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Diabetes mellitus is a group of metabolic diseases with high prevalence, mortality and morbidity characterized by prolonged high blood glucose concentrations resulting from defects in insulin secretion, insulin action, or both. This study aimed to assess the role of vitamin D supplementation in glycemic control in uncontrolled type 1 diabetes with vitamin D deficiency. It is a prospective study between 1st of October 2022 to 31st of July 2023, where ninety patients (male: female ratio 1:1) with uncontrolled type 1 diabetes and vitamin D deficiency attended The Specialized Center for Endocrinology and Diabetes in Baghdad Government-Iraq, their ages between 5-18 years were followed for 10months to assess their Hemoglobin A1c (Hba1c) and serum calcium after correction of vitamin D level with therapeutic doses of vitamin D. The findings of the study had shown that 41.1% of the patients had vitamin D insufficiency and 58.9% with deficiency regardless sex and age. All the obese children and 66.4% of the overweight had vitamin D deficiency with significant correlation with BMI (P50ng/ml (P

Abstract Nomophobia (NO MObile PHone Phobia) is a psychological condition in which people are anxious of being cut off from their mobile phones and been associated with adverse consequences to physical and psychosocial health. The objective of this study was to measure the impact of nomophobia on musculoskeletal problems in the upper extremity among adults. The Nomophobia scale (NMP-Q) was used to measure addiction to smartphone use among 5,087 Middle Eastern adults. A snowball sampling approach was used to recruit the participants between March and June 2021. Results showed that nomophobia was evident in 1,119 participants (22%) with a mean NMP-Q score of 114.1 (SD 11.1). A total of 3,396 upper extremity symptoms were reported among our participants. The binomial logistic regression showed that NMP-Q score is a significant predictor of symptoms to the thumb only (β = 0.01, p = .026). This study has provided evidence of the negative physical consequences of addiction to smartphone use. Participants with thumb-related symptoms were more prone to sustain other concurrent upper extremity symptoms, probably due to their maladaptive habits of using the phone. Thus, it is important to increase awareness about the risks associated with the use of smartphones. Implications for occupational therapy are presented. [ABSTRACT FROM AUTHOR]

Abstract Background Tuberculosis remains a major challenge in India, with an estimated 2.69 million cases each year. Although men are more affected than women, gender differences and related factors affect awareness of tuberculosis and thus impact tuberculosis diagnosis and access to treatment. Understanding the gender-specific needs and complexities when diagnosing and treating tuberculosis is essential to manage cases in India. Methods We undertook a comparative study using data from three National Family and Health Surveys (NFHS), specifically NFHS-3, NFHS-4 and NFHS-5. We investigated the prevalence and gender disparity in awareness about tuberculosis, and associated factors, using regression analysis. Results Most men and women surveyed are between the ages of 15 and 19. Across the surveys, the proportion of men and women who are unaware of spreading of tuberculosis decreases from 44.9% during NFHS 3 to 29.6% during NFHS 5. However, the prevalence ratio of men to women with no knowledge about modes of transmission of Tuberculosis increases from 0.92 during NFHS 3 to 0.98 during NFHS 5. Higher odds with younger age (NFHS 5, aOR: 1.07 (1.01–1.13)) and rural residency (NFHS 5, aOR: 1.12 (1.06–1.18)), and lower odds with unmarried marital status (NFHS 5, aOR: 0.92 (0.86–0.98)) are noteworthy associations. Women and men have differences in knowledge. Conclusions Gender disparity associated with awareness about tuberculosis in India is observed across all three nationwide surveys. Being aged fifteen to nineteen years and residing in rural area are risk factors. Being unmarried is a protective factor for women, but not for men.

Abstract Background Obsessive–compulsive disorder (OCD) is a debilitating disorder that has multifactorial etiology including genetic, neurobiological, cognitive, and environmental influences. Genetic studies have focused on the genes of the serotonin system. This study aimed to look for the possible relation between the polymorphism in the promotor region of the serotonin transporter gene and obsessive–compulsive disorder in the Egyptian population. Results This study included 94 OCD patients and 116 healthy control individuals. Blood samples were collected from all participants for DNA extraction and genotyping. The assessment of patients was done by application of the structured clinical interview according to DSM-V, the dimensional Yale-Brown Obsessive–Compulsive Scale. There was an association between serotonin transporter gene polymorphism and OCD development. The carriage of the short allele was a risk factor for having OCD. Conclusion Obsessive–compulsive disorder is associated with serotonin transporter gene polymorphism. This will contribute to considering the genetic information of patients for the prediction of best drug response and tolerability by personalizing the choice of treatment.

Abstract Introduction Ureterovascular fistula (UVF) is a rare but potentially life-threatening condition. Since its primary description by Moschkowitz in 1908, many case reports, studies and reviews have been written about this condition with the suggestive symptoms and risk factors repeatedly discussed. This study will be focusing on the different locations of 532 out of 605 fistulae published from 1908 up to 2022 besides eight new patients of our own. Material and methods A systematic review of the literature started using PubMed database searching for “ureteroarterial fistula”, “arteriovascular fistula” and “uretero vascular fistula” was performed yielding 122, 62 and 188 results respectively. Those studies and the cited literature in each study were examined to include studies, which did not appear in the primary search. A total of 605 patients in 315 publications were gathered. Only studies mentioning new patients, a clear indication of the location of the UVF, the presence/absence of urinary diversion (UD) as well as the type of UD if present were included. Ten duplicates as well as studies lacking information regarding the UVF and/or the UD (seven publications with 63 patients) were excluded, with 298 publications including 532 external patients remaining. Eight internal cases were included with a total of 540 cases. Results From the 540 included cases, 384 patients (71.1%) had no UD compared to 156 patients (28.9%) with UD. Due to the anatomical ureteral course, the common iliac artery (CIA) was the most common vascular component of UVF, irrespective of the presence or absence of UD. Any dispute to whether the crossing point is the common or the external iliac artery (EIA) was settled for the CIA. Further common vascular components besides CIA include the aorta, EIA, internal iliac artery (IIA) including its branches and vascular bypasses including the anastomosis sites. Other unusual arterial localizations were stated under the “others” category. Conclusion Identifying the location of the bleeding artery in UVF is critical and represents the most important step for successful management. We present the largest summary of described locations up to date including our own. Graphical Abstract

Despite the importance of financial development-international trade nexus and its implication for growth, studies have yet to look at the impact of new financial development indicators developed by the International Monetary Fund on international trade performance in Nigeria. This is one of the few attempts made to examine the elasticity of trade to financial development, given the inconclusive findings that permeate the literature. Therefore, this paper investigates the effect of financial development on aggregate trade performance in Nigeria using annual data from 1980 to 2021. The empirical framework is based on the ARDL approach to cointegration and error correction model. The findings revealed that (i) The ARDL bound test revealed the existence of a long-run equilibrium association between the variables; (ii) We find that a unit improvement in financial development induces a 1.1%-1.2% increase in trade performance in the short-run short term and a 9.7% in the long-run; (iii) The results show that a 1% increase in the exchange rate (depreciation) leads to a 0.01% improvement in trade performance in the short-term. The findings have important policy implications. The paper concludes that financial development contributes to trade performance.

Abstract The survey of the available literature shows that a lot of important invariant point problems of Banach and Heilpern types have been examined in both metric and quasimetric spaces. However, a handful of the existing results employed the recent approaches of interpolative contractions. Therefore, based on the new idea of interpolation techniques in fixed point theory, this article studies new notions of L-fuzzy contractions and investigates conditions for the existence of L-fuzzy fixed points for such mappings. On the fact that fixed points of point-to-point mappings satisfying interpolative-type contraction are not always unique, whence making the concepts more fitted for invariant point results of crisp set-valued maps, new multi-valued analogues of the key findings put forward in this work are derived. Comparative illustrations, which indicate the preeminence of the results presented herein, are constructed. From application viewpoint, one of the theorems so obtained is employed to introduce new solvability conditions of Fredholm-type integral inclusions.

Abstract Introduction The use of focal therapies for prostate cancer (PCa) has soared, as it controls disease and is associated with minimal side effects. Bibliometric analysis examines the global research landscape on any topic to identify gaps in the research and areas for improvement and prioritize future research efforts. This study aims to examine the research outputs and trends and collaboration landscape in the field of focal therapy for PCa on a global scale. Methods We searched Medline, PubMed and Scopus for peer‐reviewed publications on our research topic using controlled keywords. Search results were limited to the period between 1980 and 2022, screened for duplicates and then included in our study based on prespecified eligibility criteria. The Bibliometrix Package was used for comprehensive science mapping analysis of co‐authorship, co‐citation and co‐occurrence analysis of countries, institutions, authors, references and keywords in this field. Results This analysis included 2578 research articles. The annual scientific production increased from one article in 1982 to 143 in 2022 (13.21%). The average citation per year was incrementally increasing, and these documents were cited around 32.52 times. The documents included in this analysis were published in 633 sources. The international collaboration index was 22.7. In total, 6280 author keywords were identified. The most used keywords were ‘prostate cancer’, ‘focal therapy’, ‘prostate’ and ‘photodynamic therapy’. Conclusion This bibliometric analysis has provided a comprehensive review of focal therapy in PCa research, highlighting both the significant growth in the field and the existing gaps that require further exploration. The study points to the need for more diverse international collaboration and exploration of various treatment modalities within the context of focal therapy.

This paper examines the influence of magnetized Casson nanofluid flow and heat transport phenomena towards a boundary layer flow over a nonlinear stretchable surface. The characteristics of the nanofluid are illustrated by considering Brownian motion and thermophoresis effects due to which the fluid is electrically conducting. The nonlinear Casson model is very useful to describe the fluid behavior and the flow curves of suspensions of pigments in lithographic varnishes intended for the preparation of printing inks. A uniform magnetic field, along with suction and chemical reaction are taken into account. Similarity transformations are employed to convert the PDEs into ODEs, and then solved numerically (Bvp4c) using MATLAB. This scheme consists of a finite difference scheme that implements three-stage Lobatto IIIa collocation formula which provides continuous solution upto fifth-order accuracy. Excellent correctness of the present results has been acquired which is compared with the previous one. The outcomes of various parameters on heat transfer rate, skin friction coefficient, nanoparticle concentration, Sherwood number, velocity and temperature profiles are demonstrated via tabular forms and pictorially. The most important fact is that an increase in the thermophoresis parameter, radiation and magnetic parameter boosts up the fluid temperature, resulting in an improvement in the thermal boundary layer. [ABSTRACT FROM AUTHOR]

Lipids are implicated in the development of coronary atherosclerosis. Achieving a significant reduction in lipid levels remains a crucial aspect of secondary prevention following an acute coronary syndrome event. Novel lipid-lowering therapies now provide clinicians with a variety of therapeutic strategies to choose from and tailor to individual patient needs. This review focuses on evidence supporting the importance of early and intensive lipid-lowering therapy use in patients presenting with acute coronary syndrome, specifically addressing data relating to atorvastatin and ezetimibe use in this high-risk cohort of patients.

BackgroundCognition disorders not only lead to adverse health consequences but also contribute to a range of socioeconomic challenges and diminished capacity for performing routine daily activities. In the digital era, understanding the impact of digital exclusion on cognitive function is crucial, especially in developing countries. ObjectiveThis study aimed to evaluate the association between digital exclusion and cognitive function among elderly populations in developing countries. MethodsUsing data from CHARLS (China Health and Retirement Longitudinal Study) from 2011 to 2020 and MHAS (Mexican Health & Aging Study) from 2012 to 2021, we defined digital exclusion as self-reported absence from the internet. Cognitive function was assessed through 5 tests: orientation, immediate verbal recall, delayed verbal recall, serial 7s, and figure recall. Cognitive function was assessed in 2 categories: worse cognition (a categorical variable that classifies cognition as either better or worse compared to the entire cohort population) and cognitive scores (a continuous variable representing raw cognitive scores across multiple follow-up waves). Logistic regression analyses and generalized estimating equation (GEE) analyses were used to examine the relationship between cognitive function and digital exclusion, adjusting for potential confounders, including demographics, lifestyle factors, history of chronic diseases, basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and basic cognitive abilities. ResultsAfter excluding participants with probable cognitive impairment at baseline and those who did not have a complete cognitive assessment in any given year (ie, all tests in the cognitive assessment must be completed in any follow-up wave), a total of 24,065 participants in CHARLS (n=11,505, 47.81%) and MHAS (n=12,560, 52.19%) were included. Of these, 96.78% (n=11,135) participants in CHARLS and 70.02% (n=8795) in MHAS experienced digital exclusion. Adjusted logistic regression analyses revealed that individuals with digital exclusion were more likely to exhibit worse cognitive performance in both CHARLS (odds ratio [OR] 2.04, 95% CI 1.42-2.99; P.05). The fully adjusted mean differences in global cognitive scores between the 2 groups were 0.98 (95% CI 0.70-1.28; P

Background: Colon cancer is the third most common type of cancer. High lymphovascular levels are linked to a number of cancers, including colon cancer, while lymph vascular invasion levels as a predictor of outcome are not well understood. Objective: Determine the influence of lymphovascular invasion on the recurrence of colon cancer. Patients and Methods: it was collected 126 colon cancer patients who had surgery and additional chemotherapy. The patients attended in the Baquba teaching hospital oncology centre and the Al Jawad oncology centre of Alkadhemiya hospital. Results: it was shown in this study that the high percentage ages of colon cancer patients was between 55-60 years, and there were more in women (57 %) than in men (43 %). The most common stage of the tumours was stage 3 (42.9 %), and in grade 2 (76.2 %). In terms of return, in this study, 71.4 % of people who had lymphovascular invasion positive and had a return of cancer in a percentage 73.3% of colon cancer patients. Conclusion: LVI plays an essential role for increasing recurrence of colon cancer, and there were a strong link between them.

This study aims to fill a gap in understanding how customising robots can affect how humans interact with them, specifically regarding human decision-making and robot perception. The study focused on the robot’s ability to persuade participants to follow its suggestions within the Balloon Analogue Risk Task (BART), where participants were challenged to balance the risk of bursting a virtual balloon against the potential reward of inflating it further. A between-subjects design was used, involving 62 participants divided evenly between customised or non-customised robot conditions. Compliance, risk-taking, reaction time, and perceptions of the robot’s likability, intelligence, trustworthiness, and ownership were measured using quantitative and qualitative methods. The results showed that there were no significant differences in compliance or risk-taking behaviours between customised and non-customised robots. However, participants in the customised condition reported a significant increase in perceived ownership. Additionally, reaction times were longer in the customised condition, particularly for the “collect” suggestion. These results indicate that although customisation may not directly affect compliance or risk-taking, it enhances cognitive engagement and personal connection with robots. Regardless of customisation, the presence of a robot significantly influenced risk-taking behaviours, supporting theories of over-trust in robots and the automation bias. These findings highlight the importance of carefully considering ethical design and effective communication strategies when developing socially assistive robots to manage user trust and expectations, particularly in applications where behavioural influence is involved.

Abstract Backgrounds and Aims Daily lifestyle plays a vital role in modifying the risk for cardiovascular diseases (CVDs). Our daily life isn't inseparable from nutrition intake. As such, tea and coffee are often regarded as the most consumed beverages worldwide. There have been a lot of debates on the adverse effects and benefits of consuming these popular beverages. This comprehensive review explores the different types of tea and coffee and their mechanism of action. It delves deeper into their roles in reducing CVD risk, aiding CVD recovery, lowering CVD mortality, and their varying effects across populations and regions. Methods An extensive literature search was conducted on PubMed. Relevant articles were identified through cross‐referencing and manual searches. Excluded from the study were commentaries, case reports, clinical vignettes, and non‐English articles. Results Tea and coffee contain varying levels of caffeine and other bioactive compounds with cardioprotective effects against oxidative stress, inflammation, and more. Genetic factors further modulate their effects. Tea flavonoids benefit cholesterol, blood pressure, and endothelial function, while coffee constituents impact oxidative stress, metabolism, insulin sensitivity, and gut flora. Moderate consumption of both beverages may offer cardiovascular benefits, but outcomes vary depending on populations and conditions. Tea and coffee consumption may influence CVD recovery by reducing mortality and improving survival, however, it must be noted that it has the potential to be harmful to some individuals. Conclusion Evidence suggests that moderate consumption of these beverages may be linked to reduced cardiovascular mortality, although individual characteristics and pre‐existing conditions can influence outcomes. Excessive caffeine consumption, found in both beverages, may pose risks such as arrhythmias, hypertension, and cardiovascular mortality in CVD patients, with a dose‐dependent nature. Future research should delve into mechanisms, genetic factors, and diverse cultural impacts of its use. Health care providers should consider individual characteristics when advising on tea and coffee consumption in the context of cardiovascular health.

IntroductionThe impact of different degrees of hypothermia in patients undergoing type A aortic dissection (TAAD) repair remains controversial. The purpose of this study was to compare the clinical outcomes of patients who received deep hypothermic circulatory arrest (DHCA) (

IntroductionMachine learning (ML) algorithms and statistical modeling offer a potential solution to offset the challenge of diagnosing early Alzheimer's disease (AD) by leveraging multiple data sources and combining information on neuropsychological, genetic, and biomarker indicators. Among others, statistical models are a promising tool to enhance the clinical detection of early AD. In the present study, early AD was diagnosed by taking into account characteristics related to whether or not a patient was taking specific drugs and a significant protein as a predictor of Amyloid-Beta (Aβ), tau, and ptau [AT(N)] levels among participants.MethodsIn this study, the optimization of predictive models for the diagnosis of AD pathologies was carried out using a set of baseline features. The model performance was improved by incorporating additional variables associated with patient drugs and protein biomarkers into the model. The diagnostic group consisted of five categories (cognitively normal, significant subjective memory concern, early mildly cognitively impaired, late mildly cognitively impaired, and AD), resulting in a multinomial classification challenge. In particular, we examined the relationship between AD diagnosis and the use of various drugs (calcium and vitamin D supplements, blood-thinning drugs, cholesterol-lowering drugs, and cognitive drugs). We propose a hybrid-clinical model that runs multiple ML models in parallel and then takes the majority's votes, enhancing the accuracy. We also assessed the significance of three cerebrospinal fluid biomarkers, Aβ, tau, and ptau in the diagnosis of AD. We proposed that a hybrid-clinical model be used to simulate the MRI-based data, with five diagnostic groups of individuals, with further refinement that includes preclinical characteristics of the disorder. The proposed design builds a Meta-Model for four different sets of criteria. The set criteria are as follows: to diagnose from baseline features, baseline and drug features, baseline and protein features, and baseline, drug and protein features.ResultsWe were able to attain a maximum accuracy of 97.60% for baseline and protein data. We observed that the constructed model functioned effectively when all five drugs were included and when any single drug was used to diagnose the response variable. Interestingly, the constructed Meta-Model worked well when all three protein biomarkers were included, as well as when a single protein biomarker was utilized to diagnose the response variable.DiscussionIt is noteworthy that we aimed to construct a pipeline design that incorporates comprehensive methodologies to detect Alzheimer's over wide-ranging input values and variables in the current study. Thus, the model that we developed could be used by clinicians and medical experts to advance Alzheimer's diagnosis and as a starting point for future research into AD and other neurodegenerative syndromes.

OBJECTIVES:. Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN:. Retrospective analysis of prospectively collected database. SETTING:. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0–11.9 g/dL for women, 10.0–13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS:. Patients older than 18 years with acute COVID-19 infection in the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05–1.67). CONCLUSIONS:. In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.