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Abstract Purpose The treatment of critical limb-threatening ischemia (CLTI) is revascularization. Lumbar sympathectomy (LS) could be attempted when this is not amenable. Using laparoscopic techniques to perform LS adds the advantages of minimally invasive surgery. Methods Twenty-four patients, presenting with non-reconstructable CLTI and rest pain, were randomly divided into group I (14 patients) who underwent retroperitoneoscopic lumbar sympathectomy (RPLS) and group II (10 patients) who had conventional open lumber sympathectomy (COLS). Results RPLS patients had shorter hospital stays, fewer intraoperative complications, and less postoperative pain. However, the mean operative time was significantly longer (86.4 ± 9.1 min, p-value: 0.02) in the RPLS group but decreased with each subsequent case after that. The differences in post-operative capillary refill time, ABI, TBI, and TcPO2 were not statistically significant between both groups (p-values: 0.97, 0.13, 0.32, 0.10, respectively). However, the difference in the quality-of-life score was statistically significant; the mean (± SD) SF-36 score increased from 48 ± 6.8 to 81 ± 4.4 (p-value

Abstract Robots support and facilitate tasks in all life fields. Soft robots specifically have the advantages of inherent compliance, safe interaction and flexible deformability. Soft pneumatic network (Pneu-Net) is a soft pneumatic actuator (SPA) composed of network of chambers that is actuated by pneumatic power. Soft Pneu-Net fits the human interface applications perfectly. In this paper, a bio-inspired modular based design for Pneu-Net actuator is developed. The actuator mimics the elephant trunk curling to be employed for rehabilitation of human hand fingers. The actuator is an integrated four Pneu-Net modules actuator which is attached to hand’s finger. The main introduced advantages in the new developed actuator are: providing four degrees of freedom (DoF) essential for finger’s motion by single compound actuator and developing a methodology for a modular soft Pneu-Net actuator that is efficiently reproducible. The actuator’s design is developed using computer aided design (CAD) software SOLIDWORKS. The design is simulated using finite element modeling (FEM) software ABAQUS. Fabrication process uses 3D printed molds. Soft material is molded in the 3D printed molds, forming actuator’s modules. Actuator’s modules are integrated by adhesion using the soft material. A proposed non-standard hyper-elastic material biaxial tension test is introduced as a quick material properties identification method that can produce a test table used for material identification in the FEM. Enhanced version for the actuator uses reinforcement fibers. Results show advances for the reinforced actuator, as it limits the unwanted actuator’s strain and deformation. The reinforced actuator shows improved energy efficiency reaches to 46%.

Abstract Background In Lupoid Leishmaniasis, erythematous to brown papules often occur around a central old scar, which can expand over time. For unclear reasons, these lesions tend to develop on the facial area. Objectives This study was conducted to study the distribution of Lupoid Leishmaniasis lesions on the face and compare them with those of acute leishmaniasis. Methods This case‐control study included 100 patients with the acute type of cutaneous leishmaniasis and Lupoid Leishmaniasis who were referred to the dermatology clinics of Ghaem and Emamreza hospitals. We recorded lesion morphology, demographic data and locations of lesions on the face. Results We enrolled 55 patients with acute leishmaniasis and 45 patients with Lupoid Leishmaniasis, with a mean age of 21.30 ± 20.71 years. There were no significant differences in age (p = 0.78), gender (p = 0.48), and the distribution of lesions on different anatomical areas (p = 0.22) between the two groups. In both groups, the involvement of the zygoma was significantly higher than in other areas on the face (p = 0.001). Conclusions Our study reveals that the anatomical location does not play a role in lesion evolving into Lupoid form.

Introduction: Childhood-onset asthma is a chronic respiratory disease that profoundly impacts patients, their families, and healthcare systems. This study explores the lived experiences, challenges, and perceptions of mothers in managing asthma, controlling symptoms, and maintaining the quality of life for their children with asthma in Palestine. Methods: A qualitative descriptive design through semi-structured interviews was used in this study. Purposive sampling was used to identify mothers who have children with severe uncontrolled asthma in the four public hospitals with pediatric units in the West Bank, Palestine. Mothers of children with scored below 15 on the asthma control test were included in the study. The data were analyzed using an analytical framework following a thematic analysis through the NVivo 11. Results: A total of 20 mothers participated in interviews wherein they delineated the most important challenges negatively affecting asthma management from mothers’ perspectives. These challenges encompassed frequent emergency room visits, improper medication administration practices, and limitations in physical activity. The mothers expressed concerns regarding asthma control, including anxieties concerning the chronicity of the illness, adverse effects of medications, and susceptibility to weather fluctuations. The main themes that emerged from the data included reduced quality of life for the child, parental responsibility for monitoring triggers, symptoms, and medications, challenges in asthma management, apprehensions regarding asthma control, and strategies for enhancing asthma management. Conclusion: This study emphasizes the pressing need for targeted interventions to address asthma management, environmental triggers, and psychosocial disruptions related to asthma in children with asthma to enhance the quality of life and asthma control. This study highlights the importance of developing strategies that provide mothers with the appropriate information and tools to navigate the complexities of caring for a child with asthma.

Abstract Objectives Recently, a set of consensus criteria and near‐consensus criteria for the evaluation of chronic rhinosinusitis (CRS) disease control was identified by an international multidisciplinary panel of key stakeholders. The objective of this study is to evaluate patient perspectives on these disease control criteria. Methods This is a qualitative phenomenological study using constant comparative methodology. Twenty‐one one‐on‐one interviews, ranging from 6 to 15 min and based on a standardized semi‐structured script, with CRS patients from diverse backgrounds were performed. The authors analyzed transcripts of the interviews to identify recurrent themes in patient responses. Conclusions were drawn based on these themes. Results All participants agreed with the consensus criteria (overall symptom severity, nasal obstruction severity, patients' self‐assessed CRS control, and need for CRS‐related oral corticosteroids), and most participants agreed with near‐consensus criteria (nasal endoscopy, smell loss and nasal drainage severities, impairment of day‐to‐day activities, and overall quality of life) identified by the international multidisciplinary panel. Some patients disagreed with inclusion of smell loss due to common etiologies—such as post‐viral or iatrogenic causes—that would not necessarily be an indicator of active sinonasal inflammation. One theme that emerged was the need for a facial pain/pressure criterion to be added. Conclusions CRS patients overwhelmingly affirmed recently described consensus and near‐consensus criteria for CRS disease control with the caveat that a question asking about facial pain/pressure should be included as well. Recently, identified consensus criteria for CRS disease control should be interpreted within the context of patient perspectives.

BackgroundRheumatoid arthritis (RA) is a common condition treated with biological disease-modifying anti-rheumatic medicines (bDMARDs). However, many patients exhibit resistance, necessitating the use of machine learning models to predict remissions in patients treated with bDMARDs, thereby reducing healthcare costs and minimizing negative effects.ObjectiveThe study aims to develop machine learning models using data from the Kuwait Registry for Rheumatic Diseases (KRRD) to identify clinical characteristics predictive of remission in RA patients treated with biologics.MethodsThe study collected follow-up data from 1,968 patients treated with bDMARDs from four public hospitals in Kuwait from 2013 to 2022. Machine learning techniques like lasso, ridge, support vector machine, random forest, XGBoost, and Shapley additive explanation were used to predict remission at a 1-year follow-up.ResultsThe study used the Shapley plot in explainable Artificial Intelligence (XAI) to analyze the effects of predictors on remission prognosis across different types of bDMARDs. Top clinical features were identified for patients treated with bDMARDs, each associated with specific mean SHAP values. The findings highlight the importance of clinical assessments and specific treatments in shaping treatment outcomes.ConclusionThe proposed machine learning model system effectively identifies clinical features predicting remission in bDMARDs, potentially improving treatment efficacy in rheumatoid arthritis patients.

Reliable estimates of how human activities may affect wildlife populations are critical for making scientifically sound resource management decisions. A significant issue in estimating the consequences of management, development, or conservation measures is the need to account for a variety of biotic and abiotic factors, such as land use and climate change, that interact over time altering wildlife habitats and populations. The snow leopard Panthera uncia (Schreber, 1775), as a vulnerable species, is extremely sensitive to indirect impacts of climate change. Given that it is highly difficult undertaking conservation measures on the entire range of snow leopards, identifying hotspots for conservation is necessary. This study was conducted in Bagrot and Haramosh valleys, in the Trans-Himalayan region, to evaluate the impacts of climate and human pressure on snow leopard habitat. Hybrid classification of Landsat satellite data for 2010 and 2020 was performed to elucidate land use changes that suggested a decrease in permanent snow by 10 % and 3 % in Haramosh and Bagrot while an increase in settlements cover by 16 % and 23 %, respectively. Life zone comparison for 2010 and 2020 using the Holdridge life zone (HLZ) classification system disclosed a change from three life zones to five life zones in Haramosh, and four life zones to five life zones in Bagrot, caused by a temperature increase of 2°C to 3°C, indicating that the area is becoming more and more suitable for settlements and less favorable for snow leopards. This study underlines again that mountainous regions are more vulnerable to the impacts of climate change. Warming weather is making survival more difficult for snow leopards. Although they are resilient to the direct effects of climate change, indirect impacts like avalanches, flash floods, urbanization, and human-wildlife conflict make them more vulnerable and threaten their survival. Thus, we recommend establishing further protected areas, better controlling illegal wildlife trade, and conducting genetic studies to understand impacts on snow leopards and rangeland management, livelihood improvement, and human-wildlife conflict reductions.

Introduction: The emergence of the coronavirus in 2019 became a global epidemic disease. According to the World Health Organization, people with a history of chronic diseases such as brain stroke are among the main groups at risk of contracting COVID-19. Therefore, this study was performed with the aim of the determination amount of the frequency of contracting COVID-19 in stroke patients. Materials and Methods: This descriptive-analytical study was conducted on 100 patients with a history of stroke referred to Imam Hossein Hospital in Tehran (Iran) between 2019 and 2022, which had all the inclusion criteria in the study. The demographic information including (gender, weight, height) and clinical information was collected by a researcher-made questionnaire and analyzed by SPSS version 24 software. Results: The average age of the studied patients was 63 years. Among them, 53 people (53%) were infected with COVID-19. The most of underlying diseases were related to high blood pressure. All cases of stroke in patients with COVID-19 were associated with thrombotic type, and half of the other cases included involvement in large cerebral vessels. Lymphocyte count, CRP, and ESR levels were relatively higher in stroke patients with COVID-19, but there were observed no cases of pleural effusion and pericardial effusion associated with COVID-19 in stroke patients. In all of the patients with COVID-19, pulmonary involvement was observed in the Peripheral/Perihillar area. Discussion and Conclusion: According to the results and data of this research, the probability of infecting COVID-19 is higher in people with a history of stroke, and these patients have more severe strokes and more mortality than stroke patients without contracting COVID-19.

Abstract Discovering effective anti-cancer agents poses a formidable challenge given the limited efficacy of current therapeutic modalities against various cancer types due to intrinsic resistance mechanisms. Cancer immunochemotherapy is an alternative strategy for breast cancer treatment and overcoming cancer resistance. Human Indoleamine 2,3-dioxygenase (hIDO1) and human Tryptophan 2,3-dioxygenase 2 (hTDO2) play pivotal roles in tryptophan metabolism, leading to the generation of kynurenine and other bioactive metabolites. This process facilitates the de novo synthesis of Nicotinamide Dinucleotide (NAD), promoting cancer resistance. This study identified a new dual hIDO1/hTDO2 inhibitor using a drug repurposing strategy of FDA-approved drugs. Herein, we delineate the development of a ligand-based pharmacophore model based on a training set of 12 compounds with reported hIDO1/hTDO2 inhibitory activity. We conducted a pharmacophore search followed by high-throughput virtual screening of 2568 FDA-approved drugs against both enzymes, resulting in ten hits, four of them with high potential of dual inhibitory activity. For further in silico and in vitro biological investigation, the anti-hypercholesterolemic drug Pitavastatin deemed the drug of choice in this study. Molecular dynamics (MD) simulations demonstrated that Pitavastatin forms stable complexes with both hIDO1 and hTDO2 receptors, providing a structural basis for its potential therapeutic efficacy. At nanomolar (nM) concentration, it exhibited remarkable in vitro enzyme inhibitory activity against both examined enzymes. Additionally, Pitavastatin demonstrated potent cytotoxic activity against BT-549, MCF-7, and HepG2 cell lines (IC50 = 16.82, 9.52, and 1.84 µM, respectively). Its anticancer activity was primarily due to the induction of G1/S phase arrest as discovered through cell cycle analysis of HepG2 cancer cells. Ultimately, treating HepG2 cancer cells with Pitavastatin affected significant activation of caspase-3 accompanied by down-regulation of cellular apoptotic biomarkers such as IDO, TDO, STAT3, P21, P27, IL-6, and AhR.

Anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis is a prevalent autoimmune condition marked by diverse neuropsychiatric symptoms, primarily impacting young females. The exact mechanisms underlying the development of NMDAr encephalitis have not been fully elucidated. Nonetheless, studies have demonstrated that auto-antibodies targeting the NR1-NR2 subunits of the NMDAr can trigger receptor dysfunction within the central nervous system, thus giving rise to the associated symptoms. Notably, an association exists between NMDAr encephalitis and an underlying neoplastic condition, with approximately 38% of cases exhibiting this paraneoplastic relationship with ovarian teratomas being the most commonly associated malignancy.While the association between NMDAr encephalitis and renal cell carcinoma (RCC) is exceedingly rare. This case report presents the clinical scenario of a 20-year-old female patient diagnosed with NMDAr encephalitis in conjunction with RCC discovered incidentally on a CT abdomen and pelvis performed to rule out an ovarian teratoma. The presented case underscores the importance of adopting a multidisciplinary approach in the diagnosis and treatment of NMDAr encephalitis, particularly when it is linked to an underlying malignancy. Furthermore, it emphasizes the significance of expanding our understanding of the molecular pathogenesis of NMDAr encephalitis to enhance patient care and optimize clinical outcomes. Additionally, a comprehensive review of the existing literature is included, summarizing all reported malignancies associated with NMDAr encephalitis.

Conventional oil palm plantations, characterized by monocropping practices, are susceptible to pest infestations due to the lack of diversity in crop composition. This reliance on monoculture often necessitates heavy pesticide use, posing considerable risks to human health, the environment, and biodiversity. In contrast, regenerative agricultural approaches support ecosystem services, such as natural pest control, thereby reducing pesticide dependency and promoting biodiversity while maintaining productivity. The present study examined the composition of arthropod assemblages and understory plant species in chemical-free oil palm plantations, comparing farms with the integration of non-crop plant beds to those without intervention. We established either 10 square plant beds measuring 3 × 3 m or three rectangular beds measuring 9 × 3 m between the planting rows at each experimental plot. Using coloured pan traps and sticky traps, we assessed the relationship between understory plant species richness and arthropod assemblages, including the number of arthropod families, overall abundance, and selected trophic guilds. Our findings reveal that the integration of non-crop plant mixtures significantly enhances the number of arthropod families, as well as the abundance of predatory and phytophagous arthropods. Moreover, we observed that arthropod assemblages, most notably the number of families, overall abundance, abundance of scavengers and predators were significantly and positively correlated with the number of understory vegetation species. The study highlights the potential of establishing non-crop plant bed as a practical approach to enhancing habitat complexity for natural enemies, thereby fostering biodiversity and contribute to the resilience and functioning of agroecosystem within monoculture plantations.

ABSTRACTThis study aimed to describe the molecular epidemiology and seasonality of human rhinovirus (HRV) in chronic obstructive pulmonary disease (COPD) and its association with COPD exacerbations in Abu Dhabi, the United Arab Emirates (UAE). Sputum specimens were collected for analysis from all COPD patients who visited a medical center from November 2021 to October 2022. The real-time quantitative polymerase chain reaction (qPCR) test was used to detect HRV. Of the 78 COPD patients included in the study, 58 (74%) patients presented with one or more exacerbation episodes. The incidence of COPD exacerbation peaked over the winter and substantially decreased during the summer. HRV positivity in patients during exacerbation (E1) was 11/58 (19%) and 15/58 (26%) two weeks after the exacerbation episode (E2). There was no significant difference in the HRV load in these patients. No statistically significant difference was observed in the detection of HRV during exacerbation compared to patients with stable COPD. This is the first study to assess the association between HRV detection by qPCR and COPD exacerbations in the UAE. The high sensitivity of the detection technology helped collect reliable epidemiologic data. Few studies have provided similar Middle East data. This study’s pattern of COPD exacerbations and HRV detection parallels that of temperate countries. This information can help with future, more extensive surveillance of respiratory viruses in the UAE and the Middle East and their association with COPD exacerbations.

Background: Wild canids form an important component of the ecosystem but are generally less studied and least prioritized for conservation. Diet is fundamental for effective management and exhibits the role of a species in an ecosystem. Golden jackal (Canis aureus, Linnaeus, 1758), a medium-sized canid species is known for opportunistic and omnivorous foraging behavior. Methods: This research investigates the feeding ecology of golden jackals within the Hirpora Wildlife Sanctuary, Western Himalayas. From August 2020 to July 2022, trails (n = 9; 1.5–5.5 km) were walked seasonally (once per month) to collect fecal samples (n = 128) for investigation of seasonal diet composition and dietary niche breadth and biomass consumption of prey items by golden jackal. The association between the coefficient of digestibility value and food items was assessed using the Pearson correlation. We also conducted PCA to understand contribution of major dietary items. Results: Scat analysis revealed that jackals feed on both animal and plant matter. Animal matter constituted most of the diet, encompassing small mammals and domestic livestock, insects, and birds. Rodents emerge as the dominant dietary item, maintaining consistent prevalence year-round. Livestock carrion, notably domestic sheep formed a significant component across all seasons, with maximal consumption observed in summer. Notably absent from the jackals' diet were traces of threatened mountain ungulates. Domestic sheep emerged as the primary contributor (33.4 %) to the overall biomass consumed, highlighting the jackals' interaction with human-associated food resources. The research unveils an overall dietary niche breadth of 0.38, indicating a low degree of dietary diversity. Seasonal analysis indicates heightened dietary overlap in the autumn-summer transition, with rodents, domestic sheep, and birds being major contributors to this overlap. Conclusion: The findings underscore the adaptability of golden jackals to diverse food resources in a seasonal environment. This study provides foundational insights into the dietary ecology of jackal crucial for its conservation and management strategies in the ecologically fragile ecosystem. The finding gives a hint at the role jackals can play in regulating rodent populations and contributing to environmental cleanliness by scavenging.

Millions of adults and children are exposed to high levels of lead, a neurotoxicant, each year. Recent evidence suggests that lead exposure may precipitate neurodegeneration, particularly if the exposure occurs early or late in life, with unique alterations to the structure or function of specific subfields of the hippocampus, a region involved in memory and Alzheimer’s disease. It has been proposed that specific hippocampal subfields may thus be useful biomarkers for lead-associated neurological disease. We turned to a population-representative New Zealand birth cohort where the extent of lead exposure was not confounded by social class (the Dunedin Study; born 1972–1973 and followed to age 45) to test the hypothesis that early life lead exposure (blood-lead level at age 11 years) is associated with smaller MRI-assessed gray matter volumes of specific subfields of the hippocampus at age 45 years. Among the 508 Dunedin Study members with childhood lead data and adult MRI data passing quality control (93.9 % of those with lead data who attended the age-45 assessment wave, 240[47.2 %] female), childhood blood-lead levels ranged from 4 to 31 µg/dL (M[SD]=10.9[4.6]). Total hippocampal volumes were lower among adults with higher childhood blood-lead levels (b=-102.6 mm3 per 5 ug/dL-unit greater blood-lead level, 95 %CI: −175.4 to −29.7, p=.006, β=-.11), as were all volumes of the 24 hemisphere-specific subfields of the hippocampus. Of these 24 subfields, 20 demonstrated negative lead-associations greater than β=-.05 in size, 14 were statistically significant after adjustment for multiple comparisons (pFDR

BackgroundCOVID-19 has probably contributed to sleep disturbance among nurses, especially those working at emergency departments (EDs). Sleep disorders in nurse managers can negatively impact their health and impair work performance and decision-making. This study aimed to explore the quality of sleep among nurses working in EDs and its influencing factors during the COVID-19 pandemic.MethodIn this study, a cross-sectional design was employed to assess the sleep quality of nurses working in EDs during the COVID-19 pandemic. The research recruited a convenience sample of emergency nurses, who were selectively sourced from four hospitals in Hail City. This recruitment occurred over the period from April to July 2022. Descriptive data analysis was conducted using SPSS, with the significance level set at 0.05.ResultsAmong the 216 participants in the study, the majority (55.6%) were aged between 30 and 39 years, and 73.6% were female. Additionally, 64.4% were married, while 69.4% had a bachelor’s degree, 20% held a diploma, and the remaining had a master’s degree. Notably, a significant 81.5% of the nurses reported poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), with an overall mean score of 10.55 indicating poor sleep. The study highlighted that poor sleep quality among nurses was linked to being female, being married, and not exercising regularly. Better sleep was associated with nurses who manage fewer patients per shift and have adequate monthly income.ConclusionThe prevalence of poor sleep quality among Emergency nurses during the COVID-19 pandemic is high. There is a pressing need for targeted interventions to enhance sleep quality among ED nurses. Improving sleep quality is not only essential for the wellbeing of these nurses but is also likely to contribute to better patient care.

Chronic kidney disease (CKD) has been correlated with certain pathological conditions such as cardiovascular diseases and other renal-related dysfunctions. Some other reports suggested an association between CKD and the development of certain solid cancers. Therefore, we aimed to generate this narrative review to present the available literature on the risk of solid cancer development in CKD patient populations. We explored the associations between CKD, organ transplantation, and the development of specific solid organ tumors such as kidney, thyroid, lung, breast, bladder, gastric, and prostate cancers. In conclusion, the previous reports showed an increase in the risk of certain solid cancers such as kidney, lung, bladder, and possibly breast cancer in CKD patients and transplant recipients. On the other hand, thyroid, gastric, and prostate cancers showed unclear association with CKD. Despite the suggested impact of smoking and immunosuppression on the development of cancers in CKD patients, more studies are needed to elucidate the mechanism and the risk factors that might be related to the development of cancer in CKD patients.

Abstract Objectives The peer review process is critical to maintaining quality, reliability, novelty, and innovation in the scientific literature. However, the teaching of scientific peer review is rarely a component of formal scientific or clinical training, and even the most experienced peer reviewers express interest in continuing education. The objective of this review article is to summarize the collective perspectives of experienced journal editors about how to be a good reviewer in a step‐by‐step guide that can serve as a resource for the performance of peer review of a scientific manuscript. Methods This is a narrative review. Results A review of the history and an overview of the modern‐day peer review process are provided with attention to the role played by the reviewer, including important reasons for involvement in scientific peer review. The general components of a scientific peer review are described, and a model for how to structure a peer review report is provided. These concepts are also summarized in a reviewer checklist that can be used in real‐time to develop and double‐check one's reviewer report before submitting it. Conclusions Peer review is a critically important service for maintaining quality in the scientific literature. Peer review of a scientific manuscript and the associated reviewer's report should assess specific details related to the accuracy, validity, novelty, and interpretation of a study's results. We hope that this article will serve as a resource and guide for reviewers of all levels of experience in the performance of peer review of a scientific manuscript.

Abstract Background Chronic rhinosinusitis (CRS) is a heterogeneous disorder with a wide range of validated subjective and objective assessment tools to assess disease severity. However, a comprehensive and easy‐to‐use tool that integrates these measures for determining disease severity and response to treatment is still obscure. The objective of this study was to develop a standardized assessment tool that facilitates diagnosis, uniform patient monitoring, and comparison of treatment outcomes between different centers both in routine clinical practice and in research. Methods To develop this tool, published literature on assessment tools was searched on various databases. A panel of 12 steering committee members conducted an advisory board meeting to review the findings. Specific outcome measures to be included in a comprehensive assessment tool and follow‐up sheet were then collated following consensus approval from the panel. The tool was further validated for content and revised with expert recommendations to arrive at the finalized Nasal Polyp Patient Assessment Scoring Sheet (N‐PASS) tool. Results The N‐PASS tool was developed by integrating the subjective and objective measures for CRS assessment. Based on expert opinions, N‐PASS was revised to be used as an easy‐to‐use guidance tool that captures patient‐reported and physician‐assessed components for comprehensively assessing disease status and response to treatment. Conclusion The N‐PASS tool can be used to aid in the diagnosis and management of CRS cases with nasal polyps. The tool would also aid in improved monitoring of patients and pave the way for an international disease registry. Level of evidence Oxford Level 3.

The Kombong agroforestry system (KAS) has long been practiced and plays an important role in the livelihoods of the Toraja tribe's settlements, in addition to their social, cultural, and environmental sustainability. This research aims to explain the species composition and wood volume, how the utilization of plant species in the KAS has social, cultural, economic, and ecological functions, analyze the plant cultural significance of KAS of the Toraja tribe, the role of KAS for the conservation of Tongkonan Traditional Houses (TTHs) and KAS in preserving the Rambu Tuka' and Rambu Solo’ traditional ceremonies of the Toraja tribe. The research used vegetation survey methods and in-depth interviews with respondents, which were conducted using a set of guidelines for questionnaires. The research results indicate that there are 115 plant species belonging to 49 families. The plant use category is high, with foodstuffs and fruit being the use category with the highest number of species. The index of cultural significance (ICS) of the Toraja tribe varies greatly, from very high categories to those whose use is not yet known. Rice has the highest ICS value, with a score of 130. The KAS and TTHs are closely related and are always found in traditional Toraja settlements. They form a unit that supports each other, and the existence and sustainability of a TTH largely depend on the preservation of the KAS. The KAS has a close connection to both the Rambu Solo' and Rambu Tuka' traditional ceremonies. All plant species needed to build and maintain a TTH and for conducting these two traditional ceremonies are found in the KAS. Thus, the KAS is very important for the Toraja tribe because it not only supports the economic and social aspects of their lives but also functions to protect the environment and traditional culture, including preserving the TTH form and the Rambu Solo' and Rambu Tuka' traditional parties.

Background: The work environment is considered an important factor for the success of any healthcare organization that keeps upstanding and can compete with others to achieve the organization and employee’s goals. This study aims to examine the effect of the workplace environment on the structural empowerment of registered nurses in governmental hospitals. Methods: A cross-sectional, descriptive survey study. The sample consisted of 405 nurses from three Jordanian governmental hospitals. Data were collected using an online self-reported questionnaire that was distributed to the participants. The questionnaire included sections on demographic characteristics, the structural empowerment scale, and the work environment scale. Data collection took place between 1 January 2023 and 15 February 2023. Results: The participants demonstrated various levels in their perceptions of the working environment. They demonstrated a moderate perception level toward stress and work pressure, role clarity, peer cohesive subscale, and for working environment scale while they reported a low perception level on ethical, autonomy, work practices, managerial support, commitment, and social responsibility subscales. However, the nurses’ work environment overall score was found to be at a moderate level (3.15 out of 5 ± 0.61). Furthermore, their structural empowerment level was found to be at a moderate level (19.40 out of 30 ± 3.68). Conclusions: Highly empowered nurses’ work environments display higher structural empowerment. Applying structural empowerment in work environments is very important to improve nurses’ performance, ensure the highest level of patient care quality, and achieve organizational goals.

Abstract Background and Aim Breast cancer is the most frequently occurring malignant disease in women and remains the leading cause of cancer-related deaths among females worldwide. The aim of this study is to evaluate the imaging findings of breast cancer in women under the age of 40 and analyze their pathological patterns. Method A retrospective study was conducted from 2013 to 2019, involving 120 patients below 40 years of age with pathologically confirmed primary epithelial breast cancers. The data were collected from the electronic records of a tertiary hospital in Riyadh, Saudi Arabia. Mammograms were performed for 115 patients, ultrasounds were conducted for all patients, and MRI scans were carried out for 47 patients. Results All radiological findings and clinical characteristics of the 120 cases were retrieved from our digital-based system. The majority of breast cancer patients (83.4%) were between 30 and 40 years old, and the most common clinical presentation was a mass (45.8%). Out of the 73 patients who underwent genetic tests, 32.9% tested positive for gene mutations. No statistically significant correlation was found between specific age groups and breast composition (P = 0.216), specific mammogram abnormalities such as masses (P = 0.262), or microcalcifications (P = 0.421). Ultrasonography was performed for all patients, with abnormalities detected in only one patient who was diagnosed with Paget’s disease of the nipple. Masses, with or without parenchymal changes, were the predominant feature in 88.3% of cases. Conclusion The imaging findings in breast cancer cases typically involve masses with suspicious features, irregular shape, and spiculated margins on mammograms, and irregular shape with microlobulated or angular margins on ultrasound. MRI features commonly include masses with irregular shape and heterogeneous enhancement. The luminal B subtype was identified as the most prevalent pathological feature, characterized by a high proliferative index (Ki-67%). Graphical Abstract

Abstract Perovskite photovoltaics have been shown to recover, or heal, after radiation damage. Here, we deconvolve the effects of radiation based on different energy loss mechanisms from incident protons which induce defects or can promote efficiency recovery. We design a dual dose experiment first exposing devices to low-energy protons efficient in creating atomic displacements. Devices are then irradiated with high-energy protons that interact differently. Correlated with modeling, high-energy protons (with increased ionizing energy loss component) effectively anneal the initial radiation damage, and recover the device efficiency, thus directly detailing the different interactions of irradiation. We relate these differences to the energy loss (ionization or non-ionization) using simulation. Dual dose experiments provide insight into understanding the radiation response of perovskite solar cells and highlight that radiation-matter interactions in soft lattice materials are distinct from conventional semiconductors. These results present electronic ionization as a unique handle to remedying defects and trap states in perovskites.

Foodborne illnesses pose a serious threat to public health, with increasing global incidence rates driven by factors such as rising meat consumption. Rapid detection of foodborne pathogens in meat is critical for preventing outbreaks. This study investigates the potential of gas chromatography-mass spectrometry (GC-MS) and Fourier-transform infrared spectroscopy (FTIR) for identifying biomarkers and spectral fingerprints indicative of foodborne pathogens in raw chicken meat. Raw broiler chicken meat samples were surface-sterilized and inoculated with foodborne pathogens. The samples were challenge inoculated with the specific pathogen and the physical quality parameters like pH, color, texture, drip loss, and water activity were assessed. GC-MS analysis identified 113 metabolites, including potential biomarkers like ureidopropionic acid, 5-sulfosalicylic acid, 11,14-eicosadienoic acid, methyl ester for E. coli O157:H7; 11-bromoundecanoic acid, neocurdione, glafenin, eicosanoic acid for Salmonella; azepan-1-yl-acetic acid, methyl ester, tramadol, cytarabine, dipipanone for Staphylococcus and cyclopentaneundecanoic acid, phosphonofluoridic acid, î-n-formyl-l-lysine for Pseudomonas. Pathway analysis revealed the involvement of fatty acid metabolism and amino acid degradation pathways. FTIR spectral data showed significant variances between control and spiked samples, particularly in the fatty acid spectral region. The identified metabolites and spectral patterns could serve as biomarkers for developing rapid pathogen detection methods, contributing to enhanced food safety protocols.

Introduction: Prior studies have identified SSRI use as a risk factor for certain adverse bleeding outcomes. However, the risk of significant bleeding from perioperative SSRI use after brain tumor resection remains largely undetermined. This study evaluates if patients taking SSRIs perioperatively have a higher risk of intracranial hemorrhage (ICH) following elective craniotomy for tumor resection. Methods: Researchers reviewed electronic medical records of patients age 18 and older, who received elective craniotomy for tumor resection between 2010 and 2019. Data collection included subject demographics and relevant medical history. We compared intracranial hemorrhage rates and risks between perioperative SSRI-use cohorts. Results: Of 1,061 patients, 796 (75%) did not use SSRIs perioperatively while 265 (25%) used SSRIs perioperatively. Among those using perioperative SSRIs, 8 patients (3.0%) experienced an ICH within 1 week and 11 patients (4.2%) had an ICH within 1 month. Similarly, for those who stopped SSRI use perioperatively, we found 31 patients (3.9%) experienced an ICH within 1 week and 40 patients (5.0%) had an ICH within 1 month. Using logistic regression analysis, the relative risk for perioperative SSRI-use and ICH was statistically non-significant at 0.692 (95% CI: 0.260 - 1.839, p = 0.460). Conclusions: Based on our results, perioperative SSRI use does not appear to result in an increased risk of bleeding within 1 week or month of craniotomy for tumor resection. These results remained consistent when controlled for several additional bleeding comorbidities and demographics between cohorts

Introduction: Oxidative stress has a critical role in affecting in vitro fertilization (IVF) outcomes. The yttrium oxide nanoparticle (Y2O3 NPs) known as free radicals’ scavenger. The reactive oxygen species (ROS) has an essential role in the pathological effect of oxidative stress. The study aimed to evaluate the Y2O3 NPs effect on the in vitro fertilization media and in vitro culture media in mice as a mammalian model. Methods: The NPs of Y2O3 tested in two different concentrations, 25 μg/ml, and 50 μg/ml, to examine nanoparticle effect on cleavage rate and blastula rate by exposing the gametes cell for 6 h during the fertilization and 5 days on culture media till embryos reach the blastula stage. The Y2O3 NPs cubic shape, and the sizes used to be in the range of 18 ± 5 nm as measured by transmission electron microscopy (TEM) and 11.14 nm as measured by X rays diffractions (XRD). The results showed that the rate of blastocyst was significantly higher in the in the treated by adding the 25.ug/ml Y2O3 NP and the control groups than the higher treated group with 50ug/ml NP, group by the ad of Y2O3 nanoparticles. While the cleavage rate was unaffected by the Y2O3 nanoparticles. In conclusion the treatment of the Y2O3 in the IVF and early embryo development have no side effects except in higher rate in the blastula stage.

Mixed organic–inorganic halide perovskite-based solar cells have attracted interest in recent years due to their potential for both terrestrial and space applications. Analysis of interfaces is critical to predicting device behavior and optimizing device architectures. Most advanced tools to study buried interfaces are destructive in nature and can induce further degradation. Ion beam techniques, such as Rutherford backscattering spectrometry (RBS), is a useful non-destructive method to probe an elemental depth profile of multilayered perovskite solar cells (PSCs) as well as to study the inter-diffusion of various elemental species across interfaces. Additionally, PSCs are becoming viable candidates for space photovoltaic applications, and it is critical to investigate their radiation-induced degradation. RBS can be simultaneously utilized to analyze the radiation effects induced by He+ beam on the device, given their presence in space orbits. In the present work, a 2 MeV He+ beam was used to probe the evidence of elemental diffusion across PSC interfaces with architecture glass/ITO/SnO2/Cs0.05(MA0.17FA0.83)0.95Pb(I0.83Br0.17)3/spiro-OMeTAD/MoO3/Au. During the analysis, the device active area was exposed to an irradiation equivalent of up to 1.62 × 1015 He+/cm2, and yet, no measurable evidence (with a depth resolution ∼1 nm) of beam-induced ion migration was observed, implying high radiation tolerance of PSCs. On the other hand, aged PSCs exhibited indications of the movement of diverse elemental species, such as Au, Pb, In, Sn, Br, and I, in the active area of the device, which was quantified with the help of RBS.

The range of clinical manifestations associated with the infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encompasses a broad spectrum, ranging from flu-like symptoms to the occurrence of multiple organ failure and death. The severity of the coronavirus disease 2019 (COVID-19) is categorized based on clinical presentation and is divided into three distinct levels of severity identified as non-severe, severe, and critical. Although individuals of all age groups are susceptible to SARS-CoV-2 infection, middle-aged and older adults are more frequently impacted, with the latter being more likely to develop severe illness. Various laboratory characteristics observed in hospitalized COVID-19 patients have been correlated with adverse outcomes. These include elevated levels of D-dimer, liver enzymes, lactate dehydrogenase, C-reactive protein, ferritin, prothrombin time, and troponin, as well as decreased lymphocyte and platelets counts. This review investigated the relationship between baseline clinical characteristics, initial laboratory parameters upon hospital admission, and the severity of illness and mortality rates among COVID-19 patients. Although the COVID-19 pandemic has concluded, understanding the laboratory predictors of virus severity and mortality remains crucial, and examining these predictors can have long-term effects. Such insights can help healthcare systems manage resources more effectively and deliver timely and appropriate care by identifying and targeting high-risk individuals. This knowledge can also help us better prepare for future pandemics. By examining these predictors, we can take steps to protect public health and mitigate the impact of future pandemics.

The current study was designed to assess the impact of L-carnitine (LC) supplementation in the drinking water of growing Alexandria-line rabbits on performance and physiological parameters. Two hundred eighty-eight 35-day-old rabbits were divided into four groups of twenty-four replicates each (seventy-two rabbits/treatment). The treatment groups were a control group without LC and three groups receiving 0.5, 1, and 1.5 g/L LC in the drinking water intermittently. The results showed that the group receiving 0.5 g LC/L exhibited significant improvements in final body weight, body weight gain, feed conversion ratio, and performance index compared to the other groups. The feed intake remained unaffected except for the 1.5 g LC/L group, which had significantly decreased intake. Hematological parameters improved in all supplemented groups. Compared with those in the control group, the 0.5 g LC/L group showed significant increases in serum total protein and high-density lipoprotein, along with decreased cholesterol and low-density lipoprotein. Compared to other supplemented groups, this group also demonstrated superior carcass traits (carcass, dressing, giblets, and percentage of nonedible parts). In conclusion, intermittent supplementation of LC in the drinking water, particularly at 0.5 g/L twice a week, positively influenced the productivity, hematology, serum lipid profile, and carcass traits of Alexandria-line growing rabbits at 84 days of age.

Several tetrahydroxidohexaoxidopentaborate(1-) salts of N-substituted diimidazolium cations or N-substituted dipyrrolidinium cations linked through N-C6-N chains have been synthesized and characterized spectroscopically (NMR, IR) and by single-crystal XRD studies: [R(NC3H3N)(CH2)6(NC3H3N)R][B5O6(OH)4]2·xH2O (R = Me, x = 0 (1); R = Et, x = 3 (2); [Me(NC3H3N)(CH2(C6H4)CH2)(NC3H3N)Me][B5O6(OH)4]2 (3), [(C4H8N)(R)(CH2)6(R)(NC4H8)][B5O6(OH)4]2·xB(OH)3 (R = Me, x = 0 (4, two polymorphs); R = Et, x = 0 (5); R = Bu, x = 4 (6); R = allyl, x = 0 (7)). Representative samples (1 and 7) were also characterized by thermal (TGA/DSC) studies; compounds are thermally decomposed to B2O3 in air. Numerous anion-anion H-bonding interactions are present in the solid-state structures of 1–5 and 7 as giant anionic networks. Unusually, in 6 there are no R22(8) anion-anion interactions as the co-crystallized B(OH)3 bridges between all pentaborate anions. H-bonding interactions in 1–7 have been examined using Etter graph set analysis; C(8), C33(18), R22(8), R22(12) and R44(12) motifs have been identified.

Determining the gene expression and serum profile of the indicators linked to clinical endometritis susceptibility in Egyptian buffalo cows was the aim of this investigation. The buffalo cows that were enrolled were divided into two groups: forty infected buffalo cows with clinical endometritis and forty seemingly healthy buffalo cows that served as the control group. For the purposes of gene expression and biochemical analysis, ten milliliters of blood was obtained via jugular venipuncture from each buffalo cow. TLR4, IL-8, IL-17, NFKB, SLCA11A1, NCF4, Keap1, HMOX1, OXSR1, ST1P1, and SERP1 were manifestly expressed at much higher levels in the buffaloes with endometritis. On the other hand, the genes that encode SOD, CAT, NDUFS6, Nrf2, and PRDX2 were down-regulated. There was a significant (p < 0.05) elevation of the serum levels of non-esterified fatty acids (NEFAs), beta hydroxy butyric acid (BHBA), triglycerides (TGs), globulin, creatinine, and cortisol, along with a reduction in the serum levels of glucose, cholesterol, total protein albumin, urea, estrogen (E2), progesterone (P4), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroxine (T4), prostaglandin F2 α (PGF2α), calcium, iron, and selenium, in the endometritis group in comparison with the control. However, no significant change was observed in the values of phosphorus, magnesium, copper, or zinc in either group. Within the selective breeding of naturally resistant animals, the variation in the genes under study and the changes in the serum profiles of the indicators under investigation may serve as a reference guide for reducing endometritis in Egyptian buffalo cows.

INTRODUCTION: This study explores and compares the levels of readiness and confidence among faculty members in health and non-health colleges regarding online teaching in the United Arab Emirates (UAE). MATERIALS AND METHODS: The study adopted a cross-sectional research design and utilized a comprehensive survey instrument. A convenience sampling method was employed to enlist 412 faculty members from varied academic disciplines, comprising 278 from non-health programs and 134 from health programs. These participants offered valuable insights into their levels of preparedness and confidence for engaging in online teaching. RESULTS: The study uncovered nuanced differences in readiness and confidence levels between health and non-health colleges regarding online teaching preparedness. Significant gender-based variations were found, with female participants in health colleges reporting lower readiness (mean = 4.13) and confidence (mean = 4.11) compared to their counterparts in non-health colleges (mean = 4.43; mean = 4.52) (out of 5) (P < 0.05). Male participants in non-health colleges demonstrated higher readiness and confidence (P < 0.05). Academic rank and teaching experience (>5 years) positively influenced readiness and confidence (P < 0.05). Marital status, spouse working status, and years teaching online showed no significant differences. Teaching multiple online courses before and during the coronavirus disease 2019 (COVID-19) pandemic significantly enhanced readiness and confidence (P < 0.05). Professional development before and during the COVID-19 pandemic did not yield significant differences. CONCLUSION: The study contributes to the existing literature on online education, offering valuable insights into the specific challenges and opportunities faced by faculty in health and non-health colleges. The results inform decision-making processes for educational institutions and policymakers in the UAE, emphasizing the evolving global landscape of online teaching.

This study investigated how sucralose influenced rabbit intestine and caecal microbial activity, blood parameters, growth performance, carcass characteristics, and digestibility. In total, 160 5-week-old rabbits from the APRI line weighing 563.29 gm were randomly assigned to four experimental groups with four replicates—5 males and 5 females in each. Four experimental groups were used, as follows: SUC1, SUC2, and SUC3 got 75, 150, and 300 mg of sucralose/kg body weight in water daily, while the control group ate a basal diet without supplements. The results showed that both the control and SUC1 groups significantly (p < 0.05) increased daily weight gain and final body weight. Sucralose addition significantly improved feed conversion ratio (p < 0.05) and decreased daily feed intake (gm/d). The experimental groups do not significantly differ in terms of mortality. Furthermore, nutrient digestibility was not significantly affected by sucralose treatment, with the exception of crud protein digestion, which was significantly reduced (p < 0.05). Additionally, without altering liver or kidney function, sucralose administration dramatically (p < 0.05) decreased blood serum glucose and triglyceride levels while increasing total lipids, cholesterol, and malonaldehyde in comparison to the control group. Furthermore, the addition of sucrose resulted in a significant (p < 0.05) increase in the count of total bacteria, lactobacillus, and Clostridium spp., and a decrease in the count of Escherichia coli. Further analysis using 16S rRNA data revealed that sucralose upregulated the expression of lactobacillus genes but not that of Clostridium or E. Coli bacteria (p < 0.05). Therefore, it could be concluded that sucralose supplementation for rabbits modifies gut microbiota and boosts beneficial bacteria and feed conversion ratios without side effects. Moreover, sucralose could decrease blood glucose and intensify hypercholesterolemia and should be used with caution for human consumption.

Background: Appropriate cut-off values and diagnostic accuracy (DA) [sensitivity, specificity, predictive values, positive (PPV) and negative (NPV)] of electrodiagnostic findings for carpal tunnel syndrome (CTS) based on age, gender, and diabetes mellitus (DM) were not reported. Methods: In a retrospective study, we described the latency difference values and DA of comparative latency studies COLS [median to ulnar through palmar difference (palmdiff) and ring difference study (ringdiff), median to radial through thumb difference study (thumbdiff), and combined sensory index (CSI)] among non-CTS and CTS groups based on age, DM, and gender. Results: We included 632 patients (228 without CTS and 404 with CTS). For PPV > 90% and NPV > 50%, the best cut-offs among patients without DM, were 0.5ms, 0.8–1 ms, 1.4 ms, and 2 ms for palmdiff, thumbdiff, CSI (age < 60 years), and CSI (age > 60 years), respectively. The best cut-offs among patients with DM were 0.5 ms, 1.2 ms, 0.8 ms, 1.0–1.2 ms, 1.8 ms, 1–1.2 ms, 3.0 ms, and 3.5 ms for palmdiff (age < 50 years), palmdiff (age > 50 years), thumbdiff (age < 40 years), thumbdiff (age 40–59 years), thumbdiff (age > 60 years), CSI (age < 50 years), CSI (age 50–59 years), and CSI (age > 60 years), respectively. Conclusion: The cut-off values of COLS to confirm CTS and their DA were different according to age and DM.

Abstract Background Understanding the factors that influence adolescent’s perception of fast food and their fluid consumption is crucial for designing effective nutrition education programs tailored to this population. This study aimed to evaluate the associations of sex and the use of media and the internet with adolescents' perception of fast foods and the amount of fluid consumption. Methods A cross-sectional survey was conducted on school adolescents between the ages of 15 and 18 years in Kuwait, using a multistage stratified random sampling method (N = 706 adolescents; 343 boys and 363 girls). A pre-tested and specifically designed self-report questionnaire covering several measures such as: (a) types of foods that are considered fast foods; and (b) participant’s fluid consumption. Body weight and height were measured using calibrated medical scales. Body mass index (BMI) was computed. The adolescents were stratified by sex into two groups: boys and girls, for the purpose of analysis. Results Seven out of 14 food choices showed significant sex differences (p values ranged from 0.016 to

Abstract Background and Aim The impact of multiple risk factors on COVID-19 mortality has been previously reported in multiple systematic reviews and meta-analyses. The aim of this review is to provide a comprehensive update on the association between hypertension (HTN) and mortality in patients with COVID-19. Methods A systematic review and meta-analysis were performed and followed the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. A search was achieved using PubMed, Scopus, and Cochrane Databases for research publications on hypertension, COVID-19, and mortality published between December 2019 and August 2022. Results A total of 23 observational studies involving 611,522 patients from 5 countries (China, Korea, the UK, Australia, and the USA) were included in our study. The confirmed number of COVID-19 with HTN cases in each study ranged from 5 to 9964. The mortality ranged from 0.17% to 31% in different studies. Pooled results show that the mortality rate of COVID-19 among the included studies ranges from a minimum of 0.39 (95% CI 0.13–1.12) to a maximum of 5.74 (95% CI 3.77–8.74). Out of the 611,522 patients, 3119 died which resulted in an overall mortality prevalence of 0.5%. Subgroup analyses indicated that patients with COVID-19 who have hypertension and male patients had slightly less risk of mortality than female patients [the percentage of men > 50%; OR 1.33: 95% CI (1.01, 1.76); the percentage of men ≤ 50%: OR 2.26; and 95% CI (1.15, 4.48)]. Meta-regression analysis results also showed a statistically significant association between hypertension and COVID-19 mortality. Conclusion This systematic review and meta-analysis suggest that hypertension may not be the only risk factor associated with the increased mortality rate during the COVID-19 pandemic. In addition, a combination of other comorbidities and old age appears to increase the risk of mortality from COVID-19. Graphical Abstract The impact of hypertension on mortality rate among COVID-19 patients

Abstract Background The assessment of the normative values of sensory nerve action potentials (SNAP) and their diagnostic accuracies using validated neuropathy‐assessment tools to classify participants into groups with and without neuropathy was not previously described in the literature. Methods The Utah Early Neuropathy Scale (UENS), Michigan neuropathy‐screening instrument, and nerve conduction data were collected prospectively. We described and compared the values of the sural, superficial peroneal sensory (SPS), and superficial radial SNAP amplitude in different age groups for three groups. Group 1 (G1)—control participants (UENS

Abstract Objective Item response theory (IRT) is a methodological approach to studying the psychometric performance of outcome measures. This study aims to determine and summarize the use of IRT in otolaryngological scientific literature. Methods A systematic search of the Medline, Embase, and the Cochrane Library databases was performed for original English‐language published studies indexed up to January 28, 2023, per the following search strategy: (“item response theory” OR “irt” OR “rasch” OR “latent trait theory” OR “modern mental test theory”) AND (“ent” OR “otorhinolaryngology” OR “ear” OR “nose” OR “throat” OR “otology” OR “audiology” OR “rhinology” OR “laryngology” OR “neurotology” OR “facial plastic surgery”). Results Fifty‐five studies were included in this review. IRT was used across all subspecialties in otolaryngology, and most studies utilizing IRT methodology were published within the last decade. Most studies analyzed polytomous response data, and the most commonly used IRT models were the partial credit and the rating scale model. There was considerable heterogeneity in reporting the main assumptions and results of IRT. Conclusion IRT is increasingly being used in the otolaryngological scientific literature. In the otolaryngology literature, IRT is most frequently used in the study of patient‐reported outcome measures and many different IRT‐based methods have been used. Future IRT‐based outcome studies, using standardized reporting guidelines, might improve otolaryngology‐outcome research sustainably by improving response rates and reducing patient response burden. Level of evidence 2.

Background: Vaccination against COVID-19 diminishes the risk of infection and provides robust protection against severe illnesses and death when coupled with existing preventive measures. Despite comprehensive research, there are still complaints of short-term side effects of COVID-19 vaccines among healthcare workers. This study aims to specifically identify the short-term side effects that manifest after receiving the COVID-19 vaccine. Methodology: A descriptive cross-sectional hospital-based study included 100 Healthcare Workers (HCWs) at Soba University Hospital from April to May 2022, focusing on Short-Term Side Effects following Covid-19 Vaccination. Data were collected using a structured interview questionnaire distributed via Google Docs and Microsoft Teams. The survey was sent to healthcare workers, including doctors, nurses, and others, through email and WhatsApp. Chi-square, t-test, and logistic regression analyses were employed to assess the determinants and associations between side effects after COVID-19 vaccination and other variables using STATA version 17 software. Results: Among the 100 participants, nearly half (42 %) were in the age group of 20 to 30 years, and over two-thirds (61 %) of the participants were female, with 31 % being registered nurses. The majority, 91 %, received the AstraZeneca vaccine. This current study revealed a statistically significant relationship between the onset of symptoms and the type of vaccine (AstraZeneca) with a p-value of 0.001. Additionally, a statistically significant relationship was observed between muscular pain, fever, itching as side effects, and AstraZeneca, with p-values less than 0.05. Logistic regression indicated that male nurses between 31–40 years were almost 61 % less likely to report side effects. Conclusion: The study concluded that most of those who took the vaccination of COVID-19 experienced short-term side effects including chills, fever, muscle pain, and headache after receiving the vaccine after each dose but they did not develop diarrhea.

Background: Patient satisfaction is currently a recognized measure of the effectiveness and quality of the healthcare system. It serves as an essential tool in raising the standard of care. This study aimed to examine patients' satisfaction with the quality of nursing care provided. Methods: A hospital-based cross-sectional study was conducted, involving 400 patients selected through a random selection method, meeting the selection criteria. Data were collected using the “Patient Satisfaction with Nursing Care Quality Questionnaire,” comprising a total of 19 items. The collected data were then analyzed and interpreted using descriptive and inferential statistics. Data were analyzed using STATA software V17. Results: The study revealed that the highest level of satisfaction (mean 2.31, SD 1.33) was observed in the coordination of care after discharge, specifically nurses' efforts to cater to patients' needs after they left the hospital. The lowest satisfaction level was related to privacy, with provisions for patients' privacy by nurses scoring 3.9 (SD 1.00). Overall, questionnaire scores ranged from 2.31 to 3.9, with an average score of 3.26 (SD 0.64). Conclusion: Overall, patients expressed general satisfaction with the inpatient nursing care they received, and their perceived needs and care expectations from nurses significantly influenced their satisfaction levels. Therefore, we recommend that hospital administrators regularly assess patient satisfaction levels and provide specialized on-the-job training to nurses to enhance their ability to meet patients' needs and increase their overall satisfaction.

BackgroundWe conducted this meta-analysis to compare the two muscle-invasive bladder cancer (MIBC) treatment modalities in terms of cancer-specific survival (CSS) and other outcome indicators.MethodA systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. The search was conducted using various academic databases including Scopus, PubMed, Cochrane database, EMBASE, Chinese biomedical literature database, Wan fang databases, and China National Knowledge Internet databases between 1966 and December 2023. This review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) No. (CRD42023398977).ResultThis study included a total of 54,816 patients diagnosed with bladder cancer from 14 studies, of which 6,228 patients were assigned to the trimodal therapy (TMT) group and 48,588 patients were assigned to the radical cystectomy (RC) group. Based on the results, the RC group exhibited a higher rate of survival than the TMT group [pooled hazard ratio (HR) = 1.23, 95% CI: 1.18–1.28, Z = 1.46, P

ABSTRACTIntroduction:There is a variation in drug response among patients who practice intermittent fasting. Alteration in the expression of drug-metabolizing enzymes (DMEs) can affect the pharmacokinetics and drug response.Aims: This research aimed to determine the effect of intermittent fasting on the mRNA expression of major drug-metabolizing cyp450s in the liver of diabetic mice.Methods: Thirty-two male Balb/c mice were divided into four groups; control, nonfasting diabetic, non-diabetic fasting, and diabetic fasting mice. Insulin-dependent diabetes was induced in mice by a single high-dose (250 mg/kg) streptozocin. Mice of non-diabetic and diabetic fasting groups were subjected to 10-day intermittent fasting for 17 hours daily. Then, the mRNA expression of mouse phase I DMEs cyp1a1, cyp2c29, cyp2d9, and cyp3a11 was analyzed using real-time polymerase chain reaction. In addition, the liver of mice in all groups was examined for pathohistological alterations.Results: Diabetes downregulated the mRNA expression of hepatic drug-metabolizing cyp450s in diabetic mice, while intermittent fasting significantly (P

Purpose: To investigate the impact of adding a metal staple alongside the interference screw in tibial side graft fixation during anterior cruciate ligament reconstruction (ACLR). Methods: All patients treated with autograft hamstring ACLR at our institution between January 2017 and December 2021 with a minimum 1-year follow-up were reviewed retrospectively. Patients treated with a stand-alone interference screw for tibial side fixation were compared with those treated with a combination of interference screw and staple. The primary outcome was failure of the reconstructed graft. Secondary outcomes were operative time, complication rate, and reoperation rate. Results: A total of 497 patients met the study’s inclusion and exclusion criteria. A combination of staple and interference screw was used in 167 patients (33.6%), whereas a standalone interference screw was used in 330 patients. There was no significant difference between the 2 groups in terms of operative time, complication rate, or failure rate. The mean follow-up was 23.25 (±13.29) months. Conclusions: Our results demonstrate that augmenting the interference screw with a staple for tibial-side fixation in ACLR does not have a significant impact on operative time, reoperation rate, complications, or failure rates. Level of Evidence: Level III, retrospective cohort study.

Boronic acids/esters have recently emerged in the field of medicinal and pharmaceutical research due to their exceptional oxophilicity, low toxicity, and unique structure. They are known as potent enzyme inhibitors, cancer therapy capture agents, and can mimic certain types of antibodies to fight infections. They have been designed and developed into drugs, and this approach has emerged in the last 20 years. Five boronic acid drugs have been approved by the FDA and Health Canada, two of which are used to treat cancer, specifically multiple myeloma. The purpose of this review is to investigate boronic acid/ester derivatives as potential pharmaceutical agents as well as the mechanism of action. It will concentrate on six types of cancer: multiple myeloma, prostate cancer, breast cancer, lung cancer, cervical cancer, and colon cancer. Some newly developed boron-containing compounds have already demonstrated highly promising activities, but further investigation is required before final conclusions can be drawn.

Abstract Loss of function progranulin (GRN) mutations are a major autosomal dominant cause of frontotemporal dementia (FTD). Patients with FTD due to GRN mutations (FTD-GRN) develop frontotemporal lobar degeneration with TDP-43 pathology type A (FTLD-TDP type A) and exhibit elevated levels of lysosomal proteins and storage material in frontal cortex, perhaps indicating lysosomal dysfunction as a mechanism of disease. To investigate whether patients with sporadic FTLD exhibit similar signs of lysosomal dysfunction, we compared lysosomal protein levels, transcript levels, and storage material in patients with FTD-GRN or sporadic FTLD-TDP type A. We analyzed samples from frontal cortex, a degenerated brain region, and occipital cortex, a relatively spared brain region. In frontal cortex, patients with sporadic FTLD-TDP type A exhibited similar increases in lysosomal protein levels, transcript levels, and storage material as patients with FTD-GRN. In occipital cortex of both patient groups, most lysosomal measures did not differ from controls. Frontal cortex from a transgenic mouse model of TDP-opathy had similar increases in cathepsin D and lysosomal storage material, showing that TDP-opathy and neurodegeneration can drive these changes independently of progranulin. To investigate these changes in additional FTLD subtypes, we analyzed frontal cortical samples from patients with sporadic FTLD-TDP type C or Pick’s disease, an FTLD-tau subtype. All sporadic FTLD groups had similar increases in cathepsin D activity, lysosomal membrane proteins, and storage material as FTD-GRN patients. However, patients with FTLD-TDP type C or Pick’s disease did not have similar increases in lysosomal transcripts as patients with FTD-GRN or sporadic FTLD-TDP type A. Based on these data, accumulation of lysosomal proteins and storage material may be a common aspect of end-stage FTLD. However, the unique changes in gene expression in patients with FTD-GRN or sporadic FTLD-TDP type A may indicate distinct underlying lysosomal changes among FTLD subtypes.

Abstract Objective This study aims to identify determinants of high impact, measured by Impact Factor (IF) and Eigenfactor score, among otolaryngology journals. Methods Bibliometric data of “otorhinolaryngology” journals were collected from the Journal Citation Reports (JCR) database. For the years 2009–2020, we collected normalized Eigenfactor score, 5‐year IF, immediacy index, fraction of IF from journal‐self citation, proportion and magnitude of published citable articles, and total citation counts. High‐IF and ‐Eigenfactor journals were considered those within the top‐quartile of that metric each respective year. Results High‐IF and ‐Eigenfactor otolaryngology journals displayed higher 5‐year IFs, immediacy indexes, and IF without self‐citation (p .05 for 2009‐2016). Eigenfactor correlated with 5‐year IF, total citation counts, and citable articles within the same year (p .05 for 2009‐2016) predicted 2019 IF. Similarly, 5‐year IF, total citation counts, and citable articles (p

Abstract Background Lifestyle behaviors are developed during young adulthood and carried through life. Accordingly, early detection of unhealthy behaviors can help prevent the increase in non-communicable diseases in the population. College students are an especially vulnerable group who, upon entering a new environment, tend to engage in unhealthy behaviors. Objective The present study aims to evaluate the lifestyle behaviors of Kuwaiti college students and their association with markers of academic achievements. Methods One thousand two hundred fifty-nine students participated in the present study and answered an online questionnaire pertaining to their sociodemographic status, academic performance indicators, body weight and height, and lifestyle behaviors. Data were collected from November 2020 to February 2021. Results Results of the present study showed that obesity was significantly more prevalent among male participants than among females even though males were more physically active. Alternatively, females had a greater grade point average in college, slept more, and had more screen time. Interestingly, we were unable to detect a significant correlation between lifestyle behaviors and academic achievements. Conclusion The observed differences in body mass index between genders may have been attributed to energy intake rather than energy expenditure.

Abstract Background Mucociliary clearance is an important defense mechanism in human upper and lower respiratory airways. Impairment of this process by certain conditions such as cigarette smoking can predispose to chronic infection and neoplasm of the nose and paranasal sinuses. Methods This was a cross‐sectional study conducted in Kano metropolis, Nigeria. Eligible adults were enrolled, a saccharine test was conducted, and the nasal mucociliary clearance time was assessed. Analysis of the result was carried out using Statistical Product and Service Solutions version 23.0. Results There were 225 participants categorized into 75 active smokers (33.3%), 74 passive smokers (32.9%), and 76 nonsmokers (33.8%, living in a smoking‐free zone). The age range of the participants was between 18 and 50 years, with a mean age of (31.2 ± 5.6) years. All participants were males. There were 139 (61.8%) of Hausa‐Fulani ethnic group, 24 (10.7%) Yoruba, 18 (8.0%) Igbo, and 44 (19.5%) other ethnic groups. Findings in this study showed that the average mucociliary clearance time among active smokers was prolonged ([15.25 ± 6.20] min) compared to passive ([11.41 ± 4.25] min) and nonsmokers ([9.17 ± 2.76] min) respectively, with a statistical significance (F = 33.59, P

BACKGROUND: This study aimed to evaluate the effectiveness of a respiratory care bundle, including deep breathing exercises, incentive spirometry, and airway clearance techniques, on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients in Jordan. MATERIALS AND METHODS: A quasi-experimental study design and convenience sampling method was used to recruit 120 COPD patients, with 54 in the intervention group and 66 in the control group. The intervention group received additional respiratory care bundle training, while the control group received only discharge instructions and an education program. The St. George’s Respiratory Questionnaire (SGRQ-C) was used to assess participants’ QoL before and after the intervention. Independent t-tests, paired t-tests, and analysis of covariance (ANCOVA) analysis were used to analyze the data. RESULTS: The study found no significant differences between patients’ characteristics, health status, and SGRQ-C scores between the two groups at baseline. After the intervention, there were statistically significant differences in all SGRQ-C subscales, which were lower in the intervention group compared to the control group. The paired t-test showed significant reductions in all SGRQ-C symptoms components (t = 7.62, P < .001), activity component (t = 7.58, P < .001), impact component (t = 7.56, P < .001), and total scores post-intervention (t = 7.52, P < .001) for the intervention group. The ANCOVA analysis showed significant differences in scores of SGRQ-C components and total scores (f = 11.3, P < .001) post-intervention between the two groups. CONCLUSION: The study’s findings suggest that providing additional respiratory care bundle training for COPD patients can significantly improve their QoL, as measured by the SGRQ-C scores. The respiratory care bundle intervention was effective in reducing COPD symptoms and improving the QoL of COPD patients. Healthcare providers should consider implementing respiratory care bundles as part of COPD management to improve patients’ outcomes.

Type 2 diabetes mellitus (T2DM) is a critical health problem, with 700 million diagnoses expected worldwide by 2045. Uncontrolled high blood glucose levels can lead to serious complications, including diabetic cardiomyopathy (DCM). Diabetes induces cardiovascular aging and inflammation, increasing cardiomyopathy risk. DCM is characterized by structural and functional abnormalities in the heart. Growing evidence suggests that cellular senescence and macrophage-mediated inflammation participate in the pathogenesis and progression of DCM. Evidence indicates that growth differentiation factor-15 (GDF-15), a protein that belongs to the transforming growth factor-beta (TGF-β) superfamily, is associated with age-related diseases and exerts an anti-inflammatory role in various disease models. Although further evidence suggests that GDF-15 can preserve Klotho, a transmembrane antiaging protein, emerging research has elucidated the potential involvement of GDF-15 and Klotho in the interplay between macrophages-induced inflammation and cellular senescence in the context of DCM. This review explores the intricate relationship between senescence and macrophages in DCM while highlighting the possible contributions of GDF-15 and Klotho.

Background: The world has witnessed one of the largest pandemics, dubbed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of December 2020, the USA alone reported 98,948 cases of coronavirus disease 2019 (COVID-19) infection during pregnancy, with 109 related maternal deaths. Current evidence suggests that unvaccinated pregnant women infected with SARS-CoV-2 are at a higher risk of experiencing complications related to COVID-19 compared to nonpregnant women. This review aimed to provide healthcare workers and non-healthcare workers with a comprehensive overview of the available information regarding the efficacy of vaccines in pregnant women. Summary: We performed a systematic review and meta-analysis following PRISMA guidelines. The search through the database for articles published between December 2019 and October 2021 was performed. A comprehensive search was performed in PubMed, Scopus, and EMBASE databases for research publications published between December 2019 and October 2021. We focused on original research, case reports, case series, and vaccination side effect by authoritative health institutions. Phrases used for the Medical Subject Heading [MeSH] search included (“COVID-19” [MeSH]) or (“Vaccine” [MeSH]) and (“mRNA” [MeSH]) and (“Pregnant” [MeSH]). Eleven studies were selected and included, with a total of 46,264 pregnancies that were vaccinated with mRNA-containing lipid nanoparticle vaccine from Pfizer/BioNTech and Moderna during pregnancy. There were no randomized trials, and all studies were observational (prospective, retrospective, and cross-sectional). The mean maternal age was 32.2 years, and 98.7% of pregnant women received the Pfizer COVID-19 vaccination. The local and systemic adverse effects of the vaccination in pregnant women were analyzed and reported. The local adverse effects of the vaccination (at least 1 dose) such as local pain, swelling, and redness were reported in 32%, 5%, and 1%, respectively. The systemic adverse effects such as fatigue, headaches, new onset or worsening of muscle pain, chills, fever, and joint pains were also reported in 25%, 19%, 18%, 12%, 11%, and 8%, respectively. The average birthweight was 3,452 g. Among these pregnancies, 0.03% were stillbirth and 3.68% preterm (