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Abstract Optimization algorithms are essential tools used to address real-world problems through minimization or maximization processes. In the context of photovoltaic (PV) systems, various optimization algorithms have been employed to extract solar cell parameters using minimization techniques, and to identify the maximum power point (MPP) using maximization approaches. However, under partial shading conditions or during rapidly changing irradiance, many of these algorithms tend to get trapped in local minima, failing to locate the global maximum power point (GMPPT). This shortcoming leads to significant energy losses from PV cells. Similarly, the extraction of solar cell parameters is often compromised by the random search behavior and inadequate exploration and exploitation capabilities of many existing algorithms. The Jellyfish Search Optimization (JSO) algorithm is a recent, parameter-free method developed to tackle a wide range of optimization problems. Despite its innovative design, JSO is prone to premature convergence and exhibits a longer convergence time. To address these limitations, this paper proposes a modified version of the JSO algorithm, which integrates the state-of-the-art features of JSO with the Lévy flight characteristic from the cuckoo search algorithm. This combination aims to achieve a better balance between exploration and exploitation. To validate the effectiveness of the proposed Improved Jellyfish Search Optimization (IJSO) algorithm in PV systems, extensive experiments were conducted. These experiments included benchmarking with complex test functions, extracting cell parameters using various solar cell models, and maximizing energy output from PV systems under different environmental conditions. The results demonstrate that the proposed IJSO algorithm effectively enhances parameter extraction and global maximum power point tracking, making it a promising solution for optimizing energy extraction from PV cells in dynamic conditions.

Abstract Monoclonal antibodies (mAbs) are used to prevent, detect, and treat a broad spectrum of non-communicable and communicable diseases. Over the past few years, the market for mAbs has grown exponentially with an expected compound annual growth rate (CAGR) of 11.07% from 2024 (237.64 billion USD estimated at the end of 2023) to 2033 (679.03 billion USD expected by the end of 2033). Ever since the advent of hybridoma technology introduced in 1975, antibody-based therapeutics were realized using murine antibodies which further progressed into humanized and fully human antibodies, reducing the risk of immunogenicity. Some benefits of using mAbs over conventional drugs include a drastic reduction in the chances of adverse reactions, interactions between drugs, and targeting specific proteins. While antibodies are very efficient, their higher production costs impede the process of commercialization. However, their cost factor has been improved by developing biosimilar antibodies as affordable versions of therapeutic antibodies. Along with the recent advancements and innovations in antibody engineering have helped and will furtherly help to design bio-better antibodies with improved efficacy than the conventional ones. These novel mAb-based therapeutics are set to revolutionize existing drug therapies targeting a wide spectrum of diseases, thereby meeting several unmet medical needs. This review provides comprehensive insights into the current fundamental landscape of mAbs development and applications and the key factors influencing the future projections, advancement, and incorporation of such promising immunotherapeutic candidates as a confrontation approach against a wide list of diseases, with a rationalistic mentioning of any limitations facing this field.

Abstract Triple-negative breast cancer (TNBC) lacks estrogen, progesterone, and human epidermal growth factor receptors and has a poor prognosis as it is resistant to chemotherapy. A new treatment option for this type of cancer may be by putting these malignant cells into dormancy. The oocyte’s embryonic milieu presents a unique tumor reversion microenvironment by inducing growth arrest and changing cells’ phenotypes. We conducted an in-silico study to determine the most likely oocyte extract (OE) proteins involved in inducing dormancy using HDock, CluPro, and molecular dynamic (MD) simulation. Results showed low energy scores for complexes between OE proteins and four surface markers: K1C14, CLD3, CLD4, and ITA6. Apolipoprotein A1 (APOA1) and Apolipoprotein C3 (APOC3) showed the highest stability and affinity with these four surface markers: K1C14, CLD3, CLD4, and ITA6. These proteins are involved in key tumor-related pathways such as angiogenesis, proliferation, apoptosis, and migration. This will pave the way for exploring novel therapeutic options to induce dormancy in TNBC cells.

Abstract This work initiates a concept of reduced reverse degree based $$\mathcal {RR_D\,M}$$ RR D M -Polynomial for a graph, and differential and integral operators by using this $$\mathcal {RR_D\,M}$$ RR D M -Polynomial. In this study twelve reduced reverse degree-based topological descriptors are formulated using the $$\mathcal {RR_D\,M}$$ RR D M -Polynomial. The topological descriptors, denoted as $$\mathbb{T}\mathbb{D}$$ T D ’s, are numerical invariants that offer significant insights into the molecular topology of a molecular graph. These descriptors are essential for conducting QSPR investigations and accurately estimating physicochemical attributes. The structural and algebraic characteristics of the graphene and graphdiyne are studied to apply this methodology. The study involves the analysis and estimation of Reduced reverse degree-based topological descriptors and physicochemical features of graphene derivatives using best-fit quadratic regression models. This work opens up new directions for scientists and researchers to pursue, taking them into new fields of study.

Abstract In India, the spatial coverage of air pollution data is not homogeneous due to the regionally restricted number of monitoring stations. In a such situation, utilising satellite data might greatly influence choices aimed at enhancing the environment. It is essential to estimate significant air contaminants, comprehend their health impacts, and anticipate air quality to safeguard public health from dangerous pollutants. The current study intends to investigate the spatial and temporal heterogeneity of important air pollutants, such as sulphur dioxide, nitrogen dioxide, carbon monoxide, and ozone, utilising Sentinel-5P TROPOMI satellite images. A comprehensive spatiotemporal analysis of air quality was conducted for the entire country with a special focus on five metro cities from 2019 to 2022, encompassing the pre-COVID-19, during-COVID-19, and current scenarios. Seasonal research revealed that air pollutant concentrations are highest in the winter, followed by the summer and monsoon, with the exception of ozone. Ozone had the greatest concentrations throughout the summer season. The analysis has revealed that NO2 hotspots are predominantly located in megacities, while SO2 hotspots are associated with industrial clusters. Delhi exhibits high levels of NO2 pollution, while Kolkata is highly affected by SO2 pollution compared to other major cities. Notably, there was an 11% increase in SO2 concentrations in Kolkata and a 20% increase in NO2 concentrations in Delhi from 2019 to 2022. The COVID-19 lockdown saw significant drops in NO2 concentrations in 2020; specifically, − 20% in Mumbai, − 18% in Delhi, − 14% in Kolkata, − 12% in Chennai, and − 15% in Hyderabad. This study provides valuable insights into the seasonal, monthly, and yearly behaviour of pollutants and offers a novel approach for hotspot analysis, aiding in the identification of major air pollution sources. The results offer valuable insights for developing effective strategies to tackle air pollution, safeguard public health, and improve the overall environmental quality in India. The study underscores the importance of satellite data analysis and presents a comprehensive assessment of the impact of the shutdown on air quality, laying the groundwork for evidence-based decision-making and long-term pollution mitigation efforts.

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 Severe pollution-induced flashovers on insulators present a pressing challenge to power system safety. The frequent failure of high-voltage insulators, particularly in the polluted environments of Pakistan, poses a critical concern. This paper investigates the impact of insulator profile on reducing pollution flashovers, testing two designs as per IEC standard 60383 and simulated using the Finite Element Method in COMSOL Multiphysics®. The test results revealed that deep under-ribs insulators exhibited a 5.008% reduction in flashover voltage, while alternating shed insulators experienced a 3.233% decrease in polluted conditions compared to clean conditions. Notably, under both clean and polluted conditions, alternating shed insulators consistently outperformed deep under-ribs insulators, with a 25.377% higher flashover voltage in clean conditions and a 27.400% superiority in polluted conditions. Computational analysis through the Finite Element Method in COMSOL Multiphysics shows a consistent pattern in potential distribution with increasing insulator count, but the presence of a pollution layer introduces spikes in the electric field distribution, validating experimental results. These findings highlight the superior performance of alternating shed insulators, especially in polluted environments.

Abstract The transformer mineral oil is generally hydrocarbon-based and is not environmentally friendly, so it holds a significant share in environmental pollution. As an alternative to conventional transformer oil, plant-based insulation oil has been investigated globally in the past few decades. Even though vegetable oils are considered an environmentally viable alternative to mineral oil, the extensive utilization of vegetable oils could create a threat to Indian food security. The present work focuses on using Pongamia Pinnata oil (PPO) as a significant alternative to conventional transformer oil (CTO) in distribution transformers. The effectiveness of the proposed PPO is experimentally verified using thermal studies and electrical studies through a low-level distribution transformer of 1 kVA. A comparative analysis was carried out between the proposed and conventional oil regarding physical, chemical, and thermal properties. Also, scanning electron microscopy (SEM) and Energy Dispersive X-ray spectroscopy analysis have been carried out for fibreglass cloth insulation material with PPO and CTO to ensure the intrinsic structural strength of the insulation material. The structural strength ensures the bonding and life span of the insulation in the transformer. The cost–benefit analysis is also favourable for the proposed oil as a better green liquid dielectric for transformers.

Abstract QSPR mathematically links physicochemical properties with the structure of a molecule. The physicochemical properties of chemical molecules can be predicted using topological indices. It is an effective method for eliminating costly and time-consuming laboratory tests. We established a QSPR between mev-degree and mve-degree-based indices and the physical properties of benzenoid hydrocarbons. To compute these indices, we designed a program using Maple software and the correlation between indices and physical properties was developed using the SPSS software. Our study reveals that the mve-degree-based sum-connectivity $$(\chi ^{mve})$$ ( χ mve ) and atom bond connectivity ( $$ABC^{mve}$$ A B C mve ) index, mev-degree-based Randić ( $$R^{mev}$$ R mev ) and Zagreb ( $$M^{mev}$$ M mev ) index are the three most significant parameters and have good prediction ability for the physicochemical properties. We examined that $$R^{mev}$$ R mev predicts the molar refractivity and boiling point, $${\chi }^{mve}$$ χ mve predicts the LogP and enthalpy, $$ABC^{mve}$$ A B C mve predicts the molecular weight, $$M^{mev}$$ M mev predicts the Gibb’s energy, Pie-electron energy and Henry’s law. Moreover, we computed the indices for the linear [n]-phenylen.

Echinococcosis, alternatively referred to as hydatid disease, is caused by the larvae of the tapeworm Echinococcus. The primary agents of human infections are Echinococcus granulosus and Echinococcus multilocularis. The present case report pertains to an individual who relocated from an endemic region to the United Arab Emirates and subsequently manifested symptoms of hydropneumothorax. The 44-year-old male patient presented with a 4-day fever and right-sided chest pain, accompanied by cough and breathlessness for 2 weeks. Computed tomography (CT) of the chest revealed right hydropneumothorax and a ruptured hydatid cyst with consolidation. The patient was diagnosed with a ruptured pulmonary hydatid cyst based on a strongly positive hydatid serology and the presence of hydatid tissue on histopathological examination. The patient underwent surgical decortication with cyst removal and received medical treatment with ceftriaxone and albendazole. He was discharged in good condition after a 10-day hospitalisation period. Echinococcosis is a parasitic disease that most often affects the liver and lungs. Although more than half of the patients do not show any symptoms, the main symptoms observed during presentation include dry cough, haemoptysis, and chest pain. Plain radiographs or chest CT scans are used for diagnosis. Surgery is considered the primary treatment for pulmonary hydatid cysts and medical treatment with benzimidazoles (albendazole and mebendazole) is recommended. Complicated pulmonary hydatid disease can manifest in various ways, including hydropneumothorax, as observed in the present case. Early diagnosis, surgical intervention combined with medical treatment, and multidisciplinary teamwork can significantly improve patient outcomes.

Introduction The mild cognitive impairment (MCI) refers to a condition that falls in between dementia and the normal cognitive ageing process. Aim of the study: to explore how a physical therapy rehabilitation program affected patients with type 2 diabetes mellitus (T2DM) and MCI. Methods The study included 37 elderly patients with T2DM and MCI from Al-Azhar University Hospital aged from 60 to 75 years old. After a physician’s referral, they were randomly allocated into two groups. Group A: 27 patients, underwent a three-session per week, 60-minute physical therapy rehabilitation program in addition to medical treatment. The twelve-week program also included resistive exercise, stretching exercises, and aerobic treadmill walking. The 10 patients in Group B only received medical treatment for a total of twelve weeks. Researchers assessed Glycosylated haemoglobin (HbA1c), the p300 neurophysiological test, Mini-Mental State Examination (MMSE) scale, and Montreal Cognitive Assessment (MOCA). Results There were significantly decreased HbA1c and P300 post-treatment compared to pre-treatment within the study group ( p = 0.0001 and p = 0.0001, respectively) and control group ( p = 0.005 and p = 0.0001, respectively). The MOCA significantly increased post-treatment compared to pre-treatment within the study group, but there was no significant difference in the MOCA between pre- and post-treatment in the control group. The study group had decreased HbA1c, and increased MMS, MOCA, and P300 (13.72, 19.34, 18.7, and 7.2%, respectively) compared to the control group (11.06, 11.06, 9.3, 5.98%, respectively). Conclusions Physical therapy rehabilitation programs are important in helping patients with T2DM for improving their memory and cognitive function as well as decreasing the MCI progression.

Objectives There is an increasing trend of pre-diabetes and diabetes mellitus (DM) among adolescents, and sub-Saharan Africa is no exception. However, few published data on pre-diabetes among adolescents in Sudan exist. We aimed to investigate the prevalence of and factors associated with pre-diabetes among adolescents in Eastern Sudan.Design A community-based cross-sectional study was conducted from August to October 2023.Settings This community-based study was conducted in Gadarif city, the capital of Gadarif state, Eastern Sudan.Participants Adolescents (within the ages of 10–19 years).Main outcome measures A questionnaire was used to collect socio-demographic information. Anthropometric and glycated haemoglobin (HbA1c) measurements were performed in accordance with standard procedures. Multivariate logistic regression analysis was performed.Results Of the 387 enrolled adolescents, 207 (53.5%) were female and 180 (46.5%) were male. The median (IQR) age was 14.0 (12.0–16.0) years. 39.5% of the participants’ fathers were employed. The median (IQR) HbA1c was 5.5% (5.2%–5.8%). One-third (32.6%) of the adolescents had pre-diabetes or DM. Of the participants, 67.4%, 30.0% and 2.6% had no DM, pre-diabetes or type 2 DM, respectively. In the univariate analysis, the father’s employment (OR=1.60, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes; age, sex, parents’ education, the mother’s occupation, body mass index z-score, cigarette smoking and a family history of DM were not associated with pre-diabetes. In the multivariate analysis, the father’s employment (adjusted OR=1.70, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes.Conclusion Pre-diabetes is a significant public health problem among adolescents in Eastern Sudan. The introduction of early screening programmes for pre-diabetes at the community level is recommended to halt the progression of pre-diabetes to DM and to deal with existing DM among adolescents.

Abstract The present power generation government companies focus on Renewable Power Sources (RPS) because their features are zero carbon footprint, unlimited power source, fewer greenhouse pollutants, fewer output wastages, plus creatinga very healthy atmosphere. In this work, the sunlight source is utilized for the Photovoltaic (PV) standalone network. The merits of sunlight sources are very optimal human resources needed, unlimited natural sources, plus easy operation. However, the solar power resource is nonlinear fashion. As a result, the operating point of the sunlight network fluctuates concerning sunlight intensity. So, in this article, the Modified Grey Wolf Methodology with Adaptive Fuzzy Logic Controller (MGWM-AFLC) is introduced to maintain the operating point of the sunlight system at the global power point position of the PV array. This controller traces the MPP with very low fluctuations in the PV-produced voltage. The advantages of this proposed method arefewer sensing devices required, less difficulty in development, more useful for rapid changes inthe sunlight temperatures, simpler to realize operation, greater economic growth, plus highly useful for household applications. The sunlight set-up generation voltage is lowwhich is improved by introducing the new Wide Power Rating High Voltage DC-DC Boost Converter (WPRHVBC). The features of this WPRHV converter are low voltage strain on semiconductor devices, few passive elements are enough to develop the circuit, plus easy understanding.

Abstract The research aim is to clarify the effect of courtyard placement, the ratio between length and width, and courtyard orientation on energy consumption in residential buildings in hot and dry climates, to seek planning and designing alternatives for new cities and new residential complexes that are consistent with the environment and climate and save the consumption of energy used in the buildings. The research method was conducted through Design Builder software for simulation purposes. The reference model with the 157.25 m2 which accommodates a central square courtyard measuring 5 m × 5 m, on a residential building model in the New Valley Governorate of Kharga City, Egypt. The courtyard simulation is aimed to determine Less energy consumption inside the different case studies, in 9 courtyard placements The studied alternatives for Courtyard Placement, are (the center of the building, sub facades, and main facades). The different ratios are (1:1, 1.25:1, 1.5:1–1.75:1, 2:1, 2.25:1, 2.5–1). The longitudinal axis of the Courtyard has been oriented to the east–west direction for all placements, and north–south direction for all placements. Also, (orientation angle is Zero), it offered the percentages of better and worst cases in each position of the courtyard. The research findings suggest that the best Placement of the Courtyard that achieved the highest rate of saving of energy consumed inside the used building model was at the southwestern façade, with a saving rate of 18.73%. Then, the Placement of the Courtyard at the northwestern and southeastern facades with a saving rate of 17.91%, with a length-to-width ratio (2.5:1) if the longitudinal axis of the Courtyard is oriented in the north–south direction, Through the study, we conclude that the placement and orientation of the courtyard and its regular formation have contributed to rationalizing energy consumption in residential buildings, the study reached some important standards that could represent a methodological framework for designing contemporary residential buildings with an energy-efficient inner courtyard.

Abstract Based on the benefits of different ensemble methods, such as bagging and boosting, which have been studied and adopted extensively in research and practice, where bagging and boosting focus more on reducing variance and bias, this paper presented an optimization ensemble learning-based model for a large pipe failure dataset of water pipe leakage forecasting, something that was not previously considered by others. It is known that tuning the hyperparameters of each base learned inside the ensemble weight optimization process can produce better-performing ensembles, so it effectively improves the accuracy of water pipe leakage forecasting based on the pipeline failure rate. To evaluate the proposed model, the results are compared with the results of the bagging ensemble and boosting ensemble models using the root-mean-square error (RMSE), the mean square error (MSE), the mean absolute error (MAE), and the coefficient of determination (R2) of the bagging ensemble technique, the boosting ensemble technique and optimizable ensemble technique are higher than other models. The experimental result shows that the optimizable ensemble model has better prediction accuracy. The optimizable ensemble model has achieved the best prediction of water pipe failure rate at the 14th iteration, with the least RMSE = 0.00231 and MAE = 0.00071513 when building the model that predicts water pipe leakage forecasting via pipeline failure rate.

Abstract Traditionally, isolated and non-isolated boost converters are used for solar photovoltaic systems (SPV). These converters have limitations such as low voltage gain, less voltage ripples, temperature dependence, high voltage stress across the switches, and being bulky in size. Besides, the solar PV system also has non-linear characteristics between I–V and P–V, and the energy yield potential is affected by partial shading phenomena. Therefore, maximum power point tracking (MPPT) is being added to the SPV system to get the maximum output power under steady and dynamic climate conditions. Although the conventional MPPT has drawbacks such as less accuracy in predicting the MPP under partial shading conditions, low tracking speed, and more ripples, Hence, the research proposes a stackable single switch boost converter (SSBC) with a Cuckoo search MPPT controller for the SPV system. The efficiency of the proposed circuit topology has been compared with conventional boost converters with various MPPTs. Subsequently, the accuracy of tracking true MPPT by CSO is compared with that of PSO and FPNA. The results show, that the CMPPT with CBC has produced more ripples, whereas the BMPPT with SSBC produces ripple-free power under steady conditions. It is also observed that SSBC with BMPPT produces more power than SSBC with TMPPT. The efficiency of SSBC with BMPPT is better than other combinations. Finally, a prototype model has been developed and verified.

Abstract This paper presents a comprehensive approach for optimal charge scheduling and on-board vehicular control of electrified fleets based on synthetic driving cycles. The proposed approach is conducted within a real case-study in Cairo, Egypt, whereto a representative distance-based driving cycle has been synthesized using K-means clustering over a sliding horizon of gathered data-sets. Two multi-objective problems defining optimal charge scheduling and vehicular control have been formulated to achieve minimal energy consumption and operating cost of the fleet . Non-dominant genetic algorithm (NSGA-II) has been implemented to solve the optimization problems jointly considering fluctuating electricity cost of the grid. The comparative evaluation of results reveals an improvement of 19% and 28% in energy consumption and retention of on-board energy accordingly, with less than 2% mitigation of driveability. Moreover, a reduction of 40.8%, 20%, and 21.9% in fleet size, required charging stations, and annual recharging cost respectively has been realized. The main innovation of this work can be put forward as the ability to address the above-mentioned quadrilateral objectives of electrified fleets in a single comprehensive approach, considering synthetic driving cycles and electricity prices to yield a customized-optimal solution.

Background: Maternal serum ferritin is being explored as a potential predictor for Intrauterine Growth Restriction (IUGR). Early detection of IUGR is crucial for improving perinatal outcomes and reducing associated mortality and morbidity. Objective: To evaluate the role of elevated maternal serum ferritin in predicting the risk of developing IUGR. Patients and Methods: A prospective case-control study was conducted at Al-Batool Teaching Hospital, Diyala, involving 51 pregnant women divided into two groups based on pregnancy status. Demographic data, obstetric history, and risk factors for IUGR were collected through a questionnaire, and blood samples were taken to measure hemoglobin and serum ferritin levels. Results: The study found that the mean serum ferritin level was significantly higher in the patient group (209.89±50.95 ng/ml) compared to the control group (66.91±37.49 ng/ml), with a p-value of

Abstract This work presents an energy management scheme (EMS) based on a rule-based grasshopper optimization algorithm (RB-GOA) for a solar-powered battery-ultracapacitor hybrid system. The main objective is to efficiently meet pulsed load (PL) demands and extract maximum energy from the photovoltaic (PV) array. The proposed approach establishes a simple IF-THEN set of rules to define the search space, including PV, battery bank (BB), and ultracapacitor (UC) constraints. GOA then dynamically allocates power shares among PV, BB, and UC to meet PL demand based on these rules and search space. A comprehensive study is conducted to evaluate and compare the performance of the proposed technique with other well-known swarm intelligence techniques (SITs) such as the cuckoo search algorithm (CSA), gray wolf optimization (GWO), and salp swarm algorithm (SSA). Evaluation is carried out for various cases, including PV alone without any energy storage device, variable PV with a constant load, variable PV with PL cases, and PV with maximum power point tracking (MPPT). Comparative analysis shows that the proposed technique outperforms the other SITs in terms of reducing power surges caused by PV power or load transition, oscillation mitigation, and MPP tracking. Specifically, for the variable PV with constant load case, it reduces the power surge by 26%, 22%, and 8% compared to CSA, GWO, and SSA, respectively. It also mitigates oscillations twice as fast as CSA and GWO and more than three times as fast as SSA. Moreover, it reduces the power surge by 9 times compared to CSA and GWO and by 6 times compared to SSA in variable PV with the PL case. Furthermore, its MPP tracking speed is approximately 29% to 61% faster than its counterparts, regardless of weather conditions. The results demonstrate that the proposed EMS is superior to other SITs in keeping a stable output across PL demand, reducing power surges, and minimizing oscillations while maximizing the usage of PV energy.

Abstract Secondary metabolites (SMs) are the primary source of therapeutics and lead chemicals in medicine. They have been especially important in the creation of effective cures for conditions such as cancer, malaria, bacterial and fungal infections, neurological and cardiovascular problems, and autoimmune illnesses. In the present study, Aspergillus pseudodeflectus AUMC 15761 was demonstrated to use wheat bran in solid state fermentation (SSF) at optimum conditions (pH 7.0 at 30 °C after 10 days of incubation and using sodium nitrate as a nitrogen source) to produce methyl ferulate and oleic acid with significant antioxidant and antibacterial properties. Gas chromatography-mass spectrometry (GC–MS) analysis of the crude methanol extract revealed eleven peaks that indicated the most common chemical components. Purification of methyl ferulate and oleic acid was carried out by column chromatography, and both compounds were identified by in-depth spectroscopic analysis, including 1D and 2D NMR and HR-ESI–MS. DPPH activity increased as the sample concentration increased. IC50 values of both compounds obtained were 73.213 ± 11.20 and 104.178 ± 9.53 µM, respectively. Also, the MIC value for methyl ferulate against Bacillus subtilis and Staphylococcus aureus was 0.31 mg/mL, while the corresponding MIC values for oleic acid were 1.25 mg/mL and 0.62 mg/mL for both bacterial strains, respectively. Molecular modeling calculations were carried out to reveal the binding mode of methyl ferulate and oleic acid within the binding site of the crucial proteins of Staphylococcus aureus. The docking results were found to be well correlated with the experimental data.

Background: It is imperative to analyze the forces and moments produced by various auxiliaries in order to select the optimal attachments and, eventually, to maximize the efficacy and efficiency of orthodontic therapy. Through this investigation, we aimed to highlight the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment on a pre/post treatment protocol basis. Methods: After a thorough search of the online journals, a total of 482 documents were found using keywords such as “Orthodontic Treatment”, “Aligner Auxiliaries”, “Elastic Ligatures” and “Tooth Movement.” The database research, elimination of duplicate studies, data extraction and risk of bias were performed by the authors independently. This systematic review and network meta-analysis included prospective studies and clinical trials to evaluate research that had looked at the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment. Results: Eight investigations of varying designs were selected for this review. The majority of investigations revealed that aligner auxiliaries significantly improve anterior root torque, rotation, and mesio-distal (M−D) movement, as well as posterior anchoring. They also significantly improved anterior root rotation. However, few studies have presented inconsistent or non-statistically significant findings. Conclusion: Auxiliaries for aligners also appear to improve extrusion and other orthodontic movements, but there is insufficient evidence to support these claims. No research has examined posterior bucco-lingual expansion or tilting. Clarification of the effect of attachments and their related variables requires additional clinical investigations.

Background: Diabetes mellitus, or DM, is a condition that increases the risk of developing cataracts. Cataracts are one of the leading causes of blindness; some studies report that DM patients with cataracts have an increased risk of progression, while other studies report that their progression is merely the natural course of the disease. Objectives: To estimate incidence of macular edema (ME), in patients with and without diabetes following phacoemulsification operation. Patients and methods: This study is a prospective cross- sectional observational which enrolled 100 eyes of one hundred subjects, fifty patients suffering diabetes (group 1) and fifty patients suffer no diabetes (group 2) having immature senile cataract . Participants belonged to the ophthalmology department of South Valley University. OCT was done preoperatively and postoperatively by one month. Results: Mean age of patients with and without diabetes was 66.48 and 66.16 respectively. Males represent 64% of group 1 and , and 80% of group 2 respectively. Both groups showed a considerable rise in the central macular thickness one month postoperatively, but there was no potential variation statistically in central macular thickness between the two groups neither before, nor after the surgery. Conclusion: There is an increase in central macular thickness as a result of the effects of phacoemulsification on the macula in patients with and without diabetes. OCT is the single most crucial diagnostic and prognostic tool for managing macular oedema. But long-term studies are needed to prove longer effect of uncomplicated phacoemulsification and macular thickness and its visual impact.

Background: analogues of prostaglandin are usually the first-line prescribed drops therapy in patients with glaucoma, but the mechanism of their action is not completely understood. Objectives: Our study aims to compare anterior scleral thickness in glaucoma patients taking prostaglandins vs dorzolamide/timolol combinations Patients and methods: This was a interventional prospective randomized study that included 60 adults with primary OAG randomized to receive either PG analogues or Dorzolamide/Timolol fixed combination drugs. The AST was evaluated manually by the built-in calibers of a plateform provided in the OCT tools at three locations (scleral spur, 1000 μm, and 2000 μm behind the scleral spur) in the temporal and nasal meridians. Results: The AST at the nasal area showed a decrease of 15.5 microns (SD = 21.4, p = .000). 1000-micron posterior to it, a decrease of 11.5 microns (SD = 5.5, p = .000), and 2000-micron posterior to it, 9.3 (SD = 6.3, p = .000). The AST at the temporal area demonstrated a decrease of 22.3 microns (SD = 8.6, p = .000). 1000-micron posterior to it, 20.9 microns (SD = 14, p = .000), and 2000-micron posterior to it, 20 microns (SD = 13.2, p = .000) Conclusion: The use of prostaglandin analogues and dorzolamide/timolol showed a significant decrease in anterior scleral thickness in all measured points; over the nasal and temporal scleral spurs, and 1000 microns posterior to them, and 2000 microns posterior to them with no statistically significant difference between the two drugs.

Objective: Purpose of the study was to find out the prevalence of dyslipidemia in patients of newly diagnosed type 2 diabetes mellitus (T2DM) attending Federal Government Polyclinic (PGMI) Islamabad. Study type, settings & duration: A cross sectional study was carried out at Federal Government Poly Clinic (PGMI), Islamabad from November 2022 to January 2023. Methodology: The participants consisted of 125 individuals (60 males and 65 females) who had been recently diagnosed with type 2 diabetes mellitus. Individuals who had previously been diagnosed with diabetes or were taking lipid-lowering medication were not included in the study. The levels of blood glucose fasting, total cholesterol, triglycerides, LDL and HDL were documented by standard methods for analysis. Data was entered, cleaned and analyzed by using SPSS (Version 20.0). Results: Of the total, 69 (55.2%) patients had hypercholesterolemia, 73 (58.4%) had hypertriglyceridemia, 63 (50.4%) had increased levels of LDL and 90 (72%) had reduced HDL. The incidence of dyslipidemia was more in female participants of diabetes mellitus as compared to male participants of diabetes mellitus. Conclusion: This study found a high incidence of dyslipidemia among recently diagnosed patients of T2DM regardless of gender. The risk of dyslipidemia was increased by factors such as body mass index, age, waist circumference, hypertension, lack of physical activity and tobacco use. It is important to increase awareness regarding dyslipidemia and its related risk factors. Screening for dyslipidemia should be conducted early in patients with recently diagnosed type 2 diabetes mellitus, as they are more prone for developing cardiovascular diseases. It is also important to regularly monitor the lipid profile of these patients in addition to their blood glucose levels. Early intervention should be initiated once dyslipidemia is confirmed.

Background: The study aims to present the location and course of the posterior superior alveolar artery (PSAA) using cone beam computed tomography (C.B.C.T.) imaging, which is considered as a valuable part for treatment planning in sinus augmentation procedures for dental implant treatment. Materials and Methods: Data was extracted from included C.B.C.T. images using implant planning software and entered on Microsoft Excel and SPSS for statistical analysis. For each radiograph measurements were taken on premolar and molar region to determine the location of PSAA as being extraosseous or intraosseous. The distance of the artery from the floor of the sinus was also measured. Results: The study included 56 radiographic images. 44 view of right and left maxillary sinus satisfied the inclusion criteria. Each sinus had 2 points of measurements, giving total of 176 sites. The average distance of PSAA was 11.1 from the floor of the maxillary sinus and the median was 10.5mm. The PSAA was extraosseous in most instances with 57% of the total sample. Conclusions: The location of the PSAA can be mostly in extraosseous site. The artery might also move from extraosseous to intraosseous location, or Vise versa, during its course as it travel from the molar to premolar area. Correct identification during planning of sinus lift procedures can help in avoiding accidental trauma during surgery.

Population movement dynamics are a critical part of understanding communicable disease transmission patterns and determining where, when, and with whom to deliver appropriate prevention interventions. This study aimed to identify the origin of the Afghan population and their patterns of movement within Karachi, to assess the polio vaccination status of children under the age of five, and to investigate the travel history and guest arrival patterns of individuals from Afghanistan and other regions known to be affected by wild poliovirus type 1 (WPV1) within the past six months. A cross-sectional survey was conducted in selected 12 union councils of Karachi, Pakistan. The data were collected through interviews with Afghan household members and from the frontline workers (FLWs) responsible for the polio vaccination of the children of the same households. Cohen’s kappa was used to check the agreement between information provided by the household participant and FLWs. A total of 409 Afghan household members were interviewed. Travel of any household member outside the city within the last six months was reported by 105 (25.7%) participants, 140 (34.2%) hosted guests within the last six months, and 92 (22.5%) participants reported that guest children were vaccinated in their households. A total of 230 (56.2%) participants observed polio teams at relatives’ households within Karachi, and 127 (31.1%) observed polio teams at relatives’ households outside Karachi in different districts of Pakistan and Afghanistan. Fair to moderate agreement was observed between information provided by the household members and FLWs on the variable’s duration of living at current residence (Kappa = 0.370), travel history (Kappa = 0.429), guest arrival (Kappa = 0.395), and household children vaccinated for OPV (Kappa = 0.419). Substantial population mobility was observed between Afghanistan and Pakistan as well as significant movement of the Afghan population within Karachi in the last six months. These findings warrant attention and targeted implementation of interventions to enhance and sustain both routine and supplementary immunization activities within this demographic group.

The tumor microenvironment is a determinant of cancer progression and therapeutic efficacy, with nutrient availability playing an important role. Although it is established that the local abundance of specific nutrients defines the metabolic parameters for tumor growth, the factors guiding nutrient availability in tumor compared to normal tissue and blood remain poorly understood. To define these factors in renal cell carcinoma (RCC), we performed quantitative metabolomic and comprehensive lipidomic analyses of tumor interstitial fluid (TIF), adjacent normal kidney interstitial fluid (KIF), and plasma samples collected from patients. TIF nutrient composition closely resembles KIF, suggesting that tissue-specific factors unrelated to the presence of cancer exert a stronger influence on nutrient levels than tumor-driven alterations. Notably, select metabolite changes consistent with known features of RCC metabolism are found in RCC TIF, while glucose levels in TIF are not depleted to levels that are lower than those found in KIF. These findings inform tissue nutrient dynamics in RCC, highlighting a dominant role of non-cancer-driven tissue factors in shaping nutrient availability in these tumors.

Purpose To systematically review the patient’s satisfaction (PS) levels within academic hospitals in Saudi Arabia from January 2012 to the end of October 2022.Data sources Articles were gathered from PubMed, ProQuest, Google Scholar and Web of Science.Study selection/data extraction This review identified studies that assessed PS in Saudi Arabian university hospitals. Articles published before January 2012, as well as commentary letters, conference papers, theses and dissertations, were excluded. The study employed the five domains of PS as outlined by Boquiren et al. Two independent reviewers independently identified qualifying studies, used the Joanna Briggs Institute tools to evaluate the quality of each study and extracted essential data from each article.Results Out of the 327 studies identified during the search phase, 11 met the project’s objectives and criteria. Six studies reported overall PS rates ranging from 78% to 95.2%, with only one study indicating lower PS levels in emergency departments. Most studies demonstrated that technical skill is the primary domain influencing PS in academic hospitals.Conclusion There is a need for further investigation to explore the factors influencing PS using standardised survey instruments suitable for Saudi culture. Contradictory results regarding PS are clearly evident in the literature; therefore, it is advisable to standardise the assessment process to reduce discrepancies within the academic hospital setting in Saudi Arabia.

The history of measles spans centuries, marked by devastating outbreaks until the identification of the measles virus in the early 20th century and the subsequent development of a vaccine in 1963. Despite vaccination efforts, measles resurged globally in 2019 after years of decline. The COVID-19 pandemic further disrupted vaccination campaigns, leading to missed doses and heightened risks of outbreaks. By November 2020, over 94 million individuals were at risk of missing vital vaccines. As of May 2024, around 63 countries faced genuine measles outbreaks, with Iraq ranking third, reporting approximately 25,429 cases. Iraq's healthcare system, already strained by decades of crises, struggles to manage the outbreak amidst challenges such as limited access to healthcare, vaccine hesitancy, and the suspension of vaccination campaigns. Urgent interventions are needed to address these challenges and prevent further escalation of the measles outbreak in Iraq.

Background: The global prevalence of mental disorders, including depression, has steadily increased. Objective: To identifying the prevalence rate of depression and the related predictors among old-age people in Iraq. Patients and Methods: A cross-sectional study was conducted from August to November 2021. A random sampling technique was employed to gather information from the old age patients during their routine visits to outpatient clinic of three public hospitals (Baquba, Ramadi, Samarra), in Iraq. Data collection involved the utilization of a semi-structured questionnaire incorporating the validated Geriatric Depression Scale (GDS-30) administered through face-to-face interviews. Descriptive, bivariate, and multivariate logistic regression analyses were employed to examine the relationships between variables in the study. SPSS version 16 was utilized for data analysis, with statistical significance set at a threshold below 0.05. Results: Data of 344 old-age respondents (range 60-81 years) with a mean age of 75.15 (± 7.52) years have undergone final analysis. More than half were males (50.6%), married (62.2%), ranked themselves as unhealthy (72.4%), physically inactive (70.6%), and financially dependent (71.8%). The overall prevalence of depression was 74.4%. Logistic regression revealed significant associations: elderly females had 3.805 times higher risk (P

Abstract Refactoring tools have advanced greatly and are being used in many large projects. As a result, a great deal of information is now available about past refactoring and its effects on the source code. However, when multiple refactoring is performed at once, it becomes more difficult to analyze their impact. Refactoring visualization can help developers create more maintainable code that is easier to understand and modify over time. Although there is an increasing interest in visualizing code changes in software engineering research, there has been relatively little research on visualizing the process of refactoring. In this paper, we propose a Radar Chart Refactoring Visualization (RcRV) approach to visualize software refactoring of source code across multiple software releases. Radar charts are a form of 2D visualization that can show multiple variables on a single chart. The RcRv receives input from developers or through refactoring identification tools, such as Ref-Finder, to generate charts. The generated charts can show the changes made during the refactoring process, highlighting areas of the trend of refactoring over evolution for multiple refactoring, multiple methods, and multiple classes. The evaluation study conducted to assess the usefulness of the RcRV tool has shown that the proposed tool is useful to developers, appealing, and easy to use. The proposed method of visualization can be beneficial for developers and maintainers to detect design violations and potential bugs in the code, thus saving time and effort during the development and maintenance process. Therefore, this research presents a significant contribution to the software engineering field by providing developers with an efficient tool to enhance code quality and maintainability.

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Background: Drug use often leads to a range of health risks, social complications, and involvement in criminal behavior. This study aims to investigate adolescents' understanding, opinions, and perspectives on substance abuse. Methods: Between October and December 2023, a cross-sectional study was undertaken in Diyala Province, Iraq. High school students were sampled using a multistage sampling technique. Bivariate analysis utilized independent sample t-tests and one-way analysis of variance (ANOVA). Additionally, a multivariable linear regression analysis was performed to predict factors associated with knowledge, attitudes, and perceptions. All statistical analyses were carried out using SPSS version 16. Results: The study encompassed 365 students, with a mean age (SD) of 17.5 (+ 8.2), predominantly male (57.3%). Overall accuracy rates for knowledge, attitude, and perception stood at 87.1%, 86.7%, and 88.7%, respectively. Approximately 5.2% of the sample reported cannabis (hashish) use. Regression analysis revealed significant associations between higher knowledge scores and male gender (p=0.002, 95% CI:0.341, 0.729), urban residency (p US$400 (p >0.0001, 95% CI:0.907, 1573). Attitudes toward drug abuse prevention were influenced by male gender and highly educated parental backgrounds (p

IntroductionBreast cancer continues to be the most common malignancy and the leading cause of cancer-related deaths in Ethiopia. The poor prognosis and high mortality rate of breast cancer patients in the country are largely caused by late-stage diagnosis. Hence, understanding the epidemiology of late-stage diagnosis is essential to address this important problem. However, previous reports in Ethiopia indicated inconsistent findings. Therefore, this literature review was conducted to generate dependable evidence by summarizing the prevalence and determinants of late-stage diagnosis among breast cancer patients in Ethiopia.MethodsPertinent articles were retrieved by systematically searching on major electronic databases and gray literature. Data were extracted into an Excel spreadsheet and analyzed using the STATA 17 statistical software. The pooled estimates were summarized using the random effect meta-analysis model. Heterogeneity and small study effect were evaluated using the I2 statistics and Egger's regression test in conjunction with the funnel plot, respectively. Meta-regression, sub-group analysis, and sensitivity analysis were also employed. Protocol registration number: CRD42024496237.ResultsThe pooled prevalence of late-stage diagnosis after combining reports of 24 studies with 8,677 participants was 65.85 (95% CI: 58.38, 73.32). Residence (adjusted OR: 1.92; 95% CI: 1.45, 2.53), patient delay at their first presentation (adjusted OR: 2.65; 95% CI: 1.56, 4.49), traditional medicine use (adjusted OR: 2.54; 95% CI: 1.89, 3.41), and breast self-examination practice (adjusted OR: 0.28; 95% CI: 0.09, 0.88) were significant determinants of late-stage diagnosis.ConclusionTwo-thirds of breast cancer patients in Ethiopia were diagnosed at an advanced stage. Residence, delay in the first presentation, traditional medicine use, and breast self-examination practice were significantly associated with late-stage diagnosis. Public education about breast cancer and its early detection techniques is crucial to reduce mortality and improve the survival of patients. Besides, improving access to cancer screening services is useful to tackle the disease at its curable stages.

Prior research suggests exercise during pullet rearing can mitigate lay-phase bone fractures by strengthening muscles, enhancing balance, and increasing bone mass. This study aimed to confirm that Hy-Line brown pullets with multi-tier perches show increased activity and improved musculoskeletal health. Pullets (n = 810) were randomly allocated to housing systems, either with multi-tier perches (P; n = 15 pens) or without (NP; n = 15 pens), spanning from 0-17 weeks of age. At 5, 11, and 17 weeks, individual birds were meticulously monitored for activity using accelerometers over three consecutive days (n = 90 randomly selected birds/week). At 11 and 17 weeks, 60 birds underwent euthanasia and computed tomography (CT) scans to ascertain tibiotarsal bone mineral density and cross-sectional area measurements. Post-CT scanning, birds were dissected for muscle size, tibiotarsal breaking strength, and tibiotarsal ash percentage measurements. Additionally, serum concentrations of bone-specific alkaline phosphatase and procollagen type 1 N-terminal propeptide were assessed as markers of bone formation (n = 90 birds/week). Pullet group P exhibited heightened vertical activity (P0.05) during weeks 5, 11, and 17 compared to group NP. Tibiotarsal bones of P pullets demonstrated superior total and cortical bone mineral density at week 11, alongside increased cortical bone cross-sectional areas and heightened total and cortical bone mineral densities at week 17 (P

Background Asthma is a public health concern affecting millions of productive age groups. Several studies were conducted on the determinants of asthma in children. However, little is known about the determinants of asthma among adults in Ethiopia. Understanding the determinants of asthma among adults can help reduce its burden. This study was aimed at identifying determinant factors for developing asthma among adults in Tigray hospitals. Methods A facility-based, unmatched case-control study design was conducted from January 1 to April 26, 2019. A total of 698 participants (228 cases and 470 controls) completed their guided interviews using structured and pretested questionnaires by trained data collectors. A modified standard questionnaire from the European Community Respiratory Health Survey II (ECRHS II) was used to collect the data. The case definition was patients having asthma, and the control definition was patients without asthma. Data were entered and cleaned using Epi Data Manager Version 3.1 software and imported to statistical packages for social sciences Version 25 software for analysis. To identify asthma determinants, bivariate and multivariable logistic regression models were fitted. Results The response rate for both cases and controls was 95.9%. The odds of developing asthma was nearly twice higher among those who resided in urban (AOR = 1.68; 95% CI [1.13–2.50]), more than twice higher among those who have income less than 1000 ETB (AOR = 2.3; 95% CI [1.17–4.56]), twice higher among those who had history of skin allergy (AOR = 2.09; 95% CI [1.14–3.86]), over four times higher among those with family history of asthma (AOR = 4.26; 95% CI [2.63–6.91]), three times higher among those having house dust or smoke exposure (AOR = 3.01; 95% CI [1.96–4.64]), over five times higher among those lifetime firewood users (AOR = 5.39; 95% CI [3.34–8.72]), door opening while cooking (AOR = 0.35; 95% CI [0.26–0.55]), nearly two times higher among those having house dampness (AOR = 1.98; 95% CI [1.069–3.68]), over seven times higher among pet owners (AOR = 7.46; 95% CI [4.04–13] and almost twice higher among those who were physically inactive (AOR = 1.75; 95% CI [1.11–2.85]). Conclusion Asthma has been associated with urbanization, low income, a history of allergic diseases, indoor smoke or dust, firewood use, pet ownership, and a sedentary lifestyle. The community should be informed about the known risks and implement preventive steps like opening a door while cooking to lower the risk of asthma.

Background: Although several studies were conducted on treatment of localized vitiligo with multiple adjuvants, there is no ideal therapy with optimum results. Objectives: The purpose of this research is to compare the effectiveness of topical 5-fluorouracil and topical latanoprost in stimulating skin regimentation in patients with localized stable vitiligo following skin microneedling. Patients and methods: This prospective randomized clinical trial conducted on forty patients with localized stable vitiligo was divided randomly into two groups: Group (A): 20 patients were received latanoprost after microneedling Group (B): 20 patients were received 5-Flourouracil 5% solution after microneedling. All patients were clinically and photographically evaluated using Vitiligo Area Scoring Index (VASI). Results: There was no statistically significant difference between both groups regarding the degree of repigmentation in response to treatment (p value = 0.317). Excellent improvement (> 75% repigmentation) was achieved in 45% of patients in both groups. Also, there was significant reduction in the VASI score for both groups when comparing post-treatment with the baseline. As regard the complications, there was minimal complications only one case with post inflammatory hyperpigmentation. Conclusion: Microneedling combined with 5-Fluorouracil or latanoprost are both safe and effective treatments of localized stable vitiligo with no significant difference.

Background: Several countries poorly adhere to the World Health Organization’s recommendation of folic acid supplementation in the periconceptional period, especially in limited-resource settings. Objective: The objective of this study was to investigate the prevalence of and the factors associated with folic acid usage in the periconceptional period among pregnant women at Gadarif Maternity Hospital in eastern Sudan. Study design: This is a cross-sectional study. Methods: This study was conducted in eastern Sudan from April to September 2022. A total of 720 pregnant women in their first trimester were enrolled. The sociodemographic characteristics and clinical and obstetrical data of pregnant women in their first trimester were assessed using a face-to-face questionnaire. In addition, multivariate regression analysis was performed. Results: In this study, the median (interquartile range) of the age and gravidity of the enrolled women was 26.3 (24.14–29.52) years and 2 (1–4), respectively. Of these 720 women, 423 (58.8%) used folic acid during the periconceptional period, while 27 (3.7%) women used folic acid in the preconceptional period. None of the investigated factors (age, residence, education, employment, body mass index, or gravidity) were associated with periconceptional use of folic acid. Conclusion: The study revealed a low prevalence of folic acid usage in preconceptional period among pregnant women in eastern Sudan. Additional efforts are needed to promote folic acid usage in the preconceptional period as well as in the first trimester.

Objectives There is an increasing rate of elevated blood pressure, or hypertension, in children and adolescents worldwide, including Sub-Saharan Africa (SSA). Only a few data on adolescent hypertension in SSA, including Sudan, have been published. The aim of the present study was to investigate the prevalence and associated factors of hypertension among adolescent schoolchildren (within the ages of 10 to 19 years) in Sudan.Design A cross-sectional school-based study was conducted from June to September 2022.Settings Six randomly selected schools in Almatamah, River Nile State, Sudan.Participants Adolescent schoolchildren (within the ages of 10 to 19 years).Main outcome measures Sociodemographic information. Anthropometric and blood pressure measurements were performed in accordance with the standard procedures. An adjusted logistic regression analysis was performed.Results Of the 384 enrolled adolescents, 166 (43.2%) and 218 (56.8%) were boys and girls, respectively. The median (IQR) age and body mass index (BMI) were 15.2 years (14.0‒16.4 years) and 18.5 kg/m2 (16.4‒21.5 kg/m2), respectively. Of the 384 adolescents, 240 (62.5%) and 255 (66.4%) had educated mothers and fathers (≥secondary), respectively. 38 adolescents (9.9%) had hypertension (≥95th percentile). The multivariable logistic regression analysis revealed that age, sex and maternal educational level were not associated with hypertension. Paternal educational level according to secondary education attainment (adjusted OR (AOR), 2.72; 95% CI 1.36‒5.46) and increasing BMI (AOR, 1.12; 95% CI 1.02‒1.20) were associated with hypertension.Conclusion 1 in 10 adolescents in northern Sudan was hypertensive. Low paternal educational level and increasing BMI were significantly associated with hypertension. The introduction of interventional nutritional programmes at early ages is needed to ensure that adolescents are healthy in their present and later lives. To sustain such programmes, involving all educational parties at early stage is essential.

Background: Psoriasis goes beyond skin, intertwining with body systems, notably connecting to nonalcoholic fatty liver disease (NAFLD). This study aims to explore the predictive potential: liver function tests and IL-6 as early markers for non-alcoholic fatty liver disease in psoriasis patients. Methods: From March to November 2023, a case-control study was performed at the dermatological outpatient clinic of Baquba Teaching Hospital, Iraq. Individuals with confirmed psoriasis and those without underwent comprehensive clinical history and overall health examinations. The diagnosis of non-alcoholic fatty liver disease (NAFLD) was established using the Fatty Liver Index (FLI). Results: Among the 290 participants in this study, 103 with confirmed psoriasis displayed a Fatty Liver Index (FLI) score >60, indicative of non-alcoholic fatty liver disease (NAFLD). The control group, comprising 101 individuals without psoriasis or NAFLD, provided a baseline for comparison. The mean ages were 32.5 ± 16.2 and 31.5 ± 14.3 years for the case and control groups, respectively. Notably, the case group exhibited significantly higher mean ± SD levels of ALT and AST (61 ± 29 vs. 33 ± 17 U/L, p < 0.0001) and (55 ± 27 vs. 25 ± 15 U/L, p < 0.0001), respectively. Moreover, FLI criteria were markedly elevated in the case group (p = 0.0007, p = 0.0005, p < 0.0001, and p < 0.0001, respectively), and IL-6 levels were significantly higher (p = 0.0003). Conclusion: The results proposed that liver function tests and IL-6 could act as early predictors for the detection of non-alcoholic fatty liver disease among individuals grappling with psoriasis.

Abstract Background: Visceral leishmaniasis (also known as Kala-azar) is a systemic parasitic infection with many clinical presentations. The present study assesses the variation in presentations among patients who attended the Tropical Diseases Teaching Hospital (TDTH) in Khartoum, Sudan. Methods: This analytical cross-sectional, hospital-based study was conducted at the TDTH between November 2019 and September 2020. Medical records of patients who presented at the TDTH were reviewed using a structured data extraction checklist. The Chi-square test was used to determine the associations between sociodemographic and clinical presentations of patients. P-value < 0.05 was considered as statistically significant. Results: Out of 195 patients,79.5% were male and 48.2% were < 31 years old. Fever was the main clinical presentation (90.2%) while 53.3% presented with weight loss and 72.3% and 39% presented, respectively, with splenomegaly and hepatomegaly. HIV was detected in 4.6% of the patients. RK39 was the main diagnostic test. We found a significant association between the abdominal distention and the age of the patients (P < 0.05) – age groups 11–20 and 41–50 years were more likely to present with abdominal distention than other age groups. Conclusion: There is no exact clinical presentation or routine laboratory findings that are pathognomonic for visceral leishmaniasis; therefore, it should be considered in the differential diagnosis of any patient with fever, weight loss, and abdominal distention, and among patients with HIV.

Pakistan is one of two countries globally still endemic for poliovirus. While increasing immunization coverage is a concern, providing equitable access to care is also a priority, especially for conflict-affected populations. Recognizing these challenges, Naunehal, an integrated model of maternal, newborn, and child health (MNCH), immunization, and nutrition services delivered through community mobilization, mobile outreach, and private-sector engagement was implemented in conflict-affected union councils (UCs) with high poliovirus transmission, including Kharotabad 1(Quetta, Balochistan) and Bakhmal Ahmedzai (Lakki Marwat, Khyber Pakhtunkhwa). A quasi-experimental pre–post-design was used to assess the impact of the interventions implemented between April 2021 and April 2022, with a baseline and an endline survey. For each of the intervention UCs, a separate, matched-control UC was identified. At endline, the proportion of fully immunized children increased significantly from 27.5% to 51.0% in intervention UCs with a difference-in-difference (DiD) estimate of 13.6%. The proportion of zero-dose children and non-recipients of routine immunization (NR-RI) children decreased from 31.6% to 0.9% and from 31.9% to 3.4%, respectively, with a significant decrease in the latter group. Scaling up and assessing the adoption and feasibility of integrated interventions to improve immunization coverage can inform policymakers of the viability of such services in such contexts.

With the increased focus on patient-centered care, consensus on healthcare outcomes of importance to patients becomes crucial. Based on a systematic review of the literature, this study confirms the perspectives of patients on healthcare quality in GCC countries. Online databases were searched for relevant peer-reviewed articles published from 2012 to 2023. Twenty-two articles retrieved from the search were qualitatively analyzed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Most articles (90%) reported studies conducted in Saudi Arabia. Patients in GCC countries face common problems in the care delivery process, which contribute to negative perceptions of quality. These problems include diagnostic and medication errors, provider–patient communication problems, missed appointments with physicians, problems in emergency care access due to geographical distance and transportation barriers, long waiting times, and physical environments. Notably, healthcare quality is perceived to be an outcome of multiple factors dependent on the location and category of healthcare service providers; for instance, disparities in perceptions of quality were observed between patients attending Primary Health Care (PHC) centers in rural and urban areas. Issues such as lack of equitable healthcare delivery and deficiencies in Emergency Medical Services (EMS) effectiveness were disparately recognized as quality concerns by different patient populations. The findings provide insights into healthcare quality and area of weakness needing strategies and policies to ensure patient-centered, safe, equitable, timely, and effective healthcare. Healthcare providers and policymakers in GCC countries can use the results to plan, assess, and improve care delivery. Trial registration: PROSPERO ID: CRD42022326842.

Interleukins (ILs) are signaling molecules that are crucial in regulating immune responses during infectious diseases. Pro-inflammatory ILs contribute to the activation and recruitment of immune cells, whereas anti-inflammatory ILs help to suppress excessive inflammation and promote tissue repair. Here, we provide a comprehensive overview of the role of pro-inflammatory and anti-inflammatory ILs in infectious diseases, with a focus on the mechanisms underlying their effects, their diagnostic and therapeutic potential, and emerging trends in IL-based therapies.

Background: The eradication of poliovirus and improving routine immunization (RI) coverage rates present significant challenges in Pakistan. There is a need for interventions that focus on strengthening community engagement to improve routine immunization coverage. Our primary objective is to assess the impact of an integrated strategy designed to enhance community engagement and maternal and child health immunization campaigns on immunization coverage in Pakistan’s high-risk union councils of polio-endemic districts. Method: We implemented an integrated approach for routine immunization and maternal and child health in the polio-endemic district of Pakistan. This approach involved setting up health camps and actively engaging and mobilizing the local community. An independent team conducted surveys at three key points: baseline, midline, and endline, to evaluate immunization coverage among children under the age of five. The primary outcome measures for the study were coverage of OPV, IPV, and changes in the proportion of unvaccinated and fully vaccinated children. To select clusters and eligible households in each cluster, we utilized a 30 × 15 cluster sampling technique. Multivariable associations between socio-demographic factors and changes in the proportion of fully vaccinated children at the UC level were assessed using hierarchical linear regression models. Results: A total of 256,946 children under the age of five (122,950 at baseline and 133,996 at endline) were enrolled in the study. By the endline, full immunization coverage had increased to 60% or more in all three study areas compared to the baseline. Additionally, there was a significant increase in the coverage of both OPV and IPV across all three provinces at the endline. The full immunization rates were assessed on three levels of the framework: the distal, intermediate (access and environment), and proximal level (camp attendance and effectiveness). At the distal level, on multivariate analysis, family size was found to be a significant predictor of change in immunity within the families (β = 0.68; p ≤ 0.0001). At the intermediate level, the likelihood of full immunization decreased with the decrease in knowledge about vaccination (β = −0.38; p = 0.002), knowledge about polio vaccine (β = −0.25; p = 0.011), and knowledge about IPV (β = −0.06; p = 0.546). Perceived obstacles to vaccination were fear of adverse events (β = −0.4; p ≤ 0.0001) and lack of education (β = 0.23; p = 0.031), which were found to be significant in bivariate and multivariate analyses. At the proximal level, community mobilization (β = 0.26; p = 0.008) and attendance at health camp (β = 0.21; p ≤ 0.0001) were found to enhance full immunization coverage. On the other hand, the most prominent reason for not attending health camp included no need to attend the health camp as the child was not ill (β = −0.13; p = 0.008). Conclusions: This study found that community mobilization and attendance at health camps significantly enhanced full immunization coverage. The findings highlight the importance of community engagement and targeted interventions in improving immunization coverage and addressing barriers to healthcare seeking.

Abstract This meta-analysis aims to compare Apert syndrome (AS) patients with non-AS populations (not clinically or genetically diagnosed) on craniofacial cephalometric characteristics (CCC) to combine publicly available scientific information while also improving the validity of primary study findings. A comprehensive search was performed in the following databases: PubMed, Google Scholar, Scopus, Medline, and Web of Science, an article published between 1st January 2000 to October 17th, 2021. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to carry out this systematic review. We used the PECO system to classify people with AS based on whether or not they had distinctive CCC compared to the non-AS population. Following are some examples of how PECO has been used: People with AS are labeled P; clinical or genetic diagnosis of AS is labeled E; individuals without AS are labeled C; CCC of AS are labeled O. Using the Newcastle–Ottawa Quality-Assessment-Scale, independent reviewers assessed the articles' methodological quality and extracted data. 13 studies were included in the systematic review. 8 out of 13 studies were score 7–8 in NOS scale, which indicated that most of the studies were medium to high qualities. Six case–control studies were analyzed for meta-analysis. Due to the wide range of variability in CCC, we were only able to include data from at least three previous studies. There was a statistically significant difference in N-S-PP (I 2: 76.56%; P = 0.014; CI 1.27 to − 0.28) and Greater wing angle (I 2: 79.07%; P = 0.008; CI 3.07–1.17) between AS and control subjects. Cleft palate, anterior open bite, crowding in the upper jaw, and hypodontia occurred more frequently among AS patients. Significant shortening of the mandibular width, height and length is the most reported feature in AS patients. CT scans can help patients with AS decide whether to pursue orthodontic treatment alone or to have their mouth surgically expanded. The role of well-informed orthodontic and maxillofacial practitioners is critical in preventing and rehabilitating oral health issues.

The transmission of infections through gastrointestinal endoscopy is a vital issue. The main problem lies in the use of duodenoscopes due to mechanical aspects of the scope design. Even with high-level disinfection, sterilization of the scope can fail. Hence, the Food and Drug Administration has encouraged a shift to single-use endoscopes. Available options include endoscopes with single-use components (mainly single-use endcaps), fully single-use duodenoscopes (SUDs), and even those with a disposable elevator mechanism. Clinical trials revealed that both reusable and single-use scopes have the same efficacy, while single-use scopes have benefits in terms of infection control, economic considerations, and ease of reprocessing. A few drawbacks are left to be dealt with. Reusable duodenoscopes with removable/disposable endcaps are satisfactory except in specific situations where SUDs are better to use.

Background: Nursing staff are in direct contact with the consequences of the current coronavirus disease 2019 (COVID-19) crisis. Design and Methods: Descriptive questionnaire-based cross-sectional survey of a sample of nursing staff working across Saudi Arabia. Results: The study included (n = 431) nursing professionals. Coronaphobia prevalence among the nursing staff was 80.3% [95% confidence interval (CI): 76.5–84%]. There were (36.7%) who had severe cornaphobia. Working in a clinical department and being Saudi national were associated with increased COVID-19 fear (estimate = 0.109, P = 0.0153 and P = 0.010, respectively). Conclusion: Hospital management in Saudi Arabia needs to acknowledge the high prevalence of coronaphobia during the current COVID-19 crisis among nursing staff.