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Background: Medical residency is a part of postgraduate medical education and involves clinical training in a selected specialty. It is a challenging step in a physician's professional development. This study aims to estimate the impact of the residency training program and demographic factors on the trainee's state of well-being (SOW)., Methods: This was an observational cross-sectional study carried out in the year 2019-2020, which aimed to measure the SOW of residents undergoing clinical training in Riyadh, Saudi Arabia. A total of 260 residents participated in the study. A self-administered validated online the World Health Organization, Quality of Life Scale questionnaire- BREF was distributed to collect the data. The collected information on four different domains was analysed and compared across the baseline characteristics and different specialties. When appropriate, the independent sample t-test, bivariate correlation analysis, and ANOVA tests were used., Results: A total of 260 resident responses were included in the final analysis The results revealed a significant difference in physical health scores (p = 0.006), social relationship scores (p = 0.038), and environmental scores (p < 0.001) while no significant difference was found in psychological health scores among the physicians' specialties (p = 0.053). Post hoc comparison found statistically significant variations in the physical health domain between the medical and emergency specialties (p = 0.007), as well as surgical and emergency specialties (p = 0.024). There was also a significant difference between medical and emergency specialties (p = 0.008) in the social relationship domain. In the environment domain, significant variation was reported between medical specialties and emergency specialties (p = 0.001), as well asbetween surgical specialties and emergency specialties (p = 0.045). Female residents reported significantly lower quality of life in the physical (p = 0.020) and psychological (p = 0.032) domains., Conclusions: A significant relationship was found between physical, social, and environmental domains according to residents' specialties. The factors that affected one or more domains included age, female gender, marital status, disease status, the number of on-calls received, and workload. We emphasize the importance of implementing policies to regulate working hours and on-call schedules as well as prioritizing mental health support., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Chronic kidney disease (CKD) is becoming an increasing public health problem. A study that reviewed patients receiving treatment in hemodialysis centers reported 79.2% of patients from Jigawa State to be managed for CKD. This study aimed to find the factors associated with CKD among adults from high-burden kidney disease areas of Jigawa State. MATERIALS AND METHODS: A cross-sectional descriptive study design that utilized mixed methods (quantitative and qualitative) of data collection (sequential explanatory) was used to study eligible respondents from the four local government areas (LGAs) reported to have a high burden of kidney disease. The modified WHO STEPS questionnaire, key informant interview, and in-depth interview guides were employed to collect information from the eligible selected community members. Multistage and purposive sampling techniques were used, and data were analyzed using IBM SPSS version 22.0 with a statistical significance set at P ≤ 0.05. Thematic analysis was used to analyze the qualitative interviews. Results: The age of the respondents ranged from 18 to 102 years, with a median of 45 (interquartile range = 30–80) years. The period prevalence over the past five years (2018–2023) of having kidney disease in the family was 67 (18.6%), while the point prevalence (currently having a patient with kidney disease) was 51 (14.1%). In terms of the distribution of cases by LGAs, Jahun reported more cases, 33.3% in the family within the last five years, followed by Hadejia 18.7%. In the same vein, respondents from Jahun 28.9% and Hadejia 16.5% reported more current cases of kidney disease in the family. The prevalence of ever had patient with chronic kidney disease in the family was significantly higher among those with systolic hypertension (BP) ≥140 mmHg (29.3%, P < 0.001). Elevated systolic BP was significantly associated with currently having a kidney disease patient (23.3%, P = 0.001). The interviews revealed late presentation and noncompliance to medications among those with risk factors as the perceived facilitators of kidney disease. Conclusions: The prevalence of kidney disease was alarming in the high-burden kidney disease areas. The government should develop a sustainable model for mass community screening of risk factors and community-based health insurance to effectively manage all identified cases.

Background: Cosmetic and plastic surgery is becoming increasingly prevalent all over the world among both men and women. Saudi Arabia ranks 22nd among the top 25 countries with the world’s highest rates of cosmetic surgeries. This study aimed to assess the awareness of the population in the Jazan region regarding rhinoplasty surgery and to identify their main determinants. Material and Methods: A cross-sectional study of 425 participants was conducted at four randomly selected malls in Gizan City. A self-administered questionnaire was first developed to collect the data necessary to fulfill the research objectives, data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22. The quantitative data were reported as a mean and standard deviation, and the qualitative data were reported as frequency and percentage. Regarding tests for significance, the Chi-square test used a P value less than 0.05 as an indicator of significance. Logistic regression was used to detect the predictors of poor knowledge of rhinoplasty surgery. Results: The mean age of the participants was 39.46 ± 10.08. Of the participants, 53.6% have poor knowledge while 36.0% have good knowledge regarding rhinoplasty surgery. Moreover, 60.2% have an unfavorable attitude while 23.6% have a favorable attitude toward rhinoplasty surgery. The most important predictors of poor knowledge of rhinoplasty surgery are as follows: (a) old age (OR = 4.89), (b) illiteracy (OR = 4.12), (c) intermediate education (OR = 3.65), and (d) male sex (OR = 1.18). Conclusion: There was a low level of knowledge regarding rhinoplasty surgery among the study participants, most of the participants had negative (unfavorable) attitudes toward rhinoplasty surgery. Mass media plays an important role as a source of information. We recommend further studies to find out other personal factors affecting knowledge and attitude toward rhinoplasty surgery.

Abstract There is an urgent need to identify new antiferromagnetic materials that offer a replacement for IrMn alloys for room temperature and above applications. This is driven by the scarcity and high cost of Ir. Recently, MnN with {002} texture grown on a Ta seed layer has been proposed as a cost-effective alternative. However, two key issues need to be addressed before this material can be considered a realistic alternative to IrMn: thick layers of approximately 30 nm are required due to its relatively low magnetocrystalline anisotropy and nitrogen diffusion into the Ta layer at relatively low temperatures results in poor temperature performance. In this work, we show a potential pathway to overcome these issues. By using a W rather than a Ta seed layer, N diffusion is minimized, if not eliminated, at temperatures exceeding $$300\,^{\circ }\hbox {C}$$ 300 ∘ C . Furthermore, preferential {111} growth is achieved and a significantly enhanced anisotropy, $$2.6 \cdot 10^{6}\,\hbox {erg}/\hbox {cm}^{3}$$ 2.6 · 10 6 erg / cm 3 , has been measured. This value is almost identical to that measured for 3D randomly oriented IrMn.

Objective: The objective of this study was to identify the factors associated with the outcome of the 2023 diphtheria outbreak in Jigawa State, Nigeria. Methods: A descriptive cross-sectional study was conducted amongst all line-listed diphtheria cases reported from Jigawa State, Nigeria, using the 2023 Integrated Disease and Surveillance Response line list of cases that met the World Health Organization case definition of diphtheria. A total of 245 line-listed cases from January 2023 to December 2023 met the criteria for inclusion in the study. Data were analysed using IBM SPSS version 22.0 with a P value set at ≤5%. Binary logistic regression was used to identify the independent predictors of the outcome of the 2023 outbreak. Results: The maximum age of the line-listed cases was 39 years, and the minimum was 1 year with a median of 8 (interquartile range = 5–8) years. More than two-thirds (68.2%) of the cases were ≥5 years of age. More than one-third of the cases (39.6%) were from the northeast senatorial zone of the state. Out of the total 245 cases, 14 died of the disease representing a case fatality rate of 6%, and an attack rate of 3.4 per 100,000 populations. The majority of the cases (95.5%) had fever, cough (81.2%), pharyngitis (86.9%), tonsillitis (96.7%) and laryngitis (82.0%). More diphtheria-related mortalities were recorded amongst cases

Objective: To explore sexual reproduction-related awareness and knowledge, information-seeking behavior, and related information resources needed among Saudi female students. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted in King Faisal University, Al Ahsa Saudi Arabia from 1 September 2023 to 20 November 2023. Materials and Methods: A questionnaire-based cross-sectional study was conducted at King Faisal University Saudi Arabia. A sample of 328 preparatory-year female students was evaluated on reproductive health awareness through a randomized sampling method. Data was cleaned in Excel and Analyzed in IBM SPSS 29. Results: The study involved 328 female students and highlights significant findings in reproductive health awareness. Notably, 26.2% (85) experienced irregular menstrual cycles, 99.1% (325) used sanitary pads, and 78.4% (257) and 41.2% (135) discussed their first period, primarily with mothers. TV (17.1%) and news (16.2%) were the primary sources of reproductive health information while 93.9% (307) had contraceptive knowledge, and 84.5% (277) understood reasons for use. Challenges in obtaining information included uncertainty (30.6%) and shame (29.1%). Preferences included information on reproductive/sexual health (21.1%) and sexual/premarital preparation classes (18.3%). The educational status of fathers significantly correlated with sexual and reproductive health awareness and knowledge (p=0.040). Conclusion: The study revealed gaps in female preparatory year students' awareness of reproductive health. It underscores the importance of enhancing the accessibility of reproductive health knowledge resources and improving communication channels with parents to attain first-hand appropriate knowledge of reproductive health.

Abstract Reduced-fat labneh, while offering health benefits, often presents a challenge due to its diminished nutritional profile compared to full-fat varieties. Microalgae, such as Spirulina platensis and Chlorella vulgaris, are increasingly explored for their potential to fortify foods with essential nutrients. This study innovatively investigates the use of these microalgae to enhance the quality of reduced-fat labneh. The effect of incorporating different concentrations of both microalgae was investigated at different concentrations (0.25, 0.5, and 1%) on nutritional profile (including total solids, fat, protein, carbohydrates, essential amino acids, unsaturated fatty acids, pigments, and phenolic compounds), antioxidant activity, texture, sensory attributes, and viability of the starter culture. The findings revealed that 0.25 and 0.5% concentrations of both microalgae positively influenced the sensory characteristics of the labneh and significantly enhanced its nutritional profile. However, a 1% concentration negatively impacted sensory qualities. Chlorella vulgaris enrichment resulted in higher pH values but compromised texture attributes. Importantly, both microalgae varieties enhanced the viability of the starter culture during 21 days of refrigerated storage. The scanning electron microscope images provide visual evidence of the microstructural changes in labneh with varying concentrations of microalgae and over different storage periods. This research establishes the optimal concentrations for individual microalgae enrichment in reduced-fat labneh, offering valuable insights into their potential to improve both nutritional and sensory aspects. However, it’s important to mention that while both microalgae have similar effects, they might differ in their specific impacts due to their unique nutritional profiles and physical properties. Therefore, further investigations could explore optimizing a microalgae mixture and its potential application in functional food development.

Abstract The primary purpose of this article is to examine the issue of estimating the finite population distribution function from auxiliary information, such as population mean and rank of the auxiliary variables, that are already known. In order to better estimate the distribution function (DF) of a finite population, two improved estimators are developed. The bias and mean squared error of the suggested and existing estimators are derived up to the first order of approximation. To improve the efficiency of an estimators, we compare the suggested estimators with existing counterpart. Based on the numerical outcomes, it is to be noted that the suggested classes of estimators perform well using six actual data sets. The strength and generalization of the suggested estimators are also verified using a simulation analysis. Based on the result of actual data sets and a simulation study, we observe that the suggested estimator outperforms as compared to all existing estimators which is compared in this study.

Abstract Intussusception is a common surgical emergency in children. Clinical suspicion and radiological evaluation confirm the diagnosis of the disease. Enema reduction is the first line of management. This study aimed to explore the risk factors associated with enema reduction failure. A retrospective analysis of patients diagnosed with intussusception at three different hospitals in different countries from January 2016 to December 2022. Data collected included demographics, presenting symptoms, duration of symptoms, management, outcomes, and follow-ups. A total of 290 cases of intussusception were included in the study. Ages ranged from 1 to 36 months, with a median age of 15 months. All children underwent an enema reduction which was successful in 92.4%. Failure of reduction was seen in 16.7% of females compared to 6.4% of males, and it was significantly seen in children below the age of 1 year compared to older children. Failure of reduction significantly increases with the duration of symptoms and in children who present with bilious vomiting and currant jelly stool. In conclusion, Failure of enema reduction was more prevalent in females, in children below the age of 1 year and who present late, as well as children who had bilious vomiting and currant jelly stool. This study identified several risk factors associated with failed enema reduction in children with intussusception. Recognizing the risk factors can help guide clinicians in the management and anticipation of outcomes.

BACKGROUND: Spontaneous bacterial peritonitis (SBP) represents a critical and potentially lethal condition that typically develops in individuals with liver cirrhosis. This meta-analysis aimed to assess diabetes mellitus (DM) as a risk factor for SBP in liver cirrhotic patients. METHODS: Following PRISMA guidelines, fifteen studies were included, for a total of 76 815 patients. The risk of bias was assessed using the Newcastle-Ottawa scale (NOS). We represented the results as risk ratios (RR) with the corresponding 95% confidence intervals (CI) using RevMan software. Additionally, we pooled the hazard ratios (HR) for developing SBP in patients with DM from the included studies. RESULTS: The meta-analysis shows a significantly increased risk of SBP in cirrhotic patients with DM (HR: 1.26; 95% CI [1.05-1.51], P=.01; HR: 1.70; 95% CI [1.32-2.18], P

Abstract Background Vaccination has been recommended as one of the most potent ways of controlling the mpox (formerly, monkeypox) outbreak, particularly among high-risk groups. Here, we evaluated the prevalence of mpox vaccine acceptance and uptake globally. Methods We searched multiple databases for peer-reviewed studies published in English from May 2022 to 25th November 2023 that evaluated mpox vaccine acceptance and/or uptake. We fit a random-effects model meta-analysis to calculate the pooled mpox vaccine acceptance and uptake rates, with their 95% confidence intervals (CI) across population outcomes. We performed subgroup analyses among the six World Health Organization (WHO) regions (Africa [AFR], Region of the Americas [AMR], South-East Asia Region [SEAR], European Region [EUR], Eastern Mediterranean Region [EMR], and the Western Pacific Region [WPR]), as well as among select population subgroups. Results Of the 2531 studies screened, 61 studies, with a cumulative sample size of 263,857 participants from 87 countries were eligible for inclusion. The overall vaccine acceptance and uptake rates were 59.7% and 30.9% globally. Acceptance and uptake rates among the LGBTQI+ community were 73.6% vs 39.8% globally, 60.9% vs. 37.1% in AMR, 80.9% vs. 50.0% in EUR, and 75.2% vs. 33.5% in WPR. Among PLHIV, vaccine acceptance and uptake rates were 66.4% vs. 35.7% globally, 64.0% vs. 33.9% in AMR, 65.1% vs. 27.0% in EUR, and 69.5% vs. 46.6% in WPR. Among healthcare workers, vaccination intention was 51.0% globally. Conclusions Tailored interventions are needed to bolster confidence in the mpox vaccine, maximize vaccine uptake, and increase vaccine access to close the gaps between acceptance and uptake especially among key populations residing in regions with low rates of acceptance and uptake.

Purpose/Objectives: This article introduces the Key Electronic Assessment Platform (KEAP), an electronic-based assessment platform created in-house at the College of Dentistry (COD), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. It highlights the platform’s integral value and demand within the educational system. Methods: The article introduces the KEAP system design and architecture, describes its features, tests, and implementation in addition to its maintenance and security. It also presents the outcomes of KEAP utilization and the level of users’ satisfaction. Results: The KEAP item bank has been expanded by more than 26,500 questions over the last four academic years and 1,255 exams have been administered. KEAP provides a highly secure structured framework for assessment planning, conduction, and evaluation. More than 90% of students and faculty are satisfied or very satisfied with their experience using the KEAP system indicating that it is well accepted by the end users. Conclusions: The development of KEAP is based on contextual factors in COD, KSAU-HS with the aim of creating a process for assessment that is valid, efficient, standardized, and highly secure. KEAP’s design and successful implementation can provide a successful example of implementing electronic-based assessment in higher education.

Background: Dysglycaemia and diabetes mellitus (DM) are important and preventable risk factors associated with kidney diseases, cardiovascular complications, and mortality worldwide. Aim: This study aimed to identify the prevalence and factors associated with dysglycaemia and diabetes among adults in high-burden kidney disease areas of Jigawa State, Northwest Nigeria. Methods: A cross-sectional survey of representative sample of 361 adults, aged ≥18 years, was conducted in four local government areas (LGAs) of Jigawa State, considered to have a high burden of kidney disease requiring hemodialysis. Data were collected using a modified World Health Organization STEPS questionnaire using a multistage sampling technique and were analyzed using IBM SPSS Statistics for Windows, version 22.0, with statistical significance set at P ≤ 0.05. Results: The minimum age of the respondents was 18 and the maximum was 102 with a median of 45 (interquartile range = 30–80) years. The majority of the respondents 89.5% were >24 years of age. The prevalence of dysglycemia and DM in the high-burden LGAs was 10.5% and 3.6%, respectively. Dutse LGA had the highest prevalence of dysglycemia 16.7%, followed by Hadejia LGA with a prevalence of 12.2%. On the other hand, Hadejia LGA had the highest prevalence of DM 7.7%, followed by Jahun LGA with a prevalence of 3.3%. Age ≥40 years, family histories of diabetes, being overweight, alcohol ingestion, and previous blood sugar tests were identified as factors associated with DM. The odds of developing diabetes were significantly higher among those with a reported history of alcohol consumption, family history of diabetes, and overweight. Conclusion: Dysglycaemia and diabetes are significant public health problems, and many people who have the conditions are unaware they have them. Family history of diabetes, alcohol ingestion, and overweight are important risk factors. The government and all the relevant stakeholders should prioritize community screening and other relevant interventions for early detection and timely management of cases.

Abstract Stenotrophomonas maltophilia is a nonfermenting gram-negative bacterium associated with multiple nosocomial outbreaks. Antibiotic resistance increases healthcare costs, disease severity, and mortality. Multidrug-resistant infections (such as S. maltophilia infection) are difficult to treat with conventional antimicrobials. This study aimed to investigate the isolation rates, and resistance trends of S. maltophilia infections over the past 19 years, and provide future projections until 2030. In total, 4466 patients with S. maltophilia infection were identified. The adult and main surgical intensive care unit (ICU) had the highest numbers of patients (32.2%), followed by the cardiology department (29.8%), and the paediatric ICU (10%). The prevalence of S. maltophilia isolation increased from 7% [95% confidence interval (CI) 6.3–7.7%] in 2004–2007 to 15% [95% CI 10.7–19.9%] in 2020–2022. Most S. maltophilia isolates were resistant to ceftazidime (72.5%), levofloxacin (56%), and trimethoprim-sulfamethoxazole (14.05%), according to our study. A consistent and significant difference was found between S. maltophilia-positive ICU patients and non-ICU patients (P = 0.0017) during the three-year pandemic of COVID-19 (2019–2021). The prevalence of S. maltophilia isolates is expected to reach 15.08% [95% CI 12.58–17.59%] by 2030. Swift global action is needed to address this growing issue; healthcare authorities must set priorities and monitor infection escalations and treatment shortages.

Abstract Crocin is a carotenoid compound in saffron with anti-cancer properties. However, its therapeutic application is limited by its low absorption, bioavailability, and stability, which can be overcome through nanocarrier delivery systems. This study used surface-modified Nano-crystalline cellulose (NCC) to deliver crocin to cancer cells. NCC modified with CTAB were loaded with crocin and then conjugated with folic acid (NCF-CR-NPs). The synthesized nanoparticles (NPs) were characterized using FTIR, XRD, DLS, and FESEM. The crystallinity index of NCC was 66.64%, higher than microcrystalline cellulose (61.4%). The crocin loading and encapsulation efficiency in NCF-CR-NPs were evaluated. Toxicity testing by MTT assay showed that NCF-CR-NPs had higher toxicity against various cancer cell lines, including colon cancer HT-29 cells (IC50 ~ 11.6 μg/ml), compared to free crocin. Fluorescent staining, flow cytometry, and molecular analysis confirmed that NCF-CR-NPs induced apoptosis in HT-29 cells by increasing p53 and caspase 8 expression. The antioxidant capacity of NCF-CR-NPs was also evaluated using ABTS and DPPH radical scavenging assays. NCF-CR-NPs exhibited high free radical scavenging ability, with an IC50 of ~ 46.5 μg/ml for ABTS. In conclusion, this study demonstrates the potential of NCF-CR-NPs to deliver crocin to cancer cells effectively. The NPs exhibited enhanced anti-cancer and antioxidant activities compared to free crocin, making them a promising nanocarrier system for crocin-based cancer therapy.

Abstract This study introduces an innovative electrochemical aptasensor designed for the highly sensitive and rapid detection of Legionella pneumophila serogroup 1 (L. pneumophila SG1), a particularly virulent strain associated with Legionellosis. Employing a rigorous selection process utilizing cell-based systematic evolution of ligands by exponential enrichment (cell-SELEX), we identified new high-affinity aptamers specifically tailored for L. pneumophila SG1. The selection process encompassed ten rounds of cell-SELEX cycles with live L. pneumophila, including multiple counter-selection steps against the closely related Legionella sub-species. The dissociation constant (Kd) of the highest affinity sequence to L. pneumophila SG1 was measured at 14.2 nM, representing a ten-fold increase in affinity in comparison with the previously reported aptamers. For the development of electrochemical aptasensor, a gold electrode was modified with the selected aptamer through the formation of self-assembled monolayers (SAMs). The newly developed aptasensor exhibited exceptional sensitivity, and specificity in detecting and differentiating various Legionella sp., with a detection limit of 5 colony forming units (CFU)/mL and an insignificant/negligible cross-reactivity with closely related sub-species. Furthermore, the aptasensor effectively detected L. pneumophila SG1 in spiked water samples, demonstrating an appreciable recovery percentage. This study shows the potential of our aptamer-based electrochemical biosensor as a promising approach for detecting L. pneumophila SG1 in diverse environments.

Abstract The control charts are frequently employed in process monitoring to assess the average and variability of a process, assuming a normal distribution. However, it is worth noting that some process distributions tend to exhibit a positively skewed distribution, such as the lognormal distribution. This article proposed a maximum exponential weighted moving average control chart for joint monitoring of mean and variance under a lognormal process. The proposed control chart is evaluated by using the run length profile such as ARL and SDRL. The Monte Carlo simulation is conducted by using the R language to find the run length profile. An application is presented to demonstrate the design of the proposed control chart.

Background: Cardiac arrest remains a critical global health challenge, necessitating effective interventions to improve outcomes. Autopulse Mechanical Chest Compression has emerged as a potential adjunct to conventional manual cardiopulmonary resuscitation (CPR). This study aimed to comprehensively investigate the association between Autopulse use and various outcomes following cardiac arrest. Methods: A thorough literature review was conducted using PubMed, Embase, Scopus, Google Scholar, CINAHL, and the Cochrane Library. Articles were evaluated for eligibility according to predefined criteria. The collected data was synthesized, and the findings were subsequently presented. Results: Sixteen studies were included in the study. A synthesis of diverse studies revealed nuanced perspectives on Autopulse Mechanical Chest Compression. Enhanced CPR success and improved survival rates in out-of-hospital cardiac arrest were demonstrated, while potential drawbacks were suggested, warranting scrutiny of device design and implementation strategies. Meta-analyses on ROSC favored Autopulse, indicating a statistically significant advantage over Manual CPR (relative risk 1.43, 95% CI 1.07-1.92). Complication analyses showed no significant difference (relative risk 1.11, 95% CI 0.93-1.33), emphasizing comparable safety profiles. Patient survival rates exhibited variations, with Autopulse demonstrating higher rates in some studies, but nuances were observed in 30-day survival and hospital discharge rates. Conclusion: Autopulse Mechanical Chest Compression holds promise as a supplementary strategy in cardiac arrest resuscitation. However, complexities arose in longer-term outcomes, highlighting the need for contextual considerations. [SJEMed 2024; 5(1.000): 030-041]

Abstract Campylobacter jejuni is a very common cause of gastroenteritis, and is frequently transmitted to humans through contaminated food products or water. Importantly, C. jejuni infections have a range of short- and long-term sequelae such as irritable bowel syndrome and Guillain Barre syndrome. C. jejuni triggers disease by employing a range of molecular strategies which enable it to colonise the gut, invade the epithelium, persist intracellularly and avoid detection by the host immune response. The objective of this review is to explore and summarise recent advances in the understanding of the C. jejuni molecular factors involved in colonisation, invasion of cells, collective quorum sensing-mediated behaviours and persistence. Understanding the mechanisms that underpin the pathogenicity of C. jejuni will enable future development of effective preventative approaches and vaccines against this pathogen.

Cabazitaxel, a second-generation taxane chemotherapy agent, has demonstrated efficacy in treating metastatic castration-resistant prostate cancer (mCRPC) in patients who have previously received docetaxel-based therapy. By targeting microtubule dynamics, cabazitaxel inhibits cancer cell division and induces apoptosis, thereby extending survival and delaying disease progression in this challenging patient population. A systematic review and meta-analysis were done by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software. Our research reveals significantly improved outcomes in terms of patient survival rates, both progression-free survival (PFS) and overall survival (OS), for cabazitaxel over comparative treatment (PFS HR 0.77 [0.61, 0.97]) (OS HR 0.79 [0.70, 0.88]). The treatment response rates were also favorable for cabazitaxel, reported as PSA Reduction Response of more than 50% (PRR) (odds ratio (OR) = 1.59 [0.56, 4.52]) and tumor response rate (TRR) (OR = 2.34 [1.28, 4.28]). Cabazitaxel was associated with significantly more incidence of adverse events. The risk ratio (RR) for serious adverse events was 1.64 [1.14, 2.35] for cabazitaxel compared to the current regimen. A systematic review and meta-analysis were done by searching in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software.

Background: Patients are increasingly using the internet for searching health-related information. However, the quality and readability of the information available on the internet need to be assessed. To date, no study has assessed the quality and readability of web-based Arabic health information on early childhood caries. Objectives: To evaluate the quality and readability of patient-oriented online Arabic health information regarding early childhood caries. Materials and Methods: For this infodemiological study, the Google and Yahoo search engines were searched using specific Arabic terms for early childhood caries, and the top 100 searches from both search engines were considered. Eligible websites were categorized in terms of affiliation as commercial, health portal, dental practice, professional, and journalism. The quality of the websites was assessed using the QUality Evaluation Scoring Tool (QUEST), and readability using the Gunning Fog index (GFI). Results: A total of 140 websites were included after applying the exclusion criteria, of which 50.7% websites were of journalism. The majority of the websites (70%) had an overall low-quality level, with a QUEST score

Abstract Tucker decomposition is widely used for image representation, data reconstruction, and machine learning tasks, but the calculation cost for updating the Tucker core is high. Bilevel form of triple decomposition (TriD) overcomes this issue by decomposing the Tucker core into three low-dimensional third-order factor tensors and plays an important role in the dimension reduction of data representation. TriD, on the other hand, is incapable of precisely encoding similarity relationships for tensor data with a complex manifold structure. To address this shortcoming, we take advantage of hypergraph learning and propose a novel hypergraph regularized nonnegative triple decomposition for multiway data analysis that employs the hypergraph to model the complex relationships among the raw data. Furthermore, we develop a multiplicative update algorithm to solve our optimization problem and theoretically prove its convergence. Finally, we perform extensive numerical tests on six real-world datasets, and the results show that our proposed algorithm outperforms some state-of-the-art methods.

Abstract Frailty models are important for survival data because they allow for the possibility of unobserved heterogeneity problem. The problem of heterogeneity can be existed due to a variety of factors, such as genetic predisposition, environmental factors, or lifestyle choices. Frailty models can help to identify these factors and to better understand their impact on survival. In this study, we suggest a novel quasi xgamma frailty (QXg-F) model for the survival analysis. In this work, the test of Rao–Robson and Nikulin is employed to test the validity and suitability of the probabilistic model, we examine the distribution’s properties and evaluate its performance in comparison with many relevant cox-frailty models. To show how well the QXg-F model captures heterogeneity and enhances model fit, we use simulation studies and real data applications, including a fresh dataset gathered from an emergency hospital in Algeria. According to our research, the QXg-F model is a viable replacement for the current frailty modeling distributions and has the potential to improve the precision of survival analyses in a number of different sectors, including emergency care. Moreover, testing the ability and the importance of the new QXg-F model in insurance is investigated using simulations via different methods and application to insurance data.

Introduction: The circadian clock is a homeostatic regulation system comprising clock genes in the body that regulate various physiological and behavioural processes. Diet determines our health and the timing and periodicity of feeding, in addition to nutritional quality, influence circadian rhythms and metabolism significantly. Aim: To assess the association of meal irregularity and chronotypes with dietary and sleep patterns. Materials and Methods: This cross-sectional study was conducted on 375 female adults using the convenience sampling method. Information on socio-demographic characteristics, dietary patterns, sleep patterns, chronotypes, and physical activity was collected through a self-administered questionnaire consisting of 26 questions. Participants aged 18-40 years and who completed the study questionnaire were enrolled. Pregnant or lactating mothers and users of tranquilisers and psychotropic drugs were excluded. T-tests and one-way Analysis of Variance (ANOVA) were used for continuous variables, and the Chi-square test was used for categorical variables. Results: A total of 197 (52.5%) participants reported consuming their meals at a regular time every day, while 178 (47.5%) did not. Concerning eating meals at a regular time every day, a significant association was found between eating meals at a regular time every day and the number of meals per day (Chi-squared, p-value

Abstract Groundwater is an excellent alternative to freshwater for drinking, irrigation, and developing arid regions. Agricultural, commercial, industrial, residential, and municipal activities may affect groundwater quantity and quality. Therefore, we aimed to use advanced methods/techniques to monitor the piezometric levels and collect groundwater samples to test their physicochemical and biological characteristics. Our results using software programs showed two main types of groundwater: the most prevalent was the Na–Cl type, which accounts for 94% of the groundwater samples, whereas the Mg–Cl type was found in 6% of samples only. In general, the hydraulic gradient values, ranging from medium to low, could be attributed to the slow movement of groundwater. Salinity distribution in groundwater maps varied between 238 and 1350 mg L−1. Although lower salinity values were observed in northwestern wells, higher values were recorded in southern ones. The collected seventeen water samples exhibited brackish characteristics and were subjected to microbial growth monitoring. Sample WD12 had the lowest total bacterial count (TBC) of 4.8 ± 0.9 colony forming unit (CFU mg L−1), while WD14 had the highest TBC (7.5 ± 0.5 CFU mg L−1). None of the tested water samples, however, contained pathogenic microorganisms. In conclusion, the current simulation models for groundwater drawdown of the Quaternary aquifer system predict a considerable drawdown of water levels over the next 10, 20, and 30 years with the continuous development of the region.

Abstract One of the most promising, non-toxic, and biocompatible developments for many biological activities is the green synthesis of nanoparticles from plants. In this work, we investigated the antifungal activity of silver nanoparticles (AgNPs) biosynthesized from Rhazya stricta aqueous extract against several plant pathogenic fungi. UV–visible spectroscopy, Zeta potential analysis, Fourier-transform infrared spectroscopy (FTIR), and transmitted electron microscopy (TEM) were used to analyze the biosynthesized AgNPs. Drechslera halodes, Drechslera tetramera, Macrophomina phaseolina, Alternaria alternata, and Curvularia australiensis were tested for their potential antifungal activity. Surface Plasmon Resonance (SPR) of Aq. AgNPs and Alkaline Aq. AgNPs was observed at 405 nm and 415 nm, respectively. FTIR analysis indicated hydroxyl, nitrile, amine, and ketone functional groups. Aq. AgNPs and Alka-line Aq. AgNPs had velocities of − 27.7 mV and − 37.9 mV and sizes of 21–90 nm and 7.2–25.3 nm, respectively, according to zeta potential studies and TEM. The antifungal examination revealed that all species' mycelial development was significantly inhibited, accompanied by severe ultra-structural alterations. Among all treatments, Aq. AgNPs were the most effective fungicide. M. phaseolina was statistically the most resistant, whereas A. alternata was the most vulnerable. To the best of our knowledge, this is the first report on R. stricta's antifungal activity against these species.

Abstract Synthetic cannabinoids (SCs) are chemically classified as psychoactive substances that target the endocannabinoid system in many body organs. SCs can initiate pathophysiological changes in many tissues which can be severe enough to damage the normal functionality of our body systems. The majority of SCs-related side effects are mediated by activating Cannabinoid Receptor 1 (CB1R) and Cannabinoid Receptor 2 (CB2R). The activation of these receptors can enkindle many downstream signalling pathways, including oxidative stress, inflammation, and apoptosis that ultimately can produce deleterious changes in many organs. Besides activating the cannabinoid receptors, SCs can act on non-cannabinoid targets, such as the orphan G protein receptors GPR55 and GPR18, the Peroxisome Proliferator-activated Receptors (PPARs), and the Transient receptor potential vanilloid 1 (TRPV1), which are broadly expressed in the brain and the heart and their activation mediates many pharmacological effects of SCs. In this review, we shed light on the multisystem complications found in SCs abusers, particularly discussing their neurologic, cardiovascular, renal, and hepatic effects, as well as highlighting the mechanisms that intermediate SCs-related pharmacological and toxicological consequences to provide comprehensive understanding of their short and long-term systemic effects. Graphical Abstract

Abstract Intraoral theranostics, the integration of diagnostics and therapeutics within the oral cavity, is gaining significant traction. This pioneering approach primarily addresses issues like xerostomia (dry mouth), commonly resulting from cancer treatment, with a specific focus on monitoring temperature and humidity. This paper introduces the innovative Intra-Oral Portable Micro-Electronic (IOPM) fluidic theranostic device platform. It leverages conventional dental spoons by incorporating advanced sensors for precise measurements of oral temperature and humidity. Personalization options include a microfluidic chip and a tooth model, enabling targeted delivery of therapeutic agents to optimize treatment outcomes. The electronic control system simplifies the administration of fluid dosages, intelligently adjusted based on real-time oral cavity temperature and humidity readings. Rigorous experimental evaluations validate the platform’s precision in delivering fluid volumes at predefined intervals. This platform represents a transformative advancement for individuals contending with oral health challenges such as xerostomia (dry mouth). Furthermore, it has the potential to elevate oral healthcare standards by providing advanced diagnostics and tailored therapeutic solutions, benefiting both patients and dental professionals alike.

Background: Effective communication between healthcare practitioners and patients in the emergency department (ED) is crucial for patient satisfaction and quality of care. This study explored patients' perspectives on communication with nurses and physicians in the ED. Methods: A cross-sectional study was conducted using a sample of 159 patients to assess the type of information relayed by nurses and doctors. The interview data were analyzed to examine nursing staff communication, physician communication, and communication difficulties. Results: Nurses were found to be less likely to inform patients about their results or disposition. While 81.2% of physicians introduced themselves to patients, only 51.6% stated their status level. Approximately 68.6% of subjects were offered analgesia or treatment, and 60% reported no communication difficulties with medical staff. Empathy was demonstrated by 54.2% of healthcare practitioners, and nearly 80% of patient encounters were conducted in understandable language. Conclusion: The study highlights the importance of effective communication in the ED, including empathy, information provision, and language barriers. To improve patient satisfaction and healthcare quality, medical organizations should develop comprehensive work plans, provide communication skills workshops, and enhance the ED work environment. Future research should focus on the perspectives of medical staff and explore communication in larger samples and various contexts. [SJEMed 2023; 4(2.000): 128-133]

Background: Diabetes mellitus (DM) and periodontitis are the most prevalent human diseases. Diabetes worsens the periodontal condition, but periodontitis also hampers glycemic control in diabetic patients. Based on staging and grading, the latest periodontitis classification puts DM as one of the grade modifiers. Periodic periodontal maintenance prevents reinfection and could help people with diabetes maintain effective glycemic control. Dental health education and periodontal disease awareness are crucially needed for diabetic patients, especially during the pandemic. Purpose: This study aimed to examine the relationship between levels of awareness and knowledge of periodontitis in diabetic patients during the COVID-19 pandemic. Methods: A closed-ended questionnaire was distributed to new patients referred to the Periodontology Clinic of the Dental Hospital of Universitas Indonesia. Patients’ data were collected during the COVID-19 pandemic from January to June 2021. Results: Eighty-four patients participated, of which 34.5 % were diabetic patients with periodontitis. Statistically, significant differences (P < 0.05) were found between levels of awareness and knowledge of periodontitis among diabetic patients and nondiabetic patients (both groups are suffering periodontitis). Awareness and knowledge of periodontitis are inversely correlated with their current clinical periodontal status, therefore patients with less awareness and knowledge have more severe periodontitis. Conclusion: Lack of awareness and knowledge of periodontitis was found among both nondiabetic and diabetic periodontitis patients. Dental health education is required to improve understanding and awareness of the relationship between periodontitis and DM.

Background: Children are highly susceptible to injury and death from accidents. Appropriate intervention can limit disability and increase survival (Alshammari, 2021). In this review, we aim to assess the knowledge and attitudes of the public towards pediatric first aid in the Makkah region of Saudi Arabia. Methods: In this cross-sectional study, a self-administered questionnaire was distributed among residents of the Makkah region. Descriptive statistics were employed to express numerical variables and categorical variables. A p-value of < 0.05 was considered statistically significant. Results: The study included 397 respondents. More than half were female (60.2%). Approximately one-third of the respondents were aged > 50 years, and 28.5% were working or studying in the medical field. Most participants had heard about first aid (99.5%) and believed that training was required to provide first aid (93.7%). However, less than half of the respondents (45.1%) had attended first-aid training once. Almost half of the respondents (51.6%) had previously encountered an injury, accident, or medical emergency; of these, 77.6% had provided first aid to the individual who experienced the emergency, and the most common types of emergencies included cut wounds (38.5%), burns (37.6%), and fits (25.4%). Conclusion: First aid is an important tool for providing immediate emergency care for all people, and it is particularly important for children. Knowledge of and attitude towards first-aid tools are essential for providing first aid when needed. In contrast, training in first aid is crucial for providing appropriate first aid, particularly for children and young infants.

Abstract Influenza epidemic data are seasonal in nature. Zero-inflation, zero-deflation, overdispersion, and underdispersion are frequently seen in such number of cases of disease (count) data. To explain these counts’ features, this paper introduces a flexible model for nonnegative integer-valued time series with a seasonal autoregressive structure. Some probabilistic properties of the model are discussed for general seasonal INAR(p) model and three estimation methods are used to estimate the model parameters for its special case seasonal INAR(1) model. The performance of the estimation procedures has been studied using simulation. The proposed model is applied to analyze weekly influenza data from the Breisgau- Hochschwarzwald county of Baden–Württemberg state, Germany. The empirical findings show that the suggested model performs better than existing models.

AbstractBackground Type 1 diabetes mellitus (T1DM) is disease caused by the destruction of β pancreatic cells. The activation of T-lymphocyte and proliferation inhibitor are induced by protein tyrosine phosphatase non-receptor type 22 (PTPN22). However, the link between PTPN22 C1858T gene polymorphism and T1DM is still controversy. This study aimed to analyse the C1858T gene polymorphism in Indonesian children with T1DM.Materials and methods This case-control study was conducted from March 2021 to May 2022 in the Endocrinology Outpatient Clinic at Dr. Soetomo Hospital and Tropical Disease Center Universitas Airlangga. Patients with controlled T1DM during the study period were included. The PTPN22 analysis used polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method.Results Sixty-two children voluntarily participated in this study, and were equally divided into the T1DM and control groups. Most of the patients (94%, 58/62) are Javanese. This study revealed a more frequent CC genotype (9.4%) and allele-C (54.6%) polymorphism in the T1DM group, while more frequent CT genotype (100%) and allele-T (50%) polymorphism were in the control group. The C- and T-allele frequency was 54.6% and 45.4% in the T1DM group, respectively. The T1DM and control groups did not significantly differ (p= .2381).Conclusions PTPN22 homozygous genotype-CC and allele-C polymorphisms are more frequent in patients with T1DM. However, the PTPN22 C1858T gene polymorphism did not significantly correlate to T1DM children in this study.Key Messages:The PTPN22 C1858T gene polymorphism does not significantly affect the susceptibility of T1DM in Indonesian children.PTPN22 homozygous genotype-CC polymorphism was more observed in the T1DM group; thus, this genotype may play as a risk factor for T1DM children in the Indonesian population.

Abstract In this study, a versatile model, called $$\alpha$$ α -monotone inverse Weibull distribution ( $$\alpha$$ α IW), for lifetime of a component under stress is introduced by using the $$\alpha$$ α -monotone concept. The $$\alpha$$ α IW distribution is also expressed as a scale-mixture between the inverse Weibull distribution and uniform distribution on (0, 1). The $$\alpha$$ α IW distribution includes $$\alpha$$ α -monotone inverse exponential and $$\alpha$$ α -monotone inverse Rayleigh distributions as submodels and converenges to the inverse Weibull, inverse exponential, and inverse Rayleigh distributions as limiting cases. Also, slash Weibull, slash Rayleigh, and slash exponential distribuitons can be obtained under certain variable transformation and parameter settings. The $$\alpha$$ α IW distribution is characterized by its hazard rate function and characterizing conditions are provided as well. Maximum likelihood, maximum product of spacing, and least squares methods are used to estimate distribution parameters. A Monte-Carlo simulation study is conducted to compare the efficiencies of the considered estimation methods. In the application part, two practical data sets, Kevlar 49/epoxy and Kevlar 373/epoxy, are modeled via the $$\alpha$$ α IW distribution. Modeling performance of the $$\alpha$$ α IW distribution is compared with its rivals by means of some well-known goodness-of-fit statistics and results show that $$\alpha$$ α IW distribution performs better modeling than them. Results of comparison also indicate that obtaining the $$\alpha$$ α IW distribution by using the $$\alpha$$ α -monotone concept is cost effective since the new shape parameter added to the distribution by using the $$\alpha$$ α -monotone concept significantly increases the modeling capability of the IW distribution. As a result of this study, it is shown that the $$\alpha$$ α IW distribution can be an alternative to the well-known and recently-introduced distributions for modeling purposes.

Background: Thorax CT scan is one of the medical supports that contributes most importantly to the diagnosis, especially cases of COVID-19. The disadvantage that has a CT scan image is noise. When the noise is high then the Signal Noise Ratio (SNR) value produced is low. Canny operator edge detection technique is one solution to animate noise. Purpose: Analyzing differences in image quality and anatomical information on thorax CT scan images in COVID-19 patients before and after the application of canny operator edge detection techniques. Method: A quasi experimental research on thorax CT Scan images before and after the application of canny operator edge detection which amounted to 10 samples. Image assessment is done by measuring noise, SNR, and anatomical information. Differences in image quality (noise and SNR) are tested with paired T-tests. Anatomical information is tested with the Wilcoxon Signed Rank Test. Result: There are differences in image quality in thorax CT scan images in COVID-19 patients before and after the application of canny operator edge detection techniques, with p-value

Background: This study seeks to assess gender differences in the severity of COVID-19 infection, which have been noted in different regions during the early stages of the pandemic. Methods: A cross-sectional study conducted at Baquba Teaching Hospital in Diyala, Iraq, from October 1st to December 31st, 2020, included 132 confirmed COVID-19 patients. These patients underwent a comprehensive set of routine laboratory tests, including complete blood count, blood biochemistry, and D-dimer assessment. Statistical analysis was carried out using SPSS-20, with significance set at p < 0.05. Results: The study included patients with a mean age of 45.61 (±11.32) years, predominantly male (63.0%), residing in urban areas (57.6%), and presenting with comorbidities (78.8%). All patients exhibited positive results on CT scans (100%) and CRP tests (100%). However, PCR testing confirmed COVID-19 infection in 87.2% of cases, with 12.8% testing negative. Among males, there was a significant increase in IL-6 and IL-10 levels (42.57 ± 7.64 pg/ml and 255.27 ± 21.03 pg/ml) compared to females (16.43 ± 4.19 pg/ml and 187.48 ± 20.35 pg/ml), with p-values

Background Leptospirosis is a water-related zoonotic disease. The disease is primarily transmitted from animals to humans through pathogenic Leptospira bacteria in contaminated water and soil. Rivers have a critical role in Leptospira transmissions, while co-infection potentials with other waterborne bacteria might increase the severity and death risk of the disease. Methods The water samples evaluated in this study were collected from four recreational forest rivers, Sungai Congkak, Sungai Lopo, Hulu Perdik, and Gunung Nuang. The samples were subjected to next-generation sequencing (NGS) for the 16S rRNA and in-depth metagenomic analysis of the bacterial communities. Results The water samples recorded various bacterial diversity. The samples from the Hulu Perdik and Sungai Lopo downstream sampling sites had a more significant diversity, followed by Sungai Congkak. Conversely, the upstream samples from Gunung Nuang exhibited the lowest bacterial diversity. Proteobacteria, Firmicutes, and Acidobacteria were the dominant phyla detected in downstream areas. Potential pathogenic bacteria belonging to the genera Burkholderiales and Serratia were also identified, raising concerns about co-infection possibilities. Nevertheless, Leptospira pathogenic bacteria were absent from all sites, which is attributable to its limited persistence. The bacteria might also be washed to other locations, contributing to the reduced environmental bacterial load. Conclusion The present study established the presence of pathogenic bacteria in the river ecosystems assessed. The findings offer valuable insights for designing strategies for preventing pathogenic bacteria environmental contamination and managing leptospirosis co-infections with other human diseases. Furthermore, closely monitoring water sample compositions with diverse approaches, including sentinel programs, wastewater-based epidemiology, and clinical surveillance, enables disease transmission and outbreak early detections. The data also provides valuable information for suitable treatments and long-term strategies for combating infectious diseases.

Key Clinical Message Paragangliomas (PGLs) are rare neuroendocrine tumors. Sometimes, these tumors secrete excessive catecholamines, which results in the manifestations of various signs and symptoms, usually with a triad of hypertension, tachycardia, and headache. We report the case of a 42‐year‐old woman presenting with uncontrolled hypertension, right facial palsy, vomiting, and disturbed gait. Diagnosis for PGL was confirmed on postoperative histological examination of the excised mass and correlated with preoperative clinical and radiological findings. Tumor excision was done via a suboccipital craniotomy approach. Our case presents the typically severe features of a jugulotympanic PGL, but most importantly, it highlights the necessity of biochemical diagnosing, thorough probing of the causes of hypertension, and a multi‐disciplinary approach in dealing with these tumors. Moreover, the case emphasizes necessitating the use of preoperative embolization in vascular tumors of the head and neck to avoid a hemorrhagic crisis during surgery. Unfortunately, due to a lack of adequate hospital funds, the surgeon had to proceed without preoperative embolization. Despite such a risk, the excision was a success.

Background: The incidence and mortality rates of oral squamous cell carcinoma (OSCC) vary globally, yet the cancer continues to pose significant morbidity and mortality risks. This study sought to assess salivary IL-8 and IL-10 as biomarkers for identifying malignant oral lesions. Methods: Between March 2022 and May 2023, a case-control study at the Dental Center of New Baquba, Diyala, Iraq, collected saliva for IL-8 and IL-10 measurement via ELISA. An independent t-test compared IL-8 and IL-10 means based on age and gender, while ROC analysis gauged specificity and sensitivity. Results: The prevalence of OSCC was evenly distributed across genders, with a higher occurrence among patients aged over 55 years (87.5%). OSCC distribution in the oral cavity indicated the lips as the most affected area (40.0%), followed by the tongue (37.0%), and the hard and soft palate (12.50%). Statistically significant differences were noted in IL-10 and IL-8 levels between the study and control groups across all age brackets, except for IL-8 in the age ≤55 (p ≤ 0.05). Elevated mean levels of IL-10 and IL-8 were observed in the older age group (>55), with IL-10 showing a greater increase in males (71.99±3.6), while IL-8 levels were higher in females. IL-10 demonstrated higher sensitivity (90%) and specificity (60%) with an optimal cutoff point value of 43.29, whereas IL-8 exhibited a sensitivity of 80% and a specificity of 47.5% with an optimal cutoff point value of 44.48. Conclusion: Individuals aged over 55 showed higher IL-10 and IL-8 levels, particularly in males for IL-10 and in females for IL-8. Salivary biomarkers hold promise for early OSCC detection.

(1) Background: Missed nursing care, an omission error characterized by delayed or omitted nursing interventions, poses significant risks to patients’ safety and quality of car.; (2) Methods: This is a quantitative cross-sectional study on 151 nurses who work in NICUs in three main networks in the Eastern Health Province, Saudi Arabia: Dammam (n = 84), Qatif (n = 53), and Jubail (n = 14). The study uses a self-reported questionnaire (MISSCARE) and applies the 5-point Likert Scale. Statistical analysis data were analyzed using SPSS version 23.0. (3) Results: The primary reasons for missed care were shortage of nursing staff and unbalanced patient assignments. Missed nursing care negatively affects job satisfaction and was positively correlated with nurses’ intentions to quit their jobs. Inadequate equipment, supplies, and breakdowns in communication between nurses and other healthcare professionals were also significant factors contributing to missed care. (4) Conclusions: Missed nursing care is associated with overwork, nursing shortages, and lower job satisfaction, impacting the quality of care provided in the NICU. Improving working conditions, nurse staffing, and patient assignment planning should be prioritized to address this issue effectively.

Abstract Human pathogenic fungi and bacteria pose a huge threat to human life, accounting for high rates of mortality every year. Unfortunately, the past few years have seen an upsurge in multidrug resistance pathogens. Consequently, finding an effective alternative antimicrobial agent is of utmost importance. Hence, this study aimed to phytofabricate silver nanoparticles (AgNPs) using aqueous extracts of the solid endosperm of Cocos nucifera L, also known as coconut meat (Cm). Green synthesis is a facile, cost-effective and eco-friendly methods which has several benefits over other physical and chemical methods. The synthesized nanoparticles were characterized by UV–Vis spectroscopy, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction analysis (XRD), field emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), and dynamic light scattering (DLS). The Cm-AgNPs showed a UV–Vis peak at 435 nm and were crystalline and quasi-spherical, with an average size of 15 nm. The FTIR spectrum displayed functional groups of phenols, alkaloids, sugars, amines, and carbonyl compounds, which are vital in the reduction and capping of NPs. The antibacterial and anticandidal efficacy of the Cm-AgNPs was assessed by the agar-well diffusion method and expressed as a zone of inhibition (ZOI). Amongst all the test isolates, Staphylococcus epidermidis, Candida auris, and methicillin-resistant Staphylococcus epidermidis were more susceptible to the NPs with a ZOI of 26.33 ± 0.57 mm, 19.33 ± 0.57 mm, and 18 ± 0.76 mm. The MIC and MFC values for Candida spp. were higher than the bacterial test isolates. Scanning electron microscopic studies of all the test isolates at their MIC concentrations showed drastically altered cell morphology, indicating that the NPs could successfully cross the cell barrier and damage the cell integrity, causing cell death. This study reports the efficacy of Cm-AgNPs against several Candida and bacterial strains, which had not been reported in earlier studies. Furthermore, the synthesized AgNPs exhibited significant antioxidant activity. Thus, the findings of this study strongly imply that the Cm-AgNPs can serve as promising candidates for therapeutic applications, especially against multidrug-resistant isolates of Candida and bacteria. However, further investigation is needed to understand the mode of action and biosafety.

Abstract Background Medical residency is a part of postgraduate medical education and involves clinical training in a selected specialty. It is a challenging step in a physician’s professional development. This study aims to estimate the impact of the residency training program and demographic factors on the trainee’s state of well-being (SOW). Methods This was an observational cross-sectional study carried out in the year 2019–2020, which aimed to measure the SOW of residents undergoing clinical training in Riyadh, Saudi Arabia. A total of 260 residents participated in the study. A self-administered validated online the World Health Organization, Quality of Life Scale questionnaire- BREF was distributed to collect the data. The collected information on four different domains was analysed and compared across the baseline characteristics and different specialties. When appropriate, the independent sample t-test, bivariate correlation analysis, and ANOVA tests were used. Results A total of 260 resident responses were included in the final analysis The results revealed a significant difference in physical health scores (p = 0.006), social relationship scores (p = 0.038), and environmental scores (p

Abstract The effect of three independent variables (i.e., tyrosine, sucrose, and incubation time) on melanin production by Aureobasidium pullulans AKW was unraveled by two distinctive approaches: response surface methodology (i.e. Box Behnken design (BBD)) and artificial neural network (ANN) in this study for the first time ever using a simple medium. Regarding BBD, sucrose and incubation intervals did impose a significant influence on the output (melanin levels), however, tyrosine did not. The validation process exhibited a high consistency of BBD and ANN paradigms with the experimental melanin production. Concerning ANN, the predicted values of melanin were highly comparable to the experimental values, with minor errors competing with BBD. Highly comparable experimental values of melanin were achieved upon using BBD (9.295 ± 0.556 g/L) and ANN (10.192 ± 0.782 g/L). ANN accurately predicted melanin production and showed more improvement in melanin production by about 9.7% higher than BBD. The purified melanin structure was verified by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction pattern (XRD), and thermogravimetric analysis (TGA). The results verified the hierarchical architecture of the particles as small compasses by SEM analysis, inter-layer spacing in the XRD analysis, maximal atomic % for carbon, and oxygen atoms in the EDX analysis, and the great thermal stability in the TGA analysis of the purified melanin. Interestingly, the current novel endophytic strain was tyrosine-independent, and the uniquely applied ANN paradigm was more efficient in modeling the melanin production with appreciate amount on a simple medium in a relatively short time (168 h), suggesting additional optimization studies for further maximization of melanin production.

Abstract This article presents and investigates a modified version of the Weibull distribution that incorporates four parameters and can effectively represent a hazard rate function with a shape resembling a bathtub. Its significance in the fields of lifetime and reliability stems from its ability to model both increasing and decreasing failure rates. The proposed distribution encompasses several well-known models such as the Weibull, extreme value, exponentiated Weibull, generalized Rayleigh, and modified Weibull distributions. The paper derives key mathematical statistics of the proposed distribution, including the quantile function, moments, moment-generating function, and order statistics density. Various mathematical properties of the proposed model are established, and the unknown parameters of the distribution are estimated using different estimation techniques. Furthermore, the effectiveness of these estimators is assessed through numerical simulation studies. Finally, the paper applies the new model and compares it with various existing distributions by analyzing two real-life time data sets.

Aim: This meta-analysis and systematic review aims to investigate and compare the efficacy of mannitol and hypertonic saline in treating patients who have suffered from traumatic brain injury (TBI). Methods: We reviewed publications from the Medline database, Web of Science, and Google Scholar from inception to 13 October 2022 with only English-based literature. The risk of bias from included Randomized controlled trial (RCT) s was assessed using the Cochrane Collaboration's Tool. Newcastle-Ottawa Scale was employed to assess the included cohort's quality. The main outcomes of this review were treatment failure, mortality, intracranial pressure (ICP) reduction, and Cerebral Perfusion Pressure (CPP) increment. All the statistical analyses were performed using the Review Manager 5.4.1. A random-effects model was used to pool the studies when heterogeneity was seen, and the results were reported in the odds ratios (OR) and mean differences (MD) and the corresponding 95% confidence intervals. Results: The results of the statistical study found that there was a significantly lower treatment failure rate [OR = 1.80 (1.26, 2.57); p = 0.001; I 2 = 74%], the lower mortality rate [OR = 2.17 (1.26, 3.73); p = 0.005; I 2 = 0%], a greater increase in CPP [MD = -1.28 (-2.50, -0.05); p = 0.04; I 2 = 0%] associated with hypertonic saline treatment as compared to mannitol treatment. However, concerning ICP decrease, there was no significant difference between the two treatment options [MD = 1.86 (-0.64, 4.36); p = 0.14; I 2 = 70%]. Conclusions: Quantitative and qualitative analysis of trials and observational studies comparing the efficacy of hypertonic saline and mannitol demonstrates that hypertonic saline is a preferable treatment option with greater effectiveness and safety than mannitol in managing patients with TBI. [SJEMed 2023; 4(1.000): 051-059]

Wanita hamil memiliki risiko tinggi mengalami anemia. Kekurangan zat besi merupakan salah satu penyebab anemia. Salah satu buah yang tinggi besi yaitu buah naga dan buah yang tinggi vitamin C tergolong tinggi adalah buah Jambu biji. Hal ini tentunnya dapat meningkatkan kadar hemoglobin Tujuan penelitian ini untuk mengetahui perbandingan jus buah naga dan jambu biji dalam meningkatkan kadar hemoglobin ibu hamil trimester lll dengan anemia di Wilayah Kerja Puskesmas Krian Kabupaten Sidoarjo tahun 2022. Metode yang digunakan Quasy Experimental dengan pendekatan Two Group Pretest Posttest Design Populasi adalah seluruh ibu hamil TM III yang mengalami anemia sebanyak 49 orang. Pengambilan sampel secara purposive sampling sebanyak 44 orang dengan kreteria ingklusi Ibu hamil trimester III dengan kadar Hb < 11 g%, Ibu hamil trimester III bersedia mengkonsumsi jus buah naga dan jambu biji secara teratur setiap hari selama 14 hari 100 ml. Berdasarkan hasil penelitian dapat diketahui bahwa mean pengetahuan kelompok jus buah naga sebesar 2,68 dan pada kelompok jus jambu biji sebesar 2,56. Berdasarkan uji Independent T Test diketahui perbedaan yang bermakna antara kedua kelompok, hal ini dapat dilihat dari taraf signifikansi sebesar 0,693 (p

Background: Procalcitonin (PCT) has been used as a biomarker to guide antibiotic therapy in various patient populations. However, its role in optimizing antibiotic use in COVID-19 patients has not been well studied to date. Thus, we aimed to evaluate the use of serial PCT monitoring as an antimicrobial stewardship tool for COVID-19 patients. Methods: This retrospective study included 240 COVID-19 patients who were admitted to a tertiary medical institution in Saudi Arabia between January 2020 and February 2022. Patients who received empiric antibiotic therapy for community-acquired pneumonia (CAP) and had serial procalcitonin levels were included. The patients were divided into two groups: the normal procalcitonin arm (PCT level < 0.5 ng/mL) and the elevated PCT arm (PCT level > 0.5 ng/mL). The primary and secondary outcomes were the effect of PCT monitoring on the duration of antibiotic exposure and the length of hospital stay, respectively. To measure the accuracy of PCT, the receiver-operating characteristic area under the curve (ROC-AUC) was determined. Results: Among the included patients, 142 were in the normal procalcitonin arm (median PCT, 0.12 ng/mL), and 78 were in the elevated PCT arm (median PCT, 4.04 ng/mL). The baseline characteristics were similar between the two arms, except for the higher prevalence of kidney disease in the elevated PCT arm. There was no statistically significant difference in the duration of antibiotic exposure between the normal and elevated PCT arms (median duration: 7 days in both arms). However, the length of hospital stay was significantly shorter in the normal PCT arm (median stay, 9 days) than in the elevated PCT arm (median stay, 13 days; p = 0.028). The ROC-AUC value was 0.54 (95% CI: 0.503–0.595). Conclusions: Serial PCT monitoring did not lead to a reduction in the duration of antibiotic exposure in COVID-19 patients. However, it was associated with a shorter hospital stay. These findings suggest that PCT monitoring may be useful for optimizing antibiotic use and improving outcomes in COVID-19 patients. While PCT-guided algorithms have the potential to enable antibiotic stewardship, their role in the context of COVID-19 treatment requires further investigation.

Tuberculosis (TB) remains a critical global health challenge, with the emergence of drug-resistant strains heightening concerns. The development of effective drugs targeting both wild-type (WT) and mutant Escherichia coli RNA polymerase β subunit (RpoB) is crucial for global TB control, aiming to alleviate TB incidence, mortality, and transmission. This study employs molecular docking and ADMET analyses to screen echinoderm metabolites for their potential inhibition of Escherichia coli RNA polymerase, focusing on wild-type and mutant RpoB variants associated with TB drug resistance. The evaluation of docking results using the glide gscore led to the selection of the top 10 compounds for each protein receptor. Notably, CMNPD2176 demonstrated the highest binding affinity against wild-type RpoB, CMNPD13873 against RpoB D516V mutant, CMNPD2177 against RpoB H526Y mutant, and CMNPD11620 against RpoB S531L mutant. ADMET screening confirmed the therapeutic potential of these selected compounds. Additionally, MM-GBSA binding free energy calculations and molecular dynamics simulations provided further support for the docking investigations. While the results suggest these compounds could be viable for tuberculosis treatment, it is crucial to note that further in-vitro research is essential for the transition from prospective inhibitors to clinical drugs.

The use of smart locker technology has been beneficial for patients with chronic diseases who require regular medication and face challenges accessing healthcare facilities due to distance, time, or mobility issues. This study aimed to assess preferences for utilizing Smart Lockers in accessing and dispensing chronic disease medication among healthcare workers (HCWs) and patients in Nigeria. A descriptive cross-sectional survey was conducted between November 8th and December 4th, 2021, across secondary healthcare facilities in five states of Adamawa, Akwa Ibom, Cross River, Benue, and Niger. Among 1,133 participants included in the analysis, 405 were HCWs and 728 were patients with chronic illnesses. Descriptive statistics, including frequencies and percentages, were used to summarize the data, while chi-square tests were employed to assess significant differences between healthcare workers (HCWs) and patients. Results indicated a strong preference among both HCWs and patients for one-on-one counseling as the preferred method for orientating patients on using Smart Lockers, with 53.8% of HCWs and 58.1% of patients expressing this preference (p = 0.25). Additionally, there was a shared preference for hospitals or clinics as secure locations for Smart Lockers, with 68.9% of HCWs and 71.6% of patients preferring this option (p < 0.05). The majority of participants favored receiving notification of drug delivery via phone call, with 49.1% of HCWs and 48.8% of patients expressing this preference (p = 0.63). There was a significant difference in preferences for access hours, the majority (HCWs: 65.4% and patients: 52.6%) favored 24-hour access (p < 0.05). Participants identified patients with HIV within the age range of 18-40 as the most suitable population to benefit from using Smart Lockers for medication dispensing. These findings offer insights into healthcare policies aimed at enhancing medication access and adherence among patients with chronic diseases in Nigeria. The development of models for using smart lockers to dispense chronic disease medications to chronically ill persons in Nigeria and other populations is recommended.