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ABSTRACTBackground The unopposed vagal activity with sympathetic block and maternal bradycardia that is likely to occur with phenylephrine infusion might be some causes of intraoperative nausea and vomiting (IONV) during spinal anaesthesia. We aimed at comparing hyoscine butyl-bromide (HBB) and ondansetron in reduction of intraoperative bradycardia and thus IONV in women undergoing caesarean delivery (CD).Methods In a randomized, double-blind, placebo-controlled trial, women undergoing elective CD were randomly assigned to administer either IV HBB 20 mg, ondansetron 8 mg, or the same volume of 0.9% saline right before spinal anaesthesia. The primary endpoint was the incidence of IONV. Secondary endpoints included intraoperative maternal bradycardia and hypotension and postoperative nausea and vomiting (PONV).Results 55 subjects in each group received the assigned intervention. During the intraoperative period, HBB decreased only the incidence of emesis when compared to the control group (P = 0.046) while ondansetron statistically decreased the incidence of IONV when compared to the control group (P = 0.034). HBB statistically decreased the incidence of intraoperative maternal bradycardia when compared to the controls (1.8% vs 14.5%; OR = 0.1, 95% CI = [0.01, 0.90]; P

Maya Romani,1 Mohamed A Ahmed,1 Doaa O Salman,2 Ghassan Hamadeh,3 Sara A Assaf,4 Carine J Sakr4 1Health and Wellness Center, Department of Family Medicine, American University of Beirut, Hamra, Beirut, Lebanon; 2Department of Pediatrics and Adolescent Medicine, American University of Beirut, Hamra, Beirut, Lebanon; 3Department of Family Medicine, College of Medicine, Central Michigan University, Mount Pleasant, MI, USA; 4Employee Health Unit, Department of Family Medicine, American University of Beirut, Hamra, Beirut, LebanonCorrespondence: Carine J Sakr, Employee Health Unit, Department of Family Medicine, AUBMC, Cairo Street, Hamra, Beirut, Lebanon, Email Cs56@aub.edu.lbBackground: Compared to the general workforce, hospital staff has a greater incidence of chronic diseases and mental health illnesses. Wellness programs have been shown to improve the health and well-being of hospital employees by reducing risk factors and promoting healthy behaviors. In the Arab World, there are no available studies on the number, nature, or impact of wellness services provided to healthcare workers.Objective: The study aims to assess the prevalence, characteristics, and components of health and wellness programs targeting hospital employees in Arab countries. It also aims to test the association of hospitals’ characteristics and the challenges faced by these hospitals with the availability of such programs.Methods: A cross-sectional study was conducted through an online questionnaire in English and Arabic emailed to directors of Arab hospitals registered in the Arab Hospital Federation.Results: Only 39.5% of the hospitals in the Arab region have an established wellness program. No significant association was found between hospital characteristics and the availability of these wellness programs. The most provided services for hospital staff are Flu vaccine (90.7%), pre-employment medical exam (79.1%), healthy food options (65.1%), and health risk assessment (60.5%), while the least common provided services are mental health (20.9%) and stress management (23.3%). The most common challenges facing wellness services (scale: 0– 10) are financial restriction (5.95), creating a culture of health (5.88), and motivating employees (5.56). Only 4.7% of hospitals provide incentives to participate in their wellness programs.Conclusion: In general, Arab hospitals lack a wellness culture, and more investment is needed in essential wellness services such as mental health, weight reduction, stress management, and smoking cessation.Keywords: wellness services, well-being, health program, Arab hospitals, hospital staff

Abdelkhalig Hussein Elhilu,1 Maged El-Setouhy,2 Ali Sadeiq Mobarki,2 Mohammed Maki Abualgasem,2 Mohammed Ageel Ahmed1 1Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 2Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi ArabiaCorrespondence: Abdelkhalig Hussein Elhilu, Tel +966531514032, Email aelhilu@jazanu.edu.sa; hiluab@hotmail.comPurpose: The COVID-19 pandemic dramatically affected every aspect of life worldwide. Contact restrictions and social distancing during the epidemic has led to the suspension of bedside teaching (BST) and shifting to online didactic teaching and other methods of active learning. We implemented peer role-play simulation (PRPS) during the pandemic to compensate for the suspended BST. This study aims to explore the effectiveness of PRPS in developing the students’ verbal communication, empathy and clinical reasoning skills compared to BST.Methods: This is a cross-sectional observational study conducted in Jazan University faculty of medicine with the study sample including all medical students enrolled in 5th and 6th year during the academic year 2020– 21. Data collection involved using a web-based validated questionnaire.Results: Most of the students (84.1%) rated bedside teaching (BST) as extremely beneficial or beneficial in developing verbal communication skills compared to 73.3% for peer role-play simulation (PRPS). A similar pattern was found in empathy skills development with 84.1% for bedside compared to 72.2% for PRPS. The pattern is reversed with the development of clinical reasoning skills with 77.7% rating BST as beneficial or extremely beneficial compared to 81.2% for PRPS.Conclusion: Overall, peer role-play is generally a valuable and trustworthy method in the absence of bedside teaching for enhancing clinical reasoning skills of medical students during the COVID-19 pandemic from students’ perspective. It is less efficient than bedside teaching in enhancing communication skills. It cannot wholly replace bedside teaching, although it can be used reliably for that purpose in exceptional circumstances when bedside teaching cannot be implemented.Keywords: bedside teaching, clinical reasoning, empathy, medical education, peer role-play, verbal communication skills

Eiad Alfaris,1 Yasser Alhazzani,1 Abdullah Alkhenizan,2 Farhana Irfan,1 Naif Almoneef,2 Nada Alyousefi,3 Huda Alfaris,4 Khitam Alodhaibi,2 Abdullah MA Ahmed1 1Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia; 2King Faisal Specialist Hospital and Research Center, Family Medicine and Polyclinics, Riyadh, Saudi Arabia; 3Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Prince Sultan Military Medical City, Department of Internal Medicine, Riyadh, Saudi ArabiaCorrespondence: Eiad Alfaris, King Saud University Chair for Medical Education Research and Development, Department of Family and Community Medicine (34), College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia, Tel +966505424164, Email eiad@KSU.EDU.SA; efarisx2@gmail.comObjective: WhatsApp is the most frequently used social media platform in Saudi Arabia. Inaccurate information could negatively impact public health. The number of studies worldwide investigating health-related misinformation in social media increased steadily, with limited data from Arabic-speaking communities. This study aimed to estimate the validity and safety of Arabic-language health information messages circulated on WhatsApp and identify the different categories of these messages based on their credibility.Participants and Methods: A descriptive, analytical cross-sectional study was conducted from February to April 2021. A total of 374 students were randomly selected from the common first preparatory year college at King Saud University in Riyadh, Saudi Arabia, and participated by sharing up to three health-related WhatsApp messages per student that they or their relatives had recently read. Four board-certified physicians reviewed and classified the messages based on their credibility and sources.Results: 282 students provided 326 messages (1.2 messages per student). Most messages (86%) had either invalid or inaccurate content, and 83.7% came from unknown sources. Only 26 messages (8%) of the total were written by trusted scientific sources. Most of the messages from unknown sources or unqualified persons were either invalid or invalid, with potential health risks for the public, and the difference from trusted sources was statistically significant.Conclusion: This study showed a high percentage of inaccurate and invalid health-related messages on WhatsApp. Invalid messages with potential health risks were authored mostly by unknown sources or unqualified persons. Most health messages written by trusted authorities and qualified persons were valid. Trusted scientific authorities should thus be more active in public education on social media platforms. They should advise their communities on how to discern the validity of such messages. More efforts are needed to guide patients from where to obtain accurate and valid health information.Keywords: health information, WhatsApp, Saudi Arabia, social media

Nor Abdi Yasin, Abdihamid Mohamed Ali, Mohamed Abdi Ahmed, Salim İdris Keleşoğlu Department of General Surgery, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Nor Abdi Yasin, Tel +252 615732173, Email dalnurshe68@gmail.comBackground: Intra-abdominal infections (IAIs) are common surgical emergencies and one of the leading causes of non-trauma deaths in hospitals worldwide. Because of limited resources, most patients in low-income countries experience delayed diagnosis and treatment. To the best of our knowledge, this is the first study to evaluate the epidemiological characteristics, antimicrobial susceptibility profile, and outcome of patients with complicated IAI at a tertiary hospital in Somalia.Methods: This study included all patients with confirmed IAIs who underwent laparotomy or percutaneous drainage, either emergency or elective, and whose cultures showed growth. Sociodemographic and clinical characteristics, culture results, antimicrobial susceptibility profile, and the type of source control were reviewed.Results: The prevalence of CIAI was 5.3%, 144 (70%) were male, and 61 (30%) were female. The mean age was 38.6± 8.5 years. Appendicitis was the most common source of infection, accounting for 32%, followed by bowel perforation in 37 (18%). Out of 15 patients with liver abscesses, ten patients had diabetes (67%). E. coli 82 (40%) was the most common isolated organism, followed by Klebsiella pneumonia (n = 44, 21.5%). The prevalence of extended-spectrum beta-lactamase-producing and multidrug-resistant pathogens was 6.8% and 5.9%, respectively. The pathogens revealed a higher antimicrobial resistance against penicillins in 62%, cephalosporins in 54%, and fluoroquinolones in 44%. E. coli showed 2.5– 13% antimicrobial resistance against carbapenems, lower than Klebsiella pneumonia in about 4.5%. Tigecycline, teicoplanin, and linezolid revealed the highest sensitivity against pathogens, about 100%. Source control was achieved by laparotomy in 81%, while the 19% were managed in a percutaneous approach. The mortality rate in our study was 9.3%.Conclusion: The prevalence of CIAI in our study was 5.3%, with an increasing number of MDR microorganisms isolated from cultures. CIAI and intra-abdominal abscess are significant sources of high morbidity and mortality with sepsis and poor clinical outcome; thus, early detection and intervention are crucial.Keywords: complicated intra-abdominal infection, antimicrobial resistance, source control, mortality

Muhammed A Saad,1,2 Noha M Eissa,2 Mohammed A Ahmed,3 Aliaa N ElMeshad,3,4 Götz Laible,5– 7 Ahmed S Attia,8 Medhat A Al-Ghobashy,9,10 Rania M Abdelsalam,1,2 Muhammad Y Al-Shorbagy1,11 1Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt; 2School of Pharmacy, Newgiza University, Giza, Egypt; 3Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt; 4Faculty of Nanotechnology for Postgraduate Studies, Cairo University, Giza, Egypt; 5AgResearch, Ruakura Research Centre, Hamilton, New Zealand; 6School of Medical Sciences, University of Auckland, Auckland, New Zealand; 7Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand; 8Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt; 9Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt; 10Bioanalysis Research Group, School of Pharmacy, Newgiza University, Giza, Egypt; 11Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman, United Arab EmiratesCorrespondence: Ahmed S Attia, Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt, Email ahmed.attia@pharma.cu.edu.egIntroduction: Rituximab (RTX) and recombinant human myelin basic protein (rhMBP) were proven to be effective in ameliorating the symptoms of multiple sclerosis (MS). In this study, a nanoformulation containing rhMBP with RTX on its surface (Nano-rhMBP-RTX) was prepared and investigated in comparison with other treatment groups to determine its potential neuro-protective effects on C57BL/6 mice after inducing experimental autoimmune encephalomyelitis (EAE).Methods: EAE was induced in the corresponding mice by injecting 100 μL of an emulsion containing complete Freund’s adjuvant (CFA) and myelin oligodendrocyte glycoprotein (MOG). The subjects were weighed, scored and subjected to behavioural tests. After reaching a clinical score of 3, various treatments were given to corresponding EAE-induced and non-induced groups including rhMBP, RTX, empty nanoparticle prepared by poly (lactide-co-glycolide) (PLGA) or the prepared nanoformulation (Nano-rhMBP-RTX). At the end of the study, biochemical parameters were also determined as interferon-γ (IFN-γ), myeloperoxidase (MPO), interleukin-10 (IL-10), interleukin-4 (IL-4), tumor necrosis factor alpha (TNF-α), nuclear factor kappa B (NF-kB), brain derived neurotrophic factor (BDNF), 2’, 3’ cyclic nucleotide 3’ phosphodiesterase (CNP) and transforming growth factor beta (TGF-β) along with some histopathological analyses.Results: The results of the Nano-rhMBP-RTX group showed promising outcomes in terms of reducing the clinical scores, improving the behavioural responses associated with improved histopathological findings. Elevation in the levels of IL-4, CNP and TGF-β was also noticed along with marked decline in the levels of NF-kB and TNF-α.Conclusion: Nano-rhMBP-RTX treated group ameliorated the adverse effects induced in the EAE model. The effectiveness of this formulation was demonstrated by the normalization of EAE-induced behavioral changes and aberrant levels of specific biochemical markers as well as reduced damage of hippocampal tissues and retaining higher levels of myelination.Keywords: multiple sclerosis, experimental autoimmune encephalomyelitis, nanoparticle, rituximab, recombinant human myelin basic protein

Michael M Farag,1 Nevine S Abd El Malak,1,2 Soad A Yehia,1 Mohammed A Ahmed1,2 1Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt; 2School of Pharmacy, New Giza University, Giza, EgyptCorrespondence: Michael M FaragDepartment of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini Street, Cairo, 11562, EgyptTel +002-01228150250Email michael.farag@pharma.cu.edu.egPurpose: Development of hyaluronic acid conjugated metformin-phospholipid sonocomplexes (HA-MPS), a biphasic complexation product compiled for enhancing both the lipophilicity and targeting potential of Metformin (MET) to CD44 receptors on pancreatic cancer.Methods: MET was chemically conjugated to hyaluronic acid (HA) via amide coupling reaction. Then, the HA conjugated MET was physically conjugated to Lipoid™S100 via ultrasound irradiation. A combined D-optimal design was implemented to statistically optimize formulation variables. The HA-MPS were characterized through solubility studies, partition coefficient, drug content uniformity, particle size and zeta potential. The optimized HA-MPS was tested via proton nuclear magnetic resonance, infrared spectroscopy to elucidate the nature of physicochemical interactions in the complex which was further scrutinized on molecular level via molecular docking and dynamic simulation.Results: The solubility and partition studies showed a lipophilicity enhancement up to 67 folds as they adopted inverted micelles configuration based on the packing parameter hypothesis. The optimized HA-MPS showed 11.5 folds lower IC50, extra 25% reduction in oxygen consumption rate, better reduction in hypoxia-inducible factor and reactive oxygen species in MiaPaCa-2 cells.Conclusion: These results proved better internalization of MET which was reflected by abolishing hypoxic tumour microenvironment, a mainstay toward a normoxic and less resistant pancreatic cancer.Keywords: metformin, pancreatic ductal adenocarcinoma, hypoxia-inducible factor, MiaPaCa-2, hyaluronic acid

Emad HM Hassanein,1 Omnia AM Abd El-Ghafar,2 Marwa A Ahmed,3 Ahmed M Sayed,4 Wail M Gad-Elrab,5 Jamaan S Ajarem,6 Ahmed A Allam,7 Ayman M Mahmoud7,8 1Department of Pharmacology and Toxicology Faculty of Pharmacy, Al-Azhar University, Assiut, Egypt; 2Department of Pharmacology and Toxicology, Faculty of Pharmacy, Nahda University, Beni-Suef, Egypt; 3Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt; 4Biochemistry Laboratory, Chemistry Department, Faculty of Science, Assiut University, Assiut, Egypt; 5Human Anatomy & Embryology Department Faculty of Medicine, Al-Azhar University, Assiut, Egypt; 6Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia; 7Zoology Department Faculty of Science, Beni-Suef University, Beni-Suef, Egypt; 8Biotechnology Department, Research Institute of Medicinal and Aromatic Plants, Beni-Suef University, Beni-Suef, EgyptCorrespondence: Ayman M MahmoudPhysiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Salah Salim Street, Beni-Suef 62514, EgyptTel +20 1278355478Email ayman.mahmoud@science.bsu.edu.egJamaan S AjaremZoology Department, College of Science, King Saud University, Riyadh 11451, Saudi ArabiaEmail jajarem@ksu.edu.saIntroduction: Cyclophosphamide (CP) causes redox imbalance and its use is associated with marked cardiotoxicity that limits its clinical applications. The present study investigated the protective effects of acetovanillone (AV) and edaravone (ED) against CP-induced oxidative stress and cardiac damage, emphasizing the role of PI3K/Akt/mTOR and Nrf2 signaling.Materials and Methods: Rats received either AV (100 mg/kg) or ED (20 mg/kg) orally for 10 days and CP (200 mg/kg) on day 7. At day 11, the rats were sacrificed, and samples were collected for analysis.Results: AV and ED ameliorated serum troponin I, CK-MB, LDH, AST and ALP, and prevented cardiac histological alterations in CP-intoxicated rats. Both treatments decreased cardiac lipid peroxidation and enhanced GSH, SOD and cytoglobin in CP-induced rats. AV and ED downregulated Keap1, whereas increased the expression of PI3K, Akt, mTOR and Nrf2 in the heart of rats received CP. Additionally, the binding modes of AV and ED to Keap1 were pinpointed in silico using molecular docking simulations.Conclusion: AV and ED prevent CP cardiotoxicity by attenuating oxidative stress and tissue injury, and modulating cytoglobin, and PI3K/Akt/mTOR and Keap1/Nrf2 signaling. Therefore, AV and ED may represent promising agents that can prevent cardiac injury in patients receiving CP.Keywords: chemotherapy, acetovanillone, edaravone, oxidative stress, cardiotoxicity, Nrf2, mTOR

Background:severe preeclampsia (PET) is one of the hypertensive diseases of pregnancy associated with significant morbidity and mortality and require special monitoring, lung ultrasonography is a novel monitoring and diagnostic tools in intensive care and widely used nowadays with early detection of pulmonary oedema. Patients and Methods:this was a cross sectional study of 55 patients with severe preeclampsia,35 case with eclampsia and 60 healthy controls. Lung ultrasonography was done to detect B lines in 12 lung zone postoperatively in both cases and controls fluid input and output is encounted. Results:Median (Min- Max) of lung sonar was higher in severe PET than in controls p value = .0001. B lines were observed in 47.2% and 8.3% in eclampsia ,severe PET and controls respectively. There was highly statistically significant difference between cases and controls as regards input and output as ( P=.005), ( P=.003) respectively as input and output was higher in control group than cases group) While there was no statistical significance difference between cases and controls as regards net balance as (P=.09). complications occur in higher percentage in cases than control. Conclusions: Restrictedfluid policy is indicated with the finding of B pattern especially with higher lung ultrasound score. Early management in patients with high B line score (pulmonary congestion) even before development of clinical manifestations should be considered.

Wafaa MA Farghaly,1 Mohamed A Ahmed,1 Hamdy N El-Tallawy,1 Taha AH Elmestikawy,2 Reda Badry,1 Mohammed Sh Farghaly,3 Montaser S Omar,3 Amr Sayed Ramadan Hussein,4 Mohammed Salamah,5 Adel T Mohammed1 1Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt; 2Department of Psychology, Faculty of Arts, Assiut University, Assiut, Egypt; 3Department of Educational Psychology, Faculty of Education, Assiut University, Assiut, Egypt; 4Department of Hearing Disability, Faculty of Sciences of Special Needs, Beni-Suef University, Beni-Suef, Egypt; 5Department of Phoniatrics, Faculty of Medicine, Assiut University, Assiut, Egypt Purpose: The aim of this study was to design an Arabic computerized battery of cognitive skills for training children with specific learning disabilities (SLD).Subjects and methods: Nineteen students from fourth grade primary schools in Assiut, Egypt, who were previously diagnosed with SLD, agreed to participate in the rehabilitation program. The study passed through four stages: first stage, detailed analysis of the cognitive profile of students with SLD (n=19), using a previously constructed diagnostic cognitive skill battery, to identify deficits in their cognitive skills; second stage, construction of an Arabic computerized battery for cognitive training of students with SLD; third stage, implementation of the constructed training program for the students, each tailored according to his/her previously diagnosed cognitive skill deficit/deficits; and fourth stage, post-training re-evaluation of academic achievement and cognitive skills’ performance.Results: Students with SLD have a wide range of cognitive skill deficits, which are more frequent in auditory cognitive skills (68.4%) than in visual cognitive skills (64.1%), particularly in phonological awareness and auditory sequential memory (78.9%). Following implementation of the training program, there was a statistically significant increase (P

Objectives: A community-based intervention, the Crown Health Project (CHP), was developed by the Ministry of Health. It was implemented on a small-scale in Al-Jouf Region in Northern Kingdom of Saudi Arabia to assess its feasibility and effectiveness so that it can be scaled up. This study primarily aimed at investigating factors associated with the awareness of CHP in order to improve subsequent campaigns for the program in Al-Jouf and other regions. A secondary aim was to assess possible changes of public awareness during intensification of the awareness campaign between October 2011 and May 2012. Methods: A pre- and post-questionnaire cross-sectional approach was undertaken, and the intervention was an awareness campaign. Variables collected included demographic characteristics (e.g., age, gender, education, occupation, urban/rural residence) and CHP awareness (its existence, sources of knowledge about CHP, its goals and objectives, its target diseases, location of activities, participation in such activities). Logistic regression was used to analyze the awareness of the program according to participant characteristics, with a time of the survey as a variable. Results: Awareness of the program was found to be 11 times higher among postsurvey respondents than presurvey respondents. Respondents of the second survey were better at correctly identifying "health education" as the main goal of the CHP (odds ratio [OR], 4.1; 95% confidence interval [CI], 3.1-5.5), "noncommunicable diseases" as the main diseases targeted (OR, 4.8; 95% CI, 3.6-6.4) and "attention to health" as the purpose (OR, 6.0; 95% CI, 4.0-8.9). Conclusion: The different activities of the CHP were successful in dramatically increasing awareness of the CHP program in Al-Jouf.

The presence of distant metastasis is associated with an adverse outcome in papillary thyroid cancer. We performed a meta-analysis to investigate the role of molecular markers as predictors for distant metastasis in papillary thyroid cancer. Four electronic databases including PubMed, Web of Science, Scopus, and Virtual Health Library were searched, and odds ratio and its 95% confidence interval concerning the association of BRAF , RAS , and TERT promoter mutations and RET/PTC rearrangements with distant metastasis were calculated using random-effects model. In total, 42 studies with 11,109 papillary thyroid cancers were included for meta-analyses. Overall, the presence of TERT promoter (odds ratio = 5.95; 95% confidence interval = 2.95–11.99), RAS mutations (odds ratio = 2.5; 95% confidence interval = 1.00–6.22), and RET/PTC rearrangements (odds ratio = 1.92; 95% confidence interval = 1.03–3.56) were found to be associated with a significantly increased risk for distant metastasis. BRAF mutations were not associated with an elevated risk for distant metastasis (odds ratio = 0.79; 95% confidence interval = 0.54–1.16). In conclusion, our study demonstrated the promising value of few molecular biomarkers, especially TERT promoter mutations in predicting distant metastasis in papillary thyroid cancers, while BRAF mutations showed no association with distant metastasis. Our study affirms the value of selected mutations for tumor risk stratification and assessment of patients’ prognosis.

Aims: To evaluate the effect of the different curing methods conventional water bath heat–curing and microwave energy curing method and different immersion periods on the water sorption and solubility of the different types of heat–cured acrylic resins. Materials and methods: Water sorption and solubility were measured by means of mass change in the materials after water saturation and dehydration. Two different commercial heat–cured acrylic resins Major Base 2, and Quayle Dental resins were used in this study. Specimens were divided into two groups depending on the curing method. Thirty two specimens were prepared, eight specimens for each material in each group. Specimens were immersed in distilled water, and then subsequently removed from their containers at 1 week and 1 month of immersion for evaluation. Mean values wear compared statistically with one way analysis of variance followed by Duncan's multiple range test to determined the significant different among the groups at (p< 0.05) level of significance. Results: showed that the curing method and immersion period have a significant effect on the water sorption and solubility ratios of the resins. Curing by microwave energy method and increasing immersion period caused increasing in the ratios. The type of heat–cured acrylic resin has an effect but the difference was not significant. Conclusion: the curing method, immersion period and types of the acrylic resin have an effect on the absorption and solubility ratios.

The concept of weakly quasi-nonexpansive mappings with respect to a sequence is introduced. This concept generalizes the concept of quasi-nonexpansive mappings with respect to a sequence due to Ahmed and Zeyada (2002). Mainly, some convergence theorems are established and their applications to certain iterations are given.

We establish a common fixed point theorem for weakly compatible mappings generalizing a result of Khan and Kubiaczyk (1988). Also, an example is given to support our generalization. We also prove common fixed point theorems for weakly compatible mappings in metric and compact metric spaces.

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

The benzimidazole moiety in the title molecule, C19H25N5O, is almost planar and oriented nearly perpendicular to the triazole ring. In the crystal, C—H...O hydrogen bonds link the molecules into a network structure. There are no π–π interactions present but two weak C—H...π(ring) interactions are observed. A Hirshfeld surface analysis of the crystal structure indicates that the most important contributions for the crystal packing are from H...H (62.0%), H...C/C...H (16.1%), H...N/N...H (13.7%) and H...O/O...H (7.5%) interactions. Evaluation of the electrostatic, dispersion and total energy frameworks indicate that the stabilization is dominated via the dispersion energy contributions in the title compound.

Abstract Background Left ventricle (LV) volume overload is observed with hemodynamically significant PDA as it causes left to right shunting, leading to increased pulmonary blood flow. This overload causes LV remodeling as LV increases stroke volume in trial for compensation, but in larger shunts, patients may develop symptoms of congestive heart failure. Two-dimensional (2D) speckle-tracking echocardiography has emerged as a technique for objective and quantitative evaluation of global and regional myocardial function, independent of the angle of myocardial insonation. Aim of the work This study aimed to evaluate left ventricular function by 2-dimensional speckle tracking in children with hemodynamically significant PDA. Methods This prospective controlled study was performed on 54 children divided into two groups (34 as cases and 20 as controls) to compare echocardiographic measurements. Conventional Echocardiography, tissue Doppler, and Speckle tracking were done for all patients, and measurements were compared. Results There was a statistically significant difference (p value

Background: Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes. PATIENTS AND METHODS: This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10–16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30). Results: A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle. Conclusions: Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.

Abstract Assisted living facilities cater to the demands of the elderly population, providing assistance and support with day-to-day activities. Fall detection is fundamental to ensuring their well-being and safety. Falls are frequent among older persons and might cause severe injuries and complications. Incorporating computer vision techniques into assisted living environments is revolutionary for these issues. By leveraging cameras and complicated approaches, a computer vision (CV) system can monitor residents’ movements continuously and identify any potential fall events in real time. CV, driven by deep learning (DL) techniques, allows continuous surveillance of people through cameras, investigating complicated visual information to detect potential fall risks or any instances of falls quickly. This system can learn from many visual data by leveraging DL, improving its capability to identify falls while minimalizing false alarms precisely. Incorporating CV and DL enhances the efficiency and reliability of fall detection and allows proactive intervention, considerably decreasing response times in emergencies. This study introduces a new Deep Feature Fusion with Computer Vision for Fall Detection and Classification (DFFCV-FDC) technique. The primary purpose of the DFFCV-FDC approach is to employ the CV concept for detecting fall events. Accordingly, the DFFCV-FDC approach uses the Gaussian filtering (GF) approach for noise eradication. Besides, a deep feature fusion process comprising MobileNet, DenseNet, and ResNet models is involved. To improve the performance of the DFFCV-FDC technique, improved pelican optimization algorithm (IPOA) based hyperparameter selection is performed. Finally, the detection of falls is identified using the denoising autoencoder (DAE) model. The performance analysis of the DFFCV-FDC methodology was examined on the benchmark fall database. A widespread comparative study reported the supremacy of the DFFCV-FDC approach with existing techniques.

Abstract Background Percutaneous coronary intervention (PCI) has become one of the most commonly performed interventional life-saving procedures worldwide. Intravascular Imaging (intravascular ultrasound (IVUS) and optical coherence tomography (OCT)) have initially evolved to guide PCI compared with angiography. However, this technology is not universally employed in all PCI procedures, and there is ongoing controversy regarding its additional benefits to patient outcomes. We aim to estimate the efficacy and safety of imaging modalities during PCI, allowing pre-, per, and post-intervention assessment of coronary vascularization. Methods A systematic review and Bayesian network meta-analysis of randomized controlled trials (RCTs), which were retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through September 2023. We used R, version 4.2.0. Effect sizes will be presented as odds ratios with accompanying 95% credible intervals. PROSPERO ID: CRD42024507821. Results Our study, encompassing 36 RCTs with a total of 17,572 patients, revelead that compared to conventional angiography, IVUS significantly reduced the risk of major adverse cardiovascular events (MACE) (OR: 0.71 [95% CrI: 0.56 to 0.87]) but not OCT (OR: 0.91 [95% CrI: 0.62 to 1.39]), IVUS and OCT significantly reduced the risk of cardiac death (OR: 0.50 [95% CrI: 0.33 to 0.76]) and (OR: 0.55 [95% CrI: 0.31 to 0.98]), respectively, IVUS significantly reduced the risk of target vessel-related revascularization (OR: 0.60 [95% CrI: 0.48 to 0.75]) but not OCT (OR: 0.86 [95% CrI: 0.60 to 1.19]), IVUS and OCT significantly reduced the risk of stent thrombosis (OR: 0.50 [95% CrI: 0.28 to 0.92]) and (OR: 0.48 [95% CrI: 0.22 to 0.98]), respectively, IVUS significantly reduced the risk of re-stenosis (OR: 0.65 [95% CrI: 0.46 to 0.88]) but not OCT (OR: 0.55 [95% CrI: 0.15 to 1.99]), neither IVUS (OR: 0.97 [95% CrI: 0.71 to 1.38]) nor OCT (OR: 0.75 [95% CrI: 0.49 to 1.22]) were associated with statistically significant reductions in all-cause mortality, neither IVUS (OR: 0.70 [95% CrI: 0.45 to 1.32]) nor OCT (OR: 0.81 [95% CrI: 0.47 to 1.59]) were associated with statistically significant reductions in target vessel failure, neither IVUS (OR: 0.88 [95% CrI: 0.43 to 2.44]) nor OCT (OR: 0.81 [95% CrI: 0.37 to 2.04]) were associated with statistically significant reductions in target lesion failure, and neither IVUS (OR: 0.82 [95% CrI: 0.60 to 1.06]) nor OCT (OR: 0.84 [95% CrI: 0.59 to 1.19]) were associated with statistically significant reductions in myocardial infarction. Conclusion Intravascular imaging-guided, including IVUS and OCT, improved the postinterventional outcomes of PCI, notably suggesting their advantage over traditional angiography with no significant difference between IVUS and OCT.

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 The integration of artificial intelligence (AI) in cardiovascular imaging has revolutionized the field, offering significant advancements in diagnostic accuracy and clinical efficiency. However, the complexity and opacity of AI models, particularly those involving machine learning (ML) and deep learning (DL), raise critical legal and ethical concerns due to their "black box" nature. This manuscript addresses these concerns by providing a comprehensive review of AI technologies in cardiovascular imaging, focusing on the challenges and implications of the black box phenomenon. We begin by outlining the foundational concepts of AI, including ML and DL, and their applications in cardiovascular imaging. The manuscript delves into the "black box" issue, highlighting the difficulty in understanding and explaining AI decision-making processes. This lack of transparency poses significant challenges for clinical acceptance and ethical deployment. The discussion then extends to the legal and ethical implications of AI's opacity. The need for explicable AI systems is underscored, with an emphasis on the ethical principles of beneficence and non-maleficence. The manuscript explores potential solutions such as explainable AI (XAI) techniques, which aim to provide insights into AI decision-making without sacrificing performance. Moreover, the impact of AI explainability on clinical decision-making and patient outcomes is examined. The manuscript argues for the development of hybrid models that combine interpretability with the advanced capabilities of black box systems. It also advocates for enhanced education and training programs for healthcare professionals to equip them with the necessary skills to utilize AI effectively. Patient involvement and informed consent are identified as critical components for the ethical deployment of AI in healthcare. Strategies for improving patient understanding and engagement with AI technologies are discussed, emphasizing the importance of transparent communication and education. Finally, the manuscript calls for the establishment of standardized regulatory frameworks and policies to address the unique challenges posed by AI in healthcare. By fostering interdisciplinary collaboration and continuous monitoring, the medical community can ensure the responsible integration of AI into cardiovascular imaging, ultimately enhancing patient care and clinical outcomes.

Abstract SETANTA (Study of HEarT DiseAse and ImmuNiTy After COVID-19 in Ireland) study aimed to investigate symptom burden and incidence of cardiac abnormalities after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/COVID-19 and to correlate these results with biomarkers of immunological response and coagulation. SETANTA was a prospective, single-arm observational cross-sectional study condcuted in a primary practice setting, and prospectively registered with ClinicalTrials.gov (identifier: NCT04823182). Patients with recent COVID-19 infection (≥ 6 weeks and ≤ 12 months) were prospectively enrolled. Primary outcomes of interest were markers of cardiac injury detected by cardiac magnetic resonance imaging (CMR), which included left ventricular ejection fraction, late gadolinium enhancement and pericardial abnormalities, as well as relevant biomarkers testing immunological response and coagulopathy. 100 patients (n = 129 approached) were included, amongst which 64% were female. Mean age of the total cohort was 45.2 years. The median (interquartile range) time interval between COVID-19 infection and enrolment was 189 [125, 246] days. 83% of participants had at least one persistent symptom, while 96% had positive serology for prior SARS-CoV-2 infection. Late gadolinium enhancement, pericardial effusion, was present in 2.2% and 8.3% respectively, while left ventricular ejection fraction was below the normal reference limit in 17.4% of patients. Von Willebrand factor antigen was elevated in 32.7% of patients and Fibrinogen and D-Dimer levels were found to be elevated in 10.2% and 11.1% of patients, respectively. In a cohort of primary practice patients recently recovered from SARS-CoV-2 infection, prevalence of persistent symptoms and markers of abnormal coagulation were high, despite a lower frequency of abnormalities on CMR compared with prior reports of patients assessed in a hospital setting. Trial Registration: Clinicaltrials.gov, NCT04823182 (prospectively registered on 30th March 2021).

Abstract Lung cancer (LC) is a life-threatening and dangerous disease all over the world. However, earlier diagnoses and treatment can save lives. Earlier diagnoses of malevolent cells in the lungs responsible for oxygenating the human body and expelling carbon dioxide due to significant procedures are critical. Even though a computed tomography (CT) scan is the best imaging approach in the healthcare sector, it is challenging for physicians to identify and interpret the tumour from CT scans. LC diagnosis in CT scan using artificial intelligence (AI) can help radiologists in earlier diagnoses, enhance performance, and decrease false negatives. Deep learning (DL) for detecting lymph node contribution on histopathological slides has become popular due to its great significance in patient diagnoses and treatment. This study introduces a computer-aided diagnosis for LC by utilizing the Waterwheel Plant Algorithm with DL (CADLC-WWPADL) approach. The primary aim of the CADLC-WWPADL approach is to classify and identify the existence of LC on CT scans. The CADLC-WWPADL method uses a lightweight MobileNet model for feature extraction. Besides, the CADLC-WWPADL method employs WWPA for the hyperparameter tuning process. Furthermore, the symmetrical autoencoder (SAE) model is utilized for classification. An investigational evaluation is performed to demonstrate the significant detection outputs of the CADLC-WWPADL technique. An extensive comparative study reported that the CADLC-WWPADL technique effectively performs with other models with a maximum accuracy of 99.05% under the benchmark CT image dataset.

Abstract Background Acute myeloid leukemia (AML) is a clonal disorder arising from the differentiation arrest of myeloid precursor and malignant proliferation of a bone marrow derived, self-renewing stem or progenitor cells inside the bone marrow (BM) and blood due to numerous genetic mutations. Some mutations can also adjust DNA methylation and may play a critical function in pathogenesis in Cytogenetically Normal Acute Myeloid Leukemia (CN-AML). Somatic mutations in DNMT3a were pronounced in approximately 20% and ∼30–35% of overall AML and CN-AML, respectively. Most DNMT3a mutations in AML have been observed to be heterozygous, A missense mutation, R882, located inside Hot spot exon 23, has been found to be the maximum common mutation. This is a preliminary study conducted on 20 adult Egyptian patients newly diagnosed as AML where Sanger sequencing of Hotspot Exon 23 of DNMT3a gene was performed on their initial bone marrow samples and were followed up to 3 months post-induction therapy. Only De Novo AML patients were included in our study. Results Our results revealed that overall DNMT3a mutations were present in 25% of our patients, 10% having the R882 (rs147001633) mutation being 5% R882C and 5% R882H. Immunophenotyping analysis among Mutated DNMT3a (R882 and Non R882) and Wild DNMT3a revealed that AML markers exhibited no significant differences except for myeloperoxidase positivity which was significant among the groups (0.050). Regarding cytogenetics, only one case of the mutated DNMT3a had positive FISH inv (16), where the rest were FISH negative. After 28 days of induction, 75% of all our patients achieved complete response (CR), 20% achieve partial response (PR) out of which 75% are DNMT3a mutated. After 3 months follow-up, 10% of all patients faced mortality where 5% was DNMT3a wild type (died due to treatment-related mortality) and 5% was R882 mutated DNMT3a. Conclusion DNMT3a mutations are present in 25% (5/20) of our AML patients, with 10% (2/20) having the R882 mutation being 5% (1/20) R882C and 5% (1/20) R882H. R882 mutation is associated with resistance to chemotherapy, and poorer outcomes, highlighting its poorer prognostic significance in AML.

Outbreaks of Monkeypox (mpox) in over 100 non-endemic countries in 2022 represented a serious global health concern. Once a neglected disease, mpox has become a global public health issue. A42R profilin-like protein from mpox (PDB ID: 4QWO) represents a potential new lead for drug development and may interact with various synthetic and natural compounds. In this report, the interaction of A42R profilin-like protein with six phytochemicals found in the medicinal plant Ficus religiosa (abundant in India) was examined. Based on the predicted and compared protein–ligand binding energies, biological properties, IC50 values and toxicity, two compounds, kaempferol (C-1) and piperine (C-4), were selected. ADMET characteristics and quantitative structure–activity relationship (QSAR) of these two compounds were determined, and molecular dynamics (MD) simulations were performed. In silico examination of the kaempferol (C-1) and piperine (C-4) interactions with A42R profilin-like protein gave best-pose ligand-binding energies of –6.98 and –5.57 kcal/mol, respectively. The predicted IC50 of C-1 was 7.63 μM and 82 μM for C-4. Toxicity data indicated that kaempferol and piperine are non-mutagenic, and the QSAR data revealed that piperlongumine (5.92) and piperine (5.25) had higher log P values than the other compounds examined. MD simulations of A42R profilin-like protein in complex with C-1 and C-4 were performed to examine the stability of the ligand–protein interactions. As/C and C-4 showed the highest affinity and activities, they may be suitable lead candidates for developing mpox therapeutic drugs. This study should facilitate discovering and synthesizing innovative therapeutics to address other infectious diseases.

Introduction This study investigated the effect of foot muscle energy technique (MET) on nerve conduction velocity (NCV) and isometric muscle strength in patients with type 2 diabetic neuropathy (DN). Methods Forty-four patients were randomly assigned to either the MET group (group A) or the conventional physical therapy program group (group B). Electrophysiological measurements, including peroneal and tibial motor NCV studies, and isometric muscle strength using a toe strength dynamometer, were conducted. The assessment period ranged from April to November 2022, with measurements taken before the first session and after 4 weeks of treatment. Results Significant improvements were observed in post-treatment peroneal motor NCV ( p < 0.001), tibial motor NCV ( p < 0.001), and isometric muscle strength ( p < 0.001) in group A, but not in group B. Conclusions MET enhances motor NCV and isometric muscle strength in patients with type 2 DN.

Introduction: Superiorly based pharyngeal flap is one of the most common surgical techniques described for surgical correction of velopharyngeal disorders. Being a technique-sensitive and owing to its associated complications, a simple technique has been introduced and compared with it. Aim: The aim was to compare the surgical results and the phoniatric outcome of the superiorly based pharyngeal flap versus the myomucosal resection and direct closure of the posterior pharyngeal wall. Patients and Method: One hundred patients of both sexes were classified into two groups. Group A patients included fifty patients who had velopharyngeal insufficiency (VPI) and were surgically corrected by the superiorly based pharyngeal flap. Group B patients included fifty patients who had VPI and were surgically corrected by myomucosal resection and direct closure of the posterior pharyngeal wall. Results: Postoperatively, 13% of Group A patients had open nasality Grade 4 as compared to 0% in Group B patients. Hyponasality and obstructive sleep apnea were not recorded in any case of Group B patients as compared with 10% of Group A patients. With regard to the postoperative velopharyngeal gap during speech, 18% of patients in Group A had velopharyngeal gap 3 mm, while 10% of patients in Group B had velopharyngeal gap 3 mm. Conclusion: Myomucosal resection and direct closure of the posterior pharyngeal wall is a simple reliable technique for the correction of velopharyngeal disorders.

Abstract Background Many indices have been suggested to help orthodontists in predicting the ideal dental arch width. One of these was Pont’s index which was established by Pont. He suggested equations to predict the ideal maxillary dental arch width (interpremolar and intermolar) from the combined mesiodistal width of the maxillary incisors. This study aimed to test the applicability of Pont’s index as an orthodontic diagnostic tool in Egyptian population and to compare the results with those obtained from studies of different ethnic subjects. Methods This study was performed using dental casts of 184 Egyptian individuals (82 males and 102 females; age range, 19–24 years). The casts were divided into 46 casts with normal occlusion, 46 casts with class I, 46 casts with class II and 46 casts with class III malocclusion, according to Angle’s classification. Alginate impressions were taken for all patients and poured immediately using dental plaster. The real models were transformed into digital models using three-dimensional laser scanner to allow digital model analysis. Predicted arch widths were calculated using Pont’s equations. The predicted values were compared to the measured values. Results Intra class correlation coefficient (ICC) (absolute agreement) between measured and predicted arch widths was determined. Poor absolute agreement was found between measured arch width values and the corresponding values calculated according to Pont’s index. Conclusion According to the results of this study, Pont’s index is not a reliable method for predicting the ideal dental arch widths in Egyptian populations.

Abstract The beekeeping industry plays a crucial role in local economies, contributing significantly to their growth. However, bee colonies often face the threat of American foulbrood (AFB), a dangerous disease caused by the Gram-positive bacterium Paenibacillus larvae (P. l.). While the antibiotic Tylosin has been suggested as a treatment, its bacterial resistance necessitates the search for more effective alternatives. This investigation focused on evaluating the potential of bee venom (BV) and silver nanoparticles (Ag NPs) as antibacterial agents against AFB. In vitro treatments were conducted using isolated AFB bacterial samples, with various concentrations of BV and Ag NPs (average size: 25nm) applied individually and in combination. The treatments were administered under both light and dark conditions. The viability of the treatments was assessed by monitoring the lifespans of treated bees and evaluating the treatment's efficiency within bee populations. Promising results were obtained with the use of Ag NPs, which effectively inhibited the progression of AFB. Moreover, the combination of BV and Ag NPs, known as bee venom/silver nanocomposites (BV/Ag NCs), significantly extended the natural lifespan of bees from 27 to 40 days. Notably, oral administration of BV in varying concentrations (1.53, 3.12, and 6.25 mg/mL) through sugary syrup doubled the bees' lifespan compared to the control group. The study established a significant correlation between the concentration of each treatment and the extent of bacterial inhibition. BV/Ag NCs demonstrated 1.4 times greater bactericidal efficiency under photo-stimulation with visible light compared to darkness, suggesting that light exposure enhances the effectiveness of BV/Ag NCs. The combination of BV and Ag NPs demonstrated enhanced antibacterial efficacy and prolonged honeybee lifespan. These results offer insights that can contribute to the development of safer and more efficient antibacterial agents for maintaining honeybee health.

Abstract This article investigates the behavior of hybrid FRP Concrete-Steel columns with an elliptical cross section. The investigation was carried out by gathering information through literature and conducting a parametric study, which resulted in 116 data points. Moreover, multiple machine learning predictive models were developed to accurately estimate the confined ultimate strain and the ultimate load of confined concrete at the rupture of FRP tube. Decision Tree (DT), Random Forest (RF), Adaptive Boosting (ADAB), Categorical Boosting (CATB), and eXtreme Gradient Boosting (XGB) machine learning techniques were utilized for the proposed models. Finally, these models were visually and quantitatively verified and evaluated. It was concluded that the CATB and XGB are standout models, offering high accuracy and strong generalization capabilities. The CATB model is slightly superior due to its consistently lower error rates during testing, indicating it is the best model for this dataset when considering both accuracy and robustness against overfitting.

Objective To compare temporal inverted ILM flap (TIF) technique versus conventional ILM peeling (CILMP) technique in large idiopathic full-thickness macular hole (FTMH) regarding closure rate, and type of closure.Methods We conducted a randomized, interventional, prospective, comparative study. After informed consent, 40 eyes were included and were divided into 2 groups. Group 1 included 20 eyes that underwent Pars plana vitrectomy (PPV) with CILMP, and group 2 included 20 eyes that underwent PPV with the TIF technique in the period between December 2021 and July 2023. Pre and postoperative full ophthalmological assessment and OCT were done, with a follow-up period of 6 months after surgery.Results Macular hole (MH) closure was achieved in 80% of eyes in group 1 (16/20) and 90% of eyes in group 2 (18/20) after primary surgery. U-shaped foveal contour was achieved in 85%, 95%, and 100% of eyes in group 2 at 1,3 and 6 months respectively. However, it was recorded in 55% in group 1 at 1,3 and 6 months.Conclusion The MH closure rate achieved by the CILMP technique is comparable to that achieved by the TIF technique. However, the TIF technique achieves better foveal contour compared to the CILMP technique.

Intrapulmonary miliary metastasis is a rare presentation of adenocarcinoma of the lung, characterized by the dissemination of cancer cells throughout the lung parenchyma in different patterns. This case report highlights an unusual presentation of adenocarcinoma of the lung with intrapulmonary miliary metastasis, emphasizing the diagnostic challenges and management considerations. Here, we report a case of a 51-year-old female who presented to the emergency department (ED) with a 2-month history of dry cough, which started after a flu illness and was associated with mild shortness of breath, left-sided chest pain, and miliary nodules on chest imaging. During bronchoscopy, a transbronchial biopsy was taken for further pathological assessment. The results showed histopathological evidence of lung adenocarcinoma.

Abstract Background Newer generation ultrathin strut stents are associated with less incidence of target lesion failure (TLF) in patients undergoing percutaneous coronary intervention (PCI) in the short term. However, its long-term effect on different cardiovascular outcomes remains unknown. Objectives We aim to identify the effects of newer-generation ultrathin-strut stents vs. standard thickness second-generation drug-eluting stents (DES) on long-term outcomes of revascularization in coronary artery disease. Methods We searched PubMed, Web of Science, Cochrane Library databases, and Scopus for randomized controlled trials (RCTs) and registries that compare newer-generation ultrathin-strut ( 70 mm) DES to evaluate cardioprotective effects over a period of up to 5 years. Primary outcome was TLF, a composite of cardiac death, target vessel myocardial infarction (TVMI) or target lesion revascularization (TLR). Secondary outcomes included the components of TLF, stent thrombosis (ST), and all-cause death were pooled as the standardized mean difference between the two groups from baseline to endpoint. Results We included 19 RCTs and two prospective registries (103,101 patients) in this analysis. The overall effect on the primary outcome was in favor of second-generation ultrathin struts stents in terms of TLF at ≥ 1 year, ≥ 2 years, and ≥ 3 years (P value = 0.01, 95% CI [0.75, 0.96]), P value = 0.003, 95% CI [0.77, 0.95]), P value = 0.007, 95% CI [0.76, 0.96]), respectively. However, there was no reported benefit in terms of TLF when we compared the two groups at ≥ 5 years (P value = 0.21), 95% CI [0.85, 1.04]). Some of the reported components of the primary and secondary outcomes, such as TLR, target vessel revascularization (TVR), and TVMI, showed the same pattern as the TLF outcome. Conclusion Ultrathin-strut DES showed a beneficial effect over thicker strut stents for up to 3 years. However, at the 5-year follow-up, the ultrathin strut did not differ in terms of TLF, TLR, TVR, and TVMI compared with standard-thickness DES, with similar risks of patient-oriented composite endpoint (POCE), MI, ST, cardiac death, and all-cause mortality.

Abstract Background Persistent Atrial Fibrillation (PeAF) is a challenging case for rhythm control modalities. Catheter ablation is the mainstay in PeAF management; however, data regarding the comparative safety and efficacy of cryoballoon ablation (CBA) versus radiofrequency ablation (RFA) for PeAF is still limited. We aim to compare the safety and efficacy of CBA versus RFA for PeAF ablation. Methods We conducted a systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane through October 2023. RevMan version 5.4 software was used to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42023480314. Results Three RCTs with 400 patients were included. There was no significant difference between RFA and CBA regarding AF recurrence (RR: 0.77, 95% CI [0.50, 1.20], P = 0.25), atrial tachycardia or atrial flutter recurrence (RR: 0.54, 95% CI [0.11, 2.76], P = 0.46), and any arrhythmia recurrence (RR: 0.96, 95% CI [0.70, 1.31], P = 0.80). CBA was significantly associated with decreased total procedure duration (MD: − 45.34, 95% CI [− 62.68, − 28.00], P

Abstract Developing special textiles (for patients in hospitals for example) properties, special antimicrobial and anticancer, was the main objective of the current work. The developed textiles were produced after dyeing by the novel formula of natural (non-environmental toxic) pigments (melanin amended by microbial-AgNPs). Streptomyces torulosus isolate OSh10 with accession number KX753680.1 was selected as a superior producer for brown natural pigment. By optimization processes, some different pigment colors were observed after growing the tested strain on the 3 media. Dextrose and malt extract enhanced the bacteria to produce a reddish-black color. However, glycerol as the main carbon source and NaNO3 and asparagine as a nitrogen source were noted as the best for the production of brown pigment. In another case, starch as a polysaccharide was the best carbon for the production of deep green pigment. Peptone and NaNO3 are the best nitrogen sources for the production of deep green pigment. Microbial-AgNPs were produced by Fusarium oxysporum with a size of 7–21 nm, and the shape was spherical. These nanoparticles were used to produce pigments-nanocomposite to improve their promising properties. The antimicrobial of nanoparticles and textiles dyeing by nanocomposites was recorded against multidrug-resistant pathogens. The new nanocomposite improved pigments' dyeing action and textile properties. The produced textiles had anticancer activity against skin cancer cells with non-cytotoxicity detectable action against normal skin cells. The obtained results indicate to application of these textiles in hospital patients’ clothes.

The pyrazolopyrimidine moiety in the title molecule, C13H12N4S, is planar with the methylsulfanyl substituent lying essentially in the same plane. The benzyl group is rotated well out of this plane by 73.64 (6)°, giving the molecule an approximate L shape. In the crystal, C—H...π(ring) interactions and C—H...S hydrogen bonds form tubes extending along the a axis. Furthermore, there are π–π interactions between parallel phenyl rings with centroid-to-centroid distances of 3.8418 (12) Å. A Hirshfeld surface analysis of the crystal structure indicates that the most important contributions to the crystal packing are from H...H (47.0%), H...N/N...H (17.6%) and H...C/C...H (17.0%) interactions. The volume of the crystal voids and the percentage of free space were calculated to be 76.45 Å3 and 6.39%, showing that there is no large cavity in the crystal packing. Evaluation of the electrostatic, dispersion and total energy frameworks indicate that the cohesion of the crystal structure is dominated by the dispersion energy contributions.

This study examines fermented soya bean (SBM) and sunflower meal (SFM) with three biological treatments: Aspergillus Oryza, Ruminococcus flavefaciens and Lactobacillus plantarum, as well as the effects of these treatments on chemical composition, cell wall constituents, in vitro dry matter disappearance (IVDMD), and enzyme activity of the fermented SBM and SFM. After 2 h of ruminal incubation, all biological treatments (fungi, Bacteria, fungi with Bacteria) improved the IVDMD for Fermented SBM compared to that of the control (19.47, 20.65 and 18.38%, respectively). The maximum improvement values of IVDMD for SBM were recorded after 4 h and 6 h of incubation for all treatments. In addition, SFM after 2 h of ruminal incubation with any examined biological treatment (fungi, Bacteria, fungi with Bacteria), the IVDMD values have improved compared to that of the control group. Moreover, enzyme activities (cellulase, amylase, xylanase, and protease) have increased in all treatments. It was determined that SSF with A. oryzae and Ruminococcus boosted the protein content and digestibility of soybean and sunflower meals.

Abstract Monitoring heavy metal accumulation is essential for assessing the viability of aquatic ecosystems. Our methodology involved integrating analysis of immunological, stress, inflammatory, and growth-related gene expression in male and female Nile tilapia with on-site recordings of physicochemical parameters. Additionally, we assessed the effect of different physicochemical parameters on heavy metal bioavailability and residual concentration in fish and water. Samples of fish and water were gathered from three different localities: Lake Brullus, a brackish lake sited in northern Egypt; Lake Nasser, an artificial freshwater reservoir located in southern Egypt; and El-Qanater El-Khayria, a middle-freshwater location belonging to the Rashid branch of the river Nile. The assessment of heavy metal residues (Fe, Cu, Zn, Mn, and Ni) revealed that their concentrations were higher in fish specimens compared to their counterparts in water (except for Ni). In addition, Lake Brullus emerges as the most polluted area, exhibiting elevated levels of heavy metals concentrations in water and fish specimens. In contrast, Lake Nasser showed the least degree of heavy metals pollution. Gene expression analysis revealed gender-specific responses to heavy metal exposure at the three investigated water bodies. The expression of hepatic antioxidant genes (GST and MT) and inflammatory-related genes (CC-chemokine and TNFα) increased in males compared to females. In females, the immune and pro-inflammatory-related genes (IgM and CXC2-chemokine) transcripts were upregulated. Additionally, growth-related genes were downregulated in both Lake Brullus and El-Qanater; on the contrary, fish samples from Lake Nasser exhibited a normal expression pattern of growth-related genes. Stress-related genes (HSP70 and HSP27) showed significant downregulation in gills of both genders from Lake Brullus. The minimal presence of heavy metal contaminants in Lake Nasser seems to endorse the normal patterns of gene expression across all gene categories. A potential gender-specific gene expression response towards pollution was noticed in genes associated with inflammation and antioxidant activities. This highlights the importance of considering gender-related responses in future environmental assessments.

Recent decades have seen a shortage of water, which has led scientists to concentrate on solar desalination technologies. The present study examines the solar water desalination system with inclined steps, while considering various phase change materials (PCMs). The findings suggest that the incorporation of PCM generally enhances the productivity of the solar desalination system. Additionally, the combination of nanoparticles has been used to PCM, which is a popular technique utilized nowadays to improve the efficiency of these systems. The current investigation involves the transient modeling of a solar water desalination system, utilizing energy conservation equations. The equations were solved using the Runge–Kutta technique of the ODE23s order. The temperatures of the salt water, the absorbent plate of the glass cover, and the PCM were calculated at each time. Without a phase changer, the rate at which fresh water is produced is around 5.15 kg/m2·h. The corresponding mass flow rates of paraffin, n-PCM I, n-PCM III, n-PCM II, and stearic acid are 22.9, 28.9, 5.9, 11.9, and 73 kg/m2·h. PCMs, with the exception of stearic acid, exhibit similar energy efficiency up to an ambient temperature of around 29°. However, at temperatures over 29°, n-PCM II outperforms other PCM. HIGHLIGHTS The present study examines the solar water desalination system with inclined steps, while considering various phase change materials (PCMs).; The findings suggest that the incorporation of PCM generally enhances the productivity of the solar desalination system.;

Abstract Background Prediabetes is a condition preceding the development of diabetes and is associated with an increased risk of a number of complications. The primary mode of management is thought to be lifestyle modification. Pharmacological therapy, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), were not well addressed in the literature and were only evaluated in trials as secondary and exploratory outcomes with a limited sample size. Here, GLP-1RAs are evaluated as a comprehensive therapy approach for patients with prediabetes. Methods A comprehensive search of Web of Science, SCOPUS, PubMed, and Cochrane was performed on May 5, 2023, to retrieve randomized controlled trials (RCTs) comparing the effect of GLP-1RAs to placebo and/or lifestyle modification on prediabetes reversion to normoglycemia, prevention of overt diabetes, glycemic control, anthropometric parameters, and lipid profiles. Review Manager (RevMan) version 5.4 was used. The quality of RCTs was assessed using the revised version of the Cochrane Risk of Bias Tool. GRADE was performed to evaluate the certainty of evidence. Results Twelve trials involving 2903 patients in the GLP-1RAs group and 1413 in the control group were included in the meta-analysis. Low quality of evidence revealed that GLP-1RAs significantly increased the incidence of prediabetes reversion to the normoglycemic state [RR = 1.76, 95% CI (1.45, 2.13), P