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Abstract Mosquitoes, one of the deadliest animals on the planet, cause millions of fatalities each year by transmitting several human illnesses. Synthetic pesticides were previously used to prevent the spread of diseases by mosquitoes, which was effective in protecting humans but caused serious human health problems, environmental damage, and developed mosquito pesticide resistance. This research focuses on exploring new, more effective, safer, and environmentally friendly compounds to improve mosquito vector management. Phytochemicals are possible biological agents for controlling pests and many are target-specific, rapidly biodegradable, and eco-friendly. The potential of extracts of Lantana camara, Melia azedarach, Nerium oleander, Ricinus communis, and Withania somnifera against 3rd instar Culex pipiens (Common house mosquito) larvae was evaluated. Methanol extracts had more toxic effects against Cx. pipiens larvae (95–100%, 24 h post-treatment) than aqueous extracts (63–91%, 24 h post-treatment). The methanol extracts of Nerium oleander (LC50 = 158.92 ppm) and Ricinus communis (LC50 = 175.04 ppm) were very effective at killing mosquito larvae, 24 h after treatment. N. oleander (LC50 = 373.29 ppm) showed high efficacy in aqueous plant extracts. Among the different extracts of the five plants screened, the methanol extract of R. communis recorded the highest ovicidal activity of 5% at 800 ppm concentration. Total developmental duration and growth index were highly affected by R. communis and M. azedarach methanol extracts. In field tests it was clear that plant extracts decreased mosquito larval density, especially when mixed with mosquito Bti briquette, with stability up to seven days for N. oleander. GC–MS results showed that the methanol extract had a higher number of chemical compounds, particularly with more terpene compounds. A high-performance liquid chromatography (HPLC) technique was used to detect the existence of non-volatile polyphenols and flavonoids. All five methanol extracts showed high concentrations of active ingredients such as gallic acid, chlorogenic acid (more than 100 μg/ml) and the rosmarinic acid was also found in all the five extracts in addition to 17 active polyphenols and flavonoids presented at moderate to low concentrations. Molecular modeling of 18 active ingredients detected by the HPLC were performed to the vicinity of one of the fatty acid binding proteins of lm-FABP (PDB code: 2FLJ). Rutin, Caffeic acid, coumaric acid and rosmarinic acid which presented densely in R. communis and N. oleander showed multiple and stable intermolecular hydrogen bonding and π–π stacking interactions. The inhibition ability of the fatty acid binding protein, FABP4, was evaluated with remarkable receptor inhibition evident, especially with R. communis and N. oleander having inhibitory concentrations of IC50 = 0.425 and 0.599 µg/mL, respectively. The active phytochemical compounds in the plants suggest promising larvicidal and ovicidal activity, and have potential as a safe and effective alternative to synthetic insecticides.

Abstract Background Recruitment to residency programs in hospitals located in other than major hubs (“remotely located”) is a challenge in many countries. In 2011, the Israeli Ministry of Health launched a 10-year financial incentive to encourage physicians to enroll in residency programs in such hospitals. Nearly 1 billion New Israeli Shekels (260 million US$) were invested in that program which had only limited success. As a new physician association’s collective agreement is impending, we aimed to measure the effectiveness of selected incentives in attracting medical school graduates to residencies in remotely located hospitals. Methods This study included Israeli medical students in their final year of medical school. We used an online questionnaire with multiple-choice demographic questions and a 5-point Likert scale to gauge the effect of various incentives on their preference for residency location. Results Between July and November 2022, 522 students responded (405 studied in Israeli medical schools [out of 705 students] and 117 in foreign medical schools [out of 1936 students]). Forty-two percent had at least one clerkship in a remotely located hospital, and 24% had included at least one remotely located hospital among their top five choices for internship. Only 13% reported that they prefer a residency program in those institutions. The incentive selected by students as most persuasive was government assistance in acceptance to and financial support for a fellowship abroad, followed by a financial grant and fewer on-call hours. Only 7% of the students indicated that no incentive would influence them to choose a remotely located hospital for their residency training. Medical education in a remotely located university and the choice of at least one remotely located hospital among the top five choices for internship were significantly associated with positive incentive receptivity, whereas male sex and older age were associated with negative receptivity. Conclusion This study on the attitudes of Israeli medical school graduates toward incentives aimed at attracting them to residencies in remotely located institutions revealed that career development opportunities and assistance in obtaining fellowships might influence their choice.

The L-gulonolactone oxidase enzyme (GULO) catalyzes the last step of L-ascorbic acid (vitamin C) biosynthesis. This enzymatic activity is lost in primates. The full-length rat GULO has been previously produced in plants and demonstrated to be active. In this study, we compared the activity of two variants of GULO produced in Escheriachia coli cells, full-length rat GULO (fGULO) and its C-terminal catalytic domain (cGULO). The expression and purification of the recombinant proteins were optimized, and their biological activity was confirmed by two methods, the GULO activity assay in the protein extracts and the ‘in-gel’ staining for GULO activity. Both variants of recombinant GULO were biologically active in both assays. However, cGULO is more promising than fGULO for ascorbic acid production because it is more efficiently produced by bacteria. Furthermore, the optimal activities of the fGULO and cGULO recombinant proteins were observed at pH 7 and 6.5, and at temperatures of 40 and 30 °C, respectively. Kinetic studies revealed that at low substrate concentrations, Km values for fGULO and cGULO were 53.5 ± 5 and 42 ± 6.3 µM, respectively.

Purpose: This in vitro study aimed to evaluate and compare the physical and antimicrobial properties of provisional resin modified with two different nanoparticles, namely, silicon dioxide (nano-SiO2) and titanium dioxide (nano-TiO2). Methods: A commonly used commercially available polymethyl methacrylate (PMMA) provisional resin (Unifast III; GC Corp) was modified with nano-SiO2 and nano-TiO2 at different concentrations (1% wt. and 2.5% wt. respectively), while one unmodified group was used as a control. Rectangular specimens (60 × 10 × 3.3 mm) for strength (MPa) and elastic modulus, and square specimens (10 × 10 × 3.4 mm) for surface roughness (Ra, µm), hardness (VHN), and Candida albicans adhesion (colony forming unit, CFU/mL) were prepared and grouped into five groups (n = 10) according to (nanoparticles) NPs type and concentration. After polymerization, the specimens were finished and polished and then subjected to thermal cycling (5000 cycles). Analysis of variance and post-hoc Tukey test were used for data analysis (α = 0.05). The scanning electron microscope (SEM) was used for fracture surface analysis and C. albicans count. Results: The addition of 1% nano-SiO2 significantly increased the flexural strength, and 1% nano-SiO2 contributed to the highest flexural strength value, while 2.5% nano-SiO2 and nano-TiO2 showed non-significant increases (p > 0.05). The elastic modulus increased significantly for both NPs. Among the NP-modified groups, the nano-SiO2 groups showed an increased elastic modulus compared to the nano-TiO2 groups. The hardness significantly increased with NPs addition with no significant differences between NPs-modified groups. Surface roughness increased with 2.5% nano-TiO2 addition, while 1% nano-TiO2 and nano-SiO2 showed non-significant differences. Nano-SiO2 and nano-TiO2 significantly decreased C. albicans adhesion, and nano-TiO2 groups were significantly superior in their antimicrobial effect compared with nano-SiO2. Conclusions: Low nano-SiO2 addition increased the flexural strength of provisional resin. The addition of NPs increased elastic modulus and hardness and decreased the C. albicans adhesion to provisional resin. Nano-SiO2 did not alter the surface roughness, while 2.5% of nano-TiO2 increased the surface roughness.

Purpose: This study evaluates and compares the effect of printing layer thickness (LT) and post-polymerization time (PPT) on the flexural strength and hardness of three 3D-printed resins after thermal aging. Methods: A bar shape (64 × 10 × 3.3 mm) and a disc shape (15 × 2 mm) were designed for flexural strength and hardness testing, respectively. ASIGA, NextDent, and FormLabs 3D-printed resins were used to print specimens with different LTs (25 µm, 50 µm, and 100 µm). Each thickness group was post-polymerized (PP) for different times (15, 30, 60, and 90 min). All printed specimens were thermally cycled (5000 cycles) and then tested, measuring the flexural strength and hardness using a universal testing machine and Vickers hardness tester, respectively. The data were analyzed using ANOVA and a post hoc Tukey’s test (α = 0.05). Results: A PPT of 90 min showed the highest flexural strength. In comparisons of the LTs, 25 µm and 50 µm significantly increased flexural strength compared with 100 µm, which showed the lowest value for each PPT. The hardness increased as the PPT increased for all materials. In our LT comparison, 25 µm and 50 µm significantly increased the hardness for NextDent and FormLabs resins, while only 25 µm showed high hardness compared with 50 µm and 100 µm for ASIGA. Conclusion: Both parameters (LT and PPT) impact flexural strength and hardness. Increased PPT with the minimum LT is recommended.

Abstract Background Cats are now recognized as competent hosts for Leishmania infantum and a blood source for sand fly vectors. Although canine leishmaniosis (CanL) is endemic in Mediterranean Basin countries, large-scale epidemiological studies are lacking for feline leishmaniosis (FeL). This study aimed to assess the prevalence of L. infantum infections, associated risk factors, clinical signs, and clinicopathological abnormalities in domestic cat populations from six Mediterranean Basin countries. Methods From 2019 to 2022, blood and serum samples of cats (n = 2067) living in Italy (n = 300), Greece (n = 297), Portugal (n = 295), France (n = 231), Israel (n = 313), and Spain (n = 631) were collected along with animal data (i.e., age, sex, breed, housing conditions, and geographical origin), clinical signs, and laboratory blood test parameters. Cats were grouped according to their age as kittens (up to 1 year), young (older than 1 and younger than 7 years), mature (between 7 and 10 years), and senior (older than 10 years). Serum samples were tested for L. infantum by immunofluorescence antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA), and blood samples of seropositive cats were tested for L. infantum kinetoplast deoxyribonucleic acid (kDNA). Viral infection by feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) was molecularly addressed in all cats enrolled. Statistical analysis was performed to evaluate the association between the risk of L. infantum infection and independent variables, and among co-infection of L. infantum with FIV and/or FeLV, clinical signs, and clinicopathological abnormalities. Results Overall, 17.3% (358/2067) of cats scored positive for L. infantum by serological tests. Specifically, 24.7% were from Portugal, 23.2% from Greece, 16.6% from Israel, 15% from Spain, 13.3% from France, and 12.6% from Italy. Leishmania infantum DNA was detected in 15 seropositive animals. Housing condition and FIV infection proved to be risk factors for FeL. Leishmania seropositivity was significantly associated with weight loss, lymphadenomegaly, gingivostomatitis, and oral ulcers, as well as with reduced albumin and albumin/globulin ratio, increased total globulins and total proteins, leukocytosis, and thrombocytosis. Conclusions This study provides, for the first time, a large-scale epidemiological survey on FeL and its clinical presentation, revealing that L. infantum circulates among domestic cats, especially shelter/free-roaming and FIV-infected animals, living in CanL endemic countries of the Mediterranean Basin. Graphical Abstract

Abstract The use of nano additives to improve the cold properties of biodiesel is encouraged by its drawbacks and incompatibility in cold climate. Waste cooking oil (WCO) was transesterified to create biodiesel. A 20% by volume was used for combination of diesel and methyl ester. Current study aims to evaluate diesel engine emissions and performance. TiO2, alumina, and hybrid TiO2 + Al2O3 nanoparticles are added to WCO biodiesel mixture at 25 mg/liter. When B20 combined with nano materials such as TiO2, Al2O3, and hybrid nano, the highest declines in brake specific fuel consumption were 4, 6, and 11%, respectively. As compared to biodiesel blend, the largest gains in thermal efficiency were 4.5, 6.5, and 12.5%, respectively, at maximum engine output power. Introduction of TiO2, Al2O3, and hybrid nano particles to B20 at 100% load resulted in the highest decreases in HC concentrations up to 7, 13, and 20%, and the biggest reductions in CO emissions, up to 6, 12, and 16%. Largest increases in NOx concentrations at full load were about 7, 15, and 23% for B20 + 25TiO2, B20 + 25 Al2O3, and B20 + 25TiO2 + 25 Al2O3, respectively. Up to 8, 15, and 21% less smoke was released, correspondingly, which were the largest reductions. Recommended dosage of 25 ppm alumina and 25 ppm TiO2 achieved noticeable improvements in diesel engine performance, combustion and emissions about B20.

Globally, there is a growing concern about Pseudomonas aeruginosa resistance to aminoglycosides. Enzymatic modification of these drugs is the predominant resistance mechanism. Additionally, P. aeruginosa possesses many efflux systems that enable it to resist a variety of antimicrobial agents. This study aimed to determine the resistance patterns to several antibiotics as well as the possible mechanisms of aminoglycosides resistance, including aminoglycosides modifying enzymes (AMEs), genes, and active efflux system, observed in clinical P. aeruginosa isolates recovered from patients admitted to Minia University Hospitals, Minia, Egypt. Isolates of P. aeruginosa were identified by traditional phenotypic tests and assessed for their in vitro susceptibility to various antibiotics. The minimum inhibitory concentrations (MICs) of some aminoglycosides were determined without and after the addition of carbonyl cyanide m-chlorophenylhydrazone (CCCP). Aminoglycoside resistance amplified gene sequences were detected using polymerase chain reaction (PCR). Antibiotic sensitivity testing was applied on 93 clinical isolates of P. aeruginosa. The highest rate of resistance was recorded against cefepime and ceftazidime (94.6 % each), while 35.5 % of the examined strains exhibited resistance to minimally one of the evaluated aminoglycoside antibiotics. Furthermore, 49.5 % of isolates were multidrugresistant (MDR). After CCCP addition, 24.2 % of the resistant isolates restored their sensitivity to gentamicin. According to PCR analysis, aac(3)-II was the most frequently detected gene (21.2 %) followed by aph(3′)-VI (15.2 %), and aac(6’)-IIa (3 %). Multiple drug resistance was observed among P. aeruginosa strains included in this study. Resistance of P. aeruginosa to aminoglycosides is greatly influenced by efflux pumps. Coordinated measures and further investigations are urgently needed to manage aminoglycosides resistance.

Abstract Background Multiple sclerosis (MS) is a complex CNS demyelinating disease. Assessment of MS plaques in specific anatomic locations in the brain was challenging to detect by conventional MRI sequences. So, this study aimed to compare the diagnostic accuracy of 3D FLAIR (Fluid attenuation inversion recovery), or 3D DIR (Double inversion recovery) sequences to conventional 2D FLAIR and T2 sequences in detecting MS plaques in different anatomic sites, as well as counting the total lesion burden. Methods A comparative cross-sectional study enrolled 30 MS patients on the basis of McDonald’s criteria 2017. All participants underwent a brain MRI study including 3D FLAIR or 3D DIR sequences, conventional 2D FLAIR, and T2 sequences. Results No statistically significant difference between the 3D DIR and 3D FLAIR in total lesion (plaque) burden results; however, when each is compared to the conventional ones, both are superior. 3D FLAIR detected the most significant number of plaques in the periventricular region, followed by 2D FLAIR and T2W sequences, with 3D DIR being the least accurate in this region. Meanwhile, 3D DIR was the most precise and can detect a statistically significant number of cortical plaques compared to the 3D FLAIR and the conventional sequences. No statistically significant results on which sequence is best in regard to infratentorial plaque detection. Conclusion 3D FLAIR and 3D DIR were superior to 2D FLAIR and T2 sequences in detecting overall lesion burden in MS. Moreover, the 3D DIR sequence was the most precise in the detection of the cortical plaques.

Abstract Introduction Early-onset neonatal sepsis (EONS) significantly impacts neonatal morbidity and mortality, with maternal bacteremia during the peripartum period being a potential risk factor. This study aims to explore the association between peripartum maternal bacteremia and EONS. Methods A retrospective cohort study at the Women's Wellness and Research Center in Doha, Qatar (2015–2019) compared women with and without bacteremia, based on blood cultures taken from up to seven days before to 48 h after delivery, examining the association with EONS. Results Among the 536 maternal blood cultures analyzed, 102 (19.0%) were positive. The most prevalent organisms were Group B streptococcus (GBS) (39.2%), followed by Escherichia coli (14.7%) and anaerobes (10.8%). Neonates from bacteremic mothers had lower birth weights (2913 ± 86 g vs. 3140 ± 745 g; MD 227.63 g; 95% CI 61.72 − 393.55; p = 0.007), required more resuscitation (27.5% vs. 13.2%; OR 2.48; 95% CI 1.48 − 4.17; p

Abstract The combination of hydrogel and fertilizer as slow release fertilizer hydrogel (SRFH) has become one of the most promising materials to overcome the shortcomings of conventional fertilizer by decreasing fertilizer loss rate, supplying nutrients sustainably, and lowering the frequency of irrigation. The hydrogel based on carboxymethyl cellulose (CMC) and polyacrylic acid (PAA) (CMC/PAA) was synthesized. All materials, Vinasse, hydrogel (CMC/PAA) and (Vinasse/CMC-PAA) were characterized by FTIR, XRD, and SEM. The formed hydrogel was applied to control the salinity of Vinasse to use it as a cheap and economical fertilizer. The results showed that using the prepared hydrogel with Vinasse (V/CMC-PAA) as a slow-release organic fertilizer decreased the EC value through the first six hours from 1.77 to 0.35 mmohs/cm. Also, using V/CMC-PAA can control and keep the potassium as fertilizer for 50 days. The productivity per feddan from the sugar cane crop increased by about 15%, and the number of irrigations decreased from 5 to 4 times.

Abstract Background High-risk human papillomavirus (hrHPV) infection causes almost all cervical cancer. Women living with human immunodeficiency virus (Women living with HIV: WLWHIV) are at a six-fold increased risk of developing cervical cancer. This study assessed hrHPV types in cervical cancer by HIV status and histologic subtypes at Muhimbili National Hospital (MNH) in Tanzania. Methods This cross-sectional study used formalin-fixed paraffin-embedded (FFPE) archived tissue blocks of cervical carcinomas diagnosed in the Department of Anatomical Pathology at MNH from January to December 2020. Tissue sections were tested for 15 HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, and 68) using the Ampfire assay. The distribution of HPV genotypes was assessed and compared by HIV status and histologic subtypes. Results The mean age ± standard deviation (N = 227, with valid HPV results) was 55 ± 12.9 years, 28.6% (n = 65) were WLWHIV, and squamous cell carcinoma (SCC) was the most common histologic subtype (91.2%). Most cervical carcinomas (81.1%, n = 184) tested positive for hrHPV with HPV16 (44.1%), HPV18 (15.9%), HPV35 (8.4%) and HPV45 (5.7%) being the most common HPV types. hrHPV was higher among older women with 64.5%, 85.1% and 81.3% among 30–40, 41–60 and ≥ 61-year-old women, respectively (p = 0.033). HPV16 was more commonly detected in SCC (47.8%) than in adenocarcinomas (5%) (p

Abstract Bovine mastitis caused by infectious pathogens, mainly Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), constitutes a major destructive challenge for the dairy industry and public health. Berberine chloride (BER) and Cyperus rotundus possess a broad spectrum of anti-inflammatory, antioxidant, antibacterial, and antiproliferative activities; however, their bioavailability is low. This research aimed first to prepare an ethanolic extract of Cyperus rotundus rhizomes (CRE) followed by screening its phytochemical contents, then synthesis of BER and CRE loaded chitosan nanoparticles (NPs) (BER/CH-NPs and CRE/CH-NPs), afterward, the analysis of their loading efficiency in addition to the morphological and physicochemical characterization of the formulated NPs employing Scanning Electron Microscopy (SEM), Zeta Potential (ZP), Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC) and X-Ray Diffraction (XRD) assessments compared to their crude forms to evaluate the enhancement of bioavailability and stability. Isolation of bacterial strains from the milk of mastitic cows, used for induction of mammary gland (MG) inflammation in female albino rats, and a preliminary investigation of the prophylactic oral doses of the prepared NPs against S. aureus-induced mastitis in female rats. The minimal inhibitory concentration (MIC) of BER/CH-NPs and CRE/CH-NPs is 1 mg/kg b.w. BER/CH-NPs and CRE/CH-NPs alone or in combination show significant (P ≤ 0.05) DPPH radical scavenging activity (69.2, 88.5, and 98.2%, respectively) in vitro. Oral administration of BER/CH-NPs and CRE/CH-NPs to mastitis rats significantly (P ≤ 0.05) attenuated TNF-α (22.1, 28.6 pg/ml), IL-6 (33.4, 42.9 pg/ml), IL-18 (21.7, 34.7 pg/ml), IL-4 (432.9, 421.6 pg/ml), and MPO (87.1, 89.3 pg/ml) compared to mastitis group alongside the improvement of MG histopathological findings without any side effect on renal and hepatic functions. Despite promising results with BER and CRE nanoparticles, the study is limited by small-scale trials, a focus on acute administration, and partially explored nanoparticle-biological interactions, with no economic or scalability assessments. Future research should address these limitations by expanding trial scopes, exploring interactions further, extending study durations, and assessing economic and practical scalability. Field trials and regulatory compliance are also necessary to ensure practical application and safety in the dairy industry. In conclusion, the in vitro and in vivo results proved the antioxidant and anti-inflammatory efficacy of BER/CH-NPs and CRE/CH-NPs in low doses with minimal damage to the liver and kidney functions, supposing their promising uses in mastitis treatment.

Abstract In this study, a variety of probiotic strains, including Lactiplantibacillus plantarum, Lacticaseibacillus casei, Lactobacillus acidophilus, Streptococcus thermophilus, Bifidobacterium longum, Limosilactobacillus reuteri, Lactobacillus delbrueckii subsp. bulgaricus, Lacticaseibacillus rhamnosus, and Bifidobacterium bifidum, were utilized for soymilk fermentation both as free cells and as synbiotics on agro-industrial residuals such as okara, whey protein, banana peels, apple pomace, sugarcane bagasse, orange peels, and lemon peels. Among these, Lacticaseibacillus rhamnosus emerged as the most significant strain for soymilk fermentation, exhibiting a viability of 10.47 log cfu/mL, a pH of 4.41, total acidity of 1.12%, and organic acid contents (lactic and acetic acid) of 11.20 and 7.50 g/L, respectively. As a synbiotic Lacticaseibacillus rhamnosus immobilised on okara, showed even more impressive results, with a viability of 12.98 log cfu/mL, a pH of 4.31, total acidity of 1.27%, and organic acid contents of 13.90 and 9.30 g/L, respectively. Over a 12-h fermentation period, cell viability values increased by 10.47-fold in free cells and 11.19-fold in synbiotics. Synbiotic supplementation of fermented soymilk proved more beneficial than free cells in terms of viability, acidity, and organic acid content. Furthermore, when synbiotic fermented soymilk was freeze-dried to simulate the digestive system in vitro, synbiotics and freeze-dried cells demonstrated superior gastrointestinal tract survival compared to free cells. Both the probiotic bacteria and the synbiotics exhibited cytotoxicity against colon and liver cancer cell lines, with half-maximal inhibitory concentrations ranging from 41.96 to 61.52 μL/well.

Abstract Background Wilms tumor (WT) survival has been affected by the evolution in clinical and biological prognostic factors. Significant differences in survival rates indicate the need for further efforts to reduce these disparities. This study aims to evaluate the clinicopathological data impact on survival among patients after Wilm's diagnosis. Methods The study utilized the SEERStat Database to identify Wilms tumor patients, applying SEERStat software version 8.3.9.2 for data extraction. Selection criteria involved specific codes based on the International Classification of Diseases for Oncology (ICDO-3), excluding cases with unknown SEER stage, incomplete survival data, unknown size, or lymph node status. Statistical analyses, including Kaplan–Meier estimates and Cox regression models, were conducted using R software version 3.5. Standardized mortality ratios (SMR) were computed with SEER*Stat software, and relative and conditional survival analyses were performed to evaluate long-term survival outcomes. Results Of 2273 patients diagnosed with Wilms tumor, (1219 patients, 53.6% were females with an average age group of 3–8 years (50.2%). The overall mean survival after five years of diagnosis was 93.6% (2.6–94.7), and the overall mean survival rate was 92.5% (91.3–93.8) after ten years of diagnosis. Renal cancers were identified as the leading cause of death (77.3%), followed by nonrenal cancers (11%) and noncancer causes (11%). Additionally, robust relative survival rates of 98.10%, 92.80%, and 91.3% at one, five, and ten years, respectively, were observed, with corresponding five-year conditional survival rates indicating an increasing likelihood of survival with each additional year post-diagnosis. Univariate Cox regression identified significant prognostic factors: superior CSS for patients below 3 years (cHR 0.48) and poorer CSS for those older than 15 years (cHR 2.72), distant spread (cHR 10.24), regional spread (cHR 3.09), and unknown stage (cHR 4.97). In the multivariate model, age was not a significant predictor, but distant spread (aHR 9.22), regional spread (aHR 2.84), and unknown stage (aHR 4.98) were associated with worse CSS compared to localized tumors. Conclusion This study delving into WT survival dynamics reveals a multifaceted landscape influenced by clinicopathological variables. This comprehensive understanding emphasizes the imperative for ongoing research and personalized interventions to refine survival rates and address nuanced challenges across age, stage, and tumor spread in WT patients.

Background Worldwide, pleural infections are becoming more common. Overuse of empirical antibiotics has been linked to longer hospital stays and higher death rates, causing the emergence of antibiotic-resistant pathogens. So, proper care requires the identification of the pathogenic bacteria using pleural fluid culture. In addition to normal culture, pleural fluid inoculation in blood culture bottles enhances the proportion of patients with detectable infections in less time. Aim To assess whether inoculating pleural fluid into a blood culture bottle will increase the yield of isolated pathogens compared to routine culture techniques in evaluating pleural infection. Also, to compare the time of pathogen detection when comparing the detection by blood culture bottle versus the routine microbiological culture technique. Recognize the distribution of isolated bacteria from our center and their susceptibility profile to different antibiotics and predict the most effective empirical antibiotics. Patients and methods Cross-sectional analytical prospective study conducted at the Department of Pulmonology and Clinical Pathology in Cairo University Hospitals. It included 70 patients with infected pleural effusion. Under ultrasound supervision, pleural fluid was extracted and transported to the laboratory for routine microbiological culture. At the same time, an automated blood culture bottle was inoculated with 5–10 ml to be incubated. All the detected pathogens were identified and tested for antimicrobial susceptibility according to CLSI. Results The mean age of our patients was 47.1 ± 15.6 years. Empyema was documented in 16 (22.9%) of our patients, whereas 54 (77.1%) had exudative pleural effusion. Positive aerobic infection in blood culture bottle was seen in 37 patients, compared to 21 patients in direct pleural culture. A statistically significant difference was found between the culture positive rate in aerobic blood culture bottles and direct pleural culture (P=0.001). Conclusion Blood culture bottle inoculation of infected pleural fluid increases the sensitivity of microbial yield in a shorter time than standard culture.

Background: Laryngeal squamous cell carcinoma (LSCC) constitutes about 98% of all laryngeal carcinomas with high mortality rates. The transcription factors Glioma-associated oncogene homolog1 (GLI1) and pituitary tumor transforming gene-1 (PTTG1) were associated with poor prognosis in several carcinomas. To date, no previous studies addressed the role of GLI1 in LSCC and limited studies have examined the role of PTTG1 in LSCC. Objectives: This study aims to evaluate the immunohistochemical (IHC) expression of GLI1 and PTTG1 in LSCC, to correlate their expression with clinicopathological features and patients' survival, and to assess the correlation between both proteins in LSCC. Materials and methods: GLI1 and PTTG1 expression was immunohistochemically examined in 60 LSCC specimens and 50 benign vocal fold polyps (control group). Results: GLI1and PTTG1 expression were significantly higher in LSCC than in the control group (p

Abstract Background One of the most prevalent bacteria that cause nosocomial infections is Pseudomonas aeruginosa. Fluoroquinolones (FQ) and aminoglycosides are vital antipseudomonal drugs, but resistance is increasingly prevalent. The study sought to investigate the diverse mechanisms underlying FQ and aminoglycoside resistance in various P. aeruginosa strains particularly during the COVID-19 crisis. Methods From various clinical and environmental samples, 110 P. aeruginosa isolates were identified and their susceptibility to several antibiotic classes was evaluated. Molecular techniques were used to track target gene mutations, the presence of genes encoding for quinolone resistance, modifying enzymes for aminoglycosides and resistance methyltransferase (RMT). Efflux pump role was assessed phenotypically and genotypically. Random amplified polymorphic DNA (RAPD) analysis was used to measure clonal diversity. Results QnrS was the most frequently encountered quinolone resistance gene (37.5%) followed by qnrA (31.2%) and qnrD (25%). Among aminoglycoside resistant isolates, 94.1% harbored modifying enzymes genes, while RMT genes were found in 55.9% of isolates. The aac(6')-Ib and rmtB were the most prevalent genes (79.4% and 32.3%, respectively). Most FQ resistant isolates overexpressed mexA (87.5%). RAPD fingerprinting showed 63.2% polymorphism. Conclusions Aminoglycosides and FQ resistance observed in this study was attributed to several mechanisms with the potential for cross-contamination existence so, strict infection control practices are crucial.

Abstract Boswellia carterii (BC) resins plants have a long historical background as a treatment for inflammation, as indicated by information originating from multiple countries. Twenty-seven diterpenoids have been identified in ethyl acetate and total methanol BC, comprising seventeen boscartins of the cembrane-type diterpenoids and ten boscartols of the prenylaromadendrane-type diterpenoids. Moreover, twenty-one known triterpenoids have also been found, encompassing nine tirucallane-type, six ursane-type, four oleanane-type, and two lupane-type. The cembrane-type diterpenoids hold a significant position in pharmaceutical chemistry and related industries due to their captivating biological characteristics and promising pharmacological potentials. Extraction of BC, creation and assessment of nano sponges loaded with either B. carterii plant extract or DEX, are the subjects of our current investigation. With the use of ultrasound-assisted synthesis, nano sponges were produced. The entrapment efficiency (EE%) of medications in nano sponges was examined using spectrophotometry. Nano sponges were characterized using a number of methods. Within nano sponges, the EE% of medicines varied between 98.52 ± 0.07 and 99.64 ± 1.40%. The nano sponges' particle sizes varied from 105.9 ± 15.9 to 166.8 ± 26.3 nm. Drugs released from nano sponges using the Korsmeyer-Peppas concept. In respiratory distressed rats, the effects of BC plant extract, DEX salt and their nano formulations (D1, D5, P1 and P1), were tested. Treatment significantly reduced ICAM-1, LTB4, and ILβ 4 levels and improved histopathologic profiles, when compared to the positive control group. Boswellia extract and its nano sponge formulation P1 showed promising therapeutic effects. The effect of P1 may be due to synergism between both the extract and the formulation. This effect was achieved by blocking both ICAM-1 and LTB4 pathways, therefore counteracting the effects of talc powder.

Abstract Integration of diagnosis and treatment for mental, neurological, and substance use (MNS) disorders into primary health care is a recommended strategy to improve access to services in low-and middle-income countries. Despite numerous initiatives for integration of mental health care in Uganda, there has not been an evaluation of health management information system (HMIS) records to determine whether MNS disorders are routinely diagnosed. We sought to determine diagnostic pattern of MNS disorders at primary health facilities in Wakiso and Kampala districts, the most populous regions of Uganda. Lower-level primary health facilities were visited to obtain records from HMIS registers, to document diagnoses of MNS disorders. Secondary data analysis was conducted and descriptive statistics reported. A total of 40 primary health care facilities were visited representing 58.6% of the health facilities in the study districts. More than half (54.8%) and almost all (87.5%) of the lower-level health facilities in Wakiso district and Kampala district respectively were visited. The proportion of MNS disorders diagnosed at lower-level primary health facilities in Uganda is very low with Epilepsy the most common MNS diagnosis recorded. Reasons for such low numbers of diagnoses at primary health facilities are discussed as are possible solutions.

Abstract The ecotoxicological consequences of azoxystrobin on land snails have not yet been addressed. Therefore, the present study aims to provide novel data on the threat of a commercial grade azoxystrobin (AMISTAR) at two environmentally relevant concentrations (0.3 µg/ml) and tenfold (3 µg/ml) on the model species, Theba pisana by physiological, biochemical, and histopathological markers for 28 days. Our results showed a reduction in animal food consumption and growth due to exposure to both azoxystrobin concentrations. It also induced oxidative stress and led to a significant decrease in lipid peroxidation (LPO) levels after 7 days of exposure, while the opposite effect occurred after 28 days. Except for the 7-day exposure, all treated snails had significantly reduced glutathione (GSH) content and increased catalase (CAT) activity at all-time intervals. Glutathione peroxidase (GPx), glutathione-S-transferase (GST) activities, and protein content (PC) were elevated in treated snails at all-time intervals. Moreover, alterations in acetylcholinesterase (AChE) activity between a decrease and an increase were noticed. Additionally, azoxystrobin exerted changes in T. pisana hepatopancreas architecture. Our study suggests that azoxystrobin may have negative ecological consequences for T. pisana and highlights its potential risks to the natural environment.

Abstract Background Babesiosis is a tick-borne infection caused by piroplasmid protozoa and associated with anemia and severe disease in humans, domestic animals and wildlife. Domestic cats are infected by at least six Babesia spp. that cause clinical disease. Methods Infection with a piroplasmid species was detected by microscopy of stained blood smears in three sick cats from Israel. Genetic characterization of the piroplasmid was performed by PCR amplification of the 18S rRNA, cytochorme B (CytB) and heat shock protein 70 (HSP70) genes and the internal transcribed spacer (ITS) locus, DNA sequencing and phylogenetic analysis. In addition, Haemaphysalis adleri ticks collected from two cats were analyzed by PCR for piroplasmids. Results The infected cats presented with anemia and thrombocytopenia (3/3), fever (2/3) and icterus (1/3). Comparison of gene and loci sequences found 99–100% identity between sequences amplified from different cats and ticks. Constructed phylogenetic trees and DNA sequence comparisons demonstrated a previously undescribed Babesia sp. belonging to the Babesia sensu stricto (clade X). The piroplasm forms detected included pear-shaped merozoite and round-to-oval trophozoite stages with average sizes larger than those of Babesia felis, B. leo and B. lengau and smaller than canine Babesia s.s. spp. Four of 11 H. adleri adult ticks analyzed from cat # 3 were PCR positive for Babesia sp. with a DNA sequence identical to that found in the cats. Of these, two ticks were PCR positive in their salivary glands, suggesting that the parasite reached these glands and could possibly be transmitted by H. adleri. Conclusions This study describes genetic and morphological findings of a new Babesia sp. which we propose to name Babesia galileei sp. nov. after the Galilee region in northern Israel where two of the infected cats originated from. The salivary gland PCR suggests that this Babesia sp. may be transmitted by H. adleri. However, incriminating this tick sp. as the vector of B. galilee sp. nov. would require further studies. Graphical Abstract

The aluminum alloys used in aerospace applications are susceptible to corrosion. This has led to the development of methodologies that ensure the durability of the parts and pieces of aircraft. These anticorrosive processes involve the use of coatings containing chromate-based corrosion-inhibitor compounds. Although these coatings provide an excellent solution to this problem, their use in protection protocols is restricted owing to their high toxicity and carcinogenic nature.This study evaluates a different process to protect aluminum alloy surfaces that incorporates the derivatization of organic compounds using potentiostatic techniques. The metallic surface was modified in situ by the potentiostatic reduction of aryl diazonium salts, leaving the surface covered with molecular grafts. The grafting of molecules onto the surface is modulated by the application of a potential that causes the formation of aryl radicals. The organic compound selected in this study was p-toluidine in protic medium. The derivatization process in the AA2060-T8 alloy was carried out at different pHs and potentials, observing from the potential/current responses in 0.1 M NaCl solution that the maximum optimization is obtained at pH 3 and -1 V.Likewise, the E/I and electrochemical impedance (EIS) responses of the electrografted samples modified and functionalized with cerium 4-hydroxycinnamate (Ce(4-OHcinn)3) revealed that the presence of this compound in the arylic structure significantly increased the protective capacity of the organic film electrografted on the aluminum alloy.The morphologies and characteristics of the modified surface were studied by SEM, TEM, and XPS. Furthermore, TEM examinations of ultramicrotomed sections of the electrografted specimens revealed the presence of a film approximately 10 nm thick on the AA2060-T8 surface.

Abstract The therapeutic potential of insect-derived bioactive molecules as anti-SARS-CoV-2 agents has shown promising results. Hymenopteran venoms, notably from Apis mellifera (honeybee) and Vespa orientalis (oriental wasp), were examined for the first time in an in vitro setting for their potential anti-COVID-19 activity. This assessment utilized an immunodiagnostic system to detect the SARS-CoV-2 nucleocapsid antigen titer reduction. Further analyses, including cytotoxicity assays, plaque reduction assays, and in silico docking-based screening, were performed to evaluate the efficacy of the most potent venom. Results indicated that bee and wasp venoms contain bioactive molecules with potential therapeutic effects against SARS-CoV-2.Nevertheless, the wasp venom exhibited superior efficacy compared to bee venom, achieving a 90% maximal (EC90) concentration effect of antigen depletion at 0.184 mg/mL, in contrast to 2.23 mg/mL for bee venom. The cytotoxicity of the wasp venom was assessed on Vero E6 cells 48 h post-treatment using the MTT assay. The CC 50 of the cell growth was 0.16617 mg/mL for Vero E6 cells. The plaque reduction assay of wasp venom revealed 50% inhibition (IC50) at a 0.208 mg/mL concentration. The viral count at 50% inhibition was 2.5 × 104 PFU/mL compared to the initial viral count of 5 × 104 PFU/mL. In silico data for the wasp venom revealed a strong attraction to binding sites on the ACE2 protein, indicating ideal interactions. This substantiates the potential of wasp venom as a promising viral inhibitor against SARS-CoV-2, suggesting its consideration as a prospective natural preventive and curative antiviral drug. In conclusion, hymenopteran venoms, particularly wasp venom, hold promise as a source of potential therapeutic biomolecules against SARS-CoV-2. More research and clinical trials are needed to evaluate these results and investigate their potential for translation into innovative antiviral therapies.

Abstract A disposable screen-printed sensor has been crafted specifically for therapeutic drug monitoring purposes, particularly for detecting ofloxacin in biological fluids. To enhance selectivity toward ofloxacin, a supramolecular calix [6] arene serves as the ionophore of choice. The sensor incorporates a graphene nanocomposite as an ion-to-electron transducer layer, which not only boosts potential stability but also mitigates potential drift. The developed ofloxacin sensor underwent rigorous characterization following IUPAC guidelines. The linearity range spans from 1 × 10–6 to 1 × 10–2 M, with a measured slope of 59.0 mV/decade. Impressively, it boasts a percentage recovery of 100.18 ± 1.60 and a low detection limit (LOD) of 6 × 10–7 M. Stability assessments indicate reliable performance over an extended period of 8 weeks. The versatility of this sensor extends to various applications, including the determination of ofloxacin in pharmaceutical formulations, bulk powder, and biological fluids. Notably, it has demonstrated efficacy post-bioanalysis validation, adhering to Food and Drug Administration regulations. This advancement holds promise for personalized therapeutic drug monitoring in clinical pharmacy studies and quality control laboratories, thereby optimizing patient care at the point-of-care. Graphical abstract

This study aimed to assess the impact of prosthetic treatment on the quality of life of partially/completely edentulous patients through the Oral Health Impact Profile-14 (OHIP-14) scale. This pre-post observational study was conducted in the College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia, between November 2022 and September 2023. Eligible participants were those aged between 26 and 80, in need of prosthetic treatment, and able to complete the questionnaire voluntarily. The questionnaire presented to the patients had two sections; the first included demographic and dentures-related variables, and the second included the OHIP-14 questionnaire. Differences in overall OHIP-14 scores after treatment about demographic and prosthesis-related factors were assessed using the Mann-Whitney U test/Kruskal Wallis test with a significance level of 0.05. Out of 108 participants, 65 were males, and 43 were females with an average age of 52 years with different prosthetic treatments (13.9 % fixed prostheses, 43.5 % removable partial, and 42.6 % complete dentures). 59.3 % brushed their teeth twice or more daily, and only 36.1 % checked them regularly. Comparison between the OHIP-14 items before and after treatment revealed that subjects exhibited improvement in all the domains. OHIP-14 scores did not differ significantly in terms of age, gender, and education after treatment. OHIP-14 score was considerably higher for patients with medical conditions (P = 0.007) and among complete denture wearers compared to patients with fixed prostheses (P = 0.025). Prosthetic treatment positively impacts oral health-related quality of life (OHRQoL), which improved after treatment, particularly in the social domain. There was an association between patients’ medical condition, prosthesis type, and OHIP-14 score.

This meta-analysis investigated the prevalence of dental caries throughout the Kingdom of Saudi Arabia (KSA) between 2011 and 2023 as a follow-up to a previously published review in 2013 by Khan et al. and aimed to provide an update on the current status of caries prevalence in the KSA. A literature search was conducted, and thirty-three articles were included in the final analysis. To determine the prevalence of caries in primary teeth, the 2- to 12-year-old Saudi population was included in the search, and an age range of 6–18 years was used for permanent teeth. The prevalence of caries in the primary and permanent dentition was analyzed separately. As the included studies for the primary and permanent teeth had insignificant heterogeneity, fixed-effect models and forest plots were used to evaluate caries prevalence in both dentitions. In the primary dentition, the mean decayed-missing-filled teeth (dmft) index was 4.14 (95 % confidence interval (CI): 3.11–5.18), with an average prevalence of 75.43 %. For the permanent teeth, the mean DMFT (uppercase used for permanent dentition) was 1.28 (95 % CI: 0.93–1.64), with an average prevalence of 67.7 %. The average dmft/DMFT scores decreased in both primary and permanent teeth compared to the previous meta-analysis by Khan et al., suggesting a beneficial effect of preventative measures on caries prevalence. Continuing these measures is necessary to maintain the downward trend of caries prevalence in the KSA.

A large number of variants identified through clinical genetic testing in disease susceptibility genes, are of uncertain significance (VUS). Following the recommendations of the American College of Medical Genetics and Genomics (ACMG) and Association for Molecular Pathology (AMP), the frequency in case-control datasets (PS4 criterion), can inform their interpretation. We present a novel case-control likelihood ratio-based method that incorporates gene-specific age-related penetrance. We demonstrate the utility of this method in the analysis of simulated and real datasets. In the analyses of simulated data, the likelihood ratio method was more powerful compared to other methods. Likelihood ratios were calculated for a case-control dataset of BRCA1 and BRCA2 variants from the Breast Cancer Association Consortium (BCAC), and compared with logistic regression results. A larger number of variants reached evidence in favor of pathogenicity, and a substantial number of variants had evidence against pathogenicity - findings that would not have been reached using other case-control analysis methods. Our novel method provides greater power to classify rare variants compared to classical case-control methods. As an initiative from the ENIGMA Analytical Working Group, we provide user-friendly scripts and pre-formatted excel calculators for implementation of the method for rare variants in BRCA1, BRCA2 and other high-risk genes with known penetrance.

Acquired drug resistance to anticancer targeted therapies remains an unsolved clinical problem. Although many drivers of acquired drug resistance have been identified1-4, the underlying molecular mechanisms shaping tumour evolution during treatment are incompletely understood. Genomic profiling of patient tumours has implicated apolipoprotein B messenger RNA editing catalytic polypeptide-like (APOBEC) cytidine deaminases in tumour evolution; however, their role during therapy and the development of acquired drug resistance is undefined. Here we report that lung cancer targeted therapies commonly used in the clinic can induce cytidine deaminase APOBEC3A (A3A), leading to sustained mutagenesis in drug-tolerant cancer cells persisting during therapy. Therapy-induced A3A promotes the formation of double-strand DNA breaks, increasing genomic instability in drug-tolerant persisters. Deletion of A3A reduces APOBEC mutations and structural variations in persister cells and delays the development of drug resistance. APOBEC mutational signatures are enriched in tumours from patients with lung cancer who progressed after extended responses to targeted therapies. This study shows that induction of A3A in response to targeted therapies drives evolution of drug-tolerant persister cells, suggesting that suppression of A3A expression or activity may represent a potential therapeutic strategy in the prevention or delay of acquired resistance to lung cancer targeted therapy.

ObjectivesThe influence of printing parameters on the marginal and internal fit of three-dimensional (3D) printed interim fixed partial dentures (IFPDs) has been understudied. This investigation sought to elucidate the impact of printing orientation and post-curing time on these critical factors.MethodsA total of 260 3-Unit IFDPs were printed using two different resins (130/NextDent C&B MFH and 130/ASIGA DentaTOOTH). For each material, specimens were printed with three different angulations (0-, 45-, and 90-degree in relation to the z-axis). Each was further divided into 4 groups (n = 10) according to post-curing time (30-, 60-, 90-, and 120 min), while the green state (GS) group at 0-degree remained without post-curing as a control. Each specimen was scanned and then superimposed on the original CAD file. The marginal and internal fit of premolar and molar restorations were evaluated using the silicone replica technique. Digital scanning of the master die, both with and without a fit checker, was followed by data superimposition to compare the master die with the fit checker of each sample. 3D comparisons were conducted using initial and best-fit alignment methods, and the root mean square error (RMS) was calculated to quantify marginal and internal fit at each abutment and for the overall restoration. Statistical analysis was performed using JMP® software (JMP®, Version 16, SAS Institute Inc., Cary, NC, USA, 1989–2022) with a significance level 0.05 for all tests.ResultsFor the ASIGA group, 0-degree orientation generally exhibited better fit than 45- and 90-degree orientations, with some variations based on post-cure time. For marginal fit, ASIGA crowns typically showed better results with 90-degree orientation, while NextDent crowns demonstrated consistent performance across orientations. Post-curing time also influenced marginal fit, with longer durations generally resulting in improved outcomes.ConclusionWith different printing orientations and post-curing times, ASIGA and NextDent resins can produce IFDPs with acceptable internal and marginal fit. However, NextDent resin consistently outperformed ASIGA in terms of overall fit. Further research is needed to evaluate the long-term clinical performance of these materials.

Gasotransmitters play crucial roles in regulating many physiological processes, including cell signaling, cellular proliferation, angiogenesis, mitochondrial function, antioxidant production, nervous system functions and immune responses. Hydrogen sulfide (H2S) is the most recently identified gasotransmitter, which is characterized by its biphasic behavior. At low concentrations, H2S promotes cellular bioenergetics, whereas at high concentrations, it can exert cytotoxic effects. Cystathionine β-synthetase (CBS), cystathionine-γ-lyase (CSE), 3-mercaptopyruvate sulfurtransferase (3-MST), and cysteinyl-tRNA synthetase 2 (CARS2) are pivotal players in H2S biosynthesis in mammalian cells and tissues. The focus of this review is the regulation of the various pathways involved in H2S metabolism in various forms of cancer. Key enzymes in this process include the sulfide oxidation unit (SOU), which includes sulfide:quinone oxidoreductase (SQOR), human ethylmalonic encephalopathy protein 1 (hETHE1), rhodanese, sulfite oxidase (SUOX/SO), and cytochrome c oxidase (CcO) enzymes. Furthermore, the potential role of H2S methylation processes mediated by thiol S-methyltransferase (TMT) and thioether S-methyltransferase (TEMT) is outlined in cancer biology, with potential opportunities for targeting them for clinical translation. In order to understand the role of H2S in oncogenesis and tumor progression, one must appreciate the intricate interplay between H2S-synthesizing and H2S-catabolizing enzymes.

Cefotaxime is a broad-spectrum antibiotic targeting Gram-negative bacteria used for diverse infections, but it can be toxic to the stomach, liver, and kidneys. This study explored the protective effects of geranium oil against cefotaxime-induced hepatotoxicity and nephrotoxicity in rats, employing biochemical, histopathological, and immunohistochemical evaluations. Thirty rats were divided into five groups of six animals each one. Group 1 received orally normal saline for 14 days, Group 2 was given orally 2.5% DMSO for 14 days, Group 3 received cefotaxime (200 mg/kg/day IM) for 14 days, Group 4 received with cefotaxime (200 mg/kg/day IM) and geranium oil (67 mg/kg b. w./day orally in DMSO) for 14 days, and Group 5 received geranium oil alone (67 mg/kg b. w./day orally in DMSO) for 14 days. Geranium oil significantly reduced cefotaxime-induced damage, evidenced by lower serum levels of liver enzymes (AST, ALT), renal markers (urea, creatinine), and other indicators (alkaline phosphatase, TNF-alpha, IL-1Beta, MAPK, nitric oxide, MDA). It also increased levels of protective tissue biomarkers such as NrF2, albumin, catalase, Beclin 1, and reduced glutathione (GSH). Histopathological and immunohistochemical analyses revealed significant protective effects in liver and renal tissues in rats treated with Geranium oil. These results suggest that Geranium oil is effective in mitigating cefotaxime-induced hepatotoxicity and renal toxicity.

Objectives:. To provide a checklist for presentation preparation at dermatology conferences, discuss important factors to consider when preparing a presentation, and recommend strategies for effective presentations and networking. Data Sources:. With a combination of personal experience and literature review of PubMed database and dermatology society resources, this article serves as the first comprehensive guide for how to prepare a talk for an international dermatology conference. Conclusion:. Conferences are an excellent opportunity to learn more about yourself, your field, and others throughout the world. Well-prepared presentations have the potential to greatly impact your audience and expand your connections. The authors provide a step-by-step discussion and checklist that thoroughly addresses the logistics, operations, scientific content, and social aspects that are important to know when preparing to give a presentation in the field of dermatology.

The Ghanaian cocoa sector faces numerous challenges which contributes to lower yields, forcing farmers to depend on traditional coping strategies due to the absence of institutionalized cocoa crop insurance. The effectiveness of these traditional risk-coping strategies remains uncertain. This study aims to identify the influential factors shaping cocoa farmers' decisions to participate in insurance schemes and the premium amounts they can afford. Using multi-stage random sampling, a semi-structured questionnaire was used to illicit responses from 240 cocoa farmers in the Western North region. A binary logistic and a multinomial logistic models were used for data analysis. Age, education, experience, credit access, and off-farm income were identified as statistically significant factors influencing farmers' decisions to participate in the insurance scheme. Moreover, among the 3 price contracts, multinomial results indicate that the majority of farmers (50.4%) favoured a premium/acre of GH¢250 for a minimum price insurance contract of GH¢1300 per annum. The multinomial log-odds determining the amount farmers are willing to pay are influenced by age, education, and off-farm income. Despite the sector's inherent challenges, there should be opportunities for collaboration between government agencies, insurance companies, and agricultural stakeholders aimed at improving insurance accessibility and affordability for cocoa farmers, thereby enhancing the sector's resilience against various risks.

ABSTRACT: The increasing recognition of the potential advantages beyond nanoencapsulation of probiotics gained great attention owing to effective properties. Hence, we provided the most in-depth look into the influence of nanoformulated multi strain probiotics; BLB-NPs comprising Bacillus subtilis ATCC19659, Lactobacillus plantarum ATCC8014 and Bifidobacterium bifidum ATCC29521 on growth performance, antioxidant status and intestinal immunity supporting the defense against Salmonella Typhimurium (S. Typhimurium) challenge in broilers chickens. A total of 2,800 one-day-old male Ross 308 boiler chicks were divided into 7 groups; 1 control without additives, 3 probiotics [fed control diets mixed with B. subtilis, L. plantarum and B. bifidum (BLB) at concentrations of 1 × 104 (BLBI), 1 × 106 (BLBII) and 1 × 108 (BLBIII) CFU /kg diet, respectively] and 3 nanoencapsulated probiotics [fed control diets supplemented with BLB loaded nanoparticles (BLB-NPs) at concentrations of 1 × 104 (BLB-NPsI), 1 × 106 (BLB-NPsII) and 1 × 108 (BLB-NPsIII) CFU /kg diet, respectively]. All previous groups were challenged at d 22 of age with S. Typhimurium. Birds fed BLB-NPs II and III exhibited better weight gain and FCR simultaneously with upregulation in nutrients transporters genes (LAT-1, PepT-1, CAT-1 and SGLT1) even after S. Typhimurium challenge. Upregulation of immmune related genes (IL-1β, IL-6, IL-8, MyD88, NF-kB, CCL20, CXCLi2, TLR-2, TLR-4 and SOCS1) was prominently subsided in BLB-NPsIII fed group. The strengthening ability of BLB-NPs for broilers' intestinal barriers was evidenced by augmented expression of JAM, MUC-2, occludin and FABP-2 genes, diminished S. Typhimurium counts and suppressed its virulence related genes (HilA and SopD) with restored histopathological pictures of cecum. Notably, post dietary inclusion of higher levels of BLB-NPsIII, the abundance of beneficial Biofidobacterium and Lactobacillus species was dominated over harmful E. coli ones. Birds fortified with BLB-NPs displayed potent antioxidant potential signified by boosting serum and intestinal antioxidant markers alongside reducing oxidative ones. Overall, the abovementioned positive outcomes of BLB-NPs encouraged their potential application in poultry feed to attain superior performance and elicit protective immunity against S. Typhimurium infection.

Agmatine, 1-Amino-4-guanidinobutane, is a ubiquitous naturally occurring molecule present in low amounts in a wide variety of foodstuff. Clinical trials have demonstrated the safety of oral agmatine sulfate and have led to its development as an effective dietary ingredient for promoting resilient nerve functions. Although clearly required, the mutagenic and genotoxic effects of agmatine have not been previously reported. The present study, therefore, undertook to assess the safety profile of agmatine using currently accepted in vitro and in vivo mutagenicity and genotoxicity tests. The test item was G-Agmatine®, a proprietary brand of agmatine sulfate. Using the bacterial reverse mutation assay (Ames test), the study found that G-Agmatine® has no mutagenic effects. It had no clastogenic effects as observed by the in vitro chromosomal aberration test using Chinese Hamster lung cells. And it lacked genotoxic effects as evidenced by the lack of increased frequency of micronucleated polychromatic immature erythrocytes following oral administration in the mouse micronucleus test. Taken together with previously published data, results of the present study further support the safety of agmatine sulfate as a dietary ingredient.

BackgroundFollowing graduation, Israeli medical cadets complete a 12-months training period in hospitals, having profound influence on their future career. Burnout, sense of personal and professional uncertainty and disorientation are already notable in this group. The aim of the current study was to assess the potential impact of empowerment, psychological and career counseling on the level of satisfaction and burnout of medicine cadets during their internship year in a tertiary medical center.MethodsIn a tertiary hospital's education authority, we offer constructed, personalized psychological and counseling services with continuous process of appraisal. During an 18-month period we followed their monthly feedback relating to satisfaction, learning experience and level of socialization. The study was designed as comparative research assessing cadets' satisfaction before, and after intervention as a surrogate marker for their burnout.ResultsComparison of measured parameters showed statistically significant improvement, with interns stationed in the surgical departments (n = 86) showing the highest degree of improvement: the extent of acquiring new knowledge and competencies (1 to 5 Likert) went from 2.2 ± 1.0 to 3.3 ± 1.42; p < 0.005; experience from the absorption process into the department (LQR from 2.6 ± 1.2 to 3.5 ± 1.56; p < 0.05), degree of motivation to recommend peers to apply for residency (LQR from 2.3 ± 1.0 to 3.1 ± 1.6; p = 0.05) and the experience of being accepted to the department by the staff nurses (LQR from 2.7 ± 1.3 to 3.5 ± 1.1; p < 0.05).ConclusionsA combined, ongoing process of appraisal, empowerment, psychological and career counseling seems promising in the relenting effort to improve cadets' satisfaction and hopefully withhold the burnout process of young physicians.

Abstract Introduction Key populations (KPs) including female sex workers (FSWs) and men who have sex with men (MSM) in sub‐Saharan Africa are disproportionately impacted by HIV. Despite the increasing availability of pre‐exposure prophylaxis (PrEP), data on retention remain limited. This study assessed PrEP retention at 1 and 12 months among Rwandan FSWs and MSM. Methods We analysed routine clinical data on adult FSWs and MSM receiving PrEP care from 11 health facilities in Kigali, Rwanda between 2019 and 2022. Retention was defined as attendance at regularly scheduled appointments for a PrEP refill. We used logistic regression to assess associations between demographic and clinical characteristics and retention at 1 and 12 months. Results Among 2043 PrEP initiators, 1343 (66%) were FSWs and 700 (34%) were MSM. FSWs reported a median number of eight sexual partners in the prior 7 days, 70% reported condomless sex and 94% considered themselves at high HIV risk. About 1239 (92%) and 1032 (77%) were retained at 1 and 12 months, respectively. One‐month retention was lower among FSWs living with others (OR 0.59, 95% CI: 0.35−0.99; ref: living alone) or with low HIV risk perception (OR 0.12, 95% CI: 0.04−0.29). At 12 months, low HIV risk perception remained statistically significant (aOR 0.20, 95% CI: 0.12−0.32). At PrEP initiation, MSM reported a median of four sexual partners in the prior 12 months, 88% reported condomless sex and 72% considered themselves at high HIV risk. Retention rates were 96% at 1 month and 82% at 12 months. At 1 month, retention was higher among MSM with some education (OR 12.74, 95% CI: 2.74−70.93; ref: no education). At 12 months, retention was lower among MSM with part‐time employment (aOR 0.29, 95% CI: 0.11, 0.76), students (aOR 0.12, 95% CI: 0.04, 0.37) and unemployed (aOR 0.12, 95% CI: 0.05, 0.28); ref: full‐employed) and those unaware of PrEP at baseline (aOR 0.15, 95% CI: 0.10, 0.23). Conclusions We observed very high rates of PrEP retention among Rwandan FSWs and MSM. Predictors of retention included living situation, employment status, HIV risk perception and low PrEP awareness, but differed between FSWs and MSM. These findings suggest that targeted awareness campaigns tailored to different KPs could improve PrEP retention in care.

This study investigates the effect of extreme storms on the safety of flood protection dams within complex schemes. A modeling methodology is developed using HEC-RAS 2D and presented on an illustrative case, where nine scenarios are simulated. The impact of climatic shifts on extreme storms and dams’ safety is highlighted. The results showed that, despite multi-reservoir systems can be efficient in flood protection against their design storms, they can cause catastrophic damage when subjected to extreme events that have become evident nowadays due to climatic shifts. This is attributed to the successive failure of the water storage structures in a progressive (“domino-like”) manner. The consequences of such breaches can significantly multiply the hazards. These findings can be linked to storm Daniel that occurred at Wadi Derna in Libya and caused two successive dam breaches, leaving a tragedy. The proposed modeling methodology can be useful for designers in evaluating complex scenarios.

ABSTRACT Introduction Head and neck cancer (HNC) is a significant global health burden, with late presentation leading to complex treatment. While human papillomavirus (HPV) infection has been implicated in HNC, data from low‐ and middle‐income countries (LMICs) are limited. In this study, we investigated the prevalence and role of HPV in head and neck cancers diagnosed in Rwanda. Methods A retrospective cross‐sectional study was conducted using Rwanda Cancer Registry from January 2011 through December 2020. p16 immunohistochemistry as a surrogate for HPV was performed on a randomly selected case. p16‐positive cases were genotyped. Results A total of 1001 patients with HNC were identified; 82% (n = 819) had squamous cell carcinoma. The mean age at diagnosis was 51.1 years, with a majority being males (58%). Oral cavity and lip (27%) were the most common primary cancer sites. Stage was unknown in most cases (75%, n = 747). HIV status was known in 33% (n = 334) of patients with 10% (n = 33) HIV‐positive; 22% of 202 randomly selected cases were p16‐positive; 34% of the p16‐positive cases were oropharynx. PCR analysis of p16‐positive cases showed 19% HPV positivity, and HPV16 was the most common high‐risk HPV strain, and 55.5% were recorded HPV‐positive by PCR. Conclusions HNC cases in Rwanda have been increasing from 2011 to 2020, with a significant portion being HPV‐positive. Strategies to implement routine testing for p16, especially in oropharynx cancer patients, improved preservation of tissue samples, collection of comprehensive information including cancer risk factors, staging, and treatment are needed in Rwanda.

Summary: Background: Large language models (LLMs) have shown promising performance in various healthcare domains, but their effectiveness in identifying specific clinical conditions in real medical records is less explored. This study evaluates LLMs for detecting signs of cognitive decline in real electronic health record (EHR) clinical notes, comparing their error profiles with traditional models. The insights gained will inform strategies for performance enhancement. Methods: This study, conducted at Mass General Brigham in Boston, MA, analysed clinical notes from the four years prior to a 2019 diagnosis of mild cognitive impairment in patients aged 50 and older. We developed prompts for two LLMs, Llama 2 and GPT-4, on Health Insurance Portability and Accountability Act (HIPAA)-compliant cloud-computing platforms using multiple approaches (e.g., hard prompting, retrieval augmented generation, and error analysis-based instructions) to select the optimal LLM-based method. Baseline models included a hierarchical attention-based neural network and XGBoost. Subsequently, we constructed an ensemble of the three models using a majority vote approach. Confusion-matrix-based scores were used for model evaluation. Findings: We used a randomly annotated sample of 4949 note sections from 1969 patients (women: 1046 [53.1%]; age: mean, 76.0 [SD, 13.3] years), filtered with keywords related to cognitive functions, for model development. For testing, a random annotated sample of 1996 note sections from 1161 patients (women: 619 [53.3%]; age: mean, 76.5 [SD, 10.2] years) without keyword filtering was utilised. GPT-4 demonstrated superior accuracy and efficiency compared to Llama 2, but did not outperform traditional models. The ensemble model outperformed the individual models in terms of all evaluation metrics with statistical significance (p

Lead (Pb) is a serious toxic metal without any beneficial role in the biological system. Biochar (BC) has emerged as an excellent soil amendment to mitigate Pb toxicity. The impact of BC co-compost (BCC) in mitigating the toxic impacts of Pb has not been studied yet. Therefore, this study aimed to evaluate the potential of BC and BCC in improving the growth, physiological, and biochemical traits of Brassica napus and soil properties and reducing health risks (HR). The study was comprised of different Pb concentrations (control and 100 mg kg-1) and organic amendments (control, BC, compost, and BCC). The results indicated that Pb stress reduced the growth, photosynthetic pigments, seed yield, and oil contents by increasing hydrogen peroxide (H2O2) production and Pb uptake and accumulation in plant tissues and decreasing photosynthetic pigment and nutrient availability. The application of BCC alleviated the adverse impacts of Pb and improved seed production (40.24%) and oil yield (11.06%) by increasing chlorophyll a (43.18%) and chlorophyll b (25.58%) synthesis, relative water content (23.89%), total soluble protein (TSP: 23.14%), free amino acids (FAA: 26.47%), proline (30.98%), APX (40.90%), CAT (32.79%), POD (24.93%), and SOD (33.30%) activity. Biochar co-compost-mediated increase in seed and oil yield was also linked with a reduced accumulation of Pb in plant parts and soil Pb availability and improved the soil-available phosphorus, potassium, total nitrogen, soil organic carbon (SOC), and microbial biomass carbon (MBC). Furthermore, BCC also reduced the bioaccumulation concentration, daily metal intake, hazard index, and target hazard quotient. In conclusion, application of BCC can increase the growth, yield, and oil contents of Brassica napus by improving the physiological and biochemical traits and soil properties and reducing the Pb uptake.