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Abstract Background Diurnal and nocturnal mammals have evolved distinct pathways to optimize survival for their chronotype-specific lifestyles. Conventional rodent models, being nocturnal, may not sufficiently recapitulate the biology of diurnal humans in health and disease. Although diurnal rodents are potentially advantageous for translational research, until recently, they have not been genetically tractable. The present study aims to address this major limitation by developing experimental procedures necessary for genome editing in a well-established diurnal rodent model, the Nile grass rat (Arvicanthis niloticus). Results A superovulation protocol was established, which yielded nearly 30 eggs per female grass rat. Fertilized eggs were cultured in a modified rat 1-cell embryo culture medium (mR1ECM), in which grass rat embryos developed from the 1-cell stage into blastocysts. A CRISPR-based approach was then used for gene editing in vivo and in vitro, targeting Retinoic acid-induced 1 (Rai1), the causal gene for Smith-Magenis Syndrome, a neurodevelopmental disorder. The CRISPR reagents were delivered in vivo by electroporation using an improved Genome-editing via Oviductal Nucleic Acids Delivery (i-GONAD) method. The in vivo approach produced several edited founder grass rats with Rai1 null mutations, which showed stable transmission of the targeted allele to the next generation. CRISPR reagents were also microinjected into 2-cell embryos in vitro. Large deletion of the Rai1 gene was confirmed in 70% of the embryos injected, demonstrating high-efficiency genome editing in vitro. Conclusion We have established a set of methods that enabled the first successful CRISPR-based genome editing in Nile grass rats. The methods developed will guide future genome editing of this and other diurnal rodent species, which will promote greater utility of these models in basic and translational research.

Abstract Mediastinal diffuse large B‐cell lymphoma (DLBC) may manifest in different presentations including systemic symptoms and local mass symptoms. We report two cases of diffuse large B‐cell lymphoma presenting with pulmonary artery compression symptoms. The first case is of a 38‐year‐old Asian man which mimicked pulmonary embolism, and the second one is of a 27‐year‐old Asian woman who presented with fainting and respiratory symptoms due to local mass effect. Both cases were significantly improved after treatment. Local mass effect symptoms may be the first clinical presentation in DLBC lymphoma and should not be overlooked.

The objective of the present investigation was to evaluate 135 sunflower germplasm accessions through Principal Component Analysis and Hierarchical cluster analysis to assess the extent of genetic diversity. The principal components with eigen values more than one i.e., PC1 and PC2 describes 38.3% and 21.24% respectively with a cumulative effect of 59.62% of the total variation. The biplot analysis revealed positive association of seed yield per plant for 100 seed weight, head diameter, days to 50% flowering and it was negatively associated with oil content. By using Wards method of clustering, 135 sunflower accessions were aggregated in 12 clusters based on different traits in which cluster VIII includes 30 accessions and is the largest one. The accessions in cluster IV, I and VI had maximum values for 100 seed weight, seed yield per plant and oil content, respectively. The germplasm accessions 213R, 121R, RHA-GPR-110, CMS-107B, IB-11-3, SCG-107, 132R, NGM-15 and OPH-123 were identified to be potential accessions and these can be used for improvement of yield and its attributing traits in sunflower.

Objectives To identify the prevalence and determinants of continued breastfeeding in Haitian children aged 12–23 months. Methods Three cross-sectional surveys were conducted yearly during the summers of 2017 to 2019 as part of a 4-year (2016–2020) multisectoral maternal and infant health initiative in the regions of Les Cayes, Jérémie, and Anse d’Hainault in Haiti. A total of 455 children 12–23 months of age and their mothers participated in the study. A child was considered to be continuing breastfeeding if the mother reported giving breast milk in the 24-hour dietary recall. Unadjusted and adjusted prevalence ratios were estimated, and associations were assessed between continued breastfeeding and explanatory factors related to sociodemographic characteristics, household food security, maternal nutrition, and breastfeeding knowledge and practices. Results The prevalence of continued breastfeeding was 45.8%. Continued breastfeeding was significantly more prevalent among younger children, children who did not have a younger sibling, children whose mother was not pregnant, those living in the Jérémie region, children who had been exclusively breastfed for less than 1 month, and children whose mother knew the World Health Organization’s recommendation for continued breastfeeding up to 2 years or beyond. Conclusions The study results highlight the need for geographically equitable access to tailored and adequate health services and education that support breastfeeding in a way that is compatible with the local context.

Abstract Purpose An elevated number of circulating neutrophils is a poor prognostic factor for breast cancer, where evidence of bone marrow cancer-dependent priming is found. However, how early this priming is detectable remains unclear. Patients and methods Here, we investigate changes in circulating neutrophils from newly diagnosed breast cancer patients before any therapeutic interventions. To do this, we assessed their lifespan and their broader intracellular kinase network activation states by using the Pamgene Kinome assay which measures the activity of neutrophil kinases. Results We found sub-type specific L-selectin (CD62L) changes in circulating neutrophils as well as perturbations in their overall global kinase activity. Strikingly, breast cancer patients of different subtypes (HR+, HER2+, triple negative) exhibited distinct neutrophil kinase activity patterns indicating that quantifiable perturbations can be detected in circulating neutrophils from early breast cancer patients, that are sensitive to both hormonal and HER-2 status. We also detected an increase in neutrophils lifespan in cancer patients, independently of tumour subtype. Conclusions Our results suggest that the tumour-specific kinase activation patterns in circulating neutrophils may be used in conjunction with other markers to identify patients with cancer from those harbouring only benign lesions of the breast. Given the important role neutrophil in breast cancer progression, the significance of this sub-type of specific priming warrants further investigation.

The notion of Roman {2}-domination was introduced in 2016 as a variant of Roman domination, a concept inspired by a defending strategy used by the emperor Constantine (272–337 AD) to protect the Roman Empire. Since then, a considerable number of papers on Roman {2}-domination and its variants have been published. In this paper, we survey published results on Roman {2}-domination as well as the main findings on Roman {2}-domination variants found in the literature. A list of open problems related to this notion and its variants are also given.

حدث تقارب لغوي وحضاريّ بين اللغة العربيّة وغيرها من اللغات الأخرى التي وفدت إليها من الحضارات التي كانت تحيط بجزيرة العرب، فدخلت الألفاظ الفارسيّة والسّريانيّة والعبريّة إلى اللغة العربيّة، ومنها ما حافظ على دلالته، وبعضها أخذت دلالات مختلفة في لغة العرب، ولبيان ذلك جاء هذا البحث لبيان دلالة الألفاظ المعرّبة في المعجم الوسيط ، فتوزّع البحث في مقدّمة، وجانب نظريّ وآخر تطبيقيّ، تحدّثت في الجانب النّظري عن تعريف المعرّب والدّوافع التي أدّت إلى وجوده في اللغة العربيّة، وفي الجانب التّطبيقيّ تخيّرت عدّداً من الألفاظ المعرّبة وبيّنت دلالتها في المعاجم اللغويّة إلى جانب المعجم الوسيط، وكذلك ما ساقته كتب المعرّب حول هذه الألفاظ من معانٍ، وانتهى البحث بخاتمة وثبت للمصادر والمراجع.

لكلّ تركيب خصوصيّته في إبداعات الشّعراء، ولاسيّما أنّ هذه التّراكيب تُبنى بلغة شعريّة يحطّم بوساطتها الشّاعرُ اللغة المعياريّة؛ لينسج نظماً جديداً له أثره في القارئ. والشّاعر البهاء زهير شاعرٌ أجاد نظم تراكيبه الشّعريّة، وأراد أن يخرق المستوى المعياريّ للوصول إلى شعريّة خاصّة يُحقّقها الانزياح عن القواعد اللغويّة الجامدة، ففي كلّ انزياح تركيبي تخلق دلالة جديدة، ومع كلّ دلالة يصبح المتن الشّعريّ نابضاً بالإبداع والعمق الشّعوريّ، ولجأ الشّاعر إلى مفاصل التّراكيب، وقام بالنّظم وفقاً لمستويات إبداعيّة مميّزة؛ إذ حاول الوصول إلى دلالات جديدة عبر تغيير رتب أجزاء تلك التّراكيب، فلجأ إلى التّقديم والتّأخير، ونوّع في مستوياته، بدءاً من تقديم الخبر على المبتدأ، مروراً بتقديم الفضلات والمتمِّمات على الأجزاء الإسناديّة، وأيضاً تقديم الفاعل على فعله، وأشباه الجُمل على المفاعيل، وكلّ ذلك لم يكن اعتباطياً، بل كان انزياحاً قصدياً للرُّتب التّركيبيّة. ونوّع الشّاعر البهاء زهير في المستويات التّغييرية في الرّتب، فقدّم وأخّر في التّراكيب الاسميّة والفعليّة، وكان لكلّ نوعٍ من تلك الخروقات الرّتبية شفافيّة خاصّة في الدّلالة على المعنى.

The interplay between genetic and environmental factors plays a significant role in interindividual variation in immune and inflammatory responses. The availability of high-throughput low-cost genotyping and next-generation sequencing has revolutionized our ability to identify human genetic variation and understand how this varies within and between populations, and the relationship with disease. In this review, we explore the potential of genomics for patient benefit, specifically in the diagnosis, prognosis and treatment of inflammatory and immune-related diseases. We summarize the knowledge arising from genetic and functional genomic approaches, and the opportunity for personalized medicine. The review covers applications in infectious diseases, rare immunodeficiencies and autoimmune diseases, illustrating advances in diagnosis and understanding risk including use of polygenic risk scores. We further explore the application for patient stratification and drug target prioritization. The review highlights a key challenge to the field arising from the lack of sufficient representation of genetically diverse populations in genomic studies. This currently limits the clinical utility of genetic-based diagnostic and risk-based applications in non-Caucasian populations. We highlight current genome projects, initiatives and biobanks from diverse populations and how this is being used to improve healthcare globally by improving our understanding of genetic susceptibility to diseases and regional pathogens such as malaria and tuberculosis. Future directions and opportunities for personalized medicine and wider application of genomics in health care are described, for the benefit of individual patients and populations worldwide.

Aim: This study aimed to assess the prevalence and patterns of COVID-19 vaccine side effects among Syrian adults, with a focus on the AstraZeneca and Sputnik Light vaccines, in light of the low vaccination rate in Syria (below 18%) attributed to fear of side effects. Method: A cross-sectional study was conducted between January and May 2022, using probability-based and convenient sampling strategies. Data was collected through online, paper, and face-to-face questionnaires that included demographic and vaccine-related questions. Result: Out of 3,766 participants, the majority were female (56.7 %) and aged 18–24 years (53.3 %). Most participants had a university-level qualification (71.2 %) and were related to the medical sector (53.2 %). A significant proportion (47.0 %) received AstraZeneca, Sputnik Light (22.1 %) and Sinopharm (14.7 %). Common side effects included sleepiness and lethargy (50.0 %), fever and chills (45.0 %), and pain/swelling at the injection site (35.9 %). Multivariate logistic regression analysis revealed that male (OR: 0.57, CI: 0.48–0.68) and participants aged 45–65 years (OR: 0.53, CI: 0.40–0.70) were less likely to experience side effects. Participants who believed COVID-19 posed a high threat to their personal life had higher odds of side effects (OR: 1.74, CI: 1.22–2.46). Vaccine type was also associated with side effects, with Sputnik Light (OR: 2.52, CI: 1.85–3.46) and AstraZeneca (OR: 1.61, CI: 1.26–2.05) having increased odds. Conclusion: Our study found that COVID-19 vaccines are well tolerated among the Syrian population, with short-term side effects that typically resolve within three days. These findings are expected to bolster vaccination rates through enhanced public confidence and acceptance.

A vertex-edge perfect Roman dominating function on a graph $ G = (V, E) $ (denoted by ve-PRDF) is a function $ f:V\left(G\right)\longrightarrow\{0, 1, 2\} $ such that for every edge $ uv\in E $, $ \max\{f(u), f(v)\}\neq0 $, or $ u $ is adjacent to exactly one neighbor $ w $ such that $ f(w) = 2 $, or $ v $ is adjacent to exactly one neighbor $ w $ such that $ f(w) = 2 $. The weight of a ve-PRDF on $ G $ is the sum $ w(f) = \sum_{v\in V}f(v) $. The vertex-edge perfect Roman domination number of $ G $ (denoted by $ \gamma_{veR}^{p}(G) $) is the minimum weight of a ve-PRDF on $ G $. In this paper, we first show that vertex-edge perfect Roman dominating is NP-complete for bipartite graphs. Also, for a tree $ T $, we give upper and lower bounds for $ \gamma_{veR}^{p}(T) $ in terms of the order $ n $, $ l $ leaves and $ s $ support vertices. Lastly, we determine $ \gamma_{veR}^{p}(G) $ for Petersen, cycle and Flower snark graphs.

Abstract Background Changes in microbial community composition as a function of human health and disease states have sparked remarkable interest in the human gut microbiome. However, establishing reproducible insights into the determinants of microbial succession in disease has been a formidable challenge. Results Here we use fecal microbiota transplantation (FMT) as an in natura experimental model to investigate the association between metabolic independence and resilience in stressed gut environments. Our genome-resolved metagenomics survey suggests that FMT serves as an environmental filter that favors populations with higher metabolic independence, the genomes of which encode complete metabolic modules to synthesize critical metabolites, including amino acids, nucleotides, and vitamins. Interestingly, we observe higher completion of the same biosynthetic pathways in microbes enriched in IBD patients. Conclusions These observations suggest a general mechanism that underlies changes in diversity in perturbed gut environments and reveal taxon-independent markers of “dysbiosis” that may explain why widespread yet typically low-abundance members of healthy gut microbiomes can dominate under inflammatory conditions without any causal association with disease.

This study investigates the change that occurs for atherogenic index of plasma (AIP) which is a very good marker for the evaluation of the risk of atherogenicity and cardiometabolic health. This study indicates the logarithm of the triglyceride and high-density lipoprotein cholesterol (log [TG/HDL-c]). The parameters of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) are estimated and compared with the control cases. The AIP is calculated for each case during pregnancy in first, second, and third trimesters separately and each is compared with control cases. The study population comprised (80) women aged between (20–40) years distributed to (20) healthy non-pregnant women, (20) in the first trimester, (20) in the second trimester, and (20) in the third trimester in Koya health centers. The results of this study showed a significant increase in the TG level in both the second and third trimesters of pregnancy compared to the control cases. Whereas, in the first trimester of pregnancy, it can be assumed that there is a non-significant decrease of TG level rather than control cases. As well as the serum levels of HDL for all three trimesters of pregnancy displayed non-significant changes when compared to non-pregnant cases. These data illustrate that the AIP levels during both the second and third trimesters of pregnancy are significantly higher, as compared to control cases, whereas the AIP levels in the first trimester are non-significantly elevated, as compared with control cases

Introduction: N-acetylcysteine (NAC) is the first-line treatment for acetaminophen (APAP) overdose. However, using NAC inappropriately is associated with an increased risk of adverse effects as well as a substantial increase in hospitalization and healthcare costs. This study aims to assess NAC utilization for acute APAP overdose in the emergency department of a community teaching hospital in Saudi Arabia. Methods: A retrospective chart review in which the patients initiated on an NAC secondary to acute APAP overdose at KSUMC during the period of June 2015 till November 2018 were included and assessed based on developed validated evident-based protocol for administering NAC for acute APAP ingestion. Results: A total of 29 patients received NAC treatment for acute APAP overdose; 15 of which were adults, and 14 were pediatrics. Appropriate prescribing of NAC was observed in 14 (48.28%) patients, whereas NAC was inappropriately indicated for 15 (51.72%) patients; 9 of them were adults and 6 patients were pediatric. APAP-Ingestion

Background: Tumor lysis syndrome (TLS) is a well-recognized medical emergency in patients with cancer diagnosis. The diagnostic criteria of TLS have been revised many times since it was recognized, but still have many drawbacks that limit diagnosis accuracy. Summary: Autopsy studies in patients with perimortem diagnoses of TLS have shown that they may not have actually had TLS. Therefore, in many cancer patients who are at risk for TLS, clinical and laboratory criteria may be fulfilled due to other causes of acute kidney injury. In this review, we aimed to cast a spotlight on the shortcomings and pitfalls of the current diagnostic criteria for TLS, and propose a roadmap for developing more rigorous criteria that improve on the diagnostic accuracy. Key Messages: Causes of AKI in patients with cancer other than TLS should be considered. Because current diagnostic criteria may miss those differential diagnosis, specific biomarkers that can tell when TLS is the underlying process are an important need, besides appropriate criteria that can jump over the pitfalls in the current criteria and enhance the recognition of TLS among other causes.

Background: Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) have an increased risk of developing colorectal neoplasia (CRN) in the proximal colon. Objectives: To evaluate whether duration and severity of inflammation are linked to the development of CRN in this population. Design: Retrospective, case–control chart review of patients with PSC and IBD at a tertiary care center. Methods: Disease activity was scored per colonic segment at each colonoscopy prior to the first instance of observed CRN using a modified Mayo endoscopic sub-score and histologic assessment. Patients in the CRN-positive group were compared to controls that did not. Results: In all, 72 PSC-IBD patients with no history of CRN were identified, 13 of whom developed CRN after at least one colonoscopy at our institution. Patients in the CRN-positive group had significantly more endoscopic ( p

Abstract Background and Aims Despite the significant milestone of vaccine discovery, the spread of misinformation and pseudoscientific claims has resulted in an increasing number of people refusing vaccination in Syria. In this study, we aimed to explore fears and misconceptions towards COVID‐19 vaccines among the Syrian population. Methods We conducted a nationwide cross‐sectional study between January and May 2022, using a convenience sample of 10,006 participants aged at least 18 years and living in Syria. We administered a validated online/paper questionnaire and conducted face‐to‐face interviews. We used SPSS software (version 26) for statistical analysis, assessing our data using frequency and χ2 tests, with p

In the context of the massive refugee influx from Ukraine to its European neighbouring states over the last months, this update reflects on the experiences of two international exchanges led by HOUSE-IN: a JPI Urban Europe-funded project that deals with challenges at the housing-integration nexus. The exchanges revealed the impacts of this forced migration at the intersection of housing and integration in several European cities. The update analyses the civic and temporal nature of responses to this refugee movement, which have challenged major assumptions about practices of settling and integration under uncertainties of war, as well as those around access to housing and support.

Testicular cancers comprise 1–1.5% of entire cancers in men, and sex cord-stromal tumors include 5% of testicular cancers. This study aims to report a simultaneous Sertoli cell-only syndrome and Leydig cell tumor in the same patient. A 32-year-old man presented with a history of primary infertility for 3 years. Physical examination revealed normal secondary sexual characteristics. Two successive seminal fluid analyses revealed azoospermia. A scrotal ultrasound scan showed a 28 × 27 mm hypoechoic and hypervascular right testicular mass. Right radical orchiectomy and simultaneous left testicular biopsy were conducted. The histopathological examination revealed Sertoli cell-only syndrome and Leydig cell tumor with focal Leydig cell hyperplasia. Reversing fertility following the management of Leydig cell tumor is rarely mentioned in the literature. A study revealed that fertility recovered following 4 months of management in a primary infertile male. However, infertile men with nonobstructive azoospermia due to SCOS can only have a child by testicular sperm extraction technique. Despite the rare occurrence of Leydig cell tumor, it could be seen in association with Sertoli cell-only syndrome in infertile men with azoospermia. Clinical examination and imaging studies are important in these patients as the possibility of having a testicular mass is high among them.

Purpose: Despite the effectiveness of androgen deprivation therapy in advanced prostate cancer, serious neuropsychiatric consequences in androgen deprivation therapy (ADT)-treated patients, mainly depression, have been concerning and gained more attention recently. This narrative review aims to shed light on the risk and pharmacological management of ADT-induced depression in PCa patients. Methods: We searched PubMed, Scopus and Google Scholar databases using MESH keywords “Prostate cancer OR prostate neoplasm” AND “Depression” AND “Androgen Deprivation Therapy” AND “antidepressants”. Search was limited to English and studies conducted on humans. Studies’ titles and abstracts were screened, and further information were obtained from the text, if necessary, to decide whether studies are to be included in this review. Results: Our review revealed 23 studies confirming the occurrence and worsening of depressive symptoms in ADT-treated patients, which frequently require pharmacological interventions; whereas 10 studies indicated otherwise. All studies were prospective, retrospective, cross-sectional or case reports. Based on the incidence of depression provided by the observational studies, the average among ADT-treated patients was 18.23% (range: 2.1–46.9%), while it was 8.42% (range: 1.4–23.3%) in the non-ADT patients. Although several treatments have been used for depression in cancer patients, current knowledge lacks observational and controlled studies as well as clinical guidelines that demonstrate efficacy and safety of antidepressants and guide clinicians to the appropriate treatment in these patients, respectively. On the other side, a few clinical studies have been published regarding the efficacy of selective serotonin reuptake inhibitors, selective serotonin and norepinephrine reuptake inhibitors and/or saftey on other ADT associated adverse effects. Conclusions: Our work supports the recent attention towards mood issues as an adverse effect of ADT, and that greater awareness of this is warranted among clinicians. Clinical studies published regarding the use of antidepressants for other ADT associated adverse effects established the foundation that can be adopted to examine these therapies on ADT-induced depression.

Abstract Objective To assess the effect of cardiac surgery on growth catch-up of Down syndrome (DS) children with failure to thrive (FTT) and congenital heart disease (CHD) and investigate other causes of FTT in DS children. Method We conducted a retrospective observational study in tertiary cardiac center from 2015 to 2018. We included all cases of DS diagnosed with CHD and FTT who completed a 1-year follow-up after cardiac surgery. We divided the cases into two groups; “normalize group” includes children who normalized their growth parameters and “underweight group” includes those who remained in FTT category during the follow-up period. We compared both groups for multiple risk factors. Result Most of DS had FTT upon surgery. Fifty percent of cases completed 1-year follow-up including 29 (60%) in the normalized group and 19 (40%) in underweight group. Within 6 months post-surgery, the normalized group though did not reach yet normalization of growth parameters, demonstrated statically significant improvement in weight for age, weight Z-score in compared to underweight group. Within 12 months post-surgery, the normalized group achieved normalization of growth parameters and continue to show more statistically significant differences in growth parameters. Both groups had comparable post-operation course. Univariate analysis of possible peri-operative risk factors showed no difference between both groups except for presence of untreated subclinical hypothyroidism in 58% of the underweight group versus 17% in control group (p = 0.005). Conclusion FTT in DS patient is multifactorial which needs thorough investigation and work up by multidisciplinary team. Cardiac surgery may not guarantee the improvement of growth parameters.

Abstract Background Recent studies show an increase in the prevalence of iron deficiency anemia (IDA) worldwide and a concomitant rise in the number of revision total knee arthroplasty (RTKA). The literature evaluating the association between IDA and perioperative outcomes following RTKA are limited. Therefore, the purpose of this study was to determine whether IDA patients undergoing RTKA have higher rates of (1) in-hospital lengths of stay (LOS), (2) complications; and (3) costs. Methods Using International Classification of Disease, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT), a retrospective query was performed from January 1st, 2005 to March 31st, 2014. The inclusion criteria consisted of those patients who have IDA undergoing RTKA. Study group patients were 1:5 ratio matched to a comparison cohort by age, sex, and various comorbidities: coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus, hyperlipidemia, hypertension, obesity, and tobacco use, yielding a total of 106,534 patients within the study (n = 17,784) and control (n = 88,750) cohorts. Outcomes assessed included: in-hospital LOS, costs of care, and medical complications. Multivariate Logistic regression analyses were used to calculate the odds-ratios (OR) and respective 95% confidence intervals (95%CI). Welch’s t-tests were used to compare in-hospital LOS and costs of care. Following Bonferroni-correction, a P-value less than 0.001 was considered statistically significant. Results IDA patients undergoing RTKA were found to have significantly higher in-hospital LOS (4-days vs. 3-days, P

Objective. To identify the determinants of exclusive breastfeeding (EBF) among children under 6 months of age from three regions in the South and GrandAnse Departments of Haiti. Methods. Data were pooled from three cross-sectional surveys conducted yearly from 2017 to 2019 with the guardians of 638 children under 6 months of age. A non-quantitative 24-hour dietary recall was used to assess EBF the day before the survey. Using unadjusted and adjusted prevalence ratios, associations were assessed between EBF and several explanatory factors: infants age and sex; maternal age, educational attainment, mid-upper arm circumference (MUAC), dietary diversity, number of children under 5 years of age, responsibility for the main or secondary source of income of the household, initiation of breastfeeding within one hour, knowledge of EBF duration; household severe food insecurity, socioeconomic status, dependency ratio, region, and residential zone (urban/rural). Results. Prevalence of EBF was 68% in the study sample. From the fully adjusted model, prevalence of EBF was statistically significantly higher among younger infants, mothers with larger MUAC, who met or exceeded Minimum Dietary Diversity for Women (MDD-W), who initiated breastfeeding within one hour, who were knowledgeable of the recommendations for EBF duration, and living in the Jérémie region. Conclusions. The main determinants of EBF identified in this study attest to the importance of breastfeeding mothers access to nutritious food for the practice and maintenance of EBF and the need for geographically equitable access to health services and education that support breastfeeding.

In this study a new Series of aromatic heterocyclic [1, 3]-oxazepine have been synthesized by two steps. The first-step included synthesis of imine derivatives (1–7) using glacial acetic acid as a catalyst in the condensation reaction of 4-(6-methylbenzothiazol-2-yl)aniline with various substituted aromatic aldehydes. While in a second step, a series of seven-membered heterocyclic ring derivatives (8-14) obtained from Schiff base derivatives with phathalic anhydride in dry benzene. A variety of experimental techniques were used to characterize the new derivatives, including melting point, FT-IR, 1H-NMR, and 13C-NMR. Finally, the synthesized compounds were screened against two types of bacteria both Staphylococcus aureus Gram (+ve) and Escherichia coli Gram (-ve) microorganisms. The results revealed that slightly active to good active against both types of test organisms of bacteria.

Introduction Devastating cancer-related events are not uncommon, and these events have weakened communication performance and induced stress among health care providers (HCPs), particularly physicians. This study aimed to investigate the perspective of HCPs emotionally affected by poor clinical outcomes due to the failure of cancer therapy. Methods A cross-sectional, online survey was conducted over 3 months among HCPs practicing in the field of oncology in Saudi Arabia, comprising physicians, pharmacists, and nurses. Data were analyzed using Statistical Package for Social Sciences version 26.0. A P -value

Polymeric hydrogels are a complex class of materials with one common feature—the ability to form three-dimensional networks capable of imbibing large amounts of water or biological fluids without being dissolved, acting as self-sustained containers for various purposes, including pharmaceutical and biomedical applications. Transdermal pharmaceutical microneedles are a pain-free drug delivery system that continues on the path to widespread adoption—regulatory guidelines are on the horizon, and investments in the field continue to grow annually. Recently, hydrogels have generated interest in the field of transdermal microneedles due to their tunable properties, allowing them to be exploited as delivery systems and extraction tools. As hydrogel microneedles are a new emerging technology, their fabrication faces various challenges that must be resolved for them to redeem themselves as a viable pharmaceutical option. This article discusses hydrogel microneedles from a material perspective, regardless of their mechanism of action. It cites the recent advances in their formulation, presents relevant fabrication and characterization methods, and discusses manufacturing and regulatory challenges facing these emerging technologies before their approval.

Deaf people have hearing loss from mild to very severe. Such people have difficulty processing language information both with and without hearing aids. Deaf people who do not use hearing aids use sign language in their everyday conversations. At the same time, it is difficult for general people to communicate with the deaf, so in order to communicate with the deaf they must know sign language. There are two sign languages in Indonesia, namely SIBI (Indonesian Sign Language System) and BISINDO (Indonesian Sign Language). To help with communication between deaf and normal people, we developed a model using the one-handed SIBI method as an example, and then further developed it using the one-handed and two-handed BISINDO. The main function of the method is the recognition of basic letters, words, sentences and numbers using a Raspberry Pi single-board computer and a camera which are designed to detect the movements of language gestures. With the help of a special program, images are translated into text on the monitor screen. The method used is image processing and machine learning using the Python programming language and Convolutional Neural Network techniques. The device prototype issues a warning to repeat the sign language if the translation fails, and delete the translation if it doesn’t match the database. The prototype of the device requires further development providing its flexibility: to provide reading of dynamic movements, facial expressions, to provide translation of words not included in the existing database. You need to add a database other than SIBI, such as BISINDO, or sign languages from other regions or countries.

Abstract Background Dependent adults have been shown to have a greater experience of oral health deterioration and orofacial pain. This is partly because their non-dental caregivers may not easily identify oral health problems and orofacial pain experienced by them. Thus, this systematic review aimed to investigate measurement properties, interpretability and feasibility of instruments assessing oral health and orofacial pain in dependent adults, which can be used by the non-dental caregivers to establish oral care plans for those who are dependent upon them. Methods Seven bibliographic databases were searched: MEDLINE, Embase, CINAHL, CENTRAL, HTA, OATD and OpenGrey. Citations and reference lists of the included studies were also manually searched. Two authors independently screened titles and abstracts, and then full texts. A quality assessment of included studies was conducted independently by two authors using the COSMIN Risk of Bias checklist. The best evidence synthesis method was used to synthesise results from different studies for each measurement property per measurement instrument by integrating the overall rating for each measurement property per measurement instrument with its quality level of evidence. Results Nineteen eligible studies were included, which reported the development, measurement properties’ evaluation, interpretability and feasibility of nine oral health and three orofacial pain measurement instruments. Methodological quality of the included studies ranged from very good to inadequate. None of the identified measurement instruments has been adequately and comprehensively tested. Conclusions While several measurement instruments were identified in this systematic review, more evidence is needed to be able to more comprehensively evaluate these instruments. Among those identified, the OPS-NVI demonstrated sufficient construct validity, while the OHAT and the THROAT demonstrated sufficient reliability. These instruments therefore have potential for future use with more confidence once other measurement properties, interpretability and feasibility have been sufficiently tested and evaluated.

تعالج هذه الدّراسة مسألة معجمة المتجانس اللّفظي في المعجم الوسيط, وتسعى إلى وضع مقاربة نظريّة, وإجراء تطبيقيّ. وفي المجال النّظريّ تنشط الدّراسة في التّعريف بمفهوم الهمونيمي الغربي, وإيجاد مقابل عربي مناسب له, وتمييزه عن المصطلح الآخر المستقر في الدّراسات اللّسانيّة العربيّة, وهو المشترك اللفظي. كما تعمل الدّراسة على إيجاد فروقات بين المصطلحين: المتجانس اللّفظي, والمشترك اللفظي, ووضع معايير وقواعد تميّز بينهما. وتركّز المقاربة التّطبيقيّة على بناء النّصّ المعجمي في المعجم الوسيط بخاصّة؛ هدفها وصف واقع المعجم اللّغويّ العربي؛ سعياً إلى تطويره, وحلّ إشكالياته, خاصّةً ما يتعلّق بالتّمييز بين الدّلالات التي لها دوال مشتركة, بيد أنّها قد لا تكون من أصل اشتقاقي واحد, وبالتّالي هي من المتجانس اللّفظي الذي يجب أن ينفرد بمدخلين مستقلين. وختاماً تصل إلى نتائج قد تساعد مستقبلاً صنّاع المعجم اللّغوي في التّخطيط لبناء معجم لغويّ عربيّ ملتزم بأحدث معايير المعجميّة الدّوليّة.

Diet is a contributor to the pathogenesis of many non-communicable diseases. Among contributors to poor diet is high added sugar consumption, which is unfortunately on the rise nowadays. The recommended sugar intake by The American Heart Association (AHA) is 24g/day and 36g/day for women and men, respectively. The study's aim is to assess added sugar intake among adults in Saudi Arabia. A cross-sectional study design was used via an online survey among adults in Saudi Arabia using convenience sampling, and social media platforms were used to collect the data. The authors conducted descriptive statistics to present demographic variables using Chi-square χ2 tests for categorical and t-tests for continuous variables. All statistical tests used a 95% confidence interval with a two-sided P-value 60. Equivalently, there was a statistically significant difference in means of added sugar intake food across gender (P-value 0.008). Females tended to consume more added sugar in their food than males. The highest consumption was in the Northern region (123.71 g/day), followed by the Southern region (98.52 g/day), the Western region (86.14 g/day), and lastly, the Central and Eastern regions (66.95 and 62.02 g/day, respectively). The total added sugar intake of added sugar is extremely high in Saudi Arabia. Poor dietary habits lead to many adverse health consequences, including obesity and diabetes. Healthcare providers and public health officials are highly encouraged to shed light on added sugar consumption and create opportunities to promote healthy dietary patterns. The Saudi population is recommended to abide by the added sugar dietary recommendations to avoid future chronic medical conditions.

This paper is concerned with the Orthogonal Frequency Division Multiplexing (OFDM) system that is adopted by a wireless communication system for transmitting multicarrier modulated signals simultaneously with robustness against interference and noise facing the system. It presents a significant issue related to the OFDM system known as the raise of Peak to Average Power Ratio (PAPR) that is the high peaks of OFDM signals compared to its average power. Increasing the PAPR yields in the component devices of the OFDM system does not cope with the high peaks resulting in distortion and signal losses. Therefore, the objective of this article is to review different approaches of PAPR reduction techniques and compare them to select the best technique for a particular system. The approaches are mainly of three classifications; distortion, probabilistic, and coding schemes with each including several techniques.

Keberadaan tanaman sebagai makhluk hidup sangat penting bagi kehidupan manusia. Tanaman bertahan hidup dengan memanfaatkan air. Proses penyiraman tanaman yang tidak terkontrol dapat berakibat buruk pada kelangsungan hidupnya. Serta proses penyiraman yang dilakukan secara manual sangat tidak efisien karena pemilik harus berada dalam satu tempat dengan tanaman miliknya. Tujuan dari penelitian ini adalah untuk merancang aplikasi pengontrol sistem penyiraman tanaman otomatis yang berbasis android dan arduino supaya dapat digunakan secara mobilitas. Aplikasi dirancang dengan metode SDLC waterfall menggunakan toolkit milik Flutter dengan bahasa perogaman dart. Sedangkan perancangan sistem menggunakan software Arduino IDE. Hasil dari penelitian ini berupa aplikasi android yang dapat memonitor nilai kelembapan tanah pada tanaman dalam satuan waktu dan tombol on/off yang dapat menghidupkan dan mematikan pompa air penyiram tanaman. Pengguna dapat melihat nilai kelembapan tanah secara realtime melalui aplikasi android dengan menggunakan koneksi internet. Penggunaan ini menggunakan server firebase sebagai database dengan memanfaatkan fitur realtime firebase database milik server firebase. Sistem dan aplikasi yang telah dirancang diuji kegunaannya dengan pengujian terakhir aplikasi menggunakan usability testing. Hasil dari survey pada usability testing mendapatkan hasil bahawa aplikasi berfungsi sebagaimana semestinya dan mendapat kategori “Sangat Baik” sebesar 94,44% dari responden.

Gluten peptides from wheat enter the bloodstream and are excreted in urine but are yet to be chemically characterised. Here, the authors show by mass spectrometry that quantitative and qualitative differences in urinary peptides can be detected between healthy people and patients with celiac disease.

Background: Oldest-old population is rapidly increasing in all countries, with many prescribed statin therapy. Statins are associated with multiple cardiovascular benefits at various ages. The benefits of statins above the age of 75 are being questioned. The objective of this study was to measure statins use among the oldest-old population, aged 80 years and above, and to study the effect of statins on cognitive function, depression, and quality of sleep. Materials and Methods: This cross-sectional study randomly enrolled 200 community-dwelling individuals aged >80 years. Data were collected upon home visits on sociodemographic, cognitive functions, depression, sleep, chronic diseases, functional limitations, and disabilities. Cognitive function (Mini Mental State Examination), depression (Geriatric Depression Scale), and quality of sleep (Pittsburgh Sleep Quality Index) among individuals using statins versus not using statins were compared. Chi-square test and t-test were done; odds ratios (ORs) with 95% confidence interval (95% CI) were reported. Logistic regression was done to calculate adjusted OR with age, antidepressants, sedatives, antihistaminics, and sleep medicines. P < 0.05 was considered statistically significant. Results: Overall prevalence of statin use in our study population was 12%; 11.3% in women and 13.2% in men. Cognitive functions, depression, and quality of sleep improved among those using statins (P < 0.05): cognitive impairment – OR: 0.38; 95% CI: 0.16–0.91; depression – OR: 0.41; 95% CI: 0.17–1.02, and poor sleep quality – OR: 0.39; 95% CI: 0.16–0.96. On stratification by gender, men showed a significant association of improved cognitive function and quality of sleep with the use of statins, whereas women did not show any significant associations with cognitive function and quality of sleep but showed almost significant association with improvement in depression. Conclusions: The prevalence of the use of statins was low in our population. Statins had positive effects on cognitive functions, quality of sleep, and depression over 80 years of age in our population, although gender difference exists.

Sistem jimpitan desa adalah salah satu penerapan teknologi informasi yang mempermudah pengambilan uang dari satu rumah warga ke rumah warga yang lain. Selama ini sistem yang dijalankan dalam suatu desa masih menggunakan sistem manual seperti meletakkan uang di dalam wadah plastik kemudian petugas desa akan mengambilnya. Oleh karena itu, diperlukan sebuah sistem jimpitan dengan tujuan untuk memudahkan petugas dalam pendataan jimpitan yang berbasis Quick Response Code (QR Code). Tugas akhir ini menggunkan metode Waterfall salah satu dari metode Developing Life Cycle (SDLC) dengan menggunakan bahasa pemrograman Codeigniter. basisdata MySQL, dan laptop sebagai hardwarenya. Hasil yang diperoleh yaitu sistem jimpitan yang dirancang untuk layanan publik dan memiliki fitur scan QR Code, pengelolaan data, dan menyajikan laporan keuangan jimpitan yang dapat dipertanggungjawabkan. Pengujian sistem jimpitan mengunakan teknik Blackbox yang mampu menghasilkan nilai 96% di dapat melalui presentase seluruh jawaban responden. Kesimpulan dari penelitian ini adalah dengan adanya sistem jimpitan diharapkan mampu meningkatkan produktiftas desa. Digitizing the jimpitan system in Dukuh Ngluwar, Tepisari Village Abstract Village pinch system is one application of information technology that makes it easy to withdraw money from one resident's house to another resident's home. During this time, the system that is run in a village is still using a manual system such as putting money in plastic containers, and then village officials will take it. Therefore, it requires a pinch system to facilitate the officer in the data collection of the pinch-based Quick Response Code (QR Code). This final project uses the Developing Life Cycle (SDLC) method, Code Igniter programming language, MySQL for database loading, and laptop hardware. The results obtained are a pinch system which is designed for public service and has a QR Code scan feature, data management, and presents a financial report on the pinch that can be accounted for. Testing the jimpitan system using the Blackbox technique, which can produce 96%, can be done through the presentation of all respondents' answers. This study concludes that the existence of a Jimpitan system is expected to improve village productivity.

The current study involves synthesis and characterization of a new family of tetrazole derivatives. The synthetic pathway includes two steps, as described here: Initial step was synthesis of N-(4-(6-methylbenzothiazol-2-yl) phenyl)-1-(substituted phenyl)methanimine (1-7), via the reaction of 4-(6-methylbenzothiazol-2-yl)aniline with a variety of substituted benzaldehydes in absolute ethanol utilizing glacial acetic acid as catalyst. The next step was synthesis of tetrazole derivatives (8-14) by the reaction of the synthesized imines (1-7) with sodium azide in dry dioxane. Spectroscopic methods (FT-IR, 1H-NMR and 13C-NMR) were used to determine the structures of the produced products. The synthesized compounds were tested for antibacterial activity against two types of bacteria Staphylococcus aureus (Gram +ve) and Escherichia coli (Gram -ve). The results showed good activities against both types of bacteria.

# Background Global recommendations for optimal breastfeeding include early initiation, exclusivity for six months, and continued breastfeeding for two years and beyond. Although breastfeeding is near universal in Haiti, gaps in optimal practices persist. Determinants of breastfeeding practices are complex, and a contextualized understanding is needed to strengthen breastfeeding support interventions. We conducted a qualitative study to explore mothers' perceptions of factors influencing breastfeeding practices in rural Haiti. # Methods Focus group discussions were held in eight rural communes participating in a nutrition project. Study participants (n=86) were recruited from mothers' support groups. A moderator facilitated the focus groups in Haitian Creole using a question guide to elicit observations about community breastfeeding practices related to early initiation, colostrum feeding, complementary foods and beverages, and breastfeeding cessation. Focus groups were recorded, and three observers took notes which were compiled into a single report of key points and validated by participants following each session. Quotes representing the key points were selected from the audio recordings, translated into English and analyzed to identify explanatory themes. # Results Participants described breastfeeding for 12-18 months as the norm in study areas, with early and frequent use of additional foods and beverages. Three explanatory themes were identified, related to concerns for (i) infant well-being, including digestive health, nutritional needs and contentment; (ii) transmission of negative maternal emotional and physical states through breast milk; and (iii) maternal well-being, including effects on breastfeeding practices of maternal illness, hunger, stress, and competing time pressures. Underlying all these concerns is the context of rural poverty and the cultural meanings of breastfeeding. # Conclusions Findings suggest that practices which compromise global breastfeeding recommendations may persist because of their perceived value in addressing concerns for infant and maternal well-being in the challenging context of rural poverty, food insecurity and poor health. Multi-sectoral interventions are needed to mitigate these underlying contributors and create an enabling environment for early, exclusive and continued breastfeeding.

Objective: Surgical training has digitally evolved in recent years owing to technological advancements such as the implementation of tele-mentoring. Tele-mentoring enables resident surgeons to receive instruction and guidance from experts remotely, given a suitable internet connection. It is hypothesised that this augmented reality (AR) enhances the learning experience and surgical performance, by the use of overlays to live streamed surgery. Patient and surgical procedure: This study evaluated the implementation of a novel AR platform for robot assisted radical prostatectomy (RARP) procedures, assessing participant opinions, efficacy, and safety through questionnaires. Additionally, we investigated the broader utility of surgical recording in a video labelling study. All ethical protocols and patient confidentiality was maintained during this study. Results: This preliminary research demonstrates favourable results on average for ease of use, audio, and video quality rated by both mentors and mentees (Above 4 out of 5 in all fields). Questionnaire fields assessing future uses in mentees, revealed that ‘mentoring for technically challenging cases’ and ‘assessment or revalidation of surgeons’ were useful. The use of RARP recordings for video labelling yielded high success in a novice student. Among 25 video recordings, the labelled video selected for assessment showed an accuracy score averaging 93.1% with a range of 85.6% - 100% across expert examiners. Conclusion: The use of an AR telementoring platform can assist in building competency safely in advanced level surgical trainees for RARP. The self-training of a novice student in the accurate segmentation of RARP video recording confirmed a high degree of accuracy is feasible. Further research across numerous surgical procedures with a cohort of students is mandated.

Celiac disease is an immune-mediated intestinal disorder that results from loss of oral tolerance (LOT) to dietary gluten. Reovirus elicits inflammatory Th1 cells and suppresses Treg responses to dietary antigen in a strain-dependent manner. Strain type 1 Lang (T1L) breaks oral tolerance, while strain type 3 Dearing reassortant virus (T3D-RV) does not. We discovered that intestinal infection by T1L in mice leads to the recruitment and activation of NK cells in mesenteric lymph nodes (MLNs) in a type I IFN–dependent manner. Once activated following infection, NK cells produce type II IFN and contribute to IFN-stimulated gene expression in the MLNs, which in turn induces inflammatory DC and T cell responses. Immune depletion of NK cells impairs T1L-induced LOT to newly introduced food antigen. These studies indicate that NK cells modulate the response to dietary antigen in the presence of a viral infection.

BackgroundBy September 2, 2021, over 30,000 COVID-19-vaccinated females had reported menstrual changes to the MHRA's Yellow Card surveillance system. As a result, the National Institutes of Health (NIH) is urging researchers to investigate the COVID-19 vaccine's effects on menstruation. Therefore, this study was conducted to explore the menstrual changes after COVID-19 vaccination and/or SARS-CoV-2 infection and their interrelations with demographic, mood, and lifestyle factors in Arab women of childbearing age (CBA).MethodologyA cross-sectional study was conducted during October 2021 using an Arabic validated and self-administrated questionnaire. In total, 1,254 Women of CBA in the Arabic Population (15–50 y) with regular menstrual cycles were randomly selected from five countries (Saudi Arabia, Egypt, Syria, Libya, and Sudan).ResultsThe mean (SD) age of the 1,254 studied females was 29.6 (8.5) years old. In total, 634 (50%) were married, 1,104 (88.0%) had a University education or above, 1,064 (84.4%) lived in urban areas, and 573 (45.7%) had normal body weight. Moreover, 524 (41.8%) were COVID-19 cases and 98 women (18.7%) reported menstrual changes (MCs). The 1,044 (83.5%) vaccinated females reported 418 (38.5%) MCs after being vaccinated, and these MCs resolved in 194 women (55.1%) after more than 9 months. Statistically significant relationships were observed between the reported MCs and the following variables: age, marital status, level of education, nationality, residence, and BMI. MCs were reported at 293(80.6) after the 2nd dose, and were mainly reported after 482 (46.1) Pfizer, 254 (24.3) Astrazenica, and 92 (8.8) Senopharm.ConclusionMCs among women of CBA after COVID-19 infection and vaccination are prevalent and complex problems, and had many determinates.