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Background: The East African Fracture Zone (EAFZ) stands as a testament to the dynamic forces of Earth, marked by heightened seismic activity that frequently triggers geotechnical disasters such as landslides and rockfalls. Traditionally, the study of earthquake-induced geological risks has been reactive, with a focus on post-incident analysis. While significant advances have been made in spatial analysis and risk mapping, the capabilities for real-time prediction and proactive mitigation are still limited. Objectives: Current study presents an approach to predicting earthquake-induced landslides and rockfalls in the EAFZ. The aim is to change the perception of the problem by viewing disasters as manageable risks and informing decision-making in urban planning and disaster mitigation strategies. Methods: A combination of geotechnical engineering, remote sensing, artificial intelligence and machine learning, and socio-economic analysis were used to develop a holistic software framework that solves the complex problem of earthquake prediction without any problems. Results: A software model has been developed that includes a dynamic learning component that refines its predictions with new data, allowing for a deeper understanding of geological subtleties and socio-economic impacts. Considerable attention is paid to the tangible consequences of landslides and rockfalls, including human, property and economic losses. Despite the inevitable challenges of data accuracy and natural unpredictability, the proposed approach opens up new possibilities for proactive disaster management. The results demonstrate a transformational step in data-driven geotechnics and highlight the global applicability of the methods proposed in this work. Conclusion: In this investigation, was taken a pioneering stride in the realm of geotechnical hazard analysis and prediction, focusing on the complex terrains of the East African Fracture Zone (EAFZ). The results provided critical insights into the dynamics of geotechnical hazards in the EAFZ, laying the foundation for future innovations and enhanced safety measures in vulnerable communities.

Background: Hypertension (HTN), a major public health concern, poses a significant burden on healthcare systems worldwide. One of the objectives of the Iranian national blood pressure (BP) measurement campaign (INBPMC) executed in 2019-2020, was the detection of hypertensive patients who were unaware of their disease. This study investigated the effectiveness of the program in the Southeast and East of Iran. Methods: In a cross-sectional analytical study, we collected the required data from 936 individuals participating in the INBPMC, using the cluster sampling method. People over 30 years old, without neuropsychiatric or sensorimotor disorder, with at least four years of education were included. The required data were collected through a checklist. Results: The Mean±SD age of the participants was 45.5±12.77 years, with 62.1% of the participants being male. The prevalence of HTN in this study was 36.2%, of which 16.2% were newly diagnosed. Among those previously diagnosed, 59 individuals (31.5%) had uncontrolled HTN. The Mean±SD age of the total hypertensive cases was 50.59±13.480 years, while the mean age of newly diagnosed cases was 43.39(11.246) years. There were significant associations between HTN and age (P

The concept of being uniform strong interval-valued intuitionistic fuzzy (also termed as USIVIF) is an integration of two ideologies, which are called "uniformity" and "strong interval-valued intuitionistic fuzzy sets". Inspired by the study on uniform fuzzy topological indices, it is natural to introduce uniform IVIFTIs. Originally, topological indices were generalized for the fuzzy sets However, the utilization of the interval-valued intuitionistic fuzzy topological indices provides a finer approach, especially if there are multiple uncertainties based on intervals. Consequently, both theories imply that topological indices are not fixed and depend on certain situations or problems in the question. In this article, the generalized results for the uniform degree of the fuzzy sets associated with individual vertices/edges of strong interval-valued intuitionistic fuzzy graphs were presented and results for the total uniform degree of such graphs were also included. In addition, the nature of the implemented methods and models was discussed based on the cellular neural interval-valued intuitionistic fuzzy graphs of sets of membership and non-membership values.

Abstract The studies evaluating the impact of Her2 levels in neoadjuvant setting have conflicting data. The aim of the study was to evaluate the prognostic impact of Her2 status in early triple negative breast cancer(TNBC). In the study TNBC patients who were treated with neoadjuvant chemotherapy (NAC) and surgery were analyzed retrospectively. The primary aim of the study was to analyze the impact of Her2 status(Her2-0 and Her2-low) on pathological complete response (pCR). The secondary objectives were disease free survival (DFS) and overall survival (OS). 620 female triple negative breast cancer patients were evaluated. 427 patients (68.9%) had Her2-0 and 193(31.1%) had her2-low pathology. The pCR rates were similar between Her2-0 and Her2-low patients (33.0% vs. 27.5%, p = 0.098). Although Her2-0 group has better DFS (106 vs. 50 months, p = 0.002), in multivariate analysis it had a HR of 0.74 (p = 0.06). In addition, OS was similar (131 vs. 105 months, p = 0.13) with a HR of 0.88 (p = 0.61). In multivariate analysis; presence of LVI (HR:2.2 (95% CI 1.1–3.5) p = 0.001), Clinical stage T1/T2 (HR:0.39 (95% CI 0.2–0.6) p

Abstract The wind energy requirements for high temporal and spatial observations, unavailable in many countries, are met by reanalysed wind data, which are increasingly used in wind power assessments. However, these data also include unrealistic features, making their validation compulsory. The validation analysis of ERA5 and MERRA-2 wind data, two of the most successful wind reanalyses, with observations near Morocco’s coast, highlighted the existence of bias in both datasets, and other shortcomings. The study was conducted at eight selected sites in the period 2011-2020 using linear and probability density function based statistical tests. The local ERA5-BA and MERRA-2 BA velocity fields were created using Bias Adjustment (BA) Techniques. Only part of the observed and modelled datasets (training period) were used to identify the transfer function. The BA fields were verified against observations during the remaining period (verification period). They outperformed their respective non-adjusted fields and also the WFDE5 (the global bias-corrected ERA5 wind field) in the wind potential assessments, represented by capacity factor and low-wind day. At every location, the relative errors in the latter’s estimates using ERA5-BA were lowered to less than 10 %, and the same was true for MERRA-2-BA. Thus, an observational dataset of reduced length can help overcome some reanalysed wind data limitations for wind power estimations. Additionally, this methodology can be applied to the correction of each reanalysis update.

Abstract The cut method is a computational approach utilized to predict the fundamental activities of physicochemical properties of chemical networks, also called topological indices. The connection number is a new idea, that gives interesting and good results of the topological indices (TIs) and entropy measures (EMs) for structural representation of chemical compounds and networks. The physical density of chemical networks is characterized by these indices. In this paper, we determined the computational results for indices based on connection numbers for a two-dimensional lattice sheet of hydrogen-bonded boric acid. Boric acid, an inorganic compound, is not very harmful when applied to the skin or consumed. Finally, graphical and numerical comparisons of topological numbers including the number of borate hydrogen-bonded double lattice forms are also included in this study.

Abstract Background Digital literacy influences academic behaviors, especially in medical education, where students encounter considerable academic challenges. However, the effects of this phenomenon on academic self-efficacy and procrastination remain inadequately understood. Objectives This research explores the relationships between digital literacy and academic self-efficacy, emphasizing the mediating role of academic procrastination and its various dimensions among medical students. Methods A descriptive cross-sectional survey was conducted from seven medical colleges from October to December 2023. The research employed meticulously validated measurement tools encompassing a digital literacy scale, academic self-efficacy scale, and academic procrastination scale and collected data on 659 medical students. Descriptive statistics and inferential testing (mediation analysis) were performed to investigate the direct and indirect relationships of the study variables. Results The empirical results confirmed that digital literacy positively influenced academic self-efficacy and negatively correlated with academic procrastination. Among the five dimensions of procrastination assessed, self-efficacy emerged as the most potent mediator, significantly reducing procrastination and enhancing academic self-efficacy, followed by affective procrastination, time management, task avoidance, and behavioral procrastination. Conclusion The findings underscore the critical role of digital literacy in fostering academic self-efficacy and reducing procrastination among medical students. Educators can develop more effective interventions to support medical students in their academic journey by targeting specific dimensions of procrastination, particularly self-efficacy-related procrastination. Future research should consider longitudinal studies to confirm causality and explore these dynamics in diverse educational settings.

Abstract Low organic matter content is one of the main constraints in arid and semiarid regions. This constraint and its negative influences on soils and plant growth may be alleviated by biochar (BC). Furthermore, improving soil physical and hydraulic attributes by application of biochar has received increased attention. Therefore, in the present study, the effects of sugarcane bagasse-derived biochar on the structural stability, water availability, and pore-size distribution (PSD) of three texturally different calcareous soils collected from different agro-climatologically regions were examined during a long-term experiment. Low and high-temperature biochars, produced in a muffle furnace by the traditional slow pyrolysis method at 300 °C (BC300) and 600 °C (BC600) were evaluated. Pots (15 kg) were filled with three different silty-clay Inceptisols (SCInc), silty-clay-loam Alfisols (SCLAlf), and loam Aridisols (LArid) soils mixed with 0 (control), 1, 2, and 3 w/w% of BC300 and BC600 during 540 days of incubation. The high energy moisture characteristic (HEMC) data was modeled using a modified van Genuchten function to quantify aggregate stability through stability ratio (SR) and structural stability index (SSI). The plant available water (PAW), least limiting water range (LLWR), and integral water capacity (IWC) were calculated with two matric suctions (h) of 330 cm for field capacity (FC) and 15,000 cm for permanent wilting point (PWP). Then the integral energy (EI) values were calculated (EIIWC). Results indicated that the incorporation of 3 w/w% biochar significantly (p

Abstract The protein corona formed on nanoparticles (NPs) has potential as a valuable diagnostic tool for improving plasma proteome coverage. Here, we show that spiking small molecules, including metabolites, lipids, vitamins, and nutrients into plasma can induce diverse protein corona patterns on otherwise identical NPs, significantly enhancing the depth of plasma proteome profiling. The protein coronas on polystyrene NPs when exposed to plasma treated with an array of small molecules allows for the detection of 1793 proteins marking an 8.25-fold increase in the number of quantified proteins compared to plasma alone (218 proteins) and a 2.63-fold increase relative to the untreated protein corona (681 proteins). Furthermore, we discovered that adding 1000 µg/ml phosphatidylcholine could singularly enable the detection of 897 proteins. At this specific concentration, phosphatidylcholine selectively depletes the four most abundant plasma proteins, including albumin, thus reducing the dynamic range of plasma proteome and enabling the detection of proteins with lower abundance. Employing an optimized data-independent acquisition approach, the inclusion of phosphatidylcholine leads to the detection of 1436 proteins in a single plasma sample. Our molecular dynamics results reveal that phosphatidylcholine interacts with albumin via hydrophobic interactions, H-bonds, and water bridges. The addition of phosphatidylcholine also enables the detection of 337 additional proteoforms compared to untreated protein corona using a top-down proteomics approach. Given the critical role of plasma proteomics in biomarker discovery and disease monitoring, we anticipate the widespread adoption of this methodology for the identification and clinical translation of biomarkers.

Abstract Marfan syndrome (MFS) is a connective tissue disorder that can lead to cardiovascular and musculoskeletal abnormalities. Aortic aneurysms and dissections are frequently seen in patients with MFS whereas peripheral vascular aneurysms in subclavian and axillary arteries territory considered very unusual. We reported a case of 54-year-old female with known history of MFS who had undergone a mechanical valve Bentall procedure due to severe aortic regurgitation and ascending aorta aneurysm in addition to thoracoabdominal aortic repair and who presented with a pulsatile painful mass in her right axillary region that turn to be significant true aneurysms of right subclavian and axillary arteries. To relive symptoms and to avoid further complications patient underwent successful surgical repair. Our case demonstrated rare locations of true peripheral aneurysms as a possible manifestation of MFS appeared several years post Bentall procedure and thoracoabdominal aortic repair and highlights also the importance of long-term monitoring to detect earlier such manifestation and avoid complications by surgical repair.

Introduction A large population suffers from obstructive sleep apnea (OSA). Most of these individuals (almost 90%) are either unrecognized or untreated OSA. These patients are at increased risk of cardiovascular diseases. Aim The aim of this study was to assess the prognostic value of Pentraxin 3 (PTX3) in OSA compared with the clinically relevant biological markers (HbA1c, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), uric acid, and fibrinogen) and to evaluate the relationship between PTX3 levels and risk of cardiovascular diseases. Patients and methods This research used a cross-sectional design and enrolled 100 participants with suspected OSA. All the participants underwent a full clinical history, a STOP-Bang questionnaire, and a polysomnography (PSG) study, and the serum biomarkers were also analyzed. Results The apnea-hypopnea index (AHI) from PSG was used to measure the OSA severity, and the individuals were distributed into three groups accordingly. Our findings showed that there was a significant difference in Pentraxin 3 and fibrinogen levels between patients with mild or moderate OSA and those with severe OSA. Pentraxin 3, at a cutoff point of greater than 4.25 ng/ml, had the highest prognostic accuracy in OSA (96%), with an AUC of 0.96. Regression analysis revealed that Pentraxin 3, with a cutoff point greater than 4.25, and CRP were significant predictors of cardiovascular disease in individuals with OSA. Furthermore, Pentraxin 3 (with a cutoff point of greater than 4.25 ng/ml) and fibrinogen were significant predictors of pulmonary embolism in patients with OSA. Conclusion Serum PTX3 was higher in patients with severe OSA than in those with mild- to moderate OSA. Furthermore, we found that OSA severity as indicated by the AHI was significantly correlated with serum PTX3. PTX3 and CRP are useful markers of cardiovascular risk in OSA.

Dahi is a fermented milk product containing probiotic lactic acid bacteria. This study aimed to isolate, identify, and characterize lactic acid-producing bacteria from native Dahi and evaluate their viability in orange juice using natural prebiotics. Dahi samples were obtained from local shops in Chattogram and Bogura, Bangladesh. Lactic acid-producing bacteria were isolated using MRS (de Mann Rogosa and Sharpe) medium. The isolated bacteria were identified through colony morphology, biochemical tests, and probiotic characteristics. Molecular identification was performed using polymerase chain reaction (PCR) targeting conserved 16S rDNA regions. Isolates of the genus Lactobacillus and Lactococcus lactis sp. Lactis were confirmed and used to develop probiotic orange juice. Prebiotics (Asparagus falcatus and Zingiber officinale) were added to the juice to support probiotic growth. The inoculated cell’s viability and the juice’s physicochemical parameters were evaluated during fermentation (48 hours) and storage (28 days). All fruit juice samples showed a mean number of viable cells of at least 1×105 CFU/mL during the 48-hour fermentation and 28-day storage in the refrigerator. Using natural prebiotics positively affected the survival of lactic acid bacteria, as demonstrated by bacterial colony growth on Petri dishes. Developing probiotic fruit juice enriched with prebiotics could be an effective alternative for individuals allergic or intolerant to milk-based products. Incorporating lactic acid bacteria from native Dahi into orange juice, combined with natural prebiotics, resulted in viable probiotic cells throughout fermentation and storage.

Abstract Nirmatrelvir plus ritonavir received Emergency Use Authorization for treating mild to moderate COVID-19 in high-risk patients. Its efficacy against the Omicron variant of SARS-CoV-2 remains uncertain. This retrospective cohort study assessed the effect of nirmatrelvir–ritonavir in preventing severe disease progression and long COVID symptoms after acute COVID-19 in non-hospitalized adults. SALAMA medical records from Dubai’s COVID-19 healthcare centers between May 22, 2022, and April 30, 2023, were used to identify 7290 eligible patients, 9.6% of whom received nirmatrelvir–ritonavir. Treatment was associated with a notable reduction in COVID-19-related hospitalizations (adjusted hazard ratio [HR] of 0.39; 95% CI, 0.18–0.85) by day 28 of symptom onset. Moreover, nirmatrelvir–ritonavir was associated with fewer long COVID symptoms (adjusted HR of 0.42; 95% CI, 0.19–0.95). This suggests the significant effectiveness of nirmatrelvir–ritonavir against the Omicron variant, reducing both severe and long-term COVID-19 symptoms.

Abstract The major challenge for the construction industry is to design and produce sustainable construction materials that are efficient in their performance and can be affordable for construction projects. The objective of this study is to determine the viability of incorporating waste products such as sugarcane bagasse ash (SCBA) to produce concrete with polypropylene (PP) fibers. SCBA is an industry waste that has certain pozzolanic properties, however, it shows limited mechanical properties when used as a cement replacement. To improve the mechanical and durability performance, metakaolin (15%) and PP fiber (0.5%, 1%, and 1.5%) were incorporated in the SCBA blend as a ternary additive. Some of the important characteristics explored include compressive strength, tensile strength, density, water absorption, acid resistance, and sorptivity. The study reveals that the incorporation of 15% metakaolin in the composite enhanced the compressive strength by 7%, 8.2%, and 9.1% for PP fiber additions of 0.5%, 1%, 1.5%, while the acid resistance enhanced by 4%, 6% and 8% relative to the control mix for the same value of pp fiber. Furthermore, cost evaluation confirms that the overall costs of concrete with 15% metakaolin and 5% SCBA were 12.2% less than the control concrete, thus making this option economically feasible. This research proves that the inclusion of SCBA, metakaolin, and PP fibers into the concrete mixture brings a sustainable approach that enhances mechanical properties and durability while assisting sugar manufacturing plants in the proper disposal of wastes.

Abstract Glioblastoma multiforme (GBM) is the most common harmful high-grade brain tumor with high mortality and low survival rate. Importantly, besides routine diagnostic and therapeutic methods, modern and useful practical techniques are urgently needed for this serious malignancy. Correspondingly, the translational medicine focusing on genetic and epigenetic profiles of glioblastoma, as well as the immune framework and brain microenvironment, based on these challenging findings, indicates that key clinical interventions include immunotherapy, such as immunoassay, oncolytic viral therapy, and chimeric antigen receptor T (CAR T) cell therapy, which are of great importance in both diagnosis and therapy. Relatively, vaccine therapy reflects the untapped confidence to enhance GBM outcomes. Ongoing advances in immunotherapy, which utilizes different methods to regenerate or modify the resistant body for cancer therapy, have revealed serious results with many different problems and difficulties for patients. Safe checkpoint inhibitors, adoptive cellular treatment, cellular and peptide antibodies, and other innovations give researchers an endless cluster of instruments to plan profoundly in personalized medicine and the potential for combination techniques. In this way, antibodies that block immune checkpoints, particularly those that target the program death 1 (PD-1)/PD-1 (PD-L1) ligand pathway, have improved prognosis in a wide range of diseases. However, its use in combination with chemotherapy, radiation therapy, or monotherapy is ineffective in treating GBM. The purpose of this review is to provide an up-to-date overview of the translational elements concentrating on the immunotherapeutic field of GBM alongside describing the molecular mechanism involved in GBM and related signaling pathways, presenting both historical perspectives and future directions underlying basic and clinical practice. Graphical Abstract

Background: Formalin is a widely used histological fixative despite its carcinogenic properties, inadequate nucleic acids preservation, and prolonged fixation time. Aim: The study intended to prepare a novel zinc-based fixative which is, formalin-free, and cost-effective, provide optimal preservation, with rapid penetration rates, and enhanced Hematoxylin/Eosin-stained sections. Methods: Liver, kidney, brain, and small intestine specimens were collected from ten adult laboratory rats (Rattus norvegicus) and preserved in formalin 4%, formalin 10%, NBF and the experimental EZAT solution. The penetration depth (discolored edges) was measured at 6, 12, 24, and 48-hours. The shrinkage ratio was calculated by measuring the width and length of the samples before and after 48 hours of fixation. The histological evaluation, included staining affinity, cellular outline, cytoplasmic and nuclear attributes, and overall tissue structure, was conducted by a panel of academic experts and rated using a scale of poor (1), fair (2), good (3), very good (4), and excellent (5) grades. The data were later statistically analyzed to determine the significant differences among the tested fixative types. Results: Higher penetration rate was observed with the EZAT solution at 6 and 12 hours' time and the samples were reached at optimal fixation after 24 hours; with an accelerated diffusion coefficient, and a minimal shrinking effect compared to formalin 10% and NBF. The microscopic evaluation of Hematoxylin/Eosin-stained sections revealed better staining affinity, refined histological details, and enhanced cytoplasmic and nuclear properties. The overall structural evaluation revealed an excellent microscopic appearance with the EZAT solution compared to formalin-based fixatives. Conclusion: The EZAT fixative should be considered as an everyday preservative in histology and histopathology laboratories. Future studies should be focused on the potential of EZAT in cellular histochemistry and immunohistochemistry practices. [Open Vet J 2024; 14(10.000): 2599-2608]

Abstract Understanding the spatial and temporal dynamics of air pollutants is crucial for effective urban air pollution management. This study focuses on the temporal dynamics of air quality monitoring stations (AQMSs) and the association among air pollutants, particularly PM2.5, in Tehran, Iran. Using time series clustering and the Copula model, we analyzed data from 2019 to 2022. We found that the levels and dynamics of O3 and SO2 were similar across most AQMSs and unrelated to geographical positions. CO levels and dynamics were consistent among urban and border AQMSs, with higher concentrations in urban stations. NO2 levels and dynamics varied significantly among northern AQMSs with no relationship geographical positions. PM10 levels and dynamics had a relationship with geographical positions, with western clusters having the highest and northern clusters the lowest concentrations. The dynamics of PM2.5 showed significant relationship among AQMSs in the eastern, southern, and western regions, but not in the north. We also observed that PM10 and O3 levels were higher in warm seasons, whereas CO, SO2, NO2, and PM2.5 levels were higher in cold seasons. Most pollutants, except O3, peaked during traffic hours. Notably, the significant increase in PM2.5 since spring 2021 was primarily due to PM10. Policymakers should focus on these spatial and temporal variations to improve urban air quality and public health outcomes through targeted interventions.

Abstract Scorpion venom may include pharmacological substances that have the potential to provide benefits. Multiple scientific investigations have shown that particular scorpion venoms induce apoptosis and inhibit the development of cancerous cells. The present study investigated the potential anticancer properties of the crude venom derived from Hottentotta saulcyi (H. saulcyi) on both in vivo mice models and in vitro breast carcinoma cells. The venom of scorpions belonging to the species H. saulcyi was obtained with the application of electrical stimulation at voltages of 8 and 10 V. The determination of the Average Lethal Dose 50 (LD50) was conducted. The present work assessed the in vitro cytotoxicity and morphological characteristics of H. saulcyi venom using fluorescence microscopy, MTT assay, and flow cytometry assessment. Additionally, research was performed to assess the cytotoxic effects in vivo on a mouse model with breast cancer. The examination of MCF-7 cells treated with scorpion venom at a microscopic level revealed the existence of cells undergoing apoptosis. The venom of H. saulcyi has anticancer properties, as shown by the observation that MCF-7 cells had a 62.12% apoptotic rate when exposed to a dose of 1.47 mg/L. Based on the results obtained, it can be shown that the viability of MCF-7 cells has exhibited a substantial reduction (P

Abstract The disease dynamics affect the human life. When one person is affected with a disease and if it is not treated well, it can weaken the immune system of the body. Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system, of the body which is the defense line against diseases. If it is not treated well then HIV progresses to its advanced stages and it is known as Acquired Immunodeficiency Syndrome (AIDS). HIV is typically a disease that can transferred from one person to another in several ways such as through blood, breastfeeding, sharing needles or syringes, and many others. So, the need of the hour is to consider such important disease dynamics and that will help mankind to save them from such severe disease. For the said purpose the reaction-diffusion HIV CD4 $$^{+}$$ + T cell model with drug therapy under the stochastic environment is considered. The underlying model is numerically investigated with two time-efficient schemes and the effects of various parameters used in the model are analyzed and explained in a real-life scenario. Additionally, the obtained results will help the decision-makers to avoid such diseases. The random version of the HIV model is numerically investigated under the influence of time noise in It $${\hat{o}}$$ o ^ sense. The proposed stochastic backward Euler (SBE) scheme and proposed stochastic Implicit finite difference (SIFD) scheme are developed for the computational study of the underlying model. The consistency of the schemes is proven in the mean square sense and the given system of equations is compatible with both schemes. The stability analysis proves that both schemes and schemes are unconditionally stable. The given system of equations has two equilibria, one is disease-free equilibrium (DFE) and the other is endemic equilibrium. The simulations are drawn for the different values of the parameters. The proposed SBE scheme showed the convergent behavior towards the equilibria for the given values of the parameters but also showed negative behavior that is not biological. The proposed SIFD scheme showed better results as compared with the stochastic SBE scheme. This scheme has convergent and positive behavior towards the equilibria points for the given values of the parameters. The effect of various parameters is also analyzed. Simulations are drawn to evaluate the efficacy of the schemes.

Abstract This retrospective study aimed to assess different macular neovascular network characteristics in relation to changes in best corrected visual acuity (BCVA) over 3 and 12 months following treatment. Using optical coherence tomography angiography, we reviewed the medical records of 46 treatment-naïve patients with neovascular age-related macular degeneration (nAMD) who received intravitreal aflibercept injections. The change in BCVA from baseline to 3 months and 12 months after treatment was recorded. The mean vessels percentage area, junctions density, lacunarity, and fractal dimension were significantly correlated with the change of BCVA from baseline to month 3 (P = 0.003, 0.046, 0.007, and 0.005 respectively). Fractal dimension and vessels percentage area were correlated with the change of BCVA from baseline to month 12 (P = 0.023 and 0.023 respectively). The findings suggest that baseline characteristics of macular neovascular complexes may serve as predictors for BCVA changes following treatment with aflibercept in nAMD patients.

Despite the importance of Marketing Intelligence (MI) and the Internet of Things (IoT), Customer Relationship Management (CRM), and Customer Experience Management (CEM) in the competitive context, more research on the integration of these concepts for sustained competitive advantage is necessary. Thus, Snow Company must effectively utilize these concepts to establish a sustained competitive advantage. Therefore, this study investigates the impact of IoT, CRM, CEM, and MI on attaining sustained competitive advantage. By employing a structural equation model and Smart-PLS software, we analyzed data collected from 186 managers and employees of Snowa Company. Our findings indicate that integrating IoT, CRM, and CEM concepts into marketing intelligence is the most beneficial strategic approach for achieving sustained competitive advantage for Snowa Company. Through this integration, company managers can enhance their marketing and innovation capabilities, strengthen strategic solutions, and achieve sustained competitive advantage.

Abstract Background Overall, stoma-related morbidity affects a reported 20–38% of pediatric patients. However, determining the true incidence of major stoma-related morbidity is challenging due to limited cohort sizes in existing studies. Thus, the aim of this study was to investigate colostomy related morbidity among children both after stoma formation and stoma closure. Methodology This is a retrospective cohort hospital-based study, conducted in an Abha maternity and children hospital, between August 1, 2018, and August 1, 2023, among 126 pediatric patients (aged 0–12 years) who underwent colostomy formation and subsequent closure during the study period. Data were collected from medical records. Data was analyzed using Statistical Package for Social Sciences (SPSS) v.26. Results This study included a total of 126 children who underwent colostomy. (N = 37, 29.4%) of cases included in this study were emergency cases, while (N = 89, 70.6%) were elective. A variety of antibiotics were used for surgical prophylaxis, metronidazole (77%) and cefuroxime (62.7%) were the most prevalent. Oral feeding was started after 5–6 days in more than one third of cases (39.7%). Wound infection (N = 15, 11.9%) was the most reported post-operative complication, followed with bowel obstruction (N = 6, 4.8%). Emergency cases had a longer duration of hospital stay than elective cases; this difference was statistically significant (P = .04). Conclusions Majority of patients reported no stoma related complications, while among those who reported complications, wound infection was the most reported complication, followed by bowel obstruction.

Abstract Exosomes which are membrane vesicles released by cells have gained significant interest in the field of cancer therapy as a novel means of intercellular communication. Their role in immune activation and their pathophysiological functions in cancer therapy have been recognized. Exosomes carry diverse bioactive components including proteins, mRNA, microRNAs, and bioactive lipids. These molecules have therapeutic potential in promoting tissue regeneration, supporting stem cell activity, preventing cell death, modulating immune responses, and promoting the growth of new blood vessels. However, the precise roles of exosomes derived from mesenchymal stem cells (MSCs) in the treatment of various cancers are still not fully understood. Consequently, cancer stem cells (CSCs) can self-renew and differentiate into various cell types. Understanding the mechanisms that sustain their persistence is crucial for developing effective therapies. Exosomes have recently gained interest as vehicles for intercellular communication between CSCs and non-CSCs, influencing cancer progression and the microenvironment. Research is ongoing on the utilization of exosomes derived from cancer stem cells (CSC-Exosome) for cancer treatment. The composition of extracellular vesicles is influenced by the specific type and condition of the cells from which they are secreted. Circulating exosomes contain stable RNA molecules such as mRNAs, microRNAs, and long non-coding RNAs (lncRNAs). In this review, we will explore the significance of exosomes and their diverse cellular combinations in the context of cancer therapy. Graphical Abstract

Abstract The continuous growth of biofilm infections and their resilience to conventional cleaning methods and antimicrobial agents pose a worldwide challenge across diverse sectors. This persistent medical, industrial, and environmental issue contributes to treatment challenges and chronic diseases. Lactic acid bacteria have garnered global attention for their substantial antimicrobial effects against pathogens and established beneficial roles. Notably, their biofilms are also predicted to show a promising control strategy against pathogenic biofilm formation. The prevalence of biofilm-related problems underscores the need for extensive research and innovative solutions to tackle this global challenge. This novel study investigates the effect of different extracts (external, internal, and mixed extracts) obtained from Lactobacillus rhamnosus GG biofilm on pathogenic-formed biofilms. Subsequently, external extracts presented an important eradication effectiveness. Furthermore, a 6-fold concentration of these extracts led to eradication percentages of 57%, 67%, and 76% for Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa biofilms, respectively, and around 99.9% bactericidal effect of biofilm cells was observed for the three strains. The results of this research could mark a significant breakthrough in the field of anti-biofilm and antimicrobial strategies. Further studies and molecular research will be necessary to detect the molecules secreted by the biofilm, and their mechanisms of action engaged in new anti-biofilm strategies.

Summary: SARS-CoV-2 has had a significant worldwide impact, leading to widespread illness and mortality. With the lack of specific antiviral treatments, there is a growing interest in exploring the potential therapeutic effects of various nutritional supplements, including vitamin D. Vitamin D plays an essential role in health, has been implicated in modulating the immune response and reducing inflammation, which may have implications in the prevention and management of coronavirus disease 2019 (COVID-19). Patients having low level of vitamin D are predisposed to severe consequences. Vitamin D and COVID-19 have shown an inverse relationship. This review is an understanding of the remedial effects of vitamin D in COVID-19, including its potential mechanism of action, evidence from clinical studies, and recommendations for supplementation of vitamin D in patients suffering from COVID-19. Material and Methods: Google scholar, Sci-Hub, pubmed.

Abstract The objective behind developing the nanoporous alumino-borosilicate (AlBS) was to remove strontium ion (Sr2+) from liquid waste and subsequently stabilize it. The sorption capacity of the nanoporous AlBS was assessed in relation to various experimental factors, including contact time, temperature, initial pH solution, and initial concentration of Sr ions. According to the obtained results, nanoporous AlBS shows a maximum Sr2+ sorption capacity of 163.08 mg/g. In order to achieve stable immobilization of the sorbed Sr ions, heat treatments at different temperatures were applied to the Sr-containing nanoporous AlBS. Various eluents were used in the leach tests to examine the Sr ions leaching from heat-treated materials. Only 3.43% of the Sr ions initially adsorbed in the nanoporous AlBS matrix was washed out with 1 M sodium chloride eluent, showing that heating the sample to around 1100 °C successfully trapped Sr ions in the nanoporous AlBS matrix.

Using proposed system psychologists can use technology to make decisions which can provide ease for both patients and psychologists. Psychologists can check the progress of patients by analysing emotions reports of patient over time. Using historical data and emotion detection technology psychologists can make more accurate decisions. Using proposed system patient and psychologists don’t have to go to anywhere they only need a device and internet. Based on the characteristics of patient emotion psychologist only need report generated by system and prescribe medicine in emergency situation. Proposed system improves consultancy method by using machine learning emotion detection algorithm. Proposed system detects facial emotion of patient by using CNN with HAAR cascade classifier. We use FER 2013 dataset to train our model. We use VGG 19 architecture to train our model for optimization function to enhance the accuracy of model. We use RELU. We use DJANGO framework for integration with frontend. Result of our model on dataset 82.3% after find tuning the accuracy goes to 82.3% to 92%. We use recall and F1 method to check the performance of model. We trained model on the testing dataset which have gray scale images and 48*48pixel images to achieve his performance. To achieve our accuracy goal, we split dataset into trainee validation and testing dataset. We use CNN and achieve 93% accuracy in our system which help patient to get feedback only selected question and psychologist. Patients select psychologist to answer questions of psychologist system stores emotions of patient against every question to generate emotion report. Psychologist can analyze emotion report to provide better prescription to patient.

Abstract Background The rapid evolution of nanotechnology has fundamentally transformed both medical and dental fields. By harnessing nanomaterials, researchers have unlocked the ability to replicate natural tissue structures and properties, significantly enhancing integration processes. Notably, nanostructures have emerged as pivotal elements in oral medicine, particularly in combating dental caries and enhancing outcomes in dental implants and maxillofacial surgeries. Main body of the abstract Nanostructures play multifaceted roles in oral health, promoting osseointegration and expediting healing processes in dental procedures. The impact of these materials extends to improving the adhesive strength and overall properties of dental composites. This review critically evaluates the influence of nanointerfaces on the longevity of dental restorations, exploring innovative nanotechnological interventions aimed at augmenting restoration durability. Furthermore, recent strides in nanodentistry are discussed, highlighting breakthroughs in oral health diagnostics, preventative strategies, and treatment modalities essential for achieving and sustaining optimal oral health. Short conclusion Incorporating nanotechnology into dental practice presents exciting prospects for advancing oral healthcare. From enhancing restoration durability to revolutionizing diagnostics and treatments, nanotechnology offers transformative solutions that hold significant promise for the future of oral health management.

Objectives: The working situation of railway traffic control rooms (RTCR) employees makes them susceptible to human error. On the other hand, the occurrence of human error by these staff can lead to catastrophic events. Due to the lack of a standard questionnaire in estimating the probability of monthly human errors in employees of the RTCR, this study designs and validates such a tool. Methods: In this mixed-method research, an initial questionnaire of 67 questions was designed, using the literature review and experts’ experiences. To standardize and validate this questionnaire, the opinions of 15 experts, including university professors and experienced people working in control rooms were used. To determine the validity of the questionnaire, two indexes content validity index and content validity ratio were used. Meanwhile, to check the reliability, the weighted kappa coefficient was used. Results: All the initial questions were accepted and a final questionnaire with 67 questions was compiled in two sections for employees of the central control room and employees working in other RTCR. The content validity index values of the questionnaire were 0.9, 0.9 and 0.92 in terms of simplicity, relevancy and clarity, respectively. The content validity ratio value was 0.87. The reliability of this questionnaire was also confirmed by obtaining 73.71%, 87.14% and 80.31% for the minimum, maximum and average percentage of agreement between the questions, respectively. Discussion: The designed questionnaire can estimate the probability of monthly human errors among RTCR employees and can be used in future studies.

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.

Abstract Partial shading on series‐connected photovoltaic (PV) panels in conventional PV systems results in lower harvested power. To resolve this, it is vital to utilize module level power electronics (MLPE) such as Solar Power Optimizers (SPOs). This paper introduced a non‐isolated common ground non‐inverting output voltage buck‐boost converter as an SPO. Proposed converter benefits from continuous input and output currents which has a significant role in designing SPOs. Having a quadratic gain, beside acceptable step‐down range are other features of the converter. Operating principle, design, steady‐state, small‐signal analysis, and dynamic performance of proposed converter are included. Proposed converter is compared with other buck‐boost converters in terms of voltage gain, voltage stresses, continuous input and output current, and output polarity. To validate the performance of introduced converter, experimental results for a prototype with input voltage 24 V, output voltage 72 V for step‐up and 15 V for step‐down modes are given and results are examined. The maximum efficiency of the prototype is 93% and 89% for step‐up and step‐down modes, respectively. To evaluate the effect of proposed SPO for extracting maximum available power from PVs, simulation results of a grid connected PV system with two series connected SPOs is discussed.

According to ancient Iranian mythology, the world is depicted as a battleground between the forces of good and evil. Ahuramazda is revered as the ultimate source of goodness, while Ahriman is portrayed as the creator of all things malevolent, such as darkness, ignorance, pain, and disease. These mythological concepts have been passed down through references in the Avesta texts and Pahlavi literature, providing insights into the beliefs of ancient Iranians. In a scholarly exploration of these themes, the research delves into the textual evidence concerning illness, treatment, and the origins of these concepts as presented in the Bundahishn, a reliable source for understanding ancient Iranian beliefs. Ancient Iranian cosmology posits that afflictions and maladies stem from the destructive influence of Ahriman and his cohorts, who seek to wreak havoc upon creation. Conversely, the forces of Ahuramazda strive to counteract this demonic evil by imparting medical knowledge to humanity and teaching healing practices. Within this dualistic worldview, pain and disease are attributed to demonic origins, while medicine and treatment are associated with Ahuramazda. The ancient Iranians viewed the pursuit of medical knowledge and the practice of pharmacy as integral components of the eternal battle between good and evil. In this framework, safeguarding health and administering treatment are essential in the ongoing struggle against evil forces. This holistic perspective underscores the interconnectedness of physical well-being with spiritual beliefs, emphasizing the role of individuals in preserving their health as an act of resistance against demonic influences.

Abstract Background/aim Benign tracheal stenosis (TS) is a potentially life-threatening condition caused by iatrogenic events resulting from endotracheal intubation and tracheostomy. The study aimed to determine the clinical characteristics, management, and long-term outcomes of patients with simple or complex post-intubation tracheal stenosis (PITS) who were admitted to the intensive care unit (ICU). Materials and methods Retrospective analysis of patients admitted to the ICU between June 2016 and June 2022 and diagnosed with PITS were performed until June 2023. Results 76 patients (mean age 54.9 ± 17.3%, 63.2% male, 61.8% complex stenosis) admitted to the ICU were analysed. The diagnosis of PITS was made by fiberoptic bronchoscopy (FOB) in 53.9% and computed tomography (CT) in 46.1%. The most common location of stenosis was the upper trachea area (57.9%, n = 44). The median stenosis length of the TS was 1.9 cm (median 2 cm for complex stenosis, 1 cm for simple stenosis, p

Abstract Background Congenital lung malformations (CLMs) are among the rare anomalies that can be diagnosed by bronchoscopy and imaging. They can cause various respiratory symptoms and complications, especially in children with congenital heart disease. This is an interesting case report of a child with a rare combination of congenital anomalies affecting the airway. Case presentation We report a case of a 3.5-year-old boy with multiple congenital anomalies and respiratory problems since birth. He had a history of mild autism, developmental delay, and sensitivity to smell and smoke. He presented with hoarseness, shortness of breath, severe coughing, and severe wheezing, which worsened with the flu. He underwent bronchoscopy and other diagnostic tests, which revealed a posterior laryngeal cleft, a tracheal bronchus, and a very narrow distal trachea. He was treated with nebulizers, antibiotics, and serum therapy and showed improvement. This case illustrates a rare combination of airway malformations that require a multidisciplinary approach. Conclusions We presented a case of rare pulmonary malformations and chronic respiratory symptoms that improved with conventional pharmacotherapy. Increased awareness and understanding of these anomalies among healthcare providers can lead to earlier diagnosis and improved patient outcomes.

Abstract The growing need for energy and the depletion of oil wells necessitate advanced Enhanced Oil Recovery (EOR) techniques, particularly water and polymer flooding, which play a crucial role in augmenting hydrocarbon recovery rates. However, water flooding in high-permeability layers often leads to water breakthroughs, reduced sweep efficiency, and the formation of preferential channels, posing significant challenges to oil recovery and reservoir management. Conformance control treatments, including the use of polymer microspheres, offer a promising solution by sealing high-permeability zones and enhancing sweep efficiency. This study focuses on the application of fluorescent polymer microspheres based on polyacrylamide, which is extensively employed in the oil sector as an oil displacement agent. Fluorescent polymers called Poly 400, Poly 200, and Poly 600, incorporating cationic methacrylamide monomers, were synthesized through copolymerization to create amphiphilic polymers with enhanced stability and functionality. These fluorescent polymers were evaluated through flooding tests using a quarter-five-spot model of transparent quartz glass under UV light, allowing for instantaneous measurement and observation of fluorescence intensity. At reservoir conditions, the oil displacement experiments confirm that the incremental oil after water flooding by Poly 400, Poly 200, and Poly 600, is 13.1%, 9.1%, and 6.1% of OOIP respectively. The findings showed that fluorescent polymer microspheres could efficiently target high-permeability layers, adapt to varying pore throat sizes, and improve the plugging rate of high-permeability channels, thereby optimizing oil recovery. A subsequent simulation study using the CMG simulator provided further insights into the efficacy of these fluorescent polymers as EOR agents, revealing their potential to enhance sweep efficiency and enhance oil recovery. Simulation results showed that oil saturation decreased from 68% (initial) to 13.5%, 16.1%, and 18.3% after Poly 400, Poly 200, and Poly 600 flooding respectively. This work highlights the potential of fluorescent polymer microspheres as a valuable tool for EOR applications, offering significant advancements in reservoir management and oil recovery optimization.

Abstract Deforestation exerts profound ramifications on soil quality and biodiversity, thereby exerting substantial economic repercussions. The depletion of organic matter and structural integrity of soil following tree removal for agricultural purposes underscores the severity of this issue. In elucidating the soil pollution stemming from deforestation, this research employs a sophisticated five-compartment SDIFR model integrating fractal dimension and fractional order dynamics. The rigorous analysis, including the application of Picard Lindelof’s fixed point theorem, establishes the existence and uniqueness of explicit solutions. Furthermore, the examination of local and global stability sheds light on the system’s behavior, delineating between pollution-free equilibrium and pollution-extinct equilibrium states. To regulate system behavior, an adaptive control framework grounded in fractal fractional order is proposed, leveraging the Adams-Bashforth numerical approximation scheme for implementation. Through numerical simulations, the study underscores the pivotal role of parameters, thus substantiating the significance of the proposed model in comprehensively addressing the complexities of soil pollution induced by deforestation.

Abstract The hydrogen evolution reaction (HER), a crucial half-reaction in the water-splitting process, is hindered by slow kinetics, necessitating efficient electrocatalysts to lower overpotential and enhance energy conversion efficiency. Transition-metal electrode materials, renowned for their robustness and effectiveness, have risen to prominence as primary contenders in the field of energy conversion and storage research. In this investigation, we delve into the capabilities of transition metals when employed as catalysts for the HER. Furthermore, we turn our attention to carbon nanomaterials like graphene, which have exhibited tremendous potential as top-performing electrocatalysts. Nevertheless, advancements are indispensable to expand their utility and versatility. One such enhancement involves the integration of phosphorus-doped graphene. Our research focuses on the synthesis of CuS–NiTe2/PrGO, a nanocomposite with a crystalline structure, through a straightforward method. This nanocomposite exhibits enhanced catalytic activity for the HER, boasting a Tafel slope of 57 mV dec−1 in an acidic environment. Consequently, our findings present a straightforward and efficient approach to developing high-performance electrocatalysts for HER.

Abstract Direct observation of classroom behavior in young children enriches our understanding of their behavior in its natural context, informing both assessment and intervention strategies to foster supportive learning environments. However, a notable gap in the literature concerning effective direct observation tools specifically designed for this purpose remains challenging. This observational study utilized the digital format of the The Student Observation System (BASC-3-SOS; Reynolds & Kamphaus, 2015), enabling behavior recording via smartphones, tablets, or laptops. We conducted observations for 43 young children aged four and five in classroom settings. Thirty of these children had been previously identified with behavioral problems via the Strengths and Difficulties Questionnaire (SDQ, Child Psychol Psychiatry Allied Discip. 38(5), 581–6, 1997), while 13 were considered typically developing. Each child was observed over three 20-min sessions, totaling 60 min per child. The findings revealed a significant correlation between the SDQ scores and BASC-3-SOS assessments in adaptive and maladaptive behaviors. The results indicate that young children’s engagement and problem behaviors vary with teacher interactions and classroom activities. children identified with behavioral issues exhibited higher levels of maladaptive behaviors compared to their typically developing peers. The study presents the BASC-3-SOS as a promising tool for identifying general behavioral and emotional risks among young children in Qatar, suggesting its utility in enhancing early educational interventions.

Abstract Background Ethical decision making is a complex issue because it strongly depends on the religion, beliefs, traditional laws and moral views of each society. The purpose of this study was to explore the experience of Iranian family caregivers of end stage cancer patients about ethical decision making. Methods This qualitative study is based on van Manen’s method of hermeneutic phenomenology. In-depth interviews were carried out to collect data. Participants were 12 caregiver. Audiotapes were transcribed and analyzed for common themes that represented the participants’ experiences. Trustworthiness of the findings was established using the Lincoln and Guba’s criteria. Results Three themes reflected the essence of caregivers’ lived experience including; fluctuating between hope and despair, wandering dilemma, and ethical decision making. Each of these themes consisted of several subthemes. Conclusion The present study revealed that, the caregivers of terminally ill cancer patients need different information about prognosis and end of life decision making process. Our perception of how families negotiate ethical issues in their decision-making is still developing. Opportunities should be created to empowering caregivers to talk about their uncertainties and concerns.

Abstract Introduction Depression disorders are one of the most widespread mental disorders among college students. In university students, depression has been associated with lower academic performance, worse work performance, and increased dropout risk. his study aims to assess the prevalence of depression and highlight risk factors among Saudi international university students (IUS) in the United States (US), the United Kingdom (UK), and Australia. Subject and methods This cross-sectional study was conducted among Saudi students who chose to study abroad. A self-administered online questionnaire was sent to the students using an online survey. The questionnaire includes socio-demographic data (e.g., age, gender, specialty, etc.), medical characteristics, social status, and the Patient Health Questionnaire (PHQ-8) to assess the student's depression. Results Of the 401 students, 52.4% were younger (age 18 – 25 years), and more than half were males (53.9%). Most of the participants were studying in the US (46.6%), followed by the UK (40.6%) and Australia (12.7%). The rate of major depression among Saudi students studying abroad was 40.4%. In univariate analysis, major depression was influenced by age, marital status, specialty, personal and family history of mental illness, contact with family and friends, and feeling like a stranger. However, after conducting multivariate regression analysis, previous diagnoses of mental illness and feeling a stranger were identified as the significant independent risk factors for major depression. Conclusion This study provides insights into the prevalence and risk factors associated with depression among Saudi IUS. The prevalence of major depression among Saudi IUS was 40.4%. Previous history of mental illness and feeling like strangers were identified as the most prominent risk factors in this study. Identifying the prevalence and contributing factors of depression can guide academic institutions and governments in the development of effective interventions and support for IUS’s mental well-being. Future research could diversify the sample and employ longitudinal designs.

Introduction: Primary pulmonary artery sarcoma is a rare malignancy with a poor prognosis, undefined treatment guidelines, and is often mistaken for a pulmonary embolism (PE) based on similar clinical presentation and radiographic findings. Case Presentation: We present a case of a 39-year-old female with a past medical history of recurrent miscarriages who presented with a chief complaint of dyspnea. Due to a history of recurrent miscarriages, a predisposing coagulopathic condition was suspected for a PE. A V/Q scan showed high probability for a PE with bilateral perfusion defects. Subsequent CT angiographic imaging of the chest was read as positive for a massive PE. The patient was transferred to the medical ICU for tPA administration but developed worsening hypoxic respiratory failure and was transferred to an outside hospital for expert surgical consultation and thrombectomy. Intraoperative reports during thrombectomy commented on a mass within the pulmonary artery. Subsequent pathology showed a high-grade sarcoma. The patient was started on adjuvant chemotherapy with doxorubicin, ifosfamide, and MESNA; however, due to multiple comorbidities, the patient ultimately succumbed to her illness. Conclusion: This case underscores the diagnostic difficulty in distinguishing pulmonary artery sarcomas from a PE, especially in the presence of other confounders and biases.

Focus on form through oral corrective feedback has been the center of many L2 learning investigations in recent decades. Although research has been abundantly done on the impact of different single-feedback types, not many studies have included combinational feedback strategy, especially as regards the mastery of both explicit and implicit knowledge of morpheme ‘s’ by EFL students in Iran. Therefore, the present work attempted to compare the effectiveness of unmarked recast, explicit correction with metalinguistic explanation, and mixed feedback in the expansion of knowledge of third-person marker ‘s’ in Iranian task-based language teaching context, employing a pretest/posttest design. To this end, forty-eight lower-intermediate learners of EFL were selected as participants. Every feedback type was supplied to an experimental group through story retelling and picture description tasks. Control group, however, was not provided with any intervention and feedback. Untimed grammaticality judgment and elicited oral imitation tests were used as measurement tools. Results of Descriptive Statistics, One-Way Between Groups ANCOVA and Tukey’s Multiple Comparison Post-Hoc Test illustrated that all types of feedback were relatively effective. Nevertheless, mixed feedback and explicit correction with metalinguistic explanation lead to overall acquisition. The insights provided might benefit EFL instructors in Iran in employing the best way(s) of corrective feedback to foster language learning in task-based teaching approach, which can promote Iranian English learners’ acquisition of third person singular‘s’.

Type 2 diabetes mellitus (T2D) is a common endocrine and metabolic disorder worldwide. Meanwhile, Allium Porrum L. (AP) has been recognized as one of the most eminent traditional herbal medicines with substantial health benefits. The aim of the present study is to evaluate anti-oxidative and anti-inflammatory effects of ethanol extract of AP in rats with T2D. Methods: 70 male Sprague-Dawley rats were randomly divided into 7 groups of 10 animals each. The study groups were as follows: The study groups were as follows: healthy control (HC); healthy control rats receiving 100 mg/kg of AP extract (HC.AP.100); diabetic control (DC); diabetic rats receiving 10 mg/kg metformin (DT.M.10); diabetic animals receiving 50 mg/kg of AP extract (DT.AP.50); diabetic rats receiving 100 mg/kg of AP extract (DT.AP.100); and diabetic animals receiving 200 mg/kg of AP extract (DT.AP.200). Results: After 6 weeks of intervention, the level of serum malondialdehyde (MDA) and tumor necrosis factor alpha (TNF-α) were significantly increased (P=0.02) and (P=0.002), respectively; while superoxide dismutase (SOD) concentration was notably reduced (P=0.04) in DC.M.10 in comparison with that of the HC.AP.100 group. Also, compared to DC.M.10 group, all rats treated with metformin and AP showed a significant decrease in the level of MDA and TNF-α, along with an enhancement of SOD concentration (All P

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

Abstract Background Malaria continues to be a critical public health concern in India, predominantly driven by complex interplays of ecological, climatic, and socioeconomic factors. Methods This study aimed to assess the association between climatic variables (temperature and precipitation) and malaria incidence across India from 2010 to 2019, utilizing data from the Global Historical Weather and Climate Data for climate metrics and the Global Burden of Disease Study for malaria incidence rates. Generalized Linear Mixed Models (GLMMs) with a Poisson distribution were employed to analyze the data, adjusting for socio-economic status, as indexed by the Human Development Index (HDI). Results The results indicated a declining trend in both the number of malaria cases and age-specific incidence rates (ASIR) over the study period. In 2010, India reported approximately 20.7 million cases with an ASIR of 1688.86 per 100,000 population, which significantly reduced to 9.8 million cases and an ASIR of 700.80 by 2019. High malaria incidence was consistently observed in the states of Jharkhand and Odisha, whereas Sikkim reported the lowest numbers. Statistical analysis identified significant associations between malaria incidence and both temperature deviations and precipitation levels, with variations also linked to HDI, suggesting better detection and reporting capabilities in more developed areas. Conclusion The study underscores the critical interactions between climatic variables and socio-economic factors in shaping the trends of malaria incidence across India. These findings highlight the necessity for adaptive, localized public health strategies that integrate environmental monitoring with socio-economic data to efficiently predict and manage malaria outbreaks.

Abstract Studies have documented various effects of circadian rhythm and daytime variations on the cardiovascular and immune system as well as wound healing. From June to December 2016, n = 367 cardiac surgery patients were enrolled. Microbiological swabs from the mediastinum and subcutaneous wound were taken before sternal closure. Patients were assigned to groups based on operation start: morning (n = 219) or afternoon (n = 135). Bacterial contamination and wound infections were studied in relation to circadian rhythm and daytime variation. We did not observe any difference in mortality (morning: 3.7%, afternoon: 3.0%, p > 0.99) and major adverse events (morning: 8.2%, afternoon: 5.9%, p = 0.53). In 27.7% of the morning group, at least one positive intraoperative swab was observed, similar to the afternoon group (25.6%, p = 0.71). The incidence of positive presternal swabs was 15.6% in the morning compared to 9.1% in the afternoon (p = 0.18). About 90% of the germs detected were part of the natural skin flora (e.g., Cutibacterium acnes and Staphylococcus epidermidis). The incidence of sternal wound infections was 7.3% (morning) and 3.0% (afternoon) (p = 0.18). We did not find differences in the incidence of intraoperative bacterial sternal contamination, nor postoperative infections, between patients who underwent cardiac surgery in the morning or afternoon.

Abstract Open surgery for developmental dysplasia of the hip (DDH) may cause severe pain due to tenotomies and pelvic–femoral osteotomies. This study aims to evaluate the analgesic effect of ultrasound-guided Lumbar Erector Spina Plane (L-ESP) Block in pediatric patients undergoing DDH surgery. Sixty children scheduled for DDH surgery were randomly assigned into two groups. Group I (n = 30) received L-ESP with 0.5 mL/kg of 0.25% bupivacaine before surgery. In contrast, Group II (n = 30), as the control group, received the same volume of saline injection. Identical postoperative analgesia protocol was adjusted for both groups. Parental satisfaction, pain levels, ibuprofen, and opioid consumption were recorded. Pain levels were evaluated with the FLACC (Face, Legs, Activity, Crying, Consolability) scale. FLACC scores at the first 24th hours were lower in the L-ESP group than the control group (p

Abstract Background Malignant mesothelioma is an aggressive cancer with poor prognosis. Programmed cell death protein-1 (PD-1) and its ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) have recently presented as a viable option in some first line but primarily as a second-line treatment of advanced-stage malignant mesothelioma (asMM). Therefore, this systematic review and meta-analysis aims to assess the safety and efficacy of PD-1/L-1 ICIs in advanced-stage malignant mesothelioma. Methods PubMed, Scopus, and Cochrane databases were searched for all studies assessing the safety and efficacy of anti PD-1/PD-L1 agents. Primary outcomes were objective response rate (ORR) and disease control rate (DCR). Secondary outcomes were median progression free (mPFS) and overall survival (mOS). Safety outcomes were treatment- (TRAEs) and immune-related adverse events (IRAEs). A random-effects meta-analysis was performed to pool medians and to derive event rates. Results A total of 15 studies were included with total of 1064 asMM patients. ORR and DCR were 16% and 57%, respectively. A pooled mPFS was 4.53 (CI: 3.40–5.65) and mOS was 10.51 (CI: 9.03-12.00). Overall TRAEs had an event rate of 0.69 (0.50–0.83) whereas IRAEs had an event rate of 0.28 (0.15–0.46). There were no significant differences between pembrolizumab, nivolumab primarily, and avelumab subgroups for all the outcomes. Additionally, meta-regression found no covariate to be a significant factor in ORR and DCR. Conclusion In this meta-analysis we found that anti-PD1/PD-L1 treatment could be useful in pretreated asMM as they had at least comparable or greater mPFS, mOS, ORR, and DCR than other second-line agents currently being used. Registration number This systematic review was registered at PROSPERO prior to the literature search, CRD42023442350.

Abstract Introduction Post stroke elbow spasticity (PSES) affects over a third of individuals following stroke and negatively impacts on functional recovery, comfort and quality of life. Drug therapies have limited efficacy and unwanted side effects, botulinum toxin, although effective, is costly, and conventional electrical stimulation therapies are limited long term by habituation. We aim to investigate the efficacy of Sheffield Adaptive Patterned Electrical Stimulation (SHAPES), that delivers temporally and spatially varying pattern of electrical stimulation, against transcutaneous electrical stimulation (TENS) and standard care at reducing PSES. Methods and design Overall, 297 people with PSES will be randomised (1:1:1) to one of 3 arms: Standard care (no electrical stimulation), TENS (conventional patterned electrical stimulation) or SHAPES (adaptive patterned electrical stimulation). Both SHAPES and TENS are delivered using a specially designed electrical stimulation sleeve used for 60 min each day for 6-weeks. Outcome measures are completed at baseline, end of treatment (EOT 6 weeks) and then 6-weeks, 12-weeks and 24-weeks after the end of treatment. Efficacy will be determined based on the proportion of participants experiencing meaningful improvement (18%) in the 7-day Numerical Rating Scale (NRS-S) for PSES, compared between both intervention arms and standard care, and between the two intervention groups. Measures of arm motor function (Action Research Arm Test, MRC scale), and quality of life (SQoL-6D, EQ-5D) will also be measured along with a parallel health economic evaluation. Discussion The results of the SHAPES trial will inform management of elbow spasticity after stroke. The SHAPES intervention is a low cost, self-administered intervention for the management of spasticity that can be used repeatedly, and if found to be more effective than TENS or control has the potential to be widely implemented in the UK NHS healthcare setting. Furthermore, despite the wide use of TENS in the management of spasticity, this study will provide critically required evidence regarding its efficacy. The trial has been registered with the ISRCTN registry (ISRCTN26060261).

In this work, a group of unmanned aerial vehicles (UAVs) is aimed to function as relay nodes that provide a multi-hop wireless link between ground users. The communication route between the sender and receiver is established with awareness of the link path loss between the cooperating UAV relay nodes. Then, Dijkstra’s shortest path algorithm is used to find the optimal route that has the minimum total path loss among all other possible routes. MATLAB simulation results show a high-performance gain when using Dijkstra’s algorithm for establishing the communication route compared with the baseline approach in which the route is formed based on the shortest-distance path through the UAV relay nodes. It is worth mentioning that both shadow fading and nonfading radio environments were taken into account. Moreover, the performance is further improved when the standard deviation of shadow fading increases. The work also investigates the probability of selecting each of the UAV nodes in forming the multi-hop link considering the total simulated realizations. Here, it is shown that more variability is observed in the indexes of the traversed UAV nodes when routeing through a random fading environment compared to a nonfading environment.