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The outcome of cochlear implantation is typically assessed by speech recognition tests in quiet and in noise. Many cochlear implant recipients reveal satisfactory speech recognition especially in quiet situations. However, since cochlear implants provide only limited spectro-temporal cues the effort associated with understanding speech might be increased. In this respect, measures of listening effort could give important extra information regarding the outcome of cochlear implantation. In order to shed light on this topic and to gain knowledge for clinical applications we compared speech recognition and listening effort in cochlear implants (CI) recipients and age-matched normal-hearing listeners while considering potential influential factors, such as cognitive abilities. Importantly, we estimated speech recognition functions for both listener groups and compared listening effort at similar performance level. Therefore, a subjective listening effort test (adaptive scaling, “ACALES”) as well as an objective test (dual-task paradigm) were applied and compared. Regarding speech recognition CI users needed about 4 dB better signal-to-noise ratio to reach the same performance level of 50% as NH listeners and even 5 dB better SNR to reach 80% speech recognition revealing shallower psychometric functions in the CI listeners. However, when targeting a fixed speech intelligibility of 50 and 80%, respectively, CI users and normal hearing listeners did not differ significantly in terms of listening effort. This applied for both the subjective and the objective estimation. Outcome for subjective and objective listening effort was not correlated with each other nor with age or cognitive abilities of the listeners. This study did not give evidence that CI users and NH listeners differ in terms of listening effort – at least when the same performance level is considered. In contrast, both listener groups showed large inter-individual differences in effort determined with the subjective scaling and the objective dual-task. Potential clinical implications of how to assess listening effort as an outcome measure for hearing rehabilitation are discussed.

There has been increasing interests in the sustainable way of investing as enjoined by several sustainability initiatives. However, investors require effective portfolio diversification at various market conditions (stress, benign, and boom) and would consider sustainable equities to the extent that they aid in the minimisation of portfolio risks. As a result, a better way investors can mitigate portfolio risk is by forming portfolios with relevant volatility indices as enshrined in extant literature. It becomes necessary to investigate the susceptibility of Islamic stocks in a sustainable way to shocks from volatility indices to enhance effective portfolio decisions. In this regard, we investigate the asymmetric effect of implied volatility indices on sustainable Islamic stocks across different market conditions. Hence, the quantile regression and quantile-on-quantile regression techniques are employed. The study discovered an asymmetric influence of volatility on sustainable Islamic stock returns at various quantiles. Furthermore, most volatilities’ asymmetric effects were generally inversely associated to sustainable Islamic stock returns, implying diversification benefits across market outcomes. Also, with the exception of the extreme quantiles, there is a causal effect of volatilities on Islamic stock returns for most quantiles. It seems to reason that ordinary market outcomes, rather than market stress or boom, have a greater impact on causal estimates for our quantile regression model.

Integrating machine learning technologies into artificial intelligence (AI) is at the forefront of the scientific and technological tools employed to combat the COVID-19 pandemic. This study assesses different uses and deployments of modern technology for combating the COVID-19 pandemic at various levels, such as image processing, tracking of disease, prediction of outcomes, and computational medicine. The results prove that computerized tomography (CT) scans help to diagnose patients infected by COVID-19. This includes two-sided, multilobar ground glass opacification (GGO) by a posterior distribution or peripheral, primarily in the lower lobes, and fewer recurrences in the intermediate lobe. An extensive search of modern technology databases relating to COVID-19 was undertaken. Subsequently, a review of the extracted information from the database search looked at how technology can be employed to tackle the pandemic. We discussed the technological advancements deployed to alleviate the communicability and effect of the pandemic. Even though there are many types of research on the use of technology in combating COVID-19, the application of technology in combating COVID-19 is still not yet fully explored. In addition, we suggested some open research issues and challenges in deploying AI technology to combat the global pandemic.

يهدف البحث الى تحليل دور السياسات الاقتصادية في مواجهة اختلال ميزان المدفوعات في العراق للمدة (1990-2018)، من خلال تحليل استقرارية السلاسل الزمنية، توصل البحث الى تأثير المتغيرات المستقلة في المتغير التابع، من اهم الاستنتاجات ان ميزان المدفوعات العراقي قد عانى خلال فترة السبعينات من عجز كبير نتيجة لعجز الموازنة العامة بسبب اختلال الهيكل الإنتاجي وانخفاض الإيرادات العامة وذلك بسبب الظروف التي مرت بها البلاد جراء حرب الخليج وفرض العقوبات الاقتصادية اما بعد عام 2003 فقد حقق ميزان المدفوعات العراقي فائضا لكن الاختلال مازال قائما حيث جاء هذا الفائض بالاعتماد على الصادرات النفطية أي حدوث فائض في الميزان التجاري وعجز في الحساب الرسمالي والذي ادى الى اختلال ميزان المدفوعات، وأوصى الباحث بأهم المقترحات وهي تشجيع الصادرات غير النفطية، خصوصا بعد انخفاض أسعار النفط في المدة الأخيرة كون الاقتصاد العراقي يعتمد على صادرته النفطية، وضرورة الحد من حجم وقيمة الاستيرادات والتوجه نحو استراتيجية احلال الاستيرادات والعمل على جذب الاستثمارات الأجنبية بما يتناسب مع الحاجة لتحسين الاختلال في ميزان المدفوعات وبالتالي رفع معدلات النمو الاقتصادي.

Background Beta-thalassemia is one of the common genetic disorders in our community. Therefore, it is deemed necessary to study and probe it to encompass all aspects of this disorder. Aim The aim of this study was to determine the adherence of management of β-thalassemia major in Minia General Hospital to an established Standard for the Clinical Care of Children with Thalassemia in the UK. Patients and methods This study included 100 children with β-thalassemia major who were receiving regular blood transfusion; data of the patients were collected and analyzed for audit against established Standards for the Clinical Care of Children with Thalassemia in the UK; values were expressed in terms of percentage. Results The diagnosis of β-thalassemia major in our study was made mainly on the basis of the clinical background confirmed by complete blood count, hemoglobin electrophoresis, and serum ferritin level; the frequency of investigations in our study showed that abdominal ultrasound was performed regularly in most of our patients (93%), followed by liver function (74%), serum ferritin (65%), hepatitis marker (57%), echocardiography (47%), and assessments of weight and height − sitting and standing (43%), follicle-stimulating hormone, luteinizing hormone (7%), thyroid-stimulating hormone, triiodothyronine, thyroxine (7%), fundus examination (7%), audiometry (3%), oral glucose tolerance test (3%), vitamin D level (3%), and DEXA scan (1%); the assessment of puberty was not performed. The most common complication in our study was splenomegaly (80%), followed by bone deformities (76%), slowed growth rates (69%), and infection (47%), followed by bone osteoporosis (27%), heart problems (24%), chronic hepatitis, or liver fibrosis (19%). Iron-chelation therapy was used by 53% of our patients. Deferasirox is the main line (38%); hydroxyurea was used by 41% of our patients. Conclusion As a conclusion, we found that lines of management of β-thalassemia major in Minia General Hospital were not enough and not performed systematically in comparison with Standards for the Clinical Care of Children with Thalassemia in the UK.

Calcium sulfate (CS) is a ubiquitous compound that has been incorporated in several medical and dental procedures. This can be attributed to its many advantageous characteristics, including being resorbable as well as its biocompatibility. Primarily, it was used to help treat a variety of osseous defects by acting as a bone substitute. Due to its unique properties, other therapeutic applications have been identified. Whilst the outcomes of these applications are varied, they have shown to be beneficial within the disciplines of endodontics, periodontics and oral & maxillofacial surgery. The aim of this review is to thoroughly discuss CS including its characteristics, chemical and physical properties, and known relative indications in dentistry. Clinical studies reporting the outcomes of CS for particular treatment modalities are further analyzed and discussed.

Background The sensorineural hearing loss incidence (SNHL) ranges from 1 to 3 per 1000 live births in term healthy neonates, and 2–4 per 100 in high-risk infants, a 10-fold increase. Objective The aim was to estimate the incidence of SNHL among newborns in NICU at Ahmed Maher Teaching Hospital, Cairo, Egypt, and to describe the distribution of risk factors associated with SNHL and the effects of their interaction. Patients and methods The study was carried out on 710 neonates in a hospital in Cairo, Egypt. A total of 710 (401 males and 309 females) neonates were included in the study and had a birth weight ranging from 680 to 5500 g, and the mean gestational age was 35.8 ± 3 weeks. All the cases were screened for hearing loss using the transient evoked otoacoustic emission device, followed by a second-stage screening for those who failed, and cases were given a Refer then underwent an automated auditory brainstem response test. Results In the studied cases, 76.7% had hyperbilirubinemia, 8.73% were of low birth weight (

This study aims to investigate patients' knowledge of the triage system, utilization of primary healthcare resources, and expectations for waiting times in Jordanian Emergency Departments (EDs). A descriptive, cross-sectional design was employed in the EDs in the largest public hospitals in Jordan. Convenient sampling resulted in 726 participants. A self-reported questionnaire included socio-demographic information and instruments assessing primary healthcare use, triage system awareness, and expected waiting times. Most participants (61.3%) lacked awareness of the triage system. The use of primary healthcare was influenced by age, education, marital status, current job, nationality, and location. Having a primary healthcare provider was associated with higher patient satisfaction. Significant variations in expected waiting times for diagnostic test results were noted based on gender, place of residence, education, current job, and marital status. Addressing patient awareness of the triage system is crucial for optimizing healthcare accessibility and quality in Jordanian EDs. Improving patient education, communication, and primary care utilization can enhance patient outcomes, reduce ED burden, and contribute to a more efficient healthcare system. [ABSTRACT FROM AUTHOR]

Background: Posterior maxillary implant rehabilitation is a critical procedure because of the diminished bone quality and quantity, especially in severe atrophic posterior maxilla which affect the stability of the implant and raises the demand of the sinus floor elevation, bone augmentation and ensuring implant stability in order for the implant to succeed. Transalveolar sinus lifting is a valuable technique in reaching and augmenting the floor of the sinus without penetrating the sinus membrane or causing sinusitis and to avoid numerous surgical interventions. Patients and methods: This is a prospective, interventional clinical study that was carried out on 10 adult patients who had missed posterior maxillary teeth and wanted to restore it, with less than 5 mm residual bone height and greater than 7 mm bone width which treated with transalveolar sinus lifting using corticocancellous bone block containing the implant from the chin bone. All patients are followed-up clinically and radiographically by cone beam computed tomography. Results: Our technique was performed successfully in all cases without any signs of infection or sinusitis and all implants inserted were clinically stable after 6 months with radiographic significant increase in the bone height and density around the implants. Conclusion: Transalveolar sinus lifting using press-fitted corticocancellous bone block containing implant from chin bone was found to be highly effective technique for posterior maxillary rehabilitation in severe atrophic posterior maxilla. [ABSTRACT FROM AUTHOR]

In today's highly digitized landscape, securing digital communication is paramount due to threats like hacking, unauthorized data access, and network policy violations. The response to these challenges has been the development of cryptography applications, though many existing techniques face issues of complexity, efficiency, and limitations. Notably, sophisticated intruders can easily discern encrypted data during transmission, casting doubt on overall security. In contrast to encryption, steganography offers the unique advantage of concealing data without easy detection, although it, too, grapples with challenges. The primary hurdles in image steganography revolve around the quality and payload capacity of the cover image, which are persistently compromised. This article introduces a pioneering approach that integrates image steganography and encryption, presenting the BitPatternStego method. This novel technique addresses prevalent issues in image steganography, such as stego-image quality and payload, by concealing secret data within image pixels with identical bit patterns as their characters. Consequently, concerns regarding the quality and payload capacity of steganographic images become obsolete. Moreover, the BitPatternStego method boasts the capability to generate millions of keys for the same secret message, offering a robust and versatile solution to the evolving landscape of digital security challenges. [ABSTRACT FROM AUTHOR]

Introduction: Type 1 diabetes mellitus (T1DM) is a chronic auto‑immune disease in which loss of pancreatic islet β‑cells leads to the deficiency of insulin in the body thus resulting in enhanced blood sugar levels. Effective blood glucose monitoring is crucial in T1DM management to prevent complications, particularly hypoglycemia. Method: The study adopted a cross‑sectional survey to assess satisfaction and quality of life among T1DM patients using the freestyle libre continuous glucose monitoring (FSL‑CGM), and a retrospective cohort study design to evaluate changes in HbA1c over a year. Result: The study involved 98 Saudi subjects, with 46.9% (n = 46) being male. The results indicated a high level of user satisfaction, with more than 85% of the participants responding positively, yielding a total satisfaction score of 30.86. User satisfaction with FSL‑CGM was found to be significantly associated with the level of education. The use of FSL‑CGM was also found to significantly improve the patients’ quality of life. However, the levels of HbA1c had an impact on both satisfaction and quality of life. Before using the FSL‑CGM system, the mean HbA1c was 9.83%, which significantly decreased to 8.63% after using the system (P-value <0.001). Conclusion: The study’s findings align with previous literature on satisfaction and quality of life, but there are conflicting results regarding the reduction of HbA1c levels using FSL‑CGM. Given the limited sample size, future research could explore the topic more comprehensively, potentially utilizing a longitudinal study design to better measure changes in HbA1c level. [ABSTRACT FROM AUTHOR]

Plant growth-promoting rhizobacteria (PGPRs) represent a promising strategy for enhancing plant resilience and yields under drought-stress conditions. This study isolated and characterized PGPR from wheat rhizosphere soil in Egypt. Four PGPR strains were evaluated for an array of plant growth-promoting traits, including IAA production, biofilm formation, siderophore production, nitrogen fixation, ACC deaminase activity, phosphate solubilization, and antagonistic potential. Molecular identification via 16S rRNA sequencing classified three isolates (MMH101, MMH102, and MMH103) within the Bacillus genus and one isolate (MMH104) as Myroides sp. Greenhouse experiments examined the effects of PGPR inoculation on the drought-stressed Egyptian wheat cultivar, Gimmeza-9. Wheat plants inoculated with PGPR isolates showed dramatic improvements in growth parameters and stress tolerance indicators compared to non-inoculated controls when subjected to a 10-day drought period, with Bacillus rugosus (MMH101) inoculation resulting in increases of 61.8% in fresh biomass, 77.2% in dry biomass, 108.5% shoot length, and 134.9% root length. PGPR treatments also elevated the chlorophyll and proline content while reducing malondialdehyde levels. The findings demonstrate the effectiveness of PGPR inoculation in enhancing the morphology, physiology, and drought stress resilience of wheat. Isolated PGPR strains hold promise as biofertilizers for improving cereal productivity under water-deficit conditions. [ABSTRACT FROM AUTHOR]

Chickpea is an important crop that delivers nutritious food to the increasing global community and it will become increasingly popular as a result of climate change. Our objective was to use comprehensive data analysis to locate and identify candidate genes for fungal disease resistance. We used a comprehensive bioinformatics pipeline of sequence alignment, phylogenetic analysis, protein chemical and physical properties assessment and domain structure classification. In order to study gene evolution and genetic diversity, we compared these genes with known anti-fungal genes in different species of plants. A total of 19721 protein sequences belonging to 187 plant species have been downloaded from public databases, including the entire Chickpea genome. We have successfully identified 23 potential anti-fungal genes in 10 different chromosomes and genomic scaffolds using sequence alignment and gene annotation. Ca2 and Ca6 have the highest number of genes followed by Ca3 and Ca4. Anti-fungal chickpea proteins have been identified as cysteine-rich (10), thaumatin (6), pathogenesis (4) and plasmodesmata (3) proteins. Analysis of the chemical and physical correlation of anti-fungal proteins revealed a high correlation between different aspects of anti-fungal proteins. Five different pattern patterns have been detected in the anti-fungal chickpea proteins identified, including domain families associated with fungal resistance. The maximum-likelihood of phylogenetic analysis was successful in distinguishing between anti-fungal chickpea proteins as seen in their protein patterns/domains.

The Gorilla Troops Optimizer (GTO) is a novel Metaheuristic Algorithm that was proposed in 2021. Its design was inspired by the lifestyle characteristics of gorillas, including migration to a known position, migration to an undiscovered position, moving toward the other gorillas, following silverback gorillas and competing with silverback gorillas for females. However, like other Metaheuristic Algorithms, the GTO still suffers from local optimum, low diversity, imbalanced utilization, etc. In order to improve the performance of the GTO, this paper proposes a modified Gorilla Troops Optimizer (MGTO). The improvement strategies include three parts: Beetle-Antennae Search Based on Quadratic Interpolation (QIBAS), Teaching–Learning-Based Optimization (TLBO) and Quasi-Reflection-Based Learning (QRBL). Firstly, QIBAS is utilized to enhance the diversity of the position of the silverback. Secondly, the teacher phase of TLBO is introduced to the update the behavior of following the silverback with 50% probability. Finally, the quasi-reflection position of the silverback is generated by QRBL. The optimal solution can be updated by comparing these fitness values. The performance of the proposed MGTO is comprehensively evaluated by 23 classical benchmark functions, 30 CEC2014 benchmark functions, 10 CEC2020 benchmark functions and 7 engineering problems. The experimental results show that MGTO has competitive performance and promising prospects in real-world optimization tasks.

The burden of breast cancer is imposing a huge global problem. Drug discovery research and novel approaches to treat breast cancer have been carried out extensively over the last decades. Although immune checkpoint inhibitors are showing promising preclinical and clinical results in treating breast cancer, they are facing multiple limitations. From an immunological perspective, a recent report highlighted breast cancer as an “inflamed tumor” with an immunosuppressive microenvironment. Consequently, researchers have been focusing on identifying novel immunological targets that can tune up the tumor immune microenvironment. In this context, several novel non-classical immune targets have been targeted to determine their ability to uncouple immunoregulatory pathways at play in the tumor microenvironment. This article will highlight strategies designed to increase the immunogenicity of the breast tumor microenvironment. It also addresses the latest studies on targets which can enhance immune responses to breast cancer and discusses examples of preclinical and clinical trial landscapes that utilize these targets.

In this paper, the Hirota bilinear method, which is an important scheme, is used. The equation of the shallow water wave in oceanography and atmospheric science is extended to (3+1) dimensions, which is a well-known equation. A lot of classes of rational solutions by selecting the interaction between a lump and one- or two-soliton solutions are obtained. The bilinear form is considered in terms of Hirota derivatives. Accordingly, the logarithm algorithm to obtain the exact solutions of a (3+1)-dimensional variable-coefficient (VC) generalized shallow water wave equation is utilized. The analytical treatment of extended homoclinic breather wave solutions is studied and plotted in three forms 3D, 2D, and density plots. Using suitable mathematical assumptions, the established solutions are included in view of a combination of two periodic and two solitons in terms of two trigonometric and two hyperbolic functions for the governing equation. Maple software for computing the complicated calculations of nonlinear algebra equations is used. The effect of the free parameters on the behavior of acquired figures to a few obtained solutions for two nonlinear rational exact cases was also discussed.