links social media usage to brand image and shopping intention, and by using statistical techniques to quantitatively assess the effect of social media marketing activity on the brand image as a mediator. The findings exposed that word of mouth, a construct of social media, significantly positively influenced tourists' purchase intention to visit sites in Jordan. This study sheds light on the importance of social media marketing and its impact on the tourism industry in Jordan, providing useful insights for practitioners and policymakers in the field.

Biotechnology became a paradigm-shifting science among all subfields of biology. The benefits of biotechnology have reached many practical fields, whether human health, animal, and/or agricultural. However, wherever there is a biotechnology practice, there is an associated biohazard with it, and its negative impact may reach all living entities including humans. Therefore, the cooperation of the leading institutions in this field has culminated in creating the concepts and applications of biosafety and biosecurity. The countries of the Middle East are considered biotechnology-practicing and have shown a clear acceptance to this field. But unfortunately, the Middle East region is one that is facing the most multi-challenges, which would constitute real and noticeable concern at the local and international levels. Such challenges represented by wars and armed conflicts, deteriorating economic conditions, the large number of refugees, and the spread of many epidemics. Thus, limiting the region's ability to deal with the surrounding biological hazards and struggling the way to the one health concept. Therefore, this article aims to shed light on the activities of the Middle East countries in the field of biotechnology and to address potential biological threats, whether natural such as the spread of viruses, or intentional such as biological attacks and bioterrorism. The article also shows the capacity of the countries of the region in the field of biosafety and biosecurity based on available information. Accordingly, some countries are lacking the required level of preparedness to face potential biological threats. Multi-institutional and international cooperation between the concerned countries will significantly enhance the capacity of the region in biosafety and biosecurity to meet the level of biological risk.Search methodology: wide range of related keywords (based on the section) combined with the name of the region, or one country individually have been searched using available search engines and databases such as google scholar and PubMed. After scanning the content of the found results, irrelevant articles have been excluded. Figures 2, 3, 4, 6, and 7 were created by biorender.com.

Objectives: Premature infants in the neonatal intensive care unit (NICU) are exposed to environmental risks that may cause developmental problems i. The present study aimed to investigate the predictive effect of individual and environmental factors on the motor performance of low birth weight preterm infants. Methods: This cross-sectional study was performed in the neonatal clinic of Shahid Akbarabadi Hospital in Tehran City, Iran. A group of 90 low birth weight infants were enrolled in the study by non-probabilistic method and according to the inclusion criteria. Test of infant motor performance (TIMP), sensory profile2 (infant section), affordance in the home environment for motor development (AHEMD), and a demographic questionnaire were used to evaluate motor performance, sensory status, home environment, and other factors (birth weight, corrected age, parent’s education, etc.), respectively. Results: TIMP elicited score was positively correlated with the infant’s age (r=0.390, P

The absence of intelligence leadership may lead to a failure to motivate employees within universities, which leads to adverse effects on organizational excellence, primarily if the prevailing organizational culture does not support the processes of development and success. Thus, organizational culture is expected to play an essential role in enhancing the leadership’s ability to use its intelligence to achieve organizational excellence. Accordingly, the study aims to identify the mediating role of organizational culture in the impact of leadership intelligence on achieving organizational excellence in Jordanian universities. Qualitative data were collected and quantitatively analyzed. A questionnaire was designed using a leadership intelligence scale and distributed to a sample of 371 faculty members in 33 Jordanian universities. The sample size was chosen according to the statistical tables, and this sample is considered statistically acceptable. The data were processed using structural equations using SPSS and AMOS software. The study concluded that there is an effect of intelligence leadership on organizational excellence. It was also found that organizational culture mediates the relationship between intelligence leadership and organizational excellence. Therefore, the study recommends that the decision makers in Jordanian universities strengthen intelligence leadership, with the need to establish clear foundations in the selection of university leaders, ensuring intelligence leaders’ existence.

Breast cancer disease is considered to be the second leading reason for death among women. Unfortunately, even if the treatment of cancer started soon after diagnosis, the cancer cells may remain in the body, and cancer may recur. Various Machine Learning (ML) methods to predict breast cancer recurrence were applied recently, and the ML methods’ performance needs to be examined to determine the proper method for prediction. Usually, the datasets contain many features which may sometimes mislead the prediction process; as some features may lead to confusion or inaccurate prediction. Thus, in this study, two breast cancer recurrence datasets were statistically analyzed and further refined by Brain Storming Optimization algorithm (BSO). The proposed multi-stages technique consists of three main stages; first, the statistical feature selection methods (SFM) which statistically select the discriminative features based on importance ranking and features correlations and statistical hypothesis testing, to be passed to the second stage. The features are ranked based on their correlation with the class variable. The second stage namely the multi classifier (MC), which evaluates each method based on three classifiers and produces a combination of features performed by two SFM and three classifiers. In the third stage, the best combination of the selected features was recognized by the BSO algorithm to search for an optimal solution that produces the highest accuracy. In addition, the BSO algorithm has been modified to deal with the feature selection problem. The performance of the proposed technique was evaluated by stratified 10-fold cross-validation. As a result, the multi-stage learning technique showed to be effective in ranking the features and improved the classification accuracy for breast cancer recurrence.

The current study investigates the Intelligent Water Drops (IWD) metaheuristic algorithm to construct and produce good quality solutions for the university examination timetabling problem (UETP). The IWD is a population-based metaheuristic that simulates the dynamic of the river systems. The main motivations for investigating IWD algorithm for examination timetabling problem is the ability to explore the search space effectively. The main drawback of IWD algorithm is like other population-based algorithm in exploitation process where it is very efficient scanning several search space niches, but it is unable to drilling down in each niche to which it navigates. In this paper we propose a hybrid approach based on IWD and locale search algorithm to improve the exploitation of IWD algorithm. The experimental results demonstrated that the proposed algorithm (i.e., Hybrid IWD) obtained best results in three datasets when comparing with the best-known results performed by the swarm intelligent approaches. Finally, the proposed algorithm achieved one best results in comparison with the other metaheuristic approaches.

Background: Evaluation of educational services through appropriate tools is very important. The present study was conducted to translate the Evaluation and Feedback for Effective Clinical Education (EFFECT) questionnaire from English into Persian and assess the validity and reliability of the translated version.Method: Initially, the EFFECT questionnaire was translated from English into Persian based on the International Quality of life Assessment (IQOLA) for cultural adaptation. To quantitatively evaluate the content validity of the questionnaire, the content validity ratio (CVR) and the content validity index (CVI) were used. To assess internal consistency, ninety-four occupational therapy students completed the translated EFFECT questionnaire. To measure test-retest reliability, 35 occupational therapy students filled out the translated questionnaire again after two weeks interval.Results: The EFFECT scores of the items ranged from 3.95 to 4.77, all of which were at an acceptable level. The CVR scores of 48 items (necessity) were higher than 0.59. Seven items received CVR scores of less than 0.59. Fifty-one items obtained CVI scores of higher than 0.79 (clarity). Four items did not achieve a minimum acceptable score of 0.79. The test-retest reliability range of 0.75 to 0.91. The Cronbach’s alpha varied from 0.84 to 0.94, revealing a very desirable internal consistency in all seven domains. The total value of Cronbach’s alpha was 0.98.Conclusion: The Persian version of the EFFECT questionnaire has good validity and reliability in occupational therapy education and can be employed as an appropriate tool to assess the quality of clinical education in occupational therapy.

IntroductionSemantic intrusion errors (SI) have distinguished between those with amnestic Mild Cognitive Impairment (aMCI) who are amyloid positive (A+) versus negative (A−) on positron emission tomography (PET).MethodThis study examines the association between SI and plasma – based biomarkers. One hundred and twenty-eight participants received SiMoA derived measures of plasma pTau-181, ratio of two amyloid-β peptide fragments (Aβ42/Aβ40), Neurofilament Light protein (NfL), Glial Fibrillary Acidic Protein (GFAP), ApoE genotyping, and amyloid PET imaging.ResultsThe aMCI A+ (n = 42) group had a higher percentage of ApoE ɛ4 carriers, and greater levels of pTau-181 and SI, than Cognitively Unimpaired (CU) A− participants (n = 25). CU controls did not differ from aMCI A− (n = 61) on plasma biomarkers or ApoE genotype. Logistic regression indicated that ApoE ɛ4 positivity, pTau-181, and SI were independent differentiating predictors (Correct classification = 82.0%; Sensitivity = 71.4%; Specificity = 90.2%) in identifying A+ from A− aMCI cases.DiscussionA combination of plasma biomarkers, ApoE positivity and SI had high specificity in identifying A+ from A− aMCI cases.

BackgroundHypoxia plays a critical role in the tumor microenvironment by affecting cellular proliferation, metabolism, apoptosis, DNA repair, and chemoresistance. Since hypoxia provokes a distinct shift of microRNA, it is important to illustrate the relative contribution of each hypoxamiR to cancer progression.AimsThe present study aims to shed light on the hypoxamiRs that are involved in pancreatic and breast cancer progression to highlight novel targets for the development of new therapies.MethodsFor 20 cycles, MCF7 breast cancer cells and PANC-1 pancreatic cancer cells were subjected to chronic cyclic hypoxia, which consisted of 72 hours of hypoxia followed by 24 hours of reoxygenation. After 10 and 20 cycles of hypoxia, miRNA expression alterations were profiled using RT-PCR array and further analyzed using a visual analytics platform. The MTT cell proliferation assay was used to determine hypoxic cells’ chemoresistance to doxorubicin.ResultsUnder chronic cyclic hypoxia, hypoxic PANC-1 cells have a comparable doubling time with their normoxic counterparts, whereas hypoxic MCF7 cells show a massive increase in doubling time when compared to their normoxic counterparts. Both hypoxic cell lines developed EMT-like phenotypes as well as doxorubicin resistance. According to the findings of miRNet, 6 and 10 miRNAs were shown to play an important role in enriching six hallmarks of pancreatic cancer in the 10th and 20th cycles of hypoxia, respectively, while 7 and 11 miRNAs were shown to play an important role in enriching the four hallmarks of breast cancer in the 10th and 20th cycles of hypoxia, respectively.ConclusionsmiR-221, miR-21, miR-155, and miR-34 were found to be involved in the potentiation of hypoxic PANC-1 hallmarks at both the 10th and 20th cycles, while miR-93, miR-20a, miR-15, and miR-17 were found to be involved in the potentiation of hypoxic MCF7 hallmarks at both the 10th and 20th cycles. This variation in miRNA expression was also connected to the emergence of an EMT-like phenotype, alterations in proliferation rates, and doxorubicin resistance. The chemosensitivity results revealed that chronic cyclic hypoxia is critical in the formation of chemoresistant phenotypes in pancreatic and breast cancer cells. miR-181a and let-7e expression disparities in PANC1, as well as miR-93, miR-34, and miR-27 expression disparities in MCF7, may be associated with the formation of chemoresistant MCF7 and PANC-1 cells following 20 cycles of chronic cyclic hypoxia. Indeed, further research is needed since the particular mechanisms that govern these processes are unknown.

Aging and diabetes, and some other diseases that are associated with a remarkable growth of non-enzymatical cross-links (advanced glycation end-products AGEs) were considered important contributors to increasing patellar tendon injury susceptibility and low healing capacity. While a clear coupling between this collagen structural alteration (AGEs) and tendon mechanics still needs further investigation. In this study, a multiscale fibril-reinforced hyper-elastoplastic model was employed to elucidate the effect of the AGEs density alteration on the aggregate mechanics of the tendons' behavior. Our results showed a clear decrease in tendon stiffness at the pre-yielding stage associated with a higher stress concentration in the normal case. In contrast, a higher tendon stiffness and more brutal reaction were computed after the normal post-yield stage with unbalanced growth of the AGEs. This prediction has potentially important implications for understanding the tissue damage mechanism associated with collagen microstructural alteration.