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PURPOSE: To assess the diagnostic performance and utility of the ExoDx IntelliScore and an OPKO4K score to predict prostate cancer in men presenting with elevated PSA-both as independent predictors and in combination with clinical/MRI characteristics. METHODS: Patients with elevated PSA were retrospectively reviewed. Abnormal tests were defined as an OPKO4K score ≥ 7.5% and an ExoDx IntelliScore ≥ 15.6. Four regression models and ROC curves were generated based on: (1) age, PSA, and DRE, (2) model 1 + OPKO4K 4Kscore ≥ 7.5%, (3) model 2 + ExoDx IntelliScore ≥ 15.6, and (4) model 3 + MRI PIRADS 4-5. RESULTS: 359 men received an OPKO4K test, 307 had MRI and 113 had ExoDx tests. 163 men proceeded to prostate biopsy and 196 (55%) were saved from biopsy. Mean age was 65.0 ± 8.7 years and mean PSA was 7.1 ± 6.1 ng/mL. Positive biopsies were found in 84 (51.5%) men. The sensitivity and negative predictive value of an OPKO4K score were 86.7% and 72.3%; values for an ExoDx test were 76.5% and 77.1%, respectively. On regression analysis, clinical markers (Age, PSA, DRE) generated an AUC of 0.559. The addition of an OPKO4K score raised the AUC to 0.653. The stepwise addition of an ExoDx score raised the AUC to 0.766. The combined use of both biomarkers, patient characteristics, and MRI yielded an AUC of 0.825. CONCLUSION: This analysis demonstrates the high negative predictive value of both the OPKO4K score and ExoDX IntelliScore independently while demonstrating that the combination of an OPKO4K score, an ExoDX IntelliScore, and MRI increases predictive capability for biopsy confirmed prostate cancer.

High-grade (HG) urothelial carcinoma (UC) with variant histology has historically been managed conservatively. The presented case details a solitary lesion of muscle-invasive bladder cancer (MIBC) with sarcomatoid variant (SV) histology treated by partial cystectomy (PC) and adjuvant chemotherapy. A 71-year-old male with a 15-pack year smoking history presented after outside transurethral resection of bladder tumor (TURBT). Computerized tomography imaging was negative for pelvic lymphadenopathy, a 2 cm broad-based papillary tumor at the bladder dome was identified on office cystoscopy. Complete staging TURBT noted a final pathology of invasive HG UC with areas of spindle cell differentiation consistent with sarcomatous changes and no evidence of lymphovascular invasion. The patient was inclined toward bladder-preserving options. PC with a 2 cm margin and bilateral pelvic lymphadenectomy was performed. Final pathology revealed HG UC with sarcomatoid differentiation and invasion into the deep muscularis propria, consistent with pathologic T2bN0 disease, a negative margin, and no lymphovascular invasion. Subsequently, the patient pursued four doses of adjuvant doxorubicin though his treatment was complicated by hand-foot syndrome. At 21 months postoperatively, the patient developed a small (

Abstract Iron (Fe) deficiency in calcareous soils is a significant agricultural challenge, affecting crop productivity and nutritional quality. This study aimed to isolate, characterize, and evaluate Fe solubilizing rhizobacterial isolates from maize rhizosphere in calcareous soils as potential biofertilizers. Forty bacterial isolates coded as SG1, SG2, …, SG40 were isolated and screened for siderophore production, with ten showing significant Fe solubilizing capabilities. These isolates were further assessed for phosphate solubilization and exopolysaccharides production. The selected bacterial isolates were also screened under axenic conditions for their ability to improve maize growth. The isolates SG8, SG13, SG24, SG30 and SG33 significantly enhanced growth parameters of maize. Notably, SG30 showed highest increment in shoot length (58%), root length (54%), root fresh and dry biomass (67% and 76%), SPAD value (67%), relative water contents (69%), root surface area (61%), and Fe concentration in shoots (79%) as compared to control. The biochemical characterization of these strains showed that all these strains have capability to solubilize insoluble phosphorus, produce indole-3-acetic acid (IAA), and ammonia with catalase, urease and protease activity. Molecular identification through 16s rRNA gene sequencing confirmed high similarity (99.7–100%) of the selected isolates to various Bacillus species, including B. pyramidoids, B. firmicutes, and B. cereus. The study provides a strong base for developing eco-friendly, cost-effective biofertilizers to address Fe deficiency in crops and promote sustainable agriculture.

Abstract Background Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse manifestations, which resembles a clinical challenge to be managed. Lupus nephritis is a life-threatening condition as about 10% of patients develop chronic kidney disease. Aim of the work To assess the role of resistive index (RI) as a noninvasive parameter in detecting renal affection in SLE patients. Results A case–control study included 3 matched groups: 30 patients, 15 SLE with no renal affection, and 15 SLE lupus nephritis patients, who were selected, diagnosed according to ACR criteria 2019 for SLE, beside 15 age- and gender-matched healthy controls without any risk factors of chronic diseases. Written informed consent was obtained from all the three groups, and the study was approved by ethical committee. There was a statistically significant increase in both SLEDAI and renal SLEDAI scores, serum BUN, creatinine, urinary pus cells, RBCs, casts and proteins, 24-h urinary proteins, and protein/creatinine ratio beside a statistically significant increase in both right and left resistive indices in the group of lupus nephritis than the other group. There was highly statistically significant difference between SLE without nephritis and SLE with nephritis regarding renal echogenicity. There was statistically significant positive correlation between average RI and SLEDAI, rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, protein/creatinine ratio, and renal echogenicity. Relation between renal echogenicity and demographic, laboratory, and clinical data was highly statistically significant with rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, and P/C ratio. Our study highlighted that the best cutoff point of Rt average RI to detect SLE with nephritis group was found > 0.68 with sensitivity of 86.7% and specificity of 100.0%, while the best cutoff point of left average RI to detect SLE with nephritis group was found > 0.7 with sensitivity of 80.0% and specificity of 100.0%. Conclusion Renal RI is a noninvasive technique that can be used for detection renal disease activity in SLE patients, together with renal parenchymal echogenicity by grayscale US.

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.

Abstract The control of multi-robot formations is a crucial aspect in various applications, such as transport, surveillance and monitoring environments. Maintaining robots in a specific formation pose or performing a cooperative task is a significant challenge when a fault occurs among any of the robots. This work presents a Decentralized Fault-Tolerant Control (DFTC) scheme that addresses lidar sensor faults within a system of multiple differential wheeled mobile robots. The robots change the formation shape according to the number of available robots within the formation. A Graph theory is implemented to represent the multi-robot formation and communication. Each mobile robot is equipped with three sensors: a wheel encoder, an Inertial Measurement Unit (IMU), and a lidar sensor. Sensor fault detection and isolation (FDI) is implemented at two levels. The pose estimation obtained from the wheel encoder and IMU is fused using an extended Kalman filter (EKF), and this pose estimation is utilized at the local level of lidar sensor FDI. At the system level, the FDI of the lidar sensor involves computing a residual by comparing the pose estimation with other lidar sensors mounted on other mobile robots within the formation. The presented FTC scheme is simulated in Simulink multi-robot environments.

Abstract Swelling of shale in clastic reservoirs poses a significant challenge, causing instability in wellbores. Utilizing water-based drilling mud with shale inhibitors is preferable for environmental reasons over oil-based mud. Ionic liquids (ILs) have garnered interest as shale inhibitors due to their customizable properties and strong electrostatic features. However, widely used imidazolium-based ILs in drilling fluids are found to be toxic, non-biodegradable, and expensive. Deep Eutectic Solvents (DES), considered a more economical and less toxic alternative to ILs, still fall short in terms of environmental sustainability. The latest advancement in this field introduces Natural Deep Eutectic Solvents (NADES), renowned for their genuine eco-friendliness. This study explores NADES formulated with citric acid (as a Hydrogen Bond Acceptor) and glycerine (as a Hydrogen Bond Donor) as additives in drilling fluids. The NADES based drilling mud was prepared according to API 13B-1 standards and their efficacy was compared with KCl, imidazolium based ionic liquid, and Choline Chloride: Urea-DES based mud. A thorough physicochemical characterization of the in-house prepared NADES is detailed. The research evaluates rheological, filtration and shale inhibition properties of the mud, demonstrating that NADES enhanced the yield point to plastic viscosity ratio (YP/PV), reduced mudcake thickness by 26%, and decreased filtrate volume by 30.1% at a 3% concentration. Notably, NADES achieved an impressive 49.14% inhibition of swelling and improved shale recovery by 86.36%. These outcomes are attributed to NADES’ ability to modify surface activity, zeta potential, and clay layer spacing which are discussed to understand the underlying mechanism. This sustainable drilling fluid promises to reshape the drilling industry by offering a non-toxic, cost-effective, and highly efficient alternative to conventional shale inhibitors, paving the way for environmentally conscious drilling practices.

Abstract Background Preterm birth is a principal reason for perinatal morbidity and mortality increasing the incidence of severe neurodevelopmental deficits. There is growing proof that early postnatal amplitude-integrated electroencephalography (aEEG) has a prognostic value for neurodevelopmental consequence in preterm born neonates. Furthermore, MRI has been widely utilized to enhance comprehension of the brain substrate responsible for neurodevelopmental abnormalities. Thus, this study aims at evaluating the role of early postnatal aEEG and brain MRI in forecasting neurodevelopmental consequence in preterm infants at the age of 1 year. Methods A cohort study performed in the neonatal intensive care unit of a tertiary hospital during the duration from October 2021 to June 2023 including 60 preterm neonates

Kidney transplantation (KT) is a preferred treatment for end-stage renal disease (ESRD) because it offers better long-term survival and cost-effectiveness compared to dialysis. Significant global disparities persist in access to KT, particularly in low- and middle-income countries (LMICs). This study aims to assess the epidemiology and outcomes of KT in LMICs while examining the relationship between a country’s income level and its KT prevalence. A systematic review of the literature was conducted, with searches of PubMed, Scopus, and Web of Science from inception to 31 May 2024. Relevant articles reporting on the epidemiology and outcomes of KT or ESRD patients undergoing kidney replacement therapy (KRT) in LMICs were included. A total of 8054 articles were identified, with 972 articles selected for full-text screening after initial title and abstract review. Following full-text screening, 35 articles met the inclusion criteria. The data showed significant variation in KRT and KT prevalence across different geographical locations. Higher-income countries within LMICs tended to have higher KT prevalence rates. Barriers such as inadequate healthcare infrastructure, limited financial resources, and insufficient organ donation frameworks were identified as contributing factors to the low KT rates in these regions. The study highlights the disparities in KT access and prevalence in LMICs, underscoring the need for targeted interventions and international collaboration to address these gaps. Efforts to increase both living and deceased donor transplants, expand health system capacity, and incorporate KT in healthcare planning are needed to close this gap. Global partnerships spearheaded by organizations such as The Transplantation Society (TTS) and the International Society of Nephrology (ISN) are crucial for improving KT rates and outcomes in LMICs.

Abstract Background and purpose This comparative systematic review and meta-analysis investigated the incidence of ischemic stroke in intermediate-to-high-risk patients undergoing transcatheter aortic valve replacement versus surgical aortic valve replacement. Methods We conducted a systematic review and meta-analysis following the PRISMA guidelines, searching PubMed, Google Scholar, Embase, Web of Science, and Cochrane CENTRAL databases from their inception to December 2023. The evaluated outcomes were primarily incidence of stroke and transient ischemic attack (TIA), along with other secondary safety end-points at 30 days and 1 year post-procedure. Odds ratios (ORs) with 95% confidence intervals (CIs) were utilized for each study, employing a random-effects model for data synthesis irrespective of heterogeneity. Statistical heterogeneity was assessed using I2 statistics. All statistical analyses were conducted using Review Manager. Results We screened 8028 articles and included 8 studies consisting of 5 randomized controlled trials and 3 observational studies. The studies examining 30-day and 1-year stroke incidence found no significant difference between TAVR and SAVR patients (OR 0.83, 95% CI 0.59 to 1.17, p = 0.30, OR 0.92, 95% CI 0.64 to 1.33, p = 0.67, respectively). Both TAVR and SAVR also had a comparable risk of having a transient ischemic attack within 30 days (OR 0.93, 95% CI 0.24 to 3.63, p = 0.92, I2 52%) and 1 year (OR 1.15, 95% CI 0.72 to 1.82, p = 0.56, I2 0%) following the procedure. Regarding safety endpoints, TAVR had lower rates of all-cause mortality and acute kidney injury at 1 year post-procedure, but a higher incidence of major vascular complications at both 30 days and 1 year compared with SAVR. Conclusion The results suggest that TAVR and SAVR have comparable outcomes for both TIA and stroke incidence at 30 days and 1 year post-procedure, but display varying safety profiles in intermediate-to-high surgical risk patients.

Abstract Background Diabetic peripheral neuropathy (DPN) in children and adolescents with type 1 diabetes mellitus (T1DM) is a growing issue, with controversial data in the terms of prevalence and evaluation timelines. Currently, there are no clear standards for its early detection. Therefore, our aim was to assess the contribution of the Michigan neuropathy screening instrument (MNSI), lipid profile, serum neuron specific enolase (NSE), and serum heat shock protein 27 (HSP 27) to the prediction of DPN in children and adolescents with T1DM. Methods In this case-control study, fifty children diagnosed with T1DM for at least five years were enrolled and evaluated through complete neurological examination, MNSI, and nerve conduction study (NCS). Additionally, HbA1c, lipid profile, serum NSE, and serum HSP 27 levels were measured for patients and controls. Results The prevalence of DPN in our study was 24% by NCS, and electrophysiological changes showed a statistically significant lower conduction velocity for the posterior tibial and sural nerves, as well as a prolonged latency period for the common peroneal and sural nerves in neuropathic patients. In these patients, older age, earlier age of diabetes onset, longer disease duration, higher total cholesterol, triglycerides, low density lipoprotein cholesterol, HbA1c, serum NSE, and HSP27 levels were observed. The MNSI examination score ≥ 1.5 cutoff point had an area under the curve (AUC) of 0.955, with 75% sensitivity and 94.74% specificity, according to receiver operating characteristic curve analysis. However, the questionnaire’s cutoff point of ≥ 5 had an AUC of 0.720, 75% sensitivity, and 63% specificity, with improved overall instrument performance when combining both scores. Regarding blood biomarkers, serum NSE had greater sensitivity and specificity in discriminating neuropathic patients than HSP27 (92% and 74% versus 75% and 71%, respectively). Regression analysis revealed a substantial dependency for MNSI and serum NSE in predicting DPN in patients. Conclusions Despite limited research in pediatrics, MNSI and serum NSE are promising predictive tools for DPN in children and adolescents with T1DM, even when they are asymptomatic. Poor glycemic control and lipid profile changes may play a critical role in the development of DPN in these patients, despite conflicting results in various studies.

Abstract This manuscript is concerned with obtaining results for fixed points that arise from new contractive mappings on controlled metric spaces. These mappings are a mixture of Wardowski’s contractions with both multivalued, nonlinear mappings and auxiliary functions. It is also proved that the obtained fixed-point outcomes are well-posed. Additionally, a data-dependence result for fixed points is given. To aid with understanding, several illustrative examples are also provided. Numerous findings that are currently in the literature are specific instances of the findings that were made.

Abstract Objective The aim of this study was to assess management and determine outcomes of renal tumors with inferior vena cava (IVC) and intracardiac (IC) extension in a tertiary care center in Pakistan. Methods A retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, Pakistan. All patients from 1 to 18 years of age with renal tumors with intravascular extensions, surgically managed from January 1988 till June 2016, were included. Data was extracted by reviewing medical records, and the tumor details, treatment and outcomes were analyzed. Results A total of 18 patients out of the total 61 patients with renal tumors, presented with IVC and/or IC extension, with the majority involving the right kidney. Mean age was 5.9 (SD:4.9) and a female preponderance (56%) was seen. Wilms tumor (77%) was the most common tumor type, with the level of tumor extension into IVC predominantly being below the diaphragm (55.5%). Fourteen patients received preoperative chemotherapy, with tumor regression, seen in 10. Most patients underwent thrombectomy through the renal vein (56%). Regarding outcomes, frequency of mortality and morbidity was 1 and 2, respectively, with 7 patients having no recurrent 5 years post-surgery. Conclusion A greater incidence (29.5%) of IVC and or IC Tumor extension was found compared to existing literature, which could likely be due to a higher referral rate to the center. Moreover, this is a single-center study and so a multi-center study is crucial to form an assessment of surgical management in resource-limited settings. Our study is the first from Pakistan on this particular renal tumor presentation. Considering the varying case presentations and surgical techniques used, further studies are needed to standardize surgical management and optimize patient outcomes.

Abubakr A Hammad,1,2 Abdelgadir A Abdelgadir,2,3 Sitelbanat Yassin,4 Abdulrahim A Alzain,5 Elhadi M Ahmed2,3 1Department of Pharmacognosy, Faculty of Pharmacy, Omdurman Islamic University, Omdurman, Sudan; 2Department of Pharmacognosy, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan; 3Medicinal and Aromatic Plants Research Center, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan; 4Department of Pharmaceutics, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan; 5Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Gezira, Wad Madani, SudanCorrespondence: Abubakr A Hammad, Email abubakr.hammad7@gmail.comIntroduction: Antimicrobial resistance is a critical global issue, and medicinal plants, as a key source of therapeutic agents, offer potential solutions by offering new antibacterial agents. Acacia polyacantha tree, known as Al Kakamout in Sudan, is a significant source of Gum Arabic and has been traditionally used to treat bacterial diseases. This study aimed to investigate a hydro-ethanol extract of Kakamout stem bark through GC-MS analysis, evaluate its antibacterial activity against two standard bacterial strains, and conduct molecular docking and ADME studies.Methods: The stem bark of the plant was extracted by maceration using a hydro-ethanol solvent and analyzed via GC-MS. The antibacterial activity of the extract was evaluated against Staphylococcus aureus ATCC 25923 and Pseudomonas aeruginosa ATCC 27853 using the well diffusion method. The identified compounds were studied in silico to investigate their binding affinities with the target bacterial proteins. The ADMET properties were predicted for the top scoring compounds.Results: GC-MS analysis revealed the presence of 11 compounds, with the major ones being dopamine, N, N-dimethyl-, dimethyl ether (43.76%), 4-O-methylmannose (23.27%), sucrose (8.09%), 1,4,7-triazacyclononane, 1-benzoyl- (5.41%), and lupeol, trifluoroacetate (5.24%). The extract demonstrated significant effectiveness against both bacterial strains, even at a low concentration of 50 mg/mL. Molecular docking showed that compounds 1, 3, 4, and 6 had the best docking scores with enoyl-acyl carrier protein reductase (FabI) (PDB ID: 3GR6) from S. aureus (− 6.142, − 10.843, − 6.218 and − 7.14 Kcal/mol). Similarly, compounds 1– 6 exhibited favorable binding energies with LasR-TP4 complex (PDB ID: 3JPU) from P. aeruginosa (− 10.025, − 9.127, − 8.623, − 7.092, − 7.722, and − 6.019 Kcal/mol).Conclusion: This study provides the first GC-MS analysis of Acacia polyacantha stem bark, identifying potential antibacterial compounds. Molecular docking and ADMET predictions suggest several promising compounds for further investigation as antibacterial agents.Keywords: Acacia polyacantha, antibacterial, GC-MS, ADME, molecular docking

Summary: Aim: This study aimed to assess dental caries levels, as indicated by the Decay-Missing-Filled Teeth (DMFT) index, and identify risk factors and dietary behaviors associated with DMFT. Material and Methods: A cross-sectional study of 402 adults (aged 18–70) was conducted in 2022, involving individuals attending oral health outpatient centers selected through random sampling. Participants completed a validated nutrition questionnaire to assess dental caries risk factors, and DMFT index assessments were performed at dental centers. Descriptive statistics and multiple linear regression analysis were employed to determine the factors influencing the DMFT index. Results: The majority of the patients (40.3%) fell into the category of “High DMFT index” with a score of >13.9. The “very low DMFT index” group had the lowest percentage among the patients (11.90%). Higher education levels were associated with lower DMFT scores. Among oral health behaviors, frequent tooth brushing and mouthwash use showed the highest association with lower DMFT scores. Conversely, higher consumption of sugary evening snacks, sweetened drinks during evening meals, between-meal snacks, sweetened juice, energy drinks, and soft drinks correlated with higher DMFT scores. Conclusion: This study underscores a significant rise in dental caries risk among participants following the COVID-19 pandemic. The findings highlight the need for targeted interventions, education, and policies to address the increased risk of dental caries and promote oral health among adults.

Developing a model of fractional differential systems and studying the existence and stability of a solution is considebly one of the most important topics in the field of analysis. Therefore, this manuscript was dedicated to deriving a new type of fractional system that arises from the combination of three sequential fractional derivatives with fractional pantograph equations. Also, the fixed-point technique was used to evaluate the existence and uniqueness of solutions to the supposed hybrid model. Furthermore, stability results for the intended system in the sense of the Mittag-Leffler-Ulam have been investigated. Ultimately, an illustrative example has been highlighted in order to reinforce the theoretical results and suggest applications for this article.

Abstract Background The current study was aimed at constructing a questionnaire for evaluating the role of variant environmental factors on language acquisition in the three surrounding levels of communication that include familial level, preschool or nursery level, and surrounding social environmental level among children with delayed language development (DLD) due to environmental deprivation. The current study was a retrospective case–control study that was performed on 100 Egyptian Arabic-speaking children aged from 2 to 5 years. The study was carried out among preschool age children in the Mansoura governmental and private preschools (53 males and 47 females). They were divided into 2 groups: Group I (case group) consisted of 50 children with DLD due to environmental deprivation, and group II (control group) consisted of 50 typically developed children. Results The present study demonstrated several factors for prediction of DLD due to environmental deprivation. Univariable analysis revealed multiple factors as number of hours that parents present at home, time of the mother’s job, the relation between the child and the mother, the parents select certain time to talk and play with their child, joint attention of the mother, mother asking her child what he wants, long time using multimedia, divorce as a traumatic stress, bad social performance, and low socioeconomic status. Multivariate analysis revealed that longer time of the mother’s job and less time the mother select to talk and play with her child were the environmental deprivation factors which had the most precipitating effect on predicting DLD. Conclusions The constructed Arabic questionnaire was proved to be valid, reliable, and homogenous and is likely to produce consistent responses in evaluating the variant environmental factors on language development among children with DLD due to environmental deprivation in the three surrounding communications levels.

Because of its excellent mechanical qualities and weldability, titanium alloy is used in many different biomedical applications. Wire electrical discharge machining may be used to machine materials with such greater strengths and intricate forms. Using Taguchi-Data Envelopment Analysis-based Ranking (DEAR) approach and zinc-diffused coated brass wire electrode to improve Titanium alloy machining was the goal of this research project. The quality metrics that were taken into consideration were sur-face roughness, kerf width, and material removal rate. Among the selected factors, with an error of 2.7%, the optimal configuration of input factors was determined to be 130 µs (Ton), 40 µs (Toff), 50 V (SV), 6 A (IP), and 8 Kg (WT). Due to its relevance in the process of deionization, the Ton is the high-est influential parameter for creating quality measurements.

The energy storage features on natural convection in Casson fluids are investigated in this work using the finite element method. By measuring cylinders and wavy surfaces, we may examine flow patterns and the effectiveness of heat transmission systems. We study the variation of the mass and heat transfer rates as a function of the cylinder geometry. To approximately determine velocities and temperatures, the Ladyzhenskaya-Babuška—Brezzi (LBB)-stable element is employed. Following this discretization, the resulting discrete nonlinear system is linearized using Newton's method and subsequently solved using PARDISO. Fractional applications in Casson fluid analysis reveal insights into energy storage effects, employing finite element methods to explore flow patterns, heat transmission efficiency, and geometric variations while observing the impact of parameters such as Rayleigh, Hartmann, and Lewis numbers on fluid behavior and thermal properties. The preceding research has verified the accuracy of the numerical results. According to the results, concentration gradients and other modifications to liquids become more noticeable as the Rayleigh number grows. Convective heat transmission is reduced as the Ha is raised. When the Le grows, the deformation Nuavg and Shavgalso increase. Reducing the beta makes the isotherms more stable and less affected by the motion of the fluid.

Abstract Background: The War in Sudan between the Sudanese armed forces and rapid support forces has left undeniable impacts on the healthcare system which is already compromised by decades of neglect. Hospitals were bombed or occupied by conflict parties. Healthcare providers were killed or assaulted, citizens were forced to displace, and access to healthcare was impaired in many cities. Teledentistry is a modern and promising way to provide dental consultations. It is an easy, safe, and affordable solution for both patients and dental personnel in times like war. This short communication aims to urge the need to implement teledentistry to facilitate access to dental services during the current conflict in Sudan. Methods: This article discusses teledentistry, which according to the American Teledentistry Association (ADA) is the use of electronic information, imaging, and communication technologies, such as audio, video, and data communications for oral care delivery, diagnosis, consultation, treatment, and education. The healthcare system in Sudan is currently facing many challenges such as a lack of healthcare providers, economic crisis, inability to access dental health centers, and political instability. The application of teledentistry will facilitate access to oral healthcare and provide optimum solutions during the current conflict in Sudan. Conclusion: Implementation of teledentistry during military conflicts is a golden solution for both patients and dental care providers as it is a time-saving, cost-effective, safe, and quick way to access oral healthcare services.

Abstract Background Foot and ankle problems are frequently prevalent, especially among the elderly, ranging from 70 to 80%. In primary care, foot, and ankle complaints stand out as one of the most frequent reasons for orthopedic consultations. Patient-reported outcome measures are significant in the assessment burden of any condition on the effects of intervention as well as research. The Foot Function Index (FFI) is a region-specific tool that was identified as one of the most commonly used evaluation tools for foot complaints. This study aimed to translate, cross-cultural adapt, and test the psychometric properties of FFI in the Urdu language. Methodology The FFI was translated into Urdu language (FFI-U) following Beaton et al. translation guidelines. The data were collected from 230 Urdu-speaking participants with different foot and ankle pathologies. Data collection started after the written informed consent from the participants. All participants completed the FFI-U, Visual Analogue Scale (VAS), SF-36, and the Foot and Ankle Outcome Score (FAOS) at baseline while only 30 participants completed ULFI-U after one week for test-retest reliability. The psychometric properties involved reliability and validity testing. Reliability was assessed where internal consistency was measured using Cronbach’s alpha and test-retest reliability through the intra-class correlation coefficient (ICC). FFI-U was tested for face validity and construct validity (convergent and discriminant). Psychometric criteria were examined against priori hypotheses, and alpha level (p-value

Objective: To observe and compare benign and premalignant histological changes induced by Escherichia coli(E. coli) and Klebsiella pneumoniae (K. pneumoniae)in gall bladder mucosa having Pigment stones. Study Design: Cross sectional comparative study. Place and Duration of Study: This study was conducted at the department of Anatomy in collaboration with the department of Surgery, Al Nafees Medical College and Hospital (ANMC) from 14 November 2017 to 18 December 2019. Materials and Methods: Out of total cholecystectomy specimens collected during study duration, only thirty gallbladder specimens having Pigment stones and bile culture positive for E. coli or K. pneumoniae were obtained. They were divided into two groups comprising fifteen specimens each (n=15). Group 1 had bile culture positive for E. coli, while group 2 was positive for K. pneumoniae. All specimens were processed in automated tissue processor after tissue processing. Paraffin embedded sections were stained with Haematoxylin and Eosin stain. Slides were examined by consultant pathologist under light microscope. Premalignant histological lesions included hyperplasia, metaplasia and dysplasia. Chi square was applied to compare the statistical association of histological lesions between group 1 and 2. Results: Histopathological analysis revealed that hyperplasia, metaplasia and dysplasia in group 1 and group 2 were found to be statistically insignificant with p values of p= 0.715, p= 0.464 and p= 0.1 respectively. Conclusion: The histological patterns of benign and premalignant findings in both group 1 and group 2 showed minimal variation. Although this study did not observe any progression of premalignant lesions to carcinoma, the eradication of bacteria remains crucial to prevent the development of histopathological lesions in the gallbladder.

Abstract The Standard Model (SM) Higgs boson, the most recently discovered elementary particle, may still serve as a mediator between the SM sector and a new physics sector related to dark matter (DM). The Large Hadron Collider (LHC) has not yet fully constrained the physics associated with the Higgs boson, leaving room for such possibilities. Among the various potential mass scales of the dark sector, the sub-GeV mass range is particularly intriguing. This parameter space presents significant challenges for DM direct detection experiments that rely on nuclear recoils. Various innovative experimental methods are currently under investigation to explore this sub-GeV dark sector. The LHC, functioning as a Higgs factory, could explore this sector once the challenge of identifying DM signals is resolved. Due to the significantly lower mass of particles in the dark sector compared to the Higgs boson, these particles are expected to be highly boosted following the Higgs boson’s decay. However, detecting and identifying these highly boosted particles remains a considerable challenge at the LHC, despite their eventual decay into SM particles. We employ a well-motivated leptophobic Z B ′ $$ {Z}_B^{\prime } $$ model as a prototype to analyze the distinctive signatures from Higgs boson exotic decays into multi-photons. These signatures consist of collimated photons that fail to meet the photon isolation criteria, forming jet-like objects. Conventional analyses relying solely on the purity of energy deposits in the electromagnetic calorimeter would fail to detect these signatures, as they would be overwhelmed by background events from Quantum Chromodynamics. To effectively distinguish between such novel signal signatures and SM background events, we leverage advanced machine learning techniques, specifically the transformer encoder in a multimodal network structure. This neural network successfully separates dark sector signals from SM backgrounds, outperforming traditional event selection analyses.

Walid Al-Qerem,1 Anan Jarab,2– 4 Judith Eberhardt,5 Fawaz Alasmari,6 Alaa Hammad,1 Safa M Alkaee,1 Zein H Alsabaa7 1Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan; 2College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates; 3AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates; 4Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK; 6Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudia Arabia; 7Department of Pharmacy, Faculty of Pharmacy, Petra University, Amman, JordanCorrespondence: Walid Al-Qerem, Email waleed.qirim@zuj.edu.joBackground: Improving health literacy has been found to play a significant role in enhancing medication adherence in patients with type 2 diabetes.Purpose: The present study aims to evaluate health literacy and its association with medication adherence among diabetic patients in Jordan.Patients and Methods: This cross-sectional study included 400 diabetic patients, predominantly female (68.8%), with a median age of 58 years, attending the endocrinology outpatient clinic at Albasheer Hospital in Amman, Jordan, between August and December 2023. Patients were recruited using convenience sampling, including those aged 18 and older, literate, diagnosed with T2DM for at least one year, and on at least one medication for T2DM. Sample size was calculated based on the Events Per Variable (EPV) criterion to ensure sufficient power for logistic regression analysis. Data were collected using two validated instruments: the Jordanian Diabetic Health Literacy Questionnaire (JDHLQ), assessing health literacy, and the Medication Adherence Report Scale (MARS-5), measuring medication adherence. A binary logistic regression model was constructed to identify variables associated with adherence levels.Results: The study enrolled 400 diabetic patients (females =68.8%). While most of the participants (70.3%) reported high adherence levels, results revealed a window for health literacy improvement as the median for the JDHLQ score was 22 (ranging from 18 to 25) out of a maximum possible score of 32. More than half of the participants replied “never” to “I forget to take my medications”, followed by “I stop taking my medications for a while”.Conclusion: The binary regression model revealed that a higher JDHLQ score significantly increased the odds of a high adherence level. The significant association between improved health literacy and medication adherence necessitates the implementation of educational campaigns for enhancing literacy and hence medication adherence among patients with type 2 diabetes.Keywords: health literacy, adherence, Jordanian, diabetes mellitus, MARS-5

Objectives: Somali Ethiopian relations under civil rule were characterized by tension and demands to solve the border problems between the two countries‚ especially after the exploitation of Somali and the emergence of Ethiopia as a military force that wants to preserve its agreements with foreign countries to achieve victory. The study aims to explore the political relationship between the two countries in the Horn of Africa after both parties attempted to solve the border problem left by Western colonialism in the nineteenth century.Methodology: The current study's plan included an introduction and two sections: the first section dealt with the situation in Somalia after independence and its impact on the relationship with Ethiopia, and the second section discussed the failure of negotiations and entry into military confrontations Results: After analyzing the historical information, the results showed that the intensity of the differences between the two parties had increased, and the region witnessed a continuous escalation in military operations, which were sometimes carried out by the Front against the Ethiopian army.Recommendations: 1- Somalia gained independence in 1960 and demanded the reunification of its parts. 2- Somalia’s desire to reunite parts of its occupied territories through peaceful means through negotiations and mediation with the Organization of African Unity, which stipulated maintaining the borders between the two countries, and Somalia’s rejection of the borders set by the 1908 Treaty. 3- The failure of negotiations and peaceful methods to reach a solution between4- Somalia was unable to find a solution through peaceful means.It turned to military force to restore its lost parts after its agreement with the Soviet Union to train its army and provide it with military weapons 5- Ethiopia was ready to confront the attack of the Ethiopian army and was receiving military supplies from the United States of America.

Abstract Metalenses can integrate the functionalities of multiple optical components thanks to the unprecedented capability of optical metasurfaces in light control. With the rapid development of optical metasurfaces, metalenses continue to evolve. Polarization and color play a very important role in understanding optics and serve as valuable tools for gaining insights into our world. Benefiting from the design flexibility of metasurfaces, we propose and experimentally demonstrate a super metalens that can realize multifaceted control of focal points along any 3D curved trajectory. The wavelengths and polarization states of all focal points are engineered in a desirable manner. The super metalens can simultaneously realize customized 3D positioning, polarization states, and wavelengths of focal points, which are experimentally demonstrated with incident wavelengths ranging from 501 to 700 nm. We further showcase the application of the developed super metalenses in 3D optical distance measurement. The compact nature of metasurfaces and unique properties of the proposed super metalenses hold promise to dramatically miniaturize and simplify the optical architecture for applications in optical metrology, imaging, detection, and security.

Chaowen Zheng,1,2 Siyuan Li,1 Huanran Lyu,1 Cheng Chen,1 Johannes Mueller,1 Anne Dropmann,3 Seddik Hammad,3,4 Steven Dooley,3 Songqing He,2 Sebastian Mueller1,5 1Center for Alcohol Research, University of Heidelberg, Heidelberg, Germany; 2Division of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Molecular Hepatology Section, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; 4Department of Forensic Medicine and Veterinary Toxicology, Faculty of Veterinary Medicine, South Valley University, Quena, Egypt; 5Viscera AG Bauchmedizin, Bern, SwitzerlandCorrespondence: Sebastian Mueller, Center for Alcohol Research, University Hospital Heidelberg Im Neuenheimer Feld 350 69120 Heidelberg, Germany, Tel +49 6221 567121, Email sebastian.mueller@urz.uni-heidelberg.dePurpose: Both hepatic iron accumulation and hemolysis have been identified as independent prognostic factor in alcohol-related liver disease (ALD); however, the mechanisms still remain poorly understood. We here demonstrate that hepatocytes are able to directly ingest aged and ethanol-primed red blood cells (RBCs), a process termed efferocytosis.Methods: Efferocytosis of RBCs was directly studied in vitro and observed by live microscopy for real-time visualization. RBCs pretreated with either CuSO4 or ethanol following co-incubation with Huh7 cells and murine primary hepatocytes. Heme oxygenase-1 (HO-1) and other targets were measured by q-PCR.Results: As shown by live microscopy, oxidized RBCs, but not intact RBCs, are rapidly ingested by both Huh7 cells and murine primary hepatocytes within 10 minutes. In some cases, more than 10 RBCs were seen within hepatocytes, surrounding the nucleus. RBC efferocytosis also rapidly induces HO1, its upstream regulator Nuclear factor erythroid 2-related factor 2 (Nrf2) and ferritin, indicating efficient heme degradation. Preliminary data further suggest that hepatocyte efferocytosis of oxidized RBCs is, at least in part, mediated by scavenging receptors such as ASGPR1. Of note, pretreatment of RBCs with ethanol but also heme and bilirubin also initiated efferocytosis. In a cohort of heavy human drinkers, a significant correlation of hepatic ASGPR1 with the heme degradation pathway was observed.Conclusion: We here demonstrate that hepatocytes can directly ingest and degrade oxidized RBCs through efferocytosis, a process that can be also triggered by ethanol, heme and bilirubin. Our findings are highly suggestive for a novel mechanism of hepatic iron overload in ALD patients.Keywords: alcohol-related liver disease, ASGPR1, efferocytosis, heme oxygenase-1, red blood cells, scavenging receptors, iron metabolism

Inflammatory myofibroblastic tumor is a rare occurring benign tumor composed of myofibroblastic spindle cells. Lung inflammatory myofibroblastic tumor is difficult to diagnose and may mimic lung cancer or infectious etiology. Surgical intervention with final histopathologic confirmation remains the mainstay of diagnosis. We report an incidental finding of a pediatric case of lung inflammatory myofibroblastic tumor with clinical presentation, management, and outcomes at more than 2 years of follow-up at a tertiary care hospital in Saudi Arabia.

Improving photovoltaic systems to better withstand variations in temperature and irradiance, lessen steady-state ripples, maintain high efficiency, require less tracking time, and have minimal complexity is becoming increasingly important. The PV array's overall power output is negatively impacted by partial shading because the shaded cells produce less power and consume less power overall, which lowers efficiency and creates localized hotspots. Although bypass diodes may be used to counteract these impacts by rerouting current around cells that are shaded, they can result in several peaks, which complicates maximum power point tracking (MPPT). To manage several peaks and optimize power output, metaheuristic algorithms are compulsory. A recently developed game-based optimization methodology known as Golf Optimization Approach (GOA) is used in this study to find a way to MPPT in a grid-connected photovoltaic (PV) system under partial shading conditions (PSCs). Additionally, the same suggested approach is applied to get optimal parameters for the inverter with the goal of optimizing its voltage and current regulators. It aims to evaluate a plan to lower the output voltage and current's total harmonic distortion and DC voltage error. The proposed technique is contrasted to other tracking approaches such as the traditional Perturb & Observe (P&O), Gray Wolf Optimization (GWO), and Sea-gull Optimization Approach (SOA). Simulation is performed in MATLAB R2022b/SIMULINK environment. The obtained outcomes demonstrate the ability of the suggested technique to enhance the utility grid's power quality and improve the tracking system under various partial shading effects and temperature alterations. The proposed technique achieves a tracking efficiency of 99.8 %, surpassing the effectiveness of both of the previous methods which are at 97.2 % and 96.7 %.

The metaverse is a mixed blend of digital and tangible worlds, indicating the future directions of Internet sector development. This study aimed to assess the factors affecting students' intentions to use a metaverse platform. The unified theory of acceptance and use of technology was applied as the research model. Data were collected using a survey of 240 students. Two steps in SEM AMOS were conducted to analyze data. The results demonstrated that performance expectancy and social influence positively affect students' intentions to utilize metaverse technology. However, effort expectancy had an insignificant effect on students' intentions to utilize metaverse technology. These findings shed light on the acceptance and adoption of metaverse and identify influencing factors that could increase metaverse utilization. Moreover, this study offers a distinctive and fresh perspective on metaverse technology that can be used as a basis for future research in this field.

The current study aims at assessing the factors which could affect students' use of ChatGPT. The study proposed a theoretical model that included five factors. Data were collected from 136 students using a questionnaire. The data were analyzed using two steps: CFA for measuring the model and SEM for analyzing the relationships and testing hypothesis. The findings revealed that both performance expectancy and facilitating conditions significantly influenced students' intentions to use ChatGPT. Contrary to expectations, both social influence and effort expectancy had insignificant effects. By elucidating the core factors influencing the utilization of ChatGPT, this study can provide valuable insights for policymakers. Furthermore, this study contributes to the existing literature and lays the foundation for future research seeking a deeper understanding of the factors influencing the use of other AI technologies in teaching and learning.

Based on the related literature, both self-evaluation (SE) and reflective thinking (RT) play an important role in English language learning among EFL learners. Therefore, in this study, the effects of SE and RT on growth mindfulness, resilience, and academic well-being of Saudi Arabian EFL students were compared. Ninety-six intermediate EFL students were selected based on the convenience sampling method in order to accomplish this goal, and they were divided into three groups: two experimental groups (EGs) and one control group (CG). Three questionnaires were then distributed to assess the participants' academic well-being, progress in mindfulness, and resilience prior to the instruction. After that, the CG was instructed conventionally, while one EG was treated using RT and the other EG was treated utilizing SE activities. The aforementioned surveys were re-administered as study post-tests following a 21-session treatment, and the results were analyzed using One-way ANOVA and Tukey testing. The study's findings showed that the two EGs conducted better than the CG on three post-tests. Additionally, the outcomes supported the equivalent benefits of RT and SE for the development of Saudi Arabian EFL students' academic wellbeing, resilience, and mindfulness. The implications were eventually prepared for scholars, English instructors, students, and other stakeholders.

Purpose: Research investigating the impact of school leadership on teachers' emotions and practices has mostly focused on the leadership behaviors of school principals, thus ignoring the potential leadership qualities of other school members, especially teachers. The current study aimed to bridge this gap by providing further insight into the link between teacher leadership and teacher outcomes in Egyptian schools. Specifically, the study examined the mediating role of collective teacher efficacy in the relationship between teacher leadership and teacher commitment. Design/methodology/approach: The study employed structural equation modeling and bootstrapping to analyze survey data collected from 497 teachers in primary and middle schools in Damietta city, Egypt. Findings: The results supported our proposition that teachers' leadership practices have more indirect than direct effects on teacher commitment through collective teacher efficacy. That is, teacher leadership practices positively affect teachers' efficacy beliefs, which, in turn, increase their sense of commitment to school. Originality/value: The study adds a new aspect to the literature by investigating the potential role of teacher leadership in promoting positive teacher attitudes that can have a positive impact on student learning. This is significant given the growing emphasis that educational systems place on enhancing school effectiveness. Specifically, understanding the factors that contribute to teacher commitment can inform strategies for retaining effective teachers and improving the overall quality of the teaching workforce. Additionally, since most of the empirical research on teacher leadership has been produced in Western contexts, it is important to enrich the field with studies conducted in other societies, especially in the Arab region.

Lagging student performance in the Sultanate of Oman has, in recent years, led the Ministry of Education to target teachers' professional learning as a key strategic pillar in its efforts to reform the education system. While international evidence finds principal leadership can make a meaningful difference in teacher engagement in professional learning, this has yet to be studied in Arab societies. The current study collected data from 887 teachers in 78 Omani middle schools with the aim of understanding if and how their principals' learning-centered leadership influences teacher agency, teacher trust and teacher professional learning. Factor analysis, structural equation modelling, and bootstrapping were used to explore both partial and full mediation models of these relationships. Results validated a partial mediation model in which learning-centered leadership had moderate direct and indirect effects on teacher professional learning. The validated model also highlights the important role that principals can play in creating a climate of trust where teachers believe that investing their time and effort in professional learning will be beneficial for themselves and their schools. The results from Oman are compared with findings from other Asian societies and implications discussed.