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Background: In Klinefelter's syndrome patients with azoospermia, microscopic testicular sperm extraction (m-TESE) can be proposed as a therapeutic option. Aim of Study: The aim of this study is to assess the sperm retrieval rate in patients with Klinefelter syndrome in King Faisal Specialist Hospital, Riyadh. Methodology: Retrospective, Chart review of 32 patients with Klinefelter syndrome who underwent m-TESE were reviewed and analyzed. All patients had two sets of semen analysis after 3 − 5 days abstinence of ejaculation with further study of semen by in vitro fertilization (IVF) wash. The hormonal analysis was studied. Ultrasonography of testes was assessed preoperatively. Testicular tubules were sent to the IVF laboratory and were studied under the microscope looking for sperms. Some testicular tissues were sent for the histopathology diagnosis Results: Patients' mean age was 34.9 ± 6.0 years. Mean hormonal levels of E2, FSH, LH, prolactin, and testosterone were 96.0 ± 22.0 pmol/L, 29.8 ± 5.4 IU/L, 19.0 ± 2.9 IU/L, 15.4 ± 3.6 ug/L, and 10.0 ± 1.9 nmol/L, respectively. There were two mosaic Klinefelter syndrome patients (6.25%), whereas 30 patients had a nonmosaic form (93.75%). The overall sperm retrieval rate was 37.5%. All patients had small bilateral testes. Sperm retrieval was successful in three patients with hypospermatogenesis, one patient with maturation arrest, and 8 patients with Sertoli-cell-only pattern. Four patients with complete hyalinization of testicular tissues had complete failure to retrieve sperms. The pregnancy rate after intra-cytoplasmic sperm injection was 50%. Conclusions: The sperm retrieval rate in Klinefelter syndrome patients with m-TESE is in accordance with most of those reported in the literature. Regarding histopathology, hypo-spermatogenesis showed a favorable outcome. The pregnancy rate with intra-cytoplasmic sperm injection was 50%.

Clean water scarcity is an escalating global concern, necessitating the development of innovative membrane technologies. This mini review explores the multifaceted realm of membrane technology, a field increasingly engaging researchers and academics. Polymeric membranes find application in diverse domains, spanning gas separation, packaging films, protective coatings, and crucially, water purification techniques like reverse osmosis and various filtration methods. This review predominantly focuses on pressure-driven membrane processes, a classification evolving in selectivity from nanofiltration to microfiltration. It further dissects these processes based on natural and synthetic polymeric membranes. Notably, this work delves into the pivotal role of polymeric membranes in heavy metal water purification, emphasizing the evolving landscape of membrane technologies. Three notable membrane types under scrutiny are Mixed Matrix Membranes, Thin Film Layer Membranes, and membranes incorporating polymer inclusions. Their versatility and applications in diverse sectors showcase the burgeoning potential of polymeric membranes. Furthermore, this review outlines the future applications of polymeric membranes, delineating their indispensable role in nanofiltration, microfiltration, ultrafiltration, and complexation-enhanced ultrafiltration. The compelling attributes of reverse osmosis, forward osmosis, and pervaporation in advancing water purification are also expounded upon. The review culminates by providing an insight into the structural intricacies of polymeric membranes, shedding light on their diverse applications and their pivotal role in addressing the global water crisis. The dynamic and evolving landscape of membrane technology underscores the crucial need for continued research and innovation in this domain to tackle water pollution and scarcity effectively. As we venture further into the 21st century, the multifaceted applications of polymeric membranes are set to play an instrumental role in safeguarding our most precious resource—clean and sustainable water.

One of the most challenging aspects of environmental conservation is the treatment of dye wastewater. Thus, this mini-review discussed the issues and major advances in the application and performance assessment of the aerobic, anaerobic, anaerobic-aerobic, aerobic-anaerobic, and anoxic–aerobic REACT-operated SBR systems with regards to bio-decolorization and COD removal rates. In SBRs run in aerobic modes, it is possible to cultivate aerobic granular sludge for color removal. To be precise, SBR has a higher COD removal efficiency with a lower color removal efficiency. Under anaerobic conditions, lesser COD removal was observed for several dyes studied in this chapter. In an alternating anaerobic-aerobic SBR system, color removal tends to occur during the anaerobic phase, while the aerobic phase is required to further reduce the effluent COD concentration. However, molecular oxygen drastically reduced color removal in SBR during dye wastewater treatment. This chapter discusses the aerobic-SBR treatment process for dye removal. The discussion focused on dye wastewater treatment using aerobic granules, granular activated carbon, adsorbents, biocarrier white rot fungi, varying dye mixtures, dye concentrations and SBR operational parameters. Adsorbents, membranes, biocarriers, exported microbial cultures, and various operational conditions have also been used in sequential anaerobic/aerobic batch reactors to enhance system performance. This chapter assessed the different treatment mechanisms and dynamics and concluded that combining two treatment methods significantly yields better color, DOC, and BOD5 removal than a single biological or chemical treatment.

Background: The quality of randomized controlled trials from Saudi Arabia is unknown since most are observational studies. Objective: To determine (1) the quantity and quality of randomized controlled trials published from Saudi Arabia, and (2) whether significance of intervention effect varied by study quality. Methods: PubMed, SCOPUS, and Cochrane were searched with keywords for trials published from Saudi Arabia until February 2018. A total of 422 records were identified and screened, resulting in 61 eligible trials for analysis. Two researchers abstracted trial characteristics and assessed quality in seven domains (randomization, allocation concealment, blinding of assessors or participants, incomplete outcome data, selective reporting, and other sources of bias) using the Cochrane Collaboration Risk of Bias Tool. Results: A majority of the trials (57%) were published during 2010–2018. High risk of bias was present for blinding (outcome: 13%; participants and personnel: 28%). Biases could not be assessed due to lack of information (unclear risk) in the domains of randomization (54%), allocation concealment (44%), and blinding of outcome assessment (57%). When all seven domains were considered together (summary risk of bias), 0% of the trials had low risk, 39% had high risk, and 61% had unclear risk of biases. A greater proportion of high-risk trials had significant intervention effect than unclear-risk trials (79% vs. 67%). Conclusion: The volume and quality of trials in Saudi Arabia was low. More high-quality randomized controlled trials are warranted to address chronic diseases. Keywords: Randomized controlled trial, CCRBT, Research quality, Saudi Arabia

The effect of different content (0–20 wt%) Acrylonitrile-styrene-acrylic (ASA) on mechanical, thermal and three-body wear behaviors of eucalyptus fiber/polyvinyl chloride (EF/PVC) composites were studied in this research. The results show that the mechanical properties of the composites such as impact strength, tensile strength, flexural strength and flexural modulus increased with increasing ASA content lower than 15 wt%. The addition of 15 wt% and 20 wt% ASA can improve thermal stability of the EF/PVC composites in the early period of the heating, and the effect weakened on later stage due to the thermal degradation of ASA, which occurred in the temperature range 416°C–442°C. The three-body wear resistance of the EF/PVC composites can be improved by ASA, and the abrasive wear mechanism of the composites was predominated by linear travel, sand particle plough and cut action, ASA and PVC plastic deformation, and fibers debonding.

The construction industry is witnessing a transformative shift towards sustainable and intelligent housing solutions driven by advancements in 3D printing, Artificial Intelligence (AI), and the Internet of Things (IoT). Several architectural and construction firms have adopted innovative technologies to make construction easier, sustainable, efficient, cheap, fast, low generation of waste etc. This explorative review critically examines the integration of these technologies in the construction of eco-friendly intelligent homes. Drawing on a comprehensive analysis of literature spanning from 2010 to 2024, the review explores the synergistic potential and challenges associated with amalgamating 3D printing, AI, and IoT in construction processes. The increase need of smart homes equipped with sensors that can sense and regulate temperature, prevent or control fire, sense gas leakage, motion detectors and alarms for security and other application is in high demand. These types of smart homes can only be achieved by integrating different technologies together which include 3D printing (3DP), AI and Internet of Things (IoT). Despite the growing research in the field of automated construction, there are few articles that attempt to integrate these technologies together for futuristic smart homes and potential of smart cities. This study is aim at providing up-to-date advancement in technological innovation within the construction sector with regards to applications of 3DP, IoT, and AI. Key findings highlight how 3D printing enables rapid prototyping and customization of building components, AI enhances energy efficiency and occupant comfort through predictive analytics and automation, while IoT facilitates real-time monitoring and control of building systems. Furthermore, the review discusses the environmental benefits, cost-effectiveness, and societal implications of adopting such integrated approaches. However, challenges such as regulatory barriers, technological limitations, and the need for skilled labor are identified as critical barriers to widespread implementation. Future research directions are proposed to address these challenges and further optimize the integration of 3D printing, AI, and IoT for the construction of sustainable intelligent homes. In this review article, the need for 3DP in construction, advantage and disadvantage of 3DP, (AI) and IoT and the application of these technologies in addressing challenges regarding 3DP and promoting sustainability in the construction industries were comprehensively explored., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Burkitt lymphoma is an aggressive B-cell non-Hodgkin lymphoma (NHL). Primary CNS lymphoma (PCNSL) is a rare disease, and the subtype of Burkitt lymphoma presenting as a sole CNS lesion is an even rarer diagnosis. Acute sudden blindness is a rare presenting symptom of PCNSL or NHL in general. We present an interesting case of a four-year-old boy with dysmorphic features whose visual examination showed a sudden bilateral loss of vision. There was bilateral eye proptosis and complete ptosis. Extraocular muscles were fixed straight. The pupils were fixed and mid dilated bilaterally and there was grade 3/4 papilledema in both eyes. Neuroimaging showed a mass in the base of the skull, extending to orbits and sinuses. A cervical biopsy of the enlarged lymph nodes was taken and a histopathological diagnosis of Burkitt lymphoma was made. Genetic analysis showed a GNB1 mutation, and the patient was diagnosed with Kabuki syndrome by a pediatrician, based on characteristic dysmorphic features. Treatment with steroids and chemotherapy was initiated., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alghamdi et al.)

Background: A traditional narrative review was performed to evaluate clinical studies that have examined the clinical implications, risk factors, and prevention of calcineurin inhibitors (CNIs) nephrotoxicity with stress on a belatacept-based rescue regimen., Methods: The Cochrane Library, PubMed/MEDLINE, EBSCO (Academic Search Ultimate), ProQuest (Central), and Excerpta Medical databases and Google scholar were searched using the keywords (CNI AND Nephrotoxicity prevention) OR ("Calcineurin inhibitor" AND Nephrotoxicity) OR (Tacrolimus AND Nephrotoxicity) OR (Ciclosporin AND Nephrotoxicity) OR (cyclosporine AND Nephrotoxicity) OR (Belatacept) OR (CNI Conversion) for the period from 1990 to 2020. Fifty-five related articles and reviews were found., Conclusion: A better understanding of the mechanisms underlying calcineurin inhibitor nephrotoxicity could help in the individualization of therapy for and prevention of CNI nephrotoxicity. Identification of high-risk patients for CNI nephrotoxicity before renal transplantation enables better use and selection of immunosuppression with reduced adverse effects and, eventually, successful treatment of the kidney recipients. Belatacept conversion is a good and safe option in patients with deteriorating renal function attributed to CNI nephrotoxicity., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: To assess the drug-related problem among patients with type 2 diabetes at Hiwot Fana Specialized University Hospital., Results: In this study, a total of 148 patient medication records were included. More than half, 83 (57.4%) were men and the rest 65 (42.6%) were women. The mean age of the study participants was 51.26 ± 7.08. Around one-third (74.3%) of the participants had urban residency. A total of 127 drug-related problems were identified, of which dosage too low was the most common type of DRP encountered, 46 (36.2%), followed by unnecessary drug therapy, 25 (19.7%) and ineffective drug therapy, 25 (19.7%). 95 (64.2%) of the patients had at least one drug-related problem. Among patients with DRP, more than half of them, 59 (62.1%) had a single DRP. Out of the total participants, 85 (57.4%) of them were taking one anti-diabetic medication and 63 (42.6%) of them dual anti-diabetic medications. Only half of the patients have attained the desired FBG level. There was no patient who had experienced more than two types of drug-related problems at a time. Less than 10% of patients were taking five or more drugs at a time.