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Background: Several studies examined the reciprocal relationship between knee osteoarthritis (KOA), depression, and postural balance separately; however, few studies have investigated the relationship between them. Therefore, this study aimed to identify the relationship between postural balance and depression among patients with KOA in Saudi Arabia. Methods and Results: A total of 71 patients with KOA were recruited (36 males, 35 females) with a mean age of 55.0±8.6 years, mean knee pain of 7.2±1.0, and mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) of 44.9±11.6. Depression was measured using the Hospital Anxiety and Depression Scale (HADS). The participants were asked to complete the HADS, rate their pain in both knees using the Visual Analogue Scale (VAS) and the WOMAC, and undergo the Berg Balance Scale (BBS) to assess the postural balance. A significantly strong negative correlation was observed between postural balance and anxiety and depression in all the participants (BBS and HADS: r= −0.920, P

Fahad Abdulaziz Alrashed,1 Tauseef Ahmad,1 Muneera M Almurdi,2 Asma A Alderaa,2 Saad A Alhammad,2 Mohammad Serajuddin,3 Abdulrahman M Alsubiheen2 1Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 3College of Dentistry, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Fahad Abdulaziz Alrashed, Department of Medical Education, College of Medicine, King Saud University, P.O Box 2925, Riyadh, 11461, Saudi Arabia, Tel +966596130110, Email faaalrashed@ksu.edu.saIntroduction: The integration of technology into medical education has witnessed significant growth in recent years, with tools such as virtual reality, artificial intelligence, and telemedicine gaining prominence. These tool in medical education, offering immersive, experiential learning experiences.Methods: We approached medical students currently enrolled in medical education programs and who are familiar with and actively use AI in medical education. Initially, we invited 21 random students to participate in the study; however, only 13 agreed to interviews. Some students cited their busy exam schedules as the reason for not participating. The participants were informed of the objective of the study before the commencement of the recorded interviews. Semi-structured interviews were used to guide the record interviews. Audio recordings were transcribed and analyzed using Atlas.ti, a qualitative data analysis software.Results: Participants exhibited a diverse range of perceptions and levels of awareness regarding VR, AI, and telemedicine technologies. Learning with virtual reality was considered to be fun, memorable, inclusive, and engaging by participants. The use of virtual reality technology is seen as complementing current teaching and learning approaches, helping to build learners’ confidence, as well as providing medical students with a safe environment for problem-solving and trial-and-error learning. The students reported that AI was seen as a potential game-changer in the healthcare sector. Participants hoped that telemedicine would provide healthcare services to remote and underserved populations.Conclusion: The study conducted focus group discussions with medical students and residents in Saudi Arabia to explore their views on integrating VR, AI, and telemedicine in medical education and practice. Their insights highlight the need for informed decision-making and strategic development to optimize the benefits and address challenges like initial investments, technical issues, ethics, and regulations. These considerations are crucial for fully realizing the potential benefits of technology in medical education globally.keywords: learning education, medical education, medical education with virtual reality, technology in medical education, qualitative research teaching technology, artificial intelligence

This paper discusses implementing the Islamic learning approach model in Jembrana-Bali's case study in State High School (SMAN) 1 Jembrana. This paper explores the effectiveness of multicultural learning models used in Islamic religious education learning. Multicultural learning model creating harmonious interaction. Furthermore, the integration of diversity understanding between Hindu and Islamic students aims to peaceful practices in the educational environment. Data sources were obtained through unstructured observations and interviews from July to September 2019. The result showed that the learning process of Islamic religious education with a multicultural approach forms the character of students, both Hindu and Muslim, to be humanist, tolerant, and inclusive. In shaping character and fostering understanding diversity, the learning approach used is the contribution approach, additive approach, and the decision making and social action approach proposed by Allison Cumming-McCann. The interaction of students in SMAN 1 Jembrana, both Hindus and Muslims, aims to acculturation and enculturation of two different religions and traditions.

Background: Deranged thyroid hormones and TSH induces the release of inflammatory biomarkers and recent evidence has demonstrated an association between low vitamin D status and autoimmune thyroid diseases, but there is little documented evidence available about the association of vitamin D and inflammatory biomarkers. So, this study was planned to investigate the relationship between vitamin D and inflammatory biomarkers. Materials and Methods: This case-control study was carried out among 60 study participants (30 cases and 30 controls) in the Department of Biochemistry, F.H Medical College, its associated Hospital from January 2023 to June 2023 The samples were divided in to two groups, cases (hypothyroid patients) and healthy control group. Serum was separated by centrifuging blood at 3000 rpm for 10 mi. Estimation of CRP was done turbidimetric immune assay method. Statistical analysis was done by using the (SPSS) version 20.0. Pearson correlation and Student’s t-test was applied, p-value

In this paper, an improvement for the ϕ6-model expansion method is presented. In this approach, contrary to the classical ϕ6-model expansion method, obtaining explicit solutions for nonlinear ordinary and partial differential equations is congenial and undemanding of any constraint conditions, where the method can be applied and used for obtaining solutions without having any conditions on them. Moreover, the new approach is used to obtain new solutions for the new (3+1)-dimensional integrable Kadomtsev–Petviashvili equation. We demonstrated that for the same equation, the classical ϕ6-model expansion and the improved ϕ6-model expansion approaches produce the same family of solutions. However, the improved ϕ6-model expansion method is found to be more efficient and convenient.

The vacuolating cytotoxin VacA and cytotoxin associated gene product CagA, encoded by vacA and cagA are major virulence determinants associated with pathogenesis of Helicobacter pylori. The presence and prevalence of two major H. pylori virulence associated genes among gastric biopsies of Pakistani children were investigated in the current study. Fifty one gastric biopsy specimens of children were analysed for 16S rRNA, vacA and cagA genes using PCR. The results showed that 21 (41.2%) biopsies were positive for H. pylori as determined by 16S rRNA PCR. In the 21 H. pylori positive gastric biopsies, 19 (90.5%) showed vacA s1a, 1 (4.75%) was vacA s1b and 1 (4.75%) was vacA s2 whereas, 5 (23.8%) were vacA m1 and 16 (76.2%) were vacA m2. None of the H. pylori positive biopsies carried vacA s1c subtype. The cagA gene was found in 13 (61.9%) of H. pylori infected biopsies and different vacA combinations were found with or without cagA gene. H. pylori was detected with high frequency of cagA while vacA s1a and vacA m2 regions with vacA s1a/m2 genotype were predominant in H. pylori infected gastric biopsies of children.

Handling luggage systems is a critical component of a passenger terminal's operations. The proposed study attempts to find the optimal solution for a manually operated terminal concerning the luggage offloading process from arrival flights carried by a limited number of ground handling agents. Handling agents start the offloading process from the aircraft to the cargo luggage containers carried by a cargo car that will take the containers' trolleys to the cargo area to offload them into the reserved luggage belt carousel. This study aims to improve airport service quality by minimizing the baggage handling process time for arrival flights which leads to minimizing passenger waiting time in the baggage claim area. We proposed both a deterministic and stochastic approach. The integer programming method is provided to minimize the total number of flights assigned to the belt carousel under the realistic constraint of minimizing the luggage load on each belt carousel. Simulation tools were used so that the offloading process could be modeled to study the effects of various parameters such as the number of ground handling agents for different flights with different amounts of luggage. (original abstract)

Introduction: To assess outcomes of FHL transfer and V-Y plasty for chronic Achilles rupture due to insertional Achilles tendinopathy. Materials and methods: A case series of 12 patients was conducted between 1st January 2017 and 31st December 2018. The patients had short flexor hallucis longus tendon transfer with gastrocnemius lengthening by V-Y plasty for Achilles tendon rupture. Patients were allowed full weight bearing at six weeks post-operatively, and were followed up at three months and six months post-operatively, when the range of motion of the ankle was examined, and the outcome was assessed using the EFAS score. Results: Of the 12 patients in the study, the majority were males; the mean age was 50.6±8.96 years. A significant improvement in dorsiflexion and plantarflexion was noted at the six-month follow-up compared to the three-month follow-up (P=

Computing backscattering of harmonic acoustic waves from underwater elastic targets of arbitrary shape is a problem of considerable practical significance. The finite element method is commonly applied to the discretization of the target; on the other hand, the boundary element method naturally incorporates the radiation boundary condition at infinity. The coupled model tends to be expensive, primarily due to the need to manipulate large, dense, and complex matrices and to repeatedly solve systems of complex linear algebraic equations of significant size for each frequency of interest. In this article, we develop a model reduction transformation based on the notion of coherence applied to the surface pressures, which considerably reduces the size of the systems to be solved. We found that the proposed model reduction approach delivers acceptably accurate results at a fraction of the cost of the full model. A typical speedup of an order of magnitude was realized in our numerical experiments. Our approach enables backscattering computations with considerably larger models than have been feasible to date.

Naseer F, Ahmad T, Kousar K, et al. Int J Nanomedicine. 2023;18:185–205. We, the Editor and Publisher of the journal International Journal of Nanomedicine are retracting the published article. Following publication of the article, concerns were raised about the duplication of images from Figures 8, 10 and 13 with images from other unrelated articles. Specifically, The image for Figure 8A, blank NF temperatures, has been duplicated with the image for Figure 13C, SEM of lyophilized NF after 3 months storage. The image for Figure 8C, HA-coated OMV loaded TC, has been duplicated with the image for Figure 16C, lyophilized NFs after 3 months, from Kousar K, Naseer F, Abduh MS, Anjum S and Ahmad T. CD44 targeted delivery of oncolytic Newcastle disease virus encapsulated in thiolated chitosan for sustained release in cervical cancer: a targeted immunotherapy approach. Front. Immunol. 2023;14:1175535. https://doi.org/10.3389/fimmu.2023.1175535. The image for Figure 8D, HA-coated OMV loaded TCs, has been duplicated with the image for Figure 6B, CsA-loaded ThC-HA NF, from Abduh MS. Anticancer Analysis of CD44 Targeted Cyclosporine Loaded Thiolated Chitosan Nanoformulations for Sustained Release in Triple-Negative Breast Cancer. Int J Nanomedicine. 2023;18:5713-5732. https://doi.org/10.2147/IJN.S424932. The image for Figure 9D, HA-coated OMV-loaded TCs, has been duplicated with the image for Figure 10B, HA-ThCs-Cis NFs, from Kousar K, Naseer F, Abduh MS, et al. Green synthesis of hyaluronic acid coated, thiolated chitosan nanoparticles for CD44 targeted delivery and sustained release of Cisplatin in cervical carcinoma. Front. Pharmacol. 2023;13:1073004. https://doi.org/10.3389/fphar.2022.1073004. The entire Figure 10 has been duplicated with Figure 6 from Naseer F, Kousar K, Abduh MS, et al. Evaluation of the anticancer potential of CD44 targeted vincristine nanoformulation in prostate cancer xenograft model: a multi-dynamic approach for advanced pharmacokinetic evaluation. Cancer Nano. 2023;14:65. https://doi.org/10.1186/s12645-023-00218-2. The images for Figure 10, Pure MV 12h, 90µg/ml and OMV-loaded TCs 24h, 50µg/ml have been duplicated. The image for Figure 10, OMV-loaded TCs 24h, 90µg/ml has been duplicated with the image for Figure 10, MCF-10A, Pure CsA, 90µg/ml from Abduh MS, 2023. The image for Figure 10, Pure MV 12h, 50µg/ml has been duplicated with the image for Figure 10, MCF-10A, CsA-NF, 60µg/ml from Abduh MS, 2023. The images for Figure 13C, lyophilized NF after 3 months storage, has been duplicated with the image for Figure 7A, SEM image of spherical HA-ThCs-Cis loaded nanoparticles, from Kousar K, et al (2023). The corresponding author responded to our queries but was unable to provide a satisfactory explanation for how the images came to be duplicated and the editor no longer has confidence in the reported findings. As verifying the validity of published work is core to the integrity of the scholarly record, the Publisher and Editor requested to retract the article and the corresponding author does not agree with this decision. We have been informed in our decision-making by our editorial policies and COPE guidelines. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”.

Muhammad Fawad Rasool,1 Rimsha Sarwar,1 Muhammad Subhan Arshad,1,2 Imran Imran,3 Hamid Saeed,4 Abdul Majeed,1 Muqarrab Akbar,5 Muhammad Omer Chaudhry,6 Anees Ur Rehman,1 Waseem Ashraf,3 Tanveer Ahmad,7 Waleed Badoghaish,8 Faleh Alqahtani9 1Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan; 2Department of Pharmacy, Southern Punjab Institute of Health Sciences, Multan, 60000, Pakistan; 3Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan; 4University College of Pharmacy, Allama Iqbal Campus, University of the Punjab, Lahore, 54000, Pakistan; 5Department of Political Science, Bahauddin Zakariya University, Multan, 60800, Pakistan; 6School of Economics, Bahauddin Zakariya University, Multan, 60800, Pakistan; 7Institute for Advanced Biosciences (Iab), CNRS UMR5309, INSERM U1209, Grenoble Alpes University, La Tronche, 38700, France; 8Department of Internal Medicine, College of Medicine, University of Tabuk, Tabuk, 71411, Saudi Arabia; 9Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi ArabiaCorrespondence: Muhammad Fawad Rasool; Faleh Alqahtani, Email fawadrasool@bzu.edu.pk; afaleh@ksu.edu.sa

Abstract The Kuroshio intrusion (KI) is a northwestward‐flowing branch of the Kuroshio Current, which enters the South China Sea (SCS) and regulates its temperature, salinity, and water mass exchanges. However, limited direct observations hinder our understanding of KI's mechanisms and responses to climate change. Here, we present a 60‐year bi‐monthly resolved coral oxygen isotope (δ18Oc) record from Dongsha Atoll, the northern SCS. The dry‐season (December–March) δ18Oc record reveals interannual to decadal variabilities of the KI. The impact of the East Asian winter monsoon (EAWM) on Dongsha δ18Oc was more pronounced during the 1970s and 1980s and after the early 2000s, while the influence of the El Niño‐Southern Oscillation (ENSO) on Dongsha δ18Oc was higher between the 1980s and 1990s. The Pacific Decadal Oscillation (PDO) may have a relatively minor effect on KI strength or may indirectly modulate KI strength through its influence on ENSO activities. Our Dongsha δ18Oc record highlight the importance of the EAWM, ENSO, and PDO in predicting future KI changes.

Vascular closure devices (VCD) are frequently used after endovascular interventions to attain faster hemostasis, earlier mobilization, and patient comfort compared to manual compression. VCDs are safe. However, rare complications have been reported. We report a case of an inadvertent intravascular deployment of an Angio-Seal VCD causing limb ischemia and discussing management options from our experience and the previously published cases.

Pneumonia is a life-threatening disease and early detection can save lives, many automated systems have contributed to the detection of this disease and currently deep learning models have become one of the most widely used models for building these systems. In this study, two deep learning models are combined: DenseNet169 and pre-activation ResNet models, and used for automatic detection of pneumonia. DenseNet169 model is an extension of the ResNet model, while the second is a modified version the ResNet model, these models achieved good results in the field of medical imaging. Two methods are used to deal with the problem of unbalanced data: class weight, which enables to control the percentage of data to be used from the original data for each class of data, while the other method is resampling, in which modified images are produced with an equal distribution using data augmentation. The performance of the proposed model is evaluated using a balanced dataset consists of 5856 images. Achieved results were promising compared to several previous studies. The model achieved a precision value of 98%, an area under curve (AUC) based on ROC of 97%, and a loss value of 0.23. [JJCIT 2023; 9(2.000): 118-136]

Computing the backscattering of harmonic acoustic waves from underwater elastic targets of arbitrary shapes is a challenging problem of considerable practical significance. The finite element method is well suited for the discretization of the target, while the boundary element method addresses the radiation boundary condition at infinity. A disadvantage of the boundary integral method is that it yields non-unique solutions at certain wavenumbers. This failure is associated with the existence of eigensolutions of the Helmholtz equation in the interior of the complement of the fluid domain (acoustic modes). The combined Helmholtz integral equation formulation (CHIEF) credited to Schenk is employed to combine the surface Helmholtz boundary integral with equations of the interior Helmholtz relation written down at selected points within the cavity of the scatterer (i.e., in the complement of the fluid domain).The difficulty associated with this approach has always been the lack of guidance on the necessary number of interior points and on their locations. The solution to this problem proposed here is to compute the acoustic modes using the finite element method to complement of the fluid domain and to identify locations of the peaks.This novel approach aids the decision as to how many points should be employed and where they should be located. Our numerical experiments demonstrate the robustness of the proposed automatic selection of the CHIEF points’ numbers and locations.

Ershad Ahmad Mushkani,1 Fahima Hamidy,2 Tawfiq Ahmad,3 Mohammad Asef Adelyar4 1Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan; 2Department of Nursing Skills, Aliabad Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan; 3Department of Ophthalmology, Shahr Ara Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan; 4Department of Abdominal Surgery, Aliabad Teaching Hospital, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Ershad Ahmad Mushkani, Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan, Tel +93-744600222, Email ershadahmad2605@gmail.comObjective: Evaluation of the techniques of respiratory inhaler use among stable inpatients with COPD in Ali Abad Teaching Hospital.Methods: This cross-sectional study was conducted between April 2020 and October 2022 at the cardiopulmonary department of Ali-Abad Teaching Hospital. Participants were requested to demonstrate how to use their prescribed inhalation devices. The inhaler’s accuracy was evaluated using checklists that had been previously established and included key procedures.Results: We studied 318 patients performing a total of 398 inhalation maneuvers with five different IDs. Across all studied inhalation maneuvers, the maximum number of misuses was observed in those using the Respimat (97.7%), and the minimum number of misuses was observed in those using the Accuhaler (58.8%). For the pMDI, the steps “take a deep breath after activating the inhaler” and “hold the breath a few seconds” were most frequently inaccurately performed. Regarding the pMDI with spacer, the steps “exhale fully” were most commonly carried out in mistake. For the Respimat, the steps “hold the breath a few seconds after inhalation activation” and “exhale fully” were most frequently inaccurately performed. According to gender, the misuse was less in females for all studied inhalers (p< 0.05). Higher proportion of literate participant correctly used all types of inhalers as compared to the illiterate patients (p< 0.05). According to the findings of this study, the majority of patients (77.6%) lacked knowledge of proper inhaler technique.Conclusion: The misuse rates were high for all studied inhalers; however, among studied inhalers, the Accuhaler had the greatest proportion of correct inhalation techniques. In order to ensure proper inhaler technique, patients should be educated before receiving inhaler medicines. Therefore, it is crucial for doctors, nurses, and other healthcare professionals to comprehend the problems with the performance and proper usage of these inhaler devices.Keywords: COPD, misuse, inhaler

Faiza Naseer,1,2 Tahir Ahmad,1 Kousain Kousar,1 Salik Kakar,3 Rabia Gul,2 Sadia Anjum,4 Usman Shareef2 1Industrial Biotechnology, Atta-ur-Rehman School of Applied Biosciences, National University of Science and Technology, Islamabad, Pakistan; 2Shifa College of Pharmaceutical Sciences, Shifa Tameer e Millat University, Islamabad, Pakistan; 3Healthcare Biotechnology, Atta-ur-Rehman School of Applied Biosciences, National University of Science and Technology, Islamabad, Pakistan; 4Department of Biology, University of Hail, Hail, Saudia ArabiaCorrespondence: Faiza Naseer; Tahir Ahmad, Email faiza.naseer@ymail.com; tahir@asab.nust.edu.pkBackground: Oncolytic viruses are reported as dynamite against cancer treatment nowadays.Methodology: In the present work, a live attenuated oral measles vaccine (OMV) strain was used to formulate a polymeric surface-functionalized ligand-based nanoformulation (NF). OMV (half dose: not less than 500 TCID units; 0.25 mL) was encapsulated in thiolated chitosan and outermost coating with hyaluronic acid by ionic gelation method characterizing parameters was performed.Results and Discussion: CD44 high expression was confirmed in prostatic adenocarcinoma (PRAD) by GEPIA which extracted data of normal and cancer tissue from GTEx and TCGA. Bioinformatics tools confirmed the viral hemagglutinin capsid protein interaction with human Caspase-I, NLRP3, and TNF-α and viral fusion protein interaction with COX-II and Caspase-I after successful delivery of MV encapsulated in NFs due to high affinity of hyaluronic acid with CD44 on the surface of prostate cancer cells. Particle size = 275.6 mm, PDI = 0.372, and ± 11.5 zeta potential were shown by zeta analysis, while the thiolated group in NFs was confirmed by FTIR and Raman analysis. SEM and XRD showed a spherical smooth surface and crystalline nature, respectively, while TEM confirmed virus encapsulation within nanoparticles, which makes it very useful in targeted virus delivery systems. The virus was released from NFs in a sustained but continuous release pattern till 48 h. The encapsulated virus titer was calculated as 2.34× 107 TCID50/mL units, which showed syncytia formation on post-day infection 7. Multiplicities of infection 0.1, 0.5, 1, 3, 5, 10, 15, and 20 of HA-coated OMV-loaded NFs as compared to MV vaccine on PC3 was inoculated with IC50 of 5.1 and 3.52, respectively, and growth inhibition was seen after 72 h via MTT assay which showed apoptotic cancer cell death.Conclusion: Active targeted, efficacious, and sustained delivery of formulated oncolytic MV is a potent moiety in cancer treatment at lower doses with safe potential for normal prostate cells.Graphical Abstract: Keywords: green synthesis, controlled release, immunotherapeutic agent, in vitro studies, oncolytic activity, oncolytic measles virus, prostate cancer, targeted virus/drug delivery system, thiolated chitosan, tumour targeting, vaccine-based nanoformulation