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Abstract Background The present study aimed to critically revise the published literature on clinical outcomes and cost-effectiveness of Inspiris Resilia valve. Methods This work was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Full text research articles discussing clinical or cost-effectiveness aspects of Inspiris Resilia bioprosthesis published in English were included in this analysis. Studies were excluded if they weren’t exclusively conducted on patients submitted to surgical aortic valve replacement using the Inspiris Resilia bioprosthesis. Results The technical success rate was almost perfect in all studies. Reported complications included severe prosthesis-patient mismatch, reoperation, endocarditis, and paravalvular leak. In almost all studies, there were significant improvement of NYHA at the end of follow up as compared to baseline. In all studies, there were significant improvement of one or more hemodynamic parameters at the end of follow up as compared to baseline. Conclusions Surgical aortic valve replacement using Inspiris Resilia tissue valve appears to be safe and effective with low rate of aortic valve and systemic complications and mortality. Its performance appears to be equal to or better than many other bioprosthetic valves. As compared to mechanical valves, its use is suggested to be more cost-effective.

Purpose: There are no universally established guidelines for material selection in orbital wall fracture reconstruction. With an increasing preference for permanent implants, this study aimed to compare the long-term clinical outcomes of three different non-resorbable materials in reconstructing isolated orbital floor fractures. Design: A retrospective, interventional comparative study. Methods: The medical records of patients with unilateral pure orbital floor fractures who underwent orbital reconstruction using non-resorbable alloplastic implants at two tertiary referral centers between January 2017 to December 2021 were reviewed. Cases with non-pure orbital floor blowout fractures and/or

Abstract Background Wnt/β-catenin pathway has an important role in hepatocarcinogenesis. It has been involved in progression, growth, epithelial mesenchymal transition and metastasis of hepatocellular carcinoma (HCC). This pathway may represent a potential target for evolving treatment strategies. β-catenin gene (CTNNB1) has been identified as an important oncogene involved in hepatocarcinogenesis in previous trials to understand the pathogenesis of HCC. This study aimed to spot light on the role of Wnt/ β-Catenin and CTNNB1 gene mutation in HCC development and its relation with different clinicopathological features. Patients and methods This study was conducted on 121 HCC cases that were obtained from liver explants from pathology laboratory at Mansoura Gastroenterology center retrospectively in the period between 2006-2017. Tissue Microarray (TMAs) were prepared. β-Catenin and Wnt immunohistochemical (IHC) staining was performed on these blocks. Detection and scoring of CTNNB1 gene mutation were done by Chromogenic In Situ Hybridization (CISH). The relation between aberrant β-Catenin, Wnt2 IHC staining and CTNNB1 mRNA expression and different clinicopathological characteristics was studied. Results A significant association was detected between aberrent β-catenin IHC staining and larger tumor size (p = 0.011), multiple tumor nodules (p = 0.021), higher stages of the tumor (p = 0.03) and with presence of lymphovascular emboli (LVE) (p = 0.034). However, no significant association was detected with tumor site, presence of lymph node spread, distant metastasis, tumor necrosis, local recurrence and alpha-fetoprotein level. No significant association was seen between Wnt2 IHC staining with either tumor site, tumor size, number of tumor nodules, presence of LVE, tumor necrosis, tumor grade, TNM stage or presence of local recurrence. A significant association was seen between CTNNB1 mRNA expression and larger tumor size (> 5 cm) (p = 0.041), higher tumor stages (Stages III and IV) (p = 0.005) and presence of distant metastasis (p = 0.008).). No significant association between CTNNB1 mRNA expression and LVE, tumor necrosis, tumor grade or occurrance of local recurrence. Conclusion Aberrant β-catenin IHC staining and CTNNB1 gene mutation in HCC correlate significantly with tumor size, number of tumor nodules, tumor stage and presence of LVE. All of these items confer poor prognosis in HCC. A highly significant correlation was detected between CTNNB1 gene mutation and aberrant β-catenin expression in HCC cases.

Abstract The COVID-19 pandemic has caused significant mortality and morbidity for millions of people. Severe Acute Respiratory Syndrome-2 (SARS-CoV-2) virus is capable of causing severe and fatal diseases. We evaluated the antiviral properties of Aspergillus tamarii SP73-EGY isolate extract against low pathogenic coronavirus (229E), Adeno-7- and Herpes-2 viruses. The extract showed a high selectivity index (SI = 43.4) and a significant inhibition of 229E (IC50 = 8.205 μg/ml). It was stronger than the drug control, remdesivir (IC50 = 38.2 μg/ml, SI = 7.29). However, the extract showed minimal efficacy against Adeno-7- and Herpes-2-Viruses (IC50 = 22.52, 47.79 μg/ml, and SI = 6.75, 5.08, respectively). It exhibited profound efficacy against the highly pathogenic SARS-CoV-2 (IC50 = 8.306 μg/ml, SI = 42.2). Kojic acid, the primary component of the extract, showed substantial antiviral activity against SARS-CoV-2 (IC50 = 23.4 μg/ml, SI = 5.6), Remdesivir (IC50 = 4.55 μg/ml, SI = 61.45). Therefore, the extract demonstrated the most notable antiviral characteristics against coronavirus infection. Co-infecting microorganisms may contribute to immune system deterioration and airway injury caused by SARS-CoV-2. The extract showed significant efficacy against E. coli and P. aeruginosa , with an inhibition range of 3.5–10 mm at a concentration of 200 mg/ml. A molecular docking study showed that hexadecanoic, Kojic, octanoic acids, and 4(4-Methylbenzylidene)cyclohexane-1,3-dione have stronger binding affinity to the SARS-CoV-2 Mpro than Remdesivir. Molecular dynamics simulations were employed to examine the structural stability and flexibility of these complexes. This confirmed the high binding affinities of Kojic acid and 4(4-Methylbenzylidene)cyclohexane-1,3-dione, thereby proving their potential as novel anti-SARS-CoV-2.

Abstract Cisplatin is a chemotherapeutic drug, which exhibits undesirable side effects. Chitosan nanoparticles are promising for drug delivery. The aim of this study was to determine the effect of the brown alga Turbinaria triquetra ethyl acetate fraction and polysaccharides, either loaded on chitosan nanoparticles or free, against podocyturia and cisplatin nephrotoxicity in rats. Sixty-six male rats were distributed into 11 equal groups: untreated control, chitosan (CSNPs), ethyl acetate fraction (EAE), polysaccharide (PS), EAE loaded on chitosan nanoparticles (EAE-CSNPs), PS loaded on chitosan nanoparticles (PS-CSNPs), Cisplatin or cis-diamminedichloroplatinum(II) (CDDP), CDDP + EAE, CDDP + PS, CDDP + EAE-CSNPs, and CDDP + PS-CSNPs. Serum urea, creatinine, creatinine clearance, renal malondialdehyde, nitric oxide, paraoxonase 1, renal nephrin, and podocin, and their renal mRNA gene expressions, as well as urinary nephrin and podocin were determined. The results indicated that the ethyl acetate fraction and polysaccharides, either free or loaded, efficiently attenuated podocyturia and cisplatin nephrotoxicity compared to the Cis group. However, the improvement was higher in the nephrotoxic groups treated with EAE-CSNPs and PS-CSNPs. The current study revealed that chitosan nanoencapsulation showed ameliorative effects against podocyturia and cisplatin nephrotoxicity in rats compared to free extracts, offering a new therapeutic strategy for attenuating podocyturia and CDDP-induced nephrotoxicity.

Abstract Objectives This randomized prospective controlled trial investigated the effectiveness of different strategies of regenerative endodontic therapy on necrotic mature anterior teeth with chronic periapical periodontitis with 18 months follow up. Methods A total analyzed 51 adult participant with mature single rooted teeth having necrotic pulp with chronic periapical periodontitis (PAI ≥ 3) were selected. Patients had been randomly categorized into three distinct groups (n = 17 each group). All groups received the same treatment on the first visit. After 2 weeks, regenerative treatment was performed using either blood clot technique, Standard-PRF and Advanced-PRF approach. A standardized radiograph was taken, and the patients instructed for 6, 12 and 18 months follow up periods. Fisher's exact test was applied to compare the frequency of PAI scores at different follow-up intervals between the three groups. Results The results showed radiographic success at 18 months (58.8% in blood group, 94.1% in S-PRF group and 76.5% in A-PRF group). There was no statistically significant difference between the three groups according to incidence of healing at 6, 12 and 18 months. Clinical success was 82.4% in blood group and 88.2% in both S-PRF and A-PRF groups. There was no significant difference between the three groups (p = 1). The overall success (clinical and radigraphic) was 76.5%. Incidence of the gaining sensitivity after 12 and 18 months was 29.4% with A-PRF group and 41.2% within the S-PRF group, 17.6% with BC group. Conclusion PRF based regenerative technique may outperform the blood clot technique in treatment of non-vital mature teeth with chronic periapical periodontitis. There is a need for future randomized clinical studies to consolidate procedures in this field with more prolonged evaluation periods. Clinical trial registration The study was retrospectively registered with ClinicalTrials.gov (ID: NCT04606719 ) in 28/10/2020.

Abstract This paper presents a novel genetic algorithm (GA) design for current profiling in switched reluctance machines that eliminates torque ripple (TR) while inherently guaranteeing minimal RMS currents across the machines speed range. Minimising RMS current provides an increase to machine efficiency and the elimination of TR is required for potential SRM applications such as traction vehicles. This paper proposes a novel method for intentional greater‐than‐two‐phase overlap in the algorithm design. This allows any SRM configuration capable of three or more phase conduction to utilise its full speed range with zero torque ripple, in the case where it is limited using two‐phase torque sharing. An optimal set of current profiles is created using the algorithm across the full speed range of an exemplary 8/6 SRM and these are analysed. A current profiling‐based control scheme using these results is then proposed and simulated for the 8/6 SRM. This is then compared to classical and recently published SRM control methods to highlight the merits of the overall GA design and its resultant control scheme.

The inherent drawbacks of biodiesel, particularly its poor performance in cold climates, necessitate the use of nano-additives to improve its cold flow properties such as the cloud point (CP), pour point (PP), and cold filter plugging point (CFPP). In this study, transesterification was employed to produce methyl esters from waste cooking oil, corn oil, and jatropha oil. These biodiesels were blended with diesel fuel at a 20% biodiesel and 80% diesel volume ratio and enriched with nano-Al2O3 at concentrations of 25, 50, and 100 mg/L. The aim of this study is to evaluate the impact of nano-Al2O3 on engine combustion, performance, exergy, and emissions of diesel engines using different biodiesel feedstocks. The addition of nano-Al2O3 to methyl ester mixtures (JB20A100, CB20A100, and WB20A100) resulted in enhancements in thermal efficiency by 8%, 11%, and 13%, respectively. CO emissions were reduced by 12%, 17%, and 22% for jatropha, corn, and waste cooking oil blends, respectively, with 100 ppm alumina. This reduction in CO emissions can be linked to the enhanced oxidation process facilitated by the high surface area of the nanoparticles, which act as catalysts, promoting more complete combustion. Similarly, UHC emissions decreased by 14%, 18%, and 23%, and smoke concentrations were significantly reduced by 14%, 17%, and 24% across the biodiesel blends. However, the introduction of alumina led to the rise in NOx emissions by 9%, 15%, and 19% for JB20A100, CB20A100, and WB20A100, respectively. The study also revealed increases in cylinder pressure by 2%, 4%, and 8%, and maximum heat release rates by 3%, 6%, and 10% for JB20, CB20, and WB20, respectively, upon the incorporation of 100 ppm Al2O3. Exergetic efficiencies improved by 6%, 17%, and 23% for JB20A100, CB20A100, and WB20A100, respectively, and the sustainability index showed enhancements of 2%, 4%, and 7%. Among the tested blends, WB20 with 100 ppm of nano-Al2O3 demonstrated the most promising results, significantly improving engine exergy, combustion, and performance while mitigating emissions to acceptable levels. This study underscores the potential of nano-additives to advance the sustainability and efficiency of diesel engine operations, particularly in cold climate.

Objective Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of lymphoma. Circulating cell-free DNA (cfDNA) is the promising liquid biopsy in malignancy.Method Assessment of cfDNA concentration and DNA integrity index (DII) in 30 newly diagnosed DLBCL patients and correlating them with the international prognostic index.Results Circulating cfDNA concentration was significantly higher in newly diagnosed DLBCL patients than controls, while DII was significantly lower. There was a significant correlation between cfDNA concentration and adverse prognostic factors.Conclusion cfDNA concentration is potentially strong diagnostic and prognostic marker of DLBCL, however DII is only useful as a diagnostic biomarker.

The UN Agenda 2030 recognised the critical role of urban areas as cultural, economic, and social life centres that can simultaneously address different sustainability goals and provide quick and more practical responses to associated problems. Goal 9 aimed to build resilient infrastructure, enhance sustainable and inclusive industrialisation and increase innovation, as stated by the UN. This review demonstrates our novel effort toward increasing understanding of the existing literature concerning integrating digital mapping technologies in urban development: advancing sustainable and resilient infrastructure for SDG 9 achievement. The review employed a systematic approach to literature search and selection. Results showed that SDGs' Resilient Infrastructure constituted 13.2 %, Sustainable Industrialisation/Smart Cities (30.2 %), Fostering Innovation (13.2 %), ICT (3.8 %), Digital Data (5.7 %), Urban/Climate Resilience (5.7 %), and other aspects of SDG 9 accounted for 28.3 %. SDGs were not addressed by the studies relating to SDG 5 (Gender Equality), SDG 9 (Infrastructure, Industry, and Innovation), SDG 12 (Responsible production and consumption), SDG 14 (life beneath water), and SDG 17 (Goals for partnership). A comparative dearth of research was also reported from low and middle-income nations. The study further indicated a lack of reliable data on SDG 9; finding what existed was challenging. These comprise economic shifts to viable urban design patterns, including smart cities, consumption and production, effective governance, and renewed international means and partnerships of SDG implementation. Another set of challenges comprised a dearth of economic and social inclusion, extensive regional variations and rural-urban gaps, and gender inequality among women and men. Lastly, this study proposed a conceptual framework for implementing SDG 9. The study inferred that digital transformation (DT) improves SDG 9 attainment. However, it might be mediated by the e-governance/brilliant city performance and stakeholder commitment level.

Background: Blood culture contamination is a safety and quality indicator in the pediatric population. False positive blood culture negatively impacts pediatric patients' proper management, microbiology laboratories, healthcare facilities where blood cultures are ordered, and pharmacies. The study aims to appraise the blood culture contamination rate in an intensive care unit of an emergency department at an Egyptian tertiary care pediatric hospital, and accordingly design a quality improvement program to reduce it. Methods: A plan-do-study-act model is implemented over 8 consecutive months. All nursing staff members who enrolled in the study; participated in an educational program, afterward, they were assigned to collect blood samples for culture, following the instructions implemented and listed for improvement of the blood culture sampling practice. Then, blood culture samples were sent to the microbiology laboratory of this Egyptian tertiary care pediatric hospital for microbiological processing. Results: Our average contamination rate declined from the baseline of 12.6% to an average of 5.8%. Conclusions: According to our study, blood culture contamination rates can be significantly reduced when blood culture sampling is standardized.

The advent of 5G and blockchain technologies has signified rapid growth in the digital space. Their unique capabilities have already redefined communication and decentralized networks; however, their possible combined role is the subject of this research article. Objective: The article investigates the implications of 5G technology being used for integration with blockchain and how its disruptive nature would affect Binance's cryptocurrency trading platform. A mixed-methods research strategy was followed that draws upon data analytics, in-depth case study investigations and expert consultations. The key point was finding out how unparalleled low latencies and high-throughput capacities from 5G would be a procedures-changer for blockchain operations. The results indicate that the network capabilities of 5G can compensate for some blockchain major difficulties, including scalability and energy consumption. Quicker data transfer speeds up validation processes which leads to faster blockchain transaction times. This combination of advantages makes it possible to use microtransactions and facilitates scaling in terms of volume per transaction while retaining good levels of security and decentralization. Furthermore, with opportunities such as rapid cross-border payments and extensive smart contract capabilities available too — Binance certainly seems well-positioned to lead the charge in leveraging this convergence. But then again, the integration is accompanied by other challenges as well – mainly regulatory and technological challenges of innovation brought along by two cutting-edge technologies. The integration of 5th-generation mobile networks and blockchain has massive potential for cryptocurrency projects such as Binance. This partnership is poised to transform the existing blockchain landscape, ushering in a whole new era of fintech experience with an increased capability for speed and operational efficiency along safety systems.

Abstract Water microbial contamination is a serious issue that poses a risk to both animal and human health. One hundred and twenty water were samples collected from main water source and drinkers from a poultry farm. Different bacterial pathogens were isolated from water sources. Escherichia (E.) coli, Pseudomonas (P.) aureoginosa, (Salmonella) Salmonella (s). Typhimurim, Aeromonas (A.) hydrophila at different percentages. Variable degree of bacterial resistance to some commercial disinfectants commonly used to disinfect water system (iodine, terminator and H2O2). Nanoparticles were used to control bacteria in water. About the safety investigation for the prepared nanomaterials, the work results demonstrated that zinc oxide (ZnO) nanoparticles (NPs) exhibit the highest safety profile among the manufactured materials. The median fatal dose (LD50) for ZnO NPs was determined to be 3709 mg/kg body weight. In comparison, the LD50 values for zeolites and nanocomposites were 3251 mg/kg and 2658 mg/kg, respectively. Therapeutic dosages were estimated based on the LD50. Zeolite NPs, ZnO NPs and ZnO/zeolite NPs showing promising results in control of those bacteria. It was concluded that the escalating resistance of bacteria to disinfectants have led to a need to find alternative such as nanoparticles that proved promising results in control of pathogens, particularly it showed a safe effect on laboratory animals.

Abstract Background Candidemia is a widespread threat that can lead to significant complications in healthcare settings. Objectives Our study aimed to identify isolates of Candida isolated from blood culture bottles of patients with candidemia and assess their antifungal susceptibility profiles. Methods We conducted a cross-sectional study at Cairo University tertiary care hospitals over 16 months including 90 patients. Candida isolates were collected from blood culture bottles, and identified using MALDI-TOF MS technology of VITEK MS PRIME (bioMérieux) with the corresponding database VITEK IVD Database 3.2. followed by antifungal susceptibility testing using VITEK 2 Compact system. Results Candida albicans was the most common species isolated from both pediatric and adult patients with percentages of 47.3% and 36.4% respectively, followed by Candida parapsilosis with percentages of 32.6% and 25.0% respectively. Voriconazole showed the highest antifungal activity at 90.9% of isolates in adults and 95.7% in pediatrics, followed by caspofungin and micafungin. The mean hospital stays for adults ranged from 8 to 30 days and from 10 to 42 days in the pediatric group. Conclusions C. albicans remains the predominant species isolated from both pediatric and adult candidemia patients, despite a notable increase in other species. C. tropicalis and C. parapsilosis are considered the most common non-albicans Candida (NAC) species. The rise in Candida species other than albicans highlights the urgent need for effective antifungal stewardship programs. Voriconazole exhibited the higher antifungal activity followed by caspofungin and micafungin.

Abstract Background Disorders affecting the temporomandibular joint (TMJ), related structures, and the masticatory muscles are called temporomandibular disorders (TMD). The two most typical symptoms are mouth opening restriction and pain. Costen noted the connection between TMD and tinnitus in 1934. These conditions are brought about by the shared structures that connect the TMJ and the auditory apparatus (bones and muscles) through a shared innervation source and specific ligaments. Wright addresses Costen ideas, which suggest that otological symptoms of TMD could be caused by auriculotemporal nerve damage, Eustachian tube restriction, or other factors causing an incorrect intratympanic pressure adjustment. Methods Cross-sectional observation was regulated at Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University. The following are the inclusion criteria: patients with a TMD diagnosis and those older than 16 years old. The following conditions are excluded: neurological or oncological disorders, ear infection, and a history of face trauma. Results The total number was 196 patients, 63.8% females and 36.2% males. A total of 76.5% had bilateral joint pain, and 21.9% had unilateral joint pain. While 70.4% had bilateral muscle pain, 18.9% had unilateral muscle pain. A total of 91.8% had mild tinnitus, while 8.2% had moderate tinnitus. Conclusion In this study, 8.2% of patients complaining of tinnitus had severe tinnitus, while 91.8% had mild tinnitus.

This study evaluated the impact of night frost incidents on the biochemical, physiological, and reproductive functions of the olive varieties Manzanillo, Coratina, Koroneiki, and Picual. Certain cultivars were more suited to moderate cold night stress than others, based on the changes in the performance of the stressed plants, including vegetative growth, tree yield, fruit physical characteristics, and fruit chemical characteristics. Compared to other tested cultivars, the biochemical responses of the plants in terms of photosynthetic pigments, relative water content (RWC), total phenolic compounds, total flavonoid, and antioxidant enzyme accumulation demonstrated that some cultivars could withstand the applied stress. The conclusion that some cultivars responded differently to cold stress than others was supported by the plant phenology. This research could be a game-changer for farmers. By understanding how olive trees adapt to cold snaps, a common stressor in open fields, they can make informed decisions about breeding and choosing the best cultivars, ultimately leading to more resilient crops. The results showed that all tested olive tree cultivars differ significantly regarding cold stress conditions. Coratina and Koroneiki were the most resistant tested cultivars in terms of biochemical, physiological, and reproductive functions, followed in ascending order by Manzanello and Picual.

The main goal of this paper is to investigate the evolution equations for special types of timelike ruled surfaces with significant geometric and physical applications in Lorentz-Minkowski 3-space $ E_{1}^{3} $. Using the alternative frame associated with the basic curve of these surfaces, we explored their key geometric properties. Our analysis provided insights into the dynamics of local curvatures during their evolutions, enhancing the understanding of surface behavior. Finally, we present applications of our preliminary findings that contribute to the broader field of differential geometry.

Abstract Background Acinetobacter baumannii (A. baumannii) is a life-threatening and challenging pathogen. In addition, it accounts for numerous serious infections, particularly among immunocompromised patients. Resistance to nearly all clinically used antibiotics and their ability to spread this resistance is one of the most important concerns related to this bacterium. Objectives This study describes different molecular mechanisms of two multidrug-resistant A. baumannii isolates obtained from endotracheal aspirates collected from the neonatal intensive care unit (NICU), Ain Shams University Hospital, Egypt. Methods Following the identification of two isolates, they were examined for susceptibility to antimicrobial agents. This was followed by multilocus sequence typing as well as whole-genome sequence (WGS). Additionally, a Pathosystems Resources Integration Center (PATRIC) analysis was performed. Results Two isolates, Ab119 and Ab123, exhibited resistance to all tested antibiotics except for tigecycline and colistin. The WGS analysis of antimicrobial resistance genes (AMR) indicated that both isolates shared beta-lactam, aminoglycoside, macrolides, and sulfonamide resistance genes. Furthermore, each strain revealed different resistance genes such as blaNDM-1, blaNDM-10, OXA-64, aph (3')-VI, Tet-B in Ab119 strain and blaOXA-68, blaPER-1, blaPER-7, Tet-39 in Ab123 strain. Multiple efflux pump genes were detected. Multilocus sequence typing indicated that both isolates belong to the same sequence type (ST931), which belongs to international clone (IC3). Both isolates exhibited the presence of multiple mobile genetic elements (MGEs), but no plasmid was detected in either of them. Conclusions A low prevalence of the IC3 sequence type was identified among two A. baumannii isolates obtained from the NICU in Egypt, exhibiting a high resistance level. Healthcare workers must have knowledge regarding the prevalence of A. baumannii among different populations in order to administer suitable treatment, improve patient outcomes, and apply effective infection control practices.

Abstract Background The etiological diversity of pulmonary hypertension and its association with other accompanying unrelated symptoms is why this disease may be primarily diagnosed by physicians of different medical specialties. In this study, we sought to evaluate the awareness of physicians regarding pulmonary hypertension across different regions in Egypt and among different medical specialties this is because we believed that pulmonary hypertension disease awareness differed among different specialties. Methodology The survey is conducted from January 2023 to April 2023 targeting certified physicians of different medical specialties in Egypt. A self-administered questionnaire is designed to evaluate and capture information on the awareness of physicians of different medical specialties regarding the diagnosis and management of disease. The questionnaire is offered through an online Google form link, that is made available in two languages English and Arabic for dissemination. Results A total number of 177 physicians of different medical specialties participated in the questionnaire, 97 (54.8%) participants were males, and 80 (45.2%) participants were females with a mean age of 36.88 ± 7.18. Among different medical specialties, 89.4% (n = 76) of the pulmonologists and 91.9% (n = 34) of the cardiologists participating in the survey have satisfactory PH disease knowledge above 75% with a statistically high significant difference of 0.000, in addition, 87.1% (n = 74) of the pulmonologists and 94.6% (n = 35) of the cardiologists have satisfactory PH disease management knowledge above 75% with a statistically significant difference of 0.000. Coincidentally most participants encountering PH patients in their daily clinical practice have satisfactory PH disease knowledge above 75% and satisfactory PH disease management knowledge above 75% with percentages of 84.8% and 82.3% respectively with statistically significant differences of 0.000 and 0.043 respectively. Conclusions Our research highlights the importance of appropriate awareness of the healthcare providers of different medical specialties regarding PH disease essential to abide by the current guidelines in management as well as prioritizing the establishment of geographically available designated expert centers enforcing proper clinical practice. Thus, aiming at reducing the prereferral malpractice noted as the prescription of targeted therapy based on the clinical and imaging assessment only without hemodynamic study.

Abstract Background Insufficient vitamin D (VD) levels have been linked to a higher vulnerability to acute respiratory infections and the severity of COVID-19 sickness. Objective The purpose of this research is to investigate whether or not there is a connection between the amounts of VD produced by patients from Egypt and the severity of COVID-19, as well as the consequences of the disease. Methods This research used a case–control design and included a total of 90 adult patients who had been diagnosed with COVID-19, as well as 90 healthy controls who were matched in terms of age and sex. Patients were classified into mild, moderate, and severe categories according to clinical and radiological criteria. The study included measuring levels of VD and analyzing their relationships with illness severity, inflammatory markers, radiological findings, and outcomes. Results COVID-19 patient(s) had notably reduced levels of serum VD versus the control group (11.78 ± 3.24 ng/mL vs. 20.88 ± 7.76 ng/mL, p

This study examined the photocatalytic degradation of wastewater containing methyl violet dye in a recirculating slurry-type reactor using commercial TiO2 as the photocatalyst under ultraviolet irradiation. The effects of initial dye concentration (10 – 80 ppm), photocatalyst dosage (0.2 – 1 g/L), solution pH (2 – 11), and flow rate (2 – 4 L/min) on degradation efficiency were thoroughly assessed. Results showed that degradation efficiency increased with pH, peaking at neutral pH (7), before declining at higher values. Similarly, catalyst loading up to 1 g/L enhanced efficiency, but further increases caused a decline. Higher solution flow rates improved mass transfer by increasing turbulence, leading to enhanced degradation efficiency. Optimal conditions (neutral pH, 1 g/L catalyst loading, and 4 L/min flow rate) achieved complete decolorization of a 10-ppm dye solution. These findings highlight the feasibility of achieving high degradation efficiencies under practical conditions, supporting the potential for industrial-scale application in effluent treatment.

Phosphate mining is essential for global agriculture but poses significant environmental challenges, particularly in landscape degradation. This study reviews the current state and trends of phosphate mining, highlighting economic importance, environmental impacts, and sustainability issues. It evaluates restoration techniques, focusing on the effectiveness of various plant species in restoring mined areas. Key factors influencing successful rehabilitation include topsoil management, physico-chemical site characteristics, nutrient bioavailability, topography, and water availability. The study advocates for integrated land management strategies that combine tailored nutrient management plans, erosion control, and water conservation, particularly in arid climates. Strengthening and enforcing regulatory frameworks is crucial to ensure accountability in land rehabilitation, with a focus on sustainability. Recent legal advancements in Morocco aim to modernize mining operations and enhance environmental accountability. The findings recommend increased investment in research to develop innovative rehabilitation techniques and long-term monitoring programs to ensure adaptive management and continuous improvement of restoration outcomes.

Colorectal cancer (CRC) is the leading cause of death from gastrointestinal cancer, the second largest cause of cancer-related death worldwide, and the third most common cancer in both men and women. Bad eating habits, smoking, intestinal inflammatory diseases, polyps, aging, and genetic factors all increase the risk of developing colorectal cancer. More interestingly, vitamin deficiency has been associated with an increased risk of colorectal cancer. We reviewed the published significance of vitamin supplementation on colorectal cancer proliferation, survival, apoptosis, angiogenesis and migration, focusing on the possible molecular mechanisms of water-soluble and fat-soluble vitamins to provide protective suggestions to minimize the occurrence and progression of colorectal cancer.

Background: Diabetic nephropathy (DN) is a common vascular complication of diabetes Miletus (DM) that require weight control and dietary restrictions, especially for protein. A protein-restricted diet with ketoacid analogs (KA) reduces the intake of nitrogen while avoiding the harmful consequences of inadequate dietary protein intake. Objective: This study aimed to investigate the efficacy and safety of a protein-free diet with ketoacid analogs in chronic kidney disease (CKD)-affected diabetic rats. Material and methods: Sixty adult male albino rats were grouped into six equal groups (G): G (1) Control group, G (2) Normal rats. Received low protein diet, G (3) Diabetic control rats. Received standard diet, G (4) Diabetic rats. Received low protein diet for 12 weeks, G (5) Diabetic received α-keto amino acids (KAA) with a low protein diet and G (6) Diabetic received α-keto amino acids with protein-free diet. Blood sample was used to assess blood glucose (mg/dl), insulin (pmol/L), urea (mg/dl), creatinine (mg/dl), total cholesterol (TC) (mg/dl), LDL (mg/dl), HDL (mg/dl), triglycerides (TG) (mg/dl), and albumin (mg/dl) levels. Results: A significant decrease in blood glucose, serum total cholesterol, LDL, triglycerides, serum urea and creatinine were observed while insulin level, albumin, glomerular filtration rate (GFR), urine volume and HDL were significantly increased in group six. Conclusion: A protein-free diet containing KAA improves renal function, lowers blood glucose levels, maintains body weight, and does not worsen nutritional status in DN over time.

A serious challenge of the chronic administration of dexamethasone (DEX) is a delay in wound healing. Thus, this study aimed to investigate the potential of Tadalafil (TAD)-loaded proniosomal gel to accelerate the healing process of skin wounds in DEX-challenged rabbits. Skin wounds were induced in 48 rabbits of 4 groups (n = 12 per group) and skin wounds were treated by sterile saline (control), TAD-loaded proniosomal gel topically on skin wound, DEX-injected rabbits, and DEX+TAD-loaded proniosomal gel for 4 weeks. The optical photography, transmission electron microscopy, in vitro release profile, and stability studies revealed the successful preparation of the selected formula with good stability. DEX administration was associated with uncontrolled oxido-inflammatory reactions, suppression in immune response in skin wounds, and consequently failure in the healing process. TAD-loaded proniosomal gel-treated rabbits manifested a marked enhancement in the rate of wound closure than control and DEX groups (p < 0.05). The TAD-loaded proniosomal gel successfully antagonized the impacts of DEX by dampening MDA production, and enhancing total antioxidant capacity, coupled with modulation of inflammatory-related genes, inducible nitric oxide synthase, tumor necrosis factor-alpha, interleukin-1β, and matrix metalloproteinase 9, during all healing stages (p < 0.05). This was in combination with significant amplification of immune response-related genes, CD68 and CD163 (p < 0.05). Moreover, the histopathological, Masson's Trichrome-stain, and immune-histochemical studies indicated a successful tissue recovery with the formation of new blood vessels in groups treated with TAD-loaded proniosomal gel, as manifested by well-organized collagen fibers, upregulation of transforming growth factor β1, and vascular endothelial growth factor immune expression in skin tissues (p < 0.05). Overall, the topical application of TAD-loaded proniosomal gel is useful in improving the delayed wound healing linked to DEX therapy via regulating the release of inflammatory/macrophage activation mediators and enhanced antioxidant capacity, angiogenesis, and vascularity.