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This paper is dedicated to studying the neutrosophic formula of some famous matrix equations used in theoretical data mining algorithms and control systems by using neutrosophic matrices and refined neutrosophic matrices over neutrosophic real fields. On the other hand, we concentrate on the neutrosophic formula of the Sylvester equation, and Lyapunov equation, where we study their formulas and properties in terms of theorems in the neutrosophic real number field and refined real number field. Also, we illustrate many different examples to clarify the validity of our work. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims This article examines the prevalence of burnout among healthcare providers in the aftermath of the recent earthquakes in Syria and Turkey and explores the associated risk factors. Methods This cross‐sectional study included 270 healthcare providers in three Syrian cities damaged by earthquakes. Participants were asked to fill out a validated questionnaire on the fifth day of emergency response using the Geldard Occupational Burnout questionnaire. Results The mean score for the Geldard Occupational Burnout Questionnaire was 129.79, with 81.4% indicating moderate burnout risk and only 3% indicating high risk. Gender was not significantly associated with burnout, but there was a significant difference in burnout scores between city groups, with Latakia scoring significantly lower than Aleppo. Conclusion This study highlights the prevalence of burnout among healthcare providers in the aftermath of an earthquake in Syria, with the majority having a moderate risk of burnout. Gender was not significantly associated with burnout risk. Further research is needed to develop effective interventions and address study limitations. The study emphasizes the importance of prioritizing healthcare providers' mental health to ensure high‐quality care after natural disasters.

Superior mesenteric artery syndrome is a rare condition that causes duodenal obstruction due to compression by the superior mesenteric artery and the aorta. It can be related to congenital or acquired factors that reduce the aortomesenteric angle and distance. The clinical presentation is nonspecific and often mimics other causes of upper gastrointestinal obstruction. The diagnosis requires a high index of suspicion and a correlation of clinical symptoms with radiographic findings. We report a case of a 17-year-old female patient who presented with chronic abdominal pain, vomiting, and weight loss. She was diagnosed with superior mesenteric artery syndrome based on an abdominal computed tomography scan that showed a reduced aortomesenteric angle of 30° and a reduced aortomesenteric distance of 7 mm. She was treated conservatively with anticoagulation therapy, dietary modification, and physical activity. She reported symptom improvement and weight gain after 2 weeks of treatment. This case illustrates the challenges and pitfalls in diagnosing superior mesenteric artery syndrome.

The idea of the IoT began back in 1982 when a vending machine was connected to the internet, then to the concept of Mark Weiser in 1992, then RFID, and so on. A detailed evolution of the IoT and how it was transforming is given. Due to the wide embracement of IoT by industries and home users, it has become the cornerstone of the Information and Communication Technology (ICT) market. The market value of the IoT was worth 1.90 billion in 2018; 25 billion in 2020; 925.2 billion as of 2023; while it is forecasted to hit 6 trillion in 2025 at 15.12% growth rate. This work presented some major technologies integrated with the IoT to achieve a certain goal and improve an existing system. IoT’s capability to create smart applications is demonstrated and some major distinctions between IoT & the Internet were highlighted.

The integration of deep learning in healthcare has propelled advancements in diagnostics and decision support. However, the inherent opacity of deep neural networks (DNNs) poses challenges to their acceptance and trust in clinical settings. This survey paper delves into the landscape of explainable deep learning techniques within the healthcare domain, offering a thorough examination of deep learning explainability techniques. Recognizing the pressing need for nuanced interpretability, we extend our focus to include the integration of fuzzy logic as a novel and vital category. The survey begins by categorizing and critically analyzing existing intrinsic, visualization, and distillation techniques, shedding light on their strengths and limitations in healthcare applications. Building upon this foundation, we introduce fuzzy logic as a distinct category, emphasizing its capacity to address uncertainties inherent in medical data, thus contributing to the interpretability of DNNs. Fuzzy logic, traditionally applied in decision-making contexts, offers a unique perspective on unraveling the black box of DNNs, providing a structured framework for capturing and explaining complex decision processes. Through a comprehensive exploration of techniques, we showcase the effectiveness of fuzzy logic as an additional layer of interpretability, complementing intrinsic, visualization, and distillation methods. Our survey contributes to a holistic understanding of explainable deep learning in healthcare, facilitating the seamless integration of DNNs into clinical workflows. By combining traditional methods with the novel inclusion of fuzzy logic, we aim to provide a nuanced and comprehensive view of interpretability techniques, advancing the transparency and trustworthiness of deep learning models in the healthcare landscape.

Abstract Background Breast cancer (BC) represents an important cause of cancer death, its incidence rate has been rising gradually in the Arab world, and in Syria, BC is the most common cancer and the leading cause of cancer death; its prognosis gets better as we detect it early in its first stages. So, it is very important to implement one or more early detection methods such as Breast Self-Examination (BSE), Clinical Breast Examination (CBE), and mammography. BSE represents an effective method to find out changes in breast structure when they happen. This study investigates the knowledge of BSE and its practice in BC patients. Methods A quantitative cross-sectional study in Al-Bairouni hospital in Damascus-Syria was carried out using face-to-face interviews based on a structured questionnaire, which consisted of 4 sections. The data were subjected to statistical analysis using various analytical tests, including the independent t-test, one-way analysis of variance (ANOVA), and Chi-square test. Results Five hundred patients were interviewed. Only 27.4% of patients had a good knowledge of BSE, 17.4% had average knowledge, and 55.2% had low knowledge of BSE. The factors that have an impact on the knowledge of BSE were: family breast cancer history (first and second-degree relatives), education, and the region of living (between governorates). The effect of knowledge of BSE on its practice was positive. However, only 24.8% of patients have been practicing BSE; the reasons for not practicing BSE were: no one has told the patient about it (64.8% of cases), and the patient does not have any symptoms relating to the breast (21.4%).Breast cancer was identified through breast self-examination (BSE) in 15.6% of cases. Conclusion There is a low degree of knowledge and little practice of BSE among Syrian breast cancer patients. Family breast cancer history, governate, occupation, and level of education had a statistically significant effect on knowledge scores of BSE, unlike age and social status. So, some steps should be taken to increase awareness about BSE among Syrian females.

ABSTRACT--Aciduric, pH-elevating Bacillus, which cause non-effervescent spoilage of under-processed tomatoes, were shown to have an L-lysine decarboxylase optimally active at pH 5.5 and in the 48 h cultural age. Flat [...]

ABSTRACT--Of four selective media, Bacillus Tomato Juice Agar (BTJA) was the best medium to detect and enumerate aciduric, pH-elevating Bacillus, which cause non-effervescent spoilage of under processed tomatoes. One hundred [...]

Abstract Organ donation is vital to saving lives, but its success depends on people's willingness to donate organs. This descriptive cross-sectional survey aimed to investigate attitudes towards organ donation in Damascus, Syria. Understanding attitudes is crucial for the success of organ donation programs, especially in countries with similar settings. This study was a descriptive cross-sectional survey aimed at understanding patients’ attitudes towards organ donation in Damascus, Syria. Data was collected through a carefully constructed validated survey through face-to-face interviews. 600 participants were randomly interviewed, 62.8% agreed to donate their organs after death, with helping others being the primary reason. Religious beliefs were the primary reason for organ refusal in males, while for females, it was lack of knowledge and religious beliefs. However, there were no significant differences between genders or educational level and age groups in the acceptance of organ donation. The percentage of those who agree to donate their organs after death encourages taking an effective step to build an integrated donation system, not just a center. Bearing in mind that there is no correlation with age, gender or even educational level, which means that the system may include different groups of society.

Novel high-entropy alloy compositions having the same valence electron concentration (Al0.5FeCrNiTi0.25 –xSix) were developed with molar ratio x = 0.09, 0.125, and 0.25. Microstructure and corrosion behaviour were investigated using X-ray diffraction analysis, scanning electron microscopy, and electrochemical studies in 3.5 wt % NaCl solution at room temperature. Increasing the molar ratio x in Al0.5FeCrNiTi0.25 –xSix alloys stabilised face-centred cubic phase. Among the studied compositions, Al0.5FeCrNiTi0.12Si0.12 offered good corrosion resistance exhibiting the least corrosion current density (Icorr), the highest charge transfer resistance (Rct) with double layer capacitive value (Cdl), and the lowest Warburg coefficient (σ). [ABSTRACT FROM AUTHOR]

Assessing the impact of war on medical residents' specialty choices and migration decisions is critical to ensure the sustainability of healthcare systems worldwide. This study aimed to evaluate the effect of the Syrian crisis on specialty choices, related factors, and decisions to work in Syria among residents of six major university hospitals in Damascus. A cross-sectional study was conducted using a validated questionnaire from 20/4/2022 to 20/5/2022, including all eligible residents with no missing data. The questionnaire was comprised of 68 items, and residents were divided into two groups: group 1 included residents who made their specialty choice after the end of the military war in Damascus 2018, while group 2 included residents who made their specialty choice (the point of submitting their lists and applying for residency) during the war. A total of 370 residents were included, with 38.4% females and 61.6% males. Our findings revealed that 30% of residents preferred working in Syria, while 43.5% preferred working abroad. The factor of a "safer and more stable life" was significantly higher in Group 1 than in Group 2 (3.86>3.5, p-value = 0.026). Additionally, Group 1 residents were more likely to choose radiology, pathology, laboratory, and psychiatry specialization as their specialties, while choosing surgical specializations and hematology decreased compared to Group 2 (p-value2.21, Standard deviation = 0.22, p-value = 0.033). The Syrian crisis and its economic aftermath have influenced residents' specialty choices and practice locations. Even after the war's end, the high level of migration intentions could negatively affect the quality of provided healthcare services.

Key Clinical Message Cutaneous oxalosis is a rare manifestation of systemic oxalosis, typically associated with primary or secondary hyperoxaluria. We present a rare case of a 23‐year‐old female diagnosed with primary hyperoxaluria and end‐stage renal disease, who presented with papules on the palms without any vascular complications. The skin can be affected by oxalate deposition, resulting in various manifestations such as vascular complications or calcified nodules. In our case, the patient had primary hyperoxaluria and end‐stage renal disease but exhibited atypical features of cutaneous oxalosis. Histopathology confirmed the presence of oxalate crystals in the dermis, subcutis, and medium‐sized arteries. The mechanism of oxalate deposition in this case remains unclear. This case underscores the importance of considering cutaneous oxalosis in the differential diagnosis of patients with renal failure and skin lesions, and highlights the variability of clinical presentations in primary hyperoxaluria.

Background Natural disasters have a significant impact on the mental health of affected populations. The February 2023 earthquakes in Syria and Turkey caused widespread devastation. Aims To explore the mental health impact of the earthquakes in Syria on the population across areas differentially damaged by the disaster. Method This cross-sectional study conducted in Syria included 1406 adults recruited via social media platforms 1 month after the February 2023 earthquakes. Demographic information, earthquake exposure questions, the PTSD Checklist for DSM-5 (PCL-5: for probable post-traumatic stress disorder, PTSD), the Patient Health Questionnaire-9 (PHQ-9: for probable depression) and the seven-item Generalized Anxiety Disorder scale (GAD-7: for probable anxiety) were included to compare outcomes across areas severely, moderately and slightly damaged by the earthquakes. Results Probable PTSD and GAD rates were higher in the severely (57.9 and 57.3% respectively) and moderately damaged regions (55.4 and 56.3% respectively) than in the slightly damaged regions (44.6 and 48.3% respectively) (PTSD: P < 0.001, GAD: P = 0.005). More participants in severely damaged regions (60.6%) reported symptoms of depression compared with moderately (53.1%) and slightly damaged (50.8%) regions (P = 0.003). Poorer mental health outcomes were associated with being female, single, younger, having a damaged or destroyed house, seeing something tragic in person and hearing tragic stories. Seeing something tragic on social media was not statistically significant. Conclusions This study highlights the higher prevalence of probable mental disorders in areas with more severe earthquake damage, with over 50% of the population reporting probable PTSD, depression or anxiety. The study also suggests a significant cumulative effect of these earthquakes on an already trauma- and disaster-affected population.

Congenital infantile fibrosarcoma (CIFS) is a rare malignant soft tissue tumor. The incidence of fibrosarcoma is estimated to be 0.3 per 100 000 population per year, and it accounts for less than 1% of all soft tissue sarcomas. We present a case of a 7-day-old newborn with a large ulcerated and necrotic lesion on the left forearm, which was initially misdiagnosed as rhabdomyosarcoma. Magnetic resonance imaging (MRI) revealed a soft tissue mass with cystic components affecting the forearm and distal humerus muscles. Fine-needle biopsy was performed and initially diagnosed as rhabdomyosarcoma but later confirmed as low-grade fibrosarcoma with positive immunostaining for vimentin. The patient underwent a transhumeral amputation with follow-up chemotherapy at a specialized oncology center. This case underscores the importance of interdisciplinary collaboration and specialized care in managing complex medical conditions in infants. Early detection and appropriate management of these tumors are essential for improving outcomes and reducing morbidity and mortality. Despite the rarity of this case, it serves as a reminder of the importance of considering neoplastic lesions in the differential diagnosis of soft tissue masses in newborns.

Background:. Despite efforts to promote gender equity in medicine, gender disparities persist in various medical specialties, including plastic surgery. This study aimed to investigate the representation of female physicians in leadership positions in German plastic surgery departments. Methods:. This cross-sectional study collected data about the physician workforce in the German plastic surgery field. The primary outcome was the proportion of female physicians in plastic surgery departments. Data were collected from 94 departments. The physician workforce was stratified based on gender and leadership. Results:. We included 812 physicians working in different German plastic surgery departments. Of those, 76.8% were in leadership positions, and 35.1% were women. There was a significant association between being male sex and holding a leadership position (n = 158/188, 84% versus n = 30/188, 16%, P

Few comparisons have been made between low-aromaticity marine and lacustrine oil shales and their kerogens, because the reliability of structural analyses has been limited by a reliance on only one method of kerogen isolation, HCl-HF. Therefore, a detailed analysis by 13C NMR and X-ray photoelectron spectroscopy (XPS) was made for Attrat marine oil shale (Jordan) and Colorado (Green River) lacustrine oil shale (USA) and their NaOH-HCl kerogens. Some differences between oil shales and their kerogens were noted, but many structural features were considered to be true characteristics of the organic matter. The results emphasise the importance of comparing the analyses of kerogens isolated by different methods to ensure that features of the organic matter are not an artefact of the method of kerogen isolation. For both oil shales, the predominantly aliphatic character of the organic part was confirmed and the long average chain length of the aliphatic hydrocarbons was established. All shales and their kerogens showed a small cluster size for the aromatic rings. The elemental analysis obtained by XPS, compared with the bulk elemental analysis, indicated major differences between the near-surface region sampled by XPS and the bulk. The organic S was determined to be aliphatic and aromatic S with possibly small amounts of sulfoxide. Most of the N was pyrrolic with smaller amounts in pyridinic or quaternary form. Nearly all of the surface organic C in both kerogens was bonded to C and H. Two major forms of organic O were distinguishable. A good correlation between the proportion of aliphatic S and pyrolysis reactivity is suggested. This paper studies the comparison between low-aromaticity marine (Attrat-Jordan) and lacustrine (Colorado-USA) oil shales and their kerogens. Kerogens were extracted using NaOH-HCl method. The characterisations were performed using elemental analysis, Rock Eval, 13C NMR, and XPS. This work reveals some differences in the organic structure between the two kerogens. [ABSTRACT FROM AUTHOR]

Abstract Background The main way to prevent blindness from Glaucoma is by early detection and diagnosis; and to do so the awareness must be raised among people where Glaucoma is defined as an acquired chronic optic neuropathy characterized by optic disk cupping and visual field loss. Lack of knowledge about this disease is one of the most important reasons that made it develop to advanced stages. Based on that, we conducted scientific research to assess peoples’ awareness and knowledge about Glaucoma. After reviewing the literature, it was found that this study is the first in Syria. Methods We conducted a cross-sectional study in May 2022. The study included participants, who are above 20 years old, from visitors of Al-Mouwasat University Hospital in Damascus, Syria. During one week, Data was gathered according to the questionnaire, which was presented through face-to-face interviews with participants. We have allocated one point (1) to each question. Three levels of knowledge were adopted, namely; weak level from (0) to (3), average level from (4) to (7) and good level from (8) to (11). Associations between participants' demographic and other details were tested using Chi-square test and other tests, and a p-value of

Abstract Background This study aimed to evaluate the acceptance of Peer Physical Examination (PPE) in middle Eastern society with its associate factors, and PPE acceptance during Covid-19 pandemic. The acceptance of PPE is considered high in multiple studies carried out in the west, but there were nearly no studies investigating the acceptance of PPE in the middle east or low-income countries. Methods A questionnaire was shared through social media with students with focus on clinical-year students. A total number of 657 medical students were collected with a 74.5% response rate. The questionnaire gathered demographic information and recorded previous experience of PPE. A 5-point-likert scale was used to assess acceptance of PPE, factors affecting it, and the influence of COVID-19 pandemic. It also considered body’s areas students would accept to be examined. Associations between participants’ demographic and other details were tested using independent-samples T Test and other tests, and a p-value of

Abstract Introduction Breast cancer represents a traumatic experience with a psychological burden. The prevalence of psychological distress (which include depression and anxiety) among breast cancer patients is estimated to be 15 to 54%, but studies have shown that applying some psychological treatments has contributed to decreasing depression and anxiety. So, it is crucial to diagnose and treat patients with the appropriate means. After reviewing the literature, no studies discussed depression and anxiety among Syrian breast cancer patients. Methods A cross-sectional study in Al-Bairouni hospital in Damascus, Syria carried out using face-to-face interviews based on a structured questionnaire. All breast cancer patients were included, except who refused to participate, and responses with missing data were excluded. The questionnaire consisted of 2 sections: the first included Socio-demographic characteristics, and the other evaluated patients' depression using PHQ-2 and GAD-2 scales. Data were gathered using the Kobo toolbox app and then entered into an Excel sheet. Results Five hundred patients were interviewed. 35.6% of the patients had a GAD-2 score greater than or equal to 3.00, while 35% had a PHQ-2 score greater than or equal to 3.00. There is a significant negative relationship between the age of the patient and the GAD-2 score and PHQ-2 score, which means the older the patient is, the lower the GAD-2 and PHQ-2 scores are. A multivariable regression model showed that younger (age ≤ 45 years) and being widowed were associated with being positive for further evaluation for generalized anxiety disorder. Similarly, patients younger than 45 are significantly associated with the need for further evaluation for major depressive disorder (MDD). Social status had a stronger association with the need for further assessment for MDD, with divorced women showing the strongest association, followed by widowed and married women compared to single women. Conclusion This study showed high anxiety and depression among breast cancer patients. The patient’s age and social status were significant factors in determining the need for further psychological assessment. In General, Younger patients showed higher levels of depression and anxiety, the size of the tumor did not show significant association with psychological distress.