Search

Abstract Introduction Kuwait has a large expatriate community who experience both restricted access to public health services and lower income than Kuwaiti citizens. Given these conditions, we examined differences in characteristics and management of chronic kidney disease (CKD) between Kuwaitis and expatriates. Methods Clinical and laboratory data for adult CKD Stages 3–5 not on dialysis (CKD 3–5 ND) patients with native kidneys attending nephrology clinics in all Ministry of Health hospitals collected from January 1, 2022, to December 31, 2022. Cohort was then divided into Kuwaiti patients and expatriates patients for comparison. Results We collected data from 2,610 patients (eGFR: 30.8 ml/min/1.73m2; age: 62.6 years; males: 56.7%; Kuwaitis: 62.1%). Kuwaitis were older (63.94 vs. 60.3 years, p

Abstract Background Diabetic ketoacidosis (DKA) is a life-threatening condition as a complication of diabetes and represents a significant healthcare global burden. The current study goal was to determine factors affecting time to recovery from DKA in Alexandria Main University Hospital. Patients and methods One hundred fifty patients who had been admitted with DKA were included in this study. All patients were managed with hospitalization for IV fluids, continuous intravenous insulin infusion, electrolyte correction, as well as detection and treatment of the predisposing factor until the full resolution of DKA. Results Males contributed to 58.7% of the total patients in this study with a mean age of 32.16 ± 15.06 years. DKA mean time of resolution was 18.76 ± 14.07 h. The majority of patients were with T1DM (86%), while T2DM were 14%. Missed insulin dose was the leading precipitating factor (60.7%) followed by infections (38.7%). There was a statistically significant relationship between DKA resolution time with age, time of presentation, type of diabetes, initial pH, initial serum K+ level, initial HCO3 − level, initial anion gap, initial base excess, and initial RBS (p value

Abstract Purpose The aim was to investigate the effect of surgeon handedness on acetabular cup positioning, functional outcomes, and dislocation incidence during primary THA. Methods A systematic review was conducted according to the PRISMA guidelines. Studies published in English were searched in three databases (PubMed, Embase, and Scopus). A dominant side is a right-handed (RHD) or left-handed (LHD) surgeon who operates on the right or left hip, respectively. The opposite is considered to be the non-dominant side. We used odds ratios for dichotomous data and mean differences for continuous data, with 95% confidence intervals for quantitative data synthesis. Heterogeneity was assessed using the I² test, with outcomes graphically represented in a forest plot and a p-value of . Result Four observational studies were included out of 98 articles. Ten experienced surgeons participated (8 RHD and 2 LHD) and operated on 822 patients (1484 hips), divided equally between dominant and non-dominant sides, and the posterolateral approach was utilized in 80.9% of THAs. RHD surgeons operated on 1404 (94.6%) THAs. The pooled synthesis for inclination indicated no significant difference between either side [MD: 0.10 (95% CI -2.10 to 2.30, P = 0.93, I² = 91%)]. While the difference was significant for anteversion [MD: -2.37 (95% CI -3.82 to -0.93, P = 0.001, I² = 31%)]. The functional outcome was better on the dominant side [MD: 1.44 (95% CI 0.41 to 2.48, P = 0.006, I² = 0%)], and the dislocation incidence was significantly higher on the non-dominant side [OR: 0.45 (95% CI 0.25 to 0.81, P = 0.008, I² = 0%)]. Conclusion Surgeon handedness and whether operating on the dominant or non-dominant side could affect the acetabular cup positioning and outcomes during primary THAs, even in the hands of high-volume surgeons.

Abstract Water microbial contamination is a serious issue that poses a risk to both animal and human health. One hundred and twenty water were samples collected from main water source and drinkers from a poultry farm. Different bacterial pathogens were isolated from water sources. Escherichia (E.) coli, Pseudomonas (P.) aureoginosa, (Salmonella) Salmonella (s). Typhimurim, Aeromonas (A.) hydrophila at different percentages. Variable degree of bacterial resistance to some commercial disinfectants commonly used to disinfect water system (iodine, terminator and H2O2). Nanoparticles were used to control bacteria in water. About the safety investigation for the prepared nanomaterials, the work results demonstrated that zinc oxide (ZnO) nanoparticles (NPs) exhibit the highest safety profile among the manufactured materials. The median fatal dose (LD50) for ZnO NPs was determined to be 3709 mg/kg body weight. In comparison, the LD50 values for zeolites and nanocomposites were 3251 mg/kg and 2658 mg/kg, respectively. Therapeutic dosages were estimated based on the LD50. Zeolite NPs, ZnO NPs and ZnO/zeolite NPs showing promising results in control of those bacteria. It was concluded that the escalating resistance of bacteria to disinfectants have led to a need to find alternative such as nanoparticles that proved promising results in control of pathogens, particularly it showed a safe effect on laboratory animals.

Abstract Background This prospective bicentric study aims to evaluate and compare the efficacy of intradiscal radiofrequency biacuplasty (IDB) versus conservative management (CM) in treating chronic discogenic low back pain (CDLBP). Methods Forty-four patients with CDLBP were randomly assigned to either the biacuplasty group or the conservative management group. The biacuplasty group received treatment with two radiofrequency (RF) needles, positioned bilaterally on the annulus fibrosus under fluoroscopic guidance and local anaesthesia, to administer bipolar RF. Patients were monitored for 6 months, with the allowance of pain medication as needed. In the conservative management group, patients who continued to experience low back pain after three months were permitted to switch to the biacuplasty group. The study was conducted over two years, starting on July 1, 2020. Results The studied groups had comparable age and gender distributions, with no significant difference in BMI. The Oswestry Disability Index (ODI) was assessed at baseline, 1 month, 3 months, and 6 months. At baseline, no significant difference was observed between the groups (p = 0.263). However, at the 1-month, 3-month, and 6-month follow-up, the biacuplasty group exhibited significantly lower ODI scores compared to the conservative management group (all p

Abstract Background: Total hip arthroplasty (THA) by using ceramic-on-ceramic (CoC) implants has emerged as a promising solution to mitigate wear debris-related complications, such as osteolysis, specifically in younger patients. This study aims to investigate the functional outcomes after total hip replacement by CoC in patients less than 30 years old, conducted within the hospitals of Khartoum, Sudan. Methods: A descriptive, cross-sectional, hospital-based study was carried out across the major healthcare institutions in Khartoum state from October 2021 to April 2022. A cohort of 32 patients, all aged 30 or below, who underwent total hip replacement were included. Thorough data analysis was conducted using advanced statistical techniques. Results: The average age of included patients was 25.69 ± 2.7 years, among them, males had a slight predominance (56.3%) with a male-to-female ratio of 1.3:1. Most patients had a secondary school level of education (37.5%), while workers constituted the largest group (34.4%). The included patients were followed-up for more than six months. The mean visual analog scale (VAS) score was 7.91 ± 0.893. Additionally, the mean modified Harris hip score was 83.03 ± 4.9 (range: 72–91), highlighting the enhanced hip function achieved through the procedure. The majority of patients (65.6%) reported good functional outcomes, followed by 28.1% who attained fair outcomes and 25.8% who reported excellent outcomes. Conclusion: The study demonstrates that CoC THA yields optimal functional outcomes among patients aged 30 years and below. The procedure exhibits remarkable potential to improve hip function and alleviate pain in this specific patient population. These findings highlight the efficacy and viability of CoC implants in younger patients, contributing to the advancement of hip arthroplasty techniques.

Abstract Background Climate changes have led to health and environmental risks, so it has become essential to measure climate change literacy among the entire population, especially nursing students. The significant role of nursing students in raising public awareness and future healthcare roles emphasizes assessing the predictors of climate change literacy among nursing students. Aims This study seeks to identify the predictors of climate change literacy among nursing students in A Multi-Site Survey. Design A multi-site descriptive cross-sectional study adheres to the guidelines outlined in A Consensus-Based Checklist for Reporting Survey Studies collected for five months, from the 1st of July 2023 to November 2023. The study participants comprise 10,084 nursing students from all 27 governments in Egypt. The researcher used the Predictors of Nursing Students’ Climate Change Literacy scale in this study. Data was collected, with 25 min average time to complete. Backward multiple linear regression was used to identify these predictors. Results In the current study, nursing students demonstrated a moderate understanding of climate science (mean score 14.38), communication and advocacy skills (mean score 14.41), and knowledge of adaptation and mitigation strategies (mean score 13.33). Climate health impacts (mean score 17.72) emerged as the domain with the highest level of knowledge. No significant differences in climate literacy were observed across diverse student backgrounds (all p-values were > 0.05). Perceived faculty knowledge of climate change positively correlated with all four domains of climate literacy and emerged as a significant predictor in multiple linear regression analyses (all p-values were

Canagliflozin was assessed for its anti-inflammatory and antioxidant effects as an anti-aging drug in animal models. 50 Swiss albino male mice were divided into five groups; all groups received their intervention using gastric gavage; group 1 received normal saline for 14 weeks; group 2 received induction by D-galactose 200 mg/kg/day for seven weeks; and group 3 to 5 received the same induction for seven weeks, followed by another seven weeks of investigated drugs; group 3 received Vitamin C (100 mg/kg/day); group 4 received canagliflozin (3 mg/kg/day); and group 5 received canagliflozin (1 mg/kg/day). At the end of 14 weeks, all animals were euthanasiad, and heart and skin tissue were harvested for further analysis. Canagliflozin at both 1 and 3 mg/kg was successful in reducing the levels of inflammatory mediators (TNF-alpha and IL6), reducing levels of MDA, increasing the levels of SOD, and increasing the levels of collagen-1 and elastin in skin tissue. Additionally, 3 mg/kg Canagliflozin showed a better effect compared to 1 mg/kg regarding its effect on IL6, SOD, and elastin. Histopathologically, treatment with both doses of Canagliflozin attenuates abnormalities induced by D-galactose (bizarre, irregular, and hyperchromatic nuclei). Canagliflozin exhibits potent antioxidant and anti-inflammatory effects in living organisms, effectively prevents cardiac and skin damage generated by D-galactose, and possibly reduces aging.

Abstract Catalytic methane decomposition is a promising technology for reducing the reliance on fossil fuels and mitigating the effects of climate change by producing clean hydrogen and value‐added carbon without the emission of greenhouse gases. The aim of the study was to investigate the use of Al2O3‐modified MgO doped iron‐based catalysts for the catalytic decomposition of methane. The catalysts were synthesized using the impregnation method and characterized using various analysis techniques, including Brunauer, Emmett, and Teller, temperature programmed reduction, temperature programmed oxidation, X‐ray diffraction, thermal gravimetric analysis, Raman, scanning electron microscopy, and transmission electron microscopy. The activity of the synthesized catalysts was tested in a packed‐bed reactor with a gas flow rate of 20 mL/min at a temperature of 800°C. The investigation focuses on the influence of incorporating magnesium into alumina catalysts with MgO concentration ranging from (20%–70%), where higher magnesium levels improve catalytic activity by creating more active sites, positively impacting methane decomposition. Enhanced catalyst reducibility and increased particle dispersion lead to improved catalytic properties despite the reduced surface area. The FA70M and FA63M catalysts exhibited almost the same catalytic characteristics and the highest stability and methane conversion among the catalysts investigated, reaching 87% and 85% at 800°C for 120 min. Moreover, both catalysts showed hydrogen yields of 86% and 85%, respectively. The introduction of MgO further increased the total carbon yield from 103% with FA and 39% for FM to 114% and 120% for the respective catalysts (FA70M and FA63M). During the methane decomposition reaction, carbon nanotubes of varying diameters were produced. Higher iron loading resulted in a positive trend.

Abstract This research presents an experimental, analytical, and numerical study to predict the flexural behavior of reinforced concrete hidden and wide beams embedded in slabs. The experimentally studied parameters of testing eight specimens include beam depth, beam width, and beam eccentricity from the column. The obtained test results were compared to the predictions of finite element analysis using the ANSYS program. A numerical parametric study was conducted by the ANSYS program to explore other parameters affecting the ultimate flexural strength of beams. The studied parameters encompass concrete compressive strength, steel reinforcement strength, bottom reinforcement ratio, top-to-bottom reinforcement ratio, and web reinforcement ratio. The results revealed that an increase in beam depth led to higher ultimate load and secant stiffness, along with a decrease in deflection. The increase in beam width significantly affected beam depth, resulting in increased ultimate load and secant stiffness and a slight decrease in deflection. The increase in beam eccentricity from the column resulted in a decrease in ultimate load and secant stiffness while increasing the deflection. Comparisons between experimental and numerical results were made against calculations based on the ECP 203-2017 and ACI 318-19 codes, and the comparison yielded satisfactory results.

Abstract This study investigates the role of dietary Bacillus subtilis and oregano essential oil in mitigating the effects of high stocking density on growth performance, carcass traits, physiological stress indicators, gene expression, and intestinal integrity in broiler chickens. A total of, 1250 one-day-old Ross 308 male broiler chicks were randomly allocated to five experimental groups, where each group had five replicates of 50 chicks. Group 1 (control, LSD): 15 chicks/m2 fed a basal diet without feed additive, group 2 (HSD): 20 chicks/m2 fed a basal diet without feed additive, group 3 (BHSD): 20 chicks/m2 fed a basal diet supplemented with B. subtilis (500 mg/kg diet), group 4 (OHSD): 20 chicks/m2 fed a basal diet supplemented with oregano essential oil (300 mg/kg diet), group 5 (CHSD): 20 chicks/m2 fed a basal diet supplemented with oregano essential oil and B. subtilis. At 35 days of age, there was a noticeable improvement in the growth performance of broilers fed CHSD under high stocking density through the increase in body weight gain, dressing percentage, and crude protein digestibility with a decrease in feed conversion rate compared to other groups. Adding CHSD enhanced the state of oxidation and immunity through increasing superoxide dismutase, glutathione peroxidase, and the relative weight of bursa of Fabricius, while decreasing malondialdehyde, in addition to increasing plasma triiodothyronine levels. The microbial structure and morphometric parameters improved in the group that received the CHSD compared to the other groups, where villus height and Lactobacillus population increased, whereas Escherichia coli and Clostridium perfringens population decreased. Glucose transporter 2 (GLUT2), fatty acid transporter 1 (FABP1), and amino acid transferase 1 (CAT1) gene expression levels significantly increased when feeding on oregano essential oil with B. subtilis. In conclusion, combining oregano essential oil and B. subtilis supplements mitigated the effects of high stocking density by enhancing growth performance, antioxidative status, and intestinal integrity, in addition to modifying the genetic expression of genes related to nutrient absorption.

Abstract Bone scintigraphy is recognized as an efficient diagnostic method for whole-body screening for bone metastases. At the moment, whole-body bone scan image analysis is primarily dependent on manual reading by nuclear medicine doctors. However, manual analysis needs substantial experience and is both stressful and time-consuming. To address the aforementioned issues, this work proposed a machine-learning technique that uses phases to detect Bone scintigraphy. The first phase in the proposed model is the feature extraction and it was conducted based on integrating the Mobile Vision Transformer (MobileViT) model in our framework to capture highly complex representations from raw medical imagery using two primary components including ViT and lightweight CNN featuring a limited number of parameters. In addition, the second phase is named feature selection, and it is dependent on the Arithmetic Optimization Algorithm (AOA) being used to improve the Growth Optimizer (GO). We evaluate the performance of the proposed FS model, named GOAOA using a set of 18 UCI datasets. Additionally, the applicability of Bone scintigraphy for real-world application is evaluated using 2800 bone scan images (1400 normal and 1400 abnormal). The results and statistical analysis revealed that the proposed GOAOA algorithm as an FS technique outperforms the other FS algorithms employed in this study.

Abstract Background Male reproductive performance is an essential part of sheep production; therefore, the use of natural antioxidants to improve sperm quality and maintain reproductive performance in males is very important. Hence, oral administration of rosemary essential oil (REO) was investigated to improve the fertility rate, including the ultrasonographic testes, epididymal tail and genital glands, as well as semen parameters and testosterone concentration. Sixty animals were splitted into two groups, each with 30 rams; the rosemary group (C + REO) received 2 mg/kg/bw and the control group (C-REO). Ultrasound images and blood samples were collected at 15, 30 and 45 days of the REO treatment. Results The testis and epididymal tail ultrasonographic assessments demonstrated a significant enhancement in the C + REO group compared to the C-REO group. However, the rams in the C + REO group showed significant improvements in the pampini-form plexus, seminal vesicle, Cowper's and prostate genital glands compared to the C-REO group. The data showed that the sperm cell concentration (× 109/ml) and individual motility (%) were significantly improved in the C + REO group. Furthermore, ejaculate volume (ml) in the C + REO group was significantly higher than that in the C-REO group. While the animals treated with REO did not improve live spermatozoa (%), it reduced the abnormalities of spermatozoa (%) compared to the C-REO group. Also, the C + REO group significantly increased the testosterone concentration more than the C-REO group. Conclusion It can be concluded that supplementation with 2 mg/kg/bw REO improves genital characteristics, semen parameters and testosterone concentration in Barki rams.

Abstract Background Chronic hepatitis C virus (CHC) infection represents a crucial health problem, especially among children and adolescents. The ledipasvir (LDV)/sofosbuvir (SOF) regimen has been approved to treat adolescents (aged 12 to 17 years old) infected with hepatitis C virus (HCV) genotypes 1, 4, 5, and 6 and then extended to include children above or equal to 3 years old. The current study aims to evaluate the safety and efficacy of SOF/LDV combination in treating CHC-infected 12- to 17-year-old adolescents. Patients and methods This retrospective cohort study was performed on 147 Egyptian adolescents with CHC. The patients were treated with SOF 400 mg/LDV 90 mg combination once daily for 12 weeks. Possible side effects and laboratory data including HCV ribonucleic acid polymerase chain reaction (RNA PCR), complete blood count (CBC), and liver tests were recorded at baseline and week 12 after the end of treatment (EOT). Results Sustained virological response 12 weeks (SVR12) after end of treatment (EOT) was observed in 146 out of 147 patients (99.3%). The treatment regimen was efficiently tolerated with no reported cases of discontinuation caused by intolerability. Moreover, the side effects were minimal; 71.4% of the patients did not report any side effects related to the treatment. However, the rest mentioned fatigue, headache, or both of them. Fatigue was the main side effect reported in 16.3% of the patients. Furthermore, ALT and AST levels were normalized after treatment. FIB-4 and APRI scores were statistically significantly decreased 2 years post-SVR, in comparison to their levels before treatment, from 0.34 and 0.36 to 0.25 and 0.17, respectively. Conclusion The LDV/SOF regimen is one of the safe regimens used to treat adolescent patients with CHC infection.

Abstract Background Pulsed‐field ablation (PFA) has emerged as an innovative alternative to radiofrequency (RF) and cryoablation because it selectively targets myocardial tissue. Thus, we aim to estimate the efficacy and safety of PFA versus thermal ablation for atrial fibrillation (AF) ablation. Methods A systematic review and meta‐analysis were retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through September 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42023480321 Results We included 17 studies with a total of 2255 patients. PFA was significantly associated with a decreased incidence of AF recurrence (RR: 0.66 with 95% CI [0.51, 0.87], p = .003). However, there was no significant difference between PFA and thermal ablation in arrhythmia recurrence (RR: 0.92 with 95% CI [0.74, 1.46], p = .42). PFA was significantly associated with decreased total procedure time (MD: −15.15 with 95% CI [−20.23, −10.07], p

Aim: Burning mouth syndrome (BMS) is a debilitating chronic burning sensation in the oral cavity with no identifiable cause. The present research was conducted to evaluate the prevalence profile of BMS in a sample of the Egyptian population. Methods: A cross-sectional study was performed by screening 952 subjects, all individuals with burning mouth complaints were interviewed and examined to identify the site, timing, frequency, and intensity of their burning sensations. The presence of associated xerostomia, taste disturbances, and impact on quality of life was also recorded. The extent of perceived stress was assessed using the short version of the Perceived Stress Scale. Results: Among the total 952 cases, 75 cases suffered from BMS symptoms representing a prevalence rate of 7.9%, occurring more frequently in females and those aged 50 years and older. Additionally, 86.7% of cases suffered from systemic diseases, most commonly, diabetes mellitus and hypertension, and were on long-term medications. The intensity of BMS symptoms was relatively high (7.81 ± 1.72). It was significantly correlated with age, smoking, duration of BMS, presence of medical conditions, long-term medications, quality of life, and Perceived Stress Scale scores. The most involved locations were the tongue and buccal mucosa. Xerostomia was reported in 78.7% of cases, while disturbance of taste sensation was reported in 49.3%. Conclusions: This is the first reported prevalence data for BMS in the Egyptian population in an attempt to improve the limited amount of relevant literature, revealing a BMS prevalence of 7.9% with a significant impact on the quality of life.

Abstract Background Despite the fact that diarrhea is more accurately described as a clinical symptom than a disease. Diarrhea is one of the most important issues in ovine medicine, particularly in lambs, and because of high morbidity and mortality rate, sluggish growth performance, and veterinary costs, it is believed to be a major source of economic loss. Salmonella and enterotoxigenic Escherichia coli are the most common and commercially significant agents responsible for diarrhea. Objective The objective of this study was to monitor the nucleotide sequence variations, gene expression, serum inflammatory and oxidative stress biomarkers in diarrheic lambs. Another aim was to identify different pathotypes and virulence genes of Salmonella and E. coli causing diarrhea. Methodology Blood samples were taken from 50 Barki who were diarrheal and 50 who appeared to be healthy, and then divided in 3 portions, with EDTA added to the first part for CBC, DNA and RNA extraction. The second sample received 5000 I.U. of heparin calcium, and a clean plain tube was used for the third component. The second and third sections were centrifuged to extract serum and plasma until the biochemical and immunological analysis was completed. Fecal samples were collected for bacteriological examination, and the bacteria were identified by PCR analysis. PCR-DNA sequencing was conducted for immune (SELL, JAK2, SLC11A1, IL10, FEZF1, NCF4, LITAF, SBD2, NFKB, TNF-α, IL1B, IL6, LGALS, and CATH1), antioxidant (SOD1, CAT, GPX1, GST, Nrf2, Keap1, HMOX1, and NQO1), and GIT health (CALB1, GT, and MUC2) genes in healthy and diarrheic lambs. Results Virulent genetic markers of pathogenic characteristics of E. coli (astA, Vt2e (Stx2e), CFA/I, groES and luxS) and Salmonella (invA, SopB, bcfC and avrA) were detected in all diarrheic lambs. PCR-DNA sequencing of immune, antioxidant and intestinal health genes found eleven single nucleotide polymorphisms (SNPs) linked to either diarrhea resistance or susceptibility in Barki lambs. Transcript levels of immune, antioxidant, and GIT health (CALB1, GT, and MUC2) genes varied between healthy and diarrheic lambs. Nucleotide sequence variation of the genes under inquiry between reference sequences in GenBank and those of the animals under investigation verified all identified SNPs. Significant (P = 0.001) erythrocytosis, neutrophilic leukocytosis, with lymphocytopenia were observed in diarrheic lambs. Significant (P = 0.001) increases in serum IL-1α, IL-1β, IL-6, TNF-α (90.5 ± 1.7, 101.8 ± 1.7, 72.3 ± 6.6, 71.26 ± 4.89 Pg/ml, respectively), serum Fb, Cp, Hp, SAA (230.7 ± 12.4 mg/dl, 6.5 ± 0.07 mg/dl, 2.5 ± 0.09 g/dl, 7.4 ± 0.4 mg/L, respectively), free radicals (MDA, NO), cortisol (6.91 ± 0.18 μg/dl) and growth hormone, with significant (P = 0.001) decreases in serum IL-10 (81.71 ± 1.05 Pg/ml), antioxidants (CAT, GPx), insulin, triiodothyronine (T3) and thyroxine (T4) in diarrheic lambs. Conclusions The study's findings provided credence to the theory that marker-assisted selection (MAS) could be used to predict and prevent diarrhea in Barki sheep by selecting lambs based on SNPs in genes linked to inflammation, antioxidants, and intestinal health. In order to establish an efficient management protocol and determine the most susceptible risk period for disease occurrence, gene expression profiles of the genes under investigation, pro-inflammatory cytokines and acute phase proteins may also be utilized as proxy biomarkers for lamb enteritis.

Purpose: Removal of clinically benign eyelid margin lesions is frequently desired for cosmetic concerns. Although surgical excision remains the standard therapy for such lesions, it carries the risk of unfavorable outcomes. Hence, this study aimed to evaluate a more aesthetic technique entailing a posterior lamellar wedge resection of lower eyelid margin lesions through an infraciliary incision. Methods: A retrospective review of patients who underwent posterior lamellar wedge resection for benign lower eyelid margin lesions between May 2017 and June 2022 was performed. Patient satisfaction using the visual analog score (VAS) and cosmetic outcomes using the Strasser score. Results: Forty-two patients met the inclusion criteria (61.9% female, mean age: 46.8 years). Nevus was the most frequent histologic diagnosis (57.1%). Furthermore, 66.7% of lesions extended to the back of the lid margin. The mean defect size was 5.8 mm (range: 3.5–8 mm). The mean follow-up interval was 24.1 months (range: 6–60 months). Thirty-two (76.2%) eyelids had scores indicating an excellent result, and 10 (23.8%) patients had a good result. The mean patient satisfaction VAS score for the eyelid appearance was 96 (range: 70–100). There were no cases of recurrence of resected lesions. No further surgery was performed on the operated eyelid for any reason during the follow-up period. Conclusion: Posterior lamellar wedge resection for lower eyelid margin lesions was associated with excellent cosmetic outcomes, high patient satisfaction, and minimal adverse events.

Abstract Dust accumulation on photovoltaic (PV) panels in arid regions diminishes solar energy absorption and panel efficiency. In this study, the effectiveness of a self-cleaning nano-coating thin film is evaluated in reducing dust accumulation and improving PV Panel efficiency. Surface morphology and elemental analysis of the nano-coating and dust are conducted. Continuous measurements of solar irradiances and ambient temperature have been recorded. SEM analysis of dust revealed irregularly shaped micron-sized particles with potential adhesive properties, causing shading effects on the PV panel surface. Conversely, the coating particles exhibited a uniform, spherical shape, suggesting effective prevention of dust adhesion. Solar irradiance ranged from 120 W/m² to a peak of 720 W/m² at noon. Application of the self-cleaning nano-coating thin film consistently increased short circuit current (I sc ), with the coated panel averaging 2.8 A, which is 64.7% higher than the uncoated panel’s 1.7 A. The power output of the coated panel ranged from 7 W to 38 W, with an average of approximately 24.75 W, whereas the uncoated panel exhibited a power output between 3 W and 23 W, averaging around 14 W. These findings highlight the substantial potential of nano-coating for effective dust mitigation, particularly in dusty environments, thus enhancing PV system reliability.

Overheating of power transformers, low-voltage panels, and medium-voltage components in Electric Transformer Rooms (ETRs) can result from various factors, such as contact issues, irregular loads, and other similar problems. Thermal imaging shows significant potential for detecting faults in power equipment. However, its effectiveness is hindered by the complex thermal patterns of faults and variability in equipment and environmental conditions, making accurate fault detection challenging. This paper aims to study the effectiveness of transfer learning architectures for automating equipment classification in ETRs. This work applies four transfer learning architectures: AlexNet, SqueezeNet, VGG19, and GoogLeNet. The findings of the testing phase demonstrated that the use of transfer learning by fine-tuning pre-trained convolutional neural networks was highly effective in the classification of thermal images captured from ETRs, with the models achieving accuracy rates between 86.98% and 100%, and F1-Scores between 86.79% and 100%.

Applying soil electrokinetic remediation (SEKR) is considered a valuable technique to remediate contaminants-containing low permeability soils with the advantage of integration with other remediation approaches (e.g., chemical, physical, and biological). The basics and principles of electrokinetic remediation (EKR) were utilized in different fields of interest; for example, sedimentation, seed germination, consolidation, dewatering, etc. The present review is focused on the role of the electrode approaching/movement technique (EAMT) in improving the effectiveness of the SEKR. Based on our search in the collected literature, the influence of the EAMT on soil electrokinetic efficiency yielded no pertinent reviews. We looked for articles relevant to the EAMT in six search engines, and articles collected for the present review were chosen based on the data mentioned in the materials and methods section. Our objective was to illustrate the proper applicability of the EAMT from different perspectives to overcome some obstacles reported with the traditional SEKR. The effect of the EAMT is discussed/illustrated from four perspectives including a) the approaching/moving anode technique (AMAT), b) the approaching/moving cathode technique (AMCT), c) electrodes placement/gap, and d) continuously reoriented/rotating, reciprocating, and rotational electric fields. Several advantages could be gained from the EAMT application including a) improving the current passing, b) soil pH reduction, c) increasing heavy metals desorption, d) elevating the redox potential, e) reducing the energy consumption, f) increasing the removal percentages of contaminants, g) reducing extra chemical additives or pH modifications, h) enhancing electroosmotic flow, i) installing auxiliary electrodes presents a more stable current and uniform electric field, and j) ultimately reducing the environmental risks of heavy metals. Two methods were proposed for the practical applications of the EAMT (in-situ and ex-situ). Although there are various advantages were achieved from the application of the EMAT, the published research during the past 31 years (1993–2023) is few compared to other enhancement approaches.

Continuous Renal Replacement Therapy (CRRT) serves as an intervention strategy for the management of acute kidney injury (AKI) in critically ill patients. However, owing to its complex nature and the potential for complications, the implementation of CRRT demands continuous monitoring to prevent patient safety risks. This study aims to identify and validate prevalent risks linked to CRRT within a real-world clinical setting, intending to propose preventive measures grounded in expert insights. To systematically categorize and visually depict the risks, their consequences, preventive measures, and recovery controls, our study employed the Bowtie method in conjunction with the Systems Engineering Initiative for Patient Safety (SEIPS) model. In addition to considering patient-related factors that exhibit variability among critically ill individuals, our key findings showed that the most influential risks impacting the effective delivery of CRRT are incidents of clotted filters, bleeding risks arising from the necessity of anticoagulation for filter efficacy, vascular catheter-related bloodstream infections, variations in proficiency levels among healthcare professionals regarding CRRT modalities, especially in operating the CRRT machines, high nursing workload, frequent nursing turnover, occurrences of hypophosphatemia, variability in CRRT prescribing patterns, and issues related to communication among stakeholders. This research sheds light on the primary risks associated with CRRT and provides practical and viable strategies for effective management. Furthermore, the Bowtie diagram developed as part of this study serves as a valuable tool for visually representing the healthcare system and facilitating the identification of system-related risks within healthcare settings.

Abstract Introduction Unexpandable lung is a complication by which the lung does not expand to the chest wall with pleural space drainage, which will result in adverse events or intervention failure if not well recognized prior to the intervention. Aim of the work This study aimed to assess the role of pleural manometry and transthoracic ultrasonography in predicting abnormal lung expansion during pleural drainage. Patients and methods This was a prospective observational analytical study involving 50 patients that aims to predict abnormal lung expansion during pleural drainage using pleural manometry and transthoracic ultrasound. Results Regarding pleural manometry (pleural elastance), all patients in the entrapped lung group (100%) had pleural elastance > 14.5 cmH2o/L, while in the non-entrapped lung group, all patients (100%) had pleural elastance ≤ 14.5 cmH2o/L. Regarding ultrasonography, pleural thickening > 0.5 cm was found in all patients with entrapped lung (100%) and 50% of patients with non-entrapped lung with statistically significant difference. In the entrapped lung group, 20%, 35%, and 45% of patients had simple, complex non-septated, and complex septated pleural effusion, respectively, while in the non-entrapped lung group, 63.35%, 33.33%, and 3.32% of patients had simple, complex non-septated, and complex septated effusion, respectively, with statistically significant difference (p-value 0.0005). Conclusion Pleural manometry and transthoracic ultrasound can guide decision-making regarding the timing of pleural interventions and management of cases with entrapped lung.

Abstract Background Acute pulmonary embolism is recorded as one of the most common and critical medical conditions, resulting in a notable mortality rate requiring a multidisciplinary management. In this series, we address the management of massive and sub-massive pulmonary embolism utilizing catheter-based intervention, in particular the conjunction of mechanical thrombus disruption and aspiration with pharmacological thrombolysis (pharmacomechanical thrombectomy). Results 37 patients were diagnosed with massive and sub-massive pulmonary embolism based on the clinical and radiological findings. Pre-procedural vital parameters were obtained, including oxygen saturation, pulse rate, and blood pressure. Under continuous monitoring and conscious sedation, a pulmonary angiography via right common femoral vein access was performed for pre-procedural assessment. Pharmacomechanical thrombectomy was performed using the AngioJet Ultra System (Boston Scientific). Using the power pulse option, a fibrinolytic agent was infused into the thrombus. After 5–10 min, mechanical thrombectomy is performed with a maximum 3 passes through the thrombus. This technique is performed in the main pulmonary artery and lower branch. The procedure is repeated on the other side. The maximum duration of thrombectomy is 2–3 min on each side. Procedure success was based on improvement of vital signs and not related to post-procedure angiographic findings. All patients showed immediate improvement of vital signs (blood pressure, 02 saturation, and pulse rate) with progressive improvement over the following days. There were no procedure-related complications. Conclusion Pharmacomechanical thrombectomy is a safe and effective technique in the treatment of massive and submassive pulmonary embolism. It can be a first-line treatment even in patients without absolute contraindication to systemic thrombolysis.

Abstract Purpose We aimed to report the union rate after only utilizing a locally obtained autologous bone graft while correcting the deformity and performing joint arthrodesis in patients with foot and ankle Charcot neuropathy (CN) and to report on the radiographic, functional, complications incidence outcomes at a minimum of two years of follow up. Methods We included 24 patients having a mean age of 55.4 ± 10.1 years diagnosed with CN of the foot, ankle, or both. Seven (29.2%) cases were classified as Brodsky type 1, 11 (45.8%) as type 3 A, and six (25%) were type 4. Hindfoot and Midfoot bi-columnar arthrodesis was performed in 70.8% and 29.2% of the patients, respectively. Eight (33.3%) cases had preoperative ulcers. Functional outcomes were evaluated using a modified AOFAS score. Arthrodesis site union was assessed clinically and radiographically. All patients were available for a mean follow up of 35.7 ± 9.5 (24–54) months. Results Arthrodesis site union was achieved in 23 (95.8%) cases after a mean of 4 ± 1.7 (2-7.5) months. The mean modified AOFAS score was 72.4 ± 10.41 (46–83) points; 79.2% achieved excellent and good scores. Ulcers healed in 87.5% of the patients. Twenty-two (91.7%) patients were satisfied with their functional results. Infection incidence was 12.5%, and no patients required revision or amputation. Conclusion Foot and ankle Charcot neuroarthropathy deformity correction by arthrodesis of the affected joint as a salvage management option resulted in acceptable clinical and radiological outcomes. To enhance the local environment for arthrodesis consolidation, locally obtained autografts led to higher union rates and avoided the drawbacks of using other graft types.

Abstract Background Acute coronary syndrome (ACS) is responsible for one-third of total deaths in people older than 35 years old. Number of prognostic models aims to estimate the future risk of mortality, or the combined risk of all-cause mortality or MI has been developed, such as GRACE score. Objective The aim of our study is to assess the utility of GA and CHA2DS2-VASc score in predicting outcomes in patients admitted with acute coronary syndromes. Patients and methods This study was conducted on 90 patients diagnosed with acute coronary syndrome who were admitted receiving PCI, CHA2DS2-VASc score was calculated on admission, and a serum sample for GA was withdrawn within 24 h from admission. Results Combined GA and CHA2DS2-VASc score could significantly predict MACCE with sensitivity 100%, specificity 79%, and diagnostic accuracy 80.9% and significantly predict hospital mortality with sensitivity 100%, specificity 75.3%, and diagnostic accuracy 76.7%; on the other hand, GRACE score can predict MACCE using cutoff point 112.5 with sensitivity 75% and specificity 66%. Conclusion It was concluded that GA and CHADSVASC score can significantly predict major adverse cardiovascular events, in-hospital mortality, and poor clinical outcomes.

Abstract Background Eplerenone and spironolactone, recognized as mineralocorticoid receptor antagonists (MRAs), have been reported to improve clinical prognosis among individuals diagnosed with heart failure (HF). However, the difference in the clinical effects between eplerenone and spironolactone in individuals with HF remains uncertain. We aimed to assess the impact of eplerenone compared to spironolactone on clinical outcomes within the HF population. Methods An extensive search was executed in several databases (PubMed, Web of Science, Scopus, Cochrane Library). All relevant studies evaluating eplerenone compared to spironolactone in patients with HF were included. Dichotomous data were pooled as Hazard ratio (HR) or Risk ratio (RR) with a 95% confidence interval (CI). Our main outcome was all-cause mortality. Secondary outcomes included death from cardiovascular causes, treatment withdrawal, and gynecomastia. Results Ten studies, comprising 21,930 HF individuals, were included in our investigation. Eplerenone showed a lower risk of all-cause mortality (HR = 0.78, 95%CI [0.64 to 0.94], P = 0.009) and cardiovascular mortality (HR = 0.54, 95%CI [0.39, 0.74], P = 0.0001) compared to spironolactone. Furthermore, eplerenone exhibited a reduced risk of treatment withdrawal (RR = 0.69, 95% CI [0.62, 0.78], P = 0.0001) and gynecomastia (RR = 0.07, 95% CI [0.02 to 0.31], P = 0.0001) than spironolactone. Conclusion Eplerenone revealed lower all-cause and cardiovascular mortality events in comparison to spironolactone. Moreover, eplerenone was associated with lower gynecomastia and treatment withdrawal events compared to spironolactone. Further well-designed randomized controlled trials are still warranted better to identify the clinical differences between eplerenone and spironolactone. Trial registration Protocol registration: https://doi.org/10.17605/OSF.IO/VNMGK

Abstract Background Globally, Ischemic heart disease (IHD) is considered a leading cause of mortality and morbidity affecting men than women. The more the population ages, the more the prevalence. There was a concern about improper referral of women to MPI testing. We aimed to study if there a gender effect on the results of MPI studies and if this could have an impact on future referral or investigation selection for diagnosis of IHD as a general or specially in women. Results Female gender represented 266 (60%) while male represented in 177 (40%). Males demonstrated significantly higher age (55 ± 10 vs. 49 ± 9, P

Abstract Background Abamectin (ABA) is considered a powerful insecticidal and anthelmintic agent. It is an intracellular product of Streptomyces avermitilis; is synthesized through complicated pathways and can then be extracted from mycelial by methanol extraction. ABA serves as a biological control substance against the root-knot nematode Meloidogyne incognita. This investigation is intended to reach a new strain of S. avermitilis capable of producing ABA effectively. Results Among the sixty actinobacterial isolates, Streptomyces St.53 isolate was chosen for its superior nematicidal effectiveness. The mycelial-methanol extract of isolate St.53 exhibited a maximum in vitro mortality of 100% in one day. In the greenhouse experiment, the mycelial-methanol extract demonstrated, for the second-stage juveniles (J2s), 75.69% nematode reduction and 0.84 reproduction rate (Rr) while for the second-stage juveniles (J2s), the culture suspension demonstrated 75.38% nematode reduction and 0.80 reproduction rate (Rr). Molecular identification for St.53 was performed using 16 S rRNA gene analysis and recorded in NCBI Genbank as S. avermitilis MICNEMA2022 with accession number (OP108264.1). LC-MS was utilized to detect and identify abamectin in extracts while HPLC analysis was carried out for quantitative determination. Both abamectin B1a and abamectin B1b were produced and detected at retention times of 4.572 and 3.890 min respectively. Conclusion Streptomyces avermitilis MICNEMA2022 proved to be an effective source for producing abamectin as a biorational agent for integrated nematode management.

ABSTRACT: The use of essential oils (EO) has attracted interest in the food industry because of their wide range of beneficial properties. In this study, a new functional yogurt was developed using 2 EO, marjoram and geranium, at 3 different concentrations (0.2%, 0.4%, and 0.6% vol/vol). The physicochemical properties, including syneresis, viscosity, pH, and chemical composition; bioactivities, including antioxidant activity, anticancer and antibacterial effects, total phenolic content (TPC), and total flavonoid content (TFC); and sensory characteristics of the developed yogurt were evaluated. The findings indicated that the yogurts fortified with 0.6% marjoram or geranium exhibited higher viscosity and lower syneresis compared with other treatments. The yogurt supplemented with 0.6% marjoram displayed significant antibacterial activity against Listeria monocytogenes, Staphylococcus aureus, Salmonella typhimurium, and Escherichia coli. In addition, the yogurt enriched with geranium and marjoram oils at a concentration of 0.6% had notably significant (P < 0.05) higher TFC levels compared with the control sample and other concentrations. In the same context, in terms of TPC, yogurt supplemented with 0.6% marjoram displayed significantly (P < 0.05) elevated levels in comparison to the other samples tested. Yogurt enriched with marjoram oil exhibited noteworthy antioxidant activity, followed by geranium oil, compared with the control samples. The yogurt supplemented with 0.6% marjoram demonstrated strong radical scavenging activity, and the yogurt fortified with 0.6% geranium showed higher anticancer activity against HepG2 human liver carcinoma cells and oxidative stress enzyme activities. Among the various concentrations of EO tested, the yogurts fortified with 0.6% marjoram or geranium EO exhibited the most favorable outcomes, followed by 0.4% marjoram or geranium. To summarize, geranium and marjoram EO can be used as a potential nutritious ingredient and as a natural preservative for milk and related products.

Switchgear is a vital component of modern power systems, responsible for regulating the flow of electrical power. Contact issues, irregular loads, and other similar problems can cause switchgear to overheat, leading to unexpected disturbances and potential damage to the power equipment. Thermal imaging shows significant potential and is increasingly employed to detect faults in power equipment. However, the unique characteristics of thermal images often pose challenges to accurate fault detection. This research aims to study the effectiveness of transfer learning architectures for switchgear fault detection. This paper applies eleven transfer learning architectures, including SqueezeNet, GoogLeNet, InceptionV3, DenseNet201, ResNet50, Xception, InceptionResNetV2, ShuffleNet, EfficientNetB0, AlexNet, and VGG19. The results of the testing phase demonstrated that the application of transfer learning by fine-tuning pre-trained convolutional neural network architectures was highly effective in the classification of thermal images captured from switchgear units. The models achieved accuracy rates between 83.87% and 98.38%, and values of F1-Scores between 83.11% and 98.34% in the pre-trained architectures.

The optical and thermal properties of nanoparticles have attracted much interest due to their extinction effectiveness in industries like electronics, medical devices, photonics, materials sciences, drug delivery, hyperthermia, etc. In this work, the optical response of eight different geometrical nanostructures, namely Solid-CuNS, Au–Ag-coated-Solid-CuNS, Hollow-CuNS, Au–Ag-coated-Hollow-CuNS, Solid-CuNR, Au–Ag-coated-Solid-CuNR, Hollow-CuNR, and Au–Ag-coated-Hollow-CuNR, were studied for hyperthermia. Finite element analysis was performed in COMSOL Multiphysics to simulate the optical and thermal responses of the nanostructures. The size range of nanostructures was selected differently based on the hyperthermia condition to attain a temperature between 42 °C and 46 °C. An appropriate temperature distribution of 43.8 °C was achieved in the 500 nm liver domain using an Au–Ag-coated-Solid-CuNS with Dsphere = 20 nm. The minimum thermal response was 42.1 °C for both Solid-CuNS and Solid-CuNR when Dsphere was 35 nm and Lcylinder was 35 nm. The highest electric field distribution of 11.2 V/m in the surrounding area was seen for Au–Ag-coated-Solid-CuNR, with an extinction resonance peak at 475 nm. On the other hand, the Au–Ag-coated-Solid-CuNS showed the least electric field distribution of 2.22 V/m with a corresponding resonance peak of 480 nm when Dsphere was 15 nm.

The present study aims to determine the ability of algae in sequestering Lambda‐cyhalothrin (L-C) from aqueous solution. A series of experiments were carried out in batch mode to find equilibrium data for sorption of Lambda‐cyhalothrin (L-C), FTIR analysis was utilized to investigate the impacts of functional groups of algae in the biosorption process. Pseudo second-order kinetics model (R2=0.991) well describe the kinetics of adsorption of L-C onto algae sites while the adsorption mechanisms was controlled by external mass transfer as well as intraparticle diffusion. Langmuir isotherm model better fit the experimental data than Freundlich isotherm model. The higher adsorption capacity was found to be 6.954mg/g. Thermodynamic parameters indicating that sorption of L-C onto algae was endothermic in nature. Only 40% reduction in the sequestration efficiency was noticed after five sequential regeneration cycles. The maximum sorption efficiency was found to be (95.6%) under the best conditions adsorbent dosage=1g/100ml, pH=7, initial L-C concentration=10 mg/l with a contact time of 60 minutes at 25°C. This work demonstrated that algae are a promising adsorbent for L-C removal from aqueous solution.

Spontaneous stress fracture of the scapular spine associated with rotator cuff tendinopathy is a rare complication in an elderly patient. Rotator cuff tendinopathy is a common condition characterized by degeneration and inflammation of the rotator cuff tendons. On the other hand, stress fractures are small cracks or breaks in bones that occur in response to repetitive or excessive mechanical loading. We present a rare case of a 79-year-old female patient complaining of persistent right shoulder pain that was unresponsive to medication which worsened in the last week and associated with a limited range of motion and inability to raise her arms above her head. Imaging studies revealed a nondisplaced fracture involving the mid-aspect of the scapular spine with surrounding callus formation and adjacent reactive changes. Stress fractures are often observed in weight-bearing bones, but they can also occur in non-weight bearing bones like the scapular spine. The association between rotator cuff tendinopathy and stress fractures of the scapular spine is uncommon and not well-documented in the literature. The biomechanics of the shoulder joint and altered force transmission due to rotator cuff pathology may contribute to the development of stress fractures. This case highlights the need to consider uncommon complications, such as stress fractures, in patients with shoulder pain. A comprehensive approach and early recognition of rare complications can guide appropriate diagnostic and treatment strategies to prevent potential complications and optimize patient outcomes.

The mandibular condyle is a rounded bony projection with an upper biconvex, oval surface in the axial plane. Its form differs significantly among different individuals and age groups. This study aims to address the variability in mandibular condyle morphology, which can be indicative of Temporomandibular Joint disorders (TMD). Given the clinical importance of accurate condyle characterization, we developed a novel detection method leveraging deep learning and feature selection technologies. This method explicitly employs the YOLOv8 network to initially identify the region of interest (ROI) in digital panoramic images. Subsequently, the MobileViT system extracts detailed features from these regions. We introduced a modified Mountaineering Team-Based Optimization Algorithm to refine the feature selection process, which efficiently isolates the most relevant features from the extracted set. Our experimental design involved a robust dataset of 3000 digital panoramic images, classified into four distinct morphological types: round, pointed, angled, and flat. We assessed the performance of our developed method through various metrics, focusing on its ability to detect and describe the morphology of the condyle. The results demonstrate a high capability of the model, achieving an accuracy of 81.5% in binary classification and 83.5% in multi-classification scenarios.

Primary biliary cholangitis (PBC) is a rare immune-mediated disease, commonly affecting women in their 40s, and ultimately progressing to liver failure. The incidence and prevalence of the disease are increasing worldwide, possibly due to better diagnostic tools. This review will focus on its epidemiology, pathophysiology, diagnosis, prognosis, and new developments in therapy.

Abstract Objective Multisystem inflammatory syndrome in children (MIS-C) is a critical childhood disease that is associated with coronavirus disease (COVID-19). We aimed to describe the clinical, laboratory, and echocardiographic characteristics and outcome of critical MIS-C cases in Egyptian children during the first wave of the COVID-19 pandemic. Design A retrospective, observational study. Setting A single-center tertiary pediatric intensive care unit (PICU).In Ain Shams university hospitals Cairo Egypt Methods Children admitted to the PICU diagnosed with severe MIS-C as per the Centers for Disease Control’s definition from June 23, 2020, to August 22, 2020, were included. Results The patient’s mean age was 7.45 (interquartile range [IQR], 4.23) years, and the cause of PICU admission was hypotension and shock. All patients had a fever for 4.8 (IQR, 2.5) days before shock developed. Overall, 68% had a gastrointestinal manifestation, and 55.6% had a rash. Thirty-five of 45 patients had ≥ 4 elevated inflammatory markers. The cardiac troponin I level was elevated in 35 of 45 patients. The most common cardiac condition was valvulitis (tricuspid regurgitation, 29/45; mitral valve regurgitation, 28/45; pulmonary valve regurgitation, 5/45; atrial valve regurgitation, 4/45). Twenty-one patients had an impaired ejection fraction

Abstract Tamarix tetragyna is a plant grows in Mediterranean area and some Arab countries. It possesses numerous medicinal values. Purpose of our study is to explore biological activity of tamarix tetragyna extracts of both leaves and stem with investigating their phytochemical composition. The investigated extracts’ phyto-constituent composition was determined using gas chromatographic-mass spectrometric method. In addition, in vitro cytoxicity activity versus cancer cell lines such MCF-7, HepG-2, HCT-116, and A-549 was examined by MTT assay method, together with exploring its apoptosis effect by flow cytometry and western blot analysis techniques. Moreover, some phytochemical compounds were identified, and in-silico evaluated against anticancer molecular targets. Plant extracts showed good cytotoxic activity against both A-549 and HCT-116 cancer cell lines. With an IC50 value of 23.90 µg/ml that led to apoptosis and G2/M-phase arrest in A-549 cells, cytotoxicity data demonstrate leaves’ extract effectiveness against these cells. Upon GC-MS analysis, it revealed presence of some bioactive components such as Stigmast-5-en-3-ol and 2-methoxy-4-vinyl phenol, which are known for their cytotoxic activity. Our findings suggest that methanolic extracts of Tamarix tetragyna parts may have potential therapeutic uses as anticancer against A-549 cells, which opens up further avenues for investigation into its industrial applications.

Abstract The grading of non-muscle invasive bladder cancer (NMIBC) continues to face challenges due to subjective interpretations, which affect the assessment of its severity. To address this challenge, we are developing an innovative artificial intelligence (AI) system aimed at objectively grading NMIBC. This system uses a novel convolutional neural network (CNN) architecture called the multi-scale pyramidal pretrained CNN to analyze both local and global pathology markers extracted from digital pathology images. The proposed CNN structure takes as input three levels of patches, ranging from small patches (e.g., $$128 \times 128$$ 128 × 128 ) to the largest size patches ( $$512 \times 512$$ 512 × 512 ). These levels are then fused by random forest (RF) to estimate the severity grade of NMIBC. The optimal patch sizes and other model hyperparameters are determined using a grid search algorithm. For each patch size, the proposed system has been trained on 32K patches (comprising 16K low-grade and 16K high-grade samples) and subsequently tested on 8K patches (consisting of 4K low-grade and 4K high-grade samples), all annotated by two pathologists. Incorporating light and efficient processing, defining new benchmarks in the application of AI to histopathology, the ShuffleNet-based AI system achieved notable metrics on the testing data, including 94.25% ± 0.70% accuracy, 94.47% ± 0.93% sensitivity, 94.03% ± 0.95% specificity, and a 94.29% ± 0.70% F1-score. These results highlight its superior performance over traditional models like ResNet-18. The proposed system’s robustness in accurately grading pathology demonstrates its potential as an advanced AI tool for diagnosing human diseases in the domain of digital pathology.

Abstract This study explores the impact of γ-irradiation on ethanolic extracts of Solanum aculeastrum Dunal. The anti-cancer and antimicrobial properties were investigated. The obtained results revealed that total phenol (TP) and total flavonoid (TF) of total ethanol extract (100%) (FTE) were higher than 70% ethanol extract (SE), and these contents increased after gamma radiation with 5 kGy. The results of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the Solanum aculeastrum extracts suggested that FTE and 5 kGy-irradiated FTE can be used to control and prevent skin infections caused by MRSA and endocarditis, urinary tract infections, and prostatitis caused by Enterococcus faecalis. The FTE sample irradiated at 5 kGy showed cytotoxicity for A431 and Hct-116 cell lines similar to the control sample and higher than the toxicity revealed by the samples irradiated at 10 kGy. In normal cells (Bj-1), the toxicity was decreased after irradiation (IC50 = 31 μg/ml) compared to the non-irradiated extract (IC50 = 26.1 μg/ml). Molecular docking suggested Sortase A to play a role in chlorogenic acid antibacterial activity towards Staphylococcus aureus. In conclusion, γ-irradiation can be used to enhance the phytoconstituents of Solanum aculeastrum fruit extracts and, consequently, its biological properties.

Abstract To evaluate the effect of combining different bioactive root-end filling materials with composite bone graft (xenogeneic mixed with autogenous bone fragments) on the healing process of periapical tissues after endodontic micro-surgery procedure. In this triple-blinded clinical trial, 56 patients were divided into 2 main groups (28 each) according to the root-end filling material and 2 subgroups according to the presence or absence of the composite bone graft material. Group I: MTA root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Group II: TotalFill root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Healthy patients whose ages range from 20 to 50 years with small-to-medium size radiolucency in CBCT related to single-rooted maxillary teeth were included in this study. Patients were assigned a number starting from 1 to 56 and were randomly allocated to four test groups (2 main groups and 2 sub-groups) following simple randomization procedure guidelines described by IBM SPSS V23 (IBM USA) statistical analysis software. This trial was triple-blind where the patient, the outcome assessors, and the main operator were blinded to the applied intervention. Every patient was evaluated clinically and by CBCT at two main observation periods: presurgical and 12-month post-operative. They were also examined and evaluated clinically and radiographically through periapical x-rays after one week, three, and six months. Statistical analysis was performed with IBM SPSS Statistics for Windows Version 23.0. Armonk, NY: IBM Corp. Of the 56 patients enrolled in the study, 49 patients were available for the final analysis. All groups showed no statistically significant differences with regard to healing or success rates at the 12-month follow-up mark. No adverse effects were encountered. Results showed that high success rates were achieved using MTA and TotalFill in the healing of periapical lesions after endodontic surgery. The addition of bone graft in small-to-medium size lesions did not affect the success rate of endodontic surgeries.

Abstract A mathematical analysis was conducted to predict the power requirements of the olive trunk shaker. The predicted required power of the olive trunk shaker is influenced by shaking displacement, fruit detachment force, fruit mass, stem length, damping ratio, unbalanced mass of the tree shaker, and exciting shaking frequency. The Olive trunk shaker was tested in the field at five attachment heights, 400, 500, 600, 700, and 800 mm, and six levels of olive trunk diameter: 78, 84, 101, 143, 158, and 186 mm. The results indicated that the theoretical shaking power was 12.8 kW while the actual required shaking power ranged from 7.1 to 17.8 kW, with an average of 12.6 kW due to variations in tree trunk diameters and different attachment heights. Multiple regression using the least squares method was employed to establish a statistical relation between the theoretical equation and the actual required power as a function of the clamp attachment height and trunk diameter. The regression coefficient of the predicted equation was 93.6% for attachment height values between 400 and 800 mm and tree trunk diameter values between 78 and 186 mm, with a mean absolute error of the prediction model was 0.5009 kW.

Abstract Soil electrokinetics (SEK) research has been widely used in various fields such as soil remediation, dewatering, land restoration, geophysics, sedimentation, pollution prevention, consolidation, and seed germination. According to our most recent published research on SEK process design modifications during the last 30 years (1993–2022), more than 150 designs have been introduced to assure SEK’s maximum performance. Incorporating lateral electrodes/anodes was not documented in the existing literature, which motivated us to investigate the output of this design. In this study, we aimed to enhance the performance of the perforated cathode pipe soil electrokinetic remediation (SEKR) system (PCPSS) for removing inorganic pollutants by installing lateral anodes (LA-PCPSS) using two approaches. In the first approach, the LA-PCPSS was connected to different sources of applied voltages (DSAV) from different power supplies, while in the second approach, the entire operation system was connected to the same source of applied voltage (SSAV). We used the Taguchi approach (L9OA) to determine the optimal levels of applied voltages for the DSAV system. The results indicated that the DSAV-(LA-PCPSS) could be optimized at an applied voltage of 1 V cm−1 for the surface and the first and second lateral anodes. The indigenous Sr (elements found in the tested soil without artificial pollution) in kaolinite showed the best response among other elements (Ni and other indigenous elements) when optimizing the DSAV-(LA-PCPSS) using the Taguchi approach. Installing lateral anodes (position B) supplied to low applied voltage (0.5 V cm−1) improved the electroosmosis (EO) rate/dewatering. Reverse migration of ions was observed during the remediation of real contaminated soil using the SSAV-(LA-PCPSS). The DSAV-(LA-PCPSS) is considered an appropriate design for the SEKR of inorganic pollutants, and increases the EO flow/dewatering. Additionally, the increased energy consumption employing the DSAV-(LA-PCPSS) was extremely minimal compared to the traditional PCPSS, which is an economic advantage for SEKR research. The DSAV-(LA-PCPSS) is still under optimization/intensification process, and subsequent processes will be examined to achieve high efficiency.

Abstract Background Unlike acute appendicitis, chronic appendicitis is characterized by nonspecific abdominal pain and intermittent course. This may lead to late diagnosis or misdiagnosis, with the possibility of serious complications. Case report A male patient of Arab origin aged 55 years had a 2-year history of recurrent episodes of mild pain in the right lower quadrant of the abdomen. The episodes were associated with nausea, chills, and abdominal bloating but no vomiting, rectal bleeding, or weight loss. On examination, the patient showed soft and lax abdomen with mild tenderness in the right lower quadrant, with no organomegaly or abdominal masses. Laboratory findings showed normal complete blood count and C-reactive protein. The patient underwent colonoscopy to rule out malignancy, which showed appendiceal orifice polyp that required resection. The computed tomography scan showed an enlarged appendix with multiple intraluminal dense appendicoliths. The largest stone at the appendiceal orifice measured 1.5 cm × 0.9 cm and was partially protruding within the cecal lumen. The diagnosis of chronic appendicitis was confirmed. The patient underwent appendectomy and was asymptomatic a few days after discharge. Conclusions We are reporting a patient with chronic appendicitis presented with multiple appendicoliths. The patient was initially misdiagnosed as periappendiceal orifice polyp. The current finding highlights the importance of imaging, especially computed tomography in confirming the diagnosis in patients with atypical appendicitis presentation.

Abstract Chronic demyelination and oligodendrocyte loss deprive neurons of crucial support. It is the degeneration of neurons and their connections that drives progressive disability in demyelinating disease. However, whether chronic demyelination triggers neurodegeneration and how it may do so remain unclear. We characterize two genetic mouse models of inducible demyelination, one distinguished by effective remyelination and the other by remyelination failure and chronic demyelination. While both demyelinating lines feature axonal damage, mice with blocked remyelination have elevated neuronal apoptosis and altered microglial inflammation, whereas mice with efficient remyelination do not feature neuronal apoptosis and have improved functional recovery. Remyelination incapable mice show increased activation of kinases downstream of dual leucine zipper kinase (DLK) and phosphorylation of c-Jun in neuronal nuclei. Pharmacological inhibition or genetic disruption of DLK block c-Jun phosphorylation and the apoptosis of demyelinated neurons. Together, we demonstrate that remyelination is associated with neuroprotection and identify DLK inhibition as protective strategy for chronically demyelinated neurons.

Abstract Aim The purpose of this study was to evaluate the performance of polyethylene fiber reinforced resin composite fillings compared to bulk fill resin composite fillings in endodontically treated teeth over a two-year monitoring period. Method A total of 240 individuals with endodontically treated lower molars and a moderate amount of tooth structure were divided into two equal groups of 120 each. One group received polyethylene fiber reinforced bulk fill resin composite restorations while the other group received only bulk fill resin composite restorations, both applied as per manufacturer guidelines. Two proficient experienced blinded assessors assessed the restorations using modified USPHS criteria at baseline, 6, 12, and 24 months. Statistical analysis used Data analysis involved the utilization of Mann-Whitney U, Friedman’s test, and Nemenyi post hoc test, with age data being displayed as mean and standard deviation. The significance level was established as p

Abstract This study explores the potential of strain selection and adaptation for developing a fungi-yeast-microalgae consortium capable of integrated bioethanol production and livestock wastewater treatment. We employed a multi-stage approach involving isolation and strain selection/adaptation of these consortiums. The study started with screening some isolated fungi to grow on the cellulosic biomass of the livestock wastewater (saccharification) followed by a fermentation process using yeast for bioethanol production. The results revealed that Penicillium chrysogenum (Cla) and Saccharomyces cerevisiae (Sc) produced a remarkable 99.32 ppm of bioethanol and a concentration of glucose measuring 0.56 mg ml− 1. Following the impact of fungi and yeast, we diluted the livestock wastewater using distilled water and subsequently inoculated Nile River microalgae into the wastewater. The findings demonstrated that Chlorella vulgaris emerged as the dominant species in the microalgal community. Particularly, the growth rate reached its peak at a 5% organic load (0.105385), indicating that this concentration provided the most favorable conditions for the flourishing of microalgae. The results demonstrated the effectiveness of the microalgal treatment in removing the remaining nutrients and organic load, achieving a 92.5% reduction in ammonia, a 94.1% reduction in nitrate, and complete removal of phosphate (100%). The algal treatment also showed remarkable reductions in COD (96.5%) and BOD (96.1%). These findings underscore the potential of fungi, yeast, and Nile River microalgae in the growth and impact on livestock wastewater, with the additional benefit of bioethanol production. Graphical abstract

Energy Optimization in building design field now has been revolutionized due to AI and machine learning applications. Leveraging daylight to reduce artificial lighting consumption holds promise for significant energy savings, yet the nonlinear nature of daylight patterns poses challenges in prediction and optimization. This study proposes a novel approach to automated light shelf design using machine learning algorithms, specifically artificial neural networks (ANNs) such as recurrent neural networks (RNN) by long short term memory (LSTM), to accelerate daylighting simulation and optimization processes. The methodology employed two distinct approaches: Firstly, we employed the theoretical-analytical approach to explore methods for utilizing machine learning in natural lighting and light shelf parameters. Second, the practical and applied method involved creating a predictive model for designing the light shelf using appropriate AI and ML techniques. This model is based on an office geometry model at the El Arish weather file in Egypt, four-dimensional training room models with three internal zones-oriented south. Rhinoceros and Grasshopper, two parametric simulation tools, are used to normalize and optimize light shelf parameters like geometry cross-section, curvature surface, width, height position, depth, tilt angle, and reflectance materials. Then, the Galapagos plug-in and Colibri2 are used for dataset creation and optimization. The results demonstrate that automated light shelf operation has a significant impact on internal daylighting quality. RNNs enable rapid prediction of optimization models, reducing time consumption in the early design phase. ML facilitates decision-making by generating evaluative criteria from user-selected design options. RNNs were classified as good and bad and used LSTM to enhance prediction accuracy for efficient illuminance values metric in zones 1 and 2. Challenges include increasing the simulation procedure's efficiency. The results of model accuracy reached 99%. Hence, future research should prioritize resolving the previously identified concerns. In conclusion, this study underscores the importance of ML-driven approaches in early design phases to optimize building energy consumption and pave the way for sustainable architectural practices.

Laser technology has emerged as a promising tool in modern endodontics. Its ability to precisely target and interact with dental tissues offers several advantages. Studies have shown that lasers can reduce postoperative pain, eliminate bacteria and improve root canal cleaning. Additionally, lasers facilitate tissue healing and enhance the sealing process. The minimally invasive nature of laser treatment contributes to better patient comfort and overall treatment outcomes. The potential benefits of lasers in endodontic care are clear. However, current research lacks consistency in methodology, which makes direct comparisons challenging. It is essential to establish standardised protocols for laser parameters and study design to fully realise the advantages of laser technology. Further research is needed to explore the best ways to use lasers in various endodontic procedures, especially regarding tissue regeneration and long-term outcomes. Despite these limitations, lasers represent a significant advancement in endodontic care and have the potential to redefine treatment standards.