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Student performance is an important factor for the graduate career and it affects his future job. Many conditions can affect the student performance in the university such as the classroom, university infrastructure, the curriculum and the relationship between the teachers. This research paper aims to measure the effecting of classroom condition variables represented by noise, air quality, lighting, classroom weather, classroom size, and cleanness. The research model was tested using a questionnaire. A questionnaire was designed for this purpose and it has been distributed on one of the international universities settled in Egypt, a number of 274 students answered this questionnaire. The researchers used the Structured Equation modeling tests to examine the responses. Noise is the most important variable based on the results of the questionnaire. The results demonstrate that noise, classroom weather, classroom size and cleanness are significant in student performance, however air quality and lightning is not significant for the student performance.

Artificial intelligence (AI) is increasingly becoming integral to medical practice, potentially enhancing outcomes in thoracic surgery. AI-driven models have shown significant accuracy in diagnosing non-small-cell lung cancer (NSCLC), predicting lymph node metastasis, and aiding in the efficient extraction of electronic medical record (EMR) data. Moreover, AI applications in robotic-assisted thoracic surgery (RATS) and perioperative management reveal the potential to improve surgical precision, patient safety, and overall care efficiency. Despite these advancements, challenges such as data privacy, biases, and ethical concerns remain. This manuscript explores AI applications, particularly machine learning (ML) and natural language processing (NLP), in thoracic surgery, emphasizing their role in diagnosis and perioperative management. It also provides a comprehensive overview of the current state, benefits, and limitations of AI in thoracic surgery, highlighting future directions in the field.

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral pneumonia that can result in serious respiratory illness. It is associated with extensive systemic inflammation, changes to the lung extracellular matrix, and long-term lung impairment such as interstitial lung disease (ILD). In this study, the aim was to investigate whether tissue remodelling, wound healing, and neutrophil activity is altered in patients with COVID-19 and how these relate to the development of post-COVID ILD. Method Serum samples were collected from 63 patients three months after discharge as part of the Research Evaluation Alongside Clinical Treatment study in COVID-19 (REACT COVID-19), 10 of whom developed ILD, and 16 healthy controls. Samples were quantified using neo-epitope specific biomarkers reflecting tissue stiffness and formation (PC3X, PRO-C3, and PRO-C6), tissue degradation (C1M, C3M, and C6M), wound healing (PRO-FIB and X-FIB), and neutrophil activity (CPa9-HNE and ELP-3). Results Mean serum levels of PC3X (p

Abstract Background Despite the extensive research to provide a disease-modifying osteoarthritis drug (DMOAD), there is still no approved DMOAD. Dual amylin and calcitonin receptor agonists (DACRA) can provide metabolic benefits along with antinociceptive and potential structural preserving effects. In these studies, we tested a DACRA named KBP-336 on a metabolic model of OA in meniscectomised (MNX) rats. Methods We evaluated KBP-336’s effect on pain-like symptoms in Sprague Dawley (SD) rats on high-fat diet (HFD) that underwent meniscectomy using the von Frey test to measure the 50% paw withdrawal threshold (PWT) and analyzed using one-way ANOVA. Short in vivo studies and in vitro cell receptor expression systems were used to illustrate receptor pharmacology. Results After 30 weeks on HFD, including an 8-week treatment, female MNX animals receiving KBP-336 4.5 nmol/Kg/72 h had lower body weight and smaller adipose tissues than their vehicle-treated counterparts. After 20 weeks on HFD, including an 8-week treatment, male rats receiving KBP-336 had lower body weight than the vehicle group. In both the female and male rats, the MNX groups on KBP-336 treatment had a higher PWT than the vehicle-treated MNX group. Aiming to identify the receptor influencing pain alleviation, KBP-336 was compared to the long-acting human calcitonin (hCTA). Single-dose studies on 12-week-old male rats showed that hCTA lowers CTX-I without affecting food intake, confirming its calcitonin receptor selectivity. On the metabolic OA model with 18 weeks of HFD, including 6-week treatment, hCTA at 100 nmol/Kg/24 h and KBP-336 at 0.5, 1.5, and 4.5 nmol/Kg/72 h produced significantly higher PWT in MNX animals compared to MNX animals on vehicle treatment. hCTA and KBP-336 at 0.5 nmol/Kg did not affect body weight and fat tissues. Conclusion Overall, KBP-336 improved the pain observed in the metabolic OA model. Calcitonin receptor activation proved to be essential in this antinociceptive effect.

Introduction: Post-resuscitation care of cardiac arrest patients may be complicated by systemic inflammation elicited in response to whole-body ischaemia–reperfusion injury. We assessed the association between early WBC with one-year mortality in a large, unselected population of cardiac arrest patients. Methods: We collected a retrospective multicentre cohort of ICU-treated CA patients from the Finnish national ICU registry. We used locally estimated scatterplot smoothing (LOESS) curve to assess the association between the most abnormal WBC of the first 24 h in the ICU with the likelihood of death within a year. Multivariable logistic regression analyses were performed to assess the independent association between WBC and one-year mortality. In nested cohort analysis, we tested the association of delay from collapse to return of spontaneous circulation (ROSC) with WBC in linear regression models. Results: The LOESS curve was U-shaped, with the lowest predicted mortality at 7.5 109/L WBC. Based on this cut-off value, patients were divided into high (≥ 7.5 109/L) and low (< 7.5 109/L) WBC groups. In 4229 patients with high WBC, higher WBC was independently associated with increased one-year mortality (adjusted odds ratio (OR) 1.03 per 109/L, 95 % confidence interval (CI) 1.02–1.04, p

تمثل الهدف الرئيس لهذا البحث في دراسة وتحليل أثر استراتيجية الترويج بعناصرها (الإعلان، تنشيط المبيعات، الدعاية والنشر، البيع الشخصي، العلاقات العامة) على الأداء التسويقي، وذلك في عينة من الشركات الصناعية العاملة في سورية. استخدم الباحث المنهج الوصفي التحليلي، وقام بتوزيع (300) استبانة على عينة ميسرة من الأفراد العاملين في فروع الشركات الصناعية الآتية محلِّ الدِّراسة: شركة طوبى بلاست للصناعات البلاستيكية في دمشق، شركة الريم للمنتجات البلاستيكية في ريف دمشق، شركة المتين الدولية للصناعات البلاستيكية في حمص، وفي كافة المستويات الإدارية (الأعلى، الأوسط، والأدنى)، تم استرداد (285) استبانة، واستبعاد (5) استبانات منها لعدم استكمال بياناتها، وبذلك يكون عدد الاستبانات التي تم تفريغها (280) استبانة. قام الباحثان بتحليل البيانات باستخدام برنامج التحليل الإحصائي (SPSS 25). وفي نهاية هذا البحث توصَّل الباحث إلى مجموعة من الاستنتاجات وأهمّها: يوجد أثر معنوي لاستراتيجية الترويج بعناصرها (الإعلان، تنشيط المبيعات، الدعاية والنشر، البيع الشخصي، العلاقات العامة) على الأداء التسويقي في الشركات الصناعية العاملة في سورية. كما تقدَّم الباحث في نهاية البحث بمجموعة من التَّوصيات والَّتي كان أهمُّها: تحريك وعي الشركات الصناعية محل الدراسة بأهمية استراتيجية الترويج في تحسين الأداء التسويقي في جوانبه المختلفة، تدريب العاملين باستمرار على التطورات التي تطرأ في مجالي استراتيجية الترويج والأداء التسويقي، وضرورة إدخال ودعم روح الابتكار لدى العاملين وزيادة المخصصات المالية والاعتمادات الخاصة بالابتكارات الجديدة.

Objective To assess the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of single and multiple injections of M6495, a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS‐5) nanobody, in healthy volunteers and patients with osteoarthritis. Methods Two randomized, placebo‐controlled, double‐blind studies were performed. Study 1 enrolled 54 healthy male volunteers who received one subcutaneous (s.c.) injection of M6495 (1‐300 mg) or placebo (ratio 2:1), evaluating safety, PK, and PD as changes in the serum aggrecan fragment alanine‐arginine‐glycine‐serine (ARGS). Study 2 enrolled 32 patients with osteoarthritis with Kellgren–Lawrence grades 2 to 4 and pain greater than or equal to 40 on the Western Ontario and McMaster Universities Arthritis Index pain subscale at screening and evaluated the safety, PK, and PD of three doses every two weeks (75‐300 mg per dose) or six once‐weekly M6495 s.c. doses (300 mg) or placebo (ratio 3:1) over 106 days’ follow‐up. Results M6495 in single and multiple doses of less than or equal to 300 mg s.c. weekly was well tolerated with no clinically significant changes in any safety parameter. Adverse events more frequently reported in the M6495 groups were mostly mild cases of injection site reactions, myalgia, and nausea, which resolved after treatment cessation. The elimination half‐life of single s.c. doses of M6495 ranged from 79 to 267 hours. M6495 administration substantially reduced serum ARGS levels, indicative of target engagement and indicating disease‐modifying potential of M6495. Conclusion Treatment with M6495 in single and multiple doses up to and including 300 mg s.c. was found to be well tolerated and adequately safe for further clinical evaluation of potential disease‐modifying effects.

Abstract Background The incidence of Antimicrobial Resistance (AMR) in uropathogens varies between countries and over time. We aim to study the patterns and potential predictors of AMR among patients with UTIs admitted to the Urology Department at Alexandria University Hospital. Methods An observational retrospective record-based study was conducted on all patients admitted to the Urology department from October 2018 to October 2020. Data collected from patients’ records included: demographic data, diagnosis on admission, history of chronic diseases, duration of hospital stay, insertion of a urinary catheter, duration of the catheter in days, history of the use of antibiotics in the previous three months, and history of urinary tract operations. If UTI was documented, we abstracted data about urine culture, use of antibiotics, results of urine cultures, type of organism isolated, and sensitivity to antibiotics. We conducted a multivariable logistic regression model. We performed Classification and Regression Tree Analysis (CART) for predicting risk factors associated with drug resistance among patients with UTI. Data were analyzed using SPSS statistical package, Version 28.0, and R software (2022). Results This study encompassed 469 patients with UTIs. The most commonly isolated bacterium was Escherichia coli, followed by Klebsiella pneumoniae. Multidrug resistance (MDR) was found in 67.7% (149/220) of patients with hospital-acquired UTIs and in 49.4% (83/168) of patients with community-acquired UTIs. Risk factors independently associated with antimicrobial resistance according to logistic regression analysis were the use of antibiotics within three months (AOR = 5.2, 95% CI 2.19–12.31), hospital-acquired UTI (AOR = 5.7, 95% CI 3.06–10.76), diabetes mellitus (AOR = 3.8, 95% CI 1.24–11.84), age over 60 years (AOR = 2.9, 95% CI 1.27–6.72), and recurrent UTI (AOR = 2.6, 95% CI 1.08–6.20). Classification and regression tree (CART) analysis revealed that antibiotic use in the previous three months was the most significant predictor for developing drug resistance. Conclusion The study concluded a high level of antimicrobial resistance as well as significant MDR predictors among hospitalized patients with UTIs. It is vital to assess resistance patterns in our hospitals frequently to improve rational antibiotic treatment as well as to sustain antimicrobial stewardship programs and a rational strategy in the use of antibiotics. Empirical therapy for UTI treatment should be tailored to the potential pathogens’ susceptibility to ensure optimal treatment. Strategic antibiotic use is essential to prevent further AMR increases. Further research should focus on suggesting new biological systems or designed drugs to combat the resistance of UTI pathogens.

Objective Clinical observation suggests that vascular activation and autoimmunity precede remodelling of the extracellular matrix (ECM) in systemic sclerosis (SSc). We challenge this paradigm by hypothesising that ECM biomarkers are already disturbed in patients with very early SSc (veSSc) when fibrosis is not yet clinically detectable.Methods 42 patients with veSSc, defined as the presence of Raynaud’s phenomenon and at least one of puffy fingers, positive antinuclear antibodies or pathological nailfold capillaroscopy, not meeting the 2013 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for SSc, were compared with healthy controls (HCs, n=29). ECM degradation (BGM, C3M, C4M and C6M) and ECM formation biomarkers (PRO-C3, PRO-C4 and PRO-C5) were measured in serum using ELISAs. A cross-sectional analysis at baseline and a longitudinal analysis was performed.Results Compared with HC, veSSc patients showed a strongly dysregulated turnover of type III and IV collagens (higher C3M, C4M, both p