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Abstract Background Educational games make the learning process more enjoyable, fun, and create a competitive classroom environment that can positively affect learning. The purpose of this study was to evaluate pharmacy students’ perceptions of crossword puzzles (CWPs) as a learning tool in the pharmacotherapy cardiovascular module focusing on anticoagulants’ therapeutics and assessing if students’ preference of learning style influenced their perception. Methods Clues for the puzzle were developed, validated, and piloted by course faculty. A free internet puzzle generator was used to create puzzles with 10 to 20 clues. Students were given 30 min to solve the puzzle following six hours of didactic lectures about the topic. An 8-item survey instrument and Pharmacists’ Inventory of Learning Styles (PILS) questionnaire were administered to examine students’ perceptions of the game and their learning style preference, respectively. Results Two hundred sixty-seven students participated in the activity from both undergraduate programs (BPharm and PharmD) over three consecutive course offerings. Most students expressed favorable perceptions of the puzzle. Female and BPharm students had significantly more favorable perceptions than male and PharmD students on several perception items. The dominant preferred learning style (PLS) was converger (35.6%), followed by assimilator (25.3%), while 15.1% had mixed learning styles. The study did not find a significant association between PLS and students’ perceptions toward the CWP. Conclusions The CWP game presented an innovative, creative, and easy active learning tool to enhance information recall, retention, and class engagement while accommodating all learning style preferences.

Despite a significant reduction in the burden of malaria in children under five years-old, the efficient implementation of seasonal malaria chemoprevention (SMC) at large scale remains a major concern in areas with long malaria transmission. Low coverage rate in the unattainable areas during the rainy season, a shift in the risk of malaria to older children and the rebound in malaria incidence after stopping drug administration are mainly reported in these areas. These gaps represent a major challenge in the efficient implementation of SMC measures. An open randomized study was conducted to assess the effect of a fifth additional round to current regime of SMC in older children living in Dangassa, a rural malaria endemic area. Poisson regression Model was used to estimate the reduction in malaria incidence in the intervention group compared to the control group including age groups (5–9 and 10–14 years) and the use of long-lasting insecticidal nets (LLINs; Yes or No) with a threshold at 5%. Overall, a downward trend in participation rate was observed from August (94.3%) to November (87.2%). In November (round 4), the risk of malaria incidence was similar in both groups (IRR = 0.66, 95%CI [0.35–1.22]). In December (round 5), a decrease of 51% in malaria incidence was observed in intervention group compared to control group adjusted for age groups and the use of LLINs (IRR = 0.49, 95%CI [0.26–0.94]), of which 17% of reduction is attributable to the 5th round in the intervention group. An additional fifth round of SMC resulted in a significant reduction of malaria incidence in the intervention group. The number of SMC rounds could be adapted to the local condition of malaria transmission.

Background Several changes have been made to the assessment component of Saudi residency training programs. Among those is the implementation of three examinations over the course of the year. Aim We aimed to explore the emergency residents’ perspective on the change in the number of examinations, and the impact of such changes in terms of time management, knowledge gain, and social life. Methods This cross-sectional study was carried out from September to October 2022, using an electronic survey targeting emergency board trainees. Results One hundred and nine emergency residents enrolled, of whom 64.2% were male. The majority, 45%, were from the central province. Junior-level residents (R1) represented 26.6% of the sample, while R2 (second year) comprised 18.3%, R3 (third year) comprised 38.5%, and 16.5% were senior (R4) level. More than half of the participants, 56 % (n=61), did not support the change from one to three examinations and believed that it had a negative influence on knowledge gain and clinical skills. The influence of the change on time management stands out as a negative impact, in addition to its impact on social life and annual leave arrangements. Conclusions The support for three examinations throughout the year was low; a contributing factor to this may be the sudden changes effected by those tests on training and time management. A re-evaluation of testing culture and involving residents in decision-making might generate acceptance.

Understanding how different Black and other racially minoritised communities thrive is an emerging priority area in mental health promotion. Literature demonstrates health benefits of social capital (social resources embedded within social networks). However, its effects are not always positive, particularly for certain subpopulations who are already disadvantaged.The CONtributions of social NEtworks to Community Thriving (CONNECT) study will use Participatory Action Research (PAR) to investigate social capital as a resource that benefits (or hinders) racially minoritised communities and their mental health. The CONNECT study was designed within a partnership with community organisations and responds to local policy in two South-East London Boroughs, thereby providing potential channels for the action component of PAR. Taking an anti-racism lens, we acknowledge the underpinning role of racism in creating health inequities. We apply an intersectional framework to be considerate of overlapping forms of oppression such as age, gender, socioeconomic status, and sexual orientation as an essential part of developing effective strategies to tackle health inequities. Key components of this mixed methods PAR study include (1) involving racialised minority community members as peer researchers in the team (2) collecting and analysing primary qualitative data via interviews, photovoice, and community mapping workshops, (3) developing relevant research questions guided by peer researchers and collaborating organisations and analysing secondary quantitative data accordingly, (4) integrating qualitative and quantitative phases, and (5) working closely with community and policy partners to act on our findings and use our research for social change.The PAR approach will allow us to engage community (voluntary sector and government) and academic partners in decision making and help address imbalances in power and resource allocation. Knowledge generated through this collaborative approach will contribute to existing community initiatives, policies, and council strategies. This will ensure the views and experiences of racially minoritised communities drive the changes we are collaboratively committed to achieving.

IntroductionChronic obstructive pulmonary disease (COPD) is a common, irreversible but preventable disease characterized by persistent respiratory symptoms. The mortality rate of COPD is predicted to reach 5.4 million by the year 2060. Despite its heavy burden on healthcare expenditure worldwide, only 15% of cases are medically identified. The potential benefits of facemask-wearing for COPD patients remain a topic of debate.MethodsWe will conduct a systematic review of all randomized trials and non-randomized controlled trials to evaluate the impact of facemasks on COPD patients. Our review will be based on literature obtained through a comprehensive search strategy across multiple electronic databases, including the Cochrane Library, Embase, PubMed, Web of Science, the Chinese Biomedical Database (SinoMed), and China National Knowledge Infrastructure (CNKI), with no restrictions on language or date of publication. Two independent researchers will extract and assess all relevant data using pre-designed data extraction forms. The included studies will be assessed using the Cochrane RoB2 tool and the suggested risk of bias criteria proposed by the Effective Practice and Organization of Care reviews group of the Cochrane collaboration. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We will use Review Manager 5.4 software for statistical analysis.DiscussionIn the context of COVID-19, it is important for COPD patients to wear facemasks. This study aims to conduct a comprehensive and systematic assessment of the impact of facemasks on the physiology and activity of COPD patients.Trial registrationPROSPERO registration number CRD42022326265.

Increasing evidence highlights that excessive iron accumulation in the brain plays a vital role in neuronal senescence and is implicated in the pathogenesis of age-related neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD). Therefore, the chemical compounds that eliminate an iron overload may provide better protection against oxidative stress conditions that cause the accumulation of senescent cells during brain aging. Ebselen has been identified as a strongly useful compound in the research on redox biology mechanisms. We hypothesized that ebselen could alleviate an iron overload-induced oxidative stress and consequently reverses the senescence-like phenotypes in the neuronal cells. In the present study, SH-SY5Y cells were treated with ferric ammonium citrate (FAC) before ebselen, and the evaluation of the cellular iron homeostasis, the indicators of oxidative stress, and the onset of senescence phenotypes and mechanisms were carried out accordingly. Our findings showed that ebselen ameliorated the FAC-mediated iron overload by decreasing the expression of divalent metal transporter 1 (DMT1) and ferritin light chain (FT-L) proteins. In contrast, it increased the expression of ferroportin 1 (FPN1) protein and its correlation led to a decrease in the expression of the cytosolic labile iron pool (LIP). Furthermore, ebselen significantly reduced reactive oxygen species (ROS) and rescued the mitochondrial membrane potential (ΔΨm). Notably, ebselen restored the biomarkers of cellular senescence by reducing the number of senescence-associated β-galactosidase (SA-β-gal) positive cells and senescence-associated secretory phenotypes (SASP). This also suppressed the expression of p53 protein targeting DNA damage response (DDR)/p21 cyclin-dependent kinase (CDK) inhibitor through a mTORC1 signaling pathway. Potentially, ebselen could be a therapeutic agent for treating brain aging and AD by mitigating iron accumulation and restoring senescence in SH-SY5Y cells.

Germline variants in BRCA1 and BRCA2 (BRCA1/2) genes are the most common cause of hereditary breast cancer. However, a significant number of cases are not linked to these two genes and additional high-, moderate- and low-penetrance genes have been identified in breast cancer. The advent of next-generation sequencing (NGS) allowed simultaneous sequencing of multiple cancer-susceptibility genes and prompted research in this field. So far, cancer-predisposition genes other than BRCA1/2 have not been studied in the population of Bahrain. We performed a targeted NGS using a multi-panel covering 180 genes associated with cancer predisposition to investigate the spectrum and frequency of germline variants in 54 women with a positive personal and/or family history of breast cancer. Sequencing analysis revealed germline variants in 29 (53.7%) patients. Five pathogenic/likely pathogenic variants in four DNA repair pathway-related genes were identified in five unrelated patients (9.3%). Two BRCA1 variants, namely the missense variant c.287A>G (p.Asp96Gly) and the truncating variant c.1066C>T (p.Gln356Ter), were detected in two patients (3.7%). Three variants in non-BRCA1/2 genes were detected in three patients (1.85% each) with a strong family history of breast cancer. These included a monoallelic missense variant c.1187G>A (p.Gly396Asp) in MUTYH gene, and two truncating variants namely c.3343C>T (p.Arg1115Ter) in MLH3 gene and c.1826G>A (p.Trp609Ter) in PMS1 gene. Other variants of uncertain significance (VUS) were also detected, and some of them were found together with the deleterious variants. In this first application of NGS-based multigene testing in Bahraini women with breast cancer, we show that multigene testing can yield additional genomic information on low-penetrance genes, although the clinical significance of these genes has not been fully appreciated yet. Our findings also provide valuable epidemiological information for future studies and highlight the importance of genetic testing, and an NGS-based multigene analysis may be applied supplementary to traditional genetic counseling.

Soil and microbial biomass carbon (C), nitrogen (N), and phosphorus (P) play an important role in soil nutrient dynamics in biogeochemical cycles of terrestrial ecosystems. However, increased human activities as a result of agricultural intensification on soil nutrients and microbial C:N:P stoichiometry are poorly understood in this fragile forest-savanna transition agroecosystem. This study aimed to (i) assess soil and microbial C, N, and P stoichiometry in different land use systems, and (ii) examine the effect of soil and microbial C, N, and P stoichiometry on soils susceptible to human-induced land use changes. A total of 82 composite soil samples at a depth of 0–20 cm were sampled from forest, savanna, grassland, fallow and cropland for laboratory analysis. The results revealed that the concentrations of C, N, and P were low in Fallow and Cropland compared to other land use systems. Analysis of variance in microbial C, N, and P stoichiometric ratios revealed a significant decreasing tendency compared to soil C:N, C:P and N:P ratios with no statistical significance (p < 0.05). The C:P and N:P ratios were low compared to the C:N ratio in land uses. A significant positive correlation was observed between MBC and MBN (0.95; p < 0.01), and with C and N (0.69; p < 0.01). There were significant interactive effects of land use on soil and microbial variables. The estimated microbial C:N:P stoichiometric ratios (21:2:1) were well constrained in the study area. The transition from Forest to Cropland resulted in 64%, 52%, and 71% reduction in C, N, and P, respectively. This implies that phosphorus is the main factor limiting productivity. The low availability of phosphorus in these tropical soils may have resulted in low C:P and N:P ratios. Therefore, we conclude that our results highlight the importance of phosphorus limitation on ratios of microbial C:P and N:P in landuse systems. Nutrient inputs such as fertilizers, manure and crop residues should be applied to croplands to improve soil and microbial C, N and P levels. Further, effects of land use on soil nutrient status and stoichiometry at 1-meter depth will be considered in our future work.

Entomopathogenic fungi (EPF) are natural enemies which affect insect population and have long been recognized as biological control agents against many insect pests. Some isolates have also been established as endophytes, benefiting their host plants without causing any symptoms or negative effects. Here we demonstrated two entomopathogenic fungal species, Isariajavanica (Frieder. & Bally) Samson & Hywel-jone 2005 and Purpureocillium lilacinum (Thom) Luangsa-ard, Hou-braken, Hywel-Jones & Samson (2011) as endophytes in tomato plants by using the seed inoculation method and examined their effect on plant growth, B. tabaci mortality, and adult emergence. Our study indicated that tomato seeds treated with a fungal suspension of I. javanica and P. lilacinum enabled their recovery from plant tissues (root, stem and leaf) up to 60 days after inoculation (DAI). Both endophytic isolates also caused significant mortality of adult B. tabaci on seedlings inoculated with, I. javanica (51.92±4.78%), and P. lilacinum (45.32±0.20%) compared to the control treatment (19.29±2.35). Adult emergence rates were significantly high in the control treatments (57.50±2.66%) compared to I. javanica (15.00±1.47%) and P. lilacinum (28.75±4.78%) treatments. This study provides evidence that endophytic isolates of I. javanica and P. lilacinum have a biocontrol potentials for used against whiteflies and could also explored as plant growth promoters.

BackgroundCoronavirus disease 2019 (COVID-19) has emerged as an important cause of morbidity and mortality worldwide. The aim of this study is to identify the clinical predictors of mortality among patients with COVID-19 pneumonia during first and second waves in a treatment center in northwestern Nigeria.MethodsThis was a retrospective cohort study of 195 patients hospitalized with COVID-19 between April 2020 to March 2021 at a designated COVID-19 isolation center in Kano State, Northwest Nigeria. Data were summarized using frequencies and percentages. Unadjusted odds ratios and 95% confidence intervals and p-values were obtained. To determine independent determinants of mortality, we performed a stepwise multivariate logistic regression model.ResultsOf 195 patients studied, 21(10.77%) patients died. Males comprised 158 (81.03%) of the study population. In the adjusted stepwise logistic regression analysis, age>64 years (OR = 9.476, 95% CI: 2.181-41.165), second wave of the pandemic (OR = 49.340, 95% CI:6.222-391.247), cardiac complications (OR = 24.984, 95% CI: 3.618-172.508), hypertension (OR = 5.831, 95% CI:1.413-24.065) and lowest systolic blood pressure while on admission greater than or equal to 90mmHg were independent predictors of mortality (OR = 0.111, 95%CI: 0.021-0.581).ConclusionStrategies targeted to prioritize needed care to patients with identified factors that predict mortality might improve patient outcome.

In this study, digital-business card holder software was developed that digitally stores physical business cards prepared in Turkish in a cloud-based database. In the proposed software, the information on the physical business card is converted into text by optical character recognition method (OCR) using business card photos, and then the texts obtained with the help of developed algorithms are separated and grouped. Finally, the digitally obtained business card data is stored in the cloud-based database for later use. Considering the Turkish business cards, it is known that there are a wide variety of complex business cards unique to the country as well as the characters specific to the Turkish language. In this context, first of all, a method that correctly recognizes Turkish characters has been determined in the study. Later, name, mobile phone, e-mail address, company title, position and similar meaningful information were separated from the data read. In order to make these decompositions, special methods have been developed for each field and more accurate and meaningful data has been obtained with field-based algorithms. Thanks to the developed cloud-based platform-independent interface, it is possible to access data from more than one device with a single user over the internet. The study also offers a layered service architecture and database infrastructure that can be used by multiple accounts and multiple users connected to it simultaneously from a single platform. In addition, in the analyzes performed with the developed software, it was determined that 15 business cards with different features were read with an accuracy rate of over 80%.

One of the critics' habit is to use words in which they express the narrator’s state of trust and discrediting, and it has emerged through tracking those uses that they may be singular, duplicate, or compound. It indicates the discrediting alone, as their saying, 'Weak is abandoned. But sometimes some critics use words that tear between the amendment and the discrediting, which may delude or constitute the critic's intention, and among these is Imam Yaqoub bin Shaybah, who described some narrators with such complex words After contemplation, I gathered those who said these descriptions about them and compared his words to the words of other critics, so that we can come up with a summary about the aims of this imam. The idea of the research is to study these words in the sayings of some of the imams of al-Jarh and al-Ta’deel to find out what is meant by this compound, following the method of induction and analysis. God bless.

This article reports four cases of pediatric patients who underwent tracheostomy after Coronavirus disease-2019 (COVID-19) infection. The common feature of these patients was not only prolonged intubation but also the presence of significant comorbidities. Tracheostomy was well tolerated by all patients and resulted in improved outcomes. Although tracheostomy is an old surgical procedure, there is not enough experience on COVID-19 patients in terms of indications, technique, and actual timing. We presented a single-center experience and discussed the management of COVID-19 pediatric patients with preexisting comorbidities who were candidates for a surgical tracheostomy.

Biphenotypic sinonasal sarcoma (BSNS), which has been described in the recent years, is a low-grade spindle cell sinonasal sarcoma characterized by rare neural and myogenic features. It has a slow growth pattern; does not metastasize, but local recurrences are common after surgery. Non-specificity of examination findings and symptoms and similarities of its histopathological features with other spindle cell sarcomas, neural tumors, and skeletal muscle-derived tumors involving the nasal cavity make the diagnosis difficult. Therefore, histopathological features should be evaluated together with immunophenotyping and molecular studies for differential diagnosis. There are very few BSNS cases or case series in the literature. In this report, we reported our clinical approach to a case with BSNS in the right nasal cavity and the histopathological features of the disease in the light of the current literature.

Abstract Background Burkina Faso experienced an epidemic resurgence of dengue in 2016, which led to the implementation of several control strategies. In order to allow a better adaptation of these strategies, we studied the spatio-temporal distribution of dengue. Methods Monthly dengue cases from 2016 to 2019, aggregated at the health district level, were used to map the crude incidence, excess risk, and smoothed incidence of dengue in Burkina Faso with GeoDa software. A Kulldoff scan on Satscan software was then used to identify spatio-temporal clustering of cases. Results The results show that the distribution of dengue fever across the health districts of Burkina Faso is heterogeneous. Dengue was considered non-endemic in 9 out of the 70 health districts, minimally endemic in 45 districts ( 100 incidences) in 4 districts. The main cluster covered the health districts of Baskuy, Nongr-massom, Sig-noghin, Boulmiougou, and Bogodogo. The months of October and November corresponded to the peak of cases and a significant temporal cluster in 2017. Conclusion This study identified the spatial and temporal clustering of dengue cases in Burkina Faso. These results may help to develop better preventive strategies.

The United States Natural Resources Conservation Services Curve Number (NRCS-CN) method uses the CN and rainfall to calculate runoff. However, there are still some uncertainties in the method, such as choosing the most appropriate CN value. Therefore, this study attempts to evaluate the effectiveness of using the NRCS-CN method to estimate the runoff of five catchments in Sudan. For each catchment, CN values were obtained from the number of observed rainfall-runoff events using the NRCS table, arithmetic mean, median, and geometric mean methods. For each method, Nash–Sutcliffe efficiency (NSE) was obtained to evaluate the fit between the observed and runoff, and negative NSE values were found for all methods. Negative values of NSE indicate that the observed runoff and estimated runoff are not well fitted, and the NRCS-CN method is not suitable for runoff calculation in the study areas.

Objectives Evaluation of the incidence and nature of ocular surface involvement in ICU coronavirus disease (COVID)-infected patients. Patients and methods A prospective observational comparative study was carried out between March 2020 and April 2021 on ICU-admitted COVID-19-infected patients and non-COVID patients above the age of 16 years who were admitted to the ICU and met the inclusion criteria. Results Of all, 1620 patients were enrolled; 590 were in COVID group, whereas 1030 patients were in non-COVID group. The mean age was 55±22 years. The mean ICU stay was 11.55±4.22 and 8.45±3.93 days in the COVID and non-COVID groups, respectively. Ocular surface manifestations were significantly higher in patients with longer ICU stay (P=0.03). Regarding ocular surface manifestations, eye discharge was the highest incidence in the COVID group, whereas corneal ulcer was the highest in the non-COVID group. There was a significantly higher incidence of ocular surface manifestations in the non-COVID group (P=0.06). Longer ICU stays and low conscious level were significantly associated with more eye manifestations (P=0.03). Conclusion COVID-infected patients had the highest rate of eye discharge, whereas non-COVID patients had the highest rate of corneal ulcer. Longer ICU stays and low conscious level were associated with more eye manifestations. COVID-infected patients have no distinguishing characteristics from non-COVID individuals regarding ocular surface signs.

Microgels of carbohydrate polymers are non-toxic and biocompatible that can readily be used in applications such as drug delivery, medicine, and pharmacy. In this work, Arabic gum (AG) microgels and methacrylic acid modified Arabic gum microgels (AGMAA) were synthesized via the water in oil emulsion polymerization technique using Tween 20 as the surfactant and hexane as the solvent. The microgels were characterized using various physicochemical methods such as Fourier transform infrared spectroscopy, thermal stability using differential scanning calorimetry, diffraction pattern analysis using X-Ray diffraction, morphology observation using field emission scanning electron microscopy and dynamic light scattering was used to analyze the size and zeta potential. The rate of deformation was higher in the AG microgels compared to the AGMAA microgels. The particle size and zeta potential of the AGMAA microgel were found to be larger and more negative than AG microgel, respectively. The particle size and zeta potentials of the microgels were found to be dependent on the amount of methacrylic acid as the modifying agent. The microgels were encapsulated with doxorubicin through the swelling method and the in vitro release was studied in mediums with pH values of 4.2 and 7.4. The results suggest the potentials of these microgels for drugs delivery.

Production improvement techniques in use by the Construction Industry (CI) in developing countries like Nigerian are yielding sub-optimal value for customers. This necessitated the investigation of techniques to engender maximum efficiency gains. Hence, continuous improvements on new techniques that will give customer satisfaction are required to be implemented to improve the development of the sector. The adoption of Value Reengineering (VRE) could result in a breakthrough solution in resolving the challenges of customer dissatisfaction in the industry. The subjectivist methodology was utilised to establish critical success factors in thirty-four purposefully sampled building construction operators within Abuja using purposive sampling techniques. The deductive/thematic technique was used to analyse the recorded, transcribed, and interpreted interview data after it had been sorted and coded to develop information about any common pattern among the interviewees' evidence on causes militating against VRE deployment in the CI. The results revealed a significant need for the process to be reengineered through the utility of change enablers and the introduction of assistive technologies. The study further reveals that inadequate employee training to implement VRE, lack of understanding of the implementation requirements, top management commitment, quality standards of contractor’s work, and lack of employee consensus to see the implementation through is the key planning, technical and organisational related factors identified. The research concluded that VRE implementation would be achieved if adequate attention is given to the level of awareness of the operator of the technique through training and retraining of operatives in the industry. The study recommends that VRE implementation in all construction projects be encouraged, as it has the potential for the customer to achieve its desired satisfaction on value offering.

Abstract Meningeal lymphatic vessels have been described in animal studies, but limited comparable data is available in human studies. Here we show dural lymphatic structures along the dural venous sinuses in dorsal regions and along cranial nerves in the ventral regions in the human brain. 3D T2-Fluid Attenuated Inversion Recovery magnetic resonance imaging relies on internal signals of protein rich lymphatic fluid rather than contrast media and is used in the present study to visualize the major human dural lymphatic structures. Moreover we detect direct connections between lymphatic fluid channels along the cranial nerves and vascular structures and the cervical lymph nodes. We also identify age-related cervical lymph node atrophy and thickening of lymphatics channels in both dorsal and ventral regions, findings which reflect the reduced lymphatic output of the aged brain.

A partial shading condition (PSC) is one of the most common problems in the photovoltaic (PV) system. It causes the output power of a PV system drastically decrease. Meta-heuristic algorithms (MHA) can track the maximum power point in a power-voltage (P-V) curve with multiple peaks. Grey wolf optimization (GWO) algorithm is a new optimization algorithm based on MHA. It has been used to solve optimization problems in many applications including MPPT for a PV system. However, the accuracy and tracking time in the original GWO (OGWO) can still be further improved for various PSCs. Therefore, there have been some modified grey wolf optimization (MGWO) algorithms proposed to improve the GWO. Nevertheless, only incremental improvement has been made. Therefore, a modified GWO, named enhanced grey wolf optimization (EGWO) is proposed in this paper. The proposed method adds the weighting average, the pouncing behavior and nonlinear convergence factor in the OGWO. In particular, since real wolves may engage in pouncing action when they are hunting, inclusion of pouncing completes the GWO algorithm and yields great improvements. As will be shown via simulation and experiment, the EGWO can drastically reduce the tracking time (up to 45.5% of the OGWO) and the dynamic tracking efficiency can be improved by more than 2%, compared to the OGWO. Moreover, the EGWO achieves the highest maximum power point compared to some of the existing GWO and other swarm based algorithms.

Background: There is limited data in the literature about the clinical importance and prognosis of pericardial effusion (PE) in patients discharged after recovering from COVID-19, but large-scale studies have yet to be available. This study investigated the prevalence, risk factors, prognosis, late clinical outcomes, and management of PE in COVID-19. Materials and Methods: Between August 2020 and March 2021, 15,689 patients were followed up in our pandemic hospital due to COVID-19. Patients with positive polymerase chain reaction (PCR) test results and PE associated with COVID-19 in computed tomography (CT) were included in the study. The patients were divided into three groups according to PE size (mild, moderate, and large). Transthoracic echocardiography (TTE) records, laboratory data, clinical outcomes, and medical treatments of patients discharged from the hospital were retrospectively reviewed. Results: According to the PE size (mild, moderate, large) of 256 patients with PE at admission or discharge, the mean age was 62.17 ± 16.34, 69.12 ± 12.52, and 72.44 ± 15.26, respectively. The mean follow-up period of the patients was 25.2 ± 5.12 months. Of the patients in the study population, 53.5% were in the mild group, 30.4% in the moderate group, and 16.1% in the large group. PE became chronic in a total of 178 (69.6%) patients at the end of the mean three months, and chronicity increased as PE size increased. Despite the different anti-inflammatory treatments for PE in the acute phase, similar chronicity was observed. In addition, as the PE size increased, the patients’ frequency of hospitalization, complications, and mortality rates showed statistical significance between the groups. Conclusions: The clinical prognosis of patients presenting with PE was quite poor; as PE in size increased, cardiac and noncardiac events and mortality rates were significantly higher. Patients with large PE associated with COVID-19 at discharge should be monitored at close intervals due to the chronicity of PE and the increased risk of tamponade.

Introduction: Colorectal cancer (CRC) is a common cancer associated with poor outcomes, underscoring a need for the identification of novel prognostic and therapeutic targets to improve outcomes. This study aimed to identify genetic variants and differentially expressed genes (DEGs) using genome-wide DNA and RNA sequencing followed by validation in a large cohort of patients with CRC. Methods: Whole genome and gene expression profiling were used to identify DEGs and genetic alterations in 146 patients with CRC. Gene Ontology, Reactom, GSEA, and Human Disease Ontology were employed to study the biological process and pathways involved in CRC. Survival analysis on dysregulated genes in patients with CRC was conducted using Cox regression and Kaplan–Meier analysis. The STRING database was used to construct a protein–protein interaction (PPI) network. Moreover, candidate genes were subjected to ML-based analysis and the Receiver operating characteristic (ROC) curve. Subsequently, the expression of the identified genes was evaluated by Real-time PCR (RT-PCR) in another cohort of 64 patients with CRC. Gene variants affecting the regulation of candidate gene expressions were further validated followed by Whole Exome Sequencing (WES) in 15 patients with CRC. Results: A total of 3576 DEGs in the early stages of CRC and 2985 DEGs in the advanced stages of CRC were identified. ASPHD1 and ZBTB12 genes were identified as potential prognostic markers. Moreover, the combination of ASPHD and ZBTB12 genes was sensitive, and the two were considered specific markers, with an area under the curve (AUC) of 0.934, 1.00, and 0.986, respectively. The expression levels of these two genes were higher in patients with CRC. Moreover, our data identified two novel genetic variants—the rs925939730 variant in ASPHD1 and the rs1428982750 variant in ZBTB1—as being potentially involved in the regulation of gene expression. Conclusions: Our findings provide a proof of concept for the prognostic values of two novel genes—ASPHD1 and ZBTB12—and their associated variants (rs925939730 and rs1428982750) in CRC, supporting further functional analyses to evaluate the value of emerging biomarkers in colorectal cancer.

The aim of this project is to investigate the photocatalytic activity of ZnO/TiO2 composite films for the gas-phase oxidation of ethanol. Pure TiO2, pure ZnO, and their composites were formulated using a sol-gel synthesis method, and the resulting powders were cast and dried as thin films in a flat-plate ultraviolet light-emitting diode (UV LED) reactor. P25 TiO2 and commercially available ZnO were also used for comparison. The structural, morphological, and optical characteristics of the materials were characterized. The photocatalytic oxidation of ethanol vapors in air after 24 h of reactor operation was used to assess the relative photocatalytic activity of the ZnO/TiO2 composite films. Our results show that as ZnO content increased in the coupled semiconductor materials, the apparent photocatalytic activity decreased. In this study, pure ZnO (both sol-gel and purchased) had the least photocatalytic activity for vapor-phase ethanol oxidation in our test apparatus. For gas-phase photocatalysis, surface area was shown to be a critical feature for photocatalytic activity. However, the inherent photocatalytic activity of the materials was not decoupled from the effects of surface area in this study.

Cytochrome P450 (CYP450) enzyme has been shown to be expressed in colorectal cancer (CRC) and its dysregulation is linked to tumor progression and a poor prognosis. Here we investigated the therapeutic potential of targeting CYP450 using lopinavir/ritonavir in CRC. The integrative systems biology method and RNAseq were utilized to investigate the differential levels of genes associated with patients with colorectal cancer. The antiproliferative activity of lopinavir/ritonavir was evaluated in both monolayer and 3-dimensional (3D) models, followed by wound-healing assays. The effectiveness of targeting CYP450 was examined in a mouse model, followed by histopathological analysis, biochemical tests (MDA, SOD, thiol, and CAT), and RT-PCR. The data of dysregulation expressed genes (DEG) revealed 1268 upregulated and 1074 down-regulated genes in CRC. Among the top-score genes and dysregulated pathways, CYPs were detected and associated with poor prognosis of patients with CRC. Inhibition of CYP450 reduced cell proliferation via modulating survivin, Chop, CYP13a, and induction of cell death, as detected by AnnexinV/PI staining. This agent suppressed the migratory behaviors of cells by induction of E-cadherin. Moreover, lopinavir/ritonavir suppressed tumor growth and fibrosis, which correlated with a reduction in SOD/thiol levels and increased MDA levels. Our findings illustrated the therapeutic potential of targeting the CYP450 using lopinavir/ritonavir in colorectal cancer, supporting future investigations on this novel therapeutic approach for the treatment of CRC.

Demand for metal matrix composites (MMCs) is expected to increase in these applications, such as in the aerospace and automotive sectors. Adequate joining techniques, which are important for structural materials, have not yet been developed for Metal Matrix Composite (MMCs), however. This work aimed to demonstrate the feasibility of friction stirwelding (FSW) and underwater friction stir welding (UFSW) for joining Al 6061/5, Al 6061/10, and Al 6061/18 wt. %SiCcomposites have been produced by utilizing reinforce stir casting technique. Two rotational speeds,1000and 1800 rpm, and traverse speed 10mm \min were examined. Specimen composite plates 10 mm thick have been successfully welded by FSW. For FSW and UFSW, a tool made of high-speed steel (HSS) with a conical pin shape was used. The result revealed that the ultimate tensile strength ofthe welded joint by FSW and UFSW at rotation speed 1800 rpm for (Al 6061/18 wt. % SiCcomposites) was 195 MPa and 230 MPa respectively. The ultimate tensile strength of the welded joint by FSW and UFSW (Al 6061/18 wt.% SiCecomposites) was 165 MPa and 180 MPa at rotation speed 1000 rpm respectively. The microstructural assessment showed that due to larger grain sizes at FSW and UFSW, most of the fractures are located in the thermal mechanically affected zone (TMAZ) adjacent to the weld nugget zone (WNZ). It is observed that in failure, most of the joints show ductile features. As the volume fraction of SiC (18 wt.%) increases, the friction stir welded and underwater friction stir welded efficiency decreases.

The purpose of creating a brand image profile is to measure the brand perception of consumers considering brand attributes. Thus, marketing decisions can be made based on the brand's strengths and weaknesses by determining them. The brand image profile is traditionally created using the attitude scales and surveys. However, alternative methods are needed since the questionnaires' responses are careless, the number of participants is relatively low and the cost per participant is high. In this study, as an alternative method, creating a brand image profile by analyzing social media data with artificial intelligence was made for the iPhone product. Firstly, the focus group study determined the attributes related to the last version of the iPhone. Then, between December 17th, 2019 and March 23rd, 2020, 87.227 tweets that include these attributes in English were collected from the Twitter social media platform through the RapidMiner data mining tool. Sentiment analysis was performed on collected tweets by the MeaningCloud text mining tool. In this analysis, positive and negative emotions were tried to be detected through artificial intelligence algorithms. Net Brand Reputation Score (NBR) was calculated using the positive and negative tweets amount for each attribute separately. Brand image profile was created by skew analysis using NBR values. As a result, it is thought that social media analysis can be a complementary method that can be used with traditional methods in creating a brand image profile. So, it is seen as an inevitable method to use in further studies to make sentiment analysis by processing raw data received from the Social Media platforms through artificial intelligence algorithms to transform the product label or the perspectives of an event into meaningful information.

Description of the subject. In Turkey Basma tobaccos have been produced as landraces. However, little is known about the genetic and agronomic diversity of the Basma tobacco landrace. Objectives. The aim of the present study was to determine the genetic variation level in Basma type tobaccos used in Tokat-Erbaa region of Turkey, to evaluate some lines under field conditions for agronomic variations and to find out lines with superior yield and quality characters. Method. Thirteen simple sequence repeats (SSR) markers were used to determine the genetic diversity among 40 single plants collected from Basma tobacco production areas along with the cultivar Xanthi-2A. Twenty-seven different lines identified by SSR markers and cultivar Xanthi-2A were evaluated under field conditions in three Basma tobacco production areas. Results. All SSR markers were polymorphic and PIC values of the markers ranged from 0.136 to 0.679 with a total of 43 alleles. There were high levels of variation in agronomic characters investigated. The results of the field evaluations showed that most lines had good agronomic characters and some of them were considerably better in quality than Xanthi-2A. In principal component analysis performed with agronomic characters, the first three components explained 85.4% of the total variation. Conclusions. We determined that the lines 5, 7, 16, 19, 21 and 26 were promising cultivar candidates with good performance. These lines could be further examined for the aim of registration or could be used for development of superior cultivars. Microsatellites, Solanaceae, non-food products, tobacco industry, cigarettes

Purpose: Intern assessment during advanced pharmacy practice experiences (APPEs) are generally based upon each individual preceptor’s perceptions without an objective measurement of intern understanding and performance. Therefore, we sought to determine whether a pre- and post-OSCE could be used to confirm that interns achieved the goals and objectives of the Ambulatory Care rotation. The aims of this study were to determine whether a pre-rotation OSCE can help pharmacy interns self-assess their clinical strengths and weaknesses and assess whether their knowledge and skills improved after completing a post-rotation OSCE. Methods: Pharmacy interns undergoing APPE Ambulatory Care rotations from September 2018 to March 2020 participated in a pre- and post-rotation OSCE to assess their knowledge of various chronic disease states. Interns completed pre- and post-OSCE surveys to assess their perceptions about their knowledge and the OSCE experience. Results: Pharmacy intern knowledge about diabetes, hypertension, dyslipidemia, and atrial fibrillation significantly improved post-OSCE compared to their pre-OSCE scores (p

Stainless steel 316L (SS316L) as a significant bio-material, their wires were used to support the PMMA matrix. Two simple and low-cost surface pretreatments for SS316L wires were performed to enhance denture impact strength: mechanical scratching (treating SS316L wires with SiC powder inside a rotating container) and electrochemical anodizing. Three mechanical scratching samples for different periods of 60, 90 and 120min were prepared. Anodizing technique conditions were: Ethylene glycol with perchloric acid as an anodizing solution, 15V supplying and graphite rod as an anode. Anodizing process involved three pretreating periods of 15, 20, and 30min. All the prepared samples had dimensions of 65 × 10 × 3 mm. SEM technique showed different morphology nature involved holes, scratches and pores with a density of 104/μm2 and a crack length of 60μm. The PMMA reinforced with scratched stainless steel 316L wire surface for 120 min presented the highest impact strength value (42 kJ/m2) with (450.91%) increment. Anodizing samples showed a fluctuating behavior of samples with enhancing in the impact strength of anodizing wire for 20min of about 26.99 kJ/m2, which is still lower than that for scratched samples in average.

The need for unmanned vehicles is increasingly needed in certain conditions, such as distribution of disaster supply, distribution of medicines, distribution of vaccines in the affected areas in pandemic situations. The various types of goods to be distributed require a different fulcrum. This research implemented PID control for the quadcopter balance control system to achieve stability during hovering. PID control is used to achieve a certain setpoint to produce the required PWM output for the propeller to reach a speed that can fly the quadcopter tilted until it reaches a steady state. Tests were carried out on the roll and pitch motion of the quadcopter by providing a load. The results show that PID control can be implemented for the quadcopter balance control system during hovering by determining the PID constants for each roll and pitch motion with the constanta of Kp = 0.15, Kd = 0.108, and Ki = 0.05. The quadcopter takes 3 – 6 seconds to return to the 0 degree setpoint when it is loaded.

Discharge counseling by pharmacists reduces adverse medication events, emergency department visits, and readmissions. Studies indicate that pharmacy students in advanced pharmacy practice experiences (APPE) can deliver effective medication-related activities. An open label randomized controlled trial was conducted in adults discharged on warfarin, insulin, or both. Pharmacy students performed medication reconciliation, structured medication counseling, and follow-up calls 72-hours post-discharge. The usual care arm received traditional education. The primary outcome was the 30-day readmission rate post-discharge. Ninety-eight patients on high-risk medications were randomized to intervention (n = 51) or usual care (n = 47). The 30-day hospital readmission rate was lower in the intervention group (8/51, 15% vs. 11/47, 23%); (p = 0.48). There was no statistical difference in the time to first unplanned health care use (hazard ratio = 0.49 (95 %CI, 0.19–1.24), or the time-to-first clinic visit post-discharge (p = 0.94) between the two arms. Students identified 26 drug-related problems during reconciliation. Patients in the intervention arm reported high satisfaction with the service (mean 3.94; SD 0.11). Involving APPE students in the transition of care activities presents an excellent opportunity to minimize pharmacists' workload while maintaining patient care services.

Despite the improving understanding of how lung mechanics and tidal volume requirements evolve during the evolution of bronchopulmonary dysplasia (BPD), clinical management continues to be heterogeneous and inconsistent at many institutions. Recent reports have examined the use of high tidal-volume low respiratory rate strategies in these patients once disease has been well established to help facilitate their eventual extubation and improve their long-term neurodevelopmental outcomes. In this retrospective observational research study, we describe how intentional adjustment of ventilator settings based on patient lung mechanics by an interdisciplinary BPD team improved the care of the at-risk population of infants, reduced the need for tracheostomies, as well as length of stay over a period of over 3 years. The team aimed to establish consistency in the management of these children using a high tidal volume, low-rate approach, and titrating PEEP to address the autoPEEP and bronchomalacia that is frequently observed in this patient population.

Minerals such as ilmenite and magnetite better absorb gamma rays compared with silica aggregates because of their elevated densities. However, utilizing such minerals as key elements in ultra-high performance heavyweight concrete (UHPHWC) demonstrates promising outcomes, in addition to the enhanced tensile strength of the optimum radiation absorber for nuclear sites. This paper presented ilmenite and magnetite separated from black sand for use as substitutes for fine aggregates in the production of UHPHWC. In addition, nano ferrosilicon (NFS) at 1%, 2%, and 3% of the cement mass was developed using a mechanical method and mixed into the UHPHWC mixes. Their effects on the microstructure, gamma-ray attenuation coefficient, mechanical properties, and density of UHPHWC were explored. The total replacement of fine sand with ilmenite and magnetite enhanced the attenuation efficiency of the concrete mixes by 18.9% and 24.2%, respectively, after 28 days. The addition of 3% NFS to produce UHPHWC achieved the highest compressive strengths of 130.5, 167.2, and 189.8 MPa after 7, 28, and 91 days, respectively. In addition, the combination comprising 3% NFS and 100% magnetite acquired the maximum density and gamma-ray attenuation coefficient values.

Concrete is considered one of the most important building materials in all eras. One of the renowned items of concrete fabrication is ordinary Portland cement (OPC). In the production process of OPC, an immense quantity of CO2 gas is emitted. Consequently, local and trash materials are employed as partial substitutions for cement to construct eco-friendly concrete. In this research, the influence of using a combination of rice husk ash (RHA) and olive waste ash (OWA) at various proportions (i.e. 0 %, 5 %, 10 %, 15 %, 20 % and 25 % for RHA and 0 %, 2.5 %, 5 % and 7.5 % for OWA) as a partial replacement of cement on high-strength concrete is investigated. For this goal, 21 mixes are prepared. The fresh state properties are represented in slump values and mechanical properties, namely, compressive strength, splitting tensile strength, flexural strength, modulus of elasticity, and bond strength, where the compressive strength was evaluated at 7 days and 28 days while the other mechanical properties were evaluated at 28 days. Finally, the microstructure properties are evaluated. Results reveal that the optimum dosages for RHA and OWA are 20 % and 5 %, respectively. Using 20 % RHA with 5 % OWA increases compressive strength by approximately 58.7 %.

The global expansion of agricultural production has increased the amount of agricultural waste (AW). Accordingly, AW should be disposed of properly to preserve the environment. This study focuses on using rice straw ash (RSA) and palm leaf ash (PLA) as partial replacement for cement in the production of ultrahigh-performance concrete (UHPC). In particular, this research investigates the effect of using RSA and PLA as pozzolanic materials on the microstructure and the fresh, mechanical and physical properties of UHPC. Eleven UHPC mixtures are prepared as control mixtures without RSA and PLA. Five mixtures are used with 10%, 20%, 30%, 40% and 50% RSA, whilst five residual mixtures contain 10%, 20%, 30%, 40% and 50% PLA. Results indicate the efficiency of RSA or PLA as a partial substitute (i.e. 20% of cement weight), with mechanical properties and durability better than those of the reference mixture. The microstructure analysis shows that 20% RSA or PLA yields denser concrete than the control mixture. The UHPC samples with 20% RSA and 20% PLA achieve the best results of 188.5 MPa and 185 MPa by increasing compressive strength by about 13.2% and 11.1%, respectively, compared with the control mixture at a test age of 28 days. Important mechanical properties, such as splitting tensile strength, flexural strength and modulus of elasticity, exhibit a trend similar to that of the compressive strength results for all the UHPC mixtures. The average values of splitting tensile strength and flexural strength at 28 days are about 11% and 14% of the compressive strength of the same UHPC mixtures, respectively. The significance of the current study is the relatively high cement replacement percentages of up to 50% by weight and the use of AW as replacement materials.

There are many problems due to the cement industry around the world besides the air pollution by greenhouse gas emissions. The problem arises when a dense quantity of CO2 is emitted through the conversion of calcium carbonate lime (CaCO3) into calcium oxide lime (CaO), the main ingredient in cement. This transformation is made in an oven-dry by burning fossil fuels, in a process that releases more carbon dioxide. In this study, sugarcane bagasse ash (SCBA) and nano eggshell powder (NEP) are considered cementitious materials and were added to the cement at different percentages to reduce the cement contents in the concrete industry. Sixteen high-strength concrete (HSC) mixtures experimented with in this investigation contain SCBA and NEP other than the control mix. The SCBA and NEP were added to cement content by 5 %, 10 %, 15 %, and 20 % for SCBA, and 2.5 %, 5 %, and 7.5 % for NEP. This study evaluates the fresh and hardened properties of HSC. Also, EDX and SEM analyses were conducted on the SCBA, NEP, and HSC concrete to analyze the microstructure. The experimental results exhibited that the setting time of HSC is delayed by increasing the SCBA ratio by 25 % of the control mix. Adding NEP accelerates the HSC setting time compared with the control mix. The best mixture result includes 5 % NEP with 15 % SCBA, which exhibited a dense form, no pores, and no cracks, as analyzed in the microstructure.

يعد المسرح من اكثر الفنون التي تثير الدهشة والسحر والجمال وكل هذا يترجمه العرض المسرحي ، وفي حقيقته وحدة عضوية تضم مجموعة من العناصر المترابطة مشكلة مجموعة من العلاقات التي تحدد فاعلية كل عنصر، وتطور الفن المسرحي على المستويات الفنية والجمالية ، وهو الذي يوظف جماليات مختلفة في الفضاء السينوغرافي ، وغيره من التقنيات الفنية والجمالية مما يضفي عليه أبعاد دلالية وموسيقية متميزة ، فجمالية الصورة تحمل دلالة ترفع من القيمة الفنية للعرض المسرحي . وقد تكون البحث من أربعة فصول ، وتضمن الفصل الأول مشكلة البحث وأهميته والحاجة إليه ، فتحددت مشكلة البحث في الإجابة عن الاستفهام وهو كيف تمت عملية التوظيف الجمالي لأداء الممثل في عروض أنس عبد الصمد ؟ كما تضمن هدف البحث التعرف على جماليات أداء الممثل في عروض أنس عبد الصمد. فيما اقتصرت حدود البحث على العروض المسرحية . لأنس عبد الصمد . وانتهى الفصل بتحديد المصطلحات وتعريفها اجرائياً . تضمن الفصل الثاني الاطار النظري الذي احتوى مبحثين ، تناول الأول جماليات الأداء المسرحي، ودرس الثاني حداثوية الصوة المسرحية ، خاتماً الاطار النظري بالمؤشرات واحتوى الفصل الثالث على( إجراءات البحث ) التي تضمنت مجتمع وعينة وأداة البحث التي أعتمدها الباحث في تحليل عينة البحث. واما الفصل الرابع فقد تضمن النتائج والاستنتاجات وقائمة المصادر .

Rosa canina belongs to rosacea family. Rosa. canina has a high concentration of phyto-constituents such as flavonoids, carotenoids, triterpene and vitamins as vitamin C, E, and A Rosa canina have an anti-inflammatory and antioxidant effects. The antioxidant effect belongs to presence of large quantities of phytochemicals such as flavonoids and polyphenols. Rosa canina has been used for arthritis gout, osteoarthritis, urinary tract disorder, diabetes, inflammation and cancer. After grinding the leaves of Rosa canina, they are extracted by using ethanol solvent (cold extraction method), then the extract concentrated by rotary evaporator at 40 c° and leaving it to dry. Median lethal dose (LD50) has been examined on 84 mice (male and female) divided into seven groups, each one contains 12 (6 male and 6 female). The animals were monitored for signs and any behavior changes after administration of Rosa canina ethanol extract. Acute toxicity study was done on 20 rats (male and female for fourteen days. The weight of animals was taken at day 0, 7, and 14. At day fourteen, relative organ weight as well as histopathological examination for (heart, liver, spleen, kidney, lung, abdominal stomach, testes and ovaries) were taken. In addition to the serum biochemical tests for) blood glucose, urea, creatinine, ALT, AST and total bilirubin (were done at day fourteen. The result of this study, indicated that lethal dose 50 was 16.527 gram/kilogram. Acute toxicity study, revealed that there is no significant difference between relative organ weight of controlled and treated groups for all organs that were selected and mentioned above. In addition, there is no significant difference between serum biochemical tests for both controlled and treated groups. Finally, no changes have been found between controlled and treated groups regarding histopathology examination due to the p value was P ˃ 0.05. Conclusion According to the presented study, ethanol extract of Rosa canina showed wide range of safety depending on the result of lethal dose 50h (16.527 g/kg). Therefore, the extract considered nontoxic. No cytotoxic effect appeared by using ethanol extract of Rosa canina in acute toxicity study. This belongs to the results obtained, which include no significant difference between control and treated male and female rats in biochemistry tests and histopathological examination.

BackgroundEvidence-based practice (EBP) plays a crucial role in improving the quality of healthcare services by ensuring the delivery of the highest and safest level of patient care since EBP helps in justifying treatment choices to patients. Studies that examine the levels of EBP knowledge, attitudes toward EBP, and use of the use of EBP within anesthetic teams' practice are lacking, hence it is necessary to explore this.AimTo evaluate anesthesia teams' levels of knowledge, attitude toward and use of the evidence-based practice in a local hospital in Saudi Arabia.MethodIn one hospital, a cross-sectional survey was conducted using a convenience sampling technique using a validated questionnaire instrument called the Evidence-Based Practice EBP Questionnaire. The questionnaire was distributed through an online method to 173 participants. Descriptive and inferential statistics Tests were utilized to analyse the retrieved data using the SPSS program.ResultsOne hundred and forty questionnaires were completed and returned, yielding a response rate of 80.9%. Overall, anesthesia teams showed a high positive attitude toward EBP but low levels of knowledge and use of EBP. Participants with higher levels of education and/or work experience exhibited significantly higher levels of knowledge and use of EBP than those who had lower education levels and/or work experience. Also, higher levels of education and/or work experience exhibited a significant positive association toward a higher level of knowledge and use of EBP. However, attitude levels toward EBP did not exhibit either significant or associated. Physicians showed significantly higher knowledge and use of EBP than non-physicians. Lack of knowledge and lack of time due to workload were the leading barriers encountered by anesthesia teams ATs.ConclusionEducation level, work experience and job position affect the knowledge, attitude, and use of EBP. Continuous education and minimizing barriers are recommended to enhance the knowledge, attitude, and use of EBP among anesthesia teams in Saudi Arabia.

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children

This study aims to determine whether Indonesia’s nickel ore export restriction policy is in accordance with the principles of international economic law. It is because Indonesia’s actions in implementing quantitative restrictions on the export of nickel ore are deemed to have violated one of the principles in the General Agreement on Tariffs and Trade, namely the principle of prohibiting quantitative restrictions. This principle is contained in Article XI: 1 GATT. Data was collected through library research techniques. Namely by collecting and analyzing writings and literatures that are closely related to the problems that are being researched by the author, and analyzing data with descriptive analytical techniques, so that Indonesia can analyze their export restriction policies with juridical provisions in international trade law. The results shows that Indonesia’s action is in accordance with Article XI: 2 (a), which regulates the exception to Article XI: 1, with certain conditions which is a dispensation from the principle of quantitative restriction. Indonesia’s nickel ore export restrictions were also implemented to protect the environment in order to prevent scarcity and to encourage the battery industry in Indonesia to improve the economy. So that Indonesian policy is valid and can be justified by international law.

Moisture and stripping damages are the most prevalent cause of defects of both Hot-Mix Asphalt (HMA) and Warm-Mix Asphalt (WMA). Adhesion between aggregates and bitumen is a crucial factor that affects such defects. Various methods, such as incorporating additives, have strengthened the asphalt mixture's resistance to moisture and stripping. This paper aimed to experimentally investigate the effect of including a low-cost polymer additive (Superplast) into HMA and WMA mixtures. For this goal, a 60/70 penetration grade bitumen was used. For preparing the WMA mixtures, Showax was employed with percentages of 2, 3, 4, 5, and 6% by weight of bitumen. Polymer modified mixtures (HMA and WMA) were prepared by adding 3%, 4, and 5% of Superplast by weight of the binder. Performance characterizations of the unmodified and Superplast-modified mixtures include stiffness, moisture damage resistance, and bonding. These characteristics were evaluated via Marshall, Lottman, and Double Punching tests, respectively. Results revealed that incorporating Superplast improved the adhesion between bitumen and aggregates, which ultimately led to an increase in the stiffness and moisture resistance of both HMA and WMA. Moreover, Superplast-modified WMA mixtures exhibited the best moisture and stripping resistance performance compared to Superplast-modified HMA and other unmodified mixtures.

Abstract Preterm births have been seen to have psychological and financial implications; current surveys suggest that amongst the various methods of preterm prediction, there is yet to exist a reliable and standard means of predicting preterm births. This study investigates the application of electrohysterogram and tocogram signals acquired at various points during the third pregnancy trimester, alongside information from the patients' medical health record regarding the pregnancy, towards preterm prediction and an associated delivery imminency timeline. In addition to this, the impact of both linear and non‐linear dimensional embedding methods towards the preterm prediction is explored. The classification exercises were carried out using a support vector machine and decision tree, both of which have a certain degree of model interpretability and have potential to be introduced into a clinical operating framework.

The relationship between real exchange rate volatility and the trade balance has been a contentious issue since the fall of Bretton woods agreement of 1973, owing to the lack of unanimity on the effect. This article provides empirical evidence of the link between the real exchange rate volatility and the trade balance in the light of financial development, confirming the assertion that the effect is significantly dependent on the country's level of financial development. Due to Nigeria's relatively undeveloped financial system, its exchange rate dampens the country's exports. Rather than studying the relationship in isolation, we examine the moderating role of financial development on the link between export and the real exchange rate volatility in this paper. The empirical estimation is based on the Nigeria's data set spanning the years 1980–2019, and it employs threshold autoregressive non-linear co-integration and non-linear ARDL estimation techniques. According to the findings, financial development magnifies the beneficial benefits of the real exchange rate on Nigeria's foreign trade. It also states that the uncertainty in foreign capital flows has a negative impact on Nigeria's international trade. The findings have broad policy implications, implying that in order to diversify and improve the economy's future growth and associated international trade, Nigeria's policymakers should promote adequate financial sector development, as financial shocks are amplified by poorly implemented credit markets.